The reality of being uninsured: A head-on collision
I’ve always felt “young”. Even now -at 42- I feel young. Too young to die, or get a horrible disease anyway. Or so I thought.
You see, I lost two people who were very dear to me at the beginning of 2019: Juan Pablo, 33; and Grace 52. Both to Cancer.
Cancer: The Big C. The critical illness that is the second leading cause of death globally, according to the World Health Organization (WHO). The one that has taken 3 of my grandparents from me. The one my mom’s youngest sister Mireya is fighting a battle with.
Cancer is not just close to me and my family. Just in 2018, more than 9.6 million people died of cancer, according to the WHO.
That same year, insurance companies in Mexico stated that “regular” cancer treatment was priced at around 1 million pesos. Getting tested is pricey too, specially if you don’t have access to the public health system.
2019 was a year in which I had to come to terms that feeling young (or even being young) didn’t mean being invincible. A year of losses, but also of resilience and gratitude.
Being a freelance stylist, Juan Pablo kept waiting to have “some extra cash” to get some medical tests that could have shown he was sick months before he actually had them done. He said he needed around 10,000 pesos, which were eventually lent to him by a close friend. It was too late.
We will never know if that would have bought him some more time to fight the illness. Because he fought, everyday. My warrior friend faced the world with a smile until the very end. His death changed something inside me. I’m still figuring out exactly what.
And then there was Eugenia.
Life and death decisions
Eugenia, 42 and a mother of two teen girls did not die. She called me from the ER and told me there was something wrong: “Its nothing major, stay at work”, she said. She was then admitted for some tests. The rest of it is kind of a blur.
She had a thrombus, a big blood clot, that could go directly to her heart, lungs or brain and cause her death. It was not the first time this happened to her.
There were conflicting opinions for treatment, until one doctor said that the only option that gave her a real chance of recovery was surgery. He is a young doctor and well versed on the latest technologies for the cardiovascular system, he was willing to perform the surgery even when it wasn’t clear how he was going to get paid: “we will sort that out later, your health comes first”, he said.
There was a moment in which I didn’t know for sure if Eugenia would survive the surgery -or even make it to surgery- as time passed by and all the paperwork and administrative stuff had to be dealt with. Her leg kept swelling up by the minute. Things were extremely confusing, as doctors, nurses and administration people from the hospital kept asking for documents, signatures, credit cards. At the moment all of those things felt unimportant.
Watching death lurk in the shadows created by dimmed hospital lights I realized that Eugenia was my sister. I had chosen her as such. My sister by choice was fighting for her life right before my eyes: a black mirror that showed me my own fragility and strength.
A lot of hard things had to be faced that night. I battled with random thoughts as I waited all night for the doctor to come back and tell us if she was out of danger: Shall I call her father; if something happens who is going to take care of the girls; how much is this going to cost; I’m so scared of hospitals; how am I going to be able to go through this; I’m all alone in here; will her insurance cover this; I have to be strong…
Next morning, they brought Eugenia back from surgery. Everything went well. With dawn came the realization that I had to really think about my own health and financial choices. You see, having private, high-end insurance gave her a chance to live. A chance which was almost lost because her husband “forgot” to pay to renew their coverage and they had to change companies as she had already had to be hospitalized because of blood clots and it was extremely hard and expensive to get her a new insurance policy.
Somehow I managed to keep tears at bay. At least for 2 days. Then I broke down.
Keep calm and get insured
The total cost of Eugenia’s weekend stay at the hospital plus the 2 surgeries she underwent came to more than 1.6 million pesos. She needed a couple of stents, whose cost on private hospitals is quite similar to those in the United States, she also needed a tiny filter to be placed temporarily in her vein to protect her from the clots, and then taken out again. She had to have daily injections which were also expensive and had to have more tests like MRIs. The expenses do not stop there, Eugenia needs to be on anti-clotting treatment for life.
Even now, that months have passed, the insurance company has not yet reinbursed her family. They had to pay out of pocket so that the hospital would let her leave.
Scary huh? Now imagine not having the money yourself or not having anyone to help you out.
Not a “private” problem
Some may argue that those high costs are because she was treated in a private hospital, but the 2018 data shared by the Mexican Social Security Institute (IMSS)is equally alarming for those who seek public hospitals but are not covered by the national health plan (which is not the greatest, by the way): 7,757 pesos per day for a regular room and 35,400 pesos a day in the ICU. And to that add tests, doctor’s fees for consults, treatment…
The financial burden of getting sick is quite severe, considering that the minimum daily wage in 2018 in Mexico was 88.36 pesos (yes, less than 5 USD a day) with around 2.77 million people -whose average age is 35- earning just that amount according to El Financiero. This means that 5.7% of the working force -by government standards of employment- would have to work for 3 months and spend all of their salary to be able to pay for one day at the hospital.
I find this quite unfair, repulsive even. The problem does not stop with my country’s most vulnerable population. Having and accident or getting a critical illness diagnosis is something an average middle class mexican still can’t afford.
By OECD standards, in Mexico if the combined income of a household averages 14,257 pesos a month or more it is considered to be middle class, which puts 45% of homes in that category, and according to INEGI -the authority on mexican statistics- 96% of the working force earned less than 15,429 pesos a month in 2019.
We need to focus time and energy on finding real solutions for these issues. Having affordable and reliable insurance is one. Starting young is another one. Its time we wake up.
Any thoughts? Glad to read you: eva@zenda.la
