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Diary
By sugar spun (Thu Aug 27, 2009 at 01:46:19 PM EST) (all tags)
A tale of foreign people versus the US healthcare system.


I used to live in upstate New York. It was pretty cool - I worked in a haunted house five days a week, and the other two days I spent with my then-boyfriend a couple of hours south, outside of Albany. I'd leave work at 4:30pm on my last shift and run like hell to catch the twice-daily bus that runs between Toronto and NYC, then get the bus back a couple of days later and turn up at work just in time to get into costume and start my shift.

Anyway. One memorable time, I arrived in Albany and took the bus out to Troy. I walked up the hill from the bus stop, past the porno cinema (it always had birthday greetings for someone on the advertising boards outside, which never failed to entertain me), Uncle Sam's Bar and the bowling alley, through the university buildings and up to the apartment. All of this was just as normal. What was unusual was that I found my boyfriend huddled at the foot of the steps to the apartment clutching his belly, his face the weirdest shade of greyish green that any face has ever turned.

I did the obvious thing first and poked him to see if he was dead. The wail he let out suggested he wasn't, although I poked him again to see if he was Undead and might not come after my brains. He didn't, so I did the next sensible thing and asked what had happened. Apparently he'd eaten a tuna melt at the diner at lunchtime and had been feeling off ever since. He thought he might have been huddling on the steps for thirty or forty minutes but couldn't be sure. He was sweating and shivering and asking me to make sure his parents got his ashes back if he died. I asked him if he could walk to the taxi office across the street. He couldn't.

The taxi office was one of the most eye-opening experiences of my time in the US. The guy who ran it was a Hell's Angel and invited us to a bunch of parties. He delighted in introducing us to new people and then telling us toe-curlingly shocking things about them when they'd gone - we met crack whores, a couple of convicted murderers, a guy who made specialist tiny-penis pornography (apparently it pays surprisingly well). When I went across the street he responded with great good sense, locking up and coming over to take a look at the huddled mess in the stairwell.

This is where I started to get alarmed. Taxi Guy refused to drive us to the hospital, on the grounds that if he died in the car it would be messy and involve a lot of lost earnings. He asked us if both of our visas were up to date (yes), and if we had health insurance (yes) and then called 911. Within five minutes we heard the sirens and a pair of angelic paramedics descended upon us, loaded the sick one onto a gurney and in, put me in a seat alongside and off we sped, blue lights and sirens going. The movement of the ambulance seemed to cause significantly greater pain; there were wails and whimpers like nothing I'd heard before, and when we arrived at the hospital we crashed through the doors at speed and were dropped in an examination cubicle to await the doctor.

As we sat there, someone came along and asked for insurance details. I passed them on as best I could, and then we waited for a doctor. A nice nurse came in and took his preliminary obs - temperature normal, BP astronomical, pulse absurd. She asked if he still had his appendix and palpated his belly.

As she left the cubicle, his face changed from "contorted with pain" to "utterly aghast". I asked what was wrong, envisioning an apparent catastrophic loss of bodily function control that would, once he removed the blanket, be revealed to be a haemorrhage. Nothing as dramatic: the palpation had freed the agonising pocket of trapped wind to a location significantly closer to the exit, and his condition was revealed to be the result of over-enthusiastic eating and not a potentially fatal organ rupture. The offending air pocket was released just as the doctor arrived, and with blushing explanation we were free to leave, speeding out of A&E on a cloud of his toxic gases.

It was a funny story, until he got the bill: $5500 for the ambulance; $500 for the examination. The most expensive fart ever? It seems entirely likely.
< Attention Foster/Adoptive parental infidels | gah. bugs. >
If this story had a title it would spoil the end. | 40 comments (40 topical, 0 hidden) | Trackback
Best HuSi Story Yet. by wiredog (4.00 / 3) #1 Thu Aug 27, 2009 at 01:54:48 PM EST
I'd like to see what Technician could do with a rewrite of this.

Earth First!
(We can strip mine the rest later.)



I could certainly not do it as well. by technician (4.00 / 2) #4 Thu Aug 27, 2009 at 02:34:28 PM EST
But I could noir it up a bit, and it would make a decent film for someone like, oh, let's put Ryan Phillipe in the boyfriend role and Mila Kunis as the girlfriend. The old Hell's Angel could be played easily by Mickey Rourke.

[ Parent ]

Mila Kunis by sugar spun (4.00 / 3) #9 Thu Aug 27, 2009 at 02:49:48 PM EST
Can we hire Christina Ricci instead? My sense of the aesthetic would appreciate it.

[ Parent ]

Old Christina by technician (4.00 / 1) #12 Thu Aug 27, 2009 at 03:33:58 PM EST
or new Christina?

But either way YES!

[ Parent ]

Old Christina by sugar spun (4.00 / 2) #16 Thu Aug 27, 2009 at 03:43:58 PM EST
With fabulous breasts, without Anna Wintour hair.

[ Parent ]

Most Expensive fart? by georgeha (4.00 / 2) #2 Thu Aug 27, 2009 at 01:56:47 PM EST
You could google Explosive Risks in large Bowel surgery.




Yeah but by technician (4.00 / 1) #6 Thu Aug 27, 2009 at 02:38:36 PM EST
those are normally gas escapes caused by punctures or by anesthetic effect, aren't they?  I'd say a fart is a passing of gas that the farter is aware of. Anything else is wrapped in a SEP field.

[ Parent ]

probably by georgeha (4.00 / 1) #8 Thu Aug 27, 2009 at 02:42:41 PM EST
I was trying to track down one of the notorious "patient gets blowed up good during anal probe" story that pop up in the news of the weird section, but only found the exploding bowel ones.


[ Parent ]

+1 vs2fp by hulver (4.00 / 3) #3 Thu Aug 27, 2009 at 02:32:11 PM EST

--
Cheese is not a hat. - clock


Where are all the vote story buttons? by xth (4.00 / 2) #15 Thu Aug 27, 2009 at 03:42:03 PM EST
Neither this nor Technicians last post have them - is it because they are 'new' users? Can we not just fiddle the system or something?

[Splitting comments into subject and body is soooo 1994]

[ Parent ]

Aleady there. by ana (2.00 / 0) #18 Thu Aug 27, 2009 at 04:09:34 PM EST
Apparently the VS2FP button goes away once the story makes front page.

"And this ... is a piece of Synergy." --Kellnerin
[ Parent ]

...aahhh.... by xth (4.00 / 3) #19 Thu Aug 27, 2009 at 04:45:18 PM EST
three front page stories in one week...
ARE YOU WATCHING, CLOCK?

[Splitting comments into subject and body is soooo 1994]

[ Parent ]

GODDAMMIT!!!! by clock (3.90 / 10) #20 Thu Aug 27, 2009 at 06:23:53 PM EST
i NEVER said that husi was dying!!!  i said we should become isolationist and shut out the rest of the internet because they are UNCLEAN IN THE EYES OF THE LORD!!!!

READING COMPREHENSION:  HUSI CANNOT HAZ IT!!!!11!1ONE!11ELEVENTY-ONE!!!


I agree with clock entirely --Kellnerin

[ Parent ]

It's ok. We understand, clock by xth (4.00 / 4) #27 Fri Aug 28, 2009 at 04:28:25 AM EST
((HUG))

[Splitting comments into subject and body is soooo 1994]

[ Parent ]

Fantastic, by technician (4.00 / 2) #5 Thu Aug 27, 2009 at 02:37:05 PM EST
and precisely the sort of hospital bill that one expects in the US.  My wife had an ER visit in San Francisco once due to food poisoning. My insurance at the time refused full coverage because we did not go in-network, and we didn't get authorization to go out of network.

Faced with the mountain of phone calls and arguments that I was about to encounter, I paid the ~$5k out of pocket, and they paid $3k.  The itemized bill was alarming, to say the least; I resolved at that time to travel with my own bags of saline, since each one had cost me $400, and I knew I could buy some at the local hospital supply for $5.



This is what's wrong. by ana (4.00 / 3) #11 Thu Aug 27, 2009 at 03:25:26 PM EST
Billing $400 for a $5 item, and then, if there's enough kicking and screaming, and/or corporate bullying, taking the charge off. It's the phone company's business model, writ large.

I seem to recall some trumped-up scandal about the military buying a $4000 toilet seat once. Turned out it was the plastic-molded interior for a whole airplane bathroom (and short runs of molded plastic parts really are expensive), and so not all that crazy. But just a few stories like this in the press would refocus the "debate" rather nicely I'm thinkin'.

"And this ... is a piece of Synergy." --Kellnerin
[ Parent ]

You could easily lose money on a $4k toilet seat by wumpus (4.00 / 1) #21 Thu Aug 27, 2009 at 06:29:02 PM EST
imagine changing every aspect of a house during construction and trying to charge a fixed fee and you have exactly what defense companies face. I'm not saying they lose money (its actually illegal to do that without a lot of paperwork, largely built in to avoid other types of corruption), but that the absolute insistence by the government (by both the working managers and the rules them selves) in wasting money will stagger the mind.

Wumpus

[ Parent ]

but was there by sasquatchan (4.00 / 1) #7 Thu Aug 27, 2009 at 02:40:57 PM EST
any rust on the wheel wells of the ambulance ?



sounds about right by StackyMcRacky (4.00 / 2) #10 Thu Aug 27, 2009 at 03:10:29 PM EST
people were shocked when we drove my dad to the hospital when he was paralyzed earlier this year - this is why.  that would have been an expensive ambulance ride, when the car worked just as well.



There's one difference, though by ad hoc (4.00 / 1) #13 Thu Aug 27, 2009 at 03:38:22 PM EST
When you go there by ambulance, they have to take you. If you go there by private car, they can say they're full and push you off to someone else.
--
[ Parent ]

depends on the hospital! by StackyMcRacky (2.00 / 0) #25 Thu Aug 27, 2009 at 09:47:41 PM EST
in this case, my father was headed across town to the hospital where i used to work.  that's where his neurosurgeon (from a previous back surgery) is located, so that's where he went.

it's a private hospital that's only had a single John Doe case in its entire 60+ year history (ask me how I know!).  ambulances don't ever go there unless people specifically request it.

and finally, they can say they're full to ambulances, too.  it's called "drive by" status.

[ Parent ]

How do you know? by notafurry (4.00 / 1) #26 Thu Aug 27, 2009 at 10:08:56 PM EST
Hey, you SAID to ask.

[ Parent ]

my friend has epilepsy by garlic (4.00 / 1) #14 Thu Aug 27, 2009 at 03:40:46 PM EST
one thing he makes sure to tell people around him is to not let them put him in an ambulance when he has a seizure.

Suck it


In my third year of college by sugar spun (2.00 / 0) #17 Thu Aug 27, 2009 at 03:46:13 PM EST
an American exchange student died of meningitis because she didn't get to the hospital in time. Her flatmates brought her there by public transport  because they didn't realise you don't pay for ambulances in the UK or Ireland.

[ Parent ]

Everyone in the UK pays for it. by greyshade (2.00 / 0) #22 Thu Aug 27, 2009 at 07:09:34 PM EST
Just not per visit, and they have to pay wether they use it or not.

"The other part of the fun is nibbling on them when they get off work." -vorheesleatherface
[ Parent ]

Well everyone in the US has to pay for it too by ambrosen (4.00 / 3) #23 Thu Aug 27, 2009 at 07:23:22 PM EST
otherwise they die.

The question is the tradeoff between the various perverse incentives that the different systems involve.

[ Parent ]

Interestingly by Herring (4.00 / 4) #29 Fri Aug 28, 2009 at 05:36:52 AM EST
from the last figures I saw, the US government spends more, per capita, on healthcare than the UK government (based upon per capita spending being > twice the UKs and 56% of health spending in the US being govt).

So, actually, you're all being fucked over properly.

[ Parent ]

Not strictly true by Breaker (4.00 / 2) #33 Fri Aug 28, 2009 at 11:12:33 AM EST
For some cases in Soviet UKia, they do make you pay for the ambulance ride.

Like drunkeness; a mate of mine had to pay £250 a few years back.  They pumped his stomach for free though.


[ Parent ]

So the moral is: by greyrat (2.00 / 0) #34 Fri Aug 28, 2009 at 01:14:17 PM EST
Open a pub next door to a hospital.
???
Profit!

[ Parent ]

Excellent! by Breaker (4.00 / 1) #35 Sat Aug 29, 2009 at 05:49:09 AM EST
Do you have a website where I can register to invest?


[ Parent ]

It's not clear when you're a foreign national by garlic (4.00 / 1) #24 Thu Aug 27, 2009 at 09:01:15 PM EST
what you can expect when going to the hospital. On my trip to the UK I got terrible food poisoning (from the British Museum!) that lasted 24 hours, and went to the hospital there for it (not knowing for sure it was food poisoning) and was surprised not to have to pay.

Suck it
[ Parent ]

You should have had to pay by xth (2.00 / 0) #28 Fri Aug 28, 2009 at 05:23:00 AM EST
Normally when you first get seen they should ask you for your National Insuance number (or the EHIC card if you are from the mainland), and if you don't have one you pay. But I find that some hospitals don't bother checking - I suspect that's got something to do with their computer systems being crap.

[Splitting comments into subject and body is soooo 1994]

[ Parent ]

Not in A&E by ambrosen (4.00 / 1) #30 Fri Aug 28, 2009 at 05:54:39 AM EST
Those who are not "ordinarily resident" (including British citizens who have paid National Insurance contributions in the past) are liable to charges for services other than that given in Accident and Emergency departments or "walk-in" centres.

The returning expat coming back for treatment is the particular bugbear of mine.

[ Parent ]

Mmm by xth (2.00 / 0) #31 Fri Aug 28, 2009 at 05:58:45 AM EST
I've had to provide my NI number at UCH, but not London Royal or other hospitals - it may have nothing to do with paying though

[Splitting comments into subject and body is soooo 1994]

[ Parent ]

When looking into it afterwards by garlic (2.00 / 0) #32 Fri Aug 28, 2009 at 08:01:04 AM EST
it seems that the UK and US have some deal where the first visit's free?

Suck it
[ Parent ]

Had a similar situation in Italy by lolwhat (2.00 / 0) #39 Wed Feb 03, 2010 at 04:11:20 PM EST
Got food poisoning from a restaurant, and ended up in hospital in Rome with acute dehydration. It took a fucking act of God (and six hours) for them to give me maybe 500mL of saline. Given the condition I was in, I would've had much, much more than that, right away, back in the States. The thing is, I never got a bill - ever - even though, technically, I was supposed to.

[ Parent ]

international credit collection companies by garlic (2.00 / 0) #40 Wed Feb 03, 2010 at 10:32:24 PM EST
may not exist.

Suck it
[ Parent ]

Wouldn't you know by johnny (2.00 / 0) #36 Mon Aug 31, 2009 at 06:22:48 PM EST
This story has been sitting here for days, but it was my brilliant timing to read it over dinner, out here on the back porch, first decent cookout opportunity in more than a week.

P.S.

I've heard it said, "Albany is the asshole of the world, and Troy is five miles up it."  Not sure if that pertains.

She has effectively checked out. She's an un-person of her own making. So it falls to me.--ad hoc (in the hole)


Another ambulance ride cost anecdote by Phil Urich (2.00 / 0) #37 Mon Nov 02, 2009 at 02:47:26 PM EST
I've actually ridden in my share of ambulances, unfortunately; my memory tells me that it's been around $500 each time though (in Edmonton, and "Canadian" is one of my two citizenships).  It's usually been serious enough that it's seemed justified.

Conversely, one of my roommates got hit by a car while cycling the other summer, and an ambulance arrived very shortly since he was in fact only a few blocks away from a hospital.  They insisted on taking him, though he tried to say no since he was feeling merely bruised, but he was feeling too weak to really resist.  They got him to the hospital and almost immediately discharged him.

For quite some time afterwards Alberta Health kept sending him ambulance ride bills; tremendously poor, there was  no way he was going to be paying $500 even if he felt like it, and he really didn't see how he should be obligated to pay for something he had attempted to refuse (and, furthermore, was the fault of the driver who hit him...or at least would have been if Alberta had rational traffic laws, but that's another story).

The best part came later, once (as is the procedure) Alberta Health sold off the claim to a private firm, who then repeatedly called our landline insisting that my roommate pay.  They got quite exasperated.  This was right as the entire financial backbone of North America (And Beyond) was coming apart, and they had the audacity to claim at one point "think of your credit rating!  you won't be able to get a loan!"  I was on the phone too that time, and after I rather correctly pointed out that at the moment it was pretty much impossible for anyone to get a loan the frustrated teleclaims agent hung up.  We never did hear from them again.  Maybe some good came from this recession and they just outright went out of business.




It's a shame you weren't in Europe. by NoMoreNicksLeft (2.00 / 0) #38 Fri Nov 20, 2009 at 01:21:21 AM EST
An ambulance speeding you off to the hospital ER for a fart twisted in your guts is free.

--
Do not look directly into laser with remaining good eye.


If this story had a title it would spoil the end. | 40 comments (40 topical, 0 hidden) | Trackback