HEALTH CARE
Men like A. Bevan and Tommy Douglas were visionaries. They felt that every man, woman and child deserved good medial care in time of sickness, regardless of status, financial status, any form of ethnic, political, or religious beliefs etc. By their dogged persistence in parliament, they managed to get their bills passed to enshrine this very strongly held belief in their constitution.
(Another man of vision that has joined the other 2 is Mr. Obama. Congratulations, Mr. B. Obama).
While they (Bevan and TD) would be proud to see its continuation today, but they would also see that the system is breaking at its seams and a collapse is possible in the future. This behooves us to reign in excessive costs so that the vision that they had can continue, as it is so important.
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Health care is a two edged sword. A discussion of it ls like treading through a minefield. Emotions run high, which cloud the issues even further. It is can often be anecdotal and erroneous, when statements are made that it is free, or how one was personally treated; hence the system is glorified or brought down with dejection without proper rhyme or reason. It is like shining a light temporarily in a dark room, and what one sees is described without one realizing this very fact that only a glimpse of a small section was obtained.
The name itself is a misnomer. The care of health is a personal matter, and it is only the fact that when one is losing it that one wants to have the status quo restored, hence it can be called a 'Disease Care' or some such.
If the disease is insurmountable, as in an incurable disease etc when death occurs. Then everyone cries and wishes for the soul to be at peace, with words such as peace, peace, or Om shanti shanti and praises the good qualities that the departed person had, and pray that the almighty put his soul at resat and at peace. This is when it presumably becomes 'soul care'. So we have all levels of care at different stages in life. Only soul care is free.
It has to be realized that in health care, two separate and distinct players in the field are involved. It is remarkable that quite often there is a lack of perception of this very fact even in the intelligentsia, leading to very erroneous statements.
In the system that we call 'Health Care', the two are- a provider and providee (the patient).
Just who is the provider? There are many, and may include
The country one lives in, the politicians, the budget, the doctors, nurses, hospital buildings and doctor's offices where care is provided, pharmacists, ancillary staff, physiotherapists, acupuncturists, the mumbo jumbo people who pretend to provide care, only to extract money out of the unwary, the aurvedic practitioners, Reflexology, kinesthesilogy, aromatherapy, chiropracty, osteopathy,Reiki, vodoo, etc etc. (some of these are gray areas, and considered helpful by many people, hence I admit I could be wrong about some of my suppositions.
Consider the costs added to by the technologies that are advancing every day and they continue to need more and more money, drugs - many of which are expensive, but newer ones are added everyday to it, administrators (who love to call themselves Presidents, CEO etc and demand huge fat salaries, human greed, incessant demands by patients, many love to go to the doctor even if they have only colds etc: incessant recalls by practitioners and providing mediocre care as when it happens in countries that have fee for service (e.g. Canada), or the Doctor is paid according what is on their lists, hence he has no interest in providing quality care and just churns patients through (Doctors in Britain- these Doctors also do not have Hospital privileges, hence some of them have the knowledge from 'Baba Adam') and cannot be current. Or in countries like the United States where you are left high and dry if you have not bought your own insurance. In fact, Medical debt is the leading cause of bankruptcy in United States.
Thus, the Godzilla like monster grows bigger and bigger every day. Add to that that people live longer putting even more pressure on the system.
While it is obvious that the monster, even though it is fed everyday, takes more and more of its share of the GDP, and can buckle under if proper attention is not given to it.
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In actual fact, it is not in fact gloomy, and many millions benefit from it. It in fact is like a mother, who is good, but gives out care if the rules are followed. This, in fact is something like 'Tough Love'.
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Now for some statistics. In the year 2007. In percentages, spending by
Country Govt. Pte Insurance Out of pocket Social Ins. Other
Britain 80 10 10
Canada 70 15 10 5
Australia 70 15 7 8
US 32 40 (45.7 million people have no insurance of any kind!!)
Switzerland 15 30 50
Germany 10 70
Netherlands 80
France 75 :
Now let us consider in terms of US Dollars per capita that each country spends per year (2006):
Australia 3,137 Canada 3,896 France 3,601 Germany 3,588
Japan 2,581 USA 7,290 United Kingdom 2,992
Conclusion: It is evident that finances are an important cog in the wheel of Health Care if one is to provide a good health care for her citizens.
It is also erroneous to think that the care given at a particular time was free just because no money was asked for at the time of treatment.
***** In the case of a sufferer from Breast Cancer, or Prostate Cancer, their chances from dying from the disease is much higher if the sufferer was in the UK as compared to the one in the USA. In fact, in the case of Prostate Cancer, it is 6 times higher! ************************************************
Perhaps we can be enlightened by the people of India as to what king of health care is given in that country. It is very dismal in many poor countries.
Personal experiences:
National Health Service as provided in Britain: MBBS or MBChB is the qualification required to begin practice as a Doctor. although there are others, like LRCP MRCS etc. A year of 'housejob' is required. This involves working all hours in the Hospital, with very poor salaries in my day- around 1958- 35 Pounds a month- poor even in those days. I used to cycle from home to my place of work. (and I was an asthmatic). After finishing the required one year, one had to make a decision. One could become a GP or go on to further studies.
If you became a Family Practitioner, your earnings were as good as a consultant's!
If you entered the 'Further Studies' cycle, you can look forward to years of hard work and frustration.
After your 'Housejob', you can apply for a junior SHO at some Hospital. If accepted, you would be employed for a year or two. Then senior SHO at a different Hospital, then a Junior Registrar, then a Senior Registrar, then a Junior Consultant, then a Senior Consultant.
All these jobs are at different hospitals, so every time, it involves moving the family, sell the house etc. They are kind enough to provide the charges incurred for moving. How kind.
Your financial level improves as you go up the ladder, but it is not good. My salary, when I left the country, was three thousand pounds a year. That was a senior registrar's pay. With your wife slaving away, and your kids in kindergarten etc which involved a lot of juggling, it got the juggernaut moving.
By the way, if you were colored, you stopped at the registrar level. This was very subtly contrived. First of all, they would make sure you have difficulty in passing any exams that would give you a better position. Even then, a senior registrar level was unachievable. There were about 9 in the whole country at that level when I left. That was when I worked in the Chester region, with work at Chester and Clatterbridge which was about 20 miles away. Traveling allowance was there, and we looked forward to it. On my half day, I used to drive to Bangor in North Wales, where I did what was called 'Green Forms'- used as prescription for glasses. On that day, income was better then the one form the Health Service!
There was no training whatsoever. You learned by experience and watching you superiors, and supplemented by reading appropriate books in your spare time. Appear for examination and pay the fees required, it involves travel, taking a few days off, and appearing for the examination. You generally fail, and march on again.
Work involved in running the clinic and surgery.
Clinic: Generally run at the Hospital. It is chaos. About 70 or a hundred patient's tp see at a morning's clinic. About 3 Doctors assigned to it. The snag was that there is a single 'slit lamp', one that is like a microscope and needed to see the eye properly. So, even as Doctors you had to queue up for the darn microscope if you wanted to see a patient's eye properly. You often opted to do without it and just see the patient. At the same time just feel the eye pressures with the finger, as the checking machine (applanation tonometer) was attached to the slit lamp, or sometimes called the Biomicroscope. Or a nurse would oblige by using the Schiotz, a cruder instrument to check for Glaucoma, which is a common disease and a destroyer of eyesight. You might take a five minute breather for a cup of coffee in between.
Then one had to attend to the OR. There was a long list, mostly for Cataract surgery, and some for squint surgery. The lists were made by seeing the patient the day before, check what is to be done, and the anaesthetist checks on the patient's status as to the suitability and ability to undergo the surgery.
It is a log and exhausting day. You may have made some blunders but hope not. You also need a good boss who will stand by you, and mine was a very good one at that.
Then there was 'On call rota' when one was on call all for emergencies 24 hrs a day., or for any calls that the emergency Doctors wanted to discuss or seen. Foreign Bodies were common, some were in the eye, hence arrangements were made to take the patient to be taken to the O R and maybe try to remove it with the giant magnet.
IN SHORT- IT WAS FRUSTRATING AND DEMEANING TO WORK FOR THE NATIONAL HEALTH SERVICE IN BRITAIN.
Now let us look at the receivers of the plan. The family Doctor had 2 surgeries but had a lot of patients to see. On top of that, he had a list for house calls, whereby he went to the house where the sick patient was located. At times, it was hard to find. If a child was sick, often the parents are watching the Telly, while the poor Doctor generally trudged upstairs to see the patient and make necessary recommendations.
He had a list, and was paid accordingly by the Executive Council of the area he belonged to. If a patient needed to be admitted to the Hospital, he made the necessary arrangements. It is obvious that the Doctor did not ever go to the Hospital or learn anything new!.
Health Care in Canada :
The provision of the care given is quite different from the one given in UK, and more expensive. Each Province has slightly different approach. Some Provinces charge premiums to cover the costs, while the one like Alberta has eliminated premiums mainly because of the assets provided by selling petrol and its byproducts.
All of them work on 'fee for service basis', but can be open to abuse by the providers as well as by the providee.
The patient is free to go wherever he chooses, and even see a different Doctors on the same day, while each Doctor is allowed to charge the Health Care for the services he provided. Even the investigations can be repeated by each Doctor! Thus abuse can be rampant. Because of this very fact, different Governments of each Province is trying to restrict access- either by what a patient can do, or even inventing a 'smart card' which records all kinds of data a patient has incurred.
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