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Guest Column
Planning to Study in the United States? (Part II)

Dr. Sanjaya Gajurel

Hira ThapaCitizens of developed countries generally have good access to medical services, but this is not fully true about the USA. High-priced insurance here has made many Americans opt out medical insurances. Once one of my friends, who was a student at that time, had a wrist fracture on her right hand. She was in OPT (Optional Practical Training) and had no job to pay for the insurance. Desperately, she had to hold on to an unethical way to visit the emergency providing incorrect social security information to evade the exorbitant medical bills. The uninsured are recommended to another practice or an emergency room visit by appointment receptionists. So, everybody basically knows how to fiddle with the emergency law, EMTALA (Emergency Medical Treatment and Active Labor Act).

As an uninsured, you may, passing through some hurdle and feeling humiliated, be able to set up an appointment, but you will be faced with the medical bills and accrued medical debt throughout your life. According to Commonwealth Fund Biennial Health Insurance Survey, one of five of all adults under 65 is currently paying off debt from medical bills incurred in the past”. Forget about the uninsured people with chronic health conditions like diabetes and Asthma. The survey found that such people are more likely to skip medications for their conditions and go to an emergency room.

It is hard to digest that just for the hairline wrist fracture my friend accrued the fat bill of more than $3000.00. So, the United States’ medical system is bound to be abused because of uptick in medical expenses and is suffering from uncompensated care. Most of the uncompensated care from the Federal government goes towards hospitals in the form of Disproportionate Share Hospital (DSH) payments.

America has already been grappling with issues in the medical sector as the capitalists get greedier, trying to make money out of the basic human right, the medical service. The insurance in the United States is costly because of the medical costs. If you have a headache, doctors carry out slipshod assessment and put the patients through lavish tests. Any patient with headache is prescribed for pricey CT (Computed Tomography) Scan or MRI (Magnetic Resonance Imaging). Definitely, CT Scan and MRI provide more information to doctors that could have been overlooked and patients might have gone through complications as a result. The probability of the misdiagnosis could have been greatly reduced with proper assessment in the first place. Doctors are made culprit by the system. If the doctors take risk, not recommending patients CT Scan or MRI, they could be sued for their misdiagnosis. So, the doctors themselves pay exorbitant amount for medical malpractice insurance, the premium of which varies depending on the risks involved; physician pay less than surgeon. Even one malpractice can mangle their life. So, they do not want to be in a trouble and enjoin the CT Scan or MRI. Most of the doctors are handcuffed by the system to exercise their humanitarian succor despite their selfless and service oriented character.

In other countries, most of the prescriptions are contingent on the proper assessment of the symptoms in patients. There will be follow ups to assess the progress. All the medical costs - cost for expensive equipments and malpractice insurance add up to fat medical bills, and the medical insurances who cover these expenses in turn, are ridiculously expensive in US. The study released by the 34-nation Organization for Economic Co-operation and Development (OECD) in 2011 said Americans spend more than $7,900.00 per person for health care each year - far more than any other OECD countries - but still Americans die earlier than their peers in the industrialized world. Nevertheless, the results can not cover up the fact that the United States, having huge investments on the cutting-edge medical technologies, is in the forefront in medical sector, and it provides the best medical services in the world. One can not deny the fact that there might be someone among us who are willing to take risk about not going through all the expensive tests but get reasonable medical services. The rest of them who can afford and do not want to compromise when it comes to health, should be able to get the services of their choice. So, the United States should focus on providing healthcare to its citizens and residents in practice not in “had it all” speech.

The business in medicine can also be undergirded by the partiality in medical care privilege between the blacks and the whites. According to WHO/2012, 2 million Americans or 1 in 12 African Americans carry the sickle cell allele and there are incidence cystic fibrosis cases of 1 in every 3500 births. So, cases of sickle cells in the United states outnumber the cases of Cystic Fibrosis but look at the gap in federally sponsored research fundings and mobilization of private sectors.

(Gajurel, a Ph.D. in computer engineering from Case Western Reserve University, USA, works as Computational Scientist at the same university. Email: [email protected])

(Editor’s Note: Nepalis, wherever they live, as well as friends of Nepal around the globe are requested to contribute their views/opinions/recollections etc. on issues concerning present day Nepal to the Guest Column of Nepalnews. Length of the article should not be more than 1,000 words and may be edited for the purpose of clarity and space. Relevant photos as well as photo of the author may also be sent along with the article. Please send your write-ups to [email protected])

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