Richard Titmus wrote in his concept of social policy about what he called the 'stranger'. He said the ultimate in social policy is to give to the stranger because you recognise that she or he is the same as you. You don't give to the stranger because they are hungry or because they are tired but because you recognise the problems of hunger and tiredness. In other words you see them as part of yourself and part of what you are responsible for. If you see them as 'the Other, you don't get that sense of responsibility.
John Rawls, who talks about justice, also uses a similar sort of model by saying that if you punish other people you always have to work on the basis that it might happen to you, which is another formulation in a slightly different format.
It is a fact in the USA that 64 million people do not have health insurance, which means there is a third world country within a country that boasts to the world that it is apparently the best.
#1 African American low birth weight babies fare better than (white) Canadian babies? Of course they do. Ask any nicu nurse, African American babies are the best survivors in any nicu and white boys are the worst (wimpy white boy syndrome is a well known term). Many of those countries who get the highest ratings pay their healthcare professionals nothing (Cuba was among the top because docs make no money). Canada can hardly be criticized by Americans for not paying docs and nurses enough and for not getting enough bang for their buck BECAUSE they spend too much on docs and nurses.
#2 Yeah, Canadians complain about health care. Ask them the next question: Do you want an American style system and the answer is a resounding NO. Universal health care is our national religion. Endorsing user fees is a long way off from wanting private healthcare to become the norm. People want to improve the Canadian system.
#3 Canada spends less money as a percentage of GDP than the US. If our system isn't sustainable, despite government surpluses, how sustainable is the US system when we're running a deficit? Again, looking at cost saving measures is important, but there has been nothing to show that a private system will do that.
#6 Not covering home care, chiropractors and drugs isn't a sign that Canadians don't get health care. Universal care doesn't mean we will pay for EVERYTHING, it means everyone has basic coverage and you can get insurance for the rest (sound familiar? Yep, it's just like the US!!)
Specializes in Education, Acute, Med/Surg, Tele, etc.
Someone brought up the fact that Canadians come down to the US for healthcare options...and I have to agree. My best friends up in BC own a ambulance company and are starting a business of BLS (basic life support...like ambulance) taxi service for folks to go down to Washington and Oregon for treatment (I am in Oregon). They wanted us to help with the venture, but alas...hubby and I were just starting out with buying a new home and couldn't afford to invest.
Two years later and the guy owns a huge sailboat, a time share in the Bahama's, has a large retirement fund, college fund for all three kids, and a very nice home in a very scenic area of Vancouver Island! (they are just at retirement age and after a lifetime of being a paramedic..and the wife a nurse..they splurged on a fun lifestyle! Go figure!) Lets just say they found a very faithful and eager clientel...
Hubby and I are thinking of helping him out by finding quality health care facilities that fit patient needs so that these folks don't get stuck spending too much for less care here...investigating therapies specific to patient need...and get this...investigating both the US and Canada so they have options in both (I admire my Canadian friends because of their love for their country..which I feel is very very valid and well deserved, it is a wonderful country and I love what I have experienced there with all my heart!!!!) And trying to expand the BLS taxi service to other areas of Canada instead of straight shot down to Wash. or Oregon! :)
So far...ummmmmmm, patients prefer the options we have despite the cost...but who knows..could change!
I don't think it has to do with the quality of medics in Canada at all..fine wonderful medics from whom I have met (I know mainly EMS!), it is the longer waits and lack of follow up that tends to have them coming here. At least if they get Tx in the US they don't expect follow up as much as they would a clinic a few miles away..I don't blame them!
But alas..I don't know...I really haven't been schooled in the entire Canadian healthcare system...so I only go by what I have heard. I tend to wish to believe that it is just fine, just a little overtaxed...gee like that doesn't happen here too!
There are definately problems with universal health care in countries like Canada, the UK, German, Sweden, etc.
I definately think the inequalities in America are unfair too.
America consistently wins the Nobel prizes in Science and Medicine. So as bad has it is we can be proud of our accomplishments.
The poor have options. Others like myself are limited by income and out of pocket expenses we have to pay. Thus I don't get screened preventatively as I should for a guy my age. But I have options as well. I definately think being insured is better than being uninsured in this country.
We do some things right, we do some things wrong. Picking on each other do death over which system is superior isn't fair, because there's problems with it all.
I certainly don't have any answers. I think those with universal health care have this image of poor Americans dying in the streets because they are uninsured.
I have done a great deal of traveling overseas, and because of idiopathic anaphylaxis, I have found myself in emergency rooms around the world. Not that I would recommend this method of checking out healthcare facilities, but it did prove interesting (afterwards).
Aside from Saudi Arabia, where I lived, and was hospitalized twice and spent a day in the ER getting IV Benadryl and steroids, which were completed free, I also spent time hospitalized in Sri Lanka, where I received excellent care and medications, both p.o. and I.V. - treatment completely free of charge, aside from the few dollars for take home meds at discharge. This was at the 7th Day Adventist Hospital in Kandy. Naturally it happened in the middle of the night, and the doctor was awakened. He stayed by my side the rest of the night.
India, where I was seen by a physician (who made a house call) spent hours with me and gave me meds for a total of the equivalent of $10. And in Pakistan, where I was seen by a physician, then treated in an E.R. with I.V. meds, and later advised hospitalization, all free. Was in a small town, very poor, hospital ward appeared quite substandard to our western eyes, but the care was excellent, aside from the fact that they do not feed you. In that case, relatives of other patients bring you food. Free. And these are not people who look like they can afford to feed themselves, let alone an American. Taxi driver stayed with me for moral support. And absolutely refused any money.
Also sprained my ankle (was afraid it was broken) in Zanzibar. Was advised to wait until I could leave for care, and when I saw the hospital I understood the advice, and did wait.
In contrast, when I had an attack in Japan, the physician did not speak English and basically turned us away. Was told it would cost a fortune for care as well. Luckily, by that time I carried meds with me and had to give myself I.V. meds. My hands were shaking so badly that I missed the vein and had very impressive bruises, let me tell you!
I found it very enlightening and very humbling the care I recieved in what are considered third world countries and just wanted to pass the info along. :)
Well I really wouldn't call it "third world". At the hospital I work at I would say the majority of clients we have don't have insurance. How does this affect nursing care?........IT DOESN'T!!
I don't think this would happen in a third world country. When I hear of this "national health" plan thats thrown out every now and then I just gotta think........We already have it.
Sorry for rambling
BRAVO! And don't apologize - it's true. Our hospital sees ANYBODY, has a program to help folks who don't have insurance and can't pay AND "writes off" a lot of unpaid bills (ie, taxpayers pay for it). Between that and Medicaid (which, frankly, only encourages abuses of the ER for non-emergency cases - AND ambulance rides for non-emergencies) you are right - we DO have national health care.
The mere fact that even one man, woman or child in this great country goes without health insurance is disgusting.
It's funny that you would word it this way. Because the fact is that because someone goes without insurance in no way implies that they go without care. This is the problem with your argument.
What's just as disgusting is that those who do have health insurance cannot get the procedures or tests they need. Rumor has it that HMOs have been known to literally kill people. http://boxer.senate.gov/hmo_stories/stories.html
You had me, right up until you cited Barbara Boxer. Sorry, but I just can't consider her the most credible source. The biggest problem with Boxer's site is that it relates nothing more than anecdotes. (Remember, "data" is not the plural of "anecdote.") There will be abuses and mistakes in any system you might care to name. That said, it would be easy to cite anecdotal evidence for any position you would care to take. If I had the time and the inclination, I'm quite sure that for every story that Boxer relates of abuse by HMO's, I could find another person who felt the HMO had saved their life. It's been repeated time and again here in this thread that under socialized medicine, people have died while on waiting lists for needed procedures.
Nor do doctors have the free will to treat their patients as they deem fit or necessary fearing the repercussions of going againt the payor.
And you think that this situation would be improved by socialized health care? On what planet? One of the cornerstones of any program I have yet heard discussed is the rationing of care based on a decision matrix. Over 65? Sorry, no heart surgery for you. Over 70? Sorry, but you have lived a full life, ICU is not in your future. The fact is that given our population, and the rate at which it is aging, there will likely have to be some kind of rationing system in the future, no matter what health care system we have.
Those of us who do have insurance and/or our employers are paying twice for health insurance in this country. Once for ourselves (or our employer pays for us) and once in taxes to pay for those who don't have health insurance through their employer or otherwise.
And your answer for this is for all of us to pay three times our current health care costs? First, taxes for us all would go up, and go up significantly. The government would have to cover everyone. Add to that expense the cost of setting up a bureaucracy larger than the IRS to administer this behemoth. To top that off, the government would have access to your private medical information. And don't think for one minute that insurance would go away. Supplemental health care insurance (already available in Canada) would have to be purchased in case you needed a procedure that the government's decision matrix said you couldn't have. Only the well off could afford it, so there would be a definitive two tier system in the nation, with better health care going to those who could afford it. The poor would not be able to escape the government's matrix. If they passed the age limit for a certain procedure, sorry, but you are going to die. However, Mr Smith, who is older than you and needs the same procedure is going to get it, because he has purchased supplemental health care insurance. I just can't see the logic of fixing an expensive system by making it more expensive.
The talking in circles that goes on in the type of debate that's happening in this thread does absolutely nothing to solve this problem.
No one can deny that healthcare is a HUGE problem in the US. Nothing will change unitl the system itself changes, and changes dramatically.
Perhaps you should read the objections of others, rather than just saying they are talking in circles. Perhaps they are raising valid objections to what you propose. Perhaps some of us are right. Yes, there are problems in the health care system. But then, no system is perfect. The fact is that there is not a health care crisis. There is care available to all, regardless of ability to pay. But what you propose is to give one group a people a right at the expense of another group. As I understand the constitution, that ain't allowed. "Your rights end where my nose begins."
Socialized medicine.... I hate the word because I don't think anyone really even knows what that means... Now, as someone who has lived most of my life in Canada, I can tell you there is no rationing decision making matrix like you described. My step dad's 86 year old father had heart surgery about 3 months ago. Government FUNDED is not the same as government RUN. And you can pick your doctor in Canada (I can't here btw, my doc has to be on the HMO's list).
I'm living in the US again and I can't believe the stuff people here think about "socialized" medicine in Canada....
Socialized medicine.... I hate the word because I don't think anyone really even knows what that means... Now, as someone who has lived most of my life in Canada, I can tell you there is no rationing decision making matrix like you described. My step dad's 86 year old father had heart surgery about 3 months ago. Government FUNDED is not the same as government RUN. And you can pick your doctor in Canada (I can't here btw, my doc has to be on the HMO's list).
I'm living in the US again and I can't believe the stuff people here think about "socialized" medicine in Canada....
I can only relate the anecdotes I've read. I'm not condemning the system in Canada, I'm simply relating the problems a national health care system would face here in the US. Canadians, by and large, seem to be in favor of the system they have, and therefore the system is what works best for them. But, let me ask you this. If the system in Canada works so well, why are supplemental health care policies available (and profitable) in Canada? Why do many Canadians come to the US for care? I don't have access to the numbers, but neither of us can deny it happens. Certainly, the care offered in Canada is not of a lower standard than what is offered here in the US, so there must be a reason.
Care rationing decisions are a cornerstone to every system I've heard discussed here in the US. Perhaps I simplified in my examples, but the fact is that under a system such as those that have been proposed, decisions about who gets what kind of care will have to be made. But then, as I pointed out, we are not far from being forced to make some of those decisions anyway.
If you believe that government funded is not government run, then we must disagree. In order to make the decisions about who gets what kind of care, the government must, logically, have access to health care records. That access must occur just to ensure that the correct treatment was given for a condition. And there can be no denying that putting the government into the mix will of a necessity create a huge bureaucracy to administer the program. I don't know about you, but I think the last thing the US needs is yet another monolithic government bureaucracy to govern part of our lives.
I am sure many will agree: there is no fix to our current healthcare system. It needs a complete overhaul. However the current system works well for a large group of Americans. Those of us subsidised in our care by our employers in healthcare, industry or government. We also happen to be the people with a little money in our pockets and we vote. To make healthcare work for EVERYBODY, everybody needs to take it on the chin a little bit. Us "covered" Americans might need to get used to a little less care, maybe more out of pocket, to see that EVERYONE gets access. This would not be a politically popular agenda! If I was young and fresh, I would love to sink my teeth into the problem! I think it could be solved-we sent a man to the moon for heaven's sake-but it would mean a lot of changes to a lot of people.
As somebody who has walked a mile (or so) both in the USA and the UK as a patient I'd like to say this;
I've waited over an hour to see a doctor in the UK (The queue did not start at 4am
I've waited over an hour to see a doctor in the USA with health insurance and been told I had an infection one week after the labs were drawn.
Some newspaper/neighbour/Canadian/American will always have a different tale to tell.
Erm, doesn't anybody know of an American who certainly wasn't refused healthcare but had to remortgage their house? Because I do.
I've had this argument in my head a thousand times on which is better. The answer is, they both fail the public in different ways. But do please quit this "We're better than you are" nonsense.
I really do not understand the original intent of this thread. Once the question was answered, having no insurance does NOT affect nursing care, Larry continued to argue instead of feeling relieved to know that these masses of poor uninsured are truly being cared for. I must remind him that when you cite statistics of poor outcomes in the uninsured, it is often because the uninsured are not very intelligent, and I have seen many instances of non-compliance with meds and treatment among those. We have many uninsured "frequent fliers" with CHF who refuse to take their meds, even though they were free, and are once again admitted to be "drained off". We continue to teach, teach, teach, always have another social worker consult to help improve their "free to them" home visits to ensure compliance, etc. etc. etc. You can lead a horse to water but you cannot make them drink!!!!
fergus51
6,620 Posts
You're killing me Steph...
#1 African American low birth weight babies fare better than (white) Canadian babies? Of course they do. Ask any nicu nurse, African American babies are the best survivors in any nicu and white boys are the worst (wimpy white boy syndrome is a well known term). Many of those countries who get the highest ratings pay their healthcare professionals nothing (Cuba was among the top because docs make no money). Canada can hardly be criticized by Americans for not paying docs and nurses enough and for not getting enough bang for their buck BECAUSE they spend too much on docs and nurses.
#2 Yeah, Canadians complain about health care. Ask them the next question: Do you want an American style system and the answer is a resounding NO. Universal health care is our national religion. Endorsing user fees is a long way off from wanting private healthcare to become the norm. People want to improve the Canadian system.
#3 Canada spends less money as a percentage of GDP than the US. If our system isn't sustainable, despite government surpluses, how sustainable is the US system when we're running a deficit? Again, looking at cost saving measures is important, but there has been nothing to show that a private system will do that.
#6 Not covering home care, chiropractors and drugs isn't a sign that Canadians don't get health care. Universal care doesn't mean we will pay for EVERYTHING, it means everyone has basic coverage and you can get insurance for the rest (sound familiar? Yep, it's just like the US!!)