Being a med student in the Philippines is not a pleasant experience, primarily because poverty reaches its malignant fingers into every aspect of living.
I studied in one of the better medical schools in Manila, where, in the charity ward, ventilators are available for rent by the day. If you don’t have money for a mechanical ventilator, a member of your family has to manually compress a bag to deliver breaths. Patients provide their own materials such as sterile gloves and IV catheters. If I flubbed my IV line insertion, I had to keep trying with the same catheter because the family simply couldn’t afford to buy another one. A woman who has coughed up a bucket of blood from pulmonary tuberculosis does not have the means to buy standard quadruple therapy. Rather, she will take one pill whenever she can afford to buy it, hoping it will treat her but making her bug drug-resistant instead. The mother of an 8-year old girl with a life-threatening dental abscess cannot afford to have her daughter admitted for administration of IV antibiotics; she takes her chances and treats her daughter with oral antibiotics. In a phenomenon known as a birthing hospital, women are lined up according to degree of cervical dilation, waiting for one of 10 metal delivery gurneys to open up so that a medical student can deliver the baby with re-autoclaved gloves and suture the episiotomy with re-sterilized needles. These are not unique; my physician friends from other third world countries have their own share of stories of how being poor translates to inhumane medical care.
The concept of health insurance was an attractive one, and I came to the United States eager to practice medicine in a country where I could deliver appropriate patient care without worrying about my patients being unable to afford it.
Five years later, I’ve had to rethink my assessment. I have had my own battles with insurance companies to get my patients the right, albeit costly, procedure or medication. I have had patients refuse medications because the copays are restrictive. I have also had patients abuse the system for some personal gain, usually psychological or financial. But I have witnessed first-hand the unthinkable consequences of not having health insurance, and anyone who has seen what I’ve seen would be uncomfortable with it, too.
The health insurance system that I once naively thought perfect is clearly flawed, and Hillary notwithstanding, there is finally agreement that it is flawed and that it needs to be fixed. There is at least a semblance of an attempt to right some wrongs. I am by no means a socialist, but health care should not be a privilege. It should be a universal human right, and universal health care is right.