S/O Why universal health care frightens me

[kalanamak]

Not only am I afraid of the care they might NOT give, but if gov is paying the bills, then they can start deciding what care you MUST accept. This opens a whole can of worms and here are just some examples of where it could go:

 

1. If gov is paying for your prenatal care, they could force you to get tested for abnormalities and as a result terminate any pregnancy they feel would be an undue burden on the system. If you would refuse, I am sure you would then be on your own for all costs incurred by that pegnancy/child and of course go bankrupt in the process.

 

2. If they decide obesity, smoking and diabetes are adding to costs, they could force people to take drugs and treatments for those things. Not that it isn't good to control these things, but imagine not having a choice of HOW you will go about it.

 

3. The vacccine debate is relavant here. I would say that under a universal system, there would be no choice whatsoever. They could demand that you and your children get every vaccine THEY feel is necessary WHEN they feel it is necessary or again- you're out of the system entirely. There is no end to the vaccines they could come up with as being mandatory.

.

 

No one has the energy to do such things. I work where we sometimes do involuntary treatment. It has to be LIFE or LIMB threatening. It requires two MD signatures (documenting an inability to assess risk vs. benefit and also need) and the support of the line staff (a kind of jury nullification). Some of the treatment requires you to go to court and testify, so that a judge is agreeing with you. What a huge hassle. And these people are involuntarily committed. If they were not already deemed a danger to themselves or others, they could stay at home and let that huge infected wound on their hand kill them.

 

Have you ever tried forcing a lab test or a med on a person? It is not easy and it is very expensive (the facility, the restraints, the guards, the documentation, the meetings with the chart auditors.) To think that universal health care would lead to forcing people to take drugs or treatments is a slippery slope you can dry off and put away without another worry. If it came to this in the US, we'd be such a changed country, your health care would be the last of your worries.

 

Your hyperbole is, BTW, either so funny I missed the humor (not the first time) or perhaps a little worrisome vis a vis your blood pressure. :)

[Heather in the Kootenays]

Just a few reasons (of enough in our - dh and my - opinion to write a book) why we, healthcare professionals, feel universal healthcare is not good. Not good at all.

 

1) Government controlled. Need I say more? :-{

2) Like Canada, France, and other predecessors who've walked this way - you often have to wait for forever to get your care

3) Without the free market enterprise, there's no incentive to the provider to better themselves. And, if they're going to make the same income seeing 2 patients over 200, some will be inclined to see the bare minimum and be done.

4) If you happen to not like or agree with your current provider you do NOT necessarily have the luxury of switching to someone with whom you do agree or who you do like. Brrr. Shiver me timbers. This one gives me cold chills. ;-{

 

In our humble opinion, this is NOT the answer to the country's healthcare woes!!

 

You know, I think you do your fellow healthcare professionals who work under a universal system a disservice. The many professionals I know care deeply about the job they do and the people they serve. Like professionals in other field they work hard and provide the best possible care they can.

[Audrey]

but there are a few other factors which I mentioned in my previous post, one being geography (albeit perhaps not as important) but more importantly: demographics. We have a huge immigrant population, and it differs from Canada's immigrant population. The two aren't comparable.

 

And, to be honest with you, despite the current problems in our health care system, I think we have bigger fish to fry right now in the U.S. The government bailouts of Fannie Mae and Freddie Mac (and possibly intervention on Wall Street) may cost the U.S. taxpayer one trillion dollars! I think those problems first need to be addressed before this country can look seriously at the issue of UHC. If and/or when that happens, I think it's excellent to study the models of other countries, but any plan the U.S. adopts obviously isn't going to echo the plan that works for another country. In the long-run, I'm not a believer in big government. I think that government tends to function better when problems are addressed on a more localized scale. So, I'd like to see individual states have the liberty to set up health-care systems that address their demographics. Perhaps that's how Canada's system functions---each province can determine the future of its own health care. If so, I would agree that would be preferable over a national health care system.

 

But, in the U.S. at this time, I think we have more pressing issues.

 

 

Agree on many points here:

Yes... naturally the US would develop its own style of UHC. I don't believe any two countries who have UHC run it in precisely the same way. Any system, in order to be successful, would have to address the needs of its particular citzenry.

 

Yes... although I'm quite passionate about UHC (former american here, so I've seen both sides), I do believe there are more urgent needs to address in the US at the moment. The economic crisis is just one.

 

But... I still think it's worthwhile to keep a plan for UHC for America on the political radar. It would be a shame if momentum for it were quashed entirely.

[Plucky]

You know what really ticks me off? I'm pretty certain we could've started one with 700 billion dollars.

[Sharon in SC]

You know, I think you do your fellow healthcare professionals who work under a universal system a disservice. The many professionals I know care deeply about the job they do and the people they serve. Like professionals in other field they work hard and provide the best possible care they can.

 

I disagree (that I'm doing anyone a "disservice"). I don't doubt that the majority of folks who work in UHC are just like what you've described here (conscientous, hard working, etc)! I've not said anyone *would* do less than they would with more incentive, I've said some *might*. Again, just speaking to concerns I carry. If it is the experience of some that healthcare (even if just for a common cold) is not as readily available in a UHC system, we have to consider reasons why. This is one reason that I feel is worthy, at least, of consideration.

[hornblower]

You know, I think you do your fellow healthcare professionals who work under a universal system a disservice. The many professionals I know care deeply about the job they do and the people they serve. Like professionals in other field they work hard and provide the best possible care they can.

 

:iagree:

 

Not to mention that physicians here don't get paid the same whether they see one person or 200.....so there is a lot of misinformation out there about how these systems actually function.

 

A Canuck

[dawn of ns]

but there are a few other factors which I mentioned in my previous post, one being geography (albeit perhaps not as important) but more importantly: demographics. We have a huge immigrant population, and it differs from Canada's immigrant population. The two aren't comparable.

 

We have a huge immigrant population as well. I'm not sure what the possible difference in our immigrants population has to do with it though. Would you care to expand that?

[Michelle in MO]

But... I still think it's worthwhile to keep a plan for UHC for America on the political radar. It would be a shame if momentum for it were quashed entirely.

 

a number of other issues are solved. I honestly have a difficult enough time understand our own insurance company, let alone the causes of our current health-care problems! I doubt if the momentum will be quashed, because the problems are still there. Ideally, I wish everyone were employed and had access to purchase individual health care that they could afford. In our area (MO), it seems like there's a huge "blame game" going on for high health-care costs: the doctors blame unscrupulous lawyers; the lawyers blame insurance companies and doctors; both doctors and lawyers blame the insurance companies; and the insurance companies blame the doctors and lawyers. Have I missed anyone? :)

 

I just hope that our country can dig itself out of its current economic woes and get into a better position to address UHC.

[Audrey]

:iagree:

 

Not to mention that physicians here don't get paid the same whether they see one person or 200.....so there is a lot of misinformation out there about how these systems actually function.

 

A Canuck

 

 

Yes... I do know that in my province there are at least 2 ways physicians are remunerated.

 

1) they are a private practice doctor who is remunerated by the province on a per patient/visit basis. There is a scale of amounts collectable based on the service provided. The physician essentially bills the province for the services s/he has provided (much as a US doc might bill insurance companies).

 

2) they are on staff at a medical facility and are salaried. Salaries are not set on levels, but negotiated with the physicians individually. So, potentially, they can ask whatever they want. Realistically, there are budgets, so shooting for the moon isn't going to get you the job. :001_smile:

 

There may be other remuneration options, but these are the two I know about for certain.

[Sharon in SC]

[quote name=hornblower;545492.....so there is a lot of misinformation out there about how these systems actually function.

 

A Canuck

 

Well' date=' for "argument's sake", it might be reasonable at this point to say this: Let's suppose for a moment that all of my concerns from #2 on, cited in my OP above, were proven to be unfounded. I'd still carry serious reservation because of #1. I am very much unconvinced that "big" government is the answer to our society's ills. Certainly, that is just my personal opinion. But, there it is.

[Michelle in MO]

We have a huge immigrant population as well. I'm not sure what the possible difference in our immigrants population has to do with it though. Would you care to expand that?

 

we have a number of illegal immigrants coming over the border from Mexico. I'm not saying we should close our borders, but it does have an economic impact on our country, particularly on the border states. They do not have jobs, are very poor, have a difficult time obtaining jobs, and they're generally uninsured. Yet they still demand a share in our economy and will require health care. However, by stating this I am not in any way trying to be an isolationist or exclude people from wanting to improve their circumstances. The U.S. has always been a country of immigrants; during WWII, to our shame, we didn't open immigration enough, in my opinion, to Jews fleeing Nazi Germany. I think it's a different issue with Mexico, though. I think any steps the U.S. can take to help Mexico strengthen its own economy will benefit not only their population, but help prevent the overflow of illegal (not legal) immigrants who come over the borders daily. Who comprises the majority of Canada's immigrant population?

 

Anyone from Texas or other border states care to comment? Does this impact your local economies? I might add that because each state in the U.S. contains such a unique population base, I think we would be well-served to have a system in which each state could determine for itself how to best set up a health-care system for its state. What works for Washington, D.C., may not necessarily work for the rest of the country.

 

Remember, I never stated that I am completely against all forms of UHC; in my original post I stated that my father, who is very conservative, was friends with a gentleman from South Africa who said that their health-care system was great: he had good doctors, good coverage, it didn't cost the taxpayer an arm and a leg, etc.

 

My comment about the difference between immigrant populations is a sidebar issue, but I do think the immigration issue along the U.S./Mexico border impacts our economy, and I think it's fair to say that UHC in the U.S. may take a different form from UHC in Canada.

[Sharon in SC]

Yes... I do know that in my province there are at least 2 ways physicians are remunerated.

 

1) they are a private practice doctor who is remunerated by the province on a per patient/visit basis. There is a scale of amounts collectable based on the service provided. The physician essentially bills the province for the services s/he has provided (much as a US doc might bill insurance companies).

 

2) they are on staff at a medical facility and are salaried. Salaries are not set on levels, but negotiated with the physicians individually. So, potentially, they can ask whatever they want. Realistically, there are budgets, so shooting for the moon isn't going to get you the job. :001_smile:

 

There may be other remuneration options, but these are the two I know about for certain.

 

That is encouraging to hear. :)

[dawn of ns]

:iagree:

 

Not to mention that physicians here don't get paid the same whether they see one person or 200.....so there is a lot of misinformation out there about how these systems actually function.

 

A Canuck

 

I often feel that most of the time I spend talking to Americans about Canadian health care is spent deconstructing strawmen. I'm betting most, if they spent a year using the Canadian system, wouldn't notice much of a difference. Other then not having to pay out of pocket or submit claims to insurance companies.

 

On the doctor's...A doctor's office is a small business, privately run. They get paid for each patient they see, submitting to the insurer for payment the same as a US doctor would do. It's simply that all patients have the same insurer.

[keptwoman]

Health care in Canada is run by the provinces so it might be a better model for the Us states then you realize. :)

The Health care in Australia is also run by the states. To have access to public health care you need to have a Medicaid card which takes a bit of paperwork to get (I've had to do it as an immigrant) this stops non Australians coming in and sponging off of us for health care.

We also have a lot of illegal immigration...boats from Indonesia.

[BusyMum]

Despite having universal healthcare, I have not (nor do I know of anyone else)

 

1. been forced to accept prenatal testing for abnormalities though it was offered.

 

2. been forced to accept treatment for obesity, or anything else. (although the last time I went to the Dr., he offered to refer me to a dietician).

 

3. been forced to accept any kind of immunization despite my children (and many children I know) remaining unimmunized for some things.

 

I can't even imagine. Universal healthcare doesn't turn citizens into mindless, controlled drones.

:iagree: What she said! NZ has had universal healthcare for yonks and there is freedom of choice for all aspects of treatment with the rare exception of highly contagious diseases such as TB where patients can be isolated against their will if they insist on mingling with others.

[Plucky]

Yes, that's what I'd like to know, too. Someone said Australians exclude illegal immigrants. We don't exclude illegal immigrants from much here. That is one of the reasons that it would be so costly.

[keptwoman]

The reality is that there is no way that ANYONE would turn up to a hospital in Australia and not get treated if they needed it. But if they don't have a medicare card they will get billed. So yes illegal immigrants do cost the country money but they would also then come to the notice of the authorities and get shipped out kwim?

 

But I'm not overly bothered if some of our tax money goes to paying the hospital bill of an illegal immigrant. I guess I do believe that it's a basic human right to get health care and if people can't afford to pay for it should they just not be treated?

 

Clearly there would be problems in setting up Universal Health care in the USA. But I don't think they are insurmountable given that pretty much every other 1st world country has it, it seems to work pretty good for the most part. None of them seem to be planning to go to user pays. Of course every country will have it's issues and they are different from other countries. Your country is already paying for health care for illegal immigrants, it seems to me that the people who will most benefit from this change are the citizens rather than the illegal immigrants who may just find it slightly harder to slip under the radar if everyone has the same health care card.

[Plucky]

Wow. Good point. I hadn't thought about that. I am really new to my belief about health care for everyone so I know it looks like I haven't given much thought about it. I am now. I appreciate your post. I think our bailouts have put us in a bad position for it but I am interested in seeing how this would work. Thanks.

[Mabelen]

Just wanted to add my testimony if favor of Universal Health Care. I have lived most of my life in two different countries in the European Union with universal health care and I have been extremely happy with both of them.

 

I find the thought of for some reason not being able to afford medical care in this country very scary and, unfortunately, very real.

[sarahli]

I am a nurse in favor of universal health care. I had a c-section at the hospital I worked for and the bill was 2800$ after insurance. My ultrasounds were 330$ each. The ER visits were 480$ each. I paid 200$ a month for insurance.

My DH is military now, and I have to say now for the first time I'm not afraid of the bill and to get treatment I need.

 

No one forced me to do anything weird either, huh (under Tricare). No one forced vaccination on my son (he is fully vaccinated on a delayed schedule).

 

As far as I know, people living in countries with universal health care have longer life expectancies and better maternal and neonatal outcomes. That says enough for me.

[TeacherZee]

Yes, that's what I'd like to know, too. Someone said Australians exclude illegal immigrants. We don't exclude illegal immigrants from much here. That is one of the reasons that it would be so costly.

 

Sweden has proportionally to the populations as a whole a very high number of asylum seekers and they are entitled to basic care for any "emergency" medical care. Most people here consider this a basic human right. There has even been a bit of an outcry because a lot of people think they should also be treated for ongoing medical conditions. None of this bankrupts the system.

[Jugglin'5]

I am a nurse in favor of universal health care. I had a c-section at the hospital I worked for and the bill was 2800$ after insurance. My ultrasounds were 330$ each. The ER visits were 480$ each. I paid 200$ a month for insurance.

My DH is military now, and I have to say now for the first time I'm not afraid of the bill and to get treatment I need.

 

No one forced me to do anything weird either, huh (under Tricare). No one forced vaccination on my son (he is fully vaccinated on a delayed schedule).

 

As far as I know, people living in countries with universal health care have longer life expectancies and better maternal and neonatal outcomes. That says enough for me.

 

When my dh was in the AF, a pregnant friend of mine had an ultrasound that raised red flags for Down's Syndrome, and received incredible pressure from the AF doctors to abort (this was stateside - I can't remember the regs at the time, I know abortions couldn't be done overseas). They kept calling her at home, even though she had said "no" repeatedly. It was a cost cutting measures for Tricare, pure and simple. Though they didn't say it to my friend quite that crassly. It was all for her covenience of course. Of course, the irony is that the baby boy was born perfetly normal. I had two babies under Tricare myself, and it wasn't the bed of roses experience you had. I never saw the same doctor more than twice, and I had no choice as to which one would deliver my baby. I was relieved when i got sent off base for my second one, but then I had a Tricare biling nightmare. This was 10-12 years ago when Tricare was relatively new, so hopefully they have gotten better.

 

I know all about bad insurance - I paid $8000 cash for a perfectly normal delivery, while paying $300 a month for a high deductble insurance policy that didn't cover any of it (unless something went terribly wrong). It is next to impossible to get maternity coverage in Texas if you're self-employed.

[Mama Lynx]

I'm just surprised that since you work in immigration you'd be so uninterested in posting facts. Can anyone cross the border to Canada and get free health care? They can here.

 

We live in Canada for a time. Here are my experiences.

 

1) DH did have to go through a great deal of paperwork to be allowed in. He had a job there, waiting.

 

2) DH's colleague was turned away at the border, because Canada already had it's quota of outside workers in that field, and because he did not hold a degree. Those are the things that immigration told him. We did eventually get him in, but it was quite a mess (and took a couple of weeks of work).

 

3) As a U.S. citizen staying in Canada, we had to pay $25 to see the doctor. So, not free, but very, very cheap.

 

4) OTOH, the pediatricians were on strike while we were there. Now, there's a concept.

[Mama Lynx]

I think you've hit on something important here, Elaine. It's true that there are some countries who are making universal healthcare work well for their people. But by and large, they are significantly smaller in both population and geography than the US and they already have a much more federalized central government. The size and scale of the United States has historically meant that it *usually* works better for the states themselves to administer programs. Or even smaller local governments (the school system for example). I think I would feel more confident if we could point to a large, federalized program that the government is already running efficiently and without waste or abuse. Most of us on this board agree that the public school system, despite a few well-run local school districts, is a complete and utter inefficient mess. I'd love to know where one finds confidence that a universal healthcare system won't be equally screwed up within a very short period of time. And if it is...will we still be paying for it even if we opt out? As we do with our property taxes as homeschoolers? (Not that I begrudge paying some tax for the education of children in our country...but add a huge health tax to that and it could pinch pretty hard)

 

Jami

 

 

:iagree: *These* are the problems with universal health care. We are HUGE. I am very, very, very skeptical that we can do it well. And health care is too important to mess up. YES the current system stinks. YES it needs reform. But I don't believe we can do national universal health care, either.

[astrid]

If universal health care is good enough for our millions of veterans (and it's my understanding that it was based completely on the UK model) why isn't it good enough for the rest of us?

 

astrid

[MeanestMomInMidwest]

I was an "illegial immigrant" in Canada. Now you all know my secret. I went in as a visitor and ...just stayed. I worked for cash at a deli and as a nanny. While I never had to access healthcare, those I was friends with did, and there were no problems. My experience is several (like almost 20) years old now. I love, love, love Canada. None of my CN friends have any bones to pick about their healthcare, other than minor inconveniences due in most part to geography (same as in the US rural areas don't have as many providers or types of providers).

Some posts are relevant....their population is not the same as ours, etc.

The biggest difference I see, and the biggest obstacle is implementing it at this point in time in the US. In my mind it is all about timing and the view some in the US hold about healthcare.

I am a healthcare provider (here in the US) and have worked in large & small hospitals. Nobody is turned away for based on income/insurance. Anyone can walk into any ER and get the quality of care usually provided by that particular hospital. No insurance? No problem. Care is provided and a bill is sent. Of course, if you have nothing (no house, no income), just don't pay the bill. Its not like they can garnish nonexistant wages or put a lien on a nonexistant house. I've seen open heart surgery provided to illegal immigrants...they DO get the care they need. I've also heard docs say "this is my charity work" because the majority of pts in that particular hospital were "self pay" which translates to "no pay" and the reimbursement level from the govt is low. I have also seen pts who have excellent insurance kept longer than I thought necessary and sent for expensive tests with questionable value (in my opinion)....gets to the point that with some docs we RNs don't even have to look at the face page (the page in the chart that lists insurance, etc) to see if the person is insured or not. The uninsured get all necessary tests/procedures. The well insured get more...sometime an MRI when the CT was already conclusive and the MRI had no added benefit, except as a billable procedure.

Also, the healthcare provider negotiates with insurance companies as to reimbursement for certain procedures. Medicare also has these (DRG's). So, if you're self pay and not on Medicare your bill will be larger, but you can negotiate the price to Medicare's standard reimbursement (which, BTW is much lower). Medicare is our UHC for those meeting the income (or lack of income) requirements.

I have also been in the position of not having insurance and choosing not to go to the doc because of expenses. I knew I'd get a bill, and since I owned a house and was worried about my credit I didn't want a bill I couldn't afford that might ruin my credit if I didn't pay. Some aren't worried about that. Another time I got a ride to the hospital in an ambulance....got a huge bill I couldn't afford. Negotiated with the hospital for payments I could afford w/no interest, renegotiated later to reduce the bill, renegotiated again and got it reduced further, and finally, finally (I forget how many years I was paying on that) paid it. Lack of insurance in the US does not equate lack of care.

Yes, the US healthcare system has its faults and needs a fixin'. Is UHC the fix at this point? I don't know. Just thought I'd stir the pot.

[Mabelen]

When my dh was in the AF' date=' a pregnant friend of mine had an ultrasound that raised red flags for Down's Syndrome, and received incredible pressure from the AF doctors to abort (this was stateside - I can't remember the regs at the time, I know abortions couldn't be done overseas). They kept calling her at home, even though she had said "no" repeatedly. It was a cost cutting measures for Tricare, pure and simple. Though they didn't say it to my friend quite that crassly. It was all for [i']her[/i] covenience of course. Of course, the irony is that the baby boy was born perfetly normal. I had two babies under Tricare myself, and it wasn't the bed of roses experience you had. I never saw the same doctor more than twice, and I had no choice as to which one would deliver my baby. I was relieved when i got sent off base for my second one, but then I had a Tricare biling nightmare. This was 10-12 years ago when Tricare was relatively new, so hopefully they have gotten better.

 

 

My first pregnancy occurred in the UK. I opted to have the routine blood work to detect Down Syndrome. It came out high. I was told that if I wished I could go and talk with a specialist about possible options. I did go to the hospital and talked with a specialist. I said I was not interested in having an amnio or a termination. That was the end of the story. The options are there if you choose, but certainly I received no pressure at all.

[Michelle in MO]

:iagree: *These* are the problems with universal health care. We are HUGE. I am very, very, very skeptical that we can do it well. And health care is too important to mess up. YES the current system stinks. YES it needs reform. But I don't believe we can do national universal health care, either.

 

I was trying to make in my earlier posts. Health care is a critical issue in the U.S.; the system isn't working very well at all right now. We pay enormous premiums and have a huge deductible right now. Yes, it stinks. But, I'm not for a national universal health care plan, just like Mama Lynx said. I would rather see it administered as close to the local level as possible. Was is Thomas Paine who said, "He governs best who governs least?"

 

If universal health care is good enough for our millions of veterans (and it's my understanding that it was based completely on the UK model) why isn't it good enough for the rest of us?

 

Not a bad question, but I wouldn't interpret it health care for veterans this way. Are you talking about men in active service, or retired veterans? If you're talking about active servicemen, being a soldier (or sailor or whatever) is their job, so their employer (the US government) is covering their medical expenses. As far as veterans are concerned, I personally think it's a good idea to give them medical, some of whom may still carry long-term physical and emotional effects from being engaged in warfare. But, that doesn't mean they're worth more than anyone else in the United States.

 

I see it more as an issue of how to handle health care in the US---not to avoid the uninsured, but how to best deal with the problem, how to reduce medical expenses, how to reduce premiums, etc. I also think there's a question of proper timing for addressing the BIG issue of whether or not to nationalize health care. Congress has just been asked to bail out AIG and the Lehmen Brothers to the tune of $700 billion dollars. I don't think now is a good time to address this issue of health care, but obviously the issue is still there and isn't going away.

[chaik76]

If universal health care is good enough for our millions of veterans (and it's my understanding that it was based completely on the UK model) why isn't it good enough for the rest of us?

 

astrid

Because most of the veterans I know personally get abysmal care.

Obviously, that isn't a statistic...but it wasn't so long ago that there were the news stories of mold, etc. in the hospitals...I'm sure some veteran care is awesome...but it's not awesome for everyone.

 

I'm against UHC, period. Not because it can't be run well (I'm sure there must be some circumstance where it could...although I'm not sure the U.S. would be able to do it, at least at this time)...but because I'm basically against universal anything. It's actually one of the reasons we chose not to emigrate to Canada. Dh and I are both against most federally (or large state-run) programs. I have yet to see anyone point me to a large state-run or federally-run program (in the U.S.) that is doing well. As far as I can tell, none are.

[Tracey in TX]

Our health care system is problematic for many Americans. Even with the best health care available in the world, it is unobtainable for many people. Rather than providing universal health care maybe the solution would be to reduce the number of ludicrous lawsuits. (Bear with me, this is going somewhere, I promise.)

Doctors are forced to charge ridiculous sums of money for office visits, simple procedures, etc. because of their insurance premiums. They can't work without insurance, but the money they pay for fear of lawsuits is practically immoral. If we disallowed the petty, get-rich-quick, irrelevant lawsuits, the insurance companies wouldn't be required to charge high premiums. Physicians could, in turn, charge less money to their patients. this would offer a more affordable to a greater number of Americans. It wouldn't allow everyone equal health care, but would allow many more the ability to seek health care.

 

Also, the difficulty in health coverage from various insurance providers forces physicians to stop allowing certain companies. Again the doctors' offices spend more money (time and additional employees) dealing with challenging companies. If we went to something as simplistic as an ABC plan for argument sake. Each insured person has one of three plans. Any extra is out of pocket or an add-on from his policy. I think it's the insurance companies getting rich. The doctors I know are struggling to stay in practice. Good, knowledgeable doctors who should be making a lot of money waste it on "in case I get sued" insurance.

 

Maybe I'm barking up the wrong tree, but think we can't afford universal health coverage in the US currently. My experience in England, Norway, and the US military makes me think private insurance is the way to go. The others are a hassle--hurry and wait, seeing one doctor after another--and the cost gets distributed amongst everyone. Typically those who want the coverage most are those who would put the least into the proverbial pot to distribute.

[ClassicMom]

deleted

[Rose in BC]

they do help to illustrate points, and sometimes they do affect more than the individual involved.

 

 

On the flip side, there are countries where universal health care appears to work. My dad, who is very conservative and not a big fan of universal health care, said that a friend of his was from South Africa, and that this friend said his health care there was "the best".

 

 

 

Apparently this is only true for the patients. We have a large number of South African doctors practicing in our community because their medical system does not consistently pay the doctor for his/her services. (disclaimer: This is anecdotal . . comments from the doctors I have spoken with about why they come here to practice.)

[Michelle in MO]

Apparently this is only true for the patients. We have a large number of South African doctors practicing in our community because their medical system does not consistently pay the doctor for his/her services. (disclaimer: This is anecdotal . . comments from the doctors I have spoken with about why they come here to practice.)

 

I'll have to mention this to my dad. He's only heard one side of the story, to be sure.

 

Believe me, UHC is not my optimum choice, but the trend towards it seems almost irreversible. I would like to see frivolous lawsuits eliminated, insurance companies reduce their rates, and doctors to be able to purchase affordable malpractice insurance first. How to do all that? I have no idea.

[Rose in BC]

Despite having universal healthcare, I have not (nor do I know of anyone else)

 

1. been forced to accept prenatal testing for abnormalities though it was offered.

 

2. been forced to accept treatment for obesity, or anything else. (although the last time I went to the Dr., he offered to refer me to a dietician).

 

3. been forced to accept any kind of immunization despite my children (and many children I know) remaining unimmunized for some things.

 

I can't even imagine. Universal healthcare doesn't turn citizens into mindless, controlled drones.

 

And I have been a part of the system for my whole life.

 

I mentioned in another thread that my dad was diagnosed with a cancer twelve years ago that killed him in 9 months. My dad was told he would die in two weeks without treatment and 9 months with two rounds of chemo (in isolation at the cancer clinic for almost three months). They did not deny my dad treatment because he was terminal and it would be a waste of money to treat someone with a 9 month life expectancy. He was treated. Had a few great months. Died 9 months later.

[dawn of ns]

 

Having said that, I would still reject a universal health-care system. It's already hard enough to find specialists for my sons and neurologists for myself that are on our plan. Having the government in charge of my health care and my children's care scares me beyond belief.

 

The few times that we did get state help for my handicapped son, we were told where, when and how much help that he could get. It was never what he needed and never enough. It was as frustrating for his doctors as it was for me. His hospital visits were shortened to less than he needed and was always sent home too soon....we would end up in ER because of complications.

 

The more the government takes on the more socialized we become. I would much rather lose everything I own because of medical debt, than see our country turn to universal health care.

 

 

 

I see two misconceptions repeatedly brought up here.

 

1) universal health care means socialized health care. It doesn't.

 

2) universal health care means the government controls the care you get or limits your choices. It doesn't.

 

UHC simply means health care that's availible to everyone. Beyond that it means what a nation decides it means and for every country with a system of UHC there's a different way of doing it. Condemning UHC for the above reasons is like condemning ice cream because you don't like chocolate. Okay, how about instead you just pick an ice cream that doesn't have chocolate in it?

 

Seriously, if the US is a nation of ingenuity it shouldn't be hard to come up with some scheme that might fit it's needs.

[mom2att]

A question for those in countries with UHC--what's the policy regarding litigation against health care providers in your countries? Here in the U.S. you can basically sue anyone for anything, anytime--all you need is an attorney to take your case (which they are lining up to do). I see this as one of the biggest issues affecting our heath care system. Doctors are paying ridiculous rates for malpractice insurance and we are paying more as a result. IMO this is where the reform needs to start--we need to get a handle on the litigation and let doctors use their common sense instead of ordering an MRI for every little bump on the head just in case someone sues later on. So I'm wondering how this works in countries with UHC, anyone care to fill me in?

 

The negotiation that goes on here between the insurance companies and the docs certainly doesn't help--companies will only pay a certain % of the bill, so the bills are raised, and as a result you get a $11 asprin or a $60 Ace bandage. I think we need to start from scratch here and bring all parties to the table to discuss real-life costs instead of continuing with this game of highly inflating costs just to get the insurance companies to pay more.

 

And finally, I wonder what would happen world-wide to healthcare should the U.S. go to a UHC system. It's just my personal conjecture, not something I've taken the time to research to any extent, but do the UHC countries benefit from the free-market U.S. system? It's been the argument of capitalism that free markets encourage new developments by making research profitable--is this true in the healthcare industry? Are the new drugs, new procedures, new equipment being developed mainly in the U.S., or am I totally off base on this?

[TeacherZee]

A question for those in countries with UHC--what's the policy regarding litigation against health care providers in your countries? Here in the U.S. you can basically sue anyone for anything, anytime--all you need is an attorney to take your case (which they are lining up to do). I see this as one of the biggest issues affecting our heath care system. Doctors are paying ridiculous rates for malpractice insurance and we are paying more as a result. IMO this is where the reform needs to start--we need to get a handle on the litigation and let doctors use their common sense instead of ordering an MRI for every little bump on the head just in case someone sues later on. So I'm wondering how this works in countries with UHC, anyone care to fill me in?

 

The negotiation that goes on here between the insurance companies and the docs certainly doesn't help--companies will only pay a certain % of the bill, so the bills are raised, and as a result you get a $11 asprin or a $60 Ace bandage. I think we need to start from scratch here and bring all parties to the table to discuss real-life costs instead of continuing with this game of highly inflating costs just to get the insurance companies to pay more.

 

And finally, I wonder what would happen world-wide to healthcare should the U.S. go to a UHC system. It's just my personal conjecture, not something I've taken the time to research to any extent, but do the UHC countries benefit from the free-market U.S. system? It's been the argument of capitalism that free markets encourage new developments by making research profitable--is this true in the healthcare industry? Are the new drugs, new procedures, new equipment being developed mainly in the U.S., or am I totally off base on this?

 

I'm going to try and answer this.

 

Here in Sweden it depends on if you have been harmed by the doctor (or other medical personnels) neglect or other problems or by the medication.

 

If you have been harmed by medical personnel you must within three years of the event apply for compensation to the national patient insurance who determine if you were really injured through their neglect. If they find that you were harmed through neglect or malpractice you get an insurance payment (my sisters boyfriend got money this way through a botched knee surgery). You should also make a separate claim to the health board with regards to the medical personnel so that a inquiry can be made. If the medical personnel is found guilty of neglect or malpractice they will get a warning or if the infraction is bad enough they will loose their licence.

 

The procedure is pretty much the same if you have been injured by your medication.

[MeanestMomInMidwest]

The negotiation that goes on here between the insurance companies and the docs certainly doesn't help--companies will only pay a certain % of the bill, so the bills are raised, and as a result you get a $11 asprin or a $60 Ace bandage. I think we need to start from scratch here and bring all parties to the table to discuss real-life costs instead of continuing with this game of highly inflating costs just to get the insurance companies to pay more.

 

 

The price you see on your bill for any individual item ($20 Tylenol or whatever) is simply the price of that particular item. You pay for the item, the doc who prescribes it (yes, even nonprescription items in hospitals need doctors orders) pharmicist who dispenses it, the tec who stocks the pyxis (med drawer), the nurse who checks the order, grabs the pill & makes sure you're the right patient, don't have an allergy to this med and it is given in the right form, then walks it to you, listens to you complain, etc. Hospitals, like any other business have overhead that must be factored into the cost of any individual item.

[Peek a Boo]

I see two misconceptions repeatedly brought up here.

 

1) universal health care means socialized health care. It doesn't.

 

2) universal health care means the government controls the care you get or limits your choices. It doesn't.

 

UHC simply means health care that's availible to everyone. Beyond that it means what a nation decides it means and for every country with a system of UHC there's a different way of doing it. Condemning UHC for the above reasons is like condemning ice cream because you don't like chocolate. Okay, how about instead you just pick an ice cream that doesn't have chocolate in it?

 

Seriously, if the US is a nation of ingenuity it shouldn't be hard to come up with some scheme that might fit it's needs.

 

This is why I've suggested a voluntary program :)

 

 

socialized medicine

: medical and hospital services for the members of a class or population administered by an organized group (as a state agency) and paid for from funds obtained usually by assessments, philanthropy, or taxation

 

We ARE talking about socialized healthcare when you discuss UHC.

But as Colleen has mentioned, she doesn't think socialization is a dirty word ;).

The US already HAS socialized healthcare for some segments of the population. I'd prefer they reform that to be ANYone can join, but not all have to fund it.

 

I'm not "scared" of UHC, but like ClassicMom I do value the freedoms of lesser gvt vs the trappings of a well-furnished healthcare cage. I have mentioned before that if you can't fail completely, you're not completely free.

 

As for immigration --KW mentioned that illegal immigrants are treated and shipped off. What about Canada? what if some illegal immigrant has no valid address or ID to bill? The problem isn't immigration, it's how ILLEGAL immigration is handled. The US has a horrible track record of dealing w/ enforcing its own laws WRT illegal immigration.

 

here's an article from Dallas:

http://www.snopes.com/politics/immigration/parkland.asp

 

 

The biggest hurdles to UHC in America are

1. Tort reform. Malpractice insurance is outrageous.

2. Immigrant reform. Enforce laws already on the books. I would go so far as to deny dual citizenship to someone who is born in the country if their birth was during the course of a CRIME --illegal immigration. See snopes article above. Sincere Q: do other countries offer dual citizenship to babies born to illegal immigrants?

3. Keep it voluntary. You don't need to require every citizen fund it or participate in it. Countries do a UHC system w/ far fewer people than we have.

[mom2att]

The price you see on your bill for any individual item ($20 Tylenol or whatever) is simply the price of that particular item. You pay for the item, the doc who prescribes it (yes, even nonprescription items in hospitals need doctors orders) pharmicist who dispenses it, the tec who stocks the pyxis (med drawer), the nurse who checks the order, grabs the pill & makes sure you're the right patient, don't have an allergy to this med and it is given in the right form, then walks it to you, listens to you complain, etc. Hospitals, like any other business have overhead that must be factored into the cost of any individual item.

 

Then why do some health care providers have a separate pay scale for self-pay patients? Before we had insurance, my ped would charge me 40% less for appointments and vaccinations, because that's what the insurance companies actually PAID as opposed to what they were CHARGED. This is the game that I'd like to see addressed in healthcare reform.

[MeanestMomInMidwest]

Then why do some health care providers have a separate pay scale for self-pay patients? Before we had insurance, my ped would charge me 40% less for appointments and vaccinations, because that's what the insurance companies actually PAID as opposed to what they were CHARGED. This is the game that I'd like to see addressed in healthcare reform.

Insurance companies negotiate prices with healthcare providers. As do Medicare & Medicaid.

Insurance Co's have the power to negotiate lower prices because they will give that healthcare provider "in network" status or whatever (maybe preferred provider, depending on Ins Co's language), thus more of their members will choose said healthcare provider. Healthcare provider knows volume will make up for the lower negotiated price.

In the case of Medicare/Medicaid, the healthcare provider doesn't have a choice. They must accept the lower payment for those patients covered under Medicare &/or Medicaid.

You, as an individual also have negotiating power. I've done it, as referenced in an earlier post, for an astronomical bill received when I was uninsured (but still had assets upon which a creditor could place a lien). I also negotiated a cash price for the birth of my daughter, which was lower than the billed price, but more in line with what Insurance companies negotiated & paid. I hope this answers your question.

[TXMomof4]

we have a number of illegal immigrants coming over the border from Mexico. I'm not saying we should close our borders, but it does have an economic impact on our country, particularly on the border states. They do not have jobs, are very poor, have a difficult time obtaining jobs, and they're generally uninsured. Yet they still demand a share in our economy and will require health care. However, by stating this I am not in any way trying to be an isolationist or exclude people from wanting to improve their circumstances. The U.S. has always been a country of immigrants; during WWII, to our shame, we didn't open immigration enough, in my opinion, to Jews fleeing Nazi Germany. I think it's a different issue with Mexico, though. I think any steps the U.S. can take to help Mexico strengthen its own economy will benefit not only their population, but help prevent the overflow of illegal (not legal) immigrants who come over the borders daily. Who comprises the majority of Canada's immigrant population?

 

Anyone from Texas or other border states care to comment? Does this impact your local economies? I might add that because each state in the U.S. contains such a unique population base, I think we would be well-served to have a system in which each state could determine for itself how to best set up a health-care system for its state. What works for Washington, D.C., may not necessarily work for the rest of the country.

 

Remember, I never stated that I am completely against all forms of UHC; in my original post I stated that my father, who is very conservative, was friends with a gentleman from South Africa who said that their health-care system was great: he had good doctors, good coverage, it didn't cost the taxpayer an arm and a leg, etc.

 

My comment about the difference between immigrant populations is a sidebar issue, but I do think the immigration issue along the U.S./Mexico border impacts our economy, and I think it's fair to say that UHC in the U.S. may take a different form from UHC in Canada.

 

 

Take a look at Parkland Hospital in Dallas to see how immigration affects medical care. The hospital is bordering on bankruptcy ALL THE TIME because it is a public hospital and is required to treat someone if they need treatment. It also happens to be one of the best hospitals as far as advanced medical treatment goes, but it's almost impossible to get an appointment in a timely fashion because they are overrun with illegal immigrants. Their patients don't qualify for Medicaid or the state health insurance because they aren't citizens, so they take advantage of the ER at Parkland for everything from a cold to life-threatening illnesses and injuries.

[Peek a Boo]

Take a look at Parkland Hospital in Dallas to see how immigration affects medical care. The hospital is bordering on bankruptcy ALL THE TIME because it is a public hospital and is required to treat someone if they need treatment. It also happens to be one of the best hospitals as far as advanced medical treatment goes, but it's almost impossible to get an appointment in a timely fashion because they are overrun with illegal immigrants. Their patients don't qualify for Medicaid or the state health insurance because they aren't citizens, so they take advantage of the ER at Parkland for everything from a cold to life-threatening illnesses and injuries.

 

it's not just Parkland either.

But here's the link i shared above:

here's an article from Dallas:

http://www.snopes.com/politics/immigration/parkland.asp

[Tracey in TX]

I see two misconceptions repeatedly brought up here.

 

1) universal health care means socialized health care. It doesn't.

 

2) universal health care means the government controls the care you get or limits your choices. It doesn't.

 

It does mean socialized care. Any belief otherwise is naive. The whole concept of UHC requires the government (aka taxpayers) to cover cost. This becomes socialized health care. If you follow the example of US military, it will limit choices and become one massive paper trail with limitations.

[Heather in Savannah]

I've held off for 2 days now, but can't resist any longer. I think that what I am hearing is an assumption that UHC would resemble the current system provided by the US Military, Medicare or Medicaid. It doesn't have to. As many people have suggested, each country that has UHC has crafted their own version which works best for their people. In Canada, each province manages it's own healthcare, so you might have 10,000,000 people with access rather than 250,000,000. Bringing it down to a State/Provincial level makes for more accountability and manageability.

I am also hearing fears that people will be co-erced into seeing Dr.'s or having treatments they do not agree with. That does not happen in Canada. You see either the specialist your Dr. feels in the best in the field or one of your choice.

I am hearing fears about the increase in taxation due to UHC. I am living in the USA. If I take our current US tax rate, add the cost of Insurance Premiums(IF we could qualify) it basically equals the tax I would pay in Ontario. However, in Ontario, I would not be paying a co-pay or a deductable on top of that amount. In Ontario there is no middle man(Insurance Company) dictating which procedures I can or cannot have....if my Dr. recommends it, then I am scheduled.

What I am seeing in the US is to many people scooping a portion of the medical payments, whether it is self-pay or via insurance. The Dr. needs to earn a living (same as Canada), the Hospital needs to make a profit, the Radiology clinics need to earn a profit, the insurance company and the broker who sells the insurance. In Ontario, Hospital's are given a budget by the province to cover their operating costs....the other services bill the Government for each service. The patient is never left haggling with the government to have bills paid.

So, I could say lots more, as this is a huge topic, but I'll shut my mouth for now. LOL!

[nmoira]

 

The price you see on your bill for any individual item ($20 Tylenol or whatever) is simply the price of that particular item.

I would be more inclined to believe this except if these items weren't among those either reduced in rate or written off entirely between the raw billing and the insurance settlement. When I had my first child, the initial bill (the one that would have gone to an uninsured patient) included $150 for a bag which contained: OTC stool softener, a brand of painkiller I couldn't even take because I'm on anti-coagulants, some wipes, a peri-bottle, and some personal lubricant.

[nmoira]

What I am seeing in the US is to many people scooping a portion of the medical payments, whether it is self-pay or via insurance. The Dr. needs to earn a living (same as Canada), the Hospital needs to make a profit, the Radiology clinics need to earn a profit, the insurance company and the broker who sells the insurance. In Ontario, Hospital's are given a budget by the province to cover their operating costs....the other services bill the Government for each service. The patient is never left haggling with the government to have bills paid.

So, I could say lots more, as this is a huge topic, but I'll shut my mouth for now. LOL!

I'm a Canadian living in the US. We are fortunate to have very good medical insurance relative to our friends, but on top of monthly premiums (about $70), we have to budget an additional $2000 per year in our Section 125 plan for anticipated medical expenses. Only $600 of this is drugs. We're out of pocket before taxes almost $3000 per year, and after taxes (we inevitably underestimate expenses) another few hundred. Where we are lucky is that our maximum family out of pocket is about "only" $5000 per year, so we don't have to panic about finances if someone falls seriously ill. Coming from a system that mitigates at least the health portion of the financial worry, I cannot imagine the anxiety of those who not only have to deal with lost income, but also exorbitant medical expenses when a family member falls ill or is hurt.

[Heather in the Kootenays]

 

And finally, I wonder what would happen world-wide to healthcare should the U.S. go to a UHC system. It's just my personal conjecture, not something I've taken the time to research to any extent, but do the UHC countries benefit from the free-market U.S. system? It's been the argument of capitalism that free markets encourage new developments by making research profitable--is this true in the healthcare industry? Are the new drugs, new procedures, new equipment being developed mainly in the U.S., or am I totally off base on this?

 

Firstly, I think there is an argument to be made that not all new drugs and procedures really benefit the public but that's a discussion for another day.

 

Why would UHC affect product development? People and hospitals would still be buying medication etc. I haven't researched this either but I believe that many universities do the initial research into new drugs and leave the private sector to commercialize them. Either way, I don't see why it would change.

[keptwoman]

And finally, I wonder what would happen world-wide to healthcare should the U.S. go to a UHC system. It's just my personal conjecture, not something I've taken the time to research to any extent, but do the UHC countries benefit from the free-market U.S. system? It's been the argument of capitalism that free markets encourage new developments by making research profitable--is this true in the healthcare industry? Are the new drugs, new procedures, new equipment being developed mainly in the U.S., or am I totally off base on this?

 

Universities and research institutions all over the world create and research new drugs/procedures/equipment. The money for this will still be there because there will still be a market for them. And companies who want to make big money from the new drugs/equipment. I think a lot of it does happen in the USA simply because of population size but not all of it by any means.

 

The biggest hurdles to UHC in America are

1. Tort reform. Malpractice insurance is outrageous.

2. Immigrant reform. Enforce laws already on the books. I would go so far as to deny dual citizenship to someone who is born in the country if their birth was during the course of a CRIME --illegal immigration. See snopes article above. Sincere Q: do other countries offer dual citizenship to babies born to illegal immigrants?

3. Keep it voluntary. You don't need to require every citizen fund it or participate in it. Countries do a UHC system w/ far fewer people than we have.

 

1/I totally agree with point 1. It is outrageous and I do think that you guys have a litigous society and that would need to change for it to be possible.

 

2/ To answer your question. No babies born to illegal immigrants or even legal immigrants on on work or study visas rather than permanant residence do not get citizenship in NZ or Australia. I'm really shocked that the US does actually!!

 

3/ I was wondering though, if you had a voluntary system would it only be the people who couldn't afford your current system who joined i.e the poor/retired etc? Because surely part of universal health care is that to a certain extent the more affluent help make it possible to pay for the less affluent.

[MeanestMomInMidwest]

I would be more inclined to believe this except if these items weren't among those either reduced in rate or written off entirely between the raw billing and the insurance settlement. When I had my first child, the initial bill (the one that would have gone to an uninsured patient) included $150 for a bag which contained: OTC stool softener, a brand of painkiller I couldn't even take because I'm on anti-coagulants, some wipes, a peri-bottle, and some personal lubricant.

Sorry...in my post I meant to say "the price you pay is NOT simply for the individual item" then went on to list every hand that is in the pot. My point (obviously not well made with the omission of the negative) is that hospitals have overhead, expenses, employees, etc., so out of necessity individual items have additional costs built into them.