An Irishgirl abroad — New York life through a European lens

Counterintuitive thinking on healthcare

Posted in Healthcare, New York by Frieda on July 25, 2010

My shoes: hazardous to the health but clearly worth it

A number of years ago I was invited to a lovely and rather posh wedding in Oxford. I was discreetly placed at the ‘singles’ table beside an eligible doctor, in the hope that a spark might strike. That wasn’t to be. Intrigued by the English health system I asked him about his job; instead of any softer feelings my presence inspired a rant, about the horrible patients who bugged this poor doctor with their stupid worries about colds and minor ailments. Being slightly hypochondriacal, I sided with the patients.

Fast forward a few years: now living in the US, my experience of healthcare is very different and I recall with fondness the days when a trip to the doctor required nothing more than a phonecall and £6.30 for a prescription. I have health insurance of a kind (travel insurance) and I get yearly check-ups, but any superfluous doctoral visits are few and far between. I’m not the only one. At my hairdresser’s the other day, one of the stylists was limping awkwardly. It turns out she’d been wearing high heels, and made the mistake of playing football with her nephew. The result was disastrous — she broke her toe — but instead of going to the doctor, she patched it up herself, strapping it to the other toe as a nurse might have done (admittedly, she was still wearing the heels in question when I saw her so perhaps the break wasn’t that bad).

In the US, where at least 47 million people are uninsured, this sort of DIY healthcare is commonplace. Pharmacists sometimes help out, dispensing antibiotics without prescriptions (I think that’s illegal but correct me if I’m wrong). The medications you can buy over the counter are stronger than those available in Europe and presumably there’s a reason for that. People hobble on home-made canes and wait for nature to do its work unaided.

When I fell off my bike recently, I realized that my emergency Plan B — flying home to Ireland nursing my injury — would be difficult, and intensely painful, to carry out (Plan  A is just do nothing and hope for the best). My arm was extremely sore and it took days to heal. Luckily, it wasn’t broken; I got antibiotics from a sympathetic chemist and avoided an infection.

On some levels this self-care version of healthcare is good. It saves government money, and makes people hardier and less susceptible to self-indulgent anxieties. The uninsured are unlikely to waste a doctor’s time because they have a cold if it means they’ll have to shell out $150. But the real cost is a heavy one, for it must mean that early diagnosis of serious illness is less frequent.

Nor does a lack of insurance stop people taking risks, as my hairdressing-friend’s high-heeled soccer accident shows. It hasn’t stopped me either. Undeterred by her story I recently purchased a pair of rather dangerous summer sandals. I’ll just take care and avoid sidewalk-cracks and hope I don’t fall. It’s an uneasy balance, but I bet that doctor would be pleased.

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Brian Cowen’s summer holiday

Posted in Irish by Frieda on July 16, 2010

Brian Cowen at the Consulate (June 13)

Earlier this week I had an opportunity to meet Ireland’s taoiseach (~ prime minister) at the Consulate in New York. It was Cowen’s first visit this year, and he was variously drumming up business, or showing that he isn’t totally done for, depending on your perspective. At home, Cowen is facing harsh criticism, with an astonishing degree of success — indeed, he faced down a vote of no confidence from within his party just last month.

New York provided an opportunity for the beleaguered taoiseach to relax. Local Irish media reports have been politely positive and his speech at the Consulate on Tuesday was received with applause and even, from a blond lady behind me, a shriek.

The taoiseach spoke without any notes, not even a scrap of paper. This is very difficult to do, unless you’re well-practised or a brilliant orator. Probably as a result of this his language was convoluted and repetitive. He talked of the need ‘to ensure that our investment strategy,which has been so successful, is being allied with a continuation of that strategy.’ Referring to his trip to the New York Stock Exchange the day before, and to his own research into how to promote Ireland as an innovative place, he said, ‘the fruits of that work were coming to fruition yesterday.’

And he made another statement that seemed exceedingly strange but was probably meant to pander to his audience of former emigrants. Ireland is not so much a geographical location, it’s about ‘what’s in your heart.’ We are as determined as ever, Cowen said, to show that this generation is as able as earlier ones to overcome the problems of unemployment.

It didn’t seem to matter to him that emigration is often seen as a dark part of Ireland’s history and that young people’s enforced departure from Ireland now is a renewal of that tragedy. The audience clapped and cheered. Perhaps I hadn’t understood.

Later on I asked Cowen what specifically he planned to do to help young people whom circumstances are forcing to emigrate to the States. ‘It’s an issue I’m working on all the time,’ he said, smiling at me. He added that it’s very political (which immigration certainly is in the US), and said he’d met with immigration lobbyists earlier in the day — I assume this means the Irish Immigration Lobby for Reform. ‘We’re looking for more flexible arrangements.’

The statement seemed vague and I wonder if it’s enough, coming from Ireland’s current leader in the midst of the greatest financial crisis the country has seen. Working on it all the time? It’s better, I suppose, than saying he’s not working on it.

Below is a virtual flip-book of photos from the speech.

Consul Niall Burgess introduces Cowen

This was Burgess' last event in NY

Cowen takes to the podium

New consul Noel Kilkenny listens intently on the right

More of the same

As before

Cowen struck a confident pose

The speech was well received

Afterwards

Cowen greets Marie Burgess