waiting games

Further to earlier post and all manner of Facebook statuses, some funnier than others:

The first-person experience of my hospital stay now more closely resembles an absurdist play than a Buddhist sutra (“well Didi, Dr. Godot called to say he will not operate today, but surely he will tomorrow”). Today was the first day I was told that the swelling in my foot had gone down enough to operate. I was like, really? sweet. Of course, there were “fifteen people” ahead of me in the queue; fifteen seems like a large number, but I’m not sure whether that was the actual number or the doctor’s figurative way of saying “many”. At least it’s comforting to know that the swelling, as bad as it still looks, is no longer the limiting factor to getting treatment here.

Sure enough, no sooner had they stuck a new cannula in my hand and started me on fluids again than the orderly came by and told me I had already been bumped off the list. I guess all it takes is one more life-threatening trauma to knock the non-life-threatening traumas farther down the list; this is the nature of emergency care. I don’t know how different this aspect of the operation would be in the States or another country without single-payer health care, but if it means someone could die while I was getting my ankle fixed, I’m not going to complain about being delayed again.

The food service is hilariously messed up by the uncertainty, and I think I’m starting to understand better why my meal selections have been so haphazardly honored. Since surgery requires fasting, and since menus are planned a day in advance, any change of plans for when I’m having surgery throws the caterers completely off their game. I had an early breakfast this morning and expected nothing else all day; then surgery was cancelled and I got breakfast number two, as well as an early lunch, which had two sandwiches (one chicken salad and one roast beef, I guess because that’s what they had left over after the other patients had all eaten) which I got from the team that gave me an early breakfast, who must not have talked to the regular caterers. I’m half expecting to see my actual vegetarian lunch arrive more or less on time, after I’ve eaten the custard and the sandwiches have gone off.

In short, it’s probably hard to be agile and spontaneous and plan effectively for changing circumstances when everything you do requires a significant amount of lead time, as it must in a large organization or facility trying to take advantage of economies of scale.

As full of laughs this barrel is, though, every day I stay here is costing me basically an unknown amount of money. The regular procedure before going to the hospital, according to my insurance company, is to call their number to discuss what benefits are covered and to what extent, which hospital would in light of this be best to go to, and to discuss with each individual doctor I see (geez) what the “gap” between benefits and their cost is likely to be. That call center is, unsurprisingly, closed over the long holiday weekend, so I may not get to even tell them I’m here until after I’ve come out of surgery. My policy says hospital stays and surgery in public hospitals are covered, but since I have a foreigner’s plan they won’t say exactly what fraction of that cost will be covered. To find out I have to call them during regular business hours. Derp.

The only sensible thing I can think to assume is that emergency trauma, by its very nature, has to play by different rules. Canberra Hospital in Woden (my current environment) is, as Em and others tell me, not only the first place we thought of but the only place in the ACT with an emergency room at the scale necessary to do everything I needed. Even if I’d been triaged at another hospital which happened to be open, it is likely I would have been transferred here in the end. I’m certainly paying for the high-end hospital cover here, but this is the first time I’ve had to use it.

It would be ironic if, in the land without medical bankruptcy because of a single-payer health care system, this ended up being very expensive for me because I’m not part of the single-payer health care system. But this kind of thing has got to be why Australian immigration insists on people having a certain minimal level of private health cover when they take a visa to come and work here in Oz — I would hope roughly equivalent to the level of cover the national system provides. I may have to see if I can talk to someone about the unvarnished schedule, just so I can have an upper bound for my treatment — as much as a new car? as much as the down payment on a house? — and then I can keep my expectations low and be pleasantly surprised if my cover ends up paying a large fraction of it.

Then again, maybe this will all just be a hilarious cultural misunderstanding in the end because this is of course why people have health insurance. With all the insane talk about rising health care costs I’ve seen in my native land, though, I don’t think I’ll believe anything until I actually see the bill. Till then, I’m going to sit here in bed and review the process for applying for permanent residency.


About Richard

I'm an American scientist who is building a new life in Australia. This space will contain words about science and math, but also philosophy, policy, literature, my travels, occasional rants, all sorts of things I find strange and awesome. The views expressed in this blog do not necessarily reflect the opinions of my employer at the time (currently University of Sydney), though personally, I think they should.
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