When I told people I was moving to Ireland, some people said, "Oooh! Free healthcare!" Well, on the one hand, it's pretty cool to have a medical card and not have to pay for medical care. On the other hand, here's how that plays out. Remember my rant about the new Irish policy about pap smears (aka smear test)? Well I figured I should run out and get one before the policy was implemented, so I did.

Several weeks later, I received a letter from the Health Service Executive (HSE) to call my doctor for the results. Admittedly, I put this off. So a few weeks ago, when Mark was in our doctor's office, she told him to tell me to give her a call. I called. And called. And called. And...called. Finally, I got in touch with the doctor, who told me that my test came back abnormal and that she would refer me to have a colposcopy.

Let's compare to how this went down in the US five years ago when I had a bad pap: A couple weeks after my appointment, my doctor called me personally to tell me the results, and referred me for a colposcopy, which I was able to get within a week or two.

Ok, so back to the here and now. So when I talked to the doctor on Friday, she mentioned that I would need to pick up a referral letter from her office...on Tuesday. Okey doke. On Tuesday I show up, get the letter, and I'm not sure what to do with it, but I call the Rotunda and the dude on the phone tells me that I have to physically bring the referral letter, which contains the lab results, to the Colposcopy Clinic, at which time my results will be evaluated and scored in terms of how severe it is. The people who do the lab test triage (only two doctors) only do so on Wednesdays and Thursdays. In two weeks, I'll get a letter saying that I've been put into the list to get an appointment.

When I brought the referral letter to the clinic, I was told that if my lab results are as bad as they can be, the soonest appointment I'll get will be in FEBRUARY. So I could have cancer and I wouldn't find out for three months, basically. Luckily, I looked at the labs and I know that I only have a slight abnormality, and I'm not overly concerned for myself. But if I were actually ill, I would be majorly screwed. Still, I won't get an appointment until March or April, most likely.

Know what's crazy though? The guy at the clinic said that the clinic has only been swamped like this since Jade Goody died. So essentially her death caused loads of women to get smear tests. And those who had abnormalities probably never would have gotten them checked out and would be walking around not getting treatment. I know that a lot of people thought it was lame how public she made her death, but actually it seems like doing it that way has done some good in educating people.

I don't want friends and family reading this to be worried -- I'm sure it's nothing at all, and even if I have dysplasia, there are treatments to take care of it. So I'm not worried, and neither should you be! However I wanted to make this post because I think people should know that "free" medical care isn't all it's cracked up to be.

Holy smokes is Ireland in the dark ages when it comes to Pap Smears! Check out today's article about how there's going to be a "new system" for getting them. I was going to say for getting "annual exams" because that's what we call them in America. That's right, it's so common for women to get pap smears and full gynecological exams as soon as they become sexually active and/or reach the age of 18 every single year that's it's simply called an "annual." As in, "I have an appointment with my gyn on Wednesday for my annual," which is universally understood by both men and women.

Earlier this year there was a big media blitz over the death of Jade Goody, who became famous for being on the British TV reality show "Big Brother." She was only 27. Many people said that her death brought a greater awareness to the issue of cervical cancer screening. But why does some celebrity have to DIE before simple epidemiological measures are taken for public health? Why is this not standard practice as a yearly thing in the UK and Ireland? When I was in my late 20s I had a bad pap smear, and discovered that I had pre-cancerous cells. There is a simple procedure for it. If you get yearly pap smears, you are very very unlikely to ever get cervical cancer, especially since it takes a long time for those pre-cancerous cells to turn into cancer.

I am so incensed at this policy. It's as if they think pap smears are like shiny new handbags at the mall and women are just asking for them willy nilly. I wonder how much one pap smear measures up against the cost of cancer treatment. But we can't let women manage their own health - oh no! They'll spend all the government's money on those fancy gynecological tests that are all the rage nowadays! God forbid just *anyone* can go to her doctor and get a pap smear - let's make them request one and then get an "invitation" to make an appointment six months later. Elitist medicine by the HSE. Why am I surprised?

Here's an update for those concerned about Mark's uncle. We were all up in a tizzy about whether he was getting good care on his medical card (he has private insurance but isn't using it). We considered trying to get him to move to a private hospital.

For my non-Irish readers, I have to explain something that may seem strange. (And I hope I get this right.) So here you've got people with "Medical Cards," in which you get more or less free health care from doctors who have contracts with the Health Service Executive, or HSE and what they call "public" hospitals. Then you have people who've got private health insurance, who can see doctors that basically only deal with out of pocket patients and patients with private health insurance. Those people also have varying degrees of coverage for "private" hospitals. In other words, people who don't have a lot of money or who have low private hospital coverage on their health insurance go to public hospitals, and rich people or those with good health insurance go to private hospitals. So you can imagine how this plays out -- the public hospitals are overloaded and the care to the poor is compromised while the rich sit nestled in their private rooms.

So we returned to the hospital armed with loads of questions for the medical team about our uncle's various conditions (some caused from being hit by the taxi door, and others not), which include six fractured ribs, a torn ligament in the leg, upwards of five stomach ulcers, diabetes, and blood clots in his lungs. The poor man is in rough shape! I had everything written down on paper so I wouldn't forget. The doctor seemed a bit defensive, and it was a little stressful, but she answered all of our questions and at the end we felt satisfied that they were on top of the situation. Still, sharing a room with five other guys is pretty grody. The air is completely stagnant in his end of the ward, and it isn't helped by some of the patients not being able to get up to use the toilet. But the good news is that he's becoming a bit more mobile, and seems to be getting decent care, which will hopefully lead to his return home very soon.