A view of the construction of the new hospital during the wee hours of the morning - taken with my phone on the long walk to the VA.
Ladies and gents, it is hot! It's up to 104 degrees the next two days, 107 after that, and then tapered down to 96 over the next week or so. Hot! Hot! Hot! And to top it all off, we start moving this week in it! Bummer. Everything here is off the walls, everything except the curtains in our bedroom. The holes are patched and ready for the poor fool who has to paint behind us. We also start painting this week. The master bedroom will be colored something like this, with an accent wall like this. The master bath will be like this. The office will be somewhere around here, and the spare bedroom here. This is the hall bath, and I can't mimic the living room with the available text colors - it will be a khaki type color. We'll refinish the already white trim with a fresh coat, and I will replace all the power receptacles and light switches with new white ones instead of those old yellowed ones. It's gonna rock.
Life at work has been interesting. My new team is OK, but I like the old one better - aside from the attending,; I like my current attending better. I have also learned that the VA hospital presents with its difficulties. While their computer system for managing patient information is one of the best, the government-run hospital is otherwise a pain in the ass. It may take days to get simple things done. A simple at home dialysis catheter placement may have to wait a week; the patient, in the meantime, sits in the hospital to receive inpatient dialysis. Even the cafeteria is completely shut down over the weekend. It's not the end of the world, but UAMS is faster, and more accessible.
It makes me think of what health care would be like if coverage/insurance became universal. It wouldn't be all that bad - I would argue we could maintain a better system than what is found overseas. People rave about such foreign systems because everyone is covered and mortality rates are lower - and they're right, to some degree. Can we, here in America, do it better? 50 million uninsured people is unacceptable - especially when a VERY significant portion of these folks are working. Which reminds me - we have to get away from this associating insurance coverage with our place of employment - we're the only country to do this and it is causing the system to fail. We could have more money for coverage (if HMO and insurance CEO's were shot and buried) than other places, maybe. We have the money now; it's just in the wrong hands. In other countries, every woman gets prenatal and postnatal care covered, and every child is covered - here, our president makes the retarded statement that we can just send our uninsured children to the ER for medical care (he too should be shot and buried). This means money going to the wrong type of care for kids, wasted money. In other places, pharmaceutical companies aren't allowed to advertise to the general public - here, the companies spend a fortune doing it, confuse the public with their crappy, nondescript ads, and ultimately piss doctors off because people are convinced they need this new blood pressure medication instead of losing a little weight and laying off the salt. Maybe all that advertisement cost can go to help paying for drugs that some can't easily afford because they're overly priced. Suppose a man has been at a company for twenty years and has always had company insurance. He has a desk job, doesn't exercise, is fat, lazy, develops hypertension, diabetes, and eventually suffers a heart attack - all because he is a moron. But, he had insurance beforehand, so he's covered and he doesn't suffer too much financially. Suppose there's a young woman who is healthy, has insurance, and develops an autoimmune disease by fate. She's covered until she has to move and find a new job at a small company. She only goes without insurance for a little over a month before reapplying for the new insurance. She's denied because of a preexisting condition and not being covered continuously. See a problem? I think about this all the time, probably even more so than the young woman in the above scenario since I see patients from both sides of the story (unhealthy idiots and the unhealthy by fate) every single day.
There's a flip side to the problem, though. Should everyone receive the best of care, no matter how little money they have? I don't think so. Basic, but sufficient and appropriate, health care may be a right in a country as wealthy as ours. However, if you're one of the ones actually helping to pay for it, and since the poor and homeless can't pay for any of it, shouldn't there be a stepped level of care? Of course there should be - and there is. It's the difference between UAMS and Baptist, between Medicaid and private insurance. Both are great medical centers with great technologies, but patients at Baptist are more likely to get one-on-one care with a broader choice in caretakers and medications. Patients at Baptist can expect to see their doc whenever they want. Patients at UAMS can't. Universal care can only exist if everyone takes their part - pay what you can afford (which ought be determined by income/household size/etc.), and use preventative medicine instead of tertiary treatment medicine. In other words, don't get fat and hypertensive in the first place. Genes only predispose you to becoming obese; you still have to fuel the pounds with food and laziness since fat doesn't develop out of thin air. Granted, there are some cases where weight is truly uncontrollable, the hypertension uncontrollable, the high cholesteral unavoidable (this is actually more common), and the lung cancer that develops in a never smoker - but these are all pretty darn rare. I have never seen a skinny, physically active 45 year old person with hypertensive heart disease and late-onset diabetes. People in other countries don't necessarily have lower mortality just because of health care. While this plays a smaller part (and a significant enough one to justify universal care), the bigger part is the fact that they are healthier - yes, it's that simple. As these Eastern countries become more Westernized, we will see how their universal health coverage no longer lives up to its "glory" - and you remember that, fat ol' retarded Mr. Moore.
Don't get me wrong, I love what I do.
Life at work has been interesting. My new team is OK, but I like the old one better - aside from the attending,; I like my current attending better. I have also learned that the VA hospital presents with its difficulties. While their computer system for managing patient information is one of the best, the government-run hospital is otherwise a pain in the ass. It may take days to get simple things done. A simple at home dialysis catheter placement may have to wait a week; the patient, in the meantime, sits in the hospital to receive inpatient dialysis. Even the cafeteria is completely shut down over the weekend. It's not the end of the world, but UAMS is faster, and more accessible.
It makes me think of what health care would be like if coverage/insurance became universal. It wouldn't be all that bad - I would argue we could maintain a better system than what is found overseas. People rave about such foreign systems because everyone is covered and mortality rates are lower - and they're right, to some degree. Can we, here in America, do it better? 50 million uninsured people is unacceptable - especially when a VERY significant portion of these folks are working. Which reminds me - we have to get away from this associating insurance coverage with our place of employment - we're the only country to do this and it is causing the system to fail. We could have more money for coverage (if HMO and insurance CEO's were shot and buried) than other places, maybe. We have the money now; it's just in the wrong hands. In other countries, every woman gets prenatal and postnatal care covered, and every child is covered - here, our president makes the retarded statement that we can just send our uninsured children to the ER for medical care (he too should be shot and buried). This means money going to the wrong type of care for kids, wasted money. In other places, pharmaceutical companies aren't allowed to advertise to the general public - here, the companies spend a fortune doing it, confuse the public with their crappy, nondescript ads, and ultimately piss doctors off because people are convinced they need this new blood pressure medication instead of losing a little weight and laying off the salt. Maybe all that advertisement cost can go to help paying for drugs that some can't easily afford because they're overly priced. Suppose a man has been at a company for twenty years and has always had company insurance. He has a desk job, doesn't exercise, is fat, lazy, develops hypertension, diabetes, and eventually suffers a heart attack - all because he is a moron. But, he had insurance beforehand, so he's covered and he doesn't suffer too much financially. Suppose there's a young woman who is healthy, has insurance, and develops an autoimmune disease by fate. She's covered until she has to move and find a new job at a small company. She only goes without insurance for a little over a month before reapplying for the new insurance. She's denied because of a preexisting condition and not being covered continuously. See a problem? I think about this all the time, probably even more so than the young woman in the above scenario since I see patients from both sides of the story (unhealthy idiots and the unhealthy by fate) every single day.
There's a flip side to the problem, though. Should everyone receive the best of care, no matter how little money they have? I don't think so. Basic, but sufficient and appropriate, health care may be a right in a country as wealthy as ours. However, if you're one of the ones actually helping to pay for it, and since the poor and homeless can't pay for any of it, shouldn't there be a stepped level of care? Of course there should be - and there is. It's the difference between UAMS and Baptist, between Medicaid and private insurance. Both are great medical centers with great technologies, but patients at Baptist are more likely to get one-on-one care with a broader choice in caretakers and medications. Patients at Baptist can expect to see their doc whenever they want. Patients at UAMS can't. Universal care can only exist if everyone takes their part - pay what you can afford (which ought be determined by income/household size/etc.), and use preventative medicine instead of tertiary treatment medicine. In other words, don't get fat and hypertensive in the first place. Genes only predispose you to becoming obese; you still have to fuel the pounds with food and laziness since fat doesn't develop out of thin air. Granted, there are some cases where weight is truly uncontrollable, the hypertension uncontrollable, the high cholesteral unavoidable (this is actually more common), and the lung cancer that develops in a never smoker - but these are all pretty darn rare. I have never seen a skinny, physically active 45 year old person with hypertensive heart disease and late-onset diabetes. People in other countries don't necessarily have lower mortality just because of health care. While this plays a smaller part (and a significant enough one to justify universal care), the bigger part is the fact that they are healthier - yes, it's that simple. As these Eastern countries become more Westernized, we will see how their universal health coverage no longer lives up to its "glory" - and you remember that, fat ol' retarded Mr. Moore.
Don't get me wrong, I love what I do.
