Long day. . .

Last updated on: June 16, 2015 at 9:56 pm by Jane the Actuary

Long day. . . 2015-06-16T21:56:21-06:00 Jane the Actuary

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By axelvonsturm [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons

Well, it started as a fairly routine summer day around here: the oldest left for his summer school (enrichment) class, and I dropped the middle son off at sailing camp and the youngest at his day camp, spent a few minutes blogging, and had just settled into work when I got the call:

“Mrs. ——–, your [12 year old] son just fell. It looks like he dislocated his elbow. You’d better pick him up; do you want us to call the ambulance in the meantime?”

Well, as it happens, the hospital is close to home, and I didn’t think an ambulance was necessary (and I was secretly hoping that the counselor was exaggerating), so I hopped in the car, picked him up — and, well, they weren’t exaggerating. Off to the hospital we went.

This is suburbia, so when we arrived at the hospital, we pulled up in front of the ER, and within minutes were in an examination room, with the nurse settling my son in the hospital bed, positioning the arm in the least painful way, getting an ice pack, and, a few minutes later, had whisked him off for X-rays. We had to wait for the X-rays to come back, and for the doctor to examine him and the X-rays, before they started him on painkillers; ultimately, they sedated him to “re-locate” the elbow, and put a cast on. We’ll see the doctor again on Thursday to (hopefully) give us the news that the fracture will heal fine without any further intervention, a much better outcome than the initial statement that we’d be taking him into the city to the children’s hospital to have pins put in.

Add in the wait time, and the observation time after the sedation wore off, and the test-popsicle and more waiting, and we left the hospital a good 6 hours after we arrived.

Whew.

At least he’s in good spirits about the whole thing, though understandably disappointed that summer is, as he phrased it, compromised. (I’ll look into protective covers for the cast tomorrow.) At least there are four weeks before Scout camp. At least my husband, who has been travelling a lot lately, was home, and able to meet us at the ER. At least . . .

Yeah, a lot of “at leasts” —

But it’s experiences like this that are why I part ways with the “status quo ante” crowd when it comes to Obamacare.

Our family is very fortunate that, even with a high deductible, we will be able to manage the cost of my son’s treatment just fine. Heck, I’m now already thinking about whether there are other medical treatments we should have done to take advantage of having me the deductible.

But for other families, an injury like this can cause serious financial harm.

And as much as one says, of high deductible plans, that they encourage “consumer” behavior, when your kid is injured, you can’t comparison shop among hospitals, as to which is the cheapest, much less ask of the doctors, “is there a cheaper way to do this?” or “do you really need to take quite so many X-rays?”

Yes, there’s some cost savings to high-deductible plans; my go-to example is always treating a wart with an over-the-counter remedy rather than going to the dermatologist. But that’s the low-hanging fruit. Ideally, insurers will also provide the necessary information to enable the patient to choose the most provider for certain routine or standardized kinds of procedures; perhaps one can already comparison shop on a knee-replacement, for instance. But (with the reminder/caveat that I am not a health actuary) that’s a fairly limited range of services; it’s just not possible to comparison shop on a broken arm, and, even if I were told that a further half-hour’s drive would save some cash, I’m not sure I’d do it.

The other thing that this sort of accident reminds you of is that health care is a unique sort of “product.” Most of the goods and services we buy present opportunities for the poor to economize and the wealthy to splurge: do you live in an older, small apartment or a new luxury house? Do you get your protein from canned tuna, ground beef, and bone-in chicken, or from filet mignon and lobster? Do you cook or dine out? Do you buy your clothing at the thrift store or at Lord & Taylor?

But healthcare? In Germany, the basic public coverage includes a ward room, generally, a three-person room. But in the U.S., other than accepting narrow networks, or an insurance policy with shoddy customer service, there just aren’t particularly many opportunities to economize.

(That’s not my son, by the way, but a generic image.)

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