Page last updated at 12:55 GMT, Saturday, 7 November 2009

The US health system 'headache'

When the BBC's David Willis recently found himself caught up in the American healthcare system in Los Angeles, he says he only just lived to tell the tale.

An anti-healthcare reform protestor carries a placard saying "Your plan makes me sick"
The healthcare system is a huge topic all over the US

It is amazing how, within a matter of minutes, fate can build you up almost beyond recognition, only to deliver a well-aimed slap across the backside.

Going through the mail last week, I found the first envelope was marked US Immigration and Naturalisation Service and contained a laminated piece of plastic, confirming that my application for permanent residency had finally been approved.

Holding my green card up to the light, I was just about to break into an interpretative dance of celebration.

Then I spotted the second envelope in the pile and the exhilaration evaporated instantaneously.

The letter was from a company which oversees the BBC's health insurance plan.

Tearing open that envelope, I was confronted with news that my coverage - extended after I left the BBC to go freelance - had come to an end.

The news itself was hardly unexpected but seeing it in black and white filled me with horror.

Even if you are a picture of good health, all it takes is a freak accident and you are toast

Now I was on my own, it was me against the system.

I had the feeling things were about to get ugly because, when it comes to health insurance, the Americans could teach the British a thing or two about bureaucracy.

Big hypochondriac

It is difficult to overstate how vital health insurance is in America.

Find yourself in the emergency ward, strapped to machines which go "bip" and surrounded by sullen doctors who have been called in from the golf course just to deal with you, and if you do not have health insurance, the chances are you will be paying for your visit until the end of time.

Hospital room (file pic)
About 47 million Americans currently have no health insurance

Even if you are a picture of good health, all it takes is a freak accident and you are toast.

An expatriate friend of mine spent a week in "outpatients" after having the misfortune of flying a small aeroplane into the sea.

His bill was around $100,000 (£60,000). He told the cashier he had come in for treatment - not to buy the hospital.

Being uninsured was especially worrying for me because I am, well, the world's biggest hypochondriac.

If I get a headache, I instantly assume I am haemorrhaging.

The longer it continues, the wilder my doom-laden diagnosis becomes. What, for example, if it is tapeworm larvae burrowing a hole in my brain?

Such fears have led me to have virtually every test under the sun.

I have donated blood by the bucketful and enough urine to float a battleship, because I know my body is trying to fool me.

Yes, I feel as fit as a fiddle, but it is a facade.

My body is lulling me into a false sense of security while some deadly virus, some terminal disease - holed up in some dark corner of my insides - marshals its forces and starts plotting my untimely demise.

By the time he had finished, I felt like a winner on 'The Price Is Right'. The cost - £5,500 a year!

Given the fact that visits to the doctor are therefore a weekly occurrence for me (I prefer to think of it more as a pastime than an addiction) you can see how distressing the prospect of being without insurance could be.

And so, with heavy heart, I set about taking on the many-headed hydra that is the American healthcare system.

For some reason, there was no way of simply continuing the policy the BBC had in place and paying the premiums myself.

So I had to apply as if I had never had coverage before.

I found myself talking to Steve, a chirpy salesman at one of the larger insurance companies, who ran me through the details of one of their more popular policies.

Yes, I would still have to pay to see either a doctor or a specialist but he would throw in a prostate exam - and a colonoscopy every 10 years.

By the time he had finished, I felt like a winner on "The Price Is Right". The cost - $9,100 (£5,500) a year!


Barack Obama
President Obama has made healthcare reform a big priority

Steve sent me a form which delved into my every malady since emerging from the womb. I was reminded that there is one thing that health insurance companies absolutely hate - sick people.

Sick people have the audacity to require treatment, which not only eats into profits, but upsets the accountants' balance sheets. Too much of that and you could completely spoil their day.

Having explained away virtually every cough and sneeze over the course of the last 49 years, I got to question 41: Has the person applying for coverage consumed any alcoholic beverage in the last six months?

I read that several times, even at one point substituting a different pair of glasses, and no, I was not mistaken - it really did say six months.

Not six days, or six minutes, but six months.

By the time I had finished the form I had a headache and eye strain, and so I went back and added those to my pre-existing conditions and then sent the form off to Steve.

He told me my application would be assessed by an underwriter, which conjured up images of Lloyds of London weighing the fate of the QE2 or, in my case, the Titanic.

And so I wait on tenterhooks to learn whether my application has been approved.

The tension is killing me. And at my age that is not good for the blood pressure.

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