Socialized Medicine the myths and the facts

[madwife2002]

The first and the most obvious concern is the cost to the patient and their family, we all know how devastating an illness can be for patients and their family many times I have witnessed the despair when a diagnoses meant further treatment which insurances question and in some cases wont cover. I have seen patients needing costly drugs to keep them alive and being unable to afford them, causing repeated admissions to repair the damage so called none compliance has caused. The first question in none compliance is were the pts actually refusing to take their medication or was it simply they could not afford to buy their medication because they don't have enough money and other bills need to be paid first? If the real reason is the cost then surely it would be more simple of we provided these medications at a more effective price or that all medications cost $5 no matter what they had? Outrageous I hear you shout but the cost of the repeated admission is far more costly than by helping prevent a repeat admission, by providing medicine they can afford.

How about blood tests could these not be done in the doctors office before the pt leaves for home and forgets to go and have a blood draw, or simply cannot get to the lab to have them drawn. I have personally waited in doctors office hours (and paid for the privilege) then been sent to the lab, miles away to sit and wait for blood work to be done. Why could the doctors not employ somebody to be at the office to draw blood on patients?

We should be looking at improving preventative medicine rather than patch it up and see.

Many times I have seen patients discharged with a new diagnoses of diabetes, no follow up at home can be organised because in my city nothing exists to assist these people. There should be a diabetic home nurse who monitors these patients in their own home-rationale, this would again help prevent admissions for diabetic complications, and none compliance.

So you wonder what has this got to do with socialized medicine. Well, in the UK if you have...

• Children
• Over 60 for women and over 65 for men
• Diabetes
• Asthma
• Thyroid problems, etc...

...then you get all your medicines for free.

There are in place specialized RN's who focus is on preventative care in the community. There are telephone help lines which anybody can utilize for free.

Maternity care is free a midwife will be assigned to you for the duration of your pregnancy and up to 6 weeks later. The cost of the birth-nothing no matter how you deliver.

I have been asked what kind of care do you receive in a socialized medicine country and I ask them, I am a product of socialized medicine you tell me how my care differs from nurses who have paid outrageous amounts of money to train as a nurse?

Of course even in the UK you can have private care if you chose to pay, this is an advantage if you need hip replacements, knee replacements, eye surgeries-other wise you may have to wait. There are initiatives in place to reduce waiting times for surgeries in the NHS and I hear that dr's can now book surgeries from their office at hospitals all over the UK which helps reduce waiting times, plus hospitals get fined if they don't meet their quota.

I agree MRI's and CT's are not as freely available, but again initiatives are in place to improve the waiting times. Emergency care no different all patients will receive emergency care.

Poor conditions yes there are poor hospitals and there are excellent hospitals, no different to Phoenix AZ.

Questions??

[jeanny]

I worked in small, specialized hospitals, middle size to university hospitals in Germany, 8 years plus 5 years in ICU.

I can say that I always could give my patients the treatment I would wish to obtain:nurse:! Altough we had a luck of staff sometimes and very hard to work:bugeyes:, on medical ward, neurology, kardiology and ICU. I gave patients antibiotics , pain killer, special bandages, IV's... as appropriate for this illness, doesn't matter if the person is homeless or CEO of a company. Specially in ICU every patient received everything, except there was no chance and an agreement with the family and all disziplines to stop the treatment and let the client go, in an ethical and moral way and without pain. If I suggested a therapy, as competent nurse, in 95 % the doctor agreed with me and prescribed it. Prevention is very well promoted. If you live healthy, for example you have a normal weight, you participate in a fitness club... you get points and a lower insurence rate:lol2:. Magazines, brochures, TV and lessons keep you up to date how to get healtier( here the focus is more how to get beautiful, they don't care if you are healthy:smokin: or not).There are sufficient programs for mental ill or homeless people. The society general has more knowledge what healhty livestyle and nutrition is, in my opinion.

However I know there are negative sides as well. People abuse the system, get a bunch of treatments unnecessary... go to the doctor for every little issue. Others immigrate just for this reasons, not because they love the country, they just want to use taxpayer money and never want to pay in the system. Some new, innovative techniques or procedures might be available in United States first, because here is more money through the privatized medizine.

Now it starts too, that the healthcare system gets more and more privatized in my homecountry. I didn't work as nurse here, my visa is in process.

Don't understand me wrong, I don't wanna judge! I'm bias. I just want to tell you about my experience.

Jeanny

[lamazeteacher]

I wish the "s" word could be left out of peoples' minds regarding "universal" plans such as the Canadian, French, British, and most European countries.

China and Russia, both "socialist" countries have dismal medical systems, which friends of mine who lived there say is backward and inferior to other counties' technological and "state of the art" treatments. Nursing care is abysmal and families have to come to assist patients in hospitals and bring them food.

I wish Michael Moore had included those countries in "Sicko". I visited Chinese clinics there, 23 years ago and was appalled at the lack of supplies, medications, and especially the lack of hygiene (like hand washing stations). Dirt floors were at the clinic in a "commune", and nothing had been dusted in eons...... There's a reason for "flu" (the usual one for which we get yearly shots) originating there.

The preparations that have taken place for 3 years by physicians here in the USA involve the negotiation of affordable pricing for medications, and regional assignment of new expensive radiological equipment which is not appropriately utilized when every hospital has it. Utilization of computer technology for charting everything; and assistance with diagnosis and treatment will greatly lessen time spent in hospital by patients. The prevelance of nosocomial infections (especially "superbugs") will decrease when many procedures, such as transfusions and day surgeries, that can be done more appropriately in outpatient settings, keep people out of hospitals.

Doctors entering medical school will do so in the future, because they have a yen to help people, know more about bodily quirks and progressive treatment, not to make more money than it's possible to spend in a lifetime. Physicians working in countries with "universal" care earn salaries consistent with a good upper middle class lifestyle. The criteria for recognition of superior practitioners will be for those who show initiative, accurate diagnoses, appropriate logical treatment plans; and bedside manners that support ill patients of all classes of life equally (well, the latter may be "pie in the sky" hoping).

Those whose wish is to sabotage the above, use the word "socialized", as Americans have been brought up with propoganda designed to promote loathing for that. The purge of many Americans in the '50s, by Senator McCarthy is remembered by our grandparents; and communism as it was portrayed then, was greatly feared due to repercussions during "McCarthyism".

Pure socialism isn't possible I think, without voluntary involvement of people in agreement with that philosophy. A whole country trying to perform in a way that leaders decree is equal for all, have failed due to the lack of all people wanting it. Many have been negatively treated (to put it mildly) for lack of adherence to stern protocols having nothing to do with socialism.

In Israel there are a few Kibbutzim (plural for Kibbutz) that practise it ideally, where the people there understand it, there aren't those who want more than their equal share, and there's enough for everyone. The duties performed by members are those that are considered by each individual to be what they want to do most. Those who love to care for children, do that and parents visit their offspring, rather than have them with them all the time. If someone has leanings toward business, and the educational preparation, they do the buying and selling for the others there. Those who want to farm, manufacture, etc. do that. There are rich ones and less advantageous ones. People can move from one to another freely, but need to be accepted by the place to which they go, because of their common philosophy and skills.

All people in Israel have universal healthcare, even tourists and Arabs who don't wish to live separately. The level of care is equal, and in some facilities are superior to those in North America. The tiny camera used to relay pictures of the upper GI tract and small intestine was invented there. Stem cell research has been done there much longer than it has been here, with some considerable success in curing diseases. Controversial religious resistance to utilizing very young fetal stem cells doesn't exist there. Preservation of umbilical cord blood stem cells at full term birth is practised widely.

[quezen]

Hello Jeany,

I hope you find a nice hospital to work in and nice people to work with. I worked in Germany also, a good while back. My Army Reserve unit is in Germany and my husband is German so I go back quite often. I work 'PRN' agency in the US. I do not have health care in the US, but as long as I can get on the plane to Germany I can get health care if I need it. There is something wrong with this picture, my own country, the USA, cannot give me health care, but a country a little bigger than Texas can!!!

I agree, health care in Germany has it's share of problems, but, depending on where you live, you will be shocked to see that a very large group of Americans get free health care also; those who don't work, and have no income (that they claim), and others who have figured out the system get everything they want here. 'The system' makes good money off these people because the govermnment picks up the bill for care for these people(Be careful about speaking freely to a 300 lb. drug addict, the 'Patinet Advocate' will bust you in a heart beat if the patient decides to make a complaint because you suggested to the patient that they might have fewer health problems if they loose weight or clean up thir lifestyle). It is the middle class, the very backbone of a country, that gets the shaft here in the US.

You will find that a lot of Americans are 'brainwashed', when they hear the word 'socialized', it is a 'red flag' to them and their brains immediatly shut down. Another term must be used to even open up an avenue of conversation.

If you are not in a teaching hospital, or in a hospital with 24 hour 'Hospitalist' doctors you will be astounded at how hard it is to get hold of a doctor in the middle of the night. Be careful about acting like you know what the patient might need. Some nurses and some doctors here do not take kindly to nurses that can actually use their knowledge and experence to come up with treatment options, they will accuse you of 'practicing medicine without a licence'.

Nursing in the US used to be 'team based', and you worked with people you knew and had relationships with. Nowdays you get your patient assignments, find the nurse who had the patients on the last shift, get report from that person and continue on with the treatment as written on the Kardex. It is very impersonal, and there is not much opprotunity for learning or interaction between staff. Often you will work with people you have never seen before and will never see again. Don't even think about sitting down together with the staff, doctor included, and having a cup of coffe and getting to know each other. This sort of interpersonal interaction is 'verboten' in American hospitals.

I which you the best, may you luck out and find a great place to work. You will make good money so you can enjoy other facets of life here in the US, just remember, here, it is all about the MONEY$$$$$

[1a2s3d]

One thing to consider is that the UK and Canada is not the USA. You are comparing apples to oranges. In the USA our taxes would fly through the roof unless we stopped spending massive amounts of money in other areas. (Which I favor) Health care in the USA costs more because we provide more. Medicines in the USA cost more because we invent them. One thing I never hear people talking about is COMPETITION!! It seems people have an attitude that says, well our health care system is not working now so lets give up and try socialism. THE PROBLEM IS THAT WE HAVE TAKEN THE CUSTOMER (THE PATIENT) OUT OF THE PAYMENT FOR HEALTH CARE PICTURE AND REPLACED THEM WITH A THIRD PARTY THAT DOES NOT HOLD THE SELLER ACCOUNTABLE FOR PRICES THEY CHARGE. End of story! USA should be providing it's citizens with one thing and that is the freedom to provide for themselves. WE DO NOT HAVE A RIGHT TO HEALTH CARE WHEN IT'S GIVEN ON THE BACKS OF OTHERS! In as little as 100 years we have all forgotten that. Shameful!

[lamazeteacher]

My GERD is acting up really bad due to the economy and work related stress. I got the ER doc to write me a script for nexium because it works really well for me.

When I went to get it filled the cost would be $178 for 30 pills. I don't have any insurance right now and can't afford that. So it is OTC pepcid for now.

I do believe everyone should have access to free healthcare. I think we would see a big improvement if people were receiving preventive care instead of patch up the leaks care.

I have GERD, too. When the manufacturer of the Prevacid I was taking, stopped supplying samples to doctors, saying it was going to be available in generic form (after about 20 years, when trademark drugs are supposed to be in generic form by 7 years) I paid for it, depleting my savings, as I'm on other expensive medications.

If you aren't on a salt restricted diet, a pharmacist (at a discount pharmacy that didn't carry Prevacid) told me that taking NaCO2 with the Pepcid would make you as comfortable as proton pump inhibitors. However I am on a sodium restructed diet due to HTN, so I didn't do that. Check with your doctor before doing that!

You don't have to speak to too many anti universal care folks before hearing someone say, "I don't want my taxes spent on healthcare for someone too lazy to get a job!" The fallacy in that kind of thinking, is that after remitting the money you owe in taxes, it's not yours any more! It's not like a charitable donation that can be designated to a specific project......

Canadians were more than happy to have their health care plan at the beginning, and I was there, then! When I visit or talk to/email friends and family there, I ask if that type of thinking occurs in that country. They're shocked that anyone would have such a selfish thought! Now that there are some delays in treatment, those whose personalities are such that they don't assert their needs strongly enough, and who have the money, go to the United States to have treatment right away.

I laughed when I saw a young man (looking about 20-25 years) in a commercial on American TV, against universal healthcare who said that his heart problem woud not have been discovered, therefore not treated, in Canada. What it was wasn't mentioned, and from the gist of the comment, he appeared angry, and may not have gone for care in Canada for whatever it was. Being so stressed, his heart may have exhibited sounds or symptoms for an American (money hungry physician) that weren't there in Canada when he wasn't as stressed.

An orthopedic surgeon here in the USA booked me for a knee replacement, after I saw him once. I couldn't afford it, and asked for P.T. The therapist examined my knee very carefully and suggested some treatments and a knee band. That was 7 years ago, and the band has relieved the pain almost completely. I'm only aware of discomfort when I've walked a long time. I found out that the surgeon who wanted to do the surgical replacement, retired a week after he would have done it - one for the road, I guess. (By the way, I had a severe gastric bleed from taking NSAIDS that were enteric coated, before the knee band.)

I've been in the USA over 48 years, now struggling financially since I divorced my ex-husband and somehow reached 70 years of age with its physical toll. As many of you may not know, Medicare doesn't cover prescriptions, and Plan D is an insurance program dreamed up by insurance and pharmaceutical companies wherein you pay a premium to the company that manufactures your medicine. Well, how many people have more than one prescription manufactured by the same company? When I figured out how much the monthly premiums would be for all my prescribed medications, they were more than buying the medications!

I wish Americans cared more about their fellow inhabitants of this country who aren't as wealthy as they are, enough to embrace a health care program that conserves money, provides excellent well monitored care, excludes high priced insurance companies and their highly paid executives, and interior decorators that make hospitals look like 5 star resorts. We've all seen expensive treatment given insured people, that was unnecessary. With the rate of nosocomial infections climbing and prevalence of "super"bugs increasing, it's safer to treat patients at home, with Home Health nurses going in to plan and perform care there. A lot of teaching of preventive care and explanations of the rationale for treatments by them during home visits, lowers the cost of treatment, too.

Nurses will earn as much and possibly more, since another look at what we do, will cause more appreciation for our services, which should enlarge the budget for nursing care. Having nurses working in the administration of the Health and Human services Department will help that.

[lamazeteacher]

One thing to consider is that the UK and Canada is not the USA. You are comparing apples to oranges. In the USA our taxes would fly through the roof unless we stopped spending massive amounts of money in other areas. (Which I favor) Health care in the USA costs more because we provide more. Medicines in the USA cost more because we invent them. One thing I never hear people talking about is COMPETITION!! It seems people have an attitude that says, well our health care system is not working now so lets give up and try socialism. THE PROBLEM IS THAT WE HAVE TAKEN THE CUSTOMER (THE PATIENT) OUT OF THE PAYMENT FOR HEALTH CARE PICTURE AND REPLACED THEM WITH A THIRD PARTY THAT DOES NOT HOLD THE SELLER ACCOUNTABLE FOR PRICES THEY CHARGE. End of story! USA should be providing it's citizens with one thing and that is the freedom to provide for themselves. WE DO NOT HAVE A RIGHT TO HEALTH CARE WHEN IT'S GIVEN ON THE BACKS OF OTHERS! In as little as 100 years we have all forgotten that. Shameful!

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You are so right! The apple for health is Canada; and the orange which looks the same as any other, but not all of them are sweet, is the USA!

I worked for Blue Cross, and one of the first things I was taught there (in fact it was drilled in), is that the "customer" is NOT the health care consumer, their employer is the client!

Please print your post 1a2s3d, and look at it in 30 years, after you may have cared for more and more people dying for lack of medical care, due to their inability to pay for it, while some sit tight in their mansions counting their jewels, minks, and money; and having baucchanal feasts with CEOs of pharmaceutical and health care insurance companies. :bowingpur

The lost collectables for hospitals will have rendered them infection ridden (like the "houses of pestilence" they were at the turn of the 20th century), technology and DME deficient, and cause Americans to go to Canada for safer more effective medical care. Of course you won't have to look at all the employees big businesses outsource, and for whom they don't need to provide any benefits or livable wages!!

Perhaps you'll have lost your job, couldn't get another; and learned some humility and the value of caring enough about others that you'll commit to share a small portion of the country's wealth. The backs of extremely wealthy others are sufficiently large to help fellow humans, as they are the ones with enough do-re-me to feed those who starve in 3rd world countries, as well as cough up 5% of the amount they make over $250,000 yearly!! Hearing them whine about that is enough to cause deafness without benefit of money to pay for hearing aids.

[talaxandra]

we hear a lot about america's contributions to health care, and how that contributes to the high cost of the us health care system. it's true that there is considerable funding for medical research in the us, particularly in pharmacology.

innovation does occur in the rest of the world, however, including countries that also manage to have universal health care. soem australian medical advances include:

- discovering the role of lithium in treating bipolar disease

- founding immunology and antobody medicine

- the development of the frist electronic pace maker

- laying the foundation for the development of physiotherapy

- isolating penicilin so it could be used in vivo

- modern orthodotic braces

- microsurgery techniques and instrumentation

- the development of ivf and the first successful ivf pregnancy

- discovering h. pylori and treatments to erradicate most gastric ulcers

- cochear implants

- spray-on skin for treating severe burns

- creation of anti-flu drug relenza

- the world's first anti-cancer vaccine, gardasil (which prevents the virus that causes ~80% of cervical cancers)

australia has a current population of 21.7 million, compared with the us at 306.4 million. funding for r+d here comprises about 1% of global medical r+d expenditure.

my point is not that the us does not significantly contribute to the field. howver, i think that r+d funding is often used as a reason why the us health care system is disproportionately expensive, and i suspect that this is not a particularly valid reason for the cost.

[lamazeteacher]

Talaxander:

You are so right about research and development as the etiology for false claims that it alone causes high pricing for pharmaceuticals. The real reason that pharmaceutical companies have astronomical pricing, is the highly paid

representatives they send out to tell doctors what to order for their patients - with samples of those medicines. The reps also invite doctors to high priced restaurants for "education" along with company paid alcoholic drinks. That overhead isn't necessary if doctors attend bonafide conferences presenting a balanced approach to prescribing medications. There are the exhibits there, with reps giving out expensive goodies to doctors who spend a moment there, along with samples in high priced packaging.

As far as cost for research is concerned, grants for that have been awarded pharmaceutical companies from private industry as well as government sources and charitable organizations. They claim that they pay for the research, but that is untrue! They pay for the researchers who make false claims and tilt statistics to favor their products, which is being exposed now.

Money really is the "root of all evil" where medical care is concerned, in the USA. There is no way of counting the surgeries that have been done unnecessarily here, as well as those refused by money sparing insurance companies using the excuse that certain procedures that have been accepted

elsewhere as "state of the art, are "experimental". A good friend of mine had an ankle fusion instead of a replacement, and complications ensued that severely limited her ability to walk. So she had to travel quite a distance for another ankle fusion at a university hospital.

I asked if the first surgeon appealed the insurance company's decision for her, and she said she "thought" he had. Well, we all know how much office personnel love extra paper work........ There is a great need for counseling patients to assert themselves with physicians who shrug when an adverse decision is made by insurance companies who, after all, are not interested in what's best for patients. The employees of those companies get rewarded and praised for saving money. However they haven't been known for their ability to negotiate lower prices for pharmaceuticals, as countries with universal health plans do.

Some will allow mail order pharmacies that provide 3 months of a medication for less money, but stipulations that a patient must see their doctor yearly for that service, keep that alliance going.

Many Americans applaud such practises as examples of capitalism, while negating a government sponsored health system as "communism". I'm a fan of private enterprise, but the current runaway "what the traffic will bear" type of spending has written its own ending. New tax rules that uncurl extremely wealthy person's fingers from their inflated incomes, which have unbelievable tax shelters, will allow all people to have the health care they need, without having it linked to their employers. I applaud that!!!

[1a2s3d]

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"you'll commit to share a small portion of the country's wealth"

Thanks for your input!! You couldn't have given a better example of my point. It's not sharing when it's forced!! Competition IS the answer to a better health care system. That is an unarguable fact! And by the way it's not our country's wealth. It's individual's citizens who earned their wealth through initiative and desire to better themselves. Being successful is very simple and the funny thing is that ANYONE can achieve it. GET OFF YOUR BUT, GO TO COLLEGE, DON'T DO DRUGS AND ALCOHOL, DON'T HAVE SEX BEFORE YOUR MARRIED, DON'T HAVE CHILDREN BEFORE YOU CAN AFFORD THEM, GO TO WORK EVERYDAY AND WORK YOUR BUTT OFF, ENJOY THE FRUITS OF YOUR LABOR. No one is saying not do help the vulnerable and defenseless!! But if you want me to help you defend irresponsible behavior your just as insane as your comment!! My advice for you is to pick up a history book, think for yourself, and shut off that stupid boob tube!!!!

[talaxandra]

Being successful is very simple and the funny thing is that ANYONE can achieve it.

What you describe is a meritocracy - your standing in the world is based on the effort you put in, independent of other factors. Regardless of where you come from, if you put in the hard yards and apply yourself you can rise as far as you want.

We like to believe we live in a meritocratic society, and this belief is particularly prevalent in the US. There are some really interesting discussions about the validity of the concept of a meritocracy, particularly by philosopher Alasin de Botton. You might also be interested in Outliers: The Story of Success by Malcolm Gladwell, which also looks at the myth that success is achieved purely through application and effort.

This belief is undoubtably a significant part of why so many Americans are opposed to universal health care. It's unfortunate, therefore, that it's not true. While we certainly have some input into how our lives go, it is simply not the case that success is "simple" and achievable by "anyone."

[1a2s3d]

It's unfortunate, therefore, that it's not true. While we certainly have some input into how our lives go, it is simply not the case that success is "simple" and achievable by "anyone."

I have to respectfully disagree!! The American public has been listening to crap like this for so long we've been lulled into a "please take care of me" attitude. Shameful!!

So many nurses on this website spout off like they're experts just because they hear something on the television or read a biased commentary from people who either knowingly or unknowingly want nothing more than to incorporate socialism. PLEASE do some REAL historical research and you'll find in the days before Medicare and Medicaid, the poor and elderly were admitted to hospitals at the same rate as they now, and they ALL received good care. Before these programs came into existence every physician, nurse, and health care worker understood that they had a duty to help the vulnerable and defenseless and giving free medical care was a normal practice. But today, people with an agenda CHOOSE not to remember this because it doesn't fit their biased beliefs that big government needs to save all of us from America's predatory private sector.

[talaxandra]

I appreciate that you have a different perspective than I. I tend to give people with differing outlooks the benfit of the doubt, granting that they have arrived at that position after reflection, and bearing in mind that they feel as strongly about that position as I do about mine. I also accept that in discussion where the sides are generally polarised, changing the mind of someone who already has a firm position is highly unlikely.

I'd like to point out a couple of things. The first is that I'm not American, so my perspective, and the things I've been exposed to, are different from yours and those you refer to.

I certainly don't have an in depth knowledge of the history of the American medical system, and have no interest in doing "some REAL historical research" in to it. I suspect that having more historical information would, in any case, be of limited assistance given the huge differences in the way medicine is practice now.

In the days you refer to, before (US) Medicare and Medicaid medicine wasn't the giant money-generating enterprise it is now. I'm sure that, if it were up to individual doctors and nurses the poor and elderly would recieve at least some care. I'm equally sure that the majority of institutes that actually run the US system do not believe they "have a duty to help the vulnerable and defenceless."

Most of my opinions about the way the world ought to work are based on Rawlsian justice-theory, the social contract doctrine and the concept of the original position. Though they cohere with my starting position, I have not adopted these positions as a result of "listening to crap," "being lulled into" an attitude by anyone with an agenda, or concern about being saved from your predatory private sector. They come from contemplation, experience and education. I don't know where your opinions come from but, as I said at the top of this post, I'm happy to give you the benefit of the doubt. I ask you similarly do me the courtesy of not attributing my stance to whim, herd mentality or other equally disrespectful influences.