Tuesday, August 11, 2009

Let’s Take a Deep Breath

Now let’s imagine what we want our health care to be like.

I’ll start.
I want to immediately clone my all-time favorite and best doctor, who unfortunately has now retired. Here’s how I described this excellent physician back in 2007:

Once upon a time, I had as my primary care physician, a doctor of medicine who really was a prince. He always shook my hand and made eye contact. He would always sit down and chat for awhile with my husband and me about anything and everything that was happening in our lives. He believed in all that modern western medicine had to offer and was open to everything else that was well intentioned in this world. He knew and cared about our lives (work, pets, hobbies, extended families, politics, emotions...) and told us about his own. He believed the body was a temple and that it was important for him to treat it with respect. He saved me from at least one major surgery by proceeding with prudence, caution and riding herd over less experienced, less intuitive and less wise doctors. We were partners in my healthcare. Did I mention he had call hours at home every weekday morning for a half an hour? Or the fact that he made house calls to his elderly patients? A prince!

Yes, I want everyone to have a doctor who is one part Marcus Welby, one part Andrew Weil and 100% talented, knowledgeable and, above all, human.

Next, I want affordable health insurance for everyone - that includes prescription drug coverage. Heck, while we’re at it, throw in dental insurance too. Which if you think about it, it is pretty odd that one part of our body has to have separate insurance from all the other parts. Especially since we know that the best medicine treats the whole of the human being. And, yes, I want plenty of choices of insurance coverage too. That choice extends to employers, in particular small business owners, who want to offer health insurance coverage to their employees, but don’t want the premiums to suck up all their profit and stifle their growth.

After discussions with a family member who is a primary care physician, I know I also want state of the art, computerized medical records. I want the doctors (as described above) to be able to glance down at a laptop and pull up their patient’s prescription history, allergies, lab work - the whole nine yards. I want them all to have the ultrasounds, X-Rays, EEGs and any other test results and specialists’ reports accessible through that same laptop. That should cut down on repetitive and duplicative paperwork on the part of not only doctors but patients as well.

I want my 85 year old Mom and all her contemporaries to keep their current Medicare coverage. Streamlining it to improve it and provide higher quality, less cumbersome and less expensive care would be great. Thinking about elderly relatives, after having spent many hours with family members discussing ordinary versus extraordinary means and all aspects of end of life care, I know not all families are prepared for these conversations. So encouraging folks to have a conversation with their doctor about a living will and health care proxies and having that sort of office visit covered by insurance is a very good idea.

What I really want is a level playing field. I don’t want any negative implications of geography, previous health conditions, education or income to be impediments to affordable, accessible health care. Nor do I want the reverse of those circumstances to provide charmed access for a select few.

Lastly, I also want to clone the brilliant care givers who took care of Chuck’s Dad in his last year, so everyone could be so compassionately attended to in their final days. But I think even my imagination is beggared by that impossibly high standard.

What do you want?


dancingmorganmouse said...

One of the things I miss most about my home town, is my old GP. I'd seen him since I was 7 or so, he delivered my sister. He gave me my file when I left for another state. I wonder what' he's doing now?

Pink Granite said...

Hi DMM -
You'll have to head to "The Googles" and see what you can learn about your old GP.
I disliked my first pediatrician. But when I was a teenager many of my family members began being cared for by a very good doctor who was a pediatrician, but functioned more like a general or family practitioner - at least for our extended family!
The good ones are real gems.
- Lee

Pink Granite said...

P.S. I just Googled our old pediatrician/family doc and found he's still practicing. Very cool!

Sue said...

Gee, the list of things we could do in the medical line in this country is a long one.

Our state hospitals are revolting and one has to have to have medical insurance to ensure that you can go to a private hospital. While the health care is inexpensive and often free in state hospitals, you have to take everything with you, including food as well as your own bedding, which is invariably stolen. They’re over-crowded and run down. The queues are miles long and people sometimes wait all day before they are seen to. That said, these hospitals are used for training up young doctors, so the medical staff are generally of a very high level. Still, I’d pay just about anything to my medical aid fund not to have to go into one of these hospitals again (Jake had his arm done in one – scary!). So, first, I’d wish for a massive improvement in our state hospital facilities…

Second, I'd wish for sex education and easy access to anti-retroviral drugs to be a standard. In this country, AIDS is rife and it's so, so sad to see kids orphaned because their parents are uneducated and irresponsible. That said our current president, Mr Jacob Zuma, once openly declared that he had a shower after sex to prevent getting AIDS. Another parliamentarian (I’ve forgotten her name now) was overheard stating overseas that AIDS can be cured by eating garlic and beetroot! If this is the kind of information that people are being given, you can’t help them for not being scared. They need to be scared, it’s frightening…

So, I’ll leave it there for now. There’s lots that needs to be done here, but not enough money (or there is, it’s just spent on the wrong thing - 06-07/Minister_buys_two_BMW_750is).

Thanks for the vent…

Sue x

Pink Granite said...

Hi Sue -
Thank you for taking the time to write about the differences between private hospitals and state hospitals. The contrasts are stark and staggering.

And, as you know, I completely agree with you on the importance of factual, age appropriate sex education. The consequences of STDs, HIV and AIDS are so enormous that we cannot allow false assumptions and wildly inaccurate prevention strategies to continue to be promulgated.

As for the car scandal you linked to, here in Massachusetts we had a similar, but less outrageous situation. Thankfully, over here, our governor picked up part of the tab for the one upgraded vehicle.
Thanks again.
- Lee

Irene said...

I want everything you've listed, and I would like to see Medicare un-complicate itself.

Roo said...

I use the NHS, and I honestly think it is the best in the world, from my experience. I have never, ever, had recourse to complain over my care, or that of a family member. I think our doctors and nurses are overworked and underpaid, but they are still incredible.

Sue said...

Just wanted to add onto Roo's comments - the UK's NHS is brilliant. Jake and I were on holiday in Scotland last year and he developed an ear infection 3 days before we were due to fly home (we were leaving Scotland that day though). We went in to the local doctor's office, made an appointment, saw a sister and got a script for antibiotics and paracetamol, which we then collected from the neighbouring pharmacy. It did not cost us a cent! I'm sure this is not normal protocol for visitors, but we did explain that we were only on holiday and the doctor's secretary requested the local contact address of where we were staying for our forms. Freebee with excellent, friendly, quick service - we need that here!!