Johnny AveragePerson is 63 years old. He is in relatively good health. His wife passed away six years ago. He has a daughter living in Florida and a son who lives in New Jersey. Johnny lives in Brooklyn, New York and works at a bank, commuting into Manhattan each day.
Today is a pleasant spring day in May; Johnny has just gotten off the morning train and walks into the corner deli to get a doughnut and a cup of coffee. Let’s listen in!
Johnny: Let me get a chocolate doughnut and a regular cup of coffee with half and half.
Female Clerk: Can I see your medical ID card?
Johnny: Here you go (Digs in his wallet and hands her the card)
Female Clerk: Sir, I just scanned your card and it says that your cholesterol is high.
Johnny: I know, I just saw the doctor yesterday. He said it was a bit high but that it wasn’t anything to be concerned about.
Female Clerk: It’s above the limit to sell you a doughnut.
Johnny: That’s ridiculous! I always get a doughnut in the morning.
Female Clerk: I’m sorry (Hands Johnny back his medical ID card).
Johnny: Look, the doctor said my cholesterol wasn’t even high enough to warrant giving me Crestor. He said he would prescribe Crestor but he could only prescribe it if my cholesterol was higher!
Female Clerk: Would you like a bran muffin?
Johnny: No! I want a chocolate doughnut!
Female Clerk: I’m sorry. Look, there are other people in line. I can’t sell you a doughnut.
Johnny: So my cholesterol is too low to get Crestor and too high to buy a doughnut.
Female Clerk: (Getting annoyed) Sir, I don’t make the rules. Now if you’ll excuse me…
Johnny is so irritated when he walks out of the store that he trips on the door jam and falls awkwardly. He hurts his ankle and can’t get up. The clerk, with an annoyed look on her face, calls an ambulance which arrives an hour and a half later. They scoop Johnny up and take him to the hospital. At the hospital, they take x-rays. The doctor walks into the room holding a chart and smiles at Johnny.
Doctor: He puesto toda la información en su carta medica. Lleve la carta a una farmácia y ellos la prepararán la receta.
Johnny: I’m sorry I don’t speak Spanish
Nurse: The doctor is putting all the information on your medical ID card. Take the card to the pharmacist and have this prescription for painkillers filled. He is listing this as a severe sprain so you should be good to go back to work in two weeks. It’s all down in your card so you shouldn’t have any problem with work compensation for lost time.
Johnny hobbles out of the hospital on crutches with a soft cast on his foot. He heads to the nearest pharmacy.
Johnny: Hi, I want to have a prescription filled.
Pharmacist: Well, let’s just see what we’ve got here. May I have your medical ID card please?
Johnny hands over his card...
Pharmacist: Let’s just put it in the scanner....
Johnny: Is there a problem?
Pharmacist: The scanner doesn’t seem to want to read your card. Did you put your card next to a magnet or some electronic device?
Pharmacist: Well, I’m afraid you’re going to have to fill out this form to get a new medical ID card. You have to send the card and the form to this address, along with a $75 fee and you should have your new ID card in about 2 weeks.
Johnny: What about my pain killers. I’m in pain here!
Pharmacist: I can give you Advil, that’s it. I’m really sorry.
Johnny leaves the pharmacy and hobbles home. About two weeks go by. Johnny has not received his new card yet. He has not gotten paid anything from work or workman’s comp, or anything to cover his medical expenses. Worst of all, the pain in his ankle has gotten worse, not better. He can’t wait anymore and calls a number to get some help…
Johnny dials the phone: 1-8-8-8-U-S-A-H-E-A-L-T-H-C-A-R-E
Phone: Welcome to the United States Health Care System. Para información en español, marque ocho
Phone: If you would like to participate in a brief survey, please press 7 now.
Phone: If you are calling about finding a doctor, press 1. If you are calling about a claim, press 2. If you are calling about a lost or damaged card, press 3, If you are calling about our new super saver insurance plan, please press 4…
Johnny: Oh what the hell!…. Presses 2
Phone: Please enter you medical ID number, followed by the pound sign.
Johnny: Shoot, where did I put that claim form… Here it is. Presses: 02A9207C1-9965429B….waits….nothing happens…oh…presses #
Phone: Thank you. Please wait while we retrieve your records….OK, I’ve got your records here. What would you like to do? Press 1 if you would like to find a doctor, Press 2 if you are calling about a claim…
Johnny: I just did this!!
Phone: I’m sorry, I did not understand you. Press 1 if you would like to find a doctor, Press 2 if you are calling about a claim…
Finally after about 45 minutes, Johnny gets someone on the phone
Medical Rep: Good afternoon, this is Emir, how can I help you today?
Johnny: OK, I fell about two weeks ago. I hurt my ankle and they said it was a sprain but it’s been two weeks and it still really hurts. I haven’t been able to get any pain killers and I can’t get an appointment with the doctor because my card was damaged and I haven’t gotten any money back either and I’ve got bills to pay.
Emir: I think I can help you with that sir. May I have your medical ID number?
Emir: OK, I see your record. You sprained your ankle.
Johnny: I think it’s worse than a sprain. This is killing me!
Emir: Well, the x-rays were negative. I see that you’re 63 years old. Would you like to set up a counseling session?
Johnny: Counseling???? What the f#@% do I need counseling for?
Emir: We would have to schedule an MRI to see if there is any damage but that is very expensive and anyone over 60 is recommended to take counseling before we put them on the MRI waiting list.
Johnny: I’m really in pain here.
Emir: OK sir I can do that for you. I have to tell you though, that for people your age, I can’t guarantee an MRI for anytime within this month or next. There might be an opening in July. However if you take the counseling session, you might be able to get in there earlier.
Johnny: I’ll take the counseling session, if that’s the only thing I can do.
Emir: Very well. I can do that for you sir. Can you make it on Tuesday the 14th?
A meeting for counseling is set up. Johnny’s ankle has gotten very bad. He comes into the meeting sweating, not feeling well at all. He meets with a counselor by the name of Mica.
Mica: Mr. Averageperson, I’m very pleased to meet you! Please have a seat!
Johnny: Thank you. Listen I’m really not feeling well. I don’t need counseling. I need to see a doctor.
Mica: Mr. Averageperson, I think I can arrange to get you pills that will make you feel better.
Johnny: That would be great.
Mica: I’m going to be very frank with you Mr. Averageperson. Looking at you I can see that you are not well. The government just has so much money to spend on care and there are people who have a better chance of living longer, healthier lives than you do.
Johnny: I just hurt my ankle. This can be healed.
Mica: But at what cost Mr. Averageperson, at what cost?
Johnny: I’m not an old man!
Johnny disappeared soon after that. A couple of people in the Health Administration Department were reviewing some files and came upon that of Johnny Averageperson.
Person 1: We really didn’t handle this case well. This person should have gotten earlier treatment.
Person 2: Perhaps, but we must have saved, what, $50,000 all told? Maybe $100,000? Isn’t it our job to save money? I think we’ve handled this case extremely well!
In a small town in Arizona, a person by the name of Jonathan goes into his mailbox and pulls out an envelope from the government. It contains a check made out to Jonathan Averageperson for $106,000. Itemized for an MRI, x-rays, lost wages, medication and other incidental expenses.