Me: So how much is a visit?
Receptionist: 176 dollars
Me: Oh, but I have insurance (me being as naive as a new American resident can be)
Receptionist: Yes, I know, the price you see on the website, 60 dollars for a consultation, is the price you pay only after reaching your deductible.
I got a sense of relief “Oh then, there WILL be a time when I only pay 60 dollars for a visit, ok, that’s not too bad”. The conversation continued:
Me: So what’s my deductible?
Receptionist: USD 1500 dollars. That means that after you spend 1500 dollars on healthcare, you will have reached your deductible and from then on you will only pay 60 dollars for a regular visit, 70 dollars for urgent care.
Me: (Silence. I started to imagine scenarios that would require me to spend 1500 dollars on doctors and medicine, a broken leg? an infection? food poisoning? I was doing the math and thinking how many times I had to go to the doctor to start paying 60 dollars for a visit.)
Receptionist: Are you still there?
Me: Yes, I have another question, I know I need a test to find out if I have asthma or not.
Receptionist: That’s a pulmonary test, it’s 198.25 dollars.
Me: Ok, so it would be 374.25 for both, the visit and the pulmonary function test, correct?
So if you read the blog post I wrote in February, you know how it started. If you didn’t, I’ll sum it up for you. I started coughing and was short of breath, was prescribed prednisone, amoxicillin and antihistamines, the diagnostics: bronchitis. I got better after taking the medicine but relapsed two weeks after. I figured if I bought the same medicine I would get better again, I mean, that made a lot of sense since I had the same symptoms, right? and so I did, I used the same prescription and bought the same medicine. I did get better and I did relapse about 14 days after taking the medicine. It was difficult to get treated as I was living as a digital nomad, I saw doctors in the countries I was living in, Brazil, Peru, Guatemala but couldn’t have a primary care doctor, a doctor that had my history and knew me and my symptoms. When my husband and I moved to Florida, I decided “Now that I’m going to be living in the USA, it’s time to get a regular doctor and get tested for asthma”, which was suggested by a doctor in Brazil.
People had warned me, they’d told me what health care is like in the US, but you don’t fully understand it until you experience it first hand. I went to my appointment, was ready for the PFT (pulmonary function test) and it made me a bit nervous to see the doctor writing down a bunch of tests on her notes as she said the names of the tests aloud. She said I needed a pulmonary test, a test called “SHAPE”, X-rays… I asked how much all that was, she said she had no idea and that I would find out when I checked out. I was reluctant to get any tests done before I knew exactly how much I had to pay for them. So the doctor sent me to the reception and this is how the conversation went:
Me: I was wondering how much the tests are.
Receptionist: The pulmonary function test is 198.25
Me: Oh Ok, I knew the price for that one, that’s the one I came for today.
Receptionist: The SHAPE test (Submaximal Heart And Pulmonary Evaluation) is 162.47 and the follow-up visit is 133.40.
Me: (She didn’t give me the price for the X-rays, to be honest I didn’t want to know)
I’d like to have the pulmonary function test today, that’s the one I came here for.
Receptionist: Oh, you can’t do that one now, you need to make an appointment so we can schedule a technician.
Me: (Trying to understand why that information wasn’t shared over the phone when I made the appointment)
Receptionist: She continued… and first you need to book a follow-up visit, which is 133.40
Me: Wait, what? Why can’t I just pay for the test? I would be coming for the test only. I had the visit today.
Receptionist: No, you can’t. You need to have a follow-up visit when you come to take the test, so that would be 198.25 for the test plus 133.40 for the visit, 331.65 in total.
I didn’t want to leave without having done a test, after all that’s the only reason I was there for, so I asked “is there any other test that can be done now?”, and there was, the “SHAPE” test could be performed right away. “Perfect”, I said, “let’s do that one”. So the receptionist performed the test herself. Yes, you read that well, the receptionist performed the test on me. Maybe in this country people double up?
The following is conversation I overheard while I was waiting for my test results:
Receptionist: The results aren’t showing…. (I couldn’t understand what they said) Do we do the test again?
Doctor: No, there’s no need, just reboot the machine after the patient leaves.
Then the doctor came in with another doctor (a male doctor) and he said “there are some signs of asthma but we will know if there’s obstruction with the other test” then the female doctor continued “in the meantime we will give you an inhaler, which you have to use 30 minutes before you exercise”. I’d like to point out that neither doctor explained the reading to me.
Some signs? an inhaler? Where are my test results? Will you at least explain to me what that blue line and that red line mean? Will you at least tell me what kind of medicine is in the inhaler? Aren’t there like 20 different types of inhalers? Those are questions I SHOULD have asked, I was so overwhelmed and upset by them not telling me that I had to book the pulmonary test in advance that I didn’t ask those questions when the doctors gave me that vague information.
I left convinced that I didn’t want to go back to those scammers. I ordered a taxi and the taxi driver asked the wrong question, “how are you today? “
Poor guy, nothing could have warned him for what happened after, I started venting about what had happened, spoke nonstop for I don’t even know how long, I mentioned I was from Peru, then he switched to Spanish (he was Argentinean), and we both started venting together. He’d had an infection and had been hospitalized for three days, how much? 10,000 dollars. Yes, that’s the amount he had to pay because he didn’t have health insurance. I had to pay 338—WITH insurance—for a visit plus a test with no results read, a vague diagnostic and no explanation of what kind of medicine I was prescribed.
I had gotten it off my chest by the time I arrived home, or that’s why I’d thought, but the moment I saw my husband, I started venting my frustration again. Even now, after talking to him , I still need to write about it to get it off my mind. Health care in the US sucks. Asthma isn’t a critical medical condition, I wonder what the people with major illnesses on minimum wage do, die? If you are looking to move to the US and you have a serious medical condition and get free healthcare in your country, DO NOT come, unless you have a well-paid job waiting for you the moment you land. Health care is way too expensive and it isn’t even good.
I felt lucky when I explained that my company was going to pay 100% of my healthcare. However, I didn’t know that I had to reach a deductible, that the deductible was 1500 dollars and that until that happened, a visit to a pulmonologist would cost 176 dollars. Not feeling so lucky now…
That’s healthcare in the US for you.
Vocabulary for English learners:
get it off my chest: to tell someone about something that has been worrying or annoying you for a long time, so that you feel better afterwards
inhaler: a small plastic tube containing medicine that you breathe in, in order to make breathing easier
minimum wage: the lowest amount of money that an employer can legally pay to a worker
naive: not having much experience of how complicated life is, so that you trust people too much and believe that good things will always happen → innocent
prescription: a piece of paper on which a doctor writes what medicine a sick person should have, so that they can get it from a pharmacist
relapse: to become ill again after you have seemed to improve
scam: a clever but dishonest plan, usually to get money
vent: to express feelings of anger, hatred etc, especially by doing something violent or harmful