In New Zealand, we are lucky to have a public health system. It is far from perfect (with waiting lists for example), and far from complete (we pay for GP appointments for example), but it serves most people very well. Until 2002, I had little need of the system, but prior to that I had seen my sister, mother and father all have operations for various reasons. All would have struggled to pay for their treatments, and all received excellent care. In 2001, when I became pregnant for the first time, I was amazed to find that typical fees (like a visit to the GP) suddenly vanished in the face of our public health system, which provides free pregnancy-related care. A year later, and another ectopic pregnancy saw me go through three separate surgical procedures, at what would have been (I now know) considerable expense if they had been charged for. Yet the cost of my care was irrelevant. All I had to do was turn up at the hospital or my various appointments, worry only about my recovery and, at the time, my future. Never saw a bill. And to be honest, never really thought about it.
But this year it was different. When I was told I needed surgery, I could have opted for treatment in the public system, but I wanted a quick resolution to my issues. My surgeon said I qualified for public treatment, but not for a laparoscopy (keyhole operation) which he recommended, for better and quicker recovery. I also didn’t know how long I would have to wait for a publicly funded operation, and wasn’t inclined to have to do so. We have health insurance (precisely to give us this flexibility), and so elected to go private.
The first thing I noticed was the difference at the small private hospital. The quality of attention and accommodation was definitely higher. A private room was a given. The food was better. That was very noticeable. In 2002, my husband used to pick up Thai takeaways and bring it into hospital for us to share, to avoid the bland (but adequate) public hospital food. No need to do that here. My surgeon visited daily, including on the weekend.
We knew that our policy probably wouldn’t cover everything, and we were prepared for that. What I wasn’t prepared for was the level of uncertainty I experienced once I had had the operation. Feeling vulnerable physically was making me feel vulnerable emotionally, and I didn’t really expect that. Suddenly I was wondering and worrying what everything was costing. I felt helpless.
Getting the bills was brutal. That’s the only way I can describe how it felt. Yes, we had to pay more. The estimate we received though was far from accurate. And what I didn’t expect was to see absolutely everything on the bill; the containers they brought the pain relief in (5 cents each), the hospital gowns, each change of bedding when my dressings leaked, the expensive dressings (that tore my sensitive skin), etc etc. I was, it is fair to say, shocked by how vulnerable I felt receiving a bill for a medical procedure which was absolutely necessary – even when going private and therefore receiving any bill at all was actually our choice. We had no control over any of the costs (except the surgeon, who we chose – and his was the only cost which didn’t balloon out). Yet we were able to cover the extra costs. We were lucky. And if I am honest, I would go private again – now that I know what to expect.
I can only imagine how terrifying, how painful, it must be for people – especially those who have insufficient or no health coverage in other countries – who have no public option: people who, when faced with a health issue which has nothing to do with healthy living or lifestyle choices, are suddenly faced with huge financial issues; people who are faced with the prospect of reduced quality of life or even death if they can’t afford to pay. The sheer brutality, the cruelty of a system like that, is unfathomable to me. I could easily have gone public – I didn’t need to have private health insurance to survive. Once again, I am very thankful for our flawed, sometimes struggling, but ultimately well-intentioned public health system that generally serves us all very well.