By Susan Jane Gilman
With everyone getting hot-tempered over healthcare, I’d like to offer my fellow New Yorkers a drink. Let’s peruse a wine list and chill for a moment, shall we? Can I offer you a premier Cru Chablis? A 15-year-old Bordeaux? A bottle of Veuve Clicquot?
The wine list I’m using, by the way, comes from a “semi-private” hospital here in Switzerland.
In the debate over healthcare reform, everyone’s talking about Canada and England. But I’ve been living in Geneva for the past few years, and I say: Hey. Look over here. Switzerland actually has the system that’s closest to what Obama is proposing for America. And let me tell you: It doesn’t suck.
In Switzerland, everyone is required to have health insurance. This can be provided by employers (the cost deducted from your pay) or purchased privately. Frankly, it ain’t cheap. But for those who can’t afford it, a basic public health insurance is offered by the government at reduced rates. Everyone is covered, and there are no exclusions for pre-existing conditions. And, no, “big government” has not run private insurers out of business in this process, either. Turns out, there’s room for everyone.
The system is a hybrid between the single-payer, “socialized” medicine of Canada and the current for-profit dysfunction of our own. And its quality ranges from decent to ridiculously good.
Recently, I had a small, routine “procedure” done here in Geneva. In the U.S., this procedure is outpatient surgery, but in Switzerland, because it requires general anesthesia, you’re kept overnight. Doctors want to make sure you’re O.K. afterward and that infections don’t set in. Care and caution — not expediency — are the priorities.
The semi-private hospital I went to — a “clinique” — did require a retainer from our insurer beforehand. But the clinique dealt directly with the company: All I had to fill out when I was admitted was a single short form.
Then, I was led to a lovely, hotel-like room. First to see me? “La dieticienne,” who wanted to know what I wanted for dinner after the surgery. Did I have any allergies?
“Well, goat cheese,” I laughed. “But I guess that shouldn’t be a problem here.”
“Actually, it is,” she said, straight-faced. “Tonight, we’re offering a warm goat cheese salad with fresh rosemary. I’ll make sure you just get the salad.”
Then she handed me a menu.
I had a choice: seafood lasagna or boeuf bourguignon? Tarte tatin or berry cobbler?
“You’ve got to be kidding,” I said. “Ha. I suppose there’s a wine list, too?”
With a shrug, she pointed to the drawer in my nightstand. There, right between the TV remote and the bedpan, was, indeed, a wine list.
I told my husband that if I managed to survive the 20-minute procedure, he had to take pictures. Otherwise, who would believe this? I didn’t — and I was sitting right there.
Next, the anesthesiologist stopped by to confirm what we’d discussed during our uninterrupted, 45-minute consult the day before. Several nurses then checked on me before wheeling me to the O.R.
The procedure went without a hitch. Afterward, my doctor came by to see me. Twice.
Not only was I served a three-course dinner, but a three-course lunch before checkout the next day. Salad Caprese. Fish in beurre blanc with potatoes and homemade wild mushroom ravioli. I kid thee not: As I was preparing to leave, the nurse cried, “Madame, n’oubliez pas votre dessert!” then ran after me with a dish of blackberries macerated in red wine.
That was the only thing I received when I left — no further forms to complete, no bills to pay. Just dessert.
Granted, I know that comparing Switzerland with America can be somewhat specious. The entire population of Switzerland, after all, is smaller than that of New York City. Certainly, it’s easier to provide excellent healthcare to a limited number of people with a huge amount of resources — especially when these people are generally in fine shape to begin with, given their fresh, Alpine air, their high standard of living and their perverse addiction to things like hiking, biking and skiing.
Furthermore, unlike us Americans, the Swiss are, well, anal. Not only are they highly organized, but repressed. They have none of the rhetorical and emotional extremism of us Yankees. While they hate paying taxes as much as we do, they don’t loathe “government” simply on principle, either. They understand that, sometimes, you need publicly funded institutions to do stuff like repave your roads, set emissions standards, extinguish fires, educate your kids and, yes, take care of the sick.
Temperamentally and culturally, the Swiss are a lot less freewheeling and a lot more community-minded than we are. While this can make for some truly terrible rock ’n’ roll, it also makes for some remarkably shrewd and humane social policies.
O.K., you have to pay extra for the Côtes du Rhône in the hospitals. And our out-of-pocket expenses here are as high. And yes, the Swiss system has its abuses and shortcomings like any other. But at least in Switzerland, no one goes uninsured. Nor are they denied coverage because they once had a polyp. Nor do they fear that if they lose their job, they won’t be able to afford medications for their asthmatic child. Nor do they have to take out a second mortgage when their spouse has a stroke and they max out their lifetime deductible.
The Swiss have struck a balance between the private sector and public health. Surely, we Americans — with our own vast wealth and innovation — can do the same. Surely, we must.
I, for one, would drink to that.
Gilman is the author of several books. Her latest one, “Undress Me in the Temple of Heaven,” has just been published by Grand Central Publishing.
