coursework

Summer Quarter: Study Abroad Edition

Honors London: Socializing Medicine - Comparing the Concept of "Safety Net Hospitals" in the UK and US

Photo journals

Each week, we had to take four pictures to answer a specific prompt related to that week's course content. It was actually super challenging because the prompt itself was difficult to understand, let alone figuring out how to capture its essence in a picture. Below, I have compiled my four photo journals.

Podcast

Our end of course project was a podcast about a topic related to the National Health Service and safety nets in the UK, complete with library research and field research collected from our time in London. At the end of the school year, I had asked a few of my professors and TAs what they would be interested in learning about the NHS, and they all said trans healthcare, which is notoriously bad in the UK. Therefore, I was interested in the topic going in and chose it as the focus of my research. Paired with two other students collecting data on low income and homeless populations, we synthesized our research to answer the question: What are the barriers to healthcare for marginalized groups, specifically individuals who are low-income, homeless, or trans?

Podcast Submission #1 (2)Angelyiah Lim

00:00 / 14:43

Reflection

I learned so much on this trip. Here's a brief summary of my main takeaways:

U.S. healthcare is a private, market-based for profit system that thrives on the pockets of people who can afford the high cost of care, and insurance reimbursement. It is based on the premise that healthcare is a commodity, not a human right, which inevitably leaves gaps in who is treated and who is not. A U.S. safety net treats as many people as possible who are not provided care by the private hospitals, using the funds from elective surgeries and extra money saved from providing lower wages for doctors.

The Great Fire, Plague, and Revolution all shaped the way that UK provided healthcare. Additionally, the two world wars, especially WWII, which prompted the development of a new healthcare approach shaped the UK approach by birthing the NHS. Specifically, the Beveridge report set up the stage for creating a universal healthcare model that not only addressed medical care, but all the broader social determinants of health.

Upstream drivers of health disparities include imbalance in power, corruption, white privilege, wealth-poor gaps, history of slavery, and poverty. This leads to the systemic oppression of certain ethnic groups and minorities that increases barriers to healthcare, whether that be the trans folks who experience significant discrmination by doctors or people who are low-income and live farther away from hospitals. Asylum seekers and immigrants are not received very well here either which contributes to their decreased access to healthcare and subsequently worse health outcomes. The UK has responded to this by moving towards more inclusive healthcare and prioritizing trauma-based care that requires doctors and staff to be conscious of all the experiences an individual may have had when providing care. Respect and empathy are highlighted as core values of the NHS system, which is also another way the UK is making progress.

It appears that most people in London love the NHS and its services. However, due to a lack of attention and resources directed towards the NHS by policymakers and people in power, it has been struggling to treat everyone in a timely manner and people have been misattributing this to the efficacy of the system rather than how well funded and supported it is. Therefore, there has been a slight but significant shift into favoring privatization, which has also been destabilizing the universal health values that the NHS stands upon. In theory, most people support the NHS and its end goals but in reality, are impatient with the slowness of the process of receiving care and the moral hazard problem.

Overall, I think that the U.S. ought to adopt a universal healthcare system. Our private, market-driven system only benefits certain privileged populations, and hangs those systemically oppressed by society out to dry. The fact that we are the only high income country without a universal health system and we have the worst health outcomes should tell us something about the efficacy of and the need to change our medical infrastructure. Medicare and Medicaid are not enough - they do not account for enough Americans, the rising costs of healthcare, and do not provide sufficient coverage. It is up to policymakers and upstream governmental bodies to do something about our failing health systems, and prioritize wellbeing and life over wealth and profit.

It's also the responsibility of the doctors who serve the people to champion and support this change. I was shocked that the biggest pushback for the creation of a single payer system here in the U.S., and the birth of the NHS, came from the American Medical Association and British Medical Association respectively. I lose major respect for the physicians who chose money over their patients. Why are you in this profession, if not to provide a quality service to as many patients as possible? Are you really in it to help people, or to get rich? The system we have here, and its failure to accommodate for millions of Americans, definitely shows what the U.S. government and doctors value more.

Do I think this will happen? Unlikely, unless there are major changes in the legislative bodies that govern the U.S. Even if a branch of government wants to push through a universal healthcare reform, the checks and balances will ensure that such bill will not reach its full potential. We saw this with the Affordable Care Act, and I am sure it could happen again.

U.S. also needs to work on providing more welfare programs and social support. One of our guest speakers couldn't even fathom that American hospitals are providing housing for their patients, because that is the responsibility of a different sector than medicine. In the UK, they have clear distinctions between the jurisdiction of the departments of education, medicine, public health and so on. Rightfully so, since this enables each department to narrow its focus and not be spread so thin. I would like to see the U.S. government step up to provide support for Americans who experience poor living standards due to the failures of the society they live in.

I had the time of my life in London, and I cannot wait to go back, whether to vacation or study there again. I would love to work for the NHS, but I think it would be unfair to the people I grew up around to abandon ship. As much as I don't align with many of the values of many U.S. institutions, Americans are my people, and I feel a duty to serve them in the future. There are so many populations that just got unlucky in the course of history to be on the wrong side of power and privilege, and I would be contradicting my values more if I chose to leave. Now I know that I want to advocate for universal healthcare, wherever I may end up working, and be employed at a U.S. safety net hospital, serving marginalized populations that the U.S. government has turned a blind eye to. That will be the most fulfilling and rewarding thing I could do with my life.

Ratings

For funsies, I want to rate the things that I did in London from my most favorite to least.

Green Spaces

Kew Gardens: so much biodiversity and the Hive is astonishing
Battersea Park: massive, with beautiful fountains and gardens
Holland Park: kyoto gardens was peaceful, and I liked the rose gardens
Regent's Park: Queen Mary's rose garden was so aesthetically pleasing and I liked the swans
The Hill Garden and Pergola: I felt like a princess walking through that estate with all the vine-wrapped columns; would definitely go again with someone, because it was kind of creepy being alone there
St. James Park: super pleasant walk along the lake; bonus points for stork
Primrose Hill: gorgeous view of the sunset, but besides that, kind of boring and too much smoke
Greenwich Park: nice view of Canary Wharf, would have spent more time there if I had it
Hyde Park: lots of birds, saw a few movies there, but the park itself wasn't that extraordinary; speaker's corner was underwhelming and lowkey scary because it was all mean
Hampstead Heath: the hiking trails made me feel like I was in a murder mystery movie and I was being stalked, but also like I was in an adventure, wilderness movie
Kensington Gardens: can't remember much other than my phone was dying and the signs were helpful for navigation; the lake was stinky
Canons Park: not memorable since it was near Edgware, but brownie points since mom was there with me

Tourist Attractions

London Eye: amazing view, and its fun to take pictures, but not sure I would go again as its more of a one time experience
Big Ben: never knew how a clock could be so famous until I saw it
John Snow Water Pump: some guy was smoking at the base of it, but then he left; lost points for not being the original
Buckingham Palace: cool tour complete with audio guide, lots of grand rooms and a beautiful gold grand piano, but since I don't remember much, I don't think it's worth going again
Tate Modern: I liked the guerilla girls exhibit, would go back to explore more at my own pace
Chinatown: pretty large, would have to go back and explore
The Harry Potter Shop at Platform 9 3/4: cool but I don't like spending money, got Isayiah a chocolate frog
Westminster Abbey: pretty on the outside
Notting Hill/Portobello Road Market: underwhelming, colorful buildings were cute, but I wasn't bothered to look at more tote bags and jewelry; must go back on a Saturday when its most busy
Tower of London: confused by the name but I liked that there was just some random castle in the middle of the city
Cutty Sark: literally just a ship on land, not exciting
Trafalgar Square: didn't spend much time there but the pride parade and performance was cool; loses points for not having the Nurse Cavell Statue
The British Museum: boring, I don't like museums, and they didn't acknowledge Palestine as a country and closed that exhibit
University College London: it cost me an arm and a leg to get into the campus, the security guards couldn't understand that I was studying abroad there and were so rude
London Bridge: just a normal bridge, not to be confused with Tower Bridge

Day trips

Bath: super cute and reminded me of France, could spend a whole day there probably
Stonehenge: how did they carry those rocks 26 miles? it blows my mind; super windy but fascinating given the history
Oxford: loved the botanical gardens, the architecture, and the walk along the canal (and the duckies!); would definitely go again
Brighton: beautiful view of the ocean, but it was super windy and I was salty that I had to watch the soccer game on FaceTime with Ty instead of on the giant screen on the pier
Windsor Castle: really pretty from the outside but uninterested in the stuff inside
Lacock: town was cute but not much to see
Cambridge: it was too busy, less to see than the other places, and Irene and I were cranky at the end of the day; botanical gardens had a lovely scented garden where I stopped and smelled every flower; would not go again

Restaurants:

Masons Arms: delicious Sunday Roast; the Yorkshire pudding was fluffy; the vegetables stole the show away from the roast, specifically the buttery green one that tasted like popcorn and the carrots
The Cheese Bar - Seven Dials: all you can eat cheese was such a great deal and I loved every second of it, but then I got sick of cheese; make an earlier reservation because they close the kitchen and then you have to order everything at once
Fleurie: BEST COCKTAIL EVER (also first cocktail ever) - ask for a French Martini from Bartender Ben; the beef tartare wasn't my favorite, it tasted too much like radish; very fancy with the escargot and scallops; beautiful presentation but very pricey
Circolo Populare: carbonara was worse than Tonis but it came in a cheese wheel and the restaurant was the prettiest I have ever seen so I give points for ambiance
Tonis Amalfi Italian Restaurant and Pizzeria: the waiter was funny because he forgot me (but it was actually funny cuz I was the only one there); carbonara was to die for, was enough for two meals
Regency Cafe: stellar english breakfast for cheap, would not get the bread pudding again
Dishoom: overrated, but that may have been because I only tried one thing (lamb); super expensive, and definitely book a reservation
The Cheese Bar - Camden: this was low on my ratings just because I ordered the blue cheese grilled cheese and it was not good; blue cheese is not meant to be melted
Roti King: the curry and roti were nice, but I'm just not one for that type of cuisine
Brown Rice: all you can eat thai was good, but not exemplar; they had a few dishes that were tasty but I do not think I would go again unless I wanted something cheap
Uzamaki: they got my order wrong twice; at least they gave the wrong order to me for free

Pastries/Desserts:

Mamasons Dirty Ice Cream: the ube ice cream was super good, the halo halo part underneath less so, so I would only order the ube next time
Buns from home: flaky cinnamon bun that didn't feel too heavy
Krispy Kreme: slightly ashamed to have an American chain on here but Maya wanted to go, and they had friends decorations and themed donuts, so I give them a free pass (plain donut was the best); plus they gave us an extra donut
Arome Bakery - Mercer Street: I didn't care for the matcha or egg tart; honey butter toast was okay but had a weird flavor; loved the pastry with tomato, cheese and pesto!
George & Davis (Oxford): mango sorbet was yummy, would go again
Donutelier: didn't understand the hype, besides that they are very pretty donuts; I could have also just gotten a bad one, as I discovered I don't like fruit flavors mixed with donuts (passion fruit I believe); super expensive

Markets

Camden Market: so many shops and I like how they have their own space so it feels less crowded, lots of food options, would go again
Seven Dials: bonus points for the accessible, free bathroom and for the revolving cheese bar; very modern but doesn't give market vibes
Borough Market: too crowded, and the juice I got was so sticky, not my fav
Portobello Market: boring, too many totes and jewelry
Greenwich Market: cute booths and introduced me to a Scottish eggs, but nothign special

Plays/Musicals

Babies: most well-produced, relatable, and fun musical I've ever seen; I loved the soundtrack and would buy a copy of it in a heartbeat
Wicked: too loud and hard to understand, and not my kind of music
The Secret Garden: outdoor venue was cool but I couldn't take food in, and the main character was intolerable, and the music and storyline were not my favorite
Mousetrap: the theater was so hot and the seat was so uncomfortable, though I did appreciate the plot twist; it seemed to drag on for a while though