Ex-Pat HealthCare

I just saw an old patient of mine who now lives in Rotterdam for a check-up. She’s visiting the United States and what do you think she is doing with much of her time?  No, not seeing old family and friends. Guess again.  Okay, I’ll tell you: she is too in as many visits to doctors’ offices as she can.  And of course, she now has to pay for all of these visits out-of-pocket.
“Why?” I stupidly asked, “Don’t the Dutch provide free healthcare?”  “Of course they do,” she said, “But the services are terrible” For instance, she said they allow a pap smear only once every five years. So she comes here to get pap smears.  She has two friends who developed advanced cervical disease during these absurdly long intervals.  For those who don’t understand, that is the subtle way rationing is accomplished.  No one in the Netherlands would admit they ration pap smears. They would just say that they determined that once every five years is adequate.
She is just one of many American patients I have who live in Europe or Canada, and they all tell an identical story.  There are also a large number of wealthy Europeans and Canadians who come to the United States for their health care. Has anyone heard of an American going overseas to get better medical care?  So far as I can recall, if an American goes overseas for health care, it is either for an injection of a harmful cancer drug made out of nectarine pits or something else bizarre, meaningless anti-aging shots made from sheep embryos, or for worthless injections of fetal tissues into their brain in a Hail Mary Pass to treat brain or spinal cord injury. They only go for the unstudied, unproved, or the dangerous, and sometimes they end up getting all three. But it is never for a better open heart operation or for better monitoring of their diabetes.
I have discussed the issue of the quality of European healthcare with scores of people who have had personal experiences with their systems and ours.  What I learned is that their view depends on the sophistication of their understanding of medicine.  Those who have been sick or who really understand what good care is, scoff at the Canadian and European systems.  Only the healthy and uninformed will defend European care as equal to ours.
That does not mean that we do not have problems.  But we should not eviscerate our system   until someone can point to a country with better care than ours, and until they can point to a single US government agency they would trust to administer their healthcare. We must avoid hastily pushing for change that could make us worse off than we are now.