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.
Oh, and another note to Larry, please do not assume that everything you read in our liberal press that is quoted by some of our gloom and doom politicians is true.
You're harsh tone in response to my post is offensive.
Did I say somewhere that I was in favor of "socialized" healthcare in the US. Wait, let me answer...no I did not. If this country ever went to an all-inclusive type of health care, it would have to be something completely unique to the US and not based upon another country's system. And something like that, I would be willing to learn more about.
Also, I'm sorry that Barbara Boxer's ditty on HMO's didn't impress you or wasn't scientific enough for you. It doesn't mean that these unfortunate events didn't happen and don't continue to happen daily. Great! That some value their HMO and have had good experiences. Really, that's great! BUT, there should never be even one person who suffers because a needed procedure/test gets wrapped up in HMO red-tape. The good and the bad-- apples and oranges, these are two completely different things. They are not even comparable.
Your statement about paying triple the taxes is just plain not true. As long as there is misinformation and untruths perpetuated, and as long as this country is lead by the type of administration we have now, this nation's healthcare crisis will simply continue to grow while those at the top of the healthcare food-chain (including the pharmaceutical big-wigs) continue to line their pockets at the expense of the health of the citizens of this country.
an aside: My dad was very ill and needed IV meds at home which my mom administered via a picc line. It was powdered voriconazole that my mom mixed with NS immediately before each dose and then injected into a bag of NS. Their insurance covered very little of this medication and they ended up spending, out of pocket, about $1,800. After two doses, my dad had a very bad reaction and it was d/c'd. They couldn't returned the unused sealed, dry meds or the bags of NS or the unopened single dose bottles of NS. Someone tell my what's wrong with that picture?
In 2001 we were spending $1.4 trillion dollars on healthcare, 14.1% of the GDP. Hospitals are broke and closing, doctors are leaving due to the fact that they are overwhelmed by the lack of control that they have over their own practice and because of malpractice insurance rates, the #1 inpatient caregivers (nurses) are paid and treated like squat, in some cases patients don't get the care or treatment that they need, 98 thousand people/yr die from medical mistakes, the elderly can't get the meds that they need, mental health is pathetically underfunded and still a social disease as oppossed to the medical condition that it is, and the list goes on. Where's all the money going?
Yes, no one is turned away if they need medical care in this country. That's not disputed. What's wrong is how our healthcare system is managed. That's what needs to be fixed.
A "decision matrix?" On what planet? That's completely unethical and will never happen.
I'm in favor of changing our healthcare system as it is now. If we can't all at least agree that something's wrong, well then nothing will ever change.
I cannot even respond to your last paragraph in response to my post which contains this: "The fact is that there is not a health care crisis."
That's your opinion, I guess.
I've been in this debate too many times on too many message boards. I'm not interested in justifying my opinions. They are what they are.
Kevin is absolutely right, the last thing we need is "another monolithic government bureaucracy" that we, the people, will have to fund and live by. The less government in our lives, the better. People in government are there for their own reasons of power and control, I want them to stay the heck out of my health care decisions. And, if someone wants to blame our current healthcare problems on our current administration, I must ask, after 8 yrs of Clinton shouldn't it be fixed if the Democrats have all the answers? Begalli, I do not think Kevin took a harsh tone with you, I think maybe you just did not like what he said, it was not to be taken personally. We are all entitled to our opinions.
No, Begalli, I was not joking. It is a fact, seen with my own eyes. Children do not get to make their own decisions, they have to rely on a parent, and sometimes parents are not very intelligent, sometimes they buy beer instead of their children's medicine, does this shock you? I have worked in the ER, seen many children sent out with samples, and an RX, for which Medicaid will pay for, but do the parents go to the pharmacy? It is not my job to follow them there.
By the way, this economy is recovering quite well from the recession Bush inherited, and considering 911, since Clinton didn't stop Bin Laden when he was offered up on a platter, even after the first bombing in '93 of the World Trade Center. People who have been layed off receive the care they need, all they have to do is go to an ER. Then, they need to look for work, and not be too proud to flip burgers.
I apologize, I did not intend my tone to be harsh in my response to you. I simply wanted to be sure to respond to all that you said. Now, on the other hand, if everyone who disagrees with you is harsh, well then I have to admit to being harsh.
Let me say here, I am completely befuddled by your response to me. You want an "all inclusive" health care system in the US, but in the same breath tell me it doesn't have to be socialized. I don't understand. Please just give me an idea how that would work. You do know that if the government foots the bill for health care, then that is socialized medicine, right? In other words, socialized medicine exists whenever society foots the bill for the cost of health care for all, rich and poor alike. So, like it or not, what you are advocating is a system of socialized health care. You just haven't fleshed out the particulars. (See, Fergus? I know what "socialized medicine" is.)
I never said that the events outlined on Boxer's site didn't occur. I did say "so what?" Any system set up by human beings is going to have problems and errors. It can be tragic, but it is the nature of the beast. Within just a few months of setting up the system you are in favor of, there will be tales of problems that some patients encountered in making that system work. So no system you set up could correct this problem. You made the comment "there should never be even one person who suffers because a needed procedure/test gets wrapped up in HMO red-tape." Are you suggesting that our government could set up a system whereby no one would ever suffer because red tape slowed the system down? Have you ever dealt with our government? Red tape is their middle name.
Now, if it is your desire to complain about HMO's specifically, then you might find me in agreement with you. The short version is that the HMO system is set up in such a manner that it is more profitable for physicians to not treat, or provide minimal treatment to patients. I think any system that is set up so that doctors make more money by not treating patients is problematic. However, HMO's are not the only health care payers out there. And we can fix the HMO problem without social medicine.
Again, I apologize, but you are the one operating on a false premise when you say our taxes won't rise as a result of instituting a national health care system. Our government is already deficit spending. How exactly do you propose that they assume the burden of paying for health care without raising taxes? Where will the money come from to pay physicians, hospitals, nurses, clinics, and on and on? Where will the money come from to fund the immense bureaucracy necessary to administer this program (a point you have not yet addressed at all)? Further deficit spending? Of course not. Taxes will have to increase, and increase significantly. Frankly, I believe I am paying enough in taxes.
I'm sorry about your father, but you have not described a problem with the health care system. The reason your parents were unable to return unopened, unused meds was that there are regulations set up by our government that prevent that from occurring. You know, the same government you believe could do a better job of managing our health care system.
As to the paragraph you begin "In 2001 we were spending $1.4 trillion..." How, exactly, will the government taking over health care fix any of that? Do you believe that the cost of health care will decrease as a result of having a single payer system? This is the same government that pays $600 for a hammer, and $1200 for a toilet seat. You think that when healthcare is managed by the government, nurses pay will go up? Not likely. More likely, in the interest of driving the cost of health care down, salaries of all health care workers will decrease. Changing who pays for health care won't change one iota of what has you so upset in the above paragraph. Changing payers won't increase nursing salaries. Neither will it drive down the cost of malpractice insurance. Changing to a single payer system will actually take more control away from physicians, in that there will government protocols for how to treat specific diseases. Changing to a single payer system will do nothing to decrease the number of deaths due to medical errors (and you do know that that number 98,000 is based solely on extrapolation from small area, and is considered by many scientists and mathematicians to be junk, right?) Switching to a single payer system won't change society's perception of the mentally ill, either. So for this whole paragraph in which you lecture us on the evils and ills of our current health care system, you are proposing a system that will be unable to fix any of it.
As to the decision matrix, believe it. It already happens. If you don't believe it, ask the nearest organ bank what the age cut-offs are for organ transplantation. Even in nursing, we make these decisions, based on "quality of life" outcomes. How often have you complained because a family wanted everything done for granny, but you knew that "doing everything" was futile? How often have you said "let's just provide comfort care, and let the poor old lady go?" That's a decision matrix about what kind of care someone should or should not get. It's just that under a government run system, you won't have to ask these questions any more, because the government won't give the family the option of "doing everything for granny." You just don't happen to like the name I've given it. I've even read a statistic that suggests that a significant percentage of the money we spend on health care is spent on people in the last three weeks of their lives. These patients lives are slightly extended, at enormous cost. That will have to change, so...hello decision matrix.
I've been in this debate too many times on too many message boards. I'm not interested in justifying my opinions. They are what they are.
Translation: My mind is made up. The issue and my mind are closed. Don't try to confuse me with facts.
The fact is that while there are problems with our health care system, turning it over to the government will create far more problems than it will solve. And we haven't even touched on the fallacious "the right to health care." I've debated with other about that here on the board, and no one has yet to prove to me that any right to health care exists.
I have read with interest your posts - obviously this topic that i posted was of interest to many of you. As an outsider to your healthcare system your views are interesting. The UK system may not be perfect but at least I'm trained in chronic disease management and work within the NHS National Health Service. Thankfully I do not have to bill anyone in my efforts to hoilistically assess them and refer them to the best possible care.
So I'm pleased that your hospitals are helping some people who may not have health insurance - do they help AIDs cases too?
I guess nurses in the US could be considered to come from the Middle Classes - I wonder if foreign nurses working in your economy have other views.
The UK system may not be perfect but at least I'm trained in chronic disease management and work within the NHS National Health Service. Thankfully I do not have to bill anyone in my efforts to hoilistically assess them and refer them to the best possible care.
So I'm pleased that your hospitals are helping some people who may not have health insurance - do they help AIDs cases too?
No, no. We don't treat AIDs cases. We just tell them they are on their own and let them fend for themselves. Of course we treat AIDs patients! Regardless of ability to pay.
Make no mistake, we do not treat "some" people without health insurance. We treat everyone who walks in the door. The law requires it. And guess what? I trained in the management of chronic diseases, as well. I also have training that is not available in the UK, as I am a nurse anesthetist. I don't assist the anesthesiologist, I administer anesthesia myself. In truth, I have to be pretty well versed in the management of most chronic diseases in order to do this.
We are not cretins. We don't turn people away. We even have health clinics that provide preventative care for patients at low or no cost. The problem is that in most areas, the poorer populations do not avail themselves of programs until they become sick. (Not that they are less intelligent, but preventative health care is not a priority to them.) I can't imagine that having the government take over our health care system will improve that.
I am sure many will agree: there is no fix to our current healthcare system. It needs a complete overhaul.
Given that roughly 85% of Americans have health care coverage, this makes very little sense. It's kind of like saying your tires are bald, so your car needs a complete overhaul.
. 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
Care rationing decisions are a cornerstone to every system I've heard discussed here in the US.
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
Kevin McHugh
Kevin
#1, I think you're under the wrong impression. Supplemental policies are not for basic medical care. You can't buy supplemental policies to pay for surgery or hospitalization. Supplemental policies are for extras that the government doesn't completely cover and that varies from province to province (like chiropractors or massage or drugs or a private hospital room or extra home care).
#2 You don't have numbers of how many people come to the US from Canada for treatment and neither do I. It might surprise you, but I don't know a single person who has done that. Not one, and I know lots of Canadians:) Why do they do it? Cause they don't have to wait. They can pay and get treatment tomorrow. It's about convinience and I can understand that. Since our patient care outcomes are equal to the US, I can't buy the argument that waiting is killing people. It sucks, but it isn't deadly. My dad had to wait about 3 months for his knee replacement and joked about going to the US and having it done early. That's the closest I've come to seeing a Canadian go across the border for care probably because 99% of us couldn't afford it anyways. At the same time, Americans look to Canada for drugs and certain elective surgeries (we had Americans coming for eye and plastic surgeries). Pros and cons in each system....
#3 Rationning would probably occur in any US discussed theoretical universal system. It doesn't happen in Canada in any way that is different than the US (the only example I can come up with is organ transpolantation). Implying it does is just silly hype. Old people aren't put on ice floats to die because we need to ration care. Doesn't happen.
#4 Same as above. Despite what you may think, the Canadian government does not have the power to ration care or interfere in individual's care at all. Our privacy laws are actually much stricter than in the US (the patriot act even goes against our laws, causing some problems for US companies who do business there). The prime minister himself can not access my medical records unless he's willing to break the law. People in the US don't seem to understand our health care administrators are not politicians. We have health boards that function just like health care management in the US. And they don't even get to ration care! Believe me, I can think of a ton of babies who were just money pits. If the government had the right to ration care, we would never treat 23 weekers for 8-10 months in an NICU only to send them to a skilled nursing facility for the rest of their lives. Doctors and patients determine what treatment to take.
Now, you should know I also don't want a Canadian style system in the US. Shocked? Well, I don't think it's practical and I don't see any reason to reinvent the wheel. I just get tired of Americans telling me I don't know how my own country's system is run, despite the fact that I actually lived there, worked in that system and was a patient in that system. It's sort of like when British people start talking about the American system, kwim (hint hint)? Are there cons in the Canadian system? SURE. LOTS. I'll tell ya about them anytime. They just aren't the ones Americans are constantly talking about (rationning care, not being able to choose a doctor, etc).
tommycher
110 Posts
Oh, and another note to Larry, please do not assume that everything you read in our liberal press that is quoted by some of our gloom and doom politicians is true.