Monday, August 26, 2013

"Just In Case" Healthcare

About three weeks ago, I was on my way home from a lengthy bike ride.  Prior to that day, my beat up old bike had been out of action.  A piece had fallen off on a previous bike ride two years ago, and I've had so many other priorities (Read: was procrastinating like a crazy person) that I'd only just fixed it the day before this ride.  A friend of mine asked me to go for a "quick ride", which apparently was her way of saying "a twenty mile endurance test, dodging traffic and weaving in and out of tourists.".

Anyway, as I neared my house, I made a slow left turn onto a side street.  I heard a little "clang" (Or was it a "ping"?  Could have been a "clunk". Whatever), and suddenly the front wheel locked up.  I discovered later that the bike lock popped loose and got jammed in the spokes.  At the time, I really didn't care because I was far too busy flying over the handle bars.  I managed to get my right foot down, but I couldn't keep my balance.  My knee came down hard, but I still kept going.  I tried to break my fall with a roll and came down on my right shoulder.  There was a sickening little "pop" sound.

My friend was naturally a tad concerned.  She said "Are you all right?"  I said, "Yeah, I'm fine, just give me a second.".  At least, that's what I tried to say.  It probably came out like "NnnAarghMmm!" or words to that effect.  She came over with a look of horror on her face, because my arm was hanging at an odd angle.  I couldn't lift it.  She tentatively tried to touch it.  I could see her turning green.  Then she burst out laughing.  "I can't believe you wiped out!".  I have strange friends.

We eventually called another friend to help us with the bikes and give me a ride to the hospital.  My arm was in pain, but I have to admit that wasn't what was on my mind.  I knew that my emergency room copay was $300.  I could handle that, but it was still a decent chunk of change.  I don't like spending money that I don't have to.  Unless I'm spending it on frivolous things.

I walked into the emergency room hunched over to the right.  This was the only way I could stand without pain shooting up my arm.  This earned me a few odd looks, since the way I was walking resembled Igor, Dr. Frankenstein's assistant.  Still, I was a little confused by the looks.  This was an emergency room. Shouldn't they be used to people coming in a little banged up?

I was ushered into a room and instructed to lie down on a gurney.  While I waited, the nurse took the normal vitals.  Then she asked me if I wanted to watch TV, and pulled down a TV attached to an arm next to the gurney.  It had all the cable channels, or so she told me.  I couldn't reach the channel changer, because my right arm was dislocated.  The nurse had already vanished by this point.  So I had to watch the channel it was on, which (of course) was one of those asinine shopping channels.

After about twenty minutes of watching second string actors try to sell me useless crap, the nurse came back and dragged me to the radiology department.  After hobbling there, standing up straight for ten minutes (which is surprisingly painful with a dislocated shoulder), then hobbling back, I collapsed back into the gurney.

The nurse promptly hooked me up to a monitor.  Because there's always a risk of heart attack when your arm is out of it's socket, apparently.  She put an IV in me, then took some blood.  "We probably won't need this, but's it's good to take some, just in case, " she assured me.  Then she brought over an oxygen tank and put that little nose tubey thingy in my nose.  Normally, this is the type of thing 90 year-olds with emphysema have.  I asked why this was necessary.  "Just a precaution," was the answer.

Finally, the doctor came in with a physician's assistant who was there to make there were no complications from the anesthesia.  First, they gave me some painkiller (which was nice), then a bit later some anesthesia.  It wasn't the kind that makes you unconscious, just the kind that makes you woozy and causes short term memory loss.  The next thing I remember, my arm was back in, and the doctor was trying to sell me drugs.  He suggested some double strength ibuprofen and another, stronger drug if the pain got bad.  I told him to save the strong stuff.  I didn't need to get hooked on Oxycodone because of a bike accident.

The doctor told me to check in with my regular doctor and an orthopedic surgeon.  I saw my regular doctor three days later.  He said to keep my arm in a sling for five weeks and charged me thirty bucks for an office visit.  I saw the surgeon three days after that.  He said to keep my arm in a sling for five weeks and charged me thirty bucks for an office visit.

A few days ago, I finally got the hospital bill.  My $300 co-pay was charged to my credit card.  But the total cost was not quite $3,000.  And that's the moral of this ignoble and slightly goofy chapter of my life.  I think I've figured out why healthcare is so damned expensive. undisclosed number of years ago, I broke my other arm.  It was in a splint overnight, then the next morning I was put under while the doctors set it.  They took no blood.  Apart from the time in the operating room, there was no heart monitor or oxygen tank.  They only did what was necessary.

The reason my bill is so outrageous is this "just in case" healthcare.  Whenever I hear a doctor or nurse say "just in case" or "just a precaution" I hear "so I don't get sued by some two-bit shyster".  The oxygen, the monitors, the blood work, the extra physician's assistant, the extra painkiller, the two post-op visits, these all appear to be medical butt-covering.  Some people say healthcare is expensive because of overpaid doctors, but this looked like the expenses were incurred to prevent overpaid personal injury lawyers from preying on the overpaid doctors.

All I needed was an x-ray, a sedative, and someone to jam my arm back into place.  All this other crap is excessive.  Even the TV.  That's nice, but I don't want to pay for it.  Especially if I'm stuck watching HSN.  So let's stop having every procedure and test known to man.  The chances of me croaking due to lack of oxygen when I have a dislocated shoulder are probably less than my chances of winning the lottery.  I'll risk it.  I'll even sign a consent to keep the lawyers away.  $3,000 is ridiculous.  I normally don't spend that much money on anything that doesn't come with air conditioning.  And I know I don't need to spend that much to have some doc slap my shoulder back into place.  

Naturally, I don't pay all of that, but now I know why the health insurance that employer's provide costs so much.  I think doctor's are smart enough to know which complications are likely and unlikely.  They can discuss this with patients, weigh the risks, and come to a decision.  Instead, they're doing anything and everything to prevent even highly unlikely scenarios.  I think if the lawyers backed off and let the doctors and patients use their judgment, healthcare costs wouldn't be so ridiculous.

The sling came off today, and now I can look forward to several weeks of physical therapy.  Naturally, each visit will set me back a little bit.  My arm feels fine.  I probably don't need it, said the doc, but I should do it "just in case".  Hopefully, the PT place will be staffed by young, single women.  That might make it worth the extra expense.

No comments:

Post a Comment