U.S. healthcare is too costly for Kevin Steinman, so he's moving to Norway

Photo by Laura Dart
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Kevin Steinman will be a Minneapolis-based singer-songwriter until later this summer. After a farewell show at Bryant Lake Bowl on July 23, he's moving to Norway, where he can expect his healthcare treatment to be far less than $9,000 annually. Below, he tells his story.

When I named my most recent record Pre-Existing Condition, it was to the rest of the world just a metaphor, or a tongue-in-cheek reference to a medical system we're all familiar with. Until now, I've resisted speaking out about my chronic condition except to very close friends and family.

But with the Supreme Court upholding the legality of Congress' Patient Protection and Healthcare Reform Act of 2010, AKA "Obamacare," I feel like I ought to give one musician's testimony to how our present system fails us -- even those of us lucky enough to be "insured." I know that this story is only one of millions, and that many stories are far worse than mine. But I offer it to remind us that yesterday's victory still leaves us squarely in the jaws of a for-profit system, designed to make money for its shareholders.

I first noticed something was wrong in the summer of 2002, when I felt dehydrated, and had a prolonged bout of severe diarrhea. As an otherwise healthy young man, I did what a lot of Americans do: Ignored the symptoms, hoping they would go away on their own. I had health coverage - an anomaly for most working musicians in their mid-20s. My band had decided to get health insurance, foregoing a raise the previous year. Fiscally conservative parents everywhere were proud!

But I was terrified of the out-of-pocket costs associated with a round of testing at a doctor's visit. For that reason, instead of seeing my regular doctor, my first visit for this ailment was to the emergency room, after passing out on my way to the bathroom. A wrong diagnosis and another trip to the emergency room later, I finally booked an appointment with a gastroenterology clinic where I was diagnosed with Ulcerative Colitis, an immune system disorder with no known cause, and no known cure.

When you have Colitis, your gut's immune system thinks it's under attack, and goes into overdrive, 24/7. This causes a whole slew of bad stuff to happen, resulting in open sores forming on the inside of your lower intestine, preventing normal digestion. This diagnosis was a huge shock to my bulletproof, marathon-running, 26 year-old self.

I was prescribed steroids, and the mildest form of immunosuppressant pills (12 per day!), and thankfully felt better within a couple days. This "remission" period lasted nearly 5 years. Because I was signing the checks for our band's health coverage, I noticed that my health insurance premium increased at a much faster rate than my band mates'. I didn't think much about it at the time, because I was only paying five dollars co-pay for a bottle of medicine that was keeping me healthy. When I learned that the "real cost" of that bottle was $120, I felt as though the system was telling me, "Not only are you fighting a chronic sickness, but you are this close to not having enough money to stay healthy."

My remission ended two weeks before I got married in Norway in June of 2008. During final preparations for the wedding, I began having frequent, urgent trips to the bathroom as my medicine stopped working literally overnight. Worse, blood started appearing in my stool. On a Saturday a couple weeks after our wedding, I visited a Norwegian doctor, who prescribed steroids, to no effect this time.

He called me three days in a row to see how I was doing. The only two questions asked by the nurse in the waiting room were, 1. "What is your name?" and 2. "How do you feel?" They didn't care that I didn't have a Norwegian social security number, health insurance, or reside in Norway permanently. The only requirement for treatment was that I was not feeling well. The Saturday emergency visit, and medicine cost just $100. Those kind phone calls from the Norwegian doctor were free.

After returning home, I spiraled into the worst period of physical health in my life: eight full months of no relief from heavy diarrhea filled with blood. My 6'1" frame withered away to 127 pounds. Often I would spend up to six hours at a time, multiple times per day, in the bathroom. This effectively ended my social life, and took a heavy toll on my songwriting, performing -- in short, everything. Eating became a nuisance -- nothing but a source of nearly constant, excruciating pain. This period also brought with it the darkest thoughts of mortality. It was during this time of my lowest physical and emotional weakness that I was forced to fight our health system most vigorously.

Photo by Laura Dart

In September of 2008, my gastro clinic had put me on a new medicine that they said would take four months to begin working. I waited, but nothing happened. When the four months were up, I was scheduled for a colonoscopy, which was supposed to be covered under my Blue Cross preventive care because Ulcerative Colitis sufferers are at a greater risk of colorectal cancer. The results of the procedure were shocking and immediate: in the recovery room, I got the news that I had the worst case of full-blown Ulcerative Colitis my gastro specialist had ever seen. The doctor who performed my colonoscopy recommended immediate removal of my lower intestine.

While I considered my options, the bill came for that procedure: $900. I called Blue Cross in disbelief, asking if it shouldn't have been covered under their preventive care guidelines. The customer service representative told me that a polyp was found, and therefore, at that moment, it was no longer a preventive procedure. "But shouldn't it be in your company's best interest to determine whether or not I have cancer?!" I cried, to which he snapped, "This has nothing to do with cancer!" And it didn't. It had to do with whether or not they could make money. That was the moment I lost it. I was still spending upwards of 10 hours a day on the toilet, in dizzying, almost constant pain, feeling like something inside me was tearing me apart, bringing me closer and closer to dying.

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