It’ll cost an arm and a leg

The lunacy of this country’s health care system is obvious to anyone unfortunate enough to have to use it.

I haven’t seen Michael Moore’s “Sicko,” partly because I’ve been spending most of my free time battling both a broken left wrist and the maze of the insurance claims process.

What I’ve read about the film suggests Moore uses the logic-defying and heart-wrenching stories of Americans and their experiences with insurance companies to embark on a publicity stunt aimed at ginning up support for a “free” universal health care system here.

I don’t need to get turned away from the U.S. base at Guantanamo — as happens in Moore’s movie — or use my journalism credentials to get around the Cuban embargo — as Moore does in the film — to know that serious reform is needed. I was unlucky enough to need an ambulance on May 4.

My family had just paid off our portion of my daughter’s three-day January hospitalization when the first of the medical bills from my injury arrived.

American Medical Response sent me a bill for $910.42. I got it two months after my fall from the top of an 8-foot ladder.

I had lost consciousness briefly after my fall (likely a result of the pain from a dislocated and fractured wrist, bruised ribs and severely sprained knee). Others called 911 to get me help.

Both AMR and Las Vegas Fire and Rescue arrived, but it was AMR that took me to University Medical Center’s Trauma Center. Apparently, I should have told AMR not to help me.

My insurance administrator said I would be responsible for the bulk of the bill because I had yet to meet my $750 deductible for an out-of-network claim. Neither AMR nor MedicWest, the only other ambulance company in town, has an in-network contract with the Review-Journal’s insurance plan.

I was on hold more than 18 minutes with my insurance administrator before I was able to ask my questions.

My only choice now is to appeal the claim. Meanwhile, AMR wants its money and I’m guessing its billing team has already put me into the “past 60 days” category of delinquents. The accident was in May, mind you.

As I said, that’s just the first bill. There will be many more — anesthesiologist, hospital doctor, hospital, the X-ray outfit, hand doctor and, eventually, the physical therapist.

You and I both know that I write for a living, so it’s kind of important that I get my left wrist working as best it can.

After nine weeks in various casts, the hand doctor told me to go to physical therapy. “How often do you want to go?” he asked.

I was stumped by the question, having not gone to medical school myself. He finally suggested 12 sessions over four weeks, adding, “That’s usually all insurance will pay.”

Once again, I’m in a jam because I have insurance and didn’t get injured on the job. I might be able to move my wrist to the left again after four weeks. Then again, I might not.

I’ll probably be able to tell right about the time the first therapy bill arrives. Somehow, I don’t think my co-payments are going to be enough. They rarely are.

My other fun moment came four weeks after my accident when I found my knee still wouldn’t move side to side without pretty sharp pain. Because the hospital had focused on my most obvious and acute injury — the wrist — my knee wasn’t X-rayed.

So off I went to another doctor for another round of X-rays. Doc said my symptoms indicated a possible ligament tear — but, thankfully, one that would heal on its own without surgery.

He sent me off with a referral for an MRI to confirm. After waiting eight days for the doctor’s office to call me back with an MRI appointment time, I decided to bag the test.

The MRI might have proved I tore something. And then what? Another trip to the doctor to discuss the MRI, follow-up visits and more physical therapy? I’ve decided to keep limping until the thing heals.

The health care problems in this country cannot be cured with the same routine. But starting the discussion with the promise of a single-payer health care system makes about as much sense as my doctor amputating my leg above the knee.

Each Democratic presidential candidate seems to have a universal health care plan. Some would pay for it by withdrawing troops from Iraq. John Edwards says he’ll raise taxes on those earning $200,000 or more to pay for his plan.

Moore may not be the right messenger or have the right message, but he’s found the most important domestic issue.

Erin Neff’s column runs Sunday, Tuesday and Thursday. She can be reached at (702) 387-2906, or by e-mail at eneff@reviewjournal.com.