Friday, May 17, 2013

Some Non WoW ramble - Tangential thoughts about what is free

I wrote this at work, whilst I was playing with drugs and knobs and monitors...
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As our government hands down a new budget, and I was sitting at work having being called in for a sick patient for an urgent operation, I was thinking about what we are willing to pay for.  As my thoughts tend to do, they turned to World of Warcraft, and I thought about what I was willing to spend my gold on.

There are certain things that I just don't buy.  One of those is herbs.  I don't have a herbie but I have access to one (yes yes, I know, it's a good reason to make an max level alt, so I can herb) but the thought that I could go out and farm what I needed rather than spend my precious gold (I don't have a lot but it sits at a steady amount) on something I can go and get myself made me feel better.  More thrifty.  Kind of like mowing my own grass instead of paying someone to do my lawn.  Except that there are no exciting yellow dots to home in on and pick when I'm mowing the lawn.

The same goes for fish.  I would not pay any amount of gold for fish.  I can go get that myself.

However, I don't mind forking out the gold for cut gems - at a reasonable price.  I guess because I don't have a miner, nor a jewelcrafter, so gems always seem so elusive to me.  JCs out there must be happy they and make money out of people like me.  I don't know why I just don't wait till my friends are online to cut stuff for me, but I just want to see those socket bonuses lit up and my stats boosted.  Impatient, I suppose.

The beeps of my monitors and the sounds of needle holders and forceps clicking and clinking brought me back to reality, and I thought about how lucky we are in Australia that we have (essentially) free health care. Or at least, the illusion of free health care.  The cost of it is hidden in our taxes, of course, but really, I think people should be glad that they live here and are able to get emergency health care for free.

However, one of the costs of free health care, is that you have the training specialists responsible for your care, who are overseen by specialists.  Some patients don't like that, and demand that they should have the specialist come and take care of them.  Perhaps this is churlish of me, but if someone is getting something for free, beggars can't be choosers.

The opportunity to teach and learn, is part of my duties.  Care of my patient is not compromised if I am teaching or allowing my trainees to do the anaesthetics in my stead.  Naturally I am responsible overall for anything that occurs under my watch, but it's not like I unleash an untrained, unskilled anaesthetist onto an unsuspecting patient.  Just like I wouldn't bring someone who had never healed before to replace me in raid, I wouldn't let someone do something who wasn't capable unless I was assured of their abilities.  If I wasn't, then I would stand around here and watch them to make sure they did it right.  And if it was something too hard for them, I would do it myself.

I wish people would understand that is what the free health care system means, and accept it.  Because really, nothing is for free, and you always have to give a little something back.  And it's a small enough thing to ask, to let others learn so you can have a free operation or hospital stay.

However, I will tell you what I find funny.  Maybe it's because of the way our health care system works, but patients won't pay to fix their health.  No sirree.  However, they are happy to fork over $75 for nails or $150 for their hair, but if you ask them to pay that extra for my services, some will kick up a fuss.  Which is why, I'm happy to let my trainees do the work, if they will benefit from the experience.

I have heard rumours that the government is thinking of removing tonsillectomy from the Medicare Benefits schedule. What does that mean, I hear you ask?

Well, one of the ways the government measures performance and efficiency is to see if hospitals are reducing their "waitlist".  The waiting list is the length of time that patients wait for their "free" operations.  Naturally everyone wants to have their operations as soon as possible. The government decided to make some sort of incentive - or rather disincentive - for hospitals to meet their waitlist targets.  If you meet your targets, you get to keep your funding.  If you don't, the you pay a fine back to the government, which will cripple your hospital even more when it comes to operating time and equipment.

When you work in a socially disadvantaged area, where there is a lot of people on the public waitlist, then the waiting times are high, and pressure to get through a waitlist of 1000 is high.  If you work in a well off area, and most people have private health insurance, and don't go onto the public waiting list, then your waitlist is low.  So you can see it's a double whammy there.  Hospitals in poor areas do even more poorly and those in the affluent areas look like they're performing more efficiently.

So, tonsillectomy is one of those operations that are high on the waiting list and some people suggest that it's not even an operation that needs to be done.  In my opinion, that's ridiculous.  We do tonsillectomy for obstructive sleep apnoea, recurrent tonsillitis (more than 4 episodes a year) and it's amazing how children can change after a tonsillectomy to eating better, learning better because they can actually sleep at night and pay attention during the day.

So why would the government think it's not a necessary operation?  If they decide that it is not neccessary, then they don't have to pay for it.  If they don't pay for it under the medicare (free health care) then suddenly, the waiting list for tonsillectomy is gone - making the numbers for waiting list look better.
  
Now going back to WoW.  I've been thinking - if I spend 90 hours a month playing WoW, and that's $15 a month, is that more value for money, than spending 30 hours a month playing WoW?  I mean, that's 17c an hour versus 50c an hour.  Or would you think that's time you could have spent somewhere else? I could be out and about, watching movies, going out for drinks, coffees and dinners.  But gosh, that would put a dent in my wallet.  WoW is such a nice easy cheap pasttime!

LOL, the gases are making me cuckoo!  It's time to wake my patient up - and stop deluding myself that this game I'm playing is saving me money, and thinking that the more hours I rack up in the month in WoW, the closer I am to the game being free.




6 comments:

  1. Now there's a first line that could be easily misinterpreted. :p

    I'd agree that having trainees perform routine procedures is fine (and important in having a new set of specialists in the long term). However, in fairness to the patient, when it comes to operations involving needles, scalpels, scissors and other fun objects the idea that 'everyone has to learn sometime' is easier to appreciate in the abstract than on the operating table. ;-)

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    1. It's true, and it sounds scary, but really, nothing will happen because the specialist is there too to help if needed. I never let anything dangerous happen to my patients and if I think my trainee is shit, I just will make them watch me do it.

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  2. WoW can be a way to save money in that you don't go out and spend even more. Until in your case you include those collector's editions ;-) Then I think the movies might come out ahead!

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    1. Ahem, well yes... that's ahhh... a good point Cain /sheepish

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  3. We have med students do things here too: bad memory if one who wasn't really adept at ob stuff....cough....

    Great post Navi!!

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    1. Oh no! Med students doing things is worse than trainees doing it!

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I hope these comments work! Not sure why people can't comment lately, it makes me sad :(