The Parish Pump in an Age of Algorithms

By Paracelsus Asia

I’m a War Baby as opposed to a Baby Boomer, which I hope will not invalidate anything I have to contribute to a column entitled Boomer Corner. Such generational categories are helpful and fun, if not demographically or geographically exact. As a War Baby (1939-45), vintage 1944, I was born in Britain, as was my elder brother. In his case in 1940. My American cousin, if I had had one, born in the same year as my brother, would not have been a War Baby at all. He would have to have been called something else, as the US did not enter WW2 until 1941. My wife on the other hand, born in 1946, was very much in the first wave of Baby Boomerdom, or what later came to be described as the “Me generation” – don’t ask me why.

The Baby Boomer cohort lasted 18 years until 1964 and if popular music is a large part of what defines a generation, as I believe it does, it was the War Babies and the Baby Boomers who, through the 1950s, 60s and 70s, brought us the rock music and radical social change of the era. And later, alas – it must be owned, the neo-liberal and conservative claw-back that took place as they aged, prospered and put on weight. The Gen X’ers (1965-76) and the Millennials (1977-95) are the ones who created and brought us into an online world and… to the brink of a post-human future. With all that under the belt, where the Centennials (1996 onward) will lead us… we can only wait and see. Whatever that future is – War Baby through Centennial – it is something we have all brung upon ourselves… and the rest of the planet.

If early retirement can be taken aged 50, often the case nowadays as the middle-aged seek new occupations more in keeping with the people they have become, then a 50-year old man or woman relocating to Bali today would have been born in 1968, a soixante-huitard at birth and a gilet jaune at his or her “re-birth”, you could say. And – dare one hope, a portent of more equitable days to come.

Boomer Corner with the exception of myself, a male War Baby, currently comprises four Boomer ladies who could hardly be better qualified to explore and relay to the Bali Advertiser readership the ins and outs of forging an extended and pleasant stay in Bali. Ines Wynn, largely responsible for birthing the concept, ably set out the parameters; Ibu Kat, tellingly addressed the problem of medical insurance, which weighs heavy on so many of us; Susan Tereba movingly recounts her experience taking care of her husband with Alzheimer’s in Bali; and Shari, who gave the best steer possible on going grey gracefully, courtesy of Canggu Max.

Take Ibu Kat’s piece on medical insurance for example. Her report is quite chilling and the younger we take aboard the realities of how this industry operates the better it will go for us down the pike.The message is, choose early – and choose carefully, making sure there a no horrors embedded in the small print to swag you when you hit your 70’s. That requires informed research and don’t forget – portability. Then, having consulted a trusted professional (Kat mentioned several) get yourself and your family aboard.

It’s wise to check out your own country’s national health entitlements for its expatriates too, if they have one. Some, like France with its CFE, will provide overseas essential coverage at very reasonable rates which, with a small top up from the private sector, can give you coverage that equals the best anywhere. By this I mean, no age increases, no exclusions or loadings for pre-existing conditions, plus emergency evacuation. A major heart operation costing over US$100,000 in Singapore will cost under Euro 40,000 in Germany or France.

If you are an Australian, it’s a no-brainer. Australia has one of the best public health services there is (and what’s more, the service itself is in robust good health, unlike the venerable NHS in Britain or the Bolshevik tendency that afflicts the French system ).

As noted, swank new hospitals do not a good health service make. There are good doctors here and there are times when the art of medicine combined with long experience can work as well, if not better than the science of it. But are there enough such doctors? How is it that we see the same doctors’ names appearing on the practitioner boards in so many different hospitals in Bali? Do they have the modern diagnostic equipment needed and when they do, are the technicians available to operate and translate the results effectively?

I doubt it. My wife’s pulmonary specialist salivates visibly when he sees the standard and detail of X-rays she brings back from Singapore. And 18 months ago, I don’t know about now, there was only one holter heart monitor, a wearable device used to measure heart beat over a 24-hour period, available on the entire island.

For the uninsured and those with limited resources you can find good treatment from an experienced doctor here who will, if he’s doing he’s job properly, tell you if he can treat you successfully here or if you should go elsewhere for diagnosis and treatment. In which case, hospitals in Bangkok, Penang and India are where you need to look. For diagnostic purposes only, the Raffles Centre in Singapore is hard to beat. Unless you are covered or are very wealthy, do not get yourself admitted in Singapore, if it can be avoided. Once you are, the costs are eye-watering.

For all of us, insured or not, disease prevention is by far the best option. That means a healthy life style in terms of exercise and diet. Therapeutically, clinical nutrition is the great scandal and shame of modern medicine, in that it is relegated to the closet. Eating well will keep you healthy and properly applied can cure or alleviate many chronic conditions. Real food is by far the best option but effective supplementation under expert direction can work wonders.

However there are snags. First you need to know that what your taking is 1) any good, and 2) if your taking it in the right amount to do you any good. And lastly 3) supplementation and most of the alternative treatments prescribed by a qualified integrative MD may be cost-effective but they are not cheap and often not covered by insurance.

The biggest snag here is that it is next to impossible to purchase any of the formulations that can help you in Bali. As in most countries, in the past Indonesia allowed you to import nutrititional supplements by post providing they were for personal consumption and in a reasonable quantity, not for re-sale. A reasonable supply was considered to be three months worth. The import tax was minimal.

Regretably there was a ministerial land grab recently on behalf of customs department at the expense of the national postal service and now no nutritional supplements are allowed to enter the country and must be sent back to place of origin. You can’t even ‘ransom’ them at any price. They are in fact treated as if they’re pharmaceuticals , which means they cannot be imported until each individual ingredient in a formulation has been approved by BPOM, the regulatory body. This is a lengthy and expensive process and not an option for individuals. It is a misapplied restrictive practice that in theory is intended to protect us from the import of unregulated pharmaceuticals.

Until a less corporate or a more user-friendly regime prevails, the only practical option is to bring in the supplements you need yourself, or to set up an informal ring among friends and acquaintances so you can assist each other when you return from overseas trips.

As Ines Wynn says when introducing the column, she hopes there can be a lively interaction and exchange of useful information developing in and around Boomer Corner.

In a world that is already heavily influenced by manipulative algorithms, in ways we are only now beginning to perceive, an open-hearted sharing among BA readers as to their knowledge and experience of Bali is a one good way of fighting back. A lively exchange of information and views alongside this column and hopefully online would not only be an organic and valuable resource but a refreshing change.

The Boomer Corner is a column dedicated to people over 60 living in Bali. Its mandate is to cover topics, practicalities, activities, issues, concerns and events related to senior life in Bali. We welcome suggestions from readers.
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