4 Lessons I Learned From My Trip To The Emergency Room
As Ivan vaguely alluded to in our March money diary, I had the unfortunate experience of testing out our nation’s healthcare system when I visited the ER last month.
Here’s what happened:
I was washing a large glass bowl and accidentally dropped it in the sink. As the bowl shattered, a glass shard flew backward and cut my wrist open. Luckily, it missed the vein but it did leave me with a giant gash on my wrist. Needless to say, I freaked out.
Since my company had just switched to a new healthcare provider, Ivan had to look up the nearest in-network hospital, order a Lyft (fun fact: Ivan can’t drive), and locate my health card and photo ID (in various jacket pockets). When we made it to the ER, I ended up getting an X-ray and a couple of stitches.
Now that I’m able to type freely again, I thought I would share my experience with our “free market” healthcare system. Because “free market” means better, right? More competition and better care, right?
Bureaucratic redundancy. When we arrived at the waiting room, the receptionist asked for my healthcare card, driver’s license, and social security number. I produced all of this information and watched her type this into the computer. Then she handed me a paper form...so that I could write down all the information I had just given her. Apparently, the fact that I was holding a paper towel against my bleeding right wrist was completely irrelevant.
Nobody cared. Look, I wasn’t expecting VIP treatment but some level of concern and attention would’ve been nice. I understand the ER is filled with far more serious cases than mine - not to mention overworked doctors, PAs and nurses on 10-12 hour shifts - but the ER nurse who was on duty barely glanced at my cut before concluding that I didn’t need to be there. In fact, she offered me a band-aid to go on my merry way. Lady, my wrist is grinning at me. I think I’m going to need more than a fucking band-aid.
The admin/reception staff seemed lost and ill-prepared. According to the CMS, about half of all emergency services go uncompensated; the typical ER treats 1 in 5 patients without insurance or a clear method for reimbursement. I actually think that this is part of the reason why ERs go bankrupt: garden-variety incompetence. For example, when Ivan and I went to pay our insurance co-pay (which is $100 USD), here’s what happened:
The Receptionist (to her co-worker): I don’t know the link to the payment portal. Do you know it? Is it www.xyz.com?
Co-worker shrugs as if nobody has ever paid an invoice here since the new millennium.
Fifteen minutes of aimless clicking later...
Receptionist: Uh...can we just mail you the invoice?
Ivan: I’d prefer to pay by credit card (subtext: let’s get this shit over with now)
Fifteen minutes later.
Receptionist: Uh...yeah...I don’t want to keep you guys waiting. We’re going to have to mail you the invoice.
Me: Okay, but can we pay electronically when we receive the physical bill? (subtext: it’s 2017 and I’d prefer not to pay my bills like it’s 1954).
Receptionist sighs as if we’re being a huge inconvenience (btw, the waiting room was empty): Uh...I’m not sure. Sorry.
It’s been two weeks and we still haven’t received that invoice. This isn’t the first time a hospital/doctor’s office hasn’t billed us for services rendered. So are we supposed to assume the free market system is so efficient that it no longer requires my money? Stay tuned.
4 Lessons I Learned From My Trip to the Emergency Room
So, what are the takeaways from this experience?
I don’t know enough about my own healthcare benefits. It was only after this experience that I actually checked the estimates for costs and alternatives to the ER visit. I found out that I could have gone to a nearby urgent care center, which would have been faster, cheaper, and easier overall. If I could re-do the experience again, I would have set aside a go-to urgent care center and gone there instead.
In a city like LA, it’s easier to just catch a ride via a taxi/Uber/Lyft to the hospital. I didn’t appreciate it at the time but catching a Lyft in Los Angeles is way easier and less dangerous than driving (especially for a non life-threatening emergency). By the time Ivan had located my health card and photo ID and walked me downstairs, the car was already waiting for us in the driveway. No need to worry about parking or distracted driving.
We need to have our future PCP on speed dial for future incidents. It would have been so much easier to speak with a doctor that knew me well and could calm me down in a situation like this. This is also a great lesson for when we go abroad. No matter where we are in the world, always have an idea of where to go and have emergency medical attention on speed-dial.
Don’t expect too much out of hospital staff. I hate to say it but my entire ER experience only reinforced my skepticism and distaste for the American healthcare system. The staff are often overworked (e.g. 10-12 hour shifts) and have a lot of shit to deal with so naturally, they become more apathetic and careless. I think this has less to do with incompetence but a broken hospital culture.
So that was my emergency room experience. Now that my wrist is 80% functional, expect Ivan and I to get back to a more regular posting schedule.
Total Cost of the Emergency Care Visit
I feel really grateful that my company pays the premiums for my healthcare coverage in full, which is definitely a privileged position to be in. As you can see from the table below, if I didn’t have any coverage, my trip to the ER would likely have cost around $600 for a simple laceration: