"Sir, Are You Conscious? Your POS Insurance Plan Is Ready"

By Malcolm Cetawayo

Let's assume you've been gunshot a little bit (a common occurrence in the U.S., so the details are not that important right now). And you have called 911 and medical assistance has arrived. Now the fun begins. You don't have medical insurance; however, this is now mid-2015 and the Patient Protection and Affordable Care Act required you to obtain insurance coverage. But you don't like being told what to do, and conservative talk radio has told you so. So what are your options? Fortunately, Point-of-Sale (POS) insurance coverage is available. And because the question of insurance coverage was asked during your 911 call, the EMTs are accompanied by a randomly assigned POS Independent Medical Insurance Agent (POS-IMIA - "poss-ee-meeya"), (or to insurance industry insiders "Posse Comatose").

As insurance companies prepare for the onslaught of new "mandate" customers, the Point-of-Sale Independent Medical Insurance Agent Advisory Council (POS-IMIA-AC), in anticipation of numerous situations where "slow-compliers" need health insurance coverage, has been creating training scenarios to prepare agents to deal with writing insurance contracts in the context of medical emergencies, such as described above.

GvJ was offered an opportunity to observe and report about a training session:

POS-IMIA: Sir, under the Act, emergency treatment carries a presumed conscious and rational decision to pay for said treatment regardless of whether the patient is in fact conscious, or rational, or maintains rationality. Do you understand that sir?

New Insured (NI): Yes.

POS-IMIA: Thank you for your answer, which has been recorded, although an affirmative answer is presumed under the Act so as to avoid those nasty little litigation-prone situations where a patient claims he or she was in so much pain they would have agreed to anything in order to get treatment.

Now sir, you realize that under the Act the perceived necessity by you that you require emergency medical services by definition means you have a pre-existing condition which will...

NI: What do you mean pre-existing condition? I don't go around getting shot!

POS-IMIA: We understand sir, but, in this situation, a pre-existing condition means a condition existing before the EMTs arrived.

NI: Are you serious? Why would I call for medical help if I didn't need it. Of course it's pre-existing.

POS-IMIA: We appreciate your candor and your acknowledgment that you have a pre-existing condition has been recorded. For pre-existing conditions treated outside of regular medical hours by other than your primary physician...

NI: Who schedules an appointment for a gunshot wound?

POS-IMIA: ...there are certain cost multipliers applicable of 10 to 250 based on age, gender and certain indices referred to in the pending 2015 Omnibus Problem Patient Resource Recovery Act, often referred to as OP²R²A.

NI: Who is a problem patient?

POS-IMIA: Well, for one, any patient who can't pay up front - when service is rendered.

NI: I thought that's what insurance was all about.

POS-IMIA: That's an interesting idea. Now sir, let's try and get some information into my 'Droid tablet so the GitHub Health Insurance Industry Server can kick out the name of the insurance company willing to take on a loss leader such as yourself. I've asked the EMTs to slow down a bit so we'd be sure to get all of the required information in.

So, is your injury the result of a domestic disturbance resulting from, among other
things, cheating, or intentional aural blockage? I note, premiums are affected by
industry studies that strongly suggest in such cases that the man typically had it
coming to him, and is likely to have repeat injuries of a similar, or more serious nature.

NI: No, I was returning from an office party, stopped for gas and a guy robbed me.

POS-IMIA: Were you armed, or otherwise wearing protection at the time?

NI: As to the former I don't believe in guns, and as to the latter that wouldn't seem to be too useful alone in my car.

POS-IMIA: Very droll. And are you often out cruising about unarmed late in the evening?

NI: I wasn't cruising about, I was going home. And it wasn't late. Look, it's still light out.

POS-IMIA: So you say. Let's move on to some other questions where your memory may be less faulty.

[ A few minutes later. ]

POS-IMIA: Here we go, your coverage is with Brady Medical Waste Management and Health Insurance.

NI: I've never heard of that company.

POS-IMIA: Although they're new to the front end of the business, they'll probably be fine. The important thing is that you're now covered - with the usual provisos applicable to persons like yourself with a rather thrill-seeking lifestyle.

NI: Huh?

POS-IMIA: Sir, your deductible is $10,000 and the monthly premium is $2,500 for a period no longer than 3 months, after which you will dropped and shifted to one of the new health-care exchanges where you may gingerly seek coverage at reduced rate, but commensurate with your nocturnal ramblings. I am obliged to also note that there is the possibility of significant cost reductions today for organ donations within the first six hours of hospital admittance, should you care to avail yourself of that opportunity.

NI: What? Look I don't feel well, are you trying to get me angry?

POS-IMIA: Sir, if you don't calm down the EMTs will be obliged to sedate you which will necessitate the application of a higher deductible multiplier since we may be unable to record your agreement to pay for additional services, including sedating you.

NI: You know I could die just from the stress this conversation is causing.

POS-IMIA: Sir, try to stay in the moment since each prior moment could be indicative of a pre-existing condition since we arrived in addition to the pre-existing conditions which necessitated the 911 call and the beginning of the subsequent conversation in the first place. And as we indicated, although the Act requires that we offer coverage, pre-existing conditions...

NI: ...carry a higher multiplier. Look, just sedate me. I agree to it. There, happy?

POS-IMIA: Your thumb print and retinal ID scans are now complete. We wish you a speedy recovery.

A brief customer satisfaction survey form has been tucked into your wound dressing. We would appreciate your taking the time to complete it - before arriving at the hospital, where all that medical hoc-us-pocus tends to be too distracting.

Thank you for your business. And again, we wish you a speedy recovery.

Sir? Sir?

(to EMT) He's out?

(to NI) I'll just fill out that survey for you shall I? You have enough to worry about.