No-one would deny the American health service is usually efficient, for those able to pay for it. One could use the word ‘afford’, but the percentage of US citizens who can realistically afford healthcare is so ridiculously small that it would be misleading to do so.
To pay for healthcare means having suitable medical insurance, but of itself, that’s no guarantee of a free service. If a British citizen, for example, spent three days in an NHS hospital following chest pains, and required a forty-five minute procedure to insert an artery stent, to be given a bill for $3,000 (£2,000) at the end of it would probably negate any benefit the procedure afforded. He’d have an immediate heart attack.
Nevertheless, Americans can have the best medical insurance available and still expect to pay that sort of fee.
A few days after arriving home, the hopital’s bill drops into the mailbox. For the procedure outlined above, it will be in the region of $55,000 (£38,000). Sometime later, the insurance company sends it’s own account, setting out how much of that $55,000 it will pay.
Medical insurance companies have their own private arrangements with the hospital. The bill of $55,000 will be magically reduced to around $30,000 (£20,500). The patient will be expected to fork out approximately ten percent of that, depending on their policy.
Of course, for the unfortunate with no medical insurance, the hospital will demand their full $55,000 pound of flesh. These days they usually employ debt collection agencies to insure they get it.
No insurance, plus chest pains, can equal no house plus no car plus, possibly, a future career as a down-and-out.
All-in-all, a very fair system. Or, so most Americans seem to think, given their virulent opposition to social reform.
While certainly not worth the enormous expense, one benefit of the US system over a National Health Service, is its ability to not keep you waiting most of the time. Hospitals are efficient places, and waiting to see a doctor, or receive an X-ray, is a generally speedy process. After all, medical establishments are in competition for your lumbago, or cancer, or heart disease, and keeping a customer waiting is not good business practice.
Unless, of course, you’re not the customer.
A random drug/alcohol test is a necessary evil for any bus or truck driver in America. But, hell, how long can it take to pee in a cup and blow into a machine?
The answer, certainly in this part of the Heartlands, is about an hour and a half.
Now, don’t get me wrong; the process itself takes less than five minutes, of which four and a half are spent signing forms and reciting your social security number. The remaining eighty-five minutes are spent in a dingy waiting area while an inadequate number of medical personnel laboriously sift their way through the half dozen patients who were lucky enough to beat you to the reception desk and claim priority in the queue.
The only entertainment is the inevitable widescreen TV, tuned to the banalities of the NBC ‘Today’ program, and featuring two over-the-hill, toothily-grinning, female anchors who look like they’ve just leapt out of an archaic women’s fashion magazine – though definitely not Cosmopolitan, as NBC may relish banality, but only good wholesome banality.
After thirty or so minutes of these clucking hens boosting each other’s ego and smirking condescendingly into the camera, your torture is temporarily interrupted by a laconic receptionist thrusting forward forms, with a demand to, “Sign and date by the marks,” before retiring once more behind her grubby glass panel.
Finally, just as the advert for that cancer drug airs for the fifth time, a door opens and you hear your name called by some anonymous person within, who turns out to be armed with a plastic cup and even more forms.
Having waited for so long that a plastic bucket might be more realistic, the order comes to “Fill to the line, but no further,” and one is ushered to a toilet, with decor in keeping with the rest of the establishment, for the process to finally begin.
These places are businesses just like the hospitals; indeed, many are run by local hospitals. In this instance, though, you are not the customer; you are merely a chattel. They have no interest in your welfare because you cannot go elsewhere. You are condemned to be the victim of your employer’s choice, for it is the employer who’s the client, not you.
The aim of a drug/alcohol test station is to secure the employer’s custom, and the only criteria is cost. My employer – the Head Office where these things are decided – is somewhere deep in the smelly, turgid, bowels of Tennessee. No-one there gives a damn that I have to spend eighty-five minutes of my valuable time bored to death, while audibly assailed by two overly-mature vixens prancing and preening themselves before a TV camera.
In fact, someone in Head Office has probably received a hefty bonus, and a pat on the back, for securing a much cheaper contract than with the place they sent us to last year, which was clean, airy, and had you in and out in twenty minutes.
But, that’s capitalism; that’s business, and that’s American healthcare.
Filed under: Piss pot