On my way out the door after my first appointment with my new doctor up in Vancouver – this would be in 1996 – a clerk at the front desk noticed that I seemed puzzled. “Mr. Basil, in Canada, doctors offices don’t have cashiers.” I heaved a brief sob, I was so relieved and surprised. 

When I lived in the United States, my insurance was sporadic and when I had it often shitty. That fact touched every one of my days with real and awful anxiety.

Vice.com says my dear friend Karen Vogel is at the vanguard of a new profession in the United States – the “patient advocate”:

Karen Vogel, an insurance and administrative advocate, spent 29 years working in the insurance industry and became frustrated at the missed opportunities to really make a difference in patients’ lives.

“It was hard to come to terms with what was I doing and was I creating any good in the world, and who was I really serving?” Vogel told VICE News. “Because our healthcare system is so fragmented it’s so broken and there are so many opportunities to get into it to make it work for people. And I just wasn’t satisfied with the path that I was on.”

Over the past two and a half years of working as a patient advocate, Vogel has helped her 45 clients wade into the specifics of the insurance claim and reimbursement process.

About a quarter of what she finds are simple errors; the rest of her work is advocating on behalf of patients for out-of-network coverage or special considerations. Her biggest save was $109,000 by appealing out of state care to count toward in-state benefits.

I am very proud of my friend, who’s on the side of the angels.