In 2019, I became a widow at the age of 38 with four young children. My life changed instantly. Soon after, I met another young widow, and in a stroke of genius or lunacy, we started a podcast and online support group for widowed people. We interview and have widowed friends from around the world, including the U.K., Sweden, Finland, Germany, the Netherlands, Australia, New Zealand, Japan and Canada.
One eye-opening aspect of this international association is the stark difference in the experience of our friends widowed in the United States versus those in the aggregate of the developed world.
For widowed people in the United States, a massive underpinning of their experience is the question “How will I pay for this?” It runs the spectrum from sudden death to a yearslong illness. The stress of dealing with the financial fallout can be suffocating: decoding statements, fruitless and frustrating phone calls, appealing out-of-network denials, setting up payment plans, and the loss of a partner’s health insurance moving forward. And if you think a person’s health care debt disappears after they die, you are wrong in many cases.
For people widowed in basically every other developed country, this is a non-issue. The increased stress and strain are missing entirely from their stories. It never enters the chat. Never.
I have a friend who spent part of her husband’s cancer treatment in the U.S. and part of it in Canada. A Canadian citizen, she was on assignment in the U.S. when he was diagnosed. How ridiculous that she was being saddled with medical bills in the U.S., but had only to cross the border and it was no longer a concern. All his care was covered through their universal health care system. She stated, “I cannot emphasise enough how much less stress it was for me, a mom with three kids, to just not deal with any medical bills. Calling insurance companies, trying to figure out all the invoices and understand why one day’s doctor visit was covered while the next day’s doctor visit by the same doctor wasn’t covered.”
And in case you think that the quality of his care must have suffered, it remained largely unchanged. In fact, one of the trials they applied for while in the U.S. was a trial out of Montreal.
We are an extremely proud country. We boast about being the best at everything. Yet, we haven’t innovated a better way to provide our citizens with health care. In the U.S., we deal with long wait times and rationed health care. Our health outcomes are worse, despite spending more. We experience many of the downsides of universal health care but none of the upsides. I am confounded by the lengths we will go to defend a system that treats our health as a commodity on which corporate wealth is accumulated. We compare the worst aspects of other systems with the best parts of ours.
I surveyed my global friends to see if any of them would take our system over theirs. I was laughed at. Every one would take the flaws of their own program over the failures of ours.
Like many widows in the U.S., our family lost access to my husband’s employer’s health insurance within weeks of his death. Thank goodness for expanded Medicaid and the Affordable Care Act (ACA). I looked up my unsubsidized ACA health care options for next year. The cheapest plan available to me is approximately $1,300 per month with a sizable deductible. So I would pay $15,600 for the blessed opportunity to pay an additional $17,000 before it kicks in. That is THIRTY TWO THOUSAND, SIX HUNDRED U.S. DOLLARS. And that is not my out-of-pocket max. This amounts to a very expensive gamble to keep me from bankruptcy.
How can we claim to be the best when we are so far behind? No country has a perfect system. But perfection is the enemy of progress. Our health care system is broken. We are headed into a health insurance death spiral. Maybe the system will break so badly that we will be forced to figure it out. But I might break first.