February 25, 2010

A Possible Future for US Health Care

The health care debate is going to rage on for a while it seems. This raises an interesting question. Is it possible to puke blood from hearing too much bad news? Lucky for me, I’ve got universal health care. But I’m not saying this to put salt in a wound. Here in Germany, roughly 37 percent of your paycheck is taken out, most of it covering health care expenses. Ouch. As painful as 37 percent sounds, the only people I hear complaining are expatriates. But then again, I am one, and I can’t speak German.

Let’s switch gears from Germany and talk about China’s health care system. I had the pleasure of experiencing this first hand -- on multiple occasions. Food poisoning, like fireworks and smoking, is a way of life in China. Their health insurance companies are similar to ones in the States, but cost about the same as a moped. Make an appointment, show the doctor your card (if you have the strength) and you are on your way. There’s no co-pay, and basic medications are included. Sounds simple enough, but to become a resident of China, you must first pass the government mandated health exam. This is when, as the old timers say, you get what you pay for.

Make Sure They Use a New Needle

The school hired a man to drive us to the health facility, a 70 year old man named Zia and our Chinese translator, Rebecca (This was her English name. My friend Todd taught a girl who named herself Purple Micro Number Forty-Eight. She had a thing for Gobstoppers.). We drove through an area of Suzhou where sustenance gardens sprung up next to sidewalks. Dusty cinderblock buildings with brown-tiled roofs lined the crowded street. A river of bicyclists peddled alongside our van as we passed countless stalls of grilled innards and durian fruit.
I asked Zia where he was from.
“I spent some time in Italy,” he said. “But I had health problems.”
He looked like a lanky Fidel Castro and spoke with a mysterious accent one could expect from a Czech diplomat.

We arrived to an unremarkable white building blocked by a chrome gate. Rebecca handed over our passports at the front desk just before a group of Chinese migrant works stormed in. There were signs posted on the wall:
Be Silent. Wait Patiently. No Smoking. No Spitting. No Pets. No Photography.

Like most medical facilities, there was an underlying sense of sterility. This place, however, made Frankenstein’s lab look like a disco. We were led down a dark hallway. Smoked glass windows lined both sides, which projected the twisted shadows of neo-medical procedures.
The hall opened up to a ward surrounded by more smoked glass rooms. It was cold, and all of the medics wore face masks except for the woman drawing blood. I saw her working a needle into a man. A tube stuck out of his arm. There is no privacy. It is, after all, the People’s Republic. When the man came out I replaced him. A plastic pitcher of used needles sat on the desk between us. My wife had warned me, “make sure they use a clean needle. I mean actually watch her pull it out of the package.” I did just that, and then black blood loop-de-looped through the little hose. She pulled it out and dropped the needle in the jug. It was almost full.

A Picture For the Wallet

Then came the ultrasound of my stomach. I don’t know what they expect to find, but they squeezed that gooey gel onto me like a pregnant woman. The nurse dug the wand around my belly and pointed to the black and green TV screen. When it was over, I wiped off the gunk and she handed me a picture of my partially digested lunch.

An eye exam followed. The eye guy handed me a metal spoon, asked me to cover one eye with it, and call out the letters. They were all E. E’s to the right. E’s to the left. E up. E down. I figured he wanted directions.

“Um, E, E, E pointing left, E pointing down, E…”

He asked me to call out the next line and I just gave up. “E, E, E, E.” I passed, but couldn’t understand why a spoon worked better than my hand.

For the cardio gram, I took off my shirt and laid on a table while three Chinese girls stuck electrodes to my face, head, and chest. They asked me to lay still and then they disappeared. I closed my eyes and thought of someplace warm. Before long, a nurse snuck up and whispered into my ear from behind a mask. “Yor hart beat very slow.” “Thank you?“ I said. The girl handed me a post card sized readout of my leisurely vitals.

There’s not much waiting between the exams. It’s a free for all. Patients scurry in to get their forms stamped, and bolt out as if in a scavenger hunt. And then I walked into the X-ray room and all the radiologist were wearing boiler suits. I took off my shirt again, but had trouble removing the jade necklace my wife gave me.
“Put it in your mouth,” the boy said.
“You mean…” I said, and opened wide. He nodded. “You better not be screwing with me.”
“I’m sorry?”
I stuck it in, and the taste of Burberry cologne filled my mouth.

The last station was the dentist. A girl led me to a chair and reclined it until a light shone down into my eyes. When the dentist arrived, he quickly picked at my teeth and said that I had too much plaque and a broken front tooth.

I checked back with Rebecca and found her standing in the ultrasound room. Zia was laying down, surrounded by a group of about seven nurses. All of them were talking, looking to the ultrasound screen, and then back to each other. “What’s going on.” I shouldn’t have asked. It wasn’t any of my business, but I just got caught up in the excitement. Before Rebecca could respond, I heard one nurse say to another, “But he has no stomach.” They printed it out anyway. I waited on a cold steel chair until the fiasco was over.

It’s hard to say that a health care system in one country is better that another. Each country is just too different. If it came down to a solid universal health care plan, would Americans be willing to fork over 37 percent of their earnings for it? Or will cut-rate medical facilities have to serve the growing needs of the masses? Either way, you get what you pay for. The debate will surely rage on, but sooner or later, they’ve got to rip the Band-Aid off. Might as well do it quickly.

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