Anyone Got a Non-Existent, Pre-Existing Condition?

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Sarah Bunce from Great Britain shared her views of health care in the U.S. This essay was one of our finalists for microscholarship #1.

One of the biggest costs, as an international student in America, was always going to be health care. Coming from a household increasingly strapped for cash, due to my father’s recent decision to follow his dream of starting a small business selling classic motorcycles, I knew that my absolutely mandatory health insurance premium would be a struggle to pay. To add salt to the wound, I come from Britain – the home of the invaluable National Health Service. But until I was packed off to A&E once my pancreas decided to give up on me at age fifteen, I’d never really thought about how the NHS worked; it was just there. I’d never once thought – or worried – about needing to pay for life-saving medication or advice, but once I started picking up monthly diabetic supplies I stopped to consider just how lucky I was. From that point on, no one could say a bad word against the NHS in front of me.

So when I started to think seriously about my year abroad in America, health care was a huge concern. Returning exchange students stressed how expensive it was, but it wasn’t until I got the details from my exchange university – with an estimate of well over $2,000 – that the reality started to hit home. Of course, there was the option to enrol in an outside plan, but after a few hours of obsessive Googling, I realised how unrealistic this was. Because insurance plans in America rarely accept pre-existing conditions (as type 1 diabetes is). Instead, they are covered after one has held the insurance for a certain amount of months. That would be brilliant if I could put pause on my diabetes, but absolutely useless in real life. Putting that aside, other – less financially crippling – plans refused to align with what my university was demanding: either they didn’t meet the requirement of “medical benefits of at least $50,000 per accident or illness;” or the co-pay to see the doctor, even at the uni’s own student health centre, was anything up to $50 a visit. Prescription co-pays were even scarier considering I regularly have prescriptions of five items or more.

Just a selection of the supplies I shipped over in my suitcase to avoid extortionate prescription co-pays.
Just a selection of the supplies I shipped over in my suitcase to avoid extortionate prescription co-pays.

I was lucky enough to have a relative kindly loan me the money for my exchange university’s health insurance premium, and I have used it a fair bit. But I don’t use it any more than I use the NHS, and as with all insurance, it’s there “just in case,” which is incredibly annoying when nothing goes wrong. I’ve also spent these last six months in America seeing just how much money people continue to pay even after they are covered. Waiting for a prescription in CVS one day, I overheard a woman who had been waiting an hour for a prescription, only to find out that the generic-brand was out and she would need to pay $90 for a packet of pills. I’ve constantly had to refuse doctor’s requests that I have an endocrinologist here “just in case,” which would immediately cost me over $300 – in addition to the fact that I have a perfectly good one in England who I have only ever seen once every six months. I’ve heard of friends sent bills of $3,000 and told that they must pay out of their own pocket before the insurance will start the process to pay it back. I’ve been told of people going out for a few drinks and having campus police force them to the emergency room where they’ve been charged $300 to be told they’re tipsy and should probably go to bed…

Health care in America reinforces the extremely scary reality that pervades this country: if you are poor, you are quite literally screwed. I’m not saying that the NHS is perfect, but the fact that Britain provides a basic level of service for citizens and non-citizens alike, whilst America point-blank refuses to keep her lower classes alive, is absolutely crazy. It is without a doubt one of my biggest – but only – complaints about living in America.

Sarah Bunce is from Great Britain studying at George Washington University. Read her previous essay about the struggles of finding an affordable health insurance plan as an international student, click here.

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One thought on “Anyone Got a Non-Existent, Pre-Existing Condition?

  1. Sarah, Thanks for sharing. I can understand how the financial side of health insurance in the States can be a put-off, or even problematic for international students/travelers for the many reasons that you have pointed out.

    As an American living in Northern Ireland, I have had to adjust to the ways of NHS. I am sure you have been cautious about where/when you visit the doctor in the States and don’t feel as confident or as comfortable as you would with your own General Practitioner (GP) in the UK. But, on the flip-side, the same goes for me.

    Although I love the benefits of not having to pay for my regular prescriptions (thanks to NHS), I am still weary about the length of time that it takes to get into see the doctor (especially for tests and such), how you can’t schedule an appointment more than a month away, how much time and hospital beds are wasted on patients who only need tests done (instead of used for those who really NEED to stay overnight in the hospital for a decent length of time due to current health issues), and even the time it takes to receive test results. As an American, I am used to the promptness of getting seen and treated, when I am unwell. So, I have opted for private insurance, in addition to NHS – in case anything should occur, or if I need any tests done, etc.

    Additionally, I, too, have a pre-existing condition (neurocardiogenic syncope), and no private insurance in the UK will cover pre-existing conditions, which seems to be the norm no matter where you are in the world. However, I was able to select a private insurance provider who will eventually cover my pre-existing conditions after I have been with them for 24 months.

    The point is, I think no matter where you are from in the world, it can be a scary and unsettling feeling to travel to another country (with a different health care system than what you are used to). I suppose each health care system has its own set of pros and cons, but we tend to rely on what we know and trust best.

    Thankfully with NHS, you were able to get extra supplies of your meds to cover you for the duration of your stay in the States! When I travel home, I, too, tell NHS I will be gone for an extended period of time to make sure I have extra prescriptions so that I am covered while I am away. However, should you ever need to see the doctor for anything in the States, I hope that you are pleasantly surprised – as Da-Hyun was after she burnt her leg.

    Enjoy the rest of your time in America and well wishes for you and your health!

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