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Posted at 5:23 PM ET, 08/24/2009

My Health-Care Story: Refuse a Test, Pay a Price

By washingtonpost.com editors

By S. Ann Robinson
Leesburg

Here’s a true story that illustrates one way insurers limit choices and drive up costs.

Getting ready for bed one night, I experienced shortness of breath. Remembering an allergic reaction that began that way a few years earlier, I drove to the emergency room.

The doctor on duty disagreed with my diagnosis, announcing, “We’re going to treat this as a cardiac event.” When tests revealed nothing, he didn’t accept defeat. “I want to admit you anyway,” he said.

It was 2 a.m. By now I felt fine. “What happens if I just go home?”

“Well, of course, you have the freedom to do that,” he answered, adding meaningfully, “But you would be leaving against medical advice.” I just wanted to sleep, so I said: “Whatever.”

In the morning, a nurse came in with an oxygen tank. I felt completely normal, and I waved her away. “No, I don’t need that,” I said. She backed off, but she said to someone in the hall: “Patient refused treatment.”

By then, I remembered that I had moved some paint cans the night before; no doubt I breathed in just enough fumes to cause my symptoms. So, confident that I knew my own body, I got dressed. Soon nurses and doctors were trying to persuade me to stay. I offered to sign a waiver promising not to sue if my judgment proved wrong. My offer was refused.

Then I was told: “If you leave ‘against medical advice,’ your insurance won’t pay for the charges you have so far incurred.”

That got my attention. “What? That’s incarceration!”

“Nevertheless, it is true,” the nurse replied.

Luckily, a doctor finally agreed to release me. But no one should be threatened with financial ruin if they refuse a test. It’s called freedom of choice. And we don’t have it.

By washingtonpost.com editors  | August 24, 2009; 5:23 PM ET
Categories:  health care  
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