Universal Health Care

"I'm going to throw this little tidbit of information into the fray and see what happens. Just so you know, I pay medical premiums of $108 per month for a family of four. That's it. Everything is covered, other than prescriptions, dentistry and eyecare, which I can deduct on my tax return. I don't get charged extra to see the doctor, and whatever tests, procedures and operations they deem necessary are covered. I'm not saying it's the greatest health system in the world, and it clearly isn't at 30th on the list, but not being bankrupted by a medical condition would seem to be a distinct advantage."

Warning: Hyperbole and humor intended.....

You mean, you as a Canadian aren't seeing family members dying due to yearlong waiting lists? Can't be, you're just one example and not representative. I'm told all Canadians must be screwed because of socialism! Are you using rusty syringes and one 1950's x ray machine for the whole province? If you get cancer they tell you to go home and wait for the reaper, right?

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 02:41 PM) [snapback]492575[/snapback]</div>

I agree...but, unless we make "oil changes" reasonably affordable and accessible for most people, they're going to naturally tend to avoid them.

I mean, if it cost $500 for each oil change, and there were no other options...at some point, doesn't the price point simply become too high to honestly expect people to follow the stated procedures (even if that's what's required to get an new engine under warranty)?

I feel like, as with so many things, we tend to defer periodic maintenance (whether to the highway infrastructure or ourselves)...only to then get socked with a huge and (as importantly) totally "unexpected" bill when the inevitable finally happens, and something catastrophic occurs.

It just doesn't seem like good planning to me. I guess I wish that we could as a Country, invest in ourselves for the longer term sometimes.

 

<div class='quotetop'>QUOTE(dbermanmd @ Aug 8 2007, 02:08 PM) [snapback]492557[/snapback]</div>

So by you now calling it limited do you then agree that it is not "Socialized Universal Healthcare" as you originally claimed? If so than you must agree that your original claim was a LIE. You can be as sarcastic as you want my calling me an "expert" but it only took 5 minutes on Wisconsin's website to find out that you were lying.

How much would universal health care cost? Half what our current system costs. Now I'm not talking true one-payer government controlled universal health care here not the many proposed systems were the government simply pays for everyone to use the currently system. How do I come up with that number? Simply by comparing our cost to the cost paid by countries that provide universal coverage. Countries that rank higher than the US and have healthy populations that live longer.

1998 health care cost per capita from "The U.S. Health Care System: Best in the World, or Just the Most Expensive?" by the University of Maine:

U.S.A. - $4178
Switzerland - $2794
Norway - $2425
Canada - $2312
Luxembourg - $2215
Denmark - $2133
France - $2,077
Australia - $2043
Japan - $1822
Italy - $1746
Sweden - $1746
Finland - $1502
U.K. - $1406

http://dll.umaine.edu/ble/U.S.%20HCweb.pdf

What you call rationing I call equal distribution. I know it really burns you up that under a universal system no amount of money could bump you to the front of the line. Your life would only be as important as the poor black single mother of 2 sitting next to you. That is why the elite of the world come the the U.S. for care if their country does not allow private health care. Your cry of "rationing" smacks of elitism and racism. We already "ration" care. Those that can pay get care, those that can't pay get no care.

<div class='quotetop'>QUOTE(dbermanmd @ Aug 8 2007, 02:08 PM) [snapback]492557[/snapback]</div>

The rank of 37th comes from the World Health Organization's 2000 report entitled: "Health Systems: Improving Performance. It is a 215 page document available free to anyone to download if you are truly interested in their ranking methodology.

The same report from the University of Maine as a pretty good summary of the WHO's criteria for a good health care system.

"In this analysis, WHO developed three primary goals for what a good health system should do: 1) good health: "making the health status of the entire population as good as possible" across the whole life cycle, 2) responsiveness: responding to the people's expectations of respectful treatment and client orientation by health care providers, and 3) fairness in financing: ensuring financial protection for everyone, with costs distributed according to one's ability to pay. The WHO study also distinguished between the overall "goodness" of health care systems ("best attainable average level") and fairness ("the smallest feasible differences among individuals and groups"). A health system which is both good and fair would thus ideally have:
1) overall good health (e.g., low infant mortality rates and high disability-adjusted life expectancy)
2) a fair distribution of good health (e.g., low infant mortality and long life expectancy evenly distributed across population groups)
3) a high level of overall responsiveness
4) a fair distribution of responsiveness across population groups
5) a fair distribution of financing health care (whether the burden of health cost is fairly distributed, based on ability to pay, so that everyone is equally protected from the financial risks of illness)"

 

<div class='quotetop'>QUOTE(Darwood @ Aug 8 2007, 03:19 PM) [snapback]492590[/snapback]</div>

I hear that they actually still moisten a cloth with ether and hold it over your face, to put you under...

Barbarians!!

 

<div class='quotetop'>QUOTE(Pinto Girl @ Aug 8 2007, 04:24 PM) [snapback]492595[/snapback]</div>

From the WHO:

So, it doesn't look like any of the world's health care systems, even those with universal care systems, are doing all that well with preventative care.

 

<div class='quotetop'>QUOTE(jhinton @ Aug 8 2007, 04:26 PM) [snapback]492596[/snapback]</div>

No matter how "universal" you make any health system, there will always be a way to opt out of it. Or, do you mean to tell me that doctors won't be able to practice medicine if they don't participate? Call it elitism, classism, racism or whatever you want. -- if I can afford to pay to bypass the line, then I shouldn't get be forced to get stuck in it. Hell, even amusement parks get this, as they are offering premium tickets for those who want to pay more in order to not wait in line.

And, again, hospitals are not allowed to turn anyone away by law -- even if they can't pay. So, if someone goes without care, then it is their own fault.

 

Does this mean that preventive care doesn't work...or that it's not being implemented effectively?

I'd suggest the latter, but can't reliably substantiate that.

I'd also suggest that (if, for example you look at how men tend to not go to the doctor until it's really bad) there's another personal dynamic going on here, too, that might tend to defy halfhearted efforts at encouraging prevention.

I do not know, something about the way people live their lives tends to be more about doing whatever we want now, then coming up with miraculous solutions for the problems/addressing the consequences later...rather than just avoiding the problems in the first place.

I don't know if it's unique to Western culture, or more prevalent throughout the world.

It might be less of an issue with health care, and more of an issue with *us* and, perhaps, some basics of human nature too.

????

do not know.

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 03:51 PM) [snapback]492614[/snapback]</div>

This is far too simplistic, and untrue.

Using the emergency room for non-emergency situations --simply due to the lack of insurance or ability to pay-- is tremendously inefficient and unsatisfactory for everyone involved, including the patient. Waits can be long, quality of care poor, and there is little or no follow up (changing bandages, confirming freedom from infection, etc.)

It's not as easy as you say, and it's not "their fault" either; clearly you've never placed yourself in this position when you weren't feeling well. It sucks...I can assure you that most folks won't rave about the "free medical care" they're receiving in this circumstance.

 

"So, if someone goes without care, then it is their own fault."

Dang 8 year old kid ought to know better than to not have insurance! They deserve the crappy in and out care they get! (sarcasm)
As stated before, they will go anyways and any care they are able to get, ends up costing us anyways, as if we DID have universal healthcare. This is why I can't see the costs being higher than they are now.


"No matter how "universal" you make any health system, there will always be a way to opt out of it. Or, do you mean to tell me that doctors won't be able to practice medicine if they don't participate? Call it elitism, classism, racism or whatever you want. -- if I can afford to pay to bypass the line, then I shouldn't get be forced to get stuck in it. Hell, even amusement parks get this, as they are offering premium tickets for those who want to pay more in order to not wait in line."

Totally agree with this, though.

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 02:48 PM) [snapback]492547[/snapback]</div>

no, i get your point, i'm just saying that people are still going to have situations where they'll take the extra cash rather than have insurance. and that's the expensive mistake that i'm saying will condemn a person for life if severe enough. yes, we have to let people screw up. i've made my mistakes and my good choices that put me where i am today and i took responsibility for them. but there's a certain amount of harm that i just don't feel good about someone taking for making one stupid decision.

me personally, i'll take responsibility for my family on the insurance issue. and i would like to have the options as you describe them. but as i said earlier... only in a perfect world will people never ever screw up and not do something they should have done. like research, call around, decide, and buy the right insurance. and i'm sure the good coverage (you know, the $20 or less co-pay, the $500 or less deductible, the higher limit on number of specialist visits, etc) will still be quite pricey as well.

we are used to our employers just handing us an option and taking that. insurance is a lesson in apathy for many: oh look the boss says i have insurance, they sent me a little card, oh that's nice. until they need to use that insurance and see they have to pay in a bundle of money before they get any benefit out of it...

in order for your system to work, we'd need to implement a whole new attitude of self-reliance and awareness about health insurance. i'm not saying it's bad, i'm saying it's a tough road to go down.

 

<div class='quotetop'>QUOTE(Darwood @ Aug 8 2007, 03:59 PM) [snapback]492626[/snapback]</div>

Some things are simply above "I can afford to buy my way to the front of the line, so that's what I should get to do."

How about transplant organs? Should we make these available to the highest bidder? Why not everything? If you can buy it, you can have it, no matter what it is. Let the market decide...

No. Wrong.

 

Transplants, no. They are registered and through the system, so I don't see how a wealthy person could bypass that, unless they know the dying person and offer them (or their family) loads of money.

But a doctor should have the right to private practice. You can't prevent someone from having a private business transaction. You can prevent a wealthy person from jumping back into the public system at the front of the transplant line, though.
Just like you can pay extra to send your kids to private school. If you're in to that kind of thing.

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 03:51 PM) [snapback]492614[/snapback]</div>

All of the universal system is Europe also have private systems as well. Yes, you can opt out of the government run system if you want. I don't think that this is right though. I truly believe that if everyone was required to use the government system then we would have an excellent system because everyone's life would depend on it.

If you have parallel private and government systems then you end up with something similar to our current education system. Yes, the public system provides an adequate education in most areas but not a top notch education. For that you go to a private school. In some areas, the public system doesn't even provide a basic education.

The education system also shows us that an universal health care system must be nationally funded, not locally. This way you can ensure similar care regardless of the income of the local region. If it was locally funded you would have very good public hospitals in wealthy regions and poor hospitals in poor regions just like the disparity in our education system.

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 03:51 PM) [snapback]492614[/snapback]</div>

Yes, you can go to the hospital emergency room and they are required to treat you regardless of your ability to pay. However, most people will not go the the emergency room for preventative care or minor problems because regardless of whether or not they can turn you away, you will still get a bill. That bill will be in the hundreds of dollars regardless of why you visited. The hospital will not just write that debt off. They will turn it over to collections, who will hound you continuously. They will ruin what little credit the person might have making the rest of their financial situation even worse. Yes, you can declare bankruptcy but not every time you go to the emergency room. For all of these reason, the uninsured poor usually defer care until a health problem become severe rather than go to the emergency room when it is minor.

The emergency room in not the answer for our uninsured population!

 

"That bill will be in the hundreds of dollars regardless of why you visited. The hospital will not just write that debt off. They will turn it over to collections, who will hound you continuously. "

True!

"If you have parallel private and government systems then you end up with something similar to our current education system. Yes, the public system provides an adequate education in most areas but not a top notch education. For that you go to a private school. In some areas, the public system doesn't even provide a basic education. "

False!
School district success is a direct reflection of the economic and emotional stability of the families that send the children to them, as well as the quality of the teachers that teach there. Private schoolteachers make far less, and few private schools are erected in poor areas.

Also, a Private medical system outside of a public one encourages technical advancements, which can then be brought into the public system, if they prove their worth. They provide backup competition to keep the public systems in check, just as private schooling does. It should not be illegal to attend a private school if you want to pay more for it.

 

<div class='quotetop'>QUOTE(jhinton @ Aug 8 2007, 05:27 PM) [snapback]492648[/snapback]</div>

And what is your point? As the WHO pointed out, even countries with totally free health care for the masses are doing a poor job when it comes to preventative care. If people don't go for preventative care when it won't cost them a thing, then why fault the uninsured in this country for going to the hospital for their care? After all, they know the system and know that they can't be turned away and will receive the care they need.

It really comes down to the entitlement mentality. When I was just out of grad school, I worked in our county's welfare office as a Medicaid case worker. Almost every client that I saw ran to the hospital for a common cold. When asked why they didn't use a regular doctor, there response was that hospitals were open 24/7, so they could go whenever they wanted. Mind you, that these people were unemployed and had plenty of free time during the day to make an appointment with a doctor. It made no difference to them, because they weren't paying the bills.

 

<div class='quotetop'>QUOTE(Darwood @ Aug 8 2007, 04:31 PM) [snapback]492651[/snapback]</div>

So your saying that differences in regional funding have nothing to do with students performance? That a inner city school in Detroit, MI is just as good as say a public school in Silicon Valley? Is that why in 1996 my track and field team still used the original uniforms from 1962 when the school was founded and had to carpool to meets? Why we had buckets in every classroom because the roofs leaked? Why in 1996 I learned computer skills on an Apple IIe?

Or are you saying that regardless of our problems with providing a equal education to all our children, we can still provide equal health care to all our population? Health care so good that Bill Gates would see no reason to use a private parallel system and would just use the public heath care system.

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 04:47 PM) [snapback]492659[/snapback]</div>

My point is that there is a huge difference between delaying preventative care because you don't want to be bothered to go to the doctor and delaying care because you are afraid of financial ruin.

 

<div class='quotetop'>QUOTE(jhinton @ Aug 8 2007, 06:11 PM) [snapback]492675[/snapback]</div>

Evidently not, because even when the possibility of incurring a substantial financial burden is removed from the equation, people still fail to utilize preventative care!

Or, in other words, you can build it and they still won't come.

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 02:47 PM) [snapback]492659[/snapback]</div>

That says it all.

 

<div class='quotetop'>QUOTE(IsrAmeriPrius @ Aug 8 2007, 06:18 PM) [snapback]492677[/snapback]</div>

Congratulations on taking something totally out of context. You have proved nothing except for your own ignorance. I'm sure if I edited enough of your posts, I could make you sound like an anti-semite.

 

<div class='quotetop'>QUOTE(Swanny1172 @ Aug 8 2007, 05:14 PM) [snapback]492676[/snapback]</div>

Are you implying that the citizens of countries with universal health care have similar levels of preventative care as the uninsured in the US that rely only on the emergency room for all of their health care? If so do you have any data or evidence to back this up. After all that is a huge leap from one sentence or even the entire paragraph that you quoted from the WHO. I believe that the relevant sentence from your WHO quote was:

"Preventive health care is inherently different from health care for acute problems, and in this regard, current health care systems worldwide fall remarkably short."