Hell and Health Care in Romania

Party animal that I am, I spent Saturday night watching a 180-minute long documentary-style black comedy/satire about the Romanian health care system called The Death of Mr. Lazarescu. 

The nominal star of the film is Dante Remus Lazarescu, an alcoholic 62 year old retired engineer from Bucharest who wakes up with a stomach ache, which turns into a splitting headache, and which leads him to call 911 for an ambulance. About an hour into the film the ambulance arrives, and the rest of the film follows him as he’s led on his own journey through the nine circles of Romanian health care hell: he’s ignored by nurses, abused by doctors, and shuttled from one hospital to the next, each one eager to get this problem case off their hands. Meanwhile, Mr. Lazarescu himself gets increasingly incoherent as the bleeding in his brain grows worse. His guide in the trip is the ambulance driver, though it is never clear whether she’s dragging him around because she actually cares for him, or because she just needs someone to sign off so she can get her gurney back. 

All told, it is not a loving portrait of Romanian medicine. But at the same time, there isn’t a lot to it that is specifically Romanian about the parody– had the movie been shot in English it could have been set in Toronto or New York.  In fact, if anything, the truth of the matter seems to be far worse than the film portrays it. Today’s NYT has a piece about the epidemic of bribery in the Romanian health system:

A 2005 study conducted by the World Bank for the Romanian Ministry of Health concluded that so-called informal payments amounted to $360 million annually. When an illness requires hospitalization, patients typically pay bribes equivalent to three-quarters of a family’s monthly income, the study showed. Some doctors say that the bribery culture is so endemic that when they refuse bribes, some patients become distraught and mistakenly conclude it is a sign that their illnesses are incurable.

Doctors and patients say the bribery follows a set of unwritten rules. The cost of bribes depends on the treatment, ranging from $127 for a straightforward appendix-removal operation to up to more than $6,370 for brain surgery. The suggested bribery prices are passed on by word of mouth, and are publicized on blogs and Web sites.

But then again, is this even all that alien to Canadian experience? My spider sense says it is not.