Sunday, May 8, 2011

Day 18 - Jennifer

For my vocational visit, I went to a private hospital for a brief tour. Firstly, the concept of a two tiered healthcare system is something completely foreign to us as Canadians. With the recent election, there is always platform issues surrounding the privatization of healthcare. I have always been a strong advocate for the improvement of a universal system compared to the creation of private and public systems. Even with the elements of private care we Canadians have to provide either out of pocket or through private insurance (dental, vision care, pharmaceutical), we still have the right and access to quality medical care. This is something we should treasure and use appropriately for other countries are not as fortunate.

My tour guide was Dr. Teresinha Carvalho, who is my host mom Gina's mom. She is a pathologist at the hospital. Our first stop on the tour was the pathology area, where she showed me our tissue samples from patients are prepared and analyzed. Now I know what happens to my biopsy samples! We then visited some of the wards of the hospital, which focuses particularly on specialist services (ie heart surgery, cancer care, transplants).

Of interesting note, the emergency room had three stable patients. Three! And loads of staff. Apparently, this is not an uncommon occurrence in private healthcare. I still can't believe it! I tried to explain what Health Sciences Centre's (the largest hospital in Manitoba) ER department is like, but I don't think it translated.

I had a few minutes to chat with an American nurse who has been in Brazil for the last 40 years. She currently works in administration for the hospital. We had an interesting discussion on why private health care is necessary. According to her, health care dollars are given to the state from the federal level. What is done with them next varies greatly. A private hospital will receive 60 cents of every dollar from the government for each health care dollar they spend. As such, private insurance/money makes up for the difference. And of course, there is greed and money disappears before it ever makes it to patient care.

Additionally, out of state persons often receive care at a public/private hospital but the money allotted for their healthcare doesn't move with them. In Teresina, the river is all that separates the states of Piaui and Maranhao. Translation, people from the other side of the river contribute to the stress of the public system because the hospitals receive no healthcare dollars for treating them. This concept of 'Portability' is part of the Canada Health Act and allows us Canadians to receive medical care anywhere in the country.

I have worked in healthcare for the last ten years in many roles and facilities. It was surprising to draw so many comparisons and differences between the Canadian and Brazilian healthcare systems. It was apparent that the concept of universal healthcare didn't translate to the Brazilians or Americans I met, and I can understand why... it is as foreign as ice hockey and curling!


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