Wednesday, June 29, 2011

Lessons from european health care

   Since I am new here, perhaps an introduction is in order. My name is Joe Wahler and I have health issues. I am here to share my experiences with the Irish health care system. Firstly, I am an American, my wife and I had been to Ireland many times and absolutely fell in love with it. So one day we decided to take the leap and bought a small derelict farm in the west of Ireland, county Mayo to be exact, in the late 90′s with an eye towards fixing it up and semi retiring there. After we worked as many hours as was humanly possible at our jobs with the phone company in Cincinnati in order to pay off the mortgage in 3 years.  At one point neither of us had had a day off in over 100 days.  Living the dream, we packed up and moved over in early 2002.
   The house was still derelict when we moved in, with us placing plastic sheeting in for windows, no running water, no electricity, only heating and cooking from a fireplace, and a hole we dug in the field for a toilet. It was roughing it to say the least, but the walls were solid stone 3 feet thick, with a strong slate roof. To say that we had a big job ahead of us was something of an understatement, but we tucked in and got to work, celebrating each milestone as it occurred. Remembering how excited we got as each utility was turned on, how we were so thrilled when we got actual double glazed glass windows to replace the plastic sheets, when the teak dutch half doors with the separate top and bottom that could be opened independently were hung and we had “real” doors. The amazement when water actually flowed from our new kitchen faucet, and when the switch finally relegated our candles and oil lamps to the mantle. Months, and months of work, turning a derelict, dilapidated empty shell structure into our new home, our idyllic Irish country paradise. New doors, windows, stairs, wiring, plumbing, floors, insulation, furniture, and appliances, but when it was finally finished, we had our dream, and life was good.
   Then my Rheumatoid arthritis (RA) took a turn for the worse and I needed a doctor. I went into Kilkelly, the local town, and met Dr. Kennedy, a great doctor to whom I paid cash out of pocket to expedite things. I was then enrolled into the western health scheme as it’s called so I could take advantage of the Irish free medical care, which the World Health Organization rated as 19th in the entire world, far superior to the United States which was ranked a pathetic 37th. So I assumed I was going to get some of the best available healthcare there was. Well, as Gomer Pyle would have exclaimed “surprise! surprise! surprise!”.
   Dr. Kennedy recommended me to a rheumatologist in Galway and set up my initial appointment… in 6 months, oh-kaayy, I suppose I can wait…. and wait.. The day arrives, I go in, he sees me for 4 minutes, changes my prescription from methotrexate to Enbrel, and tells me to come back in a year… A YEAR? turns out that was the earliest available appointment at that time. So, I say, let’s see what happens, the Enbrel seems to be doing the trick, so maybe I can deal with this, these guys are Doctors after all. When one day a few months later I get a screaming pain in my leg that drops me to the ground, a few seconds later it’s gone, as if nothing had ever occurred. A few days later, another one, then another, and another, then multiples every day, then every hour. Dr. Kennedy is stumped, I get an emergency visit to the arthritis guy (only 2 months wait!) who proclaims that it’s all in my mind and that maybe I should see a psychiatrist.
   2 weeks after that appointment we’re back in the states to visit family when I run into my old family doctor who sees one of these attacks and has me in his office the next day.  He refers me to a rheumatologist in the Cincinnati area who is able to see me in 2 days.  She suspects the RA may have affected my central nervous system, so she gets me in to see a neurologist the very next day who confirms her suspicion. It was official, I now had something similar to epilepsy…. sure, that’s fair, why not?  By this point, I was having 70 or more attacks a day and couldn’t  go out for fear of someone calling 911 every few minutes. In the end, my American rheumatologist changed my prescription, the neurologist put me on an anti-seizure medication, and me, the guy who had to crawl to the bathroom on some days, and could not go out into public, can today take his wife dancing.
   The point is that if we go with socialized medicine, and that is the ultimate conclusion to what is now called “Obamacare”, we will have the same outcome as Ireland. How can we not? A healthcare system that works wonders for those who do not need it, and kills those who do.
   We used to hear every day on midwest radio a broadcast from Ballyhaunis something called the “trolley report”, the trolley report was a daily report detailing how many people had to sleep on a gurney in the hall at every hospital in Ireland. It wasn’t because there were no beds in the hospital, it was because those people had the wrong ailment, if you have, let’s say, cancer, and the cancer ward is full, you don’t get a bed, even though the broken leg ward across the hall is completely empty. It’s government controlled, run by the book, not allowing for problem solving, or creativity of any kind. It’s healthcare by committee, and if you do not fit neatly into the round hole, your square peg is tough out of luck. If we are so foolish as to place government bureaucrats in charge of our hearts, kidneys, livers, my RA… I think you get the point, then we deserve the nightmare that will ensue.
   A prime example of this was while still living in Ireland, I had to go into casualty, that’s the emergency room at the hospital to us Americans, with a deep vein thrombosis in my left leg one Saturday afternoon. I wasn’t swollen due to the RA medications I took and tried to explain that to them. Their answer was to tell me that they did not have an ultrasound technician available to perform the test on me, and they were certainly not going to bring him in on a weekend.  I was told that I would  ”have to leave and come back on Monday”.  In addition the hospital rep. added, “and if you don’t leave we’ll forcibly remove you”. I went home and ate aspirin like it was candy, went back on monday and they placed me into ICU, heavily sedated to keep me still, after they confirmed the deep system clot. I should have died that weekend. That was when I vowed to not allow them to have another shot at me. I came back to good old #37th place United States, where I could receive the best care on earth, and have ever since then.
   In Ireland it is legal to be buried on your property, that was my plan, I wanted to buried in the place that we built with our own hands, in the place that we loved, I just didn’t want to be buried there as a young man.
   In conclusion, I have a question for you to ponder: What is the last thing the US government ran well and on budget? Do you really think they should handle your heart attack?

                                                                     Our dining room in co. Mayo, who would want to leave that?  

1 comment:

  1. Joe, I loved this, your story, what you had to say. I too am in love with Ireland, and would prefer to die there as an old person, and not a young one. I spent a bit of time in County Kerry - it has never left my heart and mind. Thanks for bringing up some the beauty of that country and also the facts that exist regarding health care. Keep it coming m'lad.