An everyday story of US healthcare – or how a visit to the ER can cost you $10,000

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      I left my kids with my friend and got in a taxi. “How bad is a blood clot?” I’d asked my friend’s brother before leaving, and he’d reassured me it was no big deal as long as it didn’t detach. “Then what?” “You’ll die instantly.” This was concerning, particularly since the solution, he said, was “not to jiggle the leg”, but at that point my fears lay elsewhere. It’s expensive to die in New York, and as we crossed Central Park, I rang my insurers to get pre-authorisation (a promise with approximately the value of Neville Chamberlain’s piece of paper, but you may as well try.)

      The ER was half-empty. I have always wondered whether, in an emergency, my personality would undergo an exciting change, converted in the heat of the moment from a sort of vaguely up-myself diffidence to something more thrusting and American. Now I know. “How are you, how can we help?” said the check-in clerk and reflexively I replied, “I’m fine.” For five minutes, I sat in the waiting room wondering if I was about to keel over and should be raising more alarm. Another five minutes passed, and the triage nurse came over. Even delivered in my apologetic, half-assed fashion, the words “suspected blood clot” had an immediate effect and I was sent straight through to the doctor.

      It wasn’t a blood clot. It wasn’t a broken bone, either. No one that night could figure out what it was, except maybe a rip in the tendon, although they were very thorough and drew blood to rule out the possibility of low platelets. I don’t know what lesson to extract from all this, either, other than something reassuring about consistency of character.

      Mainly, I’m aware, with weary resignation, that although the swelling has gone down and the foot is definitely on the mend, in other ways this is just the beginning. After an ultrasound, X-ray, blood test and patient transport all over New York’s premier hospital, I’m waiting for the inevitable $10,000 bill and the hours I will spend on the phone to contest it. It’s the story of American healthcare; the real pain starts now.

      Jesus: Hey, Dad? God: Yes, Son? Jesus: Western civilization followed me home. Can I keep it? God: Certainly not! And put it down this minute--you don't know where it's been! Tom Robbins in Another Roadside Attraction

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