Note: if you’re squeamish, you might not want to read this one. I don’t describe anything about my shoulder dislocation in detail but I do mention things that happened.

>>>

Today’s blog was meant to be titled “On running my first marathon”. Unfortunately, I dislocated my shoulder on Wednesday playing flag football (the American Football version of touch rugby), ending my marathon plans.

Wednesday was the second time I dislocated my right shoulder; the first was in May 2017, exactly 6 days and 21 hours before my first GMAT attempt - too late to cancel. Thankfully, my second dislocation was a walk in the park compared to my first dislocation.

This time:

• I was in very little pain (I only took 2 paracetamol tablets, compared to my first dislocation where I was given a Green Whistle and so much morphine that I went through a terrible withdrawal later that night)

• Because of the lack of pain, I was able to walk to a friend’s car and be driven by hi to the hospital (vs. needing an ambulance the first time)

• My shoulder went in by itself while I was laughing (compared to last time where 6 people worked together to get my shoulder in and the first doctor called in another doctor, who both stood around for a few minutes discussing the merits of many different techniques to put in my shoulder because everything they tried wasn’t working)

• I have good mobility (when I’m not walking around, I can take off my sling and do a lot of daily activities. Vs. my first dislocation where I really couldn’t use my arm at all)

However, this experience gave me a unique insight into the American healthcare system that I would have otherwise never had (nor wanted!)

As a foreigner, I was completely unprepared for an emergency

In Australia, we have a great public healthcare system. This makes Australians (and people from other countries with efficient public healthcare systems) incredibly complacent. Back home, I had never given any thought about what I would do in an emergency. I instinctively knew that I would call an ambulance and be taken to the nearest hospital, where I would be treated well and for free.

When I was kneeling on the field with my shoulder out of its socket, I immediately cursed myself for not having updated the healthcare insurance card saved on my phone. I knew that I would probably need to show this card sometime during my hospital visit, but I didn’t know when or how I would need it.

I was also worried about not knowing whether the nearby hospital was ‘in network’ for my student health insurance or not. I knew that I would be treated regardless of whether or not I was ‘in network’, but that an out of network hospital might cost a lost of money. Thankfully, a friend who was nearby told me that the nearby hospital was ‘in network’, which put me at ease.

Since I was playing sports, I hadn’t taken my wallet or any ID with me. I completely forgot about this until the end of my stay when the billing team came to visit me (more on that later). Worrying about needing payment for an emergency is another thing I would have never thought about back home in Australia.

If you’re a fellow foreigner in America, please make sure that you have a copy of your healthcare insurance card in your wallet or that the digital card saved on your phone is up to date. Know your nearest ‘in network’ hospitals and where you might go if you need medical treatment.

Compared to Australian public healthcare, American ER’s have equal or worse service but are ‘gold plated’

Given how expensive American healthcare is, I expected the service to be incredible compared to Australia. I expected little waiting time, with quick and effective treatment, and a far better outcome.

Instead, the service was inferior compared to Australia. I will add the caveat that I may have experienced worse service in America since my dislocation was far less severe than my first dislocation in Australia.

While the initial waiting time was short, I spent a long time waiting between speaking to the first nurse, speaking to the second nurse (who put me in a bed), the X-ray, getting the diagnosis and my release.

Most of my treatment in the hospital in America was done by nurses and nurse practitioners, with a doctor literally spending around 1 minute talking to me. Instead, my treatment in Australia was done with a combination of nurses and doctors working together. While I have nothing against nurses (and my nurse, Nancy, was perfect), I am assuming that treatment by doctors is a better service than treatment by a nurse.

So if the service isn’t better, where are the dollars going. From what I saw, an American hospital is ‘gold plated’ compared to an Australian hospital.

In an Australian ER, you are in a bed in a big room with multiple other beds in the room. The beds are separated by curtains that partition you from other patients. You have visual privacy but you can hear things that are going on around you. Instead, in an American ER, each person has their own little room. I find this completely unnecessary. If I’m in an emergency, I really don’t care about my privacy and whether I have my own room or not. All I want is the best treatment at the lowest cost.

Another great example of this ‘gold plating’ was the X-ray. When they needed to take my X-ray in the Australian ER, they wheeled my bed into the X-ray room, took an X-ray and then wheeled my bed back to the ER. In America, they brought a portable X-ray machine into my room. However, setting up the X-ray machine took a ridiculously long time, that it would have probably been easier and quicker to just wheel me out to a fixed X-ray room.

Based on my experience, American healthcare seems to deliver similar (or worse) outcomes but in a fancier way that is completely unnecessary

Your hospital stay ends with a friendly visit from multiple people in billing ($$$)

This was easily the weirdest part of my stay.

I had received the diagnosis (shoulder back in place, no bone damage) and was waiting to be released. Out of nowhere, two people come along and introduce themselves. They immediately say that they are from billing, and that I need to settle the account and ask me if I have any questions, including whether I know how much my balance is.

Of course, that’s the first question I ask “How much do I have to pay?”

This last comment from the billing people really surprised me. At no point during the whole stay did anybody mention any costs for treatments. How am I possibly supposed to know what my balance is.

Thankfully for me, the cost of the visit is only $100, something that I can easily afford.

I suddenly remember that I don’t have my wallet and my friend doesn’t have his either. I ask if they accept Apple pay. They say no. I ask if they can send me the bill and they say yes. Crisis averted.

What would it be like if I couldn’t afford $100?

As my friend and I get into the car to leave the hospital and get lunch, I wonder what it would like to be a poor person in America and/or someone without good health insurance. There are likely many people in America and Australia for whom getting $100 on short notice would be difficult or impossible.

For many of you readers, this is hard to believe but it’s true. I personally don’t know anyone who would fit into this group, but I’ve met many of them on the campaign trail in Australia.

If you were one of these people in Australia, your experience would have been exactly the same as mine. You would have gone to hospital, been treated for free and enjoyed the rest of your life.

But if I was in America and I couldn’t afford the treatment, what would I have done? Would I have just gone home and tried to deal with it myself? Would I have suffered through the pain? Would I have not sought a consultation with a sports doctor and undertaken subsequent physiotherapy? Would this have led to me having permanent damage and a reduction in my quality of life?

It’s times like this that I think to myself “there but for the grace of God go I”. But If I didn’t have God’s grace, I’m damn sure I’d rather be in Australia than America. And I am incredibly proud of the healthcare system, and the society, that we have back home.