You Can Check Out Any Time You Want…But You Can Never Leave

Aw, the entity they call the “health care” system in the United States. Let me start by saying, first and foremost, that this system has nothing to do with maintaining our health – physical or mental – and ‘care’ is only at its most basic levels. In other words, care is centered on those angels of mercy (men and women) who, despite the crap (this works on a number of levels) they deal with on a daily basis, continue to provide a level of service that is beyond reproach. It’s the rest of the system that boggles my mind.

Let me throw in my first foray into this system of circuitous logic. My husband had occasion to be brought to the emergency room in our area a couple of years ago. Naturally we encountered an emergency department bursting at the seams with those who use this area as a general doctor’s office. While my husband’s ailment didn’t disappear, our patience after four hours definitely did. After weighing the odds of seeing our regular doctor the next day and whether or not he would suffer any dire effects from leaving, we went up to the main desk and told them we’d be heading home. Now here’s where it gets interesting. We have a $100 co-pay with our insurance when using an emergency department. Fine. We were more than ready to pay it despite not being seen. And here’s where it gets beyond interesting and decidedly nuts: We were told that if we left before seeing a doctor, we’d have to pay $200! Twice the amount, same level of non-service, only we’d have to stick around until at least another 10 people were seen. Yes, that’s what you heard – you can check out but you can’t leave. Not without paying through the nose.

What is wrong with this system???? Why are the insurance companies allowed to prolong this ridiculous, ambiguous, and certifiably crazy kind of service?  Here’s another one: I entered an emergency department recently after spending several days feeling as if I couldn’t get enough air, there was a strong pressure in my chest whenever I took a deep breath, I was feeling quite shaky and ill, and worst of all, the day I went in I had numbness and tingling in my hands and arms and came close to blacking out at least three times over the recent 24-hour period (once, while I was driving!) Very scary. I was desperate to get an answer and knew that the hospital was the only place to be. In my head, it could have been a very bad reaction to new medication but the people who saw me immediately felt my heart was in trouble. I knew they had more information than I did, so when the doctor said “we’re admitting you,” I didn’t argue. A day later, we checked out and thankfully, it wasn’t the worst case scenario…but it could have been.

A week later, a letter arrived. Apparently the doctors on call in the emergency room of an internationally-respected and world class hospital…in one of the biggest cities in the world, despite more than 25 years of experience, had no idea what they were doing. Apparently, it’s not enough to determine that a patient needs to have some steady testing of their system to determine that a heart episode has not occurred. No, you must also get a diagnosis from the insurance company representative who has never seen you before doing so. At least, that’s what I have inferred from the letter, which states that based on the eventual diagnosis, they are not covering any of the admitted time since I didn’t have a heart attack after all.

I hear a lot of people who say they know people in Canada who tell them that the Canadian health system isn’t anywhere near as good as it is in the United States, and that you pay through the nose for it. I can tell you, from a first person point of view, that after 40 years of living there, I never once worried, after being “cared for,” that I would receive something in the mail that would cause my heart to truly feel as if it was in danger of stopping. Because that’s what it feels like to read that your services – multiple tests, multiple doctors, many hours of “care” – are not being paid by the system that you pay into every month. Forget the crap you hear about Canadian health insurance being expensive. I pay the same amount for health insurance here and yet I remain constantly worried that a letter like this one will set me back even more. This isn’t care. This is a lack of same.