American Healthcare System: First Impressions (from My European Husband)
My Danish husband quickly learned that not only healthcare in America is expensive but it’s also absurd
There is so much to say about healthcare in America I hardly know where to start. I never gave it much thought and tried to avoid doctors for as long as possible, which was easy to do in my 20s. But two years ago, when I had to return to the U.S. (after living in Europe) with a Danish husband, two pre-teen step-daughters, and a baby on the way, suddenly, navigating our medical system has become my part-time job.
Turned out not only it was expensive to get medical treatment in America but also unnecessarily complicated. “How can something so basic as the nation’s health be turned into such a circus?” my husband wondered. He did know that moving to the U.S. meant medical expenses. He didn’t, however, expect the whole thing to be so absurd.
Here are some of his first impressions, with a few of my harsh opinions.
The simplicity of European healthcare
In Europe, we enjoyed unglamorous but simple and efficient medical care. During my two years of living in England, all my health concerns were addressed to my local GP who gave me exactly 15 minutes per visit to convey my grievances. She was a tired young woman, without any fanfare of the God-like American doctors. She patiently listened and either prescribed medication, gave a referral, or asked me to return the next day if my 15 minutes were up. Those in and out visits took care of most of my medical needs and made me feel safe.
My husband had a similar experience in Denmark where a doctor’s visit was a quick and efficient encounter, not a prolonged and tedious one, like in the U.S. Here, he quickly learned that if you want as much as to have your foot checked-out, you have to be ready for the excessive wait, unnecessary paperwork, repetitive questions, rotation of nurses, blood pressure and temperature taking, weighing and measuring, followed by more wait. Just to get prescribed copious amounts of Advil. What takes 15 minutes in Europe gets stretched out into an hour-long production in America achieving the same or lesser results. “Do they need all this to justify insane prices?” my husband asked. “Or to stroke the doctors’ egos?” He never went back.
Yet after multiple doctors’ visits with his kids, my husband pointed out that the amount of time spent on treating the patients in American clinics is much less than the time spent on administrative tasks. And this, to him, looks like a crazy way to distribute resources. He explained that in Denmark, a great emphasis is placed on getting as much “warm hands” time (doctor’s treatment) for the patients as possible instead of “cold hands” (administrative) time. Danes pay higher taxes but they expect not only free but higher-quality treatment in return, and they do get it.
Nightmare logistics of the American medical system
We didn’t expect much returning to the U.S., but we didn’t anticipate the complicated logistics we’d have to navigate just to enter and stay in the system. Groups, plans, sub-plans, co-pays, deductibles, useless letter combinations, endless insurance cards mailed and then mailed again, mountains of wasted paper, phone calls here, there, and everywhere, and don’t get me started on the government-funded programs.
No, my husband doesn’t know what PPO, HMO, or EPO is, and, frankly, he shouldn’t need to know. Getting your child vaccinated for school shouldn’t take three phone calls, followed by two weeks of wait, followed by 30 minutes of paperwork, followed by 15 minutes of useless chit chat with a doctor, then having to come back and do it all again next week, which is when the next vaccine will be approved by the insurance company. Repeat all for the next child. With two school-age children and a baby, we’ve had more doctors visits in two years than I had in my entire life. The kids have been measured, tested and (over) vaccinated more times than they cared for, and the parents have collected enough stories to write a sitcom.
Then there was a Green Card interview with its own medical requirements and a list of approved (pricey) doctors. After charging my husband three hundred dollars per person, the USCIS-appointed doctor tried to talk him into a Varicella shot for my 14-year old step-daughter which would cost another thousand dollars. The man didn’t even bat an eye when he named the price.
Luckily, I called my husband just on time to catch them in the act. With just one week of wait, more paperwork, and more measuring and weighing, we were able to get the shot for free at a regular doctor’s office. My fatigued husband learned that in America, one must remain in a state of high alert when dealing with doctors’ visits.
The mystery of medical billing in the U.S.
Speaking of prices, my husband was amazed to learn that medical billing in the U.S. is yet another scam, covered up with the bloated sense of authority and importance of American doctors.
When we first visited a rather modest OBGYN office for my pregnancy, we received a bill in the mail telling us the cost of our visit (check-up and ultrasound) was over two thousand dollars, most of it paid by the insurance company. My husband stared at it: “Two thousand dollars for what?” I didn’t know.
We asked our American-born Ivy League-educated neighbor. She laughed and said those were made-up numbers that doctors’ offices threw at insurance companies to start a negotiation. A negotiation? Was this a medical establishment or a Turkish Bazaar?
Every doctor’s visit we’ve had since then generated ridiculously inflated bills mailed to us for a dramatic effect. Were we supposed to be impressed by the expensive treatment we were receiving? Four hundred dollars for a vaccine. One thousand for an ultrasound. Two thousand for blood tests. My husband nearly fell off his chair opening one of those. “What is this?” he kept asking. This was the Wild West of American healthcare.
Once a letter came demanding we paid the full amount for the baby’s doctor’s visit — over two thousand dollars. When I called the doctor’s office, they checked and said it was a mistake and billed the insurance company instead. A mistake that could cost someone their full month’s rent. A scared and obedient foreigner like my husband, without a pushy wife like me, would end up paying the bill, no matter what it took him.
I wonder how many of these “mistakes” are made daily and billed to those who don’t have the time or the energy to catch them?
Sadly, a lot of Americans will never understand how unfriendly and absurd our medical system is. We don’t know any better. And we’re taught to be grateful to have the greatest doctors in the world. While certainly much can be said about the skills of our top-notch medical professionals, the system as a whole is shocking to anyone coming to the U.S. from a developed country.
