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Section 6: Health and lifestyle (Professional Life in the US for Immigrants)

 GaramChai.com >> Book >> Section 6

Health and lifestyle

In India, mundane medical care, doctor visits and medication is generally affordable to many. However, in the US, a complex system of public policy and privatization make access to healthcare really expensive. Indians moving to the US need to understand the nuances of healthcare and ensure that they are “protected” by adequate insurance before they land here. After observing and experiencing the western healthcare system, perhaps the best in terms of technology and advancement, I still feel that the Indian system – a mix of public and private services -- is really affordable and customer friendly. The western medical system has been glamorized by innumerable Indian movies, and the Indian media, that hype up visits by our super-rich elite class to medical centers in the US and UK. Shorn of that glamour, the system here is really archaic and unaffordable to most, unless they have a really strong (and expensive) medical insurance policy.

After having experienced an expensive web of medical and insurance systems, Americans prefer to prevent the occurrence of common ailments by following a regiment of exercising and fitness. Even Indians moving to the US realizing the significance of preventative measures, try to pursue physical activities. 

An important aspect of safety and healthcare people moving to the US need to be aware of is with respect to access to universal emergency services. In case of an emergency, people can dial “911” from any phone – public or private – and get access to an emergency care provider who will summon the police, ambulance or fire service as required. 



Health Insurance

Most of us have probably heard the popular adage...”A healthy mind resides in a healthy body”. All of us work hard towards maintaining a balance between a healthy physique and busy lifestyle. It is of paramount importance to continue to maintain good health, especially if one lives and works in a foreign country.

The western lifestyle, although relatively free of pollutants, dust and common infections, still has its share of diseases and health related problems. Of course, there is the risk of accidents to which we are all susceptible. Many of us who leave India in our twenties and thirties, come abroad to live and work do not think twice about these matters but we probably should. We are blissfully unaware of the necessity or importance of having access to assured medical care.

United States has some of the most advanced medical research, diagnostic and treatment facilities that can be found anywhere in the world. People from around the world come here for research, medical studies and treatment; even wealthy Indians have been coming to the US for advanced treatment; However, all the medical systems, treatment and access to it, come at a price which is not normally affordable to all but the extremely wealthy. Even the federal government that collects a percentage of salaries and wages towards ‘medicare’ (retirement medical care) has all but absolved itself of the responsibility of medical care for its citizens and residents.

I do not mean to imply there are no laws in place to force hospitals and medical care providers to provide basic care to everyone in the US. On the contrary, there are laws that ensure that everyone, regardless of their ability to pay, is guaranteed emergency care. The ubiquitous ‘911 system’ ensures that anyone in the US who picks up a phone and dials 911 can call for police, fire or medical help that will arrive within a few minutes.

However, for non-emergency medical care, one has to pay through their nose. Even a simple doctor’s visit can run up a few hundred dollars if not more. What then is the recourse available to us, the ordinary working professionals who might meet with an unforeseen accident, illness or medical condition that might set us back by thousands of dollars? The answer is medical insurance.  The lack of primary medical care by the government has helped the medical insurance industry become one of the largest and fastest sectors in the US. There are more than a dozen multinationals and hundreds of small insurance companies that provide insurance ranging from individual plans to group and corporate medical plans.

It would be an understatement to say that medical insurance is almost mandatory for everyone coming to the US. This applies even to visitors who may be spending only a few months with their relatives here. Employers lure employees with the bait of good medical benefits. Case in point: During the dot.com revolution, when employers were bending over their backs to entice prospective candidates, a Silicon Valley firm was offering a ‘BMW Z3 roadster’ as a sign-on bonus. Employees were also given an option of full medical/dental coverage for 10 years in lieu of the roadster. Guess what most employees opted for? The insurance package of course!

Why is it that insurance is given such importance in the US society? There are many reasons. Medical expenses are extremely high and not subsidised by the government. Another reason is that in a land of lawsuits, no one, not even doctors and medical professionals are immune. In order to protect themselves from frivolous lawsuits, doctors and medical professionals refrain from diagnosing all but the most common afflictions and make the patient undergo a slew of tests before any recommendation can be made. This over-diagnosing costs money.

Not all insurance packages provided by employers are the same. Some employers provide complete coverage without any charge or co-pay. Others expect the employee to chip in a fixed amount every month towards the insurance. Even the coverage is highly subjective and varies from (insurance) provider to provider. Many insurance companies try to scuttle huge bills that people run up, leaving them high and dry. Incidentally one of President Bush’s biggest political victories in recent times was the passage of “Patient’s Bill of Rights” that allows individuals to sue their medical care providers. It is hoped that this will bring much needed accountability into the system.

In the US, expenses related to medical contingencies cannot be prevented but adequate insurance can at least help offset the unforeseen.




Sporting: An ounce of prevention

An ounce of prevention is generally better than pound of cure. In a country where medical insurance and treatment of illness can be exorbitant, it is of paramount importance to lead a healthy lifestyle, actively taking part in sporting activities and/or exercising regularly.

The first time I came abroad, in a span of less than four weeks, I managed to gain about five kilos and it is not hard to see how. I was gorging on veggie burgers with cheese, coke while enjoying sumptuous Indian dinners with friends at local Indian restaurants. A few weeks of this lifestyle and I realised that I had to make a conscious effort to control my diet and imbibe another facet of American life — taking to exercising regularly.

In India, young professionals rarely think of flexing their muscles, content that the humdrum of daily existence is sufficient to sap one’s energies. Walking a few blocks to the bus-stop or even auto/taxi stand, a few stairs up to the first or second floor and other little bouts of ‘exercise’ adds up to burn calories. However, in the US with very little incentive to burn calories in the normal course, one is more motivated to make exercising a part of one’s routine.

One does not need to look far for avenues to exercise and stay healthy. Of course, the multi million-dollar health industry makes enough buzz in the form of advertisements and hoardings everywhere that one is constantly reminded of the need to exercise. Those inclined to take up sports and games, which they enjoyed in their childhood and youth, also have ample opportunities open to them in the form of local clubs, tournaments and what have you. Most cities have a range of clubs to choose from — clubs for judo, karate, hockey, soccer, tennis, racquetball, badminton and other athletic activities. It may come as a surprise, but a few large cities in the US have their own cricket leagues too. A friend of mine who used to play for his university back home didn’t think twice about driving 150 miles to a nearby city every weekend to take part in their tournaments. For those not inclined to playing games, gyms provide an outlet. Many large apartment complexes invest in their own exclusive gyms, so do some large companies. The YMCA a.k.a. ‘The Y’ is a popular chain of health and fitness with centers spread in cities across the country. The Y that I frequent is a huge complex, complete with its own indoor full-sized swimming pool, basketball court, racquetball courts and mechanised gyms. Of course, there are dozens of private and commercial chains of health and fitness centers that one can join. In the year 2000, 54.5 million Americans over the age of 6 (22 percent of the population), exercised at a health club.

Americans tend to take exercising quite seriously, spending huge amounts of time and money on personal trainers, fitness evaluation, exercise paraphernalia and chalking out religious plans for exercising. Most Indians on the other hand, tend to skip the expense of personal trainers etc, content to follow a yo-yo pattern - exercising regularly for a few weeks and then slacking till they feel that they need to start again. Of course, there are few amongst us who are quite sporty and go the full nine yards.

Call 911 for help

Human beings have always felt the need to communicate with others and to seek help, especially when in distress. Through the ages the process of communicating one’s distress to others has been refined to a system whereby in most nations, the society or government has taken the responsibility of providing emergency systems and services for their residents. In western nations, this system of communicating distress signals has been institutionalised into a systematic process whereby every person has access to ubiquitous means, for instance, in the US almost everyone is aware of the ubiquitous 911 emergency system.

Any person from anywhere in the country can use a phone — at home, a public phone or cell phone — to dial 911 and will be immediately connected to an emergency service representative who will notify the police, fire and/or ambulance service depending on the need. The system is so well refined that in most metros and cities in the US, one can call this number and expect help to arrive in 2 to 3 minutes flat. The 911 service is a call transfer system which enables people to be linked to the appropriate Emergency Service Provider (ESP) for the call location by dialling the digits 9-1-1. Emergency Service Provider means police, fire and ambulance agencies operating in the region.

The premise behind the extensive countrywide emergency 911 system is that a stitch in time can save nine. Accidents, fires, burglaries and social problems cannot be prevented, but a rapid response can help alleviate any further aggravation.

Most of us will probably need immediate help when facing an emergency, be it a medical condition or fire or any other law and order situation. It is imperative that we get help swiftly and efficiently. Watching an accident victim bleed without instant access to first aid or medical help is something none of us want. Speedy response from public officials and law enforcement can prevent things from getting out of hand.

In most states in the US, like in other western nations, there exists, what is commonly known as a “Good Samaritan” law. What this implies is “When anyone in good faith, renders emergency care or assistance at the scene of an emergency or accident, no liability may be imposed for any civil damages arising from acts or omissions in rendering such emergency care”. What this means is that people who aid others in distress will not be held accountable. In general, if a Good Samaritan does what a “reasonable person” would do under the circumstances, he won’t be held liable in negligence for any harm he may cause the accident victim. This encourages bystanders and those who witness accidents to report them to authorities, at the very least, call 911 and inform someone about the incident.

Sometime ago a couple in my apartment complex had an opportunity to test our local 911-response system. The lady was deep-frying their dinner and the frying pan caught fire. The husband, a friend of mine, had the presence of mind to immediately pick up the phone and dial 911. Within about 5 minutes, sirens blazing, the fire truck arrived at their doorstep. By then the residents had managed to contain the blaze using a handheld extinguisher. The firemen were prompt and professional, got the right equipment and not only controlled the fire but also helped clean up a part of the mess, all in a matter of minutes. I shudder to think what would have happened if they were delayed by even 10 or fifteen minutes since most houses and apartments here are built out of wooden boards and panels.

Human life and dignity in the US are really valued; especially since most taxpayers here consider themselves ‘customers’ of government and public service and do not hesitate to hold them (the public servants) accountable.

In order to provide the kind of responses described, there exists a huge network of systems and emergency response teams spread across the country. Phone companies are required (by law) to provide this service to every telephone. Cities and counties in all states across the US are required to maintain ‘command and control’ centers, manned by officials 24 hours a day. These officials not only take calls but are trained to provide telephonic assistance till help arrives at the scene. All these services do not come cheap. Federal and state governments have special budgets just for emergency care system. Even phone companies levy a small fee on their customers for the 911 services that they provide. The management of inter-state phone, emergency, fire, police and networks is an art that Americans seem to have perfected. The key to remember: in the US – when in distress, pick up the phone and dial 911.

In this section of the book we looked at the different aspects of healthcare, emergency services, and also looked at ways in which people attempt to maintain a healthy lifestyle. One needs to conscious about the availability of medical care and insurance since the general healthcare here is really expensive.

Until this point in the book we looked at different aspects of life and culture in the US and I hope the reader got a glimpse of what is in store. The incidents of September 11th had a profound impact on everyone in the US and the impact has been manifold. The economy took a turn for the worse, as corporate America and the government take stock and prepare for the future, we will see changes rolling down our lives and careers too. In the next section of the book we will look at the aftermath of the incidents of NYC bombing and its impact on Indians. We will also look at the different aspects pertaining to change management in our professional lives.

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Mohan Babu: All Rights Reserved 2002- 2013

All rights are reserved. Mohan Babu ("Author") hereby grants permission to use, copy and distribute this document for any NON-PROFIT purpose, provided that the article is used in its complete, UNMODIFIED form including both the above Copyright notice and this permission notice. Reproducing this article by any means, including (but not limited to) printing, copying existing prints, or publishing by electronic or other means, implies full agreement to the above non-profit-use clause. Exceptions to the above, such as including the article in a compendium to be sold for profit, are permitted only by EXPLICIT PRIOR WRITTEN CONSENT of Mohan Babu. 

Disclaimer: This document represents the personal opinions of the Author, and does not necessarily represent the opinion of the Author's employer, nor anyone other than the Author. Any mentions of commercial products, company names, or universities are solely for information purposes and do not imply any endorsement by the Author or any other entity. The Author provides this article "as is." The Author disclaims any express or implied warranties including, but not limited to, any implied warranties of commercial value, accuracy, or fitness for any particular purpose. If you use the information in this document in any way, you do so entirely at your own risk.

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Book Index

  • Intro
  • Section 1: Visas and Immigration
  • Section 2 Finances
  • Section 3 Law and legal system
  • Section 4 Consumerism
  • Section 5 Life and weekends in the US
  • Section 6 Health and lifestyle
  • Section 7 Demographics
  • Section 8 Indians in America: Looking to the future after Sep 11th
  • Section 9 Preparing for the next wave
  • Appendix
  •  

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