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Tuesday, May 24, 2005

I [heart] socialized medicine!

I don't like to use my journal to complain about the symptoms my aging carcass is throwing my way.  In fact, I've actually stopped reading a couple of blogs because the authors spent way too much time cataloging and describing their various medical problems (not to mention the excruciatingly detailed progress of the treatments).

I can't even get that interested in my own medical issues, so you can bet that I'm not a very sympathetic audience for someone else's aches and pains.

However, I'm going to share a little bit of my pain today... if for no other reason than to let you understand how much I love living in a country with socialized medicine.

For almost a week I have been suffering with sever lower back pain.  Over the course of my adult life I've had various episodes of back problems... but most of them had been in my middle/upper back or neck. 

Lower back pain is a whole 'nother animal! 

It started last Thursday or Friday, and has been getting steadily worse since then.  Yesterday my lovely (and patient) wife called up the local branch of our Health Service (Maccabi) and asked them what I should do.  They gave her the number to one of their 'Natural' clinics in Beer Sheva (not too far from my office), and told me to call for an appointment.

With everything I'd heard about the snail's pace of socialized medicine, I was prepared to be given an appointment sometime in 2007.  But to my surprise the very helpful young woman on the phone said I could come in first thing in the morning.  She asked if I wanted traditional or natural treatment.  When I asked about the difference she explained that many people with back pain opted to explore natural medicine first since neurosurgeons tended to see solutions as surgical. 

When I quickly opted for the 'Natural track', she explained that I would be seeing a physician in their 'Natural Medicine' department who would determine the nature of my injury and direct me to the proper course of treatment (if necessary).  She also assured me that if the doctor thought I was a poor candidate for natural treatment he would send me to the other side of the building to see a neurosurgeon the same day.

I have to tell you, I wasn't thrilled about going to a clinic in Beer Sheva because, well, I'm a spoiled American and Beer Sheva is, even by Israeli standards, a backwater town.

I walked into the Clinic promptly at 8:15 this morning and was pleasantly surprised by what I saw. 

The office was tastefully appointed in blond-wood furniture with lush plants and nicely framed copies of impressionist artwork adding a soothing accent to the setting.  The receptionists were wearing crisp white lab coats over earth-toned scrubs, and the air was lightly scented by the aroma-therapy candles burning here and there throughout the reception area.  The final touch was lent by the soft new-age music playing over the speakers hidden in the ceiling.

I felt as though I had walked into a spa rather than a medical facility! The spa perception was enhanced by the receptionist gently asking me to turn in my cellphone.  As she accepted the phone, turned it off and placed it in a drawer, she explained that they wanted to minimize the stress-inducing noise in the treatment areas.

The medical history that I had to fill out was the only somewhat stressful part of the process... but that was really my own fault.  It goes without saying that it's hard to provide accurate medical information when you understand only 60-70% of the words in each question.

A couple of examples:

Have you ever had [mysteryword] or suffered from [mysteryword]?

Is your pain [mysteryword]  like [mysteryword] , or more like [mysteryword] ?

Do you have a family history of [mysteryword]?

To her credit, as soon as the receptionist noticed me struggling over the questionnaire, she called me over and did a wonderful job of pantomiming the meaning of the mystery words.  The most inspired of these gestures entailed twirling her index finger around her ear and then jabbing her thumb over her shoulder.  This was a brilliant way of helping me complete the third example I gave you, above.  The question was asking me if there was a history of mental health problems in my family.  Although I could have had some fun with that question, I just smiled and said 'no'.

After a short wait I was shown into a pristine examination room where a doctor proceeded to go over my questionnaire and ask me more specific questions about my back pain.  He was very patient about my spotty Hebrew, and deliberately chose simple words while asking his questions.

Besides the standard thermometer,  blood pressure cuff and stethoscope trifecta, I was subjected to an extremely detailed head-to-toe examination (although I thankfully dodged the dreaded rubber glove).  He was clearly looking for referred pain or other medical problems that might be related to/causing the back pain.  After a very careful scrutiny of my spine from various angles and postures, he took me into a well-appointed x-ray suite and explained to the technician in great detail exactly what poses he wanted for the films.  Within a short time he was able to call up the images and point out the things he found significant. 

I won't go into too much detail about what he saw... but he said that he didn't feel a CT-scan would be necessary at this point, and that he wanted me to start an 8-week course of treatments that would combine acupuncture, deep massage and chiropractic manipulation of the spine.  I would have two treatments per week of the acupuncture and massage, and one session per week with a chiropractor.  He also explained that I would be given a detailed exercise regimen and that I would be seeing him once a week to monitor my progress.

Wow!

When I went back out to the receptionist, I was prepared for the proverbial 'other shoe' to drop.  I fully expected:

1.  The treatments wouldn't begin for months.

2.  The treatments would cost a small fortune.

To my surprise she explained that:

1.  I would be receiving my first round of treatments this afternoon.

and

2.  The total bill for the eight weeks of treatments (a combination of 24 total treatments) would be just over 1000 Shekels (about $250). 

When she saw the look of shock on my face, she mistakenly assumed I was angry about the expense and rushed to reassure me that I could spread the fees over as many as 12 monthly payments on my credit card!

I'm not looking forward to becoming a human pin-cushion (especially after recently poking fun at the practice on someone else's blog)... but at this point I think I would probably agree to Santeria or Voodoo rituals if there was a glimmer of hope that they might make the pain stop.

All I can say is, 'I [heart] socialized medicine'.  I sure hope the treatments are as pleasant as my experiences thus far.

221_16_5_2

Posted by David Bogner on May 24, 2005 | Permalink

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I couldn't agree with you more. My husband who is an osteopath (like chiropractic gentler techniques, also a medical doctor) works with the Maccabi Natural medicine clinic in Jerusalem and I have been totally impressed with the clinic and the way that they run things.

Plus, for the patient... because we have socialized medicine, people can get private visits with practitioners for lower costs than you would expect in other places. Tough on the pocketbook of the doctor's wife but nice for the general health and wellbeing of society.

Posted by: Beth | May 24, 2005 12:08:52 PM

Great timing for me to read this... I'm off to the neuro surgeon this morning. (Neck problem caused by old sports injury) I can only wish for as positive an experience, and I'm well-insured. I'm jealous

Posted by: oceanguy | May 24, 2005 2:20:53 PM

Glad the experience was good - - hope the treatment is better! (man, you're getting old...!)

Posted by: val | May 24, 2005 3:21:36 PM

We in Canada tend to take our free healthcare pretty much for granted, except to complain about this or that. It was an eye-opened for me when my first child was born - in New York State. After my hospital stay, I received a bill. What a shocker that was! An itemized bill?? For childbirth??? How bizarre...

I didn't have to pay it, mind you; my provincial coverage did that.

Nonetheless, I came away with the idea that it would be a good thing for Canadians to have an understanding of how much medical care actually costs. Don't misunderstand: I think universal health care is an excellent thing. I just think we'd value it more, and gripe less, if we had an idea of its cost.

Posted by: Ilona | May 24, 2005 3:24:05 PM

Hmmm....

I [club] socialized medicine.

Anyway, I hope all goes well and at the end of the treatment they don't decide that you need to be [spade].

By the way, I hope Zahava is feeling better. A cheerful wife is more precious than [diamond]s.

Posted by: Doctor Bean | May 24, 2005 3:52:48 PM

Oh, and another thing, did they recommend any anti-inflammatory pain medicine? If not, with the understanding that it's not "natural" (Don't get me started on nature worship -- our latest and most popular form of idolatry. Back pain is perfectly natural. Having it incapacitate you is totally natural. Don't take me to any clinic where Feral Cheryl goes.) and only if you know that you don't have ulcers and you have healthy kidneys and take no other prescription medications, let me suggest ibuprofen (in US, Motrin, Advil), 600 mg four times a day or naproxen (in US, Alleve) 500 mg twice a day for about two weeks. If you decide to do this, let your doctor know about it at the next visit.

Oh, and put some cabbage in your pants.

Refuah shlema [a complete recovery] to you.

Posted by: Doctor Bean | May 24, 2005 4:01:29 PM

I'm [hearting] socialized medicine from afar. That is amazing. Considering that I shell out $200 a month for an orthodontist who spends all of 5 minutes replacing a wire (and my insurance hasn't paid up a penny in reimbursements yet and it's been 12 months) every month I am just green. I can tell you from personal experience that acupuncture can do wonders. I was very sceptical about the idea of someone jabbing lots of needles into me and there being any kind of pain *relief* as a result but after a couple of visits to an acupuncturist 15 years ago I was sold all the way! Hope it works for you and you feel better!

Posted by: katie-yael | May 24, 2005 4:26:38 PM

When I speak with family and friends who are in Canada (where I grew up), all I hear is griping. They all tell me that as long as you're just going for check-ups, well visits, pediatrician visits, etc, socialized medicine is great. But come the time you need a specialist or specialised care, it's a walking nightmare. Perhaps Israel is different. Anyway, I hope you feel better. Your bees need you.

Posted by: Just Passing Through | May 24, 2005 4:33:03 PM

Oh, and put some cabbage in your pants.

Doc, if you think that the old man is having trouble with the visitors in the old shretuim what do you think they are going to do when he ambles up to the urinal and a salad tumbles out of his pants.


The above was said with a straight face.

Posted by: Jack | May 24, 2005 4:45:34 PM

Hey 'old man!':) Have you tried the other...remedy for back aches…..you know..the adult one? Does it get better or worse, if worse then….your def. aging, man.

Posted by: kakarizz | May 24, 2005 4:56:19 PM

A couple of years ago I was having back pain while on vacation in England. I asked my husband to give me a massage and then, I couldn't even move--he did something very wrong. Fortunately, there were numerous acupuncture shops around and out of desperation I stopped in one and paid up. The pain was gone by the next day--amazing. Except, for the scary purple bruises on my back--it was a miracle. My husband took pictures of the whole process and I nearly fainted when I saw them later..if I had know what the Chinese doctor was doing me with the fire and needles, I would have screamed!

Posted by: Naomi | May 24, 2005 5:01:04 PM

Refua Sheleima...so glad your experience was pleasant. Medical care is something that scares me about making aliyah. Good to hear that it's not so bad.

Posted by: Essie | May 24, 2005 5:12:34 PM

I've heard nothing but bad things about the medical system in Israel, but to be honest this was mostly from Americans who had moved there and then came to see me when they were in the States. It's nice to hear something positive for a change. Although your experience is more with the alternative medical system, which stresses the touchy/feely stuff more than the allopathic system.

Back pain is one of those things that does equally well in an alternative system. I wouldn't necessarily go there with cancer or heart disease. Let us know how you do.

Posted by: psychotoddler | May 24, 2005 5:30:50 PM

Phew! Good to know that Socialized medicine is not the nightmare that everyone paints it as being. One less thing to worry about. Now, if I can only figure out how to get a job while working towards my BA with minimal Hebrew, that would be great. Thanks for that.

Oh, and about the Natural Clinic...I'm glad that calmed you down. If it was me I would be frieking out. I prefer stressful doctor paging and blatant sterility to earth-toned scrubs and big leafy plants.

Posted by: tmeishar | May 24, 2005 8:55:01 PM

Well it's been a while since college but I'll try my hand at this....
I'm happy to hear you had a good experience
thus far however I'm afraid you are too small
of a sample size to say socialized medicine works
(not that you are saying it does per say).
Based on what I've read and heard about it,
I'm happy I don't have it. Regardless,
you understand that now that you have
started talking about your ailments,
I will no choice but to stop reading this blog...o.k. maybe not.

A word of advice:
Don't settle for a chiropractor...
They'll make you feel good for a while but ultimately you may have to keep going back again and again try physical therapy first.

Posted by: Shloimy | May 24, 2005 9:21:55 PM

Beth... When things start hurting, my first inclination was not to think of natural medicine. However, I also don't like the idea of surgery either. So, I'm pleased that this route is open to me until such time as my doctor and I decide it isn't helping (and I hope that day doesn't arrive). In the mean time my first tipul (treatment) went well today. I'm a bit sore from the massage and a little freaked from the acupuncture... but I've certainly no worse off than when I woke up this morning. Maybe even a touch better.

Oceanguy... At least you don't have to seek treatment at the VA hospital! That's gotta be worth something, right? :-) Good luck and Refuah Shelaimah.

Val... You know that old saw "I know you are but what am I?" Well seeing as you're my [much] older sister I think it would be a bit foolish to start arguing over who is in fact getting old, don't you? :-)

Ilona... That's a very good point. We tend to value things more when we can assign a 'worth' to goods and services. Since there are different tiers of coverage (free base medical coverage plus various additional and private supplemental plans) here in Israel, I think people do have a sense of their insurance's worth.

Doctor Bean... As I was writing this I realized that you and psychotoddler may see things from a different perspective. I happen to feel that Israeli doctors are vastly underpaid for the level of training they must attain and the value of the services they perform. However, in an economy as shaky as ours, it would be a catastrophe if universal healthcare were not available. Also, thanks for the advice about medicating myself. I should probably put you on retainer for all the free medical advice you've offered my family over the past year or so! I'm starting to feel a little guilty since I usually get my doctor friends liquored up before I pump them for free advice! :-)

Katie-Yael... I should warn you that most Israelis don't get free dental/orthodontic coverage with their plan. I happen to have it for my family because my company offers supplemental coverage to its employees. I would suggest you finish your treatments before you come!

Just Passing Through... Most of my Canadian friends rave about the level of health care they receive, but grip about the wait to receive it. I suppose there is give and take with everything.

Jack... Don't encourage him. I was all set to ignore the cabbage remark and you had to take it further! :-)

kakarizz... Mystery man... who are you? I went to your site and saw this neat flash picture and then... nothing! Anyway, maybe I've just been living a sheltered life, but what is this adult remedy of which you speak???

Naomi... See, right there is how I know you married the wrong man! :-) Seriously, my wife jokes that she married me because of my massage skills. I didn't mind the acupuncture so much today. Although the one in the side of my hand and the two in the sides of my ribcage sorta made me want to roll over and bake a crustless floor pizza.

Essie... So far so good (tfu tfu tfu). Let's just say that if something is holding you back... it shouldn't be the healthcare system.

Psychotoddler... Like I said in an earlier comment. I think it is reasonable to pursue an 8 week course of alternative treatment before sitting down with a guy who sees every problem as having a surgical solution. :-) I also liked that an MD is overseeing the entire treatment process and has empowered me to switch to a more traditional track if we see I'm not getting relief. I will let you know how things go (although probably off-line since I think my medical condition holds limited appeal to most of the folks who come here).

Tmeishar... I have to admit that I was a bit of a baby about the acupuncture. I actually held the guy's wrist and asked him about a hundred questions before I would let him start sticking me. He was a good sport about it, and even made a funny at the end when he pretended to have forgotten how many needles he put in. :-)

Shloimy... First off, you should go back and notice that I was careful not to make a blanket endorsement of socialized medicine. At this moment in time I love it because my expereinces with it have been entirely positive. Just as the say in the investment ads, 'past performance is no indication of future results'. As far as the chiropractic advice goes... I have to say that there is some good science behind some of what chiropractors do. I don't subscribe to the back-crackers who say they can strengthen my immune system, make my hair grow or cure my cold just by giving me an adjustment every week for the rest of my life. Also, the person doing the massage therapy is also a physical therapist (it just worked out that way) so I think I'm pretty well covered over here. Thanks for the advice though.

Posted by: David | May 24, 2005 9:42:01 PM

Well that's great to hear. My mother is a PT
and I asked her once regarding MT since a friend of mine was also having lower back pain ( he was only 29 at the time) and she
said it works well to relieve the pain so way to go.

Posted by: Shloimy | May 24, 2005 10:21:15 PM

I really enjoy your blog. I'm always rewarded with a chuckle or two. Best wishes to you and your family.

Posted by: David Bailey | May 24, 2005 10:42:31 PM

Your offer of a retainer is very generous. If possible, I would like to negotiate to collect it in BBQed cow whenever my family is fortunate enough to be able to visit Israel. The Bogners have a standing invitation in Los Angeles, but, sadly, we only grill.

Posted by: Doctor Bean | May 25, 2005 12:02:05 AM

Jack... Don't encourage him. I was all set to ignore the cabbage remark and you had to take it further! :-)

So I shouldn't say that everything goes better with ranch.

Posted by: Jack | May 25, 2005 2:37:08 AM

Jack: ambles up to the urinal and a salad tumbles out of his pants.

That image actually made me giggle. Thank you!

Posted by: Doctor Bean | May 25, 2005 2:45:37 AM

It's interesting to read all the comments on socialised medicine and what a worry it is for American's. Living in a country with semi-socialised medicine (complementary therapies like chiro, acupuncture etc. are not included) I wouldn't be without it. But the interesting part is that American's worry about such a system, whereas we are fond of thinking how awful it would be to live with the US system. Eek! :)

Posted by: Kay | May 25, 2005 7:00:18 AM

PS, Hope your back pain is quickly taken care of David.

Posted by: Kay | May 25, 2005 7:01:03 AM

I live in the Pacific Northwest of the U.S. and am lucky enough to have good medical insurance and a quality HMO. Mostly what people have mentioned here has to do with the quality of the care, which is obviously important. But the real tragedy of healthcare in America is how many don't receive it at all.

Given the enormous headache and cost it is for businesses, it's incomprehensible that we don't have universal coverage. From a moral point of view, it is unconscionable.

How strange we must seem to our developed counterparts around the world...

Posted by: christopher | May 25, 2005 8:07:19 AM

Shloimy... I hope she is right about that. They told me that I shouldn't expect any overnight miracles... and indeed no miracles occurred during the night. I'm still in pain... but cautiously optimistic. :-)

Jack... OK, you got me with that one [wipes water off of computer monitor]. :-)

Doctor Bean... I giggled too, but for a different reason. You see, a typical Israeli wouldn't miss an opportunity to tell you that you didn't cut up the vegetables into small enough pieces... even if said vegetables were revealed on the bathroom floor!

Kay... I'm actually a bit surprised to hear you say that Australia doesn't include these kinds of treatments under it's national insurance. I would have thought enlightened Australia would be on the leading edge of supporting alternative medicine and such. Thanks for the good wishes.

Christopher... There are two sides of every issue (although in this case one side is much larger than the other). Obviously the government owes its population some sort of universal coverage system. However, there needs to also be a bottom-up re-education of the public about well care and nutrition. Many families that are entitled to nominal healthcare through medicare and medicaid today do not avail themselves of the services except in emergencies. Using a hospital emergency room as one's family doctor is not a promising pattern of family care (not to mention extremely expensive). In all this, the poorer sector of society is always the loser... which means that even if universal healthcare is instituted... there will be a disproportionate caseload of poorer clients because they see healthcare as a way to treat ilness, rather than a way to stay healthy. Clearly some kind of sweeping educational initiative would need to accompany any sort of universal healthcare initiative.

Posted by: David | May 25, 2005 9:26:59 AM

My best friend the Orthopedic Surgeon is very adamant on this point: Try Everything Before Surgery. When I consulted him with my sudden back problem four years ago (by phone, because he is in NYC and I am in Tel Aviv) he gave me exactly the same advice as my local Maccabbe orthopod did (after asking some key diagnostic questions about what hurt when I did what): rest, physical therapy and exercise. Maccabbi paid for six PT sessions of about 15 minutes each, by which time the pain had subsided. I decided to continue with PT (I now consider PT an abbreviation for Personal Trainer rather than Physical Therapy) privately for one hour a week and have been doing so ever since (that's FOUR YEARS!) as Preventive Medicine (I'm aleady old, and getting younger now). It has made me a great believer in PT. Caveat: as in every other profession, you have to find a good one.

Posted by: savtadotty | May 25, 2005 12:12:25 PM

Savtadotty... Thanks for the advice. I can't really think about paying a personal trainer right now... but I will try to keep up with whatever advice I get from the chiropractor and massage therapist/PT.

Posted by: David | May 25, 2005 2:02:30 PM

The thing about the socialized medicine in the UK is, it's patchy. When it comes to, say, cancer diagnosis, the low-spots of socialized medicine can effectively kill you. And they do.

I dunno. I am hoping for a time when comprehensive insurance becomes a lot more affordable than it is in the US at the moment, but also those who genuinely can't afford it get free treatment according to their needs. I don't think either the US or the UK systems, at opposite ends of the spectrum, work perfectly well. But maybe Israel has got the balance just right- or at least, better!

Posted by: Alice (in Texas) | May 25, 2005 2:42:20 PM

Jack: ambles up to the urinal and a salad tumbles out of his pants.

That image actually made me giggle. Thank you!

A cucumber works better for me.

Ow did I just say that!

Posted by: psychotoddler | May 25, 2005 6:44:48 PM

Alice... My experience with the healthcare system here is so limited that I would hesitate to make any blanket pronouncements about how it compares to other countries. But I do agree with some of the sentiments expressed here that the hallmark of a civilized country is a commitment to looking after the health of all its citizens.

Psychotoddler... "A cucumber works better for me Hey, whatever floats your boat! We have a strict 'don't ask - don't tell policy here at treppenwitz. ;-)

Posted by: David | May 25, 2005 7:03:47 PM

I kept expecting you to say it was all a dream! LOL I'm sorry about your lower back pain (been there, done that - including surgery for a ruptured disk), but glad your experience in Beer Sheva was such a good one. Good luck with the treatments - may you have a speedy and complete recovery!

Posted by: AmyS | May 25, 2005 8:00:53 PM

I hope you're feeling better.
Health care in Beer Sheva has been good to us as a family; my husband and kids were born there. I do remember being a patient in a foreign language and while I was very glad to be taken care of, I didn't know that I was on a fast and ate (a pear, I knew the word for pear after that!)...
we were quite shocked to go back to the States and find out how awful it is to be without adequate health coverage (grad school coverage didn't cover prescriptions, for example). imagine calling around till you get to the cheapest antibiotic. or standing 6 hours in a mall for the free school vaccination. made Beer Sheva look pretty good.

Posted by: timna | May 25, 2005 8:13:30 PM

Psychotoddler... "A cucumber works better for me

If you really want to make an impression you ought to consider using an eggplant.

Posted by: Jack | May 25, 2005 9:08:18 PM

AmyS... No, although I can assure you the pain reached nightmare proportions before I saw fit to see a doctor. Thanks for the good wishes. BTW, I read what you wrote about Lag B'Omer and while I also worry about the danger involved with mixing kids and bonfires... I still love the holiday.

Timna... How true. Israelis gripe about their healthcare system... until they have to make do without it. I hope I don't have to many occasions to bump up against the system.

Jack... Sometimes an eggplant is just an eggplant.

Posted by: David | May 25, 2005 9:54:30 PM

An eggplant? That's just not right. Unless you're going for that "hernia" look.

Posted by: psychotoddler | May 25, 2005 10:36:13 PM

Jack... Sometimes an eggplant is just an eggplant.

But a good cigar is a smoke.

Posted by: Jack | May 25, 2005 11:10:40 PM

I can't speak for Jack, but I'd like to apologize to David for hijacking this post and filling it with sleazy double-entendres.

I will now go and fill Jack's blog with sleazy double-entendres.

Posted by: psychotoddler | May 25, 2005 11:55:00 PM

There is nothing sleazy about double entendres. There is something sleazy about a country that looks at health care as a commercial commodity.

Posted by: Jordan Hirsch | May 26, 2005 3:00:07 AM

I think this is one of the most interesting posts you've written. Keep us updated on your progress with the natural approach. I'm eager to hear how you fare with it.

Posted by: Stacey | May 26, 2005 7:12:15 AM

Psychotoddler... The folks at Mcgraw-Hill define double entendre as a "Word or phrase in comedy that has a double meaning, the second meaning often being sexual". Most of what you kids have been tossing around has lacked that original non-sexual meaning! :-) I don't mind, though. So long as nobody's sensibilities are offended you guys can continue to 'toss one-another's salads' to your heart's content. =;~p

Jordan... Sleazy might be the wrong word. If I knew a word for having criminally mixed-up priorities I would recommend it to you. Despite all the finger-pointing, this lack of will to take on universal healthcare seems to be one of the only truly bipartisan issues.

Stacey... I appreciate the compliment, as well as the implied concern. However, unless my condition takes a drastic turn for the worse I am not likely to make much more than a passing reference to it in the future. I really don't want to turn into one of those people who sits around discussing my ailments with anyone who will listen. I have a few years (hopefully) before I reach that age.

Posted by: David | May 26, 2005 8:54:39 AM

I can understand your feelings about Lag B'Omer - when we celebrated with my in-laws it was alot of fun. Hag Sameach, and I hope your back is doing better already!

Posted by: AmyS | May 26, 2005 5:38:52 PM

Jordan--for all the expense and effort that went into becoming a doctor, not to mention the ridiculous hours that I have to keep, I think I have a right to try to earn a living. I'm not sure what keeps the medical system going in Israel--probably taxes.

However there's no question that there's something very wrong going on in the US that needs fixing. Commodity? It's a profession for me, and one which not many people can do or would want to do.

Posted by: psychotoddler | May 26, 2005 8:28:37 PM

you guys can continue to 'toss one-another's salads' to your heart's content.

I am not sure that my wife would approve of that. This calls for a beer and contemplation.

Posted by: Jack | May 27, 2005 12:41:19 AM

Jack, you can toss my salad anytime! I just love a man with a big bushy beard!

Dang it! Look what you made do! I promised Trep no more sleaze!

Posted by: psychotoddler | May 27, 2005 3:31:29 AM

Psycho, and anyone else who cares to listen: I do think you have a right to earn a living. And I do think medical school is real expensive and hard.
So? It's hard work to become anything worthwhile, and some of those thing don't pay so much.
Having said that, I would never expect the kind of outlay students are required to make in a socialized medical system. Obviously, some kind of arrangement would have to be made to ensure the affordability of medical school for those interested in becoming doctors.
all I know is, health care is too expensive, doctors are richer than I am, insurance companies are way richer than doctors, and the US is shamefully low in infant mortality and life expectancy rates. Something needs to be fixed, and while i think the insurance companies are the main culprits, I will not mourn overmuch if being an MD does not automatically entitle you to a BMW and an Irish nurse to sleep with.

Posted by: Jordan Hirsch | May 27, 2005 6:30:45 AM

Mr Hirsch: First, I assume you've backed away from calling my nation sleazy. I'm happy to let it drop. If you stand by that comment, let me know, and I'll be happy to pursue it furhter.

I think you (and many other Americans) misunderstand our rights. Psychotoddler does not have a right to earn a living. He has the opportunity to earn a living, and because he's smart, well educated, and works very hard, he earns a living.

You, moreover, don't have a right to healthcare. You may wish you had a right to healthcare; you may think it sleazy that you don't have a right to healthcare; you might admire nations that collectivize healthcare costs and thereby remove any incentive from delivering excellent healthcare; but rights are not derived from such places.

Let me explain. You have the right to peacefully assemble and worship because that is guaranteed by the Constitution. You have the right to Life, Liberty and the Pursuit of Happiness, since the Declaration states that the Creator endows you with these. The Bible commands me not to murder, so you have a right not to be murdered. Tort law gives you the right to sue for various damages. Healthcare, or for that matter, Psychotoddler's right to make a living, are nowhere in there.

I was going to restrain myself (since this isn't my living room) when you called my country sleazy, but what pushed me over the edge is when you used the old slander about infant mortality and life expectancy as a slam against our healthcare delivery.

Our infant mortality (first of all it's not at the bottom) is lower than other nations only because of the babies born to drug abusing moms. This has nothing to do with the availability of prenatal care or the availability of excellent obstetrics for indigent patients, it has to do with drug addicts not making it a real priority to avail themselves of these services.

Our life expectancy rates (also not terrible) are driven down also by drug abuse and violent crime, and again do not reflect healthcare delivery, but the fact that drug addicts do not access available healthcare.

In the measures that actually relate to healthcare quality, like your probability of surviving your first heart attack, or your likelyhood of getting a kidney transplant rather than spending the rest of your life on dialysis, or the likelyhood of your next transfusion being free of HIV and hepatitis C, the American system which you so malign is at the top.

I happily drive a Saturn. I don't have (or want) an Irish nurse. If I am richer than you (which I don't know and have no interest in finding out) I assume that in a free market that's because I'm generating more value for other people than you are. You sound very bitter with your lot, and I encourage you to pursue the many opportunities in this country to earn yourself a BMW and an Irish nurse.

Posted by: Doctor Bean | May 27, 2005 8:18:21 AM

Jordan - perhaps if a socialised education system accompanied the socialised medical system, the issues of long expensive study periods would take care of themselves.

David, you said "I would have thought enlightened Australia would be on the leading edge of supporting alternative medicine and such." - You and me both. Except I know just how enlightened Australia is not, and especially just how unenlightened it is becoming under the present government. Sigh.

Posted by: Kay | May 27, 2005 8:53:00 AM

Jordan.. [warning: Irony ahead!] While I may agree with you that the US needs to do everything in its power to raise its infant mortality rate, I think it is wildly unfair to make those kinds of accusations against doctors. Many doctors I know drive Jaguars and Mercedes, and I know for a fact that the nurse Doctor Bean is fooling around with isn't even Irish!

Doctor Bean... I don't have much to add to your comment except that both you and Jordan got the infant mortality thing backwards. :-) I happen to know that Jordan is a highly trained professional in a field that requires its practitioners to invest every bit as many years of training and practice (if not more) as anyone in the medical profession. The obvious difference is that he doesn't have to carry an enormous malpractice insurance policy in case he hits a sour note on his trumpet and injures someone's sensibilities. I know Jordan for many years and am 100% certain that if you two were talking face to face (meaning in a forum where you are constantly reminded that there is a real person and at the other end of the argument) that you would still disagree on many points... but you would also learn a great deal from one another. Now I'll butt out. :-)

Kay... Having spent a month in Perth while I was in the Navy I was very impressed with how few of the social problems Australia shares with the US. You may be frustrated with aspects of your healthcare system, but it affords you a peace-of-mind that is lacking in many other places in the world. Governments come and go. I suspect the present Australian leadership's reelection is a reaction to things going on in the world and not local apathy about domestic issues. However, what I don't know about Australian politics could (and does) fill volumes. :-)

Posted by: David | May 27, 2005 12:15:25 PM

..."care for all of it's citizens"...
See, that's one problem in Israel. Not everyone that lives here is a citizen. I am a non-married partner of an Israeli citizen. As far as state medical benefits are concerned (at least for a year or so), I am nothing. So, I have to buy "tourist insurance" that renews every 6 months. If you develop a condition during the coverage period, it's considered a pre-existing condition the next time you renew coverage. Plus the coverage isn't all that great. But it's much less expensive than the same type of coverage in the US.

I am able to afford this coverage and I guess take the risks associated with this renewal game. However, I see lost of folks from Asia and other regions (people I'm pretty sure aren't Jewish) and I wonder what happens to these folks if they get sick here. Do they get the kind of care they need?

Posted by: John | May 27, 2005 3:19:26 PM

John... You'll note that in the line you quoted I chose the word 'citizens'. I don't feel that the Israeli government (or any government) owes health coverage to tourists, visiting workers or foreign students. When we travel abroad I need to take out (and pay for) a special policy for myself and my family... why should it be any different for someone visiting here? If your answer includes anything that sounds like "but I live here", then you should become a citizen (and inherit all the responsibilities that come along with that status). Foreign workers make up an important segment of the workforce, and often end up doing jobs that Israeli citizens would not want. However, they came here of their own free will. I don't care how horrible the conditions were in their country of origin...if they decided to accept work from an Israeli employer that did not include health insurance, I can't find fault with the system if they get sick and have to pay out of their own pocket for a doctor or hospital visit. The system isn't perfect, but expecting it to take care of the world's refugees and tourists is a bit much to ask.

Posted by: David | May 27, 2005 4:15:01 PM

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