Blogging this tweet because this explains SO MUCH about the mindset of pretty much all the folks I’ve known who’re against single-payer, it’s not even funny…

This….

This never occurred to me. Not once. That Americans are against Health Care because they think it actually costs tens of thousands of dollars for a broken arm, hundreds of thousands for a complicated birth, millions for cancer treatment.

Because they’ve never known anything different. The idea that a broken arm is only a couple hundred bucks; a complicated birth a couple thousand; cancer treatment only tens of thousands; all easily covered by existing tax structures.

This explains a lot.  And it’s a good example of what I was talking about in my post on scarcity being used to prop up ableism – always question the idea that a resource is genuinely scarce.  Even if it seems obvious that it is, quite often that’s the result of careful manipulation and misconceptions that you’re not even aware of.  

And never think you’re too smart to be fooled by that kind of thing, it doesn’t work like that.  Similarly, don’t think people who are fooled by something are stupid.  Nobody can have all the information about everything, and nobody has the time and energy to investigate and put together conscious conclusions about every piece of information they’re given.  It doesn’t take being stupid, or even just gullible, to believe something like this.

I currently live in a country without free medical care and still, it’s enormously cheap compared to the USA. An American expat wrote a piece for our English language paper about how she paid more for parking at the hospital than giving birth to her baby that’s pretty interesting:

https://grapevine.is/mag/articles/2016/01/06/healthcare-in-iceland-vs-the-us-weve-got-it-so-good/

Yesterday I had to go to the hospital cause I injured my eye, I’m frankly dreading what the bill is going to be, but what made me balk was being told in the pharmacy that my insurance was denied for the antibiotic eye drops and it’d be over $100 out of pocket. So I didn’t get my eyedrops.

I’ve had these same drops before living in the UK. They cost me seven GBP.

It’s the exact same drug, same steroid, same strain of antibiotic. But somehow the US gets away with charging $100 for a generic non brand version of a drug which is easy to create and widely used. It’s downright robbery, but also a form of eugenics through poverty and class warfare. You keep the poor poor by making sure basic necessities remain unattainable and then you make it seem like the norm so no one fights it.

The rest of the world is not like this.

When I was travelling in Germany once, I seriously hurt my ankle. In a few hours, it had swollen to twice its size, and I went to a little ER in a tiny town. I spoke no German and only one nurse spoke English. They ran an X-ray and an MRI to determine what had happened (turned out I had bruised my peroneus brevis muscle and pulled the tendon), gave me a ton of very regulated meds for the pain and swelling, including some supports so I could walk…and my poor little 22-year-old ass was sat there, knowing all of this would cost thousands, if not tens of thousands, back in the US. I was shaking.

I’m in the exam room, post diagnosis and with pill bottles in hand, and in walks the one nurse I’ve been able to speak to the entire time. She pats my hand and tells me (and this is verbatim—I will never forget this conversation as long as I live), “I’m so sorry. We had to run those tests, and they are expensive. You don’t have insurance so you will have to cover the full cost.”

I start crying.

She continues, softly, as if telling me someone has died, “It’s going to be three hundred.”

I start sobbing, certain I’ve misheard, certain that I would be absolutely fucked, broke and going into debt in a foreign country. “Thousand?” I clarify.

Her entire demeanor changed, and she looked at me as if I had sprouted four extra heads. “No,” she says, “euros.”

That moment radicalised me.

My family got charged several thousand dollars for a late-night trip to the ER when I was a kid after an oops at home resulted in a large cut that needed almost 40 sutures. We lived in the US at the time.

Now we live in Canada. Last year my leg got rolled over by one of the front tires on a pickup truck. I spent 3 weeks in hospital, had 3 surgeries, one of which included skin grafting to cover the half of my leg that was degloved in my accident. I had IV antibiotics 4 times a day, I had physiotherapy daily, I was on a lot of meds for pain and having complex wound dressings changed every day. After all that, I had a home care nurse visit me every 1-2 days for 6 weeks to help with my wound care. The greatest expense to us as a family for the amazing care I received was my parents and husband using the parkade next to the hospital, which was like $13 a day. If we’d lived in the US, that injury absolutely could have bankrupted us.

This information needs to be part of the US med school curriculum.

I remember the moment that radicalized me.

I went to the UK for graduate school, and being there for that long meant I had to buy insurance for the duration. 18 months was something like £800 (this was in the early 2010’s). I, being American, figured “oh ok, that’s the premium and if I need serious medical care, I’ll get charged deductibles and all other kinds of fees at the time of care), because that’s how it works here.

Some time in the early part of that winter, I got incredibly sick. I’m immunocompromised, so sometimes that happens. But being a broke ass grad student in a foreign country, and dealing with unrelated financial abuse from family members, I figured I couldn’t afford going to the hospital. I figured I’d go to their version of Walgreen’s (Superdrug, and yes that is really that store’s name, load up on cough drops, some OTC meds, and try to ride it out as best I could.

One of my friends in my program came over to check on me and offer help. When she got to my room and saw how sick I was, she asked why I hadn’t gone to hospital. I was near tears and said I couldn’t afford it.

This is when I suspect my friend knew she was dealing with an American who was ignorant of how socialized healthcare actually worked, and realized that I couldn’t really be reasoned with. So she said, “I’ll pay for it- let’s go.”

Off we went to hospital, my friend did the talking bc my voice was so shot. The receptionist said, “as you don’t have an appointment, you may need to wait quite a bit.” I heard that and figured 5+ hours was at least what I was in for.

23 minutes later, my name was called.

My friend went back with me, bc I was pretty out of it. The nurse leading us back apologized for the “huge wait” because having a sick patient wait “nearly half an hour just for medical care” was unacceptable. I was stunned.

The nurse and doc asked some questions, looked at the medical records I had on my phone (bc I was a foreigner with very little medical history in the country), did a few rapid tests. The whole time, I’m seeing an old-timey calculator ringing up charges and freaking out… even though my friend said she’d pay, I was so conditioned to believe this would cost a fortune.

About 30 mins later, the rapid tests confirm I have both bronchitis and pneumonia. Doc writes me a prescription for some serious heavy-duty meds. My American ass is thinking, “ok, so now I go home, wait for 4 days for the pharmacy to fill it, then go get it.” The doc tells me that there’s a pharmacy counter on the way out, and I can stop there to collect the meds before heading home.

I’m skeptical but thank him. My friend gets me to the pharmacy counter. I give my name and hand over the paper, fully expecting to be told that it’ll take days to fill. The pharmacist turns around, pulls a bag off the shelf, hands it to me. Because my meds were already filled and waiting.

Me: you had them already?

Pharmacist: of course- there’d be no point in sending you home without medication, that’s why you came here. To get medical help.

Me: that’s so fast? (I am very confused)

Pharmacist: well, we expect people to have these illnesses at a higher rate this time of year, so we do our best to stock up on our end.

Me: that’s so nice? Also, what do I owe you?

Pharm: sorry, love?

Me: what do I owe you? For the medication? And the visit. All of it, how much do I need to pay?

Chat, her whole fact changed. She realized I didn’t just sound funny because I was in respiratory distress. I had an American accent. She reached over and patted my hand.

“Love, that’s what the health insurance is meant to be for. You’ve already paid for this. We’re not taking extra money off you, we don’t do that here.”

The entire visit was less than 2 hours, absolutely free, and everyone worked to be as efficient as possible in the goal of providing comprehensive healthcare for me, the patient.

Once I got home with the meds, I did actually recover pretty well (and relatively quickly, as far as I’m concerned). I talked to the friend after, and she admitted that she knew it was going to be free, but that I wouldn’t or couldn’t understand that in the brain fog of serious illness, so she said what she had to in order to get my stubborn (and terrified of bankruptcy) ass to the doctor.

That’s what healthcare should be. A goal of providing comprehensive and compassionate care to your patients, being well-staffed enough that no one waits for hours, anticipating medication needs, ensuring that patients leave with the medical care they sought- and that they’re not afraid to seek it, because they know medical care won’t make them homeless.

I work in xray in Australia, outpatient. Let’s pretend that I have three patients, an Australian, a Brit and an American. There’s something wrong with their referral or something so Medicare won’t cover their xray and it’s a hundred bucks. On top of that, they have to wait an hour to get it.

• The Australian will be usually willing to wait (sometimes they get upset), but rarely want to pay. They’ll go somewhere else even though Medicare will not pay no matter what. It’d be faster to wait a few hours to see a free doctor and get a new referral for a free scan but I’m lying to them about this and just want to rip them off so they’ll spend all afternoon walking around to all the clinics and getting turned away instead. They will eventually come back seething because the other places want to charge them even more.
• The Brit will be really pleasantly surprised that they can have the xray today. They’ll either pay or wait the few hours to get a free doctor to fix it, neither really phases them because “at home you have to either be dying or wait weeks for an xray because they gutted the NHS.” At worst they’ll do some polite grumbling.
• The American will, every single time, be immediately gushing about how awesome our healthcare system is that even a completely uncovered xray is only a hundred bucks (around $66USD). If I told them a scan cost five hundred out of pocket or they could wait to see the doctor they’d drop the money without flinching, every single time. American patients are always such a delight to have here in Australia because they’re just so happy to get to be here.