Jane is young, divorced, and the mother of two toddlers. She is also the receptionist for a small business. Her job doesn’t pay much, so she qualifies for state-aid for her children’s medical care.
Two month ago, Jane’s kids got a cold. Jane took them to the ER, where the kids were seen by a nurse practitioner and sent home to recover. What Jane needed to hear was, “You don’t need to take your kids to a doctor for the common cold. The cold will go away on its own regardless of anything any doctor can do. Next time your kids get a cold, give it two weeks. If they’re worse instead of better after two weeks, take them to their family doctor.”
A dose of reality is just what Jane needed, but that’s not what Jane got. She was told, “Your children have an upper respiratory infection.” (Oh, no! They have an infection! It’s a good thing I sought medical help for them!) She was also told, “You can always come back if you’re still concerned.” Three days later the children were still coughing and still had runny noses, so mom took them back to the emergency room to be seen again.
Last week Jane’s kids came down with another cold. She said, “Last time this happened, the doctor said my kids had an infection. I’d better take them in earlier.” Back to the ER she went, this time insisting on antibiotics to fight their infection. She waited a whole week to return when the antibiotics didn’t cure her kids’ colds.
Four ER visits each for two children. Eight co-pays. That would have cost me $1200. Jane doesn’t have a co-pay with state aid, though, so it didn’t cost her a cent. If Jane had to pay cash, she would not run her kids to the hospital’s emergency department frivolously. She would ask friends and neighbors for advice, and be relieved to hear (repeatedly), it’s just a cold. They’ll get over it. Without insurance, if the kids didn’t get better and Jane really wanted a doctor’s expert evaluation, she would schedule an appointment with the family doctor and pay for an office visit. She would be much more discerning about whether consultation with a physician was truly needed.