I've really debated writing this. I've debated how opaque to be. The truth is I think there are too many things that people don't talk about, and my humble opinion is that makes us more alone. Too many people are looking for jobs, out of work, lawsuits, single, bad marriages, abused, bankrupt, sexually harassed, bullied, or have scary medical diagnoses. So I'm just going to be way too open about it. I am however doing this for a very particular reason. It's not sympathy. It's not awareness of disease. It's not validation. The completely honest truth is that if all is timed well, this will post shortly before the American presidential election. I have strong opinions about many things (shocker I know). Any one who really knows me can guess what they are... but this is the issue that literally made me leave a job I loved. It's the issue that made me, in the end, take a job so far from home. Far from the people and places I love.
**note I'm writing this for the Americans and non-Americans for different reasons so be patient if something seems mundane to you**
At the time I'm writing this, they are unsure if I have cervical cancer, the biopsies aren't 100% clear. And for kicks some added uterine problems as well. Although I hate having to deal with a new medical system, and all on my own, I am not sad that it happened now. Why you ask? Ahhhh.... the American health insurance system. I paid $300 a month for health insurance that had a $10,000 gap/deductible. It covered no preventative health care before that gap. I couldn't get cheaper insurance privately, and because I worked "part-time" (31 hours a week) my workplace did not cover insurance. To put it in perspective that $300 was 15% of my take home pay. So I never went to the doctor, and when I did it was to clinics like Planned Parenthood where I saw a different nurse practitioner every time and never got more than minimum. So I always dealt with things the best I could.
So to my fellow Americans I want you to imagine how this would play out with your HMOs and PPOs. How long would you fight with them? How long would you be getting bills for after some event? How much would they cost? How long would it take before insurance would reimburse you? How many hours of your life would you wait on hold? Would they even approve treatment? If you're privately insured would they just kick you off? What about renewal next year, what would happen to your premiums? Do you feel your stress just rising thinking about it? What if you lost your job in the middle of cancer treatment? People, our system is jacked up. I am a doctor for crap's sake. I couldn't even afford to go to one of me! There were times I did my own blood smears and lymph node aspirates (I don't recommend this).
So instead, imagine this. I go to the doctor. A specialist that I got an appointment with inside a month (would have been sooner if my work schedule didn't suck). I sit down and spend 45 minutes, dressed in an office, not in a flappy gown, discussing history, signs, and symptoms with the doctor, not a nurse, not a nurse practitioner. Forty-five freakin minutes face to face with a doctor's undivided attention. They then do an exam, always with two people in the room, no cop out on controlling costs. I get blood drawn the next day. Ultrasounds done 3 days later (the next business day). Then get this.... I get reimbursed in cash from insurance that afternoon. You read that right. Cash. No arguments. There are set fee schedules that from what I can tell are clear and used universally. Biopsies done a week from original appointment. Reimbursed the next day as well. Surgery scheduled 3 weeks out. I will have to pay out of pocket for some of it, but then be reimbursed for much of it as soon as I can submit it. Results a week later. Does this sound too good to be true? No. It is completely doable. But it means Americans have to stop being utterly selfish, short-sighted, and judgmental.
We have a chance to join virtually every other first world nation. We like to think of ourselves as leaders, so why the ever loving F are we so against the ability of people to have access to medical care? I have so many issues with so many of our politicians. None of them are great, but some of them do want the best for the people. Not the 47%. Not the ones who are legitimately raped. Not the 1%. How can we possibly be a country that people want to emulate if we have people dying of preventable disease and going bankrupt while they have medical insurance?!?!? And don't you dare say if they just got a job they would have insurance. That is so, so, so not true. I have degrees, too many of them. I had jobs, too many of them. I worked my hours, too many of them sometimes. I should have been able to go the doctor. I shouldn't have had to move to another continent to afford to live. This isn't about Republican or Democrat. This isn't about black or white. And it's not about the rich and poor. People in the "greatest nation" shouldn't die because they can't afford to even see a doctor.
For kicks I've posted a table below of what was charged BEFORE insurance. I've also collected prices from friends of costs in the USA without insurance.
Procedure Charged US Charges
First Visit 210 (45 min with Dr.) 200-400 (10 min NP)
Blood work w/ TSH 92.55 200-500
Ultrasound (2 areas) 203 600 (this was cost to a friend on their
benevolance fund) -1200
Second Visit/biopsies 380 400-1600
Uterine biopsies/surgeon 1200 1800-5000
Hospital fees ???
Anesthesia 803 1000-5000
Pathology ???
Total Cost less than 3000 in the private system anywhere from 6,000-22,000
would have been less on the public
So for those undecided, if I was your daughter or sister, which system would you have preferred for me? The one where I got the care I needed or the one where only the privileged or lucky deserve medical care? If this had happened to me in the States I would have either gone bankrupt (but can't discharge those student loans :/) or had to borrow more than a third of what I made in a year and literally spent years and years digging out of either of those holes. If I go back to the States I will be working for small businesses again. Just because I don't work for the government or corporate America does not mean I should have less ability to have access to basic medical care. And now I have preexisting conditions, won't that be fun?
And no matter what, for the love of dancing Buddha, go vote. It's another thing Australians find odd about us. Voting is compulsory here. Don't you dare whinge about the results if you don't vote!
and yes I'd doing fine now :)
You should move back and go into politics. You have lived it can tell what has happened to you. I am going through insurance nightmares now.
ReplyDeleteI have a masters degree and I have worked consistently--no gaps--since I was 15 years old. I am now 44 years old. I am recognized by others in my field as one of the best in my industry. In almost 30 years of work experience, 25 of those as a recognized "professional," I have had exactly ONE job that provided health insurance. I entered the professional workforce just as American corporations were discovering how much more profit they could turn by hiring "long-term contract" employees for whom they didn't have to provide benefits. Today I'm a freelancer. The only reason I can do what I do is that my husband is lucky enough that his giant corporate employer hired him as an "employee" rather than a "contractor."
ReplyDeleteSo yeah. I hear you about people who say "if they had a job they'd have insurance." It's simply not the case anymore.
Kelly, you made some very good points very clearly. I was in OZ when the health care system was instituted. Even though we were US Navy, each person in the country legally was immediately placed in the system and able to access it.
ReplyDeleteThe US system needs such a massive overhaul. Eliminating the legalized gambling syndicates known as health insurance companies would save darned neaar the whole system. Because of it, the health care professionals are trying to find ways to work around the insurance companies instead of concentrating on the patient's needs.
I'm so glad you are doing fine.
Glad you were smart enough to be where you are now. Myself, I worked from 15 and on, and never had health insurance (except for one semester where college required it) till I became debilitated by a disease that I had no part in bringing on. It requires regular (read-- expensive!) visits to rheumatologists, and most of those, in my area, do not take Medicaid.
ReplyDeleteI hear ya!