"I don't have any insurance"

The man was sitting in his car after just having falling in a public parking lot. The bones in his arm were obviously shattered and it was clear that he was in a severe amount of pain.

"Let us take you to the hospital", I pleaded.

"No I can't", said the man.

"Why not?" I asked.

"Because I don't have any insurance" he said.

The sad fact of life is that millions of Americans are uninsured and don't have any health insurance. Even worse is that they let that fact dictate whether or not the seek medical care and/or treatment.

In my career, I've run into multitudes of people who have no insurance and clearly are in need of medical care. Their problems run the gamut from injuries they've sustained in motor vehicle accidents, broken bones, heart attacks, diabetic problems, chronic pain, and various other ailments.

These folks my heart goes out to because I've walked miles in their shoes. And I beg them not to allow their financial situations dictate if they get care or not, especially if they truly need it. I tell them that we take payments and will work things out with them. I tell them that the hospitals will accept as little a $5 a month as long as they pay something. I appeal to their sense of gloom and doom and will just about do anything to encourage them to go.

Sometimes it works....Sometimes it doesn't.

Then there are the folks who are on state medical aid and think that their state medical card is like a taxi voucher. They think that every time they need to go to the doctor, it necessitates a trip via an ambulance to the local ED. I still work in a system that practices "you call, we haul". Whether or not the person truly needs ambulance transportation, we can not refuse to take them.

Stubbed toe? Hop in!

Nasty pimple on your face? Hop in!

Cut on your finger? Hop in!

Before I get more nasty emails, let me first say that we shouldn't be denying people medical care at all. However, there is a better way for utilizing emergency services so that a Paramedic staffed ambulance is available to the people that truly need it. I can't tell you how many times I've been on a call with someone who didn't need transport by ambulance and had alternate means to get a doctor's office or the ED and the standby unit has been called to an active MI or cardiac arrest, or a major traumatic incident and we couldn't leave the patient with a stubbed toe.

That is so frustrating to me. Knowing that we could potentially save someone's life, someone who truly needs medical care and we are tied up with someone who is too lazy to get their spouse to drive them to the hospital.

And to have someone refuse medical care or transportation simply because they don't have insurance is ludicris. If I'm having a heart attack, I'm getting care regardless of my insurance status. I'll worry about the bill later, when I'm healthy and back on my feet. I've walked down that path before. I was hospitalized a number of years ago for almost 9 days and I didn't have insurance. I wound up without a diagnosis AND nearly $75,000 in medical bills. Thank GOD for medi-cal. They paid retroactive for the month and my portion was $400. But you see, my health is more important. I'll get the care that I need and I'll worry about the finances later.

The man I had the above conversation with? He finally agreed to go, fractured arm and all. I'd like to say that my sweet nature and caring attitude convinced him to go. I'd love to take the credit for it. But I can't. No, the credit rests solely in the hands of my dear friend, Morphine Sulfate. It's a beautiful thing, those pain meds.

"Come with me, sir. We have pain medicine. I'll make sure you are comfortable."

After all, isn't that our job? Relieving suffering and treating pain? Tending to the souls of our patients?

Be safe out there. And please, get medical insurance if it's available to you. I don't like to beg so please don't make me.