Postmodern Archiving

For public libraries, one of the ways we secure funding year to year is lending. Governments don’t want to fund more books if they’re not being used and the way we measure use is by issues. Regardless of whether you read it or not, whether you have it for a day or a month, if you issue it to your library card, we get the stats! It makes the library look good!

photographer: sure did boss, real fucking sexy just like you asked

ala: what

This never occurred to me. Not once. That Americans are against Health Care because they think it actually costs tens of thousands of dollars for a broken arm, hundreds of thousands for a complicated birth, millions for cancer treatment.

I’ve had these same drops before living in the UK. They cost me seven GBP.

It’s the exact same drug, same steroid, same strain of antibiotic. But somehow the US gets away with charging $100 for a generic non brand version of a drug which is easy to create and widely used. It’s downright robbery, but also a form of eugenics through poverty and class warfare. You keep the poor poor by making sure basic necessities remain unattainable and then you make it seem like the norm so no one fights it.

The rest of the world is not like this.

I’m in the exam room, post diagnosis and with pill bottles in hand, and in walks the one nurse I’ve been able to speak to the entire time. She pats my hand and tells me (and this is verbatim—I will never forget this conversation as long as I live), “I’m so sorry. We had to run those tests, and they are expensive. You don’t have insurance so you will have to cover the full cost.”

I start crying.

She continues, softly, as if telling me someone has died, “It’s going to be three hundred.”

I start sobbing, certain I’ve misheard, certain that I would be absolutely fucked, broke and going into debt in a foreign country. “Thousand?” I clarify.

Her entire demeanor changed, and she looked at me as if I had sprouted four extra heads. “No,” she says, “euros.”

I went to the UK for graduate school, and being there for that long meant I had to buy insurance for the duration. 18 months was something like £800 (this was in the early 2010’s). I, being American, figured “oh ok, that’s the premium and if I need serious medical care, I’ll get charged deductibles and all other kinds of fees at the time of care), because that’s how it works here.

Some time in the early part of that winter, I got incredibly sick. I’m immunocompromised, so sometimes that happens. But being a broke ass grad student in a foreign country, and dealing with unrelated financial abuse from family members, I figured I couldn’t afford going to the hospital. I figured I’d go to their version of Walgreen’s (Superdrug, and yes that is really that store’s name, load up on cough drops, some OTC meds, and try to ride it out as best I could.

One of my friends in my program came over to check on me and offer help. When she got to my room and saw how sick I was, she asked why I hadn’t gone to hospital. I was near tears and said I couldn’t afford it.

This is when I suspect my friend knew she was dealing with an American who was ignorant of how socialized healthcare actually worked, and realized that I couldn’t really be reasoned with. So she said, “I’ll pay for it- let’s go.”

Off we went to hospital, my friend did the talking bc my voice was so shot. The receptionist said, “as you don’t have an appointment, you may need to wait quite a bit.” I heard that and figured 5+ hours was at least what I was in for.

23 minutes later, my name was called.

My friend went back with me, bc I was pretty out of it. The nurse leading us back apologized for the “huge wait” because having a sick patient wait “nearly half an hour just for medical care” was unacceptable. I was stunned.

The nurse and doc asked some questions, looked at the medical records I had on my phone (bc I was a foreigner with very little medical history in the country), did a few rapid tests. The whole time, I’m seeing an old-timey calculator ringing up charges and freaking out… even though my friend said she’d pay, I was so conditioned to believe this would cost a fortune.

About 30 mins later, the rapid tests confirm I have both bronchitis and pneumonia. Doc writes me a prescription for some serious heavy-duty meds. My American ass is thinking, “ok, so now I go home, wait for 4 days for the pharmacy to fill it, then go get it.” The doc tells me that there’s a pharmacy counter on the way out, and I can stop there to collect the meds before heading home.

I’m skeptical but thank him. My friend gets me to the pharmacy counter. I give my name and hand over the paper, fully expecting to be told that it’ll take days to fill. The pharmacist turns around, pulls a bag off the shelf, hands it to me. Because my meds were already filled and waiting.

Me: you had them already?

Pharmacist: of course- there’d be no point in sending you home without medication, that’s why you came here. To get medical help.

Me: that’s so fast? (I am very confused)

Pharmacist: well, we expect people to have these illnesses at a higher rate this time of year, so we do our best to stock up on our end.

Me: that’s so nice? Also, what do I owe you?

Pharm: sorry, love?

Me: what do I owe you? For the medication? And the visit. All of it, how much do I need to pay?

Chat, her whole fact changed. She realized I didn’t just sound funny because I was in respiratory distress. I had an American accent. She reached over and patted my hand.

“Love, that’s what the health insurance is meant to be for. You’ve already paid for this. We’re not taking extra money off you, we don’t do that here.”

The entire visit was less than 2 hours, absolutely free, and everyone worked to be as efficient as possible in the goal of providing comprehensive healthcare for me, the patient.

Once I got home with the meds, I did actually recover pretty well (and relatively quickly, as far as I’m concerned). I talked to the friend after, and she admitted that she knew it was going to be free, but that I wouldn’t or couldn’t understand that in the brain fog of serious illness, so she said what she had to in order to get my stubborn (and terrified of bankruptcy) ass to the doctor.

Here is Spain is basically a parallel health system: they have their own hospitals, their own medical centers. Private insurance is often offered by companies as a perk.

In my experience the private system is a bit less trustworthy than the public system, but it’s ok when you want to do some tests and not have to wait to get an appointment, or for example, things that are not that well covered in the public system (getting an official ADHD diagnosis in the public system can take a long long time, etc).

But here is the catch. I’ve just gone to Cigna’s website and entered my family data. This is how much it cost to get full coverage for a family of four with Cigna in Spain:

180€ / month, for the four of us. Not 180€ each, 180€ total.

And here’s the second catch: the concept of deductible doesn’t exist here. When you get private insurance, your deductible is always 0, you never pay a single euro for visits, tests, anything.

I take out meds like, every 2-3 months and they cost between 20$ to 80$, depending on what time of year it is due to high-cost protection. If I spend more than 300$ on medication in a year, it’ll be free. Of course I cant hoard it, I cant grab as much as I want, but it gets cheaper over the course of the year until the high-cost protection resets.

Every year, I get charged ~$500 for those required tests (which are part of my annual physical, and should be fully covered), and my insurance always initially refuses to cover any of it. I fight it every year, and only get it (part ways) covered half of the time.

5 people linked hands to save the dog, but there are only 4 in the statue...

Hedgehog-shaped jar, Neolithic period (3500-3000 BCE)