I Have Seen The Future Of American Medicine, And It Is ImmediaDent
Last time I went to Miller Motorsports Park, I wound up with pneumonia from a day digging at the Salt Flats. This time it wasn't quite that bad, but when I crawled out of bed from the first night of fever, knelt on the cold wood floor, and spit bloody pieces of a tooth into my hand, I have to admit that I made a few hasty and ill-considered vows to never again visit the Beehive State. Then I examined my mouth in the mirror. I'm currently, ahem, between healthcare. Could I let this minor bit of dental rectification wait a while?
Nope --- my reflection was enough to frighten children. More than it normally is, even. Time to investigate the wide world of cash-on-the-barrelhead dentistry.
Strictly speaking, I should have signed up for my "Obamacare" when the last dregs of my "COBRA" ran out last year, but after seeing that the best "Bronze option" plan I could find charged ninety-seven dollars per week and didn't kick in until I'd spent $6500, I decided to wait until I had a new day job.
My new day job was with the same contracting company for whom I've done half-a-dozen gigs since 2003. They explained to me that they no longer offered healthcare for full-time employees, but that I was welcome to use their ACA exchange. So now I'm paying five grand a year for coverage that doesn't kick in until I spend $6500 a year. This is, apparently, Mr. Obama's miracle. Once upon a time I paid $2000 a year for coverage that kicked in once I'd spent $250. The good news is that, uh, well --- every poor person I know doesn't pay enough taxes to see the ACA penalty, and even if they did it wouldn't change their decisions regarding healthcare because poor people have low future time orientation.
That's why they are poor. Low future time orientation.
I have the same problem. The only reason that I am not desperately poor is because I know how to make money in a hurry. Someday I will be desperately poor. I have the mentality of a poor person. That's why I didn't sign up for ACA until last month, which meant that I wouldn't receive any benefits until May, so my dental and healthcare expenses related to this Utah Ebola would be entirely paid by me. Well, they would have been anyway --- but now they won't even count towards my $6500 deductible.
Sucks to be me. I should have married that FBI agent when I had a chance. I hear the government employees don't have to deal with the ACA, for the same reason that the Waffen SS didn't test out the gas chambers on their officers. (Yes, I know the Waffen SS had little or nothing to do with the gas chambers.)
Where was I? Oh, yes --- I was arriving at "ImmediaDent", your cash-basis weekend dentist to the stars. My longtime companion Vodka McBigbra used to go to ImmediaDent when I was her source of dental insurance, and they always did a remarkably decent job on her teeth, so I wasn't all that frightened of the prospect. The problem was that they had a couple hours' worth of root canals ahead of me, so I set an appointment for the following day and promptly went to a motorcycle store so I could buy one of those bad-ass Arai helmets with the Kanagawa Oki Nami Ura on it. The girl at the motorcycle store was very pretty and I did not smile.
When I arrived for my 6pm appointment the following day, there were still a few emergencies ahead of me. Two hours later, I was still waiting. The people around me, who were also waiting, were remarkably relaxed about this, but I was not. I will pay any price and bear any burden to not wait for something. Years of semi-comfortable internment in the middle class had enabled me to forget that poor people wait. To be poor is to declare, openly, that your time is worthless. So you wait --- at hospitals, in the court system, at the check-cashing store, in the welfare line, for the relatively few restaurants in your neighborhood.
As an honorary member of the working poor, my time was honorarily worthless. So I waited, and eventually I was taken to a back room. There were two Chinese dentists, one male and one female, working on a wide variety of people. The male dentist had unconsciously adopted part of his customers' street argot.
"What hurting with you bro?" This was delivered to an enormous black man rolling around in pain on a dental couch.
"IT'S MY TOOTH, MAIN!"
"Oh, let me look... That tooth gotta come out, bro!"
"IT GOTTA WHAT?"
"It gotta come out! Talk to your family!" Then he returned to look at my poor #25 incisor. "We'll do an F6 on this."
"What," I asked, "is an F6?" He looked at me as if I were a chimpanzee who had magically acquired the power of speech.
"Three surface filling."
"No problem," I responded. About half an hour later, an ImmediaDent representative came out and gave me the total --- $338 --- to the penny.
"Let me tell you about our financing options," she began...
I handed her my Sapphire. "I refuse to finance any teeth that are not made of gold," I replied.
"We can do that, you know. We do gold teeth." For a brief moment I considered having the front twelve or so teeth in my mouth capped in gold. Actually, I'm still considering it.
The male dentist returned, jabbed a needle in my mouth, then ground the remaining surface of my tooth nice and smooth. Then he disappeared. I reached back and periodically administered my own suction to keep the blood off my tongue. I heard him on the phone.
"Grandma! This Doctor Chang! Your boy (said "boy" being my age) need the tooth to come out! We take a credit card!" Then he was called into another room, where a client was trying to talk him out of doing any anesthetic. The client was a trifle agitated. At this point it was about 9:05PM.
"DOC! I DON'T FUCKIN' NEED IT AND I CAN'T PAY FOR IT ANYWAY! JUST DRILL AND I'LL BE FINE! I'M NO FUCKIN' PUSSY AND SHIT!"
"You do nitrous!" Dr. Chang replied. "It's almost free! You big man! Handle it with nitrous only!" This reminded me of a story that a woman told me once about a night with her friends in a dentist's office. This story reminded me of every sketchy story I know about every woman I have ever loved. I started to feel very sorry for myself. This is my life, I told myself. A combination of romantic depression and late-night discount dentistry. I dipped a finger in my mouth and made a blood-infinity on the back of my left hand. Then the female dentist came in.
Without a word, she did the rest of the grind-and-fill herself in under ten minutes. I'm used to my white-collar dentists who take forever and use no fewer than two assistants at all times. Not this lady. She was fast and competent and utterly silent. It was like watching a brilliant painter at work. When she was done she turned to leave. Not a word had passed between us.
"When, ah, will..." I see you again? "...I be okay to eat something?"
"When it's not numb. You can leave now, though." Anything you say, ma'am. In another room, Doctor Chang was yelling at a patient.
"Hey Bro! You can't leave you got one more root canal left! Gonna hurt till we fix it! Might as well stay.!"
On the way out I picked up my receipt. When I got home I looked at the filling. Top notch work. I'd waited three hours for about ten minutes' service but that ten minutes had been flawless. Most interesting to me was the way the business operated. My old dentist, a thrillingly awkward and coltish woman of my own age who closed her practice without giving much warning or any reason whatsoever, had always wrapped our interactions in layers of expensive tissue paper. The quiet Muzak, the dual hygenists, the endless questions and details, ("Are you still taking multivitamins?") the mystery bill to be handed to my insurance company then balance-billed to me later after their negotiations were complete. A free toothbrush after every visit. I could predict the beginning and end of our appointments to within a five-minute window.
This, on the other hand --- this was performance art, the fascinating future of cash-basis medicine. Every price discussed and negotiated up front. No hidden profits, no massive insurance companies sending reams of paper from block-long concrete edifices. No dental records, even. If I keep going to ImmediaDent, it will eventually be impossible to identify me from dental records. How wonderful is that? Dental care in real time, for real money, with no fluff.
The next day, V. McB. called me to see how it had gone. "I told you they were fine," she laughed. "And for the record, they never make me wait."
"Nobody, darling," I responded, "ever makes you wait."
Come the first of May, I'll theoretically have "Bronze Dental Coverage" as part of my ACA boondoggle. I'm sure that if I operate the system correctly, I will eventually have access to a quiet dental office with multiple hygenists and motivational posters on the wall. I wonder if I'll go. Probably not. I think I'll just go see Dr. Chang again, bro.