“How two countries handle illness prevention”
Published 18 Jan 2018 | swissinfo.ch
by Tony Ganzer and Geraldine Wong Sak Hoi
“Preventing or addressing an early-stage medical condition is a big piece of the health care puzzle. But the practice is sporadic in both the US and Switzerland.
In our previous articles on American and Swiss health care, much of the focus has been on the costs, consequences, and construction of health care delivery systems in the US and Switzerland. That’s to say, we’ve mostly worried about the particulars of a patient getting treatment for conditions.
But health care is not just provided once a condition is diagnosed, or an injury needs treatment.
Preventive medicine is also a big piece of the puzzle. Health care screenings, vaccinations or education campaigns all add to a longer view of health care delivery. It’s not just about visiting a doctor for treatment; it’s also about living with healthy habits and periodically getting checked out to make sure nothing is developing.
Proponents credit preventive medicine with lowering costs and helping improve health outcomes over time. A 2006 studyexternal link concluded that focusing on things like tobacco cessation programs and daily aspirin use would have led to longer lives and $3.7 billion in US health care savings…”
“Two patchwork healthcare systems, and two stories of reform”
Published 2 Nov 2017 | swissinfo.ch
by Tony Ganzer and Geraldine Wong Sak Hoi, with input from Veronica DeVore
“In some ways the Swiss health care system before reform looked a lot like the core of the United States’ system, which might be why many eyed Switzerland during the wrangling over the Affordable Care Act. What changes did the Swiss make and what’s been the result?
In this first article in our series looking at health care on both sides of the Atlantic, we answer that question, sent in by one of our readers. He wondered what the Swiss system was like before reform and how it came about.
Why was there a desire for reform?
Before reform, insurance in Switzerland was not compulsory, rather voluntary, paid for in large part by premiums and co-pays. There was federal and cantonal support to help people who needed it, but that made up only 15 percent of financing. Some have argued that one “American” characteristic of this pre-reform system may have been the trend of private insurers snapping up non-profit “mutual” health plans, and refocusing on profits. This led private insurers to compete for “wealthy and healthy clients” because it’s cheaper and more profitable to insure people who are, well, healthier. Regulation existed in this pre-reform Helvetia, but wasn’t too heavy-handed.
It’s important to say that, even with more of an “American-style” system, Switzerland was still covering more than 90% of the population. (Some estimates put it at 96%). Why? Maybe one reason is because the Swiss are more risk averse, and have a strong sense of personal responsibility when it comes to health care.”
Living with dementia, is like living different parts of your life again, in no particular order. The disease pulls a person from being fully aware of life around them, like a filter has been placed on reality.
In Switzerland it’s estimated about 107,000 people suffer from a form of dementia, and nursing homes are increasingly taking up the task caring for these dementia patients.
And one home in Bern has added a high-tech virtual train to give residents an unconventional experience.
The alpine landscape flies past on the rail route from Bern to Brig, as Johnny Cash’s “Ring of Fire” brings a sense of nostalgia to the trip.
But these four train seats, the window, the map on the table aren’t in a train, and are not heading from Bern to Brig.
Patrizia Baeriswyl is director of care and treatment at Domicil Bethlehamacker in Bern. The nursing home specializing in dementia has about 72 residents. She says this is the train section, patients can come and go as they please.
Maybe the ride, and then step out to the garden.
News of this virtual train began spreading a few weeks ago, and critique was not far behind. Is this an alternate reality for the patients? Do they know what’s happening?
Baeriswyl says she thinks people are confused by the idea. She says if people think they just put residents in the train and walk away, they misunderstand.
That is not the idea, she says, this is part of a concept, and very small part of a concept where the focus is on the emotional well-being of residents.
Baeriswyl says this used to be a standard care home, but now the level of care is diversified. Quality of life is paramount, and the virtual train is just one of Bethlehamacker’s experience spaces.
There is the garden, Baeriswyl says, or a spa-like treatment room. Or a waterbed where colors are projected on walls, or another where the sky is painted onto the ceiling, with changing daylight.
All of this is to create a calm atmosphere for residents.
“The reality in nursing homes today is dementia. There are more with dementia than people without dementia,” says Birgitta Martensson, managing director of the Swiss Alzheimer’s Association.
“Care has to do with human presence,” she adds. “Then we need people who know about dementia, and how to understand what they observe, and it is about human care much, much more than technical devices…yeah, it’s human care.”
Martensson wants to be clear that she has not seen the virtual train in Bern, nor is she criticizing the work of Bethlehamacker. But she can speak generally, about treatments.
“If it is make believe, which is the case very much with the train journey, I would be reluctant, because people are already lost in their lives and in their heads, it is very peculiar to put them in a make believe situation,” Martensson says. “The problem is that we don’t have enough people working in the nursing homes, because we don’t want it to cost more money.”
Patrizia Baeriswyl at Bethlehamacker says it is not about creating an alternate reality—that’s not it at all.
And the virtual train is not taking the place of staff—all positions are filled.
In other spots, Birgitta Martensson with the Swiss Alzheimer’s Association says a lack of personnel has already caused another serious concern.
“The other option that is used far too much, and which is much more dangerous for me is drugs; is to give drugs to keep the persons calm,” she says.
Parliament is already moving on creating a national strategy on dementia care, but Martensson says health care is still a cantonal issue. So if Bethlehamacker in Bern has developed something helpful, there is no formal framework to spread the idea.
Bethlehamacker is trying to inform and spread its innovations anyway, planning an informational session with cantonal dementia groups next month.
Today we begin an occasional series about raising kids in Arizona. We’ll look at some of the benefits and troubles associated with raising children in the state. In the coming months we’ll address issues like safety, education, culture, and this morning we look at a health issue. KJZZ’s Tony Ganzer reports that kids in the Valley sometimes have a hard time finding clean air.
This morning we look at the moon…more specifically moonbeams. The Earth’s only planetary satellite has long attracted man’s curiosity, and a venture just west of Tucson stands ready to see if moonbeams are the antidote to some people’s ills. KJZZ’s Tony Ganzer reports.Continue reading “Moonbeam Collector”