So Glad I'm Livin' in the USA

I have had ten weeks to think about health care. My wife had a stroke at the end of March. I have watched with wonder and amazement the incredible high standards of care available in the U.S. system. I have zero doubt that she would have died had this happened almost anywhere else.

I also have had a front row seat for the insane hybrid payment system we have. This system is broke, kids There is little or no free market component to control costs or encourage innovation. Commode chairs, walkers, and wheelchair parts are exorbitantly priced. Like body parts for cars, insurance pays so who cares? Everything is inefficient and bureaucratic. And that’s all for a guy with fairly decent coverage.

David Asman, a FOXNews personality, had a guest Editorial in yesterday’s Wall Street Journal. His wife, a young non-smoker like my wife, also had a stroke. She had hers in London and Mr. Asnan compares the care.

He gives the British National Health Service (NHS) hospital high marks on several issues, most notably the skill, competence, and compassion of the medical staff.

The emergency workers who came within five minutes were wonderful. The two young East Enders looked and sounded for all the world like a couple of skinhead soccer fans, cockney accents and all. But their professionalism in immediately stabilizing my wife and taking her vitals was matched with exceptional kindness. I was moved to tears to see how comforting they were both to my wife and to me. As I was to discover time and again in the British health system, despite the often deplorable conditions of a bankrupt infrastructure, British caregivers--whether nurses, doctors, or ambulance drivers--are extraordinarily kind and hardworking. Since there's no real money to be made in the system, those who get into public medicine do so as a pure vocation. And they show it.

His piece does not blast the care, even though he brings up some highly negative items.

When I covered Latin America for The Wall Street Journal, I'd visit hospitals, prisons and schools as barometers of public services in the country. Based on my Latin American scale, Queen's Square would rate somewhere in the middle. It certainly wasn't as bad as public hospitals in El Salvador, where patients often share beds. But it wasn't as nice as some of the hospitals I've seen in Buenos Aires or southern Brazil. And compared with virtually any hospital ward in the U.S., Queen's Square would fall short by a mile.

The equipment wasn't ancient, but it was often quite old. On occasion my wife and I would giggle at heart and blood-pressure monitors that were literally taped together and would come apart as they were being moved into place. The nurses and hospital technicians had become expert at jerry-rigging temporary fixes for a lot of the damaged equipment. I pitched in as best as I could with simple things, like fixing the wiring for the one TV in the ward. And I'd make frequent trips to the local pharmacies to buy extra tissues and cleaning wipes, which were always in short supply.

In fact, cleaning was my main occupation for the month we were at Queen's Square. Infections in hospitals are, of course, a problem everywhere. But in Britain, hospital-borne infections are getting out of control. At least 100,000 British patients a year are hit by hospital-acquired infections, including the penicillin-resistant "superbug" MRSA. A new study carried out by the British Health Protection Agency says that MRSA plays a part in the deaths of up to 32,000 patients every year. But even at lower numbers, Britain has the worst MRSA infection rates in Europe. It's not hard to see why.
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Having praised the caregivers, I'm forced to return to the inefficiencies of a health system devoid of incentives. One can tell that the edge has disappeared in treatment in Britain. For example, when we returned to the U.S. we discovered that treatment exists for thwarting the effects of blood clots in the brain if administered shortly after a stroke. Such treatment was never mentioned, even after we were admitted to the neurology hospital. Indeed, the only medication my wife was given for a severe stroke was a daily dose of aspirin.

His review is ultimately favorable because his wife’s outcome was favorable. Reading the entire piece, however, confirms my belief that socialized medicine would have been a ticket to widowhood for me.

I am glad things worked out for them, but this was a woman who recovered on a combination of compassionate care, aspirin, and physical therapy. To get even this required the foreign journalist to pull strings, pay for private procedures and confer with a U.S. specialist.

My wife required three and a half hours of brain surgery. She spent two weeks in a very clean ICU with modern equipment (all but the machine that goes “bing!”) They monitored her Inter Cranial Pressure in real time, along with heart rate, respiratory rate, O2 levels, temperature, blood pressure. She received daily CT-scans and frequent MRIs and chest X-Rays. She was flown on a helicopter from the hospital nearest out house to one that could provide this level of surgery and care.

I didn’t make calls and pull strings to get this, nobody recognized me as a famous blogger. This is available to anyone. Insurance and payment came later.

I wish Mr. Asman and his wife the best; I couldn’t be happier that it worked for them. But reading his story, I cannot consider it a defense of socialized medicine – to me it is an indictment.

Posted by jk at June 9, 2005 6:17 PM