Part two

Wow- I caught flak when I got home for both being too brief and being too boring at the same time so I will try to wrap it up.

I guess I am just doing my best to keep my mind open about the health system here- most importantly because I have to be able to function effectively within it but also because there is a lot to learn.

In clinic today, I saw three different people that had lesions in their mouths, probably benign, but all needing to be excised.  For each of these patients I had to come up with a score based on a variety of criteria such as potential for malignant change, psychosocial consequences, risk of progression, etc.  I don't really have any idea what the score means except that each of these individuals went on to some kind of list.  The nurse told me that it would be several months.  On the other hand, when cancers come in to clinic, they go on the operative schedule within 2-3 weeks- which is actually faster than they would in the US a lot of the time.

It's a bit of a facade however to think the system is truly an equitable one.  There is actually a tiered system in place.  Private insurance is available and relatively cheap (at least by our standards).  For Jesse and I to get a basic plan, it would have been about $800 for the year.  It basically provides access to the same physicians but much sooner.  So the really really nervous guy from Bombay I saw today that is here studying for a year can pay the premium and then get the small spot on the inside of his cheek excised in the short term.

I won't be critical because I haven't seen any evidence yet that the system doesn't work.  I don't have any personal anecdotes about people waiting months for much needed surgery- at least not yet.

That's it for now- I will save my thoughts on my malpractice insurance that cost about $400US for the year and would have been $25,000-$30,000 back in the States.