My name is Eric Lambert and I’d like to share with you my experience of what it was like to live in a country that cares for it’s citizens and residents like compassionate human beings and what’s it’s like to live in a country that places profits over people and their well being.
I was diagnosed with type 1 diabetes when I was 12. I was fortunate that my father had good health insurance and that there was a wonderful team of doctors and nurses at the endocrinology clinic in my home town of Rochester, New York who helped me tremendously as I was growing up. That fortunate experience, however, sheltered me from how the real world of American healthcare worked (or didn’t work) and how it viewed us “sick” people.
I was covered under my father’s plan through university after graduation was eligible to participate in COBRA, which at that time would give me the opportunity to extend my coverage under his insurance for a couple more years for the “low” price of about $350 per month, not including co-pays of course.
I moved to Taiwan after graduating from university and since I was planning to live there for less than a year I continued to use COBRA thinking that nothing could possibly top American insurance and care. At the time, I didn’t even know that Taiwan had one of the best single payer universal healthcare systems in the world, but it wasn’t long before I found out.
Ended out staying in Taiwan well past six months and in my second year I got a legal “on the books” job teaching English. That’s when I joined the Taiwan National Health insurance system, probably the only governmental system in the world that I can say has a special place in my heart. I didn’t have a choice about joining, but that was okay. After all, I was contributing towards half of the premiums and my employer was putting in the other half. At the end of the month, that turned out to be roughly 2.5% of my income; a far more reasonable and affordable amount than my previous COBRA plan. In fact, my new premiums for Taiwan National Health Insurance were less than 10% of what I had been paying for COBRA.
I wasted no time familiarizing myself with the system. My Taiwanese friend helped me find a good endocrinologist and eye doctor. And I shopped around myself for a dentist that I liked based on location, service and the look of their office. It wasn’t hard to do and if it turned out that I didn’t like that provider it wasn’t a major setback as the co-pays for office visits ranged from just $1.50 to $5.
I couldn’t believe what I was experiencing. I kept waiting for the drawback of single payer health care to raise it’s ugly head and deny me for a pre-existing condition or make me pay out of pocket for an unapproved treatment but it never did. Sure, most of the clinics didn’t have million dollar lobbies, but the same modern technology that we use here to treat those fortunate enough to have insurance was there too. They had the same medicines, only more generics. The doctors all spoke English as they were educated here or in Canada. Well all except the Chinese medicine doctors whose services were also covered. Everyone had an insurance card with an IC chip that stored their medical records so there was never time wasted because a new doctor I was seeing didn’t have that important information. These cards were also used for billing at the doctor’s office which made each visit that much more efficient. I could see almost any doctor I needed and for the most part, I waited less there, than I did here.
I could go on and on about how the system works and site studies that show it’s efficiency and effectiveness, but there is one way it works for which no statistic, diagram or spreadsheet can express. That’s the way it worked to make me feel human, to feel part of a society that cares. To know that if any of these nice strangers I pass on the street fell ill, they’d have my support and that when I needed some help, they’d be there to support me to. We all paid in, we were all secure, and we all agreed that the value of human health was something to be cherished, cared for and protected. The system was a embodied social support and mutual compassion and it was amazing how it effected the cohesion of Taiwanese society in a positive way.
Well 7 years is a long time to stay in a foreign country, even if you do feel like they care for you more than your own. Besides, things were happening here with health care. Obama was “changing” things. As I observed the health care law take form with great frustration that single payer was not even brought to the table, I got to thinking about coming home. Sure, the health care law seemed like a huge give away to health insurance companies, but at least they couldn’t deny me for having diabetes anymore.
The uncertainty of my healthcare situation in the United States weighted heavily on my mind, but I wanted a new challenge and damn it, if I went bankrupt and lost all my savings in the first year back here, well at least I knew of a nice little island on the other side of the Pacific Ocean that would accept me and care for me. I could always fly back there for safety.
I had catastrophic accident insurance for the first three months after I moved back. It was all I could afford and still more that 5 times what I had been paying in Taiwan. I was lucky though. I was offered a position with AmeriCorps and as soon as I confirmed that they did offer some kind of health insurance, I accepted. It was a simple plan where I paid 20% and the insurance picked up the res. I felt pretty safe, that was until I had my first visit with an endocrinologist and received a bill for $630 for my thirty minute consultation! And all I really needed was a prescription so that I could buy overpriced brand name insulin to stay alive.
How was I going to cover 20% of these costs on an AmeriCorps stipend? I called the Vancouver Clinic to dispute the charge. Certainly, there must be something wrong. I was charged nearly $1000 for a single visit and lab work. They assured me there was no error in their billing and that this was quite normal in America. I shopped around and found a community health center where a physicians assistant could prescribe me insulin, then shopped around again for a place were I could buy a vial of insulin, which is a 10 day supply, for less than $115. Canadian online pharmacies had it for half the price but my insurance company wouldn’t cover medications purchased abroad. I had to buy the expensive stuff. Scenarios I hadn’t even thought of were proving the American health care industry to be far worse that I’d expected. But then came the hammer.
After I’d fronted over $3000 for a 90 day supply of insulin and other diabetic supplies the insurance company sent me a letter saying they were done covering my pre-existing condition. Turns out they had a $5000 maximum under a “pre-existing condition clause” which I had reached. Essentially, in order for them to be obligated to cover me for anything diabetes related, I had to produce a certificate of credible coverage proving that I had had insurance, without a break for more than 62 days, for the past year. It was easy enough to get that simple letter from my most recent US insurer, but it was a nightmare trying to get it from Taiwan. Not because they didn’t want to do it, but because they had no idea what I was asking for or why I would need it. I spent hours on the phone using every word I knew in Chinese to convey this desperate request to them. Finally, with the help of a Taiwanese friend I was able to get that incredibly simplistic letter that stated I had been covered by Taiwan’s National Healthcare system and force them to reimburse my.
It was a hard fought battle that characterizes the disfunction of “health care” in the US. Needless to say, since I’ve been back, I’ve spent more of my own administrative time dealing with insurance companies, providers and pharmacies than I had in 7 years of living in Taiwan. I spent over 10 times the amount of money in my first year in the US than I had in the previous 7 living in Taiwan, and that includes an ER visit, hospitalization and surgery on my right foot.
I’m fighting for universal healthcare because I know it can work. Because I know how it feels to have the security of knowing that we’re all cared for. Because I know how efficiently and affordably a universal healthcare system can function. Because I know that people are out there suffering needlessly because they lack access to healthcare. Because I know that it’s just a matter of time before we as a society take that next step and recognize healthcare as a human right.