OT: Socialized medicine in the U.S.A?

[RangerJay]

Is it time? I mean, with all of the profiteering of the drug mfrs, HMOs, and insurance companies, I think that the original intent of medical care is now lost on most Americans. The gov't couldn't agree on a plan to help sr. citizens with drug costs (don't get me started). What would be so wrong with adding that to Medicare? I think it's about time that the U.S. looked into socializing medical care. Not that it's gonna happen with the current administration, but it'd help if the topic got off the ground somewhere. I know that there are a lot of non-U.S. forum members out there, and they can contribute intelligently to this question as well. Well, what do you think? Is it time for socialized medicine in the good old USA? Too soon? Never?

[Charlie-brm]

This shouldn't stall the discussion for long before it gets started. You can read it in just over a minute and it is in plain language. It is a recent speech by a U.S. expert with the right credentials: [i]Dr. Arnold S. Relman, Professor Emeritus of Medicine and Social Medicine at Harvard Medical School and Emeritus Editor-in-Chief of the New England Journal of Medicine, Presentation to the Standing Senate Committee on Social Affairs, Science and Technology[/i] I think if someone of this stature has problems with the current state of affairs it is of concern. [url=http://www.healthcoalition.ca/relman.html]Dr. Relman speech on U.S. health care[/url]

[gtrmac]

Since I have been living in Japan for the last 5 years I have been grateful for the health care which my family and I receive as taxpayers. Everyone here is entitled to 80% health coverage and if they have catastrophic health costs there is a fund to pay for it. I know that Japan is a very wealthy country but surely the U.S. is although wealthy enough to reform health care for the benefit of all it's citizens. First the stranglehold that the insurance industry and the medical establishment has on the gov't must be removed. At this point the insurance industry owns congress through lobbying and political contributions. I think it will be nearly impossible to remove this influence but unless it is exposed and the politicians are forced to serve the voters instead of the rich insurance companies it is hopeless. I am rather pessimistic about the future of healthcare in America as long as the voters are being deceived this way.

[fantasticsound]

I'd like to hear some responses from any posters who are aware of the positive as well as negative aspects of our current system. While I respect the good doctor's credentials, it is obvious he has a bias and that it has been constant for over 20 years. What he fails to mention are the dissatisfactions I've seen posted on these forums by several Canadian and European posters about their socialist medical services. I am not an expert, so I hope they speak up again to warn us that socialist medical care is no panacea. My only gripes in the past 10 years with my family's health insurance have arisen because my wife's employer changed plan options. They've done this several time for a variety of reasons and each time doctors send various bills to the wrong provider, or providers don't have our information available when coverage began. These are beauracratic and clerical problems. Do you believe this will be better run by the U.S. gov't.? And while the doctor hems and haws about senior citizens changing from Medicare to private insurance and back again as an indication that private insurance failed them, he ignores the fact that Medicare seems not to cover expenses adequately. How many companies offer low cost add on insurance to cover the shortfalls of Medicare? Are they scamming senior citizens or is there a need for additional insurance to accompany Medicare? There are far too many questions to jump head first into socialized medicine without reforming every segment of the medical system here. On that I fully agree with the doctor's speech. Until we have answers and specific plans to overhaul the system, don't MESS WITH IT> You think it's bad now? Just wait until they "dabble" with changes over time to adapt to a socialized system.

[RangerJay]

All I ask for is intelligent discussion.

[remainanon]

Well, take the Canadians' bitching with a grain of salt... they're never satisfied! Whiners... ;) Any (sane) Canuck who has made the comparison with health services in the US will cheer their own system very enthusiastically. Allow me to expound: First of all, the US politician-types are very fond of calling it "Socialized" or even "Socialist" medicine. Purely a scare tactic to protect their lobbyists, I assure you. Ain't nothin' like it, really. What is in fact provided up there is government health insurance. When I left you still had to pay premiums, but since that amounted to a tax anyway they just rolled it into the taxes. Now I don't think people have to pay a quarterly premium. The doctors don't work for the government. They bill the government the way doctors down here bill insurance. But if you don't have that insurance you still have to plunk down cash money. I had an experience up there 6 years ago that was amazing - a full day of tests and emergency medicine, not covered by my US insurance. I paid cash - $479 CDN. All highly skilled folks, delivering emergency care in a big hurry. The same services would have cost 3-4k down here. There are lots of reasons for that. In particular, when you have the great majority of the public insured you have much, much less uncompensated care given out by hospitals and clinics. So that means it takes about the same number of people to administer billing to about 8 million people as it does to run the billing department of one major hospital in the US. Talk about less overhead... There is a great deal of misinformation about the Canadian system meted out in this country (US) by politicians and PACs/lobby groups etc. I can shoot holes in almost everything they say about it, but I'll just pick one commonly-cited issue. Yer so-called "conservative" will threaten that "socialized medicine" will remove your freedom of choice, bring government bureaucrats into the decision process for your health care, and be outrageously expensive. In Canada, because [i]everyone[/i] is insured, you can go to [i]any[/i] doctor, anytime, pretty much at your whim. It's the opposite of what they say. Hell, I like Bob Dole, but he looked right into the cameras during his campaign and said that "Canadians can't choose their doctors". Absolutely untrue. In the 31 years I lived there I never interacted with the government insurance plan, except to send them change-of-address forms and a check every quarter. Bureaucracy in Canadian medical care doesn't come even close to comparing with dealing with an HMO in this country. [b]That's one of the benefits of a publicly-owned insurance plan!!![/b] Much simpler administration, folks. Regarding expense I cite my experiences above, as well as a contrasting story: Last May my wife had to go to the ER for apparent food poisoning. Getting her admitted to the [b]waiting room[/b] took almost 2 hours, because of a backlog in the hospital's insurance records. I ended up swiping a VISA card to get her in the queue for an exam. Her total time spent beyond the triage doors in that ER was about 2 hours. Add one bag of saline and an IV kit. Total billing to our insurance? $2,250.00. My co-pay was almost $700. By contrast, my experience with St Mike's hospital in Toronto (cited above) cost much less than half, and that included medications, X-rays, 2 specialists. My wife never met the physician on the bill. Dealt only with nurses. This will be my only post on this issue, because it's a losing cause in this country. A few years go (I wish I had the cite, you'd be amazed) I read an article that pretty much showed that medical insurance in the US is the most profitable business that has ever existed, anywhere, anytime. Do you think those guys will ever allow a sitting government to fuck with all that money? If kicking corrupt insurance companies out and providing a cost-based insurance plan is such a terrible idea, why do the politicians feel they have to tell bald-face lies to the public about it? As an ex-patriate Canadian I would whole-heartedly endorse a move toward my old system. JW PS My medical emergency was a kidney stone, but it was so severe they had to rule out a cardiac emergency. I had a cardiologist and a renologist (SP?) check me out, and do ultrasound and all sorts of stuff, 80 MG of morphine. I was there 10 hours. $479 CDN is about, what, $320 US?

[Zweite Version]

I live in the US but I am originally from Europe. When my wife (who is american) lived in Europe with me, she could not believe the good health care that is provided to everybody. When I came to this country, it was like a shock. So many people just let injuries and sickness stay untreated because they don't have sufficient insurance, or no insurance at all. I am for a government that stays out of people's business, but health care of it's citizens is any governments responsibility, IMHO. I am a aware that public health care is not a cheap service, after all the taxes that I paid in Austria are exorbitantly high compared to the US, but it is worth it, because public health is nothing to mess with. I could go on...

[RangerJay]

Intelligent discussion is all I asked for, and I'm getting just that. Thank you all. While it's a subject for a whole other, lengthy thread, it's apparent that the "american" system is pretty f**ked up. Major corporations control way too much. The system is still set up from the "old boy network" frame of mind. The guys (and while the Enron fiasco gave us hope that women could be a part of American success) close to the top still win when the rest of the "little" people lose. Is this the way that AMERICA (and I use that term because most of congress are arrogant enough to refer to the USA and pull it off), and most importantly, the "founding fathers," meant for this thing to play out? I think not. I'm just interjecting, waiting for other comments.

[Zweite Version]

[quote] and most importantly, the "founding fathers," meant for this thing to play out? [/quote]Exactly. While communism is the extreme form of socialism, the US system seems to be the extreme form of capitalism. Don't get me wrong, I'm 100% for free enterprise, but like I said, health care is nothing to be left in the hands of insurance companies driven by greed. Greed is good (as the guy in the movie Wall Street says) but the life and health of the people is more important. The whole thing probably started out pretty harmless, but it grew into a "Frankenstein of capitalism". [b]The only doubt that I would have is this:[/b] While Austria is a relatively small country, the US seem to be too big to maintain a public health care system. But then again, like gtrmac pointed out, Japan has good system and there are a lot of people living there. [b]The other downside:[/b] A lot of research is done in hospitals in the US. That research costs a lot of money. In Austria there are some world class clinics that came up with some groundbreaking developments (for example Universitaets-Klinik Innsbruck), but not nearly as much as over here. With a public health care system the money for research might not be there anymore. But I'm not nearly an expert, that's just my opinion. Good topic!

[KenElevenShadows]

Well, Japan is also a relatively small country compared to the United States... I would definitely be receptive towards this system as well. Others have commented on the state of our HMOs, etc. already, so I won't repeat it, but it certainly sounds like a fine idea. Thanks for the good discussion. I hope to learn a bit from it!

[Philip OKeefe]

Med insurance is just WAY too expensive here in the USA. I just looked into costs. For my wife and me, the cheapest place I could find was Kaiser. They want $315 / month to insure a couple who are our age. And they're supposedly non-profit. I don't know what the answers are, but something needs to change - and sooner rather than later.

[Paul Berolzheimer]

"Is it time for socialized medicine in the good old USA?" In a word, fuck yes. Ok, sorry, that's two words. Having spent a fair amount of time in Germany over the last 13 years, I can tell you there is no comparison. My friends over there can't believe that we call ourselves a civilised country when they hear about what it takes to get decent medical care here, and how many folks fall through the cracks in the system.

[alcohol]

It's clear we don't have a market driven, competitive medical system. The US medical system is a controlled (socialized) system that benefits wealthy political constituencies. The regulation of who can practice medicine itself is a restriction on competition and and market forces. Restrictions by goverenment on what health care providers can be rreimbursed by insurance is a restriction of the market. The coordination of how many students can enter medical school and restrictions on entering specialties is used to prop up doctors' wages. Restrictions on who can prescribe medicine and methods of drug disbursements prop up prices for services and costs of medications. Truth is the US medical system is government controlled to satisfy private constituencies, it is a socialized system filled with all the corruption associated with socialism. It's not that we need a socialized system, we need to reform our corrupted system.

[Bobro]

Anecdotal- draw what conclusions you will, or just add it to your list things to think about. The other day I had the first dental work of my life (I'm 35). Actually if I hadn't done something really stupid and straight up broken a tooth in half :o I'd still have all perfect teeth, including all four wisdom teeth. Background- no sweets or soda pop as a kid growing up in CA. My mom was always very blunt about it- "we can't afford a denstist, so forget it". Anyway a broken tooth has got to be fixed, it started acting up and hurt like hell. Austria has a socialized medical system, but I'm not part of it- although I'm mostly here at the moment, my home since 96 has actually been south of the border, in Slovenia. Slovenia also has socialized medicine. However, many Austrians and Slovenes go to private doctors in Slovenia- it's a big business. Several of my in-laws in Slovenia are nurses- whatever the official statistics may be, according to them, there is a non-stop stream of Austrians getting private care in Slovenia. Not just little things, but major surgery and long-term work, too. So I went to a private dentist in Slovenia. The dentist was excellent; it was like kung fu, he somehow tricked me into experiencing no pain or discomfort at all, no injection, no pills. I won't even say how little it cost because it's downright embarrassing. "Next to nothing" is not an exaggeration. Well that's an anecdote. IMO, medical care simply isn't a cut and dried question of socialized/not socialized. For one thing, aside from not eating sweets, the amount of perscription medicine I've taken in my life is extremely low, which means that inexpensive over-the-counter drugs really work, never built up a tolerance. Also, here and in Slovenia, what would be called "homeopathic" or "natural" medicine in the US is [i]perfectly normal[/i] . You can go to any number of pharmacies and get herbal teas and "organic" medicines. Do they work? Of course they work. If you eat some Oleander leaves, it will kill you: you'd have to be dumb as a box of rocks not to understand that plants can have even extreme effects on the human body. But are natural medicines as effective for a person with a lifetime of man-made pharmaceutical intake? Don't know, somehow I doubt it. What's the solution for the USA? Don't know. First thing that's got to happen is a revolution against the idea of an aggressively litiginous society, and bringing insurance companies to bay. When will that happen? It will take some deep fundamental changes in society, in the way things are perceived, in value systems...good luck. -Bobro

[TBush]

I agree totally- it's almost to the point of either going completely to a centralized provider (the State) or getting the heck out of the health business (free market). There are a few doctors in the states today who are bucking the system and implementing a pay-as-you-visit model- bypassing entirely the Medicare/Insurance route- and in the process keeping their costs way below the average (see Dr. Robert Berry at the PATMOS Emergiclinic)- here's a link to a good article: http://worldmag.com/world/issue/08-03-02/opening_1.asp When the market is really engaged we will see prices for drugs and services become "normalized"-and tort reform would help by keeping the cost of liability insurance down for doctors- it's all related. This and a dollar will get you a cup of coffee...

[Zweite Version]

Bobro - How can you live in Austria and resist the good sweets and cakes? ;)

[LeiDeLi]

If you like having Congress debate every miniscule decision for four months, then you will love socialized medicine. If you like our primary educational system then you will love socialized medicine. If you think "court appointed attorneys" do a good job, then you will love socialized medicine. Recently, the question has been cast as an alternative between the two alternatives: "private medicine reaming the consumer with spiraling cost", or "socialization". But there is a THIRD ALTERNATIVE: DEREGULATE THE MEDICAL PROFESSION EVEN MORE: THe AMA is really just the most well-organized and restrictive labor union in the world. There is no reason that medical schools need to be so expensive, and no reason that first year medical Doctors need to average over $300,000 in salary. It is all just based on the arbitrary restriction of trade imposed by the AMA. There are MANY people in the world who would study there asses off and become EXCELLENT Doctors, who would charge enough to make a REASONABLE LIVING if given a chance. Musicians, above all others, should realize that commercial success has nothing at all to do with real competence and love of the profession. The AMA has for years deflected attention from the real problem with the medical economics by raising the red-herring specters of "incompetence" or "drug companies".

[henryrobinett]

I am pleasantly amazed at almost 100% agreement re socializing medicine in the US. I've been for it for years. But in England at least, you still have the option. I have a freind who has to have surgery. The downside is you have to wait in a "cue" for your turn. It may take 6 months or longer. If you don't have the patience and can afford it you can always pay for private care. This is the way I'd see it working here. There will always be paid service if you want your specific doctor or need immediate care. I know many europeans who are scared to come over here for fear of getting sick and needing hospitalization. The health care costs are crimminal, in my book. It's a big, big business and I don't think health care should be big business. It changes the role and purpose of health care. It also makes me suspicious. I don't know whether I'm dealing with a doctor or a used car salesman. Do I really need this or are profits down?

[Zweite Version]

As posted by henryrobinett [quote] I am pleasantly amazed at almost 100% agreement re socializing medicine in the US. [/quote]So am I. Governement = by the people, for the people (alledgedly), so give the people what they want. After all, it's a democracy.

[LeiDeLi]

I assure you that the responses on THIS Forum are not a valid respresentational cross section of the people of he United States. :)

[henryrobinett]

[quote]Originally posted by LeiDeLi: [b]I assure you that the responses on THIS Forum are not a valid respresentational cross section of the people of he United States. :) [/b][/quote]Yes I know.

[Bobro]

[quote]Originally posted by sunsetman: [b]Bobro - How can you live in Austria and resist the good sweets and cakes? ;) [/b][/quote]Actually you bring up a point- "sweet" here is usually not as sweet as in the US, I do eat pastries sometimes. Somewhat sweet bread with fruit, nothing like a donut. That's the problem with health statistics- quantities have to be tempered with qualities. Take for example beer. In Slovenia I drink a [i]lot[/i] of beer. But it's fresh from the brewery in a nearby town, I don't put on weight and don't get headaches, always walk to an outdoor bar, drink, walk back, and relative to the annual incomes it's fairly expensive- the whole experience is completely different than for example pounding cans of cheap chemically-loaded rice-beer on the couch in front of a TV, even if the actual amount is identical. So when you see drinking statistics, there's a lot more to it than "how much". The same amount of calories ingested in small breaksfast, big long slow lunch, tiny late dinner, is different than no breakfast, lunch on the run, and big dinner, due to the way the body digests at different times. Talking about food and activity because that's where health-care really starts IMO. "An ounce of prevention..." is the first thing to take care of. Why not socialize medicine in the USA at the state level? For some strange reason the idea of [i]national socialism[/i] just doesn't turn me on. :D And it's not written in stone that you have to have either cradle-to-grave Socialism or protection-racket insurance-driven medicine- the USA is a dynamic and multifaceted place, it seems to me that the solutions need to be dynamic and multifaceted, too. Well just some observations and opinions. This thread comes up right at the time I made a rare visit to any kind of doctor, and have been talking about all this with my mother-in-law (she's a nurse in a mental hospital in Slovenia), so I kind of rambled. :) -Bobro

[remainanon]

OK I lied - one more post. My point is, leave medical services alone, or de-regulate more. But grab medical insurance by the balls. JW

[Steve LeBlanc]

A Harvard team recently did a study that shows Tax dollars pay 60% of all medical costs in the United States...sorry I don't have a link to the study...assuming it's true (for many reasons I believe it is)...take away the ridiculous Administrative waste and you already have the money through Tax money we're already paying to cover National Health Care. Do the research yourself...the system is really fucked...and the Medical Establishment (especially the Drug pushers who profit so mightily) continue to do everything in their power to keep it that way.

[Chris Everett]

There's too many invested in the current system. Doctors, AMA, attorneys, insurance, drug companies, many of the patients, hospitals, and all of their Washington lobbies... The problem with the current system is that everyone is trying to take more than their share of the pie (profits) The money for the lawyers, the malpractice suits, the lobbies, the new 'wonder drugs' It's all out of the same small pool, and as that runs dry, health care will simply implode. It's already happening. The state of Nevada (I think) is actually paying many of their doctors directly to avoid malpractice insurance that is too expensive for doctors to afford (they were leaving the state) It will probably take a large scale implosion before there is enough force to change the momentum of this large industry. But as long as it's called 'socialized' medicine it will never, ever, get past congress. Supporters are going to have to learn that if they ever want a real shot at changing the system. Also, there are things the current system does very well. The level of care, if you can afford it, is second to none.