So I Asked Around
Last month, somewhere between a fever and a mountain of envelopes, I started texting a few writer friends — one in London, one in Toronto, one in Sydney.
We all do roughly the same kind of freelance work, earn within the same general range (somewhere around fifty-something a year), and we’ve all had the same uninvited guest: a sudden appendix situation.
The only difference? They didn’t have to pay for theirs twice.
From the conversations
Clara, London
Her taxes earmark about 7 percent of her income for the National Health Service. No premium, no deductible.
When she had her appendix removed, she paid £0 at the hospital and about £9 for post-op pain meds.
Her entire “billing process” was a nurse handing her a tea and a clipboard.
Maya, Toronto
She contributes through normal taxes — around 10 to 11 percent of her income goes to federal and provincial health funding.
Her hospital stay and surgery were fully covered.
When I asked about a deductible, she laughed. “We don’t really do those. Maybe a parking fee.”
Sam, Sydney
She pays a 2 percent Medicare levy from every paycheck.
If she wants private extras, that’s on her, but her appendectomy was public and free at the bedside.
Her biggest complaint was the cafeteria coffee.
Me, Western Pennsylvania
Freelancer plan: about $520 a month in premiums — roughly 11 to 12 percent of my income.
Deductible: $2,000, then 20 percent coinsurance until I hit the $9,000 out-of-pocket limit.
So for the same procedure that cost my friends lunch money, my final total was about $3,800 after insurance.
The arithmetic of “normal”
| Country | Health-tax share | Premiums | Hospital bill | Personal cost |
|---|---|---|---|---|
| UK | ≈ 7 % tax | none | ≈ $0 | $0 – $15 rx |
| Canada | ≈ 10 % tax | none | ≈ $0 | $0 – $50 misc |
| Australia | ≈ 2 % levy | optional | ≈ $0 | $0 – $100 extras |
| United States | ≈ 7 % existing tax (Medicare + Medicaid) | ≈ $6 k premium | ≈ $25 k gross hospital charge | ≈ $3.8 k after insurance |
(Rounded public averages; taxes shown as share of personal income.)
So, give or take, my friends pay less in total for universal coverage than I do for “coverage that covers most things, sometimes, if you can prove it twice.”
And yes — Americans already fund roughly half of our health-care spending through taxes before we even buy our own plan.
The feeling
I’m not angry so much as… duped.
It’s like discovering your fancy coffee shop charges extra for the cup, lid, and napkin, while other countries just hand you a mug.
And the part that keeps me up at night isn’t even what I paid.
It’s knowing that my “good” freelance insurance — the one that still left me nearly four grand short — is out of reach for millions of people who work just as hard.
So what happens to them?
What does someone do when they can’t even buy the privilege of being overcharged?
We don’t need to shout “revolution.” We just need to ask why the receipt for staying alive is longer than the recipe for pie crust.
Maybe one day I’ll text Clara, Maya, and Sam again — not to compare bills, but to invite them here and say, “We finally fixed it.”
Until then, I’ll keep my scarf on and my browser tabs open.
Disclaimer:
All names and identifying details have been changed to protect the guilty.
