Socialized medicine in America

I live in a country that has a socialized medical system. As an unhealthy person who needs to use the medical system more than an average person would – for visits with doctors, tests and procuring medications – you might think I would appreciate that the system here treats me just the same as anyone else, that I pay very little more for the services I use than someone who barely uses the system at all. But you’d be wrong.

Trying to see a “specialist” doctor in this country is a true nightmare. I’ve had to wait four months just for an initial appointment with an endocrinologist. To coin a phrase, it is cruel and utterly usual to tell someone suffering from lack of thyroid hormone that he must wait a third of a year before he can see an endocrinologist to discuss his problem, after which he might have to wait interminably long for the medication and for it to start working (just imagine the wait for a followup appointment…). Even seeing a “family doctor” (ie, a general practitioner) to get the most basic prescription (for Lanton, which is supposed to treat acid reflux) can be downright Kafkaesque if it needs to be done on that same day.

I’ve struggled and struggled and struggled and struggled with this system for the five years I’ve lived in this country. The doctors here can be personally nice, but as physicians the service they provide is atrocious. They’re really more like accountants, gazing into their computer screens and looking for ways to minimize everything (nothing against accountants – my father is one and so was my grandfather).

I could go on and on about the insane delays, the abusive nurses, the uncaring doctors and everything, but I want to highlight one aspect of the system here that sucks beyond belief. Our country has a Health Ministry that publishes a list of approved medications. Obviously, they’re not going to approve a medication that is more expensive and less effective than alternatives. But what about a medication that is more expensive and more effective? Or a medication that is less expensive but less effective? Or a medication that’s priced similarly but is differently effective?

Or what about an inexpensive natural medication that’s approved by the American FDA but is no longer commonly used anywhere in the world because a synthetic alternative has been developed? Such is the case with Armour Thyroid, which I take for my Hashimoto’s. Armour Thyroid is not approved by my country’s Health Ministry because they have already approved one medication for hypothyroidism – Eltroxin, a generic version of Synthroid – and why in the world would Armour be necessary if there’s already a perfectly good option available?

Well, Eltroxin is a perfectly good option, as is the branded version Synthroid – for those helped by it. For people whose symptoms didn’t improve on Eltroxin/Synthroid, the medical system here offers no solution. I can convince a doctor to prescribe it. But once he’s written the prescription, I can’t take it to a pharmacy to get it filled. I am shit out of luck.

By comparison: in America, as in my country, it is highly uncommon to prescribe Armour Thyroid for hypothyroidism. But if a doctor does prescribe it, the patient can acquire it with hardly any difficulty. The point is, it exists in America (legally, too). If the corner pharmacy doesn’t have it, they can order it. If they can’t order it, another one can. If another one can’t, the patient can order it by himself online – and probably save money, too.

Maybe the patient will spend more so he can see a doctor known to prescribe Armour. Maybe he’ll spend more ordering the Armour and ultimately getting reimbursed by his insurance for less than if he’d taken Synthroid. He has options – some better and more costly, some not as good and less so. Here, we have no options. And we slap each other on the back out of excitement for our wonderful health system.

Though I carry American citizenship, I’m not insured in America and don’t live there, don’t vote there and try not to tell Americans how to run their country. But I will say that it will be a sad day for me and for many other people all around the world who rely on America’s options when Americans accept their president’s proposal to socialize their medical system.

I get the Armour Thyroid I need from my uncle, a dentist in Philadelphia, via my mother. It costs a hell of a lot more than it would if I were insured, but at least I can get it. If an American bureaucrat some day decides that no one needs Armour because Synthroid is already available, I will again be shit out of luck.

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