s/o Why is your universal healthcare a love?

[Melissa in Australia]

What a funny thing to say. It sort of implies that the only country where doctors are trained in America! This is far from the reality. I have never met an American doctor here in Australia, never. Australia has lots of medical training universities.

And I wouldn't worry about the myth that things don't get discovered/doctors don't show initiative if they are working under UHC. Australia has discovered many advances in medicine, including ultrasound, bionic ear, spray on skin for burn victims, invitro fertilization, flue vaccine, gardasil vaccine, use of chemotherapy for treating leukemia, pacemaker, and the list goes on and on.

Edited July 16, 2012 by melissaL

[tex-mex]

Hospitals and emergencies rooms will only provide care to stabilize someone in an emergency. They will not provide you chemotherapy, radiation, or provide you with your necessary medications that may costs hundreds and hundreds of dollars each month (which are necessary to maintain health for many people).

True. Case in point:

 

Dumping of Homeless Patients in Inner City Los Angeles by Hospitals:

http://www.nytimes.com/2007/02/23/us/23dumping.html

 

I do not know if anyone has mentioned the corruption of administrators or doctors using Medicare programs to skim or launder money:

http://articles.latimes.com/2008/aug/07/local/me-skidrow7

 

Personally, my MIL (she lived in New Mexico) was in her last stages of cancer and not able to see a doctor for pallative pain relief. She got to the ER and was turned away. They told her she was fine. The pain in her spine had nothing to do with her massive brain tumor. Weeks later, when she finally got to see the cancer specialist (long story) he was horrified to discover a large tumor on her spine via a MRI. Toot suite, she was whisked to the very same hospital that denied her care (and a MRI). She died 2 weeks later. We are furious her last 2 months of life were in agonizing pain and the doctors did nothing -- too much confusion and no one to take the time to help. Ironically, she had very good insurance. But horrible doctors.

 

Son and I have a rare liver disease. "Catastrophic" pre-existing label. We see a specialist. My monthly medication is $7500 a month. We cannot afford the daily meds and as a result volunteer for a FDA Drug Study to get free meds. We are not $$ compensated for our participation in the study. The study ends in Feb 2013. I have no clue how we will afford both my and my son's daily meds which would be $15,000 a month cost -- if we had regular insurance, the co-pay in the first month alone would be impossible. The deductible would be met, but the rent would be unpaid. In the past, ds qualified for state medicaid for his doctor visits and daily meds. I went without and got yelled at by my specialist. Finally found a grant for prescription help via the NORD (National Organization for Rare Diseases) and they used to pay for my monthly medications. Now, they lack funding for the grant. With insurance or medicaid, I have run into many bureaucrats who deny treatment, meds, or specialist visits all of the time... I get used to it.

 

It is now an art to scheduling an appointment and then dealing with the denial letter and follow up calls to get the bill paid. I worry how much more confusing the new health care plan will be as already it is a nightmare in my opinion to get a bill paid.

 

I have friends (via the National Organization for our rare disease) who live in Canada with the same disease we have and they do not have to worry about costs for the same expensive meds, special medical food (i.e. Low-Protein flour is $26, for example), doctor visits, etc. Makes one wonder. I know of other friends here in the US who have declared bankruptcy due to the high costs of their child's medical care for our rare liver disease. It is crazy.

Edited July 16, 2012 by tex-mex

[tex-mex]

What a funny thing to say. It sort of implies that the only country where doctors are trained in America! This is far from the reality. I have never met an American doctor here in Australia, never. Australia has lots of medical training universities.

And I wouldn't worry about the myth that things don't get discovered/doctors don't show initiative if they are working under UHC. Australia has discovered/researched many advances in medicine, including ultrasound, bionic ear, spray on skin for burn victims, invitro fertilization, flue vaccine, gardasil vaccine, use of chemotherapy for treating leukemia, pacemaker, and the list goes on and on.

:iagree:

I know via my National Organization there are top specialists for my rare liver disease in Australia, if I should ever travel there and get ill. Ditto for Switzerland, Spain and Germany having specialists who know my disease like the back of their hand.

 

And in most other developed nations, I know my specialist here in the US is a phone call away for consult for a crisis if I travel overseas. My only worry is if I am in a poor third world country and I get sick. That is not a good scenario.

[WishboneDawn]

I said I am not in favor of mandatory government health care. I want a plan that allows me all the options I currently have without a ridiculous increase in my premium or taxes to continue with it.

 

I did the math a few years ago. I couldn't find a tax bracket where paying Canadian taxes was more expensive then paying American taxes and health insurance premiums. Taxes in Canada have gone down since that and health care premiums quoted here are much higher then the figures I was using.

[ktgrok]

Competition makes a difference, though. If you have many to choose from, they will have an incentive to keep costs and prices competitive. We've all seen what happens when there's a single payer in, say, the military, where everyday generic hardware has been shown to "cost" hundreds of times what it should.

 

It ain't perfect, but that's partly because the government's already been meddling too much.

 

Actually, between patents and insurance companies there is NO incentive to keep costs lower. Not in healthcare. People don't shop around for an oncologist based on price, and hospitals/doctors/drug companies know it.

 

I'm not going to pick my cardiac doctor because he is the cheapest around, for heaven's sake!

 

And insurance companies have things so complicated that even trying to comparison shop is beyond what most people are capable of.

[ktgrok]

Apparently the term "basic" is not understood on this board.

 

The problem is you can have "basic" healthcare costs for a long time, but that doesn't mean you won't have something crazy come up. None of us can predict if we will get cancer, be hit by a bus tomorrow, get a weird fracture stepping off a curb, etc.

 

We had insurance, really good insurance, and my ex developed cardiomyopathy and had to be evaluated for a heart transplant in his 20s. Hie was in and out of hospitals, etc. We ended up in forclosure, then selling our house to pay the bills, and getting divorced (the divorce had nothing to do with the health issues). We SHOULD have declared bankruptcy really.

 

yeah..no way to budget for that.

 

Or heck, even just my c-section with my son, and birth seems like it should fall in that "basic" category, was many thousands of dollars, even after insurance. It didn't get fully paid off until after we sold the house as well.

[ktgrok]

Apparently the term "basic" is not understood on this board.

 

The problem is you can have "basic" healthcare costs for a long time, but that doesn't mean you won't have something crazy come up. None of us can predict if we will get cancer, be hit by a bus tomorrow, get a weird fracture stepping off a curb, etc.

 

We had insurance, really good insurance, and my ex developed cardiomyopathy and had to be evaluated for a heart transplant in his 20s. Hie was in and out of hospitals, etc. We ended up in forclosure, then selling our house to pay the bills, and getting divorced (the divorce had nothing to do with the health issues). We SHOULD have declared bankruptcy really.

 

yeah..no way to budget for that.

 

Or heck, even just my c-section with my son, and birth seems like it should fall in that "basic" category, was many thousands of dollars, even after insurance. It didn't get fully paid off until after we sold the house as well.

[ktgrok]

But taxpayers are paying for those already. Paying for additional care for additional people - that will mean still more taxes, no? How can it not?

 

Yes, you will pay more in taxes, but won't pay for your health insurance. And the taxes would be less than the insurance costs, so a net win.

[Ann]

A perfect example of the differences in UHC and the American system was brought home to me while pregnant with my second. I am Canadian but got pregnant with my second while living in a country with UHC which I could not access because I was not a citizen. We relied on my DH's health insurance which was from an American company. As soon as I found out I was pregnant I called them to find out what my coverage was like. I was told I was only going to be allowed 3 ultrasounds and a 4th one maybe if the dr wrote a note explaining why I needed it. I was shocked that the insurance company dictated that. Also the dr wanted a thousand dollars worth of tests which we could not get since we didn't have the money free. We had to decide if the tests were worth the money or not- I don't have to do that in Canada. I had a c-section and we did not know how we were going to pay thousands for it.

 

I returned to Canada midway through the pregnancy. I had the blood tests done, several ultrasounds and my c-section. Total cost in Canada- 200 for a private room in the hospital. Amazing the difference and no decisions were made due to lack of money. My husband had amazing insurance for the US and we still had to make decisions based on money and not what was best for me and the baby.

[ktgrok]

Well, obviously I can only speak for myself. Our health insurance is excellent, and I've been very happy with our coverage. I am not interested in a mandatory government health plan.

 

 

 

Yes, you are very lucky indeed. But how do you feel knowing that your neighbors cannot afford the same healthcare, and that if their child is sick in the middle of the night that board certified pediatrician does them no good because they can't afford to see him?

[ktgrok]

Actually that's the case here too. I can name people very close to me who have had their lives saved in world-class hospitals despite being indigent, uninsured, and too young for Medicare. And because they were indigent, they did not have to pay one penny. By contrast, I know nobody who died because treatment was denied or unavailable in the USA.

 

Not to say we are perfect either. We have room for improvement. But it's not like we kick people into the street like road kill. People who aren't in favor of a single payor aren't heartless jerks, we just have other ideas of how to make targeted improvements. You know, not throw out the baby with the bathwater. It's hard to have an intelligent discussion when every disagreement is equated to heartlessness.

 

You are mistaken. Yes, if you are totally indigent you can get care. But if you are working, but don't have enough money to pay, often you can't. The hospitals are required to treat EMERGENCIES only, and to stabilize you. Once you are stable you have to leave if you can't pay. Yes, I know these stories personally. We DO kick people out onto the street. I have a coworker that showed up at an ER with MS symptoms. They agreed it was probably MS. But once she was stable (not cured, just not going to die in the next 24 hours) they sent her home. She can't afford the tests to finish the diagnosis, not that it matters as she can't afford the treatments anyway (another friend has MS and her meds are in the thousands a month). She will die sooner than she should, because she doesn't have the money for insurance/care, but makes too much for medicaid.

 

Another coworker found a lump on her thyroid. She is saving up for tests. If the tumor progresses too far she could die, yes, because she can't afford care.

 

The idea that hospitals HAVE to treat you is NOT true.

[Laura Corin]

 

I notice that often the folks most pro-national healthcare are the ones who would, under such a system, pay a smaller share of the cost than their family's share of the services. Perhaps they'd feel differently if they'd be out of pocket an extra $10k or so per year under such system.

 

My husband had a very good job and was paying the top tax rate in the UK. He was happy to pay for the NHS. None of us uses the NHS very much.

 

He also worked out (he works in finance and likes to have figures to hand) that he paid less in total taxes in the UK than he would pay in tax plus health insurance in the US. He didn't include any co-pays in his calculation.

 

ETA: there are few co-pays in the NHS (small prescription charges mostly) so this was more of an issue for the US model.

 

In another post you talked about people being denied treatment under 'socialised medicine' due to billing errors. There are no bills under the NHS in the UK.

 

Laura

Edited July 16, 2012 by Laura Corin

[whitestavern]

Oh, I know. Many people are in horrible situations, and our family is very blessed not to have to worry about that right now. Please don't take me for a cold-hearted person who doesn't want anything to change, even if it means people are dying because they can't pay for their insurance and health care.

 

I'm just saying I don't see the cost of health care going down if we go to a single-payer system. And I don't see how we as a country are going to pay for health care for everyone as it costs now without going broke. And I just can't see how it would be a good thing for the government to start defaulting on payments because it has to pay for health care. That won't help anyone be healthy in the long term. :(

 

:iagree: Dh and I pay $600 a month with a $10,000 deductible and no dental insurance. We pay oop for everything. We've never hit the deductible, although the year I had to have a colonoscopy & endoscopy we sure came close. But with all that, I just don't see our financial situation improving dramatically under the new health care system.

[NoPlaceLikeHome]

So setting aside the anecdotes, the research shows that people without insurance are 25% more likely to die than those with.

 

How much you wanna bet that demographically, people without insurance are also more likely to engage in behaviors that increase their risk of death, or have mental health issues that impact their health? Because people without insurance are less likely to have a steady job, which could be because they abuse drugs or alcohol, live in low-employment/high crime areas, are too depressed to get out of bed in the morning, etc. We know some are uninsurable because they are already sick (not saying that's OK, but it puts the 25% statistic in a different light; those folks didn't get sick because of no insurance, they have no insurance because they are sick).

 

I'm trying to remember anyone I know who has died without health insurance. The only ones I can think of died instantly in car accidents. Having health insurance would not have saved them.

 

Honestly, it is offensive to imply that people without a steady job or insurance are likely are likely to engage in risky behaviors or are defective in some way as if one could not be unemployed or uninsured if one does not have these problems.:glare:Wow. There are plenty Americans who do not have these problems and end up unemployed or uninsured.

 

Again, I have a loved one who was told (which was witnessed by my dh) that she could not have chemotherapy if she could not pay her bill. She also took chemotherapeutic pills and many other meds during chemo that costs hundreds and hundreds of dollars which I paid for since you cannot get these drugs unless insurance or you pay. Many people are not eligible for medicaid and do not have insurance. Obamacare will change that if the states agree, thank goodness.

[NoPlaceLikeHome]

:iagree: Dh and I pay $600 a month with a $10,000 deductible and no dental insurance. We pay oop for everything. We've never hit the deductible, although the year I had to have a colonoscopy & endoscopy we sure came close. But with all that, I just don't see our financial situation improving dramatically under the new health care system.

 

With the new marketplaces, you should have more options with better terms. There will also be subsidies for those who meet the income criteria.

[Murphy101]

I don't know anyone who doesn't want a better system.

 

That's really not the issue.

 

The issue is that many don't think what is being proposed is a better system.

 

I don't. The main cause of ridiculously high costs is insurance and I don't feel that is really dealt with. Their seems to be an assumption that if people just had insurance they'd be okay and the proof is plenty that thatnis total BS. The second issue is the presumption that expanding Medicaid is a solution. Medicaid sucks. It is NOT like UHC in other countries. Everyone I've ever known, including myself when in more dire straits, has been eager to get off medicaid and have better private insurance. That includes the retired elderly. Every old person I've ever known who could afford to carry private insurance does so and consider loosing it just as much of a scary worry as anyone else.

 

I don't know what UHC is like in other countries, so can't and thus won't comment on that.

 

But I do know it doesn't look anything like our medicare program. So we really can't compare the two.

 

And I don't know that all drs will start to accept Medicaid/Medicare if this stuff goes through. I know many options are popping up here that accept NO insurance of any kind at all. And offers cash discounts. They are far cheaper and the care seems to be far better. (At least of the ones I have been using.)

 

Stories like Joanne's make me angry too.

 

I think they make everyone angry.

 

No one is saying we don't need change.

 

The argument is whether the change being proposed is better than what we have or not. And many people think for various reasons that some aspects of it could be worse.

[NoPlaceLikeHome]

I don't know anyone who doesn't want a better system.

 

That's really not the issue.

 

The issue is that many don't think what is being proposed is a better system.

 

I don't. The main cause of ridiculously high costs is insurance and I don't feel that is really dealt with. Their seems to be an assumption that if people just had insurance they'd be okay and the proof is plenty that thatnis total BS. The second issue is the presumption that expanding Medicaid is a solution. Medicaid sucks. It is NOT like UHC in other countries. Everyone I've ever known, including myself when in more dire straits, has been eager to get off medicaid and have better private insurance. That includes the retired elderly. Every old person I've ever known who could afford to carry private insurance does so and consider loosing it just as much of a scary worry as anyone else.

 

I don't know what UHC is like in other countries, so can't and thus won't comment on that.

 

But I do know it doesn't look anything like our medicare program. So we really can't compare the two.

 

And I don't know that all drs will start to accept Medicaid/Medicare if this stuff goes through. I know many options are popping up here that accept NO insurance of any kind at all. And offers cash discounts. They are far cheaper and the care seems to be far better. (At least of the ones I have been using.)

 

Stories like Joanne's make me angry too.

 

I think they make everyone angry.

 

No one is saying we don't need change.

 

The argument is whether the change being proposed is better than what we have or not. And many people think for various reasons that some aspects of it could be worse.

 

This why I hope to see our country go one step further to medicare for all. If medicare is the only game in town, I think doctors will have no choice but to take it.

 

Unfortunately, universal healthcare was not even possible to put on the table since many in Congress were unwilling to entertain the idea.As a result, we essentially have the plan that was first proposed by the Heritage Foundation and Republicans in the 1990s. To me, it is at least a step in the right direction.

Edited July 16, 2012 by priscilla

[Murphy101]

This why I hope to see our country go one step further to medicare for all. If medicare is the only game in town, I think doctors have no choice but to take it.

 

Unfortunately, universal healthcare was not even possible to put on the table since many in Congress were unwilling to entertain the idea.As a result, we essentially have the plan that was first proposed by the Heritage Foundation and Republicans in the 1990s. To me, it is at least a step in the right direction.

 

Honestly that scares the ever lovin crap out of me. I have seen the care many people on Medicare get and it sucks. Why the heck anyone would wish that nightmare for everyone is beyond me.

 

In my mind, Medicare is what the desperate who have no other choice use. And it's that way for a reason. Everyone I've ever met on Medicare want a job with affordable private insurance so they can access better care.

 

I don't know if it would make a difference to the drs that I know who don't take any insurance at all, including state Medicaid. They don't want to deal with the overhead of paying someone to file claims and such. That wouldn't change.

[Impish]

Basically, Americans won't be able to afford gasoline at $7-8/gal. That will kill the middle class. Our rich won't be phased by high gas prices, and our low-income won't feel the pinch as much, either.

 

Canada drills and the US buys their oil. The US won't drill, but we do pay other countries to drill, AND we have to buy oil from other countries.

 

Also, how do UHC countries deal with druggies who use the ER to get their fix?

Ummm...Canada sends our oil to the States for processing, and buys it back, generally speaking. At least, that's how my decaf brain is remembering things. Our gas prices are higher than yours.

 

As for druggies, I've been caught in that web. Last ER I was in b/c of my RSD, Drs were under no obligation to treat me, b/c I didn't have an obvious injury. New hospital policy stated that it was up to the individual Dr to decide if they treat or not. Honestly, I don't see how having UHC or not would make an impact in that.

Honestly that scares the ever lovin crap out of me. I have seen the care many people on Medicare get and it sucks. Why the heck anyone would wish that nightmare for everyone is beyond me.

 

In my mind, Medicare is what the desperate who have no other choice use. And it's that way for a reason. Everyone I've ever met on Medicare want a job with affordable private insurance so they can access better care.

 

I don't know if it would make a difference to the drs that I know who don't take any insurance at all, including state Medicaid. They don't want to deal with the overhead of paying someone to file claims and such. That wouldn't change.

Hang on...why is there yet another tier in the health care system, based on income, yet again?! So you've the uninsured, the underinsured, Medicaid, and insured?

 

Wow. It really is all about the $.

[ktgrok]

Honestly that scares the ever lovin crap out of me. I have seen the care many people on Medicare get and it sucks. Why the heck anyone would wish that nightmare for everyone is beyond me.

 

 

How do you reconcile that fear with what ALL the members of this board with UHC are saying? I find it interesting that not a single one of them has said they wish they could have a private system. Why do you think it would be so awful, when those that actually have it find it very good indeed?

[Parrothead]

Yes, you are very lucky indeed. But how do you feel knowing that your neighbors cannot afford the same healthcare, and that if their child is sick in the middle of the night that board certified pediatrician does them no good because they can't afford to see him?

:iagree:I wouldn't mind some true form of UHC, but this carp they came up with is just asinine.

[Haiku]

Yes, more or less. See post 176 for example.

 

All I see is someone advocating adopting UHC, not grabbing another country's system verbatim. As you yourself pointed out, UHC can look different in different places. It's the basic premise, not the particular implementation, that is shared among countries.

 

Tara

[Dana]

Actually that's the case here too. I can name people very close to me who have had their lives saved in world-class hospitals despite being indigent, uninsured, and too young for Medicare. And because they were indigent, they did not have to pay one penny. By contrast, I know nobody who died because treatment was denied or unavailable in the USA.

 

The people you mention sound like they were in the hospital for emergency conditions (car accident).

 

My MiL died this year due to cancer.

She had just gotten insurance after going without it for a number of years due to a job loss. There were no substance abuse issues or "other issues" as you mention.

 

She'd had breast cancer when I was pregnant, had a mastectomy, went through chemo, was doing well. Due to a move, they only had insurance through FiL's job and her coverage was too expensive. She didn't get follow-up care once she'd finished up the chemo.

 

She'd had symptoms for well over a year but didn't go in because she didn't have insurance (and some other fears of what they'd find). My SiL finally managed to convince her to go in to the ER in late November - right before Thanksgiving. There was a mass in her stomach. We never got a clear answer as to whether it was breast cancer that had recurred and spread or if it was stomach cancer - so we don't know that for my husband and son's health.

 

Yes, she had insurance at the time of her death and the hospital didn't kick her out to die on the street. She also was never really stable from Dec - when she died in Jan. She was only 62.

 

The family's attitude towards going to the hospital or seeing a doctor was pretty bad due to cost. My BiL had a full set of dentures before he was 30 since they didn't see the dentist.

 

I can't imagine my MiL's care costing more had she gone in earlier - and she might have lived.

 

We have good insurance through my husband's work.

We've still been able to itemize medical deductions on our taxes on 2 years. The time dealing with the insurance company for billing issues has been a pain as well.

 

I am very grateful for the current changes and I do want a single payer system. I do NOT want my medical care to be run by for-profit groups the way it currently is.

 

And here's someone who's dying without insurance. His wife was told by her legislator to move to Canada if she wanted help.

[Amazed]

What a funny thing to say. It sort of implies that the only country where doctors are trained in America! This is far from the reality. I have never met an American doctor here in Australia, never. Australia has lots of medical training universities.

And I wouldn't worry about the myth that things don't get discovered/doctors don't show initiative if they are working under UHC. Australia has discovered many advances in medicine, including ultrasound, bionic ear, spray on skin for burn victims, invitro fertilization, flue vaccine, gardasil vaccine, use of chemotherapy for treating leukemia, pacemaker, and the list goes on and on.

 

I was not implying at all that America is the only country where doctors receive training. But there are many doctors from around the world that are receiving training in the US (not necessarily their only training, but some parts of it). And the effect on medical training is an important one to consider as well. The medical situation in America is extremely complex and there are many sides to the issue, and there may be many ramifications to whatever solution is chosen.

[QueenCat]

With the new marketplaces, you should have more options with better terms. There will also be subsidies for those who meet the income criteria.

 

:iagree:True. In the long run, many will do better with the marketplaces. And if a state doesn't enact one in a timely manner, the fed govt will.

[QueenCat]

This why I hope to see our country go one step further to medicare for all. If medicare is the only game in town, I think doctors will have no choice but to take it.

 

Unfortunately, universal healthcare was not even possible to put on the table since many in Congress were unwilling to entertain the idea.As a result, we essentially have the plan that was first proposed by the Heritage Foundation and Republicans in the 1990s. To me, it is at least a step in the right direction.

 

Yes! I'm amazed at how few know the origination of the plan that passed.

[SKL]

In another post you talked about people being denied treatment under 'socialised medicine' due to billing errors. There are no bills under the NHS in the UK.

 

Laura

 

Somebody must be billing someone, or how are services compensated? I'm not even talking about billing the end user. I'm talking about providers billing the Medicare system, for example.

 

But even if that's truly never an issue, there's still the issue of being approved for services, which is related to billing in the US but still exists on its own elsewhere.

 

I think it's great that they have the catastrophic piece figured out. We need to get that figured out too. But for everyday stuff, what is the big problem with having a bill? Are humans so "evolved" now that we can't deal with bills for everyday expenses? Why don't we also cover all food, housing and everything else because someone someday might have difficulty planning or recovering from an unexpected minor bump in the road? I just had to buy my kids a bunch of school clothes and shoes, and now I have a big bill that I'd rather not have. Oh well! I could have chosen cheaper clothes or fewer kids or a school with a more budget-friendly dress code.

 

I think we should be going in the opposite direction where an individual can directly make choices and pay the logical costs of those choices within a reasonable range of expectations. I do not appreciate having to pay higher insurance rates because state law requires my insurance to cover things I will never use. As much as I think family size, fertility treatments, etc. are each family's business, I don't think it should hit my pocketbook if the next-door neighbors want to try for number five or want to go on the pill to avoid number two. And I don't want to pay for their drug rehab either. And no, I don't think people should go to the doctor for every sniffle, but if they do, they should pay for that. The point of insurance is to spread risks, not to shift responsibility and not to transfer wealth, either. Funny thing about US politics, every government program that claims to promote overall human welfare ends up being a wealth-shifting mechanism.

 

I have a kid who is very healthy but has learning issues that are not covered by insurance. I don't need to take her to the doctor as often as the average kid goes, so I think I should be able to direct that part of my budget to her therapies. Instead I pay for both and only use one. That's not ideal. (And if our HMO is any indication, my kid would not even qualify for a referral to be tested if I had to rely on insurance / government payments to support the vision stuff. Because she hasn't bombed in school yet. :glare:)

 

I don't think it's wrong that people consider money when deciding to treat at home or go to a doctor for minor stuff. (It isn't always about money, either. In my case it is more likely to be about time limitations.) That's like saying vegetables should be free because nobody should have to consider money when choosing between beans and asparagus. I do think it's wrong that the cost of a quick office visit to rule out dangerous illness is so high in the USA. But as has been discussed before, this is really because we use "insurance" for everyday stuff, running up costs and removing the end user's reasoning from the equation.

 

And there's also been a threat that if we don't use the "preventative" services that are covered, we may not get coverage for major illnesses, even though we pay into the system. So there would be less room for making a personal decision, e.g., choosing not to go for "well visits" or get pap tests.

[chiguirre]

In my mind, Medicare is what the desperate who have no other choice use. And it's that way for a reason. Everyone I've ever met on Medicare want a job with affordable private insurance so they can access better care.

 

I don't know if it would make a difference to the drs that I know who don't take any insurance at all, including state Medicaid. They don't want to deal with the overhead of paying someone to file claims and such. That wouldn't change.

 

I think you're confusing Medicare and Medicaid. Medicare is the over 65 insurance that basically everyone gets once they're old enough. My parents' use it as their primary insurance and then buy a supplemental plan for the part that Medicare doesn't cover. My parents are very happy with Medicare because the rules are so clear, there's a lot less fooling around with appealing insurance company denials. Medicare is either going to pay or not, they're not going to deny to see if you'll just give in without a fight (like my private insurance does on a regular basis). The supplemental plan follows the Medicare rules, so there's not much insurance company gaming there either. Although my parents have had to wait for an appointment with a specialist who takes Medicare, it's never been longer than I've had to wait to get in to a specialist who accepts my particular flavor of private insurance.

 

Medicaid is a different program run through the states unlike Medicare that's a federal program (which is probably why it works better). The rules can vary, state budget priorities vary and it's seen as "welfare" so it's easy to make it into a political football.

 

Medicare is much more similar to UHC than Medicaid.

[SKL]

Honestly, it is offensive to imply that people without a steady job or insurance are likely are likely to engage in risky behaviors or are defective in some way as if one could not be unemployed or uninsured if one does not have these problems.:glare:Wow. There are plenty Americans who do not have these problems and end up unemployed or uninsured.

 

I know that people on this board are intelligent enough to understand that "more likely to" does not mean "everyone in this group does." There is no need to be offended because someone you know is in a group that is "more likely to" have certain issues. My kids have a single mom, so should I be offended when I read that kids with single moms are "more likely to" do poorly in school etc.? No, because that is indeed statistically true. It's not true of my kids - that's why they say "more likely to" instead of "certain to."

 

Having an emotional response to a fact is not helpful in conversation. My comment was not an insult to anyone, just a response to the illogical assumption that if uninsured people are 25% more likely to die, lack of insurance causes all of those deaths.

[Impish]

There's no such thing as 'approval for services' here.

[ktgrok]

 

I think it's great that they have the catastrophic piece figured out. We need to get that figured out too. But for everyday stuff, what is the big problem with having a bill? Are humans so "evolved" now that we can't deal with bills for everyday expenses? Why don't we also cover all food, housing and everything else because someone someday might have difficulty planning or recovering from an unexpected minor bump in the road? I just had to buy my kids a bunch of school clothes and shoes, and now I have a big bill that I'd rather not have. Oh well! I could have chosen cheaper clothes or fewer kids or a school with a more budget-friendly dress code.

 

.

 

Because health is very very very very different from nice clothing. Because skipping a check up because you can't afford it could be a death sentence, but having to wear old or stained clothes isn't. Because you can choose which clothes to buy, or which school to go to (maybe), but you can't choose which illnesses you inherit or develop, especially kids. No one chooses to have asthma, or type 1 diabetes, or fused skull bones as an infant. But not being able to afford basic checkups or a sick visit could be a death sentence for those kids.

 

I'm willing to pay more so that someone else's kids don't die. I'm willing to have slightly less good healthcare so that others can live. But as those in countries with UHC are saying, that doesn't have to happen anyway. But even if it did, I'm ok with it.

[Murphy101]

How do you reconcile that fear with what ALL the members of this board with UHC are saying? I find it interesting that not a single one of them has said they wish they could have a private system. Why do you think it would be so awful, when those that actually have it find it very good indeed?

 

Because Medicare/Medicaid are not a form of UHC!!! That is why all those old people NEED supplemental plans. That is why poor people on medicaid try to get private insurance as soon as they can.

 

I don't know ANY old people that would EVER want to rely solely on medicare.

[KnitWit]

Having an emotional response to a fact is not helpful in conversation.

 

I'm sorry. That is a ridiculous thing to say. Humans are created with emotions. The health of oneself or one's close family members/friends is an emotional topic. Humans who are in a difficult place due to circumstances beyond their control are emotional. We cannot discuss healthcare without emotions being involved.

 

Life does not fit in a perfect little principled box. I think it's good to remember that these discussions include/revolve around people for whom life has burst open the sides of the box and there is NO putting it back in. Compassion and understanding which temper our principles go a long way.

[Embassy]

There's no such thing as 'approval for services' here.

 

:iagree:

[SKL]

There's no such thing as 'approval for services' here.

 

Maybe we are defining "approval of services" differently. How are you defining it? I'm talking about being able to go and request a service (or have your doctor recommend a specialized service) and having it be up to someone else whether and when you get to have that service. Are you saying that nobody in Canada is ever denied a service or told it won't be covered? Because that clearly is not true.

 

So for example, if you wondered whether you have Lyme disease, could you go and say "I want the blood test" and you'd get it, no questions asked?

 

Could you go and say "my kid needs a CAT scan" and have it delivered just like that?

 

How about a boob job or sex change? For real?

[SKL]

Because skipping a check up because you can't afford it could be a death sentence.

 

And going out your door could be a death sentence because a tree branch might fall on your head. There's sensationalism and then there's logic.

 

It costs money to live. It costs money to raise kids. Everyday, non-catastrophic health costs are simply a part of the equation. Some people aren't equipped to budget well etc., but that should not mean the whole population needs to hand over the rights and responsibilities of everyday health choices.

[Impish]

Maybe we are defining "approval of services" differently. How are you defining it? I'm talking about being able to go and request a service (or have your doctor recommend a specialized service) and having it be up to someone else whether and when you get to have that service. Are you saying that nobody in Canada is ever denied a service or told it won't be covered? Because that clearly is not true.

 

So for example, if you wondered whether you have Lyme disease, could you go and say "I want the blood test" and you'd get it, no questions asked?

 

Could you go and say "my kid needs a CAT scan" and have it delivered just like that?

 

How about a boob job or sex change? For real?

Ummm, for real.

 

If a breast reduction is deemed medically needed, it's covered.

Sx changes can also be covered (I've known it to be).

 

Are there services that are NOT covered? Yup. Cosmetic services, etc.

 

None of which are *needed*

 

In my experience, I've never, ever been denied a service. Ever. The closest I've ever come is a dr or clinic refusing to accept WCB. That's not a UHC thing, but a WCB thing.

 

If my dr says I need something, then that's what happens. If I go in and ask for a test to be run, I discuss it w/him, my reasoning, and b/c I educate myself when it comes to my health, not just go off the hook, I've never been turned down. I don't know if that's the same w/everyone, but that's my experience.

[SKL]

I'm sorry. That is a ridiculous thing to say. Humans are created with emotions. The health of oneself or one's close family members/friends is an emotional topic. Humans who are in a difficult place due to circumstances beyond their control are emotional. We cannot discuss healthcare without emotions being involved.

 

Life does not fit in a perfect little principled box. I think it's good to remember that these discussions include/revolve around people for whom life has burst open the sides of the box and there is NO putting it back in. Compassion and understanding which temper our principles go a long way.

 

Emotions naturally apply to individual / family situations, but they should not trump fact when setting government policy. And they should not be exploited to make people believe what is not true (to garner votes that eventually enrich some group of people).

 

Playing to emotions is going to make some people rich. We seem to be OK with that. We let people tell us whom we should have compassion and disgust for, and someone makes money off of that. Remember that the insurance companies, after meeting with Obama, supported Obamacare. They stand to gain from it. Mark my words.

[SKL]

Ummm, for real.

 

If a breast reduction is deemed medically needed, it's covered.

Sx changes can also be covered (I've known it to be).

 

Are there services that are NOT covered? Yup. Cosmetic services, etc.

 

None of which are *needed*

 

In my experience, I've never, ever been denied a service. Ever. The closest I've ever come is a dr or clinic refusing to accept WCB. That's not a UHC thing, but a WCB thing.

 

If my dr says I need something, then that's what happens. If I go in and ask for a test to be run, I discuss it w/him, my reasoning, and b/c I educate myself when it comes to my health, not just go off the hook, I've never been turned down. I don't know if that's the same w/everyone, but that's my experience.

 

The mechanism by which it's determined what's "needed" is what I'm talking about when I say "approval of services."

 

Not to give too much weight to anecdotes, but we all know about the baby who was refused treatment in Canada for a brain condition and came to the US for treatment. Clearly that there is some mechanism approving and rejecting coverage for requested services. I'm not saying there should not be, but you seemed to be claiming that in Canada, that does not happen (as a reason why it's better up there).

[Impish]

And going out your door could be a death sentence because a tree branch might fall on your head. There's sensationalism and then there's logic.

 

It costs money to live. It costs money to raise kids. Everyday, non-catastrophic health costs are simply a part of the equation. Some people aren't equipped to budget well etc., but that should not mean the whole population needs to hand over the rights and responsibilities of everyday health choices.

This argument never makes any sense to me.

 

Your insurance cos make decisions, overriding your Dr, all the time. It does NOT happen here. Dr says patient needs x,y,z, then it happens. Period. Drs do not have to explain, justify, argue w/an outside body for what their patient needs.

 

I've never had my Dr overridden by an outside bean counter.

[KnitWit]

Emotions naturally apply to individual / family situations, but they should not trump fact when setting government policy. And they should not be exploited to make people believe what is not true (to garner votes that eventually enrich some group of people).

 

Playing to emotions is going to make some people rich. We seem to be OK with that. We let people tell us whom we should have compassion and disgust for, and someone makes money off of that. Remember that the insurance companies, after meeting with Obama, supported Obamacare. They stand to gain from it. Mark my words.

 

I'm merely referring to choice of words which present tone in discussions such as this.

[Impish]

The mechanism by which it's determined what's "needed" is what I'm talking about when I say "approval of services."

 

Not to give too much weight to anecdotes, but we all know about the baby who was refused treatment in Canada for a brain condition and came to the US for treatment. Clearly that there is some mechanism approving and rejecting coverage for requested services. I'm not saying there should not be, but you seemed to be claiming that in Canada, that does not happen (as a reason why it's better up there).

My Dr determines what a need is. Not someone that's outside my medical care team.

 

Cosmetic things generally are not covered, ie circumcision is now considered cosmetic, whereas before it was covered.

[Embassy]

Maybe we are defining "approval of services" differently. How are you defining it? I'm talking about being able to go and request a service (or have your doctor recommend a specialized service) and having it be up to someone else whether and when you get to have that service. Are you saying that nobody in Canada is ever denied a service or told it won't be covered? Because that clearly is not true.

 

My doctor did tons of referrals to specialists for me and my son. I didn't think half of them were necessary, but she wanted to be thorough. I asked the doctor if I could get a referral for a test and she thought it was a good idea - she was going to recommend it anyway.

 

There is no such a thing as getting approval from what I have seen. Some things are not covered (i.e. anesthesia for dental surgery). It isn't a matter of getting approved because it isn't covered either way. If your insurance didn't cover infertility treatments then you wouldn't try to get approved for it.

[SKL]

This argument never makes any sense to me.

 

Your insurance cos make decisions, overriding your Dr, all the time. It does NOT happen here. Dr says patient needs x,y,z, then it happens. Period. Drs do not have to explain, justify, argue w/an outside body for what their patient needs.

 

I've never had my Dr overridden by an outside bean counter.

 

Me neither. But what I've had to do is work out coverage issues after the fact. Doctor coded something wrong (elective colonoscopy - who ever heard of that???) and yes, it was a pain in the butt (in more ways than one), but it got resolved. On the positive side I had practically no wait to get the referral, prep appointment, or colonoscopy done and behind me (so to speak :lol:).

 

I don't know if there are terminology differences or what, but there's definitely some confusion in the way US & Canadian people understand what goes on across the border.

[Embassy]

The mechanism by which it's determined what's "needed" is what I'm talking about when I say "approval of services."

 

Not to give too much weight to anecdotes, but we all know about the baby who was refused treatment in Canada for a brain condition and came to the US for treatment. Clearly that there is some mechanism approving and rejecting coverage for requested services. I'm not saying there should not be, but you seemed to be claiming that in Canada, that does not happen (as a reason why it's better up there).

 

It is up to the doctor(s). Doctor(s) decide on coverage and not an insurance company.

[Paige]

Maybe we are defining "approval of services" differently. How are you defining it? I'm talking about being able to go and request a service (or have your doctor recommend a specialized service) and having it be up to someone else whether and when you get to have that service. Are you saying that nobody in Canada is ever denied a service or told it won't be covered? Because that clearly is not true.

 

So for example, if you wondered whether you have Lyme disease, could you go and say "I want the blood test" and you'd get it, no questions asked?

 

Could you go and say "my kid needs a CAT scan" and have it delivered just like that?

 

How about a boob job or sex change? For real?

 

:iagree: What they do, is say that the procedure is not necessary or not beneficial, or experimental, or something. My daughter had a specialized surgery here in the US that is completely life changing for most patients. I am part of a group for parents of patients or adult patients and I have never seen a case when someone in the US cannot have the surgery if they work for it. Either insurance or medicaid pays, or the hospital writes off some and lets the parents pay in installments. It is so eye opening and shocking to me to see what the parents of kids in countries with universal healthcare have to go through. I feel so extremely fortunate that my child lives in the USA. Most of the time, they are flat out refused. They are told their child won't benefit. I've seen many parents raise funds and bring these kids here anyway and they go from wheelchair bound to walking within months! Their healthcare system said they'd never get better and the US was only agreeing to operate for the money.

 

If they are approved or permitted, or whatever you want to call it, the wait is shameful. My daughter was seen, evaluated, and had her operation all within 2 months. These other families who try to go through their own countries' systems have to wait up to a year just to be evaluated, and then another 6mos to a year to have the procedure done. In this time, the kids will deteriorate causing many of them to either need future surgeries to correct the problems that developed while waiting and may not ever progress as far as they would have had the operation been performed earlier.

 

The post-op support in their home country is appalling too. Here, the recommended therapy is 3-5 times a week. In their countries, they cannot get more than 3-5 times a year because there are too many kids and not enough providers. They cannot pay out of pocket at home for the surgery. It's just not possible. They cannot find therapists to pay privately. It is horrible.

 

I think universal coverage is great for people who don't need much out of the norm, but when you talk about specialized cases, then things get tougher. You just don't hear about it much because it only affects a minority of the countries' citizens. I know some people with issues will receive excellent care, but there are definitely people who are hurt by the universal healthcare system in their countries.

[happypamama]

Wow. My son needed to see a neuropsych and it was a 4-6 month wait for all of them. My daughter needed a neurologist and it was about a month, and that was for possible seizures! I've never been able to get in same day with my own doctor, ever. And Pap smears, well child checks, etc take months.

 

Haven't read the rest of the thread yet, but this seems to vary terribly. We lived in one place where they couldn't schedule a sick visit for three days, and well checks took months. Another place, well checks took a while to get, but they kept a few spaces open every day for sick visits, so we could get one that day, maybe the next. The wait times were terrible too, once we got to the office; even if I was on time or early, I'd have at least a 45-minute wait.

 

Around here, the response time is amazing. When I call for a checkup, they can get us in within a week. It takes longer if I want an evening appointment (because the exam rooms are tiny, and I don't like bringing all four children to a well check for the baby), but that's understandable. When they had a concern about the baby's heart, we were able to get an echocardiogram done within a week, and when I wanted some ENT and allergy evaluations done for my 7yo, again, it was really fast. Wait times have been very reasonable here too, no more than a few minutes, even for our doctor, who is part of a group practice (5 or 6 docs, plus a NP) that takes a lot of insurances (including CHIP/Medicaid/Medicare). And we have a pretty basic health insurance program, certainly not a fancy plan or anything. The ERs are excellent too, whereas we've lived in one area where the ER was terrible. (I waited for nine hours with searing abdominal pain, trying to rule out an ectopic pregnancy or kidney stone or something, for them to eventually shrug their shoulders and not find anything, but they charged me a ton for it. My family doc diagnosed a pulled muscle a couple of days later. Another time, DD got a fishbone stuck in her throat, at age 2, and she was throwing up blood, so we went to the ER. They did nothing, and we ended up taking her home and seeing her ped the next day, who got it out with no problem.) We also have very good walk-in clinics here, which have been very helpful on weekends.

 

Also, I suppose it depends on the doctor. Ours is great; if we ask for a specialist referral, she is happy to do it. But I know not all docs are.

 

The children's dentist is the only place where we have a hard time getting a well check; it is hard to get them every 6 months. But they're a really excellent pediatric dental practice, and when we've had a concern (like, my then 6yo came to me and thought one of his adult teeth felt loose -- turned out not to be an issue), they are able to get us in right away.

 

I have no feeling one way or the other about UHC. In theory, I don't like the idea of government intervention, but I also think the system as it is now, is broken terribly. I think it's ridiculous that a lot of doctors won't see someone without insurance, so they can't get treatment for minor things until they become major -- thus needing ER care and costing a lot more money. And I think prescription meds are horrible. This summer, I needed a steroid inhaler to treat my asthma, and it was so expensive. I can definitely see why people might put off buying the meds, and then they end up in the ER (which is where mine was heading). I think we need to make it easier to get preventative care and minor treatment, but I also don't want unnecessary tests done. I think we need a better model, whereby individual needs are considered more.

Edited July 16, 2012 by happypamama

[Embassy]

Me neither. But what I've had to do is work out coverage issues after the fact. Doctor coded something wrong (elective colonoscopy - who ever heard of that???) and yes, it was a pain in the butt (in more ways than one), but it got resolved. On the positive side I had practically no wait to get the referral, prep appointment, or colonoscopy done and behind me (so to speak :lol:).

 

I don't know if there are terminology differences or what, but there's definitely some confusion in the way US & Canadian people understand what goes on across the border.

 

As a US citizen living in Canada for several years now I agree that there is a lack of understanding. I've seen US media and US citizens give a spin on Canadian healthcare that is not accurate. I hear stories of Canadians who have to go to the USA, but the only story I've heard that I know to be true is of my bil. He is a Canadian truck driver and drives a bit in the USA. He was having problems and went to doctors in the USA and they incorrectly treated him causing his problem to be worse. When he arrived back in Canada he had the issue taken care of.

 

I've seen Canadian citizens have no idea what it is like to have to pay for health care. I've heard complaints from Canadians, but when they hear how much it can cost to get coverage in the USA they are flabbergasted. Both taxes and wages are higher here. In my many years in the USA I had great insurance, not so great insurance, no insurance, Medicaid, and even billed Medicaid when I worked professionally. I admit to not fully understanding the Canadian system, but in my time here the care has been amazing and easy to get. Some things have not been covered, but they are more elective things and the costs are quite small.

[Dory]

I think there's some confusion on here as to what sort of health care Canada provides. We do not have a nationally covered health care, we have a provincially covered health care. Stories you would hear from Ontario, will not be the same as stories you hear from Alberta. Each province varies slightly on what it offers and how much everyone is charged for it.

 

In Alberta I have never found wait times for a needed surgery to be horrendous. I have never found wait times for post-op therapy to be very long either. I cannot vouch for the wait times in other provinces as I've never had to deal with the other provinces health care for anything other than strep throat.

[ktgrok]

And going out your door could be a death sentence because a tree branch might fall on your head. There's sensationalism and then there's logic.

 

It costs money to live. It costs money to raise kids. Everyday, non-catastrophic health costs are simply a part of the equation. Some people aren't equipped to budget well etc., but that should not mean the whole population needs to hand over the rights and responsibilities of everyday health choices.

 

My examples of type 1 diabetes, asthma, and fused skull bones are not senationalism. I know a child with each of these, in my small circle of friends. These are not rare one in a million things. If my friend's child with diabetes wasn't being managed very very very carefully with expensive monitors and such he would be dead. My sister and I both had asthma as children,and my niece has it now. If my parents had delayed too long with treating it she could have died. My friend's daughter's skull bones fused too early...and it was not obvious and was only caught because she could afford regular well baby visits. If it hadn't been caught she might have lived, but with permanent brain damage. These are all in my very small circle of friends/family. These are EVERYDAY issues, not sensational stories. You say, well, they parents should have budgeted better. So you are willing to let these children DIE if their parents can't get better paying jobs or budget better???????