Health Care

[Drachenlied]

Recent events have lead me to become curious about the health care of other nations.

 

I know that, according to many articles, America is the only "industrialized" nation without Universal Health care. For all those Americans, what do you think about the health care reform? For people from other nations, what do you think about most Americans resistance to the reform? What do you think of your own health care? Several flaws have been pointed out with Universal health care, but the pros seem to outweigh the cons...

 

Personally, I'm on the fence about America's reform. On one hand, I don't want raised tax rates to pay for other people's health care, because I know that there are other people who will abuse the system. On the other hand, our insurance system is flawed and partially exists because of greed... In all honesty, I'm just not too sure about it.

 

Anyway... I thought I'd put it up here for discussion, since the people I was talking to before are, well, Southerners (on FB, no less...)... and I've been called a communist (amongst other things) for having an open mind and supporting facts on the benefits AND negatives on the health care reform. Hopefully, I can have the conversation here without the rude names, as well as have the conversation be more... educated.

[renton]

I believe our health care does need reform but the way Obama is proposing it would lead our country to bankruptcy. Also, under the "Obama care" the doctors or government would decide whether or not you're too old to receive treatment. I'm not trying to get all political here it's just a sensitive topic.

 

EX>

 

60 Year old needs said organ to survive but, so does a 27 year old. Ethically speaking it would be morally right to give the organ to the 27 year old; however, how can we outweigh the possibility the 60 year old can live 20-40 more years? Heck, even live to be 100? From a moral stand point you could say the twenty year old could live longer with that organ, though how do we say who has the right to live and who doesn't? Everyone has the right to live and opportunity to get the treatment they're entitiled too. Uh, this is something considered the death panel in that reform.

 

I'm not too educated on the whole health care system and I know I'm ignorant in that respect. I don't really know how other countries operate with theirs I just know ours is MEH.

 

 

 

 

[Drachenlied]

I believe our health care does need reform but the way Obama is proposing it would lead our country to bankruptcy. Also, under the "Obama care" the doctors or government would decide whether or not you're too old to receive treatment. I'm not trying to get all political here it's just a sensitive topic.

 

EX>

 

60 Year old needs said organ to survive but, so does a 27 year old. Ethically speaking it would be morally right to give the organ to the 27 year old; however, how can we outweigh the possibility the 60 year old can live 20-40 more years? Heck, even live to be 100? From a moral stand point you could say the twenty year old could live longer with that organ, though how do we say who has the right to live and who doesn't? Everyone has the right to live and opportunity to get the treatment they're entitiled too. Uh, this is something considered the death panel in that reform.

 

I'm not too educated on the whole health care system and I know I'm ignorant in that respect. I don't really know how other countries operate with theirs I just know ours is MEH.

I'm not too well educated with it, either, so I'm learning a I go. But, I do agree with your statement. The ethicality of having a panel that decides what can be done to you is, well... Not very ethical.

 

Our health care DOES need a reform, just not one like you described...

[TikindiDragon]

I think some of us did some calculations on this a while back. We worked out that our National Insurance in the UK (which goes towards both the NHS and our state pensions) is actually less than most Americans pay per year for private health insurance. Plus no one in the UK has to worry about not being able to afford an ambulance.

[Princess Artemis]

I think our system needs reforming, but not in the direction it is going now. It has been for a long while a hodgepodge of private insurance (real insurance, what one gets for unexpected catastrophic expenses one cannot pay for, such as house fires and cars being totaled, not expected expenses), something we pay into to make our expected expenses cheaper, and socialized healthcare (because for a long time, private insurance buyers have been paying higher premiums to cover the expenses incurred to doctors and hospitals for having to provide for Medicare patients and those without insurance who cannot ever pay but still get treated). Adding another layer of hodgepodge to that mess can only end in disaster. If it is to be reformed, it makes sense to dismantle parts of the mess and get to the heart of the thing, not tack on a monstrosity of a law that very few people have actually read, even now.

 

Through my family, I know doctors who are retiring and who are no longer providing care to Medicare patients because they will not be able to afford it under the Obama law.

 

The thing about greed is, you cannot legislate it away. Do you think that abuses due to greed and corruption don't occur under more socialized healthcare systems, or that real people do not end up paying the price for being involved in a system that is too big to care about them? As for myself, I find government taking money out of my family's pocket that could be used to care for our own needs and the needs of those around us and giving it to people we do not know and as often as not who do not need the fruits of our labor to care for them as theft. It also opens the door for other people to tell you what you should or should not do with your body, because as taxpayers who have the fruit of their labor supporting your health care, they absolutely have a vested interest in doing so. Don't want your neighbors to have a stake in what you do with your body? Don't get into a socialized healthcare system.

[Kestra15]

The American healthcare system is third-world and elitist, and the more I learn about both it and the NHS, the more I am convinced I never want to step foot in the USA again and feel sorry for all of you who have to suffer with it. Every American RN I have worked with are also of the same opinion, so it's not just an English nurse's view of the American health system; it's the view of American nurses who have worked in both systems as well.

 

I'm quite happy to keep giving up a percentage of my wages knowing that every time I call an ambulance for a person in need, I am not going to financially ruin them; that every time I throw out supplies from a patient's vacated bedspace, I'm not sending that critically ill person and their family in debt; that should I ever be the one who needs attention, I don't need to be reaching for my credit card as I lie in a pool of my own blood.

[Sorrowgrave]

The American healthcare system is third-world and elitist, and the more I learn about both it and the NHS, the more I am convinced I never want to step foot in the USA again and feel sorry for all of you who have to suffer with it. Every American RN I have worked with are also of the same opinion, so it's not just an English nurse's view of the American health system; it's the view of American nurses who have worked in both systems as well.

 

I'm quite happy to keep giving up a percentage of my wages knowing that every time I call an ambulance for a person in need, I am not going to financially ruin them; that every time I throw out supplies from a patient's vacated bedspace, I'm not sending that critically ill person and their family in debt; that should I ever be the one who needs attention, I don't need to be reaching for my credit card as I lie in a pool of my own blood.

a class mate of mine got into a car wreck and had to tell the woman who was calling 911 NOT TO because they couldn't afford it.

 

I'm not sure what happend to him, I heard this from a friend of the family of theirs.

 

I'm also convinced that here in america if someone dies in a hospital due to neglect on the staff's part that the hospital should drop the medical bill, AND cover the funeral costs.

Edited July 20, 2012 by Sorrowgrave

[demonicvampiregirl]

I'm all for anything that will help my father get the support he needs.

 

He had a accident 20+ years ago that left him disabled. He can walk but he has a lot of pain because he kept the leg. His back hurts and each time there is a cold front it hurts even more. He was wanting to get his leg removed at one point but no one would do it so now he's stuck with it unless he tries again. He can't work now because of it being this bad.

 

It wasn't all that bad a few years ago but it's gotten worse. He use to use only one cane to walk and now he has to have two sometimes. I don't like seeing him like that but I can't do much. He's on SSI now.

 

I have 5 others in my family who have/are working in some form of medical field. Two cousins, one aunt, my mom and my grandma. If there is something that can help benefit them then fine let it happen. I'm sick of the doctors and the people who manufacture the meds getting rich off people suffering. I watch my dad go through it each day and it's not fun. I hide that I don't care about a lot of things but I do.

Edited July 20, 2012 by demonicvampiregirl

[Obscure_Trash]

My only problem with the reform is that there doesn't seem to be any caps in place on insurance companies or anything, so they're basically able to take advantage of us money-wise. Which is ridiculous, because of this:

 

I think some of us did some calculations on this a while back. We worked out that our National Insurance in the UK (which goes towards both the NHS and our state pensions) is actually less than most Americans pay per year for private health insurance. Plus no one in the UK has to worry about not being able to afford an ambulance.

 

Which I also remember us doing. So basically this:

 

The thing about greed is, you cannot legislate it away. Do you think that abuses due to greed and corruption don't occur under more socialized healthcare systems, or that real people do not end up paying the price for being involved in a system that is too big to care about them?

 

I really just think we need to split the US up so we can be more manageable. But splitting the US into separate countries is never going to happen.

 

~

 

I love being covered until I'm 26 under my parent's insurance. Since I'm a full-time student, I don't have a full-time job, so without that, I basically wouldn't have any insurance.

[Rosedamai]

Oh, I'm currently hospitalized, so this is a great chance to talk about the Korean system.

 

Here's a very good explanation of how the South Korean healthcare system works, which-after experiencing healthcare in Canada and South Korea-I think is pretty great.

 

Basically, everyone is covered for everything (with some amount of deductible) as long as the procedure is not elective.

 

Structure of Healthcare System in Korea

 

In Korea, doctor’s offices and hospitals are privately owned, except a small number of community hospitals. There is a national health insurance, funded by nationally levied tax, in which everyone must enroll. Private health insurance exists to cover expenses that the national health insurance does not cover.

 

The centerpiece of this structure is the national health insurance, governed by National Health Insurance Act. Every Korean citizen living in Korea (and a few others) are automatically enrolled in the health insurance. The only exception is those who receive “medical protection,” which is an out-and-out welfare system – essentially, everything is paid for and there is no premium. This is reserved for the extremely poor, refugees, children of independence fighters and other significant contributors to Korea, possessors of important intangible cultural products (e.g. artisans of very rare traditional ceramics,) and so on.

 

Everyone who is enrolled in the insurance must pay a premium. There are two avenues through which payments are made. Those who have a job pay half of the premium deducted out of their paycheck, and the employing company pays the other half. Those who do not have a job pay their premium directly to the National Health Insurance Corporation, a government-owned corporation that administers the insurance. The two types of premium are roughly the same in amount, but not identical. The amount of the premium is determined like tax -- the more you earn, the more you pay. In 2009, on average, each family in Korea paid around $8,000 a year for the premium.

 

The NHIC is run by a number of committees, whose members usually are representatives of the medical community, taxpayers, the government, etc. For example, the board of directors that governs the entire corporation has 18 members, which is broken down as follows: the chairman is appointed by the president based on the recommendation from the Minister of Health, Welfare and Family; the chairman in turn appoints five members; heads of related governmental agencies take up four positions; unions, employer associations, consumer organizations, fishing/agricultural associations can each appoint two.

 

Under this leadership, the biggest function of the NHIC is to set the cost of every single medical procedure that the law covers. This is a big range, since the law requires coverage of all medical procedures except electives and certain other expenses, such as an upgrade to a nicer hospital room or food. Significantly, this covers medicine – which makes prescription medicine extremely cheap. NHIC insurance also covers traditional medicine (herbal remedies, acupuncture, etc.) and other semi-medical practitioners, like chiropractors.

 

So this is how the whole machinery works, in a very simplified form. A patient visits a doctor. After diagnosis, the patient pays a small amount of deductible – usually a small percentage of the cost set by NHIC (which varies from the type of treatment and the type of doctors one visits) – to obtain a prescription. The patient takes the prescription to a pharmacy, where again she pays a small amount of deductible to get her medicine. Then the doctor and the pharmacist claim the full cost (which is pre-set by NHIC) of the visit to the NHIC. The NHIC pays the doctor and the pharmacist, out of the premium that every Korean has paid.

 

Although the national health insurance covers a lot, private health insurance companies still exist in Korea. Even with the national health insurance coverage, certain disease or chronic conditions – for example, cancer – can still be very costly for middle class Koreans, because the treatments for those diseases include many options that are considered elective, and the treatments tend to get drawn out while rendering the patients unable to work. Therefore, many Koreans also join a private health insurance that covers what the national health insurance does not cover, such as deductibles (which can get high, since it’s a percentage of the NHIC-set cost rather than an absolute amount,) lost wages, etc.

 

The Good

 

The benefits of this system are obvious. First, everyone gets affordable healthcare. This is huge, and cannot be stated with enough emphasis -- in Korea, everyone can visit just about any doctor for anything for less than $5 [fixed because of overstatement] relatively small amount of money. Koreans very frequently visit the doctor's office for any common cold. Often, this leads to early detection/treatment of a more serious illness.

 

Also, Korean patients almost never have to deal with any bureaucracy, since main exchange of paperwork happens between the doctor and the NHIC. As long as the patients can pay the deductibles, they can visit any doctor in Korea. Given that nearly every corner in the country can be traveled under three hours on a high-speed train, it is very easy to visit the best doctor in the country (who would likely be in Seoul) if anyone wants to.

 

On top of that, the whole system is really cheap. No one likes taxes, and Koreans grumble on the national health insurance fee as much as anyone. But Koreans on the whole spend about 6.3 percent of its GDP on healthcare, which is lower than Europe/Canada (which is around 10 percent) and a lot lower than America (which spends appalling 15 percent.) The low cost is partly achieved by having a single-payer system, which significantly lowers the administrative cost.

 

The Bad

 

First, the coverage under the Korean national health insurance is not as good as the European countries, especially when it comes to more expensive diseases. Given that Koreans generally pay less for premium compared Europeans/Canadians, NHIC tends to be more conservative on what type of procedure counts as covered. This is not a big deal with primary care where a procedure for common cold, for example, is straightforward. But this could pose a problem when it comes to a chronic condition or a complex disease like cancer where there are many extra tests, etc. that the national health insurance does not cover. (Which this makes cancer insurance a good idea for many Koreans.) It also does not help that these diseases/conditions drag on for years.

 

The end result is that while European/Canadian national health insurance pays up to 90 percent of the total medical cost, Korea’s national health insurance ends up paying around 55 percent of the total cost. While Korea does not have too many cases of a middle class family receiving treatment all the way to bankruptcy as happens in America, there are definitely cases where lower-middle class families do not invest in a private health insurance and later get bowled over by cancer treatment expenses. (Which is a popular recurring theme in Korean dramas.)

 

Second, doctors just don’t earn a whole lot of money. Korean doctors are well-off compared to the rest of the society, but they earn about half of European and Japanese doctors, and about a quarter of American doctors in PPP-controlled income. This is because even if you are the best doctor in the country, you still have to charge the NHIC-set price – and the NHIC price, compared to the rest of the developed world, is pretty low. There is some differentiation in the NHIC price that factors in the doctor’s expertise, the hospital’s facilities, etc., but that difference is not big. For each of the same medical procedure, Korean doctors can only charge one-eighth of what American doctors charge or one quarter of what European/Japanese doctors charge.

 

Doctors and pharmacists have some influence over the NHIC price through their representatives on the NHIC committees, and they actively lobby every year to raise the price. But they cannot be too vigorous in asking for a raise, since it does not look good for them in the eyes of the public given that they are still in a relatively high-earning profession.

 

This has real effects on healthcare. Think about it from the doctor’s perspective – if the price is fixed, how can they earn money? Broadly, there are three ways: (1) see more patients; (2) perform treatments that have a higher NHIC price or are not covered by NHIC; (3) find another way to get paid.

 

Because Korean doctors are incentivized to see more patients, they often cram in as many patients as they can, in a practice derisively called “five-minute diagnosis.” As of 2005, each Korean doctor sees three to four times more outpatients than doctors in other OECD countries. Many Korean patients complain about this practice, as they do not feel adequately cared for.

 

Korean doctors are also incentivized to over-treat a patient or recommend more expensive treatment. For example, Korea is the world leader in caesarian delivery – a whopping 43 percent of all births – partly because doctors are more likely to recommend a c-section, which has the higher NHIC price. Korea also has more hospital beds, CT scanners and MRI machines than OECD average, partly because hospital stay and advanced scanning has the higher NHIC price. Koreans have longer hospital stays than the OECD average, for the same reason. One can argue under this system, patients who do not require extended hospital stay are wasting resources. Also, to avoid the grip of the NHIC price, top medical students often adopt a specialty that the NHIC generally does not cover, like plastic surgery or dermatology.

 

Doctors also look for other ways to get paid under this system, and the most common way is to receive kickbacks from pharmaceutical companies for prescribing their medicine. This practice sometimes leads to a pattern of over-prescription that has a direct consequence on the national health. For example, Korean patients are notorious for having high immunity against antibiotics, because very strong antibiotics are over-prescribed partly due to doctors’ profit motives. It is also somewhat common for doctors to form an alliance with certain neighborhood pharmacies and receive some amount of fee for referring to patients there to pick up their prescription, which can be considered an unfair business practice.

 

Lastly, because the patients can visit any doctor in the country, they often opt to visit the best doctor in the country for any petty ailment. So the best hospitals in Korea – like Seoul National University Hospital, Yonsei Severance Hospital, National Cancer Center, etc. – often have a significant waiting time not unlike the horror stories one hears about other socialized medicine countries.

 

But hey, from a patient who's just got a big, invasive surgery on the heart, I don't think it's that bad. It wasn't as expensive as I thought, probably due to the fact that many of the procedures were covered by healthcare. For mundane, everyday stuff, like curing the cold or, say, getting rid of zits, it costs less than getting MacDonalds french fries.

 

So yeah, the South Korean system is really good, unless you have a very rare disease or something that's not covered by the premium, and as most prescriptions and procedures are covered by the premium, I'd say that my country has a very nice healthcare system. From the patients' view, anyway.

 

Edit: I'd also like to add that I had broken my arm a few years ago. I was hospitalized for about 5 days, during which I had my bone operated on. The doctors asked me if I wanted to get rid of the nail (which had been put into the space between my bones to keep it in place) in the future, to which I agreed. The whole thing cost....about $550.00, including everything, like the x-rays, the hospital fee, the care I got after the surgery, and the nail removal surgery I got later.

Edited July 21, 2012 by ylangylang

[NobleOwl]

60 Year old needs said organ to survive but, so does a 27 year old. Ethically speaking it would be morally right to give the organ to the 27 year old; however, how can we outweigh the possibility the 60 year old can live 20-40 more years? Heck, even live to be 100? From a moral stand point you could say the twenty year old could live longer with that organ, though how do we say who has the right to live and who doesn't? Everyone has the right to live and opportunity to get the treatment they're entitiled too. Uh, this is something considered the death panel in that reform.

 

This already happens, with far more than just organ donation.

 

Who gets an organ is decided by a national organisation, who factors in age, race, lifestyle, and disease before deciding UNILATERALLY who gets what organs.

 

Insurance companies, as they are now, decide who gets what what treatments by deciding what they will and will not pay for and for whom they will pay that. They can decide to call something as universally used as chemotherapy "experimental" when they want too.

[Aislein]

I say we need a healthcare reform but not obama care, from what I've read and seen on tv we'd all be screwed if it pass's because if you don't get healthcare because you can't afford it you get fined $2000 a year and that's money you need to live on that could be put into paying medical bills instead, in fact a few people we know have said "obama care is legalized blackmail"

 

we have seven people in our house with varying health problems and WE CAN'T AFFORD obama's healthcare reform bill, much less actual health insurance

Edited July 21, 2012 by Aislein

[NobleOwl]

I say we need a healthcare reform but not obama care, from what I've read and seen on tv we'd all be screwed if it pass's because if you don't get healthcare because you can't afford it you get fined $2000 a year and that's money you need to live on that could be put into paying medical bills instead, in fact a few people we know have said "obama care is legalized blackmail"

 

we have seven people in our house with varying health problems and WE CAN'T AFFORD obama's healthcare reform bill, much less actual health insurance

Don't believe everything you see on TV. Low income households are covered in Health Care Reform Act.

[Kestra15]

A 26kg life-threatening tumour...and the woman didn't do anything about it because she didn't have the health insurance to cover it. An excellent example as to why I think the US Health System is shocking.

 

Please note before clicking this link that there is a small photo of the tumour in the article, so don't click if you don't want to see. http://uk.news.yahoo.com/doctors-remove-51...-235308152.html

 

The text, for those who don't want to risk the photo:

 

New Jersey surgeons removed a rapidly growing, 51-pound (23-kg) cancerous tumour from a woman who had delayed treatment for more than a month until she became eligible for health insurance, her doctor said on Tuesday.

 

"She was a skinny lady with a huge belly. I mean it looked like she was literally pregnant with triplets," said Dr. David Dupree, who led the surgery on the 65-year-old woman, at Riverview Medical Centre in Red Bank, New Jersey.

 

"She was just all belly," he said in describing his first meeting with the patient, a homemaker from nearby Union Beach, New Jersey, who asked to be identified only as Evelyn, her first name.

 

About six to eight weeks before she showed up at the hospital, Evelyn noticed discomfort in her abdomen and that her normally 120-pound frame was rapidly ballooning. Dupree said she sought medical help on June 4, just days after her 65th birthday, when she would qualify for Medicare, the U.S. healthcare program for seniors.

 

"The reason she didn't go earlier was because she had no insurance," he said.

 

By now, she weighed more than 170 pounds, her legs were swollen with trapped blood, she was badly dehydrated, and, scans showed, the tumour - a malignant sarcoma - was crushing her inferior vena cava, one of the main veins returning blood to the heart, and putting her life in danger.

 

With her body too weakened to be operated on immediately, Dupree scheduled surgery for the following Monday, allowing time for her to become rehydrated and for her blood pressure to be brought under control.

 

But after she became short of breath on Sunday evening, Dupree brought the surgery forward.

 

"I knew that she wasn't going to make it through the night," he said.

 

"Either she goes now or she dies tonight," he recalled thinking.

 

Opening her up, Dupree and his team found the tumour, which appeared to have originated out of the fatty tissue around her large intestine, had engulfed many of her internal organs, and had to be sliced away "millimetre by millimetre" over the course of the five-hour surgery.

 

Evelyn was still recovering from the operation in a rehabilitation Centre on Tuesday, Dupree said. She declined to be interviewed.

 

Although the immediate threat to her life has passed, she must still see an oncologist about treatment for her cancer, which may not have been completely eradicated by the surgery, and may require chemotherapy or radiation therapy.

 

Dupree said he would advise uninsured patients to see a doctor immediately if they knew they were unwell no matter how near their 65th birthday might be. He said the hospital would have operated on Evelyn regardless of her insurance status, but added he did not know whether doing so would have cost her more money.

[Drachenlied]

@ ylangylang - Oh, wow. Thank you for that. That was really detailed.

 

@ Kestra15 - Sadly, that's not the first time I've ever heard of something like that happening because someone can't afford health care...

[Drachenlied]

Warning for some questionable comments.

 

http://news.yahoo.com/obama-embraces-healt...7--finance.html

[Fuzzbucket]

I think some of us did some calculations on this a while back. We worked out that our National Insurance in the UK (which goes towards both the NHS and our state pensions) is actually less than most Americans pay per year for private health insurance. Plus no one in the UK has to worry about not being able to afford an ambulance.

Right on. And as for insurance - all that needs to be done is capping the amount such companies can charge. It isn't rocket science. I knwo too many people in the US who are far sicker than they need be because they simply cannot afford treatment.

 

Years ago Saskatchewan bit the bullet, banned private insurance and set up universal healthcare. Thence came Canada's healthcare system, which - like the UK's - is excellent and free at the point of need. As I recall one state wanted to opt out of Obama care and bring in what they called Saskacare, as they felt Obamacare didn't go far enough. It is sad that the Republicans are quite deliberately laying out misinformation about the costs to individuals. Too many of them have shares in insurance companies....

[Princess Artemis]

Right on. And as for insurance - all that needs to be done is capping the amount such companies can charge. It isn't rocket science. I knwo too many people in the US who are far sicker than they need be because they simply cannot afford treatment.

 

Years ago Saskatchewan bit the bullet, banned private insurance and set up universal healthcare. Thence came Canada's healthcare system, which - like the UK's - is excellent and free at the point of need. As I recall one state wanted to opt out of Obama care and bring in what they called Saskacare, as they felt Obamacare didn't go far enough. It is sad that the Republicans are quite deliberately laying out misinformation about the costs to individuals. Too many of them have shares in insurance companies....

Cap the amount insurance can charge? That actually mighty help. It also might help if a Californian could buy quality Wisconsin insurance, if that insurance is better and less expensive. Give medical insurance a taste of market pressure. That actually does wonders to lower the price of medical treatment, why not try it on insurance? In the US at least, what is in essence a cure for nearsightedness, LASIK, costs $2500 total. People can have their nearsightedness cured for less than that if they shop around and go in knowledgeable. I, personally, don't know many medical conditions that involve surgery that can be cured for such a low cost, but then, I'm not a doctor. I suppose LASIK is cheaper in lands that have socialized medicine? How much, in Canada, does the government pay the doctors to perform LASIK?

 

It would also help for hospitals and such to actually have a standard rate for everyone, instead of a much less expensive per-negotiated rate for insured people and another for cash only. One that people would be able to find out ahead of time, so they can, if possible, make informed decisions about what hospital gets their money. If hospital A charges an absurd amount but actually doesn't have a stellar record to back that, if all hospitals had a standard rate they charged everyone, an insured person could take their insurance and go elsewhere. Put some market pressure on them, as well. Those who cannot pay at all would still be able to get hospital treatment for that $0, which would be, as it is now, passed along to the paying customers.

 

As far as a state in the US wishing to opt out of Obamacare and do something different, something that goes farther? That, actually, I haven't such an issue with. Do the experiment in a state, a state that has the right to determine its own government functioning (or would if the Fed weren't too big for his britches). If US citizens balk, in that state, to being taxed on the fact that they are alive, they can move to another state. If residents of other states like what they see in health care, they can move there. It's pretty common for residents of a state to move if they feel their state is no longer inhabitable, and to relocate to states that are better suited for them.

 

I wish the Several States had a greater ability to be what they are instead of having the Fed just get bigger and bigger and bigger until we all smother under it...then if one state wanted full out socialized health care, they could. Another wouldn't be forced to go along if they didn't want to.

 

As far as costs go: http://useconomy.about.com/od/fiscalpolicy/p/Mandatory.htm has some basic information about mandatory spending in the US and why making that bigger, as Obamacare will do, will, well...make that bigger. One may draw one's own conclusions on whether or not having a country increasing the size of buying off voters with the voters' own money is a good idea or not. The 'success' of and the necessity of austerity measures in other nations suggests to me that the US following down that path is not necessarily a thing to be desired. I believe that there are other ways to reform health care in the US without socializing it anymore than it already is.

Edited August 6, 2012 by Princess Artemis

[Zaxian]

... I suppose LASIK is cheaper in lands that have socialized medicine?  How much, in Canada, does the government pay the doctors to perform LASIK?...

In the UK at least, LASIK is not covered by the NHS for conditions that not progressive or sight-threatening (like short-sightedness) as it's essentially a cosmetic treatment in that case. Especially since prescription glasses are already covered by the NHS for those who can't afford them (and if you don't get them free on the NHS, Tesco do free sight tests anyway and you can buy a pair of prescription glasses + lenses from them for all of £15).

 

(See NHS Direct - Can I get laser eye surgery on the NHS?)

[Princess Artemis]

In the UK at least, LASIK is not covered by the NHS for conditions that not progressive or sight-threatening (like short-sightedness) as it's essentially a cosmetic treatment in that case. Especially since prescription glasses are already covered by the NHS for those who can't afford them (and if you don't get them free on the NHS, Tesco do free sight tests anyway and you can buy a pair of prescription glasses + lenses from them for all of £15).

 

(See NHS Direct -  Can I get laser eye surgery on the NHS?)

LASIK is cosmetic but prescription glasses are not? If one has a need for prescription glasses, then...one might very well have a need for LASIK.

 

The NHS does not cover prescription glasses for, well, everyone? Now I'm curious. What does the NHS cover? Optometry? Dentistry? These are two professions t=in the US that Medicare is least likely to cover, so I'm curious.

Edited August 6, 2012 by Princess Artemis

[Fuzzbucket]

LASIK is cosmetic but prescription glasses are not? If one has a need for prescription glasses, then...one might very well have a need for LASIK.

 

The NHS does not cover prescription glasses for, well, everyone? Now I'm curious. What does the NHS cover? Optometry? Dentistry? These are two professions t=in the US that Medicare is least likely to cover, so I'm curious.

The NHS covers health care. No-one gets to stay sick because they cannot pay.

 

Dentistry and optometry tests are free for children and those on very low incomes and the prices are capped for everyone else (the maximum you could pay this time last year (it will have gone up) for a dentistry course of treatment was £180, for which I could have had any number of crowns etc....)

 

Glasses cost unless you are very low income, but as Zaxian says, you don't have to pay huge sums - I wasn't aware of the £15 ones; I shall have to look into that.. I THINK they may still be free for children, but I've not needed to know for quite a while. Lasik is all very nice but given the comparative cost of glasses, no, you can't usually get it on the NHS. Because glasses do the job, even if you don't like them.

 

As to Canada - in Ontario, at least, there is a fixed fee for any given procedure. That is all the doctor or hospital can charge, end of. And the bill goes direct to the province - the patient doesn't even need to think about it - just waves their health card instead of VISA. WAY better.

[Zaxian]

The NHS covers health care. No-one gets to stay sick because they cannot pay.

 

Dentistry and optometry tests are free for children and those on very low incomes and the prices are capped for everyone else (the maximum you could pay this time last year (it will have gone up) for a dentistry course of treatment was £180, for which I could have had any number of crowns etc....)

 

Glasses cost unless you are very low income, but as Zaxian says, you don't have to pay huge sums - I wasn't aware of the £15 ones; I shall have to look into that.. I THINK they may still be free for children, but I've not needed to know for quite a while. Lasik is all very nice but given the comparative cost of glasses, no, you can't usually get it on the NHS. Because glasses do the job, even if you don't like them.

 

As to Canada - in Ontario, at least, there is a fixed fee for any given procedure. That is all the doctor or hospital can charge, end of. And the bill goes direct to the province - the patient doesn't even need to think about it - just waves their health card instead of VISA. WAY better.

AFAIK children get a sort of 'voucher' toward glasses - which will cover the cost of a basic pair, but you can choose to pay more for lens coatings etc.

 

As for the £15 glasses: Tesco's value prescription glasses - single vision lenses are free with these.

 

LASIK is cosmetic but prescription glasses are not?  If one has a need for prescription glasses, then...one might very well have a need for LASIK.

 

The NHS does not cover prescription glasses for, well, everyone?  Now I'm curious.  What does the NHS cover?  Optometry?  Dentistry?  These are two professions in the US that Medicare is least likely to cover, so I'm curious.

Those who are on income support can get glasses and opticians appointments for free. Those who aren't can choose to get their opticians appointments free (i.e. from somewhere like tescos) and their glasses incredibly cheaply - or pay more if they want something swankier.

 

And yes, glasses are not cosmetic because you MUST be able to see to drive, etc - the problem can be corrected completely by wearing glasses. The NHS will not stump up the extra cost (orders of magnitude more) just because you don't want to wear glasses and want laser eye surgery instead.

 

And again, with dentistry, the NHS will pay for treatments that are life threatening. As fuzzbucket said, they heavily subsidise other treatments, but if you want your teeth whitened (cosmetic!) then you'll have to pay yourself. Or perhaps a better example is braces - if you have wonky teeth that are causing health problems, or preventing you from eating/speaking properly, or preventing other teeth coming through, you can get braces and orthodontist treatment on the NHS. But if you just have really wonky teeth that otherwise work as teeth, you'll have to cough up for private treatment if you want them straightened.

Edited August 6, 2012 by Zaxian

[Princess Artemis]

Interesting. The comparative cost of glasses vs LASIK in the US sometimes, but not always, comes out in favor of LASIK as a long term solution.

 

That's why I opted to get LASIK when the opportunity arose. In the long run, it was cheaper than what I was doing, more effective than glasses, and safer than contacts. Quite extraordinarily hard to misplace my own eyes or drop them, leave them in my purse and risk having them stolen...

 

So, Fuzz, I am assuming that Canada must have some astonishingly good medical malpractice laws in order that doctors can make a living wage, since you think the US just cutting prices across the board and keeping them there would be so very easy a solution. Care to share?

Edited August 6, 2012 by Princess Artemis

[teslakana]

I think our system needs reforming, but not in the direction it is going now. It has been for a long while a hodgepodge of private insurance (real insurance, what one gets for unexpected catastrophic expenses one cannot pay for, such as house fires and cars being totaled, not expected expenses), something we pay into to make our expected expenses cheaper, and socialized healthcare (because for a long time, private insurance buyers have been paying higher premiums to cover the expenses incurred to doctors and hospitals for having to provide for Medicare patients and those without insurance who cannot ever pay but still get treated). Adding another layer of hodgepodge to that mess can only end in disaster. If it is to be reformed, it makes sense to dismantle parts of the mess and get to the heart of the thing, not tack on a monstrosity of a law that very few people have actually read, even now.

 

Through my family, I know doctors who are retiring and who are no longer providing care to Medicare patients because they will not be able to afford it under the Obama law.

 

The thing about greed is, you cannot legislate it away. Do you think that abuses due to greed and corruption don't occur under more socialized healthcare systems, or that real people do not end up paying the price for being involved in a system that is too big to care about them? As for myself, I find government taking money out of my family's pocket that could be used to care for our own needs and the needs of those around us and giving it to people we do not know and as often as not who do not need the fruits of our labor to care for them as theft. It also opens the door for other people to tell you what you should or should not do with your body, because as taxpayers who have the fruit of their labor supporting your health care, they absolutely have a vested interest in doing so. Don't want your neighbors to have a stake in what you do with your body? Don't get into a socialized healthcare system.

seconded

[Fuzzbucket]

Interesting.  The comparative cost of glasses vs LASIK in the US sometimes, but not always, comes out in favor of LASIK as a long term solution.

 

That's why I opted to get LASIK when the opportunity arose.  In the long run, it was cheaper than what I was doing, more effective than glasses, and safer than contacts.  Quite extraordinarily hard to misplace my own eyes or drop them, leave them in my purse and risk having them stolen...

 

So, Fuzz, I am assuming that Canada must have some astonishingly good medical malpractice laws in order that doctors can make a living wage, since you think the US just cutting prices across the board and keeping them there would be so very easy a solution.  Care to share?

People aren't so lawyer happy, for a start. I think it is SICK the way people keep suing doctors who did their level best - they almost TRY to find a reason to sue (I have no particular issue with suing ones who genuinely screwed up, though I'm not sure how it helps except with care costs.) But Canadian doctors all have malpractice insurance, and on the whole I haven't seen any problems. I used to work for a doctor in Canada, and I never heard of one being sued.

 

And they seemed - still seem - to make a perfectly good living. My boss certainly did - and he was an ordinary family doctor. What can I say ? Media misrepresentation in the US paid for by insurance companies (and Fox News...) I suspect....

 

It works. And you get to go to hospital without the fear of losing your home to bailiffs. I don't think the US system does work. Nor do ANY of my US friends - including a fairly high flying lawyer in Ohio.... YMMV.

 

As to the comparative cost of glasses - I've no idea what sort you buy (and equally I wasn't aware of those rather good looking Tesco ones) - but I am not about to pay for Armani frames, and I don't think a health service should either. It would take one HELL of a lot of pairs of glasses to come close to the cost of Lasik.

 

ETA in relation to greed. I am sorry to say there are some greedy doctors out there, too. And sure - there are times when your money would be paying for the health care of others (JUST AS HAPPENS WITH INSURANCE ! when did you last claim on that expensive auto policy ?) - but one day someone you know or love would be able to be treated for that heart attack/broken leg/brain tumour without the fear of a massive bill.

Edited August 6, 2012 by fuzzbucket