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Sunday, August 05, 2007

Travelers share their experiences with foreign health care

Travelers share their experiences with foreign health care
John Flinn
Sunday, August 5, 2007

Well, you're a klutzy bunch, aren't you? While traveling in other lands
you've fallen out of mango trees, tripped and bashed your head on
cobbled streets, been stung by Portuguese man-o-wars and knocked upside
down by out-of-control motorcycles.

As a result, you've gotten a look at the health care systems of other
nations, including those highlighted in Michael Moore's new film,
"Sicko," and in my column two weeks ago.

Many of you wrote to share your experiences in countries with socialized
medicine. Right off the bat I've got to apologize: So many of you posted
comments online or e-mailed me that I can only include a tiny sample of
responses here.

And further apologies to those print readers confused by our
instructions about posting comments online. Starting today you'll be
able to append your thoughts to all Travel Section stories on
SFgate.com. For instructions on how to do so, please see note at end of
this column.

It's impossible, or at least irresponsible, to draw conclusions from any
one person's experiences. But collectively, the vast, vast majority of
you reported competent and compassionate care, little or no waiting and,
even for those not covered by the national health care plans of these
foreign nations, shockingly tiny bills.

Typical was someone who posted online as Longibson.

"My daughter over a period of six months kept complaining of trouble
breathing. All the American doctors who saw her (said) it was because
she was smoking or that she was having panic attacks. When she finally
was able to join her husband in the Netherlands she went to see a doctor
about the same symptom. They correctly diagnosed her with a collapsed
lung and had her in surgery the next day. Total out of pocket money for
my son-in-law - $0.00."

Jason Gillespie of Grover Beach passed a kidney stone on a flight to
London three years ago and discovered a nifty little benefit of the
British health care system: The paramedics who treated him used nitrous
oxide - laughing gas - as a pain reliever. Note to U.S. paramedics:
Let's definitely try that.

But Dr. Kathleen Roth, a Bay Area emergency room physician, told of a
patient whose care in the capital of a major western European nation was
shockingly primitive - more akin to what you'd expect in a Third World
country. She wasn't able to say more without violating the patient's
confidentiality.

And someone posting as Chi_runner had a very un-Michael Moore-like
experience with the Canadian health care system after his 60-year-old
mother injured her head and arm in a fall.

At the hospital, "we were asked to pay $1,500 up front. They took her
blood pressure, which was exceptionally low, then we sat in the waiting
room for more than two hours before we started asking when she would be
seen. Apparently, there was only one doctor there, and they didn't have
doctors on call to deal with a waiting room full of people.

"More than two hours later (for a total of four hours), without seeing
the doctor, we took her back to the hotel. Once back in the States, she
was immediately able to see her doctor, who confirmed she had a
concussion and a fractured shoulder."

I wrote about my experience with the French system of delegating minor
ailments to pharmacists - specifically how a Parisian pharmacist
correctly diagnosed my wife's conjunctivitis - pink eye - and sold us
antibiotic eye drops on the spot. A number of travelers wrote to share
similar experiences in Europe and Latin America, and just about everyone
agreed it's something we should try in the States.

But there's a trade-off for that efficiency, as a reader posting online
as Bbb70 tragically discovered:

"We were traveling in Germany, and I (like the author) awoke with an
irritated eye. I was directed to the neighborhood pharmacy where they
gave me an antibiotic for my 'pink eye.' I was amazed at how quickly we
were serviced and how I didn't even need to see a doctor. It cost about $12.

"Unfortunately, what I had was not pink eye but a deeply scratched
cornea that was diagnosed by a stateside doctor upon our return. I am
now blind in my left eye and have lost my job as a delivery driver."

And a less serious but still significant caveat: A reader posting online
as K8cch14 dropped into a pharmacy in Italy for a flu shot and was
handed a loaded syringe. Patients are expected to inject themselves, or
have it done at a hospital.

"After a few days of getting up the nerve to stick the huge needle in my
arm, I went for it and apparently didn't make it all the way through the
muscle (and) was left with a swollen, painful lump. I went back to the
same pharmacist, who ... handed me a tube of cream that healed it in a
day, on the house."

There's not a word that can be written about Cuba that someone won't
violently object to. Everyone who visits the place - or even thinks much
about it - seems to come away with his own fiercely defended version of
reality.

And so it is in the health care discussion. After I wrote of a
dilapidated hospital I visited in Trinidad, down the coast from the Bay
of Pigs, and how it looked like something you might have seen in rural
Mississippi in 1958, people wrote to say hospitals in Cuba are much,
much better than that. And other people wrote to say hospitals in Cuba
are much, much worse than that. Draw your own conclusions.

Finally, I have it on very good authority - I can't say how - that the
Cuban hospital featured in "Sicko" is indeed open to rank-and-file
Cubans, at least those who live in Havana. Apparently there's an even
fancier facility reserved for Fidel and friends.

John Flinn is executive editor of Travel. To comment, go to
sfgate.com/travel.

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/08/05/TRPNRAINM1.DTL

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