Lukas Berfus on health care challenges: My doctor looked at me and said it’s time

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When a man reaches a certain age, his doctor during the visit trustingly puts his hand on his forearm, looks into his eyes and says that it’s time, the moment has come.

And so I recently went to the so-called preventive medical examination, the details of which I want to spare the readership. It is enough to know that it was a deeply formative experience, a process that unfolded in me a feeling that I can only describe with reverence.

Unknown forces, first pharmacology, my body and soul set out on a twenty-four hour journey, which began the night before with a complete internal cleansing, ablution. After a night of restlessness that hit me—the churning guts and another, psychological fear of the results, of the final verdict, and of facing the fragility of my flesh—I left for training around noon.

There I had to undress completely. Half-naked, in one frivolous robe, I had to lie down on a stretcher. I was completely helpless. They then injected me with a substance that, like someone flipping a switch, knocked me out in an instant. When I woke up again thirty minutes later, got up and dressed, I was given a verdict in a bare room: the conclusions were normal, the white man told me, illness and death had been postponed for the time being. On the way home, still slightly dizzy, I felt more than relieved, I was filled with gratitude and humility.

patient healthcare

When I was at home again, still full of this magic, I read about the other side of this magic, about the system, about medicine, which itself, in general, was sick and could not hope for recovery. The reasons were numerous, a perfect storm, as the Federal Council made clear in its health policy strategy.

The winds that stirred the healthcare system were caused by rising healthcare costs, an increase in non-communicable diseases, outdated structures that relied primarily on emergency care, a shortage of nursing staff, a lack of transparency, social inequality, a lack of digitalization, which in Switzerland was just in its infancy.

There was also the so-called rebound effect: the better health care, the more effective prevention, the more effective campaigns against smoking and alcoholism, the older people became. And because the net benefits that a person enjoyed increased with each year of life, and because, as experts explained, we increasingly suffered from chronic diseases requiring intensive care at the end of life, the health care system created more and more problems. for yourself through your own success.

Since the dead no longer cause any expenses, but unfortunately no longer bring any bonuses, the situation has reached a dead end. No one saw a way out, the proposals were too expensive, too marginal, too ideologized, or all together.

This crisis contrasted sharply with my recent experience. I was impressed, even stunned by the accuracy and professionalism, and I found the debate and the term “health policy” in general completely out of place. During the medical examination, I did not feel like a subject of politics. I was the exact opposite of a mature, self-determined citizen.

In medicine you are a loser

By the grace of a power whose means remained a mystery to me, I could not judge what was appropriate, reasonable, or superfluous. I lacked relevant knowledge. I had to blindly trust the medical expertise, put myself in their hands. It required hope and trust, two completely non-political categories.

Moreover, unlike in a democratic system, roles in this medical system have never been interchangeable. Political power is only on loan, one day you must return it and become an ordinary citizen again. But at the same time, there is an opportunity for everyone to receive responsibility and power.

There is no such relationship in medicine. There is no substitute. I will always be weak, always subservient, subservient. It is true that everyone will someday become sick with some probability, but it is inconceivable that everyone will become doctors. And unlike other areas of society with a division of labor, when it comes to medicine, it is not education or transportation that is at stake, but life itself.

If the term “health policy” is inappropriate, how much more does it apply to the “health market”. Not surprisingly, the umbrella organization of the economy knew how to solve health problems: with the only hammer that lay in their toolbox. More market, i.e. more competition for productivity, more personal responsibility – and what else was missing from the holy trinity of adherents of the market? That’s right, the dismantling of the regulations.

But I didn’t feel like a customer for a second during the checkout. Only theoretically, in a very abstract sense, I was given a choice between different products or services. No one goes to this market completely voluntarily, that is, to a doctor or a nurse.

Two other important economic conditions also did not play the slightest role for me as a patient: neither service nor price. Only under great pressure would I agree to a treatment that cost half as much but caused twice as much pain or promised only half the cure.

When it comes to health, political and economic conditions come to an end. I did not come into this life of my own free will, and although one day I will die, I do not intend to leave this beautiful life of my own free will.

The health sector has its own language

Politics and business are looking for functioning processes, solutions, but life itself is not a problem and has no solution. Sooner or later, we all become infirm, weak, even sick, and no policy or market will save us from this.

When it comes to health, we need other terms. They all belong to the language of metaphysics, irrationality, religion and art, and perhaps the malaise and desperate attempts to find a way out of the aporias of our health are the result of the silence that has gripped a large part of our society.

I myself was lucky, I repeat, the examination brought the desired results. But one day the conclusions will be amazing, I will have to put up with it, I will have to say goodbye, as everyone does, sooner or later.

It would be good and important for a humane society if this experience, which does not fit either politically or economically, neither in statistics, nor in a table, nor in a cost-benefit analysis, played a role.

Source: Blick