Sunday, November 15, 2009

An Unplanned Trip to the Emergency Room

To say that it was a headache would be an understatement. It was a headache from hell. It was a headache that made self-decapitation seem a reasonable alternative.

It was Wednesday, Veterans Day. It was a day off from work for me. The headache came shortly after my wife left for work. It came on suddenly, with full force, closing my left eye. I could not lie down. I could not do anything but pace around the flat howling.

It was difficult, but eventually I called my wife for help. She called neighbors.

One of our neighbors is a retired nurse. She did not take a very long look before she decided that I had to go to the emergency room.

It was fortunate for me that neither she nor her husband is concerned about how litigious this country is rumored to have become. They took me to emergency in their car when they discovered I had no health insurance to cover an ambulance ride. Such generosity is rare and foolish and wonderful. I thank God for my neighbors.

At the emergency room I was asked numerous questions as I writhed in pain. The hospital staff and I each attempted to do our separate parts with aplomb. I cannot complain about my treatment because I was out of my mind.

Blood was taken for tests. A CT scan was run. Nothing came from these or the doctor's examination. The pain was subsiding somewhat, but I was still sick. The doctor prescribed a spinal tap. He was frank about the pain. He was uncomfortably explicit about what the procedure entailed. It sounded terrifyingly medieval.

My head was in pain. I was asked to make a decision. It took time. I have no health insurance. I am spending money and I have no idea how much I am spending. I suspect it is money I do not have. I am sure it is money that was not in the budget. Who budgets for the emergency room?

There was a good chance the spinal tap would show nothing. If the spinal tap revealed anything, it would be something deadly.

I decided for the spinal tap.

The procedure was every bit as uncomfortable as promised. I will take three colonoscopies over one spinal tap any day.

The results: nothing. From the blood tests, the CT scan, the examination, and the spinal tap, nothing to indicate the cause of my sudden extreme headache.

I was sent home with prescriptions for three pain medicines to deal with the headache that might come as a side effect of the spinal tap. I doubt you have to read that last sentence twice to catch the irony. The headache I came to the emergency room with still lingered, less severe, for the next four days. I lost two days of work at a job for which there is no "paid time off."

Now there is nothing very special about my experience. There are people who suffer migraines and cluster headaches frequently. I have never been diagnosed as having either. This little episode, however, does illustrate several facts that undercut the Republican and conservative critique of universal health care.

Health care does not fit in the marketplace.

In my pain I was not offered different emergency rooms with different features. There was no choice of different CT scans with greater or lesser resolutions, or a spinal tap at the base of the spine or the base of the neck. Frankly, those sorts of choices were completely irrelevant. I wanted the pain to stop.

Neither did the services suggested come with a price up front. It was simply take the blood test, the CT scan, and the spinal tap, or leave it. The bill comes later. The doctor gave no indication that he even knew what a spinal tap costs.

Marketplace ideology does not work beneficial health care. A visit to the emergency room is not a trip to the grocery store and conservative critics of universal health care are, at best, fools for not recognizing this.

I was not going to write about this until I read conservative Milwaukee Journal Sentinel columnist Patrick McIlheran today.

Among the many falsehoods the Mr. McIlheran packed into his column was that "of course, the government now ensures the poor and the old get care. It even pays for the not-really-poor via programs like BadgerCare."

This is one of the many assertions conservatives make without support of facts – that the needy are being taken care of, even the not so needy. No need to fix what is not broken.

Well, the call came on Friday the 13th. The hospital wanted to confirm that I have no insurance and screen me concerning my financial situation to see if I qualify for assistance. I do not qualify for any assistance. I will be getting a bill in four figures from the hospital. And a bill from the radiologist and another from the doctor. I am not poor, and Mr. McIlheran is purposely vague about what he terms "the not-really-poor," but there is no Badger Care for me.

This brings to mind another myth about our current system of health care that conservatives like to assert. It is said that hospitals must provide emergency care, even to the uninsured. In addition, it is said that when the uninsured do not pay, that loss of income is simply averaged over the bills of insured paying patients. The uninsured get a free ride.

I am sure that hospitals lose income treating the poor and uninsured. I am sure that they have found some way to recover that loss from the people who do pay.

The poor and uninsured are billed, however. They are expected to pay. After several billing notices, their accounts are handed over to collection agencies. The collection agencies use all available means to recover the cost. There is no free ride for the poor and uninsured in our current system.

I have never been to an emergency room as a patient before and I hope never to make another visit. If this country had the universal health care that is popular in so many other developed countries, preventative care might have discovered and addressed whatever brought on this headache so that there would have been no emergency room visit.

As it is, I have a debt in four figures and an inconclusive diagnosis.