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Lately though, her equanimity has been put to the ultimate test, one even I'm inadequate to match, for she has slipped into the dreaded vortex that is the American healthcare system.

It began, innocently enough, with a simple backache.

After X-rays, an orthopedist assured her nothing was wrong. Severe pain continued. Eventually, she sought a second opinion, whereupon she was told to get a CAT scan.

Then the fun began. One day before an appointment with a radiologist she was told she couldn't undergo the procedure until he received an "authorization code." This process was to take a full two weeks thanks in equal measure to the insurance bureaucracy and to the ineptness of a key operative (we'll call her Nancy) at the orthopedic practice.

The scan also showed no apparent damage. The doctor frowned in dismay and dramatically told my wife that now that the simple stuff was behind her it was time to delve into "more serious stuff"--like a tumor, for example.

He ordered a bone scan, which ushered us into round two of this heavyweight bout. Again, the radiologist required an authorization code, and again in pursuit thereof we had to deal with the incompetent Nancy, or, more properly, her voicemail for another two weeks.

All the while, the physical pain, and now the mental pain as well, have continued.

Next came a form letter from the health insurer denying the claim. When my wife called to complain, she was told it was too late, that she only had 48 hours to lodge a protest, and it had to be in writing. She informed the robot on the phone that she had only received the notification two days before, a Saturday.

Sorry, said the robot, the only path at this point is to have the doctor call them directly and set up a "peer-to-peer" conversation. The odds of this happening, we thought, were slim and none.

Nonetheless, we reluctantly threw ourselves again into the hands of Nancy, who denied having received notice from the carrier a week before, despite ample evidence to the contrary.

We're still waiting on that call back, of course, and all the while the pain continues, as does the finger-pointing, with no end to the frustration in sight.

Every family in America, it seems, has a story like this, many of them for conditions far scarier than a backache. But the very ordinariness of my wife's experience points to just how dysfunctional the system is and how it breeds frustration, anger and despair.

We learned yesterday from the Census Bureau that 45.7 million U.S. citizens are still without health insurance.

"I feel like one of them," my once-patient wife says.

Mr. Obama, Mr. McCain, and all who provide and broker health insurance, take note.

THOMAS J. SLATTERY, a veteran editor and writer on industry affairs for more than 40 years, is also the managing director of Slattery-Esterkamp Communications, Baldwin, N.Y.

October 1, 2008

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