Doctors worked from 7 to 3
p.m. in the former “communist workers’ paradise” where I grew up. On weekends
the hospital was pretty much empty of medical personnel, save for a few
janitors and the guard at the gate. He had to make sure no dirty people
compromised the sterility of the hospital. The janitors did not do much work,
judging by the filth around, the stinky bathrooms, the respectable layer of
dirt, and by the blood stains and other unidentifiable marks on the peeling
walls and on the broken linoleum.
Doctors who were treated like
gods interceding between life and certain death by neglect were paid lower than
teachers but supplemented their meager income with monetary bribes brought in envelopes
and with hard to find items such as soap, shampoo, meat, cigarettes, and other
sundries. Such bribes bought a patient immediate attention, better care, a
needed prescription, a blood test that took days instead of weeks and a chance
at survival if the surgeon did not botch the operation. A doctor had a file
with special clients in it, marked by alphabetized envelopes with the patient’s
name and the amount of cash enclosed.
A few very good doctors
were besieged by patients from a wide geographical region although it was
against the law to treat them. They were to serve only the residents assigned
to them by the communist party headquarters. Since quitting time was 3 p.m.,
some doctors continued their private practice illegally in their government
assigned apartments. Everyone knew about it but the economic police did not stop
it because their families often used the doctor’s services after hours as well.
Even live chicken, eggs, butter, cheese, preserves, and wine were accepted as
payment.
The poorly paid doctors were
assigned to practice medicine in designated areas by the government, had
thousands of patients, did not keep records, and their sparsely furnished
waiting rooms were filled to capacity like sardines every day. Although medical
care was “free” and people did not get much for free, after 3 p.m., nobody
moved, everyone understood that now they had to pay to be seen.
As a child, I remember
waiting with my Mom from 7 a.m. until late into the night to be seen by a
doctor, holding a piece of cardboard with my assigned number on it, racked with
fever, hoping to get the miracle pill that would bring my fever down.
The local pharmacy shelves
were mostly empty even of that miracle drug (a bitter-tasting version of Tylenol
called “piramidon”) but the doc had his own sources and we could buy it from
him – the black market was thriving. Sometimes he even had antibiotics for
sale. They were great because it cured the burning fire in my throat quickly. He
would give me an excuse for school and I would go home and lay in bed for days,
alternating between fever-induced bad dreams and reality.
Come to think of it, when
we were in Italy recently, where medicine is socialized, Aspirin and Tylenol
were regulated by government and could not be bought on the market without a
prescription. I could not understand why since it was available on American
posts and Italians were clamoring to buy it from them.
After only six years of
medical school and no practical experience in hospitals or internships, all
doctors were ill-prepared to care for their patients. Lucky people survived,
those who were not so lucky succumbed to complications from simple procedures
which the inexperienced doctors bungled. Hapless and innocent people who
trusted doctors with incipient medical skills were laboratory rats.
Many family members died
before their time from simple procedures such as appendicitis, tonsillectomies,
hernias, thyroidectomies, and other surgeries that we take for granted here in
the U.S. Raging infections would set in, some developed septicemia and gangrene
from nicked organs and intestines, and patients died a painful and unnecessary
death. None of the doctors were held accountable because families could not sue
the government for malpractice.
The American Embassy
evacuated their personnel for medical treatment to West Germany or other developed
countries in the West, they were never sent to Romanian hospitals during
Ceausescu’s communist era.
There are private clinics
today in Romania that give stellar care and drugs are available for a fee.
Capitalist free market care does work very well. But all the public hospitals
and pharmacies that provide socialized medicine run out of their rationed
drugs, supplies, surgeries, procedures, and tests early in the year. After
that, they have no choice but to turn patients away and ration care based on
age.
Dental medicine was very
scary as well. Appointments for painful teeth that needed removing were made
six months from the onset of an abscess or a painful cavity. Teeth were drilled,
root canaled, and removed without any anesthetics in spite of the patient’s
screams, pain or bloody discomfort, and the doctor used boiling, no autoclaving
procedures for his instruments. He did not have an assistant or a nurse. Tooth
cleaning or braces were not offered; the procedures were generally considered
to damage teeth and not recommended in stomatology school.
Ambulances were a joke.
Devoid of medical equipment then, they were more or less a way to transport
patients from rural areas to urban areas hospitals. They did not arrive in a
timely manner, offered no comfort to the patient during the very bumpy ride, and,
aside from the driver who was more interested in picking up hitch-hikers to
make an extra buck, there was no medical personnel on board. Things have
improved under a more capitalist-based economy, ambulances have come a long way
since then, but care is still sketchy and rationed. Hospitals run out of government
allotted money for ambulance service relatively early in the year. After that, severe rationing occurs.
Large hospital wards were depressing
“wailing rooms” where elderly were stuck to die, screaming in pain, attended by
family members who brought them food, sheets, morphine (if available) purchased
outside the hospital, and without any nursing care much less around the clock
as is the case in the U.S. If a patient did not have a family, he/she died a
painful and neglected death.
Things have not changed
that much in 24 years. Recently, my aunt cared for her husband round the clock
in the hospital, administering his meds, giving him shots, in a more modern
version of public hospitals in 2013 Romania.
I was horrified by the
lack of medical personnel, cleanliness, and otherwise professional medical care.
Nothing like the first rate care I had experienced in American hospitals. And
this was one of the best public hospitals in Romania in which the skilled doctors
actually saved my uncle’s life following brain surgery.
I was shocked when I tried
to use the only restroom on the floor that both patients and visitors used. The
tub and shower had not been used in a long time judging by the patina of thick
grime everywhere. An elderly female patient dressed in street clothes was washing
her dirty laundry by hand in the bathroom sink. The commode stall had huge
open-wide windows, visible to the floors above. The stench reminded me of our
high school latrines.
It is no surprise that
many doctors have migrated from Romania to work in other EU countries where
socialized medicine is a little less gruesome, remuneration is more generous, rationing
is enforced by law, compliance rewarded, and euthanasia is practiced legally.
Can anyone try to imagine
what our brand of socialized one-payer medical system will be like in the
United States in the very near future?
The often repeated
rhetorical phrases, “everyone knows it’s broken,” and the Pinocchio promise, “he
will fix it,” mesmerized everyone as if by magic. One shudders to think what
the “fixes” will be when the health care itself was not broken and everyone had
universal healthcare anyway. All they had to do is show up at an emergency room
sick and they were treated.
One reader named Gene surmised
Obamacare as “A one word portent for the destruction of the world’s most
enviable, most successful, and most sought-after and effective health care
enterprise, through nationalization; accomplished tangentially, the crippling
of the national economy, and an irreparable loss of personal liberty.”
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