A TALE OF TWO COUNTRIES

high-cost-of-healthcare-mount-sinai

My mother died fifteen years ago today.   That year, October 2nd was the Last Great Day, the biblical eighth day of the Feast. The significance was not lost on me.

My father had died a few months earlier, suddenly of a heart attack. Mom was found one morning by two of my brothers, having had a stroke the night before. I flew over to England as soon as I heard the news and was able to stay there in her home, visiting the hospital every day. A few days after her death, I was able to officiate at her funeral, which I had also done for my father.

She was in the hospital six weeks. This year, I was in two different hospitals, both in Michigan, for a total of just over four months, though I had a few days at home in the middle.

Consequently, I’m in a better position than most people to compare the two health systems.

I cannot complain about my mother’s treatment.   She was 73. Her stroke left her paralyzed down the left side. She could not move without help. She couldn’t even feed herself.

After consultations with the head of the cardiac unit at the Princess Diana Hospital in our hometown of Grimsby, it was decided that she should be made as comfortable as possible for as long as necessary. The hospital could have kept her alive indefinitely by inserting a feeding tube into her stomach but she would never be restored to her former state of health. The cardiologist did not want to do anything that wasn’t absolutely necessary.

There was no “death panel” making a decision on her life. My brothers and I made the decision in consultation with the cardiologist. We knew that mom would not want to stay alive, dependent on a feeding tube, relying on others for all her basic needs. None of her sons would want that and we knew she wouldn’t.

She had her own room and was able to receive visitors at any time.

I have often wondered how things might have gone differently if she had been in an American hospital. It is more likely that the feeding tube would have been inserted and she could have lived a few more years, albeit in the hospital. As long as Medicare (i.e. the government) would pay, the hospital would have kept her alive. But that would not have been good for her.

My hospital stays this year involved two major back surgeries, MRSA, abscesses on my spine and all the complications that came directly from my treatment. On two occasions, my wife was told that I might not make it. I was told on one occasion. I’m thankful they continued to treat me.

The complications I suffered were mostly due to the painkillers and strong antibiotics they gave me. They caused chronic nausea and vomiting that left me demoralized and enervated. Eventually, I took myself off all my medications, arranged for my discharge and have been improving ever since.

The biggest problem with both health care systems comes down to one word – money.

In England, where the government controls most health care, they are always trying to save money. In the US, the health care providers are always trying to make money and will often give you treatment and medications you really don’t need. It’s not surprising that Americans have the most expensive health care system in the world, spending almost 20% of GNP on health, compared to an average figure in the western world of 8%. Yet, in spite of the amount spent on health care, we rank 37th in the World Health Organization’s annual ranking of national health care systems. The UK is at number 18. France and Canada compete for number one.

One area in which the US is seriously deficient is in prevention. Governments presiding over socialized medical systems want to save money, so prevention is important. In the US, there’s no money to be made from prevention.

In a study comparing the US and UK’s medical systems a few years ago, it was found that you are twice as likely to die from a heart attack in the United States as in England.

One of my doctors knew of this and said that the hospital I was in was making every effort to improve on this statistic. Personally, I think one factor is that in the UK, heart attack victims will, on average, live closer to a hospital than the average American.   There is little that can be done about this. There are, of course, other factors and hopefully improvements are being made. This is a concern of mine as both my parents died from heart problems.

The same study showed that you are more likely to survive cancer in the US than in the UK. American hospitals are more likely to have all the latest equipment, reflecting advances made in medical research. My wife’s cancer was dealt with very quickly and she is now cancer free. In the UK, she might have had to wait longer for treatment.

I was surprised to read that the US lags behind England and many other western countries when it comes to childbirth and early childcare. The US infant mortality rate is quite high when compared to other advanced nations.

I believe that free enterprise serves people better than government. It is also the most cost-efficient way of delivering anything, whether it be food at the supermarket, gas at the pump, utilities, education or health care. However, the American system is not really a free enterprise system.

For a start, over half of health care is now government. Most of my costs were taken care of by government. In one way I’m thankful for that but a part of me asks: where is the money coming from? Somebody has to pay for it. Government is not careful with money. It’s willingness to foot the bill regardless of cost inevitably pushes up the price and leads to abuse.

Hospitals are now taking maximum advantage of this. Some of the procedures I was subject to seemed unnecessary. They simply ran up my bill.   When I was going through a long period of chronic nausea, they kept giving me additional medications, which only made things worse. The cost of all these pills was added to my bill, for a much higher charge than the pharmacy would make you pay.

Insurance companies also distort free enterprise. The cost of health care has risen dramatically in recent years. Roughly 20% of the cost is administrative, charges added by medical insurance companies. Healthcare is big business in the US and has made a lot of people very wealthy. This was not the case before World War II, before insurance companies got in on the act. If an individual patient had to negotiate his own health care with a provider, it would help keep the bill down. A doctor’s visit would cost closer to $20 than the $100+ it costs now. Doctors could only charge what the market could stand, just as supermarkets do when selling us groceries.

My wife and I scrutinized my bills closely and found a number of charges that we questioned. They charged me $220 for a psychiatric evaluation, which I don’t remember having. Now, I’ve no doubt I would benefit from a psychiatric evaluation but how come I was charged $220 for something I don’t even remember. My hospital room was $2,000 a night, surely excessive when you consider that you can stay in the best hotels in the world for far less? I was also charged $3,000 for a back brace that I never got.   Physical therapy was also $2,000 a day for a ninety-minute session.

As I said, the two systems come down to money. I do not see how either system is sustainable long-term. The UK has been in steady decline as a global and military power as each year the National Health Service requires more funding. In the US, medical bills are now the biggest cause of bankruptcy. The average family is now spending $5,000 per year more on health care than it did ten years ago – and this in a time of declining real wages. Something has to give. There needs to be real changes, whether in the United Kingdom or the United States.

After leaving the hospital I had to consult with a G.I specialist about my nausea. I am still having digestive problems. He recommended a colonoscopy. I had my first one with him seven years ago, so he was rather insistent I have another, as I was overdue.

I didn’t say anything but my first thought was of the comparison study I mentioned earlier.

Colonoscopies are not routinely done in the UK. They are only done when it is felt necessary. The conclusion of the study was that this costs only 25 lives a year in Britain. That’s a small cost, compared to the financial cost, which would force economies in other areas.

As I’m no fan of colonoscopies, I sat there wishing I were in England!

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One thought on “A TALE OF TWO COUNTRIES”

  1. As usual, you expressed valid and insightful comments throughout your blog. The U.S. distaste for prevention makes me wonder if “Health Care” should be renamed “Health Repair.” If we CARED conscientiously for our health with preventive measures—doing what stops something unwanted (and costly) from happening—we would need far less health REPAIR.

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