"Doctor He See You Now, Mon"

(Thanks to my sister Jan for sharing this story with me. I merely repeat it.)

Not long ago, my nephew Chris and his girlfriend Megan returned to the states after 6 months or so living and working on the Caribbean island of Guadeloupe, a French protectorate. They both speak French and were there to help teach English to the locals. To do this, Chris had taken a leave of absence from his job, and Megan quit hers. The government of Guadeloupe paid them (a little) and they found a place to stay (which for a time was a cute little house literally on the beach). What a deal! Getting paid to live in a tropical paradise, drink rum, and teach your native language. How come I never stumbled into a sweet gig like that?

Guadeloupe has friendly people, beautiful countryside, gorgeous beaches, and is very "picturesque". An old college professor once taught me that when the travel brochures refer to a place as picturesque, what they mean is poor. And many things in Guadeloupe are, uh, basic -- like spotty electricity, phone service, medical facilities, etc.

I bring this up because near the end of their time there, Megan found herself at one of those medical facilities for an emergency appendectomy! Just what everybody wants -- a picturesque Caribbean operation! The procedure was a success and she's fine, but I'm told the "hospital" was an open-air place, a big tent with gurneys and scalpels. Jesus! ("No problem, mon!")

What's also interesting is that because she was in a French territory with that God-awful, single-payer, Socialized Frog universal health care, her bill was $0. ("Dat doctor, he got de powerful mojo, mon!") Timing is everything. Had Megan's appendicitis occurred after her return to the good old USA, it would have caught her unemployed and uninsured. My sister guesses it would have been a $10,000 procedure here, with billing 100% to Megan. Coulda been a real sucky welcome-home gift!

It's a good example of polar opposites in the world of health care:

In French Guadeloupe, the government pays the witch doctor, and the government pays the hospital tent. These payments are relatively modest compared to American fees, but are the accepted norm. The service is provided, and the patient pays nothing.

In America, the government is not involved (unless you're old or poor). Profit-driven doctors and hospitals provide great service at the highest prices in the world. For most people, most of those costs are covered by some sort of health insurance, but there can still be substantial out-of-pocket costs to the individual. To keep pace with our ever-increasing medical costs, health insurance premiums keep going up, up, up as well. It's a real quid pro quo arrangement. If you're unlucky enough to be uninsured at your moment of medical need, well, those good doctors and hospitals will fix you up and then send you a bill that's even higher than the bill they'd submit for insurance reimbursement. That's right, the uninsured are the only ones asked to pay no-discount sticker price. And many of 'em take one look at that unholy invoice and head straight to bankruptcy court.

Which system is simpler and more sensible? Paraphrasing W.C. Fields, "All things considered, I'd rather be in French Guadeloupe."