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Stephen Lewis on Infrastructure, Identity, Communication, and Change

Archive for April, 2009

Living the News: Health Care Refugee

Posted by Stephen Lewis on April 21, 2009

Soon after the inauguration of US president Barack Obama, I posted an entry commenting on Pete Seeger’s  inaugural day performance of Woody Guthrie’s  “This Land is Your Land,” including near-forgotten verses of the song that had gone underground during the anti-communist hysteria of the McCarthy era.

Since then, another of Guthrie’s songs has been on my mind, “Dust Bowl Refugee.” Dust Bowl Refugee was Guthrie’s ode to the plights of American farmers during 1930s who, driven off their farms by drought, soil erosion, and bank foreclosures, trekked westward, working, when they could find work, as migrant agricultural laborers and casual laborers. (For the lyrics of Dust Bowl Refugee, click here).

My own present-day version of Dust Bowl Refugee has a title of its own, Health Care Refugee. I’ve spent most of the past winter in Istanbul, Turkey, partly out of preference and partly out of necessity. Indeed, you might say that I am a health care refugee.

My Netherlands-based health insurance — a policy I inherited from a job in the Netherlands in the 1970s and that I have maintained throughout my “career” as a peripatetic freelancer over the three decades since — recently stopped covering all but the most critical emergency medical treatment in the US.  Not surprisingly, the insurance company had finally balked at the astronomically over-inflated costs of medical care in the US.  But, niggardliness and tighter strictures on policy claims also mark a shift by Dutch insurers from a culture of dedication to policy-holders to dedication to investors and shareholders instead. Even as far away as the once rigorously social democratic Netherlands, it seems, decades of US prating against “socialism” and in favor of leaving individual and social welfare to the whims of an imagined “market place,” has cast its indelible shadow.

My alternatives were simple: Pay for needed health care out of my own pocket in the US (impossible), go to the Netherlands to seek treatment (this would require renting and maintaining an apartment there), go to Bulgaria (where I already maintain an office), or seek treatment in Turkey (where I had the chance to  “apartment sit” and the opportunity to avail myself of  library and research facilities).  The only two feasible options, thus, were Bulgaria and Turkey. The inadequacy of Bulgarian health care, the state of Bulgarian hospitals, and the characteristic unwillingness of Bulgarian doctors and dentists to admit and honor the limits of their know-how and abilities made the decision easy — I headed to Turkey.  And, thus, I joined the growing ranks of health care refugees.

What state of inequality or desperation would it take for health care refugees (with means and without) to compromise a counter-flow eastward and southward to worldwide flows of economic, human rights, and life-style refugees moving westward and northward?  The subject of flight is finally being broached in the press and in commercially sponsored studies (see, for example, this March article in the New York Times and a few paragraphs buried in this report from an accountancy-consultancy firm).

Balkan Medical Corruption and Under-Reporting

Last month, the Times also posted this article on corruption in hospitals in Romania, a situation not unlike that which causes me to do anything to avoid hospitalization in Bulgaria.  The article, however, is characteristic of much of the reporting on the eastern Balkans that appears in the Times, i.e. it treats long-standing problems and developments as freshly discovered news.  This particular story appears about 19 years too late.  Is this because the Times had consider the eastern Balkans to a news backwater or a training ground for reporters with no knowledge of the locale or interest in doing  research.  Or is it because in the 1990s and the Bush years, the US press was so self-satisfied with the “fall of communism” and the “end of history” that anything the “free market” brought with it, including inequities and corruption, seemed laudatory?  Well, better late than never, although…

Lobsters or Lard?  The Times or the old New York Post?

In debates on the relative worth of weblogs and the traditional press, I almost always weigh in in favor of the “mainstream media,” but the Times’s Balkan coverage makes me wonder.  So does this recent piece from Jane Brody’s venerable reporting on personal health.  The thrust: Americans who live on steak and lobster and “creme brulee” now should discover the what she calls the basics that got us through the last depression — potatoes and fruit, she writes, rather than white flour and lard, the diet of the poor today.  Americans who live on steak and lobster? Who is she talking about?  Not people on my planet and not people hurt by the present state of the economy.  And fruit rather than flour and lard in the Great Depression?  In the richest of households maybe.  What readership (or, more probably, advertising demographics) is the Times targeting?  Makes me long for Dorothy Schiff and the old New York Post, let alone the belated Bronx PM and the old National Guardian (all “google-able” for those who don’t know them).

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