I spent quite a bit of time this past week looking at different healthcare systems. For one of my classes I had to try to understand the Affordable Care Act (not an easy task). I also wrote a paper comparing the French healthcare system with the American one. I came to the conclusion that every system has negatives and positives.
The French system provides health coverage for every person living in the country at half the cost per capita of the American system. The negative is that 81% of the funds come from payroll taxes (called "dues" or "contributions"). About 15% of a person's gross income goes to "social security" which includes healthcare, retirement, disability, workman's compensation and family benefits. Most of the burden falls on businesses who pay an additional 30% of each employee's gross income to the government to cover the rest of the costs. As one might expect, this leads to higher unemployment.
The French are able to keep the costs down by controlling what healthcare providers can charge. It only costs 23 euros to go the doctor (about $30). From my experience in France, medical personnel have little risk of being sued, pharmaceutical companies aren't spending millions on ads in the general media, and aesthetics at the doctor's office, clinic or hospital are not a priority. These are small things that help keep overall healthcare costs down and also stand in sharp contrast to the American system.
One of the affects of universal coverage is that people run to the doctor far more often. I discovered that the French go to the doctor almost twice as often as Americans each year. On the other hand, Americans have about twice as many tests such as an MRI or CAT scan as the French. Maybe the French are able to keep their overall costs down because they are at the doctor more often so serious conditions are caught when they are easier to treat. And our extra tests costs more without really contributing to better health.
Whatever your view on the Affordable Care Act, the American healthcare system needs a dramatic overhaul. However, no matter what the system, resources are limited and decisions have to be made as to how to allocate those resources. Even more importantly, the health of the nation is far more closely linked to the lifestyle of the people than the healthcare system in place.
Monday, October 29, 2012
Monday, October 22, 2012
F2F
The occupational therapy program I'm a part of at the University of Minnesota has put everything online it can while still including face-to-face (F2F) sessions. This semester covers a lot of theory and involves reading and writing papers. As a result we meet together once a month for two days from 9 to 4 or 5. As time goes on and the course work becomes more hands on we will be going to campus more often. In our final semester we will be in class three or four days a week.
This past week was our October F2F. The Occupations as Therapy class requires analyzing daily things we do, identifying the specific skills needed as well as the specific steps involved. As part of our class time we played a game with our group and identified effective and ineffective use of specific motor, process and communication/interaction skills. We were also given our next two projects: working with copper and leather. At least there is one class where parts of the assignments can be done away from my desk.
We spent the rest of the day mainly with the professor who is the head of the program. She wanted to know how we were doing which gave us the opportunity to give some feedback on it would have been helpful to have orientation BEFORE classes started rather than during the first week when we were trying to figure out how everything worked in the midst of a normal workload. She was grateful for our input and I hope next year's class benefits.
Thursday morning was spent discussing the strengths and weaknesses of various personalities and how those can affect our relationship with our clients. We spent the afternoon listening to seven 30-minute presentations on various health related topics. We tried really hard to be a good participatory audience but by the end we were all fried.
One of the best parts was being able to interact with those in my cohort for two days. By the end I was able to put a name to a face with about half of the 25. After spending two years at a community college where I dreaded group projects because it always seemed that half the group didn't really care, it is great to be part of a group of students who are used to doing well and put forth the effort. That doesn't necessarily mean that group work is easy but at least everyone will pull their own weight. After class on Thursday about half of us went and got something to drink together and I appreciated the opportunity to get to know three of my classmates outside of the classroom.
My week ended with a drive down to Iowa on Saturday. The weather was beautiful and I got some good sleep. Best of all I got to help my niece celebrate her 10th birthday. She was thrilled with her gifts because 1) she drops generous hints as to what she likes and 2) she is easy to please. Her mommy is mourning the fact that Elizabeth will be in Junior High next year and a little girl party will no longer be cool. I hope the family party will still be cool for a long time.
This past week was our October F2F. The Occupations as Therapy class requires analyzing daily things we do, identifying the specific skills needed as well as the specific steps involved. As part of our class time we played a game with our group and identified effective and ineffective use of specific motor, process and communication/interaction skills. We were also given our next two projects: working with copper and leather. At least there is one class where parts of the assignments can be done away from my desk.
We spent the rest of the day mainly with the professor who is the head of the program. She wanted to know how we were doing which gave us the opportunity to give some feedback on it would have been helpful to have orientation BEFORE classes started rather than during the first week when we were trying to figure out how everything worked in the midst of a normal workload. She was grateful for our input and I hope next year's class benefits.
Thursday morning was spent discussing the strengths and weaknesses of various personalities and how those can affect our relationship with our clients. We spent the afternoon listening to seven 30-minute presentations on various health related topics. We tried really hard to be a good participatory audience but by the end we were all fried.
One of the best parts was being able to interact with those in my cohort for two days. By the end I was able to put a name to a face with about half of the 25. After spending two years at a community college where I dreaded group projects because it always seemed that half the group didn't really care, it is great to be part of a group of students who are used to doing well and put forth the effort. That doesn't necessarily mean that group work is easy but at least everyone will pull their own weight. After class on Thursday about half of us went and got something to drink together and I appreciated the opportunity to get to know three of my classmates outside of the classroom.
My week ended with a drive down to Iowa on Saturday. The weather was beautiful and I got some good sleep. Best of all I got to help my niece celebrate her 10th birthday. She was thrilled with her gifts because 1) she drops generous hints as to what she likes and 2) she is easy to please. Her mommy is mourning the fact that Elizabeth will be in Junior High next year and a little girl party will no longer be cool. I hope the family party will still be cool for a long time.
Monday, October 15, 2012
Elevator attendant
This fall I have once again been working security at the University of Minnesota football games and I've been an elevator attendant in elevator 12. The downside of this is that I have absolutely no view of the field and my only way of knowing what is happening on the field is from what people tell me. There are TV monitors in the elevator lobbies so when things get slow, I sometimes block the elevator and watch a few plays. Iowa didn't come to town this year so the positives outweigh the negatives. For one thing, my elevator is climate controlled. Earlier in the season I stayed cool and now I'm warm. This past week I also stayed dry. I also get a stool to sit on so I don't have to stand for 5+ hours like most of the other employees.
We are far enough into the season that I recognize many of the people who get on my elevator which is reserved for those who find stairs to be difficult. Those with wheelchairs or walkers are the most recognizable and I find myself wishing I could greet them by name. One man has a seat down on the ground level but he goes up to the concourse before kickoff to get some popcorn. He is usually back after half-time for a refill. I also recognize a 2 year-old little girl who is always dressed in her cheerleader outfit. But in general I see lots of gray hair. I'm not sure if there was more gray hair than usual this week since it was homecoming but one of the men quipped, "I come to a college football game and it looks like an AARP convention has broken out."
People are often surprised to see me and try to remember which store downtown used to have elevator attendants. In one sense it does seem kind of silly. Most people can push the right button and I'm not checking anyone's ticket. My supervisor says we are there to protect the elevators. However, I think the main reason is because by switching the elevators to manual we can get people in and out far more efficiently. The other two elevators in my area take people up to the premium levels so before and after the game they never stop at the concourse level while I just go back and forth between the ground floor and the concourse. After the game, we take a load of people on the 6th floor all the way to the bottom without having to stop at every other floor where people are waiting but there is no room to put them. It's all about efficiency.
One of the main reasons I like this position is because I can take a book. The gates open 2 hours before kick-off but I usually see only staff until about 45 minutes before game time. This is one of the few times during the week I can read something that isn't an assignment. During the last two games I've made significant progress on Pain: the gift nobody wants. The author, Dr. Paul Brand, tells the story of how he came to understand that almost all of the deformities that come from leprosy are because the disease destroys one's ability to feel pain. I've found it to be a fascinating story and highly recommend it. To whet your appetite here are a few quotes.
We are far enough into the season that I recognize many of the people who get on my elevator which is reserved for those who find stairs to be difficult. Those with wheelchairs or walkers are the most recognizable and I find myself wishing I could greet them by name. One man has a seat down on the ground level but he goes up to the concourse before kickoff to get some popcorn. He is usually back after half-time for a refill. I also recognize a 2 year-old little girl who is always dressed in her cheerleader outfit. But in general I see lots of gray hair. I'm not sure if there was more gray hair than usual this week since it was homecoming but one of the men quipped, "I come to a college football game and it looks like an AARP convention has broken out."
People are often surprised to see me and try to remember which store downtown used to have elevator attendants. In one sense it does seem kind of silly. Most people can push the right button and I'm not checking anyone's ticket. My supervisor says we are there to protect the elevators. However, I think the main reason is because by switching the elevators to manual we can get people in and out far more efficiently. The other two elevators in my area take people up to the premium levels so before and after the game they never stop at the concourse level while I just go back and forth between the ground floor and the concourse. After the game, we take a load of people on the 6th floor all the way to the bottom without having to stop at every other floor where people are waiting but there is no room to put them. It's all about efficiency.
One of the main reasons I like this position is because I can take a book. The gates open 2 hours before kick-off but I usually see only staff until about 45 minutes before game time. This is one of the few times during the week I can read something that isn't an assignment. During the last two games I've made significant progress on Pain: the gift nobody wants. The author, Dr. Paul Brand, tells the story of how he came to understand that almost all of the deformities that come from leprosy are because the disease destroys one's ability to feel pain. I've found it to be a fascinating story and highly recommend it. To whet your appetite here are a few quotes.
- Each of these groups of people--Londoners who suffered gladly for a cause, Indians who expected suffering and learned not to fear it, and Americans who suffered less but feared it more--helped to form my outlook on this mysterious fact of human existence. Most of us will one day face severe pain. I am convinced that the attitude we cultivate in advance may well determine how suffering will affect us when it does strike.
- We could not "save" leprosy patients. We could arrest the disease, yes, and repair some of the damage. But every leprosy patient we treated had to go back and, against overwhelming odds, attempt to build a new life. I began to see my chief contribution as one I had not studied in medical school: to join with my patients as a partner in the task of restoring dignity to a broken spirit. That is the true meaning of rehabilitation.
- And when we outfit diabetics in special footwear and teach them proper foot care, the ulcers tend not to recur. For a time the government considered issuing free shoes to needy diabetics, but, like other proposals that focus on prevention and not cure, that project never got approval. As a rule, I have found it easier in the United States to obtain good artificial limbs than good shoes.
Sunday, October 7, 2012
A day of refreshment
I felt worn down and tired most of the week. For various reasons I didn't get to bed on time all week. By Thursday evening I was tired enough to be asleep shortly after 7:30 despite hearing the conversations of over 20 people eating together downstairs. My cohort has a Facebook page and several people commented on their low level of motivation on Friday. The only thing that helped me push through on Friday was the promise of a Saturday with nothing I HAD to do. One of my housemates was gone and the other would be at work most of the day so I could look forward to plenty of time and space to myself.
Once I got home from work about 7:30, the whole day stretched before me. I got out my guitar and played for awhile. I talked on Skype with a couple of friends. Around noon I decided it wouldn't be getting any warmer and went for a short run. My housemates often comment on how much time I spend at my desk. They leave the house, returning four hours later and are concerned to see me in the same position as when they left. While I have gone downstairs a time or two, I do feel the need to move. This week I decided that I must have time to at least go for a run three times a week. During the afternoon I watched some football, did a load of laundry, napped for an hour and talked to Mom. I did have to finish up a diagram for one of my classes but did that while watching TV. By the time evening rolled around, I felt refreshed and once again ready to face the world. As an added bonus I don't have to face my desk until Monday morning.
Once I got home from work about 7:30, the whole day stretched before me. I got out my guitar and played for awhile. I talked on Skype with a couple of friends. Around noon I decided it wouldn't be getting any warmer and went for a short run. My housemates often comment on how much time I spend at my desk. They leave the house, returning four hours later and are concerned to see me in the same position as when they left. While I have gone downstairs a time or two, I do feel the need to move. This week I decided that I must have time to at least go for a run three times a week. During the afternoon I watched some football, did a load of laundry, napped for an hour and talked to Mom. I did have to finish up a diagram for one of my classes but did that while watching TV. By the time evening rolled around, I felt refreshed and once again ready to face the world. As an added bonus I don't have to face my desk until Monday morning.
Monday, October 1, 2012
Birthday
After spending a week at my desk I was delighted to get out and enjoy the beautiful fall weather we had this weekend. My parents came on Saturday along with my niece, Elizabeth and my sister-in-law. While the others went shopping, Dad and I went to see Bethel's football game where one of my cousins plays. It was too close of a game for him to get in but it was a fun game to watch from our vantage point of ground level on about the 10 yard line. Bethel managed to pull out a one point win to remain undefeated. Afterwards we drove to Hudson, WI where we strolled along the St Croix River and ate at Pier 500, a restaurant with some really good food. It was declared to be a special event since we actually got dessert.
As I was planning the weekend, I did not at all expect for us to spend Sunday afternoon visiting an uncle in the hospital. Uncle Paul, one of my dad's brothers, was in a combine fire last week. Besides the burns on his back and arms, he has a broken leg from jumping out of the combine. It's quite a story about how he was able to roll away from the combine before it exploded and his trip on the hood of a car to get to where an ambulance could pick him up. He is being treated at a hospital in St Paul. For those of you who know him or want more info you can follow his journey at his caring bridge site. Recovering from burns is a long process but right now it is his leg that is hurting him the most. He was sleeping when we visited but we were glad to visit with his family members and meet his newest little granddaughter.
I ended my birthday celebrations Sunday evening by eating at an Indian restaurant with a good friend. Now it's back to my desk and my assignments for the week.
As I was planning the weekend, I did not at all expect for us to spend Sunday afternoon visiting an uncle in the hospital. Uncle Paul, one of my dad's brothers, was in a combine fire last week. Besides the burns on his back and arms, he has a broken leg from jumping out of the combine. It's quite a story about how he was able to roll away from the combine before it exploded and his trip on the hood of a car to get to where an ambulance could pick him up. He is being treated at a hospital in St Paul. For those of you who know him or want more info you can follow his journey at his caring bridge site. Recovering from burns is a long process but right now it is his leg that is hurting him the most. He was sleeping when we visited but we were glad to visit with his family members and meet his newest little granddaughter.
I ended my birthday celebrations Sunday evening by eating at an Indian restaurant with a good friend. Now it's back to my desk and my assignments for the week.
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