That is a large part of the point that I’m trying to make. I am in an exceptional situation in terms of HI in that the benefits I receive here are probably worth 10k/yr for my family. I’d rather become part of a 300 million person insurance pool and give up some of my perks than wind up in my last HI situation. A single payer health care system winds up costing less than and providing the same or better coverage than my previous 3 HI situations.

I’m not too sure about that. That will certainly be the case if the HI (Health Insurance) companies’ propaganda is unchallenged.

I have the best healthcare coverage I have heard of. We pay $65/month to cover my spouse and myself. There is a $20 co-pay for Doctor visits, prescriptions are $5/$20/$40. Dental is covered by a fee schedule w/ no maximum, vision is fully covered w/ $20 co-pay and includes lasik procedures. Approval is done by my co-worker, so nothing is ever denied for my family. No referrals are necessary to see a specialist. Alternative medicine, massage & chiropractors are covered to a limited extent. I would still prefer centralized universal healthcare because I know that there is a real possibility that I will not have this coverage available for the rest of my career. In my last job, I could’ve had a major medical policy (nothing covered up to $5,000, then 60% coverage for anything after) for my wife and myself for $400/mo.

I would rather lose some of what I have now than take the risk of going back to what was available in my past jobs.

Health care is rationed everywhere, here and in socialized healthcare systems. In the latter, it is rationed by factors such as age, statistical risk/benefit calculations and the like. Here, it is rationed by ability to pay, arguably the worst imaginable system, since more weight is thereby given to wealthy 86 year olds than to poor 2 year olds.

Everyone has to give up something. The question is, who?

My daughter has lived for many years in Scotland, where health care is socialized. She had her first child by C-section because he was transverse, and it was considered the safest alternative. She loved it: no labor pains. So when it came to having her second, she wanted another C-section. Scottish National Health said, So sorry, we’ve decided you don’t need that.

Now, she could conceivably have paid for it herself, but that would have been big dollars, so, on balance, she decided to go with the program. My granddaughter Fiona was born vaginally, without incident, except that my daughter bitched and moaned a lot, during and after, about what an injustice childbirth is. :) Oh well.

Scotland is a fabulous place to be a young pregnant mother, and it’s a fabulous place to be a kid (health-wise, ignoring the weather). It’s not such a good place to be an old lady with cancer, or an old lady like my daughter’s mother-in-law, who needs a hip replacement. In that case, you must keep queue, or, natch, pay for services yourself.

There are health insurance policies available in Scotland, to pay in case you decide that you want something National Health won’t pay for, or won’t pay for soon enough. But the rich always do well, under every system. As I said, I’m more worried about the rest of us.

Would Scottish National Health work here? I don’t think so. Europeans are very….docile, compared to Americans. Or that’s how they strike us. We need a system that works with the culture here. I think we can do it. I hope so, because the “system” we now have is in the process of hitting a brick wall at high speed.

The problem of course is that a lot of people talk about savings and limits and the like but NOBODY (myself included) is personallyhappy when it comes to them.

So it’s easy for me to understand in the abstract that the country may not be able to afford to give bypass surgery to every 85 year old who wants it, but it’s difficult in the personal if it’s my grandfather who is denied the surgery he needs to live a few extra years.

And that is the type of decisino which is necessary to succeed with socialized medicine. Sure, emergency care will still be there. But do you get a lot of expensive chemo to extend your life by 6 months? Do you get an expensive transplant to extend your life by a year? It’s all, sadly, costs and benefits.

I fear that those who DO currently have health care feel so entitled to the outstanding care they get now are going to fight tooth and nail against giving it up. Altruism only goes so far and it’s a hard issue.

That’s why a lot of places with socialized health care have better overall national health than we do. But in the more extreme treatment–access to a MRI for testing, for example, or speed in which one enters chemotherapy–we can be better for those who have access to it.

Make that all virtually all places with socialized health care. We spend more per capita in this country on health care than anyone on the planet, but our health scores - you pick the score - are a joke compared to, let’s say, our next competitor on price (Switzerland).

Don’t spend too much time worrying about access to health care for the rich. They’ll always get the best, in any system. Let’s talk about the rest of us.

I can agree with a lot of what you say, but…
But in the more extreme treatment–access to a MRI for testing, for example, or speed in which one enters chemotherapy–we can be better for those who have access to it.

High-end treatment, fast access will always be available for those with enough money. Well, unless you make that illegal, but I don’t see that happening.

Universal health insurance doesn’t necessarily lower the overall standard of health care. The mean can remain the same or go up, as can the median.

It DOES, though, tend to reduce the availability of the far right end of the curve. In other words, the more “nonstandard” care (read: expensive and/or currently available only to those with excellent insurance) level usually can’t be maintained. It’s just too expensive.

That’s why a lot of places with socialized health care have better overall national health than we do. But in the more extreme treatment–access to a MRI for testing, for example, or speed in which one enters chemotherapy–we can be better for those who have access to it.

In the world of capitalism and well-insured people, i can hurt my knee playing soccer and be in a MRI the next day, having seen an orthopedist. If i am diagnosed withcaner, i can probably start radiation treatment fast fast fast.

In canada (which i realize isn’t the best, but am using as an example because I happen to know the stats) it can take weeks–months, even–to start radiation treatment. Of course, more people get other kinds of care.

Since I’m currently able to afford insurance, global insurance will probably lower my personal care. But I think it’s a good idea anyway. I just think we need to be upfront about it: you cannot simultaneously treat everyone and everything. So in order to help a lot of people, we’re going to have to take things away from someone.

The only other thing I want to say is that I live in a place with a socialised medical system, and I think a lot of authors have a very strange ideas about what it entails. My best friend’s medical care over her lifetime has cost well into 7 figures, as she isn’t yet thirty. The idea that Tapetum’s mother-in-law would automatically be considered too old or to ill under a socialised system is ridiculous. While the New Zealand health system used to be much better than it is now (privatisation by stealth has been government policy for 20 years) , the cases Tapetum mentions would all be better treated under the NZ system.

January 30th, 2007 at 6:18 pm
Actually, Sailorman, our very poor get decent health care, in the same range of QoS as is received in the European countries. It’s our working poor - too rich for Medicaid, too poor for cash, uninsured - who have the problem.

And the thousands of uninsured “migrants” who illegally come across our southern border and show up at the hospital emergency room when they are hurt or sick. Then there are the millions of “undocumented workers” and their children who are already here receiving free healthcare under our current system. Those people are getting decent healthcare for free or almost free.

Ah, the repeat something often enough and lies become truth. Can you lay out your logic on this so that I’m sure I’m addressing your statement correctly?

So in order to get the uninsured to have care, you have to somehow lower the overall standard of care for the insured.

We could provide very high quality healthcare for the “uninsured” and probably save money doing it. The “uninsured” get healthcare in the most expensive place imaginable — the ER — at the worst possible time from a cost perspective — long after preventative medicine would have made it a lot cheaper to deal with.

Fix that and not only with the quality of care go up, but the cost will go down. It’s stupid-simple.

“Healthism, simply put, is an overemphasis on keeping healthy. Social critic Robert Crawford believes that many persons today (particularly, he notes, the more affluent) are too focused on staying healthy. He suggests that people have become preoccupied with controlling the more manageable health factors like smoking or diet because they feel powerless to change major factors like financial uncertainty or potential nuclear disaster. When we are overly focused on healthiness or a “healthy lifestyle” as goals to strive for (or as the measure of a “healthy” society) we deflect attention from the more important goals of social justice and peace.

Crawford also points out that even though prevention is crucial, and dangerously glossed over by conventional medicine, it, too, can be overemphasized. In expanding the concept of prevention ever further, we risk defining more and more aspects of life in terms of health and illness–that is, according to a medical model. We may end up seeing exercise, eating, meditation, fresh air, dance, for example–all pleasures in their own right–simply as measures of our potential health or nonhealth. In this way, ironically, we further medicalize our lives.

Keeping healthy can also become a moral issue. Individuals are made to feel guilty for getting sick. People shake their heads disapprovingly over those who “don’t take care of themselves.” In many cases this amounts to blaming the victim; it shows a failure to recognize the social and economic influences on health habits and illness. With personal habits, too, a certain judgmentalness creeps in: “She should have more control over her smoking,” or “She should get more exercise, stop eating so much sugar.” Even when these are matters of personal choice, moralistic healthism is inappropriate. And it doesn’t help people change, even when they may want to.”

–The New Our Bodies, Ourselves

Now would you all be responsible bloggers for a change and somebody start a healthcare thread on another blog or either here where it belongs.

( Note: This post is meant to be sarcastic and joking. I realize that emotion does not translate well over the internet so this note is for those that offend easily.)

In an ideal world, yes, everyone would get the healthcare they need, regardless of anything. In the world we have, prioritization is necessary, however distasteful and neglecting basic medical necessities (like diabetic testing supplies) for the young is an utter boneheadedly wrong way to go about it, regardless of how you get there. That one stint in the ICU for my neighbor cost the state about thirty times what providing his mother with the necessary equipment would have been.

in other words, the right tail of our health care curve probably extends farther, or is bigger, than most.

The U.S. has atrocious health care for the very poor. Compared to many industrialized nations, the LEFT hand tail of the health care curve probably extends farther, AND is bigger, than most.

Best?
Worst?

Depends on whether you happen to have money and/or good insurance.

Centralized health care (with a fixed budget) works by compressing the curve. You “fix” the left tail, so you get fewer people who are uninsured and who don’t get care. But in order to do so, you have to get that money from somewhere–and you have to to restrict either the ultimate level of quality, or the availability, or both.

So in order to get the uninsured to have care, you have to somehow lower the overall standard of care for the insured.

As FCH says, and i agree: There’s no easy answer to whether that’s a good idea.0

We won’t even go into my mother-in-law who’s caring for the unknown intestinal mass via the advanced method of “hoping it’s not cancer, or at least not malignant”. How a private system is supposed to be better for the people with no way to pay for it is quite a mystery.

As I understand socialized medicine systems, your M-I-L is basically out of luck. Too old, too ill, too bad.

The difference between socialized and private is in who doesn’t get care. In the private system the poor and uninsured don’t get care. In the socialized system the elderly and people who want ‘elective’ procedures don’t get care.

Take your pick, decide who is more deserving, be prepared to show all work in reaching your answer.