An Interesting Nightmare

Posted on by Astrid

I had an interesting nightmare last night. It wasn’t even really a nightmare in the traditional sense of the word. I mean, no violence or monsters were involved. Then again, most of my nightmares don’t involve that kind of scenario.

In my dream, the last client to contract COVID in our care home, came into my room and went straight to my bed while I was lying in it. I tried to crawl to one end to keep my distance, because of course getting out of bed would mean getting stuck touching her. I eventually managed to press the call button, but no-one came. Finally, this client left, but I was utterly distressed and tried to press the call button again, but to no avail. I then went out of my room and to the living room, even though I’d decided to stay in my room while more than half of my fellow clients are positive for COVID. Then, one of the care assistants, a woman I’ve only met briefly once or twice, came to my room to have breakfast with me (apparently it was morning), but I asked for the morning staff. The care assistant explained that the staff was busy and she was having breakfast with me instead. Then I woke up.

The nightmarish aspect of the dream was, in part, the fact that a client with COVID came into my room and my bed. This to me signifies how scared I am of contracting the virus, even though I keep saying there’s no surefire way to prevent it anyway and I’m not scared of getting very ill. I am, however, quite honestly, pretty scared of the consequences of room-based self-isolation should I be positive. I mean, I’m now basically in room-based self-isolation too, but my staff don’t have to wear PPE other than surgical masks and they can still be within a five-feet distance. I’m not sure about holding my hand or holding me in an embrace, as I’ve been cautious and haven’t asked, but I know from the times I had to self-isolate with suspected COVID last year and in 2020 that those are big no-nos should I be positive. At least, my staff wouldn’t even get within a five-feet distance even while wearing PPE then.

Another aspect that was nightmarish to me, was the fact that the unfamiliar care assistant ended up helping me rather than my trusted staff. This to me signifies how I’m experiencing attachment to this staff, and she wasn’t even my assigned home support worker or another of my favorite staff. I guess this counts as a win!

Lastly, a nightmare aspect was the fact that the care assistant told me that the staff was busy. I am forever frustrated with staff being overworked and busy and at the same time, I’m trying to accommodate them as much as I can. For example, yesterday the staff (same one who was supposed to come in my dream) forgot to come by my room at 3:15PM when she had finished handover. At 3:45, fifteen minutes before my one-on-one time would start, I’d had enough and pressed the call button. I was really frustrated, thinking that I’d be left to my own resources now that over half of the clients have COVID. That would make sense, rationally speaking, since I’m not sick or whatever. Not that the other clients are very sick, but oh well. As it turned out, the staff had forgotten to show up because she hardly ever works late shifts. This, plus my nightmare, does show how easily I think that I’m being abandoned.

Sharing this post with Scott’s Daily Prompt from last Saturday on the topic of nightmares.

Right to Health

Posted on by Astrid

In his daily prompt yesterday, Scott Andrew Bailey asks us about the “right to health”. I purposefully put that between quote marks, as obviously no-one has a right to health. We all get sick and die eventually. Okay, that was my autistic brain’s literal thinking acting up again. What Scott means is the right to medical care.

Scott asks whether medical care is something the government should provide for the people or whether it’s best left to the private sector. Are there drawbacks to your choice?

The answer to that last question is, of course, yes. Any system has its drawbacks. My answer to the first question, on the other hand, is: I’d like it to be a little of both. For my Dutch readers, the answer can be short: I like my own system best, despite its drawbacks, such as the mandatory copay and the diagnosis-treatment combinations which dictate that you’ll get care based on a diagnosis, not your needs. Those were a particularly problematic thing in mental health. I believe they’ve been altered to something else this year, but I don’t know whether it’s better or worse.

For my international readers, here is a little explanation of how the Dutch system works and why it has the best of private and public healthcare combined. Basically, what is called basic health insurance is more or less public, even though it is covered through the same insurers that will cover your additional insurance should you get it and the insurance companies are private. The government decides which care is covered under basic insurance and insurers must accept every Dutch resident for this package, regardless of health status. The basic package covers visits to your GP, hospital care, most medications, specialist mental health services (ie. services for people with more severe mental health problems), etc. Things that are not covered include physical therapy, dentistry for adults over 22 I believe, contraception (even though Christian parties have been demanding it gets put into the package to prevent women needing abortions), etc. When I lived with my husband, I had mostly just the basic package (I did have some physio coverage but didn’t use that) and I didn’t have to pay a lot of extra money for things that weren’t covered.

You can decide to get additional coverage for things like dental care, physical therapy, alternative medicine, etc. However, insurers can refuse you for those. They usually don’t for the cheaper packages, but then again getting these hardly outweighs the cost of paying for care out-of-pocket.

Basic health insurance currently costs about €133 a month if you want to have free choice of healthcare providers (I do). You can opt for a cheaper policy where the insurer has contracts with only certain providers and you have to pay 30% of treatment costs if you go to an uncontracted provider. Like I said, there’s a mandatory copay of €385 a year on your healthcare. GP visits do not count towards this.

Like I said, I think our system has the best of both public and private worlds. Before the current system was put in place, low to medium income people were covered under the sick fund, which was similar to the UK’s NHS, including its problems of extreme waiting lists and bureaucracy. People with higher incomes would need to get private insurance, but I don’t think it was much better for them, in the sense that those with private insurance would be treated favorably. That’s a good thing.

A note about those who cannot afford to pay for health insurance at all: as a general rule, basic insurance is mandatory and there are several ways in which the government aids low-income people, but ultimately if a person doesn’t pay at all, insurers have the ability to stop insuring them. In that case, hospitals can refuse care, but not in acutely life-threatening circumstances such as when someone has a heart attack. In that sense, you have a right not to die on the health system, but not an ultimate right to medical care.