ORONO — Hillary Clinton did not have to explain the nuances of quasi-governmental health alliances to the adoring crowd at Alfond Arena.
She did not have to worry about employer mandates, or debate the relative merits of Plans Clinton, Cooper and Chafee. She was not looking for new ideas — the White House has plenty, thank you.
The first lady spent two hours on an ice rink in Maine in February for one purpose only: to sell the crisis.
Sell she did, with statistics, stories and a rich, indignant voice. But with all due respect, it was not the first lady who proved that our health care finance system is hopelessly cockeyed.
It was Cathy Conn and the $15 ice bag.
Conn, a chef from Old Town, was not even going to fill out a question card. She changed her mind at the last minute, and of course, it was her name that was picked second out of a basket full of cards.
Suddenly Conn found herself talking to the first lady, 6,000 spectators and a national television audience.
When she leaned to the microphone, a little nervously, to ask why doctor’s fees accounted for only $350 of the $1,500 bill for her broken wrist, the crowd murmured approvingly.
When she asked why she was billed $15 for an ice bag and $18 for an Ace bandage she never saw, the crowd began to cheer. Warming up now, Conn asked why she was billed $50 for a physician’s assistant who did nothing more than tell her a doctor would be along shortly. The crowd burst into laughter and applause.
Hillary Clinton could have called it a day right there.
And as the battle heats up, Clinton would do well to take Conn on the road with her. There are more pathetic stories out there, certainly more dramatic, but few that so neatly capture the absurdity of the system in a bundle small enough to grasp.
Conn lost her job last year, and spent 11 months out of work. “I had told myself during that time I would stay healthy, and I did,” she said Monday afternoon, as her celebrity grew.
In December, she found a job that would provide health insurance after 60 days. Four days later, she broke her wrist.
She was out decorating her yard with Christmas pine boughs when she turned her ankle and fell. That, too, has a twist a Clinton could love: The fall may have been due in part to bone spurs on Conn’s ankle that she has never treated because of the cost.
A friend drove Conn to St. Joseph Hospital, which treated her well. Nobody blinked when she said she had no insurance, and she was out with a cast just 40 minutes later.
Though it broke in four places, her wrist healed quickly. Four weeks later her cast was off. Another imbedded moral: The health care is fine — it is the finance that presents a crisis.
Then the bills started coming in. The doctor did his job for a flat $350, which sounded good to Conn. But the $25-to-$75 X-rays added up, and each needed to be read by a licensed radiologist at another $25 a pop. Every time she visited her doctor, she had to pay Eastern Maine Medical Center a $30 room fee. The visits lasted five or 10n minutes.
Conn really began to seethe when she got the emergency room bill from St. Joseph last week. A $122 charge for the cast. A $102 fee for treatment area, which, near as she can figure it, was the gurney on which she sat for 40 minutes, in a room she shared with a boy who broke his collarbone.
And of course, the phantom Ace bandage, the expensive greeting and the infamous ice bag — not a fancy chemical cold pack, but a bag with frozen water in it. She did exaggerate a bit there; it did not really cost $15, just $14.82.
“I literally gasped when I opened it,” Conn says. “I do catering for a living and I’d be too embarrassed to put that down on a bill.
“My concern is not so much `How can a wrist cost $1,500?’ … I’m not trying to slam anybody. I don’t know who the bad guys are.
“But if they’re adding this much onto an ice bag, how much are they adding onto an MRI? How far does this cost-shifting thing go?”
Cost shifting was the name Hillary Clinton applied to Conn’s problem. Hospitals shift the cost of uninsured patients who receive free treatment onto everybody else’s ice bags and aspirins, and probably MRIs. Doctors shift the cost of procedures that public and private bureaucracies try to freeze onto new lines with new names on the bill.
In the end, it all gets paid. But it becomes harder and harder to figure out who is paying for what, and whether it was all worth it in the first place. In the meantime, the nation is investing in the world’s most convoluted paper trail.
The intuitive truth of that message, the $15 ice bag that everybody has heard about, helped put the Clintons into office. Hillary needs it now to sell health care reform.
How to fix the mess is another question altogether — the policy wonks and lobbyists will duke it out, heaven help us, and they will not come to the Alfond for advice.
But for Conn, it was a heady enough triumph for one day just to get people to listen.
As she made her way to the restroom, strangers in the crowd stopped her to say, “Good job!” After the forum, one television station pinned her down immediately, while another one invited her to appear on a health care panel that night. And there is no doubt that Hillary Rodham Clinton got the message.
Pretty good for a $15 ice bag, figures Conn: “I think it can, maybe, make people feel as though they have the tiniest little voice in all this.”