a preview of universal health coverage

[Shryke]

Universal Health Care is no different then Universal Education. There's both moral and economic and social and so on reasons why it's a good idea. There's no reason not to mention all of them.

I think you'll find most people can't understand why you'd support one and not the other. Though if you support neither, I'd say you were at least consistently insane.

[sToNED_CAT]

[quote name='Chataya de Venoge' post='1685258' date='Feb 12 2009, 23.11']Those are pretty much my thoughts on the matter, and for those who say that we are looking at being fucked French Revolution style by 15% of the country not having health insurance...think of the reverse - think of what happens when you have 40% of the country paying 100% of the taxes, which funds programs for "everyone" (but primarily the 60% who aren't paying taxes). There is a strong incentive to leave, or at least for [i]their capital[/i] to leave. That kind of tax burden and its distribution is what we're looking at if we implement UHC, per the [i]Economist[/i], so it's not something I'm pulling out of thin air.
That drain of capital is going to be great for developing nations with a rising demand for goods and services - not so much for the US. Stagnation will develop - what else happens when your capital leaves and you're trying to pay for these wonderful programs without anyone to fund them?[/quote]

No one says the UHC must be financed by progressive taxes. Surely Canadian model works that way, but in other countries it's done by payroll taxes (at least for working people). Savings are achieved by having 1 single insurer plus laws limiting expensive tratments. That means US employers would still pay healthcare for their employers, just much less (let's say half) than today, and they will pay to some kind of state fund instead of private one. Ther would be no need to increase the taxes to insure retirees, kids and unemployed, because if reduction of healthcare costs is achieved current Medicare and Medicaid $$$ might be enough to cover them.

[Sariel]

I find this belief that UHC would become such a government behemoth odd.

Now, as I wont to do in these cases where comparisons are in order, I'll bring up the norwegian system which works fairly similar to the other european UHC systems.

The individual doctor decides what treatments are necessary and writes out the prescriptions necessary for the patients. The hospital takes the cost for this. Naturally, more expensive procedures are considered by more than just the doctor. Now, people seem to fear that ridiculous surgeries such as the penis pump for an 80 year old bachelor would automatically go through such a system, but my experience is that it's the other way around. The hospitals do not have unlimited access to money. They receive a certain amount of money from the ministry of health every year based on negotiations between the hospital and the ministry. So they have to be careful with their finances too.

So the professionals decide what to spend money on, but the elected officials ultimately decide how much they get to play with. Thus the voters can influence the health care system through voting and the politicians will not be as able to throw money out the window, they're not the ones actually spending it.

If you feel that you're not getting the treatment you deserve, you can complain your case to the ministry, or, failing that, you can take it to court.

Then there's also a series of private clinics who can do whatever you want them to do pretty much, if you can afford it.

To use an anecdotal example. My grandfather got a serious infection on both eyes. One was much more serious at the time than the other, though both demanded extensive surgery. The first eye got operate on about a month after it was discovered. The second eye, not being as urgent, was set to be operated six months later. During those months he would go in for several checks to make sure the surgery became more urgent. Now, my granfather could've waited, but he found the weakness of one eye unpleasant, and didn't want to use an eye patch, so he got the other fixed at a private clinic. The government took some of the cost, but most he paid himself..

I just don't see how such a system could not work in the US. Are all your professionals spineless?

[Ormond]

[quote name='Chataya de Venoge' post='1685258' date='Feb 12 2009, 22.11']I've heard a lot of "it's the moral thing to do" to offer UHC, and that we shouldn't be overly concerned about cost. Governments don't, and I would say SHOULD'T, operate on moral principles. To do this is to allow governments to pick and choose which moral principles to operate under....do you want government dictating what is morally right? I'd rather that government focus on what it (and we) can afford.[/quote]

I agree with you that government shouldn't do anything it could afford. And I understand that there would be troubles if China refused to lend to us.

I just completely disagree that moving to universal health insurance coverage in the United States would necessarily result in either of those things happenning. I reject the idea that there is something so special or different about the USA that we cannot afford to have a universal health insurance system that would avoid those dire consequences when every other developed country in the world seems to be able to do it. In other words, our disagreement is that I believe that we definitely CAN afford it.

[aeu]

[quote name='Lord O' Bones' post='1684930' date='Feb 12 2009, 19.08']I am not rich. I have ridiculous health coverage. I went to a Stanford doctor for an allergy test and payed out of pocket 20$. It's nice. It's also why I choose to work at this company for relatively low wages for this field. This situation would not change with a basic level of universal healthcare. All of us with good jobs and good healthcare have nothing to worry about. Quality healthcare benefits will always be an effective way to get and keep quality employees. I just don't see what everyone is so afraid of.[/quote]

This just confuses me. If what you say is true, than all the arguments about a single buyer & bargaining power radically cutting drug prices are moot, no?

Is there a concrete proposal on the table (and preferably an explanation in relatively simple terms)?

[Kel]

All I know is our health system as it currently stands sucks ass. It is not set up or designed to help anyone really. I worked in the field for 15 years so I know what I am talking about here. Doctors are forced to prescibe according to formularies, whether or not it is actually what is best for the patient. Patients cannot have simple tests unless they meet certain unattainable criteria, the insurance company would rather pay (or say they would) for you once you are sick, but refuse to pay for preventative measures that would save millions of dollars each month. Once you are deathly ill, you find out that your insurance still won't pay for what you need.
As you get older, you cannot afford the life saving medications needed, because medicare sucks ass. If you make too much in your hard earned social security, you cannot qualify for medicaid either. Insurance will cover Viagra (because god forbid a man cannot get it up when he is 80), but it will not cover birth control. You can barely get someone qualified to have an MRI on an injury before they are supposed to have surgery. Being self-employed now, I cannot afford health insurance. If i am lucky, I can get some cheap ass policy that really does not cover anything and only looks good on paper. And do you know that there are actually people who want insurance companies to stop paying for mammograms and prostate cancer screenings? Ridiculous.

So tell me, please, how private insurance is so fucking wonderful?

[LindaElane]

The national health was a mixed bag. I liked my GP a great deal. Average wait time was 45 minutes. I paid only a nominal amount - perhaps ten dollars - for prescriptions.

I was given a CBC as part of the standard once in a lifetime intake procedure to the system. My NHS doctor kept following up and got me on statins, something my US doctors never did. They would just say to try to do better and check back next time. Then, when I did come in again for something they didn't check my blood.

My NHS doctor got to wear a yamuke, daily, to work.

I was told that I'd get mamograms every five years and pap smears every three, IIRC. Otherwise such checks were not covered. I could not help but wonder if that was pence wise and pound foolish. Don't a lot of women have to be treated for cancer who otherwise would not have needed expensive treatment if they had had preventative care?

The NHS also do not do the preventative things I had come to consider "normal" in the States. For example, we normal have our weight and blood pressure checked before the doc comes in. There, you go to a medical office with many doctors, and go straight into your doctor;s small office, which consists of a room with a desk and a computer. No exam table - they are in another room if needed.

I did hear that, for example, British citizens over sixty needing a kidney cannot get a transplant and are allowed to die.


I didn't learn as much as I would have liked to because I felt I would be asking too many personal questions if I quizzed friends and aquaintances about their experiences with the National Health.

[Security Squish]

[quote name='LindaElane' post='1686542' date='Feb 14 2009, 01.13']I did hear that, for example, British citizens over sixty needing a kidney cannot get a transplant and are allowed to die.[/quote]

Who did you hear that from? I'm also suprised that the British haven't learned how to do hemodialysis, or live with one kidney like Americans.

[Maltaran]

[quote name='LindaElane' post='1686542' date='Feb 14 2009, 06.13']My NHS doctor got to wear a yamuke, daily, to work.[/quote]

This seems a bit of a non-sequitur - I'm sure American Jewish doctors would also be allowed to wear yarmulkes.

As for the mammograms every five years, I assume you're under 50? I believe that over 50s get annual checks (I may have the cut-off age wrong, but older women do get more frequent scans).

[Hereward]

[quote name='LindaElane' post='1686542' date='Feb 14 2009, 06.13']The NHS also do not do the preventative things I had come to consider "normal" in the States. For example, we normal have our weight and blood pressure checked before the doc comes in. There, you go to a medical office with many doctors, and go straight into your doctor;s small office, which consists of a room with a desk and a computer. No exam table - they are in another room if needed.[/quote]

You do realise that GP surgeries are small businesses and therefore are all different, right? Just because the surgery you went to didn't routinely do blood pressure checks and had no exam table, doesn't mean that every surgery doesn't do blood pressure checks and has no exam tables. My surgery has both, as have most of the others I've ever visited.

[quote]I did hear that, for example, British citizens over sixty needing a kidney cannot get a transplant and are allowed to die.[/quote]

Well, if you heard it it must be true. Of course, the UK Transplant Authority [url="http://www.uktransplant.org.uk/ukt/about_us/about_us.jsp"]disagrees [/url]with you and says that 11% of all kidney transplants are conducted on patients over 60.

Sometimes I wonder just what country you actually visited.

Edit: Changing 17% to 11%, 'cause the kidneys and the liver are different things, as someone who drinks as much as I do should know.

[GoN]

[quote]My NHS doctor got to wear a yamuke, daily, to work.[/quote]

Why wouldn't he? :unsure:

As for pap smears, I guess it calls into question the whole money/trust issue. Do doctors in the US want you to get a yearly pap because you should, or because they want to bill you for it? Its every 3 years on the NHS, unless you've had an abnormal one, in which case its every year- and you can always pay about 60 quid for one if you feel you need it outside the NHS. I know women in the US who have never had one because they have no insurance, but exceed the income requirement for their local Health Departments, a catch 22 many people find themselves trapped in, in the US.


There's some more information [url="http://cervicalcancer.about.com/od/screening/a/screeningguide.htm"]here[/url] about how often you should get a pap. Seems 2-3 is the standard for women over 30 in the US, anyway.

And more [url="http://www.cancer.gov/cancertopics/factsheet/detection/Pap-test"]here[/url].

[quote]Women should talk with their clinician about when and how often they should have a Pap test. Current general guidelines recommend that women have a Pap test at least once every 3 years, beginning about 3 years after they begin to have sexual intercourse, but no later than age 21. Experts recommend waiting about 3 years after the start of sexual activity to avoid overtreatment for common, temporary abnormal changes. It is safe to wait 3 years, because cervical cancer usually develops slowly. Cervical cancer is extremely rare in women under age 25.[/quote]

[Aemon Stark]

[quote name='LindaElane' post='1686542' date='Feb 14 2009, 02.13']I was told that I'd get mamograms every five years and pap smears every three, IIRC. Otherwise such checks were not covered. I could not help but wonder if that was pence wise and pound foolish. Don't a lot of women have to be treated for cancer who otherwise would not have needed expensive treatment if they had had preventative care?[/quote]

A nitpick, perhaps, but pap smears and mammograms are screening tests not preventative care. If you're in a higher risk group for cervical and/or breast cancer, then you will receive more frequent screening.

[quote]I did hear that, for example, British citizens over sixty needing a kidney cannot get a transplant and are allowed to die.[/quote]

If something sounds too ridiculous to be true, it probably isn't.

[Shryke]

[quote name='Chataya de Venoge' post='1686788' date='Feb 14 2009, 13.20']Sometimes I wonder what country some of the other people who claim to be living in the States are in, as well :)[/quote]

The poor part?

[IheartTesla]

According to [url="http://en.wikipedia.org/wiki/Medicaid"]wikipedia[/url], 60% of poor Americans are not covered by Medicaid. In other words, people who should qualify for it.

At any rate, if you lose your job in June, say, your yearly income is half of what it used to be. But it may still not be low enough to qualify you for such programs. You will then be forced to buy insurance for yourself from predatory insurance companies with minimal coverage at exorbitant rates. I would be all for a safety net that allows jobless individuals and poor folk to get some kind of insurance.

[Andriy Czarchenko]

Soooo instead of paying for the drug in US she would have had to pay for it in NZ? What´s the point of that article? UHC sucks because she´d still have to pay for some of the treatments she currently pays?

[Swordfish]

[quote name='The Czar' post='1686913' date='Feb 14 2009, 13.40']Soooo instead of paying for the drug in US she would have had to pay for it in NZ? What´s the point of that article? UHC sucks because she´d still have to pay for some of the treatments she currently pays?[/quote]

It's an example that illustrates how politics and political pressure can play havoc with they system, and how people are all to happy to go along with having treatments or drugs being restricted until it happens to something they personally need.

The impact of that influence on UHC in this country would be disastrous.

[Shryke]

[quote]2. Decisions are not necessarily made logically[/quote]

:rofl:
Your current system makes decisions based on money. How much it costs, how much we can make, etc.

Although I guess that could count as "logical" by some definition.

[Swordfish]

[quote name='Shryke' post='1686923' date='Feb 14 2009, 13.52']:rofl:
Your current system makes decisions based on money. How much it costs, how much we can make, etc.[/quote]

I don't think you necesarily understand how group health coverage contracts are created.

[Maltaran]

Chat, your points 1 and 3 are IMO non-issues - there'll always be the option to pay extra for private treatment if you're not satisfied with what the government provides, this is the case in pretty much every country that has a national health service. I'll accept your point 2 is true, but the American system is similarly illogical - paying for everyone who needs emergency care, but not paying for check-ups and preventative treatment which would be cheaper, for example.

[Andriy Czarchenko]

[quote name='Swordfish' post='1686922' date='Feb 14 2009, 23.51']It's an example that illustrates how politics and political pressure can play havoc with they system, and how people are all to happy to go along with having treatments or drugs being restricted until it happens to something they personally need.

The impact of that influence on UHC in this country would be disastrous.[/quote]
We bitch about those things in our UHC all the time as people always want more and better. That doesn´t mean we wouldn´t fight against anyone who tried to take away almost anything from the current system.