Reflections on Healthcare and the Lack of It

I’ve had the (mis) fortune of getting a couple of samples of the Jamaican healthcare system.

Strangely enough, they both involve bicycle rides.

Last Christmas on a bike ride to Hollywell, I rode a mountain bike that had the seat raised too high. The result was a sore “seat,” in a delicate part of the anatomy where “the sun don’t shine.”

I worried about it for a few days, got a “rear-end inspection” from the dutiful girlfriend (now wife) and decided that it was hurting too much and needed to see a doctor of some kind. Incidentally, this was Christmas Eve – a Friday.

My mother recommended that I call her family doctor, but he was away on leave, so we decided to chance a visit to Oxford Medical Center. I called ahead, and they were open, so I quickly went down, mentally preparing for another inspection. I was hoping that my worst fears would not come true (anything starting with “in” or “im” counts as a worst fear … incontinence, infertility, impotence were included.)

I walked into an empty waiting room, having been told ahead of time that they were closing early due to the Christmas holidays. I signed a waiting book, and then was quickly called to see the doctor on duty, which all happened in the space of 20 minutes or so.

Well… surprise… the doctor turned out to be a woman. A younger woman in her 30’s.

After a detailed “inspection,” including my first prostate exam, I was judged to be fine and just had sore muscles. She wrote a scrip for a few drugs and asked me to return in a few days. The cost was about US$25. The visit took about a half an hour.

In the meantime, I returned to the US and called the doctor assigned to me by my HMO. Unfortunately, he would not be able to see me for 30 days. However, if it was an emergency, I would need to go to an emergency room. But, there might be some openings on some of the afternoons, and if I kept calling I might be “lucky” and get an open slot. I tried that a few times, and gave up. Fortunately, I was returning to Jamaica the following week, and decided to forget about trying to see the doctor in Florida, and to use the health insurance I was actually paying a whopping US$262 a month to never use.

I returned to Jamaica about 2 weeks after the initial inspection, and my doctor did a further exam (sparing me another prostate exam, thank you very much) and she decided that I needed an ultrasound. She moved quickly, and later on that day while I was at the barber’s getting a haircut, she called and told me that there was an opening the following day if I wanted it.

I quickly said yes, and by the following day after another inspection, accompanied by grainy movies of invisible muscles, I was judged to have suffered no serious damage by a doctor who happened to be a fellow Old Boy of Wolmers Boys’ School, and was a few years behind my father, and didn’t think that my father would remember him from those days as he was ahead, etc. etc. It’s interesting the things that are discussed in these inspections.

The cost was about US$50.

Just this past week, I had another opportunity to test out Jamaica’s healthcare system by dislocating my shoulder on a bicycle ride down Stony Hill, in a collision with a minivan. I’m fine otherwise, and may need surgery, incidentally.

On the way down to Andrews Memorial I was dreading the worst. I quickly called ahead and asked my wife to bring EVERYTHING to the hospital – insurance card, wallet, food, clothes, books, magazines, my laptop – everything that we would need for a LONG wait. To my surprise, the entire process was so quickly done that I didn’t even get to open the laptop. When the specialist gave his final judgment on my condition it was about 2.5 hours after we first got there, and that included nurses’ intake, seeing a doctor, getting x-rays, and seeing a specialist.

The process happened so quickly that I could not even finish my magazine article, as there was not a single waiting period that lasted more than 30 minutes.

My poor wife was left dragging my laptop and all of my other crap home… unused and untouched.

The interesting thing is that I have just gotten health insurance in Jamaica. For more coverage than I had in the US, I paid about 10% of the total bill. That’s right – the prices were that much different.

The prices that I paid for the first incident at Christmas were less than my deductible in the US.

I had no idea the differences were that broad, and while I’m aware that a US hospital has much more equipment and the latest of everything, the system was so bad that I would have to wait at least 30 days to see any of it.

In a nutshell, in the US I paid 10 times more to have the best machines, and to be treated as a widget. In Jamaica, I’ve gotten very warmly treated and run the risk of not having the latest solutions readily available.

Remarkable.