The big debate. America is one of the only countries in the world which does *not* use a version of the SHC, and Obama is in favor of it. So am I. Naturally, Americans are in an uproar about it. Mostly, because they don't understand the benefits, which far out-weight the downsides. And while I can appreciate both sides of the fence, I think it's important that people know all the facts.
Dr. Steve wrote an interesting piece on this the other day, and I have to say that I liked his analogies, because they make a lot of sense. You wouldn't want the government telling you what kind of house you can/can't buy, so how is there any difference in private health care?
But there is also the issue of the ridiculous fees attached to private health care. Which leads to the phrase I found in this article from the Associated Press, in which Britains are expressing their outrage over criticism from Americans about their health-care system.
My favorite part was the "Land of the Fee" play on Land of the Free.
Evy just had a round of dentistry over the past few weeks to remove one of her teeth. She spent several weeks in and out of the dentist. X-rays, lab work, couple of fillings on other teeth, and eventually they decided to pull this one rather than try to do a root canal. After all was said and done her total bill was 160 leva. That's about 120 USD.
We did the math on what it would have cost us, without insurance, in America, and the cost for the work she had done was well over 5 thousand USD, including office visits.
I'm sorry, but there is no comparison. While I understand there are pros and cons to each system, I don't agree with the mentality that "you can't put a price tag on the worth of your health", because all that leads to is the "Land of the Fee" mentality, which is where private medicine has arrived at in this day and age. The cost of insurance, office visits, medication, and otherwise, far outweigh the benefits of having private medicine. And while it's true that there are downsides to socialized medicine/health care, like longer lines and less personalized attention in *some* cases, you have to admit that a great many Western countries, including Britain, have been using socialized health care for years, to great avail.
Personally, I'm for socialized medicine. I think it's great that doctors and such be able to make a fair wage for what they do, because keeping us healthy is an important job, but I don't agree that doctors and health care in particular should be costing people an arm and a leg.
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We can agree to disagree, I think. I've lived in a country with a National Healthcare system for most of my life (Canada) and I much preferred the U.S. system for the four years we lived there - this part is important - as I *had* insurance which I paid through my work.
Without insurance, I may have had a different view; Which only makes sense, as my wife had a difficult first pregnancy which required us to visit a specialist and have ultrasounds once a week.
I believe I paid (in 2002/2003) about $4k for a family of three for full coverage (health, dental, vision, drug coverage, etc). The plan was very nice - 90% of all drug costs were covered (name brands of drugs, not generic - generic could be covered @ 100% if it was cheaper than name brands), glasses/contacts/eye appts were covered (1 eye appt/year, roughly 1 set of glasses a year or 12 months of contacts), etc. We also had a copay of $10 I think to visit our doctor. This was all an HMO, which I found to be very good (I never had a PPO, so I can't really comment on those).
I can compare this to the Canadian system; For Alberta Health Care, monthly premiums for my family were $88/month; Essentially this covers hospital care/clinics/etc (not drugs/vision/etc). If the province hadn't removed premiums for everyone, then my work would be paying it monthly for me. I also pay into separate health coverage here (about $2k/year) for vision/etc. plus expenses for *other* care (ie. if I go to a hospital, the Insurance Co. will cover up to a certain $ amount the cost for a private room instead of a semi-private or shared one); I choose what kind of coverage myself, it's not dictated to me by the government. So my costs are much less than in the U.S. then, for better care, you might think, right?
In my opinion - it's a VERY grey area. Again, I'm only speaking of my experience - in the U.S., if I was ever ill, I went to the local clinic, paid my $10 (or $15, now I can't remember) co-pay, and saw my doctor almost immediately (usually with 10-15 minutes). A referral? Sure, we'll refer you. You can pay another copay, and you can go see this specialist (/scribbles on paper) here tomorrow afternoon.
In Canada, when I make an appointment to see a doctor, I'd generally take the entire morning or afternoon (or even the whole day) off from work, as I could never be sure if I'd get in or not! In large cities, waits for 3-4 hours aren't uncommon. And if I need to see a specialist? Yup, you can - in 6 months, when there'll be an opening for an appointment.
Don't get me wrong - I've had excellent care here too (two large surgeries, one at 15 and the other at 17) that I couldn't rave enough about for the quality of care. The problem is that the quality of care I remember from 15 years ago is not longer the quality of care I see now when my kids need it. And that scares me, as our system is spread so thin that I don't believe it will take much to give it a push and tip it over completely.
Is it desirable to be able to give medical care to all citizens? Of course it is! But is it the governments role to do so? I don't believe so. Heck, government can't even balance it's books - and suddenly they think that they can control and improve on Healthcare?
I'm skeptical.
Well I can see both sides of the fence. I think it also depends on which country you are in, as well, as different countries have varying levels of acceptable care.
Here, for example, there are specific hospitals and offices that you just don't visit if you want quality care. Why? Because the more modern hospitals will have quicker reception, more caring nurses/doctors, and better equipment.
I think any person's view of American health-care will largely depend on if their health-care was covered by their employer, or if they were paying out of their own pocket, or had no insurance at all. I went most of my young adult life without insurance, because my employer didn't cover it, and I was *nailed* to the point of bankruptcy when I had my congestive lung failure in 2002. I'm talking over 20k in fees.
Here, if I have an issue, I go in, and while I might have to wait in line, at least I'm getting personal care without it chewing through my entire saving's account. And I don't have to pay some insurance company on the off chance I get sick.
For me, my financial security outweighs the long lines and potentially less personalized care (which we've yet to see. But we also know which places to go to get the "good" care).
Again, I see the pros and cons for both, but I think most Americans are making it out to be a bigger deal than it actually is.
That's cute..."Land of the Fee"! I like it.
I wonder if a fee-for-service private dentist could have save Evy's tooth. Is it worth it to save a tooth? How much is it worth?
[Don'r fret over it. What's done is done, water under the bridge.]
I wonder if the dentist's recommendation to pull the tooth were based on how HE was paid by the government.
I wonder if the bureaucrats in the capitol had called him the week before and said, "Hey, you're doing way too many root canals and crowns. You're gonna bankrupt us. You cut back, or we'll cut your salary, maybe fire you."
[A socialize medicine provider IS NOT going to share this information with you unless protected against lawsuits and other retribution.]
I will not trust my healthcare to politicians and government bureaucrats, ever. I know them all to well.
My position probably sounds self-serving since I practice fee-for-service medicine in the U.S. But I'm going to get sick some day, as will my loved-ones, and I want control over the care we get.
How do I get control? It's the Golden Rule: He who has the gold makes the rules. If the government has the gold (my tax dollars), it makes the rules.
When I pay premiums to an insurance company, they have my gold. But I can fire them if they do me wrong. Or sue them.
Ever try to sue a governmental body? Not advisable: they have endless resources - your tax dollars - to pay for their lawyers.
For those who have no gold right now, 1) start saving for the inevitable health breakdown, 2) get a job with health benefits, 3) buy your own catastrophic health insurance policy ($3000 USD deductible Health Savings Account in the U.S., for example), 4) depend on charity and friends/relatives, or 5) depend on the public safety net we have in the U.S., e.g., Medicaid.
Can we still be friends?
-Steve
=)
Like I said, I can definitely see both sides of the picture.
You both bring up good points, and I think it's absolutely a poignant issue for a lot of people. That's why I linked your post, Steve...as someone who practices private medicine I feel you have some of the most valid views on the subject. If there is one person who could sway my point of view, it would be you :)
In the end, I do know there quite a few people coming over here from Britain, even, because the dentists here are even cheaper than in the UK. There are also some soccer players from the US who made a splash a few years back because they came over here for dental work that was going to cost them something like 60k in the US but cost them only a couple of k here.
For many people it's simply a matter of dollars. I know I've been bit in the ass by private medicine, so I have a slightly jaded viewpoint in favor of socialized medicine.
I know for Evy and I we have been discussing setting aside a separate bank account purely fore retirement/medical funds, because we know for a fact that when we get older we won't be relying on anyone but ourselves for retirement/medical expenses.
We actually *just* discussed it earlier today out on our daily walk, lol :)
I'm fully in favor of "medical tourism," as long as people do their "due diligence." It's the free market at work.
I live in Arizona. I've seen people cross the border into Mexico to get bariatric surgery because it's half as expensive there. [These people are paying out-of-pocket - if insurances is paying, they stay here.]
In fact, there's a surgeon here who also has a bariatric clinic in Mexico. He operates here and there. He and the patient can do the operation in Mexico, and follow-up clinic visits here!
I'm not exactly sure why bariatric surgery is cheaper in Mexico. Could be monetary exchange rates, but I think other factors more likely: less bureaucracy (lower overhead), fewer trial lawyers, lower overhead, etc.
Something James brought up which I think is something I personally haven't thought about is kids. If we had kids I think Evy and I might be a little more leaning towards the fee-for-medicine way of things. Then again, I watched my father get West Nile and develop encephalitis of the brain (is there any other kind? Not a medical professional) as a side result, and my parent's insurance rates went up from 300 dollars a month for the two of them + my young brother, to over 2k USD PER MONTH!!!!!!
I find that to be ridiculous. Was it his fault that he developed the sickness? Why is he being penalized by the system for something that is out of his control? Meanwhile the illegal immigrants coming into America are getting FREE HEALTHCARE from the government because "well we can't discriminate against minorities".
My dad actually joked about going in with no ID and pretending he can't speak English so he can get free care.
The system in America is broken, I think. It has its good sides, but right now the greed/unbalanced/unchecked way of things is beyond ridiculous. Then again, I have a unique view of things because I've seen the absolute worst side of things, while others have only dealt with the good.
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