Experiencing Medical Care Overseas: An Inspiring Medical Reality

I recently returned from the Greek Isles on a cruise vacation that started in Venice.  My wife and I sat down next to a couple at dinner from Canada, and we began to swap stories.  The conversation gradually turned to health care, and then it got very interesting.

Our new Canadian friends Ashley and Chris pay 18% income tax a year, plus another 13% sales tax for public services including their health care – a total of 31%.  (Actually it’s a little less than 31% because they don’t spend everything they make, and hence are not taxed the full 13% sales tax on all their income). In fact, they’ve never spent a dime on sickness or wellness.  Everything’s covered from congestion to cancer.  They wanted to know what it was like in the United States.

I started by letting them know our federal and state taxes (combined) are usually around 25% .  We do pay a sales tax of an additional 7% for a combined tax rate of about 32% (or a little less, because we don’t spend everything we make either). 

For roughly the same amount of tax, they get free health care coverage, and we do not.  In fact, I informed them that my wife and I have spent more than ¾ of a million dollars in out of pocket costs on health insurance and an occasional visit to the doctor.

They were shocked.  “That would bankrupt us,” they said.  (They actually turned white at the realization.)  We told them we were lucky, and had good enough jobs to pay the nearly $20,000 a year in health premiums and deductibles, and still live a nice life. Many in the U.S., we informed them, DO go bankrupt as a result of medical costs. (More than 10,000 Americans each month file bankruptcy due to medical bills, or an inability to work because they can’t get care.)  “Well, that’s something we’ll never have to worry about,” Ashley and Chris agreed with relief. 

“But what about getting services when you need them?” we asked.  “We’ve heard you sometimes have to wait a long time to get what you need.”  They looked at us with puzzled faces.

“If you’re condition is not of an immediate need, like a future knee replacement that is not acute, then you will have to wait your turn. But if your need is reasonable, like you have broken arm or a fever, or a sore throat, you can get seen immediately by one of many clinics near your home.  It’s same-day service, really.” 

Oh, by the way, Canadian free medical services include pregnancy and delivery coverages, all hospital charges, eye care, chiropractic services, and even massages if you want them.  

“Diseases are often discovered earlier here too.  Instead of holding out on going to a doctor because of the cost, we can go with any concern and get it dealt with early on.”

We also learned everyone receives 1 year of maternity or paternity leave at 55% salary, or at their option, can have 100% child care services covered for one year if they choose to go back to work.

I asked, “How do the doctors like your system?”

“They’re happy,” said Chris.  They can spend a lot more time with you.  They’re paid to care, not make money.”

***

The next day I sprained my ankle on a hike on the island of Crete.  When I got back to the ship, I sought out the medic on board, and hoping to get an ankle support band to contain the swelling, along with ice and ibuprofen.  “We better take X-rays to rule out any break,” said the doctor. 

The woman ahead of me was after some medication for a condition she did not share with me.  She was informed her doctor’s visit would be $40.  “I’m not used to paying for this, you know.  I’ve never paid for any medical services.”

“Where are you from?” the attending nurse asked.  “Canada,” she responded.  She was a bit shocked that her medical need would cost her a whole $40.

 “I suppose you’re used to this,” she said, now talking to me.  I replied, “Yes, we’d pay 4 - 5 times that just to see the doctor, without the medication.  Her jaw dropped.  “Thank God I live in Canada!” she said.

Before walking out the door, the woman said, “They scare you there, don’t they, telling you they can’t afford to provide medical care for all of you.  But they’re wrong.  Yes, we pay a little more in taxes for it, but it’s worth it.  I don’t see why your government doesn’t allow it.”

I did the math and figured out if I had the chance to pay a sales tax of 13% instead of 7% over my working life, I would have saved more than $550,000 in medical costs.

My three new friends were dumbfounded, trying to grasp the draconian practices of delivering health care in the United States.  And they were delighted that their country, at least where health care was concerned, was one of compassion, caring, and sensibility.

Understanding What Drives Those With Whom You Disagree

There’s kind of a wackiness going on these days that tends to polarize people and make them defensive with one another.  When people think differently from one another with passion, it can turn to judgement and alienation.  What’s needed is an understanding of how people think so we can give up the resistance to each other based on pre-conceived ideas.

So I offer this discussion starter to help liberals understand conservatives, and help conservatives understand liberals. It’s too easy to villainize each other. Both sides think they’re the good guys, and they are.  We’re all good guys.  What is needed is an understanding of what makes those difficult-to-understand-and-different-from-us folks tick.

 “Conservative” and  “liberal” tend to be political terms in today’s climate, and I do not want this to be a political discussion.  I want it to be a discussion about human beings, about how we tend to engage with each other and with social issues of our day.  So, from here on out, I will use the term “traditionalist” to refer to generally conservative viewpoints, and “progressive” to refer to generally liberal viewpoints.

Keep in mind there are not just two groups.  Each of us lands on a continuum between the extremes.  You will likely find elements of both positions within you.

Traditionalists see the chaotic world and long for the ‘good old days’ when life was simpler.  They prefer order and simplicity.  Ambiguity tends to make them anxious, so often black and white thinking is preferred, where answers are predictable and unchanging.  In an attempt to try to control change, they prefer to backtrack to the past.  Scientific discoveries are not regarded with enthusiasm if they do not match what is already believed. 

Since for traditionalists, there is clear right and wrong, the end justifies the means. What progressives may see as rude, cruel, or disrespectful behavior, traditionalists may see as needed, appropriate, and justified to return us to the right path.  Both traditionalists and progressives share the goal of making the world a better place.

Progressives, instead of looking backward, look forward to the possibility of finding better ways of doing things.  Instead of being threatened by ambiguity, progressives believe that exploring the unknown, as well as the known, leads to valuable learning.  New ideas are encouraged.  For example, instead of supporting conventional attitudes about men having advantages over women,  progressives think seeing the genders as equals holds more potential.  Equal pay for equal work.  Respect is for all human beings alike. 

Traditionalists are prone to scarcity thinking.   There is often worry about losing what they have. For example, they may be afraid there’s not enough money to go around, where progressives will see there is plenty of money to go around for everyone to have a good life.

Whereas traditionalists tend to see those different from them (other races, religions, etc.) as threats, progressives seek the positives of diversity.  Where traditionalists may see scientific discoveries and new data as irrelevant, progressives consider it advantageous to embrace information unknown in the past.  While progressives tend to see traditionalists as being uninformed or selfish, traditionalists tend to see progressives as immoral.

For progressives, the end does not justify the means.  The means is important for them because having respect for the planet, animals, women, strangers, etc. is a matter of integrity.  For them, your example is as important as your words.

Traditionalists tend to operate with a mind-set of separation.  Some people are better than others.  Some people deserve more.  They often think in terms of win-lose. 

Progressives tend to operate with the mind-set of unity.  Instead of needing to beat those who are different, it’s more gratifying to progressives to join with, work with, and co-operate with those different from them.  They often think in terms of win-win.

As opposed to black & white thinking, progressives often see gray areas in life’s challenges.  In addition to what people do, their motivation for doing what they do is deemed significant. While traditionalists tend to be motivated by fear of things changing for the worse (taking in refugees will hurt us), progressives tend to be motivated by love and compassion (refugees need places to live and food to eat).  Traditionalists often also say they are motivated by love.  This kind of love often means controlling others (believe in God the way I do; don't be gay; don't be transsexual; don't use birth control), while for the Progressives, love means setting people free (connect with God in the way of your choice; be who you are).

Both traditionalists and progressives claim to value truth.  When traditionalists speak of truth, they are often referring to assumed truth, whereas liberals are often thinking of verifiable truth.  For example, one group may say they have not noticed a change in weather around them and think that global warming is a myth, where the other observes melting glaciers, rising oceans, and more than 100 years of data to come to an opposite conclusion. Can you tell which group is which? 

Traditionalists often generalize from isolated incidents (a terrorist claims to be Muslim, so we should fear all Muslims as potential terrorists), where progressives tend to consider broader, inclusive collection of information in order to clarify what is real for them (Muslims are a peace-loving people.  Only extremists Muslims are terrorists; much like extremist Christians.) 

Traditionalists stand for individual freedom while trying to get others to do the right thing. (stand during national anthem, and others should too).  Progressives advocate for collective freedom for everyone (standing or kneeling for national anthem OK).  What progressives see racism, traditionalists see as keeping order. 

In the Western world, seeing these varied perspectives makes it easier to understand why traditionalists might have a desire for literal interpretations of their Christian Bible, while progressive Christians notice the contradictions of the passages, the contexts in which the words were written, and are open to new discoveries about the writings that have not been assumed in the past.  Both love God, and both want to be right.

Traditionalist’s of many faiths often see a God who will punish them for not believing the right thing, and may therefore be more dogmatic about their beliefs.  They want to keep people on the straight and narrow. Progressive people of faith see a compassionate and caring God, who does not punish them for seeking truth with interest and openness.

Both groups will often see themselves as being “fair”.   For progressives, “fair” usually means everyone has equal opportunity.  For traditionalists, “fair” often means it’s OK for one group to have more than others, because they think they worked harder for it. As they see it, some people have less than others because they are lazy or made poor decisions that determined their fate.  Traditionalists do not want to support laziness.  Traditionalists often embrace a “me first” viewpoint (scarcity); whereas progressives will embrace that every human’s needs are important (inclusion, abundance).  Progressives can be concerned that struggling humans may not have had the same opportunities as those who are making a go of it.

When engaging a traditionalist, look for the need for order, simplicity, the safety of black & white thinking, individual freedom, and the fear that change and openness will threaten them somehow.  Progressives must be sensitive and honoring of that fear, not ridicule it.  

When engaging a progressive, look for that person to value openness and complexity, learning new information, inclusiveness, verifiable truth, collective freedom, and to see gray areas to issues. 

Here are some modern-day examples examined in more depth:

Immigration:

In our national conflict over immigration, a traditionalist often holds the view that an undocumented immigrant should be labeled “illegal” and be punished, because they aren’t following established rules, no matter how outdated they may be.  The progressive mind is more likely to see beyond the black/white thinking that “illegal” means “wrong”, and ask why are these illegals willing to risk breaking the law at all?  The progressive considers broader perspectives based on research such as our need for immigrants to keep our economy going, that our system is flawed in welcoming them into our country, and the problem may be our immigration policies, not the incoming strangers.  The progressive understands that labeling these new-comers “illegal” judges them as enemies (separate), not as comrades in the human race, and brothers an sisters in need of our love (unity; oneness).

Traditionalists are less likely to consider what immigrants are fleeing, which may include escape from poverty, murder, and death.  These are relevant factors to a progressive.  Traditionalists are more concerned about their own safety, and may justify mistreating people because they are breaking the established norm.  They may judge the newcomer as trying to get something they don’t deserve, or are otherwise bad people. Progressives are less likely to see fleeing danger in desperation as sufficient reason to label someone bad, lazy, or evil.  Although there may be a few foreigner “bad apples”, progressives believe that most human beings are good people, no matter where they come from.  Traditionalists tend to move quickly to suspicion, while progressives are quick to trust.

The progressive mind includes compassion, impartiality, and privilege in their decision-making, where the traditionalist does not often see their privilege. Traditionalists can be afraid that strangers will take something from them (jobs, welfare money, or hurt them physically), and are just trying to be protective of themselves, their country, and those they love. Progressives see the value of these strangers as contributors to the good of all, and see it as America’s responsibility to make it easier for those in need or those seeking a better life to cross our borders legally.

Traditionalists may justify separating families of newcomers at our border, believing they are dangerous to our society or that punishment will keep people in line.  This does not make sense to progressives who may be open to the knowledge that illegal immigrants are statistically less (25% less) likely to commit violent crimes than native-born Americans. Traditionalists are also prone to be frightened of terrorists crossing our borders from foreign lands.  The progressive finds it much more difficult to be afraid of this, knowing that fewer than 1/100^th of 1% of terrorist attacks in the US are committed by foreigners.

The fears of traditionalists often prevent them from looking at or caring about factual information.  They don't trust it.  For progressives, the research matters.  It’s harder for a progressive to be afraid of foreigners when they know from sources (like the Cato Institute), that the chances of an American being killed by a foreign terrorist in any given year is 1 in 10.9 billion.  Logically, progressives would say we should be much more afraid of being struck by lightening (nearly 11,000 times more likely than being killed by a foreign terrorist) or dying by falling out of bed (767 times more likely).

Abortion:

Just as a progressive may judge a traditionalist for being insensitive to the needs of others, traditionalists often villainize progressives for valuing what a pregnant woman feels is best for her and her entire family, rather than accepting an unwanted pregnancy.  The progressive is more likely to value compassion for a pregnant women as relevant. 

It is simple and orderly for a traditionalist to see a pregnancy as God’s will not to be messed with, where the progressive considers other factors such as how this may condemn the mother to poverty, leave the potential child hungry, uneducated, or in an unloved, neglected, or abusive family.  In wanting to return to an unchanging stability, a traditionalist may believe a women should not have a choice as to whether they want to, or when they are ready to, provide a child with a loving home. Women should be forced to have children (simple, controlling), even if they don’t want to or aren’t capable of raising them.  Women do not have the same rights as men (separation) to control whether they become parents or when.    The traditionalist may see the issue as a simple one:  Abortion is killing babies, and so it’s wrong, period!

Traditionalist “pro-lifers” often generalize progressives as “pro-abortion” (simplicity/ black & white), even though many progressives are not.  Progressives are often willing to consider abortion as part of the equation in complicated decision-making.   

Many traditionalists want to close family planning clinics that also offer abortions, thinking this will help prevent them.  Progressives, have a hard time seeing this, since they are aware closing family planning clinics does not prevent abortions, but instead makes the inevitable abortions more dangerous.  Progressives are more likely to see that making abortions illegal hasn’t stopped them anywhere in the world, or at any time in history.  They would rather see more family planning clinics to help prevent abortions, knowing that when families can be planned, many abortions can be averted.  (Research has shown that ready access to family planning could prevent as many as 350,000 abortions per year in the US.)   

Gun Control

Interestingly, traditionalists who tend to stand for the lives of the unborn, do not always hold this pro-life stance when it comes to gun safety.  The nearly 85 Americans whose lives are lost everyday take a low priority when it comes to managing the guns that kill them. Simplicity & individual freedom (2^nd Amendment guarantees rights to own guns), fear (that we won’t be able to protect ourselves, or ‘they’ll take all our guns’), and black & white thinking (the 2^nd Amendment guarantees no limitation on one’s arsenal, and does not allow for regulation), lead a traditionalist toward a rigid response to problem solving around gun safety.  Progressives are able to see more options, where the right to gun ownership can be balanced with the rights of others to live.

Traditionalists often believe (note the fear) that having a gun makes their family safer. Progressives take a broader view, open to readily available information that shows a person is 3 times more likely to be hurt or killed by a gun if that person has one in their home.  Traditionalists often also will take the position that they should be able to take guns with them wherever they go, because ‘the only way to stop a bad guy with a gun is a good guy with a gun’.   They are trying to stop violence. This runs contrary to the research that informs us guns are fired offensively more than 99% of the time, and in less than 1% of the cases is a gun used defensively.  Progressives are open to the data that despite an average of one mass shooting in the United States per day, a civilian good guy with a gun has not stopped a mass shooting in the last 30 years. Over that time, however, nearly 1 million citizens have lost their lives to guns.  

So, where does this leave us?

Instead of judging our neighbor for views different than ours, a healthier approach is to seek to understand their model of the world.  There is greater chance for appreciation and acceptance when we not only know what people believe, but why they believe it. 

Think simplicity, order, individual freedom, fear, scarcity, and black & white thinking, vs. inclusiveness, collective freedom, love, abundance thinking and gray areas.   Both groups are motivated by what they believe is the truth about the world.  So the next time you find yourself disagreeing with somebody, think about how they are trying to make the world a better place!

What are your perspectives?   No doubt you have a view or two yourself that could add to the discussion.  Thank you for responding respectfully.

Contrary to Public Opinion, the World is Getting Better

Many people depend on the media for education.  This is unfortunate.  The nature of the media is to stun us, not educate us.  Profit comes from drama.  The lead story is often the most shocking news that can be found in the moment.  There’s a saying in the media world: “Good news is no news.”

If we use the media for our education, we could come away feeling the world is getting worse, not better.  However, the opposite it true. *

Here’s a sampling of how things have improved since ‘the good old days’.  Wouldn’t you love to hear news stories about these realities?

In 1800, there were 193 places in the world where slavery was legal.  Now there are only 3.

In 1979, there were 636,000 tons of oil spilled from tanker ships.  Last year, only 6,000.

HIV infections have been cut by more than ½ since 1996.

In 1900, 43% of children born died before their 5^th birthday.  Now, only 4% do.

In 1954, nearly 1/3 of the world’s children age 5-15 worked full time to help support the family.  Now, less than 1 in 10 do.  (Time to go to school! )

Nuclear weapons around the world have been reduced by 74% since 1986.

Ozone depleting substances released into the atmosphere have been reduced by 98% since 1970.

Grain production has tripled since 1961.

There are 60% fewer people on the planet that go to bed hungry at night than in 1970.

Despite what’s happening in the United States, the number of acres of land worldwide that is now protected by National Parks or reserves has doubled since in 1985.

193 countries now allow women to vote, compared to 1 in 1893.

Literacy has increased worldwide from 20% in 1900 to 86% now.

90% of girls around the globe now attend primary school compared to 65% in 1970.

85% of the world now has electricity, and 88% now drink water protected from contamination.

Violent crime in the US has decreased 34% since 1990.

This is not to say there isn’t more to do. (Nearly 1 billion people still do not have clean drinking water.) We must always keep working on improving the world.  But look how far we’ve come!

* These figures are borrowed from the Swedish Gapminder Foundation, dedicated to finding truth independent of the media.

Mercy for our President

As I watch what happens in social media, and the broader media, and in conversations, it seems liberals on the political left appear to be acting much like the conservatives did when Obama was in power. Many dissatisfied with Trump's leadership seem to focus on standing in his way, even destroying him, just like republicans vowed to do when Obama served.

I prayed a lot for Obama, as I'm sure many did. Despite the criticism he faced, Obama pulled the rabbit out of the proverbial hat with many of his astounding accomplishments - cutting the unemployment rate in half, tripling the stock market, pulling us out of the greatest recession our nation has known since the great depression, creating 17+ million jobs, fighting for women, kids, and veterans, health care, seniors, minorities, the environment, etc., all while reducing the national deficit by 60%. He performed miracles against astounding opposition.

Although the temptation is great for those who disagree with Mr. Trump's values to attack him, I can't help but think that praying for Trump would be a better idea for the betterment of life for Americans. Instead of contributing to the negativity, liberals have a chance to ask for from a Higher Power, as we did with Obama, for support in manifesting decisions that will be good for us all, in win-win fashion, rather than the more popular win-lose mentality.

If we truly want our country to be at it's best, and for all Americans to be on the receiving end of blessings, wouldn't it make more sense for us to focus on what we want from our leaders, instead of attacking them all the time?

Despite his public image, I believe Mr. Trump has a heart, but he is so busy defending it, he can't put any energy into showing it. He is not thick-skinned like our previous leader. He is insecure and lost in an ocean he's never swam in before. Surely he needs our help more than he needs us pushing his head under the water. Wouldn't you need the same from those who disagree with you?