Europe’s health care crisis

August 22nd, 2006
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“Auntie M” was born in Vienna in 1911, the 63rd year of the reign of Kaiser Franz Joseph I. Widowed in WWII, she landed as a refugee in Germany in 1945 when all the (3.5 million) Austrians were expelled from Czechoslovakia. A robust woman of her generation, Auntie M was physically active well into her retirement, bicycling every day and tending a large garden.

Then one morning in 1985 she was getting out of bed and twisted her knee. Pain shot through the joint and she had a hard time getting around without considerable discomfort. Visiting her doctor didn’t help much. He clearly looked at the 75 year old and thought “How mobile does she have to be?” Perhaps the prognosis for improvement with arthroscopy was relatively low. In any case, he prescribed rest, not the knife.

But the joint got no better. The low-level pain became more ubiquitous, her mobility decreased; no more cycling, no more gardening. Doctors two and three – over a span of years – gave hand-wringing excuses as to why nothing could really be done. Here one sees at work the type of cold medical calculation that happens everyday – “Why should we invest any money into this person’s last years (months?) of life. They can get by”.

Well, fast-forward 19 (!) years. Auntie M is still a bright-eyed, sharp 93 year old, reading the paper every day, doing the crossword puzzles. But she’s not very mobile. One day in the paper she reads that a Catholic-run hospital in Bavaria did a knee-replacement on a 93 year old man. She mobilizes her daughter to get her to the place to be evaluated. Long story short, she has the operation, convalesces very well and is now (at 95) running around like a, well, like an eighty year old.

Recent conversations with central Europeans suggest their health care systems are about to crack at the seams. Too much demand for too many expensive services – not enough money to pay for it. This has become a litmus test of the reform-potential of the Merkel government in Germany.

Sound familiar? Auntie M’s experience was very similar to that of MrK’sUncle Jack” right here in Canada. We previously wrote that some European health care systems, like Switzerland’s, might offer a model for reforming Canada’s straining coverage. Unfortunately, it looks like many European countries are suffering the same demographic and cost pressures we are. And they don’t have the bogeyman of American health care casting a pall on reform options. They have to find their own way, and so should we.

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