An Observation On Socialized Medicine

Prior to leaving for our family visit in Lithuania earlier this month, we learned that my 92 year old grandmother-in-law, Antanina, had been hospitalized in Kaunas. She’s a hardy individual – a 1950s Soviet gulag survivor who still lives independently and has all of her mental faculties about her – but any hospitalization at that age is of concern. At first we were told it was simple dehydration, but then we learned that some pneumonia was involved as well. Thus, as soon as we landed in Vilnius, we made arrangements to drive the 1.3 hours to the hospital to visit and find out more for ourselves.

There are several campuses of the medical center in Kaunas, and Antanina was at one of the older ones. The visit to this Soviet-era hospital is a story in itself: no central climate control (or even electric fans that I could see), no private rooms, no electronic medical records, and only one tiny elevator – meaning that most staff and visitors used the un-air-conditioned staircases. Did I mention that the geriatric unit of this particular building is on the 5th floor?

Kaunas Hospital, early 1950s

Kaunas Hospital, early 1950s

Anyway, we reached Antanina’s room, and the first thing that surprised me was that she didn’t have an IV running or evidence of one having been d/c’d recently. She looked good and sat up in bed talking and later walking down the hall under her own steam. But she wasn’t able to give us much medical information, so we hunted down the ward’s doctor to learn more.

This doctor – from Ukraine – was very interested in learning the ‘American perspective’ on the current civil war in her home country (we had to tread lightly on this topic, since it wasn’t immediately apparent on which side of the divide she fell). Once we had (successfully) navigated and dispensed with the politics, we inquired of Antanina’s condition. The doctor said that she had been receiving IV fluids and antibiotics last week, but was now doing “very well” and not needing IVs any longer. There were, however, some abnormalities in her blood.

“What abnormalities,” we asked?

It seems that Antanina was mildly anemic and also had a modest dip in her serum calcium level (not unexpected in a woman in her 90s). In the U.S., neither of these findings on their own would necessitate hospitalization. An elderly person in this condition could be easily be given oral Rx and followed on an outpatient basis with an office or home health visit scheduled.

The doctor added that Antanina might need to stay in the hospital for as much as another week before discharge.

Another week?! In the U.S., 3d party payors often kick you out of your hospital room when the bandages are still bloody.

Rumor has it that medical house staff can be, er, persuaded to keep patients in the hospital a bit longer than might otherwise occur; whether the Ukrainian doctor had been thusly encouraged by others in our family before our arrival I do not know.

My GMIL seemed happy enough with her surroundings and the attention she was getting, so we visited a bit longer and then bid her farewell. I am thankful to the staff of the hospital for taking good care of her and keeping her stable and safe. But as we drove back to Vilnius, I couldn’t help but wonder if there might exist – somewhere – a happy medium of resource allocation between full-blown capitalism and the accountants who rush you out the door, and socialized medicine and what seems like overly protracted inpatient stays that aren’t entirely indicated?

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