Thursday 29 January 2015

I prayed my pregnancy in the US would be OK: I didn't have insurance

Barack Obama was forced to backtrack this week on his healthcare plans. Caitriona Palmer reports on what it is like to live in America without health cover

There are over 47 million people in America without health insurance and five years ago -- for a brief and unpleasant time -- I became one of them.

Five months pregnant, I arrived in Washington in the summer of 2004, following my husband's sudden expulsion from Iran as a foreign correspondent for The Guardian newspaper.

Our speedy departure from the Islamic Republic had happily solved my mounting anxiety about the prospect of giving birth in Iran -- an experience I was gearing up to face alone as my husband, thanks to the ruling clerics, would most likely be banned from the labour room.

But being pregnant in the Axis of Evil, I soon discovered, was a cakewalk in comparison to being pregnant -- and uninsured -- in the Great Satan.

In America, the majority of those with medical insurance receive it through their employers. But as freelance journalists employed by foreign newspapers, we had no such coverage. No to worry, we thought, let's just pay for it ourselves.

We made some calls. A representative at America's premier health insurance company told us that they would happily take us on for a monthly premium of $750. We gulped a little, filled out the necessary forms and put them in the post.

A week later came a reply. Dan would be covered but I was rejected. "Denied due to a pre-existing condition: pregnancy," the letter read.

We moved on to another company, and then another, and another. The rejection letters continued to arrive. One company denied me not only for my pregnancy but also for a previous spinal injury caused when a careless driver ran a red light some years back and slammed into my bike.

Being pregnant was bad enough, it seemed. Pregnant with a bad back? Forget it.

Another month passed -- I was now six months along -- and becoming desperate. We hired an insurance broker, an expert who knew the system, to help us find coverage.

He tried admirably but failed. "Pre-existing condition," he told us apologetically over the phone.

I began to research the prospect of giving birth in America without insurance. It didn't look pretty. Owing to America's litigious society, the birthing experience had become heavily medicalised with scalpel-yielding obstetricians and sky-rocketing C-section rates.

A normal vaginal birth in American costs, on average, $7,500. A C-Section comes in at around $14,000 although I was warned that it could be as high as $40,000. The choice seemed like a no-brainer.

And so, with a deep breath, I decided to give birth naturally -- without drugs -- the best odds to avoiding the C-section route. It was something I had always expressed interest in but now seemed the only option in a quest to keep our costs below $10,000 -- providing everything went well.

"Even if things do go wrong with you and the baby," the kindly financial officer at the hospital told me, "we won't charge you more than $20,000 total."

In the end, everything went just right. I gave birth to a beautiful healthy baby boy with no complications. The $8,000 bill did not send us into the bankruptcy courts. And in a few months, my husband's new job with excellent health benefits meant we could leave the ranks of the uninsured.

But my story illustrates the complexities and cruelty of the American healthcare system. One that President Barack Obama is desperately trying to reform despite increasing scepticism and hostility across the country that he is trying to institutionalise "socialised medicine".

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