I was telling the story of my six-hour stop in the emergency room at the Kaiser hospital to a friend the other day, who happens to be a physician--one with a sound analytical brain and rather more conservative leanings than myself. He calculated in an instant that the treatment I'd received--and excellent, thorough treatment it was--had amounted to about $10,000 in costs. Of course, what with the hospital bed, the nursing care, the non-nurse attendants who kept the place clean and wheeled the gurneys, the rehydration via IV drip, the blood samples and lab fees, the CT scan and its interpretation... when you think about it, had I received the bill for all these costs I would have been shocked, but not surprised by the bottom line.
But I did not receive the bill. I ended up with a co-payment of $55, plus a small sum for take-home medications from the pharmacy. So I suppose that the bill was paid in part by my Kaiser insurance plan, in part by Medicare. In any event, a huge sum of money for something that turned out to be relatively benign, a stomach bug that would have lost its potency with a little patience--as it did with Ellie, who came down with the same thing hours later and stayed home. The reason for my decision to go down to the hospital was Ellie's telephone conversation with the Kaiser "Advice Nurse," which led to the suggestion that there could be a heart problem involved.
Now I'm quite sure the Advice Nurse was following protocol--a protocol designed to protect not only the patient but the HMO itself from a worse outcome than mine, that evening, along with the law suits that would likely follow. We live in a society dominated by mistrust, and cause ourselves enormous, mostly wasted expense on self-protection--whether as individuals or institutions. I think of this every time I put little Luka in his car seat. I think of the days when I was Luka's age, when even his mother was his age, and baby car seats were not even yet invented, let alone required by law. On the one hand, of course, it makes good sense to keep our babies safe; on the other, you have to wonder to what lengths we go to protect ourselves from every conceivable danger.
We have become a fearful bunch. The normal risks of life have become intolerable to us and we protect ourselves from them as though they were an insult to our very right to life. There is one part of me that despises what I believe my friend, Bob, would condemn as the "nanny state"--though I believe that he and his fellow rightists go much too far: in my view, a reasonable, government-provided safety net is needed for the sick, the poor, the elderly, the defenseless. The necessary course is to find the balance; and that, in a country of three hundred million and counting is no easy feat.