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Health Care at the End of the Earth

by geezer in Paris Sun Jun 24th, 2007 at 05:57:34 AM EST

It was the winter of 1996, and Nuuk, Greenland was bitterly cold in the last days before Christmas.
The wind howled across the airport ramp as the ground crew cut down through the ice to tie down our small aircraft, and we groped our backpacks out from the back in the growing dark. I held Adrian against the wind, and to ease his shaky knees. My son was seven, and a bit shell shocked. Our trip plan had been abruptly altered when ground fog prevented us from landing at Narsarsauak for the night, and Nuuk was our alternate destination- a long, cold three hundred miles across the ice cap after a long but gorgeous flight from Goose Bay, Canada. We were supposed to be snug in a hotel in Narse tonight, and instead---what's this? "Nuuk?" (more below)

From the diaries ~ whataboutbob


On top of it all, Ivonne was getting strep --her sore throat had the classic spots, and she felt like crap. We were grateful that we were on the ground, and we were soon in a taxi en route to a place to sleep. Our
driver told us that there were two choices of hotels- the Intercontinental, which was lovely but very expensive, and the "Sailor's Rest"--far less costly, but with in-the-room entertainment that might be a bit "advanced" for our son. Reluctantly we opted for the posh, thinking that we would be leaving in a day or two, as soon as Ivonne was well, and as soon as the weather improved. Ah, the easy confidence of inexperience.

Next morning we went straight to the desk to ask about a doctor or clinic for Ivonne, who was now really miserable.
The lady told us that the hospital had a good clinic and was only a few blocks away, so we walked.
At the hospital door we met what must have been the world's oldest security guard- we felt like we should open the door for him, instead of vice versa, and get the old guy a chair. A wonderful, leathery wrinkled Inuit face with a graceful smile and whispery voice, he spoke to us in martian, and we smiled and made for the desk.
A hallway. Plain, asphalt tile, painted in pastel light colors- no plush carpets, no grand piano, no impressionist art like my dad's Riverside Methodist Hospital in Ohio. But at the end was a very nice play area for children, and chairs to rest in. A single stained glass window, lovely but oddly abstract, and nothing more. The ladies at the counter spoke good English, and, advised of Ivonne's problem, suggested we wait. We settled in for a long wait- no appointment, you know.

In about 15 minutes, the doctor came and introduced himself. Straight to his office, in the corner of a small lab, and to business. No nurse- he took a detailed history himself, simultaneously entering it into a computer, and then an exam- pretty complete one at that, and a throat culture. He used a test that would identify the exact strain of strep, and did it himself. I had never heard of it, and he told us it was not available in the US- not FDA approved yet. He smiled. "Something new?" I asked. "About ten years old." he answered.

Once he had the results, he got out a file and said, "Since you're pilots, we don't want to affect your ability to fly, or your night vision." I asked him if he encountered pilots a lot. He said, "All the time. Here, airplanes are our life blood- Greenland is not a good place to drive. By this time of year, pretty much the only way in or out is by plane."
After he had entered the results into the computer, he inserted what looked like a credit card, and pushed a button. The computer ran it through, and he gave it to Ivonne. " Save this." he said. We asked what it was for.  "With this card you can get fast care anywhere in the world where the Danish system exists, and they can get your medical history in seconds. Also, with this card, you can actually get care with few questions asked -anywhere except the United States."
We tried to thank him, but he refused the compliment with a wave. "It's basic", he said. "I'd give you all one if I could."

I asked, half jokingly, what I had to do to get one myself. He said, "Just be alive, for people who live here. For you two, you need to get sick and come to me."

Down the hall to the pharmacy we went, and collected Ivonne's  cosmic strep stopper, and then, --the grim moment of reckoning. With Adrian in tow, we went to the original window, and the same pair were there. They offered us a goodby, then looked edgy when we just stood there. So we said, "We'd like to pay our bill, please." They looked us blankly, then laughed,--then apologised.
Then they said (and their words are engraved in my heart),

"We get very few Americans here, so we forget. But this is hospital, not a business. Here, it's a human right."

Display:
Hi geezer, thanks for the diary! Hope you are well, missed you at the Paris meet-up last weekend! :-)
by Fran on Sat Jun 23rd, 2007 at 09:56:02 AM EST
Sorry to miss it- I was ill.
The Aztec two-step:
Montezuma's revenge:
Bad shit.
Sorry- got carried away. Anyhow, thanks for the thought.
Health is rather at the front of my thoughts these days.


Capitalism searches out the darkest corners of human potential, and mainlines them.
by geezer in Paris (risico at wanadoo(flypoop)fr) on Sat Jun 23rd, 2007 at 10:05:50 AM EST
[ Parent ]
Aaarrggh!! the Aztec two-step can have a nasty and exhausting rhythm to it. Hope you are better and hopefully till next time.

Glad to see you are at least well enough to write such a illuminating(?) story. The health-care system could even be used to teach a lesson to our Swiss system.

by Fran on Sat Jun 23rd, 2007 at 10:50:17 AM EST
[ Parent ]
Now, I could have helped you with your Aztec condition and for now much more than what it cost you in Greenland!  Great story with a memorable moral.

I can swear there ain't no heaven but I pray there ain't no hell. _ Blood Sweat & Tears
by Gringo (stargazing camel at aoldotcom) on Sun Jun 24th, 2007 at 09:14:04 PM EST
[ Parent ]
This is a great story.

You should email this to Michael Moore.

He's been trying to get stories with the release of Sicko.

And I'll give my consent to any government that does not deny a man a living wage-Billy Bragg

by ManfromMiddletown (manfrommiddletown at lycos dot com) on Sat Jun 23rd, 2007 at 11:56:45 AM EST
You know, this story is so full of meaning that would be totally lost to anyone who hasn't experienced health care in America. For instance:
In about 15 minutes, the doctor came and introduced himself. Straight to his office, in the corner of a small lab, and to business. No nurse- he took a detailed history himself, simultaneously entering it into a computer, and then an exam- pretty complete one at that, and a throat culture. He used a test that would identify the exact strain of strep, and did it himself. I had never heard of it, and he told us it was not available in the US- not FDA approved yet. He smiled. "Something new?" I asked. "About ten years old." he answered.


Can the last politician to go out the revolving door please turn the lights off?
by Migeru (migeru at eurotrib dot com) on Sat Jun 23rd, 2007 at 12:12:14 PM EST
[ Parent ]
Makes me proud to be (50%) Danish....

"The future is already here -- it's just not very evenly distributed" William Gibson
by ChrisCook (cojockathotmaildotcom) on Sat Jun 23rd, 2007 at 01:25:28 PM EST
[ Parent ]
I don't know whether you've read Peter Høeg's Smila's sense of snow, but it contains very strong criticism of the "civilising" role of Denmark in Greenland.

Can the last politician to go out the revolving door please turn the lights off?
by Migeru (migeru at eurotrib dot com) on Sat Jun 23rd, 2007 at 01:31:12 PM EST
[ Parent ]
Strange you should say that cos my other half was reading it when I delivered a glass of Tesco's finest ...

There's a lot the Danes do that makes me glad I'm only 50% Danish!

"The future is already here -- it's just not very evenly distributed" William Gibson

by ChrisCook (cojockathotmaildotcom) on Sat Jun 23rd, 2007 at 01:48:25 PM EST
[ Parent ]
To me, Peter Høeg's work reads as an attempt to wake Danes up from their complacency. For instance, Borderliners is an indictment of the educational system (and, shockingly, of the philosophy of NFS Grundtvig).

Can the last politician to go out the revolving door please turn the lights off?
by Migeru (migeru at eurotrib dot com) on Sat Jun 23rd, 2007 at 02:02:05 PM EST
[ Parent ]
i enjoyed smila, it was beautiful, if not easy.

i just finished a great book about 17th century denmark, 'music and silence' (great title!)

it's a love story about an english lutenist who found employ at the court of the danish king, and becomes the monarch's confidant.

the musicians played in a freezing cellar under the court, and the music mysteriously wafted into the room through a cunning array of pipes.

any one know this book?

'The history of public debt is full of irony. It rarely follows our ideas of order and justice.' Thomas Piketty

by melo (melometa4(at)gmail.com) on Sat Jun 23rd, 2007 at 04:35:11 PM EST
[ Parent ]
Mig:
You have a way of finding the heart of a piece. I saw that part as the most information dense part-- in a technical sense. Great talent.
LOTS more to that adventure, though.
"Crazy Dazy's" was a restaurant to equal the "Restaurant at the End of the World". Doug Adams would have loved it.


Capitalism searches out the darkest corners of human potential, and mainlines them.
by geezer in Paris (risico at wanadoo(flypoop)fr) on Sat Jun 23rd, 2007 at 04:14:25 PM EST
[ Parent ]
That paragraph stood grabbed my attention, and to explain why I would have had to write a piece as long as yours, with my own examples.

Can the last politician to go out the revolving door please turn the lights off?
by Migeru (migeru at eurotrib dot com) on Sat Jun 23rd, 2007 at 04:52:53 PM EST
[ Parent ]
If ever there was an understatement!

I can swear there ain't no heaven but I pray there ain't no hell. _ Blood Sweat & Tears
by Gringo (stargazing camel at aoldotcom) on Sun Jun 24th, 2007 at 09:14:54 PM EST
[ Parent ]
Thanks. I decided to do the diary after reading a piece about Moore's pretty impressive plans to leverage his documentary into real change. Wow. A nurse or doctor handing out literature on single-payer, insurance parasite- free structure, at every movie theater in America. I will send it to him as soon as I get some sleep- rough night.

Capitalism searches out the darkest corners of human potential, and mainlines them.
by geezer in Paris (risico at wanadoo(flypoop)fr) on Sat Jun 23rd, 2007 at 08:49:58 PM EST
[ Parent ]
Wow!  Keep writing geezer.  Wish I could have met you and Ivonne at the meet-up.

Our knowledge has surpassed our wisdom. -Charu Saxena.
by metavision on Sat Jun 23rd, 2007 at 04:26:37 PM EST
Remembering the long talk we had last year, I was really sorry you couldn't make it last time. I missed you. I hope you're doing better now.

Cheers!


"Dieu se rit des hommes qui se plaignent des conséquences alors qu'ils en chérissent les causes" Jacques-Bénigne Bossuet

by Melanchthon on Sat Jun 23rd, 2007 at 05:54:05 PM EST
I also really regret missing it. Am better now, but --too late. Thanks for your thoughts.

Capitalism searches out the darkest corners of human potential, and mainlines them.
by geezer in Paris (risico at wanadoo(flypoop)fr) on Sat Jun 23rd, 2007 at 08:51:53 PM EST
[ Parent ]
And thanks for the superb story!

"Dieu se rit des hommes qui se plaignent des conséquences alors qu'ils en chérissent les causes" Jacques-Bénigne Bossuet
by Melanchthon on Sat Jun 23rd, 2007 at 06:03:35 PM EST
A wonderful diary.

But it does depress me, too. Not only because it's a reminder of what we don't have here (I may not pay much per visit to the doctor, but I pay through the nose every month for the insurance itself), but because it's also a reminder of something we may never have. We are so overwhelmed and consumed with daily life here (and all its diversions) that momentum and outrage after an incident quickly dies away. I'm guilty of this, too, by the way.

Sorry, not intending to hijack the diary or depress anyone.

by lychee on Sat Jun 23rd, 2007 at 09:12:22 PM EST
Marvelous diary.

A friend of mine once told me a similar story from Italy, where she and her ageing Mum were travelling (they were both Americans).  Mum got a bad nosebleed -- the kind that threatens to become a serious haemorrhage -- and they went off by taxi in the dead of night to the nearest hospital;  here they were greeted warmly by the night staff, interviewed and treated quickly, with little formality but a lot of humanity, by friendly nurses and doctors, and then stunned to find there was nothing to pay.  The hospital was "old," she said, "but very clean, not much high technology, but the people were so competent and they treated us like human beings."

The difference between theory and practise in practise ...

by DeAnander (de_at_daclarke_dot_org) on Sun Jun 24th, 2007 at 04:15:33 AM EST
My wife went to a clinic in Spain. We were charged on the spot. I believe it was 35 euros.

Due to an alergic reaction we ended up at the hospital emergency room the next day. There was no direct bill, but a bill was sent to our house in Canada. That was 180 euros.

A certain amount of that would be covered by the Canadian government. I don't know how much because we had arranged trip insurance that covered it all.

Is the free health care at hospitals really free or are people bending the rules?

aspiring to genteel poverty

by edwin (eeeeeeee222222rrrrreeeeeaaaaadddddd@@@@yyyyaaaaaaa) on Sun Jun 24th, 2007 at 08:46:24 AM EST
[ Parent ]
Health care in Spain is not free for foreigners, that is true.

Can the last politician to go out the revolving door please turn the lights off?
by Migeru (migeru at eurotrib dot com) on Sun Jun 24th, 2007 at 08:51:42 AM EST
[ Parent ]
Pretty damn close for people used to the American system.

I had to get three stitches while in Spain (MfM-Tres putas, Enfermera-No, tres puntas. MfM-Si, lo puedo ver, tres putas.

It was a really hot day, about 45, and I hadn't been drinking water.  So I went to say goodbye to a friend who was leaving Pamplona.  And I was standing there talking to her, in this really intense conversation that dredged up a lot of "history." So one minute I'm talking to her, and the next thing I know I'm sprawled out on the floor.    

I had passed out from dehydration, and left a dent in the  hardwood floor.  Seriously.  So thus began the night at urgencias.  I had split open my chin, and was bleeding.

I hadn't realized it but the other girl (English, fun in a Russian roulette sort of way, and good friend to the girl whose apartment I was at because they met through me. It was a weird triangular sort of thing. not like your thinking, not that I didn't think about it.) was sleeping in the bedroom.  So we all three go to the hospital in a cab.  

They make a fuss about my passport, which was not with me.  And eventually take my driver's license and international student id as form of identification.  5 hours later, after 3 blood tests, an x-ray, and three stitches, I came out with a bill of 120 euros.  Super cheap.

It was a clean hospital, and the only thing that was weird was that they put me in this room together with like 5 other patients while they were trying to figure out what had happened.  So I'm off in friggin space on my cot, and I've got these two girls with me the whole way. And as we're sitting in this room, this old man next to me wakes up and sees the girl whose apartment I passed out in.

And he sits up, and staring at this girl says, que bonito es esto causing my friend to start blushing.

It was an interesting night, and I realized that night that I had a lot of friends.  I must have had 20-30 fellow Erasmus friends stop in to see me.  Those who knew the full story of me and the girls had to have been throughly entertained.

My friend was an engineer, and throughout the night, she made a point of pointing out to me the different design things that they wouldn't allow in a US hospital.  It was old, but clean, I didn't see anything at all objectionable.


And I'll give my consent to any government that does not deny a man a living wage-Billy Bragg

by ManfromMiddletown (manfrommiddletown at lycos dot com) on Sun Jun 24th, 2007 at 11:43:55 PM EST
[ Parent ]
If by foreigners you mean non-EEA nationals. Under EHIC we're pretty much treated the same as nationals, if I'm reading it correctly.
by Colman (colman at eurotrib.com) on Mon Jun 25th, 2007 at 04:58:17 AM EST
[ Parent ]
That's if you remember to carry with you your E111 form (which nobody bothered to obtain) or, nowadays, your EHIC.

Can the last politician to go out the revolving door please turn the lights off?
by Migeru (migeru at eurotrib dot com) on Mon Jun 25th, 2007 at 05:03:14 AM EST
[ Parent ]
What I'm saying is that in the one case (7 years ago) where I had to take a foreign (Danish) friend to the doctor in Spain, she hadn't bothered to get an E111 back home and we ended up receiving a bill at home, which we duly ignored.

Can the last politician to go out the revolving door please turn the lights off?
by Migeru (migeru at eurotrib dot com) on Mon Jun 25th, 2007 at 05:10:42 AM EST
[ Parent ]
I don't think hoptial is free for foreigners in France, but I believe you'll be accepted without financial question for an emergency in all cases.

It's just that the price is low so any foreign insurance will be happy if you're sick when visiting France rather than sick at home: the bill for them is way lower :).

by Laurent GUERBY on Sun Jun 24th, 2007 at 09:45:56 AM EST
[ Parent ]
I believe that is the case in Canada as well - the lack of financial proof before emergency treatment. I suspect that we are more expensive than Europe, but way cheaper than the US. On the other hand who isn't way cheaper than the US?


aspiring to genteel poverty

by edwin (eeeeeeee222222rrrrreeeeeaaaaadddddd@@@@yyyyaaaaaaa) on Sun Jun 24th, 2007 at 04:14:10 PM EST
[ Parent ]
The rules may be different for Greenland, but in continental Denmark, one has to be a permanent resident to be included in the free health care program. Emergency aid is provided free of charge, naturally.

- Jake

Friends come and go. Enemies accumulate.

by JakeS (JangoSierra 'at' gmail 'dot' com) on Sun Jun 24th, 2007 at 10:50:01 AM EST
[ Parent ]
followup on Mikey's film opening this coming weekend in the US
The point of the visit to Cuba is not to celebrate the accomplishments of the Cuban healthcare system -- which are extraordinary (Cuba has roughly the same health indicators as the United States, which is not only far richer, but adjusted for currency differences, spends 23 times more per person on healthcare than Cuba, according to the UN) -- but to say, "Hey, if this poor country can provide healthcare to all, why can't the rich power to the North."

spending 23x less to get the same benefits, that is efficiency -- unless the purpose of the system is capital accumulation at the top, in which case spending more and more to get diminishing benefits is "efficiency"...

In 1971, Edgar Kaiser, the son of the founder of Kaiser Permanente, one of the first big HMOs, went to see John Ehrlichman, a top aide to President Nixon, to lobby the Nixon White House to pass legislation that would expand the market for health maintenance organizations (HMOs). Ehrlichman reported this conversation to Nixon on February 17, 1971. The discussion, which was taped, went like this:

Ehrlichman: I had Edgar Kaiser come in . . . talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because the less care they give them, the more money they make.

President Nixon: Fine.

The next day, Nixon publicly announced he would be pushing legislation that would provide Americans "the finest health care in the world."


footnote

The difference between theory and practise in practise ...
by DeAnander (de_at_daclarke_dot_org) on Mon Jun 25th, 2007 at 03:33:56 PM EST
Yesterday, CNN proudly announced that it has scored the first post-jail interview with Paris Hilton. To make room for Paris on Wednesday, CNN canceled its interview with Michael Moore about his new health care documentary SiCKO

footnote

The difference between theory and practise in practise ...

by DeAnander (de_at_daclarke_dot_org) on Tue Jun 26th, 2007 at 04:27:59 PM EST


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