<p>I don’t think some of the countries that have universal care have a heterogeneous population like the U.S. or large number of illegal immigrants. Will illegal immigrants be covered if the U.S. has universal coverage? Already some hospitals are contemplating turning away illegal immigrants for cancer treatment because of lack of funds- see link about medical center in Galveston, TX.<br>
[UTMB</a> may stop offering cancer care to illegal immigrants](<a href=“http://www.statesman.com/news/content/news/stories/local/12/03/1203utmb.html]UTMB”>http://www.statesman.com/news/content/news/stories/local/12/03/1203utmb.html)</p>
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<p>mammall, yes, they did. As did one of my Ds who was diagnosed and has been treated for the past three years. This fear-mongering by individuals who have not actually lived under both systems is wrong. You have not addressed my question to you about the issues people in the U.S. who DO have good health coverage still have with their insurers. That doesn’t even start to consider the millions who have no coverage. Ignoring them for the purpose of this discussion, I would like you to explain why people who have good plans still have issues about getting care and getting their care paid for, after sitting on the phone for dozens of calls. Just for a minute, it might be worthwhile to stop guessing at how awful the Canadian system is and start exploring what faults the U.S. system has, even for those who are supposedly covered.</p>
<p>Do you think that the U.S system is good the way it currently is? Are you happy with your insurer? Are you confident that your kids who when no longer covered by your insurer, will be able to get good insurance coverage? Do you worry about losing your job and your insurance? I have yet to meet an American who is totally happy with their current situation regarding healthcare. Is there no room for improvement? I guess I don’t understand why people are so worried about the search for a better system.</p>
<p>Marite, I am sorry to read what you have been going through.</p>
<p>alwaysamom said:</p>
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<p>I agree. I also don’t understand why everyone is so angry when we start to discuss alternatives.</p>
<p>alwaysamom - check out the NY Times piece this week on the woman with breast cancer in the UK. </p>
<p>Here’s my problem with socialized medicine, which is of course what England and Cananda have. It rations health care, reduces choice but probably does provide some minimally acceptable level of care to all. Well, if that’s what we want then fine. What these systems DO NOT do is fund the research for innovation. And for those who are fighters and not sheep, these systems stand in the way of the care they want - which is cutting edge and the best that money can buy, indeed. I know that’s what I want when I get sick and you bet I’m willing to pay extra for it - also willing to work harder for it. And expect my adult kids will feel the same. After all, my health means a lot more to me than buying a McMansion or driving a Cadillac Escalade. If you think about it, Americans are astonishingly willing to blow money on all kinds of dubious products. It’s appropriate that their health should be expensive. It is their most valuable possession, even if they are too dense to appreciate it.</p>
<p>very happy,</p>
<p>“But I don’t understand why that means that 47 million of our citizens continue to be uninsured and to not have access even to preventive care. No one has said that with universal health care we’ll be treated for everything and anything.”</p>
<p>One thing you need to understand a large portion of those uninsured areso by choice… that said and I know that will raise the cockels of some here, who don’t know but will challenge that anyway… </p>
<p>I’m not against helping those in need, most states now have programs in place to do just that, subsidized by a few precentages of your current medical premium. Most states have a premium tax on plans. This tax helps pay for services. </p>
<p>There are systems in place to help with these needs, but one has to be of need. Most states have plans for the working poor that provide a basic level of care. </p>
<p>I deal with people who would rather drive an 08 fully insured auto, than even carry a high deductible health plan and drive something a bit more affordable.
They are also part of that list of uninsured…</p>
<p><a href=“%5Burl=http://talk.collegeconfidential.com/1059828902-post54.html]#54[/url]”>quote</a> The fact that as many as 40 million people in the USA are uninsured certainly exacts a heavy toll on both those uninsured and the rest of us.
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<p>[Health</a> Care Lie: ‘47 Million Uninsured Americans’](<a href=“http://www.businessandmedia.org/articles/2007/20070718153509.aspx]Health”>http://www.businessandmedia.org/articles/2007/20070718153509.aspx):</p>
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<p>Any health economist will readily agree that a single payer will reduce administrative costs and a lot of paperwork. But, both those on the right and left will also agree that health care, like any good or service, is rationed: the US currently rations by price; other countries ration by service. </p>
<p>There is no free lunch: a “free” service will increase demand – AP Econ.</p>
<p>Doctors leaving Britain in droves.</p>
<p>Biggest brain drain from UK in 50 years </p>
<p>By Robert Winnett, Deputy Political Editor </p>
<p>Last Updated: 12:01am GMT 21/02/2008 </p>
<p>Britain is experiencing the worst “brain drain” of any country as highly qualified professionals settle abroad, an authoritative international study showed yesterday. </p>
<p>Record numbers of Britons are leaving - many of them doctors, teachers and engineers - in the biggest exodus for almost 50 years. </p>
<p>Skilled professionals, including doctors, are leaving the UK in record numbers. </p>
<p>Over a quarter of qualified professionals who have moved abroad had health or education qualifications. </p>
<p>There are now 3.247 million British-born people living abroad, of whom more than 1.1 million are highly-skilled university graduates, say the researchers. </p>
<p>More than three quarters of these professionals have settled abroad for more than 10 years, according to the study by the Organisation of Economic Co-operation and Development (OECD). </p>
<p>No other nation is losing so many qualified people, it points out. Britain has now lost more than one in 10 of its most skilled citizens, while overall only Mexico has had more people emigrate.</p>
<p>StitchInTime:</p>
<p>I don’t think the link you cite is correct.</p>
<p>Alleging that people earning over a certain amount don’t have insurance “by choice,” as if they’re all just rich but selfish, is not exactly accurate. As we know from CC, and as we know from seeing what one’s EFC is, there’s a vast difference between what the numbers “say” you should be able to afford and what someone really can afford.</p>
<p>But I’m tired of this 90-ith-zillion post on health care, and tired of the yelling, and tired of the passion, so I’m outta here.</p>
<p>(It’s been a long day shoveling show in the East!!)</p>
<p>VeryHappy:
I think your point is a good one but ‘the devil’s in the details’. There can be a lot of emotion as well with lots of direct or indirect anecdotes. There will be emotion involved when one believes they’ll be offered what they perceive to be ‘less for more’. There will be even more emotion when one thinks the change could result in an outcome that could jeopardize the health of themselves or their loved ones. </p>
<p>I and others may be perceived as ‘defending’ the US healthcare system and yet others defending the Canadian or other socialized medicine solutions and I think that’s okay to provide perspective and (hopefully) constructive arguments for and against particular systems. I think that these arguments may give the perception that we think our respective systems are ‘perfect’ but I don’t think most of the posters really think that. There are flaws in all of the systems. Which system is truly better depends on the eye of the beholder and the individual circumstances. </p>
<p>I tend to prefer a system where I’m in a bit more control but I’m that way with everything. I know I’ll run into doctors I don’t like, facilities I don’t like, insurance plans I don’t like. I want the option to use the free market system to choose what I think is best for me. If I don’t like a doctor or facility I want to be able to ‘fire’ them. I pay extra money to ensure I have this option (I don’t use an HMO or fixed health system although these work for some people). Some others prefer for the government to provide them a fixed solution. When it comes to my health, I want more control.</p>
<p>But anyway - good luck with the snow. The exercise will help to keep you healthy - just don’t fall or wrench something!</p>
<p>“I tend to prefer a system where I’m in a bit more control but I’m that way with everything. I know I’ll run into doctors I don’t like, facilities I don’t like, insurance plans I don’t like. I want the option to use the free market system to choose what I think is best for me. If I don’t like a doctor or facility I want to be able to ‘fire’ them. I pay extra money to ensure I have this option (I don’t use an HMO or fixed health system although these work for some people). Some others prefer for the government to provide them a fixed solution. When it comes to my health, I want more control.”</p>
<p>I believe I share this sentiment. I want choice. I know if I still had the doctor who first diagnosed me with hypertension and diabetes I would have simply killed myslef as his words made me feel as if I let my family down. It was lucky for me and for him, that I fired him and found somebody else. </p>
<p>I liked having that choice and yes, I would pay extra for it.</p>
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<p>mammall, again:</p>
<p>You have yet to prove, in any way, that a socialized health care system in any way reduces health care innovation. You have not provided any empirical evidence for that claim; you have not even provided a logically consistent argument.</p>
<p>Your entire argument rests upon the assumption that a system in which the government provides a baseline level of care for everyone with price fixing and rationing of service and then allows private alternatives to compete, will by necessity buy less cutting-edge drugs and other medical tools, and as a result provide a powerful disincentive to innovation.</p>
<p>That is simply not true, and you have not provided any reason why it should be so. The fact is, the private insurers who provide 99% of the care in America will deny just as many experimental treatments as a national single payer does in other countries, and would in America. It’s not like private insurers are actually providing significantly more cutting-edge treatment compared to a public health care provider.</p>
<p>In fact, the only people who actually get truly better and more cutting-edge treatment are the independently wealthy who pay for their own care out of pocket and can afford the latest and best treatments. And the fact is, they will continue to do so even if a single payer model did exist.</p>
<p>Now, before you come back with “but if that’s so, why does much of the medical innovation in the world happen in America?” - the answer is the same as that to the question of why the innovation in any industry happens in America: it’s because America provides a unique combination of great environment for corporate activity, an incredibly advanced framework for scientific development (both government-funded and privately funded, largely through cutting-edge universities), and attracts a very singular type of populace from other countries, who come to make a good life in any way possible - which often includes innovation and invention.</p>
<p>It is not because America has its current health care model. That fact is largely irrelevant. If America had a single payer model, innovation would still happen just as fast, because the innovation is driven by other factors.</p>
<p>“That fact is largely irrelevant. If America had a single payer model, innovation would still happen just as fast, because the innovation is driven by other factors.”</p>
<p>mmm, I don’t know. Innovation is driven by profit and a free market. Price controls do have a negative effect on innovation.</p>
<p>I agree, a competitive market enhances resource allocation through the signalling and distribution functions of the price mechanism, and the profit incentive. However, price fixation and other interference in market operation only necessarily makes a market less efficient if it (a) does not act to counteract market failure (this is not relevant to this debate, but is very relevant for things like environmental controls) and (b) acts directly on the price mechanism for a particular market.</p>
<p>So for example, if the government said “you must sell that MRI machine for exactly [insert price], by law. you cannot sell for higher or lower”, then that would constitute direct price interference and probably stifle innovation. But in this case, a government single payer would not (I assume) have the legal power to do that; even if it did, it is fallacious to assume that America is the extent of the medical technology market; if a company was unable to sell MRI machines to the American government for the price it wanted (this is an over-simplification too, since generally individual facilities would still negotiate prices for technology, not necessarily the government as a whole) it could simply go elsewhere in the world, or even sell to private providers (who would assuredly still exist).</p>
<p>That’s my point - while a single payer might constitute a sort of derivative market interference, it would not necessarily result in the kind of total price control that mammall keeps referencing. Furthermore, it is not clear to me that a single payer would necessarily result in any more price fixation than the current oligopoly of insurance providers and related enterprises.</p>
<p>ucscucladad, I happen to agree with you about having the element of choice in your healthcare options. I’m not sure if your comment was an attempt to point out another distinction between the systems we’ve been discussing here but I have just as much choice in the Canadian system as I had when we lived in the U.S. What control is it that you think the Canadian system does not provide its patients? I haven’t heard this point made in the discussion so I’m curious what you mean.</p>
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<p>Having to fight an insurance company for coverage was not a false argument for UHC. I was pointing out the fact that the mere act of having private insurance does not mean you are “home free.” Only cash gives you complete freedom…</p>
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<p>I hope that the “you” here does not mean “you, marite.” I’ve smoked once in my life. Did not like it, did not continue.</p>
<p>There are lots of us who have predispositions to various kinds of illnesses. One of my colleagues has early stage Alzheimer’s. The prognosis is not good. Why? Because his family has a history of Alzheimer’s. </p>
<p>I agree that lots of people make lifestyle choices that have a negative effect on their health (and that can include sports-- one of the most developed branch of medicine deals with sports injuries). But there are lots of people who live in dangerous environments without any means of escaping from them and to include them with those freely making lifestyle choices as in your dismissive post is callous in the extreme. </p>
<p>VeryHappy: Obesity is a problem. I do believe, however, that obesity is more prevalent among poor than among affluent people. And that is an issue worth studying. Long ago, I remember reading some research to the effect that the food stamp program contributed to obesity because the types of foods that qualified under the program were high in starch and calories. Also, as poor people were not likely to possess well equipped kitchens, they were more likely to buy ready-made, highly processed, high in sugar foods. I don’t know whether it continues to be the case. </p>
<p>Traveling abroad by the way, has brought home how few rather than how many Americans smoke. I can count on the fingers of my hands the number of my acquaintances who smoke. Abroad, I seem to be moving in a perpetual fog of smoke.</p>
<p>Thanks, Dstark.</p>
<p>I’ve been with the same HMO for 30 years now, and have been consistently happy. I had to go outside the system only once for a second opinion (and am very very thankful I did). And guess what? that second opinion spared me the need for painful post-op treatment and saved my HMO quite a bit of money!
My HMO is also pretty good at preventive health care and promoting healthy living; it allows for alternative medicines, organizes support groups, etc… I know that it has haggled over the cost of my care (I have seen bills submitted and amounts allowed). But I have not been personally involved in any of the negotiations. I know that I paid $15 in co-pay for something that was estimated to have cost around $50k. That’s what I’d like to see extended to the rest of the population. </p>
<p>One problem that has not been addressed is sheer access as opposed to coverage. I realize that one reason my health care has been so great is that I live in a medical mecca. People come from all over the world to get treated. My MIL still chuckle that a French vineyard owner who’d come for a brain surgery that had been deemed too risky by French specialists treated the Interpreters’ office to a case of the best champagne. The same numbers of doctors and of hospitals are not going to be available in most of the US, in particular in rural areas where the number of uninsured is probably also highest.</p>
<p>I don’t mind seeing a single payer plan in the long run. US is already spending a very high percentage of the GNP on health care, with baby boomer getting older, it is going to get worse. Single payer may offer a long term solution.</p>
<p>The problem is that many of the single payer advocates are really more interesting in attacking the insurance company than to promote universal health care. However as many in this thread have already posted the opinion that health insurance policy, especially those provided by employers, are really quite good. So the single payer advocates’ attitude is in fact a hindrance to the acceptance of single payer plan.</p>
<p>The private insurance haters think that the greediness of the companies results in all sort of restriction on health care, and once the evil insurance companies are gone, we no longer have any restrictions. In fact, one reason private insurances cost more because they provide more. One of my most expensive regular medical cost is a very very expensive drug. Under my current issuance guideline, for the past year 98% of the time I may use that drug. Under Medicare guideline I may use it 2% of the time. So if we abolish private insurance overnight, to be replaced by a government single payer plan, there is going to be massive revolt.</p>
<p>For universal health care to be successful, we need non-ideologue to come up with a long transition plan where employee provided private insurance coexists with the government plan, until the day the government plan can prove its superiority.</p>