Saturday, March 14, 2009

I am thankful to live in a place with national single-payer health insurance

On Saturday I noticed that my husband's face looked strange - one side was droopy. Since he had been injured in a car accident at the end of the year and has been suffering from whiplash, we thought it was related.

He had lost feeling by Monday morning, so he went to the general practioner who serves as our family doctor at 9:30 a.m.

No appointment necessary, waiting time 15 minutes, cost out of pocket (30% of total) $11

The doctor told him to get to a general hospital immediately and wrote a letter of introduction.

I accompanied my husband to the osteopathic doctor who is treating him for the whiplash.

No appointment necessary, waiting time 25 minutes, cost out of pocket would have been $5.70 (cost was charged to insurance company of person who caused car accident.)

This doctor concurred with the other doctor and told my husband to go to the nearby university hospital.

The university hospital is a 5-minute drive from our home. The lobby was overflowing with people waiting for outpatient care. It was my husband's first visit to that hospital, so he had to register.

Wait time to register: 20 minutes

We were sent upstairs to the dermatology department. Here the wait was longer, about 40 minutes to see a nurse who took down the medical report. We were told that it would be quite a long wait to see the doctor. However, we overheard another nurse who had picked up a phone to say that there would be a patient for immediate admission and guessed that it was my husband. I left to handle matters at the business we run together.

My husband was seen by a doctor at 1:45 p.m. The doctor diagnosed facial paralysis (probably Bell's palsy) and ordered immediate admittance for treatment. When I returned at 2:30 p.m., my husband had completed paperwork for admission and was being pushed in a wheelchair by a nurse to the dermatology ward.

Because he had requested a private room, he was asked to leave a deposit of $3000. This would not be necessary for a bed in the 6-8 person rooms. We have a private insurance policy which will cover the cost of the private room.

Because the treatment of facial paralysis involves the aggressive use of steriods which lower the immune system, my husband was told to expect a hospital stay of two to three weeks. He is on an IV drip 3 to 6 hours a day. He is not allowed out of the hospital ward because of the danger of infection from the lowered immunity.

In the meantime, he is being examined for underlying causes. A heart problem has been detected. At the moment he is being examined by four different departments at the hospital: the orthopedic department for the whiplash, the otolaryngology department for the facial paralysis, the cardiology department for the heart problem, and the internal medicine department for a weight problem. All test results and explanations are given by the doctor in the otolaryngology department whom he sees at least once a day. A nurse checks his vital signs several times a day. All his exams are scheduled ahead of time so he never waits more than 10 minutes for a test or consultation.

So far, tests include CTscan, MRI, full set of spine X-rays, several blood and urine tests, stress tests for heart, various ear and eye tests for causes of facial paralysis - just about every test possible for his condition. The main doctor usually disusses the results the same day as the exam.

We are on the national health insurance plan (kokumin kenko hoken) as a family. We pay the top rate for the premiums for our family of 5, approximately $6000 a year. We pay 30% of medical and prescription costs up to about $750 total in a month. Other than the cost for the private room, we will not pay more than approximately $750 plus a small charge for the hospital food for the calendar month. Also, we will be able to deduct medical costs over about $1500 from our total income for income tax purposes.

Of course, we have both checked medical information on the Internet in both Japanese and English about the various conditions and concerning the diagnoses and advice we have received so far. All information we have gathered matches up with the treatment my husband has received so far. My sister has also checked on information available in Thailand. The biggest difference in treatment that we can detect is that the US relies on oral medication more while most of Asia relies on IV drip to adminster medication. Also, as far as I can tell, my husband would be treated as an outpatient in the US (and with the exhorbitant cost of hospital care in the US, that would be preferable.)

However, we are very glad that my husband is hospitalized because the amount of running around and time that would be required if he were an outpatient (not to mention the risk of exposure to infection) would play havoc with my work schedule as well. As it is, my college-age son has come home to help out during spring break.

Right now, our biggest concern is my husband's condition. We wonder how his health condition will affect our work and our family. The one major concern we don't have right now is how we will pay for the excellent care we are receiving.

If, God fobid, my husband is unable to continue work and has to close the business, I can enroll him and the children on the insurance plan that I will be on from April when I take a full-time job as a university professor. I will be enrolled in the private university and school plan, which, of course, is tied to the other government schemes.

The biggest drawback that I can see to the various national health insurance schemes here is that, without a private plan to pay for a private room, my husband would be in the 6 to 8-person ward. Those wards do look crowded. Otherwise, the treatment for the patients is all the same.

At times like this, I am particularly thankful to live in a place where national single-payer health insurance is available. I hope that, sometime in the near future, all my fellow Americans too are able to have access to medical care.
M. P. O.

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