It’s about caring and community

To hear  Republicans talk these days, you would think that the Brits, the Canadians and the rest of the industrialized countries that have (gasp!)  socialized medicine were all dropping like flies from all the rationing and long waits for necessary surgeries.

You’d think they were all unhappy and envious of America’s expensive health care system.

Turns out,  the exact opposite is true — the rest of the world is quite happy with their government-run health programs and not eager to trade it for the fragmented insurance-driven health care system in the U.S.  In addition they have better health outcomes while paying less money for their care.

But don’t just take my word for how great the socialized health programs are in other countries, listen to what some of our fellow Americans who have had occasion to receive health care abroad have to say about their experience.

First there is John Aravosis of Americablog.  He flew into France for a planned vacation and ended up having emergency surgery for a detached retina.     http://www.americablog.com/2009/10/my-2000-eye-surgery-in-france-would.html

Just went to an eye specialist for further follow-up to my eye issues, and he checked out the surgery I had in France for my detached retina, and told me two things:

1. Wow, they did a good job.
2. The surgery would have cost, easily, $20,000 in the states. It cost me a little over $2,000 in France.

It’s amazing how bad our health care system really is, when you finally get sick enough to find out. I can’t wait for Blue Cross to give me a hard time for the $2,000 French surgery when they’d have had to pay ten times that, were I to have had the surgery here. We’ll cross that bridge when the French finally bill me for the surgery that took place at the end of July…

A happy outcome for John since travel back to the U.S. was precluded by the delicate nature of the detached retina.  Prompt attention, no waiting, quality care and not so expensive that bankruptcy looms.  So the French system seems to be pretty good — but according to the Republicans we don’t want the French system because .. er, it’s socialistic — and we can’t have that pinko commie stuff in the U S of A — or can we?

Then there is the heartwarming story of  Stephen Amidon’s newborn daughter in Britain — another bastion of government-run socialized medicine.  Stephen and his British wife were living in UK when their eldest daughter was born.   http://www.salon.com/opinion/feature/2009/08/22/nhs/

My eldest daughter had a rough first week. Born after 22 hours of hard labor, her pink skin proceeded to turn an alarming shade of yellow on the second day of her life. It was a bad case of jaundice. She would need to be placed in an incubator, whose ultraviolet light would hopefully clear up the condition. If not, a transfusion would be required. My exhausted wife and I watched in numb horror as our child was encased in the clear plastic box that was to become her crib for the next seven days. What we had hoped would be a straightforward delivery had turned into a nightmare….

I was initially skeptical about the NHS. I’d grown up comfortably in suburban New Jersey; good private healthcare was always immediately available through my father’s insurance. When my English wife became pregnant soon after we settled in London, I was alarmed by the idea of having our first child born in a system I had been told was underfunded, overstressed and inefficient. After all, healthcare in the UK was free. How good could it be? Friends and relatives back in the States were spending thousands to have children. If you get what you pay for, I was about to get a whole lot of nothing….

Directly following the birth, we were taken to a large ward whose 20-odd beds were separated by curtains and changing tables. It was visiting hour; the place was alive with excited relatives, shellshocked fathers and the constant susurrus of hungry new life. That first night, however, the atmosphere grew peaceful. Crying babies were attended immediately by sensibly-shod nurses so that others could sleep. But it was after my daughter began to turn the color of saffron rice that I really began to appreciate the NHS. The moment she showed distress, we were whisked off to a private room, where we were looked after by a no-nonsense pediatrician and the imposing Irish ward sister, or chief nurse, who quickly made it clear to me that my sole useful contribution to the whole process had come nine months earlier. Blood was drawn regularly from our daughter’s tiny heel; test results came back promptly….

As my blindfolded daughter slept in the incubator’s eerie violet glow, I would take occasional strolls through the ward. It was the most egalitarian place I had ever seen. The yuppie woman honking into her newfangled cell phone, the young Pakistani mother who always seemed to be surrounded by a half-dozen gift-bearing relations, the self-sufficient older woman desperate to get home to look after her other children — all of them were cared for in exactly the same manner. Whoever needed help got it. When a terrified Afghani girl arrived, rumored to be only 14 and apparently abandoned by her family, several nurses dropped what they were doing to teach her the rudiments of child care. The rest of the mothers waited patiently until they were finished. Other wards were the same. There was no private wing with champagne service. Everybody was in this together. If you were a woman and you were in labor and you were in our part of London, this is where you came. If things went wrong, skilled doctors appeared with the latest technology. Nobody asked about insurance or co-pays….

On the day we were finally given the all-clear, there were no papers to sign, no bills to settle. All we had to do was remove our daughter’s blindfold and go.

Both of these stories of health care received abroad demonstrate the fact that the patient’s needs are paramount, not those of health insurance companies.  These countries (as well as  the rest of the industrialized world, with the exception of the U.S.) have reached a basic agreement that all members of a  society should receive decent basic health care irregardless of income or social status.

As Stephen Amidon concludes:

This, I learned, is what the NHS is about — common decency. It is about the shared belief that all the people who live in the United Kingdom constitute a society, and a decent society provides certain necessities for its members. Freedom from hunger is one. Police protection is another. Free healthcare from the cradle to the grave is simply one more item on this list.

I saw this decency at work countless times over the following decade, until my return to the United States. I saw it with the twice-daily home visits by community midwives for the fortnight after each of our newborn children’s release from hospital, and in the vouchers for free milk we were given for those babies. I saw it when our GP paid us a house call early one Sunday morning to treat our son’s spiking fever.

I saw it most clearly, however, in the treatment my in-laws received at the end of their lives. My wife’s father, who suffered from acute myloid dysplasia, spent his last year receiving constant care, including several sprints to the hospital for emergency transfusions, where doctors struggled heroically to keep him alive. His final week was spent in a very comfortable single hospice room whose French doors opened onto a terrace overlooking his beloved Yorkshire moors. When he died, he left us his house, and not a penny of healthcare debt. My mother-in-law, stricken by arthritis, got two artificial hips and two knees from the NHS, and received daily home visits from social workers during the last three years of her life so she would not have to go into a nursing home.

This cradle-to-grave big-tent approach to healthcare is universal, except for the U.S.  Much of the focus of discussions about health care reform do not focus on the needs of human beings for basic quality health care.  Instead we have endless blethering about tort reform, bending the cost curve, cost containment, CBO scoring, public option, co-ops and exchanges.

Let us re-frame this discussion.   We need to be talking about how to provide health care for everyone in this country.  We need to work to build a sense of community and caring so that we can take care of the health care needs of all Americans.

Health care is a universal human need.  We can build a better health care system if we all join hands and work together.  As Martin Luther King Jr. said:   “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

Let us build a system to meet the health care needs of all Americans, not just those who can afford to pay.  We need to build a society of caring, compassion and community so that the needs of human beings come before health insurance company profits.

Note: Comparative data about health care outcomes for industrialized countries can be found at   http://assets.opencrs.com/rpts/RL34175_20070917.pdf     The U.S. has the third highest infant mortality rate and the third highest mortality due to medical errors (Find it on page 57).  Lots of other shocking data showing  better health care outcomes in other industrialized countries.

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One Comment on “It’s about caring and community”


  1. I’m on a board with other professionals, many from Canada. I asked them (not too long ago)if they were satisfied with their health care. Here are some quotes:

    1. “Well. I know for a fact that there is a doctor shortage in Alberta, where I live. Doctors are hard to come by. But. I have an excellent doctor. I may have to wait for half an hour to an hour to see her, but I don’t pay for my care. I didn’t have to pay for my very expensive care after my son was born. I’ve had special care for my son for his asthma, allergies etc. I have complaints about wait times etc but I am happy with the quality of care and I can’t imagine being refused in a hospital becuase my insurance isn’t paid up.

    I’m happy with that part of the system. I don’t worry financially about my family’s health at all.”

    2. “I’ve lived in three of Canada’s major cities – Toronto, Vancouver and Victoria. I have to say that my family and I have received excellent medical service in all three places. The only specialist we’ve ever had to wait more than a week for was a pediatric allergist. My husband requires frequent complex medical procedures that are completely free and that would cost an absolute fortune if we had to pay for them. There is a free annual mammography program in B.C. that my sister and I have both used. I recently had a bout with food poisoning and ended up spending five days in hospital. I was seen immediately in the emergency room, quickly admitted to a private room (which I didn’t have to pay for), and had excellent nursing care. When we moved to Victoria, I was able to find a male doctor right away, but there were no women available. The one good thing that came out of my hospital stay was meeting a great female GP who agreed to take me on as a patient. I have never had a problem making an appointment within a day or two with any of my GPs. On the down side, I know that it’s very difficult to find a GP, let alone a specialist, in many small towns. I even read about one small Alberta town that runs a lottery where the prize is an appointment with a family doctor. ”

    3. “A good friend of mine was in a very serious car accident last summer while on vacation in New Brunswick with her parents. Eventually my friend needed to be airlifted from the hospital there back here to Ottawa, and has been in hospital since (first in one of the main hospitals while they made sure she wasn’t in immediate danger, then for much of the past year at one specializing in patients requiring long-term care). Thankfully, her memory and awareness have been returning, she’s walking again (with help) and they’ll be moving her to the rehabilitation center soon.

    All of this was covered, including the out-of-province expenses (health care is a provincial matter). There is no way at all they could have afforded to pay for any of this directly. But it’s just not a worry here. No trying to convince insurance companies to approve procedures, air ambulances, etc.”

    4. “The Cdn. system has its flaws, but overall it’s terrific, IMHO. The few times I’ve had truly emergent situations with one of my kids, they received very quick and thorough service (including wide range of tests/specialists/surgeries). Stuff that’s not potentially life threatening seems to be the stuff with the ridiculous waiting lists, at least in my experience. I think one of the worst things is the privatization of some services — I remember when I lived in Alberta a couple years ago there was a huge backlash against the two-tiered system that was threatening to emerge (through private pay-for-service clinics). BTW, our healthcare system does have premiums to pay (at least in BC we have to pay), but the premium is nothing compared to what the services received would actually cost.”

    There’s a lot more. That’s just to give you an idea how people feel about their system in Canada.


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