Just in case you have any complaints about the Canadian medical system...

 

Our daughter, Enid, is married to Isaac, who is a scientist working in the enormous National Lab in Richland, Washington State. Through work Isaac has a very good --and very expensive, even with the subsidy -- medical plan, which covers Enid.

Enid and Isaac recently acquired a new baby, Louis Harree Arnquist, who is perfect in every way. 

But his birth is when his parents' encounters with the health bureaucracy began. 

Here's her rant on the subject:

 

1. On Louis' 32nd day of life, Isaac tries to enroll Louis on his health plan at work. He soon finds out that he needed to do it no later than Louis' 31st day of life (which was a Sunday, we had visitors, we're tired new parents, and life is crazy). 

2. He writes an appeal letter, which has to be mailed old style. No one will answer a phone or write an email - it is simply not done even though it is 2015. We assume that the insurance will cover him retroactively once the appeal has gone through. Isaac does everything he can to make it happen faster than the maximum 30 days, but there isn't much he can do in the end. 

3. In the meantime, we make plans for alternative coverage JUST IN CASE. We fill out numerous forms on the Washington Health Plan Finder website and are able to look at plans and compare. All 56 are all terrible (not a single one has Louis' pediatrician or the Richland hospital in their network!) but it's better than nothing. We can't enroll him until October 1st - that is the rule lest you try to insure an already sick child. 

4. I call in to ask for the deadline to purchase the Oct. 1 plan. I'm told I have until September 23rd at 5pm. 

5. September 23rd, we get bad news from Isaac's work plan. They won't cover Louis because it was day 32 of his life and that is the rule. At least it's good timing, because we can still purchase alternative coverage, or so we think. I try to purchase said coverage, but suddenly I can't see the available plans. I call to find out what's going on, and the man on the other end says the website isn't working properly, and I should try on Saturday. He assumes they will be manning the phones on Saturday because the website will be down the rest of the week. I ask for assurance that they will let me get Oct. 1 coverage despite missing the deadline. He says it should be fine. 

6. Saturday Sept. 26, I try to log on to the website but it's still down. It claims it will be back on Sunday at 9:00am. The message saying the site is down is dated Sept. 23. 

7. Sunday: Still down. 

8. Monday: I can log on, but I still can't see any plans. This is the point where my memory is blurry because I talked to at least 5 people in 3 days. But I know that on Monday they told me that even though I hadn't been asked to by the website or a person on the phone, I would have to upload our financial info. The person on the other end assures me that it's not my fault and it won't affect my Oct. 1 coverage. He/she (I can't remember) is surprised that I was ever able to see plan options without having uploaded this stuff. That was an error. I upload our info within 5 minutes. I call back to find out why I still can't see plans and the woman tells me to wait. I obsessively check for a status update. At some point in the day, the website is down again. 

9. On Tuesday I talk to two more people. One woman hangs up on me TWICE by accident. Another writes a "ticket" to get someone to take a look at what is going on with my account. I can't remember what else happened on Tuesday but I definitely cried on the phone out of frustration. One woman told me that Louis was eligible for the subsidized health plan. I explained that he was definitely not, which should have been obvious from the eligibility determination and our financial information. Maybe it's her first day?

10. On Wednesday, I call again to find out why our problem APPEARS to have been fixed and yet I still can't see plans. He realizes that I need to upload Louis' birth certificate. Again, I haven't been told this or seen that this needs to be done anywhere on the website. The man on the phone is really kind, but I cry anyway because I'm so tired of dealing with new problems every day. He writes a new "ticket" to get the tech people to sort my account out properly this time. 

11. Thursday morning: website is down again.

12. Thursday afternoon: Huzzah! I can see plans!! I choose a plan! It's terrible. The deductible is in the mid-1000s and after the deductible I pay 50% coinsurance until I reach the yearly out-of-pocket maximum which is a crazy $12 500. I would pay for a more expensive plan (this one is about $111 a month, as I recall) but those ones have no out of pocket maximum for out-of-network hospitals and don't give me anything more for his out-of-network pediatrician care. I need SOME assurance that I won't go bankrupt if Louis has a serious complication. 

13. They force me to pay $25 a month for a terrible dental plan. My baby has no teeth. Obviously. He will be eligible for Isaac's plan again in January, by which time he still will not have any teeth. 

14. I apply, and I can only see that Louis is enrolled in the dental plan. I can't see anything about a health plan. I call and ask what's going on and the woman says her system isn't working. I need to call back right away and see if someone else can help. I call back and talk to a nice fellow who tells me he's going to write another ticket (this is #3!) to see if the tech people can sort this out for me. He asks me what plan I chose, but I only remember the name of the insurer because the plan names are pretty dull.

15. I wait, and REALLY hope that some insurance company will insure Louis for Oct. 1 despite the Washington Health Plan Finder's incompetence. I feel pessimistic after our experience with Isaac's insurance. If he can only be covered for Nov. 1st, we will pay a $400 penalty in our taxes for having an uninsured child for 3 months. 

I might as well mention that this week I sorted through the seven plans offered by my employer because I have to choose one for when I go back to work in December. It took me three hours to make an informed choice, and I'm still not sure I really understand the difference between the plans. It's always a gamble, because you never know what care you'll need ahead of time. Will it be cancer, a car wreck or absolutely nothing? I prefer not to gamble and choose a slightly more expensive plan (but not the most expensive one, because that one would cost me $500 a month). 

I also might add that I am fairly privileged. I have enough free time to deal with this kind of stuff (although not a ton, being a new mom with some work obligations while I'm on maternity leave), I have a lot of education that has prepared me to advocate for myself intelligently and understand complicated language in health plans, and I have enough money to pay the cost of the insurance and the exorbitant out-of-pocket costs. Many Washingtonians in my position are not so educated with so much free time and money. 

I remember fondly how annoyed I got with MSP in British Columbia. How adorable. I long for a time when I knew how much everything would cost me when I went to the doctor or hospital (always zero). Now even if I have the required insurance, I'm never sure what's covered or what it will cost me. I have to check to see if a doctor is out-of-network before I choose one (too late for Louis). I have to know which hospitals I can go to before I go to one. I have to spend hours on the phone trying to sort it out when two separate labs bill my insurance company and my insurance company doesn't pay the bill (that happened last winter).

In short, I think this is a terrible system. I do not want to hear any more politicians claiming that Americans have the best health care in the world. Maybe, but only for a select few. And even those people probably spent hours and hours trying to sort through endless healthcare choices to get the best deal from some insurance company, which is really just an expensive middle man.