The indignity of healthcare, part 1

immunization record

Getting this up to date has probably deducted five years from my life

This is a story with no ending, no neat resolutions – and it’s a topic that affects everyone. It’s about the state of healthcare in the United States. If this makes you yawn, I don’t blame you. It’s hardly a glamorous topic, but it’s one that has been on my mind since setting foot on American soil back in July. In fact, it was a recurring theme of my discussions with the English Husband. What would we do about healthcare if we decided to move back to the United States? Would we be able to afford it and how long could we possibly live without insurance?

A disclaimer before I launch in: I am not an expert on the healthcare industry and all of this is taken from personal experience. I don’t claim to have any answers, merely a lot of questions. Here’s the first big one: why does a country that is so advanced and civilized not provide even the most basic care for its citizens free of cost, without question? Some will argue that some of Obama’s reforms go some way towards making healthcare available to everyone, but people will inevitably slip through the cracks. I happen to be one of them. Being educated and middle class makes me even more of an exception.

In the UK there is universal healthcare for the entire population. When I went to live in London I never had to worry about how I would afford a doctor or what I would do if I was unfortunate enough to end up in the hospital. Despite the fact that for years I never had a stable job and that I was effectively an immigrant in a foreign country, I had as much right to healthcare in the UK as its citizens did.

The irony is that, once back in the country of my birth, I no longer have access to the healthcare I had in the UK and, to some degree, neither do my children. I came back here without a job and although I am doing my best to look for one, it could be months before something comes along. In the meantime I can’t afford to pay for some ridiculously expensive insurance plan for my family – it would cost thousands when we are trying to save money for the move. I feel like I’ve somehow been penalized for living out of the country. So what does someone like me do? You try to find subsidized care and this makes you feel like a pariah.

Healthy families is a huge headache
I hear about healthy families through my child’s school. It sounds good: affordable healthcare, heavily subsidized, for families who cannot afford to pay for it and who don’t have insurance. But trying to get this is like trying to find a cure for cancer. You will probably end up needing a doctor after the stress it causes. I happen to have a degree in English, but even I found it difficult to understand how you qualify. It starts straightforward enough – you need to fill out one of those exasperating government application forms. I get through this first hurdle and then get a letter – about a month later – with two official-looking insurance cards for my children. I think, great, this was easier than I thought. Wrong.

The letter unhelpfully explained nothing about how you get a doctor. I tried calling Kaiser to ask if they would accept these cards, and after some confusion and a stilted conversation, they tell me that they were closed to anyone with MediCal. I give up and decide to call healthy families for information. This is where I start losing the will to live. The only number you can call is constantly engaged. I spend an entire day trying to call and finally get through at 4.30pm.  I am put on hold for an agonizing 40 minutes (they close at 5pm, by the way) and I am subjected to some horrific public-service announcements that replay over and over again; this is punctuated by even worse music. Eventually a human being comes onto the line and I ask about how I can use these cards. The person tells me that she doesn’t think I can use the cards because my case has not been resolved. But, I argue, your own letter says that the children will be insured while the case is pending.

‘Does it?’ she says.

‘Yes,’ I reply. ‘But I don’t know how to go about getting a doctor and I have a child who needs immunizations for school and another child who needs a health check before starting at a daycare. I’d like to see a doctor.’

‘Why don’t you look online?,’ she offers feebly.

‘But what am I looking for? I don’t know who accepts these cards. Don’t you have a list?’

‘No, sorry.’

‘Who is your doctor?’ I ask exasperated.

‘I use Kaiser.’

‘They told me that they don’t take these cards.’

‘Hmmm… not sure what to say. Why don’t you start calling around?’

Sensing I am getting nowhere, I hang up the phone and curse myself for wasting so much time. Then, two weeks later, I get another package from healthy families, this time with more forms – more complicated than the last – and requests for documents such as original birth certificates. I take too long to get this back to them and have to spend another day trying to get through to another human being to explain that some of these documents are in another country.

‘Okay, just send us what you have,’ she tells me.

‘It’s already late,’ I say.

‘Just send what you have.’

I get the feeling they have heard this all a million times before. I wonder about the many immigrants who come to this country hoping for a better life; many of them might not even speak English and have very little education. How are they supposed to make heads or tails of this overly complicated system that makes you feel like a dimwit and a drain on society?

Getting immunizations without insurance – don’t try it without a stiff drink first

Eventually I need to get my oldest child immunized for school, and I’m still waiting on healthy families to make a decision about my case. I try a clinic that has a limited number of appointments on any given day. Well, you can just forget trying to get an appointment unless you drag your kid out of school and stand in a line at 7.30am. After trying here twice, I give up and opt to call another clinic, where I learn that I can make an appointment. This is vastly preferable. I still have to take my child out of school, but I figure I will be able to drop her off afterwards. How wrong I was.

The day dawns and I venture into the heart of darkness – deepest, depressing El Cajon, where a man with a Santa Claus hat pushes a trolley with all his possessions down the street.  I feel a bit nervous about the area and I’m not reassured when I spot a security guard standing in front of the clinic. Why do they need a guard? He tells people not to eat inside and ushers me to the front, where I sign in. This is only the start. I have to fill out more paperwork than I imagine the average bank teller has in a day. I have to answer questions about insurance, income, etc etc. By the end of it I feel like a total loser.

I take my seat with the other unfortunate people and spot a very large flat-screen Sony television in the waiting room. This says it all about the United States. Here we are, in a clinic for people with little or no money, but we are reassured by the huge television in the waiting room. Couldn’t this money be better spent on something else?  It is American wealth in all its useless glory. Unfortunately it doesn’t work, the security guard says. Typical.

Two hours later I emerge with the wailing Chatterbox, clutching her yellow immunization record like a prize. Once home, I discover that they gave her more vaccinations than she needed and they failed to stamp her for the one immunization she absolutely had to have for school, Hep B. Off I traipse again the next day, into a vast sea of people to get this stamp. Luckily, this visit only takes 5 minutes and they give me a stamp with no drama. I feel like I’ve won a battle, but I am weary and scarred.

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Filed under Healthcare, transitions

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