I have felt for a while that we should have universal health care here in the US, but I didn't know things were this bad. We really should be ashamed that GTMO Bay prisoners get free (and very good quality, from the looks of it) health care and 9/11 rescue workers are suffering from 9/11 related health conditions and have no coverage.
And hospitals removing their names from the pt bracelets of ill, unisured pts, and having cabs drop them on Skid Row?
And insurance company physicians admitting that they know they caused the death of pts by denying claims in order to save the ins company money?
What is the matter with us that our health care system is ranked #37 among industrialized nations?
To me, this is not about politics, not about personal responsibility, it's not about cost- it's just about what is right and what is wrong.
I know the Canadian and other universal health care systems have their problems, but they are not run on a foundation of greed and denial of care as ours is.
I am very fortunate that I have good health insurance, but this could change at any time. I am willing to pay more taxes so that all US citizens can get free or low-cost health care that is not connected with a job, and can move with the citizen and cover them wherever they are and whatever their circumstances are.
I decline to get into these rudimentary arguments about what system is better. I think that we have a rather unique opportunity to insure everyone so that everyone has access and build a system by which we employ the most sucessful methods from UHC systems that have been deployed in many other countries. People love to scapegoat Canadian and UK system, truth is there are many different systems and policies in most other countries worth examining. Fact is that many countries have fundamentally good systems that could use fine-tuning in one way or another, but there of course areas of opportunity for improvement, doesn't mean the system is garbage.
Specializes in Flight Nurse, Pedi CICU, IR, Adult CTICU.
Canada does have world class cancer programs.
Most of the specialists at the UCSF medical center were educated and did their residency in Canada.
Proof?
First, San Fransisco is not in Canada, so just because someone went to school in Canada, it doesn't mean Canada can claim UCSF as their own "world class cancer program." Especially if they didn't build it or operate it. If I am wrong, then any facility or institution in Canada that has American-educated 'specialists' working there could then be considered the best of America...and of course we know that's just silly.
Second, I just did a gander through their staff page and didn't find a single person who did a residency in Canada. It would seem that if "most" of them went to school and completed residencies in Canada, I would've run across at least one...and there are a lot of people working at the UCSF Cancer Center.
Canada does transport some patients with certain diagnoses from sparsly populated provinces to San Francisco. Their care is paid for.
Maybe you don't see the irony. While Canada claims to have a better healthcare system, they are exporting their sickest patients to get care in a country they claim has an inferior healthcare system.
It makes no sense to claim a better system when you really aren't operating a 'system,' but are simply using 'other people's systems.'
US patients with some insurance plans can be cared for by these specialists too. They come from other states for this specialised treatment.
The Canadian patient would have to go far from home as do US patients who live in rural areas.
In some cases...yes. But they aren't getting their care in CANADA, and that is the point; for some reason Canada can't provide that care. And Americans don't have to leave the country, and then tell everyone their system back at home is "better" while they go outside the country to get care.
To me this makes about as much sense as a Walmart employee going into Target and buying his cleaning supplies while telling everyone in Target that Walmart is a much better store.
Specializes in Critical care, tele, Medical-Surgical.
proof?
first, san fransisco is not in canada, so just because someone went to school in canada, it doesn't mean canada can claim ucsf as their own "world class cancer program." especially if they didn't build it or operate it. if i am wrong, then any facility or institution in canada that has american-educated 'specialists' working there could then be considered the best of america...and of course we know that's just silly.
second, i just did a gander through their staff page and didn't find a single person who did a residency in canada. it would seem that if "most" of them went to school and completed residencies in canada, i would've run across at least one...and there are a lot of people working at the ucsf cancer center.
maybe you don't see the irony. while canada claims to have a better healthcare system, they are exporting their sickest patients to get care in a country they claim has an inferior healthcare system.
it makes no sense to claim a better system when you really aren't operating a 'system,' but are simply using 'other people's systems.'
what is the untited states system?
in some cases...yes. but they aren't getting their care in canada, and that is the point; for some reason canada can't provide that care. and americans don't have to leave the country, and then tell everyone their system back at home is "better" while they go outside the country to get care.
to me this makes about as much sense as a walmart employee going into target and buying his cleaning supplies while telling everyone in target that walmart is a much better store.
sorry i didn't label the links.
the last two were to premier cancer centers in toronto, ontario and vancouver british columbia.
the first links have their own links to the facilities where the expert canadian physicians from canada trained.
ucsf works together with canadian researchers to provide the best care as do the facilities in canada they work with.
in canada there is a healthcare system. people are provided the opportunity to go where they can get the finest care.
the people of canada vote for the people who then make these decisions.
for very rare conditions patients from the north west territories and alberta are offered the best out of the country. these decisions are made province by province, if i'm correct. please canadian nurses let us know what you know.
i read references to the "united states healthcare system". to my knowlege the united states does not yet have a health care system. some people get the finest care and others do not but there is no system.
is there a system i don't know about?
please don't think i have an agends regarding the following links. they are just fyi.
oecd - the oecd member countries are: australia, austria, belgium, canada, the czech republic, denmark, finland, france, germany, greece, hungary, iceland, ireland, italy, japan, korea, luxembourg, mexico, the netherlands, new zealand, norway, poland, portugal, the slovak republic, spain, sweden, switzerland, turkey, the united kingdom and the united states.-
we compared health status, access to care, and utilization of medical services in the united states and canada, and compared disparities according to race, income, and immigrant status.
methods. we analyzed population-based data on 3505 canadian and 5183 us adults from the joint canada/us survey of health. controlling for gender, age, income, race, and immigrant status, we used logistic regression to analyze country as a predictor of access to care, quality of care, and satisfaction with care, and as a predictor of disparities in these measures.
results. in multivariate analyses, us respondents (compared with canadians)
were less likely to have a regular doctor, more likely to have unmet health needs,
and more likely to forgo needed medicines. disparities on the basis of race, income,
and immigrant status were present in both countries, but were more extreme
in the united states.
conclusions. united states residents are less able to access care than are canadians.
universal coverage appears to reduce most disparities in access to care.
(am j public health. 2006;96:xxx-xxx. doi:10.2105/ajph.2004.059402)
It makes sense to me that a system created sixty years ago (I'm refering here to Australia's Medicare program) needs additional funding and system upgrades - health care's changed a lot just while I've been working in it, only a third of that time. Patients are sicker, there are exponentially more drugs and interventions, and patient expectations are higher. I'm not aware of any country's health care system that's decreased in expenditure over the last... any period of time. It doesn't necessarily mean that the system being overhauled is broken, only that it needs to change with changing times.
I don't understand why people don't see that the gov't doesn't just pay for every modality that comes down the pike.
Specializes in Flight Nurse, Pedi CICU, IR, Adult CTICU.
It makes sense to me that a system created sixty years ago (I'm refering here to Australia's Medicare program) needs additional funding and system upgrades - health care's changed a lot just while I've been working in it, only a third of that time. Patients are sicker, there are exponentially more drugs and interventions, and patient expectations are higher. I'm not aware of any country's health care system that's decreased in expenditure over the last... any period of time. It doesn't necessarily mean that the system being overhauled is broken, only that it needs to change with changing times.
And insurance companies do?
I never said they do.
I remind people of this forgotten issue because one of the tactics used to support a UHC system is to attempt to discredit private insurance, using stories where private insurers denied reimbursement for certain therapies.
I just keep the discussion honest by pointing out that gov't payors do the same, and a failure to acknowledge that gov't payors are just as restrictive (if not more), than private insurers is a bit disingenuous.
I remind people of this forgotten issue because one of the tactics used to support a UHC system is to attempt to discredit private insurance, using stories where private insurers denied reimbursement for certain therapies.
I just keep the discussion honest by pointing out that gov't payors do the same, and a failure to acknowledge that gov't payors are just as restrictive (if not more), than private insurers is a bit disingenuous.
I really appreciate the fact that you research issues before posting.
However sometimes it seems that you clump all UHC systems into one entity, and selectively pick and choose which negative attributes among various countries to use to defend your argument.
As far as Canada goes, and I have tried to add objective observations about our health care system, neither defending it or praising it.
The wait lists are long but...
I have never heard (in personal life, media, school, etc) about medical procedures being denied by our government. Emergency and urgent issues are treated immediately.
Less urgent are still treated, but you may have to wait a bit.
Canadians are well aware of things the government will not cover and there does not seem to be much issue surrounding them. You will not get a new set of boobies on the tax payers money (or any other similar cosmetic issue), you will not have fertility treatments paid for...etc.
These issues are not medical related concerning health...Although if you only grow one boobie or your back hurts because of big boobies it will be covered for different reasons.
I think that your posts have been a mixture of very educated observations down to speculations and not so educated assumptions.
I just wanted to clarify the last point you made....
We DON'T dump the responsibility onto the healthcare system or the American taxpayer.
We shouldn't pick the wrong answer just for the sake of picking an answer.
If the correct answer to a healthcare problem is to implement a social policy, then get it done. Don't implement a health-care solution to a gov't domestic policy failure.
Did you read my original post?
We are already paying for it, I really don't want to explain it yet again. I will repost it- again.
I'm looking for a real-world, practical solution.
Yes, we all want all illegals deported- but it is not going to happen!
No one has come up with a reasonable, cost effective solution to this problem- "deport them" is not a realistic answer, even though it really would be the best thing, it will never happen.
Colorado is one state where illegal aliens cannot get outpt chronic dialysis paid for. So here's what these pts do- They clog up the ERs in Denver waiting for their K+ levels to become critically high so they can be admitted as inpts and receive "emergency" dialysis. Some of them even eat contraindicated high K+ foods on purpose so that their labs will sufficiently critical to allow them to be admitted and get dialysis.
If they could get outpt dialysis they could get their 3 x week tx, and be done with it. But- because of the way the system "works" they make themselves much sicker on purpose, and end up getting much more expensive inpt tx, and the ERs are filled w/ pts who are really there working the system so that they can get some semblence of their needed chronic tx.
Most of these pts play it so they do end up getting their dialysis twice a week- as inpts. In the meantime, all of their co-morbidies are getting worse due to the constant up and down of their labs, fluid overload, and lack of routine scheduled dialysis.
This is way more expensive and harmful than just giving them outpt dialysis in the first place.
Our gov't has said it has no intention of deporting the 12 million illegals in the US- so what do we do about illegal dialysis pts?
Specializes in Flight Nurse, Pedi CICU, IR, Adult CTICU.
I really appreciate the fact that you research issues before posting.
However sometimes it seems that you clump all UHC systems into one entity, and selectively pick and choose which negative attributes among various countries to use to defend your argument.
I don't know why it would seem that way; I've said that I support the Singapore UHC system, and I only introduced that because I was challenged to present what I would consider a reasonable alternative. Otherwise, I only address those systems that are otherwise introduced.
As far as Canada goes, and I have tried to add objective observations about our health care system, neither defending it or praising it.
The wait lists are long but...
I have never heard (in personal life, media, school, etc) about medical procedures being denied by our government. Emergency and urgent issues are treated immediately.
ER waiting lists are legendary.
Less urgent are still treated, but you may have to wait a bit.
Canadians are well aware of things the government will not cover and there does not seem to be much issue surrounding them. You will not get a new set of boobies on the tax payers money (or any other similar cosmetic issue), you will not have fertility treatments paid for...etc.
So there ARE things that are not covered.
The reality is that the Canadian payer system DOES ration and restrict care. You can't pretend like it doesn't.
These issues are not medical related concerning health...Although if you only grow one boobie or your back hurts because of big boobies it will be covered for different reasons.
I think that your posts have been a mixture of very educated observations down to speculations and not so educated assumptions.
I just wanted to clarify the last point you made
Many observations about the US system are also speculative, and also include unsubstantiated assumptions about gov't payer systems. I've pointed them out.
I do not believe in Universal Healthcare. I do believe anyone under 18 should be covered.
One thing I propose is that if people want to be covered by the government they have to follow certain rules. Like no smoking, get your immunizations, follow up appropriatly, take you medications and generally maintain good health. It's the chronic conditions that cost the most money. If people sign a paper to agree to certain terms then they can have coverage. If they break the rules, no more coverage unless they pay for it themselves.
I hate to see my money thrown away like it is in the rest of our welfare heavy government with all the people that have some strange sense of entitlement and think they shouldn't have to work to have the best.
If they break the rules, no more coverage unless they pay for it themselves.
I hate to see my money thrown away like it is in the rest of our welfare heavy government with all the people that have some strange sense of entitlement and think they shouldn't have to work to have the best.
Would you be including all those welfare/medicare/social security abusers above the age of 70? Plus, what's so special about those under 18. We could make the argument that the rest of us shouldn't have to pay for someone else's children...
Medicare is different that Universal Healthcare. Old people should be covered as well but they too should be held to a standard of rules, influenza vaccines and pneumonia vaccines. Anything to reduce the risk serious problems. Adults no matter what age can make their own choices. In this case it is either follow the rules or find your own private payer. Now before you go all crazy about dementia pt's or Alzheimers, there always some exceptions to the rules.
My point is if you are a 30 year old that can make other decisions and function there is no reason you can not decide to follow the rules to get your so called free healthcare.
What is so special about the children?? the fact that they have no choice if their parents are deadbeats or if they choose to spend there money on new boats and cars and don't cover a child that doesn't have an option. That's what is so special.
What I am saying is WHY should we pay for say YOUR children to get free healthcare? If they are malnourished it isn't my problem. If you are a good parent or not it still isn't my problem.
Same goes with medicare. Why couldn't they save their money or have enough family to care for them and not use my taxes?
Why are those two groups MORE deserving than regular adults? Everyoen should get it regardless.
I'm paying into Social Security that a WHOLE bunch of people are using. Living on my dime. Most likely will be bankrupt by the time I'm old enough to use it. If we can put up with that why not just have universal healthcare as well?
(I'm merely playing the devil's advocate. I'm all for Universal Healthcare)
hillarypeace2006
193 Posts
I decline to get into these rudimentary arguments about what system is better. I think that we have a rather unique opportunity to insure everyone so that everyone has access and build a system by which we employ the most sucessful methods from UHC systems that have been deployed in many other countries. People love to scapegoat Canadian and UK system, truth is there are many different systems and policies in most other countries worth examining. Fact is that many countries have fundamentally good systems that could use fine-tuning in one way or another, but there of course areas of opportunity for improvement, doesn't mean the system is garbage.