Took the baby girl - now 7 months old, thanks for asking - up to the Warwick Township health campus Monday, to an audiologist. During her six-month visit to the pediatrician, the doctors conducted a hearing test and thought maybe they detected an issue with her right ear. That was news to us. So, dutifully, both kids in tow, I journeyed to the specialist, where it took the doctor and two assistants more than an hour to try and get the baby to hold still long enough so that the earplug-like device they inserted in her ear could take readings on the eardrum’s responsiveness. Then they took her into a soundproof room, speakers at either end; from the right speaker came a series of sounds, to see if she would respond. She did. And at the end of it all the doctor told me she seemed OK.

On the way out, I paid my co-payment, and got a look at the bill in its entirety: Nearly $500.

I am virtually certain that, within two or three weeks, we will get a notice from our insurance company informing us that they are not going to pay this bill, or won’t pay all of it. And we will be on the hook, once again.

This, after my wife spent hours on the phone making sure we had the correct preauthorization, making sure this was going to be covered. But we know now not to trust the insurance company when they say we have been preauthorized, when they say it’s covered. My wife, who has had some serious health issues, needs to get MRIs relatively frequently; we just got a bill from the MRI provider saying the insurance company never preauthorized her most recent test - which it did; we have a copy of the preauthorization - and thus, we owe the MRI provider $1,000.

Next day comes a notice from the insurance company itself, stating that, whoops, they made an error, it was preauthorized - but they’re only covering half. We’re “only” on the hook for $500.

Oh, and that hearing test conducted at the pediatrician’s? Not covered. That’ll be another $250, please.

The point here is not to bash my insurance company. Frankly, I’ve got about as ironclad private insurance as one could hope for. Which in this day and age isn’t really saying much, but still.

The point, or rather the question, is: Is there a person out there who doesn’t spend hours every week on the phone with their insurance company or medical provider, arguing over what was or wasn’t covered, what should have been preauthorized but wasn’t, what was preauthorized but, due to a clerical error, was erroneously marked as not being preauthorized?”

Is there a single person out there who doesn’t spend a significant amount of time in insurance hell?

After our appointment Monday, the doctor called me at home. Yes, she said, they hadn’t detected a problem, but they’d really like us to schedule a follow-up visit in six months, just so that they can be sure.

Under normal circumstances, I would have scheduled it right then. But I can tell you that there’s no way my insurance company is going to pick up another $500 tab for a preventative, diagnostic measure like this. And so my inclination is to not make the appointment, because we are relatively sure there isn’t a problem, and would rather not spend $500 to tell us what we already know.

But I probably will make the appointment, because how can you let money stand in the way of knowing your child is O.K.?

It strikes me, though, that there are probably a lot of people in this situation, many of whom have no health insurance at all, or minimal insurance. We now have a medical system with tremendous diagnostic and preventative capabilities; but it costs so much, and the manner of paying for it is so fragmented, that it does a significant portion of the population absolutely no good.

I think of this every time we get into a discussion about our health-care system, when conservatives, recoiling at the idea of socialized medicine, loudly pronounce that we’ve got the best medical system in the world. We do. But it may well be the most convoluted, complex health care system in the world. And more imporantly, who can afford it? And if you can’t afford it, what’s the point?

If you’re wealthy, or you’re a public employee with ironclad benefits, this might not seem a big issue. But most of us are not in that boat. Most of us, I suspect, are forced, to some extent, to ration health care - to make decisions based not only on what we need, but what we can afford. That is only going to get worse.

You do what you can, and you do for your kids. And however annoying or fiscally painful it might be, you keep in mind that you’re one of the lucky ones - some people go bankrupt from this. And you realize that our system, however advanced, however “good,” is itself gravely ill.

The howling of conservatives notwithstanding, it’s one patient we can’t afford not to treat.