Health Care: Two Countries, Two Stories

NEW ORLEANS--Viewed from this city, which lost its main hospital for the indigent and working poor (so-called Big Charity) in the aftermath of the flooding and which is just now beginning to start a neighborhood-clinic approach to the problem, the national debate on health care reform has been less than enlightening. The money that both sides are spending on television ads -- the pro-reform side (if you include Harry and Louise) outspending the anti-reform side, to this point -- insures that most of what most people "know" about the subject boils down to simplistic slogans and fear-based half-truths.

And I don't know any more. But I do have two family members, one in America and one in England, each of whom has had a recent experience with the local health system. I offer their experiences for your consideration, and leave any conclusions up to what George W. Bush might have described as "the concluder".

Anna (not her real name) complained for years of chronic pain following a hip procedure. She belonged to a prominent California HMO, one which spends millions advertising on television its devotion to patient wellness with the zen-like slogan, "Thrive". In reality, doctors who saw Anna -- a bewildering series of entry-level doctors, necessary for referral to specialists, and specialists -- seemed to be practicing medicine by the clock. The appointments were brief, and each round of appointments had the same result: a prescription for increasingly strong pain medication.

By the time I intervened, and started taking her to a couple of private doctors for second opinions, she was hooked on oxycontin -- a dose that, one private doctor said, was appropriate only for terminal cancer patients. Ultimately, during one weekend in which she was hospitalized in a private facility, a stroke of good fortune brought a talented neurologist to her bed as the doctor on rounds that afternoon. He talked to her for 20 minutes, reported she had no clinical cause of the pain, and suggested it was psychological. He recommended some counseling, along with a program of weaning her off the drug. In six months, she was oxycontin-free and pain-free.

Donald (not his real name) lives in Britain. He recently began complaining of pain and stiffness, interfering with his active life. Though initially reluctant to seek medical attention, he finally made an appointment with a National Health specialist, and two weeks later, he was seen and diagnosed with a form of myalgia (Google it, I did). He was prescribed a medication which almost immediately relieved his symptoms.

All the rest is commentary.

PS: I have the best health insurance available, thanks to my show-business union.