If you have a serious medical condition and you move to a new country you may or may not have expectations of what kind of care and/or insurance coverage you can expect to receive. You may or may not also have expectations about what kind of service you can expect to receive from various medical institutions/pharmacies/insurance companies etc. If you are me, you will DEFINITELY have expectations. Because that’s just how I roll. And if your are me then you are especially lucky because you have just won an all expense paid trip to the 18 Ring Circus. Here’s how it works:

Your realize you are starting to get to the end of your medical supplies so you decide a pharmacy trip is in order. You assume all pharmacies carry insulin (who doesn’t?) but not all pharmacies carry insulin pump supplies, which you require, so you conscientiously phone ahead to make sure you can get what you need before showing up at the pharmacy.

After calling no less than 25 pharmacies you discover that NO PHARMACIES IN THE UNITED STATES SELL INSULIN PUMP SUPPLIES and you need A PRESCRIPTION to even buy insulin! This is baffling as you have never NEEDED a prescription for such a thing before.

You call your insurance provider to find out which doctors you are allowed to see because you know that there is something about that in the eighty stacks of paper you received about your new American insurance plan. If you had been in Canada you would have run to a walk-in clinic, waited an hour, and walked out with a prescription for all you needed.  In America, it seems, there are NO WALK-IN CLINICS in the city of FOUR MILLION PEOPLE in which you live. You insurance provider nicely tells you that you will have to find a doctor to see who can give you a prescription and gives you a list.

You go through the list, calling each office and talking to each grumpy receptionist who rudely tells you that they are a) not taking any new patients at this time or b) taking new patients but will not be able to see you for your “new patient visit” for at least six weeks or six months or seventeen years and no prescriptions can be given to you until that time.

You call your insurance provider back. They call many more doctors on your behalf. No dice. They suggest you go to the emergency room. You balk at this blatant abuse of the emergency room, but they insist that you MUST have a prescription for your medical supplies or the insurance will not pay for squat. But they will happily pay for your non-emergency trip to the emergency room. As long as you pay the $50 co-pay first.

You enjoy a lovely hour morning day in the emergency room, waiting to have a doctor talk to you for 30 seconds and then disappear for two hours before handing you a prescription for insulin. The doctor refuses to write a prescription for insulin pump supplies because they are unfamiliar with insulin pumps and don’t know how to write a prescription for pump supplies.

You take your handy prescription to a pharmacy where you pay through the bumhole $25 AS YOUR CO-PAY for ONE BOTTLE OF FREAKING INSULIN. In Saskatchewan you would pay nothing for insulin except the $5 service charge at the pharmacy and the total price of a bottle of insulin was $17. In Ontario you paid the service charge again, and the bottle of insulin (covered by your insurance) cost $34. In America one bottle of insulin costs $114!!!  You shed a single tear after biting your tongue clear off.

You ask the pharmacist to give you a couple of the refills at once. But OH NO that is NOT ALLOWED, you silly little Canadian, you. One bottle is all you get. Come back for refills. No soup for you. Goodbye.

You call your insurance again because the hubby thought there was some way to mail order three months worth of a prescription at once, with only one copay for the whole order which sounds a lot better than getting raped paying $25 every 9 days at the pharmacy for one single bottle of insulin. Your insurance company tells you that this is only possible if you have the original prescription which is now in the hands of the evil pharmacy. It’s your own fault for giving it to them. You speak sternly, then yell and cry and the lovely insurance representative on the phone seems to feel genuinely sorry for you, but cannot help. They do say, however, that you should have been able to get one month’s worth of prescriptions from the pharmacy at once. So you should have been able to get 3 bottles of insulin at once.

You go back to the pharmacy to find out why they would not sell you three bottles of insulin. They tell you that the ER doctor wrote that you only need one bottle of insulin per month. Despite the fact that you looked her in the eyes and all but held her hands and stroked them gently while saying “TEN BOTTLES SHOULD BE ENOUGH FOR THREE MONTHS.” The pharmacist says to come back tomorrow and another pharmacist, who is not here today, will try and contact the ER doctor (who you point out will not know who you are or what your normal dosage is) and straighten things out.

You call the 15 different endocrinologists offices that your insurance provider gave you. They will not see you. Oh no. Because you ONLY have diabetes. And don’t you know that an endocrinologist is for someone with many, MANY problems more severe than diabetes??? You explain your dire circumstances and the fact that you are going to run out of all your supplies in one week. They apologize that you are going to die, but they cannot help. They do give you the number of a Diabetes Center.

You call the Diabetes Center. They tell you that you cannot be seen until October. You weep into the phone for the third time today and explain how serious and urgent the circumstances are. The receptionist takes pity on your teary and obviously desperate self. She books you to see a nurse practitioner in the Diabetes Center for Friday. It is still not 100% clear if you will be given prescriptions at that time. But at least you feel you are getting somewhere. She gives you the name of a lovely new doctor who is taking new patients. You feel jubilant!

You call said lovely new doctor’s office. The snarky receptionist informs you there are no openings until January. You hang up in despair.

You go to your insurance provider’s website to check again which doctors you can call to get a family doctor. Your insurance provider’s website it down. Again. All freaking day. 

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I have NEVER felt so trapped by my diabetes before. Both financially, because without a prescription I will have to pay the $1000/month in expenses out of my own pocket, and physically, because without these supplies and medication I would die. I have NEVER felt so abandoned by the medical system before. I have NEVER seen such high prices for medications. I have NEVER wanted to go home more than I do do today.

I know we will get this figured out and things will likely be fine in the end. But America, I have to tell you. Your system is BROKEN.