Go figure…

Ah, health care. And, as a physician, a family physician, I should care.

And I do. I truly do.

In fact, more than ten years ago, back in rural Vermont, I was even then mindful of those who hadn’t what I had.

And, yet, I was then a freelance writer, not a physician, buying health insurance at the going rate, even if the going rate then didn’t compensate for the fact that I was relatively young and healthy, as was my wife, Karen, and our five children.

Truth is, we cost good ol’ Blue Cross nothing, not one cent, over some 15 years, and all the more so given that all five of those children were born at home, with midwives in attendance, midwives whom Blue Cross would not acknowledge as professionals, let alone cover.

Consider this: Karen and I paid cash for each of those five births, some $1,200 or so each, covering both prenatal care and delivery, this despite making the monthly Blue Cross premium, month after month, year after year after year.

But, had Karen had the usual prenatal care, with an OB doing the deal for thirty-something weeks, and then the delivery and then the post-partum visit, at, let’s say two or three times what a midwife would have charged for the full Monty, Blue Cross would have obliged, or mostly obliged, at least insofar as its “prearranged” contract with that OB, a dollar figure always lower than the billed figure (yet another inequity in a health care system rife with inequities) for those with insurance.

And, get this, had Karen had the C-section that her first 43-hour labor would likely have bought her, we’re talking beaucoup bucks, to the tune of maybe $10,000 or more that Blue Cross would merrily have paid the OB, the hospital and anyone else with a hand stretched in our direction.

Yet, none of that takes into account the $50,000 that health care cost my family over a three-year period in the late 1990s.

I’m talking premiums, deductibles, co-pays, in a span that encompassed an ectopic pregnancy, our daughter’s hospitalization for an asthma exacerbation, my own then and still inexplicable health problems, another child’s visit to the local ER, and so on.

We had that money then, only because, as a freelance scribbler, I worked hard to keep a cushion against what I, preternaturally Irish, saw as the inevitable rainy day. Even so, those health care bills those three years wiped us out, to the penny. And afterwards I worked, day, night, weekends, for another three years, to build that cushion back.

A decade and more later, no one is better off.

Not me.

Not you.

Not any of us.

Even I, now a physician, am no better off, health insurance-wise, than I was as a freelance writer ten years ago.

I still have the same kind of health savings account, then called a medical savings account, with the same $5,000 family deductible. The only thing, if anything, that is different, is the premium, which, I think, and if I remember correctly, is, believe it or not, lower today.

Still, a decade later and not much difference.

And the fact that the last ten years transformed me from a freelance writer, fortunate enough to afford health insurance, to a physician, arguably even more fortunate, matters little.

I am, as much as any employee anywhere, at risk of that single silver bullet, in terms of uncompensated health care, let alone the bullet to the heart that some catastrophic event might occasion.

Ah, America!

Home of the free…land of the brave…

A country, at least in terms of the Declaration of Independence and Constitution, of equals.

But, of course...not.

I have health insurance. Someone else has more. Somebody else has less. And all of us who have, pay the price for those who have not.

That is what it is.

In the end, given any amount of health care costs, the patient with no health insurance will pay nothing, even after any number of attempts on the part of any collection agency. And you and I and anyone else with any semblance of health insurance will pay more, our premiums, in part, going to cover the pseudo-inflated cost of our own health problems — and, by extension, the uncompensated cost of any and all uninsured patients seen in that hospital or the nearest, this clinic or the one down the street.

So, yeah, what a country.

The richest in the world, able to fund one war, or multiple wars, even on spurious reasons, on the spur of any moment, even at the cost of debt passed to our grandchildren, and likely to our great-grandchildren.

But wave even a dollar in the direction of universal health care — a right, a human right, let's face it, in any country, let alone this, the most prosperous on the planet — and you can expect a tea bag up ‘side the head, a tea bag tagged with the words, “socialist medicine.”

And yet we, those tea partiers and we teed-off partiers alike, spend the most on health care and, for our money, come up short, in terms of quality care, at thirty-something worldwide for the dollar spent.

Hmm-m…

Go figure…

And among those figures are the nearly 50 million fellow Americans — one of every six of us — who tonight sleep without health insurance; who tomorrow may use the emergency room for routine primary care, and who the next may find their homes, their families, their futures hostage to a hospital bill they can never pay; 50 million fellow Americans who are, there but for the grace of a job and for job-related health insurance, you or me or anyone you or me may now or ever love.


© 2010 Dónal Kevin Gordon