The German ER

During our recent vacation in Germany we had a little pregnancy scare that made us go to the emergency room. Now, before you go crazy, let me assure you up front that it was nothing and Emily is fine.

But at the time it was very frightening. Without getting too specific, something happened that shouldn't have. Emily called her midwife and she said, "That's not normal, you need to go to a hospital." It was seven o'clock at night, we were in a small town in the Alps, and it was the second full day of our vacation. Neither of us spoke German.

At first, I'm a little embarrassed to admit, I was annoyed. I was almost 100 percent sure it was nothing. But then I saw how scared Emily was and I felt ashamed. It's easy to write off the concerns of people who are not you. After the midwife advised us to go to the hospital, I reluctantly agreed. "Great," I thought, "There goes my once-a-year vacation." Anticipating a three to four hour wait like my visits to the ER in America, I grabbed a book before we left.

We took a taxi to the next town over. It was only a six mile drive but it gave me a plenty of time to think. They were not pleasant thoughts. At first my concerns were practical - how are we going to pay for this? Will insurance cover it? Will they even see us? How are we going to fill out forms in German?

And then my thoughts turned grim - what if this is serious? What if Emily has the baby here? How do we bring it back to the states? What if we lose the baby? What if I lose them both? I got choked up envisioning myself making phone calls telling people about the loss. I saw everything I planned dissolving away and felt powerless to stop it. I looked up at the ceiling to stop from tearing up. Emily was scared enough already.

There was hardly anyone in the hospital when we arrived. We wandered around for a bit looking for a reception desk, trying to decode 18 letter German words. After talking to two friendly nurses in our pidgin German, we took a seat in the waiting room of the OBGYN.

It was a waiting room the likes of which I hadn't seen in years, in that it wasn't spilling over with people in various states of distress. We were the only people there outside of two women quietly chatting over a newborn. Everything about the hospital radiated calmness and order. Quite a contrast from American hospitals, where it seems everything is teetering on the edge of anarchy.

We hadn't been waiting more than five minutes when the doctor came out to see us. He was dressed casually in jeans and a button-up shirt but he had a nice smile for us. He looked solid, like a mountain man or a soldier, but kind. Thankfully, he spoke fluent English. He explained he had grown up around American soldiers and spoken with them often. He seemed to welcome the novelty of treating Americans.

In the examining room, he quickly discovered the cause and assured us it was nothing. I can't describe the feeling of lightness I felt when he said this. He did an inspection and then ran an ultrasound. He took a little time to chat with us for a couple of minutes before sending us on our way. I kept thanking him for seeing us so quickly and he just smiled and said, "It's nothing, it is my job."

This experience was like nothing I had ever had before. We never filled out any forms. They never asked us about insurance. We didn't pay anything. It was only as we were leaving I realized they hadn't even taken down our names. And the longest part of the ordeal was the taxi ride.

Healthcare has been in the news lately with the release of Michael Moore's "Sicko." And it should be because this experience revealed to me that our current national system isn't just a joke, it's an embarrassment.

The sad thing about being trapped in a poor system is that it limits people's perception. People are inclined to think "Well, that's just the way it is", grit their teeth, and bear it. And that's what I thought until we went to the German ER. Only now do I realize the contrast between our system and theirs is as stark as night and day.

And let there be no doubt, our system is a disaster. In his recent confrontation with Wolf Blitzer, Moore pointed out that 18,000 Americans die every year because they lack health insurance - the equivalent of six 9/11s a year.

My personal experience with American medical care is also not good. In contrast to the German system, I've never spent less than three hours on a visit to the ER. The bureaucratic morass of paperwork I have to fill out to see the doctor makes me dread regular checkups. I once was in a three month period where I did not have any insurance. Now that I do have insurance that I pay out the nose for, I have no idea what they will cover and what they won't. And I live in fear that they will drop me for a "pre-existing condition."

I know proponents of private health insurance assert that it is the cheapest method, that competition among insurers drives the cost down. And this may make sense in the theoretical clever-clever land of economists. All I know is I am paying $12,000 this year for an insurer who will not even pick up the cost of our hospital stay (around $1,000) when our baby arrives. The median American income was around $46,000 in 2005 and $12K a year is almost a quarter of that. How can anyone afford this?

No wonder people give up on insurance, HMOs charge outrageous premiums and the profit motive drives them to not cover the cost of anything. Our system is locked in a death spiral. For healthcare to work, everyone has to buy in. Right now it's set up that healthy people (who defray the cost of unhealthy people) drop out because premiums are too expensive. This dropping out drives up the cost of premiums, which drives out more healthy people, which drives up the premiums, etc. We repeat the cycle until the entire system collapses.

Not only does this negatively affect the health of our citizens, it also hurts the economy. When Toyota was recently looking to build a factory in North America, they chose to locate it in Canada rather than Alabama, citing healthcare costs. Canadian workers are $4 to $5 cheaper to employ partly thanks to the taxpayer-funded health-care system in Canada, according to Canadian federal Industry Minister David Emmerson.

But we can be sure this issue will not be addressed until after the long national nightmare is over in January 2009. That day cannot come soon enough. George Bush will leave office with many shameful legacies. Doing nothing about the state of healthcare in America is one of them.

Update - Bush breaks out the veto pen! Today Bush rejected funding for a government program that provides health insurance for six million poor American children. He cited "philosophical grounds" for his decision and I'm sure his favorite philosopher Jesus would approve. If there was one thing Jesus hated, it was kids whose parents were too poor to afford health insurance. Damn freeloaders. No word on when Bush will launch "Kick a Homeless Person on the Way to Work Day" to go along with his vote.

Comments

[Ten Mile]

Not that I do not agree some of your points, outside the director fellow, I have some experience with American Health Care.

I have seen families divorce so the system will handle the costs of child delivery; farmers and others give their house or farm away so the system will cover the costs of terminal disease; and in one case, heard a doctor tell a patient with cancer to do such so the system will cover the costs.

I'm not altogether sure that it is the system making the costs so high to a single individual. I'm not blaming illegals, lawyers, law suits, insurance companies, drug companies or people like the pregnant ones divorcing to beat the costs. I can, however, see not blaming the system entire.

Shamefully, I can not suggest a solution either.

[The Missus]

I do blame the current system. It's a crap system. If people could be covered, then they wouldn't have to pull out all kinds of "sneaky" things just to get their health issues taken care of.

Thank God Emily and Fiona are okay!

[The WordSlinger]

I spent five years as an Analyst at the largest health insurer in the nation and I left because each day I felt that I was part of the problem. It is shameful and immoral that our system of health care is based upon profit from the treatment of disease instead of promoting health through proactive means and healthier lifestyles.

Its' fucking shameful and you're spot on in this post.

[brian]

Speaking as someone who is your friend (though I am) - ignore that.

Yes, I studied health care for four years in college.

Yes, I work in healthcare reimbursement right now.

Yes, it was the exact moment when Hillary Clinton's plan went before U.S. Congress and they tore it down - and I became a lifelong Federal Democrat.

Tore it down!! Does anybody on this forum even remember this? Yeah. That's right - because that's right before you all glommed onto the recent bandwagon to hate Bush ( or the Republican Party or whatever)

See, BEFORE the Congressional Republicans running for the second Clinton midterm office (before Moveon.org existed) promised not to impeach Clinton (do your research folks) - and lied - they did it anyway, there were Republicans slamming Hillary's ideas in public forum. Yes. Making her look stupid. And do you know how? They had this Republican-guy (I saw the C-SPAN) holding up this dictionary-thick book at the podium of the US Congress and shaking it to the camera. "Look at the size of this book!" shouted the outraged Republican congressman. They had guys cringing at "how complicated" this new system would be. What a beauracracy. What Red Tape! Oh the Humanity!

What a joke.

I read Medicare Regulations all day. Do you want to know how many dictionaries that would fit into? Or thick the Private insurance stuff I get at my desk drawer everyday amounts to? And some guy in Congress is able to LIFT Hillary's plan into his hands and complain? That's a gift, man. If he were lifting all of Medicare's regulations, his slimy, filthy Republican, misleading body would be smooshed into the pavement.

I am not afraid of, and never had been afraid of, socialized healthcare. My job, as a healthcare payment analyst-of-sorts, is going nowhere if healthcare were private or socialized. If anything, I need help. Less beuaracracy.

As I was in college, and remain so today, I am a fan of social health care. Don't fool yourself. Despite all my jokes and kidding at your expense, I don't enjoy the current situation either. We're going to go bankrupt on the current system if something isn't fixed soon. Kind of like how Bush ran 3 private corporations into the ground before he became President. And now somebody tell me again - as many did back then - (as I was the only one MAD in 2000! without any bloggers running these types of sites) that Bush and Gore were essentially the same? Does anyone remember that election? Does anyone remember when 9/11 happened and thinking, "Thank God Bush is President and not Al Gore!" Screw that! Screw you all forever!!! Thanks for being mad now. Too late.

In closing - yes, socialized medicine is the best policy. Feel free to ask me whatever else I believed in 10 PLUS years ago at my email address.

[brian]

Hi. This is Brian again. I was just rereading what I posted a couple days ago and realize that I may have come off sounding kind of angry. Yeesh! Sorry about that. I was *really* hungry at the time and was waiting for a pizza to be delivered.

[Dave G]

Update - George Bush is all set to veto the Insurance for Children legislation:
http://www.dailykos.com/storyonly/2007/7/16/7382/34602

That's a big win for people who don't want to see this country's eight million uninsured children get access to medical care.

This president is, without a doubt, the worst in our nation's history.

[Dave G]

Michael Moore on the issue:

"I have to admit, though, I do feel kinda bad taking it all out on Wolf Blitzer. It's not like he's the official representative of the mainstream media. I mean, he's from Buffalo, for crying out loud! He said to me at the end of the show last week to please come back on "anytime you want." I will take him up on that offer and appear again with him tomorrow (Wednesday). I'm not expecting a dozen roses or make-up sex -- I only want a promise that there will be no more distorted distractions so we can have a decent discussion about the REAL issues like why 18,000 Americans die every year because they don't have a health insurance card. More than 300 of them died this week. As Ehrlichman said to Nixon in "Sicko": "The less care they give 'em, the more money they (the insurance companies) make."

THAT'S the only thing we should be talking about. How profit and greed are killing our fellow Americans. How profit and private insurance have to be removed from our health care system. CNN should join me in asking why our 9/11 rescue workers aren't receiving medical care. Somebody should send a crew to Canada to find out why they live longer than we do, and why no Canadian has ever gone bankrupt because of medical bills.

And all of the media should start saying how much it costs to go to a doctor in these other top industrialized countries: Nothing. Zip. It's FREE. Don't patronize Americans by saying, "Well, it's not free -- they pay for it with taxes!" Yes, we know that. Just like we know that we drive down a city street for FREE -- even though we paid for that street with our taxes. The street is FREE, the book at the library is FREE, if your house catches on fire, the fire department will come and put it out for FREE, and if someone snatches your purse, the police officer will chase down the culprit and bring your purse back to you -- AND HE WON'T CHARGE YOU A DIME FROM THAT PURSE!

These are all free services, collectively socialized and paid for with our tax dollars. To argue that health care -- a life and death issue for many -- should not be considered in the same league is ludicrous and archaic. And trust me, once you add up what you pay for out-of-pocket in premiums, deductibles, co-pays, overpriced medicines, and treatments that aren't covered (not to mention all the other things we pay for like college education, day care and other services that many countries provide for at little or no cost), we, as Americans, are paying far more than the Canadians or Brits or French are paying in taxes. We just don't call these things taxes, but that's exactly what they are."

- from his newsletter

[Mozza]

You touched a point that is too seldom mentioned on the helthcare debate: socialized medicine is simple. There are no forms to send and re-send, no paper for the doctor to sign, no fear of not being reimbursed. You go to the hospital, you get the treatment and you're home free. Your health is enough to worry about.

The US spends 15% of its GDP on health and Canada, 10%. Who says competition drives the cost down on this issue?

I can't start to say how much I'm annoyed at the US debate on healthcare. I think it's a symptom of a much larger problem in the US political debate.

[Mozza]

By the way, I really like this page.
http://www.davegreten.com/bio.html

Totally my aesthetics and I like the short, well-written bio.

I'm sure you would love "Beautiful Evidence" by Edward Tufte. It's where "PowerPoint is evil" comes from.

[sandra]

So glad everything ended up being okay...and so glad I'm not in charge of healthcare reform.

[Dave G]

Mozza - just so happens I am also a Tufte fan, although I have not read "Beautiful Evidence" yet :-)