The experience I have related here is about the challenges an international visitor to the U.S. faced in obtaining healthcare in the U.S., but this is also the plight of many American citizens who have no insurance coverage, have very little coverage or have high deductible insurance and they cannot shop around for good quality care for less money because accurate cost estimates of tests and procedures are generally not easily obtained.

Many of us moved to this country in our youth to pursue opportunities at the time unavailable in India. We have not had to pay out-of-pocket costs for healthcare since most of us have insurance provided through our work place. Many of us are not aware of the cost of our healthcare or about the extent of coverage of the insurances we have.

We now have aging parents in India who we like to bring over for long-term visits. Many of our parents have pre-existing conditions like diabetes and hypertension, which increase their likelihood of needing medical care while in the U.S. It is well known that the U.S. healthcare system is one of the most expensive in the world. What is discussed less is the lack of transparency of healthcare costs in the US. Not knowing up-front the costs for procedures and tests makes it difficult for patients to make informed healthcare choices.

Another aspect of living in the U.S. long-term is not being aware of the improvements in healthcare systems in India. Last year, I had the opportunity to deal with both systems (U.S. and India) in trying to obtain cardiac care for my 71-year old mother, who developed cardiac issues a few days after her arrival into Boston. It gave me the opportunity to compare costs of surgical cardiac care in the United States and India. I decided to take my mother back to India for care, since I could not get a good estimate of the costs involved or the flexibility afforded by the U.S. healthcare system. While in India, I was able to get a good estimate of costs allowing us to make informed decisions.

My story is not unique. I am sure there are many others who have had similar experiences. I have written my experience in an article published recently in the Annals of Family Medicine (http://annfammed.org/content/12/5/470.full). I hope many of you will find it interesting and illuminating. This article begs the question “what do we do about this? Do we wait for the U.S. healthcare system to be revamped? Do we figure out a different insurance option for our parents when they visit? Do we lobby the U.S. government to do something about this?”

You may contact me at sowmya.rao@gmail.com if you need any further information.

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