Insurance and Bad Gas: USA vs Argentina

Photo by TheAlieness GiselaGiardino²³'s

About a year ago, my daughter was having severe stomach cramps. We are talking rolled over and can't move kind of pain. The pain was predominantly on her right side. What if it was a burst appendix we thought? As a parent, you can't dismiss stomach pain that severe as just your average stomach cramps and hope it works itself out.

Bad Gas Emergency

Being a Sunday night around 10:00, our only option was to take her to the emergency room of the local hospital. Now, those of you not from the United States might not understand the full ramifications of such a routine trip to the hospital in time and money.

My wife took her in around 10:30pm and it wasn't until 3:30 or 4:00am that they returned home. The diagnosis? Your average stomach cramps. The cost? Just under $4,000. That is right—$4,000 and over 5 hours to diagnose a case of bad gas.

But you might say what about insurance? Yes, we had insurance. In the states we had a Health Saving Account plan pushed by the Republicans as cure for high insurance and medical costs.

HSA: A Cost Saving Pipe Dream

How the HSA worked was we could put up to $5,500 of our own cash (I was self-employed) into a tax free special savings account and pair the savings account with high-deductible insurance. The deductible was equal to the limit on what I could put in my savings account. Only after I had spent $5,500 on medical expenses would the insurance kick in. And then, it would only cover 85% of my costs.

The cost for such an insurance plan? It started out at $370 per month for our family of four. After four years on such a plan, our premiums more than doubled to $770 per month. That was more than our COBRA insurance payments from my last corporate job. At least that plan had only a $10 copay and covered everything we needed.

If you do the math, we were paying $14,740 each year for shitty insurance in the US. Not only that, having to go the hospital was a nightmare and could take up to 10 hours of our time waiting in the ER.

Private Insurance in Argentina

Argentina does have universal coverage. However it can be augmented with private insurance plans that are more kin to the HMOs of old where you get access to your plans private hospitals and facilities. Think Kaiser Permanente.

I know HMO brings back nightmares of insurance gone wrong in the US. However, the insurance companies here get reimbursed by the state so they are not really concerned about denying care. Their whole purpose is to provide better care than what the state alone provides. They would be out of business fast if they were denying service you could get for free.

I pay a little over US$200 for my family of four or $2,400 per year. That is a savings of over $12,340 verse what I would of paid in the US.

Bad Gas Argentina Style

Earlier this week, my daughter and I were walking down Cuba when she rolled over in pain. She said she had never felt pain that bad and could no longer walk. We were less than a block from the Medicus hospital here in Belgrano.

I helped her to the hospital and we were quickly sent up to a room. A couple of doctors started diagnosing her and she was given a sonogram to rule out appendicitis all within 15 minutes of arriving.

The sonogram showed what they thought was leakage and before we knew it we were put in a private car and whisked to the large Medicus hospital for possible surgery. When we arrived the Surgeon met us and did a few test to make sure. Once the test came back it was clear it was just another case of "bad gas."

Our out of pocket expenses? Nada. They even paid for the remis (private car) to drive us the other hospital.

Time Spent. About an hour at each hospital. No complicated forms to fill out. Just a flash of our insurance card allowed us entry and my daughter was quickly and efficiently taken care of.

Lessons for the US

Healthcare in the US is outrageously expensive. The insurance and provider systems are broken. Yet, universal public healthcare would never fly in the US. A good solution would be a blended model where basic coverage guaranteed to all could be augmented by a private plan similar to plans in rest of the civilized world.

The thought of going back to the existing healthcare system in the US is enough to give me a case of bad gas.