Ephraim Kishon was an Israeli satirist and humorist. He was Hungarian born and a survivor of concentration camps and when he arrived in Israel, the newly integrated nation of hundred odd nationalities gave him lots of material to work with.
During one of my visits to Israel, I heard a story, attributed to Ephraim Kishon. There were so many doctors among the survivors/immigrants that the new health care system could not employ them all. So, the doctors began going from house to house to see whether there were any patients to see. The population was getting so tired of these knocks on their doors that they began putting up signs
DOCTORS RECEIVED ONLY BETWEEN 4 AND 5 PM
Currently Israel has one of the best Health Care delivery systems in the world. The Arab professionals are well integrated into the Jewish state’s health care system
USA has one of the poorest health care delivery systems in the developed world. It is a fee for service system, manipulated by many of the actors in the capitalist system: pharmaceuticals, insurance companies, financial speculators with no experience in the field of health care.
One of the commonest complaints heard until recently in the USA was: Cannot get an appointment with the doctor. Even to see your Family practitioner had become less of a guarantee, and forget about the Specialists, some of them having months long waiting lists. Americans like the illusory idea of Freedom of Choice in their providers but that is already decided for them, by the kind of medical insurance they hold.
The insurance broker in the office is a permanent fixture, a new profession called the Scribe (who writes down the conversation between the doctor and the patient as directed by the doctor in his computer). Nurses and Nursing assistants and billing clerks all mill around and you are not sure who is connected to your health care.
This last SUNDAY, imagine on a Sunday, a friend of mine got a telephone call from his specialist doctor! First ever time in his life. The doctor wanted him to make a virtual appointment and gave him a date and time of his choice. There were other calls from Family Practitioners and an array of people in the fee for service system.
In the USA, people had become afraid of going to the doctor’s office or emergency rooms (a popular way of getting acute medical care). Most private practices were reporting a drop of 30 to 40 percent in their revenues and some of the doctors were closing their practices and some even applying for unemployment insurance .
All because of a 40 nm virus!
How this virus has laid open the frailties of the American Health care system! The sudden surge in interest among the doctors for their patients has little do with patient welfare, but rather than their bank accounts. It is not fair to point out to just one cog in the big capitalistic machine wheel but unless other enterprises Medicine and Health has more sociocultural implications.
This lack of visits to the offices of the doctors may give us time to reevaluate what kind of prevention could be done, aggressive treatments, whether or not they are necessary and effective and also each of the practitioner could question their intentions and morality behind their actions taken in the name of health care.
