100 piped up to “What’s So Bad About Universal Healthcare In America?”

1. Stacia Kane Posted: Jan 7th, 2009 at 11:29 am

   1 There should undoubtedly be some form of universal healthcare in the US–at least more than the Medicare/Medicaid system, which is what we have now. I like the idea of health insurance offered through the gov’t and partially subsidized (which was my husband’s idea). There would also be tax breaks and incentives for companies of any size which provide health care for their employees; that alone I think would be fantastic. I also liked my own idea where free clinics are built and doctors, nurses etc. must volunteer a certain number of hours in them per month to keep their licenses; the amount of hours would vary according to their specialty if any and where they work. An ER nurse or doctor may not have to give many hours; a school nurse or private GP may have to give more. What I am adamantly opposed to is government health care along the lines of the UK’s system. I don’t want the government making decisions about what sort of treatment I get. I don’t want to wait a week and a half for an X-ray and then another week and a half for the results, while my bones begin to knit incorrectly. I don’t want to be examined by doctors and nurses who dried their hands with germ-breeding air dryers because they’re cheaper than paper towel; 1 in 5 patients in the UK leaves the hospital with some form of MRSA, thanks in part to gov’t budget-cutting in areas like disinfectants and sanitation. I don’t want my children denied a TB shot because the gov’t has decided there haven’t been any cases of TB in my area for a few years so it’s not worth the money to protect them from it. I don’t want to be told “You look pretty healthy, so come back if you start coughing up blood” when I have bronchitis and my lungs make sucky noises with my every breath. I don’t want to only be permitted a pap smear every three years despite my minor history of cervical dysplasia. I don’t want to be told I cannot have a mammogram until I’m 40 despite a strong family history of breast cancer, as was a friend of mine in England. I don’t want to not be permitted to “waste time and money” getting routine blood tests and annual physicals. And of course because it’s a gov’t monopoly there’s nowhere else to go without buying incredibly expensive private insurance if you even can. I don’t want to be forced to see a midwife rather than a doctor for my pregnancies. I don’t want to be refused certain tests and treatments. I don’t want to be refused certain pain medications or the opportunity to schedule a cesarian in advance. I don’t want to be stuck after the birth in a maternity ward, a big room with a dozen other postpartum women and their babies, with no phone and no privacy, and forced to go home after six hours. (Although I will say the Health Visitor thing is pretty cool.) A friend of mine had a baby in England (I SWEAR the following story is 100% true, unbeliavble as it sounds). She tore badly. For whatever reason they didn’t stitch her up for a couple of hours after. They stitched her incorrectly. Really, horribly incorrectly; crookedly, and so some of her nerve endings were exposed. Then some of the stitches started to dissolve and some didn’t. Bottom line, she was in terrific pain all the time. She could hardly walk or sit down, much less have sex. She begged the NHS to operate. They refused, because “when [she] ha[d] another baby, it would re-tear, and they’ll fix it then.” Never mind the fact that she couldn’t have sex at all. They specifically told her it was a money issue. She finally went back to the States, where her old gyno immediately gave her some numbing cream–the NHS didn’t even do that much for her–and scheduled an operation, either for free or at a highly reduced rate; the gyno could do that because it was a private practice and she owned all the necessary equipment. A year and a half after she had her baby she was finally able to have sex again. No thanks to the NHS. I could go on and on and on. I simply don’t understand people who want doctors and nurses et al to become government workers. I don’t understand people who want the government to make decisions about their health care. The government is like the worst, harshest, most tight-fisted HMO you’ll ever find. I’d love to see some reform in the American system and I believe strongly that it’s shameful that everyone doesn’t get needed care (although I wish people would remember that public hospitals HAVE TO treat you and WILL make payment arrangements with you; it’s not like medical care is completely inaccessible to the poor. My father-in-law got cancer treatment that way–good, solid, life-saving treatment–and was allowed to pay for it at something like $30 per month) I’d love to see a better system especially for childhood vaccinations etc. But the UK system is not the way to go, not for me. I understand that not everyone’s experiences may not be like those of the people I know, because of that infamous Health Care Postcode Lottery, but the UK healthcare I’ve known or heard about is shamefully inadequate. “Universal healthcare” sounds so good, so utopian. Everyone is taken care of! Everyone gets the help they need! Tra la la! But the reality is that the overall quality of care falls. JMO/JME. I’m sure other people’s will vary. (And please don’t take my feelings about the NHS to be indicative of my feelings about England or the UK in general or the people in it, okay? They’re not.)

2. Katharina Posted: Jan 7th, 2009 at 12:01 pm

   2 In my country, Austria, health care is organised and given by the government. It’s by no means perfect, but I’ve never waited to see a specialist, never been denied x-rays, important medicaments, or catched any germ-related illness in a hospital. If an operation needs to be done, it is done so and quickly. In her life my mother had breast cancer, twice, and both hips replaced. Those were operations that were arranged in a matter of weeks, because they were urgent. I sometimes get the impression that health care provided by governments t is associated with sloppiness and untrustworthy treatments. Of course there are problems, I would love to have my glasses and contact lenses taken care of, same goes for any non amalgam fillings, but in comparison those things appear minor to me. I never have to worry to loose my house in order to pay off my mother’s medical bills from cancer treatment, or go without insurance because I am unemployed or don’t have enough money to pay it. I personally don’t want my mental and physical health to be in the hands of private insurances that may or may not pay, depending on my job situation and the general state of my health (I have several friends in the States who fight every month for special treatments and pay up to a 1000$/month for extra stuff). I think it lies in the nature of us to prefer the devil we know, for US residents it’s thus the privately organised health care, for me – and I am very thankful for it – the governmental one.

3. Fae Sutherland Posted: Jan 7th, 2009 at 12:23 pm

   3 While I’d like national healthcare that is on par with private healthcare, for me it boils down to the fact that I do not trust our government enough to put my life in their hands. I don’t want the next Dubya to be able to decide that my good friend who never wants kids shouldn’t be allowed to get her tubes tied, because HE thinks women are breeding machines. I don’t want the government to be able to tell my many gay friends, some of whom are HIV positive, that their meds aren’t necessary because the current administration hates gays as much as the hatemongers who passed all those bills against them. That’s what frightens me about government healthcare. That those who the current administration, whoever it is, doesn’t like/agree with/want to deal with will be left to suffer simply because they’re not like everyone else.

4. Sparky Posted: Jan 7th, 2009 at 12:34 pm

   4 People suffering from diseases that could easily be treated – or are being bankrupted by medical costs is a tragedy. The fract it’s happening in the richest country in the world is boggling and speaks of a horrific lack of priorities People may not trust the government and government backed health care (though I have to say now I’ve never understood how Americans in particular can be so utterly paranoid of the government taking control of essential services – but so blase when COMPLETELY unaccountable and overtly out-to-screw-you-for-every-penny private company have the power.) As to the UK problems – MRSA – caused by privatising the cleaning services of hospitals in the new obsession of treating the NHS “like a business.” When the cleaning services were part of the NHS rather than outsourced to the lowest bidder it was immaculate A week for xray? I broke my arm, went in, xray and results the same day. I had a lung infection they suspected was pneumonia (it was) – in hospital same day, results next day. My aunt had breast cancer and her care was superlative. My cousin who had moved to America had bowel cancer and he WAS insured and he still had to fight tooth and nail for every treatment he needed. In the end he came back to the UK because he couldn’t take fighting his insurer for the treatment he needed to save his life. And I shudder to think what expenses my parents would have to fork out, My mum’s diabetic. My dad has high blood pressure. They’re both popping more pills than Boots stocks (and craving chocolate and bacon respectively) but at least all of their meds are paid for. I can’t imagine what such chronic conditions can do to insurance payments.

5. Angelia Sparrow Posted: Jan 7th, 2009 at 1:14 pm

   5 My co-author has high blood pressure. I am raising three children with on-going conditions. I work a job that is exacerbating the spread of arthritis to every major joint in my body to keep my health insurance. I would be more than thrilled to have some help here. The thing is, those in power (everywhere, including the media) see themselves as being stolen from to provide for the less worthy. They never see themselves as needing the help. As long as they continue to convince the majority of voters that helping others is a bad thing, there will be no reform. The insurance companies operate on a model of “no claims paid” as their ideal. How is THAT good medicine? And the idea of health savings accounts and making people shop around? When my kid is bleeding and oozing subcutaneous fat from a gash on her arm at 5 pm on a Saturday, as she was last August, I’m not freaking comparison shopping! I’m bandaging her and getting her to the nearest emergency room.

6. joanne Posted: Jan 7th, 2009 at 2:09 pm

   6 “I only have the opinions of Kondracke, Krauthammer and Barnes to go by, and quite frankly, as they’re all Fox News contributors, that isn’t saying much.” Well, there you go. You’re only going by the hard-line Republican POV. Most Americans want something to change. I think some kind of hybrid of public/private would work best here. Maybe something like France has.

7. Lolita Lopez Posted: Jan 7th, 2009 at 2:09 pm

   7 No one says that the American brand of universal healthcare has to an exact copy of the UK’s NHS or any other country. All of these country’s programs are great starting points and there’s no reason they can’t be improved upon by our policy makers. Personally, I’m quite fond of the idea of being able to access the same insurance plan provided to members of the senate and congress. I’d almost bet the farm their health insurance policy isn’t as shitty as mine. What’s really depressing though is my private health insurance policy is supposedly *great*. DH works as a medic so he gets his insurance premium paid by his employer. My monthly cost is $120. Our *fantastic* plan is a High Deductible/Health Savings Account plan. We have to hit our deductible of $3500 before we see any benefits. His employer seeds our HSA with $1500/year. We then have to shell out $2000/year before we get any coverage. DH has fairly well controlled Type II Diabetes. His routine biannual blood tests cost us $900-1200 *after* the hospital applies the reduced rates they’ve promised to customers of our insurance company. The meds he’d like to try to improve his blood sugar control aren’t covered by our insurance. Out of pocket, they’d cost us $800-1200/month. I have PCOS and POF. Because they’re infertility conditions, even simple blood tests that have absolutely nothing to do with fertility treatment but simply to do with monitoring my hormone levels have to be specifically coded by my doctor’s office or else our insurance company refuses to cover them. Obviously, any fertility treatments, monitoring, meds are denied too. And, of course, any money we spend out of pocket on infertility doesn’t count toward our overall deductible because those aren’t *covered* illnesses. Oh, and if DH and I ever lose our group health plan provided by his employer neither one of us will ever be able to get private insurance. When I lost my insurance coverage through my dad at 21, I was denied health insurance by every company I contacted because PCOS and POF are considered *rare* conditions. I was also overweight at the time and have a benign heart murmur. People who have great insurance and have never had problems with their insurance coverage don’t seem to understand just how bleak it is for the average American. If you’re overweight, have Type II diabetes, a heart condition, high blood pressure or any multitude of seemingly non-threatening conditions, you either won’t qualify for a policy or you’ll be priced out of a policy. People can’t afford $1000 or more a month for a crappy plan. I don’t think universal health care is the panacea for the USA’s healthcare woes, but, Christ, it’s a start. At least with a centralized health care insurance provider (like the senate/congressional plan), hospitals might be induced to provide services at similar costs across the country. That alone would bring a huge monetary relief to the families struggling to pay for their kids’ asthma treatments or for that person putting off a much-needed colonoscopy because of the up-front payment required.

8. Anne Douglas Posted: Jan 7th, 2009 at 2:32 pm

   8 Having lived both (coming from NZ which has a universal healthcare system also), I can safely tell you that the reason why many Americans get up in arms in this debate is frankly, because they’ve never experienced the other side. It’s quite that simple. There is this huge volume of propaganda, and it’s taken as truth. NO system is perfect. Not one. Horror stories abound on both sides of the fence. I’ve never had as bad service medically as I have here in the USA. Seriously. 6 months before I could even make an apt at a urologist for my 3 yr old, and then a 3 mth wait for the actual apt? WHAT? Or of course I could try the guy three States away and pay thousands for it as he is out of network… I’m constantly hearing about things like this “I don’t want to wait a week and a half for an X-ray and then another week and a half for the results, while my bones begin to knit incorrectly.” Frankly, it’s untrue rumour mongering. This is not some sort of standard, it’s not. Might it have happened? Yes, as I said no system is perfect, and you can see this EXACT thing happen here in the USA system. (Sorry Stacia, this is picking you out unfairly, but the quotes come from your post) And as for the pregnancy debate, I can show you just the same type of issues here in the States. The US is not the top of the leaderboard when it comes to obstetrics. And as for the govt controlling what you get or don’t get. Truely, get a clue. Your employer does that now for you via giving you less and less on your policy, and making you pay more and more for health insurance. If they are overtly conservative, you bet your bottom dollar they will tailor their policies to exclude whoever they damn well feel like. I’ve just had the fact hammered home the last week. I applied for approval for a surgery which would change my life considerably, but I’ve been totally excluded from it because the company has not included it in their insurance so they could cut costs. I now have to find twenty odd thousand dollars. I’ve heard the whine whine whine of “But you pay so much in taxes, I’m not paying more in taxes to get service I have to wait for and will be sub par”, and everytime I tell that person this: Take your taxes, add on your health insurance cost, now add on how much extra you had to pay to the hospital that the insurance wont cover (seriously a 3 day stay is an immediate 300-1000$ even if you sit in the bed and do nothing) and now come back to me on how much tax you pay. It’s a bit startling at the end of the year when, say in my instance, we pay $500 a month alone for the privilege of my son and I having coverage and no guarantee that the service we need will be covered when we need it. And just so it’s ackowledged, just because there is a universal health system doesn’t mean there isn’t a private one. In NZ you can pay for health insurance, so you can see what ever doctor you like, when ever you like, and have surgery where ever you like, and for considerably reasonable price, all things considered. But at the end of the day, no matter who you are, or where you are, you are entitled to health services at a minimum standard (which in NZ case is a fairly reasonable one, judging by my own experiences), which is not necessarily the case here in the USA. Sorry. This topic riles me up something fierce, and I will go toe to toe with my very right wing, gun toting friends on this one particular issue. And yes, I test a conservative liberal. LOL Oh, and I meant to say. In NZ they privatised the healthcare system a while back as it was a governmental nightmare. Changed the system considerably for the better. There are options that work.

9. Roslyn Holcomb Posted: Jan 7th, 2009 at 2:57 pm

   9 I’m with you Lolita. My husband lost his job back in 2007. We can’t afford the group plan at his job, and I can’t qualify for any private coverage because of PCOS. So, I have no health insurance at all and little chance of getting any anytime soon. I don’t understand for the life of me this blind faith Americans have in corporations and this blind distrust of government. Corporations routinely bend us over and fuck us up the ass, yet we still prefer them over government. If this last financial fiasco hasn’t taught us better, I guess nothing will. As for the government deciding what healthcare you receive and being conservative with it, that’s happening now. Pharmacists are refusing to fill birth control prescriptions, doctors are refusing to do procedures that are contrary to their belief system. Don’t even get me started on Plan B and RU-486. Women are being asked if they’re married before they can get birth control. Oddly enough, no one is asking men the same before they get Viagra filled. Corporations are hardly known as bastions of liberalism.

10. Rosie Posted: Jan 7th, 2009 at 3:11 pm

    10 As you can see from your comments this is a very personal issue for most people. Me too. I understand that most of the resistance is a bogus smoke and mirror twisted argument that basically comes down to money. I just resent that there isn’t any reasonable measured discussion about health care options. We just keep creating a bigger crisis year after year here in the good ole U.S. My husband and I have pretty good jobs so we have some pretty good medical insurance. This isn’t the case for many friends and other family members. My only solace is that for the first time in more than a decade I have hope and his name is Barack Obama. At the very least there might be some dialogue and at this point that’s something.

11. Karen Scott Posted: Jan 7th, 2009 at 3:13 pm

    11 What Anne said. Every damn word. TTG’s sister has cancer of the breast, bone and liver, and the care that she has had on the NHS has been fantastic. Had she had to pay for her treatments, I just don’t know what she would have done. TTG was pretty ill last year and we made the decision to go private, but that’s because we could afford it. If we hadn’t been able to afford it, then the NHS would have been more than adequate. As imperfect as our system is, at least I know that if I ever needed anything serious doing, I could trust it to treat me, without crippling me financially.

12. Cindy Posted: Jan 7th, 2009 at 3:20 pm

    12 Here in America, I called a highly recommended doctor in the spring because my heart was racing. The receptionist said “Why do you need the doctor?” I replied “Heart.” She told me the first open appointment for a new patient was a week and a half out. I wonder where the urgency for heart was. Sent for blood tests, my private insurance wouldn’t cover the bloodwork because they were routine. Lost the job and insurance due to back problem. Ended up in hospital and was approved for medicaid. Thryoid, lymphodema and who knows what else. Bills still aren’t paid and guess what? My medicaid only covers family planning prescriptions. *sigh* What I don’t need. Meantime, I have pain medicine and anxiety medicine prescriptions that I can’t get filled. And when the thyroid is gone, guess I won’t afford that pill either. Bah.

13. vein Posted: Jan 7th, 2009 at 3:28 pm

    13 Universal healthcare isn’t more expensive per se. As the increase in tax is accompanied by a reduction in insurance and co-pay. It has the potential to be cheaper due to removal of the profit motive, duplication of services (competition) and central admin. Of course it can also be run-down, unmotivated and sometreatments will not be permitted even if they could save you. Personally I think a basic level of free care is necessary and humane–just like a basic level of police protection, roads and education. But then those with wealth shouldn;t be prevented from “adding on” if the want to.

14. Lolita Lopez Posted: Jan 7th, 2009 at 3:45 pm

    14 Cindy, ooh, I know meds are expensive, but seriously, DO NOT let your thyroid prescription lapse. You can develop a Thyroid Storm. That is really dangerous, life-threatening even. Call around and see if you can get that ’scrip in a generic. DH takes a thyroid med and it’s on the $4 dollar list at most pharmacies. Roslyn, I’m so sorry you’re in that situation. As to the PCOS, have you ever checked out soulcysters.net? It’s an international support group for chicas fighting PCOS. It’s been a priceless asset in my struggle with this crap disorder. There’s tons of info on dealing with insurance companies and docs as well as general support and symptom specific forums, etc. And, Karen, you hit the nail on the head when you mentioned receiving treatment without being financially crippled. That’s what frustrates me the most. I would say a substantial chunk of American families are one serious illness or surgery or emergency away from losing their homes or filing bankruptcy. In a country that can find billions of dollars to support a war or bail out banks and Wall Street firms, it’s pretty ridiculous that we can’t find the money to enable all citizens of this country access to reasonably affordable healthcare.

15. Roslyn Holcomb Posted: Jan 7th, 2009 at 4:13 pm

    15 Yep, I’ve been on soulcysters for a while. I’m doing FitCysters now trying to get a handle on this disorder. Trying to save up enough money now to get an appointment with an endocrinologist. Don’t know when or if that’ll happen considering we had to relocate when my husband finally found a job. I still haven’t been able to find anything. It’s tougher because I definitely need a job WITH benefits. In social services that’s hard to come by these days.

16. JenB Posted: Jan 7th, 2009 at 4:19 pm

    16 I like the idea of universal healthcare…or at least semi-universal (I think taxpaying legal citizens should get top priority), but it’s tough to implement in a country that’s never had that kind of system. Quite frankly, the idea of tearing down the existing healthcare system and starting over from scratch worries me more than the current outrageous price of health insurance. I’m an insurance agent though (property/casualty, NOT life/health), and I come from a long line of healthcare administrators, so I kind of see it from a different angle than most of my peers.

17. Tuscan Capo Posted: Jan 7th, 2009 at 4:47 pm

    17 I think something has to be done, even if it does meaning starting from scratch. I read somewhere that credit collection agencies see more business from hospitals and physicians than any other industry. When you have people having to forgo medications just to pay for housing & bills, hospitals that charge $12+ for one tylenol, and individuals seeing their credit go down the drain because health insurance companies lag behind paying their due portion of a physician bill it is evident that something is sinisterly wrong with the system as it is.

18. Karen Scott Posted: Jan 7th, 2009 at 5:27 pm

    18 Back in 2005 (or was it 2000?) when the World Health Org used to produce such stats, the US healthcare system came 34th in the world ranking, with 1 being the best. That is surely not good enough for such a powerful nation? I agree with the comment about Americans distrusting their govt more than the greedy corporations who are usually out for what they can get. I just don’t get that kind of thinking at all . But I guess like somebody earlier said, it’s what you get used to.

19. GrowlyCub Posted: Jan 7th, 2009 at 5:40 pm

    19 What’s ‘wrong’ with it is the utter ignorance of the people in this country who have been brain-washed into believing that taking care of themselves as citizens is somehow ’socialist’ or ‘communist’. You’d think 60 years after McCarthyism we would be beyond letting the ‘red scare’ keep us from demanding a basic human right! I lived for 26 years in Germany, 1 year in Scotland and 10 in the U.S. and have family in Croatia (former Yugoslavia). The health care system in the U.S. sucks so bad it’s not even funny. When I lived in the UK, I was an exchange student and the NHS even paid for my birth control and I got all the health care I needed for free. Neither the German nor the UK system is perfect, and I’m sure bad things happen, and I know sometimes there are waits in the UK and in Canada for non live-threatening conditions/surgeries, but it’s utter baloney to claim that the whole system is awful because of a few bad experiences. I’m not aware that anybody I know ever had to wait for any – be it ever so little – procedure in Germany (and my whole family lives there). My mother is a cancer survivor and my aunt has severe rheumatoid arthritis and has kidney failure. My mother’s cancer was discovered during an exam when she went into the hospital to have her tubes tied. She was operated on by the chief of surgery the very next day and there was NO cost for this for my parents (besides a $3/day hospital fee/co-pay). I can tell you, however, that I haven’t had a pap smear nor a mammogram in over 3 years nor seen a doctor for the bronchitis/sinusitis I had for 8 weeks in the summer and that keeps reoccurring even though I have ‘good’ health insurance (military husband), because my primary care provider was removed from the network and the new one can’t be bothered to see me. I tried again to make an appointment when I had done something serious to my shoulder and was told since I hadn’t come before (when they wouldn’t give me an appointment because I was well) they wouldn’t see new patients until the end of March (that was in early December). The only ‘help’ they offered was to tell me to find a different primary care provider, where, guess what… the same would happen because they all treat potential Tricare patients like that. I feel sorry for (and am MAD as hell at) everybody around me who believes the utter bullshit that a government administered universal health care system would lead to worse health care than we have in this country. Even my mother’s family in Croatia (a country that was not too long ago in a terrible civil war) has better health care than I have here in the U.S. It’s all propaganda and folks swallow it because they hear ‘universal health care’ and equal it to ’socialist’ and ‘communist’ because they don’t know any better and unfortunately, the vast majority are unwilling to be educated by people who have lived in countries with such a system and who know better.

20. Shiloh Walker Posted: Jan 7th, 2009 at 6:02 pm

    20 I’d say a lot of the fear is because many would worry that a universal health care would end up something like Medicaid/Medicare. As a health professional, I can’t tell you how that scares me. We’ve had to refer patients out to specialists and since Medicaid/Medicare is just plain awful for providers to deal with, a lot of specialists won’t accept it, which means patients often end up having to drive hours to go to a clinic. Needed drugs aren’t paid for so the patient has to take something that isn’t nearly as good. The list is endless. Unless somebody came along that could convince me they could design a (much) better platform than Medicare/Medicaid, one that would be good for both patients AND the medical industry, I can’t see me supporting a universal plan.

21. Lolita Lopez Posted: Jan 7th, 2009 at 6:35 pm

    21 Shiloh, I absolutely agree that a universal healthcare plan has to be leaps and bounds beyond our uber-crappy Medicare/caid programs. As a former medic/ER Tech with a medic husband, I can tell you that the state of hospitals, specifically ERs and the costs associated with medical care, are topics heavily discussed at our dinner table. I am in no way exaggerating when I say Dave comes home at least twice a week with a story of a collapsed or deathly ill patient who has refused medical care and transport for fear of the ambulance and hospital bills. It’s sickening and crushes his spirit. I hate to see what it does to him. Interacting with 15-20 patients a day, most of them low to middle income and under-insured, is no cake walk. It’s heartbreaking to think of people dying in their homes of illnesses that are easily (although expensive) treatable. And, of course, the poor state of health insurance coverage also leads to an overload in the ERs. People put off seeing a doctor for a cough or a vaginal bleed or an ulcer until the problem is so serious it requires major and costly intervention. Those people will likely default on their medical bills. Hospitals have to outsource to credit collectors. If they don’t get paid, they write it off as a bad debt. Some hospitals collapse under the strain (especially trauma centers) and those who don’t have to raise prices across the board which means that–you guessed it–health insurance companies raise premiums. It’s a vicious cycle.

22. kelly Posted: Jan 7th, 2009 at 7:11 pm

    22 I look forward to having teeth as good as the English. Welcome to the Socialist States of America.

23. kelly Posted: Jan 7th, 2009 at 7:13 pm

    23 The government has done so well with Medicare and Medicaid. And let’s not forget Social Security. Yes please have the government help with healthcare.

24. Naomi Brooks Posted: Jan 7th, 2009 at 8:11 pm

    24 Kelly, why not read the commentary that came before yours and try to tap into that unused part of your psyche called “empathy” before commenting?

25. Emmy Posted: Jan 7th, 2009 at 8:19 pm

    25 I can see both sides of the fence. Universal Healthcare would greatly benefit people who are under- or uninsured. No doubt about it. *Some* care is better than none at all. As a healthcare provider…we don’t have the facilities for universal healthcare, and we don’t have the money to build more hospitals. If we were to go with univeral care with our current infrastructure, you WOULD be waiting months on end for an appointment, because the hospital would be required to treat everyone. As it stands now, all hospitals are required to do is evaluate (not treat) everyone who comes to the emergency room, then tell them to follow up with their primary care provider. If you don’t have a primary care provider because you don’t have insurance…well, that sucks. Because people who have no insurance, and illegal aliens, are using emergency rooms and not paying for whatever care they do receive, ER’s across the country are seen as money sucking enterprises. Something like 20% of for profit hospitals have closed their ER’s because they couldn’t afford to keep taking the financial hits. Hospitals would be overcrowded. They would admit people less and discharge them home sicker. The amount of care you get could decrease unless you can afford to purchase private insurance to cover what your government insurance won’t. Expensive tests like CT’s and MRI’s would be done less frequently. Exploratory surgery wouldn’t be done at all. Good luck with any plastic surgery from car accidents or burns. Only congenital (you were born with some disfigurement) would be covered. I could go on and on. I work for a private hospital that wouldn’t be affected in the slightest by universal healthcare, but many people would.

26. Anne Brighton Posted: Jan 7th, 2009 at 8:19 pm

    26 Our health care system in America is reliant upon the big insurance and drug companies. Don’t agree? Lemme tell you why I think this. A few weeks ago I took our next door neighbor to the emergency room. I went into the ER with her, into the room, and the nurse and doctor were great but when it came time to give her the shot…she normally gets demerol and vistaril..they said they couldn’t give her the vistaril because ‘they’d ran out and wouldn’t have any in until after the end of January so we’ll have to give you compazine’. I asked if that was normal. “Oh, yes, we run out all the time.” THEN, when they gave her the shots….one in each hip…the nurse pulled two bandaids out of her pocket. Curious, I asked how much those cost and she said “$3.75 each, why?” I told her that was ridiculous and started to open my purse. (As the mom of a six-year old daredevil child, I always have a box of bandaids in my purse). “Oh, no!” the nurse told me. “I can’t use those.” I asked why not since they were in the box in which they’d been purchased and still in the little paper sleeves. “Because it’s against hospital policy,” she said. “We have to use what comes from our supplier.” Then she laughed and said, “Don’t worry, Annie. Sheila’s insurance company won’t bat an eye.”

27. Karen Scott Posted: Jan 7th, 2009 at 8:29 pm

    27 Author Comment The government has done so well with Medicare and Medicaid. And let’s not forget Social Security. Yes please have the government help with healthcare. I’m not sure how either medicare or medicaid works, but here’s my experience of a universal healthcare system in my country: I have a lump on my foot, so I go to my local doctor’s surgery – no money crosses hands at this point. The doctor takes a look at my foot, and refers me to the nearest foot specialist, which is just six miles away from my house – I still don’t have to reach into my purse. I get an appointment date within a week, two weeks from the date that I saw my doctor originally. I have to cancel the appointment because of work commitment, so I ring up, give my apologies, and try to reschedule – sure no problem Mrs Scott, when are you next available? I’m not sure, so I tell the nice lady on the phone that I’m gonna have to check my diary, I’ll call her back. I forget to call her back, but before the end of the week, she calls me to remind me about rescheduling. I apologise once again for not getting back to her, and we arrange another date, that I’m able to make this time. At no point does she ask me how I’m going to pay for the examination. I get to the hospital, and I’m seen within five minutes of being there. The specialist is a lovely woman who examines me, and talks things through. She doesn’t ask me what kind of insurance I have to pay for her attention. She gives me a couple of choices, and I opt to have a biopsy done on my foot. The specialist tells me to make an appointment with the receptionist as I leave, which I do. She doesn’t ask me how I’m going to pay for the procedure. She just gives me some practical advice on what I should wear on my feet, how long I need to recuperate afterwards, and tells me to make sure I have somebody else drive me there on the day. I’m due to have the biop next week, but I’m pretty sure, nobody is going to ask me how I’m going to pay for the procedure, because I’m already paying for it, via my taxes. If they prescribe me medicine, then I pay for that, unless any of the following apply to me: are 60 or over are under 16 are 16-18 and in full-time education are pregnant, or have had a baby in the previous 12 months and have a valid exemption certificate, see below have a listed medical condition and have a valid exemption certificate, have a continuing physical disability which means you cannot go out without help from another person and have a valid exemption certificate hold a valid war pension exemption certificate and the prescription is for your accepted disablement are an NHS inpatient You are also entitled to free prescriptions if you or your partner (including civil partners), receive either: Income Support Income-based Jobseeker’s Allowance Income-related Employment and Support Allowance Pension Credit Guarantee Credit; or you are named on, or are entitled to (use your award notice as evidence), an NHS tax credit exemption certificate you are named on a valid HC2 certificate, see below. Now, none of the above apply to me, so I (begrudgingly of course, because I don’t realise how lucky I am that that’s all I have to pay for) pay for my prescription. If it turns out to be something serious, then they’ll do something about it, and at no point, will they ask me if I can afford to pay for the treatment. The US government’s half-assed attempt to address its healthcare problems may be a total fuck-up, but that doesn’t mean that an administration that actually has a clue, couldn’t look at some of the best universal healthcare systems in the world, and try to adopt those specific fundamentals. A couple of years ago, I was helping TTG lift something downstairs, and my back went into some kind of spasm. TTG called the ambulance (I literally couldn’t walk, and I was about to pass out), who got to the house within ten minutes. They took a look at me, put me onto a stretcher, and drove me to the nearest infirmary. They took me to the emergency room, where I was seen by a doctor, who gave me an injection on my lower back, prescribed some powerful pain killers, and sent me on my way, feeling a lot better. Not once did he ask me how I was going to pay for the injection, or the attention. Now, this may not be the same experience for everybody, and indeed, we constantly complain and moan about the state of the NHS over here, but this was my experience, and neither of my problems were even life-threatening. I may have 99 problems, but stressing over how I’m going to pay medical bills aint one of ‘em.

28. Emmy Posted: Jan 7th, 2009 at 8:29 pm

    28 @Anne…not sure what sort of hospital you went to, but I can tell you that I’ve been in the industry for almost 14 years and I haven’t the faintest idea what supplies cost. Only quantities are listed on the stocking sheet of every hospital I’ve ever worked at, and I’ve worked at quite a few, both in the US and Japan. Nor would any of my nurses be able to tell you the current going price of a bandaid. It’s not my job to know how much stuff costs. I’m there to treat people. Neither I nor my staff has anything to do with billing, other than that we document what was done.

29. Wendy Posted: Jan 7th, 2009 at 8:30 pm

    29 Well, so long as you are not shallow Kelly, and judge people on appearance. Just a clue, crooked teeth does not equal bad dental hygiene. In Australia we can be privately insured but are always covered by Medicare. I pay $55 to see my doctor and claim $32 back on Medicare. As a family we pay for prescribed drugs at around $30 a prescription until we reach (I think) a threshold of $1500 and then we pay $5 per prescription. Blood tests are free and a percentage of scans, x-rays etc can be claimed from Medicare. We have a limited insurance which covers dental and optical needs. If you earn over a certain amount you are required to have insurance or pay extra tax. We pay the extra tax and don’t quibble.

30. Karen Scott Posted: Jan 7th, 2009 at 8:41 pm

    30 Author Comment Check out the NHS Healthcosts website, this is what it says on the home page: Going into hospital to see a specialist or to have an operation can be a traumatic experience so the last thing you need are any additional worries. How will you get to hospital? do you have to pay any money upfront? Although treatment on the NHS is free at the point of delivery, there may still be some costs (for example, your journey to hospital). However, much or all of the cost can be reclaimed, which should ease any added stress. On the following pages, you will find full details of how to claim the money to which you are entitled. These expenses can be accrued for treatments for dental problems, eyesight difficulties, wig and fabric supports and prescription costs. I know that the system isn’t perfect by any stretch of the imagination, but when I read that, and think about how bad things could be healthcare-wise here, I’m secretly reassured.

31. Karen Scott Posted: Jan 7th, 2009 at 9:01 pm

    31 Author Comment Welcome to the Socialist States of America Kelly, so in your world, if you can afford health insurance, then all well and good, but if you can’t, then tough shit those folks and their kids? Can I ask a question, when did looking after a nation’s people become an ugly concept?

32. JenB Posted: Jan 7th, 2009 at 9:19 pm

    32 Well…my fears don’t have anything to do with the evilness of socialism or any of that nonsense. I think the U.S. would do well with universal healthcare. It’s the transition that frightens me. There’s just no way to do it smoothly. There will be a period of utter chaos, and who knows how long that period will last? It’s ridiculous and irresponsible to think that we’ll just go to bed one night insured by big corporations and wake up the next morning with full government coverage. It doesn’t work that way, folks. People will suffer from the transition, many of them more than they’re suffering under the current system. There will be casualties. We just don’t know how many will suffer or for how long.

33. Coco Posted: Jan 7th, 2009 at 9:52 pm

    33 I’ve been lucky to do some work with a local charity in my area called Communities in Schools. They identify and assist at-risk children with everything from weekend food programs to socks and underwear, school supplies, and medical care. These children most often have parents who are among the working poor. They may not qualify for Medicaid for a variety of reasons. The director told us stories of the children they help. I am quite familiar with hyperbole to drum up donations, but these tales needed no embellishment and she gave none, simply imforning us in a factual way of the things she’s seen. I cannot imagine my child with dental problems so bad that they bang their head against the wall to distract them from the pain. Standing with my daughter in the school doorway, begging someone to help me get her to a doctor because she’d broken her arm the previous evening and I had no car and no money to get her help. I don’t have the answers as to how we can institue a universal healthcare system in the US, but all I can say is any nation that lets ANY of its own children suffer from treatable medical conditions because they can’t pay for private insurance ought to be ashamed of itself, and has no business telling ANY other country how to run its biz. Until every child gets reasonable, competent primary care as well as access to emergency care, we have a serious problem here.

34. Jules Jones Posted: Jan 7th, 2009 at 10:05 pm

    34 First time I need to go to the doctor after moving to the US — I get the “not seeing new patients” runaround. For several days. Every single practice I phone is not taking new patients, even though none of them have told the insurance company that. I finally get one of them to grudgingly give me an appointment by explaining that I am *not* willing to wait months to have a lump in my breast checked, and I will be going to the emergency room in the hospital owned by that group that afternoon if I do not get an appointment with a family doctor. First time I go to the doctor after moving back to the UK — I have a nagging ache in my feet that’s getting worse so I want to have it checked, it’s not an emergency and they’re having a particularly busy week, so I can either book a timed appointment in a week or so when they have non-emergency slots free, or I can come in to the walk-in clinic any morning if I’m willing to wait for up to 90 minutes in the “first come first served” queue. So yes, tell me about how the service is so much better in the US, and they’ll never make you wait the way they do in the UK…

35. joanne Posted: Jan 7th, 2009 at 10:13 pm

    35 Here’s a good article by someone who was treated for the exact same serious medical condition using the UK healthcare system one time and the USA healthcare system another time. I think it’s a good side-by-side comparison. There are advantages and drawbacks in both systems. A tale of 2 sickbeds: Health care in U.K. vs. U.S. A journalist’s treatment for same condition in two countries is worlds apart. http://www.msnbc.msn.com/id/26794291/

36. joanne Posted: Jan 7th, 2009 at 10:19 pm

    36 I found the WHO’s 2000 rankings. Here’s the top 10: 1 France 2 Italy 3 San Marino 4 Andorra 5 Malta 6 Singapore 7 Spain 8 Oman 9 Austria 10 Japan UK is 18th & USA is 37th. http://www.photius.com/rankings/healthranks.html

37. Kat Posted: Jan 7th, 2009 at 10:28 pm

    37 I’m a great believer in social insurance, and I consider healthcare and welfare to be important social safety nets. Sure, they can be badly structured and organised, but that’s not the fault of the people who truly need them. I went through the Australian public system through 2 pregnancies. I have private health care, but opted not to use it because a) I didn’t have an ob/gyn and didn’t have time to find one (I opted for a shared care model with the hospital and my GP); b) the out-of-pocket cost would be around $2000 if there are no complications; c) I trust the public system. Both times, I received good care, which I think may have been just slightly better under private insurance. In the public system, there’s a bit more waiting, a little less choice and fewer luxuries, but as to the overall skill involved in addressing my medical needs, I think it was pretty good. My family has also had tests and surgery done through the private system. More expensive, but the care was more personal, which is something we’ve opted for when any of our kids need specialist advice. I saw an Oprah episode with Michael Moore and a representative from the insurance companies. I have to say, I didn’t find the rep’s arguments all that compelling. Can I ask a question, when did looking after a nation’s people become an ugly concept? That’s what I’d like to know, too. Isn’t that what government is for? Social welfare and capitalism can and do co-exist.

38. Karen Scott Posted: Jan 7th, 2009 at 10:41 pm

    38 Author Comment Great article Joanne, although the bit where she talks about the NHS stopping treatment if you’re receiving any other care is out of date now. The legislation changed a couple of months ago to allow patients to top up their NHS care with private care. About bloody time too. France and Italy’s healthcare system has been superior for quite a number of years now, and I know that at one point, the British government were looking at how they do things in order to make reforms to the NHS. Also at one point the columnist mentions that it costs us $160 billion to fund the NHS each year, I think that that’s money well spent when you consider the $700 billion that the US government just spent to bail out the car makers and the banks. The UK model is by no means the ideal, but judging from those tables, it’s a heck of a lot better than the US system. Unless things have drastically changed in eight years of course.

39. kristenmary Posted: Jan 7th, 2009 at 10:45 pm

    39 I’ve got to say I’ve been very lucky here in the US with my insurance. Hubby and I are healthy so we don’t need to go often. Even with my unplanned c-section in 2006 we didn’t run into any problems. My hospital never asked me how I was going to pay the difference between what insurance was going to pay and the cost. My insurance company never gave us a hard time. And I ended up in the hospital for 5 days since the little guy did not want to come out. My hubby has made appointments with ENT specialists because of a chronic sore throat that our doctor could not determine the cause of. We were never given the “can’t see new paitents” problem. We either have really good insurance or have just been lucky. But I think we do need to do something to provide universal health care. I agree with JenB, it will be a scary transition and a lot of people could be hurt, but I think it needs to happen.

40. Emmy Posted: Jan 7th, 2009 at 10:51 pm

    40 Keep in mind that the US already has a small universal health care system in place…for Congress and the Department of Defense (all active duty military, veterans, and dependents). It’s called Tricare. My son has this insurance, since his father is still active duty Navy. I had it til I got out. I can only take my son to a military clinic/hospital to be seen. There is no out of pocket expense for anything, ever…ambulance rides, routine visits, hospitalizations, or medications. Because he has to go to the nearest military treatment facility, our wait is subject to their availability. However, we haven’t had to wait more than a few days for a routine physical exam, and they will see him for acute illnesses usually the same day. We do have the option to take him to a provider outside the network, but it would be at our own expense. All of this is funded by taxpayers. Proponents of the UHC system are asking Congress to give the average American the same healthcare system they give themselves. Now ask any military person how happy they are with the care they get. I hear nothing but complaints about a service they get for free. The common response? “You get what you pay for.”

41. Shiloh Walker Posted: Jan 8th, 2009 at 12:05 am

    41 About Emmy’s comment…. Now ask any military person how happy they are with the care they get. I hear nothing but complaints about a service they get for free. The common response? “You get what you pay for.” When I was doing my nursing clinicals, I rotated thru the ER at one of the hospitals. A guy came in, a soldier. He lived on a base an hour away. While at home, an hour away, he cut his hand wide open while slicing a bagle. He had his wife leave work, come get him, drive him to the hospital…an hour away…while his hand was sliced open. There was a hospital on base. When he was asked why he didn’t go there, he said, “I’d only go there if I was dying…because they couldn’t do much to screw that up.” And he isn’t the only patient I’ve come across who has had that mindset. In regards to UHC in general, regardless of how wonderful UHC might seem, there are going to be pitfalls with it as well. Could it work? I don’t know-somebody would have to sit down with me and do a very in-depth discussion on the hows and whys, from both a patient’s perspective and a medical perspective before I’d even want to think about it. Should it happen, the transition, as somebody else already mentioned, will be a nightmare. Unless somebody(ies) with a good head on their shoulders-preferably a medically trained type/s, the transition to any sort of UHC is going to be beyond nightmarish. And if they only have bureaucrats or business-minded people heading things up, it’s going to be even worse a nightmare-it could very well be catostrophic. Rather like when insurance types decided that mothers could go home the very day they had their baby and all sorts of related problems arose (the least of which was increased costs related to the medical problems). Anything like that, if it happens, medicals need to be in on it because medicals see a different picture than non-medicals and I’ve yet to see or hear much about any sort of ‘joint’ discussions, with both medical and non-medical professionals discussing it.

42. Marianne McA Posted: Jan 8th, 2009 at 12:23 am

    42 My dh is an NHS manager, and he did a 3 month course in the US, which included a placement in public healthcare in Boston. As far as I remember, he came back with the view that the US did some things better than the UK, and vice versa. But in the end, he’d rather have the NHS, for all it’s flaws. Stacia – I think knowing my dh, and the people he works with – they’re fairly committed to the ideal of public service. There are, of course, cost constraints in a universal health care system – but within those constraints, I don’t believe they make decisions for any other reasons than best practice – they may be government employees, but they work for the public. And any healthcare system has cost constraints: while in a universal system costs are controlled through regulating what treatments are available, costs will be controlled in a different way in the US system.

43. GrowlyCub Posted: Jan 8th, 2009 at 12:23 am

    43 it’s going to be even worse a nightmare-it could very well be catostrophic. Shiloh, as somebody who works in the U.S. health care system, are you really seriously claiming that the system we have right now is not a ‘nightmare’ and ‘catastrophic’ to the all people who aren’t filthy rich? For people who die because they can’t pay for their medications and families who end up living in their cars because medical bills forced them into foreclosure and bankruptcy? And for the many people who *had* health insurance but that would not pay for necessary procedures and they ended up bankrupt as well? Any transition would be an issue, no doubt about it, but surely making it possible for people to go to the hospital before they are in live-threatening conditions would cut down on costs and reduce the strain on the system. I’m sorry to say, you are proving my point about folks here not wanting to even consider as valid the experiences of the people who have seen how UHC works. That’s especially disappointing from a health care professional.

44. Stacia Kane Posted: Jan 8th, 2009 at 12:47 am

    44 Ann Douglas, my own personal experiences that happened TO ME or to my husband are not “untrue rumor mongering,” and I don’t appreciate being told to “get a clue” for sharing those experiences and for advocating a form of universal health care that does not require a total government takeover of the entire system. I believe that in a country as large and wealthy as the US no one should go without care. I also believe that choice and a free market contributes to improved services. I believe the US is much, much, MUCH larger and more populous than England or Australia or France, that we have much higher numbers of immigrants both legal and illegal, and that therefore the sort of system that those countries have very well might not work in the US. And I don’t think those beliefs make me a clueless liar who is just rumor-mongering, and I don’t believe namecalling like that was necessary.

45. Kat Posted: Jan 8th, 2009 at 1:04 am

    45 Just to clarify, in Australia you have to be a permanent resident or citizen to qualify for Medicare. Everyone else has to pay upfront. In emergency cases, I *think* they bill you after. Stacia, Australia has a Medicare safety net augmented by private health insurance, and public and private hospitals co-existing. Is this along the lines of what you want universal health care to look like? Also, I wanted to point out that a larger population means a larger tax base from which to fund health care. (True, we give a higher proportion of income back as tax, but that’s the price we’re willing to pay for social welfare. I’m not sure how well that would be accepted in the US, which is another issue.) We have our share of horror stories, and waiting lists are getting longer, but I’m ever grateful for the system we do have.

46. Shiloh Walker Posted: Jan 8th, 2009 at 1:06 am

    46 Shiloh, as somebody who works in the U.S. health care system, are you really seriously claiming that the system we have right now is not a ‘nightmare’ and ‘catastrophic’ to the all people who aren’t filthy rich? I’m claiming that not everybody has the same experiences, Growlycub. I’m no where near filthy rich, however, my health care coverage is decent enough. Then there are people who make better money than my husband and I, but their health coverage is a nightmare. Finding a solution that will not cause more problems for those who don’t HAVE as many problems, yet still solve the problems of the many who do isn’t going to be easy and people need to be prepared for that. I’m sorry that my viewpoints disappoint you, but seeing as how I’ve seen, firsthand, the dire straights that many people have landed in because of government managed healthcare has made me leery-and you’re going to find that a lot of healthcare professionals feel the same way. I’ve spent hours, and I do mean hours, on the phone in for one patient trying to get them in to be seen for a problem that they need to be seen for, and the healthcare professionals are willing-but the government managed healthcare wants to try this option first, or that option first, even though those options are NOT going to work. Multiply this scenario by hundreds, and that’s some of the experience I’ve had in dealing with government managed healthcare. I’ve done the same arguing with government managed healthcare over an asthma medication that is desperately needed by a child, but they don’t want to cover it because there’s a cheaper, although not as effective option, and the child ends up in the hospital. Again, this isn’t a scenario that I’ve dealt with once, with one child, but with many children. I’ve argued with government managed healthcare over plastic surgery a child desperately needed if this child ever wanted to have a chance to look like a ‘normal’ child and it needed to be done as in now…not waiting 3 months, 6 months, to get into a clinic to be evaluated. Growly, maybe you just can’t see it from where I’m sitting, but I’ve fought with goverment managed healthcare. The only models we have in place are medicaid and medicare, then the healthcare that’s provided to service personnel and those options are so ridiculously flawed, I’d pick up a second fulltime job to help cover costs before I’d be willing to put my family on them. Basically, what I’m saying is that government managed health COULD work, but chances are it will only work if the government takes a backseat at trying to dictate how healthcare should be administered and let the medical professionals make the calls.

47. Sparky Posted: Jan 8th, 2009 at 1:44 am

    47 I don’t get this when Americans say “we can’t afford it” 2 points: Per capita Americans spend more on healthcare than any other nation on the planet. And the margin is HUGE http://www.oecd.org/dataoecd/46/2/38980580.pdf Americans spend more than $2,000 per capital than the next nation. So you’re paying a LOT more money than any other nation – and you’re getting pretty shoddy service for that investment. Or, to put it crudely, you’re being screwed. Right royally screwed. Secondly, even if you were paying less – you can’t afford it? The richest nation in the world can’t afford something nearly every western nation has? Why? How can nations with half your wealth afford something you can’t?

48. Emmy Posted: Jan 8th, 2009 at 1:50 am

    48 There was a hospital on base. When he was asked why he didn’t go there, he said, “I’d only go there if I was dying…because they couldn’t do much to screw that up.” LOLZ Shi, that about sums it up. The local military hospital here in Hawaii is Tripler Army Medical Center. It has been highly rated by JCAHO (the commission that accredidates hospitals in the US) for excellence in medical care. Triper has won multiple awards for their forward thinking and cutting edge technology. It is the trauma center of the Pacific region for the military. The rumor is they’re in the process of applying for “magnate” staus, which is the highest rating any hospital can get in the US, military or civillian. In spite all this? The local military people refer to the hospital as “Crippler”. And the US, if it were to go to UHC, would institute the same system for everyone as they have for the military. I see many many unhappy (and damned ungrateful) people on the horizon.

49. Bhetti B Posted: Jan 8th, 2009 at 1:59 am

    49 Not read all the comments but certainly some points about UK healthcare. – government being in charge of services leads to organisational and funding problems. Each hospital doesn’t think ‘let’s see the best we can do for the patient’, it thinks ‘what could be cheaper, how can we meet these government targets?’ – cleaning. – To be honest, MRSA ain’t the biggest killer, it’s waiting times. – more research is implemented in the USA – better trained professionals in the USA, we have a major problem with employing good nurses and paying up in the UK – more equipment in the USA Uk healthcare is commonly quoted to be at least five years behind US healthcare. Of course, USA advantages DO NOT compensate for the HORRIFIC consequences in my view of not giving everyone good healthcare. The way the NHS is financed is by checking how many workdays and taxmoney is lost to people being off work due to whatever ilness is in question; finances are allocated that way to a large extent actually. (The huge amount of UK tax is just the black hole that the government and their love of statues in wierd places/highly paid useless adminstrators.) It seems silly to me that the USA government wouldn’t want to limit the economical impact certain relatively cheaply managed illnesses can have on increased tax revenue. Free healthcare does actually work better in other European countries; they have a bit more conscience and commonsense for some reason.

50. Emmy Posted: Jan 8th, 2009 at 2:01 am

    50 @ Sparky: Because nations with half the wealth have half the people. We cannot do UHC with the existing hospitals. The system would be too over loaded, resulting in those dreaded 6 month waits for care. There would have to be new hospitals built in urban areas to handle the volume. However, there is no money to build new hospitals. Or buy the equipment, most of which consists of multimillion dollar machines. Ever tried purchasing an MRI machine? It’s not cheap. Add to that the fact that who the frick is going to staff this new hospital, what with a huge nursing shortage and more doctors deciding to not BE doctors anymore because malpractice insurance has gone fricking haywire, and you have a problem that you can’t throw nonexistent money at. If there were any, which there isn’t. Hello? Country in recession, possibly depression, with $2 trillion in debt, about to be more? Who’s going to pay for all this? It’s not just making a law that says we all get govt sponsored healthcare. The laws governing heathcare need to be revamped, and malpractice lawsuits capped so doctors can actually practice medicine without basically having to pay to come to work, because they sure aren’t making any money after paying their premiums. Universities need more funding to train new nurses and doctors…the list goes on.

51. Kat Posted: Jan 8th, 2009 at 2:04 am

    51 Can I ask, though, what the underlying problem is? Is it cost-cutting, or bureaucracy, or unqualified medical personnel, or demand exceeding capacity, or something else? Because if we talk about the causes rather than the consequences, then we can talk about what needs to be done to get the system to work in the US. Finding a solution that will not cause more problems for those who don’t HAVE as many problems, yet still solve the problems of the many who do isn’t going to be easy and people need to be prepared for that. Shiloh, I’m not sure I understand. Why can’t the government keep the existing private health system and augment the baseline public service to an acceptable level?

52. GrowlyCub Posted: Jan 8th, 2009 at 2:22 am

    52 However, there is no money to build new hospitals. Or buy the equipment, most of which consists of multimillion dollar machines. Ever tried purchasing an MRI machine? It’s not cheap. I’ll just mention here that I had a complete (and I mean complete) health check up before I moved to the U.S. for good, when I still had health insurance in Germany in 2001. They ran every test under the sun and then some to make sure I was as healthy as possible right there in the doctor’s office aka they had all the machines, ultrasound, EKG, doppler, endoscopy equipment, etc. One of the things I remember most clearly is that my doctor there told me during my colonoscopy (colon cancer on both sides of the family tree and yes, they do the testing with you awake) that while his machine was expensive, the charge billed the insurance company was a tenth!!! of what his U.S. colleagues were charging (that information came from medical conferences where this topic came up). I sincerely doubt that the machines cost more in the U.S. than they do overseas. Shiloh, I guess I don’t consider Medicaid or Medicare a UHS. I understand your frustration and share it and it’s certainly concerning to think that the same people could be mismanaging a UHC system that are now making Medicare such a disaster. On the other hand, what we have now isn’t working at all, and quite honestly I cannot imagine that anything could be worse than what we have. The main point of a UHC system is that you don’t have to ask for permission before you get treatment, because it’s covered! I know the state of TN has a system for low-income families and children without health insurance and from personal experience I know that people have better care under that system than I have with health insurance, so there’s some evidence that such a system can be run in this country.

53. Kat Posted: Jan 8th, 2009 at 2:24 am

    53 Emmy, if you had a private system co-existing with a public system, then you can have privately run hospitals where those who can afford to do so can avoid 6-month waiting lists, and a public system which then doesn’t have to support those people and which is funded to provide a baseline set of services. Because nations with half the wealth have half the people. I’m not sure what you mean to argue here. You’re still spending more per capita if that’s the case. Maybe the problem is that the US doesn’t tax as highly. In which case, that’s a problem of priorities. We cannot do UHC with the existing hospitals. I think it would have to be a long-term strategy. Of course it couldn’t happen overnight. malpractice insurance has gone fricking haywire This can be remedied through legislation. In Australia, for example, personal injury compensation cases were tightened in response to dodgy lawsuits. What I kind of hear people saying is that they want universal health care but don’t trust the government to manage it properly. Well, that’s a problem with the political process if you’re voting in people who you don’t think are competent to run the county. (And I’m saying that seriously–no snark intended.)

54. Shiloh Walker Posted: Jan 8th, 2009 at 2:34 am

    54 Can I ask, though, what the underlying problem is? Is it cost-cutting, or bureaucracy, or unqualified medical personnel, or demand exceeding capacity, or something else? Because if we talk about the causes rather than the consequences, then we can talk about what needs to be done to get the system to work in the US. All of the above. There’s cost cutting. Too much bureaucracy. Sad to say, but yes, likely unqualified personal. A shortage of qualified personal (and a shortage that is growing more every year). Demand exceeds capacity. Then there’s the something else’s… ~people taking their kids to the ER for a cough because they couldn’t/wouldn’t leave work early. No, they can’t risk be fired when their boss won’t let them leave to get their child see by in a doctor’s office, but when they take that child to the ER for the flu, a cold, an ear infection, that costs rolls over to an already over-burdened system. ~there are people suing medical professionals left and right. The richest country, maybe, but it’s also one that is very lawsuit prone and the medical profession is paying in spades, and often paying ridiculous amounts. The cap on malpractice that Emmy mentioned sounds mighty appealing to me. ~there are illegal immigrants getting medicaid/medicare, again adding more to an already overburdened system. Then there are citizens/legal aliens who really should be able to get government funded health care, but are told they don’t qualify. Can I ask, though, what the underlying problem is? Is it cost-cutting, or bureaucracy, or unqualified medical personnel, or demand exceeding capacity, or something else? Because if we talk about the causes rather than the consequences, then we can talk about what needs to be done to get the system to work in the US. If I had the answer to that, Kat, I would be filthy rich… but I just don’t. And somehow, until the government and the healthcare industries can sit down and rationally talk things through, the answers aren’t going to come. And I’ve got to wonder how that’s going to happen, because when healthcare workers voice our concerns about the matter, we’re made to seem as though we don’t care, don’t want things to change, won’t try to make something work. I can’t speak for every nurse/doc/emt/speech therapist/chiropractic out there, but I’d know I’d love to see everybody that needs health care coverage getting it. Although some people don’t understand it, believe it or not, healthcare workers want everybody to have the coverage they need as much, if not more, as the next person. I’ve seen kids hospitalized with preventable diseases because their parents couldn’t afford vaccines (and in some cases, they refused to go to the health care clinic to get the same vaccines they’d pay an arm and a leg for at the MD office). I’ve held the hands of parents as they cried when we tried to explain we’re doing the best we can to get the care/therapy/medicine/treatment their child needs, but their insurance is fighting it tooth and nail. I’ve also known people who couldn’t get into an OB-GYN and had to drive to a provider an hour away. Ironically, much of this problem isn’t because of patient insurance issues…it’s because malpractice insurance has pushed 1/3 of the OB/GYN practioners in this area OUT of practice-which means those who are still in practice have a larger patient base to provide for and some point, they have to cut off new patients, because otherwise the quality and safety of patient care plummets. If it’s happening like this in OB/GYN, then it’s also probably some of the issue in other fields. edited

55. Katharina Posted: Jan 8th, 2009 at 2:43 am

    55 the charge billed the insurance company was a tenth!!! of what his U.S. colleagues were charging (that information came from medical conferences where this topic came up). I sincerely doubt that the machines cost more in the U.S. than they do overseas. GrowlyCub, I would like to second that. An American friend of mine received a bill over 15000$ after one night in the hospital, without any fancy machine examinations having been done. With that money I could pay approximately 180 months of governmental health care premiums. I am currently living in France where another friend got presented with a bill of 1500€ after a three days stay in the hospital and an emergency operation. (In France governmental health care provides a coverage of 60 to 100%, the rest is covered by a supplemental private insurance. My friend moved and cancelled the old one, however, wasn’t yet subscribed to the French Caisse Primaire). I generally think that where health is concerned competition and privatisation is the wrong way to do things. Both includes the pursuit of profit and gain of money, something that is important to the economy, but completely out of place where health is concerned. Health is a matter that should never give any institution the right to make millions of it.

56. shirley Posted: Jan 8th, 2009 at 2:51 am

    56 I empathize with Shiloh’s points. Medicaid/care, depending on what state you live in or if you are with the fed, can be, and more often than not *is*, a disaster. A lot of people get screwed, hurt, hell even die, because of some ridiculous red tape being strung out by a guy/gal who has zero, and I do mean zero, medical knowledge making a call based on money and not on the needs of a patient. And no, most Americans don’t trust the gov’t not to screw up UHC. So I also agree that any UHC set up in the states should be created, implemented, and have oversight provided by medical professionals who actually care about patient health and well-being. All that said, Karen’s points are more to the heart of the matter. You can cry about chaos of changing over, how much money everyone will have to pay out in taxes, how working people are paying for the ‘lazy bastards who refuse to work or are in the country illegally’. Scream your outrage, pump your fist. Then tell me it makes you feel better about yourself when you see that kid in the supermarket who is sick as a dog, but can’t go to the doc because his mother or his parents decided feeding him was more important. Tell me it’s okay that we let men, women, and children die of curable and manageable diseases so we can save a few bucks in the figments of our imaginations. Tell me we have to take a few more decades to blow smoke up each others asses and clog up change with more red tape until nothing gets done. And instead of just a quarter of America having no medical insurance and another twenty percent having useless coverage, it’s more like seventy percent of us have useless coverage that we pay through our noses for that won’t help us out when we need it. That’s exactly where we are heading, without doubt. Each year another several million people lose there health care coverage. Yeah, cause that just sounds like something fantastic, doesn’t it? Whoopee, I can’t wait to hear the crying and whining then. But hey, you saved some money now, right? And those lives that might get lost during transition… Um, excuse me, how many people die now because they have no health care? Are you kidding me? People are dying NOW, for god’s sake. Less people will die in a transition to a viable UHC, than die everyday now because they have NO care. As to the other points, malpractice insurance, lack of facilities, etc. Well, if everyone over here wasn’t trying to get rich off the back of someone else, our doctors wouldn’t have to worry about frivolous lawsuits. Our courts wouldn’t be overworked by frivolous lawsuits. Maybe if we stopped pouring money into companies backed by multi-billionaires and into American infrastructure we could… OMG, we could create more jobs, build more hospitals, and holy smack things might start looking up. But that’s a whole other ball of wax.

57. Shelli Stevens Posted: Jan 8th, 2009 at 3:40 am

    57 How funny I just stumbled on this topic. Like two hours ago my status on facebook was: Shelli is debating marrying a Canadian or English man for insurance. If I can find one. Maybe do a Craig’s list ad… I’m so fed up with American Insurance. I have a friend with leukemia right now whose insurance won’t cover the cost of some of her meds. So who knows if she’ll get treatment. My brother just got dropped from his plan after a four day hospital stay for pancreatitis. Insurance companies have us by the balls. Has the whole government in their palms. It’s sick the way they choose money over human lives.

58. Emmy Posted: Jan 8th, 2009 at 3:56 am

    58 There are many reasons healthcare is more here: Much of the increased cost of healthcare in the US is due to the fact that alot of people skip out on their payments, so the hospital has to bill the people who are paying their bills more just to stay afloat. Insurance companies are also going under in trying to pay their share of the bills. To stem their blood flow, many have capped what they are willing to pay. For example, if you get a procedure that insurance thinks should cost $100, they pay 80%, or $80. If the hospital bills them $150, they still pay only the $80, and the patient is on the hook for the rest. Medications…keep in mind that the US consumes only something like 20% of the pills in the world, but makes up for 80% of a drug company’s profits. This is because countries with UHC have capped what the drug companies may charge the government. There is no law here. If the US makes a similar law, then drugs that are available here will no longer be available in other countries, because companies will no longer be able to offer them to capped countries at the much lower cost.

59. Kat Posted: Jan 8th, 2009 at 4:53 am

    59 Much of the increased cost of healthcare in the US is due to the fact that alot of people skip out on their payments, so the hospital has to bill the people who are paying their bills more just to stay afloat. I’m not sure what the argument here is, either. Under the Australian system, if you can’t afford health care, the government (i.e. the taxpayers) foot the bill. This works both ways because as a taxpayer, I can opt to go public or, if I can afford it, private. I just asked a friend of mine who works as a nurse in an ICU ward if at any time during a patient’s treatment the doctor or administrators discuss treatment options based on the cost to the hospital. Her answer was no. In our private system, most claims are also subject to caps. But the way the terms are set out is usually easy to understand–if not by the patient then by hospital administrators. The insurance company can usually tell you how much they’ll pay for a given procedure. The default expectation is that they WILL pay. If you can’t afford the excess, you can opt to go public. This means that you can’t choose your own doctor (you have to use the doctor on duty at the hospital, usually), you don’t get a private room, and for elective surgery, you have to wait quite a while. BUT you get treated. You will never have to choose between feeding your children or taking them (or yourself) to the GP. Now, we have our own problems–overcrowded wards, people being overlooked in triage, lack of resources, old equipment. But we hold the government responsible for these problems, and because we expect a public health system, the government is forced to find a way to keep it funded and running. If the US makes a similar law, then drugs that are available here will no longer be available in other countries, because companies will no longer be able to offer them to capped countries at the much lower cost. I find that hard to believe. If South Africa and Brazil and Argentina can manufacture generic drugs locally and sell them at 400% less than what Americans pay for them, I think maybe someone should look at the balance sheets of these pharmaceutical companies. The other issue is the way drug patents are managed. This article talks about some of the problems, specifically in the pharmaceutical industry (it’s a little dated–around the early 2000s, I’d say). In any case, if pharmaceutical companies can’t exist as viable private enterprises, then aren’t you better off either putting the industry into the government’s hands or forcing it to become a not-for-profit industry? The reason Big Pharma charges the prices it does is because it can, and often they’re profiting from work funded by the government without sharing the profits with the taxpayers.

60. West Posted: Jan 8th, 2009 at 4:55 am

    60 I am one of the 42 million uninsured Americans. I am a student, and cannot afford to be privately insured. I tried for a while, but it was just too expensive. I am living with an unknown condition that’s incredibly painful. My doctor suspects Fibromyalgia, but avoided further testing since I was losing my insurance. He didn’t want to saddle me with a preexisting condition in case I needed to privately insure again once I was done with school. So for now, I’m living with pain that I can’t afford to have diagnosed and treated. And there are 42.6 million other people like me. I would rather pay higher taxes and have the guarentee of basic healthcare at the very least, than keep going on like I am. I don’t believe it’s socialism. I believe it’s simply taking care of the citizens of this country. As someone said, no system is perfect, but something is better than nothing. And I think that after adding up premiums, coinsurance, and deductibles, there probably wouldn’t be that much difference between paying for insurance or paying higher taxes for UHC.

61. joanne Posted: Jan 8th, 2009 at 5:10 am

    61 “tell me it makes you feel better about yourself when you see that kid in the supermarket who is sick as a dog, but can’t go to the doc because his mother or his parents decided feeding him was more important.” This is not to say any form of healthcare is better than another, but as far as children in the US are concerned, they’re covered by SCHIP and most, if not all, states have health coverage for children. It might not be great (I don’t know because I’ve always had private insurance and have no experience with it) but children are NOT uninsured. Plus, every ER I’ve ever been in (unfortunately I practically lived there toward the end of my father’s life) has posters all over stating that it’s illegal for them to refuse emergency care to anyone. I do have experience with an elderly parent on Medicaid or Medicare (I always get those 2 mixed up), maybe both. Anyway, I can honestly say that he got excellent healthcare, never had to wait for anything, and had his choice of doctors. To be honest, I think a lot of healthcare disparities in the USA depend on where you live in the USA – rural vs suburban vs urban – or what state you’re in. That being said, healthcare is an expensive mess in the USA. We can and should do better. I don’t know what, exactly, the best solution is; but we’ve GOT to do better. It’s shameful!

62. Naomi Brooks Posted: Jan 8th, 2009 at 5:19 am

    62 SCHIP has income eligibility requirements. It’s a step above Medicaid for true low income families and the level where you’re -supposed- to be able to afford your own insurance. The proposed expansion to cover kids whose parents didn’t qualify currently under income, but still couldn’t afford private insurance for them was shot down by Bush veto a few years ago. And the ER can’t turn anyone away, but you are still billed by them and can be driven into backruptcy since they charge the uninsured 350% or more what they’d bill an insurance company. I’m currently facing a bill for $933 for 10 minutes of an ER doctor’s time in diagnosing me with bronchitis.

63. Lorraine Posted: Jan 8th, 2009 at 5:56 am

    63 The US should borrow a page from the 19th century Japanese Emperor Meiji. When he decided to open Japan to the western world, he sent ambassadors to each foreign country that reigned supreme in a specific area to. They were tasked with bringing back to Japan the best of the best. From Germany they learned western military procedures, from England banking, from the US heavy industry, etc. As people have commented, no system is perfect. So why not send out emissaries to the top ten countries on the WHO’s list and have them bring back the best of the best in healthcare? the WHO’s 2000 rankings. Here’s the top 10: 1 France 2 Italy 3 San Marino 4 Andorra 5 Malta 6 Singapore 7 Spain 8 Oman 9 Austria 10 Japan UK is 18th & USA is 37th. http://www.photius.com/rankings/healthranks.html Obviously countries like San Marino, Andorra, and Malta won’t have a lot to offer the US as they are much smaller. However France, Italy, and Spain have large enough populations that we could glean much useful information from. The time is ripe now with the goodwill of the world focused on our new President. At this point in history, the US is floundering in its ability to provide a safety net for its people. The majority of us lack lifetime medical benefits and employer pensions. Many people are unable to save for their retirement. Who knows if there will be any social security left for people who are now 50 and younger? Without significant healthcare reform, what will happen to all the elderly people in the baby boom generation and after? Are we going to have a country of homeless old people who lost their homes because of medical bills? Or will our life expectancy decrease because we are unable to pay for proper medical care?

64. AnneD Posted: Jan 8th, 2009 at 1:18 pm

    64 @Stacia – I’m sorry you felt my intent was to single you out. I thought I’d made that clear that it was not (Sorry Stacia, this is picking you out unfairly, but the quotes come from your post) , and I was not intending to tell you, specifically, to get a clue, but the populous in general. Of the Americans I’ve discussed their ‘low’ taxes/ my previously ‘high’ taxes with, the majority of them have never put two and two together and realised their insurance costs are just another form of tax, only coming from their insurance company, an entity that have absolutely NO control over. At least the government has the illusion of being run by the people for the people, the same can’t be said for insurance companies. As I said in my post, no system is perfect, mistakes happen, so does mistreatment. For every NHS horror story there is its companion in the USA, Aussie, NZ etc, and frankly just because someone is a doctor or a nurse, doesn’t mean they are good at their job, or compassionate. That doesn’t make being the victim of the mistake any better, and I always feel angry on behalf of the people medically mistreated. As someone stated in a recent political discussion we were having: “Socialism is the state of working toward Democracy, and Democracy is the state of working towards some form of Socialism. Neither one works very well by itself, but if we could ever get them to meet in the middle we might just have ourselves a system that will be as Utopian as it ever gets.” Healthcare is one of the things that should be in this middle ground, but even then mistakes would still happen, but, possibly, less mistreatment.

65. Marianne McA Posted: Jan 8th, 2009 at 2:09 pm

    65 About the higher taxes. I went and looked it up on the World Health Organisation site, and as far as I can make out, in the latest year they have statistics for, the US government paid very slightly more than the UK government per capita for healthcare. So while the total healthcare spend per capita in the US is greater – from memory $6,300 each as opposed to $2,600 in the UK – if I’ve understood the figures correctly of that $6,300, $2,800 is paid by the US government. So, if that’s right, aren’t people in the US paying as much in tax for healthcare as people in the UK are already? (France seems to cost a bit more – about two thirds of the cost in the US. My aunt and uncle lived there for years, and they found the healthcare system fantastic.) Bhetti: nothing wrong with highly paid NHS administrators – I’m all in favour of that:)

66. Emmy Posted: Jan 8th, 2009 at 2:17 pm

    66 If South Africa and Brazil and Argentina can manufacture generic drugs locally and sell them at 400% less than what Americans pay for them, I think maybe someone should look at the balance sheets of these pharmaceutical companies What’s being manufactured locally are the generic versions of drugs…after the patent expires. None of those countries you mentioned can remotely be considered innovators of modern pharmaceuticals. What I mentioned are the arguments being presented to Congress by the drug companies in their explanations as to why stuff costs so much here. The companies take decades to research and develop medications. 80% of the money they have to do that comes from US consumers. If prices get capped, comopanies say that they will no longer be able to support providing their products to other countries at the much lower cost. So basically, US citizens are funding the drugs given to UHC recipients in UK and elsewhere.

67. Karen Scott Posted: Jan 8th, 2009 at 2:33 pm

    67 Author Comment I am a student, and cannot afford to be privately insured. I tried for a while, but it was just too expensive. I am living with an unknown condition that’s incredibly painful. West, with the NHS, as you’re a student, you wouldn’t even have to pay for prescriptions. I can’t imagine being in pain, and having to ignore it, because treatment wouold be too expensive. The current healthcare model needs drastic changes. It’s not working, and hasn’t been working for a while. The transition will undoubtedly be beset with problems, but is that a good enough reason to do nothing? The problem is that with all the scare-mongering going on, for those people who haven’t actually seen a proper universal healthcare system in place, they will believe what they are told by wealthy politicians who have great health insurance, and don’t have to personally worry about medical bills sending them to the poorhouse. I can tell you that those politicians who tell you that a universal system would be too expensive for the country, have probably never been in a position where they had to choose between their health and their home, and if they had, then they’ve long forgotten about it. The US should borrow a page from the 19th century Japanese Emperor Meiji. When he decided to open Japan to the western world, he sent ambassadors to each foreign country that reigned supreme in a specific area to. They were tasked with bringing back to Japan the best of the best. Couldn’t agree more Lorraine. With regards to the lawsuits etc, I have never known a more litigious nation than the US. You get fat from eating a MacDonald’s burgers, you try to sue the company. You want someone to blame for all the crap that goes on in the world, you try to sue God. Your friend tries to pull you out of a car wreck so that you don’t die, you sue the friend because they didn’t do it right. The American legal system in my opinion is an ass, and if doctors are being sued left, right and centre, for anything other than incompetence, and maltreatreatment, then it may be an idea to look at reforming the legal system in such a way that time-wasters, and greedy lawyers don’t add to the burdens that the doctors face already. If the US makes a similar law, then drugs that are available here will no longer be available in other countries, because companies will no longer be able to offer them to capped countries at the much lower cost. Even if I believed this, and to be fair I don’t, then is that really something that the US needs to be worrying about, rather than the health of their own people? I’m a firm believing in looking after your own first, then looking out for others. Insurance companies have us by the balls. Has the whole government in their palms. It’s sick the way they choose money over human lives. Then why aren’t there better regulations in place? It seems to me that they can shaft people at will, and nobody steps in to intervene. Finding a solution that will not cause more problems for those who don’t HAVE as many problems, yet still solve the problems of the many who do isn’t going to be easy and people need to be prepared for that. But the ones who don’t have problems already would be more likely to continue to not having problems surely, since those people are more likely to have better health insurance cover anyway. Nobody’s proposing doing away with private health insurance, this is more about providing a basic care for all. The people who want upgraded care, can still choose to pay for it, but if those people ever hit on hard times, they know that they can rely on a universal system to look after them in their hour of need, without adding huge medical bills to their problems. To be sure, they may not have the fancy private rooms, with flat-screen TVs, but they will at least be treated. If there are people holding off on going for treatment because they are afraid of the cost, how is that any better than being put on a waiting list via a UHC programme? Give me the waiting list anyday, over avoiding seeking medical aid because I can’t afford to pay the bill.

68. Kat Posted: Jan 8th, 2009 at 3:12 pm

    68 Emmy, no, the generic versions are not out of patent copies. This is the reason why the US tried to impose sanctions on South Africa for trying to pass laws that allow it to obtain AIDS drugs more cheaply and bypass US pharmaceutical companies. The US had to back down when they were targeted by NGOs for acting on behalf of Big Pharma. Third world countries that are trying to make the most humane decisions for their citizens are being pressured not to do so because of patent law and profits. I mean, it’s outrageous. The point is, drugs can be manufactured much, much, MUCH more cheaply that they’re being sold for. If that mark-up is mostly the cost of licensing the patent, that’s screwed up. The companies take decades to research and develop medications. I would question this. If you read the article I cited upthread and the one I’ll cite below, the writer gives examples of patents taken out by drug companies where the research for the drug was partly conducted using public resources. If prices get capped, comopanies say that they will no longer be able to support providing their products to other countries at the much lower cost. So basically, US citizens are funding the drugs given to UHC recipients in UK and elsewhere. I think this is a bit of a doublespeak. If third world countries can manufacture generic copies, then the only reason drug companies are subsidising the cost of production is because they’re forcing those countries to buy from them. And I absolutely reject the suggestion that “UK and elsewhere” are receiving treatment at the largesse of US citizens. Yes, I think we benefit from some of your cutting edge research made possible by profit-making ventures. BUT people around the world contribute to the body of knowledge and ongoing research into these breakthroughs. PLUS, I resent the fact that the US seems hellbent on undermining health care policy in other countries (source: British Medical Journal). What I mentioned are the arguments being presented to Congress by the drug companies in their explanations as to why stuff costs so much here. Right. As a counterpoint, this is an article from the American Bioethics Journal refuting many of those arguments. Then why aren’t there better regulations in place? It seems to me that they can shaft people at will, and nobody steps in to intervene. Karen, I think the way the US political system works makes this difficult. If the companies are big political donors, it’s going to be hard for politicians to move against them. I mean, if the US can impose trade sanctions on behalf of pharmaceutical companies to prevent third world countries from manufacturing essential drugs locally on the cheap, you can see how much influence they have on the government.

69. JenB Posted: Jan 8th, 2009 at 3:57 pm

    69 Insurance companies have us by the balls. Has the whole government in their palms. It’s sick the way they choose money over human lives. I think if you took a look at the overall profitability of insurance companies vs. the overall profitability of drug and health equipment companies, you’d see why insurance is so expensive. Customers may feel as though the insurance companies have them “by the balls”, but that’s mostly because the healthcare and pharmaceutical industry has the insurance companies by the balls. Compare the pharmaceutical companies’ advertising, PR, and promotion budget to their R&D budget, and it’s pretty clear where the money’s going. Frivolous lawsuits haven’t helped much either. There’s no single entity to blame here. It’s the overall system and all its various parts. I guess you could call it a trickle-down effect. Capitalism is a great concept that has worked fairly well for U.S. industry, but it gets ugly when human health and lives are at stake.

70. Jen Posted: Jan 8th, 2009 at 6:12 pm

    70 Customers may feel as though the insurance companies have them “by the balls”, but that’s mostly because the healthcare and pharmaceutical industry has the insurance companies by the balls. Ehh, I’d beg to differ here. CNN Money has a nice little rundown showing that Health Insurers had smash-hit profits last year. In the billions. You know how they get those profits? They minimize costs. Which are you. Your coverage is a cost center to them. Your premiums are a revenue stream. And their goal–the only goal they truly have to pay attention to is to increase profits to their shareholders. Which means they minimize costs (you again, and every claim you make against your health insurance) and maximize revenue streams (your premiums). So the way they do business (and business is good) is to take your money (and that of your employer) and not give you anything in return. It’s an awesome business! Money for nothin’ and chicks for free. You don’t have to do a lot of digging to find all sorts of information (and you don’t have to visit a lot of partisan sites, either) about the standard practices of the big insurers. Deny, Delay, Deflect, Distract is their motto. Giving you the runaround is their job. So when Shiloh (for example) is fighting with the government red tape for her gov’t covered patients, it’s her patients or their parents who are fighting with their insurance companies on the private side. Rolling out Universal Health Care needs to follow at least two significant steps. One is–my health is not your profit. Get the market forces out of it. “The Market” should never drive health care, they’re at cross-purposes. In the long run, it always works out that people are cheap. You can always get another one. It’s always cheaper to let ‘em die because another one just like ‘em will come along right away. Letting “the market” decide means we all lose as individuals. Second step–you start it not by covering everyone, but covering everyone under 18. Cover all the children. I don’t care if your mom or dad makes 3 billion dollars a year. If you’re a kid, you’re not making that three bill, and you deserve coverage. And even if you are a kid making 3 billion a year, you get coverage anyway because you’re a kid. Grow up healthy and pay your taxes and be a good citizen. Your parents snuck over the border with you? SFW. You’re a kid–you didn’t order them to, and when you’re in the store sneezing on the same toy my kid wants to play with, I’ll thank you for not being infected with bubonic plague because your parents could take you to a doctor before it turned contagious. Once the kids are covered, move on to the elderly. Use what you learned from the kids and make the system better. And quit qualifying it. Quit saying people are “burdens on the system.” The System exists to serve the people. As it stands now, I have accountants, actuaries, insurance adjusters, insurance bureaucrats, shareholders of my insurance company, customer service reps, free market analysts, the people at the grocery store who set the prices for hamburger, and oh yeah, maybe a med professional or two down at the bottom there, Oh–and since I’m a woman, religious morality police from religions I don’t believe in and don’t want anything to do with, all making my health care decisions for me. The government can get in fscking line. Hell, at least it’ll be a different set of hoops to jump through. Maybe these ones will be on fire.

71. Anon76 Posted: Jan 8th, 2009 at 7:18 pm

    71 In the US, we are locked into this thought of “get a job that provides insurance benefits”. We all want it, we all feel we need it. Hell, we do “need” it as things go right now. However, we, and our employers, jump through hoops to get even semi-livable coverage. Number of employees, past health histories and blada blada determine what, if any, coverage an employer can afford, along with the limits and deductibles of said group. And don’t even get me started on the network of doctors, hospitals and what not. For instance, my husband lost his job. By law, he had the right to continue his health insurance at the cost his company was paying. This was a monthly cost of $650 US per month. HOLY SNARKIES. And this wasn’t even GOOD coverage. Now, as my husband was making 20 bucks per hour, I looked at the numbers. If he had been taxed at 9% for health coverage we could actually use (meaning annual checkups and a plethora of other things that still had a big percentage out of pocket with the pricey plan) that would be about $288 per month or $1.80 per hour. But what the company was being charged for insurance during the same time was $3.70 something per hour. So, hmm, the company “benifit” of insurance actually reduced his hourly pay as they could always claim that health insurance costs had a hand in it. (Which they really did, and doubled the real cost.) Hence, my point being, we in the US are always looking for jobs to provide us with insurance that in the long run may be more costly than paying for UHC. Granted, having a minimum wage job at $7.00 per hour with a 9% tax is a bit of a different story as far as monthly means, but since we already have a graduated system for income tax, I don’t see how that point couldn’t be worked out. Plus, being wiped out by health bills has no regards to income or status. (And now I will sit back and wait to be called a heathen socialist because of my views)

72. Tuscan Capo Posted: Jan 8th, 2009 at 7:50 pm

    72 Someone brought up “frivolous lawsuits”. Now while I am sure this happens I think its the exception instead of the rule, but I suspect insurance companies eagerly use such cases as excuse to jack up their rates. Yet the lack of or difficulty getting health insurance for the average tax-paying citizen has become a nationwide dilemma that just can’t be realistically denied. And I also have to ask myself, if the insurance companies cared about their clients why don’t they start penalizing these health care providers for stupid stunts like amputating the wrong limb on a patient or losing the body of a deceased infant? There’s no excuse for stupidity like these things, yet it is rare you hear of the doctors or hospitals facing penalties. On the other hand, patients are paying out the butt for just the hope of medical treatment.

73. West Posted: Jan 8th, 2009 at 8:45 pm

    73 West, with the NHS, as you’re a student, you wouldn’t even have to pay for prescriptions. I can’t imagine being in pain, and having to ignore it, because treatment wouold be too expensive. Karen, that boggles my mind- and makes me a little angry at the healthcare systems we have here. I’ve been living in pain for two years, unable to afford diagnosis or treatment. I too have heard the “horror” stories of UHC, but to me, it sounds a hell of a lot better than what I’m going through. Now granted, when I graduate in six months, I’ll be going into the healthcare field, so I’ll probably have decent coverage. But that doesn’t make up for the last two years. It doesn’t help all the other Americans who will still be in the same boat I’m in right now. And the drug companies don’t help anything, either. First, generics aren’t availible until the patent expires. And there are cases where the drug companies go back and make slight changes to the meds so they can extend the patent, for the purpose of keeping generics off the market, allowing them to keep making more money off the brands. Drug companies frequently cite research and development of new drugs as part of the reason drugs are so expensive. And this seemed like a reasonable argument- until I was talking to a friend last night, who works for a clinic trail company. My friend was shocked to find out how much her company pays doctors for running clinical trails- $12,000 per patient. Nope, not a type. Twelve thousand dollars, per patient. And the trials require a minimum of 50 patients, usually averaging over 100. That’s where a good chunk of R&D money goes to. She’s horrified at her company, and she’d love to quit in a fit of righteous anger, but unfortunately, she can’t do that, until she can find another job-which in this economy, could be a long way off. She’s furious, not just with her company, but also with the doctors who participate, because she strongly feels that doctors shouldn’t be getting paid for running clinical trials, that it should be part of their jobs as doctors (but that’s a whole nother debate entirely). But, like my friend, I was disgusted to find out how much they are making. No wonder drug companies want to keep prices here sky high.

74. Roslyn Holcomb Posted: Jan 8th, 2009 at 8:58 pm

    74 Yep, it’s official, I’m uninsurable. Just got turned down by the last company we could even think about affording, and that was going to be a strain. I’m now in my second year without a mammogram. Did I mention that I’m 44 years old and both my mother and aunt died from breast cancer? My prescription for the meds that control the insulin that’s the reason I can’t get coverage is about to expire. I’ve yet to find an endocrinologist that doesn’t charge a minimum of $350 for an office visit. That’s WITHOUT labs. Last endo I went to ran something like $2000 worth of blood tests on me. Just in case you’re wondering, no we don’t have $2350 lying around. I’m so frustrated I could scream. Oh, and about SCHIP, what a bogus program. My 4 yo didn’t qualify. In order to get insurance for him we’ve had to eliminate quite a few ‘nonessentials’ from our budget. If I thought there was a chance in hell that we could emigrate to a country that actually gives a fuck about it’s citizens I’d do it in a heartbeat. And just think I gave six years of my life for this motherfucker.

75. Jen Posted: Jan 8th, 2009 at 9:51 pm

    75 Tuscan Capo writes:Someone brought up “frivolous lawsuits”. Now while I am sure this happens I think its the exception instead of the rule, but I suspect insurance companies eagerly use such cases as excuse to jack up their rates. As soon as I hear that term, it’s time to back away. Think it out logically. You want to stop “frivolous” lawsuits, okay fine. Put a cap on them, say, 250,000 for injury and maybe 500,000 for death. Congratulations, you’ve just quantified a human life. Do not be surprised when industries across the board begin building padding into their budgets and deciding that ten or twenty percent “loss” is an “acceptable risk.” If you think it won’t happen, I used to see it happen all the time with OSHA violations. Fines were capped, and quantified, and all the businesses would have to do is ensure there was enough in the bank to cover the fine, which was often a tenth of the cost it would take to upgrade equipment with safety protection. It was more cost-effective for the company to have ten employees lose fingers or arms than it was to pony up the cash to stop a preventable accident. Once again–people are cheap. Break one, and there’s another one just like it ready and waiting to take its place. When you think about “frivolous lawsuit” ask yourself what’s the value of someone’s arm? Or someone’s reproductive system? Or someone’s health for the rest of their life? Pick a good price that sounds reasonable and fair… And then go look at your husband, your wife, your son, daughter, or mother or father and ask yourself if that would be enough for you. Giant lawsuit payouts do not exist to make people rich from dumb luck and smart tort lawyers. They exist so that large and wealthy entities like hospitals, medical insurance companies, and medical collectives feel the pinch when they sacrifice the individual for the aggregate.

76. Persephone Green Posted: Jan 8th, 2009 at 10:31 pm

    76 First, and let’s get this out of the way right now: anyone who gets their information from Faux News or from the culprits’s mouths (HMOS, insurers, pharmaceutical companies, etc.) automatically loses all credibility with me. Fox News is patently NOT objective or well-researched. The executives form opinions and then have their research teams go out and find other opinions and anecdotes that validate their own. As for private companies in a free market, they are FOR PROFIT, meaning that their bottom line is MONEY, not health care. Of course they’re biased! ‘You can’t profit if you just pay for everything you’re supposed to pay for. Like, duh!!!!!1!!1′ People expect them to tell the truth more than our government? *rotflmao* Second, thank you to GrowlyCub, Karen, Lolita Lopez, Ann Douglas, West, Kat, Rosyln Holcomb, Tuscan Capo, Katharina, Veinglory, and anyone else I’m forgetting who are not letting the propaganda go unchallenged. I am SO sick of the Red Scare. Third, two of the three authors who have been in need lately who have received help from tons of generous bloggers have had financial problems due in part to sky-high health care costs or a lack of insurance entirely: Jo Leigh doesn’t have insurance, and the other author whose name escapes me has an ailing grandmother to care for. I can’t help but think that if they had UHC, their financial problems and precipitous situations wouldn’t have been quite as bleak. All of that money could go towards keeping their homes. Thank God or whatever deities or will you please that they were lucky enough to have you there to help them; I don’t want to know what would have happened if they didn’t. What about the rest of us who don’t have awesome friends willing to fundraise? What about those even less fortunate, who have already lost or never had homes? What about the migrants whose children are making our children sick because the free clinics have run out of money to care for them and the hospitals can’t cope with the strain from non-emergencies that turned into emergencies because people can’t afford to see doctors? Why is it always ‘us’ versus ‘them?’ Let me tell you, ‘them’ does not feel like ‘them’ when you ARE ‘them.’ ‘Them’ feels like ‘us,’ and all of the quibbling over ‘entitlement’ seems callous, at best. To the people who are scared of or opposed to Universal Health Care: People I camp with in the summer (their only affordable vacation plan nowadays is to drive to a camping ground two hours away) have gone without health insurance for years. They STITCH UP THEIR OWN WOUNDS and have people pull their teeth out or wait to go to free clinics. I’ve basically lost the chance to pursue half of my career goals because I cannot afford to move without health insurance. I am a burden on my family by virtue of existing. I have PCOS and severe narcolepsy with cataplexy. I am on insurance of last resort which costs me over seven thousand dollars a year. I can’t afford it. My parents are using their retirement money to pay for my coverage. How do you think that makes me feel, to know that I can either: a) bankrupt hard-working people I love, or b)risk dying because I’d sleep twenty-three hours a day, unable to wake up long enough to brush my teeth, take my pills, eat food, clean myself? We used to be a middle-class family, slowly working our way from middle-middle to upper-middle over the course of my father’s lifetime. My parents abhor debt. Why should they pay greedy HMOs which were created under Nixon for the sole purpose of denying people coverage? My grandparents on my mother’s side both died in poverty because the last few years of their lives were spent with her and her siblings making desperate calls and cost comparisons for hospices who might be able to take them and spread their last few pennies out to make their final years tolerable. Not good, not decent, TOLERABLE. My grandparent on my father’s side had to move to FRANCE from the Caribbean because she didn’t qualify for insurance here. As she deteriorates from Alzheimers, the only uncle who can afford to visit her just lost his wife to leukemia. (This is the only major qualm I have with France’s healthcare system – all of the doctors take August off for vacation, simultaneously. There were NO doctors left in the best hospital in the country because they were all on the beach in Southern France, and the hospitals were all run with skeleton crews. It is unlikely that my aunt would have lived had her doctor been present, but the nurses weren’t even allowed to give her morphine without a doctor present. Don’t visit France in August unless you want to play Russian roulette with your life. If France’s government passed a law requiring hospitals to maintain a minimum number of doctors on call at all times, their healthcare system would be next to perfect.) ANYTHING is better than the system we have now. ANY OTHER SYSTEM. Horror stories about UHC are almost never exclusive to conditions under UHC – bad doctors, poor decision-making and malpractice happen in all systems. I would rather have growing pains in the transition than stick with the criminal neglect of this rip-off farce we call privatized insurance as our only option. We don’t need to get rid of private insurance entirely, but it’s time to make it illegal for companies to deny benefits to genuine problems or coverage to anyone.

77. Persephone Green Posted: Jan 8th, 2009 at 10:38 pm

    77 Also, what Jen said in #75. Most of the time, what conservatives mean when they talk about ‘tort reform’ is preventing legitimate class action lawsuits from making corporations pay for their ethical crimes of neglect, persecution, or apathy. If there’s a way to throw out that bathwater without tossing the baby, I’m all ears. People sue people over stupid things all of the time. But caps are not the way to do it.

78. Emmy Posted: Jan 9th, 2009 at 3:07 am

    78 if the insurance companies cared about their clients why don’t they start penalizing these health care providers for stupid stunts like amputating the wrong limb on a patient or losing the body of a deceased infant? There’s no excuse for stupidity like these things, yet it is rare you hear of the doctors or hospitals facing penalties That, they are doing. As of this past October, Medicare has stopped paying for botched surgeries and many hospital acquired illnesses (ventilator pneumonia, c. diff, MRSA, etc). Since Medicare is the largest insurer that pays hospital bills, hospitals are taking a huge hit for their screw-ups. I don’t know about quantifying life, but I do know that multi-million dollar lawsuits are causing malpractice insurance premiums to go through the roof. Rates went up an average of 14% last year, and for surgery/labor and delivery, they went up 25%. Offering a sample of what doctors will now pay, Ms. Adams says a Long Island neurosurgeon’s insurance bill will be $309,000, a Brooklyn obstetrician’s plan will cost $173,000 and a Westchester orthopedic surgeon’s coverage will cost $108,679. Those numbers could result in some doctors deciding not to practice in New York, she says. It is the first double-digit hike in at least five years, a period when increases have averaged 6.3%, with a 9% hike in 2006 and no increase in 2002. The 2007 rate matches the 14% increase in 1993 If lawsuits aren’t capped, doctors are going to be priced right out of practicing. Then it won’t matter whether you have insurance or not, because there will only be a handfull of doctors to see anyone anyways.

79. Amy Posted: Jan 9th, 2009 at 7:19 am

    79 We certainly don’t want to price out the poor doctors. So by all means cap those lawsuits, but only if the capping thing is applied both ways. In the United States my sister-in-law had a baby recently and on the itemized list she told me about finding she was charged $9 a piece for Kotexes (and we’re talking those old fashioned kind that have no tape) and $28.00 for a tube of lip balm she didn’t even ask for. The last time my mother went to the doctor she had to wait almost three hours past her appointment time, and then paid a sixty-five dollar office visit out of pocket, and that doesn’t include the $123.00 she turned around and had to pay at the pharmacy for one tube of medication.

80. Scott Posted: Jan 9th, 2009 at 12:49 pm

    80 I have been wanting to add to the conversation, since Karen flagged my blog with these questions. But I have also wanted to read all the responses, too. Too many and too little time. I will tell you that I understand that we can’t totally overhaul the health care system in the US. But some reforms NEED to be made. When we receive a letter from our provider saying that some medical procedures that are NEEDED, may not be covered, then it’s time to make some changes. What my wife is going through is horrible. It’s not life threatening, so I can see why someone trying to make a dollar wouldn’t pay all that money for her to be admitted to that hospital. But it still effects her life in such a way that at least one to two days a week she can’t function as a human being. (And selfishly, that effects my son and I, too.) Now whether it’s life threatening or not, something needs to be done. And besides, if the insurance company won’t cough up the money now for the admittance, they will be later for all of her emergency room visits or other doctor’s appointments to find other ways to take care of the problem. Or they will just drop her (which I don’t think they can do with group coverage like I have at work) and then we are screwed, because she has already been turned down in getting individual health insurance because no company is going to take a loss. They would be paying out more then receiving back in her monthly premiums. It’s time to realize that health care should be a right, not a privilege, and we need to find a way to change this.

81. Bailey Posted: Jan 9th, 2009 at 4:41 pm

    81 It may not be much to offer, but your wife is in my prayers Scott. I agree that things are out of control in the health care industry. So much greed, so little compassion.

82. dew Posted: Jan 9th, 2009 at 5:17 pm

    82 I read an article from a UK newspaper about how some people that could afford more expensive medicine were threatened that they’d lose some, or all, of their universal health coverage. IIRC, the reasoning for that policy was because it wasn’t fair to others that weren’t able to afford the more expensive medicine (paraphrasing from memory, so could be off). I don’t remember if this happened throughout the UK, or maybe it just happened in one location based off a single person’s decision. I never read a follow-up to that story, so maybe that policy has been reversed since it was posted to many universal link-sharing sites, but ewwww that’s messed up that it even happened in the first place. Anyway, I read the Australian lady’s comment about how they’re setup, and that sounds much better. I’d be for having the govt cover the basics, then being able to upgrade the coverage through work benefits insurance. But what I’m curious about in the other countries that already have universal coverage: Can illegal immigrants get the same coverage as the tax-paying citizens? If yes, is that breaking your country financially? If not, how do the illegal citizens in your country get treated? Do they have ‘underground’ clinics? And lastly, Stacia Kane, what other occupations do you feel should be forced to volunteer time out of their private lives in order to pay their bills?

83. Katharina Posted: Jan 9th, 2009 at 7:16 pm

    83 @Dew, I know that in Germany, once you go private you can’t return to UHC provided by the government. I honestly don’t know how it’s in Austria, I’ve never been interested in going private, I am happy as it is. However, you can top up your UHC, I know my brother does it, or my aunt, for about 50€/month. Until summer I am working in France, where about 80% is covered by UHC, the rest you can top up with a private insurance which costs me about 30€/moth. In case of Austria, in order to be accepted by the doctor and in the hospital, you need to present your insurance card which contains several of your contact details, your type of UHC (each region has a separate one) details and your social security number. For legal inhabitants it’s no problem to obtain such a card and normally ~7.2% from your wage are deducted (but not more than 320€) as premium. If you are out of a job, are a student, unemployed, etc… it doesn’t matter, there’s always an affordable way to be insured. Not sure how it’s in other parts of Europe, but in my country you have the right to UHC, and it can only be cancelled if you provide proof of another equal UHC (from another country) or private insurance. We do have our share of illegal immigrants, but I dare say it’s in no way comparable to the States. Not quite sure how such cases are dealt with but here’s a lucky guess. If they go to the doctor and can’t present their insurance card they need to pay cash, no exception. If they are involved in an accident, for example, and delivered to the hospital their illegal stay will be discovered there. The operation is covered but the person will be dealth with according to the law.

84. GrowlyCub Posted: Jan 9th, 2009 at 7:37 pm

    84 I know that in Germany, once you go private you can’t return to UHC provided by the government. I haven’t lived in Germany in 10 years, but I think that’s only true as long as you have a job and can pay for the private insurance premiums. I’m pretty sure that if you were to lose your job, get unemployment benefits or depended on social welfare, you’d automatically be enrolled in the government UHC system. Somebody please correct me if I’m wrong, but that’s the whole point of the ’social net’ as it’s called. That it’s there to catch people who’d otherwise fall through the cracks. When I lived there (the first 27 years of my life) the issue of illegal immigration wasn’t really much of one and I have no idea how that is addressed at a doctor’s office. It’s a much bigger concern here in the U.S., but I also think that a lot of the strain on the system would be reduced if they were covered in some way. As a legal immigrant I take a dim view on the folks who try to get the benefits of living here by illegal means, but that’s a whole different kettle of fish.

85. Katharina Posted: Jan 9th, 2009 at 9:48 pm

    85 I’m pretty sure that if you were to lose your job, get unemployment benefits or depended on social welfare, you’d automatically be enrolled in the government UHC system. A German friend explained the private vs UHC system to me thus, but we didn’t elaborate on the unemployed aspect. I will have to ask her again, but it’s strange, I agree. It would make sense that it’s always open to you, social net and everything…

86. Kat Posted: Jan 10th, 2009 at 12:30 am

    86 I’m not sure how illegal immigrants are dealt with. Basically, if you can’t produce a Medicare card, you have to pay. For emergencies, as far as I know, health needs come first and any costs are discussed later. But we probably don’t have as big an illegal population as the US (especially when the previous govt. used to keep illegal immigrants in detention centres for years without processing them–but that’s a different social problem). Katharina’s post reminded me of something. Here, you can opt to go into hospital as a public or a private patient. If you’re public, you can opt to go private at any time during your treatment. If you opt private, you can’t downgrade to public. This is a per-person choice. For example, I can give birth as public patient but opt to have my newborn treated as a private patient. If you go private, you can choose to be a private patient without your own doctor (i.e. you’ll take whoever is provided by the hospital), or private with your own doctor. This gives a better summary. I think what makes it work is that the government sets the baseline fee structure for medical costs. This avoids cost blowouts for public patients (hospitals will argue that it also underestimates real costs, so that’s a policy/budget problem). If you’re a private patient, Medicare WILL STILL COVER 75% of the cost, your insurance will cover 25% (i.e. the cost as per the Medicare schedule is fully covered) BUT you will personally cover any charges above the Medical schedule that the hospital and/or doctor/s charge. So private health insurance doesn’t have to charge extraordinarily high fees. In effect, all medical care is subsidised. Our system isn’t perfect, and underfunding is one of the main problems at the moment. But the fact is, Australians consider health care a basic right, and any attempt by the government to screw around with it is met with huge disapproval. I think that until US citizens get into a similar frame of mind (rather than saying it’s a good idea, BUT…) then it’s always going to seem an impossible dream.

87. Emmy Posted: Jan 10th, 2009 at 1:16 am

    87 You’re assuming that everyone wants UHC, Kat. I don’t. I like my health coverage as it stands now, because it’s damned good. I pay $80/month for myself. My co-pay for an office visit is $10, and my co-pay for prescriptions, regardless of cost, is $2.50. My insurance covers medical, dental, and vision. I can get a new pair of glasses or contacts every year, and insurance pays 90% of the cost of the frames and lenses. I got a $500 pair of Prada glasses last year for $50. If we were to go to UHC, I’d pay more per month for less coverage. The government is NOT going to pay to keep me in Prada. Please to be explaining why UHC would be a good idea for me, because I’m not interested, thanks.

88. Naomi Brooks Posted: Jan 10th, 2009 at 1:59 am

    88 Emmy: That sounds a lot like “got mine, screw you”. I’m going to give the benefit of the doubt that you’re not being malicious in stating the truth that you have the privilege of having health care that works for you, but many many people have no hope to be in the position that you are in right now. I, myself, have the privilege of having enough food that I don’t go to bed hungry every night. However, I wouldn’t say “I’m not hungry, so what do food stamps do for me?” And Prada eyeglasses are a luxury. If you don’t have the money for any glasses, you won’t care about a label. If Prada is a requirement, then I’m sure you could still have UHC and pay for it yourself.

89. Kat Posted: Jan 10th, 2009 at 2:00 am

    89 Emmy, that’s because you’re building all sorts of assumptions as to what a safety net health care system will look like. I get what you get, but I also have the safety net of Medicare. So really, I don’t see what your point is (and I mean that with all due respect). And yes, in a twist of fate, the last pair of glasses I bought were Prada! lol Medicare paid for the consultation with my optometrist. Private health insurance paid for about $150 for the glasses, and I paid the extra (about $130). My health premium is about $200+, but that’s family top cover. If I were single, it would probably be around $100 (which is about the same as yours converting USD to AUD). If I didn’t have health insurance, I could buy the cheapest glasses available. If I didn’t want to pay top cover premiums, I can buy a less prestigious brand of glasses. Every year, I buy contacts and my out-of-pocket cost (excluding my insurance premium) is … well, I don’t think I’ve had to pay extra, but that’s because I buy the minimum I need. The government doesn’t have to pay to keep you in Prada. But it *should* be paying to ensure that you and your neighbours aren’t walking around blind. In reality, Medicare doesn’t cover the expense of glasses or contacts. If you don’t have private insurance, you pay the cost upfront (unless you’re covered by another welfare benefit), so your example is probably not the best one to compare with the Australian system. When I visit my GP, I pay nothing. That’s probably a better comparison. Private GPs can set their own rates. Part of that cost is defrayed by Medicare. Private health doesn’t cover the rest. So if I want free GP consultation, I go to a GP that bulk-bills (i.e. charges only the Medicare schedule fee). I have absolute choice over which GP I see. When I gave birth, it cost me absolutely nothing from antenatal to postnatal care (10 days in hospital). All tests were covered by Medicare. All I paid for were the optional childbirth classes. If I had gone in as a private patient in a public hospital, it would have cost me at least AU$1500. If I had been a private patient in a private hospital, I’d be looking at a cost of at least AU$2000, depending on the doctor and the hospital. If I had had unexpected complications, or if my baby had needed intensive care, as public patients, we would have paid nothing. I pay a higher proportion of my tax for the government to be able to sustain this system, but as far as I’m concerned, it’s worth it. I suppose I am assuming that everyone wants a health safety net because a first-world government that won’t provide its citizens with basic health cover doesn’t make sense to me.

90. Kat Posted: Jan 10th, 2009 at 2:01 am

    90 I should have waited to read Naomi’s comment before subjecting everyone to my tediously verbose response.

91. AnneD Posted: Jan 10th, 2009 at 2:05 am

    91 Man, I wish I had that insurance. I have expensive spectacle tastes…

92. AnneD Posted: Jan 10th, 2009 at 2:35 am

    92 In NZ medical insurance is a true employment bonus. When hubby took his last job back there, his employment package included a further week of annual leave on top of the govt mandated 3 weeks, and amongst other things, private medical insurance. So basically there is a min coverage (obviously paid for by my hubby via taxes), but his employer paid for medical coverage above and beyond that. We didn’t really understand the medical insurance system when he took his job here and didn’t realise just how constricting policies could be here. It really wasn’t a perk at all here, (although, maybe it is becoming more so) not the way we thought at least. We severely underestimated what was and was not a good policy. But what can you do about that, you get what you’re given from your employer. We’ve learned a lot. I don’t see why a similar system can’t exist in the USA. Then employers like Emmy’s can still supply them low cost options for superior insurance, but just in case the worst did happen and Emmy lost her job, she would still have medical backup. But there in lies the rub: peoples mindsets need to change. We all pay happily our house/car/personal insurances every month ‘just in case’, and I’d always looked at it as a similar mentality when it came to healthcare when I was back in NZ. I might spend 30 years paying into the system and seemingly get very little back from it, but there were all those years before(as a child) and after (retired) where I will get my ‘moneys worth’ out of the system. And all it takes is one thing to happen (say having an emergency c-section, a 12 pd baby, 2 weeks in NICU, and coming home with oxygen tanks and various other paraphernalia) and you tend to start thinking you’re getting a pretty good deal.

93. Emmy Posted: Jan 10th, 2009 at 3:45 am

    93 Naomi, I fully understand why UHC would be beneficial to you, or to any of the millions of under- and uninsured Americans. I’m stating why it wouldn’t work for me, as a private citizen. I’m not trying to be malicious in stating that I like the coverage that I have. There are differing opinions on whether people should/should not be held financially responsible for other people’s premiums, but that’s a different discussion for a different day. (see me being restrained? I deleted three whole paragraphs that would have AL hopping all over the place. go me.) Kat: I think we’re coming at this from two different sides. You are using the coverage you have as an example. I have never said that UHC would not work- because it obviously does in several countries- but if you look at the American National HealthCare proposals set before Congress, you would see that my costs would indeed go up and my coverage would be less. To keep my current level of coverage, my out-of-pocket fees and costs for private insurance top-up would be exponentially higher. I’m looking at actual proposals and determining how they would affect me.

94. GrowlyCub Posted: Jan 10th, 2009 at 4:00 am

    94 Watch Emmy’s tune change in a heart beat, when she loses her coverage. It’s this kind of short-sighted attitude by the priviledged that’s keeping millions of people un- and underinsured in this country. Do you have no family members who have little, bad or no health insurance? Do you not know anybody you care even the slightest little bit about who doesn’t have insurance? Can’t you imagine what your life might be like when that insurance that you are so smugly talking about goes up in smoke? I hope you never lose that insurance, so you never have to figure out whether you’ll buy food or medicine or go to the doctor! Or maybe I should hope you lose it, because it irks me no end that you’d brag on your insurance paying for a pair of vanity glasses while people die preventable deaths because the self-same insurance ‘can’t afford’ to pay for their procedures.

95. Jen Posted: Jan 10th, 2009 at 4:31 am

    95 Emmy writes: I got a $500 pair of Prada glasses last year for $50. If we were to go to UHC, I’d pay more per month for less coverage. The government is NOT going to pay to keep me in Prada. Please to be explaining why UHC would be a good idea for me, because I’m not interested, thanks. Because my uninsured ass will be breathing untreated strep germs all over the same grocery carts you push, the same water fountains you use, and the same door latches you touch. I will miss more work, you don’t mind covering for me, do you? If I don’t work next to you, I work for some place you want something from. I hope you don’t mind waiting because we’re understaffed. Eventually, I will go to the emergency room when my treatable sniffle gets bad enough that I can’t self-medicate, self-treat, or ignore. I’ll be treated for a major illness, or at least stabilized and sent off. I’ll default on my medical bills because you can’t get blood from a stone, but you won’t mind paying a higher price–even if your great insurance company negotiates an 80% discount, 80% of $500 is more than 80% of $300, but somebody (you) has to take up the slack for my not being able to pay. When the hospital does finally come after me, I’ll lose my house. It’ll go into foreclosure and maybe go up for auction at a fraction of the cost. And I’m your neighbor–so sorry that you’ve just lost a hundred grand of equity on your house because it sits next door to an overgrown derelict. And finally, when my kid needs a kidney transplant that no insurer will pay for, I will steal those Prada glasses right off your face to hock in a shop to pay for it. But it’s all good, right, because you’ll only be out fifty bucks.

96. Emmy Posted: Jan 10th, 2009 at 4:41 am

    96 It’s not that I don’t feel badly for people who have no coverage. I just don’t think that compassion automatically engenders financial responsiblilty. I don’t consider myself privileged, if by privileged you mean rich. However, I do work hard for my miniscule paycheck, and I’d like to keep it, please. (As a side bar, let me debunk the theory that I’m only against UHC because I want to keep the poor people down. I’d benefit financially from a government-run UHC system because of my profession. More people with health insurance = more people go to the doctor. Bills actually getting paid = more money for hospitals = more money for Emmy, who is employed by the hospital. Yes, my medical expenses would go up, but so would my salary. I have every reason, career-wise, want UHC. I still don’t care for it as presented. Obama may change my opinion with his ideas, but that remains to be seen.)

97. lilitu93 Posted: Jan 11th, 2009 at 5:48 pm

    97 I’m American but have lived in the UK for 10 years now. I also lived in Germany for a year when I was a student in the 90s. Lack of UHC is one of the reasons that I won’t be moving back to the US, unless I become independently wealthy. (General workers’ rights are the other big thing – no way I’m going back to a ‘right to work’ state or only 2 weeks paid holiday a year, 3 if I’m lucky.) All three systems I’ve experienced as an adult have their bad points and all have their good points. I could tell you stories about trying to get insurance in the US to pay for tests my doctor thought I needed or waiting months for sinus surgery in the UK. I could also tell you stories of crap doctors in all three countries (and good ones as well). Instead, I’ll just state that I pay under £100 a year for what’s called a prescription prepayment certificate. With that, I get ‘free’ prescriptions (free in the sense of no payment there – obviously, I’ve paid for the certificate). I used to pay more than that per month in the US, since my work’s health insurance didn’t cover prescriptions. The bare minimum prescriptions I can be on at any time are asthma inhalers and sinus nose sprays. I would try to take the least amount of inhaler that I could, which wasn’t good for my health to say the least. Now I don’t worry about it and just take the meds I need. Also, in 2001, I was made redundant (along with almost everyone else who worked in the web) and couldn’t find a job for 6 months. During that time, I was also really ill with what ended up to be a kind of anemia. I did have to wait way too long to get certain tests done (not the initial blood tests but ones to try to find the cause), but I didn’t have to worry about getting the treatment I needed, and I got better. I’ve had problems with anemia since then, and I have had no trouble getting my blood tested regularly or getting treatment. Also no problems with getting blood tests to check my hormones – I also have PCOS, and it scares me to think that I’d be uninsurable if I ever moved back home.

98. shirley Posted: Jan 11th, 2009 at 11:18 pm

    98 It’s not that I don’t feel badly for people who have no coverage. I just don’t think that compassion automatically engenders financial responsiblilty. Your comments remind me of Scrooge. In fact, from your tone and wording, everything you have said sounds a lot like this: “If they’d rather die, they had better do it and decrease the surplus population.” ‘They’ being all those people you feel so badly for without proper health care coverage. I mean cause hey, if they died faster, then you wouldn’t have to worry that you might have to pay seventy bucks for those much needed Prada glasses at some point due to a raise in your OOP cost to cover said less-than-people for basic health coverage. Humbug on you and people who think like you. You’re POV sucks and it’s one of the reasons why I spent several decades watching people die because their insurance- yeah, real insurance- screwed around, delaying and denying, until there was nothing left to do. There may be a lot of good about America, but when so many believe, and pass on to their offspring, the ‘I’ve got mine, go fuck yourself’ attitude– well, it explains why the richest country in the world has a shit healthcare, education, justice, and transportation system. Why we aren’t even close to putting out kids who can compete with the east for jobs. Yep, you sure got yours, Emmy. Until you don’t. /rant

99. Emmy Posted: Jan 13th, 2009 at 8:51 am

    99 This is the American UHC template being trialed in Massachusettes. The comments are absolutely fascinating, and I think answer the original question of “what’s so bad about UHC in America.” Bob, The truth of “universal” health care in Massachusetts is that it is not true. I am one of the only physicians in my area who accepts the state health insurance. I actually pay to provide health care for these individuals. If no doctors accept this insurance, how does it provide health care to anyone?

100. Jen Posted: Jan 13th, 2009 at 2:02 pm

     100 You can screw up anything if you try hard enough. Massachusetts isn’t a true UHC. It’s mandatory universal coverage, which isn’t the same as care, and it’s not truly universal, as the national insurance companies (and to a certain extent, larger multi-state health organizations) can monkey with the books by shifting risk and costs to and from a state with a UHC variant in place. True universal health care–or even coverage–has to be universal for a good analysis of its effectiveness. There are hundreds of permutations of a solution to provide true universal health care. All of them will be crippled if insurance companies are allowed to have as big a voice as they do in creating UHC solutions. And hell, at least Massachusetts is *trying.* Even if the present system doesn’t work out, there’ll be a lot learned.