Socialized Medicine in the US are you kidding

[Fat Old Guy]

"That sounds pretty racist to me, but if that wasn't your meaning I apologize."

 

Why? Did I mention race?

 

I don't like illegal aliens of any color and I don't like them benefitting from our tax dollars when they, by definition, are criminals who don't belong here.

[kasane]

I am Canadian and I have lived in the USA for nearly 10 years. I still think that Americans have totally missed the point of what a Canadian or British health care system is about.

 

Everyone is covered - the young, the old, the sick, the well, the poor and not so poor and yes the rich.The employed, the unemployed. You don't have to worry that you will lose the house if someone gets sick.

 

EVeryone pays something into the system. What I paid through my taxes to support the Canadian medical system - my husband pays even more (and his company benefit plan) into the American system for our coverage. If he loses his job - bye bye medical coverage. He's diabetic - no other medical insurance is going to pick him up. In Canada, it doesn't matter whether you are employed or not. You are covered.

 

Sure you wait to get into see your primary physician (who doesn't). I have waited for an appointment here in the USA too and just as long or longer.

 

It takes time to see a specialist in Canada - but that is also a function of distance for many people (sometimes up to 500 miles) due to the geography of the country.

 

Sometimes the government has to step up to the plate and take the lead in ensuring a better life for its citizens. The muscle of a government (actually governments as each province manages its portion of the health care system)can buy goods and services (like drugs) at considerable discounts and provide that benefit to its citizens. (Why else would Americans be buying drugs - many manufactured in the USA - from Canada if this system didn't work).

 

I remember when the Medicare system was introduced (and it was proposed from a member of a small political party - not one of the major players (see the benefits of a multi-party democracy?) and was picked up and carried nationally in the 1960's. People were nervous, but the system worked and continues onward today - it is continually being tweaked, but no political party or government is going to dismantle it.

 

Just to point out, in case any one gets the idea Canadians have bad teeth as well - the Canadian Medicare system doesn't cover dentistry - this is still a pay as you go system (unless you buy private dental insurance). It also doesn't cover drugs except for small segments of society such as seniors and they generally have to meet a deductable depending on which province they live in.

 

Yes I "paid" for my health system in Canada through my taxes - that is one of costs of being a Canadian. I pay nearly the same amount in tax here in the USA, I get no health care benefits for all that and I still have to pay for medical insurance on top of it. Boy that's a system I want to keep (sarcasm intended).(This message has been edited by kasane)

[KoreaScouter]

We've been patients in the health care systems in both the Netherlands and S. Korea. For a variety of complicated reasons, the military health care system can't accomodate everybody's needs in-house, and they contract a lot of treatment out to hospitals on the economy in overseas areas.

 

I'd rather be in an American hospital, no matter how I was paying for it. Last time I checked, people around the world want to go to the U.S. for medical treatment. It may be a crazy, patchwork system, but you can't beat the care you get. I've never been in a British or Canadian hospital, but I suspect the standards and quality of care would be indistinguishable from an American hospital.

 

KS

[Achilleez]

Assuming makes an ass out of you and me.

[SagerScout]

Here in Texas a fairly high percentage of doctors will NOT see anyone without health insurance, even if you are able and willing to slap cash on the barrelhead. If you do manage to find one that will see you, the cost of the visit for a cash customer averages $100. I know this, as I have paid for several of these for my uninsured grandkids when their parents were either unemployed or underemployed and the kid just could not stay well.

 

Lest you say, oh, but we have PROGRAMS for the unemployed - but did you know that we ration availability for Medicaid and TANF by putting intensive physical and paperwork obstacles in the path of applicants. For instance, my step-daughter was asked to provide PROOF that she had no income, since she was staying at home taking care of her 3 pre-schoolers, and had no job. The social worker demanded to see her pay stub - from her non-existent job - and told her that she would not qualify since she couldn't provide a pay stub. (She provided the pay stub of her boyfriend, who is supporting her and her children to the best of his limited ability. More on that later.)

 

Two months and several 8-hour visits later (another limiting strategy - leave them in the waiting room with their preschoolers for hours on end until they give up or must leave to pick up after-schoolers) they finally deduced that she probably was not going to be able to provide pay stubs from the job she didn't have, or child support receipts for child support she has never received - no, not once - and finally gave her Medicaid and WIC. No food stamps though; since her ex- has NEVER made a child support payment, they can't run a report on his payment record and oh, yes, she has to have that report to qualify.

 

Medicaid is actually quite excellent insurance -but a lot of doctors no longer take it...so her work wasn't over, but it was an enormous improvement. My grandson was finally able to get the reconstructive surgery he needed for a urological birth defect.

 

Now, if you are uninsured, can't pay cash, and your baby has some minor health complaint- say, ear infection or the like- you can go to the county hospital where the wait will be somewhere in the 12-16 hour range. You will eventually be seen, get a prescription for amoxycillin, most likely, and will generate somewhere around a $250 bill which will end up on your credit report if you can't pay it. You've been protected from the feared "overprescribing of antibiotics" at a cost of a week's pay for a construction worker in this area.

 

If you DON'T do it, you could be subject to prosecution for medical neglect and could lose your kids over a bad diaper rash or an ear infection that bursts.

 

I have health insurance. My insurer pays my doctor about $38 for a visit. I pay another $10. But I couldn't find any doc willing to take that amount for a visit if I were paying it myself - the over-the counter price is double the insurer's price. My old-fashioned prescription medications frequently cost the insurer less than the amount of my $15 copay, although I do have one that's a budget breaker, or would be if my kind insurer didn't help. But I pay the $15 nonetheless, that's the way it's set up. (I'm OK with it, since they pick up that other one.)

 

The irony is clear - the consumers that can least afford it pay the highest rates. The insurers spend a double-digit percentage of our premium dollars providing benefits to their own employees (including salaries, of course), which adds no value to the medical care at all.

 

Now if we could have a total free-market system, the average cost of a doctor visit would most likely go DOWN for most of us - and UP for the big insurers. This would put a total squeeze on them as their costs would rise but demand for their services would drop, as more people would be able to self-insure, at least for the small stuff. So I'm not seeing it happen.

 

If you've never lived without a steady job and a health insurance card, and wish to offer opinions on this topic - why don't you give up both job and insurance to one of the many in my area who would love to have both (or EITHER), and live as they do for a few months? Day labor pays $6.50 an hour, no insurance, no worker comp coverage, no pay when it rains.

 

The boyfriend I referenced above is 28 and both hands are already numb and tingling due to his use of power tools 12 hours a day (paid at straight time only) when the sun shines - but his employer pays him "as a contractor" so he won't have worker comp available to him. Of course has no insurance for himself - so he'll work until he's crippled...which won't be long. And he'll have no way to get medical care then either.

 

My other son-in-law works for a government contractor (!!!!) that doesn't pay time-and-a-half over 40 hours - doesn't pay for drive time for out of state work - doesn't pay Davis-Bacon Act rates for the work provided - no insurance - and certainly doesn't pay when there is no work. They tell the workers that if they don't like it they can leave. They hire guys with records whom no one else will touch. (I bet you didn't know that having a prison record eliminates not only your right to vote, but to a large extent, your right to enjoy the protection of the labor laws?) I'm virtually certain based on MY 8 years as a government contractor that this employer is robbing you and me of our tax dollars on the pretense that he is paying these guys appropriately... but it ain't trickling down, that's a fact.

 

Now, if we had "socialized medicine" - Brian could get his cumulative trauma treated before it becomes crippling - my grandkids could have their immunizations - probably half-a-million Americans with good business sense and business ideas could START a small business, as they wouldn't be locked into jobs for the sake of medical insurance - and oh, yeah, a whole bunch of insurance company clerks would need new work.

 

Bring it on.

 

[fboisseau]

The problem with our health care system today is one that SagerScout points out in the following statement

 

"The irony is clear - the consumers that can least afford it pay the highest rates. The insurers spend a double-digit percentage of our premium dollars providing benefits to their own employees (including salaries, of course), which adds no value to the medical care at all.

 

Now if we could have a total free-market system, the average cost of a doctor visit would most likely go DOWN for most of us - and UP for the big insurers. This would put a total squeeze on them as their costs would rise but demand for their services would drop, as more people would be able to self-insure, at least for the small stuff. So I'm not seeing it happen."

 

The problem is employer paid medical insurance. When you remove the link between the person getting the service and the person paying for the service you get the problems you see in todays system. Why do the uninsured are paying higher fees for doctor visits, because those of us who have insurances (especially HMOs) have big insurance companies twisting the doctors arms to accept less and less for their customers. Even those of us in the plans are affected when the doctors say enough is enough get hurt (I had to change doctors this year because my doctors decide they could not except the reduced amount that my insurance company was offering). My solution to this problem is not to socialize the medical industry but to try to get it back to its roots with the following changes. First make in illegal for companies to pay for their employees insurances. This will force insurances companies to sell directly to the insured. This will have negative impact on some like me (overweight, family history of heart disease, wife with a chronic, but treatable neuromuscular disease) and benefit those who are heather. Second I would like to see hospitals return to the non-profit status they were in the past. This is the only solution I see, to force the system back to the state it was in before the wide spread availability of heath insurance that paid for every doctor visit and prescription drug; and when big corporations were making money off of our hospitals stays.

 

[Achilleez]

You Americans...

 

You want non profit hospitals that provide coverage for ALL citizens. You want to be safe and secure in the fact that you know you will not go bankrupt if your daughter has to have surgery. You want coverage for the employed as well as the unemployed.

 

You don't want socialized mecicine.

 

???

[packsaddle]

Achilleez, Didn't you forget:

...want something for nothing.

...want your cake and to eat it too.

???

There's always....the blue pill.

[littlebillie]

malpractice insurance on the one hand, amortizing office technology on the other...

 

in the local news regularly, there are stories of this hospital or that clinic closing their doors. always in the more disadvantaged neighborhoods, of course. above and beyond cost, then, there are issues of simple access (and not just to HMO facilities).

 

I sometimes wonder if there's anyway for the government to partner with such places to avoid shutting them down, diverting some Medicare dollars to salaries, maint., etc, and providing good free care for the needy... sorta semi-social?

 

and just out of curiosity, does socialized medicine really differ that much from HMOs and Blue Cross? isn't it just a public versus private point of view?

[Marty_Doyle]

Medicine in the US is a fairly complex, intertwined business, whose total cost structure and linkages is not fully understood by the providers of service (doctors, hospitals, etc.) nor the purchasers of service (patients).

Malpractice. What do you think an obstetrician pays per year in NYC for his or her professional liability insurance? Close enough to $180,000 to use it in an example. So, how much does that physician charge patients for each delivery?

Probably between $6,000 and $7,000. So,the physician has to deliver sucessfully 3 babies per month, every month, just to cover the malpractrice insuerance premium.(You really can't deliver half a baby). But there is a problem here. The physician doesn't always get the full amount of his/her fee. And not because people aren't paying their bills. The HMO's will only pay around $4,000 per delivery. Medicaid will pay less than $2,000.

And the physician took an oath essentially to take on all patients, so they can't really pick and choose.

And that only deals with one expense. The physician has to have an office, with rent, electricity, telephone, a receptionist, a biller, a nurse, who all have to get paid and get benefits, and the doctor would like to earn a living too.

And what happens to the physician when his/her premium goes up 50%? (That is the projected increase at my institution). In a free market, the charge for deliveries could go up. But not in our system. The insurance companies and the federal government do not increase their payments that quickly, if at all.

That doesn't even touch on the other side - who pays when there is catastrophic medical care required because of real medical malpractice.

Finally, Medicare doesn't really cover the true costs of providing health care in the US. We try to contract for 130% of MEdicare fees with managed care companies tro survivie. You may ask "How can thast be?" Where do you think our federal government looks to cut costs to balance their budget? The military? Homeland security? Nope, the Medicare fees paid to hospitals and doctors. The average Medicare reimbursement for most soecialties hgas been declininmg for the past few years. Next year, there is a proposed 4.2% decrease. And if prescription drugs are added as a benefit, there is no increase in the total funds committeed, so hospitals and doctors will get cut more.

This doesn't ebven address defensive medicine, the unreimbursed administrative burden added by insurers and the government, inherent adminstrative inefficiencies in the delivery of healthcare and the American consumers' desire for the biggest, newest, fastest medical gadget now.

I am certain that there are more MRI macines in a ten block radius of the Hospital I work at then in a number of Canadian provinces.

All of this costs.

Do you know what your doctor charges for an office visit? Or do you think it is only $10, because that is your HMO co-pay?

The vast majority of Americans will not accept socialized medicine because they equate that to a system where they wait hours for rationed health care, with no choice of who provides the care.

They want at least the illusion of being able to get care when and where they want it.

All of the above being said, having had occasion to go to doctors and hospitals in Ireland, Italy, and Ecuador, I agree with KoreaScouter about where I want my family to go if I have the choice - American hospitals (and probably the one I work at, even though I sit on the Malpractrice Committee).