Tuesday, August 28, 2012

First World Health Care, Come Again?

I had the dubious pleasure of trialing the UK private health system this summer.  I tried to get a routine appointment with a dermatologist, only to be told that I needed a GP referral.  When I said that I don't have a GP in the UK, the private hospital kindly told me that they could furnish me with a referral for a fee.  Given the choice of paying for a referral or paying for physical in which I could get a (fee-free) referral, I opted for the physical since I haven't had one in a few years. 

I booked in for the first available appointment, about five full weeks later.  I was told to fast for 9-12 hours before, counting backwards from the start of my appointment as my blood tests would be done first.  I arrived at the private hospital to find that the examining room was a fourth floor walk-up, in a building with no elevator.  That wasn't a problem for me but I figured that for some patients in the hospital, that could be problematic.  After a brief wait, I was shown to an examining room where the nurse told me she would examine me first, then I would have my blood tests done and then I would see the doctor.  I figured that was fine, despite the fact that I had passed hour 12 with no food.

The nurse asked me to remove my top for an EKG and apologized that they didn't have robes but said that they get in the way for an EKG anyway.  I could kind of see her point and didn't take huge issue with being half dressed.  After doing two EKGs, repeating a couple of other tests that she seemed to struggle doing, and talking me out of an eye exam, she sent me to see the doctor.  At this point I asked about doing my blood test first, since I was fasting and had been told that it would be done first thing.  She told me to see the doctor first.

The doctor told me to remove all of my clothes (she didn't even apologize for not having robes, I guess they don't have them ever) and did a cursory exam.  She tried to talk me out of the gynecological exam, saying that in the UK, those are done every three years but she knows the "American ladies' like to have them done every year.  Given that in the United States, those are done annually for a reason, and that my physical cost would not be reduced if I didn't have one, I asked her to do one.  Following a cursory exam in which she called me 'the patient' directly, I was sent on my merry way to the blood lab.

The blood lab actually did a great, quick job, despite the hair covered pillow they gave me to rest my arm on.  When they finished, I settled my bill, which cost the same exact amount that a full physical would cost in the U.S. with no insurance.  I was told that I could expect my results in the mail within two weeks.

The next day I received a second bill.  I called to remind the hospital that I had paid upfront for all costs and was told that the query would be settled within two weeks.  Three weeks later, I got an updated bill with a zero balance owed.  A month later, I was still waiting for the results of my physical itself and called the hospital to follow-up.  After three rounds of phone calls, I finally got in touch with the right department who told me that the doctor had not yet reviewed the results of my physical and would do it later that week since it was past when it should have been done.  The next week, I finally received my results.

If that was the private healthcare system, I am seriously afraid of what the public healthcare system in the UK is like.

At dinner last night, H made an offhand comment about how medicine here isn't exactly first rate and one of our dinner companions chimed in with how great he thinks it is.  When I asked why he felt that way he said that:
  • He can use the public or private system so if he doesn't want to wait six months for an appointment, he can go with the private hospital and wait two months for an appointment.
  • His doctor seems to remember him after reviewing his file during the appointment, despite having so many patients and not knowing his name.
  • Once they lost his blood test so he had to go in and get it done again.  Then it took about six weeks to get the results, but they never lost his blood test again.
  • He can go see a doctor in the private hospital whenever he wants, even if it is not a concrete illness but something he's just concerned about, once he waits two months for an appointment and pays a relatively high fee out of pocket.
I guess 'good' healthcare all depends on one's baseline.  

Saturday, August 25, 2012

Questioning Equality

During a recent trip on a Scandinavian airline, H and I wondered how social democratic countries that promote making everybody equal can then offer multi class cabins on the aircraft?  Even if business class only offers the same seating as economy but with the provision of free snacks.  We were surprised to see that countries whose fiscal policies have such a focus on redistribution of wealth to equalize the quality of life, and even the lifestyles, of everybody, can then offer a service that blatantly emphasizes class and wealth divides.  Unless of course, everybody's economy class tickets cost a bit more than necessary to enable those in business class to pay the same, or less, for more.

All was well though; once the ground crew came off of their government mandated break and loaded the luggage onto the plane, we were able to reach our next destination only about two hours late.  Again, laws that protect the employee but not the customer, or perhaps even the employer, is that fair in the Nordic model?

Friday, August 17, 2012

Food for Thought

H and I recently spent a few hours in Denmark.  While there we shared a danish and pondered if eating a danish in Denmark made us cannibals?

Tuesday, August 7, 2012

Salaam, or Should I Say Shukran

This afternoon I went over to a solicitor to get copies of my passport and H's passport notarized for some Australian paperwork that we're finishing.  I called the solicitor in advance to make sure that he would notarize H's passport copy without H being there.  The solicitor said that he could since he was certifying it as a true copy, but said that he would prefer that I bring a second photo identification with me for H.

Unfortunately, H had already driven to work with his UK driver's license.  I quickly thought about what other photo identifications would be in the house.

"Umm, would you accept a Qatari driver's license as the second proof of photo identification?"

"Sure, no problem," responded my new best friend Mr. Solicitor.

So off I went to the lawyer's office with our passports and my favorite driver's license to-date, courtesy of the Emir on his stallion:


The solicitor was rather excited when I arrived because he had "never seen a U.S. passport before."  He immediately began paging through one and reading aloud the first quote by Abe Lincoln.  The Qatari driver's license didn't even register on his 'cool' scale; I wonder if he's seen one of those before.  The last time I pulled one out outside of the Middle East was to rent a car at Newark Airport.  And the Hertz woman didn't even blink.