Call 911: Worry about insurance later

Very few things shock me. Sexual issues, alcohol and drug abuse, psychiatric issues, people's lifestylesnot shocking. Sticking a bobby pin in an electrical outlet, current politicsshocking. Health insurance and the way people put their health second to it really shocks me. Is the health insurance industry turning us into robots?

When I worked in DC, the place was HMO'd out. The HMO had the oddest, most inane rules for healthcare. For example, when someone came to the ER, I would be paged by the ER receptionist for pre-authorization to allow health insurance to cover the ER visit.

1am: "Dr. Hong, I have a man here with chest pains and shortness of breath. Will you pre-authorize his visit?"

2am: "Dr. Hong, a man was just brought in. He rolled his car and is pretty badly cut up."

3am: "Dr. Hong, a women is bleeding and lightheaded."

4am: "Dr. Hong, I have an asthmatic lady who cannot breathe."

I didn't dream these calls. They were actual conversations! In Charlottesville, when you arrive at the ER, they will contact your health insurer, not your primary care physician.

Once I got a page saying, "Mr. X is calling for Ms. Y, and he would like a referral to the ER because her throat is closed up and she can't breathe."

I called Mr. X immediately and I heard Ms. Y in the background choking, coughing, vomiting, and wheezing. She sounded like she was going to die. Mr. X, however, was cool as a cucumber and asked for a referral to the ER. I told him to call 911 immediately. He said, "Really? Don't I need a referral to go to the ER?"

Someone please explain to me why anyone would worry about health insurance at such a time. I understand money is important, but is it more important than saving someone's life? Has Hurricane Katrina taught us nothing?

What constitutes an emergency? Not breathing or close to itlike from a severe asthma attack or congestive heart failure. Chokingfrom anaphylaxis or a foreign object lodged in the throat/windpipe. Unconsciousness–from a stroke, lack of oxygen, or Lord knows what. Bleeding out of control–from trauma or a reproductive issue. Paralyzed¬≠from a stroke or accident. Chest painsa heart attack. As in the case above, if you have to rely on someone else to call 911 because you're too sick, girl, you're in trouble!

Some people are afraid to call 911 because they don't want to be labeled a Drama Queen if the condition turns out to be not so serious. But in healthcare, there are no crowns or scepters awarded to patients (only tiarasjust kidding). And it's very true that the Emergency Departments are inappropriately used by people who are too lazy to see a primary care physician, or by people who don't seek help early on for manageable health conditions that become emergencies. However, if you aren't going to the ER for a real emergency because you're worried about health insurance coverage, then you're like Pink Floyd's song, "Another Brick in the Wall."

If you're concerned about your health insurance coverage for an ER visit, tell you what: worry about it later when you're alive. You can't worry about it if you're dead, unless you're a character in the movie Sixth Sense. "I see dead people... and they're still mad that their health insurance didn't pay for their fatal condition."