Armchair Expert with Dax Shepard - Flightless Bird: Healthcare II

Episode Date: September 19, 2023

After two American surgeons told David he needed back surgery, he fled back to his home of New Zealand where healthcare was less scary! What he discovered in New Zealand surprised him. David calls up journalist Luke O’Neil (writer of the Welcome to Hellworld newsletter and new book A Creature Wanting Form) to chat through what he discovered: two very different medical systems with vastly different approaches. Learn more about your ad choices. Visit podcastchoices.com/adchoices

I'm David Farrier, in New Zealand I accidentally marooned in, well, New Zealand right now. Because as we informed you a few months ago, I got on a plane to fly back to New Zealand after being defeated by the American healthcare system. I needed to sort my back out, my spine, the spine of a tall 40 year old man who spends too much time sitting in a desk typing. My back had decided to create havoc with my discs and my nerves, making my life, temporarily, a kind of small living hell. But now I am back in America, back with a story to tell about my back. It's a chance to look at my very personal experiences of brushing up against the

American healthcare system, and then the New Zealand healthcare system. It's a kind of informal follow-up to the first healthcare episode we did in August last year. So, grab your health insurance information and start bracing for that excess to kick in, because this is the Healthcare Part 2 episode. I'm back. You're back in the attic. I'm back in the attic. David's home. It's been, I was away for almost two months, which is a very long time. Very.

It was confusing. Yes. And Dax wondered if you would ever return. Yeah. I heard there was a fear from Dax that I might not be coming back at all, which is such a strange concept because I was never intending not to come back. You never know when you get home, what will happen. You did leave all your stuff. I left all my stuff in America. I paid my rent check three months in advance so that I wouldn't be panicking about that. That was the main thing that stressed me out.

I have to pay my rent via check, but not via bank transfer or anything. So I thought that was my main stress. If I'm not in America, how am I going to pay my rent? Oh, God. And then I was thinking, what if I am away for months and months and my landlord doesn't get my new checks? What? Do I get all my stuff on the street? What happens?

Eviction. Oh, my God. That would be an episode. That would be. I don't know that they can actually throw your stuff on the street, though. Because California residency laws are pretty in favor of the resident. So I could be protected. Maybe.

We don't know. But yes, I'm home. But also, I can't blame. This is, I guess, immediately is controversial. Uh-oh. Let's get into it. If you're not paying rent for a significant period of time, I can't blame a landlord for saying. It would be annoying not getting that rent. You can't be here anymore.

I think being a landlord would be quite difficult if you aren't getting money. Yeah. But also if you can't afford your rent, that's also very stressful. It's stressful for anyone. All of it's stressful. But my point is I am lucky enough

to be able to have written those checks. Yes. They all got cashed. So I kept my place. New Zealand was a weird time because I was trying to sort out my back situation. Right. But I also got to see my nieces and do New Zealand things like eat cookie times. And I bought you

all some cookie times. And it looks delicious. Is it okay if I throw this cookie time towards you? So this is a cookie time biscuit. Rob, this is yours. Wow. Mine is original chocolate chunk. biscuit. Rob, this is yours. Wow. Mine is original chocolate chunk. This is the best one. So this is from the cafeteria episode where this is the main thing that New Zealand kids, when I was growing up, got from the school cafeteria. It was a dollar. You'd put it for 30 seconds in the microwave and it was the most delicious thing around. So you can take that home. Do you have a microwave?

I do. And I also bought, you have to fight over this, as I was in New Zealand, this cookie time like peanut butter came out. Okay. Why don't you ever learn your lesson that you have to get both of us equal? I got you both a cookie. I know. But there was this jar, transporting this jar back. I only had one suitcase. It was packed with New Zealand treats.

It was really difficult to do. Okay, fine. But this is Fix and Fold Cookie Time Cookie Crunch. It's brand with New Zealand treats. It was really difficult to do. Okay, fine. But this is Fix and Fold Cookie Time Cookie Crunch. It's brand new. Oh, I love brand new. This is amazing stuff. And I think this is a bit like the equivalent to America, how you have cookie dough. Have you seen cookie dough flavored topping?

Well, I think it's like Speculoos or cookie butter. What did you say? Cookie butter. Cookie butter. Cookie butter. It's's like Speculoos or cookie butter. What did you say? Cookie butter. Cookie butter. Cookie butter. It's actually called Speculoos. That sounds like some sort of STI. It sounds like jizz.

Yeah, it sounds sexual. Yeah. It really does. I like cookie butter better. Well, cookie butter also could be a euphemism. Oh, my God. It could be, actually. And this is that. This is the New. Oh, my God. It could be, actually. And this is that.

This is the New Zealand version, I think. It's just a beautiful, sweet, creamy topping for your toast. So you can try that. Living wage accredited proudly donating to city missions and women's refugee. Wow. Welcome to New Zealand. This is how we do things. I love it.

That's like our premium brand of peanut butter. And literally, as I was in New Zealand two days before I left, they'd listened to the episode we'd done about school cafeterias and sent me that so I could get it back to America. Oh, that's so nice. Yeah, it was really nice of them. So that's like a brand new thing. Did you get one for yourself? I ate it all pretty much straight away. I felt sick. You said the word too. Oh my God.

But I ate one. It's a real problem. Yeah. I just spooned it out. I guess it's like when people eat peanut butter from the jar. Yeah. But yeah, halfway through, I started feeling a bit ill. Anyway, that's cookie time.

What else can I tell you about New Zealand? It was hailing a lot of the time and wet and cold. It wasn't the ideal time to go. But I was there for a month and a half and I started feeling like I was slipping back into my old life. I was going to my old cafes I'd go to and meeting my old friends and slowly sort of slipping back into this different thing. It was quite weird. And how did that make you feel? It felt great to know that New Zealand hadn't gone away.

Like I'd spent decades in New Zealand and it's not like it had all vanished. Right. But it also made me feel a bit uneasy because I felt like America was becoming home. Yeah. And I felt like I can't have two homes. I just want to be in one or the other. So it felt odd. So by the time it came time to come back i was like i'm ready to go back

to the united states i need to learn more i've got so much more to learn about this fucking weird interesting country so much to learn but i bet because you don't like to be vulnerable oh but it's 2023 and you said you're gonna be more honest this year. I did. I feel like what you're not saying is that you feel a real connection to America. And it's conflicting because New Zealand's your home. But New Zealand's not really your home anymore. And this is hard to grapple with. This is an identity shift. It is weird. I've spent a long time in New Zealand.

Yeah, your whole life. My whole life. Almost 40 years, right? New Zealand, New Zealand, always New Zealand. And it feels really good to be somewhere. There's something about America and how big it is. Yeah. And just all the different things. I was telling you the other day, I went out to Long Beach working on a pinball episode. It's like another universe over there and i loved it so much genuinely just beach culture and the people there were so fantastic and i just think the bigness of america has me completely hooked and i think in a way being in new zealand and this is like a good thing about new zealand but it felt

very small in a way where i just felt a bit stressed because I felt like if ever I left the house, I'd bump into people I know, which isn't something to complain about. But also, I guess I'm complaining about it a little bit. I like that because sometimes on this show, we poke a lot of holes into what's wrong with America and issues with American culture. And I like that you were back home and you thought, you know what? I miss that place.

Yeah, I really did. Yeah. And I missed my friends as well. I missed you guys. I actually did. It was weird thinking about the show because we've been putting out these episodes and it felt weird to be doing it from another place. Who did you miss more?

You can't do that. That's a horrible thing to do and I won't be answering it. I miss a parent talking about their children. I love everyone equally and I miss you're the same. Everyone has their different pluses and minuses. Oh, talk about our pluses and minuses. And when you balance all those out, then it all ends up on a level playing field. Okay.

Well, you answered that correctly. Thank you. Good job not answering. Thank you. Okay. just rattle off the three things you miss the most about america friends are one thing because i think i've got really good people here yeah i miss people i miss i'm more specific i miss being able to go what i like about america and this is maybe reflects a bit sadly on me, but I love that in America you can go to a bar or a diner on your own and it's not weird. Oh, it's weird in New Zealand a little bit? Yeah, you have to go out with other people.

Oh. And so here I love that I can go to a bar and I can just sit up at the bar and that's fine. People aren't going to be looking at you going, oh, you're a freak with no friends. Right. It's completely normal. Yeah. So I miss that a lot. Right. It's completely normal. Yeah. So I miss that a lot.

Okay, that's number one. I miss my local little movie theater that I go to, to Las Feliz 3, because I love that little theater and I like watching films more than almost anything. And I miss the heat. Wow. It was really cold and I know it was baking over here. It was.

But I like being warm. I think it's better to be. It was. But I like being warm. I think it's better to be hot and to be able to cool down than to be freezing, trying to get warm again. I agree, actually. I think this is a split vote for a lot of people. Yeah, I'm on the opposite. You like being cold. I hate being cold.

So I'm with you. I'd rather be burning up. Yeah, cold to your bones is such a horrible feeling. It is. And warming up again. Having to be in that hot shower, trying to get warm again. Horrific. Shivering.

Getting warmer. Put a blanket or a sweater on. How do you get colder? Jump in a cold shower. Cold shower. You have like one option. One of those AC scarf things. Ice. Ice in your mouth.

Yeah. Ice. Ice. Ding, love ice ding ding ding ice episode i love swimming laps of pools and so i love being in la and being like really hot and being able to jump into a pool and just swim i found a local one now that's three dollars a session oh wow it's three dollars to get into the pool where i'm gonna keep it to keep it secret. No, I'm absolutely not telling anyone because no one knows about it. I hate swimming. I don't know how to swim, so you don't have to worry.

I'm not going swimming either. I'm not going to. It's too risky. David, you're so selfish. This is one of my best new discoveries. It's close to here? It's eight minutes away. So you're going to the Hollywood pool?

No. No, it's not the Hollywood pool. It's $ going to the Hollywood pool? No. Is that $3 too? It's $4, the Hollywood pool for adults. Look, I've just found a place to... You're so American. You became so selfish when you got back here, and now you won't share your secret pool. Pacific community pool?

That's it! You should have told us. Then we wouldn't have had to do this, David. now we wouldn't have to tell everyone where you swim i can't i'm really unhappy about this i feel so stressed you are squirming a lot okay okay but this is good because now we swimming is also a ding ding ding because spoiler alert you can swim and you walked in here today. I walked in. I'm doing really well. Yeah, you're doing well.

And I want to explain sort of how all this happened. Yes. And so today's little documentary is sort of looking at the New Zealand healthcare system, which I went back to experience, versus my experience in America. Great. And if anyone wants to see David swimming, it's Pacific Community Pool 509 South Pacific Avenue. I'm going to beat this out. No, you're not. I make the final calls here.

This pool is there's no one in the lanes. I'm there. It's finally a place I can swim without. Oh, you guys are such fucking. Back in May, something happened to my spine. It was while I was recording an upcoming episode on bail bonds in Oklahoma City. Back in May, something happened to my spine. It was while I was recording an upcoming episode on bail bonds in Oklahoma City. I've been to different jails, but this jail, it mentally and physically tears you down to where you lose it.

As I was talking to this man who had literally just emerged from prison, my back was writhing in a weird kind of agony. The time before I got arrested to now, all I've been trying to do is go home. And now that I got the chance to go home, I'm going home. I wanted to go home too. In short, over the last decade, I've been doing too much sitting. Too many cramped planes, too much sitting in a bad chair at a shitty desk doing what I do a lot of, writing. My lower back was a mess of electric shocks, pain shooting down my right leg to the tips of my toe. I'd first injured my back back in 2011. The old MRI report from back then said I showed,

and I quote, a disc injury at the 4-5 level with L5 nerve root irritation and a right-sided 5-slash-1 disc protrusion and right nerve compression. Whatever all that means. The thing is, once spines are fucked up, spines never unfuck themselves. That's them for life. So we do our best to fix our postures and strengthen our cores. Since 2011, things had calmed down for me through exercise, stretching, and Pilates. But America did something bad to this particular Kiwi. It made me lazy. I missed my stretches. I stopped swimming.

I never found that Pilates spot. And so in May, something in my spine, or between my spine, shifted. It was electric bolts in my lower back and then explosions down my right leg. I've had all types of different injuries in my life, and then explosions down my right leg. I'd called up Luke O'Neill as I went through all this. We'd last talked for our healthcare episode last year. Luke writes about the American healthcare system in a newsletter called Welcome to Hal World.

I'd just read his new book, A Creature Wanting Form, and was reminded he too had a bad back. This is podcast hell probably, two men talking about their bad backs. But Luke's smarter than me, so as I explained my experience, I wanted to have him on hand to chime in. I don't know if you've like tweeted about it and stuff a lot, but whenever you do, you will find dozens and dozens of people that want to talk about it. It's like a secret little, well, not a secret club, but it's like a very popular club.

I'd never meant to join the Navigating the American Healthcare System Club, but here I was. Stay tuned for more Flightless Bird. We'll be right back after a word from our sponsors. Flightless Bird is brought to you by Helix Sleep. Now one of the many things I needed to do when I got marooned in America was getting all the things I'd left behind in New Zealand, including a mattress to sleep on. A giant wonderful Helix mattress arrived at my door about a year and a half ago now, and so all my sleep problems were sorted. The Helix lineup offers 20 unique

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having loads of different supplements and wanted everything in the one place. I wanted a boost in energy, something that supports my health, and a supplement that actually tastes great. And hey, it's from New Zealand, so that's a bonus. I drink AG1 in the morning before I do anything else, really, to make sure I'm set up for the day. And it makes me feel really good. I feel sorted for the day, and it just puts me in a good mindset. It's great value for money as it replaces a bunch of other multivitamins I was using and it has probiotics for my gut health, adaptogens and a greens blend. Literally all in one scoop of powder which I add to water for a great tasting drink. It also just saves me time in the morning. It's a daily routine I can get behind, and I'm really glad I tried it and never looked back. If you're looking for a simpler,

effective investment for your health, try AG1 and get five free AG1 travel packs and a free one-year supply of vitamin D with your first purchase. Go to drinkag1.com slash flightless. That's drinkag1.com slash flightless. Check it out. When I got back to LA, I rang my PCP, my primary care provider, my doctor, what you'd call a GP in New Zealand. They couldn't get me in for two weeks, so I went to urgent care hoping to get some drugs. $150 for the visit, the tramadol and the oral steroids. But the pain kept me up at night. The tramadol did nothing but give me a fuzzy brain. And then the pain in my butt and my leg turned into pins and needles. And then I lost some of

the feeling in my right leg. And then I realized I couldn't stand on my tippy toes on my right foot. And then I realized I couldn't run. And I was walking with a limp. Here in America, I'd signed up for a shitty healthcare plan a year ago. It's $360 a month, which still felt like a lot. I mean, I feel lucky to be able to have some coverage when so many don't have any. It's an HMO plan, which means you can't see any experts without first seeing your doctor for a referral. And the list of experts you can see is pretty small. But it was a week away till I could get a spot with my doctor, and my right leg had left me.

And so I did a telehealth visit, a doctor beaming in over my phone. They told me it was urgent, and I should go to an ER. So go to the ER I did. $400 seemed horrific, but worth it. It was a squirrel bite all over again. I figured maybe the ER could get me an MRI. Silly, naive me. The ER won't give you an MRI unless your spine problem has meant you've lost control of your bladder or bowels. I had not, hurrah, but it also meant I got nothing beyond a very long wait and a trendy bracelet. Getting them to turn on the MRI machine in the first place, it's like asking them to fire

a rocket to space, you know? At the end of the following week, I finally saw my doctor. $65 copay. He didn't look or touch my leg. He didn't break a sweat. He just listened to me describe the symptoms, then offered to refer me to an orthopedic surgeon. I'd need an MRI first, and he said that would take a few weeks for the insurance to sort out. Two weeks felt really long, so I asked if I could get just a referral to a generic MRI spot and pay for it out of pocket. This meant I could get an MRI tomorrow. Money works here in America. The doctor said yes. 8.30am, and the MRI spot I'd found only took cash, $300. I'd been to the ATM the day before.

I felt like I was off to do a drug deal. Cash only? What the hell? The MRI machine looked old. Something you'd see in the medbay on Star Trek, the next generation. Paying $300, cash only, that's very funny. You have to know something is wrong there but that's the thing you were desperate right you're in pain your legs numb what are you going to do i was curious to see my spine but was handed the images on a cd-rom i requested a digital version as i didn't have a cd

drive who did they only come on a cd sir came the reply reply. Take these to your doctor. But my orthopedic appointment was over a week away and my foot felt more numb than ever. And I was walking even slower. My insurance was making me wait, but I was impatient and I was worried. I couldn't stand on my tippy toes on my right foot. Like everything in America, if you pay, you get the best care and you get it quick. This was my leg. And I figured if I was going to pay for something, I should pay for my leg. And so I rang up a fancy private hospital that did spines. I asked what a consult with one of their orthopedic surgeons would be. $500, they said. I felt ill and I said, okay, let's book it in. Then they called back later saying we made a mistake. It's actually $960. I went in for my $960 appointment a few days later and handed them

the CD-ROM. I never thought I'd be handing a CD-ROM over to anyone in 2023. I filled in forms and put $960 on my credit card and eventually I saw the surgeon. He looked like a surgeon from TV. He was handsome and trustworthy. He had great teeth and a white coat that was radiant. He said my problem discs from 2011 were worse, and my S1 nerve root was being squashed. Badly pinched, is what he said. The S1 nerve runs from your lower spine all the way down your right leg and into your foot. I'd need a disectomy to relieve the pressure, I was told.

A small surgery where they chop or shave a bit of your disc off. But the nerve might already be too damaged, meaning I'll be stuck like this, stuck with a gammy leg. I remembered that this fancy place was out of my insurance network, and for them to do it, it would cost about $17,000. My credit card limit was much lower. So I waited for the following week to see my in-network orthopedic guy. He was in a bad part of town.

He looked old and his skin sickly. He looked like death. He would not shake my hand or hold my gaze. He was the opposite of the $960 surgeon. He looked at my MRI and said I'd need a disectomy, but also that I should get my spine fused as well, which is a pretty major thing to do. I hated him, and I didn't believe him about the fusion. I don't know a lot about backs, but I knew once you went down the fusion road, you could never go back. Discs fused together,

relieving some problems, but simply putting more pressure further up the spine. It was a losing battle, and I wasn't willing to fight that kind of battle. I looked at him, or I tried to look at him, but he still wasn't holding my gaze and I knew I didn't want this man to do either procedure. I left. In a way, you feel for the doctors. I mean, some of them are just trying to gouge everyone as much as they can and get rich and there's lots of shady doctors. But a lot of them are saying now, I can't my doctor's office and told them that I needed a second referral.

I found a surgeon that my insurance covered. They seemed great and had great reviews. But it turns out they weren't in network with my PCP. I said to my PCP, dear God, what surgeons do you refer to that my insurance also accepts? They said they had a list, but they couldn't email it to me. It would have to come in the post. It would take a week. And with that news, I admitted defeat. It was either Dr. Death under my insurance policy, or the $17,000 operation and the risk of extra costs if things went wrong, including the $8,000 for every extra night in hospital.

This was crazy. I decided I'd fly back to New Zealand. Dun, dun, dun. Oh, cliffhanger. So that was my experience in America. have you ever dealt with uh american like have you ever had like an injury and had to deal with you nothing no no i have i had a seizure i don't know if you remember i'm not um i remember that was before you moved to america that's when i was born in india and i had a seizure and then how was your experience with the seizure

well you've got better insurance I do and that was why it was okay it's still expensive I still had to pay stuff but I had a PPO plan yeah so which is just way more flexible right it is you can kind of go anywhere you need to go you have a deductible and so you will pay up to that deductible which is you know a decent hit it is but it's much better than hmo plans i did tell you both this so many times and you did and i just bit by a squirrel and i reiterated that you needed to get on a ppo and then you still didn't. And then this happened. You absolutely told me very clearly that I shouldn't have been on an HMO.

I'm going to swap to a PPO, but you're locked in it for the year. So I have to get through the year. This was way before a year though. I'm PPO now. Yeah, he finally listened. You listened. Rob did listen.

And it's going well, Rob? It's going great i found out a thing about the squirrel by the way oh what apparently squirrels can't carry rabies because generally if they're bitten by something that has rabies they just like die it'll be generally be something bigger like a raccoon and it's more likely they'll just get eaten and killed by the thing okay as opposed to. Bit and then they run away. And then they run away and survive.

So I thought that was an interesting bit of trivia. And that's why squirrels don't carry rabies. Well, technically they could. Right. So they still have to give you the shot just in case. Just in case. Oh, wow. But the likelihood that it's carrying is very low.

So low. Like never happened. Wow. Like hasn't happened. And yeah, that's's carrying is very low. So low. Like never happened. Wow. Like hasn't happened. And yeah, that's just a very obvious thing that if they get attacked by a rabid dog or a raccoon, they're just going to get torn apart. Wow. Anyway. Okay, good update.

A couple of stats I found out. Okay. In 2022, the US spent an estimated $12,000 per person on healthcare. The highest healthcare costs per capita across the oecd which is just super high compared with other spots it is though but it's tricky because a lot of that is older people we need to maybe do brackets yeah but just overall yeah it's a lot of money it is 28 million americans don't have any medical insurance i thought that was illegal when obamacare happened oh they repealed that yeah no i was like they're not paying for it i guess they're on medicaid right i suppose okay that'd

be on that as opposed to like having an anthem policy or whatever policy i have okay and 77 million people lack dental coverage oh that's very common. Do you have dental? Yeah, I have dental and vision. Yeah. Wow. Good job. Fancy. You really stepped it up. Another crazy stat I found from diabetes in America,

I'm getting off the beaten track, but I just started looking at numbers. Oh my God. A toe, foot, or leg is cut off by a doctor in America 150,000 times a year. Yeah. America is like the world leader in amputations from diabetes complications. the main thing i found crazy in america with the plan i was on was just the level of slowness to

everything for instance just getting a list of in-network surgeons it had to be physically mailed to me in a letter. Right. That's crazy. It's crazy, right? That is absolutely crazy. But I think that's where you went. That doesn't sound normal to me at all. I think I had a very bad place that I signed up to. Yeah.

Even though we're living in a really nice area, this place was real bad. Hence why I went back to new zealand yeah but also you could have gone to a different place here no that's the thing i couldn't why so what do you mean because this is the thing i found crazy you could have switched pcps you went to a not good primary care the swapping was going to take three weeks to change to another one and then to get an appointment with a doctor there would take another whatever. So it was more like a time thing. I mean, you probably could have gotten further outside the city and gotten in quicker.

If you go to like Arcadia. It's because we're so densely populated here, I think. Yeah, right. That is true. So if you drive an hour outside of LA, you probably could have gotten in. You should have asked us more questions when this was going on. I think you were too... I was so stressed. You were. You should have asked us more questions when this was going on. I think you were too. I was so stressed.

You were. You were really stressed. When all this was going down, I connected you with my friend who is a physical therapist over the phone. She lives in North Carolina. She was great. Yeah, she's great. Shout out Gina.

She's an amazing PT. And first thing she asked was the same thing. Can he pee and poop? Yeah, big question. And I texted same thing. Can he pee and poop? Yeah. Big question. And I texted you, how's your pee and poop? Can you send a picture back? Immediately. I need proof. Yeah. And you were able to. So that ruled out any major, major, major stuff.

So then she hopped on the phone with you and I think gave you some exercises and stuff. She did. But you were so panicked at this point. Yeah. Yeah, because. That your leg would never work again. Totally. No, because, and I want to reiterate this, and I still find it crazy, that the doctor

I paid $1,000 to see, he looked me in the eye and told me, chances are, even if you get this operation, you will limp forever. He told me that very specifically. I'm going to go back yeah and just say what's happened since because that isn't the case right at all and then i had this other who was honestly super shady i'm not exaggerating he told me the same thing but then also said you need to get a fusion which is called sol doctor oh he was pretty much like this was dicey as hell and i looked at reviews of him online afterwards and it was just a list of people saying things like i'm saying did you find him on

the internet oh you found him from the list he was given to me by my doctor so my doctor referred me to him and so when i saw that he was that bad that's when i tried to get a separate list so i could research them and then go people are are going to be mad at me for saying this, but I have to say it. This is like what my dad, this is like his life's mission, like his mantra. You're not, okay. You were saying it would take you three weeks and you didn't have time, which I agree. But the whole purpose of insurance and having okay insurance and establishing a PCP that works for you is not to do it when you're in a crisis. That's actually the whole point is to do it when you're not so that when a crisis comes, you're set. What do you mean? Sometimes you can't

predict the crisis, right? Do it now exactly now no totally listening if they're not in crisis and they're like i just don't know because i don't want to worry or spend you have to you have to do it now or else you find yourself in this horrible position where you're going to this better call saul totally organize your stuff ahead of time yeah so that you can work within this slightly crazy system. And hopefully you never have to. Hopefully nothing ever happens and it's just really annoying to have to pay that fucking amount. After the rabies and this back thing, I feel like...

You had enough warning that you should have figured it out then. Yeah, I just wish I'd been... I just got sucked into the vortex of, I think, fear. I got scared. With the rabies, the telehealth person scared me saying I needed to go and get the rabies vaccine if I'm bitten by a squirrel. And I listened to the doctor. And then with this, those two surgeons really panicked me again and just got me in this big spin.

Plus, my back was kind of wrecked. Yeah. Yeah. So, yeah. Do you want to hear what happened when I went back to New Zealand? I do. Healthcare being illegal or not, health insurance is not mandatory at a federal level, but some states impose a tax penalty if you don't have health insurance. Okay.

But the federal government stopped doing that in 2019. Okay. It just stopped. Well, because it was under Obamacare you had to have it, but then he repealed that, I guess. But it sounds like it was just a penalty anyways on your taxes. Right. Okay. Okay.

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zero delivery fees on your first order. When you download the DoorDash app in the app store and enter code BIRD. Don't forget that's code BIRD bird for 50 off your first order with doordash okay so what happened in new zealand at 6 a.m on july 2nd i landed in auckland new zealand where my experience would be very different to america And a sidebar here, I'm really lucky in that I have private health insurance in New Zealand. I pay $888 New Zealand dollars for private insurance each year. That's $553 American dollars for a pretty decent plan. For a comparison, my shitty American plan cost me $4,320 American dollars a year. Now I could have used New Zealand's public health system,

but it is crushed under waitlists and they're not particularly great at covering spines, but it does exist. With all that in mind, I landed in New Zealand on a Sunday, and on the Monday I got a fresh MRI. It turned out the $300 MRI I'd gotten in America was pretty low quality, and the Kiwi orthopedic surgeon said he wouldn't operate off a fuzzy mess of an image. The new MRI showed up something a bit odd, so they ordered a second MRI the next day, this time with dye injected into my veins for an even clearer image. Words can't describe how quick and painless all of this was. With two fresh MRIs in hand, crystal clear this time, I also had the added benefit of my surgeon having my old spine MRI from 2011 on file, so he could compare the images. And I'm very glad

these images existed, because they told a story. First up, the thing the American surgeons wanted to operate on, the bulging disc, it's been there since 2011 and has been causing me zero problems, so that wasn't the problem. It also turns out the American MRI was chopped off of the bottom, so it missed a key detail. A bit of my disc had broken off and had travelled downwards. That was the problem. In other words, if the Americans had operated on me, chances are they wouldn't have changed a thing and they'd still be unaware of what the real problem was. The other big difference in New Zealand? The orthopedic surgeon spent a lot more time with me. He talked to me for longer and his physical exam was way

more thorough. He looked me in the eye. He treated me like a human, even made some good jokes. The other thing? He didn't want to dive in and operate. Yeah, you heard that right. He saw some slight improvements I hadn't noticed, and he said to give it some time. This was such a stunningly different message to what I'd been told in the US. And so here in New Zealand, I've been doing a lot of physical therapy, a lot of stretching, and a lot of swimming. And you know what? Things are slowly coming right. I still limp, I'm still a bit fucked, but here down at the bottom of the planet I'm gently improving. I know this is insane after the problems I was having, but that problem of a floaty disc is taking care of itself right now and my nerve is learning to cope with the change.

Might I need an operation in the future? Maybe. Probably. But right now, things are healing. My spine will never be magically healed, but it can be managed. I've got to work my ass off doing PT, and I have to make some pretty major changes to how I work. Sitting and writing constantly is not the life for anyone. So standing desk here I come, and lots of breaks. It strikes me how amazing it is that the reality you imagine can change so dramatically. I was meant to be getting surgery in New Zealand, and now I'm not. I was in such a panic with both what my body was doing and the fairly terrifying words from two doctors, but I assumed the reality was surgery.

But things change. Your imagined reality changes but in all of this of course i'm aware that i'm one of the lucky ones as well what's the trick in america because for me i gave up and i came back to new zealand which is an incredibly privileged thing to be able to do but some people can't do you have any advice at all I saw you work on podcasts and writing and stuff like that. You can make your own hours. Imagine being somebody with kids or, you know, you're working two jobs or something like that. The answer for those people here in America is basically go fuck yourself.

You're screwed. There's no hack the American health care system. It's basically be rich. If I had any great tips, if you can be rich do that if not i don't know what to tell you luke is always incredibly cynical in his view and i love his writing but i think he's got a point if i had money i would have gotten better care and without it you just have to battle a lot harder i guess you do this is this is hard i mean i think the american obviously everyone knows the american health care system has so many issues i don't

think anyone would fight back on that but i think it's a little bit apples and oranges doing a comparison to new zealand because new New Zealand is a small ass country. No, totally different system. A hundred percent. It's a different system and a different size. We can't do that. We literally, I don't think we can replicate that in the same way. And when people say the same thing about Canada, and I also have friends who are Canadian who say

the public healthcare system there isn't great. And the one in New Zealand as well, the public health care system in New Zealand is really struggling at the moment. And there's real horror stories about people there not being able to get care as well. So even in New Zealand, the public system is really struggling.

You use the private. I use my private system back there. Which is essentially what here, what he's saying is the rich person thing. Exactly. I absolutely use the rich person thing. Exactly. I absolutely use the rich person version in New Zealand. Which is just a lot cheaper than here, which is amazing. Yeah.

But it is because of the amount of people, I think. I think if it had the amount of people we do, I don't know that it'd be able to be that cheap. I don't know. The real thing that solved your problem was they had your history. Totally. They had more info in New Zealand because they had my old imaging. Which wasn't the fault then of the Better Call Saul doctor. You didn't give him enough information.

Also, the Better Call Saul doctor is obviously a crook. That is true. And I think maybe there's more room for scamming here. That, I think, could be true because there isn't public health care. So you can have these sort of shady doctors who try to leverage the money. Oh, absolutely. And yeah, obviously, some of them do get paid for surgeries. But the Ben Affleck guy wouldn't have.

The good looking Ben Affleck guy wasn't out to scandalize me. He looked like Ben Affleck. I didn't even hear that part. He was handsome with white teeth. He was just a handsome guy. Oh my god. Yeah, the guy that I paid for and a thousand dollars to, he was so across

everything. But what played into it, I'd gone and got that cash MRI. That MRI was dicey, so he didn't have all the information he needed to see everything else. I wish he had said to me, this looks a bit fuzzy. Right. Maybe we should get you another one.

I did find it very funny that, yeah, the MRI had chopped off the bottom of it, and that's where the problem ended up being. But that was the $300 one, right? That was the $300 cash job. Obviously. I'm sorry, but no, you can't pay what generally costs like thousands of dollars to pay $300 to walk in cash. Yeah, for an MRI. But again, that's crazy that that exists. That was in this area as well.

That's a scam. That's like a legitimate place that sits there. Well, it's not a legitimate place. It's just not like a great place to go. It was licensed and operating. They're allowed to operate. But just not a great image. Then being allowed doesn't mean

it's legitimate yeah totally because obviously it's not if the bottom's cut off it's not real yeah i mean they just didn't scan down far enough i think we're both on the same page like the fact that exists as a thing sure like i'm a total idiot for going there and paying cash for this thing but the fact that exists is bad in the so awful it makes it impossible to navigate yeah people that don't have time that you do or the intelligence that you do how is anyone else supposed to figure that out if you're getting scammed exactly you to figure it out so many people are getting scammed I mean that's yeah this is the most flexible job ever this podcast we sort of make our own hours and we'll work around each other.

And so if you're locked into a nine to five, like the amount of time I spent on the phone, you're with kids and stuff. The amount of time I spent on the phone was bonkers. And I can just imagine the people that just aren't able to navigate and just end up going down whatever road they're sent down and end up getting their spine fused when maybe they don't need to. Yeah.

There's this really amazing book called Crooked, which it's a play on words like crooked spines, but it's about specifically the back pain industry just in general. There's so many dicey operators that flow in around it because when you have back pain, all you want to do is fix it. Of course. It's debilitating. We learned some stats on

armchair once. Basically you have a 50% chance after a back surgery that it'll work. That's why a lot of people really try PT first. They're like, let's give it our all here. And then if it still isn't working, then we can try the surgery. But just so you know, even the surgery might not work, but that's because yes, we have the time, the resources to know that and most people don't and then yeah they're just listening to what's in their opinion a qualified doctor and yeah it sucks yeah no totally and in that doc which i'd recorded a while ago now i'm not limping at all now i'm fine now i'm pretty much back to normal and literally it was just time and pt and some stretches and stuff like that yeah and yeah obviously if you need back

surgery you need back surgery and people get it and it can help it doesn't help other people but if you can avoid it for as long as possible that's the main takeaway and i just can't believe the kerfuffle i mean i flew back to New Zealand. It was fucking crazy. I flew all the way back to New Zealand for surgery and didn't end up even getting it. I know. I wonder if you had gone to a very highly renowned doctor here. PPO doctor. PPO, highly renowned orthopedic surgeon, if they would have said the same thing your doctor said in totally just give

it some time let's think about this do pt it's hardcore and then see i kind of think they would yeah i would hope so i don't think all of our doctors here suck yeah no and they totally of course they don't well they also really don't we have the best doctors in the world and that they're expensive and then you get into i guess that's its own sidebar conversation if you're the best doctor in the world and you've worked really fucking hard to be that should you not make the money if you're doing amazing work you should absolutely get paid you just hope the incentive isn't there that you must operate. Yeah. But that means your customer base is just people with means that can afford it. And if you're not, then you get lesser care.

Exactly. And I feel that's sort of the situation we're sitting in here a little bit. And that's the tricky thing. But I do think that's a problem in a lot of places, not just here. If we were in New Zealand, it would be a similar thing. If you don't have the money for the private insurance, you might find yourself in this exact same position there. The cool thing about New Zealand is the knowledge that if you don't have any health insurance, you will get help. It might take a while to get there, but you will get the surgery and you will

get the help. Completely for free. Yeah. Completely for free. Yeah. Which is just an amazing kind of a thing. Yeah, I agree. And I think, I think there's, and this is just me probably being naive, but I think there's a world where I know we pay so many taxes here, certainly during California, but you'd think if we could all just put a bit more into healthcare and have that money for everyone. Yeah. Dax has a good point on this where he says, it's obviously annoying to have to put all this money up front. He was like, but we're going to pay anyway. And when people end up in the ER, they don't get turned away. We do take care of them. And healthcare system and catch it then, then we're not going to have to pay for all those insane number of surgeries. I totally agree. But look, it's weird.

I had a great time there. I didn't get any surgery done. Yeah, and you're fine. I'm glad to be back here. And my main aim is just to mostly avoid, at the moment, avoid doctors for a little bit while I'm here. I don't want to get bitten by anything. I don't want to injure myself. I'm going to change plans.

Yes, change plans. And you're doing PT? I'm doing PT. And I'm doing... And you're swimming at the Pacific Center. Yeah, I'm swimming at the Pacific Pool. It's really beautiful. And I'm sure they need more support.

See, there you go. Sign up. Well, we'll know what kind of reach we have if zero people show up at the pool. Also, let's not paint with a bra. Not everyone knows how to swim. No. No, they don't. Whoa.

How's your swimming doing these days? You're not big into swimming, are you? I don't think I know how. Okay, so you don't. This is interesting. i don't think i know how this is okay so you don't this is interesting you don't know this about oh my no no i know i know that swimming isn't like a favorite thing but i wasn't sure you're gonna sink eventually well i technically know how i learned when i was younger i just haven't done it in so long oh but we've got to go to glendale there's a pool like 150 feet that way. I know, but I'm too afraid. I have to try it in private.

But then the problem is if I try it in private and I drown, then I'm dead. That pool has shallow enough. You could just swim the other way and then stand up if you're drowning. Do a few little swims. I think that's important. I'm doing

Pilates here, which i found very intimidating because i was reminded of what la is like so everyone looks everyone's just fit and everyone's wearing body suits and right i didn't know where to look i walked in there and i honestly i felt i instantly like got sweaty i was so self-conscious And then I'm getting one-on-one sessions And they're amazing in there But I just remembered It was like a real welcome back to LA It was walking into a Pilates studio

They all look like models or something Right And it was It was just crazy I was just like Oh this is LA And this is mad We're gonna order you a bodysuit

Do we think like with legs? It's like a biker outfit right? Yeah Horrible Horrific No one needs that Like's like a biker outfit, right? Yeah. Oh, horrible, horrific. No one needs that. Like a onesie biker outfit.

I've already bought little grippy socks. Because that was my other thing. I had shoes on. It's like, am I mean to take off my shoes or leave my socks on? What do I do? Yeah, you need the grippies. I need little grippy socks. Yeah.

But my instructor has called my name with an A on the end. Davida. How trippy is that? So it's me and Davida. That's so LA. It's beautiful, isn't it? Wait, is it a woman or a man? It's a woman. Yeah, I thought I was booking a man.

I thought I was booking David. Right, you had told me that. Yeah, well, no, specifically when I went to book, I was so intimidated by everyone. I just wanted a guy. Right. And I missed out. One thing, because we're on the topic of fashion. No, but are we oh body suits body

suits i'm sorry because i'm definitely gonna offend right now no please we got into this conversation yesterday because you're gonna look for a suit i'm looking for a suit and i want to help you find i've never found a suit that suits me i look at it and i'm like oh horrific and people see me in a suit at a wedding and they laugh at me. Exactly. Because I'm wearing the wrong thing. And you just need one that's tailored. And we figured that out. We're going to find you a good one. But when we started talking about fashion, it seems like New Zealand doesn't care as much about it.

That's not a diss. Culturally, they don't prioritize fashion in a way that maybe American and other European places do and Asia. Yeah, I think down under. Absolutely. We're a bit looser. Yeah, because you told me the biggest fashion brand was Zambezi. Zambezi is a big one. I've just never heard of it.

And then I wouldn't expect you to. I mean, it's so far away. No, no, no, no, no, no. But the fashion brands in Italy, I know. Yeah. So I'm just saying it's not as fashion forward. Well, I think. I think you should do an episode on this.

On fashion? Yeah. I know. I think it'd be a great topic. New Zealand fashion is sort of charming in a lot of ways. Because I think people, they're more low key. I think I'm a reflection of that. Like I'm a mess most of the time but you know you'll go out to the supermarket in auckland

which is our biggest city in la and there'll be people in the supermarket in bare feet like so like it's it's loose and it's kind of charming and wonderful in that way and there are definitely really fashionable people there and definitely when you compare it to somewhere like la it's a whole different world. It's just madness. And that's why, yeah, when I'm back here, I'm just amazed at everything. It's just blowing my mind. Yeah.

Well, I think that's a future ep. Fashion. I like that. Yeah. I like fashion. Maybe specifically yoga and Pilates fashion. That's such an American thing, like the yoga pant, for instance. Oh, athleisure. It's called athleisure. Athleisure. I think that's like an american thing like the yoga pant for instance i feel like that's

called athleisure athleisure i think that's like a very american they don't have that in new zealand we're just getting it now oh yeah it's just coming in yeah it's been slow but it's arriving okay well i'm so glad you're back i'm back and my back is feeling great. This is what I shouldn't be doing. I'm starting to slouch in this couch. I need to be up like this. I need to be up perch forward like this. Engaging your core. Engaging my core. That's important. I need to keep

so if you see me slouching like that in the future, tell me. And I'm just going to keep healing and stay in America. Awesome. Alright, well we're back. Enjoy your cookie time. Thank you.