Broken bones, broken systems

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Two roads diverged in a wood and I – I took the one less traveled by, and that has made all the difference.
– Robert Frost, American poet

I broke my left arm recently. On my birthday. My birthday gift was a trail through the twin volcanic mountains of Ometepe island in Nicaragua. Which took a ferry ride of almost two hours to get across Lake Nicaragua, one of the largest lakes in the world, from Rivas city where I was staying.

Unfortunately, I was climbing volcanoes on an ATV which I was riding on for the first time, the guides ahead were speeding on their motorbikes and as we tried to keep up, we veered off the beaten track and crashed on the timber outlining fences, my left arm absorbing the brunt of the crash.

It is kinda surreal I tell you, the dazed feeling as you lie there on the dirt road, miles away from everything, with your hand bent out of shape, not knowing if it can be put back right.

Worse, wondering how and when you will get access to a hospital that can do that. It took an hour plus to get to the island hospital which did not have an x ray machine that worked, so the doctor pumped morphine in my bloodstream, made a makeshift cast and the ambulance drove me to the ferry jetty and then from there I sat cradling my broken bones until we reached the other side two hours later, where an ambulance took me to the Rivas hospital. A nurse was with me throughout the trip to check on my hand.

All of this was free, as Nicaragua has a great public health system. Doctors were good, service was fast and efficient, hospitals were clean and not crowded. And all totally free.

Then it came to the part about doing the surgery, and then they said that the metal plates and screws needed to set the bones back in place has to be ordered and we need to wait two to four weeks for it to come before we could schedule a surgery, since it was a government hospital.

We had the option to go to a private hospital and pay the normal premium for a surgery. I of course opted for the quickest surgery so I could come home as fast as I could.

So, a surgery at the capital city of Managua was set, another two-hour drive, and the doctors did a superb job of putting my hand back so fast, that I am told the cast can be removed in three weeks. I am writing this now just 5 days after the surgery, a mini-Wolverine with metal in my bones.

But this got me thinking. It is the same here in Malaysia too. You have two separate healthcare systems. Public and private. The public health care system exists to justify the tax collected – free or minimum cost healthcare all the way to surgery, but there is such a ridiculously long wait for surgeries to be scheduled, or even follow-up appointments to see doctors, that many opt for private healthcare. I really don’t see why this dual system exists at all.

Every government in this world is obligated to give its citizens excellent and free healthcare systems that go from check-ups to surgeries to post surgery care. With speed and efficiency. If not, there is no rationale for tax to be collected.

I am perplexed as to a need for private healthcare systems. There should only be one healthcare system, totally funded by the government with all the doctors in the country working for the betterment of the citizens. This removes the need for health insurance too, because seriously now, why burden the people with more expenses?

The existence of healthcare insurance is due to exorbitant costs of healthcare in private hospitals and staggering costs of surgery for merely the manpower cost of surgeons and nurses, and accommodation, with materials used that are not made of gold and diamonds but simple stuff such as sutures, gauzes, monitoring machines which should all be funded through taxation and drugs which are in many cases 1,000 times higher than manufacturing costs.