Tag Archives: health insurance

Checks and big balances

If the stubs on my book are anything to go by, in the three years preceding my move to the US, I think I probably wrote maybe one chequecheck. And even then I can’t be sure that I wasn’t just in desperate need of a piece of paper to write a phone number or address on. From the big stores to Mr & Mrs Badcrumble at the farm shop, everybody takes plastic and the cheque is practically obsolescent.

Of course, plastic is equally omnipresent here in the US. The banks even discourage check use by charging customers for their check books – a practice that seems to me to be akin to giving a friend an expensive birthday present and him subsequently invoicing you for the time taken to unwrap it. Yet despite this, I seem to go through check books like a particularly wealthy philanthropist with a peculiar writing fetish.

Finally I’ve come to the realisation that it’s because I pay for our medical bills by cheque. And despite being a remarkably healthy family, that means writing at least 87 different checks a month to around 43 varied medical providers.

Naively, when I signed up to give away a healthy proportion of my salary to a health insurance company, I assumed that this would mean that my health bills would be paid if and when I had a problem. Sure, I knew that there would be a “co-payment” (surely an insurance company invention to ensure that hypochondriacs don’t go to the doctors every other day) but I somehow believed that would be the end of it. How wrong could I be?

Essentially a health insurance card is less a payment mechanism, more a discount scheme. You might get about 20-50% off the total amount, but they’ll still come after you to cover the costs after your ‘discount’. I can just imagine the ad campaign…”Got a broken leg? – it’ll normally cost you $8000, but with Blue Cross insurance we’ll let you hobble away on crutches for just $6800! It’s a deal so good, you’ll feel like breaking your other leg!”

Whether it’s a simple injection or a laborious operation, insurance companies have got a way to ensure that they never have to pay the full amount, leaving you hoping that you only have to go to hospital during the January sales (heart bypasses half price, and buy one ingrowing toenail removal, get one free). Although if medical care was indeed like shopping and you’re anything like me, you’d go out with the intention of having an appendectomy, and come back having had your tonsils out because they were on special offer.

After all, how do you think I got my third nipple?

Spot the difference

July 2007

A man walks into a doctor’s surgery in South West London, under extreme pressure from his wife-to-be, to get his allegedly high blood pressure looked at. The surgery smells like all doctors the length and breadth of the UK – a heady mix of two parts flatulent old lady, one part Brut aftershave, and one part child’s vomit (three day vintage). The scene is like something from a refugee camp in war-torn Uganda, with the sick of the area having wheezed, oozed and staggered their way into a waiting area so large that the end-of-season football playoffs could conceivably be played there.

Stepping over the wounded to get to the cinder block reception, the man stands for five minutes waiting for Doris to finish her conversation with Patricia about the size of Mr Harris’s piles. No, not Mr Harris from Watling Close – the one from Ridgemount Drive who was having the affair with the hairdresser from Belmont Hill. You know, the one with the hoop earrings who’s already on her third marriage?

Eventually Doris turns to the man and asks which of the seventeen doctors he’s here to see. Once he’s been redirected to the reception on the other side of the room, and endured a similar delay while he waits for Mabel to discuss last night’s episode of Heartbeat with Sandra, he eventually checks in and scans the room for somewhere to sit.

Our hero uses both hands to lift and move the beer gut occupying the last remaining space in the room, wiping off some unidentifiable residue from the orange plastic seat as he does so. Wedging himself into the seat alongside the aforementioned Beer Gut, he ducks quickly to avoid a flying red plastic Fisher Price brick which has ‘accidentally’ ‘slipped’ from the hand of the five year old convict-in-waiting to his left.

On the table ahead of him lay three magazines. Having rejected a copy of Hello magazine from 1994 (featuring Mandy Smith on the cover) and Weight Watchers’ 101 Low Fat Classics, he plumps for a relatively new (only four years old) copy of Top Gear magazine. Sadly, the cover is merely masking an issue of Coeliacs Monthly, the new publication for intestinal disease sufferers everywhere. He wearily puts it down and forces himself to read an informational pamphlet on the warning signs to look out for when you’re having a stroke.

Forty five minutes later, the man is convinced he has at least three symptoms, although the pain running up and down his left arm could conceivably be caused by the angle at which he’s having to hold himself to avoid resting his elbow on his neighbour’s man boobs.

Finally, an announcement over the loudspeaker informs him that it’s his turn to see the doctor, and gives him a lengthy set of directions to get to the relevant office. Given that the PA system is now 43 years old and replacement parts are no longer available, the muffled instructions (to head down the corridor, take the first right, and then the fourth door on the left) are unclear, and our hero spends the next ten minutes inadvertently interrupting old men having their prostates examined before finally managing to track down his GP.

July 2008

A man walks into a doctor’s surgery in New York’s SoHo, under extreme pressure from his long suffering wife to get his allegedly high blood pressure looked at. He takes the liftelevator to the second floor, and quietly remarks to himself that he wishes Americans would accept that it’s really the first floor. Stepping out of the elevator, he walks past a gentle waterfall that takes up an entire wall in the corridor that leads to the reception desk.

Eva Cassidy’s version of Sting’s “Fields Of Gold” plays gently across the loudspeaker as he approaches the desk. The receptionist looks up, smiles and asks how he is. By name. Having extracted a $20 fee (or “co-pay”, as she calls it) by credit card, she asks him to settle down in one of the chocolate brown leather sofas nearby. He is the only person in the waiting area.

Healthcare free at the point of entry vs extortionate health insurance. You pays your money (or not), you takes your choice.

I still had to wait forty five minutes with eight year old magazines as my sole entertainment, though.