Wednesday, August 12, 2009

Glue Me Baby

Falls into the category of too big for twitter, too political for Facebook, and too personal for blogger. But I'm going to settle on blogger, since it is, aside from occasional AY-related link love, where I have the fewest followers. Probably because I'm pseudonymous.

Was getting my daily fix of the Guardian this morning when I chanced upon this article about how opponents of US healthcare reform are using the UK to demonstrate how poor a job government does at providing healthcare. This is a laughable claim, and I'll come to some substantive criticisms in a moment, based on my experiences of both systems.

But first, this little nugget:

To the dismay of British healthcare professionals, US critics have accused the service of putting an "Orwellian" financial cap on the value on human life, of allowing elderly people to die untreated and, in one case, for driving a despairing dental patient to mend his teeth with superglue.

I found this particularly funny since I have false teeth and have indeed been driven to fix them with superglue. Here's the thing. It sure as hell wasn't in the UK where this happened, and it was at the suggestion of a US dentist that I resorted to this fix. When I finally got round to getting a new one, I gently reminded the dentist that whatever impression he took of my gob should take into account the wonky teeth I'd had in it the last few weeks.

But US dentists essentially just subcontract all this sort of work to outside makers and have very little interest in the details of this work. It's also telling that the denture I got in the UK lasted for about seven years, while my two US ones have managed maybe three years each. [Actually, it turns out that that the UK anecdote involves a man supergluing a crown to his gums, which is a little different]

Of course what any of this has to do with US healthcare is beyond me, because there is no such thing as publicly-funded dentistry in the US. Dentists have little interest in being subject to any kind of cost control, government supervision, or the demands of common sense. They are, if you will, all thieves.

But it segues nicely into my larger observation about healthcare reform: how on earth do you have a sensible conversation about the proper functioning of your body and money at the same time? Now a supporter of the hopelessly bloated and unequal US system would say "how can you have a sensible conversation about the necessity of medical treatment?" They'd also add, and I confess they're entirely right, that the UK has built a medical system around its founders' inability to discuss money with its medical practitioners, and it's had the fortunate effect of being very fair too poor people.

And they're sort of right, but they very rarely say that the US is super-awesome at treating rare and expensive diseases and awful at dealing with the more pedestrian ones. We're talking about huge copays for drugs that cost pennies to produce, little attention paid to preventative medicine, this weird way that America is proud of Medicare and the VA system and seems to hate public medicine.

I'm biased. I'm writing this as I'm trying to work out how to settle some BS copay for a chest x-ray that diagnosed me with walking penumonia rather than Swine Flu. Was I informed about this when treated? Nope, via a snotty letter that says I'm inches from going to a collections agency. It's by no means a horror story along the lines of a lot we've had, it just indicates what a wasteful and time-consuming process private healthcare can be. We focus too much on the cost in money of employer-provided healthcare and not enough on the time cost. Maybe if we did, there would be companies other than GM prepared to face down the private health lobby.


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