According to an article I read recently, writing about Obama increases the rate of viewers of a magazine or a web site by 50 percent. So we play along…

The Obama health act is difficult to analyze without knowing truly the conditions in US. For a finn, it sounds like a good idea to ensure that everyone has rights to proper medical care – if that has not been the case so far.

We witnessed an accident in NZ (nothing to do with Obama), in which a maori lady was dangerously burnt by boiling oil when the oil that she used for making donuts fell on her. Her family tried to give instant care by pouring water on her from garden hose but the pain she suffered was devastating. Not been able to help made me very sad and angry. Watching the family to bring kids inside away from patient and their efforts to support her mentally were heart breaking.

As we moved away I noticed two St. John’s Ambulances about 100 meters way from emergency scene and one nurse drinking coffee with her friend next to it. I asked weather they knew that their help is very much needed nearby and she said yes and recommended me to mind my own business.

Afterwards, in the bus I was thinking what happened and why. I believe that the maori family decided not to ask for professional help but eat the pain and save the money. That tells me that it is not so easy to assess the situation in other cultures and policies…

In Finland, the propable cost for person without insurances would have been few hundred dollars. Naturally, the tax payer would have payed 90 – 95 percent of the costs. I believe that in this kind of damage, the best possible plastic surgery would have been covered from the tax payers pockets. However, the decission for care would have been left to doctor to assess. In some cases, we have had problems when doctors start to confuse their role and acting as judge by starting to think if the patient really deserves the possible care.  

Other difference in favour of Finland is that the Ambulances are typically driven by firemen, so they are fast to arrive and generally the best possible men or women we can put to emergency site of any kind – but they do not make business.

I do not have first hand experience in healt care in NZ, but can assume that business wise the structure follows US model. At least, the ambulance was from the same company that treated Johanna in California after our sailing accident.

The ambulance and hospital costs in US we happen to know because they were charged from us via credit cards and we were able to get refund from our travel insurance.  The ambulance cost was 1500 dollars and the whole operation cost roughly 10 000 dollars.

We assume that the proper treatment of the maori lady would have caused atleast the same level of costs. In these circumstances, it becomes clear that decission making in emergency site can be very thrustrating. I think, it would serve everybody’s interest to ensure that everyone has insurance and ambulance personnels can work to offer best possible care based on medical knowledge instead of complex financial reasoning.    

In an effort to understand the US system a bit better we need to get back to our accident and see the other costs created. 

The US tax payer paid all the costs related to US Coast Guard and Ventura Fire Department when we had the accident on sea. One can imagine what does it costs to send an airplane and a helicopter to 400 NM trips to stormy seas and take care of us when sailed back to California. We were never able to compensate anyway the help both of these top professional organisations gave to us – crazy finns sailing far from our home land – and we do not know the real costs but can imagine the magnitude.

We contacted USCG for medical assistance to assess the severity of Johanna’s head damage and inform them about the situation. In other words, I was not able to make clear decission by myself what should be the best action in that situation but wanted to see if they would have a better solution that we had.

I discussed with USCG using satellite connection but naturally it was very difficult to them to say anything without seeing the patient. On the other hand, I told them that Johanna is not willing to leave the vessel without kids. I believe that they understood all the time, that getting kids to helicopter in those conditions would have been the last call.  

In the end, we can see that we were lucky and head injury was not critical – Johanna has a tough head. But if we would have been unlucky and Johanna would have lost her consciouness while at sea –  we would have been regretting if we would have not started the operation early enough. For us that it is still the most important thing when we think what to do in the future if some thing like this happens.    

If I think again the possible decission making scenarion in emergency in both of these cases,  I believe that we need to offer our health and emergency professionals working environment where they do not need to consider the costs but can work to offer best possible care for their patients – no matter if they have insurance or not. Otherwise, their job becomes so cruel that their mental strength will be in test. 

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