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Tuesday, May 24, 2005

I [heart] socialized medicine!

I don't like to use my journal to complain about the symptoms my aging carcass is throwing my way.  In fact, I've actually stopped reading a couple of blogs because the authors spent way too much time cataloging and describing their various medical problems (not to mention the excruciatingly detailed progress of the treatments).

I can't even get that interested in my own medical issues, so you can bet that I'm not a very sympathetic audience for someone else's aches and pains.

However, I'm going to share a little bit of my pain today... if for no other reason than to let you understand how much I love living in a country with socialized medicine.

For almost a week I have been suffering with sever lower back pain.  Over the course of my adult life I've had various episodes of back problems... but most of them had been in my middle/upper back or neck. 

Lower back pain is a whole 'nother animal! 

It started last Thursday or Friday, and has been getting steadily worse since then.  Yesterday my lovely (and patient) wife called up the local branch of our Health Service (Maccabi) and asked them what I should do.  They gave her the number to one of their 'Natural' clinics in Beer Sheva (not too far from my office), and told me to call for an appointment.

With everything I'd heard about the snail's pace of socialized medicine, I was prepared to be given an appointment sometime in 2007.  But to my surprise the very helpful young woman on the phone said I could come in first thing in the morning.  She asked if I wanted traditional or natural treatment.  When I asked about the difference she explained that many people with back pain opted to explore natural medicine first since neurosurgeons tended to see solutions as surgical. 

When I quickly opted for the 'Natural track', she explained that I would be seeing a physician in their 'Natural Medicine' department who would determine the nature of my injury and direct me to the proper course of treatment (if necessary).  She also assured me that if the doctor thought I was a poor candidate for natural treatment he would send me to the other side of the building to see a neurosurgeon the same day.

I have to tell you, I wasn't thrilled about going to a clinic in Beer Sheva because, well, I'm a spoiled American and Beer Sheva is, even by Israeli standards, a backwater town.

I walked into the Clinic promptly at 8:15 this morning and was pleasantly surprised by what I saw. 

The office was tastefully appointed in blond-wood furniture with lush plants and nicely framed copies of impressionist artwork adding a soothing accent to the setting.  The receptionists were wearing crisp white lab coats over earth-toned scrubs, and the air was lightly scented by the aroma-therapy candles burning here and there throughout the reception area.  The final touch was lent by the soft new-age music playing over the speakers hidden in the ceiling.

I felt as though I had walked into a spa rather than a medical facility! The spa perception was enhanced by the receptionist gently asking me to turn in my cellphone.  As she accepted the phone, turned it off and placed it in a drawer, she explained that they wanted to minimize the stress-inducing noise in the treatment areas.

The medical history that I had to fill out was the only somewhat stressful part of the process... but that was really my own fault.  It goes without saying that it's hard to provide accurate medical information when you understand only 60-70% of the words in each question.

A couple of examples:

Have you ever had [mysteryword] or suffered from [mysteryword]?

Is your pain [mysteryword]  like [mysteryword] , or more like [mysteryword] ?

Do you have a family history of [mysteryword]?

To her credit, as soon as the receptionist noticed me struggling over the questionnaire, she called me over and did a wonderful job of pantomiming the meaning of the mystery words.  The most inspired of these gestures entailed twirling her index finger around her ear and then jabbing her thumb over her shoulder.  This was a brilliant way of helping me complete the third example I gave you, above.  The question was asking me if there was a history of mental health problems in my family.  Although I could have had some fun with that question, I just smiled and said 'no'.

After a short wait I was shown into a pristine examination room where a doctor proceeded to go over my questionnaire and ask me more specific questions about my back pain.  He was very patient about my spotty Hebrew, and deliberately chose simple words while asking his questions.

Besides the standard thermometer,  blood pressure cuff and stethoscope trifecta, I was subjected to an extremely detailed head-to-toe examination (although I thankfully dodged the dreaded rubber glove).  He was clearly looking for referred pain or other medical problems that might be related to/causing the back pain.  After a very careful scrutiny of my spine from various angles and postures, he took me into a well-appointed x-ray suite and explained to the technician in great detail exactly what poses he wanted for the films.  Within a short time he was able to call up the images and point out the things he found significant. 

I won't go into too much detail about what he saw... but he said that he didn't feel a CT-scan would be necessary at this point, and that he wanted me to start an 8-week course of treatments that would combine acupuncture, deep massage and chiropractic manipulation of the spine.  I would have two treatments per week of the acupuncture and massage, and one session per week with a chiropractor.  He also explained that I would be given a detailed exercise regimen and that I would be seeing him once a week to monitor my progress.

Wow!

When I went back out to the receptionist, I was prepared for the proverbial 'other shoe' to drop.  I fully expected:

1.  The treatments wouldn't begin for months.

2.  The treatments would cost a small fortune.

To my surprise she explained that:

1.  I would be receiving my first round of treatments this afternoon.

and

2.  The total bill for the eight weeks of treatments (a combination of 24 total treatments) would be just over 1000 Shekels (about $250). 

When she saw the look of shock on my face, she mistakenly assumed I was angry about the expense and rushed to reassure me that I could spread the fees over as many as 12 monthly payments on my credit card!

I'm not looking forward to becoming a human pin-cushion (especially after recently poking fun at the practice on someone else's blog)... but at this point I think I would probably agree to Santeria or Voodoo rituals if there was a glimmer of hope that they might make the pain stop.

All I can say is, 'I [heart] socialized medicine'.  I sure hope the treatments are as pleasant as my experiences thus far.

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Posted by David Bogner on May 24, 2005 | Permalink

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So there, Jordan. If you mess with me I will have Dr. Bean taunt you a second time! And I happen to be fooling around with a Norwegian nurse.

BTW Bean, my right to earn a living = my pursuit of happiness. Or my escape from unhappiness.

Posted by: psychotoddler | May 27, 2005 5:02:36 PM

Psychotoddler... I should point out to the other readers that you and Jordan know one another from the music business. Otherwise I would not be pleased with what appears to be taunting. :-) As to your other statement, I would have thought that your pursuit of the Norwegian nurse = my pursuit of happiness.

Posted by: David | May 27, 2005 5:08:38 PM

Jack, you can toss my salad anytime! I just love a man with a big bushy beard!

How did I miss this yesterday. Whoa, maybe my friends at Ohr Sameach were telling the truth about yeshiva life. ;)

Posted by: Jack | May 27, 2005 5:42:34 PM

Yes, yes, I'm just kidding around with Jordan. We see eye to eye on everything.

And I'm also kidding about the Norwegian nurse. She's actually Korean.

Posted by: psychotoddler | May 27, 2005 10:05:51 PM

Yes, I included the word citizen for a reason...see, it takes years for me to become a citizen in Israel. Either I convert (yeah right- don't get me wrong, "some of my best friends are Jews", but my personal religious beliefs conflict.), or I am in a long haul process to become a resident (I've started). Either way, one is not able to enroll in the health insurance system for quite a while. There are gaps. What if I get cancer in those gaps?

My main point was that if I were a tourist, an illegal resident, a legal resident, a person with enough money to buy, ...well, I could buy private insurance coverage in the US. My gripe is that because of the "universal" coverage, there's no basic private insurance to cover those of us that are non-catagorical....not tourists, not yet residents, but might experience health problems while in Israel.

I have a work permit (granted no job- wanna hire me?!). But if I were working, my taxes would support the health care system, but I wouldn't directly benefit from it ... yet.

I agree with you that a country should look after its own first. But deciding what "its own" means in this modern world (in Israel!) is tricky. I just don't want to get tricked or sick.

Posted by: John | May 28, 2005 1:58:43 AM

John... It seems as though you have sort of made my point. A country (any country... not just Israel) is responsible to look after its citizens. Most countries also make it difficult to become a citizen (except to repatriate people who have an ancestral connection, in which case there are fast tracks such as Israel's law of return). You are indeed in a difficult position from a healthcare standpoint, but that situation is of your own making. No country in the world can be expected to provide blanket coverage for people who just happen to be in the country, whether as tourists, students or foreign workers. Yes, if you are working, your taxes help finance a system from which you don't receive full benefits. But that isn't to say you don't get any benefits. You live in a free society where the garbage is picked up from the streets... there is a police force and a judiciary... there is a relatively clean, functional infrastructure of roads, bridges and tunnels... and an economy which provides opportunities for citizens and non-citizens alike. If (g-d forbid) you were to be hit by a car, an ambulance would take you to a well-equipped hospital and you would be treated to the full extent of the staff's capabilities without regard to your status or ability to pay. Assuming of course that you survive your ordeal, you would be responsible for either providing some sort of insurance coverage or paying out of pocket... but that would be the case with any foreigner in any foreign land.

I wish you luck.

Posted by: David | May 28, 2005 9:23:44 PM

Dr. bean makes a good point in his response to me, although I consider it somewhat legalistic. It is true that I do not have a right as guaranteed in the constitution to make a living, nor does psycho, nor do I have a right as guaranteed in the constitution to health care.
But rights are not strictly defined by what is guaranteed in the Constitution. There is a concept of human rights that I think we as a western democracy adhere to as well, and one could make the argument that access health care is one of them. I also think that earning a living pursuing meaningful work is a human right, and we are entitled to speak of it that way.
The rights that Jefferson spoke of in the Declaration are not legally binding, but they are morally binding, and we might as well try to live up to them. I would argue that Life, liberty, and the pursuit of hapiness fall under ther category of human rights, and include the rights of which I speak.
One of the rights that is guaranteed in the constitution is free speech, which strict constructionists understand to mean political speech. As such, as my as I love my country, I stand by my characterization of it.
As far as statistics go, you are of course correct regarding the statistics you brought. But i would argue that Drug addiction is a health problem, and our country cant seem to stop treating it as a criminal problem, which is why we have been so unsuccessful. You know we could sling statistics at each other ad infinitum, and not get any further. But in a country with as many uninsured as we have, and as many with less than stable insurance, and as many with insurance who still have to go through hoops to get what they need, and anybody who has had a parent suffer a stroke as I have had know of what i speak, that our Health Care system is broke.
As far as nurses go, remember, Norwegians are more common in the old northwest. But I live just outside NYC. So pardon my prediliction for the daughters of the fair isle.

Posted by: Jordan Hirsch | May 29, 2005 6:48:07 AM

Mr. Hirsch: I appreciate your response, and also appreciate that you must be a good guy as you are pals of Bogner's and psychotoddler's. So, since I know none of you personally, I will try to debate with the humility and etiquette befitting an outside geek.

I was actually speaking both legally and morally. Moral rights are always accompanied by equivalent moral obligations. For example, Joe's right not to be murdered places a moral obligation on Mike not to murder him. Meaning Mike does something immoral if he murders Joe. Your (moral not legal) right to healthcare means someone has the moral duty to treat you, and is behaving immorally if he refuses. But no one has that duty. (Again I mean morally; I'm not talking about laws. You actually do have a legal right to emergency care.) Who is obligated to treat you if you're sick? Meaning, who is immoral if you go without care? You may wish you had a right to healthcare, but again, philosophically and morally, that is not where rights originate. The same exact thing goes for the imaginary right to make a living.

I suppose at the base of our differences is that I accept that ours is a nation of opportunity, not of guaranteed outcome. This has created an unimaginably prosperous middle class and a standard of living even for our poor that is much greater than that of socialist paradises in Eastern Europe.

Oh, and I have no problem with drug legalization.

Posted by: Doctor Bean | Jun 2, 2005 6:55:23 AM

Oh, and I also have no problem with redheaded nurses!

Posted by: Doctor Bean | Jun 2, 2005 6:58:01 AM

Ah, dr. Bean, I agree that ours is a nation of opportunity, not guaranteed outcome. But there are a few basics that come with that. What we disagree about are what those basics are.
Your point about whose obligation it is to provide health care is interesting. I guess on the individual level, one might argue that no particular Doctor is obligated. But then again, I never made that claim. My claim has to do with society's obligation to ensure, (and insure) access to health care. I believe that is a human right.
By the way, I have done OK with Red Heaed nurses, even the jewish ones. Dave Bogner is now going to laugh until he pours coffee out of his nose.

Posted by: Jordan Hirsch | Jun 2, 2005 4:46:24 PM

Jordan... ROFLMAOASCOOMN! [rolling on the floor laughing my ass off and spraying coffee out of my nose]. You're lucky I know and love both you and your wife or I would be powerless to keep myself from making a rude tongue in, um, cheek comment. :-)

Posted by: David | Jun 2, 2005 4:55:13 PM

Um, I guess I'll let Jordan have the last word since we're now talking about some nurse escapade of which I and Jordan's wife are blissfully ignorant!

Be well.

Posted by: Doctor Bean | Jun 2, 2005 9:59:46 PM

No, my wife knows (it was before we dated) and the nurse and I moved on to being friends.

Posted by: Jordan Hirsch | Jun 3, 2005 9:48:02 AM

I find it hard to comprehend the near-hysteria that is generated by the topic of 'socialized medicine' in the U.S. Since virtually all of the industrialised nations of the world have some form of 'universal health insurance' to protect their citizens from prohibitive health care costs, it seems ironic, yet tragic, that the allegedly richest country on Planet Earth has no such scheme in place, instead relying on a far more bureaucratically wasteful regime to deliver medical care to those who pay dearly for it through various private 'plans' as offered by the health care industry. Time and time again, we learn of people, often desperately ill, in the U.S. who are denied the care they need because they cannot afford either the insurance premiums or the cost of the treatment. Surely a nation so rich as America can afford to spend at least as much on looking after its population in this area of 'human rights' as it does on Weapons research and dubious Space ventures? Not much good having wonderful new tools of healing if 40 million uninsured people have no access to them? Does money dictate everything in the U.S.A.?

Posted by: Colin Cumner | Jun 17, 2005 10:06:30 AM

In my view we need to provide some kind of arrangement would have to be made to ensure the affordability of medical school for those interested in becoming doctors

Posted by: Susan R | Jan 27, 2006 11:40:44 AM

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