an "outsider's" view

By Tony Zoppo
Health care and all of the sub-issues included in it is one of the most explosive topics in our society today. Horror stories are continually told about, among other things, the costs of insurance, the inability to receive care, and so on. There are plenty of problems with our system here in the United States. Listen to a doctor from India share her reflections. Dr. "Daniela Raje" (name changed) sat down with me to discuss American health care compared with that of other countries, along with many other topics involving medical care.

Why American medical costs are so high:Business Week
Why American medical costs are so high: Scientific American
Pros and cons of socialized medicine
ECU Student Health Services

As you walk through the doors of the ECU Student Health Services, you sense that you're now in a very healthy and caring environment. The check-in folks greet you with a smile and ask you when your appointment is for and point you in the right direction. As you walk toward the back end of the facility, nurses are present, shuffling around going about their daily business. You place your check-in sheet in a box at the end of a counter top and sit down to wait until you're called in.

Who would have guessed you are about to get some pointed commentaries on American medicine and medical insurance from a practitioner born in India.
"I do think people are afraid to get sick. I think sometimes you don't get covered for a certain condition within the first year of having a particular insurance, so if you have that condition, you won't be seen for a certain amount of time. I believe that ís a big problem,' says Dr. "Daniela Raje," who has practiced with the East Carolina University Student Health Services since 1989.

This is just one of the Indian born doctor's comments when this student/writer had the opportunity to interview her on a variety of health care issues during a recent visit to the Student Health Services.

The interview brought out both the more technical and more opinionated side of the doctor.

Health Care is one of this country's most controversial and explosive issues and Dr. "Raje" offered input as to some problems she has had with insurance, what the problems in our system are, how they can be fixed and a few interesting comments on citizens of America and how they take care of themselves in general.

As this writer entered the Student Health Services, this is what he encountered:

The nurse calls you in after about a five-minute wait and checks all your vitals. You expect to be greeted by a doctor who is barely interested in your problem, listens impatiently, prescribes something, and rushes you out. It's a student health service; they have a lot of patients to see so why not expect them to be a little rushed and cold?

As you're thinking this, the doctor walks in. She sets her papers down on the counter near the sink and turns to face you with a lovely smile. Dr. "Daniela Raje" has the kind of appearance and air about her that inspires confidence in patients that they will be taken care of. As she asks you about your problem and suggests solutions to it, you notice a caring gleam in her eyes. It's apparent that there ís more to this doctor than a M.D. and a stethoscope.

Dr. "Raje" was born and raised in New Deli, India to a father in the Navy and a mother who was a housewife. "Daniela" had wanted to be a doctor since a very young age. Her grandfather was in the medical field and in India, family has a very large impact on intended careers.

Dr. "Raje" received her degree while still in India but left shortly after she turned 23 for the United States. She completed her residency here in the U.S. and her first job was with a group practice in Snow Hill, North Carolina. After working with that practice for two years, she found her ideal job at the ECU Student Health Services in 1989.

Dr. "Raje" lives in Greenville, NC with her husband and three children, Vijay, Bela and Asise. Vijay is the eldest (19) and one of two sons. He attends Wake Forest University in Winston Salem and is not sure what he wants to be yet, but it doesn't involve the medical field. Bela, Daniel's 17-year old daughter, wants to follow in mom's footsteps. Bela is a student at Rose High School and is still deciding on where she would like to continue her education. The other son and youngest of the group, Asise, is 15 and also attends Rose.

When I recently sat down with Dr. "Raje," these are some of the exchanges which occurred:

Tony Zoppo: I imagine the job at Snow Hill is very different from here at ECU, how did that work for you? Did you have any nightmarish experiences in that group practice?

Dr. "Raje": Well I worked there after I finished my residency and it was rough because you were on call and had to take patients to the hospital and also had to be at the clinic. You had to see everyone who came through; most patients there were indigent and on either Medicare or Medicaid. It wasn't the normal private practice setting where you saw only those with insurance. It was hectic, not because patients were on Medicare or Medicaid, but because you were everywhere all at once.

Zoppo: So you obviously enjoy this job much more, do you feel it fits you better?

Dr. "Raje": Well, this is a great job because of my family and children, I think it works out very well. I have no night call and that can be a disadvantage of working for hospitals. I believe if you have a family that can be a real pain. I think this is a great job.

Zoppo: What particular insurance do you receive through the Health Services?

Dr. "Raje": We are state employees so we get the state employee insurance. The University has to apply for the medical malpractice care that covers us but we are all on Blue Cross Blue Shield.

Zoppo: Have you ever had any problems with getting or keeping your insurance? Have you had any problems getting care if you need it?

Dr. "Raje": No, luckily I've been pretty healthy. If you work for the state, you're well off and it isn't a problem getting insurance as an employee of the state. Plus I'm also covered under my husband's group insurance through his job. But overall, we really haven't had to use our insurance yet.

Zoppo: Hypothetically, if someone was stricken with an unfortunate illness in your family, do you feel like your coverage would take care of you or that person?

Dr. "Raje": Yes, I think it would.

Zoppo: Do
you believe that a lot of people fear getting sick because of common health care problems or expenses?

Dr. "Raje": I do think people are afraid to get sick. I think sometimes you don't get covered for a certain condition within the first year of having a particular insurance, so if you have that condition, you won't be seen for a certain amount of time. I believe that's a big problem.

Zoppo: Do you feel that doctors have an easy time getting insurance?

Dr. "Raje"
: I believe so. They get a private insurance but I suspect they have an easy time acquiring it as long as they are healthy.

Zoppo: Do you believe that everyone should be cared for and covered?

Dr. "Raje": I think everyone should have a chance to be cared for. Medicine in India is socialized and in a government-run hospital, everyone can go there and be covered. (See
Socialized Medicine: Pro and Con)

Zoppo: Do you believe that Socialized Medicine works better than our system?

Dr. "Raje": I think people aren't as scared about getting sick. You don't have the fear of not being able to afford medications or other care. If I'm not mistaking, if you have your family covered on a plan like the state plan, it's around $400-500 a month.

Zoppo: How are the doctors paid in a socialized medicinal society?

Dr. "Raje": The government pays them.

Zoppo: What do you feel that this country needs to improve on when it comes to Health Care?

Dr. "Raje": Well I think you have to have universal health insurance. Its so horrendously expensive in this country for care from the medications to hospital rooms. I also think patient's expectations are so high that they feel as if they're going to go in and be cured immediately and they have to realize that medicine is not an exact science. I believe that they are so ready to be better in a day or two that there should be a pill for most things.

Zoppo: Do you believe that's a large problem? That people have one little thing go wrong and they immediately need a quick fix?

Dr. "Raje": I think it is. You take responsibility for your health and the body has an amazing ability to heal and you just need to do the right things in allowing your body to stay and keep healthy. Sometimes you have to give yourself time to heal, no matter what is wrong. There is also such a large demand for technology improvement in the medical field that everyone expects the best care, and with those expectations the expense has nowhere to go but up.

Zoppo: Shifting gears slightly here, what about the malpractice insurance for doctors? How expensive is that?

Dr. "Raje": It's terribly expensive. I believe for specialists, who are more procedure-oriented, such as a gynecologist, have to pay about $1500 a month for the malpractice coverage. That is a huge cost. But it is needed for any lawsuits and liability, taking the risk in not being right when diagnosing patients.

Zoppo: Is that a big fear for most doctors?

Dr. "Raje": Yes, absolutely.

Zoppo: Is that common in countries that have socialized medicine?

Dr. "Raje": No, not at all.

Zoppo: Do you believe that people's attitudes toward medicine in wanting it to be an exact science and being right all of the time is a big problem?

Dr. "Raje": Yes, that is a problem, people cannot expect anyone to be right 100 percent of the time, but it isn't the only problem. I think the cost of technology is so high and it keeps advancing and people want that kind of care but they have to pay for it. I think society needs to decide how much they are willing to pay for that kind of care


Anthony Richard Zoppo was born in New Brunswick, NJ and was raised in Edison, NJ for 13 years. He and his family then moved to Wake Forest, NC in 1997. Anthony has resided there for the last six years and he is currently a sophomore at East Carolina University. He is the Assistant Sports Editor at The East Carolinian and is studying to be a Physical Therapist.

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