It is still a form of culture shock sometimes, for me, living the life of a poor American. That is to say, a typical American. The haves and the have-nots all live here, and to many the difference is hard to tell.
I never feel the divide as strongly as when I try to get that most basic and fundamental right of all---health care.
Yesterday, while visiting friends in Mammoth Lakes, California, an outwardly upscale but basically typical American town, I had the need for a doctor. Because after finishing a 2800 mile walk, my foot was very badly swollen and I began to worry that a severe infection was going to possibly cost me the foot if left untreated. My hostess took me to the local clinic, where it was announced by the receptionist that just to get in to see the doctor would be anywhere from two hundred to almost four hundred dollars. Of course the dreaded question was asked, “Who is your insurance provider?” and they received the same dreaded answer, ” I have no insurance.” It was also announced for the second time that payment was expected at the time of service. We couldn’t justify that kind of money, nor did we have that kind of money and I opted for the old standby—the Emergency Room at Mammoth Hospital. There, I received a brief checkup that consisted of a blood pressure check, a temperature check (where a gizmo was swiped across my forehead and I was told that I had no fever) and that was it. After a few minutes an X-ray tech took me in and three x-rays were taken of the foot. A doctor then came to see me, asked me a few questions, looked at the X-rays, and after a short while told me that I had a stress fracture, would need no antibiotics and basically if I just took ibuprofen and didn’t do too much walking it would heal. And that was it.
This all happened before any mention of payment, or insurance. When I told them that I had no insurance, there was no big gasp, or exaggerated reaction. A woman from the billing office came in and ran down some options for me, and I will try to make payments as I can, in installments. Where I have a problem is that no one could tell me how much the bill was. A cursory checkup, three e-rays, and a non-prescription should only run me a hundred bucks or less.
Back to that divide that I mentioned. It has happened many times in the past as well. It is almost as if the insurance companies have managed to make their “product” so desirable and such a symbol of status that those of us who can’t afford it are mere peasants. I actually feel ashamed and embarrassed to tell the receptionist that I have no health insurance. In reality, I am very angry that insurance companies have all of the power that they do, because insurance at its most basic level is just you, the consumer, paying money on speculation that something is going to happen. You pay your money, and nothing happens. You keep paying money, and nothing happens. Then, when something DOES happen, the insurance companies dont want to cover it because it means they dont get to keep all of your money. It is so fundamentally screwed up that it is almost criminal.
So we go through life hoping we don’t get sick, or hurt. Yesterday I went to the medical office with nothing more than a broken foot, a slightly broken foot at that. I will undoubtedly receive a bill for 4 or 5 hundred dollars for a medic, albeit a very pleasant and kindly medic, to tell me what I basically already knew. In all of the avenues of American life, the medical arena seems to be the one where we get the very least value for our money. Let me re-phrase that: we do not get our money’s worth.
And its one aspect of daily living that makes me ashamed of this country, My friends from other countries who are here now still lament what they left, and I cant say I blame them. Do we need to make that tradeoff? I think not. Health care should not bring a feeling of shame.