Wednesday, November 6, 2013

American healthcare, encounter 1 in detail

I have been meaning to take Max for a checkup/shots since our insurance paperwork was handed in sometime in September, however I’ve been putting it off. Why? Because the entire process, the system here in the US has seemed so complicated to me, and even just starting to make sense of it has been too daunting. It’s not just that the insurance works so differently from anywhere else, but finding a good doctor when there’s no centralized system or database, and you don’t know anyone else with your insurance or who is part of your network, is difficult.

Yesterday when we woke up though, I had no choice. Max’ hangnail from the other day had got infected, and with our recent struggle with staph infections fresh in mind, I didn’t want to take any chances. His fingertip wasn’t just a little red around his nail, but there was a large pus sack surrounding the entire cuticle. His finger was red, sore and swollen.

I found a list on the Emory website of affiliated providers, and started calling around. It turns out the list was outdated, and/or most doctors on there wouldn’t take in any new patients at the moment, and especially not on the same day. Eventually I found one, 22 miles from our house, however, apart from the distance, it turned out this was quite lucky: not only was this doctor’s credentials quite impressive, but she was also from the Middle East originally and spoke Arabic. Not that I would need or even like to speak Arabic to her, but because most of Max’ medical papers are in Arabic, which has turned out to be quite a turn off for people here in the US who have had to deal with it, and now I wouldn’t have to translate or explain anything.

Four filled out forms later, a lot of waiting (while we were waiting, Max was sucking on his fingers, and managed to break the pus sack open with his new sharp teeth, resulting in a very disgusting moment, let me tell you: pus all around and in his mouth – eww!), and a successful examination (the doctor prescribed antibiotics against the staph infection) I finally arrived at the check-out desk, which is what I had been fearing the most: I had no idea what it was going to cost. It could be $20, or it could be $300. Our insurance only starts paying for part of our costs after we’ve reached our deductible, which is $2,700, so I knew that whatever the amount, I would have to pay for it in full. It turns out the price was somewhere in between what I had expected: $90 for the actual doctor’s visit, plus a $35 one time paperwork fee. It didn’t ruin us financially, but it was just enough to hurt. Good news is that the antibiotics was free at Publix (grocery store) – how is THAT possible?

I have lived in several countries. In Belgium we paid about $100/year for insurance, and everything was paid for – there was no deductible, no reimbursement amount. We could go to any doctor we wanted, and she was available to us 24/7 – or someone from her office. (No, our taxes were not a lot higher than our US taxes.) In Lebanon our insurance is quite expensive (but yes, our taxes are not as high): we pay around $300/month which is only 50% and our employer pays the rest, but there too, everything is covered and there is no deductible. The cost of the insurance is not proportionate to any normal health care related costs since it’s relatively cheap there (an ultrasound costs about $80), but if something really does happen to you and you need surgery, for example, you get your money’s worth.

I mean, what kind of idea is that – a deductible - anyways? “You will pay us thousands of dollars every year, but only if absolute disaster strikes and your healthcare costs - which are totally inflated, by the way – exceed a ridiculously high amount of money, which will already lead you to financial ruin, only then will we pay PART of your costs.” That really shouldn’t be called ‘healthcare,’ but ‘disaster aid’ or something like that.

Anyways. I’m hoping we can all stay healthy for the rest of our time here in the US. That way - if we only have to pay for the insurance and not ALSO for our health care - we'll only feel halfway ripped off. Or not, I guess. Sigh.

And next time we come here, I will make sure to bring more prescription drugs, so that we don’t have to go to a doctor when we know what treatment is needed anyways.

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