by Rick Pongratz
After a public contract dispute that led an East Idaho hospital to become out of network with a major health insurer, the two businesses agreed to a contract. The deal brings Portneuf Medical Center in-network for Regence BlueShield of Idaho, according to a joint announcement made Saturday by the hospital and insurer. For two months, the hospital had been out of network for Regence, the insurer for state government employees and other private plans. —Idaho Capital Sun, August 18, 2026
You need to pray for the negotiators
to reach an agreement and resolve this.
Dan, my health insurance customer service rep,
tells me this over the phone.
I can’t see him.
I can’t see the words either,
but his voice and tone
remind me of the youth pastors
from when I was a kid.
The ones that never studied
at a seminary—but, by golly,
they sure loved Jesus.
My insurance company and my hospital refuse
to agree on who gets most of my money.
My doctor wants me to get x-rays
for a bone spur under my toenail.
It causes the nail to rise up—inflating
is the word my insurance company uses
for the prices of the hospital.
And that nasty nail just won’t let go—greedy
is the word my for-profit hospital uses
for the insurance company
that won’t agree to terms.
And this little toenail,
it’s quite a small thing,
but it’s holding a whole foot hostage.
All the other toenails lie in their beds,
just taking the space they need.
They don’t hold out for a ransom,
expecting a kick-back
in exchange for not causing pain
when I knock the soccer ball
around with my kid.
But that’s toes for ya.
So this little fella needs
to have a bit shaved
off the top of that bone.
But the doctor wants
to see what he’s looking at.
And the hospital tells me my portion
of the x-ray price is $293, up front.
I tell the billing specialist
that Dremels are on sale
at Lowe’s for $39.98.
I can buy seven Dremels to grind off
my toenail, just like the doctor does,
and still have enough money
left over for ice cream.
I show her the Lowe’s website on my phone.
She says I’m wasting her time,
and it seems we are at an impasse,
so I call off negotiations.
I go for the ice cream.
I never was the best with delayed gratification.
But it seems that sometimes miracles,
they do happen,
and my hospital
and my insurance company
have agreed
on how rich they should each get.
I haven’t called to see how many
Dremels the x-ray will cost now.
I’ll probably just have to settle
for the words spoken
by youth pastor Dan
to reach an agreement and resolve this.
Dan, my health insurance customer service rep,
tells me this over the phone.
I can’t see him.
I can’t see the words either,
but his voice and tone
remind me of the youth pastors
from when I was a kid.
The ones that never studied
at a seminary—but, by golly,
they sure loved Jesus.
My insurance company and my hospital refuse
to agree on who gets most of my money.
My doctor wants me to get x-rays
for a bone spur under my toenail.
It causes the nail to rise up—inflating
is the word my insurance company uses
for the prices of the hospital.
And that nasty nail just won’t let go—greedy
is the word my for-profit hospital uses
for the insurance company
that won’t agree to terms.
And this little toenail,
it’s quite a small thing,
but it’s holding a whole foot hostage.
All the other toenails lie in their beds,
just taking the space they need.
They don’t hold out for a ransom,
expecting a kick-back
in exchange for not causing pain
when I knock the soccer ball
around with my kid.
But that’s toes for ya.
So this little fella needs
to have a bit shaved
off the top of that bone.
But the doctor wants
to see what he’s looking at.
And the hospital tells me my portion
of the x-ray price is $293, up front.
I tell the billing specialist
that Dremels are on sale
at Lowe’s for $39.98.
I can buy seven Dremels to grind off
my toenail, just like the doctor does,
and still have enough money
left over for ice cream.
I show her the Lowe’s website on my phone.
She says I’m wasting her time,
and it seems we are at an impasse,
so I call off negotiations.
I go for the ice cream.
I never was the best with delayed gratification.
But it seems that sometimes miracles,
they do happen,
and my hospital
and my insurance company
have agreed
on how rich they should each get.
I haven’t called to see how many
Dremels the x-ray will cost now.
I’ll probably just have to settle
for the words spoken
by youth pastor Dan
and pray for the negotiators;
as I know they prey.
Rick Pongratz is a poet and mental health clinician. His writing appears in Rattle, Bellevue Literary Review, The New Verse News, Unbroken, and elsewhere. Rick specializes in ecotherapy and studies creative writing at Idaho State University. He currently resides in Idaho where he enjoys getting lost in the woods with his family and dog.
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