Sometimes the best way to deal with something is through humor.

So in the interest of keeping

my blood pressure way, way down, MOTHER’S DAY OUT proudly presents herewith,
heretofore, and hereunder, a non-partisan/bi-partisan/post-partisan (did I cover all the bases?)
bill for your consideration. It’s already made it through her House, so let’s present it to the
Senate—those guys really look like they could use a good laugh right now! Best part: it’s only
THREE pages. (Old Mother knows you have the attention span of a gnat.)

The $640 Popsicle

or, My (Medical Insurance) World and Welcome To It!

Old Mother’s
Radical Blueprint for Health Care Reform
By Helen Black
October 31, 2009
 At our house, insurance coverage consists of:

1) essentially, catastrophic care ($5,000 deductible),

2) the privilege of a twenty dollar co-pay whenever we visit the doctor (rarely*),
and
3) the implication that we are getting a special discount on services above and
beyond that (supposed to make us feel better about the whole deal & does if
we don’t think too hard, which is easiest when the martini bucket is close at
hand).

* because the kidlets are super-skinny and otherwise physically and psychologically sound, and we strive to
provide them with healthful habits they will carry through their teenage years, during which they will not engage in
risky behaviors that threaten life and limb (their own or others) because they are as aforesaid psychologically
sound, and will therefore survive into adulthood, during which they will be energetic and productive members of
society because they are, as aforesaid, physically sound, and will continue to live out the good health habits
tattooed on their foreheads by Old Mother and Old Father and so continue to be no burden on society health-
spending-wise (the lion’s share of healthcare spending being on obesity-related illnesses), insofar and inasmuch
and in point of fact being the actual individuals who will create the value in the marketplace which will then be
taxed to provide health spending for other members of society who are not so favored and so is there a tax credit
for this yet please?

For all of the above Old Father and I pay about the equivalent of the annual GDP of a
small, newly-minted Balkan republic. This is in pre-tax dollars, because we are self-
employed. It all works fine, if as I said you’re not thinking too hard about it, UNTIL
somebody has to go to the emergency room, because they are bleeding from an open
wound and it’s a Sunday.

This brings us to: THE EMERGENCY ROOM.

Ah, the Emergency Room. Why is it whenever I walk into the Emergency Room I feel
like there are huge arrows and flashing lights over my head spelling out GOLDEN
GOOSE?

(I was going to title this little ditty the $350 popsicle, because until my recent triple-header I hadn’t been to the
emergency room since 2006. I’m here to tell you that it’s now the $640 popsicle. And by the time you read this, it
will probably be the $656 popsicle.)

Suffice it to say that a single visit to the Emergency Room can blow a big, wide hole in
that personal household TARP plan. Yes, that sucking sound you hear is the dread music
of our wallet being sucked into the black hole of deficit spending. In a quaint attempt to
stem the tide I have strategically posted around the house signs which read, to wit,
heretofore, and hereunder:
 NO ACCIDENTS OR ILLNESS AFTER 9 P.M. ON WEEKDAYS
(this is when the urgent-care place closes, which only charges the regular co-pay)
OR ON SUNDAYS WHATSOEVER
(when absolutely nothing is open)

Despite this practice of defensive medicine (I suggest placement in kitchen, bathrooms,

garage, and workshop), accidents will happen and there will inevitably be a trip to the
emergency room, for example, ibid, nota bene, gaudeamus igitur, heretofore and
hereunder, when:

a barefoot child steps on the partially-concealed tine of a rake, resulting in a neat little
puncture wound; a pre-verbal toddler runs a high fever and won’t eat or drink; someone
falls backward though a picture window and cuts his scalp just enough that you know a
stitch (or staple) will be required; a teenager, playing a toddler’s favorite game called
“Swirly,” wherein he swings him around by the hands, accidentally dislocates toddler’s
elbow; a child inserts a small bead into her ear; or jokingly demonstrates a baseball pitch
IN THE KITCHEN, which even though it is done with a spongy nerf-type ball triggers a
Pavlovian catching response in yet another child who comes down over and onto the
counter in such a way as to catch an art glass bowl cutting his hand just enough that you
know a stitch will be required.

Disclaimer: I am NOT SAYING that any of these things have actually and definitively occurred in my OWN house.
Maybe they happened in someone else’s house. Some of them probably did. But I’m not telling which. My lips
are sealed. I will say, however, that that was my FAVORITE art glass bowl and because of its colors really looked
nice with pears in it, pears that were home-grown without the use of chemical pesticides (is there a tax credit for
that please?).

What do you do?

You go to the Emergency Room and you get coded six ways till Sunday!

Coded for emergency room visit, office visit, accident treatment, surgery (if human
contact is required), and supplies (if they give you so much as a kleenex).

And that’s even before they start treating the patient! JUST kidding. But seriously, each
code is worth $150 at least (at this writing), except for the supplies, which are coded
individually and are $54 each, unless they’re made of metal, in which case they are $154
a piece. If the doctor has to leave the room and come back, they get to code it twice.
And if they need x-rays, many are taken, the extras going into a storage vault as required
by the terms of their contract for liability insurance.
Codes rule! They allow the hospital to price a la carte and jack up retail sky-high to
make sure they see something out of the insurance company. Hey, I don’t blame ‘em.
They’ve got their personal private parts in a vise. And the insurance companies do too,
thanks to Medicare and Medicaid. The upshot of it all, though, is that I have to sign a
lien on my house or hand over my first-born son (hmm—might not be a bad idea—he’s
fifteen now and does abrade the nerves occasionally) in order to ransom a child with a
staple in his head, a splint on his finger, or a popsicle in his mouth.

So just off the top of my head, I want a loyalty card for the Emergency Room just like I
have at the Little Bookworm Coffee Shop next door to my favorite independent
bookstore. Like: “Buy three visits, get one free!” But with perpetual rollover— no use-it-
or-lose it provision. Or how about an incentive plan? All parents know that judiciously
parceled-out incentives can be quite successful. How about a policy formula that reduces
your rate for a low-range BMI? That would definitely motivate me to drop those last few
pregnancy pounds…especially since the pregnancy is way too old to be using as an
excuse anymore…like…about five years.

But this is just tinkering around the edges. The real fix has to go to the root of the
problem, and here it is.

REAL FIX.
Pretend you have three beautiful, new, expensive cars in your garage, and a teenager,
who’s just gotten his driver’s license, totals one of them. You wait a bit, give him the
keys to the second car, and he totals that one too. Now—are you going to give him the
keys to the third? Like heck you are! You’re going to make him take ownership of the
problem. Fix up those cars, and on his own nickel. Prove he can drive them steadily and
consistently without mishap, before you’re ever going to let him touch the third. So, Old
Mother’s Radical Blueprint is a homework assignment for Congress: fix Medicare and
Medicaid, get them running like tops, and THEN think about putting all the rest of us
under that big tent. A fab idea, but do this first. Then come back. We’ll talk.

While I’m waiting, I’m going to ask my absolutely sensational doctor and my absolutely
sensational pediatrician (who by the way has NEVER suggested tonsillectomies for my
children in order to finance winter frolics to sunny climes; she’s a hardworking mother of
four herself)—I’m going to invite them to the Little Bookworm Coffee Shop and over a
nice cup of java nail down exactly what a reasonable and appropriate fee-for-service
would be if they didn’t have to spend hours and hours on bureaucratic paperwork and
also factored in the extremely low likelihood of a medical malpractice lawsuit from my
family. I mean—we’ve known each other for YEARS! We’ll reach an agreement. I’ll
pay cash on the barrelhead, and escrow one-quarter of what we pay in health-insurance
premiums into our own personal HSA for those jaunts to the Emergency Room.

Hey—I gotta cut the cord here. This golden goose is just about out of eggs!

Helen Black is the author of “Seven Blackbirds,” a Highly

Entertaining and Inspirational Work of Literary Fiction about a
young mother rebuilding her life after an abusive marriage, and
is the top-subscribed female author on Scribd, where she
publishes a humor column MOTHER’S DAY
OUT. She lives with her family of five children
and four chickens in Portland, Oregon, and is
often seen lurking around Powell’s City of Books
in her favorite t-shirt, emblazoned “I travel for
book groups.” She is also an active advocate of
domestic violence prevention.