National Health Service

I have avoided sticking my hand into this hornets nest for the longest time. But as the topic of a national health plan is being hotly debated back in the States, it is as good a time as any to put my two cents worth in. Let me state, right from the start, that I do not have a definitive answer to the U.S. healthcare question that decidedly needs one. I do have direct experience in different national health services, self-insured companies, private health plans and public clinics.

Important to remember is that a National Health Service is the ultimate in managed care. Think: the mother of all HMOs. An NHS cannot be all things to all people. It tries to do the best it can with what it has to work with, both in resource and population. Which is why no two Services are alike despite the fact that they are all in the health care business.
For example:
In Australia, hospitalization is free (except for Workers Comp claims which are covered by employers private insurance.) This is nice for me at 3a.m. suffering from a kidney stone. Ultimately, it is better for OZ as hospitalization is cheaper than lifelong acute maintenance of
an untreated population. Doctors appointments are entirely different: you pay the doctor up front ($55) and then apply to Medicare for a predetermined refund ($31), you pay for the special diagnostic work ($390) at time of service and get rebated afterwards ($205)-every time, there is not a deductible amount before a higher benefit is reached. Private insurance is strongly recommended by the government with disincentives for delaying its purchase. Medicare does not cover glasses, teeth, feet or alternative medicine like chiropractic. And doctors say with some pride that they are not Canada.
Canada, free hospitalization and free doctor visits at all NHS facilities. Woo hoo, sounds great. But there are trade-offs here. The waits for appointments and diagnostics can be a whole lot longer than Americans are accustomed to, doctors have salary caps (which sends many of the high-specialty docs south of the border for big bucks) and there is rationing of services based on resources and demographics (100 hip replacements per year in Winnipeg, I believe. Mr. 101 has a long painful wait for the new year.)
In Korea, I was fairly fortunate. The polluted air gave me chronic bronchitis. The doctor I went to gave me three days worth of medicine-as a courtesy to a foreigner-whereas natives also on the national plan had to come in daily. A mild hemoturic condition of mine was a problem for the government immigration office (but not for me personally) which could have been a pain dealing with the not-quite-Western-sterile hospital. My assigned urologist happened to be a student of mine and the "problem" was dispatched in a flash.
Of course, we have all heard of the famously comprehensive national health scheme enjoyed by Cubans (who enjoy precious little else) and the infamous dirty sheets & one needle for the entire ward care given in Russian hospitals.

So why do I mention all of this? Am I anti-national health insurance? No. Although I think putting the entire U.S. on a NHS unfeasible and undesirable. Have I languished for hours in public clinics/hospitals waiting for whatever service I can get? Yes. Have I had incredibly good health insurance coverage at low cost with small payments and zero deductables? Yes and didn't appreciate it as much as I should have.

My point is that my fellow Americans should really give a great deal of thought as to what kind of healthcare they feel is imperative, what can be dropped to a lower tier of importance, how much inconvenience they are willing to incur and, as medical care is not cheap regardless of who pays for it, what they are willing to pay for it. My fellow citizens might also stop awarding & applauding high court settlements for minor medical mishaps--malpractice insurance is driving those healthcare costs to the moon. Do your research and then get to a town hall meeting near you with real, constructive input.

Canning Vale Market

Stymied by the lack of U-Pick produce farms and far-off farmers markets, I headed out this morning to an airplane hangar.

Well, it looks like it anyway. The Canning Vale Market. Monday through Friday it caters exclusively to the wholesale trade. On Saturday morning, the gates of the agricultural version of Willy Wonka's chocolate factory open to the public. No more glamorous looking on the inside than out, I am a kid in a candy store with the offerings made available to me.

The cavernous shed is divided into huge wire cages. Inside each a wholesaler sets up pallets loaded with boxes and plastic tubs of their offerings. If it is in a box, that is the quantity you are buying (yes, I will be able to do something with a bushel of rutabagas), in plastic tubs or humongous cardboard cartons are individual items or bags to choose. I imagine that at opening-5:30 a.m.--everything is quite orderly, neatly set-up and the prices (written on the ground near the pallet in white chalk) are easy to read.

Of course, at that hour, the selection is best. At around 8 a.m.-two hours before close- a slight whiff of dealer desperation is in the air. Prices come down, product movement between containers entirely more fluid and hysteria builds within the shopping ranks. The clientele here is very mixed ethnically and I suspect that some wholesale transactions do take place. Or is that tiny Vietnamese family really going to eat three bushels of red bell peppers and 50 pounds of carrots this week? I wonder if the young Italian guys shout out prices of their goods during the wholesale week.

Hop over to the next hangar for the meat and fish. Another zoo. The numerous fish here are not artistically displayed in beds of ice. Fish are tossed onto shallow metal carts, labelled with a whiteboard and lined up against the walls and center island. Looking beyond the retail area towards the loading dock is a man working a band saw. Wearing rain boots, heavy oilcloth apron and dragonhide gloves, he is running shark through the blade effortlessly. Scoop out a few innards and staffers run the new offering to the now empty metal cart. Once the House has been served, the fish monger takes care of customers who are lined up outside the loading dock waiting for their turn to have their purchased salmon, ocean trout or frozen mackerel quickly sliced for them.

The meat store is less chaotic. Everything is prepackaged in fairly large quantities. I do like the whole lamb and goat carcasses hanging by the door. Must be some luau to have one of those on a spit. The whole goat was unusual, as the butcher told me that African immigrants like their goat already cut into chunks. No slaughtering done here, those houses are in Gingin, just meat processing.

So what will I do with my red peppers? I will make/can some pepper relish and make some roast red pepper soup and eat some just the way they are.

Television

After (entirely too) much research, it is high time I reported on Australian television. A perfectly legitimate reason for someone in the biz to delay talking about it exists, as you will soon see.






The Players: ABC (noncommercial gov't supported), SBS (Special Broadcast Service-lots of foreign language news & movies, any bicycle race), and the three networks; 7,9 and 10. This is the same throughout the entire country as the population is way too small and spread out way to far to do any different. "Local" (as in the closest of the 6 major cities) news is the only thing that separates them. In fact, until several months ago, Channel 9 network was owned by a single family by the name of Packer.

When I lived in South Korea, only one U.S. television show was available: Beverly Hills 90210-in English with subtitles and dubbed into Korean. I couldn't bear to watch either. Fortunately, there are a lot more choices here in OZ. Channel 7 airs quite a few NBC programs, Channel 9 is buddies with ABC. Shows usually found on cable in the U.S. are intersticed everywhere as are programs which air after prime time. "Two & a Half Men"-a program I couldn't stand at home- is regular 7pm viewing now. "The Simpsons"- another not watched program- keeps Channel 10 alive along with various "Law & Orders". Of course, the Australian version of many shows [e.g. Australian Idol, Australia's Got Talent, Australia's Funniest Home videos] keep the channels within the domestic content regulations. Some of my favorite shows: "Gruen Transfer" (OZ program about advertising), "Spicks & Specks" (OZ program with musical quizzes), BBC's "Antiques Roadshow" (despite the 'experts' appalling handling of artefacts, I love the history the show provides), "Desperate Housewives" and "NCIS".

Beyond explanation is the timing of the programs. All programs will start at 6:00pm as scheduled. The second program will start at 6:32 or 6:34. Programs scheduled to start at 9:30pm may start at 9:33pm or 9:37pm. If, in a rare attempt to be accurate, the TV guide will say an ABC program will start at 9:40pm, you can count on it being closer to 9:46. I (nor Kev) has any idea why this is so. The networks do reset their programming to the clock a few times a day, but regularity ends with the first program. Cracks me up.

Oh, and in case you were wondering, soap operas are soap operas the world over as are really obnoxious commercials.

Culture of Alcohol

Much is said about the laid back, no worries, "larrikin" lifestyle of Australia. Many find the permanent vacation mindset the ideal way to live, others wonder when the collective body will finally grow up. In the fulcrum of this particular clash of viewpoint is the culture of alcohol here in Australia.


Aussies love their alcohol. Beer is a perennial favorite, hard booze is appreciated and those lucky enough to live near spectacular wine regions have an endless choice of quality 'drop'. Quality is not an issue, quantity frequently is. According to the Australian Medical Association and the Preventative Health organization (a government initiative), people over age 60 are likely to have a drink daily (to your health!) but drinking is starting earlier and harder. In the 20-29 year old category; 25% are binging monthly (seven drinks at one occasion), 1 in 6 down 29 standard drinks per week. The AMA used to state that two drinks per week for a pregnant women was within safe limits for the fetus. But the problem was to convince women that a standard drink was three ounces (3 ozs or ~90ml) of wine- a rather small pour- and decided to state that it was "more beneficial" not to drink during pregnancy. The drinking patterns of people living in non populous areas like Northern Territory and of the aboriginal people are further causes for concern.

This drinking comes with a price: to the auto accident rates (w/injury or death) and to the national health service coffers treating alcohol related health issues. Remember our "larrikin" population? Doesn't take well to being told not to do something, especially drink, so one does not see "Don't Drink & Drive" or "Don't Drink during Pregnancy" signs everywhere. Smartly, the government takes a more subtle tack: reducing the blood-alcohol level to .05, promoting the "skipper" concept (designated driver) for people visiting wineries, calling the initiative "ReThink Drink" , increasing the consequences for repeat infractions including confiscation of automobiles-regardless of who actually owns the car- and trying to reduce the presence of alcohol company sponsorship/advertising in sports. This latter proactive position has gotten a lot of reaction. Cries of 'nanny state' and 'wowserism' rise from the ranks who feel penalties should be reserved for those who commit alcohol-related crimes against others and themselves. I suppose they keep that hue & cry up until someone they are close to is tragically affected by excessive drinking, at which point those free spirits will wonder why the government didn't do more to prevent this kind of thing happening.

Don't get me wrong, I enjoy a glass of wine with supper, a Tanqueray & tonic on a hot summer day or a glass of champagne anytime. But I don't see the benefit in drinking so heavily that an AFM is necessary on a regular basis. AFM-alcohol free month-it's what you do when your liver is just about to go on strike. It makes your weekends reeeaalllllyyy long, your friends pining for the day when you will be "back" and body parts shudder from toxic relief. At the very end of the month, the idea forms that perhaps your life does revolve around al.....and then the first round arrives. Why not just drink less and you'll have no physical reason to stop? Not subtle enough of a question.

Weekend mornings

Funny thing about weekends in OZ; their dynamic patterns seems reversed from North America. Back home Sunday mornings are for church or sleeping in, followed by a leisurely perusal of the biggest newspaper of the week, with a chance of a fine Sunday roast thrown in. Saturdays are for scurrying around to garage & produce sales, athletic participation-formal or casual, picnics, entertainment and general merrymaking.

Rather opposite here in Perth. There are more garage sales and plenty of farmers' markets on Sunday than Saturday, people make their way out of their homes first thing and there is Sunday shopping starting early in the downtown area. On my way home from church this morning, I took the few blocks worth of detour to visit the kangaroo on Heirisson Island. The foreshore was a busy beehive: a 10K footrace was underway, jillions of independent joggers and enough cyclists in regulation wear to think that the Tour de France had changed location. Even the mob of 'roo was out in full force.
It's Saturday mornings where naught but birds bother to get excited about the day. The biggest newspaper of the week is the Saturday edition. Even the lawn bowls clubs don't bother to unlock their doors before noon, which is odd considering the high temperatures during the long summers.

I haven't figured out why this is. Perhaps it is the contrariness, er, I mean, independent spirit of the place that moves to a nonconforming beat.

A local tourist

Today, I played tourist.

Look, after 15 months one starts developing a routine, digging ruts into the same path trod on a daily basis, seeing the same things over and over again. I needed to break free and the diversion needed to be cheap...impecunious person that I am. So I picked a random Transperth bus line and hopped on, waiting to see where local public transportation would take me.

Line 34 is hardly a line. This was one of those routes that has inspired more than a few rollercoaster designs. This bus had more turns than a woodworker's lathe and to call some of these roads 'tertiary' is being quite generous. Sweeping up all the strays standing by the familiar logo. But look what I got to see: Canning-it is more than a street of big box businesses. Bentley- it has a library! Penrhos College- say, I've read about them. Como- hold it, that purple building looks familiar, the art nouveau theater and shoreline must be close by. South Perth- more than a shoreline of the Swan, look at all those cute shops and waaaaay too expensive homes. The Perth Zoo- a bus does go here. The Old Mill- an historic site, although I am missing the immediate thrill of this tiny structure by the bridge. The bridge- a view toward Heirisson Island and the Causeway home. A few more twists and turns and we are at the main Esplanade Bus Station. That was interesting!

Of course, you might say that I got on the wrong bus, had absolutely no idea where I was and just rode it to the end of its run. But it doesn't sound as adventurous.

6 RPH - 990 on the AM dial

"What's this about a radio show? Do you have a radio show?" Gee whiz, if I'm getting this from my mother, that pretty much means no one else knows, either. So let me tell you what keeps my brain working and me out of arrestable trouble.

I volunteered for years in Columbus (and for one summer in Claremont, California ages ago) at the Radio Reading Service for the Blind. These services, found all over the world, make print publications accessible to the blind & print handicapped by having them read on a dedicated radio channel. However funded, they rely heavily on volunteers to get the reading done. Occasionally, there are shows that are more than dry recitations of articles from the daily papers, magazines like TV Guide, Time and Playboy (just the articles) which will have guests, call-ins from listeners or a rogue host incapable of walking the charter's straight & narrow. (nolo contendere)

By chance, I heard about the local service within a week of my arrival in OZ and signed up for training. I have to admit that I was rather dismayed to see how rigid the guidelines for readers were and to the apparent extremes volunteers took those. Well, it wasn't too many more months longer when I had my own show, "What's On Where"-- your radio guide to what is happening in and around Perth that is fun and affordable. At first, I would read event announcements from whatever freebie publications I could get my hands on. It sounded mechanical and geocentric to where I lived. Nuts. This show needed diversity in its offerings, a wider geographic outreach, a more efficient collection of material and a free rein at the mike.

Enter Cowgirl Hilary.

I insisted that WOW needed its own station-based email, printed up business cards (on their color printer) and then started spreading the word like manure. I wanted to grow a huge database of sources who would email/snail mail their events to me--rather than me chasing them down or spending countless hours on 582 websites every week. I started electronically managing the info sent as well. And loosened up the delivery on-air. Eventually, I further engaged the listener and venues by offering on-air promotions (read: freebie tickets given away in contests.) Because the concept is new for the show/station, not all tickets get picked up but that's OK because that way I get to go places myself.

Like most other radio reading services, this one is run on volunteer power-so, no I don't get paid for this. But, unlike Voicecorps in Columbus, which requires a special receiver (or is retransmitted in the hospitals or on cable TVs program channel audio) Information Radio is on the AM dial. Anyone and Everyone who has a radio can listen to my show. My on-air delivery is not perfect yet, but I am firmly in the saddle. Yeeee haaaa.