What We Talk About When We Talk About Healthcare: The Autostraddle Roundtable

Picture 4Hey you know what no-one ever talks about anymore? Health care! No but seriously, everyone is talking about President Obama’s new plans for reforming the health care system in America … and we thought it would be worth a look at what we all deal with in the day-to-day when it comes to Health Care. [I guess if there's three things Americans are terrible at talking about honestly, it'd be money, the inner workings and healthy functions of our naked ugly bodies, and (right now) employment.] We’ve heard the absolute horror stories (and there are many), but these are our stories. ‘Cause you know – Sicko ain’t the whole story.

Team Autostraddle often lacks the diversity of perspective/experience we wish we could for most political discussions. But we found that when it comes to employment, finances, and health care, perhaps “your twenties” is precisely the time period when one is most likely to have a group of friends with wildly variant situations.

In addition to the core team reporting — including our resident Australian Crystal -- this week’s roundtable includes Intern Emily (representing Canada), Intern Daphne (Belgium!) and Natalie’s friend (that’s right, a boy!), who currently resides in The UK, to participate.

So what’s your situation? If you’re a big ol’ lez, it’s likely your struggles to get adequate care are even more pressing than for strais who can marry their way into benefits. Let’s begin.

healthcare-roundtable

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Alex – 24 – New York, USA  – Insured (via ex-employer)

“What the f*ck is my plan good for? Really Papi?”

Since I lost my full-time job in June, I pay a modest monthly cost for Cobra through my former employer. Luckily, Obama raised Cobra’s subsidy under the new economic stimulus package to cover 65% of this cost for me. So anyone who has lost their job (me!! meee!) gets 65% of this monthly health insurance charge covered by the government. I’m really thankful for this.

“It’s still taking me way too long to figure out what is and isn’t covered under my specific plan.”

While I was working I was covered under Oxford Health Insurance… I believe it was the POS* Plan? It’s still taking me way too long to discover what is and what is not covered under my specific plan. They make it fucking impossible with their big fancy words!

Basically, I recently had an upper endoscopy (it was 10 minute procedure in which I was put out and they stuck a camera down my throat,) and then I got a $600 anesthesia bill and a couple months after that a $1100 bill for the endoscopy itself. Nice. What the fuck is that plan good for? Really papi.

Needless to say, I guess I’m pretty ignorant about health insurance and its issues. Howevs, I do know that the state of health care in our country is absolutely deplorable and things ’round here need to change. It was a similar scene in 1965 when our prized Medicare program passed the Senate despite the same grumblings from the right about “socialized medicine”. Yes, the financial situation today is more complicated. But had the very distant financial projections of the Medicare program been made known at the time, the Medicare bill wouldn’t have passed. Just my little piece there… totally up for discussion.

* “Piece of Shit”

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Stef – 25 – New York, USA – Uninsured

“I’m 25 and often feel like I’m 80.”

I haven’t had any kind of health insurance since graduating college in 2004. I can’t afford the state-wide programs my worried Jewish mother forwards me articles about. It hasn’t modified my behavior per se — it’s not like I was doing a lot of skydiving or skiing before –but I’m definitely cautious as I know emergency healthcare just IS NOT AN OPTION for someone like me. Every time I get a stomach cramp, I think oh God, it’s my appendix, I’ll need surgery, I will go bankrupt. I often tell people that if I ever break an arm or a leg, you may as well take me out back and shoot me.

I often tell people that if I ever break an arm or a leg, you may as well take me out back & shoot me.

Presently, I only see doctors in absolute emergencies, like ruptured eardrums or extreme strep throat. Last year, I experienced the profound joy of trochanteric bursitis, which is an inflammation of the shock absorbers in my left hip. Basically, the bones in my hip were grinding together constantly, causing excruciating pain and making me literally unable to walk. I lived in a fifth-floor walk-up in Spanish Harlem and didn’t have the luxury of… well, anything, so I saw an orthopedist. It took the doctor about a minute and a half to diagnose me — for a $400 charge.

I was told to take expensive arthritis meds for a month & attend physical therapy twice a week for eight weeks at $75-$125 a pop. A month later nothing was better so the same orthopedist gave me a $400 cortisone shot.

vintage healthcare

Luckily, my parents stepped in and helped me out, but this was a problem that should have resolved itself within a month. After eight weeks of therapy, I was still limping but couldn’t afford treatment anymore. My parents literally asked if I could “just take an Aleve or something.” It took me a few days to understand that I wasn’t actually mad at THEM; they were helping me out as much as they could. I was mad at the SYSTEM.

Now this supposedly temporary ailment is something I live with almost constantly. If I’m super active, doing a lot of walking or even dancing, my hip will start aching and I’ll have to slow down. I’m 25 and often feel like I’m 80. I simply cannot afford to have this properly treated, and have instead become a huge fan of homeopathic remedies and illegally acquired pain medications.

It blows my mind that in other countries, emergency medical care is a given, and doctors are something you can just see whenever you want to. I would absolutely LOVE to have public health care that I could afford, and I would love to be able to be more pro-active and conscientious about my own health. It would literally HELP ME DANCE.

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Intern Emily – 19 – Canada, USA – Insured (government)

“The biggest problem in Canada is long lines.”

Canada has a healthcare system very similar to that of Australia’s. It’s publicly funded and offers all residents access to hospital/doctor/basic treatment, with variations among provinces as to how much has been set aside. In Quebec, we all have “compulsory” health insurance — the word sounds bad, but why wouldn’t anyone want to be able to show their Medicare card and get a doctor’s appointment?

“…why wouldn’t anyone want to be able to show their Medicare card and get a doctor’s appointment?”

Thankfully nothing serious has ever led me to test the system, but I hear good things about it and I’ve never had to worry. My Mom had cancer and my Dad says our Quebec health insurance did cover standard treatment, which is great ’cause most people couldn’t afford it otherwise. I had a free eye doctor ’til I turned 18, and though my parents have to pay for my glasses & contacts now, in the grand scheme of things they’re not complaining.

The biggest problem here is long lines. ‘Cause it’s free or prepaid, people go to the doctor for everything just ’cause they can.

For more serious cases obvs people with emergencies get to go first, but even people who don’t have life threatening injuries/illnesses will sometimes have to wait months for surgery. Though after reading the rest of the roundtable and listening to This American Life’s podcast about the health insurance industry, I’d rather wait in line.

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Laneia – 28 – Arizona, USA – Insured (via husband)

“As a mother, I’m constantly aware of my own mortality.”

Health care is a serious pain in my neck. As a mother, I’m constantly aware of my own mortality. I mean, if I die of cervical cancer [one of at least six diseases I'm convinced I have at any given moment because I might be a hypochondriac], there are two tiny people who will seriously miss me. Then they’ll grow up to be angry, bitter men, unable to truly love someone because of their gripping fear of abandonment. Right? Right. It’s sort of my job to stay alive. And in order to stay alive, I need preventative care, which requires health insurance. The health insurance I currently enjoy is provided to me through my husband. That’s right. I’m still married! On the one hand, this affords me health care. On the other hand, I’m still married.

“On the one hand, still being married affords me health care. On the other hand, I’m still married.”

I could probably obtain health care through a state-run program, but I haven’t looked into it. My partner’s employer does provide domestic partner benefits, but in order to receive them we have to actually be domestic partners [go figure!], which requires a filling out of forms and oh yes, neither of us can be married to someone else. What a lovely corner I’ve painted myself into! Happily, divorce is in my immediate future, so I’ll soon be swimming in the confusing sea of acquiring new health insurance.

Kids at the doctorI’ve never been without good health care, which is sort of just dumb luck on my part, and despite my hypochondria, I’m relatively healthy. I’ve never experienced the stress of being unable to afford a hospital bill, yet. I think it’s realistic to say that we’re all just one terrible accident or moment of fate away from being in that position, and that’s a pretty frightening thought.

The fact that quality health care is seen as a luxury in this country is reprehensible. It is a basic human right and should be provided to everyone, plain and simple. I still support a public option because I believe it will force the private health insurance industry to stop being such assholes and it would give me the opportunity to insure myself, as opposed to always being someone else’s dependent.

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Tess – 28- Indiana, USA – Insured (small business owner)

“Health insurance is by far the largest expense my company incurs.”

I’ve never gone a day without health insurance. I’ve either been covered under my parents or through my company. Currently, I technically pay out of pocket for my insurance. I own a small company and provide health insurance to my employees and myself via a group plan which is by far the largest expense my company incurs. I spend $40,000 a year to insure 8 people. The plan doesn’t include dental or vision and comes with a very small discount. I generally don’t use the insurance outside of my yearly trip to the lady doctor and yearly allergy shots.

However, this one time I almost died and racked up over two million dollars worth of hospital bills for which I only had to pay $10,000. I have no clue what would’ve happened to me had I been on a government plan or uninsured. I can’t even begin to think about that.

Thankfully I can afford to carry this coverage and will continue to pay the inflated price to keep it. I do think that the government should provide some type of plan to those who can’t afford it but not at the expense of quality care. The way the government currently provides insurance sucks. Yeah it’s better than nothing, but that shouldn’t be the case.

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Next:It’s exactly what the anti-universal-health-care people fearmonger you about — mediocre doctors, overcrowded clinics, impossible bureaucratic paperwork mazes to navigate for basic care and indignant overworked asshats on every “service” line.”

Stories from Carlytron, Crystal, Riese, Robin and Intern Daphne

Pages: 1 2 3 See entire article on one page

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49 Comments

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    Hi Tinkerbell, my friend proposed to his girlfriend by sticking the diamond ring inside a Build-A-Bear. Probs the most idiotic of all possible responses to this very insightful and upsetting look at the state of healthcare in the US, but just FYI.

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    natalie’s friend, i feel you. i’m moving from montreal to new york city in a month and i’m going to be uninsured for the first time in my life, too, and it’s fucking scary. i think i might be eligible for the po’ folks medicaid like riese is on, but i don’t even know. i’m a carpenter, too, so i’m going to be at a higher risk than if i was staying in the cushy legal world that i’m in now. what if i take a nail gun to the hand? what THEN?? i am nervous. i just can’t grasp the concept of everyone not being able to just walk into a hospital and get help without having to pay.

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    My uncle went to the doctor for like a sprained wrist or something. The doc gave him a shot and wrote him a prescription. When he got the insurance statement, it showed that they payed over $4000 bucks for a surgical procedure that he didn’t have. He tried to ask the doctor about it, and the doc brushed it off saying, “You aren’t paying for it anyway right?”. FUCKED UP.

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    Great, timely discussion. One of those things that maybe people aren’t paying enough attention to, but should be.

    I loved hearing everyone’s input based on their experiences. Personally, having grown up in a country with universal health care, and moving to a country without, the differences are HUGE. Of course, no system is perfect but the mere fact that I paid something like $500 for 3 months of health insurance between graduating college & getting a full time job is pretty indicative that change is needed.

    Now when you consider that last time I was in Australia I was able to go to the Doctors and just by virtue of being an Australian citizen, got immediate attention without having to think twice about being charged an obscene amount of money – says something about the merits of health care reform.

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    After graduating in June and starting a full-time job I’m no longer covered by my parents, but have my own plan through work.
    I’ll admit that I’m kind of naive when it comes to this stuff because growing up in Canada, I’ve been afforded the luxury of being a bit of a hypochondriac and have taken things for granted, but now that I’m older and wiser (ha!) and actually working in healthcare, I’m far more appreciative of the system we have.

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    Right now I have ridiculously expensive COBRA that runs out in December and somehow still doesnt cover everything. I have pretty bad asthma/allergies and when I have to go in for new meds it doesn’t count as my yearly physical or ‘well woman’ exam or anything. There is this ‘test’ called a Peak Flow where you breathe into a cardboard tube to make a little plastic marker move. I own one of these little plastic contraptions. I could probably make on of these things. It takes a few seconds for me to puff out the air to make the marker move and for the doctor to write the number down and throw the mouthpiece away. This gets billed to me as a $78 ‘Expired Gas’ exam. Yep. On top of the cost of seeing the doctor for something outside of ‘the norm.’ At the same time, I recently went to the ER because I was really sick, and in the end I only had to pay ~$400 of the ~$3000… But since I’m paying out the ass for this COBRA, I guess it’s still like I paid that $3000, just in prepaid installments. I’m just going to move to Canada or Spain where I can get married AND have reasonable health insurance.

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    About a month ago I took my girlfriend to the doctor for back pain. We were both expecting her to get pain meds and go home. An emergency room visit, 4 days in the hospital and 2 surgeries later the various bills have just started to roll in. She has insurance that we pay for ourselves because she isn’t allowed on my insurance at work and her job doesn’t offer benefits.

    The sobering thing was that after she was released the insurance company sent over a handy little cheat sheet of the many thousands of dollars in bills we can expect along with a breakdown of how much it WOULD have cost without insurance. We do complain about the fact that her insurance comes out of our pocket, but if we didn’t have it we would have gone seriously broke.

    Also, Robin, if you can, please get health insurance. If you’d insure your car you should insure your body. It’s way more important than a piece of metal.

    I read Intern Daphne’s segment in a Belgium accent and I don’t even know what a Belgium person sounds like.

    Boys!
    “Fire brigade” English people are adorable.

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    I live in the UK at the moment and I have been working for a long time towards relocating to the US. The US healthcare system terrifies me and is one of the reasons I have yet to move.
    I am incredibly accident prone (I once hit a badger on a motorbike and the badger ran off fine..I was not quite so fine..also, who the fuck hits a badger on a motorbike??)so the thought of thousands of dollars of medical bills makes me want to cry into my cake. Which is wrong because cake is a happy event!

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      Yeah I know what you mean – I live in Scotland, but fell in love with DC this summer and really want to go live there at some point, but the only thing that makes me doubt if I should is the healthcare problem. Also if I did go be an expat, and then had kids I would move back to the UK straightaway where the NHS would be there to take care of them if needed.
      I just don’t get all why all these people are railing against extending healthcare. How can they be so angry about the thought of more people being able to see a doctor? Why is that even a viable opinion? It blows my mind.
      Also – at these town halls/in the press I keep seeing bad things said about the nhs, but I don’t know anyone whos ever had a bad experience. My doctor is ace, and any time I’ve been to A&E the staff have been amazing, despite the fact that they’re all underpaid and stressed out by ridiculous targets. I’m terrified about what will happen if the Conservatives win the next election though, as their plan is to cut spending by 10% across the board. It won’t affect me in Scotland, but I worry about my grandparents in England who pretty much live at the doctors these days!
      I feel like Obama is totally screwing up his shot at making this even a wee bit better, and he really needs to man up against the republicans/crazies/pharma companies!

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    Pretty sure I’m trying to get a full body scan before I graduate….just in case. beacause REALLY it’s only a matter of time before I fall down a flight of stairs or have a seizure, and I bet it will happen after I become uninsured. ANY kind of a public option would be good…people shouldn’t have to debate whether or not to get help because they can’t afford it…ridiculous!

    I worked in a financial billing office for a hospital in philly for 3 summers. I wrote off like a bajillion of dollars. everything is so expensive & complicated ahh!

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    So a huge issue with me right now is I want to have a baby. My insurance doesn’t cover the IUI procedure I need, but that’s fine. Now when the baby comes out, I could quit my job and my gf and I could live on one income (and our 2nd part time job), but then I wouldn’t have healthcare. So I’ll have to go on hers. Nope, they won’t put the baby on hers cuz it won’t be “her baby”, and it would cost like $700+ a month to do so. There goes our 1 income living. I could be put on state medical like Riese because I would legally be single and have a baby, but then I’d have to stay single and my gf would have no rights to the baby, or to see me in the hospital in a tragedy, etc. And will I have to say we don’t live together if I want this state assistance? Who knows. This is so frightening for me and I have no idea what route to take and I have no one to talk to about it. Do I need to pay a lawyer too, besides the doctor and the sperm bank and the ovulation kits and the shipping fees and the insemination fees and the hospital fees? Straights are lucky. I cringe when I think of all the wasted sperm and unwanted pregnancies…all of it FREE!

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    This is a very serious topic but I appreciate that levity that Tinkerbell brought to the table. Thank you Tinkerbell and good luck with that restuffing. Now, if only our country’s health care policies were are compassionate as the people at Build-a-bear.

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    So I wanted to share this story…

    It was May and my first weekend living in Chicago. I was enjoying a drink with my employer when my cell phone rang. It was my sister so I just ignored it, planning on calling her back later. However she called me back three more times. When I answered she said two words that deafened me to the rest of our conversation. “Mike died.” Mike was my best friend. Our mothers taught together and raised their families on the same block. “What?” I asked her over and over again. She repeated herself. “You keep saying that but I don’t know what you mean.” It wasn’t that I didn’t understand the words. I knew who mike was. I knew what death was. But those words paired together made about as much sense as a foreign language. I got off the phone and I actually started laughing. Lola, with whom I had been drinking, asked me what was so funny. I just looked at her and laughed. I stopped as soon as I saw the damp blot a tear had just made on my t-shirt. I looked up at her and I tried to speak but instead I choked. Then I threw up.
    Mike had been in a great deal of physical pain for at least 6 years, maybe longer. When he was 22, a doctor diagnosed him with a condition called avascular necrosis of the hip. That means the blood supply to his right hip was dying and the left hip wasn’t much better. He was told then that he’d eventually need to have his hip replaced, but “until he was old enough” he’d have to get by on strong pain medicine. That’s how he first became addicted to vicodan. When that happened, his doctor sent him to a methadone clinic. All this happened, including the original diagnosis and treatment, without his family’s knowledge, because Mike was an adult, and I guess he was trying to deal with his issues on his own at first. When sharing this story with me, his Mom told me that if Mike had asked either of his parents what they thought, they’d have probably suggested going to a bone specialist for a second opinion–it was just a GP who put him on the vicodan. This was the only doctor he was able to see at the public clinic and without insurance he didn’t have the option of a second opinion. He knew his condition would break his family financially and he didn’t want to live with his physical pain as well as guilt. He never went to anyone for help until he was addicted to heroin, hated the mess he’d gotten himself in and needed help getting clean. Mike was brilliant. He knew the dangers of drugs like heroine. He was a normal guy and got into his share of teenage trouble, but he was not the “type” to become an addict. He certainly never meant to die.

    Since his death his family has looked up possible courses of treatment for “avascular necrosis” on line, and according to the Mayo Clinic site, the best treatment is to put the patient on CRUTCHES and not use drugs at all, and sometimes the problem goes away. But once Mike got into the drug dependency loop, he went from vicodan to methadone to heroin–to maintenance methadone. Mike had gone off Methadone a while ago because he said it caused arthritis- like pain in his joints, and he already had enough pain and he didn’t need any more. His doctor had said “OK, see if you can do it,” and he did fine until early May when he tripped on his sister’s old back steps and fell and hit his hip. He could barely walk at first. He called his doctor but couldn’t get in to see his regular physician at the clinic, so had to make an appointment with someone else. We don’t know what happened, but we think whoever Mike saw didn’t read his chart well enough or possibly didn’t have his chart to know that he was a recovering addict because he should never have been given an addictive drug like oxycodone. Mike must have been in too much pain to have the mental strength to refuse it. And he was in so much pain he kept taking too much of the medicine. The morning he died, he got up early to talk to his dad about calling a pain clinic. They had already talked about it and he was planning to call that day. He just didn’t live to make the call. Apparently the pain must have been especially bad that morning and he panicked and finished what was left of his medicine. He died on May 22 and the prescription was supposed to last until June 5th
    A letter I received from his mother a few weeks ago read, “I know it isn’t right that he’s dead, Jordan, and I’m so sorry. He needed health insurance, and some better way to cope with his pain, but part of the problem was that he had a preexisting condition, which no insurance plan would cover. If he just could have held on until the national health insurance plan passed, he might have been OK. He was counting on that to be his ticket out of pain, because then he might have been able to get his hip replaced. I know that his death was an accident. He did not plan to die. He was just tired of hurting so much. He ran out of time.”
    So he’s gone now. And there is nothing I can do about that. But I can tell his story. Without knowing him I can see how it would be easy to point fingers. His story is exactly the kind you don’t want to hear. Drug addicts would abuse the system. Hard working Americans would have to pay for reckless abuse of prescriptions. However, underneath the surface tale is another layer of hidden truth. The truth that the heath care system failed him years ago, has failed all of us who were close to him. They have stolen from me for twenty three years. And you know what, steal my money. It’s fine. But not him. Something has to change.

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      wow. i don’t know what to say, i’m in tears. i’m so sorry for your loss. so heartbreaking. thank you for sharing mike’s story. it’s stories like his – and there are so many tragic stories – that hopefully will make people see that this is bigger than politics. these are people’s lives. people’s families. my thoughts are with you, and with mike’s family and friends.

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      Jordan- The health care system failed him years ago, you are right, when he was prescribed the Vicodin for something that could have been potentially treated without any medication at all. Seems like it just kept right on failing him as time went by as well.. I am very sorry for your loss, thanks for sharing this story.

      Something definitely has to change.

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    This is the kind of story people need to read to get this idea out of their heads that “the only people who need national health care are lazy people”. Someone said that on my facebook today. I responded, “They aren’t all lazy and lying around. They are serving you dinner at your fav restaurant and folding your new fucking GAP shirt.”

    I feel like (and I could be wrong) it’s the rich people who think it’s a bad idea? No?

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      I got into a Facebook argument this evening with a guy who claimed that nobody in this country dies due to lack of health care and that if you don’t have health insurance and that all you have to do is go to the ER and all your medical problems will be solved. Um, WHAT?!

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    This may seem like a gigantic tangent, but in many ways the root of the problem is that we are living in opposition to what our bodies were designed to do. We’re expected to work 60 hours a week, sleep 4 hours a night, seem happy and together all the time, not get too stressed out despite 600 stressors, pay for our own g-dforsaken health care, have ten babies and two jobs and keep 50 friendships going strong. We could save a lot of money on addiction and mental health treatment if we all had access to fresh food, a non-stressful work environment, clean air, good schools, time to read & relax, eight hours of sleep a night and people who worked with us instead of constantly trying to eat us alive while drilling us to keep up with the Joneses. There’s no work-life balance, or school-life balance, there’s no focus on how to make people’s lives better and healthier, it’s just on how to be more successful and get more things. And why do we want these things — this wealth & power? So that we can afford to take a fucking vacation. AMERICA!

    ETA: I HAVE A LINK

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      This reminds me of a report that was done on women on campus when I was in college by the “Women’s Initiative”. They ended up coining the term (which I’m sure has been used in the past), “effortless perfection” to describe what women at my university tried to portray and achieve in their daily lives. Will get into this more tomorrow probably. If not, google it, it was really interesting and totally rocked the mindset of the school (though not much ended up changing).

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    oh my god, i have so many feelings about this. as an australian pharmacist-to-be, i can tell you, people here don’t get how good they’ve got it. please stop bitching at me about the price of your medication. no one seems to appreciate that the medication they’re paying $5.30 or $32.90 for is actually sometimes worth hundreds or thousands.

    also, i went to class yesterday (i know, right?!) and learnt that the Australian Govt only spent 0.8% of their gross profit on medications in 2008, while the US govt spent 2%? I don’t get it, where is it going?

    also, re: homeopathic medications. I’m a bit skeptical. probs because I’ve been taught in a way that’s a bit bias, but i don’t get how a substance can “leave it’s imprint” on the surrounding solution once it’s been diluted, even if it WAS shaken vigorously. it’s like paying for water! but if it works, then yay. the thing with complementary &/ alternative medications is that there isn’t enough evidence to back them up w/r/t safety & efficacy and if they do/don’t interact with other things and it stresses me out.

    Also, there’s this massive misconception that because something’s “natural” rather than a chemical or drug that it can’t do any harm. But if something is strong enough to have a therapeutic/beneficial affect then it too has the potential to have side effects etc.

    um. that was a bit off topic. *calms down*

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    In 2002, my partner and I went to Portugal with our son who was then 10 months old. While there, he developed an incredibly high fever and we had to take him to the emergency room. They did an incredibly thorough exam (including urinalysis, xrays, etc.) They determined that it was viral and sent us to pay our bill. The total came to $50. We had that in cash. There is no way that we could walk into any hospital here in the US and pay cash and I say that as a white professional who is solidly middle-class with privilege out the wazoo. If I can’t do it, who can?

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    as a health professional i have a lot of feelings about this, and as an australian i feel extremely lucky! we still have increasing issues with under-resourcing and under-staffing esp in public hospitals, to the point where outcomes are starting to be affected. but, i think the system here in general works well, maybe we need more hospitals and people to work in them and more streamlined bureaucracy, but the right of every citizen to health care thankfully isn’t an issue.

    but what exactly is hampering the US in being able to put in place universal health care? i’m a bit unclear on this. is it politics – are there certain groups of people unwilling to pay for the health of others? is money an issue regarding the cost of overhauling the system? (because the US outspends every other country!!) is the system different in every state? are doctors just allowed to charge whatever they please? even in government hospitals, is there a set schedule of fees?

    in the private sector of my profession (dental) we set our own fees, patients either pay in full or pay a ‘gap’ not covered by (affordable) insurance. but public clinics are free or greatly subsidised; usually you must fulfill low income criteria but even if you don’t you can pay. the only issue is long long waiting times, up to several years for comprehensive treatment in some regional areas, due in part to workforce shortage, because the public system just cannot pay as well as the private system does. and so this is where it starts to get more and more expensive, when chronic conditions fester and then start to explode. and which country but the US is the poster child for chronic disease waiting to detonate.

    i guess the US first needs to figure out where all the money is going?? why is it so expensive compared to elsewhere in the world? maybe there’s a huge bubble somewhere waiting to be popped..

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    also, this roundtable is incredible. i think the “ignorance” issue also needs to be addressed as we talk about reform. based on a lot of these personal accounts and my own experience, people don’t really come to understand what is/is not covered by their insurance plans (or lack thereof) UNTIL some sort of disaster strikes. ask most recent grads and first-time employees what all those capital letters in their health plans “mean” and you’ll be hard-pressed to find one who could answer. knowledge is power. so it makes sense that under our current “for profit” health care system, companies will create complex and confusing language to maintain control (and $$$). my girlfriend, by the way, USED to work for a health insurance company and boy does she has some stories to tell!!! A single, simple change in the wording on an insurance form can mean the difference between coverage/no coverage. I’ll have to see if she will write something for this board but, in a nutshell, it’s a fuckin’ mess.

    even if the public option is sacrificed by the dems to get the reform passed, the government MUST do something by way of making health care and insurance information more accessible.

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      oh man, I know I would love to hear a story or two your girlfriend could share! For real.
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      Also, thats totally true: that under our current health care system, companies will create complex and confusing language to maintain control and money.
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      Anger.

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    I’ve got to say, I’ve watched this debate (overall, not just here) with interest, and sometimes wonder what planet the commentators are from!

    Statistically, the US spends a larger proportion of its GDP on healthcare than other first world nations, for poorer outcomes. It’s not difficult to understand!

    The for-profit motive has resulted in a system which is very good at doing procedures and very expensive (as the procedures are expensive), but not actually good at “healthcare” which requires a focus on patient health rather than profit.

    Compare simple statistics – for example, life expectancy. The US is 35th. By comparison, the UK is 25th, Canada is 6th and Australia is 5th.

    What’s the difference between the US and Canada? Well, probably not as much as the Canadians would like to think :) But for some strange reason, being born on the other side of that little line means you will live, on average, 3 years longer. So Canadians who are irritated by the lies being told about their system in the current US debate don’t need to worry… they’ll get the last laugh :D

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    I’ve only really skimmed this cause I’m going out in a minute but one of the strongest arguments for health insurance became clear in a project I had to do recently. It was all about the rates of poverty compared to the rates of cardiovascular diseases. In a place like Merthyr (old industrial town, that’s a bit of a shit hole) there is nearly triple the amount of cardiovascular diseases (and I’m almost certain it’s the same with most diseases) compared to a town that is wealthy. So really it’s the people who can’t pay for health insurance that need it the most.

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    This is an issue very near and dear to my heart, so I’ll apologize in advance for the rant that’s about to happen…

    I am 24 and live in the US. I’m a state worker (a park ranger to be exact), and I don’t have insurance. It was always something that somewhat worried me, but I thought “I’m young and healthy; I’ll be fine.” This thought process came to an abrupt end almost a year ago.

    I got very sick and finally forced myself to see a doctor. The doctor charged me over $700 and told me that I had leukemia. He referred me to a hematologist/oncologist, and after about $2000 I found out that I actually have aplastic anemia instead, which is a very rare blood disorder.

    The only way to treat it is to let my body deteriorate, do several rounds of chemo to knock out my immune system, have a bone marrow transplant, and spend about 6 months in a very sterile hospital room (bubble boy jokes, GO!). If, and that’s a big if, I survive all that, I’ll have to come up with a way to pay for the millions (yes, MILLIONS) of dollars in medical bills. Why even bother living?

    Clearly the system is FUCKED UP.

    I also have the, uh, privilege of viewing the healthcare crisis from a different angle. I’m a volunteer EMT as well. We have a program where a resident pays $50 per year and gets free ambulance services. I can’t tell you the number of times I’ve quickly filled out a sheet, put the wrong date on it, and collected everyone’s lunch money to cover the $50.

    A woman’s number one concern while a DEAD FUCKING BABY is hanging out of her in a toilet shouldn’t be “how am I going to pay for this?”

    I shouldn’t have to wrestle a gun away from a diabetic man who needs his leg amputated because he feels that killing himself is a better option than possibly leaving his kids to pay his medical bills.

    I could go on and on and on. I’ve already ranted too much. The health care/insurance situation in this country is absurd.

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    I live in BC now, but have lived all across Canada. I don’t want to say too much on health care costs comparisons, cuz it’s just gonna make people groan. I’ve always been on the preventative side and just lucky because I lived for quite a while with no coverage, self-employed, couch surfing, living in a van, working seasonal outdoors – and just luckily never had any big probs medically.

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    since i’m a college student who has always been insured under my parents, i fall into the “ignorant and privileged” category. this was definitely helpful and makes me want to know more [starting with emily's link to this american life].

    all i know right now is that last week, my roommate [uninsured] was hit by a taxi while she was on her bike and is going to owe the hospital an inordinate amount of money. the most confusing thing about it was how much the hospital was forced to act like a business and not as a caregiver. like how they would only admit her to the hospital if she agreed to go in an ambulance [$500] because they didn’t want to be held responsible for anything that might happen if someone took her in a car. eugh.

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    Great Article!
    I can totally relate. I graduated in May with a Ph.D. and still cannot find a job. So I am unemployed minus the unemployment ‘benefits’.

    So with out any income coming in I have to pay for insurance out of pocket…an empty pocket. And now bill collectors are calling for my student loans.

    Praying I don’t get sick. #nevergotogradschool

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    I didn’t really appreciate how fucked up the system is until this past year. Between my mother spending one night in the hospital (for chest pain they never found a source of but just ruled out heart trouble) and having to pay half her income on bills for the next couple of years and experiencing European healthcare, I just want to SCREAM. How do people not see health as a HUMAN RIGHT?

    I had a throat infection last November and went to the doctor with a note I’d written saying “I have no voice. May I have an appointment, please?” and managed to whisper “American” and point at the part of my ID that said I was on exchange when asked why I didn’t have my own GP. I was given an appointment for the same afternoon. I was asked for my address and phone number and that was it. No forms, no payment. I got a prescription for meds – 3 kinds – that totaled about 10Euro. Why can’t America do this?

    And talking to my English, Italian and French friends, they can’t fathom what I grew up accepting – that if you can’t afford it you simply don’t get treatment. Not one person I’ve met has said, oh I would rather just pay and have the American system. NO ONE. I want every person who opposes reform to have to come over here and talk to Europeans about their healthcare one on one and then see if they can justify not changing things. Parents SHOULD NOT have to hold benefit concerts to pay for their child’s cancer treatment.

    But as Emily mentioned with Canada, the system does get a little over-used here. A co-worker had a cold and everyone in the department kept insisting she see a doctor even though she’d already got non-prescription meds for the symptoms.

    And Riese and Brooke are spot on about needing lifestyle changes and education.

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