Saturday, October 10, 2009

Life on Mars

Two weeks ago I actually did begin writing a post about the outcome of the German election. And then, things happened. Nothing overly dramatic, mind you, however it was all distracting enough to pull me away from the computer. The German, Dude and I are currently on our biannual family vacation in Motown.

We have been here for about a week and everything is going pretty well. The flight was as I expected . . . long. The Dude only slept 1.5 hours out of the 8.5 hour flight. That was . . . fun. But it turned out for the best. After playing a bit with Grandpa when we got to the house, he crashed at 8:30pm and slept until 7am. Within two days he was over the jet lag.

This trip has been a bit odd, however. For the first time, I have come home, looked around and thought, "Have I landed on Mars??"

I first had this thought as we drove past all of the empty strip malls. The bumpy roads had pot holes the size of my Smart. A drive through my Grandfathers old Detroit neighborhood was down right scary. The German thought it looked like Sarajevo. We went up to Kmart to get a few things, and the very nice woman at the check out line was older than my grandmother. Seriously, she could have easily been 68 (the German guessed 72).

As we left, I turned to my husband and said, "What is she doing here?! Shouldn't she be at home playing with her grand kids or drinking tea with friends. Isn't that what you do in retirement? Hasn't she worked enough?" It really upset me.

But the best was yet to come . . .

The Dude got sick on Monday. A small cough got worse and worse, and even though he did not have a fever, he was clearly not feeling well. On Thursday I decided to call a few pediatricians to get him an appointment.

The first place turned me away. They informed me that they could not see us because we do not live in the area.

"I am still a Michigan resident. I have a driver's license and bank account. Besides WE HAVE INSURANCE."

"Will you insurance cover you here?"

"Yes! We can go to any doctor in the world and we are covered. I pay enough for it."

"Sorry, you will have to go to an emergency room or free clinic. We cannot run the risk of the bill not being paid."

OH MY GOD. Are you kidding me? In the greatest country in the world, a sick child with insurance cannot get a doctor's appointment?!?

So, I called the next doctor on the list. "Sure, we can take you. Could you we send the bill to your dad's house?"

"You know what, can I just pay cash? I can get reimbursed by my insurance company later."

"Come on down!" (For my readers, future reference, "cash" is the magic word in the US health insurance system.)

The doctor was actually quite nice and the nurse was fabulous. She was so good with the Dude. Turns out that the baby was not just being fussy. He has an upper respiratory infection and an ear infection. Nice. They called in a prescription.

When I got to the pharmacy, I was told, "We cannot fill this. You do not have insurance on file." "Can't I just pay cash?" "Sure!" (There's that magic word again.)

The entire cost of a doctor's visit and antibiotic in the US: $190.

This entire experience has left me absolutely dumbfounded. It proves that in the US it is difficult to get access to affordable care, even for those with insurance. The costs are outrageous; the same bill in Germany would be less than half that in the US. How can anyone look at this system and think that it does not need to be fixed? What is wrong in the US?

I posted this on my Facebook page and naturally one of my more to the right friends (I am trying to be nice) said, "I love the US. Always have. Always will." What does that have to do with anything? I love the US, too. I actually believe that it is one of the best countries in the world. But health care is a problem. My friend also said that being ranked 14th in the world is "okay," what are people complaining about? This is also the problem. Those that have not had any of these experiences and have not gotten sick do not understand what millions of Americans go through everyday.

Satisfaction with mediocrity is not an option; maybe on Mars but not in the US.


ann said...

I paid around €130 for a doctor's visit and flu meds in Austria (and that was 6 years ago). I think I got about €30 back from my German insurance, which should theoretically have covered me.

The fees are nuts in the states, but I think you are likely to run into trouble here, too, if they know they can charge whatever they want.

Did you try an urgent care center?

don't get me wrong - starting with booting sick people from the insurance rolls and ending, well, nowhere there are problems with the US system.

vailian said...

Your report is worrying. I am off to the States tomorrow with Daughter,11... and I am just hoping no one gets ill! I pay top bracket insurance here in Germany, but no insurance company here will insure me, as an American, for medical coverage in the States... I am assuming you are covered on your German husband's policy... if you have any idea how or where ex-pats can get coverage for holidays in the US (I can easily get coverage for any other place in the world, including darkest Africa), please let me know!

Anonymous said...

I'm glad your little boy is okay.

I love it when people make irrelevant comments like your "I love the US...always will" friend. I had a "huh?" moment the other day while I was on the phone with a friend. I told her that I'm thinking of going to a sleep therapist and getting an evaluation. She replied, "Well, you better do that now because you won't be able to if Obama gets his way!" HUH? Isn't it the opposite??

cliff1976 said...

I was wondering about coverage in the U.S. too, shortly after moving here to Regensburg, so I signed up with SDK for a policy specifically for coverage while traveling for pleasure. My normal Krankenkasse coverage covers us in the EU and anywhere I am on a business trip, but since we spend so much time traveling privately, I wanted to have a policy that covers us for the U.S.A, Mexico, etc. I picked SBK based on a recommendation from some German friends who spend a fair amount of time travelig on business. I've heard horror stories about Americans living in Germany, insured for coverage in Germany, who were visiting family in the U.S. and needed emergency surgery (an appendectomy or gall bladder removal — something relatively rouine, but also potentially acute), and had to pay out-of-pocket. Yikes.

We haven't ever had to use the extra coverage yet though. So far so good.

Anonymous said...

The U.S. is ranked 37th in healthcare by The World Health Organization not 14th. If you are able to have biannual visits to the U.S. then the sight of senior citizens having to work in order to provide even the most basic necessities in their lives should not surprise you at all. Life is hard here and most americans will never have the chance to travel outside of the U.S. thereby being able to see for themselves that there are indeed other countries where life is as good as or BETTER than the U.S..

The countries infrastructure is falling apart, the gap between rich and poor is growing larger everyday and of course the number of uninsured are growing everyday. This is not due to our current economic cycle, this is just life in the U.S.A..

But hey, as long as people believe that we are the greatest country in the world then I guess it's okay.

Anonymous said...

I too love the U.S., but I am thinking of moving to England with my husband's family. Things here are bad and I feel our quality of life would be so much better over there. I have a college degree and a good job but can barely pay the bills and feed my family at the same time. I took the 2 older kids to the dentist for cleanings each has a cavity, but I cannot get them filled till I pay off the $250.00 bill from the cleanings! By the way I have some of the best insurance coverage in the U.S.!

Martin said...


if travelling out of Germany you should add a "Auslandskrankenversicherung".

It covers many many things and cost you 15-20 Euros a year per family!

All health insurances should (Krankenkassen) provide this.

Usually you can order this online.


PS: Great blog! I am waiting on your election bash!

Martin said...

Oops, should be "waiting for", of course.


LizE said...

Wow that is really terrible. I can only imagine how frustrating that was to deal with.

That's an interesting perspective on having the older woman wait on you. I tend to think that it is great to see someone older staying active since I see so many at the senior center just waiting to die. But like most things the truth lies somewhere beyond what we can see because an older person working to be able to survive is far different than an older person trying to stay active. The problem with snap judgements in both directions I suppose.

Oh and about the health care debate. Just because I think the bill being proposed is fiscally shortsighted and deliberately misleading doesn't mean I don't agree 100% reform is in order. The problem with the way your friend reacted, and indeed how ideologues on both sides are acting, is that we can agree there is a problem even if we disagree over the approach. It makes you wonder when it was that our government went from being respectable advocates to school yard bullies.

Hope your vacation has been going better after your bumpy start!

Anonymous said...

To LizE
I think your thoughts on older people working to stay active are actually a sad statement about life for the elderly in America. In Germany retirees recieve a generous pension and can spend their free time going hiking, visiting castles or historic villages taking short river cruises, visiting spas etc. at very little or sometimes at no cost to them. It is amazing how many elderly people one sees in Germany vacationing or just taking day trips. Inexpensive and extremely efficent public transportation also helps make this very easy.

For an older German the last thing they would think of to stay busy is to go out and get a job.

In the U.S. due to lack of funds, the sheer size of the country, the necessity of needing a car and cultural differences that type of retirement is not available to many people.

I think --maybe-- the blogger is beginning to see life in the U.S. a bit more through german eyes.

LizE said...

Hi anonymous,

Having lived abroad, I think it is a very positive thing to be able to look at your home and be able to determine what you think is working well and what could be improved.

I do find your comments very interesting because it seems like you view work as a pejorative whereas I view it as a way of continuing to contribute to society. Also, there is a substantial amount of research that indicates maintaining a job, even volunteer or part time, helps to ward off brain atrophy. But again, as I mentioned before, there is a world of difference between wanting to work and being forced to work. Certainly no one wants to see a 70 year old put in that position. My only point was that I don't think you can assume. Also, I can't see why working and enjoying vacations/day trips needs to be mutually exclusive.

I also have to question your vast generalizations about life for the elderly in the United States. Each state has its own culture and resources so making blanket statements about transportation and such simply doesn't take into account the vastness of experiences for the elderly within this country.

Anonymous said...

Hey Claire,

You have to remember that Metro Detroit has been in a never ending recession for the last 8+ years. The interest in cash payments came about because so many *didn't* pay their bills.

Having said that, I'm a native Detroiter who lived in Stuttgart for some time and is currently in Arizona. Things here are quite different, even though economically we're suffering like the rest of the nation. The difference is the depth of suffering, and frankly nothing compares to what I've seen in Michigan. When I lived in STR in had a lot of ear infections, and as long as I reminded them I had private insurance I was attended to very quick. The days there were new people behind the desk I waited for hours.

Could the US System be improved? definitely! Is the German system the be-all end-all? No. But could we meet somewhere in the middle to the benefit of all? Absolutely!

As for the elderly, there was an interesting recent article in the Detroit News that you might want to read:

All the best for your time in the D. I miss the fall colors and apple cider so much!

Rositta said...

I have a blogger friend in Detroit and hear about the dire situation in that town. The recession has hit harder than in other places with the exception of California. Health care is an issue when traveling no matter where you go. I needed a doctor in Germany last year and had to pay cash even though I had travel insurance. Even traveling in Canada to another province you will have to pay cash in advance and then be reimbursed by your insurer. A doctor visit will set you back about fifty bucks, a trip to the ER over three hundred bucks and in Canada drugs are not covered at all unless you have private insurance...ciao
ps. I currently have jet lag too, yuck.

Sally said...

Don't forget to mention that medicine for children under a certain age is free unless it's some super-duper rare and really expensive thing. My son had some sort of fungus on his face once and the doc prescribed this really expensive topical ointment. I think we had to pay € 2.50 for it. Everything else, even over-the-counter cough medicine, if your doc will give you a prescription for it, is free.

And we have ADAC Auslandsreisekrankenversicherung for us when we travel. We've gotten reimbursed in full for visits and meds in Morocco with no probs at all.