Fainting in This Country Can Carry a $10,000 Price Tag
TRUE LIFE story of someone who fainted at a mall!
found online at alternet.com
There's really no good time or place for a blackout, though some are significantly worse
than others. Mine, one subzero evening in downtown St. Paul, Minn., last December, fell
solidly on the inauspicious side of the spectrum.
The Level 2 lobby of the Ordway Center for the Performing Arts was teeming with people
waiting for the second half of a fine production of Irving Berlin's White Christmas to begin.
I was standing with my mom, sister and her three young-adult kids. Through the windows
of a dazzling curtain-wall that spans the front of the trapezoidal building, I was admiring the
golden lights on the canopy of trees in the park across the street. On the warm side of the
glass, a professional trio of carolers had just finished a short intermission set. I was in a
good mood; a fantastic woman in Duluth was expecting my call after the show to finalize
plans for our first date the next night.
Suddenly, I felt weirdly lightheaded, so I turned to hasten to my seat. I took three steps,
got the spins and took a nosedive, just missing the edge of a wine and coffee bar. Upon
impact, I regained some consciousness and sat half-sprawled with my elbows on the
carpet. A short-haired middle-age woman was crouching next to me, asking me if I knew
my name, what day of the week it was, where I was. I did, which eliminated the possibility
of stroke. "You blacked out ... I'm not a doctor ... That happens to me ... You should lay
down," I recall her saying.
Assuming the dead man's pose in the Ordway lobby sounded fairly embarrassing, so I
resolved to head for one of the lobby's posh benches several paces away. With someone's
help, I got to my feet, and within two steps, a heavy wave of dizziness nearly sent me back
down. I made it to the bench and sat, feeling exhausted and nauseated, and exchanging
glances with the horrified faces of my mom and sister. I hoped my nieces and nephew
were inside watching the rest of White Christmas, not their uncle's freak show.
There was talk of an usher who was also a paramedic. He -- a polite young man in a dark
suit -- appeared and took my blood pressure, which was very low as was my pulse. He
said calmly that one option was to call an ambulance. I was afraid, I thought I might be
dying, I was thinking about my deductible. The number "$2,500" flashed through my
mind. Or was that my maximum "out of pocket"?
I knew for sure that I was enrolled in a $129-per-month emergency and hospitalization
plan with Blue Cross Blue Shield of Florida. Like everyone, I'd heard that a trip to an
emergency room could cost several grand.
"I can't afford that," I muttered.
"Now isn't the time to worry about money," my sister responded, slightly scolding.
Then my eyes rolled upward into my skull as I blacked out again, my chin dropping to the
top of my chest and the rest of me still just sitting there.
Moments later, I awoke from a frenzied dream, intensely disoriented, then realized I was
still on the bench. The usher was looking at me. "You did it again," he said. Not certain I
wasn't in the early stages of some kind of gradual heart failure -- I had felt some weirdness
in my chest before my sprawl on the carpet; I consented to the ambulance ride.
Within a few minutes I was rolling feet-first on a stretcher, into the elevator, out into the
subzero air and aboard the rescue truck. As I recall they affixed an intravenous tube into
my arm and asked me to open my mouth so one of them could toss in some tiny
nitroglycerine pellets, which dilate the blood vessels. "I bet you don't wear those shoes in
Miami," one of the paramedics joshed, referring to a pair of (my dad's) old brown rubber
jobbies that clashed badly with my black wool suit pants. Then they put an oxygen mask
over my mouth.
Soon I was in an emergency room bed at United Hospital in downtown St. Paul, still
connected to an IV while nurses further hooked me up to an EKG and drew blood from
my arm to start testing for heart attack enzymes.
Within an hour came the impression from my emergency-room doctor, a serious, trim,
capable-looking man. I had suffered syncope, a manly term for fainting. The question now,
the doctor continued, is why. There were many possible causes of syncope. "When your
heart rate drops to 40 all of a sudden and you pass out, it's a good idea to find out what's
going on," he said tersely. Thus, I would be spending the night in the hospital, having my
heart monitored and my blood analyzed.
The doctor had me recap my day. I live in Miami Beach. Flew to Minneapolis a few days
ago. Didn't eat much today. Went for a three-mile run this afternoon (in 7-degree
weather). Felt great afterward. Had a glass of wine at dinner a few blocks from the
theater. Saw first half of White Christmas. Etcetera. The doctor mentioned something
about blood sometimes "pooling" in people's legs when they sit or stand for extended
periods of time. Then he left. Eventually, I was rolled upstairs to a room in the cardiac
The nocturnal heart monitoring, followed by a midday echocardiogram, turned up nothing
but a very healthy heart. Diagnosis: a case of dehydration-induced syncope. Dehydration
(apparently caused by the cumulative effects of my Miami to Minneapolis plane ride, a
long hot sauna at my parents' house, too much alcohol and coffee, not enough glasses of
water and the desiccating air of a very cold, extraordinarily dry Minnesota winter) had
reduced my blood volume. It pooled in my legs as I mingled in the Ordway lobby. There
wasn't enough left to make it to my head. My low heart rate was from conditioning, the
doctors said, because I tend to run for an hour about several times a week (in Florida).
I was discharged, my sister picked me up, and off we went to enjoy a white Christmas. I
put the ordeal behind me and managed to forget about my deductible -- until late January,
when the bills started arriving at my Miami Beach apartment.
I received six of them from the hospital -- for "Emergency Department Visit," for "Initial
Hospital Care," for "Facility Service," for "Hospital Discharge Day," and more -- and one
from the ambulance company. They all added up to thousands of dollars. I'm still not sure
how much I really owe.
To their credit, the folks at Blue Cross Blue Shield send their customers concise
statements that summarize medical services rendered and billed. According to the one I
recently received, the total cost of my fainting emergency: $10,260.
But lucky me. I owe only $2,267. "Your savings: $7,992.87," the summary states. Good
thing I paid BCBS $1,500 in premiums over the past year to cover me for emergencies,
one of which is now costing me an additional two thousand.
Of course, I was relieved, if not grateful, to learn that I'm not liable for the whole $10,260,
and thus not like guys who faint and don't have emergency coverage. But upon further
inspection of my statement I noticed a curious and disturbing thing. BCBS had to pay only
$2,582 -- about one-fourth -- of that $10,260. So who paid the balance of my $7,992 in
"savings"? I wondered. No one.
The $7,992 was all discounted because hospitals let BCBS and other big insurance
companies pay lower rates than ordinary, underinsured Americans.
Similarly, the statement indicates that BCBS would have gotten a huge discount on, and
had to pay only one-fourth of, the $1,409 ambulance bill that St. Paul Fire & Safety
Service is now pressuring me to pay in full. I'm responsible for all but $17.65 of it, BCBS
says, because the ambulance service was "out of network." BCBS has been kind enough
to cover less than half of the $48 worth of oxygen I inhaled during my ambulance ride.
Hence the check for $17.65 that BCBS mailed me. Some of the oxygen was "in network,"
A few years ago, in order to control price gouging, Congress ordered up a national fee
schedule for Medicare payments to ambulance services. According to that legally binding
schedule, Medicare, like BCBS, would have to pay St. Paul Fire & Safety Service only
about one-fourth of the $1,409 the company says I owe.
My date in Duluth gave me a break. When are America's health care givers going to give
all of us one?
* * * * * * * * * * * * * * * * * *
SOLUTION & ANSWER from Senator GEORGE MCGOVERN: LET'S EXPAND MEDICARE
- What seems missing in the current [healthcare] battle is a single proposal that everyone can understand and that does not lend itself to demagoguery. If we want comprehensive health care for all ourcitizens, we can achieve it with a single sentence: Congress hereby extends Medicare to all Americans. . . We know that Medicare has worked well for half a century for those of us over 65. Why does it become "socialized medicine" when we extend it to younger Americans? . If Medicare needs a few modifications in order to serve all Americans, we can make such adjustments now or later. But let's make sure Congress has an up or down vote on Medicare for all before it adjourns this year. Let's not waste time trying to reinvent the wheel. We all know what Medicare is. Do we want health care for all, or only for those over 65 ?. . As matters now stand, the insurance companies claim $450 billion a year of our health-care dollars. They will fight hard to hold on to this bonanza. This is a major reason Americans pay more for health care per capita than any other people in the world. . . Consider the campaign funds given to the chairman and ranking minority member of the Senate Finance Committee, which has jurisdiction over health-care legislation. Chairman Max Baucus of Montana, a Democrat, and his political action committee have received nearly $4 million from the health-care lobby since 2003. The ranking Republican, Charles Grassley of Iowa, has received more than $2 million. It's a mistake for one politician to judge the personal motives of another. But Sens. Baucus and Grassley are firm opponents of the single-payer system, as are other highly placed members of Congress who have been generously rewarded by the insurance lobby. . . In December 2007, the 124,000-member American College of Physicians endorsed for the first time a single-payer national health insurance program. And a March 2008 study by Indiana University -- the largest survey ever of doctors' opinions on financing health-care reform -- concluded that 59 percent of doctors support national health insurance. signed George S. McGovern, Washington Post
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