Sometimes traveling internationally as a person who lives in the United States can feel like a bizarro version of that scene from The Matrix when Keanu Reeves wakes up, bald, slimy, and hooked to some Borg-like contraption, which connects him to a whole slew of other sleeping humans. His life, he discovers in horror, has been a simulated lie. Except in the traveling scenario, you wake up in a nicer place, aware that perhaps, your regular life back home is not quite as great as you have been led to believe.
In this analogy, the contraption is, naturally, our health care system.
Case in point: I’ve been in Paris this month thanks to a fortunate apartment share situation. I’m lucky, too, to have a network of friends here who hail from a variety of places: Europe, Britain, India, and also America.
Inevitably, and even more this year than in years past, our dinner conversations slide to health care. Here’s how it happens: We start discussing, say, French real estate. One friend has bought, one is looking to move, one has just moved. Landing an apartment in Paris is similar to New York with regards to level of difficulty (in terms of buying…renting here as a foreigner is actually quite complicated), and as a person who harbors dreams of one day doing so, I’m always interested in people’s stories. Particularly as a freelancer, who cannot provide pay stubs, I’m curious how mortgages are attained. This leads to discussion about what is required for a down payment, which leads to questions about monthly overhead expenses, and how, outside of family help, down payments are difficult to come by, which leads to, you guessed it, health care. I was going to say, when you are a freelancer, it always, always leads back to health care. But it’s probably more accurate to say, when you are an American it always, always leads back to health care.
Then the discussion goes something like this:
Me: “…and then I pay close to $800 out of pocket a month for health insurance..”
Expressions and exclamations of shock.
I repeat myself. More shock.
Then I pause for dramatic effect and say, “and I have an $8000 deductible.”
Then I often must explain what a deductible means.
Then I spend five minutes convincing people that this is in fact a true story.
If your response to the above numbers is that they are not so bad and you are thinking, wow I pay so much more because (insert health concerns) or, wow, lucky you, that doesn’t seem like a lot, I have to cover it for myself and my whole family, then let me be the one to tell you, you are still in the Matrix.
If your response is to talk to me about high taxes, then let me just say in New York my taxes are not that much less, or rather, they are not less enough to make up for what I don’t get as a result of paying them.
If your response to above is an overwhelming temptation to list all the things that are wrong with universal or socialized medicine, please save your energy for more useful endeavors. I am aware.
I was born and raised in Canada. I’m familiar with the shortcomings. I am reminded of them when I visit family and am told of the increasing restrictions regarding what health care covers. I’m also reminded of them here in Paris when I have to go to the pharmacy to purchase ibuprofen, which is kept behind the counter and comes in packs of twelve. As in, twelve pills for five euros. Or when my friend tells me she needs to get a prescription from the doctor if she wants a tube of Polysporin for her daughter. Universal health care is not a perfect system.
If your response is to show me a graph of France’s high unemployment numbers, I know. It is high. However, being unemployed in France is quite unlike being unemployed in America: you can still go to the doctor (also the museums, which are free to the unemployed). You do not, as the majority of Americans filing for bankruptcy have done, need to file because your health is tied to your employment. And when you lose your job, which many did this past year, you do not also lose your need, during a pandemic, to have your health looked after. See aforementioned bankruptcy.
The truth is these conversations, in which I shock people with tales of deductibles, (or tell them, for instance, that in order to go back on the pill I need to see a breast surgeon to get the go-ahead because of a questionable mammogram last year, and making that appointment will cost in the hundreds of dollars), mostly just function as a way to remind myself that the way we live in America is not okay, and often feels borderline abusive. These conversations are not really about me wanting to relocate to France, or Europe, or Canada (where I could relocate should I choose). Instead, they are a weirdly cheap, therapeutic way for me to be reassured by the looks of horror on the faces of people I’m with that I am not, in fact, crazy. Our health care system is insane.
Over the past few months, this newsletter has returned again and again to what amounts to a realization that the idea of America is often an exercise in gaslighting: we are relentlessly encouraged to subscribe to a way of life that is enormously damaging, with the belief that it is actually the best there is. America actually is great in many ways, but if anything, this is the most infuriating part: we are capable of more. If the last year has taught us anything (and let’s hope it has) it’s that we could and should be doing so much better.
Finally, that these conversations have been taking place against the terrible news and images coming out of Afghanistan gives them an extra strange weight. Americans are constantly told there is not enough money to cover…insert whatever you’d like covered here, be it better infrastructure, healthcare, education…it’s a long list! Whatever your feelings about America’s departure, the amount of money spent during our twenty years there, only to have it end like this is a reminder the U.S. can and will spend on things it deems valuable. Now seems an especially good time to ask, why our health is not one of those things?