Shades of Health Care Gray

My (Alicia’s) first-ever post on our newly renovated PashbyMaul Blog is in response to one of our amazing weekend adventures to the Italian Emergency Room (Pronto Soccorso)!

Andrew came home from Senegal on Saturday, 1 February feeling slightly nauseous.  I thought the feeling would quickly pass as he got some decent rest and adjusted to our time zone and climate.  Unfortunately, that was not meant to be.  Around 4pm he started emptying all of the contents of his stomach into our toilet.  Of course, being sick with the flu is not something to visit the ER for.  But by 9:45 pm, I couldn’t get any fluids into poor Andrew and knew that he was already too dehydrated.  So after a quick call to the ER to ask if there was an English-speaking liaison available, we drove to the ER.

Both in Bahrain and in Ukraine, the other countries where I’ve lived, I experienced care at private hospitals or clinics.  That made this trip my first experience with a state-sponsored health-care facility.  I could give you a lot of details, but who wants a bunch of gory-blood-filled ones?  Probably not many.  So I will give you the summary of our care:

• Long waits in several no-frills waiting room.
• A lot of people waiting for care.  (This makes sense; Italians are much more likely to go to a doctor than Americans, who, as classic work-a-holics, always wait until the last minute.)
• No privacy.  We had to stay overnight in one of the waiting rooms in the ER and there were people being wheeled in and out all night!  They also had to stay in the ER all night, and so our “room” was in a constant state of beds shifting in and out.  There was no way to make the room dark.
• Not much in the form of comfort.  There was only one pillow in the entire ward, and an old and frail lady sleeping behind us (at one point) had it.
• No one was making rounds.  When Drew started to bleed into his IV, I had to go and get someone.
• Nurses and assistants don’t take their time searching for veins.  They poke pretty hard!
• A FREE English-Speaking Patient liaison was available to us.  She was kind, good-natured, and very helpful.  (This perk is most likely located at this hospital because there is a huge American military population but no ER on the military base.)
• Professional care; Infectious and Tropical Diseases doctor was very good-natured and helpful.
• After staying overnight and having several tests run multiple times, guess how much our bill was? 56 Euros! (About $75!)  BEFORE INSURANCE!  Almost not even worth submitting insurance claim for us!!  All we had to do to pay our bill was to put the bill in a machine and insert cash or credit card to pay the balance!

It got me thinking…

If we had been in the States, we would have seen and received much different care:

• Poshly-decorated waiting rooms with many different forms of entertainment available.
• Nurses and assistants (generally) poke veins much gentler.
• If we had been advised to stay overnight, we would have been taken to a regular wing of the hospital instead of kept in the ER.
• In a regular hospital wing, there would have been much more privacy (curtains separating beds).  Americans are obsessed with privacy.  This is something I’ve both noticed and had to overcome in many ways in many places where I’ve lived.
• There would have most likely had been more comfortable beds/pillows.
• There may not have been a patient liaison to help us if we had not spoken English.
• The price for all of the tests, plus staying overnight, BEFORE INSURANCE, would have been AT LEAST $1,000.

Living overseas for the last 7 years has brought me in contact with many different ways of doing things, and caused me to meet so many different people who have helped me become more open-minded.  I can no longer think of things in black and white, but see a lot of the big-ticket “politically-charged” items in shades of gray.  Why is health care SO EXPENSIVE in the United States?  What if we had been super-strapped for cash, but had this emergency occur and not been able to finance it?

While neither system is perfect, in my mind, we can learn a lot from socialized medicine.  While I wouldn’t rate our ER stay high in the comfort or privacy department, we were only out 56 euro at the end of it.  America, can’t there be some happy-medium?  Is there a way to preserve people’s dignity without raising the cost of health-care through the roof?