Western Medicine and Health Care...compared.

I have been reading, with interest, the debate regarding the health care system in the United States over the past few weeks. Seems even moving 8,000 miles away cannot keep me completely out of politics or what is going on back home… Without television (we got rid of our TV package through Satellite about a month ago), I rely on computer and newspaper…and I cannot tell which ones are more biased at this point.

Living in Africa has given me a unique opportunity to see this issue from a different point of view. There are cries from all walks of life in America about how broken the system is. The Democrats feel that the system does not properly guarantee all citizens the right of excellent, affordable medical care, physicians are not held accountable for their actions, and that the government should predicate what services the public should receive. The Republicans appear to want zero government regulation, the system is not broken, leave it alone. The libertarians seem to think that it is each person’s responsibility to provide themselves with health care coverage and make do with the free-markets system. Here in Africa, folks just die.

There are numerous hospitals here in Nairobi…probably some of the best in Eastern Africa and outside of South Africa. Medical services are quite reasonable here. We took our daughter to a clinic, a very expensive clinic in Karen, and the total cost was about $50 USD for everything…without insurance. There are other, much more affordable clinics that will cost one about $10 to see a physician but this is in a hospital setting and one worries about what one might catch sitting in the waiting room for an hour or so prior to seeing the physician. In a land where Aids and TB affect 33% of the population…that can be worrisome. The major point is healthcare here is affordable…for those who have a good income. Those that do not…well, it is just like in the States; either go to the Government Hospital or do without.

There are a lot of smart Kenyans. No doubt. There are also a lot of smart Kenyans that are becoming physicians. They go through very similar training as American physicians except it seems that their Medical School is also part of their regular College training where US Physicians require four years of pre-med college and then another four years of medical school prior to Internship and Residency.
The Hospitals here in Nairobi, on the outside, look very much like modern hospitals in the States. They are large, have hundreds of “white coats” walking the halls and even have very nice private rooms. One of the setups we checked out was the “Princess Zhara” pavilion at Aga Khan Hospital. This is a Women’s hospital ward that has the best of the best delivery rooms in the country. Very nice, like a nice hotel and has amenities for relatives as well as mother and child. We chose to deliver in the States instead of moving here sooner because it is kind of like Rock Candy…nice and shiny on the outside but you really do not know what is inside. Nice clean rooms but does the hospital have a competent NICU? Maybe it has a CAT scan? Probably does not have an MRI scan. What about state of the art laboratories? Medicine manufactured in the States or is it made in China with melamine?

Patients are pretty much the same everywhere…except when society does not have the abilities required to follow a structured plan of recovery. For example, if there are medicines that require a strict time-table…must be taken every four hours to be effective…what if you do not own a watch? What if one believes in “traditional” healing more than “modern western” medicine? You know, sacrifice a goat and rape a virgin to cure HIV? I’m not making this crap up either… Regardless, patients that are not able to follow a structured regiment are not going to get well no matter how smart doctors are or what technology is available. I had to mention that in all fairness.

Now, the big differences between Kenya and the United States…MONEY! WEALTH! FORTUNE! HUGE HOUSES! HUGE INCOMES! MONSTROUS PAYCHECKS! It is that simple. Higher cost of medicine provides better end results…really. It is also a contributing factor as to why the rest of the world’s medicine is not as accomplished as the United States health care system. Very simply, we have the best technology, the best hospitals, the best staff, the best physician, and the best medicine…period.

U.S. Hospitals are very unique in that they have almost every medical instrument required to diagnose anything at any time. There is not an MRI machine in this area of the CONTINENT where I live now. But health care is cheap! If required, a physician can get an MRI done to find something that is wrong with a patient in the States. In Africa, India, England, Canadia…it might take WEEKS to get a test completed. Thank God it is cheaper there though.

U.S. Hospitals are also very well equipped in regards to support staff (Administration, Nursing, Maintenance, Cafeteria, Janitorial, Cleaning, Patient Education, and Support of all kinds). When one enters an American hospital, they know they will have clean water coming from the tap, sterile equipment, clean and sterile rooms (hopefully), climate control systems, consistent electricity, and a great infrastructure that guarantees excellent communication systems, tracking systems, and even cable television. Heck, U.S. hospitals even have excellent support systems of volunteer networks to assist in the process.

U.S. Physicians are the best in the world. It is not because they are American…as any idiot can see at any hospital in the States…rather it is a collection of the best people available in the world! In Six Sigma, one can find the root of most any problem by following the BOB’s and WOW’s. Best of the Best (BOB’s) and Worst of the Worst (WOW’s). There is no question that the BOB’s of the medicine world predominately practice in the United States and for one reason…MONEY! Other than the UAE and certain places in the Middle East, there is no other place in the world where a physician can earn this type of income…and very few folks want to live in a Muslim country in the middle of the desert!

This also contributes to poorer medical service in places like Nairobi…all the really good physicians want to relocate to the States to earn a great income instead of earning $36,000.00 USD a year in Kenya. Maybe $48,000.00 if they are a specialist and very good at what they do. Why in the world would they want to go to the States and earn a starting salary of $150,000.00 a year up to $1,000,000.00 a year? Each year there are thousands of foreign doctors that want to gain admission to U.S. Medical Schools and Residency programs for this reason. Also, they understand they will get the best available education in the world, albeit it will cost 10 times as much. When I am laying in a hospital bed (God forbid) dying from some disease, I do not want some “WOW” that barely made it through medical school determining my course of action…I want the “BOB’s” of the world checking me out…and I am willing to pay for it and/or suffer the consequences.

Medicine is the best of the best in the United States because free enterprise drives the best people to invest in the best practices, technology, and medicines…period. It is the envy of the world and has never been duplicated. Sure, there are people that suffer without services…but that does not mean we should make it cheap! There is cheap healthcare here in Africa! Very affordable! Why does one not see tons of people flocking here to get treated? It is cheaper in Mexico, why do the Mexicans flock to U.S. Hospitals when they could go back home and get treated cheaply or for free? Why do English folks die from cancer when there are available treatments…? Albeit expensive ones the government will not pay for? I am willing to bet that the ones that are pushing for “Free Health Care for All” would not suffer the decrease in services provided…so who is going to pay for this; the wealthy? You mean make the ones that are providing the service to suffer the cost? What is their motivation to invest $200,000.00 in medical school costs, suffer the horrors of Internship and Residency to become physicians if you are only going to take their earning potential away?

If the U.S. is not careful and allows the liberal agenda to move forward unchecked, our health
care system will deteriorate and become very similar to the less-effective ones found elsewhere in the world. A world-leader in Medicine becoming a third-world provider… This author does not have all the answers, that’s for sure. However, he does have experience in the medical field, particularly with physicians and hospitals, in different countries. This is only one angle but the author feels it is a very crucial element that is ignored during the health care debate. After experiencing a “less than stellar” health care system that is very inexpensive allow a young man to die from something that was very treatable…and hundreds of other stories exactly like his…do you really want that in the States?