Socialized Healthcare

You have heard the debate. You have seen the Michael Moore movie. You may have received a denied claim. Some of us have worked in the health care industry and know the problems with our American healthcare system.

If you would have asked me just 3 years ago, what my position was on universal healthcare for Americans, I would have said hell yes! Having worked with many children with no insurance or the underinsured truly affected the way I felt about this issue. However, I have come to disagree with their view and my previous view on this issue.

Politicians and a film maker would have us believe that achieving universal healthcare would be utopia, a win-win situation for all. But, living in a country that has this system, as well as speaking to other expats (including our neighbors to the north), I just cannot see it the way I did before.

In Poland, every working citizen must pay a certain percentage of their salary into the system not unlike Social Security in the US. This would not be a problem if Polish citizens could actually get what they pay for.

If you have insurance in the USA and you get sick, you can pick up the phone and likely secure an appointment for yourself on the same day. If you have no insurance in the USA, you go to a free clinic, urgent care, or the ER and wait an infinite amount of hours equivalent to your degree of distress before being seen, but you will likely be seen at some point that day (unless you live in NC, click here).

However, what if you paid into the system and you get sick (minor to catastrophic illness). You’ve paid your dues and you deserve to see a doctor. But the next available appointment is not for several weeks, possibly months? You end up waiting hours (not unlike the ER) for something you have paid your hard earned money for. Then, you find out you need to see a specialist who does not have any available appointments for months or is on strike because the doctor’s are paid the equivalent of $700 USD per month. If you have the money, you can choose to go to a private practitioner and pay out of pocket for a visit that you technically already paid for. If you don’t have money, or friends with money, you wait and a) pray your symptoms go away on their own, b) hope it isn’t serious, or if it is serious, c) die!

Welcome to universal healthcare for all, folks! Does this sound like something you want invading our country? There is a reason so many people travel to the United States for medical care. Heck, former Polish president and Solidarity movement leader, Lech Wałęsa, traveled to Texas earlier this year to have a pacemaker installed. What does that say to you when a former head of state of another country chooses our country for his medical care?

Let me give you more to think about…

When you are hospitalized in the US, say to have a baby, you may bring some personal items from home to make you feel comfortable. However, the bulk of your needs are taken care of by the hospital. You get clean sheets (changed daily), towels, three meals and snacks, a phone, TV, even a gown if necessary. Your baby gets fitted like a clone in an outfit to match his nursery mates, he gets formula, diapers, a receiving blanket and a bulb syringe for his personal use (never lose this one – you will never find one of the same caliber).

From the accounts of people I have spoken to who have been hospitalized here, all you seem to get is a bed. You must provide your own supplies. This is no different than stories I have heard from family members about Cuba’s healthcare system that was so distorted in Michael Moore’s film. Do you really think that Castro allowed Moore to film in a real Havana hospital? A true Cuban hospital looks nothing like the one depicted in the movie. Many Cubans get their medical supplies (including gauze, stitches, ointments, and equipment) from their Miami family members. If you don’t have family in Miami, good luck to you!

An American friend whose son was hospitalized here in Warsaw could not wrap her mind around the fact that 1) the hospital ran out of the European equivalent to Tylenol and asked that she or her husband go to the local Apteka and purchase some and 2) that they did not have a thermometer for her son’s use. She had to bring her own. Her husband is Polish so they pay into the system, but they choose to pay privately for routine care because of time consumed in trying to find care publicly. Further, you may have a contagious illness, but you will still be placed in a room with a bunch of other beds. Forget private rooms, unless you are willing to pay for a private facility.

Another friend informed me that she is actually happy that she is having her baby here and paying privately because she knows she would not receive the same quality of care in Canada as she is here. Don’t get me wrong – medical care here is great for an expatriate with funds. It’s everyone else that gets shafted.

A Polish friend whose daughter plays with Thing 2 informed me yesterday that she spent two days trying to find a doctor after her daughter had an allergic reaction to some drops she was given for her eyes.

And, with that said, let me tell you about the hospitals here. I went on a tour of several hospitals with our Embassy nurse earlier in the year. I came home and told Thing 1 that breaking a bone or getting into a serious accident here is unacceptable. After seeing the trauma unit in Warsaw, I was traumatized! The private hospitals are comparable to where I previously worked. The public ones are not even remotely close to even Jackson Memorial in Miami or DC General. At a public hospital for adults, I saw a woman with a naso-gastric (NG) tube, smoking a cigar outside the hospital entrance. I’m sure our American patients try to do the same, but I want to think that our hospitals stop that kind of behavior. Then, again, I still remember healthcare workers at my hospital smoking in front of the Cancer Center! Still, these were healthcare workers, not patients!

I don’t deny the need to cover America’s children. I think that all children regardless of income should at least receive routine and preventative care. I don’t deny the need for coverage for the millions of Americans with no coverage. However, I have a big problem with someone telling me that they are going to take a portion of my earnings to fund something that takes my current level of insurance down several notches and expect me to use it and like it. I don’t think so. This is like my generation paying into Social Security that we will likely never see or see very little of. After receiving my annual SSA report this month, I compared it to last year to find that my monthly check has already been significantly reduced.

Certainly those who do not have coverage or are under insured would welcome this change. If you don’t have or have very little coverage why not support a plan that would give you full coverage? However, for all the other Americans who pay into an insurance plan and receive reportedly good care, why would they want to risk having the quality of their healthcare reduced? People are able to opt out of Medicare, why not universal healthcare? Further, it is not about having universal healthcare, but about having “access” to universal healthcare. You can print up billions of fancy universal health plan cards insuring everyone in America, but they don’t mean squat if you can’t access care when you need it.

In general, I have come to think that this is a bad idea. People who have the money will still get prompt, quality care, while those who don’t won’t.

If you still can’t wrap your mind around what I am saying, think about this…Polish healthcare workers (doctors and nurses) have spent the better part of the year on strike because of the pathetic wages their government is choosing to pay them. If they stay put in Poland, they only do the bare minimum in their job.

With Socialist style medicine, there is no incentive for such doctors or nurses to go beyond the call of duty. On one of the strikes earlier this year, people were turned away from hospitals unless their condition was an emergency. Even terminally ill people were turned away because, hey, you ‘re going to die anyway and there really is nothing they can do. Most doctors eventually choose to go the way of private practice or they move to the UK where doctors are paid in Euros and fair much better financially. The quality of care is compromised when situations like these are allowed to fester.

If our politicians want to provide such a plan, I think that 1) doctors who choose to participate need to be given a fair wage and 2) they should make it optional for citizens. I think that a person or family should be able to choose whether they want to invest in the system or retain their current employer funded coverage. If they want all children covered, they can ask parents to prove that their children are covered under another plan – problem solved. If people choose to invest in such a system, they should be able to recover some costs that they spend in seeing a private physician when a public one is not available. For example, if a physician charges $100 per visit, but a public provider charges $60 (completely covered by the government), then the patient should only had to pay $40 (like a co-pay).

A few years ago, our government instituted a law in which every American was eligible for one free credit report per year. Why not institute a law where every American regardless of age or ability to pay is eligible for a full physical with labs annually?

I have yet to see something that the government dabbles in turn to gold! Even Social Security has its caveats as we have found in the last 20 years. Like certain political philosophies, they all look good on paper, but have no practical application for the long run.