Monthly Archive for August, 2009

Links: Obama’s Lost Causes

Written by Colin. Published on August 28, 2009 ago in Current Events. 1 Comment

Perhaps Obama is trying to hard. He’s not only touching but also getting seriously involved in every lost cause of the past few decades: first was Iraq and Guantanimo, second healthcare, and now the Middle East. Is this his way of trying to out-do past presidents?

Add a few more trillion dollars to the US debt tab.

Someone who follows the White House’s twitter account asked for numbers and statistics behind the decisions they’ve made in the Democrat healthcare reform bill. The White House responded.

Why Conservatives and Liberals Dislike Libertarians

Kentucky’s Homeland Security can’t require dependence on God

A video explaining the great threat the UNCRC Treaty poses to American families…

International News
Police ‘Turn to Car Crime’ 

Responding to the furor over the release of the Lockerbie pilot, one person suggests a great answer: boycott them.

Christian Morality and Universal Heathcare

Written by Colin. Published on August 25, 2009 ago in Philosophy, Politics and Theology. Closed

Like posts that assert a “Christian” position in favour the legalisation of drugs or are against war, I am going to have to qualify this one with a disclaimer or two.

I don’t propose to have an authoritative (as in God-inspired) word from on high about this or any political issue. However, I do think there are some biblical and theological principles that can be remembered and considered in the discussion about how to provide healthcare for people.

Just as with the question of drug or prostitution legalisation – there is a very clear line between endorsing something and believing that something should be forced on everyone by law. Healthcare for all is something that every Christian should be advocating and supporting. Part of our calling as Christians is to (at the very least) pray for the welfare of our fellow man, including strangers and enemies. But what it really should look like is material support in the form of giving, labouring and strategic action in the form of practical service to our community.

However, I believe that Christian support for government-run (or controlled) healthcare is a well-motivated, but mistaken way to apply these principles.

The chief problem with some form of government-mandated care (no matter who ultimately provides it – the government or private companies) is that in order to “give” healthcare to some, it must be taken from others. Christians can and should support giving – but it is incompatible with Christian principles, no matter how noble the goals – to support taking.

Healthcare is a scarce good. It has to be produced by someone – doctors, nurses, technicians, R&D people, chemists and other scientists. In order for us to give healthcare to people who cannot afford it, we must make those people work against their will. They have to go into involuntary servitude for our morals.

Consider the incompatibility of that idea – what kind of “morals” would condone involuntary servitude? How can Christians claim that we are acting on godly motives, if we support and even participate in the enslavement of our fellow man?

If we want to see a healthier world, we should achieve it by biblical means – educate people about healthy choices, give money freely and encourage others to do the same, volunteer or provide health services as part of one’s job. But we cannot claim to be doing God’s work when we make people support our morals (that is by threatening them with fines, jail or worse). The power of the state is not a means that Christians should be using to “help” God in his plans.

But we can still do something.

The less scarce that healthcare becomes, the cheaper and more accessible it will be. Socialistic healthcare is one way to distribute care, but it is a horrible way to produce it. The profit motive of capitalism drives men and women, even while serving their own interests, to ultimately provide goods to the public. Capitalism is the greatest productive force that man has ever devised. And while not perfect, capitalism could easily make healthcare as abundant as any other good and service we currently take for granted.

Christians are to be good Samaritans – if we see someone in desperate need of care, we should be the one stopping. But it would not be Christ-like to see someone in need, and rather than doing something ourselves, pull out a weapon and force someone else to help them. This is essentially what government control or provision of healthcare means in today’s world of scarcity.

Christians must set a good example by doing, and then, based on that record of self-sacrifice, encourage and educate others about their need to help as well. I suspect that the problem of healthcare access in America could at least be temporarily eliminated if every Christian gave or worked the equivalent of a few hours of labour. However, because this is not happening, does not give the rest of us the right to make others do our work for us.

Like any political issue – Christians need to pursue activism and effort in biblically compatible ways. With drugs and prostitution, it means condeming the behaviour as sinful, whilst refusing to compell people to follow Christian morals. With healthcare, it means seeking universal and equal access without violating the fundamental rights of the honest people who have worked hard, invested or otherwise produced goods and services.

Some medical issues the same on both sides of Big Pond

Written by Colin. Published on August 21, 2009 ago in Current Events and Politics. 13 Comments

The Register Guard, my local paper when I lived in the United States, has printed a guest column by a familiar face.

The article basically details some of the conclusions I have reached about Universal Healthcare from my experience here in England. I held back a lot of the polarising language that I otherwise might have included, because I wanted people to mostly get an idea of the fact in my case:

  • It’s not free
  • There are long waits
  • The care is no better, and may in fact be worse

It’s an anecdote – it isn’t scientific by any means. But my biggest hope for the piece is that people will stop looking at this as Democrat/Republican issue, and really stop to consider what they would be signing up for in giving the government even more control over their health.

Links: Loads of Healthcare Links

Written by Colin. Published on August 21, 2009 ago in General. Closed

Obama’s Town Hall meeting in Grand Junction, CO

Perhaps Daniel Hannan wasn’t the only Tory wanting to get rid of the NHS

Even the outright lies are influencing the public opinion on healthcare.

A Commonwealth study that highlights healthcare across seven different countries…back from 2007. The winner in that study was the Dutch system which also had the shortest wait times for surgery.

Congress Deadlocked Over How To Not Provide Health Care

Healthcare From the Left
What free healthcare looks like in the US right now. Even if one disagrees with the general argument for a single-payer system, there must be something better than what the US currently has. This kind of ‘free clinic’ is, IMO, unacceptable for any modernised, developed country.

Letter to America (insert witty banter about motes and planks in eyes)

Down’s Syndrome in the US

Politics
Since we mentioned some Tory MPs last week, I thought it’d be fun to dirty their name with something completely unrelated to the NHS. They want to double their current salary in light of the expense scandal from earlier this year.

Tory leader David Cameron tries to recover from the Hannan row by pledging to intensify Labour’s ‘good’ reforms.

More Links
An interesting article about the relationship between Christian and secular linguists was published in Search Magazine. Quoted below is an introduction from the author Michael Erard’s blog:

This piece, which was published in the July/August issue of Search Magazine, is about the relationship between academic linguists and SIL International, a language research organization with a Christian mission. I’ve encountered SIL as an organization and individuals with SIL affiliations quite a bit, and written about SIL linguists’ work (the Science piece I did in April is partly about SIL work in China), and always was intrigued by the theological underpinnings for their work — not in its connections to evangelism, necessarily, but a view of creation and history and the role of science — and how those underpinnings provided a more robust model for doing work with minority languages than anything that academic departments and universities had so far been able to come up.

Some have complained that religion and science are incompatible, and for most sciences I would agree. On the other hand, no science is ideologically pure in its motivations or ramifications, so any criticism of SIL as a Christian evangelical organization that doesn’t also critique other aspects of the endangered language agenda is showing its ideological bias.

And here is the link to the article itself, Holy Grammar, Inc.

While forecasting trends is always an enterprise waiting for failure, there’s one out that says life expectancy in the US may have just peaked.

More of what is wrong with the world

Healthcare-ish

Written by Christopher Roussel. Published on August 20, 2009 ago in Current Events, General and Politics. 10 Comments

This is part 1 of a yet-to-be-determined length in a series on the healthcare reform debate in the USA.

Since healthcare is such a big issue these days and there seems to be a lot of discussion as to what the ‘socialist’ suggestion by the Democrats will and will not do, let’s look at the actual bill in question. Feel free to follow along and/or verify the information I’m reporting here; I have tried to merely summarise the bill without much commentary. It’s really long, so I’ll be highlighting sections rather than try a line-by-line analysis. A few things are clear to me after reading through the sections on the healthcare industry reform (Division ‘A’ of the bill).

  1. This is not setting up a single-payer system (e.g. the ‘socialised healthcare’ of the UK or Canada), but rather a government-run insurance ‘company’. In other words, it would be better to see this as the government setting up public schools while not removing private schools rather than the government setting up and consolidating militias into government-run militaries.
  2. The second aim of this bill is to introduce minimum standards for healthcare. Keeping with my above example, it is similar to the government requiring particular subjects to be taught in school for a particular amount of time (e.g. 3 years of mathematics). These standards do not appear very strict; in fact healthcare plans that I have had previously already meet these requirements.
  3. In order to carry out the above two aims ‘universally’, there are additional regulations and points of enforcement. Most of these are aimed at health insurance companies and employers. The only line of enforcement aimed at the individual taxpayer is a 2.5% tax based on an individual’s adjusted gross income (§401). This tax applies only to individuals who do not have a healthcare plan that meets the minimum requirements (i.e. the previous point).

Purpose And Overview (§101-§116)
In general, it appears this bill is supposed to establish standards for the health insurance industry. Plans that take effect after the change date (not listed in the bill) must meet the new standards (of this bill). People may choose to remain on their current plan, but insurance companies cannot enrol new people under that plan after the change date. Additionally insurance companies must apply rate increases to entire ‘risk groups’ and cannot change any of its terms or conditions on plans that people choose to keep. These kept-back plans must switch to meet the standards within the 5 year grace period after the change date. There are some exceptions to this, notably flexible spending accounts, onsite employer facilities (e.g. a first-aid station), and coverage that only provides mental health, dental, and/or vision care. Insurance plans cannot use pre-existing condition exclusions. Insurance companies are prohibited from dropping clients except in cases of fraud. Insurance premiums are prohibited from excess variation. Variation is allowed by predefined age groups (as long as the highest premium is no more than double that of the lowest), area, and family/group bundling (as long as the variation is uniform compared to individual premiums). A report on the financial aspect of these changes is due within 18 months of the bill. The report will evaluate and compare group-insured and self-insured plans/markets. Insurance company may use a provider network, as long as it provides transparency in the cost difference between in-network and out-of-network coverage. Additionally, these provider networks must meet standards established by the Commissioner. If a plan does not meet a predetermined medical-loss ratio, it must provide rebates to enrolled participants to meet the ratio. In other words, if a company has a low payout on a plan one year (say 20%), it must (in effect) refund the people on that plan until its payout meets the required magic number.

Health Insurance Exchange (§201-§203)
Sets up the Health Insurance Exchange. This will serve as an insurance gateway in addition to offering a public insurance option. The Commissioner is responsible for overseeing the operations of the HIE (e.g. ensuring plans offered through the HIE are qualified, fair, etc). Insurance companies do not need to offer any insurance plans through the HIE, however they still must meet the minimum standards. Individuals who continue to get health insurance through their employer will have choice of any insurance plan offered through the HIE once the employer begins offering any plan through the HIE. It is also here that insurance companies may offer multiple plans through the HIE but if they do, they must conform to the listed package levels In other words, all plans through the HIE must meet the basic plan requirements but there are optional levels of enhanced, premium, and premium-plus which require at least one plan in a lower package level (e.g. if a company offers a premium plan through the HIE, they must also have a basic and enhanced plan available). Only plans at the premium-plus level may offer benefits beyond the required standards. Plans not offered through the HIE may offer benefits beyond the basic requirements (§121).

Required Services (§122)
Defines which services must be offered by every insurance plan: hospitalisation, emergency services, outpatient services, all healthcare professional services (assumingly, this is so that the insurance company cannot deny payment to a professional along the chain, such as an anesthesiologist), equipment and supplies necessary for a health professional to deliver care (again, probably so that a company cannot deny payment for the bottle of iodine used during that surgery), prescription drugs, rehab services, mental health and substance abuse services, recommended preventive services (e.g. vaccination), maternity care, baby and child care (including dental, vision, and hearing) for children under 21. Companies may offer deductibles, but these are limited annually to $5000 for an individual and $10,000 for a family. That limit can change annually (increments of $100). For plans offered through the HIE that are not premium-plus levels, companies may utilise copayments but not coinsurance (i.e. an individual may still have the $20 copay for office visits but not the 10% payment for surgery). Plan prices should be designed to split healthcare costs at 70/30 (i.e. an individual should pay no more than 30% out-of-pocket).

While I am not going through the section on bureaucratic establishments in its entirety (§205-§208), I did want to mention a few pieces of information here. Children born in the US who are not covered by an acceptable plan get up to 60 days on Medicaid automatically. Additionally, any individual who is eligible for Medicaid and is not enrolled in another plan will be automatically added to Medicaid. Adds a trust fund in the US Treasury for the operation of the HIE. This will be funded by individuals not enrolled in a qualified plan and employers not providing a qualified health plan through taxes. If a state wishes to run its own HIE, it is free to do so, however its offered plans cannot cost more than the federal plans.

The Public Option (§221-§226)
The government will offer a public health option offered solely through the HIE. Its premiums will be geographically-adjusted and comply with the rules form above (§113). This public option will be funded by its own premiums; it makes no mention here of any increase in taxes. As of now, I believe, then, that this public option will be functionally like an independent company and not a government agency. The government is giving the public option a $2B loan, which is to be payed back to the Treasury within 10 years. Initially, payment rates will be similar to those currently under Medicare and extrapolated from there for things not covered by Medicare. As an incentive, these payments will pay an additional 5% for the first 3 years. Current Medicare providers will be considered ‘in-network’ to the new system unless they opt-out. The in-network physicians and other participating providers (e.g. chiropractors) must agree to the payment rates the new system sets. Physicians may choose to participate out-of-network, but they must charge within a certain ratio of the in-network price. Healthcare providers who choose to not participate may do so.

Employer-offered plans (§311-§314)
Employers have three requirements to meet.

  1. They must offer each employee coverage under a qualified plan (see above on §201-§203 and §122) or under a grandfathered plan (which will be phased out at the end of 5 years).
  2. They must contribute to the full-time employee’s plan as already required (which is 72.5% of the premium for the lowest cost plan offered for an individual or 65% for family coverage). They should also contribute to any part-time employee’s plan proportionately (e.g. as a proportion of the average weekly hours the part-time employee works to minimum full-time weekly hours). Also, these contributions must not correspond to a reduction of employee’s compensation (i.e. it can’t come from the employee). Unless an employee opts out of coverage, s/he is automatically enrolled in the plan with the lowest premium.
  3. After the second year of the HIE, if an employee declines an employer-offered plan and takes coverage through an HIE plan (other than as part of a spouse’s or parent’s family plan), the employer must make a contribution (equal to 8% of the employee’s average pay) to the HIE trust fund. Small Businesses that have annual payrolls under $400k will pay a smaller percentage.

Rates for Low-Income Families (§241-§246)
Individuals who are enrolled in a plan through the HIE that has a family income below 400% of the Federal poverty level for his/her family size and is not eligible for Medicaid will be eligible for a reduced rate on the basic (bottom-level) plan offered through the HIE. This reduced rate does not apply to full-time employees whose employers offer coverage under a group plan that meets the above specifications specifications unless (after the first year of the HIE) the premium exceeds 11% of family income (Adjusted Gross Income as reported to the IRS). The reduced rate will be determined as a percentage of the family’s expected annual income (see the table in §243(d).1. For reference, the FPL for a single person in the Lower 48 for 2009 is $10,830. For an example here, let us assume an individual earns $30k a year (AGI). This would mean that the premium for that individual would be between $175 and $225 per month.

Extra Revenue (§441-§442)
Individual taxpayers who earn more than $350k (AGI) must pay an additional surcharge tax (1% for AGI between $350k and $500k, 1.5% up to $1M, and 5.4% for over $1M). This tax will increase for tax year 2013 (to 2%, 3%, 5.4% respectively). If this tax generates more than $150B, the increase for TY2013 will not apply; if more than $175B, the surcharge for AGI below $1M will be removed. This income will be determined by the OMB by 1 Dec 2012.

Thus ends the first section of HR 3200. The remaining two sections to be analysed deal with restructuring Medicare/Medicaid and development of public health and workforce.

In Defence of Daniel Hannan And His “Unpatriotic” Comments on Universal Healthcare

Written by Colin. Published on August 18, 2009 ago in Current Events. 3 Comments

Britain is currently up in arms over the comments of a conservative MEP (Member of the European Parliament) who went on American television and gave his opinion about the NHS.

The reaction has been incredible. Among other things, he has been called:

What did Daniel Hannan say that was so outrageous?

The most striking thing about it is that you are very often just sent to the back of the queue. You turn up with a complain, an ailment, and you are told”ok, how about October of next year” or whatever it is.

We’ve lived through this mistake for 60 years now… the reality is it hasn’t worked. ….The government for a long time would always say “well, we can just make this work a little bit more if we spend more.” So the current government has almost increased by about 80% the spending on healthcare. No amount of extra spending is going to rescue it.

Yup. Hannan simply stated what I have discovered in Britain and what economists have also said – that socialised medicine is fundamentally inferior to that which is available if government is not involved.

The hospitals in my area (South West of England) are easily a step below those that I encountered in the US (in Oregon). Compared to my experience with the NHS, my healthcare in the US was cheaper and I had more freedom to chose where I went, who I saw, and what kind of insurance coverage I could get.

But more important than my own experience, is the reality of economic law.

The more control a government has, or the more it intervenes in the market (via mandates, regulations, taxes and subsidies), the less calculation can happen – and resources are squandered and wasted, and reckless shortages and surpluses begin to pile up. This is not a matter of empirical observation – it is fundamental to the way that the universe works. It will and does happen.

The question is not – is the NHS better than the US (or vica versa)? But rather, is the NHS the best way that healthcare resources can be produced and distributed? Unquestionably – the answer is “no.”

Hannan has the guts to call out the NHS for what it is – a waste of money and an unsustainable way to care for the health of British people. Everyone loses – British people get a poor care (again, than they otherwise would under a more free system) and they spend more money and waste more resources on healthcare.

The criticism against Hannan has been almost entirely ad hominem and diversionary. The substance of what he’s saying has not been addressed at all by the British media and politicians. They are simply spitting and stammering – how dare he say such a thing!

The US health system has a lot of problems, and I am not interested in defending it. And for many, the NHS has provided a good experience of care. But the fundamental economic problems remain – for every successful special interest that has been served by the NHS (and if you have benefited, you are a special interest – benefiting by the exploitation of someone else) there is a forgotten man who has paid for it – some stranger whom you have demanded the government steal from to give to you.

This is not the way a just and moral society operates.

Rather than being dismissed with name-calling, demagoguery and political posturing, Hannan’s comments should be considered weighted in the reality of economic law and experience.

Links: Healthcare, Homosexual Conversion, and Microsoft

Written by Colin. Published on August 14, 2009 ago in Current Events. 26 Comments

As a quick aside, this website has some interest in the current US healthcare debate. Myself, as well as Chris R. are both Americans who live in the UK, and have developed some thoughts on healthcare and how it should be provided. We’re looking forward to writing about these thoughts (which I expect will be different from one another) in the coming weeks.

In the meantime… LINKS!

The American Psychological Association (APA) recently released a report opposing conversation therapy for homosexuals. The report states that “efforts to produce [a change in sexual orientation] could be harmful, inducing depression and suicidal tendencies.”

Julia Duin at the Washington Times informs us that the APA task force was stacked with gay rights activists, and that nobody with dissenting opinions was permitted on the team. The task force started with the assumption that homosexuality is a normal form of human sexuality.

Perinatal hospice offers an alternative to the trauma of aborting a disabled child

Microsoft in hot water again. This time, it’s in the US for infringing upon someone else’s patent. As a result, Microsoft is banned from selling and importing Word 2007.

An American expat’s thoughts on the NHS

Daniel Hannan (Conservative MP) has ticked off a ton of Brits for criticising the NHS.

How to Talk Libertarianism with the (European) Left

Written by Colin. Published on August 12, 2009 ago in Essays, Philosophy and Politics. 8 Comments

I have been in Europe a year now and one of the greatest benefits of being out of the US is that I tend to have complete control over how much American politics comes into my life. I feel like I can breathe. Americans (and I am one) are opinionated – and they tend to get riled up over some of the silliest political points. The media in the US is in your face – cable news will beat a story to death, every hour of every day. American journalists continue, year after year after year to say dumb things like this – calling lower state budget increases: “budget cuts.”

Anyway, having a year out of this has been great. Really great. But I have been in political conversations over in England. And they are generally rather relaxing – people listen to each other. They aren’t trying to figure out whether you are a conservative or a liberal – and this determines whether they will ignore you or agree with you (in both instance, without listening to you, of course).

In talking with Europeans, I have found that I am able to communicate my points by listening to what they are concerned about first, and then offering a solution that actually takes into account their view of the problem. If we agree about the problem, then were working together, rather than talking past each other.

Capitalists need acknowledge that this mess isn’t our fault. In fact, we should be more upset than the left right now because not only is this a statist problem, but we’re getting the blame for it! Let people on the left know that you are not happy with greed, corruption and the secret deals going on in the present system.

I have gotten favourable responses from people when I have then added that these problems are not going to go away by giving more power to the state. After all – it has been with the help of the state (and the power and authority the state represents) that these measures have been taken. By increasing regulation (and hence, creating more power to abuse) we are merely setting ourselves up for future exploitation.

The European left gets this. They see the corruption of power a lot more easily than Americans do (many Americans live in a bubble, where the costs of their government’s policies are externalised onto the rest of the world in foreign wars, debt and other interventions).

What the European left lacks is the libertarian and capitalist framework to explain it. For the past century, they have primarily had Marxist framework to express their dissatisfaction with the state. But if this is worked through, then it is clear that many of the objections of the European left are actually libertarian in origin. There is strong support for civil liberties here, principles of innocence before guilt and even private property. But these concepts have to be discussed in “European language” and often with leftist framework.

Rather than saying that I am for “free-trade,” I left people know that I support the free movement of people and goods and cultural exchange. These are goals that the EU is supposed to support, and people have generally seen the benefits of an economically integrated Europe. I talk about the correlation between trade and peace, and how trade can cause people who otherwise hate each other to act cooperatively.

Rather than saying I am for “deregulation” or “privatisation” (words which have come to mean cronyism and exploitation) I explain that I am for regulation – but not regulation that creates increased power in the hands of government (and the corporations that are closely allied with it).  The kind of regulation I support is from consumers, customers and local communities – even the voluntary actions of unions and other groups using legitimate means to accomplish change. These are decentralised ways to check the greed and avarice in human nature without creating bigger problems of government largesse.

I have also has a lot of success talking about our equality as individuals. That as people, we should acknowledge the same rights in others that we see in ourselves. Europeans like equality as a concept, but often they haven’t thought about the inequality of attempting to legislate equality. It is far more constructive to talk about the natural equality of people as an inherent value – rather than as a value we can only obtain from an external authority: e.g. the state making us equal.

Again, it comes down to listening, and learning. This is the most important thing. Preaching talking points at people belittles them and is insulting. But offering real libertarian strategies for people’s actual problems can go a long way.

Links: It Appears US Healthcare Already is Governent-Run

Written by Colin. Published on August 7, 2009 ago in General. 5 Comments

Chart Source

Artists should be paid for their work – Nancy Sinatra

Gay ain’t a diseas declares the APA…and trying to ‘cure’ it can be very harmful

Private healthcare has already won

Closet socialists in the reform

My Latest Experience with Universal Healthcare

Written by Colin. Published on August 5, 2009 ago in Politics. 32 Comments

In case you didn’t know, or don’t normally read this site, I live in England where I am working on my PhD.

Last week I injured my middle finger on my left hand. I presumed it was just a “jammed” finger – these things heal within a day or so and life moves on. However, my finger continued to swell and bruise all over, and soon became rather painful. I chose to take an adventure and see the doctor.

First of all, I want people to understand that Universal Healthcare is not free. We have one income right now, and our family pays roughly $222 per month for the National Health Service (when I am also employed, this cost will rise to about $873 per month for both of us). I also want you to realise that this is our our of pocket expense in taxes and does not include any additional fees, co-payments or bribes. This is currently MORE than we paid in the US for private cover (but less than what was paid in total for us – employer paid some of the premium).

The Good
Anyway, the clinic near my university is extremely nice. The paint is new, the doors are made of glass and there is an automated system for letting them know you have arrived.  The reception area is lit by those hip, soft, little round lights. It’s like walking into a nice business office. This is because the facility basically just gives out contraception and deals with the young and healthy – but its financial distribution from taxes is huge. The clinic is in a nice neighbourhood and it has a large amount of patients and the funding that comes with that (nearly every student registers with this clinic). For those in the US, imagine what a public school would look like if it got funding for 2,000 students, but only needed resources to teach 300 – and to those it only taught reading (no sports, no math, no PE, no expensive chemistry ingredients). That school could paint the walls with diamond dust.

Anyway, the nurse I see has no idea what is wrong with my finger. She is not trained to handle this sort of thing. So she pulls a favour with one of the doctors who (fortunately) didn’t have anything to do at the moment. He looks at my finger and concludes that its fractured, and gives me a pink piece of paper which will get me an x-ray at one of two hospitals in a city of just under one million people.

It takes me about an hour to find parking. The hospital has NO parking. If you want to park for free, you must scour the neighbourhoods a half-mile away and farther and then walk (hope you aren;t at the hospital for your legs or feet). If you want to pay (and the hospital DOES NOT validate), you may pay roughly $5 per hour and park on the street (again, still difficult to find).

The Bad
The hospital is one of the grossest working buildings I have every been in. There is no air-conditioning. The walls and floor are dirty. There is used gum stuck to various things. There are two types of signs on the wall that look like they are out of the 1960′s (probably were) 1) informing people of the fact that they will be waiting 2) telling them not to be rude, hostile, aggressive or violent. The lighting is dim, and several lights flicker or are not working.

I give my pink slip of paper to the reception in radiology and I am told to go to “waiting area 3.” I ask the receptionist how long I might be waiting – “not long” I am told.

The room I enter is even more disgusting. There is a thick layer of dust and dirt on the floor. The bright green (again 1960′s) chairs are torn. The cieling panels are broken and some have yellow stains on them. There is a broken table across from me with riped and torn magazines on it, and a big piece of chewed gum stuck on the front. The windows are so smeared that it is difficult to see out of them, and many have the insulation torn and hanging down in dried, cracked strips. Ants are crawling on the floor near my feet.

After waiting in this room with another person, I am called in an hour later for an x-ray. This doctor believs that I may have an “old injury” in my finger and also a torn ligament. He says that I’ll need to wait to see another doctor, this time in urgent care, who can tell me more. He gives me a piece of paper and tells me to give it to the receptionist there.

I have to leave to move my car so I don’t get a parking ticket (one thing the government seems to do well here). This takes about 45 minutes.

The Ugly
I go to urgent care. Again, the conditions are such that it takes me a moment to remember that I am in a hospital in one of the world’s richest countries. The walls are scratched and gouged. Large red signs warn against violence and aggression. There are police in the room. The reception is blocked by thick glass windows to prevent violence against the hospital workers. The chairs look a little newer (1986ish, I would say), but some are broken. The floor is dirty.

The receptionist takes my piece of paper and begins asking me a series of questions required by the government (meanwhile I am liberally soaking my hands in sanitiser) – some are normal: where I live, when I was born, etc… But some are a little more invasive: what do I do, what is my religion, what is my race, where was I born, etc… I then wait for another hour or so.

I am admitted to see another doctor. He tells me that I actually have a serious problem with my finger – that it is broken and also out of joint. He says that I need to see a specialist right away, because it is “unstable” and could be more severely damaged with just the slightest movement. He goes and tries to call a specialist but gets no answer. He gives up and then writes on a piece of paper “needs hand appointment ASAP” and tells me to give it back to the receptionist.

I go back into the main room and give the receptionist the doctor’s note. She passively takes it and sets it aside. She then dryly tells me that it will be at least a month before I can see a specialist. The government will make an appointment for me and call me with orders about where and when to go.

I leave the hospital at 3:30pm after starting my visits at 9:30am that morning. I have no concrete diagnosis, no appointment, nothing has been done, my broken (maybe?) finger is not taped, casted or otherwise treated, and I have no idea when the government will next be able to see me. I may be without treatment for up to a month – hopefully my finger does not incur more problems while I wait for the government to start caring for my heath.

By the time I see a doctor, another $222 will have been taken from our income so that I can have this wonderful “free” healthcare.