I am hoping to get a few weeks away on holiday this year. Response I get from my colleagues. “What? You’re dreaming, no one gets more than a week at a time and if you get that you’re lucky.”

I moved back to the USA in 2015 after living in BC, Canada near Vancouver for 18 years. I am American born, NY to be exact and thought how hard wold it be to re-acclimate to my home country? I was in for such culture shock. Moving back to a country that does not share the fundamental values of most Western countries, including my Canada was very overwhelming. Depressing too.

What fundamental values? I will focus on healthcare & vacation time plus family time.

I have had the “privilege” to experience USA healthcare practically from the moment I landed on Long Island. Dreaded motorcycle accident. Broken tibia with a recovery timeline of 7 months.

Ambulance brought me to the nearest trauma hospital 8.9 miles away. Paramedic didn’t put me in a c-spine collar nor could he get the pulse ox to read my vitals yet he somehow told the hospital over the radio what my vitals were. Hmmm…how did he do that? Hospital was great. They triage me right away. Very thorough diagnostics. I was thankful until I received medical bills for the only on call orthopedist and radiologist.

You see in the USA doctors can work in a hospital that takes your insurance but they do not have to by law and bill separately. Really? You are in a trauma situation and I was told from my insurance company I should have asked if the doctors took my insurance. If they were in my “network”. Since ambulance companies are private they can charge whatever they want. I was charged $125 for 8.9 miles plus an ACLS fee totaling $2900. My partner who shared the accident was charged $1200 for sitting on a tool box in the same ambulance as me. $4100 to transport us to get care after an accident. This is when I realized I wasn’t in Canada anymore.

“Health care in the United States is a $3 trillion industry, accounting for nearly 18 percent of the gross domestic product, up from 14 percent in 2000. Health care inflation outpaces inflation in other markets. Federal, state and local governments share the financial burden of health care with employers and individuals. In the aggregate, states spent $199.2 billion of their own resources in 2013 on Medicaid health services. Medicaid spending accounted for 16.9 percent of all state-generated funds —4.7 percent more than in 2000.

But the return on investment has been disappointing in some areas. The U.S. spends twice as much on health care per capita compared to other industrialized nations but isn’t the healthiest nation, by far. Americans have shorter lives, higher infant mortality rates, higher incidence of chronic diseases and more than many other high-income nations.”(http://www.ncsl.org/research/health/cost-and-quality.aspx)

Healthcare is seen as profit making. An ED doctor told me he never knows if his patient is covered by insurance. He doesn’t want to know so he can actually treat his patient not worrying about possible personal expenses his patient may incur. Not only is it for profit, with some exceptions like the VA, you need an advisor to choose your insurance coverage. I was asked by my insurance company when I signed up, “So, how do you think you will feel this year? Do you think you will be seeing a primary physician a lot? Or do you think you might be hospitalized?” My body is a crap shoot?

Main articles: Health insurance and Health insurance in the United States

• AARP
• Aetna
• American Family Insurance
• American National Insurance
• Amerigroup
• Anthem Blue Cross and Blue Shield
• Blue Cross and Blue Shield Association
• CareSource
• Cambia Health Solutions
• Centene Corporation
• Cigna
• Coventry Health Care
• EmblemHealth
• Fortis
• Golden Rule Insurance Company
• Group Health Cooperative
• Group Health Incorporated
• Health Net
• HealthMarkets
• HealthPartners
• HealthSpring
• Highmark
• Horace Mann Educators Corporation
• Humana
• Independence Blue Cross
• Kaiser Permanente
• Kaleida Health
• LifeWise Health Plan of Oregon
• Medica
• Medical Mutual of Ohio
• Molina Healthcare
• Premera Blue Cross
• Principal Financial Group
• Shelter Insurance
• State Farm
• Thrivent Financial for Lutherans
• UnitedHealth Group
• Unitrin
• Universal American Corporation
• WellCare Health Plans
• WellPoint

More competition is how this country rolls. President elect Trump wants more competition because he believes this will lower costs? Costs to whom? Insurance companies according to me have it made. They make billions because when you are covered there are deductibles to be met, for me $3000, out of pocket expenses, for me and my non-married partner $9000. I am still confused why my insurance company pays for some things and not for other. The other surprise to me is how much Federal tax I pay, not anymore than I did in Canada (see link below) and I had full medical coverage without networks. Coverage supported financially through Provincial and Federal taxation. I actually netted more money in Canada than I do here. No pensions anymore as well in the USA.

I have diabetes and so far from June, 2016 I have spent over $2000 on top of my healthcare premiums to take care of myself. Things got more complicated with a new diagnosis autoimmune disease as well. I am not even close to my deductible because not everything I have paid for goes towards that amount and then there is out-of-pocket. Who the hell knows the difference? In the USA you HAVE to be married if your gay to not get dinged covering a dependent. Added to my pay very 2 months is $1200 for my partner. There is no such thing as common law that is recognized by the IRS.

OK, so you get my point about the USA healthcare system. It’s broken more than Canada yet I always hear “we” have the best system, people from all over the world come here to get care. Hmmm, really?

In the USA families hardly get anytime away from work to have their children. I think it’s 12 weeks now if you are employed. In Canada family is seen as a priority. You can take up to a year off when you adopt or have a child. It is believed in Canada the more time the parents have with a new-born the better the bond. Holidays away from work are emphasized. Compensation for work is emphasized. Comparing my jobs between both countries the pressure to work all the time in the USA allows time to only dream about a lengthy vacation.

I have been told go back to Canada if you don’t like living in the USA. Part of me wants to, a huge part but I love my American partner and my family. I have dual citizenship so I can go back. Like everything else it’s complicated and my bond to my partner and family is greater than the country I live in. I just wish or dream that the US would be more humble and acknowledge other healthcare systems & family time are about sharing the costs and actually work.

Everything you read here is my opinion and even my million dollar brother’s wife with “great” coverage complains about the costs of healthcare. Most do in the country but nothing is done to make life, health something to not worry about because the pharmaceutical and insurance companies run the USA system. Check out this site…for tax info. Do Canadians really pay more taxes than Americans?

Don’t get me started on the mortgages here either. Another very confusing system. Oh since I appear to be bashing the USA healthcare system…I am seen as not Patriotic.