In the three days since I posted my surprisingly popular Breaking Bad: Anywhere But America Edition comic strip, and since Michael Moore very kindly retweeted both the comic and my unscientific poll on socialized health care, my blog and Twitter have become venues for discussions of the American health care system and its alternatives.
And I have a confession to make: I’m not informed enough to really engage in this debate. I mean, I know the basics, and I’m suddenly motivated to get much deeper into the policy, but even though I’m a bit of a policy wonk, I know a lot less about health care policy than I do about, say, Constitutional law and related jurisprudence.
What I can do is share my own personal experiences with health care in the US—and [pullquote]if you are kind enough to share your own experiences, especially as they contrast with my own, we might really produce something illustrative and useful.[/pullquote] So here we go:
For starters, when I was 15 I fractured a vertebra in my lumbar spine. Never mind how; the story involves high school gym and a tall set of bleachers and a massive moment of personal stupidity. Luckily my dad had a job with good health insurance, and we were able to afford the ensuing hospitalization, the back brace I had to wear for a few months, and the physical therapy. Though looking back now, it may very well have put my family on the verge of bankruptcy, and my parents never told me—though I doubt it.
While that fracture healed and has impacted my life since age 15 almost not at all, my orthopedist did explain that due to the slight curve my spine healed into, there was a chance—somewhere between 5 percent and fifty percent, he helpfully volunteered—that I would lose the use of my legs at some point before I died.
Now here’s the important bit: He also advised me that, from that day on, I had to have health insurance every day of my life, because otherwise my broken spine would become a pre-existing condition, and health insurance companies would refuse to pay a penny toward any health issues that developed from it—including any future paralysis, physical therapy, wheelchairs, and so on. As long as I maintained coverage without any momentary lapse for the rest of my life, my back injury would always be covered.
I will point out here that the Affordable Care Act (AKA “Obamacare”) made it illegal for health insurance companies to refuse to cover pre-existing conditions. This is one of those few important ways in which the ACA really did improve American health care. Now, if for any reason my health insurance were to lapse for even a day, I wouldn’t have to worry for the rest of my life that my spine was a ticking financial time bomb—I can stick to worrying that it might someday take my legs away.
In 2006, when I was twenty-seven years old, I was hospitalized in Allentown, PA for acute appendicitis. I was once again lucky in that I noticed the problem early, and there were no complications from the surgery. I was hospitalized overnight, stayed an extra day for recovery, and went on my merry way.
For the next three years, my health insurance company and the hospital into which I’d been admitted argued over exactly how much my two-night stay should cost, and who was responsible to pay it. During that time, I would periodically receive invoices from the hospital for roughly $19,000. Sometimes I would get harassing phone calls from collectors, threatening legal action if I didn’t pay the bill. Just for perspective, my net worth at the time (accounting for student loans and payments on the car I needed to get back and forth to work) amounted to approximately negative $11 thousand.
When I would phone my health insurance company (which soon became my former insurance company thanks to a job change, though the billing issue continued) they would advise me that this was just part of the negotiation process, that they were going to pay the bill and I wasn’t liable, but they were negotiating for a lower price on certain services and in the meantime the hospital was harassing me, but I shouldn’t worry and I shouldn’t pay. This went on for three years, including a period of time when I changed my cell phone number, and the hospital collection agents instead harassed my parents at my old home number.
This past April, my girlfriend, Liz, was at the finish line of the Boston Marathon when two bombs exploded. She wasn’t close enough to be injured, but she was close enough to feel the blasts and, having just completed a marathon, to join a crowd of people screaming and sprinting for what they believed were their lives—the common belief at the finish line, as she has explained, was that the explosions were bombs, and that there were probably more of them.
Along with being a really excellent personal trainer and running coach (plug, plug) Liz is an actress and gets her health insurance from the Screen Actor’s Guild, but because she only barely qualifies for their most basic plan, her coverage does not include mental health care*. The Boston Athletic Association, which did a pretty top-notch job of dealing with a horrific and unexpected end to their annual celebration, did offer free mental health consultations to runners and spectators impacted by the bombings. After a week or two unable to sleep through the night, Liz phoned them. They told her she had all the symptoms of Post-Traumatic Stress Disorder, and that she should wait three months and call back if she was still having trouble.
In general, I should note that I have been very fortunate with both my health and my health insurance. I have been lucky to live most of my life as a privileged upper-middle class white male, which means I’m automatically better off than about 90 percent of Americans. I was covered under my parents’ plan throughout my childhood and through college, and I’ve had better-than-average plans through my employer for my adult life. I’ve been lucky not to have many serious health problems or illnesses. When I needed PT in the mid-2000s because of muscle problems stemming from my back injury, my insurance paid for it. When I needed rhinoplasty a few years back because of breathing problems, my insurance paid for it. And when I went through a period of major depression a year or so later and desperately needed a therapist, my insurance paid for that—well, mostly. I was on the hook for $35 a session, which I realize is still more than a lot of people could afford.
But as I said, I’m lucky. I lived most of that time in Pennsylvania, which has better regulations on insurance companies than a good bit of the country. I also got lucky to find several very good doctors, who helped me navigate the nebulous world of insurance billing, and often wrote prescriptions in a way that gave me the best chance at coverage. I could just have easily been victimized by crooked doctors who were interested in helping my insurance company make a profit, and maybe getting a nice year-end bonus or a free trip to the Caribbean.
So that’s a quick summary of my major experiences with health care in the United States. Now here’s what I’d ask you to do, if you’re willing:
If you’ve had health problems similar to my own, would you share what your own experiences were in dealing with doctors, hospitals, and insurance companies? Especially if you live in a different country, a different state, or a different economic situation than I’ve experienced myself. There are a lot of readers coming in from Europe right now, and I’d love to know what happens in Europe if you break your back, if you require emergency surgery, or if you’re suffering PTSD or similar mental illness.
I think if we can show some of the contrast of experiences, we might really be onto something. After all, we’re all human, and our bodies all work pretty much the same way in terms of illness and injury. What differs are the political and economic systems in which we find ourselves.