Friday, July 24, 2009

Obama-Care: What You Can Look Forward To

Ok, I said I would try to stay away from politics or almost avoid it. This is the "almost".

Let’s break it down into language we can all understand. As many of you know, I am an American living and working in the socialist haven of New Zealand, and I have some personal and vicarious experience in the system that is in place here. The model is the same, with a few differences, in just about every other socialized Western Democracy.

Here is an all too common scenario faced by patients in socialized health care systems such as what we have in New Zealand.

You plan ahead and go to your GP (general practitioner/family doctor) for a regular physical or check-up. By the way, only surgeries, hospital and emergency care are “free”; you pay out of pocket $40-$50 to see your GP, plus whatever blood work or prescriptions you need. Only infants get free GP coverage. Now, let’s say the doctor finds something wrong, and he/she refers you to a specialist for further evaluation.

Here’s where the fun starts.

You call to set-up that appointment and get put on a waiting list, and that can be as little as a couple of days to as long as 8 or 9 months – or longer. There is no negotiating or haggling on that. It’s done based on category of severity which is assessed by the district health board, and YOU have NO SAY in that matter – you are what they tell you you are, and that’s that. You finally get to see the specialist, and if further treatment is needed, you get put on a priority list which is, again, assessed by the district health board.

Now the REAL fun starts.

When it comes down to it, the older you are (once you’re over 50 or 60), the further to the back of the line you go. There are only so many resources available (it’s called rationing in any other universe), and the bureaucrats at the district medical boards decide who will get what first based on what value you have to the system. In other words, if two people need, let’s say, a hip replacement, heart surgery, cancer treatment – whatever – and one of them is 20 and the other is 65, the 20 year old will most likely get it before the 65 year old will. Why? Because as a 65 year old, you’re already retired, collecting your retirement, and basically, your days are numbered as a contributing tax payer – the state isn’t going to get any more production out of you. The 20 year old, well, the state looks at him or her as a cash cow with a whole life ahead of them that the state can milk for taxes to pay for all the other shit the state pays for.

Now, you can jump up and down, write letters, protest all you want, but it won’t likely get you anywhere. Here in New Zealand you can’t sue. There is only so much money to go around when the tax base is so limited in a small country like NZ, and there are so many government entitlement programs competing for funding. Doctors and nurses and every other state-funded health care provider are on a fixed salary, and to top that off, they all have unions, so it seems almost every other week one group or another is going on strike.

But do you know what the real problem is? The bureaucracy. Inevitably what happens is that any time there is an increase in funding or expanding care in the form of treatment and/or facilities, who gets a big portion of that funding? The bureaucrats – mid level administrators to oversee the programs, commission feasibility studies to determine cost effectiveness, and all the other bullshit. In other words, people with job titles and no real job get their money first, leaving little left over for the front-line healthcare providers, the facilities, the pharmaceuticals, etc., where the money SHOULD be going. Regarding prescribed drugs, the state has a list of approved drugs and providers, and you have little or no say in that matter either.

As a result, we are facing a constant shortage of quality people to work in this country’s health care system because so many New Zealand-educated doctors and nurses leave here for greener pastures overseas in places like Australia (which has socialized health care but can pay a better wage and is close to NZ), Canada, the UK (not much better than NZ) – but guess where a lot of New Zealand’s best medical professionals end-up: The US of A. So we have a lot of doctors from India and other parts of Asia and other parts of the world, many of whom, despite having to qualify by New Zealand standards, have questionable qualifications and slip through the cracks. The big saving grace are the professionals (and not just in medicine) who come from South Africa – and they aren’t the ones who are of the same skin hue of Nelson Mandella, if you know what I mean. I’ll say it right here: Thank God for the white South Africans or Afrikaners coming to New Zealand because without them this country would be severely fucked, and as long as things in South Africa remain as fucked-up as they are, the Afrikaners will keep coming here to fill the void left by quality New Zealanders leaving.

If all that sounds good to you, then by all means, support Obamacare, because that is what you’re going to get – or something very close to it.

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Blogger jdpeiper said...

Good work there Joe.
Here in UK, the GP is No Charge.
Meds likewise are on NHS. Even aspirin. Which I think is pretty outlandish. The waits are long. Wife waiting about two months for her hearing problem. She might be losing hearing in one ear, and has problem in other.
I've likewise waited some months for an appointment with a doc, and as you say it is then some more months before exam or surgery.
The only thing I can say that might put you off, is that home in the states, even with ins. the system can break ya financially.
Here ... it only breaks the country. Bit of dark humor there.
What they have in place under the name of rights and humanity is breaking the bank. Literally. Legals and illegals and especially the immigrants that even top officials know for a fact, come here strictly for medical attention. And they ALL get it.

1:59 AM GMT+12  

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