Tuesday, August 23, 2011

The truth about... Healthcare

Everyone seems to have their own viewpoint, and of course, "everyone is right in their own mind." After hearing so many negative remarks about socialized healthcare, here's my personal experience. For what it's worth.

One of the heated debates of the past years has been universal healthcare for Americans. A former coworker posted a note from a chair in a government waiting room. His surroundings were sticky, dirty, and crowded. He used the germ-y setting to note that he wouldn't want the US govt to run healthcare. Hmmm, is that a bit like saying we wouldn't want our surgeon's office to administrate our bus drivers? Or that we wouldn't want our plumber's union to be in charge of driver's ed because they're not competent in licensing drivers?

In response to the first post, another former coworker sent a video link of some actor exploring healthcare in Canada. Not pleasant, this footage. He flew to Montreal, found a clinic closed on the weekend ("Go to the emergency room" where he had to wait for service, etc.) and otherwise was not impressed. I watched the Canada healthcare video - from Montreal (not the most efficient, those Quebecois, either at grocery stores, serving customers in shops, etc.) That's comparing the worst of one place with the best at home... the debate might be different if we'd ask those who can't afford good healthcare (and who also have no power to effect change).

May I note the following after watching the clip on YouTube? Waiting can be a nightmare in the doctor's offices of the US as well as Canada, not to mention the chaos of urban emergency rooms... (as we've experienced with ongoing appointments with our children over the years.) Many clinics close on weekends in the USA, and US city hospital emergency rooms are often so overcrowded that patients go from hospital to hospital to find someone to treat them unless it's critical care. Even then, patients report long waits and incompetent treatment.

Okay, now about me. HA HA

We had our first three kids in Canada @ free (1st 2) and $5 (Timo). That included excellent prenatal care, 3-4 day hospital stays ("Do you think you'd like to go home today, my dear? You can stay another day if you like,") several pediatric nurse home visits (they came to our house after the babies were born to teach us to bathe the baby, answer questions, give practical help), free vaccinations, pediatrician visits, etc. which was all included in our $300/yr premium. I'm sure it's much more now, but let's compare apples to apples - Jono was born within 3 years of our move to the US from Canada.

After insanely steep premiums, thankfully matched by our employer, Jono cost us $2000. That didn't include our deductible. I went for five awful doc visits that took forever, both in scheduling and once we got to the office. No family doctor would see us; we had to go to a "specialist" OB/Gyn. (Lawsuits made it too risky for her, said our family doc.) We had an Ultrasound done for a reasonable amount in Vancouver with our former family doctor, who sent the files to the specialist in Seattle; we couldn't afford the test in our adopted land.

When Jono was born at our local well-respected (Overlake) hospital, a doc who was on call and who I didn't know, got there just in time to catch the baby. He left a few minutes after checking that the baby and afterbirth were healthy. My own doc had been at the symphony that night so "wasn't available" at midnight when we got to the hospital.

I called for the nurses when I was ready to push. They'd left me and W on our own after check-in, including my trip to the restroom a few minutes before I rang the nurses that I was about to deliver. Within a few minutes, Jono arrived. They scrambled to get things ready and call a doctor (as above). The nurses put the baby on my stomach after checking our vitals and swaddling him in a towel. They gave him eye-drops, and since it was slow on the floor with no other moms-to-be that night, they walked away and forgot all about us. I could hear them laughing and visiting with each other at the nursing station for 3 hours.

I finally pressed the call button at 3.30am and said, "Anyone want this baby? I have to sleep." Jono hadn't been washed, cared for, or otherwise cleaned up other than vitals taken, and a swish with a towel... I was exhausted, dirty, and numb from trying not to have my baby slip off me.

"Oops," said the nurses. "You were so quiet we forgot about you." (Dear W had gone home as well, in the day before cellphones were common.) The nurses cleaned me up (oh yes, I was still filthy from giving birth.) They settled me into room about 4am, and started clanging about at 5.30am, talking loudly to each other in the hall, slamming the swinging doors open and shut nearby, and otherwise making it impossible to sleep.

"Help yourself, dear," said the nurses to my inquiry about the ziplock bag of pain-pills, enemas, and hernia cream left on my night table. "We'll count the meds you used after you leave and add the tab to your bill."

What?! I told them they could just carry the lot back to the pharmacy. I'd never heard of such careless medical treatment. They tabulated every bed pad, swab, piece of laundry, and utensil used for and around us... and added that to our bill as well. We were stunned at the exact bean-counting when we received several different invoices in the mail, from every department that could have billed us.

I went home at noon the next day, absolutely wiped out and glad to be out of their "excellent" medical care. Our $2000 covered 5 pre-birth visits to the doc (I couldn't endure more of the indifferent, impersonal appointments), the one-day hospital stay, one 6-week post-op doc visit, no home care, no doc's calls to see if we were doing ok... and none of the other extras which "terrible" socialized Canadian medicine had conditioned us to expect after having a baby. Subsequently, we paid for every  trip the kids and I made to the doc (not many, as you can imagine). We visited our folks in Canada every time a vaccination was due... Jono got his shots done free at our hometown Canadian health clinic.

Years later while living in England, we took Jono to a clinic (more "awful" socialized medicine) where he got exceptional treatment, a reasonable waiting time in a clinic, and a reasonable invoice. Socialized medicine? We'd take it over the robbery and over-charging that passes for private care here anytime!

Maybe the issue is perspective, though. Maybe our experience included the best Canada had to offer vs. the worst of American healthcare, exorbitant payment for relatively good and bad care. Our boys had good treatment here when their lungs collapsed lungs. They might have done as well in Canada for less money. Our daughter continues to seek treatment for arthritis, but says after exploring many options, her docs throw up their hands and say, "We don't know what else to do." She could probably get that in Canada, England, Germany, or other "socialized" countries as well. (However, more medication options are available in Europe and Asia because drug companies don't have to go through the expensive certification processes here.)

Maybe it's a moral dilemma. Greed drives business, including healthcare, in the West. This country's residents are independent-minded, not wanting people to know our business, wanting to customize our experiences. No one wants to be lumped in with others in government-run healthcare because we aren't impressed with other gov't agencies. Trust and confidence is very low.

Docs enter the field for various reasons, not all of them noble, both in Canada and the USA. Many healthcare providers find their insurance premiums so high in the US ($230,000 annual premium for my ear, nose, and throat specialist in 1990), or have long line-ups for patients in Canada, so they treat people like numbers instead of caring for them as individuals. Such attitudes rarely underly good medical care.

My folks and W's have good doctors in Canada. We've been mostly happy with our docs here, too. Our family isn't very picky who treats us for routine care. Since my doc went on maternity leave 14 years ago, I haven't bothered to get another family physician. W's doc seems competent for him and did fine on our occasional visits with the kids. He'd probably work well for me when I need a doc some day.

The media makes a big deal out of the healthcare issue, so political debates become cumbersome, ineffective, and unwieldy. Our Ami friends are terrified of hostile health takeovers by their government. Meanwhile, our family has experienced both sides of the healthcare border and the ongoing debates. We'd rather pay a reasonable amount for similar care. We're living here, happy to be here, and paying through the teeth like everyone else. We're puzzled and bemused by the fear of our friends and the media hype about the dangers of  "socialized medicine."

I bet human and government inertia and an increasing demand for health services keeps us just where we are. The Americans who stay home because they can't afford to fly to Asia or Europe for cheap, up-to-date treatment will continue to lose their shirts, houses, and savings to emergency or old age care. Canadian docs will keep moving to the USA to get rich. Wealthy Canadians will gladly follow these doctors to the USA or go abroad for the services and experience the docs take with them. The rest of Canadians will take what they can get from their government-run healthcare, happy to stay at home as long as possible, without ruinous medical costs.

What's your experience? Are you happy with the care, costs, and future of healthcare where you live in the Americas, Europe, or Asia?


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  3. I appreciated the different perspective I read here. As a clergy member I have spent lots of time visiting folks in the hospital, I have worked as a chaplain in hospitals and on emergency response crews, and my wife has worked in the healthcare field for over 30 years from a CNA to a Registered Nurse. I have spent time ministering in India, Africa, and Mexico. I could not disagree with you more. But in the midst of my disagreeable angst I have hope (if not faith) that you are right and I am wrong.