Part VIII: The Coverage

Phlox glanced sideways at Randall, waiting for the go-ahead signal. Randall gave it with an nearly unperceived nod, as if she was not really giving permission, but just happened to be there, looking over Phlox's shoulder like that of an auditor, crunching over numbers, looking for an odd line item to smite with her calculating eyes. She'd checked over Trip's account deductibles and maximum allowances, but surely, there was room for error given Dr. Phlox's hyper enthusiasm to treat his patients with whatever he deemed necessary. This included things that S.H.I.T simply did not cover, so Randall had to hover and advise the physician before he treated without the proper authorization.

And that was just from trying to get a diagnostic.

"Doctor, what the hell is wrong with Trip?" Malcolm felt boned tired just standing in Sickbay.

"Well, it looks like he's got what human females call PMS, Pre-"

" I know what that is, Doctor," Malcolm hastily interrupted, before pausing a beat. "Wait, but, he's a man." Blink. Blink. He lowered his voice just a bit, "Isn't he?"

"Well, yes, but due to the alien pregnancy he experienced, his body is showing some latent effects of the typically female production cycle. Perhaps not as regularly as human females, but then I've always found-"

"Let's…stick to the issue at hand." Malcolm really didn't want Phlox to expound on his thoughts regarding the female reproductive cycle. "But he's behaving very erratically, not like regular PMS-so I've heard."

"There appears to be a tissue bundle releasing a rather large amount of alien hormone, analogous to estrogen, which will induce behaviors such as you've seen in Command Tucker. I should be able to treat it with an EXP-ENS-IV inhibitor compound..."

"I'm sorry, Dr. Phlox, but the EXP-ENS series isn't covered in the formulary under Commander Tucker's plan. The drug dispensary won't produce it if you enter Commander Tucker's information." Randall gestured at the large industrial looking machine that took up an entire wall of Sickbay. It had the logo of a curled up brown snake, the large letter S H I T on top of it. Malcolm frowned at it. When it was installed, he could swear that if one were to look at the snake from a certain angle, it would look like a pile of turd.

"Hmmm, how about ALS-EXP-ENS-IV inhibitor?" Dr. Phlox asked Randall.

"Those are covered, but only for women."

"Mmm," Phlox stroked his chin.

Malcolm quietly was growing desperate.

Trip swung off the Sickbay bed, the hem of his muumuu up at his knees, his feet stretched out in front of him. He asked, as he surveyed his own bare legs, "Do you think I have cankles?"

The Amory officer grabbed Phlox into a corner, out of Randall's hearing, and whispered, "Doctor, can't you simply enter Trip's information into the drug dispensary but enter him as a woman? We can say it was a data entry accident."

Phlox shrugged. He knew Randall had a job to do and he'd let her advise him on the proper procedures, but accidents do happen. So before she could see what he was doing, he'd transmitted the necessary information into the drug dispensary. The machine groaned into action. The lights in the interface flickered once, twice, and then died. No drugs were made. Malcolm pounded the wall with his head while Phlox sat, deflated. Trip cried in the corner upon discovering he did have a cankle.

Randall read the output of the machine and then shook her head at the men like they were misbehaving children. "You can't change his sex and leave everything else male, the dispensary can't calculate the correct metabolic dosage that way."

Phlox sighed. "Well, I can certainly see why that happened, but this is an unusual circumstance. As his primary physician, can't I override this restriction?"

Randall brightened. "Now that you mentioned it, yes you can. There is a form available for you to fill out." She magically pulled out a bundle of papers, one inch thick. "This will need to be filed in triplicate with a S.H.I.T plan accountant. You should get a response with six to eight weeks."

"Six to eight weeks…" Malcolm stared at Randall, his eyes bloodshot and his trigger finger twitching. "That's…" The armory officer closed his eyes and breathed deeply before continuing, "…unacceptable. We can't have an unstable Chief Engineer for six to eight weeks."

"Is that your medical opinion?" Randall asked dubiously.

What gall! If Malcolm had pearls, he'd be clutching them. The crewman appeared to have forgotten that he was British and was so very good at dealing with such insolence. His eyes turned cold as he replied, "I apologize. Obviously your S.H.I.T training extends from medical procedures to intergalactic starship operations. What would you recommend? Perhaps you'd like to take over as Chief Engineer while we wait for S.H.I.T's decision?" He almost smiled as she flinched at his icy tone.

"Ah!" Dr. Phlox exclaimed suddenly, "Perhaps we can do this the old fashioned way? We can operate and physically remove the cell bundle."

Malcolm glared at Randall, daring her to speak, to deny the procedure. She sighed and muttered, "We would still have to get approval for any type of operation." Randall took a step back as Malcolm's eyes started to take on a crazed tint. "But, this type of approval can be quick, we can connect to an approval agent right now!"

Randall punched in a few keys on a computer terminal, and sure enough, a bored looking man in a suit and tie appeared on screen.

"S.H.I.T, how may I assist you?"

"Yes, I am Dr. Phlox of the Starship Enterprise, I would like to request approval for an operation."

"Account number for approval?"

"NOWAY-4NO1."

The approval agent entered a few keys before looking up and giving Phlox an apologetic smile that seemed all too rehearsed.

"I'm afraid we can't approve the removal of this class of living tissue from Miss Charles Tucker, III."

Phlox blinked. "Commander Tucker is not a woman."

"According to our latest records, she is. The last drug dispensary transaction indicated she is a female. If she's not, I'll have to file an insurance fraud alert in the system."

Malcolm swore he could hear blood rushing between his ears. Phlox was handling this better than him. "That was a data entry error. Commander Tucker is male."

"We can't approve this procedure either way. S.H.I.T is dedicated to preserving life, not removing it."

Malcolm was having none of this anymore. He pushed Phlox aside and had to stop himself from taking the computer screen and shaking the hell out of it.

"What life? What on earth are you talking about?"

The agent was nonchalant and replied with practiced ease, "The tissue bundle as mentioned in Dr. Phlox's diagnosis, of course."

"That's not life! No more than that alien nipple was."

"Nipple?"

"Nevermind! Look, do you know where I am right now?"

The agent sighed, as if he's heard this line all his life. "No, I'm afraid I don't know who you are..."

"No, no. I'm not asking if you know WHO I am. I'm asking if you know WHERE I am."

"I'm afraid I don't understand…"

"We're in bloody outer space! Commander Tucker has been infected with alien cells and we want to remove it. We have to remove it. You wouldn't give him the drugs because it's not covered or it's not for men and then you wouldn't let Dr. Phlox remove it because it's life? How on earth do you expect this person here," Malcolm dragged Trip over to the communication console and gestured to the pink muumuu wearing, hysterically sobbing man, "To work on a Warp 5 engine like this?"

"Perhaps he should consider another career?" the agent suggested hopefully.

Malcolm wanted to strangle someone. His fingers itched and he dearly wanted to feel a neck between his hands. At this point, any would do. His own neck would do too as he felt that only the sweet release of unconsciousness would relieve him of this bubbling cauldron of homicidal rage.

"You want the Chief Engineer of the Starfleet flagship to give up his career and livelihood and put the entire ship in danger for a bundle of hormone secreting alien cells?"

"S.H.I.T aims to reflect the moral fiber of the public at large. We simply will not condone operations such as these."

Malcolm stared, mouth agape. "Condone? Are you a medical professional? What makes you think this operation is something to be condoned?"

Finally the agent seemed to have an emotion other than boredom. Bristling, he replied to Malcolm's questions, "I am a certified accountant trained in the reduction of the medical loss ratio. If there is nothing else, have a nice day, sir." The screen blinked out, leaving Malcolm at a complete loss and Trip still a blithering idiot. No progress what-so-ever and what the hell was a medical loss ratio?

The Sickbay doors opened as Sub-Commander T'Pol stepped through the threshold.

"I wish to speak to Commander Tucker," she said. She looked at Trip, pausing as she took in his attire and blotchy face, and then turned to Malcolm. "Is he unwell?" she asked slowly, her tone forcibly understated.

Malcolm opened his mouth to explain. He narrowed his eyes at T'Pol, then turned back to look at Trip, who was trying to determine whether he had one cankle or two. Malcolm closed his mouth without a word and appeared to be deep in thought.

T'Pol raised an expectant eyebrow at him.

"Sub-commander, I…that is, Commander Tucker has a proposition for you."

The rest was a blur of solemn vows, lifetime promises, and the exchanging of health insurance information.

At the end of the day, Malcolm fled to the quarters that he shared with Hoshi. He felt like he'd been through hell and back and desperately needed her to tell him that life was still worth living.

"Oh Malcolm," Hoshi said, running a comforting hand through his hair.

He hugged her tighter. "I did the best I could under the circumstances."

"I know you did, but you do realize that only a third of the crew have their own healthcare systems? What'll happen to the people that can't marry into better insurance?"

Malcolm shuddered in horror. "I don't know, Hoshi. I've seen so many terrible things in my life, but this…I can't ask anyone to go into a dangerous situation knowing they might get injured and have to deal with S.H.I.T. It's too much!"

"Don't you think I know that first hand?" Hoshi didn't even want to think about the pain and confusion she suffered through when S.H.I.T refused her treatment.

He gently kissed her on the forehead, where her operation scar had faded. "Being married to you was the only good thing to come out of this."

Tears glistened in Hoshi's eyes. She blinked them away and squared her shoulders. "Look, I'm going to walk Porthos in a few minutes, I think it's time Captain Archer know about this."

"But the Admiralty approved this…" Malcolm was still a stickler for the chain of command.

Hoshi glared at him, her hands at her waist. He swallowed.

"Let me come with you. Screw the higher authorities."

She smiled with a sly twinkle in her eyes. "I do love it when you say 'authority'."

It turned out though that Porthos was not in Captain Archer's quarters. Malcolm and Hoshi entered Sickbay just in time to hear Crewman Randall explain the rules and regulations of S.H.I.T coverage.

"Porthos is not covered by S.H.I.T. As a network physician, Dr. Phlox can't utilize any authorized S.H.I.T drug dispensaries without company authorization. Since Porthos isn't covered by any insurance companies or Starfleet affiliated alien health care representatives, he won't be able to treat him."

Hoshi blinked at Randall and uttered a sentence she never thought she would ever say out loud. It was such a betrayal to her profession. "I don't understand the words that are coming out of your mouth."

"Oh, hell no." Trip, still recovering in a Sickbay bed, oversaw the whole thing and tugged at his new wife's uniform sleeve. When T'Pol raised at eyebrow at him, he asked, "Am I still hallucinating? Did she just refuse treatment for Porthos? The Captain's dog?"

"I believe so." T'Pol was as bewildered as a Vulcan could be. The concept that health care that was dependent a health insurance company designed to maximize profit was as alien to her. The goals appear to be contradictory and illogical. To refuse treatment for the Captain's canine, however, was simply not done.

Trust Trip to put it far more succinctly, "Oh no, she didn't." He shook his head at the hapless crewman. One does not screw with a man's best friend. Especially if that man is the Captain.

"Malcolm," Jon called out, gritting through his clenched teeth, "Escort Crewman Randall to the brig. I'll contact Starfleet to arrange a transport and speak to them about this S.H.I.T fiasco."

"Captain, the restrictions were all stipulated in the group plan contract, speaking to a plan accountant would be futile." Randall tried to soothe the irate captain, but succeeded only to deepen the furrows of the Captain's brows and redden the angry veins that popped on his neck.

"I'm not going to speak to a damned plan accountant! I will speak to the Starfleet Admiralty directly regarding this mockery of a health care system! This isn't the private premium health care they promoted. We're just talking to a bunch of accountants who'd rather let us suffer than do the things we paid them for!" Porthos whined at his owner's loud exclamation. Jon promptly picked him up in his arms. And as Porthos nuzzled at him with his little button nose, Jon growled with finality that sent to a damp chill down Randall's spine.

"The line must be drawn here!"

Porthos howled with enthusiastic approval and Dr. Phlox grinned that unnatural grin of his, certain and happy to never deal with S.H.I.T again.