American Views Abroad

The shock came with a too early Christmas card, not sent from North Carolina but from New York City. A very old friend who recently retired from teaching Japanese and history in a good high school in New York chose to move to Boone, North Carolina. He wanted to 'talk the talk and walk the walk' of a real American, whatever that means. An odd choice it seemed for someone born and bred in Manhattan, no less. He seemed happy doing volunteer work, mowing the lawn, getting a huge dog, driving his wife to work. She being another 'real' New Yorker has no driver's license. Imagine living outside a big city in North America and having no driver's license. It sounds politically correct in these days of global warming but it makes life impossible for there is no other way of getting around other than driving. Living in Manhattan where the line for a non-driver's license needed for identification is longer than for those renewing their driver's license is a world away from Boone. In the end a move from NYC to Europe, even considering struggling with another language later in life, is probably easier to adjust to than settling down in what is a truly lovely area but a world away in lifestyle. Sometimes the perspective living abroad divides the world up between those who stay put and those who are willing to venture out, plunge in and learn the talk and the walk. You learn to admire both: those with close connection to their roots and traditions as well as those willing to test the waters of something new and different.

The shock was a diagnosis of pancreatic cancer in October. It's often called the silent cancer since symptoms aren't noticed until it is usually rather advanced. He still seemed in shock on the phone from a hospital bed in NYC yesterday. He wasn't expecting something like this now and he was very worried about his wife, who is 12 years younger than he and as he explained when he goes, so goes everyone's health insurance in his family. With all the unforeseen problems that such an illness creates, all the misery and pain, the sorrow and fears, it seems particularly crass and inhumane that in such a situation patients have to worry about their loved ones and how they are going to survive afterwards. Will she at age 50 regain her old teaching job in NYC and get adequate health insurance? Forget North Carolina he said because she can't drive. Thus her job and the life they built up there is gone.

These past three years have been hard ones here with a diagnosis of Parkinson's, one silent stroke, another less silent one that at first caused the left side to go lame, but excellent and immediate health care literally saw the symptoms reverse the lameness within hours, and then months later a major heart attack. With all the life and death issues one is confronted with, here one doesn't have to worry about medical bills or the cost of all the various pills needed. Within a system where everyone who works and earns over 400 euros a month is required by law to have health insurance, it is there when you need it. Everyone is covered. Insurance companies are required by law to make deals with the drug companies and pass savings on to their customers. Thus for Parkinson's two drugs don't even require the normal co-payment of 10 euros and the other medicine which does cost about 400 a month only costs the patient 10. The doctors are required to try out less expensive medications, but if the patient can't cope with it and needs the more expensive one, once this fact has been proven the insurance covers it. There is also an astounding network of rehabilitation that is provided by one's health insurance. Hamburg has an array of heart physical therapy, stress coping exercises and assorted other groups aimed to help the patient cope with lifestyle changes.

All of this comes with a price and perhaps at the end of the month with less money to spend on other things. In our case it's 860 euros a month, but it brings peace of mind and with many other problems on the table, we certainly will not be confronted with concerns about if we can afford medicine or how to pay doctors bills or if the surviving partner is going to have health insurance. All this is included along with a free choice of doctors and excellent hospitals. Of course, it seems only fair that after having paid into the system one's entire working life, it's there for you when needed.