20 March, 2010

Healthcare in America as it is in Sri Lanka

starry-nightI was born in a country usually described by those subscribing to the dominant paradigm of development as being poor and developing. Year after year, beginning from first grade, in our classrooms both public and private (we have a national curriculum), we learned mathematics, reading and writing, but also world history. We studied world civilizations, cultures, economic foundations, imports, exports and religions. We learned of most things as facts, only questioning choices – within political systems, for instance – when we reached the senior classes. There was, however, one thing that it would never have occurred to a Sri Lankan student to ask: Do American have the same access to health care that we do here?

In order to ask such a question, Sri Lankans would have to be suffering the same deprivations that Americans suffer today. They would also have to take it as a given that health care is something that is not commonly provided to all but, rather, reserved for a few. In the absence of those realities, no Sri Lankan child could conceive of a society where people are routinely denied medical care, where children remain un-vaccinated, and where the elderly perish because they cannot afford to visit a doctor. They would have to imagine a milieu where parents must decide between food and medicines, between dead-end employment with health care v. fulfilling work without health insurance, and between taking care of a sick parent and going into debt, or setting those parents adrift and saving for their children’s future. Indeed, they would have to conjure up a way of living that was routinely, relentlessly, psychotically preoccupied with the dread scepter of sickness rather than the much more joyful activity of the conduct of life.

Sri Lankans cannot do that. While I have joined this American life where all of the above have become my reality, every single one of my countrymen in Sri Lanka continues to enjoy first-class medical treatment in hospitals which provide it to them entirely free. Should a Sri Lankan not wish to avail themselves of free medical care, they have the option to visit a multitude of private hospitals. The same caliber of physicians serves at both. After a free education, Sri Lankan doctors are required to serve in public hospitals. They are also free to engage in private practice so long as that fundamental requirement – giving back to the country what it has given to you – is met. The decision of a patient to go to one or the other depends upon the patient’s idiosyncrasies; I have wealthy friends who have preferred to give birth in a shared dorm in a public hospital rather than in a private room at a fee-charging medical facility, my father vacillates between one or the other.

Yes, it is not perfect. Last time I checked, they do not have the capacity in Sri Lanka to separate twins sharing hearts or lungs. They do not have the Childrens’ Hospital of Philadelphia (CHOP), they do not have Memorial Sloan-Kettering. What they do have are the kinds of services, including advanced care services, which are pertinent and ought to be accessible to 99.9% of human beings. And what they do have is a society where should a particularly specialized form of medical care unavailable in the country be required by one of its members, citizens will routinely donate the funds necessary to send that patient overseas. It’s a lot cheaper to chip in the equivalent of about $5 to help a fellow-citizen about once a year than to live as we live (and die), now, here in America.

We are here today on the brink of a vote on making health care substantially more compassionate than it is currently is in America. It is a day that dawns with one of the last independent hold-outs from the left, Dennis Kucinich, deciding to make possible what is possible rather than wait for what will forever be denied. It is a day that alters the fate of three close neighbors, all of whom are professionals with doctorates and halves of two-income families in one of the wealthiest suburbs in America, who are trying to make ends meet without health insurance. They aren’t poor people, they have jobs; nonetheless, they cannot afford health care in this country. What then of the millions of others struggling with neither wealth nor employment? Which reminds me of a few words spoken on January 20th, 2009, in Washington DC by a new President:

“For as much as government can do and must do, it is ultimately the faith and determination of the American people upon which this nation relies. It is the kindness to take in a stranger when the levees break; the selflessness of workers who would rather cut their hours than see a friend lose their job which sees us through our darkest hours.”

This will, hopefully, be the end of that darkest hour for Americans. It is an hour that has lasted for more than five decades. Surely it is time for the leaders of this country to recognize their obligation to their fellow citizens. Surely one of the wealthiest nations in the world can finally do for its people what one of its poorest has done throughout its history.

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8 Responses to “Healthcare in America as it is in Sri Lanka”

  1. john matthew says:

    HI RU,

    well expressed. I am linking to the article through a blog post.


  2. Let the debate begin!

  3. sat mar 20 2010 obama quoted the great abraham lincoln as

    “I am not bound to win, but I’m bound to be true, I’m not bound to succeed, but I’m bound to live up to what light I have.”

    he said this in a special congress session for the house members who JUST VOTED to pass the hostoric health care bill of rights!!!

    ru, u should be thilled just as many millions all over US and world about this landmark bill just passed.

    im malindas friend from college. how did your meeting go in american center few months ago? malinda asked me to blast some emails reg that. hope it went well.

    nish (eznish@gmail.com)
    los angeles

  4. Sara Stowell says:

    Thanks Ru, for the enlightening reminder that the ruling paradigms taught in the American classrooms are often far from reality, insulting, and worse, deeply damaging to Americans themselves who in their desire to believe themselves the best in everything choose not to change anything.

  5. Ru says:

    Friends – Here was my status update on FB last night: “Charles Rice-Gonzalez + Emily Raboteau on the A train leaving 125th street when we got the news that the healthcare bill PASSED (Thank you for letting me know Claire Conway, neighbor extraodinnaire). So where were all of YOU when you heard that BO made history?” If there is a silver lining to the vote, then it is that the Republicans (and 31 Dems), aligned themselves fairly and squarely against the people of this country. And I found the President’s sagacity and lack of self-congratulation or preening refreshing. This is huge, but there is work to be done. Let us do it.

  6. People like to say “One day…” when talking about things getting where they need to be. I’m afraid to hope too much but maybe, just maybe, we have a president who gets that and wants to see that day too. Common sense is so refreshing. How this country says “We hold these truths to be self evident, that all men are created equal” but not everybody gets health care unless there’s ample money to back that up has baffled me my entire life. Money has to stop being America’s prime motivator.

    If it’s OK with you I’d like to place a link to your excellent piece on my blog.

  7. I normally roam all over the internet because I have the tendancy to read a lot (which isn’t always a good thing because the majority of blogs just copy from each other) but I want to say that yours contains some great substance! Thanks for stopping the trend of just being another copycat site! ;-)

  8. Very true. The difference arises from the Asian cultural identity with the four societal shields which are non-negotiable and to be provided to all for free. 1) Food and security from physical harm 2) Medicine 3) education 4) truth. The first was provided by kings, the second by doctors, the third by teachers and the fourth by the clergy. They have gratis, put themselves in the firing line, made their work a calling and were revered for it by the people. We still revere those who provide us with those things but these days, very few deserve it :)

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