zhisou

The world has gone healthcare mental.

Fox “News” with their hyper-ventilating self-righteous spokespeople that cherry-pick bits and pieces of stuff they barely understand.  People in Town Hall meetings comparing discussions on end of life policy with the Nazis.  Glenn Beck constructing arguments that public healthcare is a terrorist threat, or that it would lead to the government killing babies and old people.  Rush Limbaugh, himself not a stupid man by any means, pedaling lies to the stupid people he manipulates with his half-truths, out of context snippets and outright lies.

Look.  There is no coherent argument against public healthcare.  Look at countries with public healthcare.  They still have private coverage, they still have employment packages with healthcare options.  Good doctors still earn good money. Even in the US, Medicare and Medicaid work.  Not perfectly of course – but how many lives have they saved?  People purporting to be pro-life and anti-euthanasia seem rather quick to dismiss the medical needs of those who can’t afford private insurance.

Take one extreme:  The UK.   In Britain, the monstrous NHS is perhaps the antithesis of the American private system,  the government pretty much directly manage hospitals.  In Britain, the Secretary of State can be held responsible for germ outbreaks or funding shortages when health authorities mismanage their funds.  The UK barely has a private sector of any great importance in most medical fields, at least outside of London.  Nurses are in such short supply they have to get them from Spain – a country which not only has a universal government run national healthcare service but a thriving private one too.

Yet, despite this massive public sector solution, in the UK people don’t die because they haven’t got insurance.  Everyone – rich and poor – can get treatment that is roughly based on need not cost.  A bit idealistic, sure, it’s not quite that good, but it’s a long way in that direction much of the time.

It’s full of potholes and problems.  It’s nowhere near perfect.  It could be improved a thousand-fold.  But it is not evil, it is not Nazism, it is not even socialism, you might just argue, if you really really wanted to, that it is a socialist accomplishment in a gentle Western European sense – one that has become Labour’s millstone and something the Tories just don’t know what to do with.

And that is the UK.  Even there, the NHS basically works.  Spain, a more socialist country in many ways,  has universal coverage for anyone who pays their taxes (the UK covers anyone living in the UK, whether or not they contribute).  Despite this, Spain has a thriving private health sector – there are loads of private providers, who charge per hour directly or via insurers.  The insurance market is not overly competitive with only two or three big providers, but that’s another issue.

This doesn’t mean that the answer for America is to copy what works in Europe – but it does mean that what works in Europe can work, does work and is not evil or somehow inhumane.

That said, I am not actually a big fan of public healthcare.

I don’t mean I am against it, I am not.  I would just rather avoid it if I can.  It is one of those great levellers, like the airport.  This is why I don’t like airports either.  I certainly appreciate efforts to avoid this levelling and allow for shortcuts for those of us who don’t fancy waiting in line with Other People.

I like private healthcare.

The reason I like private healthcare is not because I am a snob – nothing could be further from the truth, readers of my blog, listeners to my podcasts, will know that there is not a snobbish bone in my body.  No sir, not a single snobbish thought has ever entered my head – it is just that I like to treated with respect and civility.  Where I am a customer, I like to be treated like a customer.  What I don’t like is being bossed about and made to wait – neither by unpleasant public nurses nor airport security guards.  Both of which need a jolly good slap in my book.

In Spain, where I live, the health service is actually pretty good.  Most hospitals and health centres are fairly clean and modern.  The medicine, from my knowledge (Grey’s Anatomy, House, ER etc.) seems up to scratch.  When I go for blood tests, I tend to leave with my arteries unscathed and only a tuft of blood-stained cotton wool clutched to my inner elbow to show for my suffering.  It’s fine.  It does its job.  It hasn’t killed me and so far has cured the mundane occasional malady I’ve brought to their attention.

But where’s the service?

When the wife was in having the first kid, she shared a room with a woman from such ill-breeding that her partner slept in the same bed all night.  The poor woman had just given birth, yet old selfish-head was squashing himself down one side of the already hyper-narrow mattress.  I had the good grace and chivalry to sleep on the floor, even if that did mean spending the night staring at the cracks in the wall as the wind whipped in and cut my sleep in two with its evil chill.

A couple of days ago I had a scan.  Checking the old internal organs due to a higher than expected GGT count.  I had to wait months for the appointment, then turned up a good ten minutes ahead of schedule.  Bear in mind this was a 12.10 appointment and the rules demanded the patient not having eaten for 8 hours beforehand, which in reality was closer to 15 hours due to my opting to sleep through the night.  I was barely able to crawl in, so desperate was I for coffee and a croissant.  Men have died for less.  I’d already got in a huff because I’d gone in the wrong door and been made to walk round, up and though the main entrance before being directed down the steps to where I’d been in the first place.  Then, 12 o’clock, I’m there, in an uncomfortable moulded plastic chair in a dark corridor,  surrounded by Other People.

The building itself was the kind of thing an architect would produce.  This is not a ground-breaking statement to describe a construction, most are produced by architects, at least as far as I know.  The thing is some buildings look like they’ve been put together by an architect who had lots of ideas and wanted to try and include them all.  Less in more, fellas, less is more.

Anyway – 12.10 ticks by, nothing.  Not a sausage.   Door firmly shut.  Some people arrive and out-of-breathedly ask me what time my appointment was.  I told him, and they seemed worried but had used the polite “Usted” form, instead of the formal knockabout “tu“, so I thought that that was nice.  A nice moment in an otherwise terrible sea of coffee-less suffering.

12.20.  Nothing.  Let me add that the corridor was painted a dull grey colour.  The kind of colour that no one anywhere ever would ever choose.  Ever.  It wasn’t a colour.  There was no colour in it.  It was a public statement that we didn’t matter – we didn’t warrant colour or natural light or adherence to pre-arranged appointments.  We had to wait, in an over-designed building with grey walls in uncomfortable chairs screwed to a grey tiled floor.

12.30.  Nothing.

12.40, who opens the door, but the scanner woman.   No smile, no apology, no shrug of the shoulders to emphasise a smidge of empathy.  She just called out for appointment papers and we dutifully walked up and handed them over, smiling as nicely as possible so as not to seem like a Trouble Maker.  No point making enemies now we’ve got this far.

I get called third in line.  12.50 nearly – I am now planning in minute detail what I’m going to have with my coffee – I’d picked out a coffee shop earlier, the nicest one on the row in front.  Some were more bars, some quite smokey, some stank of booze.  I chose a proper coffee shop with homemade breakfast treats.  I had my eye on a slice of apple cake – without wishing to leap ahead, it was nice but as disappointing as cake usually is.

I do the scan thing and the woman must be highly trained to manage to be so disengaged from her patient and her work.  She scribbles on the paper and prints off some snaps that look like pregnant scans.  I can just about make out a baby on them, or at least as much as I can on an actual pregnant scan.

Then, next day, several coffees later, I’m at the Doctor’s.  The one who ordered the scan, just to be sure, having seen the GGT numbers.  She looks at the pictures and I josh that I’m not pregnant after all.  She’s not my usual smiley Doctor that I like, she’s another one, but she’s pretty and nice and I like her too.  She can’t understand a word of the scan though – she bundles the handwritten report up with the photos and sends it back for the handwriting to be interpreted – does it say “con” or “sin” (“with” or “without”), it appears to say both and neither?

So.  There you have it.  Quite a tale.

This is pretty poor customer service.  It’s pretty bad architecture and interior design mixed with miserable disengaged employees and no coffee facilities.  It’s time consuming, it’s annoying, it’s humbling.

But it’s better than being dead.  It’s a very very long way better than nothing at all.

And that’s it at its worst.  Even then, even in the midst of the most tedious long wait to meet the most downcast uncommunicative bore, even then you don’t think to compare it to Hitler and his pals.

The Nazis just don’t come up.