NEW YORK LETTER
There are two ways to tell the story. The first is to flatter French prejudices about the inhumanity of the American health system and to explain that, after receiving a bill of 62,174 dollars (51,650 euros) from the hospital for the operation for sciatica, A few weeks later, I received a second, for $ 43,970, for the surgeon’s fees, which the insurance stubbornly refused to cover.
The second way is to sell the wick and explain that in fine I was for 750 dollars out of my pocket. In the United States, when you have a health problem and, like 55% of Americans, benefit from private insurance (average annual cost of $ 21,300 for a family, generally paid for three-quarters by the employer), we have many fears, but we are treated without having to pay the amazing sums announced.
This account does not describe the condition of people who are uninsured (a little less than 10% of the population in 2019, according to the Kaiser Family Foundation) or covered by the public authorities because they are poor (Medicaid, 19.8%). , elderly (Medicare, 14.2%) or military (1.4%). Less glamorous or tragic, it is about a classic episode, “middle class”, which allows to relate the pitfalls of the American system.
A preliminary agreement that is dragging on
It all started in May 2020: I have sciatica. The pain is severe, I limp, and my GP sends me to see a specialist at Mount Sinai Hospital. Located south of Harlem, along Central Park, the property looks like a citadel in these times of Covid-19. The verdict is immediate: it is necessary to operate, otherwise the paralysis of the foot will be irreversible.
I am immediately placed in the hands of a surgeon, who proposes to operate urgently, the same evening, or to wait… three days, on Thursday, time to carry out the preparatory examinations. Go for Thursday. On Wednesday, I see the cardiologist, I have an MRI and a Covid-19 screening test. Medically, everything is fine … Except the insurance. The latter has still not given its prior approval for the operation. The surgeon’s secretariat alerts me late Wednesday morning and explains that the insurance requires that I call him directly, to explain my case.
In the midst of stress, over the phone, an ubiquitous forty-five minute conversation began with the insurance teams. I explain my medical condition to my interlocutor. On the surgeon’s instructions, I give him the code of the planned surgical procedures, the tax number of the doctor and the hospital. I hang up, dismayed by this interminable discussion which should not be my responsibility. And then, nothing more.
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