When Nicholle Joyce learned she'd been exposed to a rabid bat at a Spirit Lake home in May and she was nine days into the 10-day window for a lifesaving vaccine for the fatal disease, she did what her doctor's office suggested - she went to the emergency room.  The result: A $5,000 bill for her, and another matching one for her friend who was in the same bind. Joyce had insurance, but it had a $3,000 deductible, and is only paying about $830. Her friend had none; Medicaid covered the shots for the friend’s 15-month-old son, but not the single mom. “It’s absolutely impossible for everyone to get a due-on-receipt of $5,000 and just go with it,” said Joyce, a veterinary technician from Athol.

Health officials said they, too, were shocked by the high price of the rabies vaccine, which consists of five shots on four specific days over several weeks; so far this year, three bats have been found in North Idaho that tested positive for rabies. But it’s something that’s so rarely needed that few doctor’s offices would stock it.

“That sounds absolutely, egregiously horrible,” Bob Marsalli, CEO of the Montana Primary Care Association, which oversees community health clinics in that state, said of the cost, “unless it was a hospital administering the vaccine. Here’s what we know: The worst place to get primary care is in the hospital emergency room, and the charge schedule for hospitals is one of the reasons why health care has reached the place it is.”

Now, the Dirne Community Clinic in Coeur d’Alene, which hasn’t offered the rabies vaccine in the past, is looking into it because of Joyce’s case. “It certainly would be a lot less,” said Dirne CEO Mike Baker; his community health center charges patients on a sliding scale based on their income, and works with both insured and uninsured patients; you can read my full story here from Saturday’s Spokesman-Review.