Monday, 3 May 2010
A taste of American medicine
On the list of things I thought I'd never say when I moved to America: I miss the NHS.
I yearn for it's simplicity. At home, one GP does it all and you get a swifty hospital referral if your problem is looking serious, or you're near to death. If not, the wait is so long that the problem will likely clear up before your appointment date. It's a simple system and it works. Compared to what I've experienced in New York, it's medical utopia.
Here, you've got to find a 'Primary Healthcare provider' which I think is like a G.P. except this PHP farms you out to various sub contracters, who then cost you more money and time to see. We've been to ten different medical practitioners since we arrived. Each one comes with reams of paperwork and a $25 co-pay, which is what they call an insurance excess.
What I imagined in America, land of the free but no free healthcare- was gleaming surgeries, with glossy surfaces adorned with fresh flowers. I thought of immaculate doctors with luminous skin, who speak of preventative medical care. I dreamed a dream of receptionists who don't resent my very existence.
Let me paint the reality: Shoving 15 page forms in your face as soon as you walk in, receptionists who are not just rude, they teach the class in rude. Grotty worn out surgeries with grey plastic fixtures and fittings and more than a few dirty floors. Doctors who have just as little time to see you as the ones in the UK. Getting refferals then discovering the referrals don't take your health insurance, so calling around endless places to ask if they will accept you.
Then there is the taking of blood. They do it every time and they call it 'bloodwork'. Like blood is something that needs work. Every time. Blood, blood, blood. It's a secret society of vampirical doctors obsessed with Medieval blood letting.
And the Teenager is terrified of needles, it also means doctor's visits are fraught. I reassure her that this needle won't be as bad as the last, but they always fail to find a vein and she starts to cry and give me pleading eyes and I can see the actual sweat appearing on the brow of the nurse.
So this is what you get for your (insurance companies') money. What you get when you don't pay is much worse. Like the Chelsea Public Health Clinic where we went to get The Teenager one of the multiple inoculations required by school pupils in New York. She needed them fast before she got suspended from school for being a 'public health risk'. I had found her a doctor only to be told that she had to have a pediatrician, because she's under 18. I didn't have time to find one, so I took her to the free clinic. I figured- How bad can this place be? Turns out it was on one of the biggest housing projects in lower Manhattan. There was security guards. The teenager was too scared to go to the toilet.
The American had no sympathy.
"Honneee, why did you go to a *screws face up*...public health clinic? We have great health insurance, you don't have to suffer with the... *deep breath*...uninsured."
"Uh, 'cos she only needed a shot and she needed it fast and I didn't think it would be that bad."
"You didn't think a public health clinic in the projects would be that bad?"
"Well, I didn't know it was in the projects did I?"
"Well now you do. We have health insurance, you don't need to do this to yourself!"
"Ugggh. Aneurin Bevan would be turning in his grave!"
"I have no idea what you're talking about."
"ANEURIN BEVAN. He was a man, a great man!"
"Yeah. You just sound like you're speaking in that Lord of Rings language again."
"He was Welsh yes! He was the architect of the NHS!"
"Yeah, well just look where your socialised healthcare bullshit has got you!"
"It's got me doctors that don't make me fill in loads of paperwork and check I can afford them before I'm through the door."
"Exactly!" and he walks off satisfied.
For all of the doctors, my dentist is the only one worthy of any praise. He's on 5th Avenue and the building has an tasteful green awning with gold writing. There is a doorman. My dentist patched up my cavity with a white filing. That's a white filing as standard. This I love. They haven't done amalgam in the U.S. since the early nineties apparently. This is civilised.
My dentist also shared his wisdom about relationships while drilling my tooth.
"You see Barbara, my wife, she's a lawyer. Well Barbara always wants me to change, to improve and I say Barbara, I'm a man, but really I'm a boy ya know? Now she's a woman, so she's better than me and she can continue to grow. Men, we don't do any maturing past 21. That's it! You're stuck with me, I say to Barbara. So ya married Emma?
To which I say "Ewwchhhafunafewmons." and a lot of dribble comes out.
To which he translates and says "You've been married for a couple of months huh? Early days! But your husband won't change you know? Just don't expect him to."
At which point I feel a bit depressed and wish he'd give me some more Novocaine.
So, I have come to summise that even though things are so different here in that the insurance companies fund medical care, rather than the taxpayer, things are not really that different at all. There is clearly not enough money or time to go around in either system.
Maybe the medical grass is greener. By which pun- I should move to California where pharmaceutical pot is legal and apparently fairly easy to get.
Maybe after smoking a few prescriptions I might have a different view on the American system.