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I would like to share with you the good news that Anthem Blue Cross, who covered my health insurance for the first five years I was in America, recently sent me a refund. My annual premiums were between $7,000 and $11,000 in those years, with $1,500 deductible. I was grateful to them because no other company I approached would accept my business. It would have been vastly cheaper to pay my own bills without insurance since I never reached the deductible level, but hearing of the astronomical rates of hospitalization, and being in my sixties when cancer or a heart attack might be devastating but not a big surprise, I decided to pay up and suffer that a quarter to one third of my pension was going on health insurance. I didn’t want to go bankrupt.

My Doctor charged $75 for a routine visit, of which Anthem Blue Cross paid $1.50. Fortunately I had little in the way of medical bills in those years, and after five years I was entitled to Medicare which costs me, with prescription coverage, around $600 per month. Not having paid into your system it’s reasonable to pay full price and I’m jolly grateful for it. It’s worth paying to live in this country to be near my son and grandchildren. Healthcare is free in retirement in England but the standard of care leaves something to be desired, unless one has a serious issue like cancer, when by law one is treated within two weeks. And they never ask for a credit card on admission to hospital.

It’s two years since I waved goodbye to Anthem Blue Cross, so I was surprised to receive a letter from them today. I was even more surprised to find a check therein.

The covering letter explained that the Affordable Care Act requires them to issue a rebate “if Anthem Healthcare Plans of Virginia does not spend at least 80 per cent of the premiums it receives on health care services such as doctors and hospital bills and activities to improve health care quality,” and “no more than twenty percent may be spent on administrative costs such as salaries, sales and advertising.” Since they missed the 80 per cent target by 0.3% of premiums received, they must rebate 0.3% of my health insurance premiums by August 1, 2012. Only 0.3% of such a bumper chunk I thought might at least buy me lunch at Ruby Tuesday’s.

I don’t know why doctors’ surgeries are often expensively furnished with upholstered mahogany chairs and artwork on the walls. I didn’t come for that. Leave me alone with my thoughts of colonoscopy, flowers don’t help. Americans take for granted a level of luxury the rest of the world lives without, but one cannot blame them, they only know how this half lives.

In my last year with Anthem Blue Cross I paid $923 a month, times twelve equals $11,076. (More than $40,000 over five years.) I looked at the check today. It’s for 39 cents. The stamp on the letter cost 47 cents. Their letter has ‘NON-NEGOTIABLE’ printed on it in large letters. I’m afraid to write to them in protest in case they ask me to refund their stamp. If the bank charges me to cash the check I’ll pay it, because I don’t want Anthem Blue Cross to get away with the 39 cents.

I think there’s something wrong here, like the way America organizes its Health Care.

Eileen Dight

Eileen Dight is a retired British specialist on trading in Spain, now resident in Harrisonburg, Virginia, USA: Spanish- and French-speaking, graduate (at 46) of International Politics and History; former editor, interpreter and fundraiser. Her family of five sons and twelve grandchildren live around the globe in four different Time zones. She has lived in England, Wales, Spain, France and now in North America. In 2012 she published her  Memoir Plate Spinner,  and Only Joking, over 200 pages of collected jokes in categories by topic for easy access, both available on Amazon.com

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