Sunday, April 01, 2012

America.  The Best Healthcare?
Thursday night my elderly mother-in-law fell and broke her wrist.  She called 911 and the paramedics took her to one of the major hospitals in Los Angeles.  We were at the theater.
Fortunately a friend in her building happened by and saw her on the floor and called our house.  Fortunately, we had a houseguest staying in our guest room.  Fortunately the friend was home. Fortunately we saw the message at intermission and sped to the hospital. 

Otherwise, they might well have sent her home in a taxi, drugged, confused, and very unsteady on her feet, with no support at all.

When we arrived around 8:30, she had been there for two hours, confused and in pain.  They had x-rayed the arm, wrapped it in a soft cast, hung her fingers unwrapped in wire hangers to let the arm set and pumped her full of pain medication.  Six hours later, around 12:30 they took some more x-rays and said we could take her home with a prescription for pain pills she was to take every 6 hours and a referral to an orthopedist. 

I asked for a social worker or case manager so we could get home health services.  “Don’t have anything like that,” the nurse told me.  “No discharge planner?”

 “No.”(The hospital actually has a home health department with an emergency number.  We found that out two days later from their website.)

I asked the ER doctor, “What do we do with her?”
Her answer did not include “I’ll write you a prescription for a visiting nurse to evaluate her.”  Her answer was, “She’ll have to go home with one of you.”
(Note: they did not even give us one extra pain pill that she could take at 6am.  Instead, my husband had to drive from 1:30am to 2:15 in search of an all night pharmacy.  Fortunately I was at the house and could take care of her, while he was gone.)


Clive said...

All well and good; but national health care is no picnic either.
Take this quote direct from the U.K. National Health's own web site:

"For conditions that aren’t urgent, you have the right to start treatment led by a consultant within 18 weeks from when your GP, dentist or other healthcare professional refers you. "
How many of us would think waiting 18 weeks to see a specialist was the holy grail of health care?

Alex said...

Sounds like you're conflating quality and timeliness of care with coverage. The dissatisfaction rate with NHS is in the 30% range, sure. Dissatisfaction with Canada's system is about 15%. The dissatisfaction rate with US health care coverage is about 70% and US dissatisfaction with quality of care is at 35%. Western nations all have about the same (dis)satisfaction rates with quality of care, but you can sure bet that Britons would be much, much angrier if they had to pay for care. Also, try making an appointment with a US specialist some time. I once has to wait 2 months. Finally, I note that 18 weeks is the maximum, not the minimum time you'd have to wait.

Clive said...

Sounds like you're conflating quality and timeliness of care with coverage.
Quality, quantity, timeliness and cost are an inextricable matrix. Basic economic theory. Add a layer of ethics and the point of equilibrium is one on which people, each of good faith, will disagree.
To be more concise :>) It ain't simple.