The $640 Popsicle

Sometimes the best way to deal with something is through humor. So in the interest of keeping my blood pressure way, way down, MOTHER’S DAY OUT proudly presents herewith, heretofore, and hereunder, a non-partisan/bi-partisan/post-partisan (did I cover all the bases?) bill for your consideration. It’s already made it through her House, so let’s present it to the Senate—those guys really look like they could use a good laugh right now! Best part: it’s only THREE pages. (Old Mother knows you have the attention span of a gnat.)

The $640 Popsicle or, My (Medical Insurance) World and Welcome To It!

Old Mother’s Radical Blueprint for Health Care Reform By Helen Black October 31, 2009

At our house, insurance coverage consists of: 1) essentially, catastrophic care ($5,000 deductible), 2) the privilege of a twenty dollar co-pay whenever we visit the doctor (rarely*), and 3) the implication that we are getting a special discount on services above and beyond that (supposed to make us feel better about the whole deal & does if we don’t think too hard, which is easiest when the martini bucket is close at hand). * because the kidlets are super-skinny and otherwise physically and psychologically sound, and we strive to provide them with healthful habits they will carry through their teenage years, during which they will not engage in risky behaviors that threaten life and limb (their own or others) because they are as aforesaid psychologically sound, and will therefore survive into adulthood, during which they will be energetic and productive members of society because they are, as aforesaid, physically sound, and will continue to live out the good health habits tattooed on their foreheads by Old Mother and Old Father and so continue to be no burden on society healthspending-wise (the lion’s share of healthcare spending being on obesity-related illnesses), insofar and inasmuch and in point of fact being the actual individuals who will create the value in the marketplace which will then be taxed to provide health spending for other members of society who are not so favored and so is there a tax credit for this yet please?

For all of the above Old Father and I pay about the equivalent of the annual GDP of a small, newly-minted Balkan republic. This is in pre-tax dollars, because we are selfemployed. It all works fine, if as I said you’re not thinking too hard about it, UNTIL somebody has to go to the emergency room, because they are bleeding from an open wound and it’s a Sunday. This brings us to: THE EMERGENCY ROOM. Ah, the Emergency Room. Why is it whenever I walk into the Emergency Room I feel like there are huge arrows and flashing lights over my head spelling out GOLDEN GOOSE? (I was going to title this little ditty the $350 popsicle, because until my recent triple-header I hadn’t been to the emergency room since 2006. I’m here to tell you that it’s now the $640 popsicle. And by the time you read this, it will probably be the $656 popsicle.)

Suffice it to say that a single visit to the Emergency Room can blow a big, wide hole in that personal household TARP plan. Yes, that sucking sound you hear is the dread music of our wallet being sucked into the black hole of deficit spending. In a quaint attempt to stem the tide I have strategically posted around the house signs which read, to wit, heretofore, and hereunder:

NO ACCIDENTS OR ILLNESS AFTER 9 P.M. ON WEEKDAYS (this is when the urgent-care place closes, which only charges the regular co-pay)

OR ON SUNDAYS WHATSOEVER (when absolutely nothing is open)

Despite this practice of defensive medicine (I suggest placement in kitchen, bathrooms, garage, and workshop), accidents will happen and there will inevitably be a trip to the emergency room, for example, ibid, nota bene, gaudeamus igitur, heretofore and hereunder, when: a barefoot child steps on the partially-concealed tine of a rake, resulting in a neat little puncture wound; a pre-verbal toddler runs a high fever and won’t eat or drink; someone falls backward though a picture window and cuts his scalp just enough that you know a stitch (or staple) will be required; a teenager, playing a toddler’s favorite game called “Swirly,” wherein he swings him around by the hands, accidentally dislocates toddler’s elbow; a child inserts a small bead into her ear; or jokingly demonstrates a baseball pitch IN THE KITCHEN, which even though it is done with a spongy nerf-type ball triggers a Pavlovian catching response in yet another child who comes down over and onto the counter in such a way as to catch an art glass bowl cutting his hand just enough that you know a stitch will be required. Disclaimer: I am NOT SAYING that any of these things have actually and definitively occurred in my OWN house. Maybe they happened in someone else’s house. Some of them probably did. But I’m not telling which. My lips are sealed. I will say, however, that that was my FAVORITE art glass bowl and because of its colors really looked nice with pears in it, pears that were home-grown without the use of chemical pesticides (is there a tax credit for that please?).

What do you do? You go to the Emergency Room and you get coded six ways till Sunday! Coded for emergency room visit, office visit, accident treatment, surgery (if human contact is required), and supplies (if they give you so much as a kleenex). And that’s even before they start treating the patient! JUST kidding. But seriously, each code is worth $150 at least (at this writing), except for the supplies, which are coded individually and are $54 each, unless they’re made of metal, in which case they are $154 a piece. If the doctor has to leave the room and come back, they get to code it twice. And if they need x-rays, many are taken, the extras going into a storage vault as required by the terms of their contract for liability insurance.

Codes rule! They allow the hospital to price a la carte and jack up retail sky-high to make sure they see something out of the insurance company. Hey, I don’t blame ‘em. They’ve got their personal private parts in a vise. And the insurance companies do too, thanks to Medicare and Medicaid. The upshot of it all, though, is that I have to sign a lien on my house or hand over my first-born son (hmm—might not be a bad idea—he’s fifteen now and does abrade the nerves occasionally) in order to ransom a child with a staple in his head, a splint on his finger, or a popsicle in his mouth. So just off the top of my head, I want a loyalty card for the Emergency Room just like I have at the Little Bookworm Coffee Shop next door to my favorite independent bookstore. Like: “Buy three visits, get one free!” But with perpetual rollover— no use-itor-lose it provision. Or how about an incentive plan? All parents know that judiciously parceled-out incentives can be quite successful. How about a policy formula that reduces your rate for a low-range BMI? That would definitely motivate me to drop those last few pregnancy pounds…especially since the pregnancy is way too old to be using as an excuse anymore…like…about five years. But this is just tinkering around the edges. The real fix has to go to the root of the problem, and here it is.

REAL FIX. Pretend you have three beautiful, new, expensive cars in your garage, and a teenager, who’s just gotten his driver’s license, totals one of them. You wait a bit, give him the keys to the second car, and he totals that one too. Now—are you going to give him the keys to the third? Like heck you are! You’re going to make him take ownership of the problem. Fix up those cars, and on his own nickel. Prove he can drive them steadily and consistently without mishap, before you’re ever going to let him touch the third. So, Old Mother’s Radical Blueprint is a homework assignment for Congress: fix Medicare and Medicaid, get them running like tops, and THEN think about putting all the rest of us under that big tent. A fab idea, but do this first. Then come back. We’ll talk. While I’m waiting, I’m going to ask my absolutely sensational doctor and my absolutely sensational pediatrician (who by the way has NEVER suggested tonsillectomies for my children in order to finance winter frolics to sunny climes; she’s a hardworking mother of four herself)—I’m going to invite them to the Little Bookworm Coffee Shop and over a nice cup of java nail down exactly what a reasonable and appropriate fee-for-service would be if they didn’t have to spend hours and hours on bureaucratic paperwork and also factored in the extremely low likelihood of a medical malpractice lawsuit from my

family. I mean—we’ve known each other for YEARS! We’ll reach an agreement. I’ll pay cash on the barrelhead, and escrow one-quarter of what we pay in health-insurance premiums into our own personal HSA for those jaunts to the Emergency Room. Hey—I gotta cut the cord here. This golden goose is just about out of eggs!

Helen Black is the author of “Seven Blackbirds,” a Highly Entertaining and Inspirational Work of Literary Fiction about a young mother rebuilding her life after an abusive marriage, and is the top-subscribed female author on Scribd, where she publishes a humor column MOTHER’S DAY OUT. She lives with her family of five children and four chickens in Portland, Oregon, and is often seen lurking around Powell’s City of Books in her favorite t-shirt, emblazoned “I travel for book groups.” She is also an active advocate of domestic violence prevention.