Issue link: https://www.epageflip.net/i/177798
6B Daily News – Tuesday, September 24, 2013 A trip to the hospital without health insurance By Andrew T. Gray Special to The Washington Post The doctor was adamant. "This is America, not Sweden," he told me. "We operate." How did this happen to me, I wondered, looking at him across the ER exam room. How could I, a health-care provider, not have insurance? I had awakened that morning with a mildly upset stomach. Nonetheless, I'd gone to my job (begun only six weeks earlier) as a physician assistant at a clinic in Beverly Hills. I'd seen patients until lunchtime, then attended a research meeting. Despite crampy stomach pain, I continued to see patients until 3 p.m., when the pain became steady: on a 10-point scale, I gave it a 6. I left work early. I hoped to go home and relax, maybe take a nap. Crawling into bed, however, I realized that my pain had coalesced in the right lower quadrant of my abdomen. Could it be appendicitis? Panic flooded me. After six weeks at my new job, I now qualified for health insurance, but I'd neglected to fill out the necessary paperwork. Only an hour after leaving the clinic, I returned. Almost hysterically, I completed and faxed in the insurance forms. "Go to the emergency room right now," urged one of my supervising physicians. I felt it would look better, though, if I didn't show up at the ER on the day I'd applied for insurance. Because I had no fever, nausea or vomiting, I decided to return to my apartment. I spent a sleepless night tossing and turning. At 6:30 a.m., I walked to the large, prestigious nonprofit hospital located three blocks from my apartment. Waiting for the ER doctor, I recalled that, at some point in my schooling, I'd read a Swedish study about treating appendicitis with antibiotics. Googling the study on my smartphone, I found it. By the time the ER resident approached, I was ready. "I don't have health insurance," I said calmly. "Can I be treated with antibiotics instead of surgery?" "I doubt they're going to let you do that here," he said. "But keep expressing interest." When the ER attending physician came in, I repeated the question. "Absolutely not," he replied flatly. "This is America, not Sweden. If you have appendicitis, we operate." They sent me for a triplecontrast CT scan. The results: early acute appendicitis. Next I met with some members of the surgical team: a resident and a medical student. "I'm familiar with the literature about antibiotics in lieu of surgery," the resident said, sounding annoyed. "But those studies were in pediatric patients, not adults." I pulled out my phone. "The study says 558 patients. No mention of pediatrics. Seventyseven percent success rate." He turned to the med student. "We have to get the attending." The attending surgeon arrived and heard my spiel. "Seventy-seven percent is a horrible number for a surgeon," he said firmly. "We're looking for much better than a 77 percent success rate." "But I don't have insurance," I protested. "Man, you already got a CT scan — your bill is going to be huge anyway," he said irritably. "This is a simple surgery. I can put you on for 4 p.m." I was given a dose of IV antibiotics in preparation for surgery. Once in my hospital room, I tried not to move; it hurt too much. They offered me morphine, but I refused. If I took it, I'd no longer be able to use my pain levels to gauge the seriousness of my situation. A nurse entered the room. One hand held a survey. "What's the primary goal with regard to your stay here?" she asked. "That it be as cheap as possible," I replied, my spirits sinking. I knew how impossible that was. She looked at me intently. "Sir, we want you to focus on getting well. Please don't think about the cost; that can all be worked out once you're healthy again." So many times, I'd heard myself say these very words when a patient expressed concern about treatment expenses. But now I realized the truth: No one involved in my care actually knew the cost of any of the treatments they were suggesting. Despite the evidence I'd found online, it was hard to stand up to an army of MDs telling you that you need surgery. Although I feared that my insurance coverage wouldn't come through, I resigned myself to going under the knife. At 5 p.m., my nurse informed me that emergency surgeries had pre-empted all the anesthesiologists and that my procedure would happen as soon as anesthesia was available. "Don't worry," she said reassuringly. "Appendectomies don't get canceled." My phone rang. It was another supervisor from work. "How do you feel?" he asked. "The pain is 5 out of 10," I said. "A little less than this morning." "Andrew, get out of there. We'll schedule you for an appendectomy as an outpatient procedure tomorrow. You'll save a lot of money." Seconds after hanging up, I pulled out my IV. I walked out of my room and down to the nursing station. "I'm signing out against medical advice," I told my nurse. She looked shocked. "Sir, please don't do this. You could die." "I'm not going to die," I said. "If I need to, I'll come back." I texted my supervisor, asking him to call in prescriptions for the antibiotics used in the studies. That night, I started taking them. The next morning, my pain was down to a 3. I declined outpatient surgery. Over the weekend I lay low, and on Monday I worked a full day. On Tuesday night, I attended my regular yoga class with no problem. On Wednesday, I got word that my insurance would apply retroactively from the first of the month. Then the bills started to arrive. The full tab for an ER visit, a CT scan, a dose of IV antibiotics and hospital admission came to more than $30,000 — and that was without an appendectomy. Two weeks later, I finished my oral antibiotics. Total cost: less than $50. It's now six months later. I haven't missed a day of work, and I feel great. Had I known that my insurance was active, I certainly would have had that appendectomy. In retrospect, I'm thankful that I didn't know. A 77 percent success rate may not be acceptable to an American surgeon, but it was good enough for a guy without insurance. Now if I need an appendectomy, I know it will be covered by insurance. It's easy to tell a worried patient, "Let's worry about the cost once you're healthy," but having been that patient myself, if only for a day, I know how thoroughly the fear of medical bills can obliterate any concern about health or healing. Nowadays, when someone asks me how much a treatment costs, I no longer get annoyed. I go and find out. HOME SERVICES DIRECTORY TWO SIZES TO CHOOSE FROM Full Size $ Half Size 112 67 $ Per Month .50 Online: Publishes 24/7 www.redbluffdailynews.com Three additional online locations at no extra cost! Per Month In Print and Online Every Tues.-Thurs.-Sat. No early cancellation, non-refundable Construction Burrows Construction Alle Construction ns Constructi on Residential • Commerical PATIOS • DECKS Remodel, New Additions, Siding Repair and Replacement, Water and Dryrot Damage Specialist, New Construction Foundation to Finish REFRENCES Lic#824770 Ph: (530) 515-9779 House Remodel / Specialist Rental Turnovers / Repairs Bathroom Remodels / Tile Painting • Electrical • Plumbing • Drywall Repairs • Fences • Decks • Concrete • Garages Quality at a reasonable price FREE ESTIMATES 530 949-6162 CA LIC#914460 Firearm Instruction Clarence Davis NRA Certified Firearm Instruction Concealed Carry Initial & Renewal Classes (530) 529-4224 Advertisement If this was your Service Directory ad customers would be reading it right now!! Call us at 527-2151 For more information LEGAL NOTICE Self Help Home Improvement Project is looking for C17 Licensed - Glazing Contractors to perform work on the Department of Energy's Weatherization Assistance Program and the Low Income Home Energy Assistance Program (LIHEAP), interested Licensed Glazers should contact Dee Marshall @ 530-3786905 x 121 on or before 10/01/2013 for more information. Publish: September 20, 21 & 24, 2013 LEGAL NOTICE SECOND REQUEST FOR PROPOSALS ECONOMIC DEVELOPMENT SERVICES Tehama County is requesting proposals from qualified Economic Development consultants and Economic Development consulting firms to provide various Economic Development related services including: Administration and implementation of County's existing businesses assistance loan program, and portfolio management related to the County's participation in various Economic Development programs offered through the State of California's Community Development Block Grant (CDBG) Program. All interested persons are invited to respond. Information regarding the Request for Proposals is available for review at ww w.co.tehama.ca.us or the Tehama County Planning Department, 444 Oak St., Room I, Red Bluff, California 96080 (530) 527-2200, Monday through Friday, between the hours of 8:00 a.m. and 5:00 p.m. Submittal deadline is October 21, 2013 at 5:00 p.m. Publish: September 24, 25 & 26 ,2013 LEGAL NOTICE NOTICE OF TRUSTEE'S SALE T.S No. 1380349-36 APN: 078-09045 TRA: 082001 LOAN NO: Xxxxxx8726 REF: Manasco, Robert IMPORTANT NOTICE TO PROPERTY OWNER: YOU ARE IN DEFAULT UNDER A DEED OF TRUST, DATED October 06, 2004. UNLESS YOU TAKE ACTION TO PROTECT YOUR PROPERTY, IT MAY BE SOLD AT A PUBLIC SALE. IF YOU NEED AN EXPLANATION OF THE NATURE OF THE PROCEEDING AGAINST YOU, YOU SHOULD CONTACT A LAWYER. On October 09, 2013, at 2:00pm, Cal-western Reconveyance Llc, as duly appointed trustee under and pursuant to Deed of Trust recorded November 01, 2004, as Inst. No. 2004-022599 in book 2591, page 0342 of Official Records in the office of the County Recorder of Tehama County, State of California, executed by Robert Craig Manasco A Married Man As His Sole and Separate Property, will sell at public auction to highest bidder for cash, cashier's check drawn on a state or national bank, a check drawn by a state or federal credit union, or a check drawn by a state or federal savings and loan association, savings association, or savings bank specified in section 5102 of the financial code and authorized to do business in this state: At the main entrance to the tehama county courthouse 633 Washington Street Red Bluff, California, all right, title and interest conveyed to and now held by it under said Deed of Trust in the property situated in said County and State described as: Completely described in said deed of trust The street address and other common designation, if any, of the real property described above is purported to be: 25346 Ward St Los Molinos CA 96055 The undersigned Trustee disclaims any liability for any incorrectness of the street address and other common designation, if any, shown herein. Said sale will be held, but without covenant or warranty, express or implied, regarding title, possession, condition or encumbrances, including fees, charges and expenses of the Trustee and of the trusts created by said Deed of Trust, to pay the remaining principal sums of the note(s) secured by said Deed of Trust. The total amount of the unpaid balance of the obligation secured by the property to be sold and reasonable estimated costs, expenses and advances at the time of the initial publication of the Notice of Sale is: $136,942.04. If the Trustee is unable to convey title for any reason, the successful bidder's sole and exclusive remedy shall be the return of monies paid to the Trustee, and the successful bidder shall have no further recourse. The beneficiary under said Deed of Trust heretofore executed and delivered to the undersigned a written declaration of Default and Demand for Sale, and a written Notice of Def l d l i ll h Blinds Need Blinds? C P A A L U L L Paul Stubbs 527-0842 North State Blinds & Draperies www.nsbd.biz Lic.#906022 , fault and Election to Sell. The undersigned caused said Notice of Default and Election to Sell to be recorded in the county where the real property is located. NOTICE TO POTENTIAL BIDDERS: If you are considering bidding on this property lien, you should understand that there are risks involved in bidding at a trustee auction. You will be bidding on a lien, not on the property itself. Placing the highest bid at a trustee auction does not automatically entitle you to free and clear ownership of the property. You should also be aware that the lien being auctioned off may be a junior lien. If you are the highest bidder at the auction, you are or may be responsible for paying off all liens senior to the lien being auctioned off, before you can receive clear title to the property. You are encouraged to investigate the existence, priority, and size of outstanding liens that may exist on this property by contacting the county recorder's office or a title insurance company, either of which may charge you a fee for this information. If you consult either of these resources, you should be aware that the same lender may hold more than one mortgage or deed of trust on the property. NOTICE TO PROPERTY OWNER: The sale date shown on this notice of sale may be postponed one or more times by the mortgagee, beneficiary, trustee, or a court, pursuant to section 2924g of the California Civil Code. The law requires that information about trustee sale postponements be made available to you and to the public, as a courtesy to those not present at the sale. If you wish to learn whether your sale date has been postponed, and, if applicable, the rescheduled time and date for the sale of this property, you may call (619)590-1221 or visit the internet website www.dlppll c.com, using the file number assigned to this case 1380349-36. Information about postponements that are very short in duration or that occur close in time to the scheduled sale may not immediately be reflected in the telephone information or on the Internet Web Site. The best way to verify postponement information is to attend the scheduled sale. For sales information:(619)590-1221. Cal-Western Reconveyance LLC, 525 East Main Street, P.O. Box 22004, El Cajon, CA 92022-9004 Dated: September 06, 2013. DLPP-433040 Publish: 09/17/13, 09/24/13, 10/01/13 Professionally Designed Business Website for only $399? 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