In the wake of the debacle of my last diary, I was asked to put up my perspectives on the health care situation, in Athens, Greece as opposed to back home in the United States.
Back home, I dealt with it through the good offices of privately purchased insurance, with massive support from my family, because since I got laid off in mid-2002, I hadn't had a job which gave health benefits.
Now, once again, I'm uninsured, waiting through a mandatory waiting period before government insurance kicks in, and seeing how it goes in Athens, Greece.
Background: about three years ago, I was diagnosed with Graves' disease, an auto-immune thyroid disorder causing severe biochemical imbalances. It hit me at a very stressful time, so it initially got mis-diagnosed as an apparent mental breakdown. Thank goodness the psychiatrist who saw me suggested a complete physical workup, and made a suggestion that my mother kicked herself for not recognizing.
Tremors, nervousness, mental scattering - all could be written off as the end result of someone living through a hyper-stress environment for five years. The eyes coming out of their sockets, and the rapid weight loss, though, were tip-offs. Sure enough, when I had a full blood workup done, my thyroid hormones were in the danger-red zone.
The (ridiculously expensive) private insurance I had paid for my doctors' visits, less a deductible of $20 or so, provided of course that I went to a doctor on the HMO's list. The medication was also expensive, but again, I was only responsible for a deductible.
It took a year, with blood tests every month and a half or so, and adjustment in medication each time to try to keep things straight - sometimes the dose would be dropped, and a week later I'd notice the tremors coming back with a vengeance, so the dose would have to be upped again.
I was one of the lucky ones, though - it was caught in time that I didn't have to go through the radioactive iodine treatment that would forced me to take synthetic thyroid hormones for the rest of my life.
That was from about October 2005 to around about April 2006. That summer, I was offered an internship in an Athens law firm, which was the closest to a job offer I'd seen since getting my bar card. I went, and they liked my work ethic enough to hire me on full time, provided issues with immigration and such could be worked out.
Fast-forward through a year and a half of brangling with about six levels of bureaucracy in Greece, to this past July.
My dual citizenship (by right, through my mother's birth in Greece) had finally been confirmed, so I could stay in Greece full time. I went home for a week, visited the dentist, saw my last game at Yankee Stadium, and came back to Athens, just in time to get assigned to a due-diligence investigation with a truckload of information to analyze and a very short deadline.
Anxiety. Mental scattering. Tremors. Sounds like a job for a therapist, yes?
Plus rapid weight loss, incessant thirst, and bulging eyes. Time to visit an endocrinologist.
This time, I didn't have any HMO lists to guide me, and no insurance to draw on. I was pretty much completely on my own. I had to take a day off from work (and boy, the firm's partner in charge of the investigation was livid about that) and go to a hospital recommended by my family to get tested.
And for every step I took, I had to pay in advance. Ninety some-odd euros before I could see the doctor. (Once I got in, he was nice and professional.) Four hundred euros to get blood work done. Another two hundred some-odd euros for an ultrasound scan of my thyroid. Payable in advance before each step was taken.
But the care was professional, if a little scattershot, requiring me to navigate a bit of a maze in the hospital, relying on my limited (not broken, thankfully) Greek. And once I was out, I had a diagnosis (not surprisingly, the Graves' disease was back with a vengeance), a prescription, and an appointment to follow up with the doctor in his private office near the American embassy.
(Just as an aside, the American embassy in Athens is the most paranoiacally designed building compound in the entire city, not excluding the Parliament building. It suffered a rocket-propelled grenade attack sometime in the past few years. Not sure which is cause and which is effect.)
With the scrip (for Prothuril, as opposed to the Methimazole I'd been prescribed Stateside) came a somewhat nicer surprise. The tests may have chewed up all the money I'd saved up for an emergency (and lord, I was thankful for that prescience; would that George W. Bush had been so cautious, though I suspect he never had to face an emergency like this without his family's millions standing behind him), but the medication was much more reasonable - while Methimazole is supposedly somewhere in the range of two hundred dollars for a month's dose, I ended up paying €7.50 for a box of sixty 50mg pills of Prothuril (though I needed several boxes that first month; my dose got upped from three a day to five after the doctor got a look at my blood work a few days later, with an instruction to dial back to four a day at the beginning of September). Without insurance, remember.
The next month, mid-September, I had to go again for tests, to see how well the treatment was working; there's a sort of private medical testing clinic in the neighborhood, near the famous Athens Hilton. The tests ordered cost about three hundred euros, again payable in advance, with the results available at the end of the next business day. Results in hand, I made an appointment with the endocrinologist, who allowed that I seemed to be improving (my eyes were also coming back into their sockets, something which the doctor back home had said was unlikely to happen even after my other symptoms faded), wrote me a refill prescription, told me to cut back to three a day come the first of October, and get tested again mid-month. The doctor's visit cost me one hundred euros, payable at the end of the session.
Wednesday, the 15th, I went again to get tested - this time, the tests were only about two hundred fifteen euros, payable in advance as usual. (I suspect that as my symptoms come back in line with normality, the doctor has been removing tests from the battery he orders up.) The blood draw only took a minute or so, and the tests would be ready in two business days (i.e. after 6:30 this evening). I have another appointment with the endocrinologist next Tuesday to review the results.
My insurance paperwork was put on file with IKA (the Greek equivalent of Social Security) in September, and there is a delay of three to four months before I get issued a medical care booklet. After that, my procedures may change, but this is what I've seen so far.
As an aside: my absentee ballot came in today, after some adventures. I had to send my application, along with a letter of authorization, to my parents to take to the New York County election office, where they received my ballot, security envelope, and return envelope, and sent the whole kit to my via FedEx (an additional contribution to the Obama campaign, as they put it). When it arrived, I went ahead and filled it out - somehow, scribbling carefully into the ovals didn't feel momentous enough for the occasion, and putting the stamped return envelope into the international mailbox didn't have the same sense as bringing it to the fortified embassy, passing through the several layers of gate guards, and formally handing it over to my nation's representative in this ancient land ... but sealing the security envelope did give me a bit of a thrill.
This may be my heritage, I tell myself every day as I look out over the city of Athens, old before the first Vikings stumbled across the Americas.
Then I get to work, pull my Yankee Stadium souvenier cup out of my bottom file drawer, have a drink of water, and tell myself, But this is still what I call home.
Even when I get conscripted into the Greek military, to fulfil an obligation that falls on every male citizen, that won't change.
I think that on January 20, 2009, I will go to the Embassy. If the election goes as I hope ... I want to be standing on American soil, however paranoically fortified, and bear witness, even if I can't be watching it live.
I want to put on the Yankee cap I got as a giveaway when I was in the upper deck the day Dave Righetti pitched his no-hitter (they consider Yankee caps to be trendy here, Lord knows why), and stand, and listen, and hopefully watch, on the sovereign territory of the United States of America, as the Chief Justice of the Supreme Court says: "Repeat after me: I, Barack Obama..."