18 months ago, my 27 year old daughter packed her bags and moved to New York City for work and adventure. She was excited by the opportunity to live and work abroad for a few years and was also pleased that her US employer was providing private health insurance.
Earlier this year she began developing health issues that required surgery. She was relieved when her US health insurer informed her that it would cover almost all of the costs associated with the procedure and referred her to appropriate doctors in its panel. That sense of relief was short lived.
The first problem she experienced was the length of time she had to wait to secure an appointment with doctors on the insurer’s panel. The average wait was three months. This is ironic when one considers that the major criticism of a public health system is lengthy waiting times for medical procedures.
At these initial consultations, the doctors told her that her problem was not their area of expertise, so she had to be referred to other doctors with an additional three months wait. Throughout this time her symptoms and pain were worsening.
One day prior to her appointment with the appropriate specialist, the doctor’s office called her and told her that it does not deal with her insurer (even though this doctor was listed on the insurer’s panel) and that the procedure would cost her US$70,000. My daughter spent days on the phone trying to find an appropriate specialist that would perform the surgery with payment from her health insurer. Finally one doctor told her she would not find a doctor in New York because her health insurer does not pay its bills. This doctor explained that he was still chasing payment for a patient he operated on six months prior and the insurer does not reply to his calls or emails.
Six months on from the beginning of this saga, my daughter discovered that her insurer owns a local hospital and the doctors there would most likely have to see her. The surgeon at the hospital saw my daughter and told her that she required urgent surgery. This doctor organised many imaging tests and scheduled surgery within that same week. This was not possible, however, because one of the surgeons that needed to be in attendance was on holiday and it would be another two months before they could schedule what was an urgent procedure. Furthermore, there were problems with the insurer approving some of the tests the hospital said were critical for proper diagnosis.
In the end, my daughter returned to Australia and entered the public system. As I am typing this article, she is now in an operating theatre at Royal Price Alfred Hospital in Sydney undergoing the much needed surgery. We were able to start this process while she was still in New York by supplying doctor reports and test results from the US. She flew into Sydney five days ago, underwent more tests, saw her surgeon and will be out of surgery within the hour. All of this was done as a public patient with her only out of pocket expense being for some of the pre-surgery tests and consultations.
I cannot speak highly enough about the benefits of a strong public health system that provides access to quality medical care to all citizens. I hope Australia never goes down the care for profit model where insurers dictate medical treatment rather than doctors.
My daughter will return to New York to resume her work later in October, but she still proudly calls Australia home.