Sicko

[beccatoria]

So I watched Michael Moore's "Sicko."

Medicare took great care of my grandpa when he had a stroke. But I was also viscerally reminded of the incomprehension and fear that hit me when one of my favourite people in the world told me her husband (who had also had a stroke) had a set time by which he had to return to work, or he'd no longer be covered by his insurance and she wasn't sure he was going to make it. And that he had a set amount of money his policy would pay out for medical bills over the course of his lifetime, and, at fifty-something, he'd already eaten half-way through it.

I want to move back to America someday; at least for a while. But this film scares me. And leaves me in bewildered confusion. Because America has always been, in my experience, a vastly generous and welcoming nation. In Britain I see people misunderstand their approach to capitalism constantly because in Britain we think, there's only one pie, and if I have a bigger slice, that's less for someone else. America, founded on frontier mentality and a sense that you'd never actually get to California, seems to believe in an infinite number of pies, if only you're enterprising enough to walk down to the pie shop. If only you're ingenious enough to set up your own pie shop. And that's a kind of boundlessly hopeful and loving capitalist philosophy that encourages everyone to take risks and be responsible and dream big; in Britain we don't really get the American Dream. It's just a phrase, and insult, often enough, for driving big, honking poluting SUVs and being too fat.

And I'll always love America for that; because I'm left-wing, I'm pro-union and pro-welfare state and pro-free university all those uncapitalist things. But America teaches me that there's nobility and positive attitudes in capitalism too; that it has inspired people to extraordinary things.

Lincoln was a total dude. And I can't imagine him approving of all this.

But the healthcare system stands out, glaringly, as a throwback to the worst kind of capitalism, with no adoption of any suggestions from any other political arena. Unlike free education, free police protection, fire departments and judicial system.

There were parts of that film that made me want to cry. Like when that woman found out the inhalers that cost her between $120 and $240 a month out of her $1000 benefits would cost her ten cence in Cuba.

I'd use this opportunity to make some comment about how we Brits should stop whinging about the NHS, but I think that would miss the point. It's noted that perhaps in France (which kicks Britain's ass in both healthcare, childcare and education) the system is so good because the government is afraid of its people, not vice versa. Because the French will protest anything.

So I think I'll be grateful that we care enough about the NHS to think it should be better and to demand that it perform at a higher level.

Though I think I'll take a break from that for just a minute and *hug* it; and not just because it pays me every month. I remember when Kev had an allergic reaction to some antibiotics he got given - didn't really know where he was, was nearly too weak to stand. So I called NHS direct, who got a doctor to call me back within half an hour, who spoke to Kev and me and gave me great advice, and arranged for an alternate prescription (this is at eleven at night, mind you) to be waiting for us at the local hospital late-night dispensary. Which cost us £6.65. And I was scared enough, and I didn't have to be scared to call a doctor/take him to a hospital in the first place.

Thank god we care too much about the NHS to let the government do it what it did to free university education. Not even Margaret Thatcher was that ballsy.

Losing about a third of my paycheck to various types of taxation and pensions doesn't seem so bad on days like this.

Comments

[proggrrl.livejournal.com]

You SHOULD hug the NHS. I live in the USA, I am single with no kids - I dread, absolutely *dread*, pondering what your late night allergy story would have been like here in the states. And I don't even want to think about what it might have cost you if your insurance wasn't decent.

My (conservative, and also healthcare industry working) parents insist that whatever portion of SICKO was filmed in Cuba, we are seeing unreal situations. IE, they are showing their best Cuban face and it doesn't represent what most Cubans would experience when the cameras are shut off. Also keep in mind that ten cents in Cuba is probably 1/10th of a weekly paycheck or something!

Meanwhile, hug your NHS again!!!

[beccatoria.livejournal.com]

Yeah, I feel pretty lucky right now.

I'm willing to believe that the Cuban thing was slightly better represented and that the relative cost of medication isn't as cheap as it first appears. But living in the UK and working for the healthcare system, I can say that it really didn't misrepresent what it's like here.

The only place it might have been slightly more favourable was with the cashier paying out for people's transport, and I'm only commenting on that because I used to have the job of arranging the transport for this area and they've just changed it over and it's an utter nightmare in this area right now. But that's not true nationally. And you do have to show proof of benefits and stuff before they'll refund bus fairs/hospital car fairs, so it's not quite as easy as it was made to look in the documentary.

That said, the intention is the same and if you need an ambulance to get to the hospital, not just a car, or help paying for the bus, it's totally free. Like if you're in a wheelchair, or you need lifting assistance to get in and out of vehicles or something. You just have to remember to call up a few days in advance if it's for a scheduled appointment, or get your GP to call the urgent admissions line if you need to be admitted in the next four hours (anything more urgent than that needs to go via the blue light 999 service).

*hugs NHS*

[raincitygirl.livejournal.com]

Well, I haven't seen the movie, and I don't work in healthcare, but my understanding is that Cuba has a lower infant mortality rate than the USA. So they're doing something right. It's kind of pathetic actually. A baby born into a wealthy First World democracy has less chance of making it past the diaper stage than a baby born in a Third World dictatorship people want to get the hell out of. I suspect, though, that it's not so much them doing something right as the US doing something wrong. i.e. Uninsured pregnant women are less likely to have potential problems caught early. And once the kid's born, it's less likely to get medical care that's not in an emergency room. Preventative care and maintenance care make for healthier patients. Whole lot cheaper, too, than letting it get to a crisis and only then treating the problem. Mind you, according to the report I read, Cuba does have an unusually good healthcare system for an impoverished devoloping country. Most countries that are comparable to Cuba by every other economic indicator have extremely sketchy medical systems. But it's still pathetic.

I'm Canadian, and I've been plagued by chronic mental illness since I was 14. It's taken me a long time to get to teh point where I'm a taxpayer with a job and a mortgage and a pension plan. And yeah, the health system has probably put a lot more into me than it's gotten from me, between free medical care and free prescriptions when I was too sick to work or working but not making enough to pay for the meds, but I've got 35 more years ahead of me before retirement age (maybe longer if they raise it), and I figure over 35 more years it'll turn out to be a good investment by the state. Certainly cheaper for them than me ending up on disability/welfare/prison/assisted living facility/hospital/homeless shelter. All of which would've been very real possibilities if I hadn't been able to get free care. Crisis management is a lousy way to deal with chronic illness, whether physical or mental. but if your parents work in healthcare, you probably know all that.

[beccatoria.livejournal.com]

I've gotta say, actually, mental health is one of the things I was wondering how they deal with in America. Because that's the field I work (not as a clinician). And while I'm sure that insurance covers that sort of thing too - if you need to see a psychiatrist, nurse, need medication, etc., but do they have a kind of...general support plan there? If so, how, if it's not government funded?

I'm just thinking of the rather complex network of community psychiatric nurses we have here where people with mental health issues will often be seen by them on a regular basis (up to three times a week, I think, any more than that and the patient probably need admission) sometimes just to go and have coffee with them and provide some companionship, sometimes to do serious interventions. And the MH crisis line is about ten feet away from my desk - which is available 24/7, in an attempt to offer care if the person is in crisis and stop it from escalating further/provide a point of contact to patients/doctors/family members who need urgent advice.

Are there private companies that offer that sort of care in the US? I guess there must be, but it's not something I've ever heard of before. And it's something I have some trouble imagining as a private enterprise, though I guess there's no reason it shouldn't be technically workable. It just...it strikes me as a very different model of care to the way we provide care for physical conditions, and I only really understand America's model for providing care for physical conditions...

Either way, I'm glad that you were able to get the care you needed. And...and I think something that's missing here is that even if it didn't turn out that you paid back to society what you got out of it (though I'm sure you will), I doubt your care would have been more expensive than, say, keeping you in prison if you were a long-term convict, which is HORRENDOUSLY expensive, and even mentally ill and unable to work, you'd contribute more meaningfully to society than someone behind bars. Which I think is the real thing I find confusing about the States. They do socialise so much - education, prisons, firemen, police, the mail system - that it seems odd that healthcare has been left out. No one complains that they have to pay for the education of other people's kids, or keeping petty thieves in jail, but they sure as hell don't want to save potential assets to society from cancer or mental health difficulties. *headdesk*