Counterintuitive thinking on healthcare

My shoes: hazardous to the health but clearly worth it

A number of years ago I was invited to a lovely and rather posh wedding in Oxford. I was discreetly placed at the ‘singles’ table beside an eligible doctor, in the hope that a spark might strike. That wasn’t to be. Intrigued by the English health system I asked him about his job; instead of any softer feelings my presence inspired a rant, about the horrible patients who bugged this poor doctor with their stupid worries about colds and minor ailments. Being slightly hypochondriacal, I sided with the patients.

Fast forward a few years: now living in the US, my experience of healthcare is very different and I recall with fondness the days when a trip to the doctor required nothing more than a phonecall and £6.30 for a prescription. I have health insurance of a kind (travel insurance) and I get yearly check-ups, but any superfluous doctoral visits are few and far between. I’m not the only one. At my hairdresser’s the other day, one of the stylists was limping awkwardly. It turns out she’d been wearing high heels, and made the mistake of playing football with her nephew. The result was disastrous — she broke her toe — but instead of going to the doctor, she patched it up herself, strapping it to the other toe as a nurse might have done (admittedly, she was still wearing the heels in question when I saw her so perhaps the break wasn’t that bad).

In the US, where at least 47 million people are uninsured, this sort of DIY healthcare is commonplace. Pharmacists sometimes help out, dispensing antibiotics without prescriptions (I think that’s illegal but correct me if I’m wrong). The medications you can buy over the counter are stronger than those available in Europe and presumably there’s a reason for that. People hobble on home-made canes and wait for nature to do its work unaided.

When I fell off my bike recently, I realized that my emergency Plan B — flying home to Ireland nursing my injury — would be difficult, and intensely painful, to carry out (Plan  A is just do nothing and hope for the best). My arm was extremely sore and it took days to heal. Luckily, it wasn’t broken; I got antibiotics from a sympathetic chemist and avoided an infection.

On some levels this self-care version of healthcare is good. It saves government money, and makes people hardier and less susceptible to self-indulgent anxieties. The uninsured are unlikely to waste a doctor’s time because they have a cold if it means they’ll have to shell out $150. But the real cost is a heavy one, for it must mean that early diagnosis of serious illness is less frequent.

Nor does a lack of insurance stop people taking risks, as my hairdressing-friend’s high-heeled soccer accident shows. It hasn’t stopped me either. Undeterred by her story I recently purchased a pair of rather dangerous summer sandals. I’ll just take care and avoid sidewalk-cracks and hope I don’t fall. It’s an uneasy balance, but I bet that doctor would be pleased.

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Comments
2 Responses to “Counterintuitive thinking on healthcare”
  1. Benjamin Peim says:

    Interesting post. I’m not sure how a lack of healthcare makes people hardier, ie healthier. What it does do is impede early and/or preventative treatment. People’s healthcare problems, consequently, mushroom until they become debilitating. Whatever money private insurance companies save (not the government, really) in the short-term doesn’t outweigh the long-term consequences for the individual or our society.

  2. Frieda says:

    Hi Ben, thanks for the note, and for correcting my statement that fewer trips to the doctor on the part of citizens might save the government some money (but, if the people in question do not have insurance, the insurance companies don’t save either, do they? Perhaps the point is irrelevant to the US system, but applies, hypothetically, to the UK: if fewer people there visited doctors, then the British government would indeed make savings. Not that I think that would be a good thing).

    You make an eloquent point about the consequences of poor healthcare for the individual and for society in the US. Healthcare insecurity makes life terribly hard for many and I bet it also has more superficial societal repercussions, such as causing employees to stay in jobs they don’t enjoy because of insurance benefits.

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