Friday, May 4, 2012

New country = new medical system

When the opportunity arose to move to the USA, all the new and exciting things to explore were always in my mind. There was however always this niggling thought of the thing I had been dreading... The American health care system. I had heard horror stories all over the place of people ending up with significant debt from minor injuries and so making sure that Mitch's work provided good medical insurance was pretty important for us before making the decision to move here.

Now, I have to say - my experience so far hasn't been anywhere near as bad as I was expecting. It's definitely not like Holland where although you do pay a reasonable monthly premium, you have no out of pocket expenses (I never payed a cent for having a baby there, not even for the wonderful kraamzorg service!), I guess it's been a little more like the private system in Australia. 

I have been feeling a bit under the weather lately (I'm blaming the lovely jasmine bushes on our street - they smell gorgeous but they don't get on well with my sinuses) and the 'acetaminophen' just wasn't cutting it anymore. With a blinding headache and nasty ear pain, I suspected an ear infection and finally cracked it one day and called my insurance company to find out how to see a doctor. Although I had to be transferred a bunch of times to various departments to choose my physician and then set up an appointment, they had me booked in to see someone in ONE HOUR! I was amazed considering how hard it used to be to get in to see my doctor in Holland. 

They do have a small out of pocket expense for each visit, which I guess is much like Australia. Like every other country I've been in, the wait time was horrendous but once I finally got to see the doctor, I couldn't believe just how easy it is to get things prescribed here. The doctor tells me that although my ear is red (probably from a little boy with sharp fingernails whose latest obsession is trying to stick his fingers in Mummy's ears and nose, gah!), it's not infected - but hey, would you like some antibiotics anyway? I politely declined, explaining that as I'm still breastfeeding I would prefer to avoid antibiotics wherever possible. Despite this, she still added them to my account and I was informed that I could get them at a later date if I wished. I know a lot of doctors are a bit antibiotic-happy but considering that in Holland, I had to resort to breaking down in tears on not one, but two occasions in order to get antibiotics (both for legitimate causes, the doctor confirmed I was sick with something that elsewhere results in an antibiotic prescription), it came as a real shock to my system. Honestly, I kinda liked the Dutch approach because it seems that they are handed out a little too freely sometimes BUT I hated that it was such a fight to get them prescribed when I wasn't going to get better without them. It seems that it's the total opposite here! From my experience, Australia falls somewhere in the middle of the two extremes. 

The pharmacy system here actually reminds me a lot of Holland. After seeing the doctor, they send your prescription automatically to the pharmacy you've registered at. No pieces of paper like Australia (that I was prone to losing), it feels very streamlined. The only difference between here and Holland is that you have to pay for prescriptions here BUT I have to say they are quite low cost and if you order online and get it posted, you get a pretty decent discount and no postage costs. Obviously this only works for ongoing medications, nothing urgent but hey - who doesn't love the thought of avoiding the lines at the pharmacy!

The other thing that I found a little different here is that your general doctor seems quite limited to what they can handle. I decided to cross a few things off my to do list seeing as I was forced into a visit anyway, but upon asking my question to my female doctor was told that it was 'women's business' and she wasn't familiar with it and I'd have to see an ob-gyn for that. I'm not talking about anything complicated here either - just getting a new prescription. So now I've experienced the ob-gyn system too... It's all fun and games when moving to a new country!!! Honestly though, my experience of the healthcare here so far has probably exceeded my expectations. I love that I can now schedule appointments online and order my prescriptions online. You can even email your doctor with your symptoms and if they think they can prescribe you without a visit, you don't even have to go in.

I think though, if we didn't have medical insurance I wouldn't have such a positive spin on the healthcare system here. I can see why a lot of people don't have insurance - if your employer doesn't provide it (or pay the majority of your premium like in our situation), it really is unaffordable. It saddens me to think of all the people out there who either avoid necessary medical care due to cost or those who end up with debt they simply cannot afford to pay off. I guess though no country is perfect - Australia has its flaws, the Dutch system has its flaws (try getting an appointment after the receptionists all go home at 1pm - you have to CRY and beg) and the American system certainly has it's downsides too. Lately I've been thinking of things I am thankful for each week and today I have to say, I am so very thankful for insurance!

But that's me - this month we get to discover how the system works for children now that I've chosen Oliver's pediatrician... Time to see how much my big boy has grown, it's been quite a few months since his last check up!!!


  1. Ah, the fun times of exploring a new health system. Sounds like you managed pretty well. Although, it seems like you need to do a bit of Dr Googling to make decisions about what medication you should except from the medication-happy doctors. Good luck at the pediatrician!

  2. You gotta love Dr Google - is it sad that I always consult the online oracle before going to the real doctor? I think it stems from so much time in a non english speaking country... You know how it is!


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