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GaramChai.com >> Book >> Section 6
Health and lifestyle
In India,
mundane medical care, doctor visits and medication is generally
affordable to many. However, in the US, a complex system of
public policy and privatization make access to healthcare
really expensive. Indians moving to the US need to understand
the nuances of healthcare and ensure that they are “protected”
by adequate insurance before they land here. After observing
and experiencing the western healthcare system, perhaps the
best in terms of technology and advancement, I still feel
that the Indian system – a mix of public and private services
-- is really affordable and customer friendly. The western
medical system has been glamorized by innumerable Indian movies,
and the Indian media, that hype up visits by our super-rich
elite class to medical centers in the US and UK. Shorn of
that glamour, the system here is really archaic and unaffordable
to most, unless they have a really strong (and expensive)
medical insurance policy.
After
having experienced an expensive web of medical and insurance
systems, Americans prefer to prevent the occurrence of common
ailments by following a regiment of exercising and fitness.
Even Indians moving to the US realizing the significance of
preventative measures, try to pursue physical activities.
An important
aspect of safety and healthcare people moving to the US need
to be aware of is with respect to access to universal emergency
services. In case of an emergency, people can dial “911” from
any phone – public or private – and get access to an emergency
care provider who will summon the police, ambulance or fire
service as required.
Health
Insurance
Most of
us have probably heard the popular adage...”A healthy mind
resides in a healthy body”. All of us work hard towards maintaining
a balance between a healthy physique and busy lifestyle. It
is of paramount importance to continue to maintain good health,
especially if one lives and works in a foreign country.
The western
lifestyle, although relatively free of pollutants, dust and
common infections, still has its share of diseases and health
related problems. Of course, there is the risk of accidents
to which we are all susceptible. Many of us who leave India
in our twenties and thirties, come abroad to live and work
do not think twice about these matters but we probably should.
We are blissfully unaware of the necessity or importance of
having access to assured medical care.
United
States has some of the most advanced medical research, diagnostic
and treatment facilities that can be found anywhere in the
world. People from around the world come here for research,
medical studies and treatment; even wealthy Indians have been
coming to the US for advanced treatment; However, all the
medical systems, treatment and access to it, come at a price
which is not normally affordable to all but the extremely
wealthy. Even the federal government that collects a percentage
of salaries and wages towards ‘medicare’ (retirement medical
care) has all but absolved itself of the responsibility of
medical care for its citizens and residents.
I do not
mean to imply there are no laws in place to force hospitals
and medical care providers to provide basic care to everyone
in the US. On the contrary, there are laws that ensure that
everyone, regardless of their ability to pay, is guaranteed
emergency care. The ubiquitous ‘911 system’ ensures that anyone
in the US who picks up a phone and dials 911 can call for
police, fire or medical help that will arrive within a few
minutes.
However,
for non-emergency medical care, one has to pay through their
nose. Even a simple doctor’s visit can run up a few hundred
dollars if not more. What then is the recourse available to
us, the ordinary working professionals who might meet with
an unforeseen accident, illness or medical condition that
might set us back by thousands of dollars? The answer is medical
insurance. The lack of primary medical care by the government
has helped the medical insurance industry become one of the
largest and fastest sectors in the US. There are more than
a dozen multinationals and hundreds of small insurance companies
that provide insurance ranging from individual plans to group
and corporate medical plans.
It would
be an understatement to say that medical insurance is almost
mandatory for everyone coming to the US. This applies even
to visitors who may be spending only a few months with their
relatives here. Employers lure employees with the bait of
good medical benefits. Case in point: During the dot.com revolution,
when employers were bending over their backs to entice prospective
candidates, a Silicon Valley firm was offering a ‘BMW Z3 roadster’
as a sign-on bonus. Employees were also given an option of
full medical/dental coverage for 10 years in lieu of the roadster.
Guess what most employees opted for? The insurance package
of course!
Why is
it that insurance is given such importance in the US society?
There are many reasons. Medical expenses are extremely high
and not subsidised by the government. Another reason is that
in a land of lawsuits, no one, not even doctors and medical
professionals are immune. In order to protect themselves from
frivolous lawsuits, doctors and medical professionals refrain
from diagnosing all but the most common afflictions and make
the patient undergo a slew of tests before any recommendation
can be made. This over-diagnosing costs money.
Not all
insurance packages provided by employers are the same. Some
employers provide complete coverage without any charge or
co-pay. Others expect the employee to chip in a fixed amount
every month towards the insurance. Even the coverage is highly
subjective and varies from (insurance) provider to provider.
Many insurance companies try to scuttle huge bills that people
run up, leaving them high and dry. Incidentally one of President
Bush’s biggest political victories in recent times was the
passage of “Patient’s Bill of Rights” that allows individuals
to sue their medical care providers. It is hoped that this
will bring much needed accountability into the system.
In the
US, expenses related to medical contingencies cannot be prevented
but adequate insurance can at least help offset the unforeseen.
Sporting:
An ounce of prevention
An ounce
of prevention is generally better than pound of cure. In a
country where medical insurance and treatment of illness can
be exorbitant, it is of paramount importance to lead a healthy
lifestyle, actively taking part in sporting activities and/or
exercising regularly.
The first
time I came abroad, in a span of less than four weeks, I managed
to gain about five kilos and it is not hard to see how. I
was gorging on veggie burgers with cheese, coke while enjoying
sumptuous Indian dinners with friends at local Indian restaurants.
A few weeks of this lifestyle and I realised that I had to
make a conscious effort to control my diet and imbibe another
facet of American life — taking to exercising regularly.
In India,
young professionals rarely think of flexing their muscles,
content that the humdrum of daily existence is sufficient
to sap one’s energies. Walking a few blocks to the bus-stop
or even auto/taxi stand, a few stairs up to the first or second
floor and other little bouts of ‘exercise’ adds up to burn
calories. However, in the US with very little incentive to
burn calories in the normal course, one is more motivated
to make exercising a part of one’s routine.
One does
not need to look far for avenues to exercise and stay healthy.
Of course, the multi million-dollar health industry makes
enough buzz in the form of advertisements and hoardings everywhere
that one is constantly reminded of the need to exercise. Those
inclined to take up sports and games, which they enjoyed in
their childhood and youth, also have ample opportunities open
to them in the form of local clubs, tournaments and what have
you. Most cities have a range of clubs to choose from — clubs
for judo, karate, hockey, soccer, tennis, racquetball, badminton
and other athletic activities. It may come as a surprise,
but a few large cities in the US have their own cricket leagues
too. A friend of mine who used to play for his university
back home didn’t think twice about driving 150 miles to a
nearby city every weekend to take part in their tournaments.
For those not inclined to playing games, gyms provide an outlet.
Many large apartment complexes invest in their own exclusive
gyms, so do some large companies. The YMCA a.k.a. ‘The Y’
is a popular chain of health and fitness with centers spread
in cities across the country. The Y that I frequent is a huge
complex, complete with its own indoor full-sized swimming
pool, basketball court, racquetball courts and mechanised
gyms. Of course, there are dozens of private and commercial
chains of health and fitness centers that one can join. In
the year 2000, 54.5 million Americans over the age of 6 (22
percent of the population), exercised at a health club.
Americans
tend to take exercising quite seriously, spending huge amounts
of time and money on personal trainers, fitness evaluation,
exercise paraphernalia and chalking out religious plans for
exercising. Most Indians on the other hand, tend to skip the
expense of personal trainers etc, content to follow a yo-yo
pattern - exercising regularly for a few weeks and then slacking
till they feel that they need to start again. Of course, there
are few amongst us who are quite sporty and go the full nine
yards.
Call
911 for help
Human
beings have always felt the need to communicate with others
and to seek help, especially when in distress. Through the
ages the process of communicating one’s distress to others
has been refined to a system whereby in most nations, the
society or government has taken the responsibility of providing
emergency systems and services for their residents. In western
nations, this system of communicating distress signals has
been institutionalised into a systematic process whereby every
person has access to ubiquitous means, for instance, in the
US almost everyone is aware of the ubiquitous 911 emergency
system.
Any person
from anywhere in the country can use a phone — at home, a
public phone or cell phone — to dial 911 and will be immediately
connected to an emergency service representative who will
notify the police, fire and/or ambulance service depending
on the need. The system is so well refined that in most metros
and cities in the US, one can call this number and expect
help to arrive in 2 to 3 minutes flat. The 911 service is
a call transfer system which enables people to be linked to
the appropriate Emergency Service Provider (ESP) for the call
location by dialling the digits 9-1-1. Emergency Service Provider
means police, fire and ambulance agencies operating in the
region.
The premise
behind the extensive countrywide emergency 911 system is that
a stitch in time can save nine. Accidents, fires, burglaries
and social problems cannot be prevented, but a rapid response
can help alleviate any further aggravation.
Most of
us will probably need immediate help when facing an emergency,
be it a medical condition or fire or any other law and order
situation. It is imperative that we get help swiftly and efficiently.
Watching an accident victim bleed without instant access to
first aid or medical help is something none of us want. Speedy
response from public officials and law enforcement can prevent
things from getting out of hand.
In most
states in the US, like in other western nations, there exists,
what is commonly known as a “Good Samaritan” law. What this
implies is “When anyone in good faith, renders emergency
care or assistance at the scene of an emergency or accident,
no liability may be imposed for any civil damages arising
from acts or omissions in rendering such emergency care”. What this means is that people who aid others in distress
will not be held accountable. In general, if a Good Samaritan
does what a “reasonable person” would do under the circumstances,
he won’t be held liable in negligence for any harm he may
cause the accident victim. This encourages bystanders and
those who witness accidents to report them to authorities,
at the very least, call 911 and inform someone about the incident.
Sometime
ago a couple in my apartment complex had an opportunity to
test our local 911-response system. The lady was deep-frying
their dinner and the frying pan caught fire. The husband,
a friend of mine, had the presence of mind to immediately
pick up the phone and dial 911. Within about 5 minutes, sirens
blazing, the fire truck arrived at their doorstep. By then
the residents had managed to contain the blaze using a handheld
extinguisher. The firemen were prompt and professional, got
the right equipment and not only controlled the fire but also
helped clean up a part of the mess, all in a matter of minutes.
I shudder to think what would have happened if they were delayed
by even 10 or fifteen minutes since most houses and apartments
here are built out of wooden boards and panels.
Human
life and dignity in the US are really valued; especially since
most taxpayers here consider themselves ‘customers’ of government
and public service and do not hesitate to hold them (the public
servants) accountable.
In order
to provide the kind of responses described, there exists a
huge network of systems and emergency response teams spread
across the country. Phone companies are required (by law)
to provide this service to every telephone. Cities and counties
in all states across the US are required to maintain ‘command
and control’ centers, manned by officials 24 hours a day.
These officials not only take calls but are trained to provide
telephonic assistance till help arrives at the scene. All
these services do not come cheap. Federal and state governments
have special budgets just for emergency care system. Even
phone companies levy a small fee on their customers for the
911 services that they provide. The management of inter-state
phone, emergency, fire, police and networks is an art that
Americans seem to have perfected. The key to remember: in
the US – when in distress, pick up the phone and dial 911.
In this
section of the book we looked at the different aspects of
healthcare, emergency services, and also looked at ways in
which people attempt to maintain a healthy lifestyle. One
needs to conscious about the availability of medical care
and insurance since the general healthcare here is really
expensive.
Until
this point in the book we looked at different aspects of life
and culture in the US and I hope the reader got a glimpse
of what is in store. The incidents of September 11th had a profound impact on everyone in the US and the impact
has been manifold. The economy took a turn for the worse,
as corporate America and the government take stock and prepare
for the future, we will see changes rolling down our lives
and careers too. In the next section of the book we will look
at the aftermath of the incidents of NYC bombing and its impact
on Indians. We will also look at the different aspects pertaining
to change management in our professional lives.
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