Rounding third base during a pre-season baseball scrimmage game where we shut out the competition by an obscene margin, I ruptured my achilles tendon. I didn’t know what it was at the time, but it felt like someone had kicked me in the back of the leg, and then all of a sudden my foot didn’t work anymore. At first I thought I had been beaned again, since I made it to first that way (and now have a nice bruise on my inner thigh to show for it), and I thought to myself, “By God, if they frigging beaned me again I am going to tear someone’s spine out and shit down the hole.” And then the pain hit, things started getting fuzzy, tunnel vision, and I hobbled into the dugout to spend the rest of the game icing my ankle. We still won, despite being short-handed to begin with.
Then began my expedition through the Chilean health care system.
After waiting 48 hours to see if it was just a bad sprain, it was clear that it was not. Stuff was flapping around as if it was disconnected, and that’s bad. LaserBob showed up to visit me for a vacation in Chile just in time, “Hey, we can’t go anywhere since I am a cripple, and I can’t drive either. Fun!” But bless her heart, she has helped drag my immobile corpse around town to throw me to the doctors. So I went to find a leg injury specialist to see what was wrong.
My health insurance works sort of like a PPO, where you have a “home clinic” and are mostly covered for stuff that will happen to you there. It provides partial coverage for “out-of-network” stuff and international. So I went to my home clinic and they had no specialist consults available there, but set me up with one the same day at another branch across town.
He took one look and said, “Yeah, that’s bad,” and told me to go get an ultrasound and find out where exactly the tear was. So we then checked the ultrasound availability, but there were none until the 21st (this is the 9th, more or less). He told me to go to the ER, in that case, since this is not an injury you want to wait more than 10 days or so to get fixed. He wrote “Urgente” at the top of his order for the ultrasound.
Total cost for the specialist consultation: US$19.00
And so to the ER I went, where I had to wait for about 4 hours but got my ultrasound. They verified that my achilles was wrecked, and I would need surgery to fix it. They then recommended a doctor to go see about this specific injury, gave me his phone number, and told me to call in the morning. They also issued me a Frankenstein Boot to wear.
Total cost for the ER visit, before insurance coverage: US$336.37
Total after insurance coverage: US$170.16. That includes the boot for which I will have to be reimbursed, so if you take that out, then the cost was $96.84
I called the doctor in the morning, and set up an appointment to see him the next day. He had already been informed of my case. And so I went and saw him, and he told me about what would need to be done to fix my tendon. Then we made an appointment for surgery, and I was issued a set of diagnostic stuff I would need for the anesthesiologist: blood tests and ECG.
I also got an estimate for the whole procedure, from the hospital, and for the whole thing, including surgery, recovery, etc, the cost I would have to pay out of pocket if I had no insurance, was just US$2831.24. After consulting with LaserBob and MomBob, who are both medical people, they both figured that the cost for the same thing in the USA would be at least $30,000.00. Probably more. Saved by a factor of 10.
But wait, there’s more. I also went to the insurance booth to find out just what they would cover for this operation, and they said they would cover 100% of it. Score!
There is a little diagnostic place right next door to where I live, so I went there to do them.
Total cost, diagnostic blood work and ECG: US$27.70
Arriving early in the morning on Saturday, at the hospital admissions desk, DeskTrollBreaucratLady did not want to let me check in because I was missing some stamped paper from something.
“Am I in the system there?” I asked.
“Yes.”
“And the entry is scheduled, with this procedure, with my name?”
“Yes.”
“And you have my ID which proves that I am who I am, and I am here, to undergo this procedure, which the hospital has scheduled in their system.”
“Yes. But I cannot admit you without the blahblahblah paper.”
“Well I am not going back home to get it. As you can see I do not get around easily, hence my presence here.”
Now in Uruguay, the story would have ended here, with me not getting my surgery, and the hospital wasting thousands of dollars while doctors and staff sit around a prepped ER waiting for a patient who won’t show because the desk jockey simply refused to admit him, and to hell with the urgent surgery to prevent him from being a cripple for life, you are breaking the rules and must not be permitted to enter, you filthy yanqui capitalist!!!
However, she found a way, and summoned her precious paper from the aether. But she came back with a new form for me to fill out because she found “making money” an unacceptable entry under employment, on the one I had already filled out. I could not conceive how marital status or type of employment had any bearing on getting hospital treatment, but she wanted it all her way and the forms must be completed or the planets will fall out of alignment, fire and brimstone falling from the sky, dogs and cats living together, mass hysteria.
“Are you sure I can’t put Super Hero on here?”
She didn’t laugh or even smile at that. “This is a legal document.”
Which makes me wonder which tribunal I would be called to testify in, where I would be chastised and told I cannot have this operation because I am not, in fact, a super hero.
Once we had passed beyond Checkpoint Charlie, the surgery went quickly and efficiently; it was done within an hour. I did not fit well on the operating table, and so they modified it by adding arm holder thingies to better support my upper body; I was hanging precariously off of both ends. It was a source of giggles among the staff; they are not accustomed to working on ogres. They sedated me after the spinal block, not before, which I thought should have been done the other way around. I could hear my heart beeping rapidly, which did not help calm me either, while they stuck the needle into my spine. Regardless I felt no pain and the procedure was well-done; I was mostly conscious through the whole thing and could see that they took good care of me.
Rolling me over and transferring me to a gurney afterwards was also a source of giggles, since I could not move my lower body and they all had to have a conference to plan how they were going to go about it. They finally agreed to put a sheet under me and take their places; 6 people gathered around, counted down, and slung me onto the gurney.
The supervision ward afterwards was a bit stressful, since there was a child in there who was scared and wailing nonstop. They should have wheeled him into somewhere away from the other folks. Seriously, it went on for the entire 3 hours I was in there. The supervision ward lady kept asking me if I had the urge to pee, and I kept telling her that no, I did not feel the urge, and I could not feel anything below my waist. She seemed surprised I didn’t have to pee, and kept hooking me up to new IVs. Once I could prove I had control over my legs again, they wheeled me out to my own private room, where it was another 3 hours or so before I gained full control over my extremities, and my bladder 🙂 I swear, peeing out all those IVs was the longest pee I ever had in my entire life, longer than the press conference pee scene in Naked Gun. LaserBob, who was there to drag me home, and the nurses present, were all giggling as I counted off “cinco litros… seis litros…” I have to admit I found amusement in it, not just for its standard excrement humor, but because I could not believe my own neverending bladder capacity.
The doctor came in to check on me before I was discharged, and made an appointment in a week’s time to have a look at how it is healing, and start my physical therapy. Then we waited for another hour while crutches were signed out of the bureaucracy and the wheelchair guy came to take me to the taxi stop outside.
So, total outlay to fix my ruptured achilles tendon: US$216.86. And that’s before I am reimbursed for the FrankenBoot. This medical insurance costs me about US$200 per month to maintain.
expatbob 