Healthcare Stories

Nancy (Netherlands)

After a bad horseback-riding fall in Belgium, I was taken to emergency. The nurse came to the car with
a wheelchair and I was moved to a private room and given pain meds within minutes and in x-ray less
than 30 minutes later. In-and-out in under 2 hours. I was living in the Netherlands at the time, so I
received the bill (from Belgium) in the post. I was afraid to open it, but when I did, it was 120 and
107 for the follow-up in a clinic for scanning. My Netherlands insurance covered everything, plus
rehab.

Jeromy (Pennsylvania - Belgium)

As an American living abroad, I have to say that I was a bit more than culture-shocked the
first time I experienced universal healthcare. Being a lifelong sufferer of asthma and allergies,
I am constantly being prescribed inhalers and epipens (for those big emergencies). Just prior
to moving to Belgium, I was also diagnosed with hypertension and Type II diabetes. In any
case, I was completely floored the first time I went to the checkout at a Belgian pharmacy.

The price of an albuterol inhaler in the US (with insurance, I would like to add) is about $40. It
doesnt seem like much, but with constant use, it adds up over the years. When the
pharmacist told me that the price here in Belgium was 78, I initially thought, Wow! Thats a
bit more than I expected. It wasnt until the pharmacist clarified that it was 78 cents and not
Euros that I virtually went into anaphylactic shock. The rest of the prices for medication in
the universal healthcare system are equally shocking (in a positive way). My epipen costs
about 12 euros, compared to over $400 in the US. In addition, my medication for diabetes is
completely free. The non-capitalist approach to healthcare for the patient has actually made
me less worried about going to see a doctor. At least now if something is wrong, I dont have
to entertain the thought of pawning a kidney on the black market just to afford the medical
expenses.

Furthermore, to better illustrate my point, I ended up spending 3 days in a hospital last year. I
needed to have surgery to remove a kidney stone. In addition to attentive nurses and doctors
who regularly sought me out to either check on me or explain things, the total bill for the 3
days was less than the co-pays for similar procedures in the US. On top of that, I was
reimbursed a portion of what I had actually spent.

Finally, the universal healthcare system is set up in a way that rewards proactive measures
concerning ones health. If you regularly go to the dentist, it costs less. Memberships to gyms
result in 2 months for free. Interventions for quitting tobacco are reimbursed. The list goes
on.

The main point is that growing up in the US, I learned to avoid being sick as much as possible.
I developed a certain aversion to hospitals and doctors in that it meant debt, and lots of it.
Here, where healthcare is universal and not designed to empty your pockets, I have never
felt healthier nor the least bit bothered by going to see my family doctor or specialists.

Robynn (Massachusetts - Belgium)

American politicians who oppose universal healthcare or centrally regulated healthcare

policies such as those created by the Affordable Care Act (now being decimated by
Congressional Republicans) are fond of criticizing other countries' national healthcare
institutions by only ever calling attention to the negatives, the stories of long waiting periods
or the supposed restrictions on provider choice for example. But they never seem to
acknowledge the wide range of positives and successes in countries that have universal,
affordable healthcare. What Americans and American policy makers need to know is that
while no system is perfect, in countries with affordable universal healthcare, the positives
drastically outweigh the negatives.

As a resident of Belgium, Ill admit, I hear plenty of complaints. The cost of visiting a doctor
who isn't "conventionn," for example sets some Belgians teeth on edge. Belgiums partially
socialized system allows doctors some flexibility in what they charge, and many charge
slightly above the agreed-upon rate covered by regulated national insurance schemes (called
mutuelles in French). Americans are familiar with this practice: its like the reasonable and
customary rates that most American insurance companies work out with their preferred
providers. So on the face of it, one might argue that the socialized Belgian system doesnt
manage to avoid some of the same pitfalls of the American private one. But heres the
difference that neither Belgians nor Americans will immediately recognize. Whereas in the
U.S. the reasonable and customary excess kept in check by private American insurance
companies can amount to hundreds of dollars, in Belgium we're usually talking about 10 or
20 that the patient might have to pay -- an amount still significantly lower than the co-pay
an American with private health insurance will pay for every visit often after first meeting
steep deductibles and always after paying enormous premiums. Whenever a grumbling
Belgian complains about the additional 10 their doctor is allowed to tack on because the
system isnt adequately regulated, their jaw drops in astonishment when I report how much
U.S. doctors charge per visit. And they always assume Im exaggerating when I tell them that
before moving to Belgium, my husband and I paid $580 for a plan with enormous deductibles
before upgrading to one with lower deductibles at $800 per month.

A Belgian sees 9.90 per month deducted from his/her paycheck as a contribution to the
mutuelle. No, I have not misplaced the decimal. Nine euros and ninety cents. There is a
larger, global social security contribution based on salary that is also deducted, but that
includes pension and other social benefits. The basic right to healthcare insurance costs
9.90 per month, per family.

And yet the Belgian system is not entirely "socialized." There is an element of free-market
independence built in. You generally pay the insurance provider an annual fee of something
like 100 to 250, which is essentially a membership fee for your plan of choice. Plans and
annual membership fees vary in what they offer on top of certain guaranteed and regulated
coverage. Perks such as health club membership rebates, reductions on glasses frames, or
weight loss or smoking cessation programs, etc. keep the plans differentiated and
competitive. You have a free choice from among a range of privately run plans, but since
they are generally non-profit mutuelles that are federally subsidized, they are all subject to
regulation, keeping the costs and rules for basic medical coverage in line with equitable
national standards. A mutuelle can't charge more than the regulated monthly contribution
for basic medical coverage, and regular medical costs are always covered at 80% of the
conventions, or agreed-upon ("reasonable and customary") rates.

This doesn't sound all that different from the U.S. system put in place by the Affordable Care
Act and it isnt, until you understand what the actual costs are. A typical doctor's visit in
Belgium is about 24 to 28. Total. That's not the co-pay. That's the total amount the doctor
earns for the visit. The agreed upon rate is roughly 24, so the mutuelle will reimburse you
approximately 18, meaning your out-of-pocket expense, at the high end, is about 10. That,
plus the roughly 10/per month and 100 to 250 or so annual mutuelle membership is all
you pay.

So, it's not free. But it's affordable extraordinarily so compared to the U.S. where, in 2001,
my husband and I paid $580/month, and never got a single penny in reimbursements
because we never reached the annual $5,000 deductible that would have triggered them.
Belgiums system requires everyone to pay something, unless you are unemployed and
receiving social benefits. And those at the low end of the income spectrum have access to
social assistance if costs exceed their means. For everyone with at least a living wage, the
basic cost is affordable, and there are plans with no or very low annual membership fees and
in all cases, every mutuelle must offer the same basic coverage, at the same rate, to
everyone.

The ACA reigned in much of the profit-driven greed of a private system that used to enslave
working and middle class people to health insurance plans that could both charge outrageous
fees and limit patients access to coverage and reimbursement. Through any number of
hidden or difficult to understand terms and conditions, people could find themselves
restricted by preferred provider network limitations, pre-existing conditions clauses, and
unregulated reasonable and customary fee ceilings.

Again, no system is perfect, but the ACA went a long way toward reforming a system that
was so far from perfect as to be inhumane. Belgiums part free-market, part social welfare
approach to healthcare is the best model I have ever seen. The result does not violate
free-market principles; it makes use of them to encourage a fair and humane system that
ensures equal-access and affordability for all. I would urge American policy-makers to stop
whining about the supposedly insurmountable problems of transforming Americas
free-market health insurance system into a universal one, and instead start paying attention
to the places, like Belgium, where they have already done it. Its not as hard as you think.
The only hurdle is the thinking.
Lori (Los Angeles, California - Germany)
I'm an American who has lived in Berlin for about 15 years now, and I don't really have an
exciting story about my health coverage. I think that's the point. I am covered by one of
Germany's public health insurance funds, and I'm very satisfied with the coverage and the
service. I've rarely had to wait more than a week or two for a non-urgent appointment.
When I've been sick, I've always been able to see my doctor on the same day. Last year I
turned 50 and promptly received an invitation for a free mammogram. At the moment I
have a good job with a good income, so I pay more than some people do for the same
coverage. But I'm happy to do so because if I ever lose my job I won't lose my insurance,
and my payments will fall.

My future husband, who is German, once had a back problem while he was visiting me in
the US. I was in grad school and used my university's health center, but that option wasn't
available to him. I had to spend several hours on the phone before I found a clinic we could
visit so he could get the prescription he needed - because even though his insurance would
reimburse his costs when he got home, we didn't have the hundreds of dollars on hand
that a regular doctor's appointment would cost an "uninsured" patient. After listening to
me for a while, he remarked how sad it was that the only thing that seemed to interest
anyone was his insurance. Now that I've seen how much more humane and effective the
German system is, I understand where he was coming from. If Americans had the chance
to try out German healthcare, I am confident they would never go back.

Gabrielle (Westchester County, New York - Belgium)

I am self-employed and on getting my work permit some thirty years ago I had to choose a
mutual society for my pension and health insurance from the ones on the market within a
three-month period. Otherwise, I would have been affiliated with the State mutual society
automatically. At the time, only major medical expenses were covered, so x-rays and
surgery but not dental care, prescription drugs, and doctor's visits. The law changed a few
years ago and now everything is covered (prescription drugs, doctor's visits, dental care,
and a contribution to the cost of glasses and orthotics). Consultations of specialists are
billed at about 25 euros if the specialist bills the statutory rate and I pay 12 euros to consult
a doctor, with the rest (about 12.50) paid by the the insurance scheme. I pay about
one-third of the cost of my prescription drugs, medical imaging, and labwork, while
mammography exams are free after the age of 50.
The various mutual societies also have special offers above and beyond the statutory
requirements, such as reimbursing membership fees in sports associations to the tune of
some 50 euros a year, various hospitalization insurance plans, and even coverage of part of
the cost of female and male (as of April 2017) contraception (e.g., 50 euros for the pill, 150
euros for contraceptive injections or IUDs, and 40 euros for condoms)!
The statutory health insurance that covers me in Belgium is a life-saver. Without it, I
would be in a wheelchair and on welfare (in the United States, as Belgium would kick me
out), or I would have had to sell my house to pay for an operation!
Examples of how I benefit from the statutory health insurance scheme:
2012 Total annual social security contributions (= pension + health insurance) of
6430.45 (based on my taxable income three years prior) + 8 euros a month for
supplemental coverage (glasses, sports clubs, etc.).
I got 50 euros back for my water aerobics class (which costs 12 euros a week).
I paid 10.73 out of a total of 85.03 for a dental repair.
2016 Total annual social security contributions (pension + health insurance) of 4349.68
(based on my taxable income three years prior) + 9.49 euros a month for supplemental
coverage (glasses, sports associations, additional hospital coverage)
Total hip replacement
Item total cost billed to billed to
insurance patient
x-rays, labwork, doctor's fees 102.42 84.94 17.48
pre-op exams 160.44 119.13 41.33
radiology 74.74 45.74 29.00
radiology 140.08 106.19 33.89
Hip (titanium stem, ceramic head, ceramic cup, 2735.44 2088.11 647.33
etc. - Johnson & Johnson)
surgery + 1-week hospitalization + 3 weeks' 12,219.22 11,377.13 842.09
rehab

The surgery + rehab were was followed by thirty -hour sessions of physical therapy at a
cost of about 26 euros/session, of which 2/3 was reimbursed.
As my business grossed about 19,000 euros in 2016, I would never have been able to pay
for a new hip without this insurance.
Gina (Massachusetts Suffolk county - Canada)
I have lived in Canada since 2001, and I am grateful for the healthcare we receive and also
for the knowledge that everyone around me receives it, regardless of their economic
background.
There are flaws - hard to get second opinions/referrals without a family doctor, access to
family doctors especially in rural locations - but overall we feel the Canadian healthcare
system delivers high quality.
For instance:
-I never once worried about the cost of delivering my two children or any of the tests that
were needed during pregnancy.
-When we thought my daughter broke her wrist December 2016, we brought her to the
Sick Kids ER in Toronto and were in and out in 1.5 hours, including x-rays (which
determined she didn't have a fracture).
-When we were in the ER with my daughter's concussion February 2017 in rural Ontario,
we said, isn't it nice that we don't even think twice about coming here or what the cost
will be? Or all the times she's been to the doctor since then.
These are just a few tidbits

Laura (Virginia - Germany)

I am a US citizen currently living in Germany. I left the US in 2002 to move to Greece and
then made the move to Germany in 2013. Aside from picking an excellent husband, moving
to the EU was the smartest decision I ever made with regard to my healthcare.
I was diagnosed with Systemic Lupus Erythematosus at age 7. For years, I was a drain on
the medical insurance of my father's work, and eventually he was actually let go because
the company didn't want their premiums to keep going up because of my expensive illness.
I was in-and-out of hospitals for years until age 22, almost died of kidney failure once, and
both hips had disintegrated (the left one collapsed) due to high doses of steroids meant to
keep me alive. I was lucky enough to get good healthcare coverage through my work in my
20's, and when I left that job was fortunate to live in a state with universal health care
coverage. Despite that, doctors classified my necessary hip replacement surgery as
elective surgery, so I could not get relief for the terrible pain I was suffering in my hips.
The left one got so bad that my pelvis shifted 6 centimeters in total over the years.
When I left the US for Greece in 2002, I was immediately on their health care system.
Doctor visits didn't cost me a thing. Medicines were cheap even without a prescription. I
consulted with an orthopedist about my hips but there were other health considerations
that needed to be dealt with first, and so those were taken care of, and then I moved to
Germany.
My hips had deteriorated more immediately after I got to Germany and I could barely walk.
The orthopedist was shocked by the condition of my hips and especially that it would have
been considered elective surgery in the US. I was referred to the best orthopedic hospital
in my region and had both hips operated on within 8 months of each other. The left hip
required a specially made prosthetic because of the advanced degree of decay that had
begun when I was still in the US. I have had the greatest hospital experiences of my life
here in Germany, and I am grateful for the level of care and after-care I have received. I am
still in physical therapy two years after the second operation because I still have so much
pain - likely the result of so much damage to the hip, along with problems that can arise
from Lupus. My disease is controlled by a specialist every four months. I get all the care
and medication I need. While a significant portion of my husband's paycheck every month
goes towards our health insurance, we pay very little for my care outside of that and are
very happy to pay our share into a public healthcare system that works very well here in
Germany.
The US needs a good system for health care like Germany. I don't want any other person
to have to go through what I have with my hips. It is unnecessary, and just means a greater
burden on the system, because without surgery I would have eventually been unable to
work.
Thank you for listening to my story.

Jessie and Mark (United Kingdom)

I am writing to share the very positive experience my family and I have been having in the
UK on the National Health Service. While every healthcare system will have its bumps
and flaws, we have been so privileged to be able to have it at our disposal.
I am an American citizen living abroad with my English husband and our dual citizen
children, both of whom were born using the NHS. Since moving here nearly 10 years ago, I
have been so thrilled at the service we have received. Yes, our overall taxes are higher
than in the US but the burden of wondering if our medical problems will be covered, if we
can afford the down payments, etc. has been taken from us. That stress is no longer a part
of our lives.
Both of my pregnancies and labours were fully managed on the NHS as well as the
complications that I suffered afterwards. My husband suffers from asthma and one of my
daughters has allergies that have been addressed on the NHS as well. We have also, as
many parents do, had to seek emergency medical care for our little ones and have been
able to be seen immediately when the situation required it.
My husband still has access to private medical care through insurance provided by his work
should we ever need it, so the NHS does not restrict access to that, but we are so very
pleased to be able to use the NHS.
I would be willing to advocate for universal health care and answer any questions that
someone might have about our experiences with using a universal heathcare system.

Bethany (New York, 11554 - Canada)

I have been a resident, now dual citizen, of Canada for the last 20 years. In the last 20
years I have not seen a doctor bill. I have had two children, several visits to emergency
(for myself, my children, and my husband), and general health maintenance which I fully
participate in given that preventative healthcare is covered by my Ontario health insurance
plan (OHIP).
My children were both delivered by midwives, covered in full by OHIP, and the first was
delivered in hospital. She was in ICU for a week, and had many specialized tests. She was
rushed to ICU directly after birth, and I stayed in the hospital for observation for 2 days. At
one point the doctor wanted one of many tests to be expedited and walked it over to the
childrens hospital himself. The nurses worked around the clock. I saw a breast feeding
specialist, an occupational therapist (for my daughter) and numerous and regular
appointments and specialized tests (including MRI and CAT scans) during her first year of
life at the remarkable Toronto Sick Kids Hospital.
I cannot estimate how much all of this would have cost if we had been in the United
States, but what I do know is that while all of this was going on, during an incredible time
of stress, I cant possibly imagine also feeling concerned about the cost of the bills and
whether we would be able to afford the care we were receiving. My daughter is fine now
and I am eternally grateful for the level of care - both in quality, speed, and compassion -
that I received at St Michaels Hospital in Toronto. I have never encountered a situation in
which my healthcare was compromised under this system, and in fact feel that the
attention I received was superlative as compared to the care I received while living in the
United States.
I also lived in Germany where I received incredible care, also covered by the
public/universal health insurance system. I had doctors working together to solve a
respiratory condition I was suffering from and never saw a bill or had a less than quality
office or testing experience, and I had shorter than believable wait times at every
appointment. It was efficient, well thought out and generous. This is a much longer time
ago, and I am not as familiar with the current state of health care in Germany, but this was
my first experience with Universal Health Care, and it made an incredibly positive
impression on me.

Jenise (California - Japan)

There isn't a day that goes by that I am not grateful that my son was born in Japan,
where we enjoy universal healthcare. My husband, son and I pay $500 - 650/month
depending on our income the previous year, which covers 70% of my husband and my
medical expenses and 100% of our son's.
My son is now a healthy vibrant 7-year-old, but I can say with almost complete certainty
that he would be much less verbal than he is - if he would be speaking at all - had he been
born in the United States. Theo was born with Down syndrome and with some of the
medical issues that most newborns with Down syndrome have. In his case, this was a
complete AVSD requiring open heart surgery and esophageal atresia (his esophagus not
connected to his stomach). He spent his first 9 months in the hospital and required six
surgeries in total.
After his second operation, it was discovered that he had tracheal malaise (which meant
that the cartilage was not strong enough to keep his trachea sufficiently open). The doctors
had two options: (1) move his open heart surgery up and include a secondary procedure
that would tie his trachea to his aorta and keep it open enough until his cartilage was
strong enough to keep his trachea open on its own or (2) a tracheostomy. Here in Japan,
there are no insurance companies to approve or reject a doctor's recommendation, and my
son's doctors were able to decide their course of treatment on their own, with our
approval. They opted for heart surgery with the secondary procedure, even though it was
not guaranteed to work and it would require an extra two weeks in the ICU. Thankfully,
they did, because in my son's case the secondary procedure did work and he is now in first
grade at the local elementary school - a healthy, active, happy boy.
In the US, insurance company-driven protocol requires that patients who cannot be
extubated within 10 days receive a tracheostomy. The only other option would be
out-of-pocket payment for an extended ICU stay. We would have been bankrupted (most
likely way before this with the initial surgeries required), and my son would've had a
tracheostomy that would've stayed in place until he was 4 or 5 years old. His speech
would've been delayed, as would his physical development. The subsequent therapies, not
to mention the ongoing care for the tracheostomy itself, would've generated a great deal
in additional expenses.
In our case, thanks to universal healthcare, we paid $100 - 200/month (in addition to our
monthly insurance bill) while he was in the hospital to cover diapers, food, and a cot for his
parents to sleep next to him at night.
Not a day goes by that I don't reflect on how very lucky we are.

Diane (California - Scotland, United Kingdom)

Hello from Scotland!
I will happily share my healthcare experiences here in the UK which you may wish to edit as
it is extensive. In summary:
1-Birth of second child - normal childbirth and an amazing experience with the best
imaginable aftercare (first child born in the US with HMO through employer- Caesarian
delivery. Funny that. Terrible aftercare and zero breast-feeding support. In fact, they tried
to stop me breast-feeding due to my newborn's breast milk jaundice). Second baby also
had the same jaundice and I was encouraged NOT to stop breast-feeding but to feed right
through and that the jaundice would pass. It did).
2-Breast cancer 1992 and second primary again in 2004. Two separate occurrences in same
breast. Have had nine surgeries due to a few problems and one fluke situation when I fell
on way home following surgery, triggering rupture of internal stitches and an infection that
caused septic shock. I probably survived because of the policy of the breast unit where I
receive treatment allowing me to come straight to the unit rather than A&E. On this
occasion they took one look at me and admitted me immediately for emergency surgery. I
know my breast surgeon well, having known him now for 25 years and he has created the
Breast Unit at the Western General hospital in Scotland that provides care for breast
cancer sufferers that is second to none. I have had a double mastectomy with full
reconstruction- you would not know to look at me that I have had reconstruction.
One particular story about the personal level of care I have received involves the follow-up
of my reconstruction surgery with the cosmetic surgeon six months post surgery. The
surgeon noticed a swollen lymph gland under my right arm (same side as the cancer and
where they had sampled my lymph nodes previously). I could see on his face that he was
concerned and he immediately phoned my breast cancer surgeon, Prof Mike Dixon, to
discuss it with him. Not only did my surgeon take the call, he told me to be in his office
the following morning. Less than 24 hours after being faced with potentially devastating
news, I was seen by my surgeon who examined me by ultrasound himself in his office
which allowed him to show me that the enlarged node did not show signs of a malignant
node and that I had nothing to worry about. Within 24 hours I could breathe a big sigh of
relief! My lymph nodes continued to play up until my surgeon asked if I'd be happier having
the swollen one removed which I did in 2008.
Because of my history of breast cancer , I am in the system such that any complaint with
my lungs, my bones or lumps, etc, gets me an immediate referral for tests to rule out
secondary cancers. We are now quite certain that I am unlikely to have a recurrence or
secondary, due to the type of cancer cell.
There is an awful lot more I could say of a positive nature but more importantly, I have not
one complaint and I have never been charged a penny for this excellent care.
3-SensoryAxonal polyneuropathy diagnosed in 2008 as idiopathic but now known to be
heriditary. When I learned in 2015 that my brother and father suffered from the same
condition, my neurologist had my brother come in and give blood while my brother was
visiting from the US in order to carry out genetic tests. There was no charge for this.
4-Cervical Degenerative Disc Disease and myelopathy diagnosed when symptoms were
inconsistent with my neuropathy. During my neuropathy consultation that I requested
because I learned about my family history of neuropathy, the neurologist found my
reflexes to be inconsistent with neuropathy. The head of neurology was called in and they
agreed that I should have an MRI. The MRI showed that my spinal cord was being
compressed between my 4/5 vertebrae in my neck and I was offered surgery to correct it.
Once again, I experienced exceptional and professional treatment under the NHS with a
highly respected NHS surgeon (who many pay to consult privately as most private care
here in the UK is delivered by NHS doctors, not private only doctors).
It is a fact that for any life-threatening conditions, most patients here in the UK choose to
be treated by the NHS. Private Medical Insurance only covers the cost of consulting and
receiving treatment directly and without delay but for the most part, the doctors are still
NHS as NHS trained doctors are considered the best. I have never felt the need for
insurance.
Finally, my family doctor practice offers a full range of primary care and the ability to see a
doctor same day if necessary. Out of hours is NHS 24 where you can come in for treatment
after a telephone conversation if it is deemed necessary. Increasingly, GPS are offering
telephone/smartphone consultations for convenience which particularly cuts down on
employee absence from work.
Still, the NHS is in crisis due to it being a political football rather than being pulled off the
political agenda. Care is definitely considered to be better in Scotland than England and
Wales but I don't know the reason for this.
I pay nothing for my care. I would, however, be willing to contribute. For example, I
understand that the annual government contribution per patient on a GP list is... wait for
it... 136. That's right. What people don't understand is that an insured system works
poorly because the people who seek insurance are the ones most likely to need it. This
drives the costs up to an unaffordable level. Add the bureaucratic nonsense that Americans
suffer with their insurance and you have an unnecessary cost. Insure EVERYBODY however,
( ie not privately through insurance but through income tax like we do) the cost per person
is negligible because the fact is that more people don't need to see the doctor than do. I
am the exception that proves the rule. I cannot ever return to the US because even if I
could get healthcare, I could not afford it.
Is this what is meant by single-payer healthcare? One payment by government for
standardised, centralised cost primary care and care for life-threatening conditions and let
the insurance companies fight over premiums from the privileged few who can afford
luxury healthcare.
It works when the private sector does not corrupt it.
Oh, and did I mention my prescriptions are free? Of course, the NHS strictly controls the
cost of drugs, something the US seems incapable of for some reason...
Last point- I'm afraid our doctors do not get rich. They're pretty much too busy treating
people.

Koshka (Massachusetts - Sweden)

My name is Koshka Hellqvist. I moved to Sweden on 18 June 2016 to be with my Swedish
husband. In the eight and a half months I have been here, I've seen doctors or nurses five
times, and I've also gotten a flu shot and had a mammogram and a pap smear done. I have
asthma and spinal arthritis, and have several regular prescriptions.
About a month after I got here, I got a letter in the mail saying I had a mammogram
appointment scheduled. I didn't have to do anything - they had my personal information in
the system and, based on my age, decided I needed a mammogram. They happened to be
correct, as I hadn't had one yet this year. A couple of weeks later, I got a letter saying I had
a pap smear/pelvic exam appointment scheduled for me. Again, I didn't have to do
anything - they just made my appointment, which yes, I did need as I hadn't had one this
year either.
I've had two colds this year, and needed prescription medicine for it. Both times, I called
the health center for an appointment and got in to see a doctor the same day.
Prescriptions are wired to the local pharmacies automatically, and you can pick them up at
any Apotek within about 10 minutes. All you need is your ID card. Also, there is a sliding
scale system for prescription cost. The most you will pay in a 365-day period is 2200 SEK
(about $254 USD), and this is not a calendar year, but a year that begins with the date you
get your first prescription. My year starts in October. You pay full price for your medicines
until you reach 1100 SEK. Then the amount you pay is reduced according to an incremental
system. Once you get to that 2200 SEK threshold, all your medicines are free for the rest of
that year. Between my regular prescriptions and the two bronchial infections I've had, I'm
very close to that limit and it's only March. For my most recent cold, I was prescribed three
different medications: an inhaler, prednisone pills, and a liquid cough medicine. My total
cost for these prescriptions was 243 SEK (about $26 USD). The inhaler alone, without
insurance, would cost at least $25 USD on its own!
There is also a high cost protection system for clinic visits. To see a doctor, I pay 100 SEK
(about $11 USD), and to see a nurse it's 50 SEK (about $5.50 USD). Once you hit 1100 SEK
(about $121 USD), all your clinic visits are free, too. And this is a 365-day period rather than
a calendar year, same as the prescriptions.
The downside is there is no plan for routine dental visits or regular vision care (eyeglasses
and contact lenses) for adults, but children up to the age of 19 years get free glasses. Eye
diseases (glaucoma, keratitis, cataracts) fall under the doctor program.
I don't know much about surgical procedures, as I haven't used it, but there is a limit on
what those cost (I think it's 300 SEK - $33 USD) and the most you can be charged for a
hospital stay 100 SEK per day. I haven't needed to go to the ER yet, either, but I believe the
charge is around 200 SEK (about $22 USD). These prices vary by county; I live in Vstra
Gtaland, and our medical prices seem to be on the lowest end of the spectrum.
But the thing is, I only have the Swedish equivalent of a green card; I was granted a
two-year temporary residency permit (when I renew it, I should be granted permanent
residency). Even though I'm just an immigrant with a green card, I am entitled to the
same healthcare as a Swedish citizen.
It's amazing to me. It's so simple here! When I think back to when I lived in the States,
where I had health insurance through my job, and how I had to fight for every little doctor
visit and procedure charge (was it necessary? Was the doctor really in network? The
procedure code was incorrect, so that isn't covered. We can't call the hospital to correct it,
you have to do that. That kind of injury could be from an accident - are you sure this isn't
covered by the other party's insurance?), how I spent hours on the phone calling the
insurance company and the hospital billing departments (because of course they can't just
talk to each other)...the Swedish system is just incredible. It's effortless. It's affordable -
cheap, even!
I honestly do not understand why the US can't do this. Healthcare should be a basic
human right, not a privilege.
Thanks for collecting all these stories!

Nancy (Oregon - Philippines)

I'm an Oregonian, married to a Filipino and have been living in the Philippines for about eight years.
The Philippines is a lower middle-income country, with a long way to go in many fields.
However, basic primary health care coverage is very extensive and well maintained.
I live in a rural provincial center in the northern Philippines and I have accessed the public
health care system several times - for pneumonia, bronchitis, hives, and an animal bite.
Each time, I have received prompt, highly professional, courteous and helpful care. Each
time, I have paid only for medications, never for the professional consultation or the care
of staff.
My husband needed elective, non-emergency surgery, which was performed in a public
hospital by a private surgeon. We paid for the surgeon's and anesthetist's care, as well as
for the hospital stay itself. The total cost for surgery and five days' hospital stay was under
USD 1000. If he had been employed at the time, he would have been covered under the
national insurance system, which is paid out of withholding from wages, and he wouldn't
have had to pay for the hospital stay.
I feel very confident about my access to health care living here in a rural area of the
Philippines. National programs maintain primary health care for all, and there are also
programs in place to help the destitute.
It's a model that wealthier countries would do well to copy.

Norma (Minnesota - Canada)

I'm an American abroad. I have lived in Canada since 1975. I am 66 years old. I have seen
my GP regularly for my yearly physical. I have had surgeries quickly. I have regular
mammograms and pap tests. Yearly eye exams are free. I have been referred to specialists
for various conditions, and I have never received a bill because I pay through my taxes.

I have private insurance for dental, drugs, glasses, physiotherapy, chiropractor and natural
path, semi-private hospital rooms and travel insurance.
All Ontario residents pay into the provincial health plan. It is great!
Ed (Ramsey County, Minnesota - Taiwan)
I've been living in Taiwan for the past 25 years. During that time Taiwan instituted a
universal healthcare system. When it began I was still employed by a local company. Your
total monthly premium is determined by your yearly salary with, I think, 4 or 5 ranges.
The employer pays about 70% with the employee paying the balance. I don't recall how
much I paid since it wasn't very much and I have been retired for 4 years. Now that I am
retired I pay about US$195/Quarter.
Below are 4 examples of the benefits I receive.
1. I have quarterly checkups and receive medications for hypertension and cholesterol
levels. This includes a blood test as well as consultation with my primary physician. My
total co-pay for this is about US$13.
2. Last year I had a cyst removed from my back. This required minor outpatient surgery
and 8 follow-up visits. My total co-pay was about US$75 while the insurance paid US$355.
3. This was about 8 years ago so I don't recall the details accurately. I was hospitalized for
3 days due to gastric bleeding. I recall being surprised as to how little I paid out of pocket.
I believe the charge to me for a semi-private room, tests, medication and nursing services
came to about US$430.
4. There is only minimal dental services provided. Semi-annual cleanings and cavity
treatment. If a cavity is found during cleaning a follow-up visit is normally required to treat
the cavity. Each visit to the dentist has a co-pay of about US$5.
Medical services in Taiwan are generally excellent. Many physicians have received some
or all of their training in the US, Canada, or UK. As an example my dentist, who specializes
in oral surgery and implants, received his degrees at NYU Dental School. Additionally,
medical equipment at hospitals is state-of-the-art.
There are some drawbacks or deficiencies in the Taiwan system. There is no central
medical record keeping. So if you visit more than one clinic or hospital they don't have
access to your records and they must rely on the patient to inform them of any
medications. Since the co-pays are so low it can lead to abuse. Some people will visit a
clinic for colds or minor aches and pains. Some of this may be understandable due to the,
in my opinion, unreasonably high cost of OTC medications.
Depending on your age and sex you're also eligible for free periodic general physical
exams. Also, not all health services are necessarily provided under the National Healthcare
system. Various city governments provide additional service. For example, the Taipei City
Government just announced free screening for cervical, colon, oral cavity and breast
cancers. Adults aged 40 to 64 are eligible for a free examination once every three years,
and senior citizens above 65 are eligible for a free examination once a year.
Margaret (Massachusetts - Canada)

I am an American citizen living in Canada since 1991, and a permanent resident since 1993. I
have had a few surgeries since living here, nothing serious (breast microcalcification, torn
meniscus in my knee, other minor injuries), and have not had to pay extra for any of it! Yes, I
was on a waiting list, but got fast-tracked, and had to pay for an air cast and other
miscellaneous items, but healthcare has not bankrupted me! Not exactly sure how to read
my paystub, but my total for group health coverage for 2016 was $395, and I pay extra for
critical illness, $1083 for 2016. So there you are! So affordable.

Tracey (Chicago, Illinois - Belgium)

Just a few months after we moved to Belgium, before we'd had any need to test the
healthcare system, my husband and I took a trip to Switzerland. Unfortunately, while there, I
had an accident and hit my head. I was bloody and bruised, unable to see out of one eye, and
I was in and out of consciousness. But, when the Swiss people around me said they were
calling an ambulance to take me to the hospital, I actually asked how much that would all
cost, because maybe I could just tough it out: Even with what turned out to be a concussion
that required an overnight hospital stay and a few months of recovery, I had learned from
growing up in the US that you have to decide whether treatment is really worth the
financial burden.

Fortunately, because of the government mandate to provide healthcare and insurance to

legal residents, nearly all of my bills were covered -- the ambulance, the ER, the hospital stay,
the medications and follow-up appointments. And the quality of the facilities and care was
top-notch. Knowing I can take care of my health without risk of bankruptcy is worth its
weight in the taxes we pay.

Carolyn (Fairfax County, Virginia - Germany)

My only experience with universal health care is here in Germany. I had a bike accident 2
years ago and tore up my knee. The service was amazing. Two passersby called an ambulance
for me and I was taken to the emergency room and examined. I was released because there
wasnt any bone damage, but told that if the pain persisted for a week that there may be soft
tissue damage. I could still barely walk a week later, so I went to an emergency ortho. He
recognized right away that there was a potential for damage, so he got me into an MRI scan
as quickly as possible (1 week). The results came back that I needed surgery ASAP, so they got
me in just one week later. All in all, it was 3 weeks from accident to surgery. I was on crutches
for 4 weeks and had 6 months of physical therapy, including 3 steroid injections. In total, I
paid a few hundred euros for everything (eg. ambulance, ER, ortho assessment, MRI, surgery
and therapy).

The service was excellent, fast, and inexpensive. I couldn't have been happier. I'm on public
insurance, by the way, not private. But I have been told that because my situation was a true
emergency that it didn't matter. They (in Germany) always move that fast in cases of
emergency.

Randy (Germany)

Word of warning: all those that went rushing to private healthcare around 12 years ago
ended up paying more and are less happy because they aren't getting "special treatment" like
they thought they would. I know several people that have fought for years to get off of
private healthcare and return to public. I stayed on AOK because I wasn't fooled by the hype.
Also, AOK was highest rated for adding kids, too. Now Ian has his own card and goes to the
doctor himself. It is awesome.

Rick (Alaska - Sweden)

PhD (economics) & freelance copy-editor

Besides other occasional fairly trivial medical problems or concerns, I've had major care three
times in the last 7 years. As a result, I am a total believer in the Swedish single-payer system
of universal medical insurance as well as in the excellent state-provided healthcare. (All my
other experiences have been equally good.)
In 2010, I had HPV-induced tongue-base cancer which was diagnosed and treated promptly. I
had 6 weeks of daily radiation treatments plus weekly chemo, followed by brachytherapy
(radiation inserted directly into the tumor). I was on a feeding tube for over 3 months
because of resulting pain in my mouth. I was in the hospital twice for a week each, once
because of a radiation burn, which got infected, and once for the brachytherapy and resulting
complications. I got charged approximately $10/day when I was in the hospital to cover my
food and I paid something for the food pouches for the feeding tube the rest of the time too,
but not a lot (probably about the same amount per day). I was totally wiped out physically
and emotionally, and my wife was close to the breaking point, too, because she was keeping
track of all my many medications (as well as her other family responsibilities regarding our
two kids, etc.). If we had been in the States -- quite apart from the unexpected huge
expense -- we would have been flooded with insurance paperwork. Here, there was none
whatsoever.

In 2013, I was diagnosed with bladder cancer and received prompt treatment: surgical
removal of one tumor ("shaving" it away) and cauterizing a few smaller ones, followed by
BCG treatments twice (6 weeks each time) and finally by in situ chemo treatments (6 weeks).
Recently -- 9 months after the last treatment -- I was checked and there was no sign of
cancer.

Last August (2010), I experienced atrial flutter and fibrillation resulting in heart failure and
spent 2 weeks in the hospital, during which -- after several extremely sophisticated diagnostic
procedures (e.g., CT scan and angiography) -- I had surgical ablation to break a faulty
signal-pathway that was causing my too-rapid pulse, and was also placed on multiple
medicines on which I remain. But I've now been discharged from cardiac care -- referred back
to my local clinic -- and told that my risk of a recurrence is no higher than anyone else's.

My experience with both bladder cancer and heart failure was equally impressive as earlier
with oral cancer: excellent care and no insurance headaches. I couldn't be more grateful.

Roberta (Dee Dee) (Massachusetts - Mexico)

I live outside of Guadalajara, Jalisco, Mexico. Even though I paid into my social security and
Medicare account my entire working life in the US, I am not eligible to use my Medicare
here in Mexico. It would cost a lot less for the US to allow us to use Medicare in this
country. The costs of returning and dealing with the very complicated healthcare system in
the US (waiting months for an appointment with a doctor, trying to get services at a hospital,
etc.) make it difficult.

I have chosen to remain in Mexico and pay for insurance to cover me. I will not return to the
US for my coverage. Since I live close to Guadalajara, I feel fortunate to have healthcare
options close. This is one reason why so many Americans have chosen to live here.
Roy (Australia)

I had a heart attack ten years ago, which would have been fatal if not for surgery, which I
received for free from medicare. I was sent to a public hospital, then transferred by
ambulance to a private hospital, where I got my stent fitted. As I arrived by ambulance, this
was also free. I'm grateful every day since for medicare, as I consider that I would have lost
my life without it. At the time, I was driving a taxi and unable to afford insurance.

Phil (Australia - Michigan)

Universal health care is an interesting topic in our family. I am an American citizen from
Michigan, living in Australia. My son, in Melbourne, recently posted the following on his
Facebook page:
Really, really incredibly grateful for our fantastic quality free health system today. Bram,
(our grandson) needed x-rays, plaster and crutches last night for a busted ankle. In around
3pm, out by 7pm and with a total bill of $38.

It doesnt matter who you are or what your income level everyone is treated equally.

I am not an expert on the Aussie Medicare system, but I can tell you that when the system
was first brought in, we had a Medicare levy of 1% added to our income tax rate. That levy
has been raised to 1.5% then 2.0% over the past 40 odd years. This is a quote from the
Australian Government tax office.

Medicare gives Australian residents access to health care. It is partly funded by taxpayers
who pay a Medicare levy of 2% of their taxable income. Your Medicare levy is reduced if your
taxable income is below a certain threshold. In some cases you may not have to pay the levy
at all.

My wife and I spent 12 years out of Australia and returned in 2006. I have been semi-retired
since then and have not paid a Medicare Levy in the past 10 years due to my relatively low
taxable income. If one chooses to go to a medical clinic for health care, there is no fee. If, as
I do, one goes to a private physician, there is a co-pay of about $50/visit. If one is on a
pension, which is means tested, there is no fee to visit a private physician.

It works for me!

Becky (Belgium - Deschutes County, Oregon)

As a longtime resident of Belgium, I participate in the national health system, which provides
coverage throughout the European Union. I can go to whichever doctor, specialist or
hospital I want.

The cost is means-tested and can vary with my income. It takes the form of a single,
quarterly payment that covers both healthcare and pension. I estimate the healthcare
component at 1500-2500 euros/year. It has no deductible and covers about 75-80% of my
healthcare expenses. I also have optional, complementary private insurance (1400
euros/year) that covers 80% of the remainder of the treatment in Belgium and also covers
80% of the cost, up to a ceiling, of any treatment worldwide outside the EU.

In 2002, I had a back operation for a slipped disc, was hospitalised for six days in a 2-person
room and received two months' of physiotherapy afterwards. The total cost of the treatment
was approximately 20,000 euros, which was covered. I ended up only 169 euros out of
pocket.

During the same period, a friend in the United States had the same operation and was only
allowed to stay in the hospital two days. Her expenditure was considerably higher and had a
deductible before the insurance kicked in.

I believe that the Belgian system works well for two reasons. Although there is a wide choice
of administrative bodies to manage reimbursement, known as "mutual societies", they are all
run on a non-profit basis. Secondly, the government regulates the reimbursement rates for
all healthcare services and pharmaceuticals. No political party or group questions the need
for national healthcare, although rising costs have led to the widespread use of
complementary/supplementary insurance.

Andy (Belgium - Michigan)

Before moving to my current residence in Belgium, I lived in Spain.

While living in Madrid with a tourist status, I went home to the U.S. at Christmas time to
visit my family and broke my wrist in a snowboarding accident.

As a result of the break, I spent the next 3-4 hours in a nearby hospital where I received
fantastic care from a specialist who not only reset my wrist (non-surgical intervention), but
lightened the mood, made me laugh and truly added a personal, human touch to the always
traumatic experience of a breaking a body part.
Although still under the relaxing effect of the administered anesthetic upon leaving, the
mood quickly became somber when I stopped at the check-out window and was presented
with the bill. As an unemployed and uninsured young person (under the age of 26) living
abroad at the time, a 60% reduction was applied to the cost of my treatment, with an
additional 10% discount available, pending the payment-in-full of the remaining bill
amount within 30 days. Fortunately, my parents were able to assist me in covering the
outstanding 30% of the total bill. Unfortunately, the total bill still amounted to over $2,000
USD.

A week-and-a-half later, I returned to Spain, where, despite my unofficial status as a tourist

(eg. 3-month visa-free tourist agreement between the U.S. and the 26 countries in the
Schengen area of the EU), I had already registered myself as a temporary resident in Madrid
thus providing me the opportunity to have a tarjeta sanitaria (medical card) for
foreigners and nationals alike in Spain. With my medical card, I was not only able to visit a
general practitioner for routine care, but hospitals and emergency rooms for more intensive
care as well.

Over the next several weeks in Madrid, I proceeded to make visits to a hand/wrist specialist,
have x-rays taken and attend rehabilitation sessions with a physical therapist, paying a grand
total of 0.00 ($ 0.00 USD) out-of-pocket for all services provided.

Years later, I fondly recall the entire experience as the time period in which I became a firm
believer in universal healthcare not only as sensible, long-term economic planning for more
egalitarian societies, but as a human right and moral imperative.

DOMESTIC (U.S.) STORIES

Kristin and Jason (Arkansas)

My husband and I fall very well below the poverty guidelines. Not by choice but by statistical
standards of being raised in poverty and living in it, once grown. My husband and I have tried
our hardest and put both feet forward because we refuse to be another statistic. We have
both tried to go to school. Myself majoring in Early Childhood Education and Jason double
majoring in Biology and Mathematics. Because of the life we've had to be condemned to, we
both couldn't afford to live and go to school, so we weren't able to finish. That hasn't stopped
us yet. We are both hell bent on going back and trying harder than ever to start back this
following Fall term. I have had major medical issues which include:

PCOS (Polycystic Ovarian Syndrome), high blood pressure, diabetes, asthma (thought to be
COPD), ADD, anxiety and severe depression

I am only 26. These ailments were brought on not self consciously, but rather by genes and
the PCOS.

Before my heath insurance with Blue Cross Blue Shield through ObamaCare, I couldn't even
afford all of my much needed medications. I would go each month trying to figure out which
medications I needed the most in order to afford them and take the very high possible
chance of dying, I repeat, at age 26.

With my insurance, now I am able to receive all of my medications that are needed and the
help I was never even offered before. I have tried to receive temporary disability benefits
because I cannot work at times, but to no avail. The insurance I currently have, I can't be
taken off of. I truly believe I would die. I haven't even began to live the life that I know is here
for me. I know better things are out there for both my husband and myself. With the
exhausting and strenuous amount of effort we put forth daily to live and strive NOT to be a
traditional statistic, I know there's more for us. If only given the opportunity to prove
ourselves, we could absolutely show that poverty doesn't RULE the lives of the individuals it's
bestowed itself upon.

Thanks for listening to my story.