Welcome to Hot Takes, where we discuss real-life healthcare stories and pose questions based on our experiences. Do you have a Hot Take healthcare experience? Let us know at firstname.lastname@example.org.
This is a true story that was shared with me over Thanksgiving. Here is an account of a surprising healthcare experience:
A family friend had been suffering from severe stomach pain for a couple days, but she was due in for a colonoscopy on Friday so she decided to wait it out and have the gastroenterologist check everything out. When the appointment came, they didn't find anything suspicious and sent her home. But on Saturday, when she couldn't even sit up because the pain was so debilitating, her husband decided to take her to the emergency room.
They went to St. Vincent Hospital in Indianapolis, where she works in the associate pharmacy. They admitted her, decided to remove her gallbladder, and got her ready for surgery. Since this is all happening late on a Saturday evening, there was only one doctor on call to perform the surgery. When she woke up the next morning, she also woke up to a massive bill: although the procedure was covered by her insurance, and my friends had hit their deductible, the doctor on call was not part of the network, and therefore was not covered by their insurance. She was in such horrible pain, what could she do – she had to have the gallbladder out, but at what cost?
Question: Should the hospital have informed her before they performed the emergency surgery that the surgeon was out of network? Should they have asked her if she wanted to wait for the next surgeon on call who was in her network? Is it even ethical for hospitals to let patients in pain wait around for insurance purposes?
This debate puts healthcare's growing reliance on insurance plans in sharp relief. As patients, we spend trillions a year on health insurance for the peace of mind that we will be covered in an emergency. To actually be in an emergency situation and have that peace of mind shattered deeply effects one's faith in the healthcare system. But, on the other hand, healthcare professionals have a duty to serve and help those in pain.
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