The first person I was anxious to see was my good friend Raees when I visited my homeland Pakistan after more than a decade. With a bundle of gifts I went to his home, only to find him extremely depressed. There was a halo of gloom all around; the reason was that his seven-year old son was diagnosed with a complex heart disease – a hole in his heart, which needed urgent surgical treatment for which he had to pay a heavy amount in advance to a hospital. Raees was not rich; he hardly managed to pull on with the salary he drew from the place he worked with. I also learned from him that the family had no health insurance, simply because health insurance was never a part of life for the people in Pakistan; and even if a few private companies offered insurance it was beyond the reach of a common man.

The gloom was somewhat lessened as we sat on a dinner table, relishing a delicious meal prepared by my friend’s wife Sara.

The next few days we visited some hospitals and met with the administrative staff to find out how to cope with the financial side of the surgery. The specialists we saw were hopeful of the outcome of the treatment, but that involved huge payment – around a million rupees (approximately ten thousand dollars) in advance. Free hospitals showed a very discouraging scenario. They were full to the brim; some patients were seen lying in the corridors with drips on their arms. A complex surgery like that of my friend’s son was hard to get, and even if they agreed to take such a patient, there was a wait for months before a bed would be available. I could very well imagine the type of treatment he would get. So this option was out of question.

We went to see the specialist who was treating Asad, my friend’s son. After much persuasion he agreed to operate if at least seven hundred thousand rupees (seven thousand dollars) was paid in advance. I had four thousand dollars with me which I gave to Raees who very reluctantly accepted. I promised to give the rest as soon as I went back to Chicago.

The surgery was scheduled next week. As such, I hurried back home and looked into the credit limits of my various credit cards. I got ready to borrow cash from some of these cards. But as fate would have it, three days after my arrival, I got a call from Raees. I could hear him sobbing and my heart sank. I was informed that Asad passed away two days after I left Pakistan.

About a month later, my neighbor John in a Chicago suburb informed me about the illness of his daughter Julia. She had a similar condition – a hole in her heart. As soon as she was diagnosed she was admitted to a clinic in the suburb. John also was not rich. In spite of doing two jobs, his earning was below poverty level. He did have a health insurance, but it did not cover most of the expenses. When Julia was admitted he didn’t have to pay any advance. The surgery was successfully performed and Julia recovered pretty soon. When the bill came from the hospital, some of the amount was paid through insurance, the rest; about eleven thousand dollars had to be paid by him. He approached the administrative officer and expressed his inability to pay off the bill. The administrative officer checked his pay stubs and other assets, made some inquiries and informed John that a part of the payable amount will be paid by the hospital’s charitable Trust and the remaining balance could be paid by him in easy installments of fifty dollars a month.

Julia is doing well and is able to do all activities a normal child could do.

The stories of Asad and Julia are similar, but one of them was ill-fated.

*Names have been changed to protect identity