A Second Opinion on Health Care
I'm a medical tourist of a different sort. I'm not traveling to Mexico for a lap band, or to Bangkok for cosmetic collagen injections, or to India for a knee replacement—I'm going to New Zealand to spend three months taking part in a "roving locums" program sponsored by the New Zealand Rural General Practice Network (NZRGPN) to provide rural general practices and practioners with short term coverage so that they can beef up staffing or take a break.
I am a 56-year-old family physician who has practiced primary care in the United States for 28 years in settings from rural New England and South Carolina to urban Chicago and metro Seattle. I have witnessed the delivery of superb medical care and I have also seen patients denied the very basic standard of care for lack of health insurance or financial resources. It is this denial of health care access—and in a broader sense, the denial of the human right to health care—that I wish to address in this blog, drawing both from my extensive experience in the U.S. and from my new experiences in a fundamentally different delivery system of New Zealand.
Why New Zealand? Well, aside from the renowned natural beauty of the place, they have a functioning single payer health system and I have a strong desire to experience, first-hand, how such a system really works.
The second opinion portion of the heading reflects my need to reassess my career professionally and politically. In medicine, it is a time-honored tactic to obtain a second opinion if the diagnosis is unclear or if the therapy isn't working. Fresh thinking and ongoing collaboration often offer new insights and better outcomes. And for health care in the U.S., a second opinion is desperately needed. While politicians argue and posture, patients are dying for lack of access to even the most basic care. Last year alone there were over 45,000 excess deaths in the U.S. due to lack of health insurance. If over 1,000 wide-body airliners had crashed last year, we would be seeing more than political wrangling and corporate manipulation.
What will I find in New Zealand's health care system? Utopia? Bureaucratic dysfunction? Probably neither. But I do hope to see another approach to any number of questions, such as:
- How do New Zealanders themselves feel about their health system?
- What do they love or hate about it?
- How would they change it?
- How is access to procedures and specialists?
- What is the approach to end-of-life care?
- Is there a problem with abuse of prescription pain killers?
- Are there class or ethnicity-based health disparities?
The specific questions are limitless, but I think a general picture will emerge. I hope to learn from these experiences, both clinically and as an advocate for reform at home.
Dr. Ken Fabert wrote this article for YES! Magazine, a national, nonprofit media organization that fuses powerful ideas with practical actions. Ken has been a practicing primary care physician in the United States for 28 years, from rural New England and South Carolina to urban Chicago and metro Seattle. A member of Physicians for a National Health Program, he is spending three months as a roving clinician in New Zealand to find more about how their single-payer health care system works.
Read Dr. Ken Fabert's most recent blog posts here.
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