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Lord Bless Us and Save Us
By Kathy Hare

"Fire, Fire!" said Mrs. O'Dwyer. "
Where, where?" said Mrs. O'Hare."
Down in the town." said Mrs. Brown. "
Lord bless us and save us" said old Mrs. Davis.

This little ditty became popular after Mrs. O’Leary’s cow allegedly kicked over a lantern, thus starting the Great Chicago Fire of 1871. While recently in Ireland, the saying kept popping into my head whenever I read opinion columns about the American health care system. Most of the articles were written with a sense of urgency - in a panicky tone - as if the sky was falling or a great conflagration was actually consuming the United States. “America is in a great financial crisis,” the reporters contended.

Well that’s true enough. But then in a vast leap of logic the authors inevitably concluded Obama’s “public option” health plan is the only way to save the American economy from total collapse. I find this difficult to fathom, and counterintuitive in light of Ireland’s own “public option” health system.

 A column by Lara Marlowe appearing in the “Irish Times” is a good example. Referring to the Labor Day recess she asked, “Will America return to its senses when Congress reconvenes on Tuesday? After mass-migration to cloud cuckoo-land over the summer recess, can President Barack Obama regain the initiative?” The mass-migration was members of Congress flying back home to town hall meetings. And all Americans who oppose “Obamacare” are the “cuckoos.” She then writes about the violent republicans and blue-dog democrats who disrupted these meetings, telling readers some of “those standing outside the gatherings are even armed!” 

Calm down Marlowe, I thought. No shots have been fired yet. And if you want to talk about armed and dangerous, perhaps you could write about the 600 lb. bomb the “Continuity IRA” planned to detonate in Ireland this September. Violence is hardly an American phenomenon, and in the case of town hall rabble-rousers I’ve only seen a vocal protest. But Marlowe is just one of many Irish columnists who can’t understand why Americans don’t know how to play “Follow the Leader.”

Another more light-hearted article by Joseph O’Connor appeared in the “Irish Independent.” It was entitled: “If you go to a doctor in Manhattan, be afraid, be very afraid.” It seems O’Connor had the misfortune of having both his sons become ill while on vacation in Manhattan. An American friend called their doctor who saw the boys immediately. O’Connor like that, and found the doctor knowledgeable and caring.  After a quick examination and test she wrote prescriptions for the boys’ ear and throat infections. All was hunky-dory until O’Connor was asked to fork over $400 for the doctor’s visit. This incident alone proved to O’Connor that health care reform is absolutely necessary in America. Then he too proceeded to report on the “angry scenes at town hall meetings up and down the land.”

O’Connor said the problem with American health care is that we consider it to be a commodity, something to be bought and sold. I wondered, as opposed to what, something to be given away out of the kindness of the physician’s heart? Kindness doesn’t pay Manhattan rents, but if O’Connor needed inexpensive health care perhaps a trip across the bridge to New Jersey might have saved him a few bucks.

Health care in the Old Sod is nothing like here, but their system is pretty darn close to the “public/private option” President Obama first proposed. Irish law states, “Everyone is entitled to health care in Ireland, and this is partly funded by your PRSI (social security) contributions.” But a reality check shows while everyone is entitled to health care, only 31 percent of the population holds a “medical card” that allows them to receive free medical care. Who gets the card is determined by means testing. For example, a family of four making less than $25,824 a year would qualify, but allowances for housing, transportation to and from work, and an endless list of deductions lets people making far more than that finagle their way into “free” care.

That leaves the remaining 69 percent to foot the bill via taxes, in addition to having to purchase private insurance to cover their own health expenses. Ok, but did the “public/private” system promote competition between insurers as proponents here say it will? No, it didn’t. Since the plan’s inception most private insurance companies have fallen into the bog. BUPA, the second largest health insurance provider pulled out of Ireland in 2006. You see once the Irish government started fiddling with health care it became almost impossible for private insurers to break even, let alone turn a profit. Now most of Ireland’s private insurance is provided by one company – and its balance sheet is covered in red ink.

Still, privately-insured patients have a great advantage over those covered by the “public option.”  They are placed at the top of the list when they need a hospital bed. Even so, with over 250 patients a day waiting on gurneys in the hallways of Irish hospitals, because not enough beds are available, even private insurance can’t guarantee you will receive an operation or medical care when you absolutely need it. Private enterprise could solve this problem, but not as long as the government decides what services and how many beds will be available at each facility.  So as with all things political, places with the most voters have the best medical facilities. Consequently, hospitals outside of large cities are short on beds, have very few specialists, and not enough nursing stuff to handle the volume of patients. Head injury patients in County Mayo often have to travel 150 miles to see a neurologist in Dublin.

While Irish columnists were condemning American opposition to government-run health care, I couldn’t help but wonder what they thought about the death of Evelyn Flanagan. Ireland’s health care system certainly was no help to Flanagan as she lay dying in a pool of blood after the birth of her second child. At her inquest the jury found her death was the result of “medical misadventure.” That’s the Irish term for medical incompetence. But “misadventure” hardly seems an appropriate term for Flanagan’s fate; criminal negligence would be a far more fitting term.

Shortly after giving birth, an unnoticed tear in her womb caused Flanagan to start hemorrhaging. Blood soaked her mattress and spilled onto the floor before staff at Mayo General Hospital noticed Flanagan was in trouble.  They then started administering blood and fluids, unfortunately no one on the nursing staff recorded how much fluid they were pumping into Flanagan’s veins. Consequently, she received 18 units of blood, eight units more than were necessary, combined with eight liters of fluids over the recommended amount. After reviewing Flanagan’s case, Prof. James Walker concluded Flanagan would have survived the blood loss caused by the tear, but she died “from cardiopulmonary failure secondary to fluid overload.” While medical malpractice cases can be found in any country, Flanagan’s “misadventure” is a sad example of what happens when hospitals are understaffed.

The future of Ireland’s health care system doesn’t look too bright either. In September, Ireland’s “Health Service Executive” warned the government faces a funding shortage of 1.4 billion Euros ($2 billion) this year. That’s not good – especially at a time when more people are qualifying for “medical cards” due to the recession. And a quick look at cancer survival rates shows the Irish system just doesn’t stack-up to America’s cold hearted health care. In the U.S., five-year survival rates for breast cancer patients are 83.9 percent and 92 percent for prostate cancer sufferers. In Ireland those rates are 69.6 percent and 62.8 percent respectively.

Therefore, I wish to thank all those “violent men and women” who are expressing their concerns over the socialization of our medical system.  Because when it comes to government involvement in health care all I can say is: “Lord bless us and save us.”

First published in The New Falcon Herald
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