Health Insurance: What a Fulbrighter Needs to Know!

Dear future Fulbrighters, This blog post is especially for you and it is about something important: health insurance. I want to share some first hand experience – things I wish I had fully understood before coming to the United States. Let me tell you my story. The election weekend in November was an extended weekend, so I decided to visit a friend in San Francisco. I had a great time, however short it was. After coming back to New York, I started feeling a sharp pain in my chest. I thought it to be a muscle ache, but decided to go to the doctor on campus when it got worse the next day. The doctor ran a couple of tests and found out that my blood values were distorted. She sent me to the ER with a referral for the CAT-scan. While waiting for the tests to start, the pain in my chest became unbearable and I started to realize that something serious was going on. I was right. The scan showed a number of small blood clots in both of my lungs. The verdict: pulmonary embolism. They kept me in the hospital for four days, monitoring my vital functions and running more tests on me to make sure I had not developed more clots. Luckily for me, everything else seemed to be fine. With the right medication I would not be too much affected by it. Today, I am in a pretty good shape, also thanks to the people who surrounded me when all this was going on. I was really fortunate to be a Fulbright student, because both my Fulbright contacts in Belgium and my contact person in the United States did everything they could to help me. As a Fulbright student, my insurance plan was included in my grant. At my university, it was also mandatory to buy the health care plan they provided. I remember how much I revolted against the idea of buying multiple health insurances. I had never been sick, no serious injury, and no hospital experience whatsoever. Why would I need to buy such an expensive health care plan? Well, here is why: health care in the United States is insanely expensive. When my hospital bills started pouring in, I almost went insane when I saw what they charged me: $26,500. Both my insurance companies covered parts of this sum (my primary insurance plan took care of the first 80%), but it was not sufficient to cover everything. Coming from Belgium, where health care takes place in a safe – yes, a caring – environment, I found it very hard to deal with the situation in the United States. I was puzzled by the situation I had ended up in. A couple of weeks ago, I found an article that partly answered my questions about the American health care system. Journalist Steven Brill had decided to follow the money involved in health care and came to the following stunning findings. (I summarized the main points, but you can also read the full article or watch a short video.) Health care has become a huge business in the United States. What many people don’t know, but what is common practice in American hospitals is the use of a “charge master”. That is an internal list in each hospital of items that they can sell at exorbitant (and completely arbitrary) prices. Hospitals and the drug industry make huge profits by overcharging their patients. Luckily for me, I had various insurance plans. The charge master has the most devastating impact on the poorest people, those without insurance, who are charged the full price. Insurance companies in the U.S.A. operate in strange ways, especially when you are used to a very straightforward European system. However, according to Brill, they are not the main problem. The heart of the problem lays in the fact that hospitals have moved from a non-profit position to a free market position in which prices have risen uncontrollably. But without a good insurance plan you are out of luck. So, don’t rely solely on the health care plan Fulbright provides for you. Buy the plan your university suggest you to buy. I would even consider buying a third extensive health care plan back in Belgium. I learned that it is not because you have never been sick that you never will be. Of course, I wish all of you a happy HEALTHY year and for most of you that will indeed be the case, but you are better insured than sorry. All my best, Sara]]>