By Patricia Lee Sharpe
Time: a sunny afternoon, blue sky, temperature in the Fifties, no wind to speak of, a perfect day in New Mexico.
Place: Act I: the Dale Ball trail system in the foothills of the Sangre de Cristo mountains, elevation about 8000 feet. Act II: the hospital emergency room.
Dramatis personae: Just me and the doctors.
What happened? I love to hike and do so regularly in the hills and mountains around Santa Fe. A few weeks ago I tripped on a rock and the doctors had to clean up the mess: contused forehead, black eye in the making, bloody lip, scraped palms and knees, dislocated left elbow, chipped arm bones.
Charges (so far) for emergency room treatment and follow up care: about $6000.
Cost to me: Zero. Sure, I pay for health insurance, but 12 times the monthly fee is much less than $6000 per annum.
Total cost to you, a similarly situated “young indestructible” who listens to Republicans claiming that insurance rates unfairly exploit healthy young people to reduce the cost of covering sickly old people: $6000. You may be young and healthy, but—believe me!—if you fell as hard as I did, on rock, you’d have ended up as I did, with real damage. Consider this: can you afford to lay out $6000 on top of your worrisome college debt and your car payments? (As for the unfairness charge, the whole idea of insurance is that the cost/benefit ratio works out pretty equitably within a population and over a lifetime.)
The Gory Details
The trail head parking lot was in sight, not far below. The distance I had yet to cover was an eighth of a mile, maybe, after a glorious 4 1/2 mile hike. And the trail, as I remembered it, was perfectly smooth. So why shouldn’t I have been scanning the horizon, enjoying the vista? Except, as I discovered when I checked it out a few weeks after the tumble, there was one rock—one rock deeply embedded in the trail!—and yup! That one rock tripped me up, flinging me off and over the edge of the path. I belly flopped facing downward on a 45 degree slope. It took me a few seconds to figure out how best to get to my feet. Trying that, I discovered I’d have to find another way. My left arm was floppy and useless. Broken, I surmised.
Cradling the useless arm, I reached my car, unlocked it, managed somehow to buckle in and drove (slowly, one-handedly) about five miles through light traffic to the hospital. Xrays showed a dislocation in my left elbow plus two small fractures, from bones jammed against one another as I landed. Re the dislocation, I had a choice: bones yanked back into place with or without anesthesia. I chose not to feel the pain, which naturally meant an anesthesiologist and all his paraphernalia added to the cost of getting me back into action. Meanwhile, my upper lip had two wounds that needed stitching, but an MRI had determined that I was not concussed. Thank goodness! No bed rest required.
And so, hour by hour, procedure by procedure, the costs mounted to that $6000, even though I declined the services of a physical therapist to help me regain full range of motion to my arm once it was out of a splint. Oh ho! say the bean counters! Patients need to shop around. Yeah, right. The nearest alternative hospital for emergency care is in Albuquerque, 60 miles away. And which, if any, xray view was superfluous? How would I know?
Luck and Bucks
What happened to me on a largely benign trail can happen to any hiker of any age who doesn’t pay constant attention to where his/her feet are going—and who does? Just as unpredictable from the point of view of incurring health care costs: appendicitis, with or without complications. And auto accidents happen to the healthy as well as to the chronically ill.
But say you’re one of the truly lucky ones who, for a lifetime, never gets sick and never slips on the ice and avoids every other kind of accident. So what if you’ve paid for insurance you’ve never had to use! Wouldn’t it be worse to be sick, sick, sick, and get your money’s worth? Meanwhile, your contributions have helped someone else who might otherwise have died too soon from lack of affordable treatment.
That doesn’t seem unfair to me. It seems sane, sensible and compassionate.