It Makes Me Sick

At the end of the year, we lost our health insurance coverage as my husband transitioned from a traditional job with an employer-paid health plan to being a consultant. The company was slow to send us our COBRA paperwork so we could have uninterrupted coverage and my daughter Miriam came down with a fever that lasted several days.

Normally, I wouldn’t have taken her to the doctor because it always seems to be the same diagnosis, a virus that you just need to wait out. But this time, she had already missed three days of school and she told me that she had a very sore throat and a stomachache, which I know can be symptoms of strep throat, so I made the appointment.

I had some doubts about whether we were still covered because the company had deducted money from my husband’s last paycheck for our portion of the health insurance premium, and I wasn’t sure if that was for the following month or the one that had just passed, and I thought I’d just have to take my chances and pay if necessary.

When I got to the pediatrician’s office, the first thing they did was check the insurance and got some nebulous status like “inactive,” rather than something definite like “cancelled.” I told the office staff the situation and they said they would try to contact the insurance company and get a clear answer as to whether we were covered or not.

They made me wait with my 8-year old sick daughter and 4-year old in the waiting room for over an hour. Finally, they called me up and asked me to sign a promise to pay, something they could have asked for when the issue first became apparent. Instead, they made us sit there, while we watched every other person go in to be called before us.

I signed the promise to pay. Then, because I knew that sometimes doctors will lower their prices to those who have no insurance, I asked if that was an option. No, I was told. Either they put in for the insurance or they reduce the cost for “self-pay” patients, but if the insurance company rejects the claim, then the patient must pay full cost, even though in effect, we would then become self-pay patients.

My daughters were getting antsy, to say the least, and Miriam in particular wanted to leave. She looked like she was feeling better, and in truth, she probably should have gone to school, but she’d milked it for all it was worth and got another day off.

I looked her in the eyes and asked her, “Do you really feel that you are sick and need to see the doctor or do you just want to go home, because it may end up costing me $100 or more.” I paused, and added, “If you are sick, we’ll stay.” As I’d expected, she elected to leave.

I’m not in the medical field, and I know that they have their own hassles to deal with, like collecting from insurance companies, processing mounds of paperwork, and, well, dealing with sick people. But I would imagine that when each of the doctors in that pediatric practice decided to pursue medicine as a career, and to specialize in pediatrics, if you would have asked them why they’d made that decision, they would have answered something along the lines of “to help people,” or “to help sick kids” and not “to make money helping sick kids whose families have health insurance.”

As I left the “Sick” section of the pediatric office that day with my two daughters, sick is just how I felt.