Category Archives: International

Broken Healthcare

Broken Healthcare -From an American traveling abroad

I was having a fancy dinner with a new friend when I received the phone call no mother wants to hear. 

“Mom, I have to go to the hospital,” my son said. 

Just then the waiter began bringing out our food. I jumped up, threw down some cash on the table, and gathered my belongings. My son was doubled over in pain and had been vomiting nonstop for two hours.  Ordinarily, I would rush home and bring him to the hospital, but we weren’t home in New York. We were almost 5,000 miles away. 

I was helping my son settle in Spain

We had recently arrived in Spain, where my son planned to spend the year playing soccer. He’s only 16 and had never been away from home, so I rented an apartment for a few weeks to make sure he settled in before heading back to New York.

I arrived at his residence and one of his coaches drove us to the hospital. My friend from dinner, knowing I didn’t speak Spanish, kindly accompanied us. As I signed papers I didn’t understand, I fleetingly wondered how much this emergency visit would cost but was thankful he had health insurance through his soccer academy. 

The nurses triaged him quickly, taking his vitals and making sure he was stable. Then I assumed we were in for an hours-long wait, as we probably would’ve been in the US.   

It turned out to be nothing serious, but I was worried about the cost

When they examined my son an hour and a half later, the doctor explained that it was likely a bad stomach virus. I was relieved it wasn’t appendicitis. They did blood work and administered an IV filled with four types of medications.

Now that my son was improving, I began worrying about the cost. When the doctor said my son would need four prescriptions, I added that up in my head, too. I was told I’d have to pay out of pocket for the medications, and since we weren’t residents, it could be pricey. In the US, an emergency room visit could set us back a few thousand dollars and medications could run into the hundreds. I braced myself for the bad news. 

“How much?” I asked. 

“If you were a resident, it would be about 50 cents to 2 euros, but unfortunately, you’ll have to pay between 2 and 10 euros per medication. I’m sorry.” 

I nearly fell out of my chair laughing. This proves how needlessly expensive healthcare is in the United States. I talk about this in my recent book, “Knocked Down: A High-Risk Memoir,” where I highlight gaps in healthcare and how a lack of accountability can change a person’s life. Two to 10 euros for medicine seemed more than fair. 

Early the next morning, I headed out to fill the prescriptions. I was told to find the closest pharmacy, hand over the script, and they would give me the medication on the spot. This sounded too easy. Often I had to fight with my insurance company to cover medications, and then I’d have to wait precious hours to get the prescription filled. In Spain, the total cost was 12 euros and the whole process took less than five minutes.

The normal reaction to a story like this is but how much do citizens of Spain have to pay in taxes? Also, how about the overall quality of care? Ok, here are a few facts. The overall quality of care is comparable between the two countries. The overall tax burden in the USA (including all taxes: income, property, sales, etc. (on average) is 24.7%. In Spain, it is 34.7%. Using the average US family income of $71,000 this amounts to an extra $7,100 or about $2,200 per person for the average family of 3.2. So there, that explains it. Or does it? One more fact. The average per capita cost of healthcare in the US is just under $12,900 while it is just under $4,000. The difference is almost $9,000 per person in hidden tax. The issue we have is cost. Why is it so much higher here? I have answered that question in several prior postings.`

Who is paying for the outrageous cost in our country? It breaks down into about thirds with 1/3 paid for in the form of Medicare and Medicaid, 1/3 paid via company healthcare plans (which reduces funds for salaries), and another 1/3 paid out of pocket in the form of premiums, copays, and deductibles.

How is Brexit Going?

I have often wondered if Breit was a good idea. I found the following article interesting. Warning, it is quite long and several months old

Britain is slowly waking up to the truth: Brexit has left us poorer, adrift and alone

Now Boris Johnson’s gone, all but the most hardened of leavers have been forced to see through those rosy visions of life outside the EU

Last week, having whiled away two joyous days at the Tories’ conference in Birmingham, I spent a long afternoon an hour’s drive away, in the cathedral city of Worcester. The plan was to sample the mood of the kind of place once considered to hold the key to British elections: remember “Worcester woman”, the swing-voting stereotype talked up in the New Labour years? But I was also there to gather more evidence of how much the UK’s current woes are affecting the kind of average-to-affluent places that might once have weathered any economic storm.

Not entirely surprisingly, people said they were worried and scared. Some talked about grownup children suddenly terrified that a mortgage is beyond their reach; others described a new and unsettling habit of using sparing amounts of gas and electricity. The autumn’s increasingly awful mood music – from talk of cancelled local Christmas markets to the possibility of three-hour power cuts – informed just about every conversation I had.

Mention of politics drew some very interesting responses indeed. “I just miss Boris,” said Julie, who works at the city-centre branch of Boots, and told me she had long since got used to conversations with her customers about the impossibility of their living costs. As she and a few other people saw it, Johnson had successfully managed the Covid vaccination programme, and brought some pizzazz and humour to the boring world of politics, which had now reverted to type. They also voiced something I have heard a few times lately: a belief that he had represented the last hope of Brexit somehow opening the way to a happier and more prosperous country, a dream that died when he left Downing Street.

Clearly, that is a very generous opinion of a man who told just as many self-serving lies about leaving the EU as he did about most other things. At the heart of some lingering fondness for him, perhaps, is a lot of people’s refusal to admit how much they were duped. But that view of life before and after Johnson highlights something that is now settling among all but the most hardened Brexit supporters: a quiet, slightly tortured realisation that all those optimistic visions of life outside the EU are not going to materialise, even if the crises triggered by Vladimir Putin eventually subside.

British people being British people, this is not yet a matter of any widespread anger. Though they probably ought to, no one is about to charge into the streets and demand any kind of Brexit reckoning. But if you want to understand the current political moment – and some of the reasons why the Conservatives have so suddenly and spectacularly imploded – here is a strangely overlooked part of the story.

Whoever people blame for our current predicament, one vivid fact is inescapable. The future that 17 million voters bought into six years ago has now collapsed into its precise opposite. In the summer of 2016, let us not forget, Johnson, Michael Gove and the former Labour MP Gisela Stuart jointly put their names to an article in the Sun which insisted that once Brexit happened, “the NHS will be stronger, class sizes smaller and taxes lower. We’ll have more money to spend on our priorities, wages will be higher and fuel bills will be lower.”

A year later, Jacob Rees-Mogg – who still seems to be trying to sniff out undiscovered “Brexit opportunities” – assured anyone who would listen that leaving the EU would open the way to much cheaper food, and therefore increase people’s disposable income. Brexit is not the only thing that has revealed the impossibility of those dreams, but that is not quite the point: making promises like that was both stupid and dangerous, and we are now starting to live with the consequences.

For Liz Truss and her government, post-Brexit politics is proving to be impossible. They want life outside the EU to mean Darwinian economics, public spending cuts and a smaller welfare state – which is not what millions of leave supporters thought they were voting for in the 2016 referendum, nor what the Tories offered in the two elections that followed. Meanwhile, trying to wriggle out of Brexit’s endless constraints in pursuit of growth threatens to tie the government in knots. Suella Braverman, a home secretary who embodies all of modern Conservatism’s nastiness and introversion, says she wants to cut net migration to “tens of thousands”. But Downing Street has been signalling that it wants to liberalise the UK’s immigration system, a move that would definitely send a certain kind of Brexit voter into paroxysms of fury. Everything is a mess because the logic of Truss and her allies’ position cannot hold: as the Brexit revolution that upturned Conservative politics and brought them to power unravels, the reason for their success is also a guarantee of their failure.

Given its longstanding refusal to question our exit from the EU, Keir Starmer’s Labour party faces some comparable contradictions, but seems to be tentatively trying to find a way through. One of the most fascinating moments of the past two weeks of political theatre happened during Starmer’s conference speech in Liverpool, when Starmer actually mentioned the B word, and tentatively talked about what Brexit’s calamities mean for people’s view of politics. Many who voted for Brexit, he said, did so because they wanted “democratic control over their lives … opportunities for the next generation, communities they felt proud of, public services they could rely on”. This was a slightly rose-tinted reading of recent history, but it just about rang true. He added: “Whether you voted leave or remain, you’ve been let down.” His claim that he will somehow make Brexit work still sounds deeply questionable, but this is a start: an acknowledgment, at least, of the lies and cynicism that got us here.

Whether mounting disappointment and resentment will simply mean a neat switch from the Tories to Labour is another matter. The untruths Tony Blair told about the Iraq war eventually played their part in the huge crisis of public trust that led on to Brexit, and the endless political flux that followed it. Now, 2016’s deceits are being revealed in an even more toxic political environment, awash with conspiracy theory and polarisation. Anyone who assumes that a mood of cynicism, fear and dashed hopes will put politics the correct way up ought to maybe think about recent events in Italy, Sweden and France – and, closer to home, that instant nostalgia for the reckless, authoritarian style of leadership that Johnson combined with his more showbiz aspects. Once Truss is out of the way, the ultimate Brexit paradox may yet materialise: a horrific boost for the very kind of politics its failure ought to have killed stone dead.

  • John Harris is a Guardian columnist. To listen to his podcast Politics Weekly UK, search “Politics Weekly UK” on Apple, Spotify, Acast or wherever you get your podcasts. New episodes every Thursday

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The Ollantaytambo temple is an impressive architectural ensemble. It is located at 2,792 meters altitude and is 3,500 years old. It is believed that its construction was oriented towards the city of Cusco, as its architects sought to defend themselves against the Incas. They also chose this area because of the underground water channels they discovered at great depth. The Ollantaytambo builders designed an aqueduct system, which is still fully operational today. Each fountain was carved out of rock with its own characteristics and designs. The best known and considered the most beautiful is the ñusta fountain, made of a single stone and decorated in the form of a portal.

According to researchers, this complex has its origins in the Aymara culture.

In the fortress, we can find six huge rectangular stone blocks that belong to the Templo del Sol (Temple of the Sun). They are located in one of the highest areas of the place and it seems to be a construction that has been left unfinished. The largest monolith is over four meters high and two meters wide. The construction has a plaza in which a large block with perfect edges is located, and which, at the same time, is oriented towards the cardinal points. The streets are divided into straight lines through which the water flows through channels.

One of the most surprising details of Ollantaytambo is that the rocks found in the complex are perfectly polished, have impeccable cuts, and are intact, which means that the builders were able to lift the stones and transport them without suffering any damage. This is quite a feat because the fortress is built on a very steep slope. Without a doubt, Ollantaytambo is one of the great wonders of Inca architecture that to this day generates doubts and questions, many of them still unanswered.