How the Cost of Health Care Turns Patients into Triage Nurses

I took our family Jeep into the auto shop today. It’s served our family well, but it’s showing its age. The mechanic and I have an Carie Shermanunderstanding: He focuses on the problem then scans it for things that compromise safety. He inevitably calls with a lengthy list of everything that’s broken (thankfully the cassette tape deck still works!). Today I asked him to get us through the next three months. When he calls, we’ll agree to the cost of the parts and the labor. He will fix it and I will stop worrying about it breaking down and start saving for the next round of repairs.

I recently presented a webinar on the 7 “Sins” of Health Communication, in conjunction with Talance, Inc. (I earn a living helping health care organizations with their written communications.) I talked about my experiences as a patient and ways people in communication roles can help build trust and understanding while reducing the fear we patients have when our bodies break down.

The final “sin” I talked about surrounded money. At this time, cost of care is one of my biggest concern as a patient. I almost avoided the topic of money altogether—mostly because I feel angry and defeated by the amount of money I’ve paid in the last six years. And I feel ashamed by the amount of money I owe at this very moment.

This is my theory: the cost of health care turns patients like me into triage nurses. Like the triage nurse, we scan our bodies and decide on the “broken” things that take priority. Unlike the triage nurse, we are not trained professionals. 

There are a bunch of things I would love to fix on my body right now. I won’t bore you with details. But frankly I spend so much time in the rheumatology clinic that it’s easy to ignore the rest of my body. Plus I have a stack of bills from a procedure I had earlier this year. So for now I wait, hoping the issues resolve on their own. Though I’d love to feel better, the cost of health care has my bank account bleeding out.

Everyone knows the cost of care is a hugely debated topic. I find it interesting that people like me are finally starting to demand answers. Health care organizations need to be more upfront about costs. Like my mechanic, they need to start thinking about how they can help us “frequent fliers” spend our limited health care dollars. I get that I’m responsible for my portion of the cost of my care. But let’s face it: when you’re in pain, you’ll do anything to feel better. Including taking your doc up on the referrals, tests, and medications you’re offered. Cost is the last thing on your mind. And unless you’ve got Cadillac-level insurance, the costs quickly become overwhelming.

I don’t have a Cadillac health plan. But I’m still lucky to have insurance. After working in health care for nearly two decades, I’m fairly health literate. But I’m also human. I’m ashamed that my body fails me. I’m worried about the next time it fails. I’m scared that I’m wasting my health care dollars on the wrong stuff. I’m embarrassed that I can’t write a big check and clear all these bills. I’m terrified that people more vulnerable than me are going to lose their coverage. And as they become triage nurses for their own bodies, they’ll get sicker, and sicker, and sicker, eventually ending up in the emergency department for things that could have been improved had they not been forced into triage mode.

One comment on “How the Cost of Health Care Turns Patients into Triage Nurses

  1. Racquel Garcia

    This is so true for so many of us. This is part of the reason I skipped my my latest Rituxan infusion. I simply can’t afford to feel better. I had to pick sanity and vacation over an 8 hour, $23,0000 infusion. I’m already in debt from the last two infusions and didn’t figure I needed to add more to that cloud over my head. Therefore I picked sanity and a trip to Seattle With Friends. I still feel crappy but my soul is happy. Great article!

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