Insurance

Sometimes you find yourself wandering along a beach, marveling at the beauty all around you and then life comes at you with a whoosh and suddenly you find yourself standing on the opposite shore scratching your head and wondering how you got there.

Literally.

Rochi has had an ear problem for months now. We saw five different doctors in Hawaii and nobody could fix it. All along we’ve been paying cash for these services because we can’t even apply for insurance until open enrollment in November. That insurance doesn’t take effect until January, and when/if we finally do get it, the monthly premiums cost as much as our Tokyo rent used to cost except that rent did not also demand deductibles and co-pays and other fancy words that boil down to “shut up and do as you’re told.” Until then, I had been feeling smug that I had bought a house and, for the first time in my life, was not paying rent. Lesson learned.

The last doctor we saw said we’d done everything we could do at the clinic level. The next step would be a CT. Without insurance, the test alone would cost at least two months’ rent. She told us point blank that we’d be better off coming back to Japan.

So that’s what we did. We arrived on a Tuesday night. By Wednesday lunch time, he had insurance, we had seen doctors and been given medication. Total cost: about $50. A week later we spent a full day at the hospital, he had multiple examinations, two CT scans and prescription medications. Bill for the day: almost $200.

As we were riding the shiny new escalator toward the exit from the clean, modern hospital, we were both doing the math in our heads. In the States, that day alone would have cost us two trips to Japan, flying business class and staying in fancy hotels, maybe even a Rolex or two. Or about 2.5 years’ rent.

In the United States, people die, they DIE, because they’re afraid to go to the doctor. It’s not the pain that is so scary, it’s the bills that arrive weeks later, unexplained but final. Thou shalt pay. End of story. They even send email with the heading, “Great news! You have a new e-document.” I understand these documents are sent by computers but at some point, some actual semi-human organism must have written those words with that intended purpose. “Great news! You’re still sick and now you owe a bazillion dollars! Yay!” This is cruelty that borders on sadism. But the real irony, and the ultimate insult, is that there is nobody to explain and nobody to blame. You can call every number they give you, but everyone you speak to will tell you the same thing: “We don’t make the rules. We just send the bills.” I keep hearing voices in my head saying, “I’m not responsible. I was just following orders.” Where have we heard that before?

I have even sensed an undertone of, “You should be grateful you got to see a doctor at all.”

Really?

Are we talking about the same United States? The land of the free, where we have a right to the pursuit of happiness but not to basic healthcare? Is this the same home of flag-wavers who claim a love of God and equality for all but run for cover when we talk about universal health coverage? I thought we were talking about the United States where we have indoor plumbing and clean running water and safe food and cell phones and WiFi and Sunday football. But I guess these pleasures don’t extend to anyone who is running a temperature.

It seems fundamentally wrong that we have so many basic freedoms, things we take for granted, when millions of people around the world go without milk or shoes or education. We complain about slow Internet while people in our own country, maybe even next door, die of a simple infection they can not afford to treat.

We are lucky. We had the Japan option. But what happens to people who don’t? Not for the first time, I am ashamed of the country I represent.