Twenty Thousand Dollars

We got the bill yesterday.

Twenty thousand dollars. That's the price of my life right now. Twenty thousand dollars, not counting all the rehearsals leading up to this point. Appointments, blood tests, ultrasounds ... that sort of thing. My husband told me the amount before he and the bearded young giant left for church today (leaving me behind for the last time, I might add - perhaps the sound of such an amount of money was the shot of adrenaline I needed to finish my "healing.")

I went to the doctor for the two-week checkup on Thursday this week. Since I wasn't in the hospital any more, and since I had had two weeks to recover my lucidity, she was ready to tell me a bit more. She told me that the "papillary serous tumor, borderline" was more than "not nothing." She was ready to tell me that her best guess is that it would have been ovarian cancer within about a year.

Two and a half weeks after the fact, we have the bill. And we have health insurance. Our deductible and our "out of pocket" and all the rest of the things that translate roughly to, "you've got a safety net but it's full of holes," will mean that this will be expensive for us, but it will not be the whole twenty thousand dollars expensive. The safety net keeps us from dying in a big splat on the ground. It keeps us able to go to the doctor and have tests and go to the hospital and have surgeries when we need them. It doesn't keep us from falling off things in the first place because the net is not located at the edge of anything. It's nearer to the ground than that. To use it, we have to fall first.

This morning, in the living room, while the bearded young giant was off brushing his teeth, my husband told me the amount. Twenty thousand dollars. After I could breathe properly again, I wondered, "What would we do without insurance?" And then I answered my own question. "I'd have cancer. That's what we'd do." And he said, "Yeah - because we just wouldn't go to the doctor in the first place." He's right. We wouldn't.

Insurance doesn't pay for the acupuncture or the herbs from the Chinese Medicine people (without which this whole thing would have been quite the nightmare, and with which, early enough, I might never have gotten here at all), and insurance also doesn't pay for the prescription of bio-identical hormones currently making my life comfortably possible. It doesn't pay for things like naturopathic care or massage or other preventive health maintenance measures. It doesn't pay for blood tests that might find problems before they become papillary serous problems. Insurance pays for crisis management only.

That's the way it works in this country. We build small cities for "health care," employ small armies of intake and office personnel, attendants, nurses, assistants, billing people, and housekeeping. We pay doctors piles of money so that they can pay for their insurance - and their schooling. We pay for expensive cutting edge drugs to manage the effects of obesity, sedentary lives, stress, anxiety, and other drugs. (Drugs are the adverbs of the medical world, modifying verbs, adjectives, and other adverbs, telling us when, how, or how much.)

But the patient? The patient is just a bit player in this complicated little cultural drama -- bit player and ticket buyer. If you have insurance, you get a discount on the tickets -- but at least you get to see the show.

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