Art critic Adam Mendelsohn stitched his own face after being bitten by a dog, because he couldn't afford a trip to casualty. He bought drugs in a pet shop, because "you can get amoxicillin and tetracycline from fish antibiotics". As a freelance writer, insurance is prohibitively expensive for him. "If there's something wrong with you, the first place you go is the internet, not a doctor," he says.
Annie Granatstein, a film producer, had good insurance, but when she suffered chronic back pain following a road accident, her specialist demanded additional payment.
"The day before my operation, when I was on all kinds of medication and didn't know what was going on, he had me sign a form that waived my network benefits and agreed to pay him $6,000," she remembers. When she found out the procedure was actually covered by her policy, she decided to fight. "The surgeon called me at home, on a Sunday, yelling that if he accepted the amount offered by my insurer it was going to put him out of business."
Oliver Helden and his wife Susan were bitten by a rabid dog on holiday in Zimbabwe. They had the first vaccine injection for free before leaving the country, but required a course of seven more each on their return to the US. "Without the full treatment, there's a high chance rabies can be fatal," he says. Each injection cost $350, plus hospital fees. The total bill: $7,000.
After holding fundraising parties at their flat and putting the maximum on their credit cards, they still couldn't pay, so they declared bankruptcy. This is less unusual than it sounds: according to a Harvard University study, two more Americans go bankrupt every minute as a result of medical expenses.
I heard from a couple who were told to drive 100 miles to their primary care clinic when their baby caught pneumonia because it didn't qualify as an emergency; a woman who discovered a cyst on her ovary but can't afford the follow-up scan and must hope that it is benign; a lighting designer whose insurer pays for genetic breast cancer screening, but will double her premium if the test comes back positive; a taxi driver who ruptured his knee playing baseball, but cycled to hospital on one leg because it costs $1,000 to call an ambulance. These are mundane, everyday occurrences.
Phyllis Zolotorow, from Maryland, has spent half her adult life battling the insurance industry on behalf of her son, who was diagnosed with cancer as a child, and her husband, who had a heart attack while uninsured. Considering her struggle, she is remarkably good-humoured, with an incredulous laugh, as if she can't quite fathom what has happened to her.
"None of us can believe it, but that seems to be the way it is," she says. "In this country? In Somalia, maybe, but in the US? It's absolutely disgraceful."
Her son, Craig, has Hodgkin's Lymphoma. He was covered under the insurance she received through her job as a florist, but the policy's lifetime maximum was only $250,000. This lasted a year, after which he became uninsurable. "Who wants him? In a good year, if absolutely nothing goes wrong, his healthcare bill is $35,000." A friendly nurse handles his monthly gamma globulin injections at home, as a favour.
Now that the family's savings have been exhausted and both his parents are unemployed, he qualifies for the government welfare programme, Medicaid. He will start university this autumn knowing that it is almost impossible for him to get a job without losing his health insurance, because employers will be wary of the increased premiums.
His father, Mike, lost his job after a workplace injury and couldn't afford to maintain his health coverage. Two years later, while trying to get fit, he started feeling sick. Phyllis wanted him to go to hospital "but he said, No, I have no insurance, I'm nauseous, it's probably just a stomach virus.'" A week later he suffered a massive heart attack and almost died. It took two painful, hideously expensive years before he qualified for Medicare, during which the Zolotorows incurred debt that they can never pay off.
