BS: Nationalized Healthcare, good? bad?

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Charmion
Date: 14 Jul 09 - 03:20 PM

Another contribution from Canada, province of Ontario:

The Ontario Health Insurance Plan was introduced in 1965. I was eleven years old, and I remember that year as the time when our standard of living began a sharp upward trend. My mother had a chronic lung disease that had kept us poor; up to that point, we never ate anything that cost more than forty-nine cents a pound.

I have been a steroid-dependent asthmatic since my early 30s. In 1994, I suffered a retinal tear that required immediate surgery to ensure I would not go blind. Consequently, I have experience with both a potentially catastrophic injury and a chronic illness that requires constant management.

The eye problem was handled seamlessly and flawlessly by not one, but two world-class surgeons. One reason it went so well is that my city has a major teaching hospital that includes a world-class eye clinic. The other reason is that I recognized the grey shadow at the edge of my visual field as most likely the result of something wrong with my eye, so I went to my optometrist to find out what it was. I picked him because he has the equipment and experience to perform a basic retinal examination and, as a primary-care provider, he would see me without a referral. (Eye surgeons are not primary-care providers, and they don't see patients without referrals.) Sure enough, the optometrist knew an opthalmologist who saw me the next morning, and the first opthalmologist knew that my retinal tear was outside his area of expertise and sent me to the world-famous eye surgeon who fixed it within 12 hours. Total time from optometrist's office to eye surgeon's bench: 36 hours.

If we lived in the States, we would have needed a second mortgage on the house to pay the surgeon, but I walked away without so much as putting my hand in my pocket.

The asthma is a different matter. It is managed by me, with periodic consultation with my family doctor. In 20 years I have been assessed by a respirologist twice, once to establish that I do, indeed, have asthma, and once to establish that it is, indeed, getting worse as I get older. Thanks to 25 years of recurrent illness and the gentle, persistent nagging of my faithful family doc, I am extremely persnickety about: avoiding things that trigger attacks, taking all the medications as often as I should, and getting enough sleep, even when I would rather sing all night at the Getaway. I also go to see my family doctor whenever I catch a cold (as I do about twice a year, just like everyone else) because I know it takes only 24 to 48 hours to develop into bronchitis.

The asthma drugs cost me about Cdn$150 per month. Antibiotics run about $60 for each bout of bronchitis. I have never had any trouble getting into the doc's office; if he's jammed up, he will fit me in between people because he knows that I know exactly what's wrong with me. I get good results because (1) so far I am pretty good at figuring out what my problem most likely is, so I have not been subjected to the agony of protracted, expensive testing that doesn't produce diagnostic results, and (2) I follow the treatment plan religiously. It helps that my major problems are both common and treatable, and my family doc of 15 years is still on the job.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: John P
Date: 14 Jul 09 - 04:39 PM

Part of the problem is the US is that our business "leaders" were allowed to dismantle our economic system -- including health care -- by sending most of our jobs overseas. We have a health care system that depends on people having jobs. It's never worked for the unemployed and the poor, of course, but now it's also not working for the middle class. More and more people are out of work, and more and more employers are simply not offering insurance. We allowed a poor-but-sort-of-OK system to be dismantled, without requiring that anything be created to replace it. So now we have an even poorer system that's getting worse every day.

The whole concept of health care as a source of wealth for insurers and health care providers is absurd. The whole concept of having employers responsible for providing health care is absurd. The whole concept of having millions of children who can't go the doctor when they get sick is absurd. I say "absurd", but tragic is really a better word.

Another anecdote: a friend of mine needs a liver transplant. The hospital won't even talk to her about it unless she can show that she has insurance that will cover at least $500,000 toward a transplant, which is expected to cost between $500,000 and more than $1,000,000. The insurance she's been paying for for years only covers $250,000 toward a transplant -- in other words, they don't cover it (since she can't even make an appointment to talk to a doctor about it on that much insurance). She is scrambling to find supplemental insurance, but she has an extremely serious pre-existing condition. She will probably manage to get the transplant and stay alive, but she will also be financially ruined fro the rest of her life. Meanwhile, the insurance company executives, the doctors, the drug companies, and the owners of the hospital are all multimillionaires. How can anyone live with themselves when they are getting filthy rich while killing or ruining people?

I wish Obama was more ferocious about getting a real health-care system. The need to placate the wealthy - so they can get even more wealthy - is a real shame.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: artbrooks
Date: 14 Jul 09 - 05:55 PM

Doug, my apologies. Having been the target of a similar diatribe early in my experience on Mudcat, caused by my not knowing that the use of my name was reserved for another individual, I never use the simple "Art" here.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Ruth Archer
Date: 14 Jul 09 - 06:30 PM

"The asthma drugs cost me about Cdn$150 per month."

they cost me less than UK £5 per month. The other thing I realised during my mum's illness is that perscription charges in the US and even Canada can be pretty debilitating...

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Peace
Date: 14 Jul 09 - 06:37 PM

Prescription drugs in Canada are costlier than I can afford, so I just don't for the most part.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Emma B
Date: 14 Jul 09 - 06:59 PM

Now I'm 64 and 'jubilada' I get my UK prescriptions free - fortnately, I think I've only had one course of antibiotics in a 12 month period and I elect to buy non prescription drugs 'over the counter' although I'm eligible to receive these too.

As I'm also a 'country woman' my doctors surgery is, in addition. a dispensary so I don't have to travel to get prescriptions made up.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: kendall
Date: 14 Jul 09 - 08:51 PM

Any American who has traveled in Canada or the UK knows the lies our medical and insurance fat cats are telling us. They are frantic to save their cash cow so they lie and lie some more knowing the uneducated will believe them.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Rowan
Date: 14 Jul 09 - 09:27 PM

From reading the entire thread I get the impression that, while various Canadian jurisdictions have versions of a nationalised health care system, Britain's version is the one regarded as the benchmark. This may be because it was the first to become well known and because it attempted to 'go the whole hog', so to speak. Sandra is the only one to post on the Oz system, which used to be much the same as Britain's prior to the introduction of the NHS. It was costly for us low-paid people and I was glad to be covered by Melbourne Uni's arrangements with its health service and engagement with the three local hospitals (Royal Melbourne - largely built for US servicemen during WWII, Royal Women's and the Dental Hospital) and the Victorian Optometry College.

When the nationalised health care system was introduced by the Whitlam govt (nationally, as a Commonwealth program), almost the only objectors were the medicos, whose union (the AMA) complained bitterly about govt control of their salaries. This was largely a repeat of the nonsense from their BMA equivalents as described above. Originally, copayments were required only for specialists. When the conservatives (they call themselves Liberals) got back into govt they dismantled the universal aspects of coverage but these were reinstated when the Hawke govt got in. The conservatives weren't game to take on the electorate with a complete dismantling, when they got in, so we now have copayments for almost everything and a penalisation if you don't have private insurance.

That said, I've had a menisectomy, a couple of sessions with kidney stones, two kids delivered and brought up and a colon resection, all in public hospitals at no cost. I have a good relationship with my GP and Ophthalmologist, both of whom have kept tabs on me in hospital. crutches loaned, scripts, physio; all were provided as required and at no extra cost.

Another aspect of the Oz system is the control exerted by the Pharmaceutical Goods agency. Advertisements for specific medical treatments (including medicines) are not allowed in Oz and prescription medicines are assessed for inclusion in the Pharmaceutical Benefits Scheme; once included, most cost the customer no more than about $30 ($5.30, once you're officially an Old Fart) and, should you spend more than about $1500 in a year, you become eligible for further cost reductions. This has meant my expenses for long term treatment for glaucoma have been no more than $50 for the drops (now I'm an Old Fart, this has reduced to $10.60) and the copayment every six moths for the ophthalmologist. The govt covers the rest of the wholesale price of the prescription medicines and negotiates with pharmaceutical multinationals to cap the wholesale prices they wish to charge. Needless to say, the multinationals have tried every trick in the book to get rid of the Pharmaceutical Goods agency; the latest situation (introduced by the late and unlamented conservative coalition) was the removal of the most independent pharmacological academic from the assessment panel and have him replaced by a couple of "industry representatives". Even with this handicap, the system is still working.

But dentistry is still suffering from an 18th century view that it is not medical in nature so cannot be covered by the national health care system; the school-based dental service for schoolkids was dismantled by the conservatives when they were last in govt.

It costs me nothing for ambulance transport, even if I'm beyond the black stump, where the Royal Flying Doctor Service does it all.

Contrast this with my observations in South Carolina a few years ago. An African-American man died of a cardiac infarct because he lived in an area that was so poor it paid no County taxes; this meant the ambulance refused to attend, as it could not reclaim its expenses. A muso friend in Columbia has to spend an enormous part of her salary to deal with various optical problems even though employed in a govt funded agency (which the Governor is trying to close) and thus, presumably, covered by an employer-funded insurance policy.

Oz and a few other countries may not have contributed the same number of medical innovations as the US (although, for Oz at least, I'd put money on parity on a per capita basis, and most European countries innovated before the US existed) and I regard most of Scott Atlas' assertions -as posted by Ebbie- as mere jingoism but I reckon the health care I have access to as the equal of anything available east of the Pacific Ocean and, because the money I pay goes to the govt (and thus back to me in services available) rather than directly to those with a profit motive uppermost, I suspect it is more cost-effective across the whole community.

Cheers, Rowan.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Ebbie
Date: 15 Jul 09 - 12:12 AM

One of the infuriatingly brainless aspects of it is that for some reason, and time after time, we act as though we have to start from scratch, the wheel has to be re-invented every time. Why is that? Why can't a country look at the experiences in other countries and cherry-pick, so to speak? Why do we pretend that we know best?

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: DougR
Date: 15 Jul 09 - 01:24 AM

No need to apologize, artbrooks, it was my fault.

DougR

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: McGrath of Harlow
Date: 15 Jul 09 - 10:06 AM

It's not just in life-threatening situations that the NHS comes up trumps.

Like many of us my hearing's deteriorated a little with the years. So I've got a digital hearing aid for each ear, courtesy the NHS, completely free of charge.

On Monday the bit that holds the battery fell off, because the plastic hinge had worn out, what with getting opened and closed every day.

So this morning I called into the audiology department at my local hospital and asked the lady at the desk if they could fix it. "You'll have to have an appointment" she says, and clicks into her computer to set one up. "Will 11.15 be OK?" It was five past 11 at the time.

Though I must admit it was 11.20 before I was in fact seen.

There and then I was given a brand new digital hearing aid, programmed on the spot to match my prescription, and adjusted to fit on to my earpiece. Not a penny to pay, and no paperwork at all.

That's the NHS for you, the way it's supposed to work, and the way it does work does most of the time in my experience. So to anyone worried about "Nationalized Healthcare" what I have to say is, "Come on in, the water's lovely."

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: katlaughing
Date: 15 Jul 09 - 12:19 PM

My apologies if this has already been posted; it just came in my email and I thought it would be of interest:

Dennis Kucinich - www.Kucinich.us

Healthcare: Change the Debate
Support a Real Public Option

Dear Friends,

In mid-May, in an effort to reach consensus, President Obama secured a deal with the health insurance companies to trim 1.5% of their costs each year for ten years saving a total of $2 trillion dollars, which would be reprogrammed into healthcare. Just two days after the announcement at the White House the insurance companies reneged on the deal which was designed to protect and increase their revenue at least 35%

The insurance companies reneged on the deal because they refuse any restraint on increasing premiums, copays and deductibles - core to their profits. No wonder a recent USA Today poll found that only four percent of Americans trust insurance companies. This is within the margin of error, which means it is possible that NO ONE TRUSTS insurance companies.

Then why does Congress trust the insurance companies? Yesterday HR 3200 "America's Affordable Health Choices Act," a 1000 page bill was delivered to members. The title of the bill raises a question: "Affordable" for whom?.

Of $2.4 trillion spent annually for health care in America, fully $800 billion goes for the activities of the for-profit insurer-based system. This means one of every three health care dollars is siphoned off for corporate profits, stock options, executive salaries, advertising, marketing and the cost of paper work, (which can be anywhere between 15 - 35% in the private sector as compared to Medicare, the single payer plan which has only 3% administrative costs).

50 million Americans are uninsured and another 50 million are under insured while for-profit insurance companies divert precious health care dollars to non-health care purposes. Eliminate the for-profit health care system and its extraordinary overhead, put the money into healthcare and everyone will be covered, everyone will be able to afford health care.

Today three committees will begin marking up and amending HR3200. In this, one of the most momentous public policy debates in the past 70 years, single payer, the only viable "public option," the one that makes sound business sense, controls costs and covers everyone was taken off the table.

In contrast to HR3200 ... HR676 calls for a universal single-payer health care system in the United States, Medicare for All. It has over 85 co-sponsors in Congress with the support of millions of Americans and countless physicians and nurses. How does HR-676 control costs and cover everyone? It cuts out the for-profit middle men and delivers care directly to consumers and Medicare acts as the single payer of bills. It also recognizes that under the current system for-profit insurance companies make money NOT providing health care.

This week is the time to break the hold which the insurance companies have on our political process. Tell Congress to stand up to the insurance companies. Ask members to sign on to the only real public option, HR 676, a single-payer healthcare system.

Hundreds of local labor unions, thousands of physicians and millions of Americans are standing behind us. With a draft of HR3200 now circulating, It is up to each and every one of us to organize and rally for the cause of single-payer healthcare. Change the debate. Now is the time.

The time to act is now!

Sincerely Yours,
Dennis


PS - Over the next several months, I will be engaging all of you with frequent updates and will ask you to continue a movement to fight for what needs to be done now; ending this war in Iraq and stopping the escalation in Afghanistan, attaining true single-payer healthcare for all Americans, standing up for my brothers and sisters of organized labor.

After you have contacted your member of Congress, please tell us your thoughts and ideas on how you are organizing your friends and neighbors towards a single-payer movement and all of the other issues that are important to us.

Contact us at [e-mail]

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: DougR
Date: 15 Jul 09 - 01:18 PM

Kevin: Your hearing aid is not FREE. Your taxes pay for it. Nothing in life is free except maybe advice.

DougR

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Ebbie
Date: 15 Jul 09 - 01:29 PM

Doug, the point has been made over and over on this thread that nationalized health care is not free- but free at the moment you need it. Sit up and pay attention,if you please.
******************************

Has anyone else noticed the new television ads? They've been running in Alaska for at least a week, raising the alarm: "Can you trust Washington with your life?

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: McGrath of Harlow
Date: 15 Jul 09 - 02:44 PM

Obviously, everything has to be paid for. But "free at the point of use" is the point here. If I had to shell out hundred of pounds for a replacement hearing aid it'd be a real pain, even if I can do it. And there are a good few people who just couldn't. And when it comes to major medical treatment where it's not a cae of a few hundred but a lot of thousands

"Free at the point of use" makes sense. Road maintenance costs money. Running a fire service costs money. But it'd be a drag if every time you wanted to walk down the road outside your house you had to pay an admission charge. Or if your house caught fire you had to pay the firecrew before they could do anything about it.

It's the basis of private insurance of course - except there there's exclusions and exceptions, and paperwork to try to get payment agreed in advance, or to get back the money you've paid out.

Why make life harder for everyone, most especially for people who are sick and frightened? All for the sake of some ideological commitment to avoid "socialized medicine"?

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: GUEST,mg
Date: 15 Jul 09 - 06:31 PM

I think ultimately it will be good, but the transition to a single payer would probably be terrifying for many. I am glad they will keep some structures in place as they move toward some form of universal coverage. It is not totally broken; it is just not available for too many, some of whom could afford to pay at least something, just not the whole amount. We should try to extract a reasonable amount from every financially able person, on a sliding scale, depending on use etc. Nothing that would cripple them or ruin them financially, but bring in income and reduce recreational or unnecessary doctor visits.

There are tons of things that can be done. First of all, unless you have something really complex, a nurse educator can probably do a better job than many doctors. Some very easily-trained positions can be filled with unemployed people -- such as reception, maintenance, some medical records work, data entry etc. Also, easily-trained and totally monitored unemployed people could be used to provide some human contact and follow up for chronic conditions -- have you taken your blood pressure today, tested your blood sugar, gotten some fresh air, taken your medications. Monitored phone calls and perhaps home visits by lpns etc. could go a long way.

One thing that is not mentioned is the reduced stress that would come from knowing your extended family members would be covered -- for some of us we are OK but family members might not be, and how much could we have to chip in for their care?

We really need to address the extensive doctor use by some people -- some are lonely and in need of social contact. This could be satiated by people with an AA degree rather than an M.D. or RN. There could be group discussions for people with diabetes, or lupus, or kidney stones.

Again, lots of neighborhood clinics, employing as much as possible neighborhood people. Public hospitals in low-income neighborhoods with community colleges attached right there for training and education.

Better biology training in high school so people can move shovel-ready into LPN or RN or tech programs right after graduation.

It is really important to hire impoverished people right at the point of use. I remember working for a while at Harborview in Seattle, which serves many very low-income people. I was struck by the number of recent Etheopian and Etutrian??? immigrants who would come in pleading for any sort of work -- janitorial, groundswork, cafeteria.

Someone as smart as me and Obama can work all this out. We have sick people, unemployed people, ..here is a plan...the unemployed people can take care of the sick people. Win-win.

I am not one who sees all sorts of evil lurking in this system -- I just don't see a well-developed system is all. And we need health workers -- for prevention and encouragement and helping people watch their diet and exercise...these health works could get some sort of certification, again be closely monitored to see they are not dispensing actual medical advice -- but could go a long way in preserving health. And so much of health depends on the basics -- food and shelter and a crime-free neighborhood so you can go shopping, so stores will flourish in your neighborhood -- the linkage of crime to poor health has many aspects, which I will discuss at some point. If you can't get outside for fear of the young gang members, you can not get good groceries. You can not get exercise. You can not see your doctor or hairdresser or church group. You can not get Vitamin D, which is linked to so much. Someone needs to bring this to the attention of the ygm and ask them to cease terrifying their neighbors. mg

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: gnu
Date: 15 Jul 09 - 06:39 PM

Mum, 82 years old, is failing by the day. Eyesight, knees, hips, oldtimers... thank goodness we live in Canada. It ain't perfect, but it beats living in a country that don't give a fuck.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: McGrath of Harlow
Date: 15 Jul 09 - 07:12 PM

"...the transition to a single payer would probably be terrifying for many."

I think that's what is so puzzling to people who have lived most of their lives in such a system, and cannot envisage how it can be possible to cope with the idea of a set-up where you have to worry about whether it will be possible to pay for medical treatment you need - whether the insurance company will be willing to pay up, even if you are insured.

It sounds as if somebody has done a great job in persuading people they need to be terrified about changing to a system where those kind of worries are few and far between.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Ebbie
Date: 15 Jul 09 - 07:36 PM

I disagree that the system is not broken. People with unlimited disposable income can afford to pay as many buckets of money as they wish. But for the person who is living with one eye monitoring next month's mortgage/rent, the family's food budget, the children's school clothes, the occasional night out on the town or the annual vacation, and who is all too aware that if he or she loses the job it will all come crashing down cannot begin to afford the insurance costs each month for the whole family.

Even a single person can't afford it.

During college, my daughter worked as a temp for a really BIG insurance company and while she was there, the CEO retired. With a pension and perks that amounted to more than 35 million dollars.

That's a HELL of a lot of premiums.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: dwditty
Date: 15 Jul 09 - 08:35 PM

My problem with the status quo is that, for example, at the last company I worked for, I paid over $1100 per month for health insurance - and lousy coverage at that. High deductibles. $40 co-pays for medicing. (I have one medicine for which it is cheaper to pay cash tahn the co-pay to have insurance pay for it.) Obviously, this is a company that no insurance company wants for a client...and that is the rub. The insurance companies hold all the cards. If someone is risky - jack the price. Pay doctors whatever the hell they (the insuarance companies) want regardless of the bill. Access to health care should not be dependent (in my opinion) on whether a person works for company A or company B. Personally, I would like to see national helth, but that is just me. At the very least, the cost of medical insurance should be a level playing field.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Riginslinger
Date: 15 Jul 09 - 09:19 PM

The time for nationalized healthcare was before Hillary tried to get it passed the first place. The advertising budgets of the drug companies and private insurance companies are the only things that prevent more people from realizing that.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: katlaughing
Date: 15 Jul 09 - 10:22 PM

In the past three months we have spent over $700 extra for doctor visits and prescription copays for a bout with pneumonia; that's with health insurance. And, it will be more once i get the bill for the ER visit. It's extra money we don't really have. It might not have cost so much if the nurse practitioner who first saw me had diagnosed correctly and treated me aggressively. My doctor agrees with me on that. We went through a comedy of errors with the front office people, etc., and that is not the first time that has happened. I would be very wary, any more, of going to a less-than-a-doctor for any seemingly acute problems.

Whatever they do, it needs to be as simple and worry-free as possible for everyone and they need to do it NOW! My daughter works for a hospital collection agency - first collector, so there's no pressure, just get payments lined up. She knows people who have put their homes in trust to be sure that they don't possibly lose them if the medial bills get to be too much; she has even recommended it to some of her clients to help them out. That's just plain wrong to have such stress.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: GUEST,Chris B (Born Again Scouser)
Date: 16 Jul 09 - 12:07 PM

McGrath, as usual, is correct about the importance of the service being free at the point of delivery. However, the general argument here misses a very important point.

All the major social reforms of the last century or so, from the 40-hour week, paid holidays, free education, sick pay, old age pensions, equal pay for women, abolition of child labour and so on occurred not because those in power were persuaded by logic or morality. They occurred because they were perceived to be necessary in order to stave off revolution by a politicised, organised, class-conscious workforce.

Most of them were first conceded at a time when there still appeared to be an alternative way of organising industrial societies besides US/Western European style capitalism. In order to maintain the legitimacy of liberal-democratic capitalism, reforms like the NHS were conceded as a result of working-class struggle by a ruling class that saw conceding such reforms as a preferable alternative to the revolution they feared.

Now that no-one is talking about an alternative to capitalism the ruling class has no incentive to make any concessions for the simple reason that the bastards aren't scared anymore.

There is no mass, effective class-based political movement in the United States and so there will be no significant reform of the healthcare system.

And we'd better watch it in the UK as well.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: DMcG
Date: 16 Jul 09 - 01:11 PM

That doesn't strike me as a particularly accurate account of what motivated Bevan and co. More to the point, I doubt if that argument will assist those in the US who would like health reform to persuade the doubters.

But I will go along with your sentiment that "we'd better watch it in the UK as well".

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Q (Frank Staplin)
Date: 16 Jul 09 - 01:30 PM

The Senate sub-committee vote went strictly according to party lines. Unless Obama et al. can hold all of his Democratic congressional members together, which is doubtful, his proposals face a rough time.

The Democrats may be able to get some stopgap legislation through, but it looks like comprehensive revision will not be accomplished in the near future.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Don(Wyziwyg)T
Date: 16 Jul 09 - 02:58 PM

I have been a beneficiary of the British NHS since my birth at the beginning of 1941, and in the whole of that time I have received treatment (emergency, surgical etc.) completely free of charge, and I have never been asked to pay back one red cent of what that treatment cost.

Throughout my working life I have paid very reasonable National Insurance contributions fom my wages, so that others may have the same service.

There can be no possible system of healthcare which better serves the needs of both rich and poor without favour or bias.

It is only very recently that spectacles and (due to a reduction in dental practitioners willing to do NHS work)dental treatment have been placed largely outside of the NHS remit, and most of us can live with that.

If there is one thing I would change about the system, it is this. I would remove much of the bureaucratic superstructure, and place the budgets of health services in the hands of those who know how to spend them.......The DOCTORS.

That said, I am eternally grateful for the fact that my medical history has NOT left me with a huge debt to a rapacious bunch of moneygrabbing profiteers, which I would be utterly incapable of repaying.

Those who are happy with corporate insurance schemes such as Medicare are, I think, labouring under a delusion that they will always be covered. Experience of insurance (both buying and selling the stuff), leads me to suspect they will be very disappointed at some future time.

Don T.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Ebbie
Date: 16 Jul 09 - 03:25 PM

Don T, in what important ways does the NHS differ from the Medicare system in the US?

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: McGrath of Harlow
Date: 16 Jul 09 - 05:20 PM

The big difference from Medicare is that everyone is entitled to receive care under the NHS. Not just emergency treatment at hospitals, the lot.

As for the USA, I can understand why there may be people working for insurance companies, or getting money from investing in them, who would be scared of a change that might threaten their livelihood or their income. And I can just about understand that there would be some doctors and so forth who might be frightened of a change that they have been told might threaten their income and job security.

But why people whose only involvement with the health system is as patients or relatives of patients should be frightened, that is very hard to understand.

The propaganda put out by the insurance companies and such must be incredibly clever adverts to get people to believe that they should be frightened of change.

Belloc's words seem to sum up that attitude prettty well:

"Be sure to keep good hold of nurse
For fear of finding something worse"

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Ebbie
Date: 16 Jul 09 - 06:31 PM

I still don't understand the remark about Medicare. Everybody who has paid anything at all into Medicare eventually gets onto the Medicare rolls. There is a big difference in pay, it's true- ranging from the maximum (I think something like $3,000 a month) to the bare minimum (around $600, I think). Most of us come down somewhere in between.

Plus when a spouse dies the surviving person has the option of retaining their own Medicare or switching to the spouse's payment if the other amount is greater.

In addition to that, if a person has divorced after 20 years after marriage, that person can switch to the divorced person's payment, if it's greater than the amount they themselves accrued. The divorced spouse need not even be notified of the fact that someone has tapped into his or her allocated amount.

This presupposes, of course, that the person qualifies as a Medicare recipient, whether through age or physical condition.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: DMcG
Date: 16 Jul 09 - 06:46 PM

Everybody who has paid anything at all into Medicare eventually gets onto the Medicare rolls. There is a big difference in pay ... Plus when a spouse dies the surviving person has the option of retaining their own Medicare or switching to the spouse's payment if the other amount is greater...This presupposes, of course, that the person qualifies as a Medicare recipient

That's not a bad list of the differences between the NHS and Medicare! The amount paid out by the NHS is *not* related to the amount paid in via taxes, *everyone* qualifies, *eventually* only comes into it according to medical need, not what's been paid (although as has been said above, the system works rather better for acute than chronic conditions in terms of responsiveness.)

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: McGrath of Harlow
Date: 16 Jul 09 - 07:42 PM

This presupposes, of course, that the person qualifies as a Medicare recipient, whether through age or physical condition.

Precisely.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: artbrooks
Date: 16 Jul 09 - 07:44 PM

Ebbie, I think you have Social Security and Medicare confused.   Medicare has a common cost - $96 per month for medical care and nothing (in most cases) for hospitalization, regardless of how much a person paid into the system.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: katlaughing
Date: 16 Jul 09 - 08:07 PM

It is so screwed up over here that they can declare a person handicapped and put them on disability social security BUT they have to wait for two years before getting any medicare/medicaid? benefits!

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: artbrooks
Date: 16 Jul 09 - 08:13 PM

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Q (Frank Staplin)
Date: 16 Jul 09 - 08:37 PM

Alberta Province in Canada pretty well administers its own program, although there is federal as well as provincial funding.
The major gripe is with elective treatments. The province has severely trimmed its budget.

An example is Cateract eye surgery, which is limited to a certain number. The number has been cut from over 10,000 to 8500. To get the free surgery, Alberta patients end up on a waiting list, now estimated at about one year. The clinics have the staff and time to do more, so paying patients from other provinces and the States get their operations done quickly. The alternative for Alberta patients with money is to go out of the country.
Wait times soar

The quota system applies to several procedures. Many elect to pay approx. $800 for an MRI rather than wait their turn.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Bobert
Date: 16 Jul 09 - 08:42 PM

Ebbie's point is that Medicare is a public option and costs less to administer than private insurance... Much less... The reason that Medicare is facing financial challenges is not it's cost to administer it but becuase it is not funded correctly...

Actually, Medicare is a very good example of what governemnt can do with a lot less $$$$.... Like Obama said in reference to the insurance companies, "If you are doing such a great job then a public option shouldn't scare you at all".... (paraphrased)

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Ebbie
Date: 16 Jul 09 - 09:01 PM

gulp I did indeed mix up a confusing brew. Most of what I described was about Social Security. Medicare is a different, but related, component of what I was talking about.

Let's see if I can get it right this time: I draw Social Security each month, and I enrolled when I was 62. I could have waited until I was 65 years old but opted for the earlier date. Everyone who has worked - and paid into Social Security at any time- will eventually be eligible to draw. What I said about opting for the greater amount viz a viz spouses refers to Social Security.

When I become ill or if I need surgery, I present Medicare as my medical payer. It covers about 80% of a given cost. I have the option of enrolling in other insurance on top of Medicare if I wish.

Incidentally I was not intimating that the US system of Social Security/Medicare is the ultimate. Far from it. I am merely pointing out that Social Security/Medicare as a single payer does work.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Art Thieme
Date: 16 Jul 09 - 09:31 PM

To clarify what we can discern from Social Security:

In order for a worker to get SS, they must have worked enough units of time. Those units are called QUARTERS.

My wife did not work enough of those quarters to get SS when she reaches 62. Also, we've been told that because of too few quarters --she can't EVER get it. Not SSI either. --But my income is too high for her to get on SSI----even with our Pub. Aid spend-down amount each month assuring that we are "broke" enough to get the Public Aid card.

There are at least two Catch Twenty-Twos there for ya --- all in one sentence I think.

When I die, Carol will get some percentage of my SS payments---and $300.00

Art

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: DougR
Date: 16 Jul 09 - 10:31 PM

I agree with Q. Unless Obama can convince the "Blue Dog" Democrats to vote for the current Bill, it will not pass. The cost is just too prohibitive even for conservative Democrats.

DougR

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: katlaughing
Date: 17 Jul 09 - 12:15 AM

Art, that's same situation we have. I don't have enough recent quarters to qualify for disability (nobody told me I could apply many years ago when I did have, in fact they told me no) and Rog makes too much for me to qualify any other way. If he retires on Social Security, I've been told I may qualify for something, but it was confusing and I don't they even knew what they were talking about.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: GUEST
Date: 17 Jul 09 - 12:35 AM

Dear Kat,

You have just pointed to one of the difficulties of a system that does NOT understand itself.

If the US government makes a mistake on anyone's taxes, it is NOT responsible. The bureaucracy of the US government does not even understand its own tax laws. Prima facie.

Example from Canada: I am now able to apply for old age security. However, I cannot do so--it is most unwise to do so--until I have been unemployed for at least one month. My situation is such that I cannot afford to be unemployed for one month. SO, I lose $350ish/month because I need the cash and don't have the wherewithal to BE unemployed for a month.

Reminds me of a joke:

Guy goes to a bank and needs to borrow $1000. The bank says, "What do you have as collateral?" He says, "Nothing." They said, "Then we can't lend you any money. He says, "IF I had collateral, I wouldn't need to borrow!"

I do wish you well with the problem. In a word, it sucks.

Bruce

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Don(Wyziwyg)T
Date: 17 Jul 09 - 07:35 AM

The simple answer to all those examples is this.

ALL my medical treatment, whether emergency, acute, or chronic is fully funded by the NHS.

I NEVER PAY ONE PENNY DIRECTLY TO THE NHS FOR TREATMENT, NO MATTER WHAT THE COST!

Don T.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Bobert
Date: 17 Jul 09 - 07:40 AM

The point is that "single payer" is more efficient than having a highly privatized sysytem that is in the business purely to make a profit and here is where a large portion of the 17% of our GNP goes: into the hands of the health insurers... This is where the overall savings will come...

Yes, paying for it is a sticky point but left out the discussion is that people wil actually be purchasing helth insurance from the government... That is something that the Repubs conviently don't wnat to talk about... Right now we have hundreds of billions being paid to private health insurers by people who are getting ripped off... That money won't be going to the thieves with a public option...

Of course the conservatives will claim that the government will then be ripping them off but that is pure bull... Does the governemnt rip off folk who have Medicare???

B~

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Stringsinger
Date: 17 Jul 09 - 11:11 AM

The cost of not doing single-payer is far more costly on the backs of citizens. People die when insurance companies stand between the doctor and patient. The US can't afford not to do it.

If we can spend trillions on war and occupation, we can spend a pittance of that on nationalized health care. The US is bankrupting itself on the defense industry.
Blackwater gets your tax dollars.

Stingy Republicans don't see it that way. Their priorities are not to the citizen but beholden to corporate greed.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Sandy Mc Lean
Date: 17 Jul 09 - 11:24 AM

("The cost is just too prohibitive even for conservative Democrats.")

This statement seems inane. People in the USA are now paying exhorbitant rates for health insurance that they would no longer need. Deduct profit and greed from the system and the per person cost should be much lower.

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: McGrath of Harlow
Date: 17 Jul 09 - 12:46 PM

Here is a chart of spending on health care (private and public) in the various OECD countries, giving percentage of GDP spent on health, and money spent per head.

It comes from this site , "Health Affairs - the policy journal of the Health Sphere.

It shows the USA as spending a great deal more of its GDP on health than anyone else, and far more per head than virtually every other country.

Doug's comment about the notion of a switch to a universal health system, on the lines of other countries - "The cost is just too prohibitive" - reminds me of the man who was found burning piles of folding money. When asked why he didn't go out and buy some wood he replied "Are you crazy - how could I afford to go buying wood when it's already costing me a fortune to stay warm".

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Leadfingers
Date: 17 Jul 09 - 01:56 PM

GOOD !!! And 100

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: katlaughing
Date: 17 Jul 09 - 02:53 PM

Some examples of what I consider to be obscene:

We have insurance through Rog's workplace. If we go to their "preferred providers" it costs them and us less money. For instance, for an xray reading:

Total charge = $44
Total charge allowed after "negotiation" = $12.86
Total paid by insurance = $9.00 with us responsible for the remaining $3.86.

On the report it explains that the provider cannot bill us for any of the difference. They have agreed to settle for the $12.86 total.

Another one is for $156 total; they paid $39.69, and we are responsible for $17.01, so they brought that total down a lot, too.

Here is where I think it gets ugly AND how they pay for those discounts: people with NO insurance have to pay the total amount because they have no insurance company "negotiating" for them. They are not in a "pool" of insured people who can drive a harder bargain, so to speak. Almost five years ago, I was one of those people. What I was charged for hospitalization and treatment of congestive heart failure was obscene and there was NO negotiating any lower charges with the hospital; my daughter tried, they refused. We are still paying them on a $13,000 bill for the few days I was in.

So, the very people who need the help the most, those without insurance and, possibly without a job, have to pay MORE. How fucked up is that?

If they don't fix it this time, I do believe there is enough momentum folks will not let them slide by. We saw the power we had when we used grassroots to elect Obama. Those same grassroots folks are now working on health care and other issues. We are not going away...not going gently into that good night. We WILL see change NOW!

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: Art Thieme
Date: 17 Jul 09 - 03:41 PM

Kat and Rog,

Hello! You know, I'm with you on those points--and more...

Luv,

Art

Subject: RE: BS: Nationalized Healthcare, good? bad?
From: artbrooks
Date: 17 Jul 09 - 03:43 PM

Another piece of that, kat, is that the medical provider is absolutely not losing any money on what they charge your insurance. That is, the $12.86 represents their cost plus a modest return. The balance of the $44 (that would be $31.14) that they charge the uninsured is pure profit.   I suppose some people would say that that some portion of that pays them back for those whose bills they eventually have to write off - I think I'd call it something else.