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Guilt Bot

I don’t usually listen to voicemail left by robots, but this one was from my health-insurance company, so I stayed on the line long enough to jot down the 800 number I was instructed to call for “important health information.”

I was hesitant to dial — what if they wanted to tell me something I didn’t want to hear? Were they raising my rates? Did someone, somewhere, request my records for some innocent reason and inadvertently discover I had a life-threatening anomaly? There are some things I’d rather not know. Let me live my life in peace, without the devastating awareness that either my bank account or my body is about to suffer.

Of course I dialed — the consequences of ignorance always outweigh those of knowledge. A woman’s voice answered the call — this one wasn’t a robot, but I could tell from her steady cadence that she was only the recorded echo of a real person. I confirmed who I was by responding “Yes” to the question of my identity and wondered how a recording could tell if I was lying or not; I doubt the line was equipped with voice recognition.

“It seems it’s been a while since your last checkup,” the woman’s voice said. “Is this true?” She gave me options for how to respond: “You can say, ‘yes,’ ‘no,’ or ‘I’m not sure.”’

“Yes,” I said. I couldn’t remember when I’d last been to a physician, or even the last time I was sick. I had a runny nose and a persistent headache for two days after a long flight to Japan 13 months ago, but that could have been chalked up to jet lag. My strong constitution is reinforced by my reasonably healthy lifestyle: I hit the gym at least three days a week, I eat as much for nutrition as I do for pleasure, and I get an average of eight to ten hours of sleep a night. My spastic neurotic mental shit and fervent taste for wine aside, there’s no doubt I fall on the healthier side of the wellness spectrum.

“It’s been over a year since your last cervical cancer screening,” the agreeable voice continued. “Also known as a pap test” — I was so happy she didn’t say “smear”; that word has always grossed me out — “this kind of screening checks for signs of infections or abnormal cells in your cervix that can turn into cervical cancer.”

When she’d finished explaining the importance of screenings, the woman’s voice asked, “Do you plan to call your doctor?”

“Yes,” I said, thinking that would be the end of it.

“When? You can say, ‘this month,’ ‘this week,’ ‘today,’ or ‘I’m not sure.’”

I didn’t like being put on the spot. “I’m not sure,” I finally said.

There was a pause at the other end. When she spoke next, the woman’s voice seemed to have taken on an admonishing tone. “You know,” she said in a way that made me forget she was a only a recording, “this isn’t just for you — your health affects your friends and family as well.”

“Are you trying to guilt me?” I said before realizing the entity on the other end of the line had no ears with which to hear me.

I listened as she finished her automated guilt trip. “I know it’s hard to find the time, but there is nothing more important than your health.” Now she was starting to sound like my dad. One of his mantras is, “If you don’t have your health, you don’t have anything.” Dad’s a big proponent of preventative maintenance, whether it’s for bodies or cars. “Nowadays,” he says, “with the level of technology and equipment, if they catch something early enough, they can do something about it.” He was proven right last year, when a routine screening revealed a few tumors on his kidneys.

The recorded matron wouldn’t allow me off the phone until I promised I’d call my doctor to schedule an appointment “soon.” Sure, I could have hung up on her at any time, but she’d reduced me to the brain state of a child heeding her mother’s advice, and that kid wouldn’t dream of hanging up on her mom.

Once I’d disconnected, I called my sister Jane, who is also my health consultant. As a health-system account manager for a major pharmaceutical company, Jane works with all aspects of what she calls “integrated delivery networks.” As part of her job, she has to be versed in everything from patient-privacy laws to health-insurance mandates.

“Yo,” I said when Jane answered. “Why would my insurance company want me to go get checked out? Don’t they have to pay the doctor every time I go in?” As a self-employed freelancer, the last thing I wanted was for my already ridiculous monthly premium to get jacked up after a visit. Say I mention something in passing to my doctor that ends up as a note on a chart that marks me as a future health risk. I’ve been denied insurance for stupid shit before; I don’t like to mess with what I’ve got. I like to keep it around and in good standing in case something major happens.

“No, no, you have it backwards,” Jane said. “Insurance companies save money by sending people in for preventative care. The doctors get paid a stipend, regardless, so they actually stand to make more money when you don’t go in. I mean, don’t get me wrong, both doctors and insurance companies have an interest in your health because then you wouldn’t need to go in as much or need expensive treatments, but right now, the insurance company is already paying for you as a member — it’s called capitation. The good news is, everyone makes more money if you stay healthy.”

“So it’s like I’m paying anyway, and they’re paying anyway, so I might as well go in,” I said. Jane agreed. It’s not like I had a choice anymore, anyway. Once the woman’s voice had uttered the C-word, my fate was sealed. Because now I’ll be convinced I have cancer until someone in a white coat tells me I don’t. Thanks, Blue Shield.

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