September 28, 2009

I finaly have watched film Sicko by Michael Moore and  I honestly was very dissapointed seing things presented in such a way as everybody is suffering with medical help in USA and  in other countries survaved things are just great – you get the best medicine available with no wait and money to pay.  And… it also does not seems to cost anything in taxes.

I believe there are people happy with medical care in Europe or Canada same as there are in USA and there are ones which are NOT happy. I do not know about ratios but it is surely far from black and white.

Personally as I lived 1.5 years in UK (one of featured countries)  the US health care (PPO) was something I missed a lot. On the top of that I paid similar amount in Healthcare taxes to what was full cost of my health insurance in USA. Of course my situation does not apply to everyone  and especially those who are with no health insurace or HMO would like UK medicine more but surely not me. We had denied referrals to specialists multiple times.  There are also significant wait times for some operations or longer times between certain things you’re entitled to.   Under my US health insurace I’m entitled to once per year full medical exam which would be once per 5 years or something in UK. There is an option to make a house call but once I tried to do it for my doughter  being 1yo at that time I was pushed to bring her in instead.

My mother visiting us here in US had an incident so she had to get to ER. She has gotten MRI and bunch of other exams immediately. Now back in UK she is still waiting to be scheduled for followup MRI exam. She tells me they will likely write her back in 3 months and she may get appointment 6 months out or so.   Well  no surprise there is a special BUPA private insurance in UK which makes sure you get admitted to private exam if NHS does not schedule you within the defined wait period.

Of course you may say this is life threatening ER visit which can’t be compared to the followup visit (though if you had rushed to ER I’d expect it to be quite important to find out what was wrong with you)  So I can tell from the personal experience. Few years ago I had a brain surgery so I need MRI checkups which are far from urgent.  I was always able to schedule them basically the next day in US and my insurance have not have any problems.

Other thing which I remember which was covered by a lot of press was cancer drug which was rather expensive and generally prolonged life to the terminal cancer patients few months.  NHS decided it is not wise to spend limited money it has such a way and this drug was not covered. I got impression this is not the first neither the last case.

Another thing which surprised me in the film  was showing Canadians worried to go to US without insurance because of medical costs. Well what would you expect, really? The medical care has its costs and why tax payers of the other country should pay for someone outside?  Unless there is no special treaty between the countries foreigners should be paying…  and yes getting travel insurance is a good way to do it. This is for example what my mover wisely did for her trip to US.

What do I mean to say? Do not take it black and white. People die. People die with public or private health care.   And as the saing goes the grass is always greener on other side of the fence.

Also  whenever your like it or not the health care will always be better for people more powerful and/or reach.  This is just fact of life –  there supply of brilliant doctors is limited same as certain equipment.  This is  very politically inconvenient and tough reality. Expecting us all to get same quality of care is same as expecting everyone to drive in the same kind of cars or live in the same quality of hourses. We can starve to provide some good base level to everyone but not even it out completely.

Imagine for example there is a magic cure which gives every person  10 more years to live. It however required 20 years worth of “labor” looking at productivity of average person. The basic math tells us it will not be possible to provide to everyone and well modern medicine is close to that.

If you look at medical research over years you can see (same as with other sciences) it becomes more niche and focuses. Few hundred years ago doctors were often dealing with general “fever” or “infection” while it changed now to many thousands of different decieses with its own diagnostics and cures which all had to be researched.  If you see research happening now you would see focus sometimes being the special condicions for the special kind of cancer which  one out of 100.000 people or less may get.   If only 1000 people can be helped in a year by given research imagine what the cost would have to be to cover research costs. In case of government doing funding similar things happen – budgets are limited so some projects are funded and others not.  Some people get cure found for their decieses others left to die.

If you’re Bill Gates, Warren Buffet  you can fund research of your conditions (or conditions you’re likely to get based on your DNA)  of not you’re left to count on someone targeting your “market” being it government or private group.

If you ask me what I think about health care in US I think it is too regulated (bringing hosts for basic care too high) and there are way too many litigations. Doctors make mistakes. People die. There should be responsibility of course but to harsh concequences lead to fear and restrict innovation.

I think universal health care is good and practical but same as with Schools it should be up to the certain level. The Emergency care is something which should surely be covered same as base prevention. However you should be able to reach to private care if you need something special what  social medicine which only has so much per capita of spending in budget can’t allow you.   Government could be helping to ensure there is an insurance available for these low probability but high impact events.

Notify of
Inline Feedbacks
View all comments
Would love your thoughts, please comment.x