There is an American joke that pokes fun at every private healthcare system in the world where a doctor says to his patient, “I will examine you for $20” to which the patient replies, “Go ahead, Doc. If you find it, you can have it”. I know the doctor’s sentence was meant to be a play on words but you know what? In a way the doctor actually was examining him for $20!

I often think that the healthcare field in every country is difficult to get ones head around.. Unless it’s a public health service, I believe that any advice you receive from a healthcare worker in a private facility anywhere in the world, is often neglected by the patient. Because there’s a payment for everything involved. Patients often avoid follow ups or buying the added medication, simply because there’s a cost involved, unless of course the patient has health insurance.

Being admitted into a private hospital is not like checking into a hotel, although the room might look like it and the bill at the end of the stay might actually give you a heart attack! It includes the cost of every nurse or doctor who walks into your room to do anything. It includes every blood pressure check, every aspirin administered and every IV.

 In fact, every time a hospital medic walks into your room, or does anything, make no mistake that it will be added to your bill. In fact, patients without health insurance who have no choice but to be admitted to a private facility spend half their time in the hospital wondering how much of a hole the bill is going to burn in their pocket. They start to doubt a doctor when he says take this IV or see my doctor ‘friend’ in another field. Do I really need this? Or is he also trying to make money for his friend’s department?

They spend every single day in there insisting they want to be discharged. They might need the medical attention but their mind is weighing up the cost of the stay against the treatment they need. And if they have no health insurance, it is likely that patients might forcibly discharge themselves because things are too expensive. Under such circumstances who would want to go into a private health facility?

Even being an outpatient often casts doubts in the minds of the patient and his family. Years ago I visited a GP for a routine sore throat. Most doctors would have said to drink lots of fluids and have some rest. This doctor, on the other hand, ordered a battery of tests; it was just a sore throat! So I began to wonder if the tests were in my interest or the doctor’s cash flow. I declined the swabs and several days later I was just fine!

I also think that some private healthcare officials have a very poor bedside manner and the aftercare service is often non-existent in that you can’t always do a follow up by phone. Unless the doctor has known you for decades, a private doctor is very reluctant to offer even the minutest piece of advice over the phone to a critical patient because every time there is no face to face consultation, there is no payment. There are some doctors who will oblige out of courtesy to the age and condition of the patient but there are a good many who have absolutely no manners whatsoever and will be quite blunt to the patient’s family, often right in front of the patient who is still very sick.

And being discharged from a private facility is as equally gut-wrenching as being admitted. It seems that patients are not allowed to leave their room until they have settled their bill. Sad.