Our National Health

from Jacqueline

This is a long post. You may want to read it in chapters, though on the other hand, given the points raised in Jim's post yesterday, it's not a bad idea to practice reading something longer than a text message.

Well, the pot’s really been getting stirred up lately about healthcare, hasn’t it? I was talking to a guy outside the local organic foods market the other day – he was petitioning for a universal healthcare system – and a customer had just told him where he could shove his healthcare reform ideas, because if we weren’t careful, we’d end up like Cuba. Really? Cuba has more doctors per capita than any other nation, as far as I know, and also sends more doctors into the troubled zones of the world, as well as the untroubled – Finland’s doctor shortage has been helped out by doctors from Cuba. But that’s all beside the point. I thought that I would weigh in with some observations based upon the experience of living in a country with a universal healthcare system (UK) and one without (USA). Neither are communist, although the second gives the impression of being pathologically afraid of communism and there are many people who seem sure that taking care of our sick and needy will take us all the way down the slippery slope towards the red terror and backwards into 1917, Lenin and all.

When I first came to the USA, I had no healthcare insurance. I didn’t go to the doctor for several years and tried not to have accidents or get sick. Fortunately, I was in great health, apart from this niggling little thing where my heart kept missing beats then had lots of beats all at once. Then I landed a job with benefits, and went along to the doctor. Wow, all these forms to fill out – but never mind, only the once, eh? After all, notes get passed on by the doctors ... don’t they? Anyway, it transpired that the ther-thump, ther-thump, ther-thumpety, thumpety, thumpety .... thump, was more than a little blip and needed some attention, if only to rule out imminent cardiac arrest. I was sent somewhere else – well that was quick, next day service. Then they gave me all the forms again. Why more forms? Why the same truckload of questions? Doesn’t anyone talk to anyone else around here? And it was a bit it worrying too, because when they red-tag you though like that back home, it means it’s serious. But it wasn’t so bad after all, and eventually after a raft of tests I cancelled an appointment for yet another test due to being busy at work and just assumed I’d be called back again, because that’s what I had been used to in the UK. Nothing happened, and I was surprised – I might as well have fallen off the earth. Then I started to get all these bills and wondered what the heck a copay was, and what was a deductible? I felt like a car. What was all this about? I began to get the measure of how healthcare ran in this country, and how much sheer energy and worry goes along with any visit to the doctor – and that’s when you’re covered by health insurance and all you’re doing is filling out the forms.

Britain’s healthcare service was founded on the heels of the Second World War, and as Tony Benn said in Michael Moore’s documentary, Sicko, “If you can find money to kill people, you can find money to help people.” If you want to hear what he had to say, go to this link: http://www.youtube.com/watch?v=a3HyK5rB9jY.

But to put it in context, prior to the war there was no healthcare system in Britain. This meant that, when my Uncle Joe was about six years old and had all the symptoms of an acute appendicitis, for him there was no ambulance to the hospital and emergency surgery. Instead my grandmother carried him on her back and walked for miles, from hospital to hospital before she found one to take him in, because she didn’t have the money for a doctor to see him. By that time his appendix had burst and he had peritonitis. The war brought with it severe and terrible civillian casualties in Britain, and the country had to take care of the injured – especially as so many came from the poorest areas. They demanded – finally – the “land fit for heroes” promised during the First World War, and a man by the name of Clement Atlee made the promise of a national health service – a promise that paved his way to Downing Street. He gave the country universal healthcare, though at the time the designers of the system could never have imagined the expensive and high tech animal healthcare would become.

I’d read reports about how terrible the National Health service was becoming, mainly due to the pressure on it by asylum seekers, and people who knew that, once on British soil, if you are ill you will be treated, free and gratis; and if you are there illegally, they won’t throw you out if you’re sick. Even if you’re on vacation, they’ll take care of you. To give you an example, last year some American friends were over in the UK, and while there the woman fell and broke her arm. They reported that the treatment they received was excellent. And it didn’t cost them a penny.

But I confess, I read the doom-mongering in one British tabloid in particular, and when my mother was so ill a few weeks ago I felt forewarned, and was ready to duke it out with anyone who gave her less than excellent medical care – after all, I was used to America, where you may have to fill out all those forms, but you get cable TV in your room. Our first stop was her local doctor, and from the second we walked into his office, I felt my hackles smooth out. “Joyce,” he said, reaching for her hand. “You don’t look your usual self – you are very poorly. Let’s find out what’s going on.” He introduced himself to me by his first name, Peter. He listened to her for about 15 minutes or more, then asked if he might examine her. It wasn’t an instruction, but a respectful request of a senior citizen. Another five minutes and he said that he was admitting her to the general hospital, and why. By the time we reached the hospital, I was in get-things-done-now mode, so much so that my mother said, “Don’t you go in there bossing everyone around with your American ideas.”

In the assessment ward nurses immediately began the vital signs checks, taking blood (“Really sorry, Mrs. Winspear, but we’ll take enough so we don’t have to do it again.”), etc. Then a young – and heck, I mean young – doctor came in, huge grin, held out his hand to my mother and said, “Hi, I’m Ken. I’m going to ask you loads of questions and another doctor is going to come in soon and ask you most of the same questions. We all hear things differently, and this ensures we don’t miss anything, because we exchange notes and we can make a better diagnosis when we do it this way.” I was beginning to be impressed. After all, this is nationalized healthcare, the big bogey man. And my mother didn’t have to fill out one form, because at the touch of a computer screen, notes, x-rays, test results, etc., were available from previous visits and from her GP. I knew that, on the performance scale, this hospital was not the best, not the worst, but somewhere in the middle; but they were up there in my estimation. The other thing was that there were hand sanitizers everywhere and for everyone. Doctors, nurses, patients, visitors had to sanitize their hands before entering a ward, and on the way out. There were hand sanitizers at the end of each bed, at every nursing station, hanging on the walls. I sanitized my hands so much I will probably never get sick again!

My mother had the best of care in that hospital. Not only was she diagnosed with heart failure but the psoriasis she had suffered from for the past thirty years or so went haywire. She lost every layer of skin from most of her body, so looked like a burns victim. She’s eighty-two years of age and, contrary to the impression given by some American politicians recently, no one tried to euthanize her.

I was leaving the hosptial one day after seeing my mum. I had canceled my flight back here and was wondering how things were going to work out, and I was really worried about her, so was in another zone as I walked along the corridor. Suddenly I felt someone touch my arm, and one of my mother’s doctors was standing in front of me. “Let’s talk about your mum,” he said. We chatted for another ten minutes, with him giving me a prognosis and an estimate of when she might be able to leave. Chalk up another raft of points on the satisfaction scale. I’m not used to doctors speaking to me without an appointment.

There are people in the UK who are very disatisfied with the National Health Service, who marvel at American medicine (well, who wouldn’t, when you’ve got George Clooney as an ambassador), but many of those people don’t really understand the alternative. When I broke my arm in 2001, I was in the emergency room and separated from another patient by just a curtain. I had medical insurance, so even though I had wept in pain while trying to fill out the forms – which were insisted upon – I felt blessed. My neighbor had no insurance and had just had a bad accident in his garden. His wife was crying and he was refusing painkillers because he knew that with every shot, every test, every word from the doctor there would be a charge – and they couldn’t afford it. God knows what happened to him.

The UK also has private medical insurance companies, one of the largest being BUPA, which has a huge corporate market. In recent months BUPA has experienced an increase in cancelations, given the economic downturn and the number of people losing their jobs. Same thing’s happening here, except that in Britain, they’re covered automatically, because there’s a National Health Service. It’s not perfect, but it’s bloody good, all things considered. And a woman no longer has to carry her son screaming in pain from hospital to hospital to try to get someone to see him.

There’s more I could say, but I’ve said far too much already – making up for the weeks away. The truth is, we’ve got to get away from the idea that if we pay for universal healthcare with our taxes, someone, somewhere will be getting something for nothing. Medicare doesn’t distinguish between those who were productive workers and those who weren’t, and the Veterans’ Administration doesn’t look at the on-the-job performance of our servicemen and women; we just know we need to take care of them. And in my estimation, there is something lacking in a country that does not take care of its people – all of them – when they need it. But that’s just my opinion, and as we know, opinion is not fact, just a personal truth based on the writer’s experience and world view.