Healthcare Around the World

I watched a rerun of an interesting Frontline report by T.R Reid entitled ‘Sick Around the World’ in which he compared the health care systems of five capitalist democracies, i.e United Kingdom (U.K), Japan, Germany, Taiwan, and Switzerland. According to an excerpt from his upcoming book on international health care ‘We’re Number 37!’, there are four basic health care systems: the Beveridge model, the Bismarck model, the National Health Insurance [NHI] model, and the Out-of-Pocket model. He chose the U.K as an example of the Beveridge model, Taiwan as an example of the Canadian-style NHI model, Germany, Japan and Switzerland as examples of the Bismarck model. He focused on three Bismarck countries on the theory that the U.S would learn more from these private-sector systems than the British-style National Health Service. Each example offered a system that delivered health care for everyone - but with remarkable differences and concerns.

Here is the full report:



The title of T.R Reid's newest book 'We're Number 37!', which is scheduled to be published by Penguin Press in May 2009, refers to the U.S's ranking in the World Health Organization 2000 World Health Report. Although some have criticized the WHO 2000 report, most agree with the 2007 report by the Organization for Economic Co-operation and Development (OECD) that the U.S spends more of its percentage of gross domestic production on health care than other nations including the U.K, Germany, Japan, and Switzerland. Defenders of America's health sector claim that it delivers superior health outcomes, such as longer cancer survival rates. Detractors claim that other nations' systems deliver equal or better health outcomes such as longer life expectancy and better infant mortality rates. The Frontline report shows that nearly every system faces problems of rising cost and lack of access to care. Still, as the U.S looks to reform its health care system, there are lessons that it can learn from these countries. I found the following excerpt particularly interesting:

“These four models should be fairly easy for Americans to understand because we have elements of all of them in our fragmented national health care apparatus.

When it comes to treating veterans, we're Britain or Cuba [the Beveridge model].

For Americans over the age of 65 on Medicare, we're Canada [the NHI model].

For working Americans who get insurance on the job, we're Germany [the Bismarck model].

For the 15 percent of the population who have no health insurance, the United States is Cambodia or Burkina Faso or rural India [the Out-of-Pocket model], with access to a doctor available if you can pay the bill out-of-pocket at the time of treatment or if you're sick enough to be admitted to the emergency ward at the public hospital.

The United States is unlike every other country because it maintains so many separate systems for separate classes of people...”

La Vida ...

After a month of absence for the holidays, I returned to my regular workout schedule at the end of January. This time, I am starting to even motivate complete strangers. For example, a month ago, I was on a treadmill next to a red-haired guy. After a 15-min walk, I started to increase my pace and eventually sprinted. The red-haired guy next to me started running too. I increased my pace; he increased his pace. I did it again; he did it again. As I was feeling proud to have challenged my red-haired companion, I saw from the corner of my eye that he was about to collapse. He stopped; I stopped. He was breathing heavily. I panicked a little bit. Oh My God! What if he collapses? After a few minutes of huffing and puffing, the red-haired guy left with a red face. He is okay.

I am also attending a Pilates class. The instructor is a sweet Southern lady who likes to end her class with Il Divo music. I think that is her way of preventing her students from leaving the class early. Clever!

La Vida Sin Amor: lyrics

Cuando el sol cae un
dia mas
se que no quieres dormir
La pasión nos vuelve a desnudar
Porque sin ti yo no se vivir

Y en la oscuridad enloquecer
A un
hombre y una mujer

LA VIDA SIN AMOR
ES UN FUEGO SIN PASIÓN
LA
VIDA SIN AMOR
NO SIRVE YA A MI CORAZÓN
PUES OLVIDE AMAR

Lagrimas
que nunca lloré
Suplicas que no te di
un mundo .igual que solo sabe huir
dejando atrás todo mi sufrir

Y en la oscuridad piel sobre piel
El alma calma su sed

LA VIDA SIN AMOR
ES UN FUEGO SIN PASIÓN
LA VIDA SIN AMOR
NO SIRVE YA A MI CORAZÓN
PUES OLVIDE AMAR

Y
en la oscuridad piel sobre piel
El alma calma su sed

LA VIDA SIN
AMOR
ES UN FUEGO SIN PASIÓN
LA VIDA SIN AMOR
NO SIRVE YA A MI
CORAZÓN
PUES OLVIDE AMAR

February: Black History Month

If you are an immigrant to the States, you may be surprised to find out that the month of February is also known as Black History Month. When I first heard about it, I wondered about its relevance. Isn’t February the shortest month? Isn’t Black history considered American history? It was then that I discovered that one of my favorite writers, Alexandre Dumas (père) was one-fourth Haitian and if he were an American, he would be black. Wow!

Ever since, I stopped wondering about its relevance. You live, you learn. This year, in order to celebrate Black History Month, Dr. Isis posted a fabulous link, which I enjoyed reading.

*Picture: Alexandre Dumas (père) by Nadar (Wikipedia)

"Dream Deferred"

As I look at the amount of work I need to do before I can apply to medical school, I wonder if I will ever apply, get in and then find what I am seeking. I have been trying to analyze my motivations to go back to school. Frankly, I do not understand them.

When I was fresh out of high school, I seemed to be really focused. I knew where I was heading with certainty. Now, everything seems gray. When I feel this way, I like to read "Harlem" (sometimes called "Dream Deferred") from Langston Hughes' Montage of a Dream Deferred (1951), from which a line was taken for the title of the play A Raisin in the Sun.

What happens to a dream deferred?

Does it dry up
like a raisin in the sun?
Or fester like a sore--
and then run?

Does it stink like rotten meat?
Or crust and sugar over--
like a syrupy sweet?

Maybe it just sags
like a heavy load.

Or does it explode?

Valentine's day thought

“It’s no good trying to fool yourself about love. You can’t fall into it like a soft job, without dirtying up your hands. It takes muscle and guts. And if you can’t bear the thought of messing up your nice, clean soul, you’d better give up the whole idea of life, and become a saint because you’ll never make it as a human being. It’s either this world or the next.” John Osborne (Jimmy speaking to Helena, in the play Look Back in Anger)

If I were one of the characters in Look Back in Anger, I would retort back, “Love is sometimes not worth messing up your soul.” I hope Time does not prove me wrong.

Birdie Num Num

One of my father’s favorite actors was Peter Sellers. He first introduced us to Sellers by renting the movie, The Party, a 1968 comedy written and directed by Blake Edwards, also starring Claudine Longet. We thought the film was hilarious; we spent that Saturday afternoon in hysterics. We enjoyed watching Peter Sellers as he played Hrundi V. Bakshi, a well-intentioned, but hapless, Indian actor who is accidentally invited to a lavish Hollywood party, where he causes havoc. Two decades later, I still burst out in laughter when I remember some of the scenes, especially when Bakshi talks gibberish and overfeeds "Birdie Num Nums" to a macaw.

I wonder how well received the movie would be if it were released in today’s politically correct environment. Did you know that, at one time, India had banned the film? [Read this]. Furthermore, according to Wikipedia, acclaimed Bengali Indian filmmaker Satyajit Ray was at one time set to make his American feature debut with Sellers in a leading role for his science fiction film, The Alien. When Ray came to visit Sellers on the set of The Party, he was so disgusted by Sellers' performance and the film, he refused to meet Sellers again. He felt it was a coarse caricature [Read this for more]. Apparently, Ray and other critics of the film do not share the same sense of humor as the fans of Peter Sellers. Richard Combs, the Film Comment writer, put it well when he said The Party is "both classic farce and trenchant satire, a self-sufficient fantasy about the fantasy of Hollywood life."

Had I not seen this movie with my father when I was a child, would I have the same feeling toward it? I do not know. What actually surprises me is that ever since I watched that movie I have been using the line “Birdie Num Num” to say “I am hungry” or “The food tastes good”. Oftentimes, I do so without even realizing it. Recently, my sister brought her future in-laws from out of state to introduce them to the family in a traditional ceremony. When she went back, she emailed me a clip of “Birdie Num Num” scene. I had a good laugh. Next time you are in a restaurant and you overhear someone say “Birdie Num Num”, don’t fret because you might just be seating next to me.

With apologies to Satyajit Ray, enjoy:

Let’s party and be sane!

The more you live, the wiser your parents seem. “You need to have an active social life to be sane” is something my mother always said to me and my siblings. I never really paid attention to that daily advice. I enjoyed being a "recluse". When my mom first moved to the U.S., she missed her very active and high profile social life the most. I never quite understood the importance of her social life to her well-being until I read about a recent Swedish study reported in the journal Neurology which claims that socially active people who were not easily stressed had a 50 percent lower risk of developing dementia compared to men and women who were isolated and prone to distress.

Past studies had shown the association between chronic distress (i.e. neuroticism) and greater risk of dementia, and the association between active lifestyle (i.e. high extraversion) and lower risk of dementia. The new study sought to examine the individual and combined effects of neuroticism and extraversion on the risk of dementia.

The study was based on a 6-year follow-up of 506 elderly people from the Kungsholmen Project, Stockholm, Sweden, who showed no signs of dementia upon the first examination. The volunteers’ personality traits were assessed using the Eysenck Personality Inventory. Specialists diagnosed dementia according to DSM-III-R criteria.

Among the different combinations (i.e. high neuroticism and high extraversion, high neuroticism and low extraversion, low neuroticism and high extraversion, low neuroticism and low extraversion), low neuroticism in combination with high extraversion seems to be the personality trait associated with the lowest dementia risk. However, among socially isolated individuals even low neuroticism alone seems to decrease dementia risk.

Hui-Xin Wang of the Karolinska Institute in Sweden, who led the study, said in a statement reported by Reuters.
"In the past, studies have shown that chronic distress can affect parts of the brain, such as the hippocampus, possibly leading to dementia, but our findings suggest that having a calm and outgoing personality in combination with a socially active lifestyle may decrease the risk of developing dementia even further."

Mom, you seem to be right!