In America health insurance is connected to your employer. No employer? No insurance. Maybe you'd be poor enough to qualify for Medicare, but probably not. Since the insurance goes through the employer, the employer chooses which package they're offering in their benefits package. On a related tangent, a lot of employers schedule their workers for just short of 40 hours a week so that they don't qualify as full-time and therefore have to be offered benefits like health insurance. The employer invariably picks the shittiest, cheapest plan possible. The one that covers the equivalent of one trip to the doctor. God help you if you ever really get sick or seriously injured. It won't cover that and it will probably cost you both your insurance and your job, because: America.
I have known people who had to look for a new job because the health insurance offered by our employer didn't cover things like diabetic supplies. I've known people who started with simple, treatable problems who didn't go and see a doctor. Instead of getting it treated they'd nurse it along with folk-remedies and try to get by until the situation became truly life-threatening and they went to the doctor finally when it looked like they might die.They'd end up in the hospital with an enormous hospital bill that they'd never pay off. I've seen families driven into bankruptcy by medical debt. It destroys people financially, and aside from insurance there is nothing you can do to plan ahead for sickness or injury. People go into work sick and start localized epidemics because they don't dare to stay home when they're sick. I've known people to get bronchitis and not get it treated until it becomes pneumonia. And all the while they're going into work, because they can't afford the doctor's visit and they can't afford to miss work. How messed up is that? One person I knew collapsed at work, which you really don't want to happen because the next thing you know somebody calls an ambulance and you're getting a bill for $5,000.
You can't just get your own insurance apart from an employer either, because that costs more than most people can afford. If they have to cover a family, it's just not going to happen. In America you'll see these jars next to the cash register in family restaurants and gas stations. Usually they'll have a photo of a kid undergoing chemo on them and a plea for donations to cover their treatment. Here in Europe parents don't have to beg to get their children medical treatment. Now it's a trend in America to put out a call for donations on GoFundMe for medical costs. People have to do that to cover the distance between what their insurance will cover, what the hospital puts on the bill and money they don't have. In some places there are fairs where free medical and dental treatment is done. People camp out overnight and come in by the thousands because it's the only way they're ever going to get to see a doctor. Doctors donate their time and expertise for free because even they can see how big the problem really is.
Pay attention to how the local news covers the story of one of the donation jars being stolen. It makes it sound like it's inspirational when the whole situation is appalling. The fact that a kid with cancer had to resort to begging for the money to keep him alive in the first place is appalling. The fact that there are people out there so desperate that they would steal from a kid with cancer is maybe the saddest thing of all. It's not inspirational, it is deeply depressing. You will see these jars in every truck-stop and waffle house in America. Not just for cancer, but to save people from homelessness after a house fire and things like that. Because if something bad happens to you in America, you're on your own. You have to ask for the charity of your neighbors and hope they feel sorry enough for you to help.
America privatized the medical treatment field and deregulated the pharmaceutical industry. Hospitals charge astronomical prices for routine procedures and every thing they do for patients. They charge extra for putting on bandages or emptying bedpans. Sometimes hundreds of dollars for a bandage. If they get prescribed medication, it might cost hundreds or even thousands of dollars a month because the pharmaceutical companies set the price so high and the insurance refuses to cover it. Regular people are the losers in every scenario. Even things that should be cause for celebration like having a baby have become an expensive proposition if you do it in the hospital. They charge rape victims for their own rape kits (which never get processed in America, just charged money for) and then send them to collections if they refuse to pay. I knew one person who went to the hospital and brought his own medication. The hospital gave him his own medication and billed him for it.
I remember another person I once knew whose husband died of an asthma attack, but not until after he'd been found unconscious and taken to the hospital. Attempts to resuscitate him failed and he died. The hospital sent the widow the bill, over $100,000. She had just lost her husband, the love of her life, and she had to try to support and raise two kids without him. The poor woman later lost the house they'd renovated together and lived in when a flood hit. She got sick after the flood and spent a couple of years sick before she died. They never figured out what was making her sick. I shudder to think that the hospital collections presented her kids with the bill, along with whatever remained of their father's bill. I'd be surprised if there was enough money left to bury their mother.
Mental health care is even less accessible than medical care. Usually it's not covered, or if it is it's just enough to work through a mild case of depression. If you do get access to mental health care, odds are they'll throw pills at you and you will not work out your problems. And you have to be careful about asking for help too. There are mental healthcare networks that will do an intake interview with the objective of getting you to say anything that could be taken as "suicidal ideation" so that they can put you on an involuntary hold until your insurance runs out. People have been shanghai'd and lost their jobs, or been unable to contact their families to let them know where they are. People who weren't suicidal, just stressed and depressed. Almost nobody in America gets actual help for mental health issues.
Overall, America seems committed to withholding help of any kind from its citizens, but this is most visible in the healthcare system. And people there think it's normal. Now when I have to try to explain what it's like there to Dutch people I refer them to a show called "De Verenigde Staten Van Eva", in which a Dutch woman travels to America and interviews the poor. The first episode is about a health fair where poor people go to get treated for free. It's heartbreaking to see my people in that position. Even now I feel guilty about going to the doctor in the Netherlands, because I still carry the American mindset that healthcare is out of reach.
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