The Puurlee Podcast with Nika Lawrie

Rethinking Healthcare Delivery with Megan McCormack

• Megan McCormack • Season 2020 • Episode 6

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In this insightful episode, Nika engages in a thought-provoking conversation with Megan McCormack, a recent law school graduate with a broad spectrum of experience ranging from civil litigation to immigration and environmental law. Drawing upon her diverse legal background and her significant international experience, including an 8-year tenure in Spain, Megan brings a unique perspective to the table. As someone who is not only well-versed in the legal landscape but also bilingual and holds a master's degree in Bilingual and Multicultural Education, she offers valuable insights into the comparative analysis of healthcare systems in the US and Spain.

Together, Nika and Megan dissect the intricacies of healthcare management in both countries, identifying the strengths and weaknesses inherent within each system. Their discussion delves into the core elements that contribute to the efficacy and efficiency of healthcare delivery, patient care, and overall health outcomes. By exploring what works and what doesn’t in both contexts, they aim to uncover potential strategies that could inspire improvements in the United States' healthcare system. Megan's expertise and international exposure enable her to contribute meaningfully to the dialogue on how cross-cultural insights and diverse healthcare management practices could inform and enhance the US healthcare landscape.

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Nika Lawrie:

Hey everybody, I am super excited for today. Thank you so much for joining me. My guest is one of my favorite people in the whole wide world. She is my beautiful cousin, Megan. Guest is one of my favorite people in the whole wide world. She is my beautiful cousin, Megan, but she also has had some pretty incredible experiences in her life and I've actually invited her on to talk about the difference between US healthcare and healthcare in Spain and she has a unique vantage point or viewpoint on it and she and I have had multiple conversations about the differences and how I think we might be able to better things here in the US. But anyways, thank you, Megan, so much for joining me. How are you?

Megan McCormack:

Great, thank you Thanks for having me.

Nika Lawrie:

Yeah, yeah, so you spent nearly a decade living in Spain. Can you tell me a little bit about what that was like and why you moved there in the first place? And, just you know, give me your background story about that.

Megan McCormack:

Yeah, absolutely. So I moved out there originally when I was studying abroad in college and I spent six months in southern Spain, granada, and I fell in love with the language and the culture and ended up having to go back home to UNM and finish my degree before I could actually go back. But I decided instead of doing that, I finished my degree doing correspondence online so I could just move back to Spain right away. I lived in Sevilla and then I moved up north to Valladolid, which is like northwest of Madrid. Okay, I lived there for a year and then I moved back to Madrid and I lived in Madrid for most of my time. I think I was there a total of six and a half years and Madrid is definitely my home. I consider Madrid my home.

Nika Lawrie:

Yeah, yeah, beautiful. I don't know why I didn't take the opportunity to visit you there. We were there. I should have the opportunity to visit you there. We were there. So you've recently moved back to the States to pursue a career in law. What inspired you to make that kind of change? I mean, that's a huge change to make.

Megan McCormack:

That was a really hard decision to make, actually, because obviously I was really happy with my life in Spain. I just didn't really feel like I was living up to my potential in Spain. I really enjoyed teaching. You know, I taught English on different in public school and private academies, different things, and I got a master's in bilingual education while I was there and I really enjoyed it. But I didn't think that I was really doing what I was made to do. And because I'd studied political science, I thought, you know, doing what I was made to do and because I'd studied political science, I thought, you know, I'd always wanted to go to law school and then, especially after the 2016 election, I, yeah, maybe I need to go back and do something that's worthwhile. You know, that was a really big um catapult for me to come back and actually go to law school, definitely so.

Nika Lawrie:

Like I mentioned a few minutes ago, you and I have had multiple conversations about the healthcare systems, especially while you were in Spain. But since you've been back as well, can you explain a little bit for the listeners, like what are kind of the fundamental differences, or the approaches that are different, between the Spain's healthcare system and the United States?

Megan McCormack:

So the biggest difference is that Spain has universal healthcare. It's subsidized by the government through taxes, which would be called, I think a single payer is what we call it and the main difference is that everybody, no matter how much money you make, if you have a job you don't have a job, if you're actually a resident or not you can go and get free emergency care and usually long-term care if you have any kind of paperwork. But if you have a visa, for example, I had a visa and I had my paperwork so I could apply to be part of the healthcare system and they give you a little card and you can go to your local clinic for checkups and you know, any kind of medic like medication you need, um, completely free. The most expensive prescription I ever got was maybe three euros and yeah, what? $5. Yeah, something like that. Yeah, um, I, you know, you can go to whatever pharmacy you want. There's no, you have to go to this pharmacy or you have to go here.

Megan McCormack:

Um, that was, I think, the biggest issue.

Megan McCormack:

For me was like I feel sick, I'm gonna go to the doctor, and it took me maybe a year and a half to think, wow, I have bronchitischitis, I'm going to go to the doctor.

Megan McCormack:

You know, we're taught here in the US like, unless you're dying, don't go to the hospital. You don't have to pay to go to the hospital, whereas there, you know, I think it's kind of a double edged sword where there are a lot of people that take advantage of that system where they have, you know, a bump on their shoulder and they're like, oh, I have to go to the emergency room. You know, I think that's a really big issue that they have there, but generally speaking, people use it because they pay for it, right, and I think that the big trade-off for us in Spain is that, you know, you don't have to pay out of pocket for anything because it's already taken off your paycheck. So every month you'll see what you're taking off in taxes to go to the system, and people don't mind because they know that they're actually getting the benefit of those resources.

Nika Lawrie:

So in a sense it's very similar to how, when we work for a corporation, we pay for insurance through a private company, but it's taken out, you know, beforehand in our paychecks. So it's the same kind of concept. You really don't think about it, but you actually have straightforward access that even when you have private insurance here sometimes you may not have that direct access. Yeah, so one of the complaints that you hear a lot here when people talk about single payer healthcare or, you know, making a universal healthcare system here in the States, is is long lines or you wouldn't be able to see the doctor of your choice, or you know they're going to control the decisions of your health, those kinds of things. Did you ever personally run into situations like that when you were in Spain?

Megan McCormack:

You know, I did go to a specialist once. I had my hands x-rayed because I broke a finger and I went to the emergency room and they said okay, we're going to send you for x-rays. I had to go maybe a mile up the road to a bigger hospital and sat there for maybe 45 minutes.

Nika Lawrie:

So not like the 12 and a half hours that you sit in the ER here, okay, no, absolutely.

Megan McCormack:

I mean, I think the longest time I ever spent waiting was for an appointment I made because people come in, you know, when they don't have appointments and they take it open. So I think I sat longer in a hospital waiting for my appointment because there were people that had, you know, more urgent needs than mine. Right, right, even maybe three hours, you know, I don't think I ever spent longer than three hours waiting for anything, and I know that you know, if you have scheduled procedures, things like you need a hip replacement, replacement or and I know that going to see a gynecologist is actually the hardest thing to do, it took, uh, four months for me to actually see a gynecologist. Uh, those kind of things that are specialized services. If you go through the public system, they take longer you know, because there are less professionals.

Megan McCormack:

But generally speaking there aren't any lines that you sit in for a whole day to get service. No, and people do private insurance. You can pay. Most people have private insurance through their job or you know they want extra care and they can go to private hospitals for that. You know they have a private option too.

Nika Lawrie:

Yeah, yeah, and you when you look at you know the specialty issues here. Like I have a loved one who needs to see a neurologist here and his appointments are usually about six months out. And recently he had waited six months and then COVID hit and they shut all you know everything down here, obviously, and then he's got. He's now been pushed out another six months and so it's been a year now that he's been waiting, or it will be a year he will have been waiting to see a neurologist, yet he still hasn't seen one. And we don't even know if, when, his next appointment if that's going to still, you know, be there he'll be able to get in. His next appointment, if that's going to still, you know be there he'll be able to get in. And so you know, four months to six months to a year isn't, isn't quite as bad.

Megan McCormack:

Right, and then you still have to pay for that.

Nika Lawrie:

Yes, yeah, yeah, yeah. So one of the things that I really try to focus on as a health coach just trying to get my clients to understand a holistic approach to health. So it's not just, you know, people always think health is just eating well and exercising right, but there really are a lot of other fundamental aspects that feed into your overall health, and part of that is like rest and rejuvenation, so getting good sleep, relaxing at times, meditation, mindfulness, those kind of things. Relaxing at times, meditation, mindfulness, those kind of things. Mental health support, really trying to focus on keeping your stress and anxiety down, making sure you're not in a depressed state, and then other things like focusing on your relationship and family and those kind of things.

Nika Lawrie:

I know, in general, spain's culture is kind of different than the US. Spain's culture is kind of different than the US, especially with, like CS says, and stuff like that. Do you think that they take a cultural approach to the healthcare system that we may not do so here in the US because we're so driven by go, go, go. It's all about the hustle kind of thing. Do you see a difference in the cultural approach to health?

Megan McCormack:

Absolutely 100%. I think one of the yeah, like you mentioned siestas are a really big deal, no joking matter.

Nika Lawrie:

So for the listeners who don't know what siestas are, can you explain what a siesta is?

Megan McCormack:

Sure, a siesta is a nap essentially. So people get off work around one o'clock, two o'clock usually, and they have an hour, two hour break from school. They let students out from their school to have a siesta. They go home, eat lunch, take a nap and then go back to school and most jobs have the same. Restaurants will be closed, businesses will be closed. Most businesses shut down between two and four and this is to allow people the time to go have time with their family, go pick up your kids, have lunch, take a nap, come back to work and they have quarter work days. Of course, I think they usually get around seven as opposed to five, but they have that break in the middle of the day and it's really really beneficial for the mental state of everybody. Um, and they, it's really really beneficial for the mental state of everybody.

Megan McCormack:

I mean, I personally benefited a lot from the siestas yeah, yeah.

Nika Lawrie:

What do you mean? What was kind of the driving force behind that? Do you know why that became such a such an ingrained thing in our culture?

Megan McCormack:

well, because spain originally was all agrarian, like a lot of you know agriculture and during, especially in the center of the country, it's really, really, really hot in the course of the day. Nobody wants to work in the sun when it's 35 degrees outside Celsius, which is 102 degrees Fahrenheit Fahrenheit, yeah, and you know nobody wants to work those hours, so they would just take a break and then go back when it was cooler.

Nika Lawrie:

So you mentioned a little bit about your personal experience with the healthcare system. But in general, did you find it fairly easy, or was it more cumbersome or difficult to use, I guess, and in comparison to using the healthcare system here in the United States?

Megan McCormack:

I've actually found it pretty easy. I think the hardest part was the bureaucracy. You know you do have to get your paperwork in. And the biggest issue was if you move, you know around the city they organize how you get your healthcare by the region of the city you're in. So if I move apartments from one area to another, I have to redo paperwork to get my to go to see the doctors in that area. So that is an issue that people say oh, you can't have. You know, with universal health care you can't have your doctor, right? I think that's something that you know because the spanish system has really well-trained doctors.

Megan McCormack:

That's never really true to them. They don't think of that as a problem and they you know people don't tend to move. If you buy a house, you live in that area. Right, right, right. Yeah, you know, you just have to get new paperwork saying I'm a resident of this region, of this area, I'm gonna go see this doctor and you just change your paperwork. It's not any worse than it is having to go through your HMO. You know where you have to really fight with your insurance provider to get them to cover things. I would rather just go to a different doctor, or have to do hours of paperwork instead of you know, knowing that it's going to be paid for, instead of actually having to fight for that money.

Nika Lawrie:

Right, right, yeah. So in your opinion, what are some of the things that we as a country here in the US could do to improve our healthcare system? Maybe, you know, take away some of the things that do work in Spain and implement them here. Do you have any thoughts on that?

Megan McCormack:

Well, I think diet is a really big deal. In Spain they have, you know, a diet based on olive oil and tomatoes and fish and a lot of you know natural foods, where they don't eat a lot of processed foods. I mean it's increasing. You can see more in the grocery stores like more food that comes kind of from the United States, where I think when I first moved to Spain, it was impossible to find peanut butter.

Nika Lawrie:

I really wanted peanut butter and I would find it it would be 10 euros for a little jar of peanut butter. I heard somewhere that there was a fight over like Nutella or something like that.

Megan McCormack:

Is that true? Nutella is actually really common in Spain. Really, I don't know.

Megan McCormack:

Maybe that was somewhere else, yeah, yeah, put Nutella on toast for like a normal, yeah, but anything that's kind of more Western, I would say more American, they don't really it's not part of their main diet. And the people now that are moving like globalization, everything, yeah, it's a little bit easier to get foods that aren't from that country, right, but any kind of foods that are processed really aren't typical in a family, you know, especially because they live with their grandparents or they live with their parents until they're married usually. So they kind of center around the family and they center around the tradition of making food, like paella, you know, which takes hours, and that's the kind of slow way of the spanish culture is. Like me, eating is something that is, um, it's a process, it's not just let's go eat something and then go.

Nika Lawrie:

Food is a priority. Meals are a priority, opposed to just a means to keep going, kind of thing. Yeah, yeah, I think that's a really important thing that we need to shift here in the US is understanding the value of food, and when I say value, I mean the quality of food that we're eating and then taking time to enjoy those meals to you know. Look at meal prep and actually sitting down and eating those meals as some of the most valuable um most valuable time we have throughout the day.

Megan McCormack:

I definitely agree. Yeah, it really occurred to me once when I wondered why restaurants? We go to a restaurant for hours. You know you have tapas and you have drinks. You know it's a long process. The reason why it was so weird to me was that you know American restaurants are driven by turnover Right. Who has ever worked at a restaurant? You know, as a waitress, you want more tables.

Nika Lawrie:

Right.

Megan McCormack:

You want them to go come in, eat and work, and the way that that works in Spain is that they don't get paid by tips. You know, you get paid a salary, so they don't care if you're there all day, right, yeah, and it really took a while for that to occur to me. Like why don't they mind us sitting here? Oh, because they're not waiting for their tip.

Nika Lawrie:

Right.

Megan McCormack:

Yeah, yeah, everything kind of links in together.

Nika Lawrie:

Mm-hmm. So what are some of the things that you think you know us as private citizens can do to support or push through possible change in our healthcare system?

Megan McCormack:

That's a really hard question, because I think everybody knows that healthcare is something that is really far reaching and that something that may work in my state won't work in someone else's state, right? Um, but I think, in general, people have to be more participative in their democracy. I think number one everybody has to vote for people they believe are really going to work for their interests and not based on party, like I. You know, I know people that they that vote straight down party lines and in my past I don't think I I've probably done that a couple of times, but I think now that you get older, you kind of realize what they're actually about is more important, right? People that really care about investing in preventative issues or preventative healthcare. People like that should be the one who are voting for, as opposed to people that just want the status quo and to maintain, you know, private healthcare is the only way Right, and maybe even also understanding that you can register to vote in a party.

Nika Lawrie:

So, whether that's Republican or Democrat, or as an independent, but then, when you're actually there, day of voting, consider yourself more of an independent and do your research on the different candidates and, and especially at a local level, really focusing on you know how people are voting, how the candidates are voting for different topics or issues.

Megan McCormack:

Absolutely. I think another issue that we kind of forget about is that there is a really big influence of corporations in everything and you know. Being aware of what corporations you support and where you spend your money, I think is also something that we really should be better at. I don't know if everyone is so conscious about where they're buying their groceries or where they're buying you know whatever, because whatever corporations do with that money also affects our politics, and I think that's a big issue too.

Nika Lawrie:

Yeah, bouncing off of that, you know I went camping with my family this weekend and I was having a conversation with my mom about, you know, some of the political things that are going on in the world and especially in our country right now, and that, even though you may not feel like your vote counts or matters because of everything that's going on, your checkbook matters and that I really try to pay wholehearted attention to where I spend my money and what kind of products I buy, because dollar bills will shift political change. Dollar bills will change systems. Dollar bills will change you know what products are being created and offered to us and so, yeah, you know power power's in the checkbook for sure.

Megan McCormack:

Absolutely.

Nika Lawrie:

And I think that the debit or credit card I should say, since nobody really writes checks anymore.

Megan McCormack:

But yeah, but yeah, I think that's something that really affects us more in this country than in a lot of other countries, because they have different systems where money isn't such a big driver in their political parties or their campaigns, whereas I think everybody knows here that that's the main driver. Right, and I think that's one of the things that, if we're all just more conscious about, we can at least push towards a better future. Maybe not fix everything right now, because that's impossible, but you know, at least do something where we're moving in the right direction Right, definitely.

Nika Lawrie:

Definitely. So. Moving forward with law school, you know kind of getting a little more personal here. What's your plan for the future, what you know? You talked about kind of wanting to make a difference.

Megan McCormack:

What's your focus with law school going forward? Well, right now, I mean, originally I went to law school because I thought the situation with the immigration in this country has become unbearable, and I personally cannot stand what's happening on the border in the country and with detainment situation like there's a number of issues, but I really, I really think that that's something that I'm passionate about. It's also a really hard topic to deal with on the you know, on the daily. Yeah, that's something that I really like to do, but maybe not forever, because I think you can. There's a really good chance of burnout if you go into a situation or anything where you know, emotionally, there are hard topics to deal with.

Megan McCormack:

I think one of the things that I've been thinking through recently is that civil rights law is something that I'm recognizing more and more every day, especially right now. How civil rights are things that we just take for granted, absolutely, and I would really really like to work with the ACLU. You know like places that are really doing work to protect people from, you know, infringing on their civil rights and and that means everything you know I think people think that you know, having the Second Amendment is more important to them, or the second amendment is more important to them or the first amendment is more important to them that it will squash the other one, right? You know? I think that that's absolutely incorrect. So, going forward, I think what I'm really going to do is work, work on trying to get into policy, work, because that's where really laws can be changed and that's kind of my future. I think that's where I could thrive. I'm not sure, I'm not sure yet.

Nika Lawrie:

Of course I love that I'll have to have you back on when you get farther into it, cause the reason I named this podcast how change happens is to look at how change happens within us personally, how we change our habits and behaviors. How we change, you know the system and different issues that we're facing. You know, especially around health and food and those kinds of things, how we change that at a at a local level through our government and our community activities, and then also how we look at making that change at a national level too. You know how do we make global policies that are going to make things better for everybody, for humankind in general, and and so when you get further down with you know policies and making change, I'd love to have you back on Absolutely yeah, yeah. So, megan, where can people find you online? Where can listeners connect with you?

Megan McCormack:

Um, I'm on Instagram, I'm on Facebook. I do have LinkedIn, but I don't use it for any kind of personal issues. Yeah, and those are the ones I really use. I don't believe in Twitter. I know everyone loves Twitter, but I just don't have time for Twitter.

Nika Lawrie:

It's where the trolls live. All right, megan. Last question for you what advice do you have for someone who wants to make change either in their life, their community or at a global level?

Megan McCormack:

I think number one you really have to know what you want out of yourself before you can really do anything to change anything outside of yourself. That's something that I struggled with a long time when I was in my early 20s. That's something that I struggled with a long time when I was in my early 20s, and it takes a lot to see. This is what I want to do and know what your goal is and take baby steps on how to get there. Yeah, nothing happens overnight. But being passionate and knowing what you're passionate about and finding ways to work towards helping what you're passionate about, I think it would help everybody. Anyone can do it, no matter what they're passionate about. I think is it would help any everybody. You know anyone can do it, no matter what they're passionate about.

Nika Lawrie:

You know I love that. To quote the, you know the personal development King, tony Robbins, his thing is always clarity is power. And so you know you get clear on what you want, get clear on your goals. It gives you power and motivation and momentum to make those things happen. But if you don't know what you want, you aren't gonna be able to get there. Absolutely Awesome. Well, thank you, megan, so much for your time. I am super, super grateful for just your insight and your perspective and just your experience going through the different healthcare systems and again, I can't wait to have you back on when you're further along with your law school and just your career.

Megan McCormack:

Absolutely, thank you.

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