Adventures in Overseas Medical Care and the Downside of Universal Health Care

Recently, my father had a medical emergency in Korea where a hole formed in his esophagus, causing all sorts of pain and problems around his chest area, including fluid in his chest cavity.  This occured after he came back from a mission trip in China and had a checkup at a Korean hospital, where they gave him some medicine that he threw back up.  He is still there, but he is recovering well and hopefully will be home by the end of the month.

His stay at the Korean hospital, though, has not always been that smooth up to this point.  At the time, my sister and mother were with him, and my sister in particular had interesting stories to tell about what transpired in the Korean hospital.  Korea has universal healthcare and, reportedly at least, a good system for it, but there is no such thing as a free lunch:  Everything has its downsides.  This is actually a well-known hospital system too.  I shall relate the stories I can remember below.

Disclaimer:  I’m not trying to dog on Korea by itself, nor is this a comprehensive reason to reject universal healthcare.  It is just one story among many, and while people love using single anecdotes to create universal principles, that is definitely not what I’m doing.  It is just food for thought.

So, my father went into the emergency room with severe pain in his chest.  I will enumerate the stories starting from my mother’s 9-1-1 call (or 1-1-9 in Korea):

Sorry, wrong number:  When my mother called the emergency number, she told the operator the address, to which the operator promptly told her, “You called the wrong location.  Go find the number for the other one.”  My family was staying at a place right outside of Seoul, but when my mom called 1-1-9, the call went to Seoul rather than the exact location they were in.

Obviously, it is positively absurd to tell someone that used a well-known emergency number that they called the wrong number, and if it is the wrong location, it should be incumbent upon the operator to connect my mother to the right people rather than telling her to hang up, look up an exact number, and call.  You know, since it’s an emergency.  My mother screamed at the operator for this ridiculousness until the operator connected her to the “correct” folks.

I can’t find your address for delivery:  A while later, my mother received a call from the ambulance, asking for the address again.  My mother promptly yelled at them for the silliness of not receiving the address from the people she initially called, whom she gave it to.

I know that you say it’s your chest, but…:  When my dad arrived at the ER, he continually complained about pain in his chest.  Naturally, of course, the interns there ordered a CT scan of his stomach because they speculated he might have a ruptured intestine.  When my mother, a former nurse, questioned the logic of this, the intern asked her, “So, do you want your husband to die?  We need to do this.”  Obviously, they found nothing wrong with his stomach area with that scan, and after that, a doctor and that intern got an earful from my mother.  The doctor then turned to the intern and said, “You, come with me,” before going away to chew him out.

That technology only existed 30 years ago:  As someone who has gone through his own chest/lung problems, I know X-rays of your chest is a pretty basic thing to do to try to figure out what’s wrong.  However, the Korean doctors told my father at the ER, who was in pain and collapsed earlier that day, that if he could not physically go to the X-ray room and take an X-ray standing up, they couldn’t do one.  My mother, incredulous, pointed out that technology to take X-rays of patients in bed even existed when she was nursing 30 years ago, but the hospital claimed they had no such thing.  So my father, despite severe chest pains, received no X-rays in the ER.

No tube for you:  Perhaps related to this, despite my father showing symptoms of fluid being in his chest cavity (and confirmed by another CT scan), he did not receive a chest tube for over 12 hours after he was in the ER.  This was around the time I first got a call from my sister about my dad’s situation, and she told me they had been there for that long yet he had not gotten a chest tube.  When I got to the ER with a collapsed lung, I got a chest tube immediately after they confirmed my situation, which took like 30 minutes.

He’s a flight risk, your honor:  My father was flat refused admission into the hospital because they felt that, because my family lives in America, they might just flee the country without paying their bills in full (even though much of their care requires payment at the time of treatment anyway, like CT scans).  Remember, even though there is universal healthcare that doesn’t mean there is 100% coverage.  So my dad had to stay over a day in the ER until my uncle on my mother’s side came to give his information to satisfy the hospital’s suspicions.

Nursing is such a chillax job:  In Korea, apparently you have to have a family member or friend there with you at all times so that they can do such things as roll you to the X-ray or CT scan room, wash your clothes, change your sheets, etc.  You know… things that nurses are supposed to do.  Once, my sister asked for my dad’s clothes and sheets to be washed… and the nurse merely pointed her in the direction of the laundry room.  As hinted, my family had to roll my dad to his X-rays and other tests.

Why didn’t you do my job?!  Once, when my father came out of getting a CT scan, his catheter was messed up and leaking.  My sister noticed and pointed it out to the nurse, who looked at her and asked, “Why didn’t you fix that?”  My sister, furious, chewed out the nurse on how ridiculously stupid it is to ask her to do the nurse’s job, so the nurse sheepishly apologized.

Germs, shmerms:  The nurses in Korea do not wear gloves when they do they work (including checking and re-bandaging the chest tube sites).  They do not change plastic covers for ear tests.  Or at least, they did not at this hospital.  Lovely.

Sorry, we have a shortage of pillows:  Because my dad was in a lot of pain, he had difficulty sleeping so my sister asked a nurse for an extra pillow so that my dad could get more comfortable.  The nurse promptly answered, “No, patients only get one blanket and one pillow each,” and the left.  My mother and sister were peeved but just got extra pillows from unused beds.

One tube, three tubes, whatever:  My father ended up having as many as three chest tubes in him, but the doctor initially did not bother to explain to my family why he needed to do that because he was “busy,” which of course only got him yelled at.  To his credit, he later took my sister to his office and explained everything.

If you aren’t too busy…:  My mother got a call during my father’s surgery, and initially she was worried that something had gone wrong.  Instead, the call was from the admin office asking for their current address, which my mother had given the hospital multiple times.  My mother yelled at the lady that she was stressed and occupied and that it was silly that the hospital can’t get a handle on one address, so the lady said she’d look for it in their system.  You think?

Whoops, didn’t see that:  Despite taking X-rays everyday, the doctors did not realize that there was more fluid in my father’s chest cavity, which had become infected (which is why he had been having a fever).  It was five days straight of X-rays and they didn’t catch that until they actually opened him up, and by then it had become infected.  Um, oops.

Really, is that all you can do?  Right after my father came out of surgery, he was rolled back up to his rooms.  For some reason, in this hospital, rather than just using that same bed for his room, they needed to move him to another bed.  My father, not only weak from surgery but also because he had been unable to eat or drink anything for like two weeks, was in a lot of pain and kept saying so, yet one of the nurses looked at him and said, “Hey, can you move by yourself?”  My sister was utterly livid and viciously berated the nurse in English for being stupid enough to ask an older patient right out of surgery to move himself out of bed.  The other nurse, trying to defend her colleague, told my sister that she must have misunderstood, to which my sister repeated exactly what was said in Korean.  The nurse answered, “Oh…, um, well, we say that a lot to some patients here, so it just slipped out.”  Naturally, that excuse did not satisfy my sister.

No pain, no gain:  My father was in a lot of pain after his surgery, and he did not have the pain killer button I had (where you can push a button every eight minutes and have a small amount of pain medication enter into your system).  He was quite disappointed, asking, “Why don’t I get the button thing that Isak got?”  More interestingly, the hospital refused to give him normal pain meds like hydrocodon because they argued that he is “too old.”  I told my pharmacist girlfriend this, who promptly looked at me like that was the nuttiest thing she had ever heard.  He did have a ball of painkiller attached to him to numb the area he was opened up, but that doesn’t take care of all the pain, and he just had to live with it.

Move, get out the way:  This is a side story since this is not one of the hospital staff, but as my family had to be there for my dad, other people had family members at the hospital.  When my sister was rolling my dad in his wheelchair down the hallway, a woman was brushing her teeth and walking towards the opposite direction.  She literally stopped in front of a guy with a wheelchair and… waited, assuming my sister would move my dad out of the way for her (maybe due to Korean seniority over my sister?).  It didn’t work; my sister glared at her with eyes that said, “If you don’t move, I will remove your legs and concuss your head with them,” before the ahjumma relented and moved out of the way.

Your optimism disturbs me:  The doctor, when talking to my mother, my sister, and my uncle about my father’s situation, told them that the worst case scenario would be that my dad would need to have his entire esophagus removed and could face serious problems.  My sister cried and my mother was in shock.  My uncle, angry, asked the doctor why he had to be so negative and dish out the worst case scenario, and the doctor said that he felt that my mother and sister had “too much hope.”  My uncle was not pleased.

Unfortunately for that doctor, my uncle, a wealthy dude, has a friend who is one of the head honchos of this hospital branch.  He placed a call to his friend, who then called the hospital and personally requested that my family be treated well.  After that, the doctors became noticeably nicer.

Needles are fun:  When I got IV’s, they typically lasted a while and simply needed to be flushed with saline.  For whatever reason, they kept poking into my father and giving him new IV’s almost everyday, which of course just caused more pain.

Your lung is absolutely normal now:  One of the patients sharing my father’s room was a nice man who got treatment for a collapsed lung.  After treatment, there were no breathing exercises like I had to do.  None.  Good as new, automatically!

WiFi adventures:  In most American hospitals now, there is probably free WiFi.  While Korea has the reputation of being arguably the most wired country in the world, it’s actually pretty tough for non-Korean residents to get wireless access because the so-called universal wireless is only available if you have an internet account in Korea.  My sister tried to buy some time with it herself… and the website only took Korean credit cards.  So my sister and mother spent much of their time without wireless until they could get all that straightened out.

Television is bad!  To watch television, you have to pay like a dollar for every twenty minutes of viewing time.  No, I did not make that up.
Well… there you go.  To be fair, a couple of years ago my mother had to get surgery in Korea, and the hospital she went to (in Busan) wasn’t bad and her stay there was ok.  However, this experience made my sister tell my parents that they should just get all of their medical care done in America, even though it is tons more expensive, because it just isn’t worth the hassle they had to endure and the questionable care.

As for me, it made me understand that I should be thankful for the level of care I got.  Yes, the United States needs some basic healthcare reform, but not only was I treated well, I was forgiven much of the debt that I owed.  I still have had to pay a good sum of money, but the hospital was generous and it’s not such that I’m being pushed to starvation.  And I’m alive and well.  For now ;).

The lesson in all this?  There are no easy answers, and those that pretend that there are are either really ignorant or pompous (or both).  Korea has a nice system of universal healthcare, but doctors and nurses are underpaid there and some hospitals are understaffed, and the level of care there, at least when it comes to surgical patients, falls short of the standards that are indicative of the best hospitals here.  Cheaper?  Absolutely.  Better?  Not necessarily.  I’ve seen both sides of the equation, and I can appreciate how complex the issue is.  I think a country should strive to have its citizens covered for basic healthcare, but that money doesn’t come from thin air and there is a real risk of a dropoff in the quality of care.

Nonetheless, while I found many such stories to be absolutely ludicrous, I do not just put blame on the hospital staff.  I’m sure they are overworked, and I am thankful that they were still able to treat my dad, even if it was not in the smoothest way possible.  He is on his way to recovery, and that is something we can be thankful to God for.

By the way, Korea ain’t all bad.  Food is great :).

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