One of my first posts when I started this blog was about trying to find subsidized healthcare in the United States. Without a job I was very worried that I would become one of those Americans who has to pay for full healthcare out of their own pocket or who simply chance it and hope for the best. According to a 2002 census report, 15% of Americans had no health insurance for the whole of that year, a total of 43 million people. The proportion of uninsured children was 11 percent of all US children (8.5m people) in 2002. These numbers are likely to have risen in the ensuing years.
Before boarding the plane to start a new life here, and for weeks afterwards, I had visions of being in a car crash that would leave me bankrupt for the rest of my life. I couldn’t envision my injuries, but I could envision the medical bills piling up.
I was finally approved for a healthcare plan in late December – subsidized by the state of California – and the coverage started on January 1. Less than two weeks later, the Chatterbox gets a minor illness and I get to put my new plan to the test. Monday morning: the first thing I realize is that I don’t know what I’m covered for and I don’t have a clue who my doctor is. This is an uncomfortable feeling and one that makes me realize how precarious my existence is in the United States. I don’t know how the system works and I feel like I’m blindly groping for the light switch. I may have been born in this country, but I have never had to worry about my own healthcare because I was always covered by my parents’ insurance plan. Now that I am responsible for someone else, I am slightly panicked about how to get the best care I can afford. These are not problems I encountered with the NHS – and I was very thankful for that.
Getting an appointment
I call up one number listed on a form and then another. I’m eventually told that the Chatterbox has been registered with a clinic 20 miles away. Back in December I filled out some forms choosing a local doctor, but for some reason they did not honor this. Not that surprising, really. I call up the clinic and it takes ages to get through. Then I’m told the computer system has crashed and they can’t see what appointments they have that day. Then I’m told I’ll be put through to reception. Then the phone gets disconnected. Then I call again.
‘Come now,’ says a woman on the phone.
‘This minute?’ I ask.
‘Yes, now, before it gets too busy.’
I grab the kids, throw them into the car and head in what I believe is the right direction – and I am bad with directions. It takes me half an hour to find the place. It’s not a good first impression. What can I say? It’s a depressed area with a lot of squat dilapidated houses, surrounded by liquor stores and fast-food restaurants with neon signs. Beat-up cars rumble down a busy street. The only cheery thing around here is the sunshine. Outside the entrance there are cracked plastic seats – I can’t tell if they have been cracked by the sun or overuse. Things don’t get better inside. It’s dark and dingy, with seating arranged around a semicircle. There is a television with no sound in one corner, and a vending machine dispensing unhealthy snacks. I fill out yet more forms that make me feel like a non-person: questions about insurance, about liability, about social security numbers, driver’s license numbers, etc.
I sit outside on the plastic chairs that face a parking lot, because everyone inside is hacking. I imagine tentacles of illness in the air, germs smeared all over the old furniture. Nothing looks like it ever gets cleaned. An older man with a terrible cough walks outside and spits in the dust. I pray this won’t take long. It does, of course. We are finally ushered inside and the nurse tells us to take a seat while we wait for the doctor. We are in a tight hallway with one ancient green plastic chair. Not even the kids want to sit on it. Instead, I lean against the wall and wait.
And the bill is…
There is nothing seriously wrong with the Chatterbox, which is a relief. I was imagining an infection because of her nasty cough and the fever she has had for two days – but I’m told her chest is clear. I am prescribed an antibiotic as precaution (is this necessary?) and a nasal spray.
I still don’t know what, if anything, I will be charged for this visit; but when I go to the pharmacy to fill the prescription I am told that I don’t need to pay a thing for the medicine. I was imagining at least $20. My mother begins whispering in my ear about why this country is bankrupt. She is half joking, but I don’t listen. I want to pay my way; this is just a blip while I try to get on my feet. Should I feel guilty? I don’t know. I’m not going to seek welfare or go on food stamps, but if I got slapped with a huge medical bill, I know it would be a struggle to pay it. Yet I feel a stab of shame when I hand over my plastic insurance card, for people on low incomes, to the pharmacist.