The Health Care Marketplace – an Anecdote

I had a little personal experience with the American health care system today. I took a tumble Wednesday night playing tennis, and hurt my foot. Although I went on to finish the set, my foot was still swollen and painful to walk on two days later, so I went to a walk-in storefront clinic here in Murfreesboro today to get it x-rayed, to see if it was broken or not.

After the usual rigamarole, filling out forms, being told that they did not take medicare, and that medicare plan A wouldn’t cover it anyway, being weighed, having my blood pressure taken, I was ready for my close-up.

I asked the Physician’s Assistant (I never did see an actual MD), what it was going to cost. He was a nice guy, but a little taken aback by such a question. He said, “Let me go check.” A little while later he came back and said it would be $50, was that OK? “Yes, that’s fine,” I said, pleasantly surprised.

So they took some x-rays and sure enough my foot is fractured. It is fractured in two places and the fracture is slightly separated. They put a splint on it and advised me to go and see an orthopedist, who might just put a cast on it, or might recommend surgery and the installation of a pin to bring the fracture more tightly together, and then put a cast on it. They kept asking me if I wanted anything for the pain. It doesn’t really hurt that much, so I said no, but I could have gotten all kinds of salable on the street prescription dope. Oh well.

When I went to pay, the girl said, “That will be $100.”

“I was told it was $50,” I said. After some consultation among the staff, I was informed that the $50 was just for the x-ray. There was an additional $50 for the office visit, and presumably the application of the splint, although nobody said that. I argued. More people became involved. I was told I was lucky to be getting such a great deal, that I would be charged as much or more anywhere else, which I’m sure is true. There was no apology. There was no admission of error. Everything was my ignorant fault.

But, damn it, I had asked. If he had said $100, I would have said fine, but he didn’t say $100, he said $50. No auto mechanic would try to pull that kind of shit. I got pissed off, I felt insulted, taken advantage of, I lost my temper, eventually informing them that, “I’m not paying you anything. Goodbye.” and walked out. I did not, however, utter a single swear word.

It just doesn’t occur to them, in their medical arrogance, that I should have any say in the cost, or even get to know what the cost will be for the service that they provide. I should just take whatever they dish out. They are medical professionals. I’m not a customer who is always right. I’m a patient, who should just shut up and do what I’m told, and pay what they tell me to pay, after the fact.

My Volvo mechanic would never, ever, do anything to the car without telling me exactly what it was going to cost and getting my OK. I never even have to ask. He just does that as a matter of course, like any small business person dealing with his or her customers. But of course the medical profession doesn’t work that way, because most people are insured and don’t care what it costs. This is why health care costs are rising. My health care costs doubled just in the brief time I was in the clinic getting my foot x-rayed.

My grandfather, Ralph Nichol, broke his arm cranking a Model T that backfired on him long ago up in South Dakota. His arm never did get set quite right, but he played a wicked game of tennis well into his 70s. I called and canceled the appointment with the podiatrist that the clinic had gone ahead and made for me. I can’t afford it, and I’m pretty sure that my foot will be alright once it heals. It’s feeling better already. This is free market rationing. This is how it should be.