These days, if you happen to be sick in Perry County, it is the best of times and the worst of times.

I’d like to tell you about two of my friends from Spring Township. I was planning to protect their identities, but one of them, Jeff Heikenfeld, was on the front page of this venerable newspaper two issues ago, so I figure his cover is already blown. The story was about a man who’d had a brush with death while trying to clear the overflow pipe in his pond.

Jeff was the first person I met in Perry County, on account of the fact that my wife and I bought his house on St. Peter’s Church Road. Over the years, he has helped to introduce us to life up here, both by way of his business, Jeff’s Auction in Loysville, and the hospitality of his family.

The other friend I’m going to talk about is the kind of man who hates it when people make a fuss over him. So, in order to respect his privacy, let’s call him Jerry.

Those of you who read the recent story about Jeff will already know the details of how he got sucked out of his boat and onto the overflow pipe, breaking three ribs and collapsing a lung in the process. The overflow pipe was under water, thanks to the recent torrential rains. So Jeff was underwater, too, and drowning. You’ll also know that by a combination of good sense, good luck, and good friends, he was rescued, transported by ambulance and Life Lion to the Hershey Medical Center, and is on his way to a full recovery.

In other words, Jeff’s story is about the miracle of modern American health care. A man in trouble on his pond in Spring Township is only a helicopter ride away from the finest care available just about anywhere on the planet.

But there is a secret subtext to Jeff’s story, which can be summed up in two words: health insurance.

Any calculation of the true cost of the care Jeff received would, of course, have to include the amount, in health insurance premiums, that he and his family have been paying over the years. These premiums, which surely amount to thousands and thousands of dollars, represent a kind of medical savings account, a hedge against a medical emergency just like the one he experienced. No one forced him to have health insurance. In fact, as a small businessman, Jeff has probably paid a lot more than most for his coverage.

But he bought it anyway, figuring that he and his family would surely need it at some point.

It was a smart bet. The ambulance was covered. The ride in the Life Lion was covered. A four-day stay at the Hershey Medical Center, which included a surgical procedure, a CT scan, x-rays, medication, round-the-clock care, etc., was covered.

And it’s a good thing, too. Thanks to some help with the numbers from a Medicare insider (my wife), I calculate that Jeff’s ride in the Life Lion alone cost nearly $6000. Tack that on to the bill from Hershey, and we’re probably talking about a total cost for Jeff’s care in the tens of thousands of dollars.

According to Jeff, who was very open with me about all of this, he’ll wind up paying only the insurance deductible. Something in the hundreds of dollars.

That’s still a lot of money, but considering the level of care, also a real bargain.

Now let’s talk about my friend Jerry. Jerry is a tradesman. He’s incredibly hard-working, and lucky, knock on wood, to be in generally excellent health. The last time he saw a doctor, before his recent mishap, was fifteen years ago, when he hurt himself badly on the job. He paid for his treatment out of pocket. It nearly wiped him out, but  health insurance was  a monthly expense he simply couldn’t afford.

He still can’t afford it.

Jerry was working at home a couple months ago, moving five gallon buckets full of stone. He’d been moving stone on his property for weeks, pushing himself to finish up an excavation. Turns out, he pushed himself a little too hard. While he was climbing out of the hole, he heard a loud “snap.” Then he found himself flat on his back, unable to move his leg.

I dropped in on him about ten minutes after this happened. He’d managed to drag himself into his house and was stretched out, his face absolutely white with pain, on the sofa.

He knew it was serious. I knew it was serious. I wanted to drive him to the hospital right then and there, but he refused, saying it wasn’t that bad. What he was really saying was that he was afraid he wouldn’t be able to afford how bad it actually was.

“Well,” I said, “if you’re not going to go to the hospital, then you should at least make an appointment with your doctor. You need to get it looked at.”

He said he didn’t have a doctor. In the past, he’d tried to find one, but was told, on several occasions, that the doctor wasn’t accepting new patients.

He was convinced that “no new patients” was inextricably linked with his telling the receptionist that he didn’t have health insurance.

Whatever the reason, Jerry didn’t have a primary care physician to turn to. So he lived with the pain for several weeks, until finally his fiancé made him go to the emergency room. She was worried about him. The leg wasn’t healing quickly enough. There were strange bruises. There was numbness in his foot from time to time.

She took him to the ER kicking and screaming. “They’re not going to tell me anything I don’t already know,” he said. “Plus, they’re going to charge me an arm and a…leg.”

Turns out, he was right.

They went to the Carlisle Regional Medical Center. They waited a long time to see a doctor, who, when he finally examined Jerry, spent about fifteen minutes reviewing the x-rays and squeezing the leg. The doctor concluded that Jerry had torn his calf muscle, that it was healing, and that he should take some aspirin and try to rest up.

Total bill? Over $600, which represents a discount from the nearly $900 they initially wanted to charge. And there are more bills to come.

Moral of the story? Health care these days is great if you’ve got insurance.

If you don’t, you’d best be rich.

This column was published in the Perry Co Times on 25 June 2009

For more information, please contact Mr. Olshan at writing@matthewolshan.com