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It’s All the Same: Love The Docs, Hate The System

I’ve spent the last few days with much of our European team, today in Madrid, Spain.

Here are a few quick observations, as the American reform process continues.

1.  Every country’s health care system has developed in the unique circumstances of its history.  That is, the health care system of each country is the result of a collection of changes, fixes, restrictions, reforms, market developments and whatever else has happened over the last several decades.   The result in each country are systems that work better or worse, but which in most all cases are very confusing to the people that work in them or get care from them.

2.  In my travels, when I talk to people about what it is like to get care in their health care system, everyone speaks highly of their doctors and poorly of whoever it is that pays for their health care.  It’s true whether it’s the government paying or a private insurer.  I think that, at least in the Western world, people just don’t like the idea that health care is an economic activity.  There is, I think, a sense that there is something almost religious about health care.  And so the idea that someone should pay someone else to deliver it seems, culturally, somehow distasteful.  The trouble is, no matter what people have tried to do, health care is a business.  I think some of the dissatisfaction people feel with their health care systems has to with how hard it is to reconcile these two conflicting ideas.

3.  The experience of being sick, or caring for a family member who is sick is very similar no matter where you go.  Most people feel that they can handle being sick; the part they can’t handle very well is the uncertainty about what to do next, and whether what’s being done to them is even the right thing.  Everywhere you go people talk about the enormous amount of information available on the internet about their  medical condition – but also about the insufficient time they get with their doctors to talk about what they’re finding, what they’re worried about, and how to deal with their anxiety around these things.  There is, it seems a, growing sense that it is ok, and in fact important, for patients to educate themselves about their medical situation.  And, certainly, a growing sense that it’s ok to ask your doctor questions, to want to be satisfied with the answers, and to make sure you have the best chance possible to get well.

In all events, here’s a photo of me with some of the terrific team in our office in Madrid:


*This blog post was originally published at See First Blog*

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