In our twenties and thirties, living in the US, we had fantastic health insurance. When I gave birth to my eldest son, I was installed in a large, private hospital room with a view of the Empire State Building.
Every specialist and the paediatric nurses were at my beck and call (did I want to keep the baby with me at night? Did I want to send the baby to the newborn ward so I could rest? Did I want to keep the baby but press the bell by my bed when he needed to be changed? Because obviously even if I kept him with me, I wasn’t expected to change a nappy after delivering a child.) I gave birth on a Friday.
When I was admitted to the hospital, my husband and I were asked to select food options from their special “candlelight dinner menu”; after my hard work was done, they wheeled in a small table with a tablecloth, (fake) candles, (fake) champagne, and grilled salmon with steamed vegetables. It was a proper Shabbat dinner. Total out-of-pocket cost: $0.
For all that, every time a bill arrived after a medical visit, we panicked. We would open the envelope with shaking fingers and typically find a paper – entitled “THIS IS NOT A BILL” – that looked like this:
Blood test: $1,250.25
Insurance paid: $113.00
You owe: $0
It never made any sense!
Moving to the UK and the NHS certainly came with challenges. Like when I had a biopsy on the lump on my breast and had to wait weeks for the results, the number of the breast clinic on auto-dial (“Sorry… junior doctor strike.” “Sorry… no one available to speak to you. Sorry… can you stop calling?”).
But was there an upside? You bet. Not one: THIS IS NOT A BILL.
To my own surprise, I find myself back on the other side of the pond. Now, I’m not in my twenties; I’m in my (gulp) fifties. And neither am I without a medical history. This time around, I’m a cancer survivor.
My insurance is not stellar. But it does cover preventative medicine, something at which I find the UK does not excel, so I made an appointment for a check-up. I met with a nurse. She talked me through my medical history and checked my weight, blood pressure, oxygen, and pulse. So far, so good.
A couple weeks later, I got something in the post. I looked for the “THIS IS NOT A BILL” heading, but it wasn’t there. I read the document. For 20 minutes of the nurse’s time, I had been charged $750.
The $500 for the “annual physical” was covered by the insurance, as promised. OK, though it did rather beg the question how I could have had a physical without physically being there. But the “doctor’s office visit” – and I didn’t even see a doctor, I saw a nurse – was not covered. Eh? Plus, the $750 did not include the bloods they took the following week.
That was another $2,000+. So, I did what Americans have to do on a shockingly regular basis: I made a beef about my medical bill. “You’re such a Karen,” my kids said using my name as a slur. No, I’m a strong, independent Jewish woman who stands up for herself.
“I don’t know,” said the clinic receptionist when I called to ask what was meant by “doctor’s visit”.
It soon became clear, however, that I had no plan to hang up, so she put me on hold. She returned after five minutes. “Yes, you had something on your right breast?”
“The something was breast cancer, and it was removed two years ago. Am I being charged for mentioning having had breast cancer?” I was put on hold for another ten minutes.
When the receptionist returned, she sounded smug. “You were discussing family planning,” she declared.
Um, I’m on a medication that puts me into medical menopause, I replied, with equal smugness.
She paused. “So, you want to challenge the charge?” She was not actually chewing gum, but if she were, I could imagine her snapping it in my ear. She was clearly bored by the conversation at this point.
“To be honest, I just wanted to know what it was for.”
She sighed. “I’ll put in a query. You should have an answer in about 45 days.”
And with that, she hung up.
No one ever called me back, though one day, the charge was simply removed from my account.
Go, Karens of the world. A small victory, indeed. But I still miss the NHS.
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