Just making myself feel at home

I was quizzing Dr. Yabar in el carro on the way to work this morning about how health insurance works here. The explanations are starting to seem more consistent and I think that I am actually understanding it now. People with no jobs, no money and no insurance go to charity hospitals (like Santa Rosa; see previous blog). The Peruvian government requires all legal employers to register their company and their employees with the government health insurance plan (which is called Es Salud) and to buy health insurance from Es Salud for all of the employees unless they are buying from and insuring their employees with a private (more expensive) insurance company. Unemployed parents and spouses of employed/insured workers and children 18 years and under of insured workers are covered on the working family member's plan. Employers typically give their employees the option of which insurance they want (Es Salud or more expensive private company) and deduct a percentage from their pay check (this is the 75 soles a month that Peruvians have been telling me about for Es Salud). Small companies try to ignore the law and the government has a difficult time policing this law for all but the largest companies leaving some employed people uninsured and needing to go to charity hospitals. Es Salud operates its own hospitals (Rebagliati is one of them) and only patients on the Es Salud insurance plan can use those facilities. There are numerous "Clinica's" that are much nicer than the Es Salud facilities. These Clinica's provide care for the private insurance companies that they have contracts with and only persons on those private insurance plans can go to these facilities. Those of you reading this who know me well will understand how this conversation somehow led me directly to the topic of abortions in Peru. They are illegal here and it is the person who performs the abortion who is breaking the law, not the woman who has an abortion. This, of course, means that wealthy women can pay (lots of) cash for an abortion at a private clinic if they are on one of that clinic's private plans. Uninsured or Es Salud insured women pretty much do their own abortions leading to high rates of injury, infection and maternal deaths. I explained to Dr. Yabar how pretty much every election in the USA now (even school board elections) can be swayed by a small group of highly vocal abortion opponents. He thought that I was kidding but, then again, he didn't believe me when I told him about the Breck School graduates repeatedly vandalizing my house.

Today's word is "ambos" or "los dos" both of which mean "both." It comes in handy along with "lo mismo" which means "the same"(as in, Estados Unidos es loco lo mismo como Peru.) Today's photo's include my office at Rebagliati which I have discovered smells so uncomfortably like xylene and formaldehyde because the windows in the office are directly above the air vent for the chemicals in the Histology Laboratory. I can't complain (in part because every time I feel like complaining I remember that Dr. Paul Farmer, "Mountains beyond mountains," guy and I feel guilty about complaining), at least my office has a door that locks so my computer can't get boosted.