I’ve Lived Both Sides of the Healthcare System. This Is What I've Learned.
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brykmantra This debate has been furiously argued on both sides for several months, so I thought I’d throw my hat in the ring. I lived with the British National Health Service (NHS) until I was 26 years old, and then I moved to America. For the last 9 years, I have lived with private healthcare.
Obviously this is just one man’s opinion. You have your own opinion, and that’s cool. That’s what’s great about this country. What is also great is that we can talk openly about this in a public forum, and (hopefully) spark some intelligent debate and questions. So, let me first begin with my experiences from both sides of the pond.
Living With The British NHS
You will hear horror stories about British healthcare, and I will be the first to say the system is not perfect. But it is no archaic nightmare filled with medieval torture devices and untrained doctors. On the whole, my treatment was great.
When I wanted to see a doctor, I saw a doctor. No co-pay. It was the doctor of my choosing, and my family has had the same GP since way before I was born. He was always being retrained on new techniques, and he wasn't overzealous with a prescription pad. When I made an appointment, I was seen within 10 minutes. If I came in without an appointment, the wait could be an hour or more. I never waited longer than 90 minutes, and that was only because I was a walk-in. When I saw my GP, I was never rushed in and out of the consultation room.
I had several small operations in Britain and everything went very smoothly. The wait from diagnosis to treatment was a few weeks. This may not be the case for everyone, but it was for me. Every hospital I ever went to was clean, efficient and, well, full. Yes, I will admit that there are too few hospitals, but that never stopped me getting treatment in a timely manner. When my sister had a baby, she was in a beautiful room which she shared with one other lady. It wasn't a private room, but it wasn't like a M*A*S*H ward either! And it's also worth noting that private insurance is available in Britain as an addition to standard coverage. BUPA is one example. So, if you have the money, you can upgrade to private rooms, jump ahead on a waiting lists, that kind of thing.
Doctors and nurses, in my honest opinion, usually seemed quite happy with their work. However, most doctors in Britain earn a far more modest income than in the U.S. As far as I know, it's not a sticking point, but then again I'm not a doctor. I'm sure some salivate when they see the amazing salaries commanded by many U.S. doctors.
Were there major downsides? Well, taxes were higher to help pay for the NHS. But, there were usually no co-pays, and prescriptions were filled at a standard price (around seven pounds last time I checked). There are definitely limits imposed on people in Britain, too. For instance, you may have to reach a certain age to be entitled to a hip replacement. And as I said, hospitals are sometimes few and far between. My own parents usually have to travel to the next town for some treatments because the hospital within their town is small and has limited services. But I never had to stand in line for a day to see a crummy, overworked doctor. It was not some “Glenn Beck Nightmare” with rusty beds, abandoned wards and filthy patients roaming the hallways of darkened hospitals. I was just fine, healthy, and happy.
My Treatment In The U.S.
Great. I can't deny it at all. I've had plenty of co-pays over the years, but I think that equates (kind of) with paying higher taxes for healthcare in Britain. Here, I pay out of pocket; back there I was paying before I saw my money.
Prices for my medicnes, until this week, were fine. I have always been on a $10/$20 plan for generics and name-brand. That did just change, and now I dread the day when I may have to take a name-brand drug, as I am no longer covered for those.
My waiting times here have been great, too. They were the same as in Britain, with no wait for scheduled appointments and up to an hour for a walk-in. The operations I had went fine, were painless, and came with a small $50 outpatient fee. My wife had two babies here, both births went very well, we had our own private room, and each time our total cost was just $200 (I saw the bill that went to the insurance company...$20,000!).
Overall, when I was privileged enough to have good insurance through an employer, I was fine. But now, that's no longer the case, and I'm just hoping none of us ever get really sick or need major drugs, as we'll see ourselves facing huge bills.
In conclusion...
After living with both systems, and seeing very little difference in the actual quality of treatment, I have to say that I am for a public plan. The idea of making a profit healthcare, well it just leaves an incredibly nasty taste in the mouth. Knowing that while some people are being denied coverage for the most puerile reasons, CEOs and shareholders of these companies are earning billions of dollars, it's just plain wrong.
Right now, a friend of our family is facing untold horrors because of the healthcare system. They are millions of dollars in debt because their daughter was diagnosed with cancer and they could not afford the $1200 per month for private family health insurance. They could lose everything, and at the same time still have to support a sick little girl. Is this fair? Not when you know that vast, vast sums of money are wasted in our current system, and that money goes to pad the bank accounts of the wealthy.
It’s an argument I’ve been having with people for years. “What’s wrong with profit, what are you, a socialist?” Not at all. Profit is great and I applaud it. If you want a Ferrari, and you can afford it, by all means go and line the pockets of the Ferrari company. I don’t care. If you want an Omega watch, go get one. I hope Omega makes a fortune. If you buy Starbucks coffee, you are making the Starbucks corporation rich, and I say good for them.
But here’s the thing.
No one needs a Ferrari. No one needs an Omega watch. No one needs a coffee from Starbucks. For that matter, no one needs most things that are available today, from your average family-sized pizza to a luxury home in the Hamptons. They’re all wants.
People NEED healthcare. It's that simple.
They need to live. They need help when they’re sick. They need operations to fix broken legs or arms, or heart transplants, or brain surgery. It’s not like they can say “nah, I’m just not really digging this whole cancer treatment thing, I’ll shop around and see if I can pick up a DIY version at Sam’s Club.”
Now, when you couple a “need” with profit, you get slammed. We all saw it with the massive rise in gas prices not so long ago. How many of you stopped driving completely? It just didn’t happen, because we need gas to get around. So, we paid the price and the oil companies had demolition derbies with Rolls Royces.
Healthcare for profit, that’s even worse in my book. There is all this talk of “death panels” and old people being denied coverage, but these things already exist! There are people employed by health insurance companies to keep costs low and profits high. That’s why this enormous and ever-growing list of pre-existing conditions exists. My doctor once told me he was wary of removing a suspicious mole I had because I may not get future coverage for skin cancer! What kind of madness is this?!
To a health insurance company, it’s a risk and rewards game. They give you coverage, but it’s all conditional. They can deny coverage at will it seems, and they give you lifetime maximums that, because costs keep rising, are now being met, even by children. I recently read a story of a young boy who can no longer receive new prosthetic arms because he’s hit his max. But something tells me the CEOs are still getting big bonuses and rising salaries.
And then there’s the issue of switching jobs. Sometimes, you can’t leave a company even if you want to because you cannot give up the health benefits. It’s called “golden handcuffs” and it can cause real misery.
I had none of the above problems in Britain. Did I have to wait for operations? Yes. But it wasn’t a long wait. In all honesty, my care and service was almost identical to the service I receive here, except it was all paid for out of taxes. I paid more taxes than I do here, but not a lot more. And I can tell you this…no one EVER goes bankrupt in Britain because of medical bills. No one. Not a soul. No one worries about medical bills. It’s not an issue.
You should not fear for your health. You should not be afraid that an illness could lead to bankruptcy. You should not be terrified of the cost of simply staying healthy and alive. And corporations SHOULD NOT profit from healthcare. Because at the end of the day, you and your life will always be less important than the price of their stock.
Now, feel free to mow me down with comments, but consider this. Unlike most people, and most of you, I have lived with both types of healthcare. And I choose the public option. There is nothing to be afraid of. Do the research, forget the hype and fear mongering. In your current healthcare system, over $700 billion is wasted each year in administration costs! You deserve affordable healthcare.
For further reading on the current healthcare debate, check out our sister site, The U.S. Healthcare System: The Good, The Bad, And The Ugly
- The U.S. Vs. The World On Healthcare Quality
- Solidarity (At High Costs): The French Healthcare System
- Socialized Medicine In Britain: Is It Really That Bad?
- End Of Life Care: The Big Bad Wolf Of Healthcare Reform
- The Underinsured: The Sleeping Giant In The Healthcare Crisis
- Understanding The Healthcare Reform Debate: The Uninsured
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I'm sorry but I cannot trust the government in this regard. Medicare/Medicaid fraud and waste is rampant with little hope of resolution. I cannot see public health care being any better. The whole thing smells fishy to me. What will govt mandate next?
Pardon me - you are talking about MedicAid/MedicCare fraud. Where? Please provide some details. I haven't heard of this being a problem.
And just curious - how much have the insurance companies been defrauded? Do you know?
Well Stacey I personally think that the private healthcare system in the US is worse than a public option. It is rationed care and strictly profit driven. Now profit driven because wall street demands a certain target and doesn't give a rat's @#@$ about the individual who may need healthcare. They care about the share holder's and not that is bad in itself but when it comes to people's lives dependent on healthcare it needs to be taken out of the profit driven madness in this country.
I assume you are a Repug and a conservative because you are espousing or reurgitating their words. Don't get all testy now. My family members have had private and medicare and the veterans healthcare. They would choose medicare or the veterans over private.
I am on several health-related email discussion groups with people from around the world--and the Brits are telling me that the NHS has degenerated greatly in the last decade, most of which you have been here.
Likewise, death rates from the cancer you mention are far lower here (among other major illnesses).
We are far from perfect, but the government here has shown time and time again it simply cannot be trusted to run large programs effectively or efficiently. Now, they are cutting existing services to pay for what they propose to foist upon everyone.
Since not all public plans are created equal, I suggest you look at what they are actually proposing rather than apparently assuming it would be similar to Britain's.
There are other means of caring for those not insured than to scrap the whole system...and have 180 different government offices deciding how, when, and how much healthcare you can receive.
It's called capitalism and its worked well for this country for a couple hundred years.
Doctors and insurance companies have a right to make a profit on the services they offer.
If you or the government can all of a sudden decide that Health Care is too important or needed so that it shouldn't be allowed to make a profit then where does it stop?
We all have to eat, maybe farmers shouldn't be allowed to make a profit. We all need power to operate our homes and run our businesses, maybe Utility Companies shouldn't be allowed to make a profit.
What about shelter? Everyone deserves a place to live that's clean and safe, right? Maybe construction workers, architects, general contractors shouldn't be allowed to make a profit.
You can't live w/o money. Maybe banks shouldn't be allowed to make a profit either.
If you prefer a socialist setup then there's plenty of options out there for you.
Capitalism is the best economic system around - but that doesn't mean it is the perfect solution to every problem. If it was all highways would be for profit and you would have to pay a toll every time to got on a road - because our public highway system is by definition socialist. Public schools....socialist. That doesn't mean we should start charging families per student to attend elementary school. Would you want to be charged by the fire department to save your house if it was burning? If you didn't have money to pay for their service - they would just let your house burn because....that is capitalism. The point is, some services may not make sense to privatize - which is why we have government. I personally think health care is one of these services because decisions on a person's health should not be made by companies wanting to turn a profit. And...you shouldn't be excluded from healthcare because you can't afford insurance.
The US has been a country for a couple hundred years, however, as far as capitalism "working well" on its own without government assistance is a different matter entirely. For instance during the 1800s there was a certain capitalist trade that was allowed to make a profit. It was called the slave trade. People that are quick to scream socialism when they get a whiff of government intervention are the same slippery slope preachers that honestly would've said "Hey Lincoln...slavery seems wrong, but if we let you and the socialists take control of how the southern agrarians are allowed to make a profit then before we know it the government will be running our lives." Don't get me wrong capitalism is a great idea. But call your landlord and ask if he'll take great ideas instead of money for rent. If capitalism worked well on its own I cannot imagine what happened during the early 1930s...Or what is happening right now. I didn't hear anyone scream socialism when the 700 billion of "government infringement" went to retarded 7 house owning people in the banking industry whose failing companies are still giving out millions in bonuses. Of course its not infringement when it goes to people on the top of the heap...is it? Yes, capitalism has worked well for this country, with the net and crutch that is government stabilizers, maybe it's time for people to read books that aren't by glenn beck and ann coulture.
By the way farmers don't make a profit and they are government subsidized(not capitalism)construction workers don't "make a profit" they scrape by like everyone else that actually works for a living.
I work a good job and thought I had fairly reasonable coverage, but my plan only covers 75% of costs - so when I had a minor outpatient surgery earlier this fall, I was handed nearly $3,000.00 in bills that I was responsible for. My fiancee is a student with no coverage, and his father was recently laid off and can't even get his own private coverage because of a heart condition. I'm sorry, but I'd rather pay higher taxes and take my chances with the government.
...if capitalism has worked so well, why is this country in such dire straits? Why do we have more debt than any other country in the world? Why are 6500 people applying for 120 jobs at Applebees? Why is the gap between the rich and the poor growing? And let us not forget how many times "Socialism" has been chanted in this country. From public parks and public schools to public transportation, it seems to me that people are very frightened of change. I'm not saying the NHS is perfect, but our current system in America needs an overhaul. Profit is one thing, but denying people a basic right so that someone can make an extra .5% on their stock options is just plain wrong. In my opinion.
YOu are exactly what is wrong with our country. You lack the intelligence to see that Capitalism isn't what has put us in the dire straits and massive debt we find ourselves immersed in. The failed policies of a corrupt government has lead us where we are. When you have Barney Frank telling Fannie May and Freddie Mac that they have to write loans to people who they would normally not, it creates huge problems. When you have a Federal Reserve made up of foreign bankers creating money out of thin air, artificially manipulating interest rates, and hiding their actions from the public, it creates problems. When you allow the military industrial complex to waste billions every week fighting wars we have no business fighting, it creates problems. When you have out of control social programs that reward lack of effort (a welfare entitlement state) combined with an open boarder, it creates problems. Study the facts and analyize them.
You're right! Barney Frank is the reason for the housing crisis! Thank you so much for clearing that up.
Let's get back to reality. Yes, the government mandated loans to people that shouldn't have gotten them. But the mortgage banks decided to mitigate this risk by putting these people in homes they had no chance of being able to afford. They did this because they could fulfill these government mandates and still profit greatly by selling these houses (after the owners foreclosed) at a much higher price than the original mortgage, thanks to inflation of housing prices.
Your argument is ignorant, nearsighted and worthless. Saying, "the government failed at x, so it will fail at healthcare" is not convincing. I could easily say the same thing against the private industry, and it'd be just as pointless.
"But the mortgage banks decided to mitigate this risk by putting these people in homes they had no chance of being able to afford. They did this because they could fulfill these government mandates and still profit greatly by selling these houses (after the owners foreclosed) at a much higher price than the original mortgage, thanks to inflation of housing prices."
Please check your facts before posting....foreclosures have been a nightmare for most banks due to house price deflation. Foreclosures didn't pick up until after home prices collapsed. If you owned a house and couldn't make the payments, but had a profit due to house price inflation. the rational move would be to sell the house into what was then a hot housing market.
How many corporations would still be around if they were run like our government?? The answer is "none".
The government has failed:
1) To balance the budget despite public outcry against it.
2) Has failed to properly fund Social Security so the future taxes will have to climb precipitously our participants will have to face sharp cuts in benefits.
3) Has driven Medicare to the brink of insolvency
4) Has run the post office to the brink of bankruptcy
5) Amtrak - continue to post huge losses
6) The 'War on Poverty' started in the 60's, yet $tt's later, poverty levels are still on the rise.
This isn't about Dems vs Repugs, both sides are equally at fault...its about an increasingly flawed systems where lobbyists and campaign backers have more pull than the electorate.
Healthcare is not a basic right.
It isn't change itself we are afraid of- it's the change to socialism or government provided services we are afraid of.
"A government big enough to give you everything you want is big enough to take away everything you have." - Thomas Jefferson
How can you even maintain that health care is not a basic right? Do you even know what socialism is? This country is not exempt from "socialist" programs (see: police department, fire department, public libraries). Would you like to start paying premiums on police protection?
Introducing a public option is a lot like having public education. Harvard didn't close its doors because we establish the University of Texas.
Fearing "socialism" is an unnecessary and impractical fear. Learn about how the government works first.
Actually, the police are not a socialist program. It is actually spelled out in the Constitution. We pay money for a service. If a private company can do a better job and keep us safe, we should switch to that.
What I don't want to do is have to pay for my healthcare through taxes and then have to purchase an additional plan to cover areas the government doesn't.
The author of this post forgot to mention that.
"How can you even maintain that health care is not a basic right? Do you even know what socialism is? This country is not exempt from "socialist" programs (see: police department, fire department, public libraries). Would you like to start paying premiums on police protection?"
i What we currently have _is_ a form of Gov't health care. I can buy car insurance from any company I want, based in any state, as long as it meets 2 conditions. 1) It's licensed to do business in my state. 2) It meets state required minmums.
If I want health insurance, It has to be licensed in my state, which restricts the number of companies that can sell it. There is *no* competition, unlike car insurance. The state even decides what I can buy, as far as "coverage." Fully Gov't run insurance can only be worse.
Competition guarantees that the products are supplied at the least cost, and best quality. Compare the USPS and FedEx/UPS. FedEX/UPS have to compete against each other and the USPS. The USPS doesn't have to compete against anyone. They are guaranteed a profit, and monopoly service. Is that the health care you want?
Thanks for your objective, and complete posting comparing these two health care systems. I hope we end up with a workable, and affordable system.
John DeFlumeri Jr
Thanks for writing about this. I have family on both sides of the Atlantic; some of those on the other side (all employed with good jobs, BTW) are there because of the health care system comparison (i.e. they get better and more affordable treatment in Europe).
Beyond the important issues you raise, the current US system strikes me as a tremendous drag on our economy. I sat through hours of meetings at one of my employers as the organization negotiated a new health care plan for the coming year (it had provided BCBS, but that got too expensive). The cost of the hours spent on otherwise unproductive activities (i.e., we weren't doing our jobs, just trying to sort out the health care coverage) must have been ridiculous. And of course plenty of people cannot leave jobs or start small businesses because they cannot afford coverage.
I was born in England and lived there for 28 years and have spent the last 29 Years in the United States. Another advantage of the British system is that when you are unemployed health care coverage continues uninterrupted. Also changing jobs is a lot easier with health care independent of your employer.
However, I still prefer the U.S. system. I do not trust the federal government to run health care. These are the same guys running the Post Office, Social Security, and our budget deficits.
A better way is to keep what works and expand on it. Reform what doesn't work. Millions of people are happy with the current system. It would be nice if our premiums were less (mine are over $500 a month) but I believe it is because there are monopolies that prevent market forces from operating. The way to solve this is not for government to start its own monopoly but to attend to the real cause.
One would think that if health care profits are sky high that other companies would want to enter the market and grab some of the profits. If this is not happening, why not? If Congress had spent time asking this question instead of stupidly trying to change the whole world as we know it, maybe we might have a solution.
But at least government action on health care might bring some benefit as opposed to the mindless cap and trade fiasco Congress embarked on.
@Paul Michael
Why is it such a bad thing that there is a gap between rich and poor. Would you rather I take $100 and split it evenly between 100 people, or I take $100,000 and split it unevenly between those same 100 people, such that no one person received less than $2? In the latter case there is huge inequality, but every single person is better off than any given person in the first scenario. That is what we have here. Inequality? Yep. But EVERYONE is better off.
"But EVERYONE is better off"...
Maybe so compared to other countries but do not forget that one of the reasons that this is so in America is because our citizens have demanded higher standards since our nation's inception and fought hard for them. Reforming health care now is just another chapter in our ongoing demand as Americans for higher standards. We shouldn't just say "Oh well at least everyone here is better off" and then just call it a day. When that day comes we can start to kiss our higher standards goodbye.
I am a Registered Nurse. I was born, raised, and educated in Canada, and have lived in the United States for the past 12 years. Your arguments are solid, and I agree wholeheartedly.
I do enjoy working in the United States, but I just cannot understand how any caring, compassionate, civilized society can allow profit and health care to be uttered in the same sentence.
Because work isn't free. You are entitled to your personal liberties and that's it. Everything else, you must work for. I don't work my butt off to pay for some lazy thug to go to the doctor. I don't put in 50 hour work weeks so a bunch of illegal aliens can get a flu shot. Personal responsibility. Have any of you socialists ever heard of that? I do not work to support your 5 kids from 5 different unknown fathers. There is plenty of room to improve the system, but forcing me to pay for your lazy a** is Fascism. Take care of yourself.
So Marc, why are you still here? You're right, every person who doesn't have a job giving them a full work-week and healthcare coverage must be a thug or a slutty mom. /sarcasm
Should we go ahead and privative police coverage, fire protection, and military defense as well? I mean, according to your logic we should just let everyone suffer and/or die if they can't individually afford them.
I'm afraid you'll just have to continue sitting in your home and remaining terrified and red-faced that some of your tax dollars might just end up saving the life of someone who just doesn't deserve it quite as much as you.
OK, Marc. Those of us still working will wave at you on the side of the road when your industry tanks or you get injured or sick and can't keep your job or your insurance.
BTW, you ALREADY work a 50 hour week to pay for all those folks because the hospitals cannot turn them away when they show up in the ER. It would be cheaper to treat a lot of those "lazy thugs" with some preventive care before they have that heart attack and have to be hospitalized for a week on our collective dime.
I applaud your post. I think you made great points. I agree with all of them.
The only thing that I would add/comment on is that at the very bottom of all of this is personal responsibility. I have no problem with providing health care for all - public, single payer, universal, whatever the proper vernacular is. I understand people become sick of no fault of their own. However, one thing I can't stand is people making poor decisions about their personal health (like overeating and not being physically active) or not investing in their own health at all and everyone else pays. I think that's the core of the anti-health care reform push. And I can understand that. I feel like there needs to be transparancy and visibility into healthcare costs and the cause and effect of personal decisions about health. I don't know how to do that, but I think it's the missing link...
It's something to think about. I understand one of the reasons Europe is so regulatory about products and their environment is precisely because the governments pick up the tab for healthcare. They are more attuned to dangerous, potential cancer and other illness causing products and production outputs.
All of the commenters who don't trust the government - are you saying you trust the insurance companies?
Lesser of two evils - the government at least has to make a good show of serving the public. Insurers answer to investors only - that's not who I want deciding whether I get treatment or not.
How about opening up interstate competition between insurance companies? What about reforming the insurance industry? These are better options that putting your trust into the government, and taxing me even more. You want to see government healthcare in action? Look to the shameful way the VA hospitals take care of our servicemen and women. That's government run healthcare. Lesser of two evils? You are clueless. Do some actual research and stop basing your talking points on what Nancy Pelosi says. Reform the insurance industry, reform Medicare and Medicaid, but forcing me to buy this huge tax is the opposite of a free society.
Am I the only one who thinks that giving $100 to 1000 people would be fair? And that getting $2 would suck when the person next to you gets $10,000? That's how riots start, no?
As an American who has lived in Canada, I have to agree completely about the public option. There is nothing to fear about a public option. I got great care in both systems, but the cost of prescription drugs in the US when I didn't have good insurance with drug coverage was prohibitive. A 30-day supply of Prevacid in Canada, even before I had the provincial plan, was $60. In the US, it was $180, so I ordered it online from Mexico for $35. (I couldn't order it from Canada because I couldn't afford the office visit to get a new prescription). The Mexican drugs were fine, BTW. But anyone who says Canadian drugs are unsafe is dead wrong. I'm a nurse and worked in a Canadian eating disorder program. While I did see some long waits to get in to the program, patients were treated on general medical floors while waitng so nobody went without SOME treatment. I think the answer for the US lies somewhere in between these two systems, but the Canadian one is NOT some Glenn-Beck fueled communist nightmare.
but why is it so wrong to question it? I agree that the military-industrial complex is a huge problem, right now you have a military that is waging wars for coporate concerns. Money makes the world go around, but take a look at which nation has the happiest people. It sure as hell isn't America, if I recall it's a Scandanavian country with huge taxes. Isn't quality of life better than being rich and miserable?
To some of the commentors: you don't trust the government but you trust a company that's only out for profit? At least you have A say in the government, regardless of how insignificant it MAY seem. After all, a government is only as effective as it's citizens. If you dislike how things are run, start paying attention to your local elections and vote on ALL levels. Pay attention to the legislation that's being debated and stay in contact with your representatives. It matters.
To the author of this post: thank you so much for this article, especially the part about profits and needs. Healthcare is an absolute necessity and it concerns me the way some Americans express their "socialist" concerns. Perhaps this country would be better off if we could learn to care for each other and our neighbors instead of only ourselves.
"you don't trust the government but you trust a company that's only out for profit?"
The real question is who do you trust least and who do you have the most recourse against. I have been in contact with my representatives, and have only gotten a form letter in response. Representational government only works when our elected officials respresent those who voted for them. In this country, our elected officials appear to be more beholden the the lobbyists and big campaign backers than to the single voters.
At least I can sue an insurance company with some hope of winning.....
The government is better at legislating, not running large complex operations.
You must have awesome health care coverage. two years ago I had to pay around $3000 for my baby to be born... and the bills to the insurance company were higher than what you quoted too. Its almost pointless for me to have health coverage now because i have to pay $1000 out of my own pocket before they pay ANYTHING!
We do NOT have a "health care" system in this country, we have a "health insurance" system. I find it rather laughable that folks who defend our current system describe it as "health care" when it is a for profit insurance.
You can delude yourselves for now if you are young, healthy, employed and never had to dip into Big Insurance pockets. However, once something does go wrong you will see how gracious our system is to the sick.
The best solution is single payer. We would have the exact same system we have now except the government pays for it. Simple...that is why it hasn't succeeded, yet.
This is a great post. I have been engaged in the same argument with various people, but my experience is with the Australian health system (pretty similar to U.K).
Too many people spouting negative comments about a "Public Option" or "Nationalized Healthcare" have no experience with such systems. They are just listening to Glen Beck or Palin - characters that have no experience with them as well!
Now to capitalism. I came to America because of this capitalism. Because people are driven to succeed. Who knows - maybe people are driven to work hard or to start companies because if they don't, they will go hungry and will not have healthcare! Maybe this drives America forward? Then again - I do know many people who would leave their corporate jobs in a flash to launch a startup if they did not have the "golden handcuffs" that Paul mentions.
Finally - I am amazed at how many Americans talk about being afraid of their Government and they are truly afraid to have their government involved in their health. Don't get me wrong - people are pretty skeptical of their Government in Australia, but the conspiracy theories (death panels) and fear that the "Government is out to get us" (so lets stock up on guns) - I have never heard people talk like this in any other industrialized nation I have visited. Not saying it is wrong - just pointing out that this culture is coloring the argument.
... so let's privatize the police, fire service, and the military. "I'm sorry, ma'am. We can't come out and arrest your husband for beating you if you can't afford our $200 fee."
There are services that are NEEDED, and these services should not be left in the hands of those who are motivated by profit and not by patient care. I recently spent a month in England, casually observing the NHS for a Rotary program. I didn't see any kind of deficit in care over what we receive here in the US. In fact, in some ways they were far more innovative in managing certain disease states. And when I was there, legislation was passed requiring that anyone who was suspected of having cancer receive follow-up testing within two weeks of the doctor's initial suspicion. I'm a nurse, and I can tell you I sure as heck can't guarantee that for my patients here.
Thank you for writing this thorough article with regard to health care in the US and Britain.
You are right, there is NO WAY anyone should be afraid of getting sick because it could cause financial ruin.
I still find it shocking that people are fighting for the insurance companies to keep taking our money and providing nothing in return. Looks like a big ole case of Group Think... whatever the TV says, people believe. We need more people like you telling their stories. Thank you... nicely done.
I'm all for the public option!
I'll give you one reason why we desperately need to reform the current health care situation in America: your kids.
I'm 22. I couldn't afford college right after high school so I had to put it off. Because of this I was dropped from my parent's insurance coverage. And a lot of the retail jobs I've worked don't even offer benefits. I went a year without health insurance. In that time frame, I went to the emergency room twice for kidney stones and once for the flu. Cost? $15,000 dollars.
What kind of future are you condemning your kids to when they're just "starting out" and already have thousands in medical debt? What chance are you really giving them?
The emergency room is not "health care." I can assure you that I could have easily saved thousands had I had access to preventative care.
You're an adult.
This country's real problem is personal responsibility. No one wants to accept it anymore.
I know the media, MTV, etc has conditioned the youth to believe that they have a RIGHT to a life w/o any problems but that's not reality and eventually reality catches us all. Government is not the solution it is the problem.
Sooner people learn this the better we'll all be.
Special interest groups, lobbyists, career politicians, and corruption are the problems, not capitalism. Had banks not been strong armed by the government, to give loans to people who could not afford them, this would have never happened. There should have never been a bailout. The government owning everything on "your" behalf is crap. It only provides more fertile ground for more stupidity to grow.
I find it interesting that all of the people who oppose the health care reform continue with the same tired arguments.
"Oh we don't trust the government. Oh, we don't need this. Oh, who cares about the have-nots, I am upper-middle class and just plain peachy!" Blah, blah, blah.
Yet they fail to come up with a better plan. They fail to make any real argument. They fail to do anything but throw their tired and uneducated arguments about with no regard to what happens to anyone but themselves.
The thing is, not having proper health care could happen to any of us. The people who whine about health care reform have never been poor, never had to sacrifice food for medicine, never been terminally ill, and have never had any serious issues with the health care system so how would they know what's best for everyone? They don't. And what's worse is they continue to lie to people and they have no evidence to support what they are saying whatsoever!
All they do is complain and whine because they are so afraid of what will happen to their pretty little pocketbooks.
A public option (for the last freaking time!) is NOT a government takeover of the health care system. It is an OPTION available to the underprivileged. The government will not be running health care. Ever. No matter if this passes or not.
Political debate aside, and although I personally lean to the free market system, it's refreshing to read about someone who's experienced both systems first hand and has used them for anything of major importance with their health.
You bring up a lot of great points that I hope we can debate going forward. Part of the "problem" is how complicated this debate really is--there are so many components to something as large as a health care system that it's never going to be a yes-or-no kind of thing.
Hopefully, all of us in the States can have enough perspective to evaluate everything and come to a decent conclusion.
I'll take a public option. The US hasn't been at the top of the health care system for a while (and I could go on a huge rant re: tech innovation). Cancer screenings/outcome for those under 45 are comparable to that of Europe, while age 65 is better. Why? Medicare - many people get their first screenings/insurance at that point.
- World Health Org. ranked the US at 37 of 191 health systems
- Infant mortality rate in the US is high compared to other developed nations
- The average life expectancy in the US is lower than most developed nations
- The US has one of the highest rates of preventable deaths among 19 industrialized nations
- Even people with good insurance get recommended treatments only about half the time.
- Among other developed nations, only Mexico and Turkey have such large proportions of uninsured residents. None has a similar rate of medical bankruptcy.
- Institute of Medicine reports that thousands of uninsured people die every year from preventable illness
Here are the statistics for infant mortality per country. The countries with universal health care all provide a better chance for a baby to survive to his first birthday. These statistics do _NOT_ include abortions:
https://www.cia.gov/library/publications/the-world-factbook/rankorder/20...
If I was pregnant, I would seriously consider being a reverse boat person, and sneak into Cuba for health care. They are one of the "developed" countries with a lower infant mortality rate.
This needs to be addressed by taking a long, hard look at costs. Overbilling on insurance is rife, and I remember one instance where I saw our medical bill and there was a $55 charge on there from a box of tissues! Because we don't pay, it's assumed we don't look. But that doesn't stop these absurd charges appearing. In the end, we all pay. If we could get costs under control, maybe we could all afford great, private healthcare. Where are the watchdogs and regulators?
Just another viewpoint to throw into the debate:
http://www.investors.com/NewsAndAnalysis/SpecialReport.aspx?id=510262
The reason for the $55 box of kleenex (charged by a hospital I assume) is because the hospital needs the extra mony to pay for all the emergency cases of uninsured patients they have to treat. If those people would had insurance, then hospital costs would be more equalized for everybody. I hope to God we come up with some kind of reform.
I've been thinking about the healthcare reform long and hard ever since it started popping up on the news and have a lot to say (esp since I've been a healthcare provider, married to one, had great insurance, had bad insurance and no insurance) - so, I even wrote a blog post on it: http://kevnjacks.blogspot.com/2009/07/my-thoughts-on-healthcare-reform.html - I'd love some feedback! But, honestly, I feel that the main reason that our healthcare system is the way it is today is due to the fact that there is declining integrity on all fronts - insurance companies who want to make more (esp execs), those patients who abuse the system, and those doctors and hospitals trying to make more. Of course not everyone is like that but there are enough of these folks to wreck the system, even if it was working earlier.
And I really think that healthcare is a commodity, rather than a right. None of the other rights involve any money nor does is it a service provided to you (ie right to free speech, etc). It is a good that can be purchased. Sure, I believe everyone should have it, just like I think everyone should have life insurance, etc. I really wish the gov't would just reimburse tax dollar for preventative care (so ppl aren't paying for what they don't want) and that insurance would cover the bigger stuff (not unlike car insurance and homeowners insurance).
I don't even really want to get into the discussion of comparing other nation's national healthcare plans vs our current America healthcare system - we get different things because we pay for different things. They pay way more taxes than we do to fund their system.
I also think it's really sad that we can only talk about the gov't option in terms of what we HOPE it will be - we don't honestly know enough of what it will be like in the end because our legislator like those close door mtgs, give special deals to try to gain votes and change the bill every few days. That's another thought for another day...
If the insurance companies are making life and death decisions concerning patients, i.e. whether or not a person receives treatment, shouldn’t they have some kind of “Hippocratic Oath” ?
When I was a grad student in England, I, too, was on the National Health for my medical care. I was very satisfied with my experience with them in terms of doctor's visits and so on.
But to come more to the point, the REAL difference came when I had a slip and fall accident on some split milk (really) around the corner in the supermarket aisle. I was immediately taken to the hospital for xrays to see if I had broken anything. (Luckily not.) End of story - in a similar case in the US, I would have to go to healthcare, provide either insurance or cash - and then go after the insurance company of the grocery store for my expenses.
Here's where the bureaucrats & lawyers come in along with a lot of red tape & added time and trouble. This is part of what creates such a litigious society. If basic healthcare is a RIGHT for every citizen, then NO PROBLEM!! & no INSURANCE COMPANIES!! equalling less expense involved. And P.S., I think we should also consider the selfish benefits of providing general public health - Do you want your food server to have T.B. or any other communicable disease? These are issues that everyone has to face, and basic public health benefits all of us.
You don't have to take it if you don't want to and I think it would be great to give insurance companies the competition. Higher rates and denied coverages are happening now and will continue if the insurance companies are going to keep making record profits. My "company provided" insurance, for which I pay the total premium, sucks but I have to take it due to a pre-existing condition. And by the way, just because the insurance people will have to take us with pre-existing conditions doesn't mean that they can't charge us more than everyone else. Before I had insurance I went to a discount clinic run by the local junior college and I am tempted to dump my insurance and go back there. At least they understood that they needed to make healthcare affordable.
Great article, thanks for your perspective.
I hear a lot about personal responsibility whenever this issue comes up. It's usually spoken in the same breath with the importance of free market capitalism. The legal structure of incorporation (the current primary manifestation of free market capitalism) basically creates a situation in which the individuals who created and make up the corporation are exempt from the responsibility of the corporations business practices. So, essentially, when Hershey buys cocoa processed by slaves along the ivory coast, the corporation of Hershey is not responsible for employing slaves, although that is essentially what they are doing. Where is the responsibility when places like CIGNA, for instance, hire people to deny enrollees coverage or prevent them from getting necessary procedures in order to keep costs down for the sake of their profits? If we're going to talk about taking responsibility, let's start with dismantling the corporate structure of capitalism. Responsibility is a two-way street, in both the public and the private sectors.
...you would have already paid for it with your tax dollars. It would be hard for me to opt out of a plan that gives me benefits for 'free' if I have already paid for it.
Thank you for your article and insight. I absolutely agree. So far my family has been fortunate enough to have coverage through one or another employer but I know plenty of people who don't. I agree that it is wrong to profit off healthcare the way our system works now. I think so much of what is being said right now against a public system is just plain untrue, scare tactics being used by those who currently profit by our present system. There are plenty of ways to earn a buck without denying others care they should be able to receive affordably. We are a nation of smart, inventive people. We should be able to figure this out.
I'm American. I've lived in Japan, Canada, and the Netherlands, and part of my family lives in the UK. I would gladly take ANY of those systems over the one we have now. No, they're not perfect, but even with whatever money/resources are wasted due to government bureaucracy, and the small minority of people who get decent-but-not-exceptional-care, they're miles better than the US system - better outcomes at a fraction of the cost. I'd rather pay 1% higher taxes every year, knowing that if I get cancer or get hit by a bus 10 years from now, I won't go bankrupt while I'm trying to recover. No one's health care plan should consist of simply crossing their fingers that they don't get ill or have an accident. And if you think that's not what a huge percentage of Americans' health care plans really amount to, you're fooling yourself.
If it were only 1% we all would have signed on. Do you really think $10T dollars of spending is only going to cost you 1%?
"I'd rather pay 1% higher taxes every year"
I've also lived with both systems, in the US and in Australia, and I have to agree with you 100%.
18 years ago I was young, employed, healthy (or so I thought) with good health insurance (or so I thought). Then I developed a rare cancer -- from pregnancy -- that nearly killed me. The cost for my treatment was around $100,000, which was about 70% covered by insurance. That left me and my husband $30,000 to pay out of pocket, which we eventually did. It nearly bankrupted us then, and the cost today is estimated to be about $1,000.000, with my share being about $300,000.
The kicker is, a few months into my treatment, a clerk from the insurance company called me and tried to convince me I should stop the treatments, "as they are not working anyway and they cost a lot." A clerk -- not a doctor or a nurse -- was giving me "medical" advice to just give up and die. This is not so different from insurance companies today that deny coverage outright, hoping their clients will die before they are able to appeal the coverage denial. Isn't this tantamount to insurance companies as "death squads"? My insurance company would have liked to deprive my child of her mother, my family of its main breadwinner (hubby was a student) and my husband of his life partner -- for the insurance company's profit.
On top of that, the cancer I had is somewhat rare and not much was known about it at the time. My case established the treatment protocol for the type of cancer I had, which means other women have since been successfully treated. (Did I mention that my cancer, at the stage it was discovered, was usually fatal 18 years ago?) So depriving me of treatment would have cost my life, and also the lives of other women who get this type of cancer.
Since then, I cannot get health insurance that is not part of a group plan. For many years I was locked into my job so I could get the medical treatment many Americans take for granted, such as treatment for a torn muscle, or for an ear infection. I am luckier than some, because I now have insurance through my husband's work (for which we pay $1,000 a month for lousy coverage and nearly no prescription coverage).
So, did my lifestyle choices cause my cancer? Well, yes. I chose to have a family. If I had made a different choice,I would not have gotten cancer, but the world would be minus one brilliant, productive, creative and kind young woman (my daughter).
Did I ask anyone for "free" medical care? Nope. I paid my premiums, copays and deductables. If we had single payer, I would be paying taxes for that. Am I asking you to cough up money out of your pocket to pay for my medical care? Nope. Many of us who are pro-health care reform are not looking for a free ride. We just want access to health care so we can work, take care of our families, and ultimately, live. The way things are now, health insurance is exclusionary, too expensive and just doesn't work for anyone who may at some point actually need health care. It's kind of a "one strike and you're out" medical system.
I can deal with the bureaucracy of government-run healthcare more than I can stomach the bureaucracy of insurance company-run healthcare. After all, I can vote out the bureaucrats, but I have no voice at all with the insurance companies.
Thanks for the thoughtful comments, Paul. Well put.
I think you have some really good points and I agree with you. I've been in healthcare for 35 years and have seen a lot of things happen. the thing that worries me are the taxes that would be needed for universal healthcare. I think we already pay about 33% and our government is asking for more. Also our government has made such a mess of things, what's to say they wouldn't make a big mess of that too. It would really be nice if universal healthcare could be could be worked out. But I don't know if I trust the big guys.
I've been an RN in the US for 30+ years. I've never experienced healthcare in other countries. That said, I KNOW what is wrong with our healthcare system as does any other medical professional. Our hospitals are run by MBA's who are totally clueless about what a patient needs to get better. Walk into any modern US hospital and look around. First, you'll see that multi-million dollar lobby with a water feature and a fireplace. All private rooms with 42" plasma TVs and leather couches for your "guests". Now look at the equipment that is intended to actually keep you alive and get you well. They're the cheapest and least reliable monitors and IV pumps on the market. But hey, as long as you can watch ESPN while your loved one is in the bed having a heart attack undetected by the faulty monitor (that LOOKS good but is a piece of crap) the CEO's happy. And let's not forget how many staff positions were cut so you could enjoy that nifty specialty coffee shop found in every modern US hospital. Hospitals need to put more money directly to patient care and less into trying to appear to be a 5-star resort. I've yet to see a 42" plasma change a patient's outcome. Healthcare professionals need to be in charge of hospitals again. Not bean counters.
Excellent read and I appreciate your thoughts.
I too work in healthcare. A majority of the folks I work with agree that some sort of public option is more viable.
That said, to the naysayers... before you do anything else, watch this video: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/view/
Learn how 5 other *Democracies* handle their healthcare. What I find most unfortunate is how infrequent the national discussion is in regards to other countries' healthcare.
Watch this: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/view/
This seems to more a post on how to get lots of people to comment. What happened to "living large on a small budget"?
Politics and controversy gets lots of comments, I get it already.
I can assure you that this was not the intention. Healthcare, in any incarnation, affects the wallets of every single one of us. I wanted to give my perspective as someone who had lived both sides of the coin. As we have said many times, we need to have the freedom to post something that is not 100% about bargains or deals. By all means pick and choose the articles you like. As Wayne's World once said, "Led Zeppelin didn't write tunes that everyone liked. They left that to the Bee Gees."
I'll take the public option if all members of congress, senate and the Obama administration are forced to take the public option as well. If it's good enough for us it should be good enough for them. Anybody here see that happening?
It is an OPTION. You don't have to take it. You are more than welcomed to keep your current coverage. The OPTION is for those who have no coverage or poor coverage and who have no other viable options.
How long does it stay an option. If the government plan is $500 less than a private plan, how many corporations will not take it? Let's think a little into the future.
"Healthcare is not a basic right." So we can have free speech and guns, but not be healthy enough to use either?
There are better solutions. It seems you were fine with the insurance here when your company subsidized it. Well, why cant individuals get the same benefits. We should be able to purchase private health care just like we do with car insurance. You shop around, you educate yourself, you pick a plan that works for your family, e.g., you don't get acupuncture if you don't want it. (NY State makes you pay for this if you want it or not). By choosing your own company with your own features you can purchase cheaper, affordable healthcare coverage on your own. But this is not being talked about. We are talking about taking it from corporations and giving it to the government. I would rather have control over the money I make.
Now people talk about all these great drugs and how cheap they are to purchase elsewhere. Where does all of the research money come from for these drugs. The U.S. Pharma companies. The UK government is not innovating new drugs and equipment.
Our capitalistic society and military is what affords a nation like Canada to spend most of their tax revenue on health care. Even Canada's president of CMA says they can keep up with the costs and need to find private solutions.
This all comes down to work. Some work hard, others don't. Those who don't want to share with those who worked hard. I guess if you worked in environment like this all of your life you wouldn't know any different.
I think everyone deserves care that does not cost them everything they have. We shouldn't lose homes over cancer.
But here's my thing. My grandfather and father (and currently my husband) and many other family members served in the military. They were sent off to wars and promised that the one thing they didn't have to worry about was health care because the government was going to provide that care or insurance for the rest of their lives.
Since their bodies and/or minds were ruined by those wars, it was a good thing.
And then those promises? Those CONTRACTS and promises in writing? Taken away. Substituted with a new plan with deductibles and co-pays and not being able to use the military hospitals. Forget what we promised. That was Clinton.
And this new plan?? Pages of new things they are taking away from the vets. Again.
That sucks.
I can't support that.
THis government can promise anything it wants and even put it in writing. The next one can make it worse. And the next one can make it worse. And the next one....
A single-payer plan for the U.S. would be great, as long as everyone agrees to live with the consequences.
Right now Medicare covers anything for which there is a billing code, no matter the cost.
That's not the way the rest of the world does it.
Other public health plans evaluate treatments on strict cost-benefit criteria.
In reality, the older you are, the less benefit you'll see, so treatments would indeed be restricted as you age.
We do that backwards right now in the U.S. - the longer you live, the more care you get, without considering the expense.
We cannot afford to do that under universal coverage - hard choices will have to be made.
I'll never understand how people who don't trust the government, their democratically elected government, to handle healthcare, but they are more than happy to trust a profit-driven insurance company to do the same job.
My health insurance is provided by the Government of Canada. My Health care is provided by my doctor. The government never, ever tells me that i'm over my limit, or that I'm not covered because I have a pre-existing condition. But I hear lots of horror stories about how US health insurers do that.
Nope, if my doc prescribes a treatment, I tip my hat and say "thanks doc!" and I don't pay a cent, and I can go and get the treatment without this government interference you're all so afraid of. It's awesome. And no US insurance company saying, "oh look, you had your wisdom teeth out once, that's a pre-existing condition. "
It's not a perfect system by any stretch, but it's a hell of a lot better than yours!
Health care itself is not a right- we have the right to have access to health care. In our current situation, we have that. Everyone has the ability to go see a doctor. We have the right to vote- but that doesn't mean that everyone gets to vote who shows up or that everyone does vote.
Education is a right and it is mandatory for all children to attend school, therefore we need to have public schools. I agree with funding them with tax money, but I think the money should be returned to families sending their children to private schools (in our town, it would actually save the town money to do that and keep taxes down).
And in our town and many surrounding ones, the FD is all-volunteer. Of course the town pays for the trucks and whatnot, but the firemen are all volunteers, so we really aren't paying that much for our fire service. I would argue that having a FD, PD, or Library is not a right, either. They are certainly good things to have and we need them, but I wouldn't call them a right. A right implies that we deserve whatever it is we are talking about, and being a human being does not mean you are entitled to anything you want.
Socialism is not an unnecessary fear- it takes away our choices and does not understand that everyone is different and we all require different things in our lives to make us happy. If the gov gives us everything, what motivation is there to work? What if I don't want the public option health care? I may not have to have it (right now) but I still have to pay for it. What if I don't want any health insurance? Then I am SOL. THAT is what is not right.
"A right implies that we deserve whatever it is we are talking about, and being a human being does not mean you are entitled to anything you want."
Are you serious? You are comparing being entitled to "everything you want" with being entitled to HEALTH CARE? As humans, we don't DESERVE the right to be treated for an illness that we didn't raise our hand to get in the first place?
Treatment for a disease, terminal or otherwise, is not something we feel entitled to. We work, we struggle; why must I suffer just because I don't make as much money as you do?
This is exactly the same bullshit thinking from "2012." 1M Euros for a seat on the "arcs" and it was one man who felt that LIVING is a right of the people, who changed it all.
I had Laryngitis and Bronchitis last March. I couldn't stop coughing. I ended up cracking a rib from the coughing (though I didn't know it at the time). After trying to go to work and realizing I couldn't even move without bawling my eyes out in pain, I decided I HAD to go to the hospital.
I was checked in and the routine "What's wrong with you?" began with the first nurse. I was then shown to the room, where I sat for 10 minutes. The doctor came in, I tried to explain what happened, which was difficult considering I had never experienced ANYTHING like it before. She told me I just pulled a muscle. I knew it was more than that and demanded an Xray.
20 minutes after the Xray was complete, the nurse returned saying I should have bet her, 'cause I would have won. I cracked my 6th rib. She wrote out a prescription for Vicodin and Ibuprofen and sent me on my way.
Now the whole point of that description of my trip is this:
The only equipment used on me was the Xray machine: $34.
The hospital bill: $200 (that white PAPER liner on those chairs is damn expensive!)
The doctor bill: $437 (because her blowing off my pain and making a joke when she's proven wrong is worth that much money.)
Now, I work at McDonalds, minimum wage. Sorry, it's the only thing available in my little town anymore without a degree (and even those jobs are scarce). I can't afford college cause hell, that's expensive too.
That 700 odd bucks is probably on my credit by now. Because I can't afford to pay it. My dad is out of work and on unemployment, while also trying to pay for school (which I also help him with).
It's not my RIGHT to have been able to get a diagnoses and medication to help (without it affecting me negatively) so that I could recover as quickly as possible to return to work and continue slaving away for bills that continue to mount? **** you.
Healthcare is NEEDED, not WANTED. People have a RIGHT to live, work, and prosper. Otherwise, why don't we all just go kill ourselves if we don't "belong" here because it's not our right.
Well said!!!
What fraction of health problems are self-imposed through poor lifestyle choices?
What fraction of illnesses are beyond a person's control?
Leave unsubsidized illnesses with known behavioral risk factors.
Subsidize illnesses for which there is no behavioral risk factor.
If health care were provided free and the government just raised taxes, I'd be for the health care reform bill. There is no doubt that we need health care reform. The cost is ridiculous. I am self employed and pay $628/mo. for two adults and 1 child. Believe that I want reform. However, I do not hear any part of the hcr bill say that there will be free health care. What I hear them say, what I've read, says there will be higher taxes along with premiums. As an employer, I'm scared. How can I pay for my employee's coverage when I can barely pay for my own? Where are you hearing that this bill is proposing free health care (higher taxes, but free out of pocket?)
Reading your article definitely made me think about some things. Frankly, I would love to see healthcare reform in this country, just not the way the president is proposing. Right now, there are senators writing amendments to the bill that would allow abortions to be paid for under healthcare. Already, we have tax dollars going to fund abortions in D.C. As a member of the Susan B. Anthony List I cannot go with anything that pays to end a life. And there are other issues that are big deals that don't translate into what most people think about when the subject of healthcare comes up.
And ok, I've never been to Britain, so I don't know what it's like there, but I have been to Mexico where they have a public option and private healthcare. I know that America is very different from Mexico and so it might not be as extreme as it is there, but having personally experienced Mexican healthcare, I feel I need to make the point. When four other Americans and I got sick, two of us went to a private hospital and the two others were treated by a personal doctor of the family we were staying with. When we were just starting to feel sick, we asked the Mexicans around us what their healthcare was like. All of them said the private healthcare system was much better, and they would have to wait for hours if they went to the public system, and only recieve secondary service. And ok, this might not be all of Mexico, but their responses stuck out in my mind.
So right now, I don't feel like the government taking over health care is the best for America. Actually, I would love to see the churches in America stepping up and actually doing their jobs to help fill the need in this field. Many hospitals and schools around the world only came about because of the Christians who did what they could to help the poor, and personally I think it's time they step up again to do the same thing.
We're a lot more like Britain than Mexico, economically speaking. We don't have rural villages where people finish school in the 8th grade, and don't really read. We're not undergoing a massive shift from farm life to city living. We've already urbanized.
That said, our healthcare system certainly seems reminiscent of Mexico's, where the private system is expensive but generally functional, and the public system is underfunded and considered inferior, and there are long, long waits.
I've been to America's public health system, which is designed to provide service to the poor and uninsured. It's okay, but the waits are terrible. The quality varies by clinic, and one might be good, and another might be bad. The system seems underfunded - and they do all the tricks private hospitals use to overbill and over-test. They have to fight for their piece of the budget.
The good part of American public health care is that they generally put health first. The buildings are spartan, but functional. The materials are photocopied rather than offset 4-color. If you need a treatment, they'll tell you, and if you can't afford it, it seems to be covered in different ways, depending on eligibility. Of course... the paradox is that nobody receiving care is paying into this system. In a "socialist" system, they would be paying something.
If the so-called public option were really a kind of public health, operated by nonprofits and universities, I'd drop my private insurance and sign up in a second. Too bad that's not exactly what it is, and it's not available to everyone -- but i still support it, because it's the first step down that path. I'll take anything at this point.
Perhaps I am reading your response wrong, but I'd like to assert myself and request that you do not assume anything about my level of personal responsibility. I have plenty. And I work hard just as you do.
Not for one second do I believe that I have a "right to live without problems." I am not an idiot.
The difference between you and I is that I see government as a tool, given the fact they're my Elected Body of Officials. We put them in a position to make hard decisions for the rest of us because if we left all decisions up to the individual, NOTHING would ever be accomplished. And instead of fearing the government, I stay active. I vote in ALL levels of elections and have done so since the age of 18. I am consistently writing to my elected officals and educating myself on the policies, from all angles. I make sure I understand who I am voting for and to what extent. I get that it's not a perfect system, but to expect perfection is a never-ending expectation.
I am not afraid of my government.
As for healthcare, it is better for all of society if we take care of each other. It is our civic duty to pay taxes and if paying a little bit more in taxes means myself or my neighbors can go to the doctor without fear of financial ruin, then I'm all for it. Granted, I'm less for the public option and more for single payer, but it's all baby steps. Regardless, the system right now is seriously flawed and capitalism won't fix it.
Please don't let your god affect my personal choices.
I'm a healthy mid 30's guy who has never had to use a hospital or had anything major medical wise. i lost my job earlier this yr and didn't take the cobra option so i have no insurance at the moment. i consider myself politically independent, but here's my research that makes me lean against a public option: after my cobra option expired, i compared possible plans to pay on my own (i used the ehealthinsurance website) and my choices are Humana, Medical Mutual, Unitedhealth, and about 4 other companies, with plenty of options for deductibles and coverages. i'm planning on getting basic catastrophic coverage, not office visits or dental/vision. the avg competitive cost per month is around 65-75, with a 2500/yr deductible and 3-5 million lifetime max benefits. not bad. perhaps my options don't apply to everyone, but you should at least check if there's better coverage at a lower price for you.
the recent profit margins for insurance companies range from 3% to 8%, not terribly outrageous. media stories tend to not report this but rather reflect only a relative pct rise i.e. "68% rise in profits" or absolute profits "25 billion last year!" without the overall context of total revenue vs. total costs. (for a math example, an absolute rise in profit margin from 4% to 6% is a 50% relative rise, and should not be insinuated as a 50% profit margin). perhaps the math illiterate tend to have their emotions inflamed by less than accurate reporting. Blue Cross and others are already nonprofit.
a good analogy for me would grocery stores... they don't have terribly high profit margins and there's fairly good choice, and a gov't grocery store option simply would not bring down *costs*, the main driving factor in my point of view.
when i had insurance, my impression with doctors has been "useless and clueless" albeit well intentioned. for example last year my insurance company Aultcare had to pay a $600 bill for a 2 hr nonhospital visit, with only a $15 copay mine. i would never have authorized the doctor's ear and throat tests if had been told the cost and would have had to pay directly. health costs are high because "someone else" pays for it. i tend to blame doctors a little more than some would, experiences vary.
i would consider supporting a public plan but for catastrophic care only, and for only the "uninsurables" (me not included) and preferably just kept at the state level.
I've always lived in the US, and I'm "privileged" enough to have a very good health plan, but I would firmly support a public option or even a complete public plan. What we have now is ridiculous. It should not be a privilege to have the sort of plan that I have, with copays, reliable doctors and specialists - this should be something that everyone has, regardless of their employer. You sure aren't kidding about the golden handcuffs. Mine are firmly attached.
It's interesting to note that little mention is made of the fact that employer-sponsored health insurance is a direct result of unions - you know, those nasty organizations that boycotted work places because the bosses were making too much money and paying the rank and file too little? After a certain number of employees, companies are required by the federal government to provide health coverage. How is a government sponsered option any different?
It's merely a matter of how insurance coverage is provided. Does it come out of my employer's pocket, OR does my employer hand over the money she was paying to insurance companies to me, and I'll either purchase my own - based on MY choices - or pay the premiums in taxes? Either way, it still comes out of all of our pockets. NOTHING is free.
the u s counts every breathing baby as a live birth no matter how ill or premature. other countries have minimum weight,length,period of gestation requiremets. percent of live births is skewed and is meaningless for comparing health care systems, so you might want hop out of that "reverse boat" and do some real research.
Health insurance may sound very advantageous at first of course as you hear all those good words, benefits, etch... But I think they are all the same, companies gain more than the insured person I guess, it's practically a business for them so they benefit more before the plan holder. One good thing is that we are having the means for our needs in the future time of uncertainties.
Having to choose the best that suits your foremost needs is not that easy, thorough study of various company and their legitimate capabilities on delivering quality service is a must process in order to get a substantial plan that will benefit you the most.
Health care is not a zero-sum game. Profit leads to research and innovation that would not occur otherwise. Advances in medicine made in the US are now available to other "non-profit" health systems because doctors and hospitals are motivated to compete for patient care and provide better service. If you want to freeze innovation where it stands today, remove the profit motive. Want an example? Walk into any government office today (department of transportation for example) and look around. Try to find a solid example of innovative thinking and improved customer service. The complacency and indifference is breathtaking. I Shudder to think of where our healthcare would be today if we had removed the profit motive after world war II like much of Europe did.
My experiences are very similar to the author's - I'm an ex-pat that moved to the United States in my 20's. Bear in mind that was 15 years ago, so I'm a little out of date, but my family tells me by and large it's improved since. Here's my take:
GOOD SIDE
(1) The health care I got in the UK was almost always excellent. Much the same as I've seen in the US. My close friend has Cushing's Disease and she gets regular treatment in London with world experts, all at no cost. People travel from elsewhere in the world to get care in the UK, like they do to the US (same for college)
(2) I had a choice of GP's.
(3) It was sensible - all medications were generic if available, and they won't prescribe just because you saw an advert. All medicine is free if you have no money or if it's for a child, otherwise it's about $10 a month, max.
(4) It's scientifically based, google for "NICE". That means that they won't use treatments that don't work. Sounds silly, but it's world-respected. If a treatment is 10x the cost but 10% more effective, they'll go for the cheaper one. Disadvantage too -- see my list of bad parts below.
(5) You never have to worry. This is huge. I've seen both sides in the US. When I first arrived I had no insurance and my wife had a serious illness. It was scary, and we were in debt for years. I don't want to think about money when I go to a hospital. These days, I have some of the best insurance you can get, from my company, and outstanding treatment.
(6) No @#$#@ fighting with insurance companies. If you have great insurance, like I do now, you don't see this. When you have bad insurance, it saps your life force, just when you are most sick.
(7) Morally superior. Let's get it out there :-) I'm not a liberal - I believe each person should work hard to support themselves and be self reliant, and otherwise, have a sense of shame, quite honestly. But just as everyone, no matter how lazy, has a right to basic nutrition and a roof over their head, and every child to an education, I believe everyone has a right to basic healthcare. (That's a personal opinion - I respect disagreement. It's colored by being European, no doubt.) Beyond that, the fruits of life are yours to earn by yourself.
BAD SIDE
(1) No choice of specialists. Sometimes, long waits. Whenever it's an emergency, you get rushed through. But my brother hurt his foot, and had to wait 2 months. Need a hip replacement, it could be 3+ months. As the author mentioned, you can pay to have it done immediately, and some companies offer that as a benefit.
(2) Dowdy. Your doctor or hospital won't have fashionable furniture or remodeling. It will be clean and high tech, though.
(3) Higher taxes: 28% overall tax burden in the US, 37% in the UK - although that's still lower than most of the West, and you get other benefits, like cheaper but still world-class college educations. I don't like the cost either.
(4) Treatments are ranked against cost. No, not death panels. But they will spend more for a baby than an old person, or use a drug that's not quite as effective but costs 10x less. If you don't like that, I respect that. But consider that no matter how much money you put into healthcare, you're making these choices. It's just a matter of whether you do it consciously. If you have $1m to spend, do you spend it on a newborn or a 90 year old? What would you do? You do HAVE to choose.
(5) No way to be an intelligent consumer, because you don't see the prices. Except dentistry -- which is far better in the US.
My take -- I want the best of both. I want solid healthcare to be free at the point of use for everyone. But I DON'T want the government to run the hospitals, to run the system. Everyone has a right to food, but htey don't run the supermarkets! Have a medicare system, where you don't have to see the bills. Secondly, have some exposure to the cost. If you can afford it, pay 50 pounds to go to the emergency room, 10 pounds to go to the doctor.
I hope this is interesting for anyone who's only been exposed to the US system.
Respectfully , Joe