41 Days

We don't have heat in our flat but we got spirit(s)!!!

Pictures?

View from Ponsonby Road back toward the needle on a winter night

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.

Apologies for the hiatus

It's been awhile for me since my last post.  Our goal had been at least a couple of updates a week but work has really sped up for me and thus I haven't been keeping up my end of the bargain. 

Fear not however as I have come up with a solution.  Since most of what I have been doing is working, I thought it might be interesting to write a bit about working.  Just as a tidbit, the news about what is happening in Washington with the US debt is HUGE news here.  Obviously, American culture is pervasive- from the radio stations all essentially playing hiphop all the time to the fact that everyone in this country seems to have an iPad or iPhone or both.  But one doesn't always remember how closely economies in the rest of the world are tied to us.  Anyway, it's interesting but maybe I will save that for another post.

What ever name you put on this system (socialized, public, equitable health), it's quite different in a lot of ways.  Maybe I should start by saying that I truly believe the US health care system is broken.  Waste occurs at every turn for a multitude of reasons.  In a fatalistic way, I was ready to give Obamacare a shot (even if he does think tonsillectomies are evil).  The US health care system is simply not sustainable and I figure that something has to change.

More to come later on today . . . have to get my clinic going.