Why Get Medical Care in the US?

Because of the state of the US, we are more seriously considering relocating overseas. We'll see what actually happens, but in evaluating different countries, I've started to think maybe we should've left a long time ago. It might have actually improved my healthcare.

In many countries overseas, most prescription meds are over-the-counter. There's a lot less gatekeeping. If you know what you're doing, know what you need, you can DIY the whole damn thing.

Better quality of life, lower costs, less medical stress (just the time savings alone omg). I know my meds. I know my labs. I don't need help at this point, just access to MRIs every so often.

But I was trying to think if a specialist ever did anything...well, special? Because what if I have a blind spot? What if there's some magical procedure they do that I might need?

I've not seen much that impresses me to date, however.

What I have experienced... 

Argue with me? Yes 

Deny testing? Yes. 

Deny medications for established diagnoses*? Yes. 

Scream at me**? Yes. 

Not read my labs and stubbornly refuse to diagnose me? Yes.

Misdiagnose me? Yes yes yes. Constantly.

Not be available in an emergency? Always. 

Cost too much time and money to do all the above? Yes.

When I had an adrenal crisis, it was because of the specialist. Hell, when my adrenal glands suppressed, it was because of the specialists. When I developed Exogenous Cushings trying to treat the adrenal insufficiency, it was because of the specialists. 

When my endocrine tumor didn't get diagnosed for ten years even though I knew what it was because it was that obvious...it was because of the specialists. My liver tumors were left to fester because of the specialists.

What do specialists do exactly? When are they special? (Note to the universe: I am NOT inviting you to personally show me. It's a rhetorical question. Don't come at me. Thanks.)

So, like...why stay in the states? I can do it better and cheaper elsewhere. I'm fairly stable. I largely know what I'm doing. I go to all these specialist appointments only because this system forces me to in order to access meds and testing. They look at me and prescribe medication I can figure out I need by reading a Healthline article. Where's the expertise?

So why am I here again? What's the point? It costs a fortune to get treated like shit in the US. Why bother?

For the longest time I thought having a good relationship with good specialists was key. That I should stay put for that. Then they all left their practices within a six month period driving home the lesson that it's only a transient relationship. There is only the illusion of continuity of care. Or that a specialist will do anything. It's all a fever dream. All of it. A fever dream that serves profits not patients.

I hadn't thought of living overseas as a hack to improve my care and cut the hassle before. Now I'm utterly tantalized by the idea that I can stop the hamster wheel of appointments, and in one pharmacy visit and one lab order, I can take care of everything for the whole year.

One and done.

Can you imagine how amazing that would be?

I could be free.

At this point, all the Americans are probably angry. I mentioned my thoughts to a few folks and they were deeply, deeply insulted. America is the greatest nation on earth. We have the best healthcare in the world.

Oh, honey. No. That's propaganda, not reality. 

Well, they say, anger steaming out of their ears, how do you know the medications are good? If the doctors are good?

Well, one of my degrees is in geopolitics and I worked in international business, am multilingual, have traveled extensively, and have already had to navigate care in some pretty dodgy places while travelling (thanks to asthma pretty much everywhere I go and my greater saphenous vein completely and randomly failing while in rural E. Europe. Ever shop for compression stockings in a hole in the wall in the former USSR? I have. And yes, I literally can go nowhere without some kind of health clusterfuck. It's a curse.). 

I've also had friends and family who've lived overseas, and believe it or not, medical care is often better than the US in some pretty poor places. The corporatization of health care has done a lot more damage than people realize.

They don't want us to know that, though, because that would interfere with the profits. We are purposely not told how poorly the US ranks across several key health metrics. They put that information in print media because they know no one reads. You'll hardly ever see it on TV news. At most, people might have a vague awareness that our maternal fetal mortality rate is unacceptably high.

Anyway, moving on...I know where the good democracies are,  where the world's largest rising middle class is, who's got water I can drink without getting the shits, even know how to avoid pit vipers, and failing that, there are large expat communities online for any country you can think of. It's doable. I just never seriously considered doing it until I got hit by the confluence of losing all my specialists right when women's healthcare was being criminalized.

I've already been coaching the teen to make sure her education is appealing to other countries as I could see there probably wasn't much of a stable future here with all the polarization. So we've been slowly inching toward this for a while. The switch really flipped after we lost Roe.

Why are we here when we could probably be happier and healthier and freer someplace else?

Hmm. We'll see. I've got to get the teen through college, but after that, and assuming we don't have to flee the country in order to access healthcare before then, we may very well pack our bags and go. 

*The most egregious example continues to be that completely unhinged allergist who told me I didn't have asthma, refused to prescribe maintenance meds, told me I had blood clots instead and then refused to actually treat me as if they really thought I had blood clots...such an interesting choice given how malpractice laws work.

Oh wait. I forgot the nut who told me they could cure my rare tumors but wouldn't tell me how because I didn't do a weight for the nurse. Can you imagine being that fucking petty and grandiose?

**The irony is I'm most often screamed at when my oxygen is so low, I'm barely talking. I'm pretty sure I'm not somehow being offensive because I'm not saying much. 

I'm always bemused by those physicians who lose it on me when I've said maybe ten words total. I think the most famous incident (which I believe I mentioned years ago here) was when I'd lost twelve pounds from weeks of out of control asthma...I was barely hanging on and stuffing my face with insane calories only to lose even more weight every time I turned around. After weeks of going to the primary over and over because I was just getting worse and worse, I was finally referred to a jackass of a specialist. 

The pulm screamed--literally screamed--at me 'who said you had asthma, who gave you a nebulizer' and all I could do was just blink at that horror show of a dumbass and then strain like a strongman trying to life a car to heave the next tiny sip of air into my lungs.

My theory is they know I can't fight back and the baseline for them is likely asshole so I get drop kicked because they had a bad day or need to use someone as a whipping post. Acute asthma is a gag that just makes me easy pickings.