Sunday, February 11, 2007

Insight from an Ethiopian Cab Driver

As I left Washington D.C., I had an interesting conversation with my cab driver. She was a 45 year old woman originally from Ethiopia. She drove a taxi part-time to supplement her income and allow her to spend evenings with her two children. Her husband was also in the transportation business, driving a car for a limousine service.

After a few remarks about the unseasonably cold weather, she brought up the subject of healthcare in America. I t seems that I was her first fare of the day because she had been at a local hospital with her father during the morning. Her father was a diabetic with circulation problems and had had some type of surgery to restore circulation to one of his legs. She told me that the surgery had gone well, but that the family members now took shifts at the bedside to assure that the patient was fed, cared for, and given the correct medication. This family vigil was necessary because the patient was in a “no insurance” hospital. My cab driver believed that American hospitals were divided very clearly into “insurance” and “no insurance” hospitals. “No insurance” hospitals had no nurses, the worst doctors, and dirty facilities. “Insurance” hospitals had plush rooms, private nurses, and the very best doctors.

For this reason, my Ethiopian cab driver and her husband paid for an individual (as opposed to an employer subsidized group) health insurance policy. The policy did not include the children, and cost them $450 dollars per month. Now, I’m not sure exactly what part-time cab drivers in D.C. make for an annual salary, but I’m fairly certain that $5,400 per year in insurance premiums takes a good portion of it. Her insurance policy had a $1,000 deductible which she planned to borrow from her family if needed. Her children are currently covered by Medicaid, but she fears the day that they are no longer eligible, forcing her to purchase additional insurance for them.

My cab driver was skeptical about Mr. Bush’s plan to give a tax credit for health insurance. Her exact words were, “…the insurance companies will just charge enough to take it.” She did not know anything about Health Savings Accounts, but did not think they would purchase a ticket to enter an “insurance” hospital. She did not have any ready solutions to the have/have not situation in healthcare. In her opinion, Americans talk about change, but seldom achieve it.

I left D.C. enlightened by the wisdom of a naturalized citizen who works a job, raises a family, and talks turkey in her cab.


Val Jones, MD said...

Dear Dr. Gardner - welcome to the blogosphere! I heard about your blog from Grunt Doc and Kevin MD. I look forward to reading your posts. This one about the Ethiopian cab driver was quite near and dear to my heart (I live in DC and I don't have a car). Her perspective is sad - but rings true. I'm the Senior Medical Director at Revolution Health and we want to do all we can to educate consumers, and empower them with a sort of AAA service to navigate the system. Would love to think through the issues with you and ACEP... Warm Regards, Val

DA said...

Hello! as a hungarian reader of your blog, may I point out, that this taxi driver drives her cab in Washington DC, not Addis Abeba. And of course this doesnt give the right to be content of what you have achieved, but at least Americans are trying.