It has been a week now since returning from my month in the States and of the myriad of wonderful conversations and experiences and reunions, one topic has stuck in my mind: health care. Maybe it is because I came back home to a letter telling me my application for a “cure” had been approved by the national health insurance. That means that I will be spending three weeks in a “cure spa” in the mountains near Salzburg exercising with trainers, getting physiotherapy, eating healthy, and learning to replace my bad old sedentary habits with better and healthier ones. And yes, the whole thing is covered. My copay comes to $9.35 per day.
There are other reasons that health care in the States has been on my mind. In conversations with friends and family, the subject came up often. A lot of us are nearing or at retirement age, slowly winding down our careers and making decisions about “the right time to go”. In the case of two couples, the husbands were working into their 70s – putting off retirement till the day their wives qualify for Medicare. Another woman wanted to stop working and had saved enough of a nest egg to do so – she just couldn’t afford the private health insurance in the interim. One woman who was basically self-insured through her own business talked about how much those costs ate into the company’s earnings. Two more women – one with a pre-existing condition and another with a special needs child – knew that losing their jobs would have more than mere ripple effects – it would mean a financially ruinous tsunami washing over them.
“People like the health insurance they get through their employers.” How many times have I heard that statement since the start of the health care debate way back in the Clinton era? 100 times? 500? 5000? And I have never understood it. I know very few people with 100% job security, so if the employer decides whether or not you continue to have a job, don’t they also decide whether or not you continue to have health insurance? Doesn’t that yoke you to your place of employment and limit your own freedom and self-determination?
The last school year was not the best for me. There were even times when I considered leaving – to the point where we had a mini family conference about it. It would have meant bridging the last two and half years of my professional life with other “unofficial” work (tutoring, translating, etc.), but what to do about health insurance was not one of the considerations. I find myself wondering now what my situation would have been, if I were on my own and in the States . . .
I decided to make myself a fictional 57 year old single woman with no dependents, living in Milwaukee and earning $50,000 a year. A nifty paycheck calculator online told me that I would end up with $3,196 a month to live on. Ouch! That seemed pretty low. I thought Americans paid a lot less in taxes, but this was only slightly more than the Austrian equivalent of this fictional woman would take home. In her case, about $700 a month would be skimmed off the top to pay for her health care and pension.
From there, I went to the Healthcare.gov website. After first figuring out what “deductibles”, “out of pocket” and “copays” meant, I entered my fictional information and clicked on “See Plans”. Of the 24 options, here were two at the opposite ends of the spectrum:
The cheapest Bronze Plan – “only” $709 a month. (Gasp!) But if I understand deductibles correctly, I would have to pay my own medical bills up to the tune of $650 a month before the insurance ever kicked in. So . . . why am I paying the additional $709??
The best of the Gold Plans. If I’m doing the Math right, I could technically afford this one with my $3200 monthly take-home pay – that is, as long as I never go to a doctor. Or take any medicine. Or own anything requiring maintenance. Or go on vacation. Or eat out.
Again. I don’t understand.
People protested last year to save this system. They camped out at congressional offices and marched on streets with signs saying “Don’t take my health care away”. They clearly supported this system in which they pay what seems like exorbitant prices to keep insurance and pharmaceutical companies profitable. I assume many of their employers have to pay such high prices too. It must make the cost of labor a burden on their bottom lines, which in turn incentivizes downsizing, relocating, outsourcing and all of the other euphemisms for “You’re fired!”
Navigating this system, making financial or life decisions based on this system, being constantly worried about losing this system . . . that all must create a great deal of stress in people. Anxiety too. Sleepless nights. Depression. All things that can lead to other, more serious illnesses . . . but never fear! The pharma industry is on it! Whatever your problem is, they’ve got a pill for that. What’s that? You don’t know what your problem is? Well, here’s an array of possibilities to choose from . . .
I only watched about three or four hours of TV during my month in the States – but that was more than enough to get a picture of what is going on. Rachel would do her 20 minute A block without interruptions, but from then on it was a constant flow of commercials broken up by sporadic 3 minute news segments. And it seemed like a third of those ads came from pharma companies. So here’s what the experience was like:
Rachel tells me about an explosion during a Russian nuclear missile test and how the radiation is spreading in my direction.
Then a nice woman in a commercial asks me if I ever feel anxious. If so, I should ask my doctor for xxxxx which, in some cases, might lead to dry mouth or mysterious sounding “sexual side effects”.
Then I see a short report about an immigration raid with desperate crying children, after which
a pharma commercial guy asks me if I am feeling sad. If so, I could try yyyyy (but I should watch out for such side effects as fever, confusion, uncontrolled muscle movement, decreased white blood cells, seizures, impaired judgment, coma, suicide or death).
The next news report is about a recent mass shooting by a white supremacist, followed by
another nice lady asking me if I am having “racing thoughts” and trouble sleeping. I should try zzzzz (but beware of tongue swelling, memory loss, and/or hallucinations). Her successor knows what I could take for my “restless leg syndrome”, but it might increase my gambling urges or make me fall asleep while driving.
In the final news report, I hear that the pwesident is leaving to go on vacation. He has done nothing in his 2½ years so far to combat the country’s widespread addiction to painkillers, but never fear,
there is now a treatment for OIC (opioid induced constipation)! Just watch out for nausea, vomiting, stomach tearing and constant pain.
I think most people -me included – have a touch of hypochondria (aka “Illness Anxiety Disorder” or IAD) in them. Who doesn’t hear of some new disorder and think briefly “Ooh! Maybe I have that!” So I wonder what the cumulative effect of all these messages must be. And then to continually hear these gruesome lists of possible side effects which often seem to end with “death”. It’s unbearable. Four or five more hours of watching this stuff and I’d have started tearing my hair out.
The industry is working on a treatment for it.
I appreciate living in a country with a social welfare economy, but that doesn’t make me a Socialist. I also don’t believe in Capitalism for Capital’s Sake. From everything I have seen, a healthcare system that is privatized and profit-driven has every inducement in the world to keep the country sick. As long as it continues on like this, there will be no cures.