Replies to This Discussion

Permalink Reply by Louis on August 19, 2009 at 1:30am

I'm sorry for the losses of your father and mother in laws but they were being served by a system that is not at all like what is being planned here.

Healthcare in England is served almost entirely by the NHS. There was some private insurance and some doctors in private practice but not many. Almost all private doctors in England are specialists, there are some private hospitals but all things considered NHS totally dominates the healthcare industry of England. With that kind of system you inevitably get the waiting lines etc. etc. It's the same thing that happens when you have an abundance of demand with a severely limited supply.

However, that is not at all what is being planned by anyone here. There is no discussion about taking over existing health insurance companies or forcing individuals out of private insurance into public. Private insurers will continue to function as they always have, just with a new state run competitor. The NHI being talked about isn't even a free system, individuals will still be required to pay to be part of the program; the return is that they can never be dropped or refused coverage by the US NHI. The US NHI being proposed doesn't mimic any other existing system. The US NHI is focused on Universal Availability, not Universality, of Health-care.

Trying to find a good comparison, look at the Japanese system. There are two types of health insurance; the Kokumin-Kenko-Hoken and the Kenko-Hoken; the former being social insurance provided by employers the latter being national insurance provided by the state. In Japan all people are required to have health insurance (not something that is being seriously considered in the US debate) and so if one is not employed, one has the secondary option available. Naturally, national healthcare is not as comprehensive as social healthcare and cannot be used outside the country as social healthcare can. While it's not a perfect comparison, it shows the kind of system being proposed. There is no plan to strip private insurance from anyone, they just want to introduce a secondary system for those unable to get into the current.

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Permalink Reply by Jason Spicer on August 19, 2009 at 2:46am

I remember reading about Deamonte Driver at the time. Poor kid. It looked like he had a chance with the brain surgery (because of a bad tooth!) to excise infected tissue, but he died anyhow. He should be the poster child for health care reform in the US. What's better, $80 and life or $250,000 and death? Duh. Then some asshole rightie would point out that he'd probably soak up more than $250K in health benefits over the course of his lifetime, without bothering to notice the taxes he'd pay or the effects of compound interest. Like I said, immoral.

Permalink Reply by Фелч Гроган on August 19, 2009 at 10:19am

Dave: I pay over $800 a month for medical (Blue Cross), dental and eye insurance for myself, wife and two kids. The company kicks in a further $400 per month.

That's not medical insurance. That's a protection racket. It's raw profiteering. The extreme top shelf medical cover in OZ is lucky to break $300/month. This only shows that you have lost control of the medical industry itself - allow them to charge what they see fit to subsidise their yachts and private Carribean islands. If you can break this blatant and systemic exploitation (actually, looting is probably a more appropriate term), the costs of universal healthcare would suddenly be a lot more realistic.

A degree in medicine should not be a guarantee to join the millionaires club, nor should being a sales rep for a pharmaceutical company.

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Permalink Reply by kj on August 19, 2009 at 10:23am

felch, you are so rational and make so much sense... you also give me hope that perhaps ALL humans aren't useless skin sacks with flimsy ego's behind the wheel. Thanks for providing me with hope in an otherwise hopeless existence.

Permalink Reply by Dave Rogers on August 19, 2009 at 11:15am

By stating the ridiculous amount I pay for health coverage I was trying to illustrate it's in no way cheap to even have health care in this country. You also have to add the $400/mo my company kicks in as a benefit to me. From 2000 to 2005, I had my own business and paid about $1000 to $1200 a month for my own family's coverage. It is insane. One cost problem I've experienced is the over testing doctors do to cover all the bases to avoid a malpractice lawsuit in case they missed something. All I wanted once a couple years ago was to refill to an allergy medicine and ended up getting a full finger-up-the-butt physical and stress test. I once had a day-patient hernia operation and it cost over $15,000 (only $50 co-pay for me though). It's the unrestricted profits that doctors, hospitals, pharmaceuticals and insurance companies can make that needs to be either eliminated or at least regulated to bring down costs for everyone, including me. If they could bring my cost down to $300/mo like OZ, I'd be very willing to pay an increase in taxes to help insure everyone.

Permalink Reply by Caveman on August 19, 2009 at 11:51pm

What's interesting is that I hear different stories about the health care in different countries. For instance in Canada and Britain I keep hearing about the long waiting periods for certain operations. Then on the other hand, supposedly France and Norway have ideal systems. I'm sure each system is operated and managed differently. It will be interesting to see what kind of system we're going to end up with. I sure do hope the emergency room wait times go down. That would at least be a good start.

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Permalink Reply by Louis on August 20, 2009 at 12:07am

The French and Norwegian systems differ greatly from the Canadian and English systems.

The English and Canadian systems are dominated almost entirely by the respective NHI system. There are very few private hospitals or physicians, not as a function of law but as a result of NHI being so all encompassing and having little to no competition. That is not to say there are no private doctors in those countries, only that they are rare; most doctors in Canada and England are part of public institutions and not in private practice.

The French and Norweigan systems are incredibly good. They are also almost entirely dominated by the NHI. They, however, have mostly private doctors in private practice who participate in their NHI. In France it is normal for an individual to choose to see a non-NHI physician with the understanding that the individual must pay all costs out of pocket. In Norway, individuals can opt out of their NHI all together and pay out of pocket. The standard of care between private and public doctors is not measurably different; only the timeliness differs.

I wrote this all out much better somewhere earlier in this thread.

Permalink Reply by Angie Jackson on August 20, 2009 at 1:40am

If more people have primary care, then we won't have to use the ER for ear infections, and everyone's wait times will go down. It's epic WIN on that front.

Permalink Reply by Jo Jerome on August 20, 2009 at 1:55am

As I understand it, it's kind of like Londoners bitching about the Underground always being late. At the end of the day, most Americans could not even comprehend such an efficient public transit as London has.

As for waiting times, they definitely exist now. My MVA a couple of weeks ago left me with a complete break in my collarbone; the two ends skewed and crisscrossing each other. And yes, that's every bit as painful as it sounds and then some. Whole left side of my body useless, rest of it not much good either as I could barely move anything, couldn't lie back, the hospital couldn't get enough morphine into me. It still took 20 hours to get me into surgery and that was putting a rush on things in the last couple of hours as my condition worsened.

The icing on the cake though, I think I mentioned elsewhere in this thread, was the team of hospital accountants standing 'round my bed asking if I want the surgery. "You have nowhere else to go. Your life is in our hands. We'll save your life but in return you will live out the rest of your days in financial ruin. 'K?
:-*"

-_-

Sorry for the mini-rant, but said shoulder is bugging me tonight and seeking to have it's little voice heard.

Permalink Reply by Jason Spicer on August 20, 2009 at 2:09am

The secret to a short wait time in the ER: 5:30 to 6:30AM. The overnight drunken injuries have cleared out and nobody has fallen off a ladder yet. I'm not saying the ER is always deserted at this time of day, but when I was up all night with appendicitis and finally went in around 6:00AM, I was the only patient in the ER. I was practically diagnosed before I got to the receptionist. As I walked in thru the sliding glass doors, she said, "Abdominal pain and shortness of breath?" Clutching my side, I gasped, "You nailed it!". I was on morphine 15 minutes later. If the admitting nurse had had a pocketknife, I could have been back in my car within the hour.

Permalink Reply by Jo Jerome on August 20, 2009 at 12:01pm

I'd also add that two more tips to a shorter ER wait:

- Small towns. Their hospitals are usually way less crowded.

- On your way to the ER for a throat infection, take a hefty spill off your bicycle so you can go in all bloodied up as well.* Ok, that wasn't intentional when it happened to me, but it did get me in to see the doctor a lot faster than I otherwise would have.

*Yes, I actually injured myself in a bicycle wreck while on my way to the urgent care for an unrelated issue. It's days like those I wonder if there really are gods, and there is a small pantheon of them devoted just to mocking me. :-/

Permalink Reply by Anne Halligan on August 20, 2009 at 1:20pm

Dave, I'm sorry you feel your family didn't receive adequate care under our NHS service. however I feel you statement needs challenging. Since May of this year my 80 year old father has had his life enhanced, if not saved at least 3 times, thanks to the NHS. This on top of a lifetime of care for a myriad of health problems which, were we required to pay, would have seen him dead while I was a young child. The British NHS is not perfect and there are regional discrepencies in the effectiveness of care, BUT it is ALWAYS available. There is no need for anybody here to weigh up the seriousness of an illness vs the amount they can pay to treat it, prior to seeking such treatment.

I for one think it is 1 of the priorities for my tax money and would happily pay more tax to boost that system. I cannot comprehend how a country as advanced as the USA, in the 21st century is still without national healthcare for all, at source. It beggars belief that this is even an issue requiring debate.

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