Commentary: Medicine & Health:

Health Care and Security Coverage

 

By Helge Edholm

Kaohsiung, Taiwan

 

In the human life, there is no issue more important than security of the individuals and families. It is necessary for a good and responsible government to make sure that its citizens are well covered and are able to set a high level of safety for human life. I am fully convinced that all can agree to that.

 

However, the problems in disputes at this point are the way the US government intends and wants to take care of it citizens. It cannot be emphasized too strongly that the purpose of a government is to rule justly and fairly without special favour to some, which obviously will harm someone else. Therefore, it is also necessary that a government may not be engaged in any businesses that can be handled as well by the private sector; the government is elected to rule and not to engage in business.

It is illusory to postulate that a government can do things cheaper and better than a private institution; only in the beginning could it possible be seen a little improvement, but later and things government turn into politics, disputes, cover ups and favouritism to the controlled institutions vis-à-vis supplements and/or special tax rates.

 

At the same time, it is necessary that a government educate its citizens to be responsible and to take care of their own lives as best possible by inducing them to establish their own life and health insurances, much as they have to do for cars and realities. Citizens who are on emergency aid and simply cannot afford to pay the health insurance can only then covered by the government. In no way can and must a health insurance be paid over taxes, but must be kept totally independent, and again, must emphasize that the government only rules and control, but cannot and must not run or own healthcare as a business.   

    

It is important to mention that of all the health care institutions that are managed privately, only institutions connected to universities or with a special purpose must be controlled by government, but those must not be in direct competition with the private sector.

 

Establishing a government-controlled health care is tantamount to running a socialistic system, where the government is fully are able to control the people; by having such control, it is inevitable that some will be favoured over others.

By introducing such a system, there are several deficits:

-                      First, citizens come to rely on the government to take care of them, will become irresponsible, and will require ever more care and services.

-                      The encouragement to citizen to take care of and be responsible for their own life and family are removed.

-                      The entire health sector under government control will be political and will always be squashed down to minimum, but still postulate that they perform well.

-                      The patients are for the health sectors and not the health sector for the patients.

-                      There will always be priorities, when governments are in control due to some patients cost more without contributing to the economy, such as people in the pension age.

-                      As the time passing and the efficiency drops the cost increase, the services drops and the tax will increase. 

 

Government must never, never be in control of health care centres, hospitals and special clinics etc, but shall set up proper rules and regulations.

-                      It is proved in so many countries that by under the government control, it will sooner or later have a disastrous result.

-                      The health sector will easy become the most important issue of any government and most of the time will be spent on this issue and without any good outcome, as we know that all the many concerned parties involved will always judge according to own benefits and not what is best for the health sector.

-                      No government can control and run any business efficiently including hospitals and other care centres and the cost will gradually escalate with less and less proper services and efficiencies. It is easy for a government to control the private sector, but dammed difficult to control it self.

-                      There will be shortage of doctors, nurses and other people

-                      Hospitals etc will be closed down and concentrated in large hospitals with the excuse of efficiency and shortage of doctors and nurses.

-                      The hospitals will almost always be under budgeted or loose control of it.    

-                      The efficiency will go down and the cost will increase.

-                      There will be limited and only approved equipment and medicine will be available.

 

     

I am from a country which is regarded to have one of the highest degrees of welfare for its citizenry anywhere in the world, and I must agree that they are also recorded as the most satisfied people in the world.  The health care system is all under the government control and each individual receives a health certificate card which always must be carried in case of accident. All cost is collected via the tax system and same as other cost covered up in the financial system.

 

However, I am most critical of this system of health care and hope no one will ever copy it. It is correct that when one is seriously ill they are always able to come to see a doctor, and depending on one’s status, it could be free. Hospitals are always free, but it is becoming so difficult to go there if not by an ambulance, and once admitted one could wait many hours before being able to consult a doctor.

 

One can always go and visit one’s assigned family doctor during office hours;

The family doctor can handle common sicknesses and is able to consult specialists. If a visit to a specialist is required, the appointment must be made by the family doctor and take from three months to more than half a year to see the specialist after the appointment is made. It is impossible to consult other doctors for a second opinion, which leads to many mistakes, of which I can mention several (including my own father, who became so angry at the system that in the end he did not trust anyone connected with the system, and called them useless. He died far too early).

 

The hospital doctors usually have their own separate clinics, and often spend more time at these clinics than at the hospital itself. The result is that some doctors can become more concerned with their own businesses and earning money than the main hospital work they are actually employed to attend to.

 

One of many cases I can mention is that of a small happy playful boy, who recently became ill and the mother took him to emergency hospital and informed the doctor that he possibly had swallowed a button battery and suggested that they check via x-ray, but the doctor did not believe her and said it was impossible that a small boy could swallow a battery and an x-ray was out of question, due to cost and had to involve other people. He was given some stomach medicine and sent home, but he became sicker, crying and not sleeping, he was taken to the hospital again, checked, and got same result. He got very ill and was brought to a major hospital where he was finally scanned and found that he had indeed swallowed a battery. Unfortunately it was too late and the boy past away. In total eleven doctors were involved in this case.

 

My very good personal friend got breast cancer and had a single-mastectomy, after which she was then declared healthy and all the dangerous tumours had been removed. She therefore booked for a new artificial breast, but she felt some dizziness and problem with her balance and therefore visit her own doctor, who then referred her to an ear specialist, as he judged that it could be some ear problem.  The ear doctor told her it was inflammatory middle ear and he had to puncture the eardrum. She told me later that that was the worst and most painful thing she had ever experience or could imagine and would never wish it for her worst enemy. However, she did not improve and finally her sister’s husband made appointment with a major hospital and she was then scanned and they found brain tumours, but it had spread too much and it was too late.  Just a few months later she died. This is another case where it may have been possible to have saved someone’s life, had there been proper medical attention. Many other similar cases could be cited here, and whatever good intentions of the government, it will not change or even improve a little the present system.

 

I am now living in a small country which does not have a high score on the world measurement scale regarding health care. However, this government is not doing so badly, even if there could be mentioned many improvements.

 

They are controlling their medical costs quite well via the NHI card which everyone has to have, and which requires a monthly fee of from 20 to around 60 USD (this is totally independent and budgeted separate from the tax system). Citizens then can receive basic and life treating coverage; however, many items are not covered, for which patients must establish their own or family insurance or must pay out of their own pocket. Patients are always requested to pay a portion of the bill if they are not from an enlisted family which are exempted due to special conditions.

 

There is a mixture of government hospitals and private in very good cooperation and the good thing is that patients can always visit any hospital at any time, and emergency care is always available. The private clinics are also open from morning to late evening, and are only closed for a short time in the afternoon. Sundays and special holidays are closed.

 

Due to my happy life (I suppose), I have high blood pressure, diabetes and serious heart artery blockage. Fortunately I have the three best doctors possible, one for heart, one for heart surgery and one for diabetic disorders.

 

Eight years ago it was found that I had serious high blood pressure and needed to have medication for it. My heart was checked and the doctor found that my heart only functioned about 30% of capacity; that being the case, I was sent to the hospital for further check up. The surgeon doctor then found that I had a serious artery blockage in the heart (of around 11cm or about 4.5 inches), and there were two choices: either have a series of bypass operations or undergo a balloon operation. I was far from happy with the bypass and therefore chose the balloon operation as the best option.  The next day I was on the table, but after two hours the doctor had to give up, as he had only been able to penetrate 2 to 3 cm due to the degree of hardness. New equipment later became available and he therefore tried again two more times over a year with same result, not successful. I then waited for a long period until one Thursday evening I went back to the doctor again, as I did not feel well. I asked my doctor if he thought there was any possibility for him to be able to penetrate and utilize the balloon method or else I had to undergo the bypass operation soon. This doctor is specialist in balloon operation and could not do the bypass, but he knew a very good doctor, who he recommended. However, he informed me that a very highly qualified Japanese doctor was scheduled to visit the hospital on the coming Monday and he would ask him if he could assist or carry out this operation. I immediately signed up for this opportunity and next Monday I was again on the operating table; the two doctors performed the operation on me from 8:30am until 5:00pm (during which time I was conscious and had to be tied down); I now have an 11cm stench inserted. The operation must have been strenuous indeed for the two doctors as well. The local doctor told me that each time he meets with the original innovator of this kind of operation and whenever he attends a medical conference, he always discusses my case. Six years have now passed and all is well. I remain deeply grateful for the fine medical care I received and I dread the day I am forced back to the socialistic welfare system of my former homeland, a system under which we are all are supposed to be equal. In theory at least. But theory does not always hold up well under the pressures of reality.

 

In truth, the socialistic system is not all bad in basic thinking, but there are three fundamental failings in such a system:

1)                  The responsibility of the individual is forcefully removed.

2)                  The Government takes over the control for the individuals

3)                  The patient will be for the institution and not the institution for the patients.

 

The healthcare situation in my former homeland stands as testimony to the fact that the end result of this type of socialized medicine is that the government will take over and direct people in the way they wish and desire, seducing the citizenry with beautiful promises, all the while putting lofty dreams of a healthcare utopia over recognizing the harsh realities and inevitable drawbacks of putting such a system into actual operation.