3rd World Healthcare

Ok, enough fluffy-nice stuff, back to vitriol.

Here is a story about a boy from Atlanta, from my very own high school and community, albeit a good deal younger. He got Hodgkin's Lymphoma while studying in Yeshiva in Israel. So he goes to the highly paternalistic Israeli doctors, here is an excerpt:

“By the l6th blood test on the fifth day, they said, ‘We see something in your blood,’” Khandadash said. “Now to give you a behind the scenes view, the doctors there would not tell you anything. It’s not like in America where you have a right to know everything. They literally would not tell you anything. I was like, ‘Maybe they think I’m a kid?’” 

Two things:
1) 5 days to get to a HL diagnosis?! Earlier reading of the article puts HL up on the list: age, persistent respiratory illness, fevers, night sweats. A positive CXR! I did relatively average on the heme/onc test, and I can tell you this kid has B-symptoms written all over him. What a bunch of quacks!
2) I know that I've been force fed like a veal-to-be the line about patient and family centered care, which is a buzzword, but it's also real. Patients aren't a piece of meat, nor are they simply patrons who come to the grand wizard for his almighty opinion. Clearly they mismanaged his case, and he might have been more forgiving had they not been royal D-Bags about the whole thing. If I've learned one thing in medical school, it's that as much as we do know, we really don't know, and modesty is good as gold in this profession.

So moving along, he realizes that the gig is up, and he purchases for himself private insurance. And the insurance co. immediately drops him once they find out it's HL. Now I feel awful that this young man got sick, but this is total pre-existing condition, and he bought insurance only after realizing, "oh wait, this isn't good." It's irresponsible not to have some sort of coverage. Insurance is not for if you get sick, it's for when you get sick. Now, the greater issue is insurance companies doing this at all, and this illustrates the serious flaws of 3rd party payer managed care. Of course, Israel has a socialized system which still has the downfalls of point 1, but he didn't have access to the social system regardless.

So he goes to his American doctor at Scottish Rite. A good hospital:

Khandadash then thought to himself what the Israeli doctors told him, that his lungs looked fine on the x-ray he saw overseas. He informed his doctor what he was previously told.

Doctor: “Are you serious?”
Khandadash: “Yeah, this is what I saw in Israel.”
Doctor: “They didn’t catch anything in Israel?”
Khandadash: “No.”
Doctor: “Well, you see this?” The doctor points to outlines of two objects.
Khandadash: “Yeah, my lungs.”
Doctor: “You see these two big things over here and over here? Those aren’t supposed to be there.”

 Like I said before, a bunch of quacks over there. his doctors were displaying some quackery, it seems. (Disclaimer: Not all Israeli doctors are quacks, but his seemed to be, based on this article. Maybe BennyPoo can calm down now).

Thankfully, HL generally has a good prognosis. Imagine this kid walked in with something more serious that they completely overlooked in Israel. He could be way worse off at this point. I've heard lots of people, particularly family members, defend Israeli Healthcare to the hilt (possibly due to their religious-zionist bias swinging them away from objectivity [but aren't we all swung that way?]), as if its this perfect system. But I know, based on my experience there as well as the anecdotes of others, that its all-around better over here. Not to say that you don't deal with loads of bullcrap from doctors over here. Trust me, I know the people in my class, the future dotors of America. But still, we can, and will, and do, do it better.