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Vice Blog

NEW YORK - HOW TO STEAL WHAT BELONGS TO YOU: HEALTH CARE

On the other side of the room an 80-year-old woman suffered from the following medical conditions: diabetes, osteoarthritis, osteoporosis, complications from a previous hip surgery, complications from a previous gunshot wound (!), chronic seizures, chronic dizzy spells, etc. She and I were three feet apart, separated by a freestanding partition that divided one small office-type room into two even smaller ones. I was trying to explain to the emergency room nurse on my side of the partition that I had a mysterious swelling/pain in my left leg, but sound bytes from the 80-year-old woman's unbelievably grim medical history kept drifting over and drowning me out. The juxtaposition of my leg pain and the 80-year-old's total physical implosion was sort of unflattering, and, when I was done describing my condition, the nurse looked at me as if I had just spent the last five minutes explaining how I was the world's most gigantic pussy.

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To be fair, my leg wasn't in terrible shape. Though it was still a problem. The outside of my left shin had been experiencing a sharp, stabbing pain that got worse with walking. I don't have a driver's license (which, in the Midwest, is like saying you don't go to the bathroom), so I have to walk everywhere. As a result, my leg had been getting worse and worse over a period of weeks with a lot of swelling and discoloration. It was starting to look pretty gross – but compared to the Cronenberg script that was taking place with the woman on the other side of the partition, I was the picture of physical fitness.

The nurse seemed to be waiting for me to elaborate, like she was hoping I'd tell her that the swelling in my leg was causing my diabetic bullet-hole to act up. But when I didn't say anything, she just shrugged and sent me to an observation room down the hall. Her quasi-contempt was actually understandable for the most part; I was in the emergency room when my condition was not that big of a deal, and when I could have just as easily waddled into a regular doctor's office. What she seemed to understand was that the only reason I was in the emergency room was because I didn't have any insurance.

As a person with next to no money, my approach to personal finance borrows very heavily from my understanding of The Great Depression and the film The Road Warrior. Therefore, I conduct myself at all times with a shameless, don't-care-how-embarrassing pragmatism. So whenever a problem with my health presents itself, I just head to the emergency room with no intention of paying anyone for anything.

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Treating the emergency room like a free clinic isn't uncommon. Emergency departments are required by law to screen and stabilize people with emergency conditions regardless of their ability to pay. Some even offer programs for financial assistance, but, because it's assumed that your condition is an emergency, all the hoop-jumping and paperwork is expedited. So while some other poor bastard is filling out a mountain of forms to see if he qualifies for Medicaid, I've already gotten my free tetanus shot.

And even if a hospital decides to pursue my bill, I have no assets for them to go after. Also, because my credit score is already the numerical equivalent of a peaking woman, I can't really think of any ramifications of my inevitable decision not to pay. As long as I don't delude myself with dreams of one day financing a house or of answering my phone without getting yelled at by a stranger, emergency rooms are basically a

Supermarket Sweep

of free medical treatment.

In this sense, I have much easier access to health care than most people with a real income. The only downside is the cold shoulder I get from the nurses and doctors, who spend a majority of their time trying to help people with genuine emergencies, and who are noticeably pissed when they see me strolling into their ER with an owie on my leg or a tickle in my throat. Typically, I spend most of time in the hospital futilely trying to ingratiate myself to people who seem to be irritated that I'm not more injured.

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After a few minutes of waiting in the observation room, I met with a harried-looking ER doctor, who seemed upset that I was still wearing my jeans. In an unmistakable, I-know-you're-wasting-my-time tone of voice, she told me to put on a gown. Then she disappeared down the hall and was gone for another 15 minutes. I took off my jeans but opted to leave my hoodie on. With the addition of the gown it gave me this great, monastic look. There was a full-length mirror in the observation room, and I stood around admiring myself while I waited for the doctor to come back. I could already tell that she didn't like me, and, though not surprised, I was kind of disappointed.

It can be disheartening to spend so much of my time annoying the bejesus out of health care professionals. However, it helps to know that I'm not the only person in this position. In fact, my whole situation is so common that the insurance industry even has a name for it. As a person in my twenties trying to make it without insurance, I'm what's called – in medical-industrial slang – a "young invincible." Now, say what you will about big insurance companies, like, how it's morally dubious to turn a profit on a basic human necessity and to do it in a way that, in general, tends to avoid segments of the population that are already underserved – but whoever they've got in charge of nicknaming demographics is doing an amazing job. Young invincible? That sounds fantastic. As long as insurance companies keep giving me bitching nicknames, I don't care how morally up-the-creek they are.

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Then again, there is something slightly ridiculous about this nickname in that it sort of implies that the only reason young people fail to provide themselves with insurance is because they're naïve and see themselves as being invulnerable. Of course, the reality is a little more complicated than that.

Since World War II, employers have been almost solely responsible for providing people in the US with health care. This was a terrible arrangement from the get-go, because (despite the fact that employers were encouraged through tax subsidies to take on the role as the primary source of health care in the US) there was never anything put into place that required employers to offer health benefits. So now that less and less employers are offering health care, there's no new arrangement to replace the old one, which has left many young professionals with no viable means of getting insured. Also, state-mandated risk-pooling of policy holders regardless of age (designed to keep health costs from becoming too high for the old) makes most insurance plans unreasonably expensive for people in their twenties, who are bound to use their plans less. Though, I'll be the first to admit that very little of that actually has anything to do with my situation. I'm just too lazy to find a real job. Plus, I'm pretty sure I'm invincible.

When the harried-looking doctor returned to look at my leg, she said it was fine. I told her it hurt a lot, which caused her to seem suddenly exasperated.

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"Alright," she said. "What do

you

think is wrong with it?"

I tried to explain to her that I don't really know how legs work, and that I had come to the hospital for that reason. I also told her that my leg got much worse after walking.

"Well, stop walking so much," she said.

She pronounced the word "walking" as if it were the most decadent activity on the planet. It was as if I had just told her that my penis hurt every time I put it inside a pizza oven.

Well, stop putting it in a pizza oven.

I asked her what alternative treatment she might suggest for a person who finds locomotion to be an important part of their daily routine, and she told me, while leaving the room, to keep it wrapped.

So yeah, it's not the best treatment that Western medicine has to offer – but it's fast and basically free. I walked out of the emergency room that day feeling, as always, a little stupid for having wasted everybody's time. Though I also felt reassured. There's a certain peace of mind that comes with the knowledge that your left leg isn't going to rot and fall off, that the only thing a doctor was able to tell you was to keep it wrapped. I also knew that later, when people asked me why I had gone to the emergency room, I would be able to tell them that it was no big deal, just a check-up.

SETH FRIED