A couple of months ago, one of our kids had a health emergency in the middle of the night. We had no choice but to take him to the "local" community hospital, 18 or so miles away. The doctor got him taken care of, and the problem was resolved in the Emergency Room without having to admit him as a patient.
They charged us an outrageous amount of money, only about $250 of which was for the doctor. More than TWICE (over $500) was for simply using the ER at all. I called and pointed out that this is the sort of pricing we'd expect from a for-profit corporate hospital, not a "community" hospital like these folks purported to be. The woman understood my point, particularly since we'd be paying the bill out of pocket. After a bit of internal wrangling and review, they agreed to knock some additional dollars off the total.
It was still a lot more than we would have paid in a doctor's office (and the procedures the doctor performed could have easily been provided in an office --- we only went to the ER because it was so late), and a lot more than an urgent care / sub acute facility would have charged. But note well, all those considering moving to an isolated rural community: THERE ARE NO OTHER OPTIONS in many such places. The closest urgent care to where we lived in Illinois was 35 miles away...or roughly double the distance to the closest ER. Much like the crazy prices we paid for electricity, the crazy ER prices seem to be a hidden "tax" that's charged to enable these services to be offered at all in such isolated places.
But one little thing continues to bother me. We got the final bill the other day, and something jumped off the page: a grammatical error that even my fourth grader knows better than to commit. See if you can spot it:
Each of us has certain things that particularly grate his nerves. For me, as a writer, it's seeing it's used in the place of its (and vice-versa, and variants such as "Dog's For Sale"). And it's one thing to see this kind of error on a hand-painted sign. It's quite another to spot this error on a statement from a medical facility asking to be trusted to save the lives of one's family members. I found myself wondering, If you people can't tell the difference between a contraction and a possessive, how can I trust you with the health and safety of my family members?
I'm probably making a lot more of this than it deserves, and part of my indignation at their grammar is probably due to frustration at the still-outrageously-high amount they're charging. But I think there's a lesson here for us all: make sure you get the little things right. People do notice when you don't --- and those little things shape people's perceptions of your abilities on the big things.