Who Needs a Sputnik Moment? AT. SOTU address writers and speaker may sell hope and change, but reality indicates otherwise.
On the inevitable road of pre-tipping your doctors, nurses, and other health care personnel to facilitate service, when government runs health care. Discreet cash lubricates delivery of care.
People in the United States are not used to baksheesh, but if our health care system is in the future run by bureaucrats, the country will soon get the hang of it. It might not start out as the blatant kind of bribes found in the former Soviet bloc, but bribery is sure to soon become the rule in one way or another. In France, for instance, the government bureaucracy recently introduced a €1 franchise on every medical consultation, described as a contribution au remboursement de la dette sociale (contribution to the repayment of the social debt). That was followed by an €18 franchise on “costly” medical procedures. Now the French patients are learning that if they discretely slip an envelope with cash into the pocket of the doctor’s white lab coat hanging in his office, they’ll get more “attention.” And a little extra attention may be vital in a such a government-run health care system, where doctors are obliged by law to see sixty to seventy patients a day.
In 2008, the world’s leading general medical journal, The Lancet, reported that Russia’s current Semashko health care system was still being run by a huge government bureaucracy, that each doctor and nurse still had “his or her little tax,” and that “they all prefer cash in envelopes, of course.” Nurses took 50 rubles (U.S. $2) to empty a bedpan and 200 rubles ($8) to give an enema. Operations started at 300 rubles, but “the sky’s the limit” [3]. The Lancet also noted that “there is a large gap between Russia and other G8 countries in terms of health outcomes. Life expectancy at birth is 66 years for Russians; 16 years less than for people in Japan and 14 years less than the European Union average.”
A little something for your trouble.
“Can you count them?
Image courtesy of http://www.gifbin.com/981914.
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