Public Address | Cafe | Polity: Land of the brave little kids

jb

Tue, 04 Aug 2015 15:29:42 +1200

This is how it works in Germany: http://youmustbefromaway.com/2014/08/22/socialised-medice-in-germany/
Dental care's also included for basic stuff, co-payments for flash stuff

Angela Hart

Sat, 01 Aug 2015 16:54:42 +1200

The wheels turn but slowly, it is now clear that this vitamin C therapy does have a significant beneficial effect, such that money could be saved if this treatment was used to make the traditional treatment more effective. But this type of decision often seems to take an age for…

Rosemary McDonald

Sat, 01 Aug 2015 12:38:59 +1200

This was part of what was lacking in Judi’s care experience.

...and the part of Judi's account of her care experience that could possibly cause the most upset to those In Control, would be her use of IV High Dose Vitamin C.

And the obvious benefit to her(other than having…

Angela Hart

Sat, 01 Aug 2015 12:15:17 +1200

A good report for Rehab from Ron, which we also have found to be patient centred although we did have to fight to get permission for me to stay and support my daughter- the focus being on independence so obviously you don't want family stepping in and doing stuff that…

Rosemary McDonald

Fri, 31 Jul 2015 22:50:06 +1200

Or this....treasure...

http://www.hqsc.govt.nz/assets/General-PR-files-images/atul-gawande-forum/GR011-Ron-Paterson.pdf

wish I knew how to display image...

Rosemary McDonald

Fri, 31 Jul 2015 22:43:00 +1200

Here's a MUCH more positive one from Ron...

https://www.youtube.com/watch?v=cJoGzJFz784

(my you- tube history has no record of me watching the speech about Judi's awful experiences.)

Angela Hart

Fri, 31 Jul 2015 21:46:50 +1200

Your you-tube video has been removed Sacha, perhaps it's a bit too challenging for the Misery.

Amy Gale

Fri, 31 Jul 2015 02:49:22 +1200

The most important drivers of their excellence in that area are (1) population size, leading to specialisation; and (2) country-level affluence, leading to purchasing the best talent.

I think there is a third important driver, and it also applies to other areas (eg education): massive, massive inequality allows elite institutions…

Rob Salmond

Thu, 30 Jul 2015 13:58:43 +1200

Certianly my post wasn't intended to defend the insurance-based provision of healthcare, prevalent in the US. I think it has a lot of downsides, and the single-payer model we have in New Zealand is better. The bureaucracy, contents attempts to cut corners and deny coverage, and constant ripping off of…

Rob Salmond

Thu, 30 Jul 2015 13:48:50 +1200

I read your story about your daughter Rob, and I teared up at work. I hope things are easier for you now.

Than you Stephen, for a really nice comment. Of course, the pain of losing a child never disappears, and no parent ever "gets over it." Put Sophie's struggle…

Rob Salmond

Thu, 30 Jul 2015 13:46:54 +1200

How often, I wonder, are the outcomes for the child proportional to the Bolshie levels of the parent?

Sadly, quite a lot I think, and that means kids fortunate enough to have well-educated parents with flexible jobs have better outcomes. When the system relies on parents to advocate or make…

Tinakori

Thu, 30 Jul 2015 13:37:10 +1200

Never had that problem with Southern Cross, including for oral surgery that could just as easily be done by a dentist.

Angela Hart

Thu, 30 Jul 2015 12:16:31 +1200

:-) not even expletives as far as I know. It remains to be seen whether the quality of information available to the public will improve.

Rosemary McDonald

Thu, 30 Jul 2015 11:44:56 +1200

and corrected their misconception.

Were explosives involved?

ChrisB

Thu, 30 Jul 2015 11:30:43 +1200

Anecdotal evidence from my involvement in facebook and other groups suggests that children is the US with global development delays get very good access to early intervention therapies. Sometimes daily speech, physical and occupation therapy visits.

This can be compared to the NZ system which promises a lot but the…

Angela Hart

Thu, 30 Jul 2015 11:12:06 +1200

Thanks Sacha, that is a tremendous presentation by Ron Paterson and resonated with me on many levels. I met Judi, although I didn't know her well. I knew of her illness and that she continued to work in spite of it until it simply wasn't possible any more.
The issues…

Rosemary McDonald

Thu, 30 Jul 2015 11:00:24 +1200

got medical insurance in the 70s when they discovered they had no hope a getting a routine operation in the public system

Ditto for an old friend, an ardent National supporter. However when she was sent to the Public Hospital for an assessment on a painful gallbladder issue, she took…

Paul Campbell

Thu, 30 Jul 2015 10:43:05 +1200

those US tax decuctable accounts are a bit of a trap, essentially you put a portion of your income in a pre-tax box at the beginning of the year and can take it out to pay for non-reimbursed health expenses during that year ....

The catch is that if you…

Zach Bagnall

Thu, 30 Jul 2015 10:31:51 +1200

I believe there is also a trend towards higher insurance deductibles (excess) in the US. High deductible plans come with a tax advantaged savings account attached to help you save for upcoming costs.

So even if you have "employer provided" health insurance, you're still on the hook for a few…

Tinakori

Thu, 30 Jul 2015 10:31:26 +1200

In NZ you do best with both the public and the private system. My folks got medical insurance in the 70s when they discovered they had no hope a getting a routine operation in the public system for my mother's condition that caused considerable discomfort. They had to pay to…

Bart Janssen

Thu, 30 Jul 2015 09:38:00 +1200

I'll echo Rob's experience in the US. We were on a good healthcare insurance scheme in the US (University post-doc counts as staff for insurance).

When I fell and damaged my ankle the surgery was with all the bells and whistles as good a care as anyone could hope for.…

Stephen Judd

Thu, 30 Jul 2015 09:20:00 +1200

I read your story about your daughter Rob, and I teared up at work. I hope things are easier for you now.

Paul Campbell

Thu, 30 Jul 2015 08:27:02 +1200

no it's more an issue of the Insurance companies not wanting to spend money on diagnostics or specialists and pushing back at every possible point.

My doctor's practice in the US (5 GPs sharing space) had 4 people working in the receptionist's area, one working as a receptionist and 3…

Katharine Moody

Wed, 29 Jul 2015 23:25:59 +1200

Not surprised about the futzing around in the US – my experience is that some specialists and most hospitals/clinics there often milk the insurance for all its worth before getting around to what should have been done many $$$ earlier.

Paul Campbell

Wed, 29 Jul 2015 23:12:17 +1200

Having lived in/with both systems I'd like to descibe the experience I had getting my gall bladder out in the US .... I had really good minsurance ... took me close to 6 months to get a referal and then an an appointment with a specialist, 3-4 more months of…

Joe Wylie

Wed, 29 Jul 2015 20:37:59 +1200

Thanks Katharine, I'd just assumed they were still out there. In the 1950s all primary school kids, including those in Catholic schools, had their sight and hearing tested in school time by state-employed nurses. Yet another example of our slow slide from 1st world status?

Katharine Moody

Wed, 29 Jul 2015 20:21:00 +1200

When did NZ's school nurses go missing?

Not missing altogether but predominantly part time in secondary and not sure what if anything much at primary from what I've read;

http://www.scoop.co.nz/stories/PA1306/S00067/health-minister-is-wrong-school-nurses-are-needed.htm

Sacha

Wed, 29 Jul 2015 20:16:53 +1200

I'm a stroppy person, and I'm told I project a certain confidence, and I bet my bottom dollar Judi did too

yep

Rosemary McDonald

Wed, 29 Jul 2015 20:03:10 +1200

Oh, the irony.

You know, I'm a stroppy person, and I'm told I project a certain confidence, and I bet my bottom dollar Judi did too....despite her intent to be a 'mystery shopper'.

Those people who are not confident, literate, articulate....do not have family and friends riding shotgun....do not know…

Sacha

Wed, 29 Jul 2015 19:48:34 +1200

Have not been privy to conversations but I believe Ron is carrying out that responsibility for Judi. As architects of the HDC Code and its execution, the experience must have been upsetting for both of them given how long our health system has had to lift its game.

Joe Wylie

Wed, 29 Jul 2015 19:32:40 +1200

One comparative aspect where NZ falls short is in not having school nurses.

When did NZ's school nurses go missing? While it's been some time since it's been an issue for me, we certainly had them right through the 80s.

Rosemary McDonald

Wed, 29 Jul 2015 19:15:18 +1200

One of the Young People did their real estate agent course. The very first class involved reading and discussing just how much shit rains down upon the head of an agent who stuffs up.

Switch to the three fourth year med students on 'section' in the Far North.
Had never…

Katharine Moody

Wed, 29 Jul 2015 19:05:47 +1200

And, another big difference twixt here and the US is that doctors and nurses who screw up over there get their asses sued.

That can have a real downside as well in the US. It is particularly difficult, even if you have written a 'living will', for your relatives to…

Rosemary McDonald

Wed, 29 Jul 2015 18:58:29 +1200

We crossed comments Sacha...I had heard about this...but godallbloodymighty...Judi's story is as bad as it gets.

Did she make a complaint?

Katharine Moody

Wed, 29 Jul 2015 18:57:36 +1200

One comparative aspect where NZ falls short is in not having school nurses. At my primary school in the US, the school nurse was part time on a daily basis. In my secondary school (a larger student roll) the school nurse was full time. I cannot help but think many…

Hilary Stace

Wed, 29 Jul 2015 18:52:22 +1200

Angela – that story was from a time when we had a more or less functioning welfare state. Doubt you get offered these things now.,

Rosemary McDonald

Wed, 29 Jul 2015 18:49:35 +1200

as parental Bolshie-levels rose towards 11

How often, I wonder, are the outcomes for the child proportional to the Bolshie levels of the parent?

I recall an A&E Head Honcho on telly years ago, after the death of a child who had received dismissive attention from a hospital A&E, saying that parents…

Sacha

Wed, 29 Jul 2015 18:25:17 +1200

more likely it's because Cancer

Even they don't have things sorted yet. Current Ombudsman and former Health and Disability Commissioner Ron Paterson delivered a great presentation recently about the experience of our late colleague Judi Strid as she dealt with cancer as a patient rather than an advocate – [[http://www.hqsc.govt.nz/assets/General-PR-files-images/atul-gawande-forum/ron-paterson-Jun-2015.pdf|12pg…

Angela Hart

Wed, 29 Jul 2015 17:33:11 +1200

I could've done with counselling, childcare and household help back in the day, but I guess it shows we are constantly improving. Or more likely it's because Cancer.

We have a great medical care system with a few problems which tend to be addressed over time. Complex cases and rare…

Hilary Stace

Wed, 29 Jul 2015 16:48:11 +1200

My daughter and a friend's son were diagnosed with leukaemia about the same age although we were in Wellington and he was in the US. His treatment seemed to be much more intense and longer with long stays in hospital and chemo via lumbar punctures. My daughter's was administered via…

Paul Paul

Wed, 29 Jul 2015 16:35:35 +1200

For the benefit of the (thankfully) innocent: 'GSW' in the middle of Rob's article refers to Gun Shot Wounds.

Eric Crampton

Wed, 29 Jul 2015 15:35:41 +1200

Agree. NZ has something pretty close to a sweet spot in combination of public and private provision.

Public Address

Wed, 29 Jul 2015 15:35:41 +1200

Discussion from blog post.