About the Struggles of Foreigners in the U.S. Health Care System

Health care including insurance and Obamacare have generated an enormous debate during the past several years in the U.S., but international students provide a perspective that is often missing in the discussion. In order to understand the cultural perspective, interviews were done with three international students from China and Germany.

Xiaoyi Zhu, a University of Denver (DU) grad student who is writing her thesis, says she was not aware of how expensive health care really is in the U.S. As any international student, Zhu attended the international student orientation week at DU. Zhu remembers the health care system, therefore, the insurance need was addressed. She also says “I was just overwhelmed during this event; so many people with different important topics talked to us, I just missed completely the significance of getting health insurance.” She added that she would have liked to see follow-up guidance on this topic, but it is just a onetime announcement during student orientation.

As a result, Zhu started to ignore smaller health issues. Once she had a problem with her eyes which made her see a doctor. She can still hardly believe that her one minute visitation of the doctor costed $150 (she did not have health insurance at that point).

However, her lack of knowledge of the system and how to interact with it were finally addressed when she was hired and trained by the University of Denver Health Center. She says, “the health care systems of China (her home country) and the US are so different, I just did not know anything about it and it took time to learn, I am still learning.”

Zhu’s boyfriend, Chang Liu a former DU grad student who now works in Denver, points out two other issues which bother him a lot. Liu says, “I am worried about my communication with the doctors and the transparency of cost” as those have been the biggest problems in his own experience.

As a student, Liu was not insured, simply to save money. One day he injured his back playing basketball. He went to see a doctor who told him to wait and see if it disappears after a few weeks, so he could save money. As this was not the first time that Liu injured his back he wanted to get an x-ray to see what was wrong with his disc. Liu says, “in China when this injury appeared the first time I was sent to get an x-ray straight away.”

In the end Liu did get an x-ray in the U.S. and his concern he even asked for was simply “Can I afford it?” or “How much is it?” The only thing he was told is it would be alright and he should not worry, but Liu says, “I finally found out how much it was weeks later when the bill arrived via mail.”

International students are struggling to understand how to interact in the health care system when they are not told how to.

Communication is for both Zhu and Liu an issue; they are both unsure if they can always address their health needs and describe their problems to doctors in the right way. Zhu says, “after being in the U.S. for more than two years, I still don’t have confidence in talking to a doctor, it is just such a special vocabulary needed which I don’t know.”

Using prescriptions is another concern for Zhu because she does not know a lot about medical terminology. In general, Zhu does not like to take medicine neither American nor Chinese. Zhu brought therefore a pack of basic medicine from China to the U.S. to be able to take care of herself. She knows these products well after having utilized them for years.

A similar approach, was taken by a German DU undergrad student Sonya Knebel, she even says she has a hard time trusting doctors and the prescriptions given to her.

Knebel says she tries to avoid seeing the doctor as much as she can. She once did not fill the prescription she was given by her doctor, because she thought the drugs would be too strong. Knebel says, “I am worried; the US drugs have different standards and limits then the drugs I am used to in Germany.” A big concern for her are pain killers; she thinks the dose prescribed by US doctors is often too high. She also dislikes the frequent use of antibiotics and misses homeopathic drugs.

Zhu thinks that the German and Chinese perspectives divert because they are used to different standards. For example, Zhu’s boyfriend, Liu fears if he gets injured or seriously sick he might not be able to work or maybe even lose his job. Knebel in contrast fears an injury, e.g. a broken bone, which forces her to completely rely on the doctors and the prescriptions given by them.

One point they all agree on, they not always feel to be taken seriously and that their concerns are taken care of in an inappropriate way. With Zhu’s one minute consultation in mind, this sounds to be a reasonable point of critic.


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