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Personal Socialized Medicine Experiences: Not for the Weak-Hearted?

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The sharp pain in my abdomen left me bent over, unable to stand up. I had just woken up from a night's sleep and it was a couple of days before I was schedule to fly back home to the States from a visit to the Hebrew university where I was giving a talk. I left my native country of Israel almost a decade earlier to pursue graduate school training in Canada but at the urging of my mom, I kept my Israeli health insurance rights (at a cost of less than $300 a year), so I was still covered by the socialized health care every citizen enjoys there. As the pain persisted, I went to an emergency room at a local hospital. In less than four hours I was seen by an emergency room doctor (twice) and a nephrologist, received a CT and MRI and admitted to a hospital internal medicine unit with a diagnosis of a kidney stone, which relieved my anxiety that I had appendicitis. I spent the next two nights at the hospital, even though the pain subsided after only one day. The stone was too small to necessitate surgical intervention but knowing that I had to take a long flight in two days, they left me there for observation to be on the safe side. The care was exceptional. The bill came to $0.

Unfortunately, I did not pass the stone in these couple of days. The doctors have warned me that the pain could come back any time with a movement of the stone, but I had to get back home so I boarded my flight. I spent the last few hours of the flight fighting off increasing pains, to the extent that I was offered a seat in the business class that I couldn't even enjoy properly. At JFK, I was taken off the plane in a stretcher and two friendly paramedics drove me to a local hospital. I spent a couple of hours in the hospital where a doctor saw me for about five minutes and I received a CT scan. With a high dosage of painkillers, I was released to take my next flight up-state. The bill arrived in the mail a couple of days later with over $5,000 in charges that my health insurance company did not indicate willingness to cover at the time. It took them a few weeks and occasional updates to assume responsibility for the lion's share of the bill, leaving me to pay only my co-pay. As a postdoc living on an NIH fellowship, the thought that I might need to pay the bill myself was anxiety-provoking. I know many people with health insurance who deal with similar anxiety when they experience medical emergencies, and are still in limbo before their insurance companies approve the coverage. Remarkably, we are the lucky ones. The unlucky ones often have the choice between ignoring obvious medical warning signs or facing medical bankruptcy. With health costs at the level they are today, these attractive choices also apply to many in the middle class.

In the short time I have lived in the U.S., I've heard much about the horror of the socialized medicine systems in other countries. Interestingly, all these comments came from people who never lived in such countries, not to mention used their health care systems. The lack of experience does not stop them from making confident yet outrageous comments on these systems. I do believe that one does not have to experience shooting heroin to make a strong, educated opinion on the practice. However, this does not seem to be the case when it come to health care, as these opinions seem mostly like a disjointed array of personal tragic anecdotes that were given a stage by interested stakeholders in the profitable health care game.

I was unfortunate enough to need health services when I lived in Israel and Canada, as I put my body in harm's way. Yet I was fortunate enough to have these systems there for me to provide me with great and timely care. In 2002, I traveled in Thailand for a couple of months. I rented a motorcycle on one of the islands and ended up in an unnecessary and unpleasant rendezvous with a careless tree. I was sprawled on the ground with the snickering tree towering above me. Later on, at the hut I stayed in, I fell asleep with a half full glass of soda next to me. I woke up with a rat darting from side to side on a beam that held the thatched roof above me. I celebrated this lovely experience with a swig of the warm soda piss (literally) next to my bed.

A couple of weeks later, back in Israel, I experienced an aching body as I never did before. A visit to my family's doctor produced a prescription for aspirin and rest but no real remedy. A couple of days later I checked myself in a local hospital and was immediately put in the ICU once they realized my kidneys shut down. Fortunately, they called various doctors to aid with my diagnosis and a local tropical disease expert correctly diagnosed my condition as an exotic disease name leptoperosis, which one can get from exposure to infected rat urine. This diagnosis and the follow-up care saved my kidneys and probably my life (I was at the ICU for two days with my fever breaching 104 degrees at time). Needless to say that my bill came to $0.

I left for Canada a week after I was released from the hospital and did not need medical services for a few years. However, I did notice that whenever I take a knee (playing sports, proposing marriage, fixing a leaking pipe) there is a sharp pain running up my right knee. A visit to a doctor (of my choice) led me the get an x-ray that showed a foreign body in my knee. I was referred to a surgeon and was able to see him in less than a week despite the lack of emergency. Using local anesthetics he removed a piece of glass from my knee that was lodged there since my motorcycle accident in Thailand. The bill: $0.

These are just my own personal experiences in the vilified world of government-run health care systems vs. the lauded one of a privatized system. There are many with experiences similar to mine (for a personal account of a staunch Republican's experience with the Canadian Universal Healthcare system look here) and some with horror stories on these different systems. None of them is perfect. However, relying on someone's personal experiences, which has more intuitive appeal to most of us compared with dry numbers, is reflecting a very limited and often biased picture. My experiences are idiosyncratic, but so are the experiences you hear that make your hair stand. Compiling these stories together often serves an agenda of those who compile them and publish them. Insurance companies will search and bring you horror stories of government-run systems with notable zeal, sparing no expense. I have an agenda too which I will not hide -- I'm baffled by individuals' defense of a system that is designed to make profits out of their maladies. That is the reason that I think one will be better judging the system on its cost and performance using widely accepted yard sticks. I offered some of these in a previous post. However, I know that personal stories and experiences are more easy to relate to than numbers and I was happy to share mine with all of you who may not have had the chance to experience a health care system that is not motivated by greed and profits.

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