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Where in the world is the best health care? - The Pasadena Star-News

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The week before the most recent statewide lockdown, I had (very) minor surgery. (I’m fine, thanks; great job by nurses and docs alike. As you read this I’ll be surfing at Bolsa Chica.) Spending most of the day in one of Southern California’s largest hospitals, I had plenty of time to quiz staffers from receptionists to surgeons about how they are holding up as frontline workers during the deadly coronavirus pandemic.

Suffice it to say they are not happy campers.

Just as with the RNs and other health care workers who are threatening to go on strike over local hospital conditions, they said their workplace was “alarmingly unprepared” for COVID-19. Though they mostly have adequate access to PPE now, they are still really, really ticked off at the initial drastic rationing of medical masks, which in the early months of the outbreak were literally kept under lock and key in their surgical unit. Staffing shortages are still very real for them.

A friend of mine who works in the same hospital is still mad about her colleagues being told last summer to show up for work “even if they have a known exposure unless symptomatic,” as she wrote me at the time.

Last week: “The numbers we are seeing in the hospitals are unfathomable.”

I would only note that a worldwide plague is hard to plan for. And that, while I did my financial part by having a mostly elective surgery, and paying the piper for it, Southern California hospitals are hemorrhaging red ink just when they need cash flow the most.

Knowing there would plenty of downtime before the laparoscopic knife, I brought some reading material: the Oct. 22 New York Review of Books, with an essay by David Oshinsky, a medical scholar who wrote the history of Manhattan’s storied Bellevue Hospital, discussing the new book “Which Country Has the World’s Best Health Care?” by Ezekiel Emanuel.

Of the 11 countries the University of Pennsylvania medical ethicist studies in the book, the only reason that the United States doesn’t come in dead last is that he decided to include China instead of the usual group of 10 major worldwide democracies. Emanuel, who has Harvard doctorates in both medicine and political philosophy, says you don’t want to get sick in China.

Essayist Oshinsky reports on the fascinating turnabout the American Medical Association has made in the last 75 years since President Truman first tried to pass a plan for national health insurance. Shocked at what they saw as a potentially pinko left turn for Americans, the docs’ lobby decided to sexualize the proposal, saying it would turn he-men Yanks into “dainty, steam-heated, rubber-tired, beauty-rested, effeminized, pampered sissies.” Truman’s plan, the AMA said, was “blueprinted in the Kremlin headquarters of the Communist Internationale.”

Here in 2020, you might say the docs won. It costs close to a very un-commie $30,000 to have a baby in the United States today thanks to what one study calls “a wasteful overuse of drugs and technologies”; it costs about $4,000 to have a baby in Western Europe. We spend about half of the $1 trillion paid out worldwide each year for pharmaceuticals; we have 5 percent of the world’s population. The two largest American political lobbies: Big Pharma, followed by the insurance industry.

Oshinsky says Emanuel is cagey on which country really does health care best, but Germany, the Netherlands, Norway and Taiwan are in his top tier. So Holland, in a pinch. Best thing about our system: “innovation and experimentation.” Best thing about today’s AMA: Docs now support Joe Biden’s plans to expand the Affordable Care Act.

Larry Wilson is on the Southern California News Group editorial board. lwilson@scng.com.

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Where in the world is the best health care? - The Pasadena Star-News
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