I stand by my opinion that America should provide a very basic level of healthcare for everyone from tax money, and then if anybody wants to receive a higher level of coverage then they are free to purchase it from private companies. This allows the healthcare companies to stay solvent and all of America gets basic coverage from the government. I beleve that this is a good compromise between completely socializing healthcare and letting everyone fend for themselves.
This is essentially how the UK's system works. Everyone is covered through the National Health Service (NHS), but patients are allowed to purchase private plans (which allow more freedom and may provide preferential treatment). They also have extremely long wait times for many treatments and elective procedures, such as hip replacement. Wait times of a year or longer are not uncommon (
http://www.telegraph.co.uk/news/uknews/1537385/Patients-wait-year-for-hip-surgery.html).
Same with long wait times for mental health services:
http://news.bbc.co.uk/2/hi/uk_news/scotland/8048685.stm
One 3 year old girl who needed life saving heart surgery has had her surgery canceled and postponed three times due to hospital bed shortages:
http://www.timesonline.co.uk/tol/news/uk/health/article6147701.ece
Cancer patient having to wait two months to start treatment:
http://news.scotsman.com/health/Cancer-survivor-confronts-the-.5095291.jp
One man was admitted to a hospital after breaking his leg. He waited
three days to see a pain team, developed an infection, and eventually died.
http://news.bbc.co.uk/2/hi/health/7959730.stm
This would
never happen in the United States. One big point you keep touting is the lack of access to care, which is nonsense. Firus covered it:
Not to mention the fact that you can go to the emergency room for free and they CANNOT turn you down. I've known of people that took their kid to the emergency room for ear infections so they didn't have to pay.
He is correct. ERs across the country are required to take in patients regardless of insurance (why do you think so many uninsured and poor use ERs as their primary care facility?) and give them the same battery of tests and treatments they would to an insured patient coming into the ER. In the US, this man with a broken leg would have come into the ER, been given an MRI, splinted, sutured, and given antibiotics to take home within a matter of hours.
Canada also has a system similar to the UK's. Canada, however, is much more strict about private facilities. A few private clinics have popped up, though they are not allowed to charge patients for services that are normally paid for by the government ("insured services"). They bill the government for these services and do not charge patients. Instead, they are promising better care in exchange for a fee; for example, $3000 a year for access to a full team of medical professionals, customized health regimens, 24 hour access to an on-call doctor or professional, short waiting times, and longer appointments.
http://www.calgaryherald.com/travel/Private+clinic+eroding+health+care+critics/1739105/story.html
Other clinics following a similar model have been attacked by the government:
http://www.canada.com/topics/news/story.html?id=16141a15-58d5-4e05-a1d2-78eaaeae207a&k=29315
http://edmonton.ctv.ca/servlet/an/local/CTVNews/20070104/privateclinic_spat_070104?hub=EdmontonHome
Similar things have happened in the UK with the NHS, where patients have been forced to pay entirely out of pocket if they chose any drug or procedure that was not covered by the NHS. In this first article, a 64 year old woman was being treated for cancer by chemotherapy, paid in full by the NHS. When she heard about cetuximab, a drug that would extend her lifespan but was not paid for by the NHS, she paid out of pocket for it. Upon finding out, the NHS stopped paying for her chemotherapy, and forced her to pay for everything - chemotherapy, cetuximab and all.
http://www.dailymail.co.uk/health/a...drawn-paid-privately-life-extending-drug.html
Wait times there are also an acknowledged problem:
http://economix.blogs.nytimes.com/2...ut-their-health-care-wait-times-and-spending/
Additionally, since it is all government provided, healthcare expenditures are absolutely enormous. The same article says, "Health care accounts for 43 percent, or 42.6 billion Canadian dollars, of provincial government spending in Ontario, the most populous province."
The people who want to become doctors don't want to do it for the pay, they want to save people's life.
Yes, becoming a doctor requires some intrinsic sense of wanting to help people, more in some countries than others. But it would be foolish to think that after all the stress, education, and training that docs go through, not to mention the importance of health and medicine to society, they would not want to be compensated properly.
One of the reasons the US has so many foreign docs coming in is that it offers an incentive for them to practice here. It is why so many Canadian trained docs come to the US:
http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20070409/cda_doctors_070409/20070409?hub=Canada
However, even more, my mother was killed not by a doctor, but by a middle man, a man who prolonged the medicine, waiting for a price drop, by which the time my mother was doomed. What purpose did this middle man serve? A common rebuttal to this I hear is that medical stations will be so over crowded that the people who need it won't receive care. This implies that some patients are 'more worthy.' a 20 year old or a 30 year old has just as much to look forward to life, can contribute just as much to society as a 10 year old. A child with a broken leg is equal to an older man with a broken leg. That more people receive care, that more people, not the 'right' people are saved and treated, this is what should be important.
Don't get me wrong, I hate what insurance companies in the US are doing. I think insurance needs to be overhauled. Make no mistake, I have no sympathy for insurance companies. But socialized medicine, which would cut out all the "middle-men" in exchange for a "middle-man" (a single payer system), would not solve the problem. It's not about some patients being "more worthy" than others (that is an altogether different debate). The problem is long wait times and waiting lists for procedures. In theory, more people would receive care. But we don't have to theorize. We need only look at the state of medical care in the UK and Canada, where wait times are so long that the people who need care the most don't get it in time.
Under universal health care, it isn't an automatic "You get any and all treatments you need". No, the GOVERNMENT gets to decide whether or not you get the treatment you need. I don't know how old your grandmother was when she died, but it's very possible that the government would decide that she was too old for them to justify giving her any treatment.
Another good point. The trend today in the US is a cookie-cutter, one size fits all approach to medicine. Insurance companies are trying to remove clinical judgment from the matter. It often goes something like this:
Scenario 1:
Dr. Smith, a primary care physician, sees patient John Doe, a 19 year old with asthma. Based on John's previous history and Dr. Smith's clinical workup, Dr. Smith prescribes Drug A to John for his asthma because he believes it will be more effective than Drug B in this case. John's insurance provider, Happy Health Care Inc, denies the claim because 80% of the time Drug B is more effective than Drug A in the 18-25 age group. John and his doctor are forced to waste time and submit paperwork to justify why he should get Drug A. In this scenario the insurance company subverts the doctor's medical training and expertise, resulting in more paperwork and bureacracy. This is one of the reasons that paperwork is consuming more and more of doctors' time. In one study of reproductive health and medicine, 80% of claims were initially denied by insurance companies.
http://humrep.oxfordjournals.org/cgi/reprint/11/1/72.pdf
Further reading:
http://www.huffingtonpost.com/2009/08/06/denied-claims-placed-at-h_n_253160.html
Scenario 2:
Dr. Hart is a cardiologist working out of a hospital. A 67 year old patient, Jane Doe, was referred to Dr. Hart after her primary care doctor saw symptoms of a blood clot. Jane is a healthy, active woman with no history of serious medical conditions. Dr. Hart treats the blood clot, and she prescribes an anticoagulant to Jane to prevent clotting problems in the future, since Jane is at risk for them. Jane's insurance company refuses to cover the cost of the drug because her life expectancy is 76 years. The company does not feel the cost of providing the coverage for 9 years is worth it. This, of course, ignores the fact that Jane is not a statistic and that life expectancy is an average. Jane, as a very healthy 67 year old, might in reality live another 30 years or more.
This second scenario is very real: it happens in the UK with the NHS. Older patients are often denied treatment on account of their age alone.
http://www.independent.co.uk/news/u...-equal-treatment-for-the-elderly-1435098.html
Additionally, it's important to remember that just because everybody has health care does not mean everybody will be treated. It may force rationing of care because the government does not have enough to pay for everybody. According to this article:
"The NHS currently issues more than 60,000 treatments of steroid injections every year. NICE said in its guidance it wants to cut this to just 3,000 treatments a year, a move which would save the NHS £33 million.
But the British Pain Society, which represents specialists in the field, has written to NICE calling for the guidelines to be withdrawn after its members warned that they would lead to many patients having to undergo unnecessary and high-risk spinal surgery."
http://www.telegraph.co.uk/health/h...efuses-to-pay-for-painkilling-injections.html
You're leaving out the fact that the statistics may have you believe that the 25% of people that are uninsured are all uninsured because they can't afford it. I would actually be willing to bet that at least half of that 25% is uninsured by choice. It may not make sense to you and me, but that's moot. There are people that don't get their own health insurance by choice.
This is also a very good point (also, the number of ininsured by the way is 15.7% not 25%). According to the Dept of Health and Human Services:
"27% of the uninsured have incomes above 300% of poverty, with one-in-ten (11%) uninsured above 500% FPL."
So about one quarter of uninsured can in reality afford it.
http://aspe.hhs.gov/health/reports/05/uninsured-cps/index.htm
I agree that for the rest, health insurance should be made more accessible and affordable. Again, a socialized single payer system is not the answer. I also support Obama's decision to mandate health insurance for all children. I would not oppose paying for children's healthcare with public funds.
You've socialized many things before. Let's take a look at your education system - is this something you consider a right? A right to education? How come - is it because it levels the playing field and gives an equal opportunity at success for everyone?
Sort of. And I agree with you: all children should be given access to school and education. That's why there's a mandatory public school system, which I fully support. It's also why I support federally funded health insurance for all children.
Also, this whole argument about forcing people to live healthier lifestyles along with universal health care is baloney. Your taxes pay for plenty of things that you shouldn't have to pay for. Even something as simple as road repair - what if you don't own a car? What if you take a hot air balloon to work everyday? Sure it sounds ridiculous, but if you didn't use the roads that you're paying repair bills on, you could argue the same as these idiots who think we shouldn't pay health bills for the guy who enjoys his Big Macs. We all need health care, we ALL have vices, and we all will get sick in our lifetime, with varying degrees of severity.
I think the issue is in the distribution, disparity, and severity.
Enough people use roads (ie, almost everybody) that it makes sense to use public funds (taxes) to pay for their maintenance.
Healthcare is fundamentally different. It's not as simple as "uses roads" and "doesn't use roads." There are so many different types of people, lifestyles, illnesses and conditions, that it does not make as much sense to force everybody to pay for the treatment of certain individuals. This is especially true in the US, where 33% are overweight and 34% are obese. How many doctors do you think give their patients the "you need to lose weight" talk? How many patients do you think actually listen? Why should I pay for Bob Smith's medications, when he continues to eat unhealthy food and brought about his condition with his own habits?
Yes, I realize not everybody is overweight for lack of trying (there are people with legitimate conditions) and that not everybody is sick because they're overweight (a lot of people can't control when or how they need healthcare). I am not referring to these people. I'm referring to the smoker with COPD, emphysema, and hypertension who buys his meds at the pharmacy and then goes next door to the general store for a pack of cigarettes. I'm referring to the hepatitis patient that won't stop drinking, or the overweight diabetic who will continue to have insurance pay for his diabetes meds but will never make an effort to exercise or eat less.
Anybody who's worked in an ER, doctor's office, or pharmacy knows this. People feel this sense of entitlement. Somebody complains that they have to pay a $5 copay but has no qualms about paying $10 for cigarettes, or claims that they can barely afford to pay $40 a month for pills but just got a new TV or video game system. I'm referring to those people, and they are quite numerous.
The idea that we should all pay for everybody's care is a little misguided; it is very reactive. "People eat a lot and become unhealthy and require more medical care. Thus, we should have everybody pay for it so that we can afford it." I think we need to take a more proactive, preventive approach. Instead, we should spend money towards getting people to eat and live healthier. I understand that not everybody has the time or money to research healthy foods or that not everybody has access to healthy food. We should make it easier for these people to understand and obtain healthy food and live better lifestyles. We need to give incentives for more medical students to go into primary care. These will result in fewer health problems and lower costs. A socialized or universal system would be like putting a band aid on the problem without actually fixing it.
This whole "every man for himself" attitude is really depressing. I feel deeply disturbed by some of these posts - I'm not kidding.
Just for the record, I don't believe in "every man for himself". I think it's important that the people who need healthcare get it. I just don't agree with the method that you support.
As an addition to my post, I just want to mention that we do have a model of socialized healthcare in the United States: the VA (Veterans Affairs). I didn't discuss it in the rest of my post but it is noteworthy.
Anybody who's been following the news knows all the criticisms that have been leveled against the VA. The VA is absolutely horrendous. If you want a taste of what socialized medical care would be like in the US, just do some reading on how the VA has failed.
