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15 March 2012 @ 04:47 pm
Our So-Called Health System  
TheJournal.ie had a piece yesterday about Amnesty's ad campaign for an equal health system in Ireland.

(Incidentally, for me, this comment on that article sums up exactly why a one-tier, free-at-point-of-access health system is really the only defensible approach: "...as soon as rich people have to avail of the same services as the rest of us you’ll be amazed how quickly it gets sorted.")

So I went to sign the petition, and ended up finally writing something that's been brewing for months.



Dear Taoiseach, Tánaiste and Minister for Health,

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MY BIT:
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In January this year I had two experiences that gave me a shocking perspective on our health system.

First, I had a kidney stone and had to call an ambulance. I spent the proverbial Saturday-night-on-a-trolley-in-A&E (which we middle-class folk are so fond of holding up as the ultimate ordeal from which our wealth is supposed to protect us).

Yes, it was a fairly basic form of accommodation. Yes, I've slept in more comfortable beds. And at the same time, the care I received was excellent: kind, competent and respectful.

Of course, I was billed the following week: €100 for the ambulance. Happily, I am rich, so this didn't present a cash-flow problem. That someone on less than half my household income still has to pay that fee is a roaring, screeching, thundering disgrace.

But I digress.

The second experience came a few days later, when I attended a previously scheduled appointment with a private consultant at a certain south-Dublin medical mall.

I needn't describe the contrast between the surroundings here and in the public A&E. You can picture without my mentioning them the ankle-deep carpets, the accent lighting, the architectural pot plants. There was - I am not joking - a chandelier in the waiting room.

A chandelier.

It wasn't even switched on. The room was lit by downlighters. The chandelier - oh, the symbolism! - was for show.

All I could think of was that scene in Father Ted where the villainous Hud Hastings and Fargo Boyle are revealed as having bought a fur coat and a crown with their ill-gotten gains.

I gather I was supposed to feel grateful to be getting such an exclooosive care experience, as signified by the five-star decor and the size of Mr Consultant's computer monitor. Oh, and the eye-watering fee, which obviously keeps the riff-raff away.

The care was fine. But oh, boy, did I not feel grateful. Unclean, yes. Angry, yes. To get rhetorical for a moment, how many CT scans does that redundant chandelier represent? How many ultrasounds would a choice of hard-wearing vinyl instead of deep-pile carpet have paid for?

I don't know the numbers, but what I'm talking about is the principle. The message. This is decline-and-fall-of-the-Roman-Empire territory we're in here. The sort of vile, oozing, blinkered luxury that tends to give the prospect of bloody revolution a refreshing appeal.

I'm not (necessarily) saying that nobody should have carpeted waiting rooms, or that consultants should make do with refurbished PCs. But what we've got is ridiculous. It's undignified.

Could we maybe split the difference?

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AMNESTY'S BIT:
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The healthcare system in Ireland is extremely unequal. Many people living in poverty cannot access medical cards. Those who rely on the public system wait longer for care. This is unacceptable.

Equal access to healthcare is one step in ensuring people have the right to health. Health reform by your Government must be based on human rights standards and equality.

I call on you to ensure that health reform includes a robust legal guarantee that no matter who you are, or what you can afford, you will have equal access to quality healthcare.

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ME AGAIN:
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Yes. Do this. You know that it's the only moral approach, and I've heard rumours that it also makes economic sense.

The End.

[The Name of the Radzer]



I wonder will it be read?

I've sent an edited version as a letter to the Irish Times, which is probably still too long to print, so I thought I'd just publish it here too. You know, for closure.

It's worth noting that until ailbhe and I were discussing my A&E experience I had no idea how low the cut-off point for a medical card actually is. If I'm reading the Citizens' Information figures correctly, a 40-hr/week job at minimum wage puts you over the threshold unless you have 3+ children and no other household income (if you're under 66, that is).

Anyway. Go and sign the petition, if you're in Ireland.

If you're not in Ireland, feel free to gnash your teeth at our iniquitous set-up.
 
 
( 2 comments — Leave a comment )
Snail Always Winsredshira on March 15th, 2012 06:44 pm (UTC)
I signed, and left a long rant about how if my husband with Marfan Syndrome hadn't been rich, he could well be dead now, because an *urgent* referral for an echocardiogram was answered with a letter saying the wait was two years. It surely goes without saying that if a doctor thinks you need your heart & aorta looked at, you can't afford to wait two bloody years for it. I don't even want to think about the number of dead Marfs who'd be alive if they'd been rich enough, as we thankfully were, to get it done privately within a week. I moved to Ireland from England in 2008, and although I'm extremely grateful that a) we can afford insurance b) we're not in America, I'm not exactly overjoyed to have become familiar with things like having to choose between fixing the car or going to the doctor. And we're rich people with no children; the stress must be horrific for people with more average incomes and/or who have kids.
The Milkman of Human Kindnessradegund on March 15th, 2012 11:54 pm (UTC)
I know. It's so utterly wrong, the way we have it set up at the moment. There is no defence.
( 2 comments — Leave a comment )