I’ve been reflecting a lot recently about medical care here versus the US.
I initially injured my back in 1995 playing tennis in high school. I had the occasional issue with my back throughout the years, and would get short term physical therapy to resolve it.
In 2006 I injured my back in June. My insurance required me to jump through roughly a zillion hoops, refusing to allow an MRI or even a surgical consult. It wasn’t until September when I had to be taken to the hospital via ambulance from work, and was hospitalized that an MRI happened. The doctors at that hospital decided that I needed surgery. However, they couldn’t fit me in for several weeks after I was discharged, and because my insurance wouldn’t cover that hospital in a non emergency setting, it was yet another month before I finally got the surgery in October.
It was four months of increasing agony until I couldn’t walk on my own, using a walker and wheelchair.
The insurance company only allowed x number of follow up visits and x visits of physical therapy. It wasn’t enough, but seeing a doctor would’ve cost upward of 400 dollars, and doctors won’t charge you in cash in the US–it must go through an insurance company.
It was absurd, it took forever, and it is the root of many of my current issues. Had I been in Singapore the process would have been a zillion times faster, I would have received more follow up care, and if/when my insurance ran out I could afford to pay for whatever dr’s visits I wanted.
Not long after my surgery I started having pain radiate through my hip and down my leg. It was never really examined–based on symptoms, it was diagnosed as bursitis. I’ve been dealing with it on and off for just over seven years.
Last year when I hurt my back here in Singapore things moved fast. I was admitted, given an MRI, and solutions were proposed. We went with one, but when it didn’t work I had a spinal injection less than a week later. Total time from injury to solution–2 weeks.
Since May 2013 I’ve seen my surgeon and pain management specialist regularly. I’ve received weekly PT, and once my insurance cap ran out, I was able to afford the fees. If necessary, I could pay for my doctor’s visits as well.
More importantly, the pain that has recurred since 2006 has finally been correctly diagnosed and is finally being treated properly.
I have been diagnosed with piriformis syndrome, which is a longer term recurring issue with the pirformis and the sciatic nerve. My doctor has posited, and I tend to agree that because my nerve was compressed for such a long time, it has suffered some permanent damage, making it more easily agitated and more painful when the piriformis becomes inflamed than it might otherwise be.
Today my friend Kirsten posted this link about a US medical bill and the atrocious cost of medical care in the US. When I searched for the cost of treating appendicitis in Singapore, I discovered it would cost roughly half of this IF I were among the most expensive bills at the most expensive private hospital. At the least expensive public hospital it would be 1/10th the amount even it’s among the most expensive bills there.
When we first moved to Singapore I was scared of the medical care here–after living in one of the best cities in the world for medical care, I didn’t trust local care. I would have preferred US care.
Four years later, after significant experience with the medical care here in Singapore, there are areas where I do still prefer US care (Elanor’s stroke follow up–although that’s in part because there are no pedi stroke specialists in SG). However, for the majority of most care, I prefer Singapore.
The benefits to (private) care in Singapore are that generally speaking you can get an appointment quickly (as opposed to weeks or even months later in the US). Issues are dealt with promptly, and doctors are allowed to use their best judgment.
I do have insurance, but that has also been far more streamlined. I pay for most things up front and then put through claims for reimbursement. In emergency hospitalizations, paperwork is faxed and dealt with quickly. For non emergency situations–like my proposed tonsilectomy–I can send in an answer and get a response within a month. I have caps for the most part, rather than procedure specific instructions as I do in the US.
When my insurance doesn’t cover something or I exceed my cap for physio (for example) the cost of seeing a doctor, or paying for a procedure is fairly affordable for our family (although I’m aware that they’re still expensive for many people in Singapore-I’m aware of my financial privilege).
While I have yet to adjust to Celcius measures of temperature, height and weight, preferring US Customary Units, I have adjusted to my many options for medical care in Singapore and I am grateful for them
I would, however, like to know what medical care is like for other people in Singapore. What someone who makes minimal wages (McDonald’s pays 1500 SGD per month, for example) could afford to do or would do in the case of a medical emergency. Whether or not there is subsidization of care for low income patients–although I imagine the likelihood is low as Singapore is opposed to social welfare? I have been typically asked for proof of ability to pay for care as I enter the A&E (at KKH for the girls) or before I am admitted (at parkway hospitals)–what happens if you can’t? What about regular medical care like annual exams, or care for strep throat etc.
Please do share answers to those questions in comments if you know them. Thanks in advance.