Saturday, February 23, 2008

Treat Others as You Would Be Treated

I've done it again, hired a documentary . . I watched Sicko . . hey the video shop has 4 for the price of 2 so I was pressured at the checkout to get another one.

Now firstly, I am VERY aware of Michael Moore's bias but this one wasn't quite as glib as Farenheit except for the Cuban stunt which was clearly done for dramatic purposes but it did make a point. What it brought to bear was the idea of socialised medicine, universal medicine vs pay your way. I'm not going to bash Americans here because 250 million of them have insurance and feel safely cocooned that they're covered for everything as long as they don't have a prior record of yeast infections. (For the record, a client of ours had a skiing accident and had she not been covered for a broken leg would have been charged $25,000 American Dollars for the surgery) It is clear that American citizens need to read the fine print very carefully and I've never, never heard of an insurance company 'changing their mind' after granting cover "oops, sorry, we found out that you scraped your knee in 1975 so you don't quality for a knee replacement".

It emphasised the principle that those who can, look after those who can't and I'm a strong proponent of that philosophy. Does that make me a socialist. I think not, I think it's human nature to help those in need or in a position of disadvantage.

I was very impressed by the bonus system offered to particularly British and French doctors for assisting in preventing disease. Now there's a revolutionary concept. I can't find out whether that exists here as we move towards a two tier health system.

In Australia, if I'm in a car accident or experience an emergency trauma and cannot pay - I don't. I choose to have health insurance because it guarantees the hospital and doctor of my choice for elective or non emergency surgery. Both my mother and my husband died in hospital after being rushed by intensive care ambulance and treated with every resource available. There was no bill even though we were covered.

If I'm all smashed up on Windsor Road, I'll likely be taken to Westmead or Blacktown but nobody will refuse to treat me, charge me through the nose or dump me on the street because I cannot pay.

What really interested me about this doco was France, Canada and Britain. They all have an NHS type system as do we (only more expansive $10 for a prescription of anything which exists here but PBS prescriptions are set at $25) but the French also offer Government sponsored child care and nanny assistance to new mothers. Six month paid maternity leave, five weeks annual leave and even a week to enjoy your honeymoon. Last time I looked, the French economy isn't suffering too badly for all it's social security payouts. Sure they, like us, pay higher taxes to cover the expense but I really like the idea that people look after other people who are less fortunate, it's the foundation of all religion and simple humanity.

I don't understand the anti-socialistic paranoia of the Americans. Well actually I can because their electoral system relies solely on donations to get candidates up. Therein lie the seeds for corruption and influence right in your face! Canada has a free health service. America's health service is inching above that of Slovinia! Patients are declined for the silliest of reasons.

Oz is in the top ten countries for health care, given a small population of only 20 million and the gargantuan size of the place, that's not half bad but we are in grave danger of following the US model. I found the absolute paranoia of the US government over many years amazing. They've never fought a war on home soil (except against each other), 7/11 terrible as it was has been blown out of all proportion and billions spent on defense, space stations, war, fucking Hollywood movies! Yet they don't look after their own in the simplest region of public health. According to the documentary in 1948 Britain, torn to pieces after the ravages of war, announced the NHS . . "if we can spend millions on war, why can't we spend millions on infrastructure and health?"

What was interesting about France is that it's people still have the verve to protest. They won't tolerate a government that doesn't serve their interests. In Australia, much like America we have lost that sense of public protest we have become lazy and complacent. We have an 'I'm alright Jack' and "not in my back yard" (NIMBY) attitude. How does a nation get to the point that they 'believe' what they're fed. The French have a reputation for being arrogant and dissident. Perhaps Australia and America should adopt that stance instead of just taking what's dished out to us. An affluent lifestyle has made us lazy and complacent.

I'd be interested to hear what my Northern Irish friends have to say about their health system as opposed to the Republic which appears to be in tatters. I am so glad that ClareBear is travelling on a British Passport and can access their system if she gets into trouble.

Bottom line - those who are capable, need to look after those who aren't. Pharmaceutical and health providers need to stop looking at their bottom line. This is not the province of a 'nanny state' this is simple human kindness to take care of those who can't take care of themselves. Health and Education are rights not privilidges and both should be free. And don't even get me started on the cost of AIDS medication to Africa. . .or the price of medicines for the chronically ill like Diabetes sufferers, asthmatics etc. How much can a bunch of chemicals cost?


Anonymous said...

'Sicko' is on my list but watching the undead 'Rise' tonight. This post has been very interesting to read, also just returned from the medical center and albeit fear of having caught something off the couch in the waiting room, feel well looked after. Health care IS a right and NOT privilege. I'd be dead now if living in America; REALLY!

Quickroute said...

I liked Sicko too. I think it over praised the UK health care system. It's good but struggles from being overloaded. Waiting time for a non life threatening operation can be ridiculously long.
Both my parents who live in Dublin had hip replacements recently. Without insurance the waiting time was 3-5 years! Thankfully they had insurance - waiting time was one month.
I lived in the US for 10 years and had work subsidised health insurance. Without it, I would have been Fu(ked!
You need health insurance here in Argentina too and it's expensive compared with cost of living here. For those who can't afford it, there still is free healthcare albeit very basic.

Brianf said...

Please don't refer to Comrade Moores movies as a documentaries. They are not. They are one sided stories, mostly lies and half truths. If our system is so bad please explain to me why people come from all over the globe to be treated here? Have you ever heard of someone being flown to Cuba for their treatment? your communist based health care system makes sure everyone get the same level of care, poor.
What is obviously missing from all this is what we call community hospitals where everyone is treated. Opps, I bet ol' Mikey never mentioned them. Community hospitals or sometimes they're called county hospitals treat everyone irregardless of if they can pay or not. They are privately funded but for some reason noone wants to talk about them.
We don't want a Stalinist based system that makes everyone equally poor. We take care of our own. We don't want another large government burocracy to screw things up some more.
My Father was a Doctor and use to say that socialist medicine would take a vocation and turn it into a 9 to 5 job.

Nick said...

Brian, you strike me as fanatically pro-USA and fanatically anti-everything else. The Cuban health service is known to be one of the best in the world (though their political repression is another matter). The UK health service is also pretty good and very much socialist with its principle of free medical treatment for anyone through general taxation. Unfortunately this principle is being gradually eroded with a lack of medical staff, a lack of beds, and a lack of specialist equipment. There are still long waiting lists for routine scans, tests and consultations, as well as operations. Optometry has been virtually privatised and dentistry's going the same way. Some people are resorting to pulling their own teeth out! And the UK is another country where people don't protest enough and deteriorating services are tolerated.

Grannymar said...

Food for thought Baino.

With regard to the UK health service I am with Nick. I hear horror stories all the time, but personal experience shows a different picture.

Baino said...

Thanks folks. Wow this reply is almost a post in itself. Interesting to hear what goes on at ground level in other countries. I did mention that I am VERY aware of Moore's bias although this doco was less sensational than his past efforts. I agree, it gave over-glowing reports of foreign health systems without mention of waiting lists. All socialised systems have waiting lists for 'elective' surgery. Mind you elective includes things like knee and hip replacements, hernia, cochlear implants etc.

I think the 'horror' stories hit the press and I'm aware that Ireland particularly has an MSRA problem but given the amount of people who go through the system, I'd rather the socialist model.

Quickroute, nice to get a perspective from a foreigner living in America. I have friends who returned to Australia to have certain procedures (within the private system I might add)as they wouldn't have been fully covered in the US. I recently paid $100 for 3 days hospitalisation and major surgery that was billed at almost $6,000 thanks to my cover.

Brian he did touch on a community hospitals actually and wasn't scathing of them at all. The issue was about insured Americans and the widespread practice of delving into someone's medical history to deny cover or indeed to retrospectively re-claim monies paid for a particular procedure. It wasn't a criticism of the hospitals but more how big insurers do not have the health of the patient in mind but are bent on self preservation and returns to shareholders.

Now, Nick is right about Cuba actually which now has 60,000 physicians, or one for every 136 people on this island. (the US has one per 4,000) They have so many doctors that Cuba exports them for humanitarian purposes to other poor countries. Today, 14,000 Cuban doctors provide free treatment to Venezuela’s poor and 3,000 Cuban medical staff worked in the aftermath of last year’s Kashmir earthquake. When Hurricane Katrina ripped through Florida in 2005, the Cuban government immediately offered assistance and promised that within 48 hours 1,600 doctors, trained to deal with such catastrophes, would arrive with all the necessary equipment plus 36 tons of medical supplies" The US rejected the offer! Go figure. You're comments about socialist medicine are noted but moot as
Medicaid is jointly funded by the Federal and State Govts in the US and Medicare (although it only covers you if you are over 65 or have particular conditions) is entirely funded at the federal level so the system already exists but is dwarfed by privatisation.

If you're really interested, take a look at this

And finally, IMHO there is nothing inevitable or necessary about a system that enriches insurance companies, private health care providers and drug manufacturers but shortchanges absolutely everyone else. Sadly, Australia is going the same way but our level of insurance cover is excellent for those who can afford it.

Not bad for 4:26am! Clare woke me up - apparently it's mid afternoon in Bolivia . . .

Absolute Vanilla (& Atyllah) said...

It is the concept of "noblesse oblige" that has been lost and with that loss, a lot of old values have also gone down the Swanee. Even medieval feudal lords knew their duty to the serfs...

Re Brian's comment on Cuban healthcare - their doctors are, surprisingly, some of the best in the world, likewise Cuban healthcare is one of the best in the world.

Oh, right, she said reading further down the comments, you've already picked up on that latter point of mine.

Emperor Ropi said...

I would rather avoid the accident.

Baino said...

AV: Hit the nail on the head. It's at the very core of moral values (and Christian if you are one) to take care of those in a position of disadvantage. The Community Hospitals in the States do this but their focus is short term care from what I've read. Chronic illness is not well addressed by them. It's more the manipulation of politicians through enormous contributions from the Drug Companies and private health care lobbies that I object to . . where's the incentive to move to public health when this lobby is financing your campaign!

I look at countries like Denmark who have an amazing social security system across the board. It works very well and is exclusively publicly funded by taxation . . Norway, Sweden and Denmark are constitutional Democracies, not socialist states.

Single payer universal health care is not socialized medicine. It is health care payment system, (through everyone's tax) not a health care delivery system. Health care providers are fee for service practices, and not employees of the government, which would be socialized medicine. Single payer health care is not socialized medicine, any more than the public funding of education is socialized education, or the public funding of the defense forces is socialized defense.

Baino said...

Ropi: You are young and healthy for now but accidents by nature cannot be avoided. Fortunately, Hungary has a universal health care system so you will be well looked after if you trip over your hockey stick!

nonny said...

You are right we should look after the less fortunate and unfortunately Ireland does have a two tier health care system, you will be treated in a hospital here without health insurance, you will just have to wait a hell of a lot longer. I have a good health care plan and have never had to wait more than two weeks. In saying that my Grandmother had the same policy as me but, having waited 18 hours on a hospital bed returned home to die on her sofa in my grandfathers arms with little old me at her side, holding her hand. People are tangled in this web of a debate about private patients getting priority and a lack of funding, but neither of these should be an issue, certainly not of Rep. Ireland anyway. The problem is simply bad management. Last year there was an enormous surplus in the health care budget here. You have politicians, doctors, HSE and even priests running hospitals, they are not managers nor should they be accredited with such responsibilities. They are not sufficiently equipped to deal with basic operational issues, listen to the politicians and the HSE, they have fantastic ideas, and they propose strategies and practises that would dramatically improve the standard of health care in Ireland. Why are they not implemented? Because our government and the HSE are deeply rooted in bureaucracy, they cannot agree on anything and they simply don’t know how to make the changes they themselves propose. Obviously the nature of the “business” would require a lot more compassion, but where hospitals to be ran like business it would give rise to a much more efficient and competent health care system. Private health insurance would go back on its shelf, merely serving to ease the minds of the wealthy or indeed the faint hearted.

Baino said...

Point taken Nonny. I'm surprised your Grandma was sent home but without knowing the details I can't comment. Beaurocracy I think is also what Brian is very much against and it is an endemic problem in the public hospital system although our hospitals are run by medic but as you say, they themselves are to some degree at the mercy of ministerial approval for adequate funding. Nobody here is turned away and unlike America, if you're damaged, you're fixed through and through not just given a band aid solution. The other side of the coin is private hospitals run by business people, returning profits to shareholders and that's no solution either. It's a controversial topic alright. As I said, in France it would not be tolerated. People would be out in the streets! Governments are by the people for the people and need to be brought to account!

nonny said...

No, I don't mean ran like business to make a profit, I just mean managed by business people, they would be better able to implement changes and such.

Incidently was I very rude?

Baino said...

Ah right! I thought so. Rude? Of course not anyway, I must away and start the day. Have a good weekend!

steph said...

Baino - sorry! I've only just found this post.

Good on ye for putting a welcome focus on healthcare. It's obvious to me that you have a better handle on healthcare policies than any of the bureaucrats in power in this country. Ireland is definitely buying into the Boston model which is a disaster for those with chronic illnesses or those needing emergency care, regardless of their health insurance status.

The Irish health service desperately lacks direction. I don't suppose you'd like a new job? ;-)

Andy said...
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