Ladies and Dudes,
Just a quick off-the-cuff response on the issue with health care that was started on a friend's Facebook account. (Since I 'surrendered' my Facebook privileges earlier this year, I thought it best to move the issue here...so have a gander, don't laugh too hard at my 1st draft grammar skills, share your convictions, argue with me [but be cool please!] or whatever strikes you. Your call.)
I’ve read with interest regarding the debate over socialized Health Care from afar here in Great Britain. As the developing world goes, America’s pejorative ‘older brother’ across the pond may offer ‘clues’ over what to expect if socialized health care is approved. To clarify, the United Kingdom (more specifically, England) has historically, before America, taken the first ‘steps’ towards many of today’s freedoms and social advancements worthy of mention; (abolishing slavery, granting women the right to vote, discontinuing capital punishment, and socializing health care.) [I’m at least sure there is NO debate over the efficacy of the first two ‘advancements’…]
Though the concerns are understandable and I’d like to take a few moments here to explain how socialized Health Care has affected my family and friends during our combined 5-years living here.
The NHS has made the cost of the birth of my two children…free. (Or at least that cost has been incrementally ‘melted down’ and collectively shared by myself, and the fine tax-paying citizens of the UK.)
I’m a fairly ‘private’ person by nature so it may come as a bit of a surprise to share here that during my son Corin’s first year, he developed an infection that required immediate care. Twice we rushed him to the NHS hospitals seeking assistance for his anguishing ailment. Twice we were told that his condition would require minor surgery to alleviate it. Just a simple non-threatening procedure and all would be fine.
We waited for over a year for this ‘minor surgery’ to resolve his infection. We knew that in the United States the procedure would’ve been scheduled within a week of the first instance and resolved before the following week’s time. But the NHS, despite its advantages, was making us wait, for reasons that were never clear to us, a whole year. During that time, my son's suffering increased. From me all I could offer was a blessing of comfort and love. During that time, two further emergency visits (one memorably on Halloween during his first Trick-or-Treating experience) were required to treat my son’s condition where we were again told to wait. So for a whole year, helplessly we waited. And waited.
As the scheduled date drew closer, my wife and I booked time off of work, rearranged our schedules to allow time for him after the procedure. (During that time, we tried in the best way we could to explain to our 2 year-old ‘what’ was going to happen…and I have found explaining ‘pain’ to a 2 year-old one of the most difficult things in fatherhood.) With schedules in place, our anxieties stretched thin, one week before the scheduled procedure for our son…the NHS sent us a simple letter informing us that the year-long scheduled procedure…was postponed for an additional 6 more months…with no explanation for this! (The ‘new’ date was, in a further ‘slap’ now scheduled to coincide on my wife’s birthday.)
So, despite our ire, we waited again the full 18 months for the NHS to perform a 25-minute procedure to resolve an infection with my son that would have been resolved in a fraction of that time in the US.
I’m now happy to say the surgery was a success and that our son has made a full-recovery. But when he cut his lower lip horsing around in our living room the next year…requiring a single stitch to his lip…the downside with the UK’s NHS would again be abundantly clear. Our local 60 million pound hospital --despite being full of NHS-paid doctors refused to apply the stitch and told us the procedure was done in the neighboring town hospital 20 miles down the road. So, we took an expensive taxi ride to the hospital where my son was to sit in a waiting room for over 4 hours with a bloody lip (which was dripping all over their ER.)
After the 4 hours, the staff then told us that they in fact did not have the required ‘specialist’ available to apply the single stitch and that we would need to go to another hospital an additional 20 more miles down the road. Would the NHS foot the bill to transfer us to another hospital? Of course not…and another taxi ride was required (we would spend 52 pounds—over $75 on cab fare alone to the two hospitals.)
After another 4 hours in another hospital, we were finally ushered in. But the doctor at this hospital didn’t want to apply the stitch and tried to convince us to wait until the next evening on the following day to see someone else because [and I quote] he “hadn’t had as much experience applying stitches” as his colleague.
Could you believe it? One simple stitch, three hospitals later, over 50 quid in travel cost and the NHS-paid doctors were now trying to send us away with our son’s mouth caked with [now] dried blood on his wound. It was there that we had to NEGOTIATE with the doctor to apply the stitch then and there. That’s no joke! We actually had to insist that the doctor apply the stitch! So with no anesthetic, the stitch was eventually applied (despite my son’s shrieks) and he looks fine.
When I was my son’s age, I gashed my forehead at a drive-in theatre and less than 30 minutes later I was sewn up with 5 stitches and back at home…and that was in 1977!
Now the NHS has been good to us, but it’s also been a pain in the butt as well. And we have seen others suffer as a result.
Two years ago we attended the funeral of a work colleague of my wife (held in the same church where Shakespeare is buried), a mother of two in her mid-forties. We sang hymns, we cried, we gave flowers and marked the August occasion with hugs and conciliatory grief. In the woman’s courageous honor to the cancer that took her and her tremendous spirit in the face of death--(she was still doing cancer walks and hikes just weeks before she died) we named our daughter after her.
So what happened?
Jane had been visiting with the NHS for years complaining of stomach pain…and her health issues were often discussed at length with my wife. Each time, full-examinations were never forthcoming--[in fact she was advised that they were not necessary] and her ‘pain’ was temporarily alleviated through prescribed medication. (If you’ve ever lived in the UK, one thing the NHS does VERY well is prescribe medication to treat literally everything…for reasons that, on occasion are a bit dubious.) So the pain continued, and in lieu of wider, more-expensive/expansive examinations, Jane was told that her ‘discomfort’ was treatable.
And so the months rolled on. And the pain increased…until it was too late. When her health predicament became obvious to even the untrained medical eye, Jane was given mere weeks to live in an inoperable cancerous condition. The bitter side was even more crushing as she was eventually told that had her cancer been detected earlier, her life might’ve been spared. Too little too late.
We were a bit astonished that there wasn’t a deeper sense of outrage for the failings of the NHS in this affair. There seemed to be acceptance that people live and die in this life and when it’s your time, it’s your time. Perhaps there’s something in the saying that ‘familiarity breeds acceptance’.
[This also happened to the wife of one of my professors at my college a couple years ago…who for months complained of back pain, which was medicated, only to discover that it was cancer all along which when diagnosed gave her only 3 weeks before she died.]
These are some of the experiences we’ve had and observed with the NHS here. The NHS isn’t evil. It’s not some Stalinist program designed to take away each others' rights. But over the years, by declension, it has devolved into a bit of a joke. It’s now in need of a serious overhaul. And one of the many blunders here of the NHS is the ethos of ‘treating’ the symptoms rather than ‘preventing’ them. Preventable care seems to be the bastion in the private sector for health care.
Now I don’t want to beat up on Obama. I didn’t vote for him, but then again I wouldn’t have voted for the feckless McCain either. Love him or hate him, Obama is our president and is trying to ‘fix’ our nation’s health care…and I think it needs some attention and some type of option for everyone is a dignified and humane endeavour. But the bill is [reportedly] over 1,000 pages long. I haven’t read it. You haven’t read it; [have you cover-to-cover?] Most of our politicians haven’t read it either. I have questions and concerns like anyone else. I don’t know if there will be ‘death panels’ or not.
But how people can so blindly abdicate their right of being ‘informed’ to one party’s claims on a document that they themselves haven’t read is remarkable. Whether or not you’ve carried a gun to a town hall meeting, bit the finger off an old man or not is beside the point. Though I don’t know what the long-term implications of foisting a socialized health care program on the US will be, I do however know from experience some of the ups and downs from socialized health care here.
Maybe the US will be smart enough to avoid the problems here. Maybe not. (In fact, judging by history, probably not.) I don’t know if the purported millions of illegal aliens residing in the US will have access or not. But there are questions to be asked in a dignified manner and judging by the track record of the NHS here, there ought to be sufficient pause. Some pause is good. Too much pause is procrastination. Something needs to happen...
20 comments:
(Had to post in 2 segments - I must be wordy!)
Hey man - good to read your perspective on socialized health care. I'm sorry you had to go through that trauma with Corin - what a trooper he was! And I'm sorry to hear about your friend Jane. I've heard some very similar stories like yours from relatives in England, and it has always made me so grateful that the program in place in Canada seems to work much better. Since that is where I have had experience with universal health care, that's where my opinions/ideas originate from.
I, too, had some childhood medical conditions that sent me to the hospital numerous times. I've talked to my mom about these visits, and all the specialists I saw, and the subsequent major surgery I underwent when I was 10. According to her memory (mine's not so good), we saw doctor's whenever we needed to, saw the specialist the next week after being told we needed to see him, surgery was discussed and booked within a month of seeing the specialist, and my hospital care was magnificent (well, as magnificent as a 2-week stay at a hospital can be). Oh, and my parent's didn't pay $60,000 or whatever ridiculous amount a parent in the US would have to pay. In fact, I'm pretty sure through their taxes and teacher coverage the bill was in the negative.
Since moving to the US in 1997, I have estimated that I have paid over $50,000 in "health insurance" - a scam that I have bought into for 12 years now, because I, like everyone else who has health insurance, have been made to feel insecure about my health and the unknown that lies ahead. "What if _______ was to happen? My bill would be astronomical if I didn't have insurance." (And then I remember that, wait, the bill will still be astronomical, but at least my insurance company will pay for...25%...that's it???)
Have I ever had to use my health insurance for a big health scare? No, thankfully. Have I tried to use it for health maintenance? Yes. Does it cover that? No. Did the $700/month I paid for health insurance cover maternity? Of course not.
So of course I went to my homeland for the birth of Asher. Since I wasn't a resident, he wasn't free, but man - the care I received, the birthing center I stayed in, the measly $2,000 we had to cough up...was so much better than the $20,000 we would've had to cough up in the US in a smelly overrun hospital with corrupt doctor's who prescribe c-sections so they can hurry off to their golf games.
Those are my personal experiences with universal health care. I agree with you that prevention is key to this health care reform argument. But prevention needs education and access. Thousands (hundreds of thousands even?) do not have access. Insurance has come to be a "privileged" person's thing - and if you don't have it, what's the point of visiting a doc when you just can't afford the high costs?
That seems so wrong to me. Every human being in this "free" country should have the right to take control of their health. They should have access to health care centres - wherein they should be taught how to prevent disease and illnesses. (In my opinion, Planned Parenthood is the smartest clinic that's ever been started)
They shouldn't have to worry about how they're going to pay for it. The cost of doctor visits and hospital stays needs to be drastically reduced, so we can have that little extra bit set aside for an unfortunate event.
Compassion is a funny thing. It seems to bring out the worst in people, when really isn't it meant to bring out the best? (I'm not referencing you, Joe, just some other people who have astonished me with their lack of.)
For me, this issue is all about compassion. It is simply unfair that Asher has health care coverage because Nathaniel & I can afford (barely) to write the check every month, but his little friend Sally does not. And will not ever get the care she requires because the health care system bites. Drastic reform is needed. And I think we agree on that, right?
You are so right - I really should take the time to read the bill. And I'd like to - but for now, I'm going with my experiences and my gut.
Peace.
Thank you Felicity for this. You're right, we do agree that there must be some reform with health care in the US.
But I'm nervous about that bill. I'd like to read more of it. I have found a few interesting things apparently worded in the proposed bill that are cause for some concern:
Section 1904, subsection 440 says:
‘(v) provide parents with--
‘(I) knowledge of age-appropriate child development in cognitive, language, social, emotional, and motor domains (including knowledge of second language acquisition, in the case of English language learners);
‘(II) knowledge of realistic expectations of age-appropriate child behaviors;
‘(III) knowledge of health and wellness issues for children and parents;
‘(IV) modeling, consulting, and coaching on parenting practices;
‘(V) skills to interact with their child to enhance age-appropriate development;
‘(VI) skills to recognize and seek help for issues related to health, developmental delays, and social, emotional, and behavioral skills; and
‘(VII) activities designed to help parents become full partners in the education of their children
Yikes! That reads as though the bill would authorize the government to enter our homes [presumably upon request] and educate parent[s] on cultural norms and social morays with regard to the development of their children. "Modelling", "consulting" and "coaching" are fraught with problems for me.
Wow. That's a slippery slope. Because 'who' in the government is going to decide what those skills are? Will those 'skills' consider the religious and cultural diversities that are endemic to the demographics of the American family? Will a Jehovah's Witness family, Jewish family, Muslim family, Amish family, Atheist family, Mormon family, Southern Baptist family each receive the same 'modeling', 'coaching' and/or 'consulting'? Or will it be varied according to the religious and cultural needs of those families?
Article 7 almost sounds as though the government might suggest a form of Family Home evening to unite families. That's nice, but is that really the right role for the government?
Now, I don't think the government is going to start sending in suits with badges to 'police' and rectify the parenting practices of the American family. And if you don't want the visit, then the advice on this would be don't request it. (And of course, could we actually imagine the Amish requesting this to begin with? I've used them a bit melodramatically only to illustrate the wider point.)
But my BIG problem with this is this:
What does THIS have to do with Health Care Reform?
Section 1904, subsection 440 of the proposed Health Care bill has little or nothing to do [directly] with health care. This section seems far more suited to the government social services...and should be debated there.
Someone somehow found this section 'embedded' within that exhaustive 1,000 page bill...and it's 'discoveries' like that which give me pause...
Herein lies the major problem with health care reform - if anything is passed in legislature, there will be so many differing interpretations that it will be impossible to enforce the law. I read in to that section you shared so differently.
Initially I thought, "Great! There are so many parents out there who probably shouldn't even have kids, know nothing about the health and well-being of their kids, and need this kind of counseling." I didn't read it as invasive, but rather trying to find a solution to the problem of dysfunctional parenting that is so prevalent in this country.
But I can totally see it through your lens too - and I can see how this is going to be a long battle to make everyone satisfied. It probably never will happen anyhow - health care reform, that is. Hasn't it been attempted in many administrations before this one?
As far as section 440 not being directly connected to health care - again, I see it very differently. Well-being is what a good health care system needs to be focused on - not the "treatment." These points are all very valid and good, and frankly, it's counseling that should already be happening in wellness visits to pediatricians/doctors/clinics - so I think the wording here just indicates that the bill would try to enforce that that happens in those places.
But again, as we read it through such very different lens' - it does make one pause to think of all the variables out there.
(Also had to post 2 segments as well...I guess brevity is no longer the soul of my wit!)
Thanks Felicity for your reply. Indeed we have common ground on many points on the issue of health care.
You’ve hit the proverbial nail on the head with regard to Section 1904, subsection 440 because I don’t think there could possibly be a single interpretation that will satisfy everyone.
But on your point that “there are so many parents out there who probably shouldn't even have kids, know nothing about the health and well-being of their kids, and need this kind of counseling”, I have a few comments.
1) It’s unclear to me ‘when’ this type of counseling would be necessary. If it’s ‘before’ parents have children, ‘who’ decides when it’s required? [I know that these government grants will be at the discretion of individual states…and that decision may ultimately be with the states who participate in this.] If it’s after-- ‘how’ is it assessed and ‘who’ will determine so for the families?
2) Well-being is already under the jurisdiction of Child Protection Services. It’s [supposed to be] one of their primary functions. Billions are spent each year to enable them to do this for America’s families. Whether they do it competently or not is an entirely different debate. If legislation is put forth to make CPS more effective, I’ll get behind that bill. [But CPS is very, very fallible…and I know, painfully from firsthand experience…but once again, I think that’s the subject of another discussion.]
3) However, if ‘well-being’ is now being absorbed into the Heath Care proposed bill…then there are [by that logic] so many ‘other’ factors to consider that equally affect the health and vitality of Americans. Such as:
a) Nutrition. That’s easy enough to agree on. Quality food and access to nutrition is paramount to a healthy lifestyle. The bill could, insofar as it concerns the ‘health’ of its citizens make a major emphasis on the ‘preventable’ ethos we discussed earlier by absorbing some of the authority of the Food and Drug Administration to ‘tax’ unhealthy food and penalize peddlers of the junk Americans slam down every day of the year. This was is now being done with the Tobacco Companies…it’s not impossible. Since Heart disease is the number 1 killer in America and lack of nutrition enables this…I’m surprised that the proposed health care bill doesn’t already address this. (Maybe it already has…embedded somewhere on one of those 1,000+ pages.)
b) Environment. Clean air is a must. Research has shown that asthma is on the rise in children and many blame the increase in the explosion in urban living and its inherent polluted air as a factor. Billions are already being spent each year treating this and other respiratory problems. Perhaps the bill could absorb some of the authority from the Environmental Protection Agency to ensure Americans are informed of ‘factors’ that may be adversely affecting their health.
c) Media. Images of violence, debauchery, alcohol and drugs are beamed into Americans’ homes through music and television [and the internet] every day for hours a day. Violent crime and gang crime is, not surprisingly the highest in America among the western world. The bill could, in an effort to stave off the ever-increasing trend of violence [especially in youth culture] absorb some of the authority from the Federal Communications Commission to ensure that Americans are more informed and ‘shielded’ within their communities and neighborhoods about the dangers of these types of influences affecting their health and safety. (This might even be covered somewhere within Section 1904, subsection 440 — possible articles III, V, VI, and VII.)
There are so many ‘definitions’ of what well-being is in America and a variety of factors that affect it that were the proposed Health Care bill to encompass everything pertaining to it, doubtless we could describe it as the One bill to rule them all, One bill to find them, One bill to bring them all and in the darkness bind them.
If there is a new direction being spearheaded by the government to improve families in America…and its being appropriated into a health care bill, all this does is engender more questions and concerns. Will those ‘consultations/modeling/coaching’ procedures be compulsory? At whose discretion, the parents’ or the states’? And again, ‘what’ is the standard by which all families will be judged by their government if state requires said type of consultation? Will the state wait for parents to request it? Or will it be doled out arbitrarily? Is the government REALLY laboring under the assumption that confused parents will bypass their own extended family, friends, church, school, community, dozens of self-help books and other forms of media and voluntarily b-line for the government’s assistance with parenting techniques?
The gist of Section 1904, subsection 440 (perhaps with the very best of intentions) seems [by design] determined to improve the quality of life in America’s oftentimes fractious and diversified families. Well-being is certainly a part of that. But to the parents with whom you feel should not even have children (and you may well be right), this is where Child Protection Services should come into play.
I don’t think we’re necessarily talking about children being fed Happy Meals and letting them watch Nickelodeon all day. In my opinion the parents or ‘parent’ who should not be allowed to have children are those with whom are directly endangering the physical and mental safety of their child through continual neglect. This is where CPS should enter the equation. That is their job. That’s where my personal tax money has been going for over 20 years.
If Section 1904, subsection 440 is mostly just for the education of families in general, then this now negates the existence of community, school and state-run agencies available in almost every town, and sector in America. And, once again, this dovetails into yet another government-funded program: Planned Parenthood.
So if our government is already covering these functions, what then is the raison d´être for Section 1904, subsection 440’s inclusion within a Health Care bill?
It’s very, very right to question its presence (even more suspicious that it’s embedded in there all the way on page 838.) And I’m still waiting for the Obama Administration to assuage my concerns by explaining why sections [such as this] are necessary to this bill when they belong elsewhere.
If it’s there because it hasn’t been working in the ‘other’ government-funded auxiliaries, then what’s missing is an open discussion about the failings of those government auxiliaries and a proposal to ‘fix’ them through proposed legislation.
(Egads…my third post…very sorry…a PhD students gets writing and boy he doesn’t know how to shut-up sometimes…bear with me..)
My next problem is with the bill’s assurance that “well-trained” and “competent” staff will be providing parents with the aforementioned ‘skills’, ‘knowledge’, and ‘expectations’ in their child’s development. Here again this gives rise to a lot more problems. Is there a single field or theory of child development universally accepted in America? In the world? Of course not! So ‘what’ will these “well-trained” government workers be sharing with the families of America?
Would these “well-trained” and “competent” government workers be within their right to advise expectant mothers to abort their children if they deem that they shouldn’t be parents given their circumstances? Maybe some parents shouldn’t have children. Will this bill authorize workers to suggest the same?
Again…questions. Important questions— (even the outrageous ones) deserve to be asked and to be answered. And when Americans— (even the kooks, and right-wingers), assemble in the town halls…to exercise their constitutional rights as Americans to do so, they don’t deserve to be demonized by the Democratic Speaker of the House as “Un-American” or erroneously characterized as “carrying Swastikas” – (the latter of which was found to be completely untrue and an unfair characterization.)
People, even the idiots and ideologues…including those maligned in their ignorance by party-propaganda and fear-mongering, deserve to ask their government questions and for that government to answer them.
Excellent piece!
I appreciate the first person view of Britain's system. Nothing beats reality.
I spent seven years uninsured, due to my self-employed status. The oft-repeated inplication that 46 million uninsured are 'bereft of options' is an exaggeration and not based in reality.
First, no person in the US can be denied health care. Second, many people opt out of health insurance for cost reasons. I was one.
During my noninsured tenure when I required health care, there were several government-funded options extant. The first was a community health care program that scales health care cost to your income, which is what I used. Inasmuch as my income was very low when I needed minor surgery on my foot, the entire set of treatments cost me less than $40 total. But I recieved our stellar care, no waiting (saw the physician within a day of phoning in), and thorough treatment.
Is health care expensive? Yes. The insurance companies are popularly demonized, but nothing in the legislation deals with the two primary drivers of costs here in the US.
Number one is government intervention and regulations. I recently participated in a health care forum and focus group for the local health care industry, seeking to evaluate needs and reduce costs. FYI, our local HMOs must send out new brochures and literature to members nearly every month, due to changing regulations from the government.
Insurance is not portable: this is why there are currently 1300 insurance companies in the US. A man living in New Jersey can pay four times as much as a man across the river in Connecticut due to this phenomenon.
Number two: litigation and fear of same. The problem is not so much the malpractice (of course malpractice happens); it's the abuse of malpractice that hurts. For every legitimate malpractice claim, there are frivolous claims. There's the "Big Score" many lawyers seek: see John Edwards and his $80 million dollar award based on a later-disproved claim. Who pays for that? What about jury-shopping to inflate claims?
The legislation being pushed makes no mention of these. Tort reform and portability.
I now work for the government. In many areas, the government is finally realizing that things are done better, cheaper, and more effectively when handled by the private sector, and with less micromanagement. My area of work; building of facilities and development of housing, is finally outsourcing much of its work into Public-Private Ventures. This gives the government far more bang for the buck and improves the lives of every person it touches. I'll be glad to get specific.
Some things government must do and provide. Controlling health care is already a mess, and more government can only make things worse.
Thank you Marc...excellent insight as always.
I failed too, to share that after my Masters finished in 2004 and we returned to the US [Texas]...I was unemployed with a wife and a new baby for 5 whole months.
In that time vaccinations for Corin and regular check-ups were periodic and required.
But Corin received health visits free of charge and the requisite vaccinations without missing a beat. Free Health Clinics abound all over America and so some form of health care is always available even in rudimentary form.
I think the wheels on the Obama Administration are starting to come off and those falling poll numbers cannot in their entirety simply be attributed to the Republican Attack/Spin machine.
Even Obama's most ardent supporters are befuddled with what is happening.
Camille LaPaglia recently shared this:
"Why has the Democratic Party become so arrogantly detached from ordinary Americans? Though they claim to speak for the poor and dispossessed, Democrats have increasingly become the party of an upper-middle-class professional elite, top-heavy with journalists, academics and lawyers (one reason for the hypocritical absence of tort reform in the healthcare bills). Weirdly, given their worship of highly individualistic, secularized self-actualization, such professionals are as a whole amazingly credulous these days about big-government solutions to every social problem. They see no danger in expanding government authority and intrusive, wasteful bureaucracy. This is, I submit, a stunning turn away from the anti-authority and anti-establishment principles of authentic 1960s leftism."
My MAIN problem with socializing health care in the US is this: should Obama's bill pass, nothing guarantees that a future Administration [Republican or Democrat] won't one day try to make cuts to government entities in order to balance the budgets as they see fit. Clinton cut military spending during his presidency. Bush [obviously] increased it.
Cuts in government spending are part-and-parcel of Administrations who try to achieve their agendas for what they see is best for America.
So nothing guarantees that one Administration won't one day make cuts in socialized health care spending...which is a dangerous gamble. Let's hope [should the bill pass] that some future Administration doesn't cut spending to health care right before something like a massive Swine Flu epidemic breaks out. What will the government do then?
It took FEMA a week to bring water to New Orleans...so my faith in the government's capability to solve all of my problems is understandably shaken.
If cuts are ever made to socialized health care -- (and never say never), we'll end up with rationed health care instead. And waiting lists.
It's happening right now in the UK...and I still don't know what Obama's plan is to guarantee that the fate of the UK's NHS won't in turn one day befall us.
(Here's my response...in 2 posts!)
Comparing the proposed healthcare reforms in the US to Britain’s National Health Service is flawed. Although Britain does have socialised healthcare those who can afford it (or else, those whose employers provide it) can have access to private healthcare (and therefore diagnostics tests and treatments that may be unavailable on the NHS, as well as little or no waiting lists). The British system therefore does not require ALL to have health insurance; those who want private healthcare pay for it, and those who do not have the means, or perhaps are philosophically averse to the idea (or indeed, neither of these!), still have access to healthcare. (There is of course, the argument against this model, as it leads to a two-tier healthcare system, where those who can afford private healthcare get quicker and more efficient healthcare, but that is an discussion for another day!)
Are there problems with a universal service? Absolutely! I have worked with the NHS for the past 9 years and have seen first hand the inequities, inefficiencies and mindless bureaucracy that can restrict even the best intentions of healthcare professions. In addition, there is no doubt that this approach stifles innovation. Indeed, NICE (the National Institute for Clinical Excellence) has the power to not only restrict and limit (and by this I mean ration; try explaining the notion of qualis to someone who has been denied treatment because it doesn’t offer enough qualis to be fiscally viable) diagnostic tests and treatments in the NHS but also in the private sector; private healthcare insurance companies use NICE guidelines to decide which treatments they will and won’t reimburse. I appreciate that treatments need to be proven (as far as is possible) to be efficacious before being used on the general population, but this approach absolutely, without doubt, does not provide any incentive for innovation.
Within the NHS system, there will always be situations (or should I say, horror stories) where patients have not been referred early enough, or a practitioner miss-diagnosed, etc, however, there are also stories that illustrates how efficient the NHS can be. Indeed, two weeks ago, my uncle passed away from lung cancer. He was diagnosed before Christmas, and has received nothing but exemplary care from the NHS. He visited his GP only twice before being referred to a specialist, whom he saw within two weeks. Diagnosis and treatment (although ultimately unsuccessful) was swift.
I am not averse to the US system in principle; indeed, those who do not have health insurance do (as Joe and Marc have both mentioned) have access to healthcare. I object to the fact that even those who have insurance can be financially ruined because their insurance company will only partially cover their bills. I know of one family in the US whose son was brain damaged as a result of a hit-and-run; this family lost their home in their quest to pay their medical bills (even though they had health insurance), and the bills are still mounting. They have (along with many other families who find themselves in the same predicament) had to resort to fund raising drives just to pay for the medical costs. How can this be right?
As you have all pointed out, the healthcare reforms have yet to be fleshed out (the devil, will, indeed, be in the detail). During an interview yesterday, Obama admitted that his “vagueness” in explaining his reforms in detail has contributed to the animosity towards the idea. There can be no doubt that reform in required, but the issue (for me-although I have no right as a Brit to have an opinion of course!) is what those reforms will be. Obama has said that reforms will only be passed if they: 1) reduce costs; 2) guarantee that every American has the freedom to choose their own health plan (including a public plan); and 3) ensuring that all Americans have quality and affordable healthcare. Surely, most Americans cannot object to these principles?
Dear Felicity, Donna, and Marc,
I think what we have here is an excellent and uniquely diverse group among us.
We have a Canadian, a formerly uninsured American, a British Health Care worker, and an American-living-in-Britain weighing in on this issue for socialized Health Care. Cable talk shows would struggle to fill a panel with as varied as ours.
Donna, thank you for joining in on this debate. We have much that we agree on. You're right, a direct comparison to the UK's NHS is flawed insofar as it won't give the US a mirror image of what to expect. But to dissuade looking at its pros and cons would be foolhardy.
There are, ostensibly, differences with Obama's proposed Health Care Bill [exclusive to the US] that are worth looking at.
Last night, after Obama promised his Health Care Bill would not provide access to illegal immigrants, a Republican lawmaker disrespectfully shouted [on live tv] "You lie!"
(Donna, I know that sort of thing is de rigueur during the Prime Minister's chats with MPs, but in America this is tantamount to lobbing a shoe at the President!)
But is there 'something' in that Republican's outrageous and immature outburst?
Technically, yes.
FACT:
Obama’s Health Care Bill, while claiming it won’t insure illegal aliens, has no plan, that's right, NO PLAN whatsoever to introduce verification provisions to keep illegals from applying anyway to get benefits.
Once word of this gets out…guess what’s going to happen to illegal immigration? The United States currently 'houses' anywhere from 20-30 million illegal aliens (mostly from Mexico and South America.)
Something tells me that (like all other government services) initially there will be enough Health Care allocated to go around for the citizens of the US. (I've heard 46 million 'citizens' are currently without it, last night Obama suggested just over 30 million...so really knows.)
I don't think the authors of Obama's Health Care bill are stupid...they didn't 'forget' to write in those verification provisions to prevent false benefits claims. So Obama's Health Care Bill, by intentional negligence, WILL allow illegal immigrants to access those services if they so choose to exploit an intentional loophole inherent in that bill.
If 30 million illegal immigrants decide to do so...this will strain Health Care services nationwide.
Furthermore, this lack of provision will do more to encourage illegal immigration across America's southern borders...
That's a pretty BIG problem that's being completely ignored...and has serious nightmarish potential.
Darn my grammar...apologies.
This is a very good discussion.
Heath care in the US is in need of some serious fixes, I think we all agree. Many of us think they should be dealt with in a targeted manner and not by a massive takeover by government.
For example, When I buy health care, I really don't want to pay for mandated coverage so my wife and I can get boob jobs, transgender surgery or psychological counseling, or holistic healing. I don't need that coverage, and should be allowed to opt out. But many states mandate it, and everyone has to pay. That's why it can cost vastly different sums for basic health care between states.
But there's a vast disconnect between what needs to be done and what the proposed bill tries to do.
Sadly, we have had nothing but words from our politicians claiming "my health care plan won't give coverage to illegals," but it effectively does just that by failing to fix the current problem.
The issue is not Democrat/Republican in its nature, as much of the legislation in the past to fix specific aspects of health care in the US has been stymied by both parties. Specifically, tort reform and portability, and coverage for illegals.
But it has become so. Recently, several Republican bills have been introduced attempting to seal some of the public promises made by the administration into law. One tried to close the loophole that gives illegals free health care; the other preventing funding for abortion. But they were quickly killed. In fact, this administration has prevented Republicans from participating in the health care panels since April.
You really can't believe the feel-good verbiage coming from our president right now, as his parsing of words is misleading at best. Tell the people what they want to hear, but just don't look for proof in the bill.
My last point. Explain to me the huge rush for this health care legislation. Congess and the President tried to ram it through just like the 'stimulus package,' without time for debate, examination and true scrutiny.
If it's so urgent, why does the bill specifically not go into effect until 2013? That's right, 2013, ostensibly the year after Obama gets reelected. Can it be that the bill is much less about fixing health care than about government taking control over 1/6 of our nation's economy?
I will be brief and to the point. As long as there is greed and corruption there will be no good solution to any of the problems we face. Our government has along way to go. Where does greed and corruption ultimately get you? Not a good comfortable place. As for me and my family we will endure to the end and work for, and look forward to a comfortable place. In the mean time rock it!
Speaking of the NHS...
http://www.telegraph.co.uk/health/healthnews/6216559/One-in-six-NHS-patients-misdiagnosed.html
Uh-oh: FINANCE COMMITTEE DEMOCRAT WON'T READ THE TEXT OF THE HEALTH CARE REFORM BILL.
Senate Finance Committee Democrat, Delaware's Sen. Thomas Carper, interviewed by CNSNews revealed that he doesn't "expect" to read the bill.
"I don't expect to actually read the legislative language because reading the legislative language is among the more confusing things I've ever read in my life."
Senator Carper furthermore questioned whether anyone could the read the text of the bill and claim to understand it.
"...anyone who says that they can do that [read the bill] and actually get much out of it is trying to pull the wool over our eyes."
Carper goes on to describe the language of the bill as "arcane" and "gibberish".
A "plain language description" of the bill is currently underway.
(Link to Carper's interview)
http://www.cnsnews.com/news/article/54930
Earlier in July, ranking Democrat Sen. Dick Durbin had already pledged to read the whole text of the Health Care Reform Bill; [long before any discussion for a "plain language" version was put into action].
So what are you going to believe: That Dick Durbin will
1.) Actually read the 1,000+ page bill,
or
2.) That he will actually UNDERSTAND the text once he does?
(Link to Durbin's interview)
http://www.cnsnews.com/cnsnewstv/v/Gd4zkU2GaG
Hi, I stumbled onto this via Joe's comment on a Ke Alakai article and thought I'd add my two cents. (Hello to everyone, btw. We're in Maine for now, teaching at Bates College). First, a link to my own blog where I posted some thought on this a few weeks ago, just to get a sense where I stand.
http://blognotwo.blogspot.com/2009/09/my-two-cents-on-health-care-reform.html
Then to respond to some arguments that have been made. First, an overall comment that speaks to many people's comments. NONE of the current health care plans on the table nationalize the American health care system. (I personally think that might be the way to go, but politically it isn't an option.) If you currently have health care, nothing will change, except that your insurer will no longer be able to drop you when you get sick because you filled your paperwork out wrong. When I tore my ACL, they kept sending me a bill for 50,000 because of some paperwork. I had to spend several hours on the phone several times over several weeks to finally get it taken care of. Every time I have had an expense this is what happens, and I had a really good plan through school. Basically, in the current system, you are paying for people whose job it is to figure out why the insurance company shouldn't pay your bill. The health care market is anything but a free market. You never know how much anything is going to cost and the Dr. couldn't even tell you, because he doesn't know what insurance you have. The entire situation was much clearer in Japan, where you pay a set percentage for set services. The doctor always knew how much something would cost me and I could easily opt out. Also, they adopted many simple cost saving measures, as they did in Taiwan, like having Bekah weigh herself prior to her prenatal checkups. In contrast, my ACL surgery bill was 50,000, of which I was responsible for 2-3,000. At no point in the process did I hear a price for anything. My friend had the same surgery in Oregon and the entire cost as 3,000, and he paid nothing.
In response to Joe on preventive care. Most of the health care plans on the table mandate that preventive checkup be covered, something that is not true of the current system. Marc suggested that in the US, no one can be denied care, and Joe suggested that some level of free care is available at clinics. This is not exactly true. When my friend Wendell, also a BYUH alumni, got into a motorcycle accident (he was run over by a woman without car insurance), he was literally on the operating table (in Utah) and the doctor asks him if he had insurance. They were trying to decide if they should try and save his leg, which would be very expensive and not necessarily successful, or amputate. Fortunately, though he was young and underemployed, his parents were wealthy enough to buy insurance for him, so he could say “Yes.” So, they saved his leg, after several extremely expensive months in rehab, and much more at home, he can walk, and even participate in some sports. If he had not had insurance, he would have gotten care, but an amputation instead of reconstruction. Likewise, when my uncle went in for a stroke, after the doctors saved his life, they totally berated him and yelled at him when they found out he didn’t have insurance. He is a self employed artist. (I think he just didn’t say anything.) Assuredly he would have gotten a much different kind of “treatment” if they had known from the start. Marc, I also disagree that litigation and government regulation are the primary drivers of health care cost. I highly recommend at article by Atul Gawande in the New Yorker that explores the issue of health care cost in the US. The conclusion challenges our idea of how market principles apply to health care.
http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande - http://www.newyorker.com/reporting/2009
Finally, just for the record. I am not worried about illegal immigrants receiving healthcare. Are we not all beggars? They work hard for very little. Many pay taxes. California used to theirs anyway. Many sectors of our economy depend on them. We really need a legal, guest worker program big enough to fill our needs and to protect them from being abused. Japan paid for my health care when I was there, as did Taiwan. I had a visa, sure, but they also paid for my wife and kids. In fact, during our 7 years as graduate student, Bekah only had health insurance while we were abroad. I think, as a nation, we can do better than that.
Thank you Jesse for joining this debate and sharing your experiences. I’ve said it elsewhere within this blog, but perhaps it merits repeating again: I believe we NEED Health Care Reform! Many of the points you’ve raised show exactly why it is necessary.
But I’m convinced that the current Health Care Reform Bill is the wrong way to go and it is disappointing that no one in Washington came up with something better.
The very idea of reforming Health Care in the US has been the dream of several administrations, a veritable Holy Grail of American politics. (The ‘Fountain of Youth’ is probably a better metaphor here!)
I think there are too many in love with the concept of reform and will support whatever permutation it takes. This is evidenced by how quick the Democrats want the bill voted on and approved without even reading it! Earlier this year Americans fell asleep with the $789 billion stimulus bill that quickly got pushed through.
Now unemployment is ballooning to 10%, the dollar is spiraling ever downward and a lot of Americans are starting to wonder ‘what’ good the stimulus bill ever was. (There’s even talk from Democrats on Capital Hill [including Nancy Pelosi] of introducing ANOTHER stimulus bill in reflection of the failure of the first). The adage of “Fool me once” – (something Dubya famously flubbed up on) springs to mind.
When Montana’s Max Baucus ‘sold’ the idea of his Health Care Reform Bill (or colloquially known as ‘ObamaCare’), to the White House it was only supposed to cost the US under $1 trillion and not inflate the deficit. However, the Cato Institute (a respected, non-partisan DC-based think tank) after scrutinizing the proposed ObamaCare, have pinpointed the cost at double, $2 trillion. Moreover, Harry Reid one of ObamaCare’s most vociferous proponents now seems to agree with the Cato Institute estimates:
http://www.youtube.com/watch?v=a6Ul7E8IR_Y
What are Americans about to get themselves into? There doesn’t seem to be a consensus.
On the subject of immigration, you’re right; many do work very hard for little. Their positive contribution to the national economy is not in dispute with me. (Many contribute simply by paying sales tax and estate taxes). But were ObamaCare to become ‘universal’ then what strata of society will be paying taxes to provide those Health Care benefits for them?
As I mentioned earlier, I suspect that the lure of free Health Care will only exacerbate tensions with Border Control and contribute to an explosion in illegal immigration. That might be good for the nation’s economy, but with it too comes an explosion in crime and gang violence. Concerning the latter, you probably won’t have much trouble there in Maine to the extent that it does in Texas where my extended family lives.
Great to hear from you and thank you for weighing in.
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