I don’t care if you sit on the red or blue side of the aisle, there is no question that our health care system is broken. The bottom line is that the operative word, CARE, is missing from our attitudinal vernacular. I write a lot about politics and get a lot of hate mail. It speaks volumes that I got exponentially less mail and fewer comments on the very personal post I wrote about the importance of the Affordable Care Act. The health of our nation depends on health care. If we follow Mitt Romney’s lead, only the wealthy will have access to medical services, education, jobs, nutrition, and well, the pursuit of happiness. It’s social genocide.
Health care reform is critical. Both patients and doctors have a lot to gain and lot to lose. I know a lot of doctors, many I consider close friends. I have a great deal of respect for doctors. In fact, I wanted to be a doctor when I was a kid. It turns out that being bad at math and science doesn’t bode well for medical school. I resorted to the next best thing back then. Waitressing.
I am always intrigued by doctors’ perspectives on the health care debate. I know some docs who are more concerned with the trappings of being an MD than actually caring for fellow human beings. There was the a-hole in San Francisco years ago who tried to get a table at a busy restaurant by demanding to talk to a manager “because I am a doctor, dammit!” Yeah, that went over well. He was still waiting for a table after we had eaten and left. That, my friend, is karma. It’s one thing for a patient to regard her doctor as “god,” but another thing entirely for the doctor to think himself divine. I once had a dermatologist who told me he chose his specialty so he didn’t have to ever be on call and could make lots of money. That’s not something he should be telling patients. Bedside manner FAIL. I don’t want to get into a debate about what doctors get paid or how much medical school costs. I value doctors and have been blessed with fantastic medical care for my family (former dermatologist excluded).
My friend Martha is a doctor. I happen to think the world of her, and not just because she is a fellow Wahoo. Martha is incredibly dedicated, generous, warm, and inspiring. She really demonstrates total patient care in her pediatric practice and has an indomitable passion for helping families in need. Martha recently shared her family’s story about a medical emergency while traveling abroad in Italy. She’s given me permission to share that tale with you. Note that when we met Jimmy Carter recently, he too shared a similar story about his experience in an emergency room in Norway.
Here’s Martha…
Italian kidney stones are less expensive than American ones. This is how I know:
On our second day in Rome, my husband started writhing on the floor of our hotel room in agony. We initially assumed he had strained his back, and I was overwhelmed with guilt since he had carried my bag as well as his (It was small! I swear!). But then we figured out it must be a kidney stone. He has never had a kidney stone. Apparently Italy is as good a place as any to have your first one.
So off I went in search of something stronger than ibuprofen in Rome on a hot Sunday morning.
Times like this, it is good to travel with friends. Our friends, the Schauers and the Greens, whisked our children away to tour every Roman ruin in sight while I repeated the “for better or for worse mantra” over and over in my head.
Here is a little known fact about Roman pharmacies: they are all closed on Sunday morning. At least the ones within a mile of our hotel were. I returned to the hotel room empty-handed, much to my husband’s dismay. He had now been writhing in pain for about four hours. Agony does not begin to describe his condition.
When I imagined touring Rome, I imagined touring the Coliseum, the Forum, the Spanish Steps, the Trevi Fountain, the Pantheon, with several stops along the way for cappuccino and a gelato. The Roman Emergency Room was not on my list. But it became clear that would be our next stop.
The taxi dropped us off at the door and zoomed off.
There was no wait. Because everyone in Italy has access to healthcare, no one was there with a cold or a hangnail, waiting for hours to be seen, then sent to collections for a bill they could never begin to pay.
When I first posted this, a friend commented that it seemed counter-intuitive to have no wait in a place where everyone has access to healthcare. My explanation was that apparently people use the emergency rooms for emergencies in Italy. It is an amazing thing. They see their regular doctors for regular things. In this country, many people either have very high deductibles so avoid going to the primary care doctor until they just can’t stand it any more, or they have no insurance and cannot be seen anywhere except the ER which is not allowed to turn anyone away (and is the most expensive possible source of medical care—and the worst for routine problems).
We rang a little bell, and out popped a provider who took a brief history, did a brief physical exam in which Nat ran away from her when she tried to thump on his left flank (inflamed, hydronephrotic kidney located there), then showed me to the waiting room and took him back for further evaluation.
Evaluation included a urinalysis, some blood work, and a renal ultrasound which confirmed that he did indeed have a kidney stone, and he received IV fluids and Toradol resulting in immediate relief.
Ninety minutes later, he was strolling down the hall toward me, insisting that we tour the Coliseum, the Forum, the Spanish Steps, the Trevi Fountain, the Pantheon, stopping along the way for a couple of cappuccinos and a gelato.
But our first stop was a little shop down the street so that he could buy his new ER buddies a couple of boxes of chocolate because when he asked about the bill for the excellent care he received, they laughed and said “there is no bill for this!”
Nat and I fully understand that there are some drawbacks to socialized medicine, but as patient and patient spouse last Sunday, we became fans. As we toured Rome, we did not come across any physicians begging for Euros on street corners and wondering how they were going to feed their family that night.
Several days later, Nat had a very interesting conversation with a Swiss citizen on our bus ride to Siena about their healthcare system (which has many similarities to the Affordable Care Act). They require their citizens to purchase insurance from private companies from which there are many to choose. He felt that it worked very well.
It is true that the Italian economy is not in great shape… but last time I looked, neither is ours. Since the Italian ER did not drain our finances, we did our best to buoy the country’s economy in other ways.
Healthcare bills remain the number one cause of bankruptcy and misery for families in our country. I have a friend whose daughter recently suffered a complicated course of kidney stones (to be fair, much more complicated than Nat’s). Last I checked, the bill was nearing $100,000. Fortunately, she remains on her mother’s health insurance because of Obamacare. Another spent six hours with her daughter in the ER for stones: a $20,000 tab (and they were uninsured, having recently returned from a mission trip to Africa. They are still paying it off, several years later). Yet another recently had knee surgery and spent one night at the hospital. She recently received her bill: $70,000.
We liked our bill better.