|Living in Canada, with free health care, I have always had a misguided view on Hospitals and health care: I always believed that it's a right to receive proper medical treatment. In a system with government regulated health care, it's very easy to forget that health care is first and foremost a business. These people are getting paid, in most cases, very well*.|
Growing up I was taught that there are some people, practically demi-gods, who you could trust above all others: Doctors, Nurses, Police, firefighters, lawyers, judges, etc... Those learned people who are entrusted with keeping the rest of us safe, who dedicated their lives to the service of others... I was led to believe that a doctors knowledge and abilities knew no bounds, and that after umpteen years of post-secondary schooling, they knew it all. (Sorry for rambling, but I'm setting up for what I personally found to be a crushingly devastating relevation)
See, I was under the impression that doctors do what they do because they are altruistic. Sure, some actually are, but many are doctors just for the money. Whether it's the government that signs their cheques or a private health care provider, it's all just a business like any other. Larger than most, even.
I also believed that if a doctor said something, it's true, because of their positions in life, their schooling, and their sheer confidence which can sometimes escalate into arrogance. It took me much longer to realize the fallibility of doctors than that of my parents. We tend to place doctors on pedestals and think of them as nearly all-knowing. But as a doctor friend of mine told me, they obviously can't know everything, but will often pretend they do so not to shatter the patients illusions. Sometimes this actually has a placebo effect.
So I do believe that there is a discrepancy between the ideology of hospital/medical care and the reality of treatment. I think that the discrepancies are born in our own imaginings of what health care should be and what it really is. I believe that we hoist such high standards on our hospitals and doctors that it's impossible for those standards to be met. Worse, the doctors themselves believe in our impressions of them and sometimes they become inflated with self-importance and our eventual treatments suffer for it.
Which is one part of the problem. Another part of the problem goes back to the health-care-as-business model.
For example, here in Ontario, a doctor will receive a minimum $65 per patient seen. I believe that for a walk-in doctor, they can see a maximum of 10 patients per hour but I may need to check back on that. If a patient books an annual physical, the doctor must spend a minimum of 15 minutes with the patient, and they receive the same minimum. Now obviously it will pay more for a doctor to focus on a high-volume walk-in practice than a family practice, the type usually required to get an annual physical (one of the reasons its so damn hard to get a family doctor here these days...)
So we end up with a revolving door medical system: State your problem, fill prescription, next!
So there are problems with health care, and it's my personal belief that the problems are directly proportional to the amount of money involved in the system. Of course the cost of becoming a doctor (or nurse, or support staff) is not cheap, either financially or temporally, and the people involved have loans to pay, etc... However, I have seen some "doctors" spend 8 years in post secondary schooling to become a mere legal drug dealer/pusher. (Seriously: prescribing Oxycontin for a broken toe?)
The system seems to be set up to facilitate a revolving door practice, and punish the doctors who want to invest in a deep quality doctor/patient relationship. On the other hand, with free health care, some patients themselves abuse the system by running to a clinic because they have a sniffle or because they are drug seekers.
Some people think that a 100% privatized system would ensure that the system is abused, because, hey, a free market always finds its own level, right?
There are socialist leaners who believe in 100% state run health care: Cubans enjoy fantastic health care for all. (So I'm told by several people - if you have an opposing view, please let me know.)
Despite it's problems, I think a mixed system is still the best option we've got at the moment, but we need to re-educate ourselves on exactly what health care means and how it's practiced. And while doctors deserve respect, they should not be placed on pedestals - everyday people need to be aware of the limitations on health sciences and should be taught that doctors are not the be-all-end-all authorities that some think they are.
*I know that there are many Nurses and support staff who are grossly underpaid and overworked: it depends on the environment in which they work. For example, a private clinic (Which also accepts provincial health cards) that hires staff straight from school may find it easy to underpay the nurses and support staff because those they hire tend to be younger, already burdened with financial difficulties, inexperienced, or easy to bully. This is not to say that this doesn't ever happen in federally funded institutions, but it happens more often in the private sector where there is less chance of a unionized environment, which can be another problem entirely.