Over the Hill

At the mercy of emergency health care

My wife, Mamie, went by ambulance Sunday to the emergency room. That started me thinking about the way we buy health care.

I later Googled “health care market forces.” I found an article on Forbes.com, written by Dean Zaras.

In one place he wrote, “If we want widespread access to great health care, we need widespread low prices, and only market forces can deliver them.”

Anyone who writes for Forbes must know a lot about business, but I still don’t agree with him.

Market forces and competition may deliver fair prices if we’re buying medical insurance or prescriptions. We can shop around for the best deal. We are customers.

But if we are seriously ill or injured, we want the closest and quickest help. We’re unable to pick and choose and bargain. We’ll take what’s offered and never mind the price. We’re no longer customers; we’re as powerless as beggars.

That’s what happened to Mamie and me. She started feeling unwell last Friday. On Sunday, she really got worse. Her doctor’s office was closed, of course. I called the on-call doctor and begged for help or advice.

She suggested I call an ambulance. I dithered for an hour and finally admitted I had no choice. I dialed 911, which is also a way to beg for help. The dispatcher was friendly and helpful. So were the firefighters and ambulance medics who soon filled our living room. I didn’t ask about cost. I would have agreed to pay anything.

At the emergency room, the doctor said Mamie needed blood tests, intravenous fluid, a urine analysis, an X-ray and a CT scan. I didn’t ask the prices. I just wanted Mamie to be helped.

I never doubted that the doctor sincerely believed those measures were necessary. I assumed they are the standard operating procedures. And, he might even open himself to criticism or lawsuits if he’d left any stone unturned.

I never asked any of the prices. I hoped Medicare and our supplemental insurance would cover them. I’ll find out.

After about three hours, Mamie’s problem was relieved. She was sent home with instructions to see her doctor the next day, which she did.

I think our experience shows that market forces and competition aren’t a cure-all for the rising cost of health care. People with serious, urgent problems have no bargaining power. They can’t shop around.

An outside authority is needed to protect us from the few unscrupulous doctors, hospital companies and insurance companies.

It could also lead the honest ones “not into temptation.”