Universal Health Care

[K Frame]

"That stands opposed to the American system, which has 90 day plus waits for random kinds of surgery..."

Just where do you come up with that fanciful figure?

No one I know, not a single person, has ever waited that long for surgery of any kind, necessary or elective.

I've never even heard that reported as a possibility in the American medical system, either.

My Mother needed shoulder surgery several years ago. From initial consultation to procedure was less than 2 weeks. Initial consultation to surgery for her mastectomy a couple of years later was a little over a week.

My sister-in-law, a Canadian, needed neck surgery to repair a disk issue and resolve acute pain. Just getting an MRI in Canada would have required a wait of more than 5 weeks. She crossed the border and had the MRI done that day, and 3 days crossed again to have her surgery in an American hospital.

Mtnbkr didn't wait anywhere near 90 days for his surgery several years ago.

A coworker who was having chronic shortness of breath went from afternoon doctor's appointment to having his chest cracked less than 12 hours later.

My friend Chuck, who needed hip surgery to repair the effects of an injury, had the longest waiting time I know of, a little over 5 weeks, but most of that was because of conflicts between his and his surgeon's personal schedules.

From New England Journal of Medicine on knee replacement surgery (average wait, 3 weeks from consultation to surgery in the US) - http://content.nejm.org/cgi/content/full/331/16/1068

[anygunanywhere]

I shattered my left fibula in an industrial accident while working in Edmonton, Alberta in March. EMS had to transport me 30 miles outside Edmonton because all of the closer hospitals were on drive by status.

I had to wait on the stretcher in the ER doors until they made certain I could pay even though it was covered under ALBERTA workmens comp. Once I showed two American Express cards I was treated.

The ER physician told me they could repair the fracture but I would be on a waiting list. I told him to turn the foot around so the toes on the left leg were no longer 180 degrees out, splint it so I could fly, and I would fly to Houston to the Texas Medical Center, thank you very much. Thank God for Hermann Hospital and the University of Texas Health Science Center orthopedic surgeons. BTW, you can not fly with fresh cast, only an elastic bandaged splint. This little bit of trivia might be usefull.

My response to anyone who insists that government run socialized medicine is the answer is for them to move to Canada or Australia or wherever it is in effect. As is typical of these ideas, those who advocate the switch to socialized medicine are of two types. Either they are healthy and do not need treatment or else they can afford to bypass the system.

If you actually think that those in the government would put themselves at the mercy of the same health care system they want to put us under then you really are living in a fantasy land. They have their own retirement and are not subject to Social Security. Why would they use socialized health care?

As I have read on here often, if the government is the answer, then it is indeed an extremely stupid question.

Anygunanywhere

[Iain]

Explain that situation more clearly - you are a US citizen, you were working in Edmonton Canada? How long was this waiting list?

As is typical of these ideas, those who advocate the switch to socialized medicine are of two types. Either they are healthy and do not need treatment or else they can afford to bypass the system.

Or, and I'm not a particularly strong advocate of our system as I said earlier, you're like me and deeply concerned about long term regular healthcare under a system where you are an awful insurance risk.

I know that I could get seen if and when I need it under the US system if I had no insurance, but that is not particularly conducive to effective management of longterm health problems. It's not a good idea to wait to get sick and then go if you could have caught and treated it earlier, regular check ups/tests/investigations pick up problems before they are problems. Each infection causes damage, each bit of damage could potentially knock months if not years off lifespan.

[makattak]

Explain that situation more clearly - you are a US citizen, you were working in Edmonton Canada? How long was this waiting list?

Or, and I'm not a particularly strong advocate of our system as I said earlier, you're like me and deeply concerned about long term regular healthcare under a system where you are an awful insurance risk.

I know that I could get seen if and when I need it under the US system if I had no insurance, but that is not particularly conducive to effective management of longterm health problems. It's not a good idea to wait to get sick and then go if you could have caught and treated it earlier, regular check ups/tests/investigations pick up problems before they are problems. Each infection causes damage, each bit of damage could potentially knock months if not years off lifespan.

And so your idea is, rather than have people who have continuing health conditions get their own insurance and take care of themselves, you want to force people who are fairly healthy, but paying for their own health insurance to subsidize you because you don't like risk.

You want to force me, a fairly healthy person, to pay for your insurance because you're opposed to the risk a free market creates.

I've got an idea. There are MANY places in the world that don't make you face the dangers of a free market. GO TO ONE OF THEM and let us have at least one place where those who aren't afraid of taking risks can be allowed to take them.

[anygunanywhere]

Explain that situation more clearly - you are a US citizen, you were working in Edmonton Canada? How long was this waiting list?

Global economy. My territory was Arctic Circle to Guatemala. Under NAFTA I was allowed to work in Canada because I possess "specific proprietary knowledge and skills" not available in Canada.

The waiting list was two weeks. I guess I did not have enough trauma and my fracture was not considered life threating. It hurt like hell but they did have some nice pain killers.

[mtnbkr]

Mtnbkr didn't wait anywhere near 90 days for his surgery several years ago.

From when I first suspected a problem to the surgery was 2 months, but much of the delay revolved around me trying find time for the tests (one sonagram, another gallbladder specific test I can't recall).  Since it was a relatively minor issue (not the intense pain many sufferers have) and only a problem if I ate fatty foods, I felt no need to rush the process.  I was with Kaiser Permanente at the time and all of the tests, office visits, and surgery totaled up to about $50. 

I had a colonoscopy last year to diagnose what turned out to be diverticulitis.  My first attack, which went unreported was in April, the 2nd in May.  I went to the doc in May for that one and he properly diagnosed it and told me how to avoid further attacks, but also said I'd get the metal snake of love if it happened again.  I went off my diet in order to see if it would, it did in mid June, and I got the snake in July, less than two weeks after the third attack.

I've never known anyone to wait 90 days against their will.

One reason I'll never support Universal Healthcare is rationing.  At least under our current system, you can get the care you want as long as you can pay for it.  In early 2006, my grandfather came down with viral meningitis.  He suffered seizures and had to be put in a medically induced coma.  The doctors and nurses all said he wouldn't survive, but we stayed the course and he pulled through.  When his wife was in ICU with complications from surgery, he ran into some of the same nurses who thought he was going to die.  Every one was surprised to see him alive, much less walking and driving.  My grandmother passed away due to her ordeal, but my grandfather is still living independently. 

I was born two months premature with a heart defect at a time with preemies such as myself had a very poor chance of survival.  My brother was also two months premature, contracted meningitis from a nurse who didn't know she was sick, and nearly died after having a stroke.  Would we get the same level of care under a Universal Health plan?  Know what?  I don't want to risk it. 

The current system is flawed and expensive, but at least we can get access to the care we want as long as we're willing to pay for it.  I do not want to risk living in a world where your ability to pay won't gain you access to the services you need or want.

Chris

[ctdonath]

No one I know, not a single person, has ever waited that long for surgery of any kind, necessary or elective.

Merely one anecdote:

A few months ago I was diagnosed as needing a new heart valve + pacemaker. 10 days flat from diagnosis to open-heart surgery, delayed only by scheduling an MRI. ...and that was only becuase something might go wrong; I felt fine going in.

In contrast...

My Canadian mother-in-law was diagnosed with lukemia years ago. It was 5 years before chemotherapy began. Subsequent side-effect resulted in 6 months of misdiagnosis, rescheduled surgery ("ready? oh, sorry, no operating rooms are available today, come back in a month..."), and overburdensome beaurocracy ("sorry, the doctor can't see you, he has too much paperwork to do...").

[ctdonath]

Every Emergency Room lobby has a sign to the effect of "you will be treated regardless of ability to pay". That's your "universal health care" right there: if you need medical attention you'll get it. Everyone gets the care they need; nobody is turned away.

Objections addressed:

"But ... they'll give you a bill anyway! What if you can't pay?" Few truly can't pay. My own open-heart surgery, if I paid for all of it, works out to $10/day for life. Is your life worth $10/day? They'll work out a payment plan and/or discount if only you'll talk to them about it. Oh, sure, they won't make it easy - that's a lot of money we're talking about. Nonetheless, lots of people get ER care for free. The system is in place already, just not widely advertised to encourage abuse.

"But ... what about ongoing non-urgent care? or preventive care?" Is your life worth $10/day? Work & save accordingly. There comes a point where demanding support for expensive care for non-urgent issues should be your problem, not mine. There are very few who truly can't afford basic care; we can talk about them, but let the able care for themselves & buy their own insurance.

If your annual medical bills are less than your entertainment (cable, movies, sweets, dining out, etc.) expenditure, stay out of my wallet.

[mtnbkr]

I once spent a month in Toronto working on a project.  One of my Canadian coworkers had to take an entire day off in order to take his daughter to see the doctor.  The time off was to wait in the doc's office, not care for her afterwards.

Last dozen times I took my kids to the doctor, I was in and out in an hour.

Chris

[Iain]

"But ... what about ongoing non-urgent care? or preventive care?" Is your life worth $10/day? Work & save accordingly. There comes a point where demanding support for expensive care for non-urgent issues should be your problem, not mine. There are very few who truly can't afford basic care; we can talk about them, but let the able care for themselves & buy their own insurance.

Let's talk about them, because the first part of your paragraph is just not realistic for large numbers of people I meet everyday. $10 a day is not a lot I agree, but try figures like $800 a week. Drugs that cost $40 a dose needed daily. Lots of those people just can't work.

mtnkr - I can go see my doctors any day that I need to. I can be in and out in a few minutes if seeing the GP, but multidisciplinary specialist teams can take a couple of hours to be seen by them all if they need to see you.

On the subject of anecdotes - my grandfather was diagnosed with cancer three years ago and still hasn't had chemo and only sees his doctor every couple of months. Shocking huh? Except that it's lymphoma and I'm told his white cell count is too low for chemo but he isn't getting sick so only needs infrequent checkups but can see his doctor at a moments notice and can go straight in at the first signs of any infection. I'm not saying people are trying to mislead, but anecdotes can be misleading in that they are a fraction of an individuals full story, and by definition they are not a full picture of the whole system.

makattack - I predicted you in my first post, and I'm not going to respond to screeds like that.

[red headed stranger]

For most people, the problem isn't a lack of health insurance, but a lack of portability. People are stuck at jobs they'd like to leave but can't because they would lose their health insurance. McCain's idea of tax credits to purchase health insurance sounded positive, at least to the extent that any government plan to help pay for health care can sound positive.

I really think working our some means of portability would make a huge difference for the US people getting healthcare insurance.  It should be much easier for people to get group rates that they can keep.  I know lots of people who have stayed in dead end jobs because they can't "lose their benefits." Also, something has to be done about the way that insurance companies can abuse the "preexisting condition" excuse to deny coverage.   

[makattak]

Let's talk about them, because the first part of your paragraph is just not realistic for large numbers of people I meet everyday. $10 a day is not a lot I agree, but try figures like $800 a week. Drugs that cost $40 a dose needed daily. Lots of those people just can't work.

mtnkr - I can go see my doctors any day that I need to. I can be in and out in a few minutes if seeing the GP, but multidisciplinary specialist teams can take a couple of hours to be seen by them all if they need to see you.

On the subject of anecdotes - my grandfather was diagnosed with cancer three years ago and still hasn't had chemo and only sees his doctor every couple of months. Shocking huh? Except that it's lymphoma and I'm told his white cell count is too low for chemo but he isn't getting sick so only needs infrequent checkups but can see his doctor at a moments notice and can go straight in at the first signs of any infection. I'm not saying people are trying to mislead, but anecdotes can be misleading in that they are a fraction of an individuals full story, and by definition they are not a full picture of the whole system.

makattack - I predicted you in my first post, and I'm not going to respond to screeds like that.

My apologies, I did not notice that you already are in one of the other places where they don't make you take the risks yourself.

So long as you want to keep your own and don't want to kill American healthcare- I can live and let live.

One question though- what percentage of useful medical research takes place in countries where people are allowed to pay for their own healthcare?

[Manedwolf]

High-tech medical care with scanners and $20 million dollar pieces of equipment and stents and all is a direct result of free market innovation. Companies invested millions in those products.

Since when did it become a "right", just because it's medical care?

You don't have a "right" to be given a $60,000 car just because they've become more advanced.

Why would you have a "right" to be given a $60,000 implant?

And if that is demanded and mandated, where is the incentive for companies to innovate any further on new products if they're not allowed to profit from them?

[kino74]

Its amazing to hear the long waits of weeks and years from socialized health care and makes me wonder about the quality of care.  Is it quality care to wait years for a MRI or chemotherapy?  I guess thats why Canadian leaders come to the US to get medical treatment.

How have all these international studies determine what quality care is?  Do they take into account vehicle accidents, drug abuse or just simple filthiness?  How about ignorance of health care services?  One time in my life I lived near a trailer park and my God, you should see how filthy those people lived!  It was no wonder they would come down with some unusual sickness or were constantly sick.

Maybe we should look into curbing costs rather than rationing our medical services and start taking care of ourselves.

[cassandra and sara's daddy]

i know of hundreds of folks who come here for treatment  and only a handful of folks from here who go overseas for medical treatment.  why is that?

[ronnyreagan]

i know of hundreds of folks who come here for treatment  and only a handful of folks from here who go overseas for medical treatment.  why is that?

Because if you can afford to fly some place outside the US to get treatment, you can probably afford to get it here. I don't think anyone is arguing that we don't have the best system for people who have a lot of money. That seems pretty obvious. The problem people have is that we have the worst system for people without much money.

Part of the problem seems to be that we have a back door to socialized medicine through the emergency room. You don't get turned away there, so people who can't afford the cheaper preventative care wait until it's a more expensive emergency and have us pay for it then. If we're truly going to let the free market work, people who can't pay can't be getting treatment.

[makattak]

Because if you can afford to fly some place outside the US to get treatment, you can probably afford to get it here. I don't think anyone is arguing that we don't have the best system for people who have a lot of money. That seems pretty obvious. The problem people have is that we have the worst system for people without much money.

Part of the problem seems to be that we have a back door to socialized medicine through the emergency room. You don't get turned away there, so people who can't afford the cheaper preventative care wait until it's a more expensive emergency and have us pay for it then. If we're truly going to let the free market work, people who can't pay can't be getting treatment.

Welcome to socialized medicine: We're all screwed, but we're all EQUALLY screwed! <disclaimer: unless you know people in power>

[Manedwolf]

Again, a different perspective on this that the media has done its best to obscure.

Medical care IS EXPENSIVE PRODUCTS AND SERVICES.

I've gone and seen the stents being produced. It's a very complex multistage process involving an alloy of cobalt and chromium being joined at a precise microscopic level, then woven into a precision mesh in a superheated furnace unit. The stent is handled by precision robots that cost several million dollars, inspected by microscope and lasers for flaws, literally dozens of people have their hands on it. Then it's packaged and sterilized with radiation.

Why on earth does anyone think they're entitled to such an expensive, jewel-like piece of precision product for FREE?

And if they are by mandate, why the hell would we make any more of them if we can't make a profit?

[makattak]

Again, a different perspective on this that the media has done its best to obscure.

Medical care IS EXPENSIVE PRODUCTS AND SERVICES.

I've gone and seen the stents being produced. It's a very complex multistage process involving an alloy of cobalt and chromium being joined at a precise microscopic level, then woven into a precision mesh in a superheated furnace unit. The stent is handled by precision robots that cost several million dollars, inspected by microscope and lasers for flaws, literally dozens of people have their hands on it. Then it's packaged and sterilized with radiation.

Why on earth does anyone think they're entitled to such an expensive, jewel-like piece of precision product for FREE?

And if they are by mandate, why the hell would we make any more of them if we can't make a profit?

Hey hey, NO ONE deserves that much medical care.

Now please get back in the line to wait for your pills to ward off the pain while you die.

[Manedwolf]

Hey hey, NO ONE deserves that much medical care.

Now please get back in the line to wait for your pills to ward off the pain while you die.

You're not getting it.

We make it because there is a market for it. Because we can make a profit by developing technology into innovative medical products.

If we can't make a profit, we will stop researching new tech, and we will stop making them. So will all the other manufacturers. No more stents, because unless they can be sold for several thousand dollars, they're not worth it to make. They cost a lot to make. So, nobody has stents. Or valves. Or grafts, mesh, films, titanium joints, all of the other things that cost a lot to buy because they cost a lot to make. If the companies can't make a profit, they will not sell them. They will stop production.

And then where will the "medical care" be?

[makattak]

You're not getting it.

We make it because there is a market for it. Because we can make a profit by developing technology into innovative medical products.

If we can't make a profit, we will stop researching new tech, and we will stop making them.

And then where will the "medical care" be?

No I am getting it. Do you think my line about getting back in line and dying was serious?

I realize that without rewards, there is no incentive to create expensive medical technology.

Not only that, there is little reason to take risks and develop any NEW technologies.

Which is why I asked earlier whether the majority of medical research came out of socilized medicine...

[Manedwolf]

No I am getting it. Do you think my line about getting back in line and dying was serious?

I realize that without rewards, there is no incentive to create expensive medical technology.

Not only that, there is little reason to take risks and develop any NEW technologies.

Which is why I asked earlier whether the majority of medical research came out of socilized medicine...

Alright, and yes...that's it precisely. ALL major medical advances are market-driven! It's why socialist medicine tends to be stuck in the 1960's in places like Cuba.

[Nick1911]

I just got done writing several monthly checks to the tune of $300/month total.  I payed $10 a day for a year because last December, my uninsured fiancee had an accident, received a concussion and broke a tail bone.

At the time of the accident, we didn't know exactly how bad the damage was.  The next morning, she was blacking out.

Within two minutes of walking in the ER, we saw a doctor. 
Within 10 minutes, they had X-rayed the tail bone. 
Within 15 minutes they had taken a CAT scan of her head. 
Within an hour we had results and were on our way.

That hour cost us over $3000.  $10 a day for a year.

You know what? 

It was worth every penny.

[Manedwolf]

I just got done writing several monthly checks to the tune of $300/month total.  I payed $10 a day for a year because last December, my uninsured fiancee had an accident, received a concussion and broke a tail bone.

At the time of the accident, we didn't know exactly how bad the damage was.  The next morning, she was blacking out.

Within two minutes of walking in the ER, we saw a doctor. 
Within 10 minutes, they had X-rayed the tail bone. 
Within 15 minutes they had taken a CAT scan of her head. 
Within an hour we had results and were on our way.

That hour cost us over $3000.  $10 a day for a year.

You know what? 

It was worth every penny.

And you were also paying for all the years of science and engineering at GE or Siemens or Olympus that developed those machines. People don't realize that.

[lupinus]

You're not getting it.

We make it because there is a market for it. Because we can make a profit by developing technology into innovative medical products.

The part you are missing is the socialism.  Obama will be happy to have everyone pay for said research, because letting the free market and greedy things like profit pay for it is evvvviiiiilllllllll.

Just like under his plan the free market wont pay for research of "alternative fuels", you me and all our closest APS friends will.