Monday, November 19, 2007

The Great Healthcare Debate (REVISED)

The question each person must decide regarding healthcare is do some people deserve it while others do not? Is healthcare a right or a privilege?


Let's make it real for you like it is for me. First of all, I want to say that I have health insurance. Actually, I have darn good health insurance. With my place of employment, I don't even have to pay a premium for coverage for me or my wife. I do have a deductible, but there is a mechanism built into my plan that frees money up to pay the deductible. So for me, there is no health coverage problem. However, as I have said in other posts about other things, it isn't about me.

My sister is in another place, however. As I wrote in NEWS FLASH #17 (from October 17), she ". . .STILL hasn't been granted "disabled" status although she has multiple physical problems that prevent her from walking much. Plus, she is in pain quite a bit and is an acute diabetic. She cannot work; she is going to lose her apartment (the power has already been cut off). She applied for disability two years ago and even has attorneys working on it. Now, she is sleeping on my mothers' couch. Because she isn't technically "disabled" yet, she also cannot get healthcare or consistently take her prescribed medications. She needs insulin twice a day, but she rations it. I am genuinely concerned about her future here on Earth."

Nothing has changed in her status after since I wrote this, except that she is sick now (as I mentioned in the most recent NEWS FLASH) on top of her other problems. Is she not deserving healthcare because she is unable to work and has $0 income? She does TRY to go to the clinic that is for poor and indigent people. Guess what? If she doesn't have the minimum of $16, they won't see her. We (my family) try to help as much as we can, but there are only so many resources we can draw from. I told her that we should put on her tombstone, "I didn't have the 16 bucks." This doesn't even cover any medication (like her insulin).

But that's okay; she isn't entitled to healthcare, that leaves more for the rest of us who are deserving, right? Besides, we are getting a little overcrowded here in America the way it is with the big influx of people from Mexico and such. Maybe we need these worthless people to die to make room. The good news is, according to the Institute of Medicine of the national academies (iom.edu), there are 18,000 unnecessary deaths in the US every year because of the lack of health coverage.

Oh, but isn't that better than (insert evil laugh here) SOCIALIZED MEDICINE? What is it that folks are afraid of? Is any aspect of socialism so scary that we want to make sure that no facet of life is tainted by it? Should we do away with public schools? If one can't pay to have his children be educated, then the children should just not get an education, right? We need people to have careers at McDonalds and others to spend their lives making sure that the grocery carts are returned to the store from the parking lot. Maybe we should hire our own police and fire departments. Why should the government supply these things? It is too socialized; it must be bad! Close the libraries and have all books come from bookstores. Maybe we can rent books like we do movies. That will make sure that the right people are educated - it will be only those that can afford to send their kids to elementary school.

Oh, but Jeff, what about all those pesky wait times in Canada? Our system is MUCH better than that.

There are so many ways to respond to this, it wasn't easy to determine which wayto list first.

1. The US is not Canada. We don't HAVE to do things exactly the way other countries do them. We can take the best aspects of others' systems and come up with our own - a better mousetrap.

2. I haven't heard a Canadian yet say that they would trade their system for ours. There are a number of Canadians who read my blog. Do I have any takers on that? Evidently, the Canadians value their "inferior" NHS because they haven't tried to change it and they voted its pioneer, Tommy Douglas, the greatest Canadian of all time.


4. Everyone in Canada has free healthcare. There are 40 to 50 MILLION uninsured Americans, according to the Center for Disease Control. Wait times for medical procedures are bound to be a heckuva lot shorter if 50,000,000 people jump out of line in front of you, no? Coversely, if you give 50 million more people Blue Cross/Blue Shield in this country, the wait times would be longer, no? So the argument about waiting times is not really against socialized medicine, it is about everyone being covered. What greed!

5. The wait times in Canada have been greatly exaggerated. According to the Canadian government, one can expect to wait four weeks for a specialist visit, three weeks for a diagnostic test, and four weeks for non-emergency surgery (like a knee or hip replacement). In addition, the waiting times for half the patients in emergency rooms were six minutes (six minutes to actually see the doctor) and 86% were seen within a half hour. This beats the heck out of anytime I have ever been to the emergency room here for myself or with a family member.

I know there are and will be some problems with a national healthcare system here in the states. I might have to wait a week or even a month longer to see a doctor about my knee or a skin condition. However, I would gladly wait a little longer if it meant that people like my sister would not needlessly suffer, and God forbid, DIE like 18,000 others will this year because of lack of health coverage. Wouldn't you?
THIS HAS BEEN REVISED BY INSERTING LINKS TO MY SOURCES. COMING SOON (probably next week because of holiday) THE GREAT HEALTHCARE DEBATE, PT II.





15 comments:

Sayre said...

Ah, Jeff - I don't even know where to start. Like you, I am gifted with great health insurance through my job. I have a wonderful doctor and get blood drawn or stress tests or mammograms whenever he thinks they are necessary.

But, I also know of the other side. My friend "Laura" died this past week of breast cancer. She put off going to the doctor because she didn't have health insurance. She and her husband owned a small business and had no spare money for doctor visits, much less tests, treatment, or drugs. She let it go too long, then refused to let her husband go into debt to try to treat something that was going to kill her anyway.

Case #2 is my own brother, a tow-truck owner/operator. He works for himself. Whenever he needs medical treatment (metal shards in his eyes, hit by lightning twice) he goes to the emergency room and waits and waits and waits - then is treated as an indigent. He owns his own home, his cars and has his own business, but he cannot afford to pay the outrageous amounts needed to get independent health care. A couple of weeks ago, he was hitching up a car when his hernia, which he's had for 15 years or so, extruded intestine. Back to the emergency room, where he was told he had to have surgery or risk losing his life. One of my brothers and my parents chipped in and managed to cover the surgery, but because he was having trouble breathing, he had to stay overnight for observation. That tacked another $4000 on to his bill!!!

Unfortunately, the USA is a litigeous country. If the tiniest thing goes wrong, sue someone. I'm not saying that doctors shouldn't be held accountable, but the malpractice insurance they have to carry, and the technology that gets more and more expensive every day make it difficult to know exactly how to go about implementing universal health care and keep it affordable for both the government AND the people.

Sorry for the rant, but these things are very recently on my mind. I shall return you to your blog now...

Jeff said...

Sayre: Seldom have I talked to someone about this problem without hearing some horror stories of their own. The US is behind times on this issue. As far as healthcare, it is the laughing stock of the free, industrialized world.

As far as the lawsuits and such, I don't know. I am not sure how that really has any bearing on nationalized healthcare. They sue now, what's the difference? My suspicion is that if the federal government is the backbone of healthcare in the US, lawsuits would decline rapidly. It isn't easy to sue the federal government. It seems to me a federal system would take some of the heat off doctors and lessen the coffers of malpractice insurance providers. However, I have never looked into it. I

Does anyone in Canada or the UK that reads PW, know how malpractice is handled in your countries?

Sayre said...

That's an interesting point. I know that malpractice insurance is part of the reason OUR healthcare costs are so high. My ex-SIL is in medical school because she always wanted to be a doctor, but the insurance issues for her are extremely daunting. I'm not sure how a "socialized" version of care would work in that regard.

The Real Mother Hen said...

I absolutely hate the healthcare system here. I pay $400 A MONTH on my health insurance, yet I get limited coverage! The only part I'm fortunate is because I have residency in other countries including Singapore which means if I'm very sick, I can get good treatment there for a fraction of the cost here.

Today, US ranks very low in number of doctors per capita, lower than 43 countries, including Mongolia and Lebanon. Time to wake up!

kristen said...

I too have great healthcare, of which I am extremely grateful. And I am sorry for you sister and her struggles.

However, universal healthcare is NOT a good idea. I’m not sure where you got your numbers, figures, stats, etc, but from my own reading/research, I have found the following detrimental effects of socialized medicine:

Out 28 countries with this plan, Canada placed 26th in terms of medical outcomes for every dollar spent; 18th in access to CAT scans. Health expenditure amounts to 29% of the provincial budget of Quebec. The average citizen pays $1200 in taxes to have access to public health care (way more expensive than the most comprehensive private plan). The average wait in Canada for an MRI is 12 weeks. In Britain thousands are dying from a preventable blood condition simply because the wait to get into a doctor is so long. 1/5 of those in the U.S. with breast cancer die; it’s 1/2 in the U.K and New Zealand. Countries with public care have shortages in doctors, hospital beds, and supplies.

Basic economics shows us that a zero price = increase in demand = decrease in supply = shortage. Government-run means red tape and bureaucracy....which means price controls and ceilings on income; this leads to mediocrity, inefficiency and lack of innovation. Whenever the government takes over something it ALWAYS screws it up.

I personally would like to see the privatization of education, which is why I voted for vouchers in my state. As a teacher I see all the waste and garbage that goes on in public education. The free market works.

Most importantly I think socialized medicine is unconstitutional. We are guaranteed the right to life, liberty, and the pursuit of happiness; not health care. And where is the $ going to come from? Some people are already paying 39% on their income. I call this bondage and just plain wrong. Providing voluntarily for your neighbor in need may be morally good. Forcing your neighbor to help you is morally wrong. (Which is also why I think our welfare program needs a major overhaul.)

Sure—some poor people will benefit; but the majority of Americans will lose. Is this fair? I think not.

[Ok, that was lengthy; but I could have kept going ;-)]

Anonymous said...

Some of the comments here reinforce one point - this society operates on polarized opposites, everyone has his/her own set of data to show... and judge other countries for doing/ not doing certain things :)
I bet no one here REALLY knows how lucky those people in other country feel! :)

Russell said...

The NHS here in the UK is FAR from perfect but in a lot of ways we've the best of both worlds: free care for everyone, sooner or later; quick care for those who can afford it. I can't imagine living in a country where the emergency staff check your credit rating at the same time as your breathing, or is that my misapprehension?

Jeff said...

I sent a reply but for some reason it didn't print it or hasn't yet. It was quite lengthy. Because of its length and the involvement of the arguments. I will probably post The Great Healthcare Debate, Part II soon. But in brief . . .

Mother Hen: That's a good plan B if you can get it. It is a shame that it comes to that - having to get healthcare in another country because the system is so bad here.

Kristen: Most of my response to you will be in the stated part 2. I do want to answer your minor charge and state that I mentioned my sources in my post. So, "that's where I got my numbers".

Anonymous: Yes, it is too bad that our political system is set up to encourage polar opposites. Still, some simple and moral things - you would think we could find consensus.

Russell: In a manner of speaking, it is that bad. Hospitals and other providers can and do reject people for lack of insurance and/or proof of being able to pay for the service.

kristarella said...

In Australia we have private (pay-by-the-month, quick service) healthcare and public (free apart from taxes, which are not obscene).

The system could be better, but from what I hear it's a heck of a lot better than the US. There's just no cause to not go to the doctor because you can't afford it, if you need to go you can... I've been on public for several years and I have a lovely doctor who lets me pay via the public system, even though she usually charges much more than the government gives her for that. I'm looking forward to my husband starting work so that we can afford to see specialists when we need to (I think I need to see an orthodontist), but those are not life threatening things.

"We are guaranteed the right to life, liberty, and the pursuit of happiness; not health care."
Surely, if you die because you couldn't afford treatment your right to life is stripped.

Jeff said...

Kristarella: Your system does sound much better than ours. I also agree that our "rights" DO include healthcare. The preamble of the Constitution of the United States states, "promote the general welfare". Welfare as defined by YourDictionary.com is, "the state of being or doing well; condition of health, happiness, and comfort; well-being; prosperity". So I would argue that NOT providing a way for the citizenry of the US to have free healthcare is unconstitutional.

Michelle said...

Sayre... that really is horrific about your friend. :-(

Jeff
South Africa used to have a fairly good structure. You could always get free health care, especially if you were poor. It might not be fast, but it was fair, clean and "there". Now...? The last ten or so years things have degenerated badly. Even the private hospitals are struggling to keep up and they cost a bomb.

So yeah, there is way worse than the USA out there, but considering the reputation of the USA as a world leader their level of incompetency is disgusting, IMO!

Tai said...

It seems to me that for people without insurance, life must be terrifying in so many ways.
I'm so sorry for your sister's troubles.

And though us Canucks do have some problems with our system, you're right...I wouldn't trade it.
I'm not sure how malpractice is handled here, financially, I mean.

Random Magus said...

Americans are still better off than most other third world countries in the world

The Real Mother Hen said...

You gotta watch SICKO :)

Jeff said...

Michelle: I agree. I find it unbelievable that the US is so barbaric when it comes to insuring that the basic needs of its citizens are available.

Tai: I suspect that not too many Canadians would trade down like that. I guess the very wealthy AND unconcerned might.

Amber: LOL, most OTHER third world countries? That's funny. However, considering our GNP, don't you think that is a hollow victory?

Mother Hen: Ah, it comes full circle. This whole thing started when I asked, nay BEGGED you guys to see that documentary.