The $20 Bill

So I found a $20 bill in my yellow windbreaker on Thursday, which felt a lot like when my Aunt Shirley used to send me $1 in a Valentine's card, which diminished the awkwardness of getting a valentine from your aunt. It was an amazing surprise which for a 5-year old was a million dollars….I told the wife she could now get the physical therapy on Friday AND the massage. The $20 bill was a sign, both hope and opportunity, our luck turning, like when dad found a $20 bill in his underwear drawer in the 70s and said "kids, we're going to Antonio's tonight but this time we're getting pepperoni AND meatball." The $20 bill has an important history in healthcare - it's the defacto copay just to get in the door, and strangely the exact amount the government pays for 1 unit of anesthesia, which I'm told can't get you far for a colonoscopy, but might be just enough for those times when the doctor numbs your toe for a 15-minute soft-tissue repair. The joy is not so much the number on the bill but the discovery itself. It's a feeling engrained in my being when I was in my 20s, making $7.00 an hour writing obituaries for the Bergen Record, just enough to buy a Blimpie 12-inch sandwich on Washington Street in Hoboken on a Friday, but not enough to afford the extra $1 for more oil and vinegar.  Times must have been tough for Blimpie, and so for this young reporter that $20 bill in my pocket was an exhilarating almost spiritual experience. In healthcare, giving out $20 is rare but welcome. Medicare's insurance plans have splurged in recent years, using extra money to give out gift cards to people called supplemental benefits. "Is this $20 gift card from Aetna a joke," Dad said last year. He bought Advil and a tooth brush. Many folks don't really know the feeling, those with the means for the $5K laser eye surgery, the skin botox, the 60-day rehab, the hydration IVs or, in parts unknown, the concierge doctor. Having these things no doubt must feel luxurious, stress lowering and freeing, at least that's what I'm told. But for many of these folks they really won't know the feeling you get when you put on your jacket to go fill up the car, feel a piece of paper crumpled into your left pocket, and pull out a $20 bill.  It's a sign that things will be alright, that at least for a night, you are fortunate and free...