A thorn in my health care

A thorn that became embedded in my right index finger opened my eyes to the wild and wacky world of modern medical care. Here's what I've learned, along with what still mystifies me.

The first rule of keeping your health care costs down is: Don't be an idiot. I failed this test with flying colors. I was walking the dog along a path on our property when I decided to do some spontaneous pruning, caveman style. With one bare hand I snapped the offending thorny bough in two. I thought I had successfully placed my thumb and index finger between the barbs, until I felt a sharp pain. Accustomed as I am to splinters and garden bloodletting, I paid it little mind. It was in there pretty good, but it was tiny.

What I didn't know at the time was that I had contracted Sporotrichosis, aka 'Rose gardener's disease,' which is caused by the infection of the fungus Sporothrix schenckii that resides, among other places, on the tips of thorns. It is the plant's natural defense system against homeowners and other annoying species.

The next day my finger began to ache and swell. At regular intervals my wife urged me to go to the local clinic, as I kept popping anti-inflammatory and pain pills to no effect. Then she noticed the red lines snaking up my right arm. So off to the clinic we went.

They dug out the thorn and put me on intravenous antibiotics. The nurses and doctor on duty did a wonderful job right up to the point where they refused to see things my way: I wanted to go home. The doctor explained that those red lines meant the infection was heading toward my lungs and brain. I could lose the finger and what was left of my mind. He was saying, in effect, don't be an idiot twice in the same day. My wife took his side, of course.

As we drove to the nearby hospital to continue the IV treatment and to see a hand specialist, I remembered the story my mother told about my grandfather, who was a gardener too. He had died of a fairly minor infection 10 years before I was born - and two years before penicillin, which almost certainly would have saved his life, was introduced. He was 64 years old, as I am today.

The hand specialist recommended an operation on my finger that would both identify the strain of infection and help to clean it out at the source. My delay in seeking treatment hadn't helped matters any. At least I had become a better listener by this point. I was in the hospital for four days. People were amazed that a thorn could bring down a specimen like me. Colleagues at work had a field day with it.

But wait, my saga gets even more amazing. The total bill for my care when I was released from the hospital (there would be thousands more in doctor visits and physical therapy) was $33,739. Ouch, babe! But I am alive and have all 10 fingers. I also had health insurance. The amazing part came when the insurance company unilaterally declared that it would pay well under half of the hospital's bill - 42.7 percent of it to be exact, or $14,410.

My first thought was sheer panic: I assumed that I would be on the hook for the nearly $17,000 difference - on top of the $2,380 that was remaining on my annual deductible. The hospital had to get paid, right?

I was relieved to learn that the hospital would accept what was offered by my insurance company. It apparently was making money at the lower figure. That seemed a little creepy. What if I had not had insurance: Would I have been liable for the higher billed amount? Could two individuals, one with insurance and one without, pay dramatically different amounts for the same services? Or can individuals bargain with hospitals over inflated bills just like insurance companies do?

I don't know the answers to these questions. I do know that I got good care at what seems to be a whimsical price. I also know my index finger makes a very good case for universal, affordable health care. Had I been uninsured, I likely would have waited longer to seek treatment, which has the potential to bankrupt people. Obamacare isn't perfect, in part because the 'loyal opposition' and others fought it tooth and nail. But it's a good start.

David Holahan is a freelance writer who lives in East Haddam, Conn.