I had a scary night last night. D (aged 2 and three quarters) woke up at 2 am needing to go to the toilet, was trying to yell out to get help, and discovered that he couldn’t talk, and could barely breathe. So I heard some strange barking noises, went to investigate, and discovered a terrified child who was trying to simultaneously breathe and pull his shorts down. I was pretty sure (from the barking) that it was croup, but two years ago, when D had croup, I got a pretty severe lecture from the nurse treating him that if he had trouble breathing, I should take it very seriously.
After a brief confab with E, I called 000, and an ambulance came and took them both to hospital. He was absolutely fine – by the time the ambulance came, he was just wheezing a bit, and after some drugs at hospital, and an hour or so of observation, they were sent home in a taxi.
I’m now wondering whether to feel guilty about over-using our wonderful health system (all completely free, by the way). Should I have waited the extra two minutes it would have taken to make it clear that a drive to hospital would have been adequate (rather than an ambulance)? Should I have then given him some ventolin (from previous wheezing episodes), and put him to sleep in our room and listened to his breathing all night instead of using getting the hospital to check him out?
Certainly any parent of a child with asthma would deal with that kind of breathing trouble pretty regularly, I imagine. They would probably laugh at my alarm. But they would also have strategies to deal with the little episodes, that I don’t have. I also know that asthma, left untreated, can kill a child (it put one of my cousins in intensive care for a few days at age 20), and D has shown wheezing tendencies in the past.
Upper-middle class parents like me are more likely to have the sense of entitlement that leads them to just call the ambulance, rather than feeling a burden on the system and waiting until it’s clearly a matter of life and death.
So which is right? The over-use of the hospital system to make sure nothing terrible happens, or rationing yourself to make absolutely sure it’s necessary?
Most studies of the rationing of health care that happens when patients are charged for it show that patients don’t have enough understanding to decide which treatments are necessary, and which are not. The trouble is that charging for it is unlikely to change the use. I would still have called the ambulance, even if it cost me a fair bit of money, and the parent who is already worried about being a burden on the system would be even less likely to, as they would have the added worry about being able to afford it.