My Twitter followers will recall that several weeks ago, I started tweeting with the hashtag
#StainlessSteelHeadThwack2011, to chronicle the aftermath of being bonked in the forehead when a stainless steel water bottle (full of water, but with a protective and cushioning neoprene cover, thankfully) fell off of the shelf over my bed.
Because I started having some symptoms after that — pain, swelling and most worryingly, massive drainage from my sinuses and a nosebleed — a few days after the thwack itself, I took myself to an emergency room in worry that I’d done damage to my sinus frontalis. The pain wasn’t the worst I’ve experienced, but living with chronic pain, my threshold of and tolerance to pain are both high, and I’d been taking painkillers, anyway. In any case, if I’d fractured a sinus, I was going to need medical care, and the best way to get that, being uninsured, was to go via the ER.
It depresses me that I know these things.
Anyway, I went in. I waited for about five minutes after signing in, went through a very quick triage, was given multiple bracelets (allergy warnings, I also got a bright orange warning sheet on top of my chart) and sent back to the treatment area. I wasn’t even given a gown, just told to sit and wait, and offered a blanket if I was chilly. (It’s always cold in ERs. I don’t know why.) A physician assistant came in, pressed her thumbs into my forehead so hard that I saw stars, asked a bunch of questions, made me follow her fingers with just my eyes like a sobriety test (or am I thinking of something else?) and said that she didn’t think I fractured anything, because that frontal bone is really thick, and if it was fractured, I wouldn’t have been able to withstand her pressing against it. But she said she’d go talk to the doctor. She was with me for about four minutes — I know because I was tweeting when she came in and tweeted when she left.
I waited, and the doctor came in. He did all the same things the PA did, but when he pressed on my forehead, he pressed in different places, and much harder. He also looked up my nose with penlight. (I hope it wasn’t all crusty in there.) He said that he didn’t want to put me through the time, cost and radiation of x-rays or a CT because he thought it was just a coincidence, that the thwack maybe loosened up some sinus congestion and the drainage was actually a good thing. He gave me a list of symptoms that should bring me back, and a prescription for a decongestant to speed up the drainage so that it wouldn’t be such an irritant, and sent me on my way. He was there for 6 minutes, tops. (Again, by timing of my tweets.)
I got a bill for the doctor’s services a couple of weeks ago. $263.
Today, I got the bill for the ER services. $746.
That means that the doctor’s time bills out at $2,643 an hour, or $44.05 a minute. I’m trying to figure out what I got for that hospital bill. Blood pressure, pulse, and temperature, a sheet (I presume that they stripped the bed I sat on, but maybe not) and a chart. Neither the PA nor the doctor wore gloves, and there was no medical equipment actually used for me at all.
Even if we assume the PA bills out at half of the doctor’s rate, at $22 a minute, there’s apparently hell of a lot of overhead that has to be covered by nine minutes of treatment.
I should’ve waited a couple of days and gone to see my regular physician. It would’ve cost me $50 for the exact same diagnostic and result, and he would’ve checked in on my overall health in the process, including this pesky shoulder injury that just won’t heal. But it was a Saturday morning, and I was hurting and nervous and gunk was pouring down my throat. I needed reassurance.
Reassurance is going to cost me $959 more dollars than I really had. All my plans for fun and frivolity for the next six months — at least the ones that would’ve been on my dime — are out the window.
And people wonder why I’m an advocate for a robust public health system. Yes, socialized medicine. Single payer. You know, like Medicare. For everyone.
Because there is no ethical, moral or reasonable argument why 10 minutes of healthcare, delivered without supplies or equipment, should cost more than a mortgage payment.