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Obamacare is an important issue and it seems everyone has an opinion. But to my knowledge no one has written about it, Lithuania, and baksheesh.

Baksheesh is defined as a payment (as a tip or bribe) to expedite service. Note that it expedites service and may not exactly be quid pro quo – it can be like a tip, or a gift. But in the Western world, such payments constitute bribery.

Baksheesh drives Lithuania’s medical system. Lithuania had been occupied by the Soviet Union from World War II until 1990. It has something like universal health care, which it inherited from the Soviets.

Health care is free. There is a system of clinics: there is no limit to the number of times a person can use them. If one needs a specialist, one gets sent to one. All free.

Except it isn’t. It isn’t free. Baksheesh is required. Of young and old. To the doctors and other health workers.

Oh, no one extorts the bribe, per se. If, however, you don’t pay it, you are treated completely differently. No care is taken. Your operation is not scheduled. And you won’t see the specialist again, let alone a good one. (One gets to see the good ones only by using clout – and a bribe.)

I recently spoke with an eighty year old woman about this. She said she paid a bribe to her doctors. I asked why. She said, leaning forward, because they treat you completely differently. Meaning that they actually take care, instead of going through the motions.

Baksheesh is an unavoidable consequence of limited resources

Bribery of one’s physicians is so ingrained that … the Civil Code, as adopted in 2001, contained provisions specifically devoted to this and seeking to legitimize and even legalize it. (The code section — 6.470 (4) — was repealed only in 2006.) (Interestingly, the usual documents accompanying a repeal are unavailable.) It seems the general opinion is that the repeal facilitates bribery by removing any restriction, although interestingly it is not considered bribery as such. Baksheesh, rather. Something natural.

The point is that if Obamacare is not repealed, legitimate choices are going to decline – and unlawful activity (such as accepting patients off the books) will be encouraged and legitimized. It is likely to bankrupt the insurance companies and equally likely to demand a bailout – resulting in even more government control of health care. Similar to Lithuania. Very natural.

Baksheesh is only natural, too.

 

 

 

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3 Comments

  1. Geras Taduk, Geras!

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  2. The article about baksheesh and medical care is completely correct – I know, because I am now permanently disabled because of the poor medical care I received in the Klaipeda Hospitals. When I first became ill, I was passed from one doctor to the next – with none of them recommending anything except multiple exams and medications – and the 7-8 doctors I saw all wrote different and conflicting diagnoses in my health booklet, but none considered it serious enough or cared to do anything more. Finally I collapsed one day, bleeding internally, and was taken to the hospital, where they did a sloppy ileostomy surgery and left me to die in a re-animation room. After 1 month in a coma, I woke to find that my legs had been allowed to atrophy and I was covered in bedsores. While I was transferred from department to department as I recovered, I found that no one ever appeared to know much about me – so much for “reading a patient’s chart” or caring. – and the simple fact that forgot to take out my stitches on time – and when they did, missed and forgot to take out a couple stitches, is just one example of what sloppy ignorant care they are capable of. The absolute worst thing is that no one could speak English – as I am an American, and my Lithuanian and Russian are very poor – especially in trying to indicate what was wrong with me. The highest level of English was very low, and this was from only a handful of doctors and nurses. After a while, my wife and I noticed that all the relatives and patients were constantly giving “gifts” to the nurses and doctors – everything from candy to straight cash. The level of care and attention I received improved a little as soon as I started giving the medical staff “gifts”. i have been able to re-learn to walk a little, but I am still very weak and will never be as healthy as I used to be. They left me with an ileostomy that doesn’t work well, and I am in constant pain and discomfort from all the complications that occurred from the poor care and attention I received. The things that happened and the situations I experienced in the Hospitals are simply too ridiculous to believe. Some of the nurses and doctors should lose their jobs or be punished for what they have done. My experience has been unbelievable and horrible in many ways, and I am lucky to be alive! I could write several pages about the completely idiotic things that happened to me, but the most important thing to understand is that Lithuanian healthcare is not very good at all unless you can bribe your way through it. Everything is “all show and no go” at the medical hospitals and facilities.

    • I am sorry for your terrible experience. Others have experienced a very good level of care. But nearly everyone is agreed that the system works only through baksheesh.


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