I have a pretty narrow view about the health care systems of other countries because I never truly experienced their care first hand. Whenever I travel internationally, I always make sure to have my a abundant supply of meds to cover me for the entire duration of my stay and additional meds should my stay be delayed in any way. I have never had to receive emergency care while abroad. I have heard arguments about other systems being superior to our system, but as that may be, I would still choose our US system. For me, this decision primarily deals with the advance medical care available in the US.
When it comes to medical care in other countries, people always talk about how the cost of medical care is covered and that there are little to no out of pocket expenses for the consumer. As this may be great, I believe with this type of system there has to be some shortcomings. Whether it be quality or length of time till you are seen by the appropriate medical care giver, I believe that there is no way to compare countries with fundamentally different medical systems.
I believe that the movie SICKO paints a very biased portrait of our system. I'm not saying that the US system can not be improved. There are many aspects of the system that could use reform. What I am saying is that we can't afford a radical change by revamping our entire system. We need to make small adjustments, that lead to a more comprehensive coverage for a larger percentage of the population while at the same time reducing the cost of medical care.
Wednesday, March 11, 2009
Health Care comparison between the U.S., Canada, France & England
When one takes a close look at health care in the United States, there is no doubt that things need to be reformed so that the system can be more efficient, effective, and cover more uninsured Americans. According to a report from The World Health Organization U.S. health care system performance in 2000 was ranked at 37th, and overall health of Americans at 72nd place. When you compare the U.S. with other countries such as Canada, France, and England, the U.S. has the highest health care costs of GDP, highest percentage of government revenue spent on health, and it has the lowest percentage of health costs paid by government.
In Canada, the various levels of government pays for about 70% of Canadians' health care costs. One key difference between Canadian and American health care is that all citizens have coverage in Canada, but access can sometimes be limited. Under the terms of the Canada Health Act, the publicly-funded insurance plans are required to pay for medically necessary care, but only if it is delivered in hospitals or by physicians. There is considerable variation across the provinces as to the extent at which such costs as outpatient prescription drugs, physical therapy, long-term care, home care, dental care and even ambulance services are covered.
In France, medicine is based on a widely held value that the healthy should pay for the sick. The sicker you get the less you pay. All French citizens are given universal health coverage. Chronic diseases, such as diabetes and critical surgeries, such as coronary bypass, are reimbursed 100%.
Similar to France, the English have two types of health services. Primary and secondary health services are provided by National Health Service units known as "trusts." Primary Health Care includes health services such as GP's surgeries, dental and optician services. Secondary Health Services consist of specialized health services like, hospitals, ambulences and psychiatric health services. The other method of arranging health care in England is through the outsourcing of treatment to private companies. In comparison to NHS, private health care has limited infrastructure and in most cases cater to the primary health services.
While it is fair to say that none of these countries have a perfect health care system, each country, however, has many positive attributes worth analzying. In doing so, we can further appreciate and see what would work best for our nation when reforming the American health care system.
In Canada, the various levels of government pays for about 70% of Canadians' health care costs. One key difference between Canadian and American health care is that all citizens have coverage in Canada, but access can sometimes be limited. Under the terms of the Canada Health Act, the publicly-funded insurance plans are required to pay for medically necessary care, but only if it is delivered in hospitals or by physicians. There is considerable variation across the provinces as to the extent at which such costs as outpatient prescription drugs, physical therapy, long-term care, home care, dental care and even ambulance services are covered.
In France, medicine is based on a widely held value that the healthy should pay for the sick. The sicker you get the less you pay. All French citizens are given universal health coverage. Chronic diseases, such as diabetes and critical surgeries, such as coronary bypass, are reimbursed 100%.
Similar to France, the English have two types of health services. Primary and secondary health services are provided by National Health Service units known as "trusts." Primary Health Care includes health services such as GP's surgeries, dental and optician services. Secondary Health Services consist of specialized health services like, hospitals, ambulences and psychiatric health services. The other method of arranging health care in England is through the outsourcing of treatment to private companies. In comparison to NHS, private health care has limited infrastructure and in most cases cater to the primary health services.
While it is fair to say that none of these countries have a perfect health care system, each country, however, has many positive attributes worth analzying. In doing so, we can further appreciate and see what would work best for our nation when reforming the American health care system.
My Canadian Experience
Having a lot of family in Toronto, I visit Canada at least once a year, and over a span of 22 years of doing so, I was bound to come down with something at least once and need a visit to the doctor. Unfortunately (or fortunately), however, I'm not a Canadian citizen so I wasn't entitled to get the access to healthcare that everyone else in the waiting room was getting (luckily the doctor was my aunt's neighbor though so he hooked it up).
BUT, I did notice a little bit about how things worked and looking back on it, it resembles the United States' version of an emergency room. Patients would enter and sign in with the receptionist and give a brief description of what was wrong and fill out the necessary paperwork and give some form of documentation (I don't remember exactly what it was because I wasn't paying very close attention to it at the time). The patients then proceeded to wait until their turn to see the doctor and would then be treated.
Interestingly, most of these "primary care doctors" (I put it in quotes because I don't know what they're known as up in Canada) work in offices that they don't individually own and these offices are often right next to pharmacies such as Shoppers Drug Mart, with doors connecting the two to one another.
That's all that I really remember from my personal experience there other than the people working in the offices were much more friendly than ones I've encountered here. Maybe the movie will bring back some more memories tomorrow morning though.
BUT, I did notice a little bit about how things worked and looking back on it, it resembles the United States' version of an emergency room. Patients would enter and sign in with the receptionist and give a brief description of what was wrong and fill out the necessary paperwork and give some form of documentation (I don't remember exactly what it was because I wasn't paying very close attention to it at the time). The patients then proceeded to wait until their turn to see the doctor and would then be treated.
Interestingly, most of these "primary care doctors" (I put it in quotes because I don't know what they're known as up in Canada) work in offices that they don't individually own and these offices are often right next to pharmacies such as Shoppers Drug Mart, with doors connecting the two to one another.
That's all that I really remember from my personal experience there other than the people working in the offices were much more friendly than ones I've encountered here. Maybe the movie will bring back some more memories tomorrow morning though.
Tuesday, March 10, 2009
SICKO
Honestly...the idea of comparing health systems to other countries did not really come to mind until Obama and USC. I mean I guess I did not really know much about our health system: How it worked? Why it was so expensive? What are the Pros and Cons? And today during my CPR class, my classmates were asking me (because of MPH) what I thought our healthcare system should be? No one has really asked me this question. My response: I think that our healthcare system really needs reform. I am not sure how and what should be done...but I do know that it will take a very very long time and lots of negotiation because HMO, PPO, Healthcare professionals, and the government. I feel like we should take a little from every system and completely recreate our system. I think the Universal health care is great but it probably won't really work in our country. I think that Canada's system is also great...but Can we really affoard to limit access and availability to certain professions/technologies? I am not really sure how to answer this question, but the general consenus is that our system needs a change.
NHS
I think that universal health care is a great system, but just like anything, there are pros and cons...
My cousin and her husband have lived in London for about 10 years now and because they both have heart conditions, they have had much experience with National Health Service. When asked about it, she assured me that it was definitely not free. It maybe free for the unemployed or for all the tourists who may use NHS, but for others, it comes out of tax dollars. She expresses that socialized medicine is a great system, but it is simply overused in Britain and there are more people than it was designed to support. Appointments are difficult to come by, sometimes two weeks to see a doctor. And they are limited to 10 minutes, which is unrealistic for a medically uneducated public. In addition, she says that preventative care is almost non-existent even for common screening such as diabetes, blood cholesterol, and heart disease. You only get tested if you complain of something or indicate pain. And test results arrive through "snail mail" (no phone calls) and only if something abnormal shows up. Furthermore, the wait time for an angioplasty (common heart disease procedure) was up to 18 mos., where in CA it is diagnosed and fixed in the same day.
Along with NHS they also use private health care, where they pay 100GBP for an appointment. They use NHS if they don't need immediate attention, but go private if there's anything serious or potentially life threatening- "just because we are under the probably misguided impression that we will get better care if we are writing a check for it"
Since medical care is so expensive in the US, my cousins probably wont be able to afford it if they ever decide to move back, especially since they both have pre-existing heart conditions. Their assessment of NHS is that it will save your life if you're in need of emergency treatment. Which is something you'd expect an overburdened system to do, take the critical cases first. Of course it is a lot easier to list off what you don't like about the system, than it is to list the good. And I'm sure that cons to the US health care system would be a lot longer.
My cousin and her husband have lived in London for about 10 years now and because they both have heart conditions, they have had much experience with National Health Service. When asked about it, she assured me that it was definitely not free. It maybe free for the unemployed or for all the tourists who may use NHS, but for others, it comes out of tax dollars. She expresses that socialized medicine is a great system, but it is simply overused in Britain and there are more people than it was designed to support. Appointments are difficult to come by, sometimes two weeks to see a doctor. And they are limited to 10 minutes, which is unrealistic for a medically uneducated public. In addition, she says that preventative care is almost non-existent even for common screening such as diabetes, blood cholesterol, and heart disease. You only get tested if you complain of something or indicate pain. And test results arrive through "snail mail" (no phone calls) and only if something abnormal shows up. Furthermore, the wait time for an angioplasty (common heart disease procedure) was up to 18 mos., where in CA it is diagnosed and fixed in the same day.
Along with NHS they also use private health care, where they pay 100GBP for an appointment. They use NHS if they don't need immediate attention, but go private if there's anything serious or potentially life threatening- "just because we are under the probably misguided impression that we will get better care if we are writing a check for it"
Since medical care is so expensive in the US, my cousins probably wont be able to afford it if they ever decide to move back, especially since they both have pre-existing heart conditions. Their assessment of NHS is that it will save your life if you're in need of emergency treatment. Which is something you'd expect an overburdened system to do, take the critical cases first. Of course it is a lot easier to list off what you don't like about the system, than it is to list the good. And I'm sure that cons to the US health care system would be a lot longer.
One-sided Opinion
I haven't really been exposed or took the time to research the disadvantages that come with a universal health care plan for our country. I must admit that I have supported the idea of such a plan due to the information that I have been exposed to and experienced as an American involved in the health/medical field. Consequently, I took the time to look into advantages and disadvantages and came across a posting that pretty much put together a lot of what I read (see below). Moreover, I realized that the overarching opinion is simply better access to health care for more Americans... if there is a better approach than universal health care, then so be it.
Advantages:
Every citizen would be covered under a national united health care system and administrative costs could be drastically reduced. According to the article Make Healthcare a Right. It's Cheaper! by By John R. Battista, M.D. and Justine A. McCabe, Ph.D., studies have shown that with a publicly administered system health care costs would have been reduced in Connecticut by two billion dollars in 1999 by the reduction of administrative costs along with other different medical buying techniques such as buying medications in bulk.
Disadvantages:
Income taxes would increase and private insurance companies may be put out of the health care administrative business. Not to mention many Americans are worried it is just another route to socialism so therefore taking away private health care is un-American.
sicko
I have never personally experienced health care in a foreign country so I asked my coworker who moved to the states from Taiwan what her impression of health care there was. She said that everyone has access to health care in Taiwan. Primary care and basic pharmacy needs are met at no cost to all citizens. Surgeries and more advanced care came at a cost of 10% to the patient. I asked her what might happen if someone couldn't afford the 10% copay and without any hesitation she said they would be provided for somehow. In America we would never make that assumption because in reality we know that when catastrophic medical events occur people sometimes don't get help and end up bankrupt or under treated. As we were finishing our discussion of health care in Taiwan, my coworker said, in answer to my question of whether she thought America could function like her country, "No, because of the caste system that exists in America".
I have had the benefit of working in a few different areas of our healthcare system and am aware of many of the pros and cons that we have to offer. There is a definite negativity regarding expenses and access to care in our country, however, we do have some of the best technology and treatments available for some of the most intense and debilitating diseases. In comparison to foreign systems, there is much of the same talk among its own citizens.
What I have heard and experienced is interesting. During my 7 months spent living in Australia, I learned that the Aussies HATE their medical system and it is quite difficult to receive the best care. It appears as though the quality of the clinicians is inferior to the US, England or France. Many of the Aussies feel slighted by the healthcare system and most of my friends I met there hadn't been to a doctor in years. They told me that most people, unless something is clearly serious, they just ignore it and hope it goes away.
As for the UK, I have encountered many in my travels that love the system they have. It is easy to find a doctor and they don't have to pay-so citizens often wonder why they would want anything else. Interestingly enough, many of the English say that they view their healthcare system so positively because many have not experienced anything other than their own.
On a personal level, it is hard to say which system one would prefer if they have never had the benefit of experiencing both sides. The problem with our system is that the US does have such an advantage with the medical technology and advances that we have available to our patients-but have we almost given too much and now we cant support it? It will be interesting to see if these other countries reach this point as well.
Same thing happens in China
I learned a lot about the U.S health care system from this course, and found that actually people in China are facing the similar problem. Medical services are extremely expensive for those poors who live in rural areas. One visit to local hospital may cost all their savings, not to mention there're so many unnecessary services. For those in big cities? Maybe a surgery will take away one year's income.
What's worse, most people dare not challenge the authority of physicians. You do what they say, that's all. I don't know whether it happens in U.S., but it's an unspoken rule to give bribes to surgeon if you have a surgery. For those low SES families, this is an extra cost. It's not because you want the surgeon to treat you more carefully, it is because everybody else are doing the same thing......
The industrialization of education system in China has already caused many problems, making poor children harder to go to school. And now the health care sytem has the same trend. It's hard to imagine that the money we cannot even afford the education of our children and the medical service but it's happening. I could only wish that I live healthily.
I've been to Canada twice in my life. It's cold, basketball is NOT a popular sport, and there is only like 1 golf course in the country. There are a lot of negative things about Canada, but damn it the health care system is pretty enticing. My cousin's wife (who lived in Canada at the time) was on maternity leave from her work. She got 9 months off from work, and got paid from the government for the time off. Moreover, during her first few post-baby months she continued to receive aid and tax breaks from the government. Oh and by the way she didn't have to pay a single penny (or loony) for the coverage she received.
Certainly, such a generous system does not exist in the US, and if it did, it would probably make a lot of people unhappy with the extremely high taxes that would follow. And I guess that is the issue with a universal health care system; with so many people covered, something in the system is going to be compensated (i.e. higher taxes, poorer quality of health care, ect.) So there is certainly going to be some catch-22 action happening.
If there's one thing we should keep in mind about health care it's that the cost of health care is going to keep rising at an astronomical rate. With the new administration taking office that seems quite eager to initiate a health care reform and with the nation's economy in shambles, the next step we take on health care might be one of, if not the most critical. As for me, I do not currently have a pregnant wife living with me so the high costs associated with delivering and taking care of a baby do not bother me that much. And since I'm not in Canada you can find me running a pick up basketball game or playing golf at my local golf course, cigar in hand.
Certainly, such a generous system does not exist in the US, and if it did, it would probably make a lot of people unhappy with the extremely high taxes that would follow. And I guess that is the issue with a universal health care system; with so many people covered, something in the system is going to be compensated (i.e. higher taxes, poorer quality of health care, ect.) So there is certainly going to be some catch-22 action happening.
If there's one thing we should keep in mind about health care it's that the cost of health care is going to keep rising at an astronomical rate. With the new administration taking office that seems quite eager to initiate a health care reform and with the nation's economy in shambles, the next step we take on health care might be one of, if not the most critical. As for me, I do not currently have a pregnant wife living with me so the high costs associated with delivering and taking care of a baby do not bother me that much. And since I'm not in Canada you can find me running a pick up basketball game or playing golf at my local golf course, cigar in hand.
So, who really IS the best?
To be quite honest, this class has been my first major introduction to the US and other health care systems around the world. Considering what little background in this topic that I have, there hasn't been much that I've learned about other health care systems. The extent of my knowledge of other health care systems spans only as far as Canada. I've heard that since they do function as a Universal Health Care system, it has its pros and cons in comparison to our system. On the upside, they are able to provide coverage to everyone, regardless of employment status, which is becoming a bigger and bigger issue here now that thousands of people are being laid off of their jobs. But, on the flip side of that, I've heard that access-wise it is just as difficult to schedule appointments for people without private insurance in Canada as it is for people here as well. So in trying to reform our current health care system, it will be interesting to see how Obama and Co. will weigh all of these pros and cons versus each other to come up with the best solution possible. As far as our health care system goes, growing up I always heard and read that our health care system was the place to be if you became ill. If you had the proper means to, you would be able to access the best services and quality of care for your money. Sure, we still pay through the roof for most of these services, but the fact is that quality-wise I feel that we do rank amongst the best. I had never heard of the movie Sicko until I read in the syllabus that we were going to be watching it this week so I think it will be really interesting to learn more about these other systems to see if anyone really comes off as having the BEST system.
money talk$
so throughout the years, I've gone to different shops to have some work done on my car. what I find as a general consensus is that the places that you can get the cheap work done for is on a lower echelon than those who you pay top dollar for. thats how it is, usually. there may be every once in a while where a cheap shop will hook you up or just take their time for some reason on yours and do a very good job. however it is not really in their best interest because theyre trying to pump cars in an out of that place to get their work done.
this is kinda what ive heard about the health care system in other countries. of course they are cheaper, if not free, especially compared to the US health care system. however, it might be a case of you get what you pay for. you know that in the US, most of the time if you can afford it the high cost health care, you will pay for it and have a good sense of knowing that you will decently get taken care of. however, when you go to or hear about the services at public hospitals, where the services are provided at low or no cost, then you know that there is that side of the coin also. I have heard from many that in these other countries, although the health care is provided at minimal or no cost, they sometimes feel that any type of care should be acceptable because the patients are getting it for free. after all, what motivation do they have to give better services when they arent really getting much out of it?
i have not yet seen sicko, but i guesssssssssssss ill see what all the hype is about. i know that our health care system isnt tip top, so ill see what else mista moorizzle has to knock on it, and how he'll portray the ressssssssst of the systems.
The Necessary Choice Between Evils
I completely agree with superwoman that there is no "free lunch" in healthcare; that is, that every service has an intrinsic value and thus an intrinsic cost. I feel that Americans, with our conflicted sense of capitalism, have the paradoxical tendency to not only criticize "for-profit" insurers or providers for changing too much for too many unnecessary services, but also for attempting to contain costs by cutting those services (for instance, by setting up managed care programs). There seems to be no winning for these people--if they increase prices, the public is upset because high costs inhibit universal access. But if they turn around and try to decrease costs instead, the public is still upset because cost containment limits individual choice.
The problem is that we want everything. If you put together every goal that American healthcare reform has ever touted in the past several decades, the final product that we are all working towards would look something like this:
Comprehensive healthcare services (including catastrophic coverage) available to all US citizens regardless of health status or income level, with little or no share of cost, accessible at any time, with little or no wait, performed in compliance with the highest quality standards, and with no limits on provider choice or utilization.
Is there anyone on the planet who doesn't want this? I want this. I want this in the same way that I want there to be a limitless source of clean and renewable energy that costs nothing to generate. I want this in the same way that I want there to be infinite tracts of farmland on which to grow crops year-round without using water, soil, or pesticides, and from which food can be distributed instantaneously to every person on Earth at no charge.
But while we can all agree that an infinite supply of energy and an infinite supply of food are both absurd notions, I think there's some hesitation to admit that an infinite supply of healthcare is equally impossible and absurd.
I've seen Sicko before, and it seems to imply that other countries (most of them socialist) have achieved the ultimate healthcare dream: limitless, universal, comprehensive, affordable care. But they have not. Like many of the people who've posted here, I've lived in England and heard many stories about people forced to delay care due to extreme wait times. I've talked to doctors in the UK about the enormous administrative burdens due to government bureaucracy. But the point here is not that they have failed to create a better healthcare system than ours, or that their problems are just as bad, if only different, or that we are all at fault because none of our healthcare systems are up to scratch in the final analysis.
The point is that none of our healthcare systems will ever be up to scratch--not if we're trying to create the kind of perfect (and therefore absurd) product I described earlier. Healthcare services will always cost something because someone has to manufacture the equipment, build and maintain the hospitals, create and distribute the drugs, make the diagnoses, and render the treatments. This means that someone else must always be paying it. When someone walks into a Swedish hospital and gets "free" care, the care isn't free at all: the person is simply paying higher taxes in exchange for a $0 co-payment. Healthcare is not free, and can never be free, because resources are finite. The question posed in healthcare reform shouldn't be, "how can we produce free and unlimited healthcare?" but "how can we best organize our payment and service structures to make do with what we have?"
What that means is that, however unwilling we may be, we must choose between evils--do we want people to pay only for what they need, or do we want to pool risk and force people to pay for what others need? Do we want more choices or higher cost? Are we willing to take on a single-payer system in exchange for longer wait times? And so on.
Sicko gives the impression that America is morally handicapped because we have made some of these evil choices and other countries have not. I think it's closer to the truth to say that we have made some of these evil choices, but unfortunately, we have not made them as well as some other countries have done. But to say such choices are unnecessary is not only false but also dangerous; it undermines health reform instead of advancing it.
The problem is that we want everything. If you put together every goal that American healthcare reform has ever touted in the past several decades, the final product that we are all working towards would look something like this:
Comprehensive healthcare services (including catastrophic coverage) available to all US citizens regardless of health status or income level, with little or no share of cost, accessible at any time, with little or no wait, performed in compliance with the highest quality standards, and with no limits on provider choice or utilization.
Is there anyone on the planet who doesn't want this? I want this. I want this in the same way that I want there to be a limitless source of clean and renewable energy that costs nothing to generate. I want this in the same way that I want there to be infinite tracts of farmland on which to grow crops year-round without using water, soil, or pesticides, and from which food can be distributed instantaneously to every person on Earth at no charge.
But while we can all agree that an infinite supply of energy and an infinite supply of food are both absurd notions, I think there's some hesitation to admit that an infinite supply of healthcare is equally impossible and absurd.
I've seen Sicko before, and it seems to imply that other countries (most of them socialist) have achieved the ultimate healthcare dream: limitless, universal, comprehensive, affordable care. But they have not. Like many of the people who've posted here, I've lived in England and heard many stories about people forced to delay care due to extreme wait times. I've talked to doctors in the UK about the enormous administrative burdens due to government bureaucracy. But the point here is not that they have failed to create a better healthcare system than ours, or that their problems are just as bad, if only different, or that we are all at fault because none of our healthcare systems are up to scratch in the final analysis.
The point is that none of our healthcare systems will ever be up to scratch--not if we're trying to create the kind of perfect (and therefore absurd) product I described earlier. Healthcare services will always cost something because someone has to manufacture the equipment, build and maintain the hospitals, create and distribute the drugs, make the diagnoses, and render the treatments. This means that someone else must always be paying it. When someone walks into a Swedish hospital and gets "free" care, the care isn't free at all: the person is simply paying higher taxes in exchange for a $0 co-payment. Healthcare is not free, and can never be free, because resources are finite. The question posed in healthcare reform shouldn't be, "how can we produce free and unlimited healthcare?" but "how can we best organize our payment and service structures to make do with what we have?"
What that means is that, however unwilling we may be, we must choose between evils--do we want people to pay only for what they need, or do we want to pool risk and force people to pay for what others need? Do we want more choices or higher cost? Are we willing to take on a single-payer system in exchange for longer wait times? And so on.
Sicko gives the impression that America is morally handicapped because we have made some of these evil choices and other countries have not. I think it's closer to the truth to say that we have made some of these evil choices, but unfortunately, we have not made them as well as some other countries have done. But to say such choices are unnecessary is not only false but also dangerous; it undermines health reform instead of advancing it.
Nothings Perfect
For my group presentation, we are comparing UK's healthcare system against ours. In order to get a better understanding (and a more personal perspective) I contacted one of my friend's who is a teacher in the UK and this is basically what he told me:
" So, all in all, I have benefited from the NHS.
On the flip side it is extremely poorly managed and is under constant attack from the press and the public. Nurses are poorly paid (around 20,000 a year) whilst GP's receive 100,000 a year. It is nearly impossible to arrange a convenient time to see your GP due to massive patient lists and workloads so that I often just don't bother unless it is serious. Many patients for operations are put on massive waiting lists, often waiting up to years for operations. There is a lack of communication and true co-ordination between all the major departments and agencies which create the NHS. This is trying to be remedied by a massive database that can be accessed from all medical establishments, but despite this costing numerous billions, it still doesn't work properly and raises questions of confidentiality. The state of the hospitals can be quite horrific but this varies from place to place. Lack of cleanliness has seen a rise in superbugs in the wards, most notably MRSA. Public opinion sees the NHS as a free hospital for anyone in Europe funded by the British taxpayer. Many people travel to the UK to use the NHS for healthcare and then simply disappear back to their home country and avoid paying any costs which is a massive financial burden. There are numerous reports you can look up on this.
To couteract the points above many companies offer their employees private healthcare. So despite paying into this masive system many people also pay an additional £50 odd pounds a month to companies like PRUHEALTH and BUPA so that if they need attention they will receive a much higher level of care. I myself have been a member of PRUHEALTH in the past and also paid to see a private GP when fed up of a recurring skin problem which was remedied within a couple of weeks of going private, but dragged on for two years under state health.
I think, to summarise, that a person's experiences of the NHS vary greatly depending on what happens to them, where it occurs and where they are taken. Also where someone lives in the UK can have a huge influence. I believe the NHS is a fantastic idea, and functions considerably well, all things considered. However, it has become too large and unwieldy and thus loses a lot of money through over-management and misplaced funding"
" So, all in all, I have benefited from the NHS.
On the flip side it is extremely poorly managed and is under constant attack from the press and the public. Nurses are poorly paid (around 20,000 a year) whilst GP's receive 100,000 a year. It is nearly impossible to arrange a convenient time to see your GP due to massive patient lists and workloads so that I often just don't bother unless it is serious. Many patients for operations are put on massive waiting lists, often waiting up to years for operations. There is a lack of communication and true co-ordination between all the major departments and agencies which create the NHS. This is trying to be remedied by a massive database that can be accessed from all medical establishments, but despite this costing numerous billions, it still doesn't work properly and raises questions of confidentiality. The state of the hospitals can be quite horrific but this varies from place to place. Lack of cleanliness has seen a rise in superbugs in the wards, most notably MRSA. Public opinion sees the NHS as a free hospital for anyone in Europe funded by the British taxpayer. Many people travel to the UK to use the NHS for healthcare and then simply disappear back to their home country and avoid paying any costs which is a massive financial burden. There are numerous reports you can look up on this.
To couteract the points above many companies offer their employees private healthcare. So despite paying into this masive system many people also pay an additional £50 odd pounds a month to companies like PRUHEALTH and BUPA so that if they need attention they will receive a much higher level of care. I myself have been a member of PRUHEALTH in the past and also paid to see a private GP when fed up of a recurring skin problem which was remedied within a couple of weeks of going private, but dragged on for two years under state health.
I think, to summarise, that a person's experiences of the NHS vary greatly depending on what happens to them, where it occurs and where they are taken. Also where someone lives in the UK can have a huge influence. I believe the NHS is a fantastic idea, and functions considerably well, all things considered. However, it has become too large and unwieldy and thus loses a lot of money through over-management and misplaced funding"
Better Healthcare Experiences Elsewhere
I have watched SICKO in the past and before that watching it, I never really thought about other country’s health care systems. I figured that if healthcare had to be paid for in the U.S., it would be the same elsewhere. Nothing is free anywhere right, especially not health care, I thought. My family and I have received health care through private insurances, Medi-Cal, and the free community clinics at some point in my life. My experiences with all of them have some criticism to each. With insurance, it was always expensive as far as premiums and deductibles. Co-payments were reasonable but when we had to pay for prescriptions it sometimes became expensive. With the Medi-Cal we always had to get approval for certain services, go to certain clinics, wait months for appointments, and sometimes by then our income levels rose and we would be dropped from the program. With free-clinics, for available appointments you have to schedule months ahead, and drop-in waiting time ranges from 2-4 hours, with appointments you still have to wait at least an hour and then most specialty services are not free.
As for the healthcare in other countries, I have heard a few stories and have a few of my own. Four years ago, I decided to study abroad. Before our departure, our school offered us an insurance to buy for our stay. I rarely get sick so I didn’t think I needed the insurance. I left to Italy without insurance. During my stay, I got sick once and as I walked into the doctors office I waited no more than 20 minutes, saw the doctor, got my prescription and then asked the doctor what the fee was for the doctor’s visit. To my surprise, she said I had to pay nothing. I thanked the doctor and left quickly thinking there probably was a mistake. To what I remember the medicine I purchased was not as expensive as I expected from U.S. prices. My friend’s father went to London to visit family about 6 years ago. During his visit he got really ill from pneumonia and needed to be rushed to the hospital. His emergency visit and services cost him nothing. I believe he only had to pay for prescriptions. When I hear stories, such as these I wonder how much the U.S. would improve the health of individuals if services weren’t so expensive and inaccessible.
As for the healthcare in other countries, I have heard a few stories and have a few of my own. Four years ago, I decided to study abroad. Before our departure, our school offered us an insurance to buy for our stay. I rarely get sick so I didn’t think I needed the insurance. I left to Italy without insurance. During my stay, I got sick once and as I walked into the doctors office I waited no more than 20 minutes, saw the doctor, got my prescription and then asked the doctor what the fee was for the doctor’s visit. To my surprise, she said I had to pay nothing. I thanked the doctor and left quickly thinking there probably was a mistake. To what I remember the medicine I purchased was not as expensive as I expected from U.S. prices. My friend’s father went to London to visit family about 6 years ago. During his visit he got really ill from pneumonia and needed to be rushed to the hospital. His emergency visit and services cost him nothing. I believe he only had to pay for prescriptions. When I hear stories, such as these I wonder how much the U.S. would improve the health of individuals if services weren’t so expensive and inaccessible.
Is the grass really greener on the other side of the border?
I'm not so sure that it is. I know that the US pays through the roof for medical care that I doubt any of us would call perfect, but I also know that Canada struggles with a lot of problems that we don't necessarily notice when we notice their publicly-funded health care system.
My mom is Canadian, and her entire family lives in Canada -- mostly the greater Vancouver area, so we're not talking rural farmland here. I spent a LOT of time up there growing up, and have two relatives who are successful in their medical careers, as well as relatives who've had a million health problems. I think I have a pretty good idea of some of the benefits as well as the drawbacks to the Canadian system.
First of all, they have the public system called Medicare, but they also have a private sector that provides insurance through employers, similar to the US, for dentists, optometrists, some prescription coverage, and also allows you to effectively "buy" yourself better access to health care. This means you jump to the front of wait lists for appointments, you get to choose better hospitals, and better physicians. This seems odd to me.... if the system is supposedly a single-payer system that a lot of people see as being superior to the US, then what about the advantage that some people get just because they get a second health plan through their employer? Now, I'm not saying that the public system is inferior to ours, because personally I think the opposite, but it's not truly a single-payer system, if there is private insurance in the mix, is it?
Secondly, I cannot tell you how many times I've been to Vancouver and seen the nurses on strike. I understand the idea that they need to be fairly compensated for the care they are providing, but what does it say about your health care system when the nurses walk out of the hospitals and their patients because they don't like the amount they are making and the extent to which they are overworked? It doesn't sound like everything is better. There is a huge shortage of nurses and the like up there, and it never gets better. There is a lack of funding to the point where the Vancouver General Hospital, which is supposed to be the best in the area, has to close a huge part of its (new in the last 10 years) facility because they don't have the staff to operate it. This leaves the people without the best care possible. Sure, ambulance rides are covered, prescription drugs are covered, but when there aren't enough beds, doctors, or nurses, I don't think their system is quite what we glorify it to be.
Finally, their rate of health care spending is second only to ours. That's not saying much, since we are so much higher than all the other developed countries. However, to be fair, the numerous medical problems that have struck my family members haven't bankrupted them, even though they dealt with most of these after they were retired. Their comprehensive coverage actually is pretty comprehensive, if they could get in to see their doctors. I hate to say it, but I am pretty sure that my relatives in the medical field pulled a few strings to make sure that my sick relatives got in to see the right doctors at the right time. I hate to think what would have happened if they hadn't had that connection.
I think there are actually some benefits to our health care system here in the US, but mainly IF you have the right coverage and live in the right area. I think there are also many areas that need vast improvements, as we've been talking about this semester. I know Canada has a different/better overall system of delivering care, but I also have seen the improvements that they need to make. Are they further along in the right direction than the US? Probably. But they have a few things that could be fixed as well.
Hot tub chatter
While recently seeking resuscitation for my tired muscles at my complex's hot tub, I got to talking with Los Angeles transplants from Toronto, Ontario. Hot tub banter is of course a favorite past time of mine, and being that PM508 has made health care an important issue on my radar, I got to talking with my neighbors about their health care experiences in both countries.
They expressed their sentiments very clearly: if you can afford health care in the United States, it is bar-none the best they have experienced. They went on to say that on the whole, Canada offers tremendous care on the aggregate and to EVERYONE, but that wait times are often horrendous, even laughable. One of the young man's grandfather waited in vain for a heart transplant that never came.
A contrasting personal story: My grandfather happened to be a dear friend of the famed heart surgeon, Dr. DeBakey. When he needed a new heart, his friendship with DeBakey proved to be beneficial, as he some how moved up a number of spots on the transplant list. He was, at the time, the oldest heart transplant recipient on record (age 74). There is no way that he would have received a heart without having the connection that he did, and in a system run entirely by a single payer.
So these stories illustrate a catch-22, and if we reform the current system, we need to weigh the good with the bad, which of course is easier said than done.
Thoughts on what I have heard about the health care system in Canada, England and France. When I get pregnant I want to move there…hehehe..I would not mind having someone come and help me do laundry and clean up while I take care of mommy duties. I also would not mind having a doc come and take care of me in the middle of the night. I have seen the movie however I have never received services from any of these countries. If the movie portrays it this way, there must be some truth to it as well as some hidden cost we Americans are not full aware of or simply would not want to pay. I look forward to watching the movie for the second time and checking out things I missed the first time.
health care system in sweden and taiwan
In addition to a lecture on health care workforce issues, we are going to watch SICKO, which paints an idyllic picture of health systems in Canada, England, and France. I want us to watch this film with a critical eye, so what do we know about these systems already? Tell us what you've heard, have read, or have even experienced (or what your "friend who once knew this guy who..." has experienced). What are your thoughts about what we know or have heard?
My brother's friend's aunt lives in Sweden, and she has big problem with Sweden's health care system, and it might applies to many other European countries. She complained that she one time had a severe cavity but her appointment was two months after (can you imagine by the time she finally got to see her dentist, her teeth probably already fall off and nerves already dead). She also shared another story about a friend of hers went to ER due to some acute infection, however, the friend had to wait for at least a week till she get to see the doctors. It is so ridiculous and make me wonder what Swedish' doctors are doing?? Maybe that make me feel a little better about the health care system in the U.S, but I know some other countries such as my own country- Taiwan has a much better health care system than both the U.S and Sweden.
In Taiwan, I can get to see doctors whenever I want, there are clinics open everywhere and walk-in is always welcome. And you only need to pay less than $2 U.S dollars to see a doctor/dentist each time, because rest of the pay are cover by the government. It is a much more convenient system but I guess it is due to the culture difference between Asian countries and European countries...the work ethics and goals are different.
My brother's friend's aunt lives in Sweden, and she has big problem with Sweden's health care system, and it might applies to many other European countries. She complained that she one time had a severe cavity but her appointment was two months after (can you imagine by the time she finally got to see her dentist, her teeth probably already fall off and nerves already dead). She also shared another story about a friend of hers went to ER due to some acute infection, however, the friend had to wait for at least a week till she get to see the doctors. It is so ridiculous and make me wonder what Swedish' doctors are doing?? Maybe that make me feel a little better about the health care system in the U.S, but I know some other countries such as my own country- Taiwan has a much better health care system than both the U.S and Sweden.
In Taiwan, I can get to see doctors whenever I want, there are clinics open everywhere and walk-in is always welcome. And you only need to pay less than $2 U.S dollars to see a doctor/dentist each time, because rest of the pay are cover by the government. It is a much more convenient system but I guess it is due to the culture difference between Asian countries and European countries...the work ethics and goals are different.
Sicko
I've seen Sicko and I have to say that I was really impressed when I watched it. However, the more I talked to people about the issue, the more I realized how many dimensions were lost in the documentary. I don't have any personal experience in health care in other countries but I have heard a complaint that many people have brought up already. Many people I've talked to have brought up the issue of long waits for medical care. Yes, the services are there and available, but they can often take a long time to receive. People really do have to wait in line to get treated and if you're far down the line, good luck. I'll be honest and say I don't really know of the details of the issues but I do recognize that Sicko is far from a viable source of information on the subject. I can't wait to hear where the discussion takes us.
The no-free-lunch saying rings true with me, but wait there is more!
Your second sentence is interesting to me, superwoman, because I thought the very same thing. Ever since I saw this movie, I could seriously consider moving to another country. Still, I realize that there is no "free lunch" anywhere but that is what inspires me to want single payer or universal health care for the US even more. Ultimately, it is a matter of what route the county's economy is going to take, but with an added bonus if it does the universal/single payer plan. If not paying for health insurance through higher taxes we are paying for it from our own sales taxes and personal payroll. For example, each USC student currently pays about $935 a year. According to the National Coalition on Health care about 80% of US population has health insurance. If those people, through some way or another, hypothetically released and pooled their yearly premium money together, assuming a US population of 300 million, it would add up to at least 240 billion dollars a year, payable to a kind of universal/single payer health insurance. The bonus being able to cover the other 20% who are currently uninsured.
When I see the movie, for the second time, tomorrow I am going to question every positive aspect of universal health insurance. Our country's own form of single payer health insurances are not doing so good. I was talking to a friend yesterday who's doctor she works due to plan reimbursements does not accept Medicaid because it pays too little but does accept and barely makes her money back with Medicare. If we ever switch to a single payer or universal health plan, we need to make sure this will not happen. In a way Medicaid and Medicare are mini experiments for single payer and that worries me, just a little bit, shh don't tell anyone!
When I see the movie, for the second time, tomorrow I am going to question every positive aspect of universal health insurance. Our country's own form of single payer health insurances are not doing so good. I was talking to a friend yesterday who's doctor she works due to plan reimbursements does not accept Medicaid because it pays too little but does accept and barely makes her money back with Medicare. If we ever switch to a single payer or universal health plan, we need to make sure this will not happen. In a way Medicaid and Medicare are mini experiments for single payer and that worries me, just a little bit, shh don't tell anyone!
There is no such thing as a free lunch
I’ve seen Sicko numerous times for previous classes in Ethics, Human Rights, and even Philiosophy. After watching the film the first time, I was very much galvanized to move to France or Canada for better security in public healthcare. The film stresses that access to healthcare is not a daily worry for people outside of the U.S.because their governments securely provide universally healthcare for their citizens. We on the other side of the spectrum view healthcare access as a luxury affordable and available to a few elite. I have a family relative who immigrated here to the U.S. and is working as a domestic house keeper. Unable to access health insurance through her employer and clearly unable to pay fee for service rates for healthcare, she takes care of all her dental and primary care needs when she returns to her native country since fees there are much cheaper. I have even heard of citizens who have been living and working in the U.S. for years who still resort to travelling to Mexico or the Philippines to get dental work and surgeries done for a cheaper price because the cost of healthcare service here in the U.S. is obscenely high. Although other countries may provide comprehensive access to healthcare and are more generous with maternity leaves and time away from work due to illness, I’ve heard that taxes are extremely higher in those nations. So where they are successful in healthcare, citizens still pay higher taxes out of their pocket to serve the better of the whole public….”There is no such thing as a free lunch”…”There is no such thing as universal healthcare” anywhere…….
Monday, March 9, 2009
My Thoughts
To be quite honest I had not heard much about these systems prior to coming to USC. I had a friend tell me that I HAD to watch SICKO. I knew that any Michael Moore movie would be very opinionated and bias, so I was reluctant to watch it. The little that I have heard about other health care systems is always about how they are more efficient than ours. I am a fan of Universal Health Care, but I don’t believe that we should copy the model that works in another country because it may not work here. I have heard that to be an allied health care professional and get paid well it is better to practice in the United States compared to Canada. I also think that it is very interesting that people having “better” health coverage in other countries still come to the US to have procedures done. I must say that if I was very sick I would want to be in the US to get the best care, because of some stories I have heard about the care that goes on in other countries.
England's Health Care
Like Amy, I've heard of people coming from Canada to the States to get treatment... but that's as much as I've heard. However, my sister recently came back from doing her rotations at a hospital in London so I've gotten to hear a little more about England's health care system. Based on her experience, the system overall is good and provides adequate services. However, long waits for major treatments are a huge complaint. Also, based on her opinion, the system as it is now will not last much longer. The government is spending more money on health care than what is coming in due to loopholes that have been depleting their sources. This is occurring despite the fact that people pay taxes for everything... including television taxes.
thoughts
I've seen sicko before and it definitely makes it seem that the healthcare system in the US is really horrible and the universal health systems in canada and europe are perfect in most senses. From friends who are from europe, most of them complain that the healthcare in the US sucks, especially for women's maternity leave and other related healthcare. The comment they often make is that it seems no one respects women and care for all they do to continue the human race. In any case, some other friends also say that it is a hassle in the system sometimes. My father's friend from Canada needed a surgery and instead decided tried to come to the United States to do it because he would never be able to get the surgery done in Canada until it was his turn in line. He said he didn't get to have the choice to have things done sooner because it was universal health care and he wished he had the choice because he really felt like he needed it.
What my Grandmother Told Me...
Here's the story:
My grandmother and grandfather were celebrating their 50th Wedding Anniversary, and my parents and I had a fabulous celebration idea! Reunite my grandmother with her sisters in Paris, and be able to celebrate the wedding anniversary there. My grandfather, grandmother and I all went to Paris (my parents couldn't make it because of there work schedule) and celebrated one hell of an anniversary. It was one of the greatest moments of our lives - a joyous occasion beyond measure. However, two days before her scheduled return to the States, tragedy struck. Fluid build up in her lungs lead to her having congestive heart failure and admittance to one of Paris' hospitals. Here, the nurses and doctors did chest x-rays, checked vital signs, drained the fluid in her lungs, and performed renal dialysis to address her condition. She was there for almost a month! She was not even a French citizen, and the hospital covered all her medical costs during that time (which accumulated to almost $40,000 U.S. Dollars). She was very happy with the care and service she received from the nurses and doctors in Paris. Since then, she has been admitted to the emergency room here in the U.S. several times as well for exhibiting similar, but less severe, symptoms (i.e. shortness of breath, congestion, chest pain/discomfort, etc.). Her reviews of how the nurses and doctors took care of her here in the U.S. were just as, if not more, favorable. Outstanding care, first rate technology, and ultimate comfort. So...
Here's the Verdict:
My grandmother is very lucky to be going strong in her 80s now, and although she has a long list of chronic conditions (you name it, she's got it), the marvels of modern medicine have taken very good care of her. I asked her about both experiences, and where she would want to be if such an incident occurred again. She had difficulty choosing, because of the outstanding care she received from both hospitals (a public hospital in Paris, and St. Joseph's Hospital in Burbank, CA). Overall, she gave a slight edge to the U.S. for better service, better technology, and more comfortable rooms/beds/overall conditions in the hospital itself. But it is important to emphasize her high praise for the care she received from both facilities.
Here's the Caveat:
My grandmother is a dual-eligible Medi-Medi patient (Medicare and Medicaid) and had access to all these great services in the U.S. She was "officially" and "financially" not entitled to receive the care she did in France, but got it anyway and was not charged a dime. If the roles were reversed, the story may not have been the same. We have great health care in the U.S. - the best service, technology and comfort it seems. But access to it is a big issue; unless you're one of those "lucky" Medi-Medi patients, you probably want to be in the city of lights with a glass of Bordeaux, riding down the metro to the cafes at Montmarte.
My grandmother and grandfather were celebrating their 50th Wedding Anniversary, and my parents and I had a fabulous celebration idea! Reunite my grandmother with her sisters in Paris, and be able to celebrate the wedding anniversary there. My grandfather, grandmother and I all went to Paris (my parents couldn't make it because of there work schedule) and celebrated one hell of an anniversary. It was one of the greatest moments of our lives - a joyous occasion beyond measure. However, two days before her scheduled return to the States, tragedy struck. Fluid build up in her lungs lead to her having congestive heart failure and admittance to one of Paris' hospitals. Here, the nurses and doctors did chest x-rays, checked vital signs, drained the fluid in her lungs, and performed renal dialysis to address her condition. She was there for almost a month! She was not even a French citizen, and the hospital covered all her medical costs during that time (which accumulated to almost $40,000 U.S. Dollars). She was very happy with the care and service she received from the nurses and doctors in Paris. Since then, she has been admitted to the emergency room here in the U.S. several times as well for exhibiting similar, but less severe, symptoms (i.e. shortness of breath, congestion, chest pain/discomfort, etc.). Her reviews of how the nurses and doctors took care of her here in the U.S. were just as, if not more, favorable. Outstanding care, first rate technology, and ultimate comfort. So...
Here's the Verdict:
My grandmother is very lucky to be going strong in her 80s now, and although she has a long list of chronic conditions (you name it, she's got it), the marvels of modern medicine have taken very good care of her. I asked her about both experiences, and where she would want to be if such an incident occurred again. She had difficulty choosing, because of the outstanding care she received from both hospitals (a public hospital in Paris, and St. Joseph's Hospital in Burbank, CA). Overall, she gave a slight edge to the U.S. for better service, better technology, and more comfortable rooms/beds/overall conditions in the hospital itself. But it is important to emphasize her high praise for the care she received from both facilities.
Here's the Caveat:
My grandmother is a dual-eligible Medi-Medi patient (Medicare and Medicaid) and had access to all these great services in the U.S. She was "officially" and "financially" not entitled to receive the care she did in France, but got it anyway and was not charged a dime. If the roles were reversed, the story may not have been the same. We have great health care in the U.S. - the best service, technology and comfort it seems. But access to it is a big issue; unless you're one of those "lucky" Medi-Medi patients, you probably want to be in the city of lights with a glass of Bordeaux, riding down the metro to the cafes at Montmarte.
U.S. vs. Canada
I have a friend that works at a rural hospital in Canada. Overall, she thinks that their health care system is very good. She says there is no paperwork for billing and scheduling an appointment to see a primary care physician only takes about 1-4 days. Other strengths would be that they have the freedom to choose their own family doctor and hospital in which they are treated. Their health care system also covers most services and they have the option of getting extra coverage for dental and prescriptions by going through employer benefits such as BlueCross. (They have to pay extra for those services) However, she says a major problem there is the shortage of staff which effects wait times and creates an increased patient to nurse ratio. She’s also noticing a trend where more people are being encouraged to go with an insurance company to get services as the government cuts down on coverage.
Sunday, March 8, 2009
In Canada...
While I am a proponent of nationalized healthcare, single payer systems, etc., I feel it's important to acknowledge that these systems are usually far from perfect. For example, I "know a guy who knew a guy" (actually it's my uncle who has a friend...) who lives in Canada, and while his Canadian citizenship entitles him to free medical care, including all the costs of the surgery for his "potentially dangerous but slow-growing cancer." Apparently, because my uncle's friend's tumor could potentially have become dangerous but was thought to be slow growing, he was told that his the earliest time he could have his operation was 3 months from the time he was diagnosed. While I can see the reasoning behind giving a "non-emergency" tumor lower priority (people who are at risk of iminent death should be first in line for care etc.), I can also see how perturbing it would be a for someone who was just told that they have a tumor that they would be unable to have it removed for at least 3 months. My uncle's friend flew to the states shortly after to have his operation done here.
On the other hand, I have a friend in Canada who recently told me about how they were sick during final exams, and that they managed to be seen by a doctor, get a prescription, and pick-up their medication (for free, of course) in less than 90 minutes. Maybe these systems are only beneficial if you have a cold?
On the other hand, I have a friend in Canada who recently told me about how they were sick during final exams, and that they managed to be seen by a doctor, get a prescription, and pick-up their medication (for free, of course) in less than 90 minutes. Maybe these systems are only beneficial if you have a cold?
US vs French Medical Care
I dont have a personal experience, but this is what I found when I was looking at what people think of the European health system.
I lived in the States for 18 years, I live in Europe now. I reside in Madrid but today I had a medical emergency while visiting Paris. It was so well taken care of that I would like to write an unusual post in favor of the French Health System. This is clearly a case and not a statistic but I will try to draw some general conclusions comparing the US and French health care experience.I will limit myself to three key elements of the medical experience, the quality of the medical care, the paperwork and the cost.
The case: I had a 3 cm cut on my chest that urgently required stitches. I was rushed to Hopital St Antoine which is not far from Place des Vosges where we have an apartment (my wife is French and we come frequently to Paris). I was successfully treated and sent home in less than 90 minutes.
During the years I lived in the States I had many occasions to go to hospitals mostly for two reasons: one is that I do a lot of sports and tend to get into silly accidents, the other because of my four kids three were born in the States. When you enter a hospital in America, you are greeted by a mountain of paperwork. The first surprise in France is that there´s no paper needed anywhere, no forms, no signatures. The French have developed what I would call the USERNAME system of medicine. Just like many web sites who just want you as a user and don´t really care about your real identity, the French Emergency Health care system is the same. They would like to know who you are but they do not need to know who you are when you are in a medical emergency. They only need to know that “whoever you are”, you are in danger and they treat you in a rush. As I had to go to the hospital without preparations, I did not have any documentation on me. As I walked in, I worried about this. The first good news was that there were no security guards at St Antoine, no ID was required. Secondly there´s absolutely no paperwork. I had never seen anything like that. You tell them your name, they believe you, you tell them your address, they believe you. They don´t ask you for medical insurance nor for any kind of payment and the whole admission takes at most 45 seconds. Compare this to the situation in America where while you are bleeding you have to hear about insurance, malpractice, payments, you have to fill out forms about allergies and medical history. Again I am one case and not a statistic, but this was indeed my experience after being hit by my opponent with a squash racket in the face and rushing to being admitted at Columbia Presbyterian in NYC (I told you I have silly sports accidents…). Here in Paris they did not care if I lived in France or not, nor that I did not have any documentation on me. They treated my injury with great professionalism and sent me home in less than 90 minutes. They were courteous, they did ask me of course if I had allergies or other usual medical questions but this was all done by the doctor before treating me. It was done as a medical procedure not as a legal requirement. From what I could see the legal system is mainly absent from French medicine. When it was all done it was shocking for me to leave the hospital without having to sign any release forms. The surgeon herself notified the administrative staff that I was done and she released me simply saying that I could go home without seeing anybody. But since I don´t pay taxes in France and everything had gone so well so quickly and free of charge, I felt like thanking everyone at the hospital and I did. They just smiled back probably thinking that I was some weird foreigner. The French see free medicine for all as a right and don´t make a habit of thanking medical care workers, something I feel is wrong as they earn half of what their American counterparts make and their work is mostly vocational.
http://english.martinvarsavsky.net/general/us-vs-french-medical-care-my-personal-experience.html
Saturday, March 7, 2009
Not always "idyllic"
I've never gotten sick while traveling (knock on wood!), so here's an anecdote about someone else:
Last year a family friend went on a study abroad trip to France. One weekend she decided to go horseback riding with some classmates. Long story short, she was thrown from her horse, and broke her leg.
Perhaps a native French person would have had an easier time of it, but my friend's parents had to jump through a lot of hoops to get treatment for her. First, there was a major language barrier. None of the hospital staff spoke Mandarin. When they tried to negotiate matters in English, the staff was even less accomodating. My friend did end up going into surgery in France, her family had to pay a huge sum, and she eventually flew back to the States to receive physical therapy here.
...Not quite the speedy, no-hassles-involved story that SICKO liked to portray. But then again, like I said before, my friend is not native to France, and her medical problem wasn't simple, so the whole process being quite complicated for her is not all that shocking.
In Asia I suppose it's a bit different because aside from the health care system, there are also traditional herbalists, who are considered in almost as high regard as physicians who practice Western medicine. Oftentimes there are longer lines and more crowded waiting rooms outside the OMD's offices; that's how popular they are. They are also more accessible. When both my parents came down with food poisoning in Taipei, we went to see an OMD, who simply took a physical, ground up some funky-looking roots and herbs, and sent us on our way. The whole process took maybe 40 minutes, and the only fee paid was for the medicine, which wasn't even expensive to begin with.
Last year a family friend went on a study abroad trip to France. One weekend she decided to go horseback riding with some classmates. Long story short, she was thrown from her horse, and broke her leg.
Perhaps a native French person would have had an easier time of it, but my friend's parents had to jump through a lot of hoops to get treatment for her. First, there was a major language barrier. None of the hospital staff spoke Mandarin. When they tried to negotiate matters in English, the staff was even less accomodating. My friend did end up going into surgery in France, her family had to pay a huge sum, and she eventually flew back to the States to receive physical therapy here.
...Not quite the speedy, no-hassles-involved story that SICKO liked to portray. But then again, like I said before, my friend is not native to France, and her medical problem wasn't simple, so the whole process being quite complicated for her is not all that shocking.
In Asia I suppose it's a bit different because aside from the health care system, there are also traditional herbalists, who are considered in almost as high regard as physicians who practice Western medicine. Oftentimes there are longer lines and more crowded waiting rooms outside the OMD's offices; that's how popular they are. They are also more accessible. When both my parents came down with food poisoning in Taipei, we went to see an OMD, who simply took a physical, ground up some funky-looking roots and herbs, and sent us on our way. The whole process took maybe 40 minutes, and the only fee paid was for the medicine, which wasn't even expensive to begin with.
Friday, March 6, 2009
Diagnosing American Health Care System-- and "Sicko" too
To add on what Howard had mentioned, I also found one interesting interview about various national health systems while listening to NPR.
In 2007, NPR's "Fresh Air" broadcasted a 39-minute interview with Jonathan Oberlander, a political scientist with expertise in health care politics and policy and the University of North Carolina at Chapel Hill. He mentioned “Sicko” in the interview as the jump off point for the discussion.
Listening to Professor Oberlander, I came away impressed that it was one of the most informed and dispassionate discussions of the U.S. health care system, as well as many of the other industrialized systems we have heard about.
If you want a straight down-the-middle 39-minute tour de force of leading international health care systems, as well as our own, give it a listen.
You can access it here.
In 2008, there was also a very good PBS program called,"Sick around the World". It was the "Frontline" Report on International Health Care, which was an hour long tour of the health care systems in Great Britain, Japan, Germany, Taiwan, and Switzerland and asked what can we learn from them. I also came away impressed with this hour long tour de force "Sick Around the World" program, which I found is a constructive contribution to US national health care debate.
I strongly recommend you spend an hour online watching, "Sick Around the World."
In 2007, NPR's "Fresh Air" broadcasted a 39-minute interview with Jonathan Oberlander, a political scientist with expertise in health care politics and policy and the University of North Carolina at Chapel Hill. He mentioned “Sicko” in the interview as the jump off point for the discussion.
Listening to Professor Oberlander, I came away impressed that it was one of the most informed and dispassionate discussions of the U.S. health care system, as well as many of the other industrialized systems we have heard about.
If you want a straight down-the-middle 39-minute tour de force of leading international health care systems, as well as our own, give it a listen.
You can access it here.
In 2008, there was also a very good PBS program called,"Sick around the World". It was the "Frontline" Report on International Health Care, which was an hour long tour of the health care systems in Great Britain, Japan, Germany, Taiwan, and Switzerland and asked what can we learn from them. I also came away impressed with this hour long tour de force "Sick Around the World" program, which I found is a constructive contribution to US national health care debate.
I strongly recommend you spend an hour online watching, "Sick Around the World."
National Public Radio's Health Care For All
I was listening to National Public Radio (NPR) when I was driving and I heard a story about an 89-year-old British World War II pilot. He was told by Britain's National Health Service that he would have to go blind in one eye before it would pay for treatment for his age-related wet macular degeneration, a disease of the retina that can progress rapidly. He eventually took on the government and got the treatment he needed.
This case could definitely happen in America, but I was struck by how the National Health Service of Great Britain pays for treatments. Like most people in Great Britain, the 89-year-old British World War II pilot gets his care through a tax-funded system. The physicians are paid by the government. The patients don't see a bill as long as the local government board approves the treatment. I was also surprised to find out that most treatments are approved.
I went to the NPR's website and found many other stories like this in the U.K., Germany, and other Western European countries (just click the links for different stories and click the links from different countries on top of the webpage): http://www.npr.org/templates/story/story.php?storyId=91971293
This case could definitely happen in America, but I was struck by how the National Health Service of Great Britain pays for treatments. Like most people in Great Britain, the 89-year-old British World War II pilot gets his care through a tax-funded system. The physicians are paid by the government. The patients don't see a bill as long as the local government board approves the treatment. I was also surprised to find out that most treatments are approved.
I went to the NPR's website and found many other stories like this in the U.K., Germany, and other Western European countries (just click the links for different stories and click the links from different countries on top of the webpage): http://www.npr.org/templates/story/story.php?storyId=91971293
If only we were like Italy...
Over the summer two of my friends went on a European tour for a month with Contiki Tours. The tour was set up so that they travel to different countries on a bus with the same 50 people the whole time. Because these people were together 24/7 for a month straight, whenever someone got sick, the whole bus got sick. Unfortunately, while they were in Italy, a few of the girls, including my friend, broke out in a really bad rash with bumps all over their arms. They were all rushed to the hospital to be treated and each received excellent treatment from the doctors. None of them had to pay a single thing. My friend said it was the weirdest experience to walk in and out of a hospital without having to pull out her wallet even once.
I think it's sad that so many other countries have free healthcare and America's is just getting more expensive. We should have the same system as Italy where anyone who walks into a hospital will be seen without having to worry about paying for their bills later. Healthcare should be a right and not a privilege.
Wednesday, March 4, 2009
Sick in America videos
Before we watch SICKO, you might want to view these "Sick in America" videos (there are six parts that add up to a total of an hour) to hear some of the strong opposing views in contrast with the film. I think the host of this 20/20 show on ABC sets up his interview with Michael Moore a bit like a boxing match to make this more entertaining, so hopefully its a little entertaining too.
Follow this link. If that doesn't work, go to http://video.aol.com and search for the video.
-GS
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