Sunday, November 18, 2007

I'd like symptons of a Pulmonary Embolism for $400, Alex.

If, like me, your employer provides health insurance and other insurance options then it’s likely open enrollment time for you as well. Make sure to get those forms in on time.

I just completed my insurance and elective forms this morning. Upped my 401K some more. Feels good. After completing these same forms for six years I think I finally am starting to understand how it all works and what it all means. At least at my company. Copays. Out of pocket maximums. Alternative medicine. Preferred Providers. Cafeteria Plans. But it got me thinking about the insurance industry, healthcare and our recent vote in Oregon to defeat a healthcare bill funded by a cigarette tax.

If you’ve ever had a health scare you know what it means to have proper insurance coverage. About two and a half years ago I had that scare. I was about two hours into my workday and rapidly had trouble breathing – I could barely move enough air to form a complete sentence. I have had mild asthma for several years but never anything like this.

I went to my local urgent care where they did my vitals and quickly got me on an EKG. My symptoms: shortness of breath, elevated (way elevated, actually) blood pressure and rapid pulse were just chest pains short of a classic pulmonary embolism. Except my chart said I had chest pains even though I responded ‘no’ twice when asked if I had chest pains. What a typo that turned out to be.

Have you ever had an EKG? Pretty cool. Except for the part where you think you’re about to die. Not cool. They also have to shave little circles into your chest hair for the EKG pads, which creates a sort of reverse leopard effect for a guy like me. Also, not very cool.

So the Doctor evaluates things and is concerned enough that he wants me to go to the emergency room for further evaluation and maybe a chest x-ray. He also tells me that he can’t allow me to drive myself as I am at risk for dying at the wheel. Wow. So I get my first ride in an ambulance.

Now, mind you, ambulance rides on TV and in the movies look pretty cool. The lights. The gurneys. The really attractive EMTs. The perfect crisis management and hero moments. The actual thing is so much less as to be enough to cause a pulmonary embolism.

When the EMTs arrived, they checked my vitals again and unhooked the electrodes. Gurneyed me (not that easy as I was at my heaviest that day) and strolled me out through the lobby. This was the least cool part of the whole ordeal – except for the constant perception that I was going to die. Here I am – half naked with electrodes attached to my leopard spots, my pasty white skin and perfectly cultivated microbeer belly for all to see. I think I heard the theme song from Free Willy.

Once inside the ambulance they hooked the electrodes to their EKG (I was making a perfect metronome by this point, wish I’d had my guitar) and gave me a dose of nitroglycerin, which can aid in preventing a further heart issue from cropping up in transport. Now, nitro is what some people make bombs out of so the prospect of ingesting any of it, even in a dose the size of a 10-pt umlaut is odd. The pill burns a bit under the tongue but other than that it was fine. I didn’t explode.

The amenities in an ambulance are nothing like the movies. It was about as comfortable a ride as when I’d be in the bed of my Uncle’s pickup truck on a quick trip from Neskowin to Pacific City. Except that was fun. And I was twelve. Wasn’t worried about nitroglycerin and embolisms on that trip. But the ambulance itself is grey and chilly. The EMTs were professional but I certainly didn’t make a love connection with the stoic female EMT. I don’t even recall her reacting to my jokes. And I know I made some funnies.

Anyway, the visit to the emergency room was quite pleasant. When you arrive in an ambulance you don’t wait in the lobby unlike all the other times at the ER when all the people that arrived after you get admitted first. That was cool. I felt rather important. By this time my vitals had totally stabilized and they allowed me to call someone to wait with me. Of course I called my mother. The doctors actually laughed when they had run their tests and determined that I had just suffered a severe asthma attack. Y’see, my chart still said I had chest pains. Even after telling every doctor, nurse and EMT along the way that I didn’t.

I guess they knew what was best for me.

So, I was finally discharged late in the afternoon – the whole ordeal lasted about six hours. I got two new inhalers and a final bill for about $400. If I hadn’t filled out my insurance forms properly that year the whole thing would’ve cost about five times that.

So, fill out your forms. Especially the cafeteria plan – the single best way for an idiot like me to prepare and pay for healthcare expenses.

But, with all of that, we need insurance reform. The idea that tens of thousands of children in this state go without basic healthcare is criminal. The systems have too many layers and too much bureaucracy. Care is too inconvenient. Forms are too confusing. I don’t have the answers but apparently taxing cigarettes isn’t the right one. At least not for the voters of the great State of Oregon.


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