Healthcare in the First World

One perk of belonging to the suburban middle class–health insurance.  I love me a comprehensive health plan. Nothing at all like my dinky ‘health card’ from when I was a struggling employee (aka cog in the wheel) for a multi-national company back in the Philippines. I do get my consultations and minor work ups covered and boy, did I take advantage of it all. I had my yearly OB-Gyne visits, dental and dermatology, had my heart checked out back in 2009 because of a pesky arrhythmia condition that eventually disappeared. My braces I had to pay for myself, because it was considered cosmetic. I wondered how that could be because I was able to get my facial warts removed for free. Hm. Anyway, because my parents didn’t have health insurance when I was a child, I had to wait until I was grown and making my own money to have all the necessary stuff done–like getting braces. I had an overbite and one incisor that was recessed. I hated my teeth–it made my poverty too obvious. I was also a fanatic of an annual executive check up. I wanted to make sure nothing is wrong with me.

In the Philippines (at least among the working class), braces were an unheard of luxury.  In 2012, the average monthly income of a Filipino household belonging to the poorest decile was PhP6000 or US$126.48 today. I doubt an average American guy can live on that sum for a whole month without resorting to pan handling to keep body and soul together. What can you buy for $126 these days? A week’s worth of groceries, I guess, and that’s for the two of us, without kids. That’s the essentials–bread, milk, eggs. That’s without my brownie mixes and ice cream. In the Philippines in 2012, PhP6000.00 spells the difference between living a regular life and going hungry. It pays for food, rent (for those renting), electricity, water bills. It’s hard to imagine now. And that was just 4 years ago. My childhood was in the early 90s. I wasn’t able to get any raw data online that would tell me how much the average household income was but based on my family’s experience alone, it was not a lot more than PhP6000. My father served in the Philippine military and my mother did not work until 1995. There were six of us living on one pay check for a while. It helped that we didn’t have to pay rent because we were living in my grandmother’s house, and the water came from a well in the yard. Our only bill was for electricity. We didn’t own a television set so it was not that much. We made do and we got out of it okay.

So imagine having to pay for braces. We couldn’t even afford to buy new clothes every year, what more a set of braces that cost 25,000 pesos at its cheapest? That’s probably already a fourth of my father’s yearly income.

So if you wanted braces, you had to pay for it yourself–ten, fifteen years after you knew you needed them, you work and save and finally have your teeth fixed at age 25. Nothing wrong with it.

A couple of weeks ago, I went to the dermatologist to have some irksome little bumps under my eyes looked at. I’ve already read about those; in fact my dermatologist in the Philippines suggested getting them removed after I had my warts removal procedure. Unfortunately it wasn’t covered so I would have had to pay out of pocket for those. So I said I’d scrape together some money and come back. I never did. There was just a lot more important things to throw my money at besides non-emergency dermatological procedures. I could barely afford a regular supply of oil of Olay, to be honest. Anyway, fastforward to years later, I talked to my dermatologist here in the US about it, and he basically said I should just leave those bumps the hell alone. He said that they are harmless tumors that are really just sweat glands, they’re passed on to one’s children and it is usually women who get them. I can attest to that because my husband, who doesn’t have a single product in his side of the bathroom (save for sunscreen when we go swimming) has youthful, smooth skin sans bumps or age spots. I tell you, that’s pretty good for 34 and for not obsessing daily about his face. He also has prettier feet than I do in my opinion and he has never had a pedicure in his life. Where is justice in all this, God?

To move on with my story, the doctor further informed me that any procedure available currently would most likely not make me happier than I am now with the appearance of my under eye skin considering the cost I will have to bear to undergo those procedures. He did give me a card of a cosmetic surgeon who would be my best bet if I decided to go ahead with it. Further, I was instructed to Google the condition so I wouldn’t be suckered into paying huge sums to a fancy spa promising to do something about my complaint. He emphasized that there is no complete cure or treatment for what I have but that I shouldn’t worry because they are not too obvious. He basically told me to stop worrying about nonsensical things and not to bother him with pointless dilemmas. He was a serious doctor, for God’s sake! Come to me when you get skin cancer. Ok that last bit I just made up but the poor third world country girl in me felt a little frivolous for even making the trip. I knew it was minor and wasn’t all that bothersome. I just thought there was something to be done about them (as my Filipino dermatologist once alluded to) but I guess not. However, he pointed out that I do have an acne situation in my forehead and chin and that I should try some medication for that. He also pointed out that my under eyes are very dark and would I consider purchasing a cream to lighten it up?  I said yes to both because I figured, I was already there. Might as well get a prescription out of it.

We paid $40 for co-pay and left. Yesterday, I received a bill for $76 for the good doctor’s trouble. Hilarious. He is a nice, polite guy but 10 minutes in his office where he told me to Google my condition and 2 pieces of prescription do not an over $100 fee make! At least in my opinion. I’m sure a lot of doctors who studied 4, 5 years and spent hundred of thousands of dollars to get their degrees would disagree. I just couldn’t get over the amount though. To me it felt like having an engineer look at out house for renovations, and that engineer told us to YouTube a DIY video and then charged us for it. It was a whole month’s income for a family of 6 in the Philippines! (Now I’m just being patronizing).

I am still grateful for healthcare though, without which I wouldn’t have any opportunity to obsess over my facial flaws needlessly.