ERrrrr...?

A couple of months ago the Boy had a bit of a medical emergency and ended up in the ER of a local hospital.

Now, in the UK in similar circumstances you would turn up at your nearest casualty unit, get treated, and all being well go home and get better. End of story.

Over here things are a little different.

For one thing, of the dozen or so hospital people you have to speak to on admission, one of the most important is the one who takes down your insurance details. If you are poor enough to qualify for Medicaid you will get treated for free. If you aren't sufficiently poor, but are uninsured or under-insured, look out - it's gonna cost you.

We have good insurance, arranged by the Man's company, so no worries there. Our son received excellent service and had all the necessary tests etc over the course of the night. We had to pay a standard emergency treatment "co-pay" of $50 and we knew that insurance would cover the rest.

A week or so later we received a "This is not a bill" notice from the insurer, letting us know that the hospital had submitted a claim for a four figure sum, they (the insurers) would be paying out a three-figure sum (and how that works to everyone's satisfaction I can't understand) and all was settled.

Or so we thought. Today we received a bill for nearly $500 from an organisation representing the emergency physician. They claim that although the hospital, the nurses, the radiographer etc.. are on our insurance plan, she is not. She is employed by a totally separate organisation - some sort of sub-contractor arrangement - that doesn't participate in our insurance network. Kindly pay up please, maybe your insurer will pay you back...

Were we supposed to know, as the Man drove up to the hospital in the middle of the night with a kid in a bad way that even though the building was on our plan the doctor wasn't? He wasn't told this was the case - but if he had known, was he then supposed to rush off and find another hospital?

Conceivably our insurer will cover the services of the off-plan doctor in these circumstances, though there may have to be some silly process of payment and repayment. So, though I was shocked when I first opened the bill, it may all turn out just to be an annoyance. But what if this happened to someone in a different, less favourable situation? Suddenly being slapped with a hefty charge two months after the event could be seriously stressful - definitely not good for anyone's health.

The healthcare system in this country is bafflingly complex, even if you are insured to the hilt. At its worst, it fails to serve a great many of the people who need it most, and can leave people in crippling debt. Maybe Obama's reforms, making health insurance obligatory (like car insurance), will mean more people have access to healthcare - a good thing. But I fear it will go nowhere towards making the system less complicated.

The British NHS undoubtedly has its faults, but if healthcare free at the point of use is available to you be grateful and know how lucky you are.