I am Canadian. I make a modest living working part time at a video store, plus running an online business and a couple of other creative endeavours. My husband is self-employed, doing props and wardrobe for the film business. We have one teenaged son and live in a small house with a small mortgage in a small town near Toronto.
If we lived in the United States, we would not have health insurance from work, and we would certainly not be able to afford our own insurance.
Three years ago, I started feeling a little sick. Nothing major, just a weird sort of constant low-level nausea that got worse when I tried to eat. I thought nothing of it at first - in fact I was pleased that I was losing weight - but after a couple of months I decided to go see my doctor.
My regular guy was on Christmas vacation, but I got in to see someone else the day after making the appointment. When I told him I'd been taking close to the maximum recommended dosage of Advil for cramps recently, he thought that might have been causing gastritis and so prescribed an acid blocker (he actually gave me samples since I didn't have supplemental insurance from work to cover it). He told me to come back if things didn't improve after two weeks.
Two weeks later I was back, this time to see my regular doctor. He wrote up a requisition for a long list of blood tests which I took to the hospital to have done. A couple of days later, the phone rang. I figured it was a telemarketer because I was in the middle of cooking dinner, but to my surprise it was my doctor.
"I need you to go to the hospital right away," he said. "Your tests came back, and your kidneys are shutting down. There will be a nephrologist waiting for you when you get there."
I was a little taken aback, and not at all sure I understood the severity of the situation. I asked him if it would be ok if I finished dinner first, and he said, "No. Go now. Don't dally." Then he explained to me what creatinine was, what my normal level would be (75) and what my current level was (over 400). The upshot: my kidney function was kicking around 10% of normal and falling fast, and if it didn't start improving immediately I'd need a kidney transplant or face a lifetime of dialysis.
I spent the next five days in hospital, scared out of my mind. The basic treatment - gallons of IV saline plus drugs to bring up my iron levels - stabilized and then slowly brought up my kidney function. But the big question remained: why would an otherwise healthy 42 year-old woman have her kidneys suddenly shut down for no apparent reason?
So the tests began. 10-20 vials of blood pulled out of me every day to test for everything from creatinine and iron levels to possible traces of heavy metals or other toxins. Every ounce of urine saved, measured and tested. Ultrasounds to check for stones, blockages or cycts. And then there was the kidney biopsy - an experience I really don't recommend unless you are particularly curious about how it feels to have chunks of one of your internal organs removed through your back.
As awful as it all was, the doctors and nurses were wonderful and did what they could to put me at ease. I had two nephrologists - day shift and night shift - handling my case and updating me twice a day, and my own GP popped in regularly to see how I was doing. By the end of the week my kidney function had returned to something approaching normal and I was sent home, although the explanation for my sudden illness would remain a mystery for several more months.*
My follow-up care was also excellent. Every few months I went to the Kidney Clinic at the hospital where I was tested, questioned and advised by a team consisting of my nephrologist, a dietitian, a pharmaceutical specialist, and others whose roles I don't recall. After a year and a half, I was given a clean bill of health.
The total cost for all this? $8.00 for the TV in my semi-private room. And I'm pretty sure I never got around to paying the bill.
Now. As Americans, I'd like you to think for a moment how this story might have played out for you. If you are uninsured as I certainly would have been, what would your final bill have been for all this? $50,000? $100,000? More to the point, how sick would you have gotten before you actually sought medical attention? Even with no worry about the costs, I didn't feel it was worth the trouble to check into until two months had gone by, and that was nearly too late. How long would you have waited?
If you are insured, what would the co-pays have cost you? How many of those tests would have been done? Would you have received the same follow-up care? I had a history of kidney stones and infections - would that have been used as an excuse to deny coverage? And again, how long would you have waited?
I don't know the answers to these questions. I only know that I am deeply grateful to be living in a country where such things are not even considered. Because while the outcome may not have been quite as extreme as my title suggests, I have absolutely no doubt that if I was an American, at the very least I would have lost both my kidneys and my house.
What's that worth to you?
____________________________________
* The mystery cause of my illness turned out to be an incredibly obscure phenomenon called Tubulointerstitial Nephritis and Uveitis syndrome - TINU for short. We found this out when, a few months later, I developed an eye inflammation which was somehow connected. They still don't know why or what causes it, but at least it had a name and a fair certainty that it wouldn't recur. It would make a great House episode.