US Healthcare- you’re breaking me.

I was travelling from early to mid-May. It was a wonderful time, there was a family wedding, I met up with friends and co-workers in Austria, and spent a good amount of time in Munich, one of my favorite German cities.

And I came back to a letter from my health insurance, informing me that, maybe, or maybe not, my healthcare provider was leaving their network end of June, they were in negotiations.

A network, for those of you outside the US, or those who are chronically healthy and never had to deal with healthcare, is a group of providers (doctors, hospitals, labs etc) that are under contract with an insurance company. Depending on the insurance health plan you are on, your insurance will cover your medical expenses either when you only go to the network they are working with (exclusive provider organization, EPO), or when you go to a network they work with. If you still go to a provider outside of your network, they will still cover some of the cost. As an example, you need to go to the ER and it is in a hospital that is out of your network, they will still cover, but much less than if you went to a hospital that is in your insurance’s network (PPO- preferred provider organization).

Then there is an HMO- a health care management organization, pretty much a closed off system, in which members receive all of their care within the system.

There are a few more options, such as a Health Savings Account, a Point of Service accounts, some states have their own healthcare plans, and then there is Medicaid and medicare. If you want to read about the state of insurance in the US in all its depressing details, here is the latest survey from the Commonwealth foundation (2022)

I am on a PPO plan, so I could have continued to go to my provider (Providence), but it would have been much more expensive. I started to come up with contingency plans- how long would it take to find a new gastroenterologist? Could I deal with a possible interruption of care? How long could I afford out of network care until I had everything transferred to a new place? How long would it take to transfer my infusions and the financial aid package that comes with it?  I felt a tinge of panic, because I did not really want to leave my gastroenterologist- the one who managed to get me into the longest remission I have ever been in. All those people who defend the private insurance system, because of “personal choice of doctor” have clearly never engaged with the healthcare system.

It’s such a strange, infuriating, and infantilizing feeling, there are these two big, faceless organizations negotiating the future healthcare (or lack thereof) of thousands of patients.

I called my insurance, who probably overwhelmed with calls, told me they’d get back to me about a possible continuation of my in-network care. I could apply, but would need signatures from different doctors etc. They also couldn’t tell me whether this would be forever or just buy me time. I was frustrated to say the least.

Then, today- the insurance sent a message that they had come to an agreement, and that everything would continue as it was. No changes. Oh, so I just spent days worried, hours on the phone, for nothing. Other people have hobbies in their free time. Still, I am relieved.

I know that I, and I alone am responsible for my reaction of panic. My reaction however, is informed by a lifetime of learning that if you don’t look after and stand up for yourself in the healthcare system, little to nothing happens.

Crisis averted for now, I guess.