Health and Wealth of A Nation

January 10, 2014

Ocean Beach – San Francisco

Ocean Beach – San Francisco

My December 2013 holiday saw me spend two weeks with my wife over on the West Coast of United States of America. We were looking forward to two weeks of pure relaxing, with no agendas, no to-dos nor sights to see. We had flown from my wife's hometown of Dallas, Texas to San Francisco in California. The weather we left behind was bitterly cold and were pleased to be greeted by a warm winter sun in the high teens, without a sign of a cloud in sight for our stay.

Our first was week was pleasant enough we had lazy days sleeping in late and going out for evening meals in Chinatown or The Chieftan Irish Pub across the road from our hotel. It was a hole in the wall pub selling UK and Irish beers as well as food from those shores. The ales could not be tampered with but the food was Americanized to say the least. Yet we enjoyed ourselves for the convenience and simplicity of the fayre.

I have been travelling between the US and UK since 1992 so I was enjoying being on the West Coast for the second time and my first in San Francisco. However, on the Monday of the second week my wife came down with a flu virus that had her temperature soar through the roof. I was using cold cloths to bring her temperature down with temporary relief. I purchased NyQuil and DayQuil flu syrup which afforded her some comfort.

It was New Year's Eve Eve and we were discussing what to do about the surprise boat cruise my wife had booked for us on the Bay under the Golden Gate Bridge to watch the fireworks. We were waiting and watching to see how she felt towards the evening before making a decision. Alas, the fireworks would have to be foregone, as by that night I was struck down by the same influenza. My body was shivering, sweating profusely and trying to stay awake was a monumental battle that I lost. I was conscious about my wife's state too, so jointly we nursed each through the first night.

New Year's Eve was spent in our hotel room watching the ball drop in Times Square New York, and missing the strike of the midnight clock in San Francisco. Our conditions did not improve over the next two days and we had to fly back to Dallas on Thursday January 2nd. On Thursday we left reluctantly not wanting to leave our beds, our heads were hurting, our bodies were aching. We drugged ourselves with Tylenol based medicine and flew to Dallas.

Arriving in Dallas we were trying to get to our hotel asap, yet luggage delays and a dead battery in my wife's car meant that we did not get to our destination until past nine'o'clock that night.

By Friday morning I was feeling even worse and on the advice of my wife I visited Texas Health Huguley Hospital. I left my wife in bed and went to the ER at the hospital. I was registered and seen pretty quickly. My vitals were checked and was told to wait for a doctor to see me. When the doctor arrived he had an assistant with him taking notes on a laptop. The fellow was a pleasant man and I guessed the note taker was to ensure everything was recorded in case of litigation.

My doctor had a Polish name on his badge that ended in 'ski', who went through a series of questions to ascertain my maladies. Upon later research I find that his name was Peter in Polish. What struck me was the following snippet and his response to my answer.

Doctor: "Have you had your flu shot?"

Me: "No, as it is not recommended for someone my age and health in the UK"

Doctor: "Yes, the UK bases its decision on whether to give flu shots or not on data, where until the data is erroneous or proven wrong flu shots are not given to everyone"

Me: "It's only the old and infirm who tend to be given the shot"

Doctor: "Whereas in the US we are purely driven by money, so everyone gets a shot"

The doctor checked me over and ordered a nasal swab to check for the flu virus. The swab came back negative, yet I was issued antibiotics, steroids and cough medicine. Upon departure he suggested that a good restaurant to dine out in Fort Worth was Ellerbe's. We shook hands and said our farewells.

Subsequently a nurse came and gave me the prescription which I took and went to a booth at reception to settle my bill. As I sat down the lady totaled the bill and presented it to me sheepishly, maybe thinking I would have a shock at the amount. 

Bill Collector: "Sir, the bill is $979 (£595 GBP) excluding the doctors fees and the swab test, but if you pay today then it is...$479 (£291 GBP)".

I gave her my Visa debit card and paid the reduced amount. She took my wife's postal address so that the bill for the doctor's time and the swab test could be posted for payment. I then got instructions to the nearest CVS pharmacy and left the hospital.

At the pharmacy I dropped my prescription off stating I will pay as I am from overseas. The pharmacy technician quotes me a bill of $107 (£65 GBP)for the three drugs. I left the store and drove across the strip mall to grab a taco to abate my lunch hunger pangs.

Forty five minutes later and I am now served by a different technician. She asked me if I was insured, I told her that I was paying cash. She asked for $107, which I gave to her in $20 bills. As he took the money she made a comment which I wasn't sure what to make of.

Technician: "That's my weekly rent which I gotta pay today".

Not knowing what to say I smiled as she gave me back my change and waited on the medicine. Waiting for the medicines, three things struck making me realize how the US medical system is a mess and in my opinion Obama's Affordable Care Act may not be perfect but is a must for the United States.

Firstly, the comment made by the doctor about how money drives the medical industry and not empirical evidence supported by historical data. Especially when the giant drugs companies (as do other companies) have such a sway over the US political machine. Such influence and stranglehold by corporations on politicians is something that should be cut in order to serve the interests of the people. I am sure by having medical companies being held to account over pricing and charging as well as bringing in competitive tender would bring down prices of all medicines, products and services.

Secondly, I was fortunate enough to pay cash for my medicine and for the hospital's services. I have the doctor's bill and lab test costs to pay which I will have my travel insurance policy cover. According to the IRS adjusted gross income for half of the households in the US in 2013 was less than $35,000 (£21,264 GBP approx.), which after Federal and State taxes is not a lot for a family with two children.

According to the BBC, in 2012 a husband and wife with two children living in London would need £36,800 ($60,569 approx.) to live acceptably. Now I know London is not comparable to some regions of the US apart from the major metropolis' like New York, Chicago and L.A. What I have found during my extensive travels in America is that even in some of the rural and suburban parts of the US the cost of living is not necessarily cheap.

Finally, the pharmacy technician who made the comment about her rent payment for the week could possibly be earning in the region of $35,000 as per the IRS. According to the  pharmacy technicians earn on average between $11-$17 an hour or have a median salary of $30,429, and if they are certified they earn a median income of $35,454. Again after taxes, travel costs, rent or mortgage their net income will be substantially reduced.

I personally do not know the circumstances of the technician who served me, but I am guessing she and millions of others in the US highly value the medical benefits that come with their jobs. To have that peace of mind of health insurance for themselves and their family is one less burden to worry about. I know of friends in the US who have spent hundreds of thousands of dollars if not millions on self paying for medical costs. It must be an extremely scary prospect to think that if you are uninsured you could become bankrupt due to sudden medical emergencies.

Health care for many Americans is one of privilege and not a right, according to a study done by Harvard Medical School a lack of health insurance causes 44,789 unnecessary deaths per year in the US.

Take Libya under Muammar Gaddafi, the country enjoyed universal free health care for all of its citizens as well as free education. Free health care was a human right under Gaddafi. Mexico in 2012 achieved universal healthcare for all its 100 million citizens enrolling 52.6 million within a decade. Other notable countries to have such cover is Cuba, Brazil, Argentina and Kyrgyzstan among others.

The question is why do nations have universal healthcare? Whether it is free or subsidized.

Well, in my view the health of a nation determines the wealth of that nation too. If people are healthy, they are happier and far more productive and able to work. Felicia Knaul director of the Harvard Global Equity Initiative and a senior executive for the Mexican Health Foundation stated in 2012;

"...this country (Mexico) chose to believe in the fact that people’s access to health care should not be defined by where they work but rather by their need for health care..."

" addition to this being a right, a social entitlement, it was good for human development, for social development, for economic development, to make sure people were not going bankrupt and suffering impoverishment and catastrophe from trying to figure out how to manage the cost of health care.”

I think the Affordable Care Act is a move in the right direction, over time lessons will be learned and mistakes made, but universal health care must no longer be a privilege.