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??

[Ginger's Mom, MSN, RN]

Fever of 104 -105 with no doctor....she has been know to go to 107. WIth the conversions , long distance calls, and time difference I thought she needed ( and she did) medical care. Where do you go when in a foreign country and have not established care with a MD?

Her ankle had a sprain the worst an ankle surgeon has seen only second to a complete break. She was refused to be seen at two hospitals, I asked her to been seen by the nurse ( and at the time her dorm had a nurse) and was turned away.

If I was making public policy I am wrong to be shaped by personal experiences. But this is very personal to me, since I feel if I lived in the UK and was not given aggressive surgery and chemo in a timely fashion I would not be posting here.

And my I add, when someone has a US horror, story my third cousin's neighbor friend, it doesn't get questioned.

[madwife2002, BSN, RN]

Medsurg32RN

I am sorry to hear about your health issues and I can certainly see why you advocate non socialised medicine.

I think the screeening is an issue in the Uk so you could well be right on the identification problem. I know many people who have breast cancer in their family and they do recieve early breast screening. My friend was offered a bilateral mastectomy in her early 20's for being such a strong candidate of breast cancer.

My friend got diagnosed with Ca last July she went to her GP on the monday had blood tests, was in the hospital by wednesday then started on radical treatment on the friday. I doubt treatment could have been started any quicker anywhere in the world. It didnt save her life but definatly was not because she didnt recieve early treatment.

[talaxandra]

Hi MedSurg - I really don't want you to feel attacked, and I am genuinely sorry that your daughter's medical experiences were so unpleasant here. I suspect that the questioning of personal experience as a basis for making a decision about health care models is because it was combined with a more objective source. In reality, this mix of objective information and subjective experience is how most of us arrive at or (more often confirm) our decisions, particularly about big things.

I was intrigued by your statement that your daughter's "been known" to have fevers to 107F/41.7C fevers. The fever she had on this occasion certainly was also high, but the way you phrased made me wonder if there were other health issues.

I'm glad your experiences with insurance have been favourable. I'd like to point out that insurance is an option in Australia, in addition to Medicare; that a citizen here would certainly have been treated for a sprained ankle regardless of how severely (or not) it was injured; and am wondering if she presented at public or private emergency departments. I'd suspect treatment in this case would be more forthcoming in the latter but am still surprised she wasn't seen at all.

[KBron2000]

I know of people who call and get information from medicare. It might take patience and sometimes more than one call, but they obtained the answers. I really don't believe the US would fashion government run health care after another country. We have always been a progressive country and I do not believe that would stop. It might take awhile before some of the new drugs are added to the covered list, but that is no different than a regular for profit insur. co. Right now at my place of work I am trying to get 5 residents medication approved who have medicare part D. I've been working on it almost a week now. I looked into my insurance provided by my employer (BC/BS) and the meds are not on my drug list either.

[ghillbert, MSN, NP]

So far, I've lived in Australia about 25-30 years, and spent a third of that time working in public and private hospitals. I have *NEVER* met or known of ANYONE who was refused treatment. I still do not understand what happened or what the rationale was.

If you don't have a GP in Australia? Go to a GP clinic. About $45, and much more appropriate than ED.

PS: I don't doubt your story, I just don't understand it as it's so far from my wide experience in Australian healthcare. Unless she was told to go home because it would be a long time before she was seen..??

[Ginger's Mom, MSN, RN]

So far, I've lived in Australia about 25-30 years, and spent a third of that time working in public and private hospitals. I have *NEVER* met or known of ANYONE who was refused treatment. I still do not understand what happened or what the rationale was.

If you don't have a GP in Australia? Go to a GP clinic. About $45, and much more appropriate than ED.

PS: I don't doubt your story, I just don't understand it as it's so far from my wide experience in Australian healthcare. Unless she was told to go home because it would be a long time before she was seen..??

All I know from my very credible( Phi Beta Kappa, Honors Graduate, Masters degree in Clinical Research, and now Medical Student) daughter is she presented herself to several emergency rooms and was turned away from the person who sits at the desk. One did tell her a place to buy crutches ( without any instruction). She was in Melbourne and she was originally staying in Sydney. I believe she went to one in Melbourne and the second in Sydney. I would not know how I would find a GP in Australia, obviously She didn't I guess she and I are not as smart as you Ghilbert. I know when she was sick with a fever and I had the University intervene it took them half a day to find a GP to see her. I guess the University is not as smart as you either. As I had posted previously she had access to the credit line on my credit card and we could have transferred money in a minute.

I have to add my daughter prior to this had traveled to Europe, Asia, and Africa alone as a teenager to visit my sister, so she is well traveled and not naive but obviously stupider than the average Australian according to you. She is a healthy person and has no medical issues other than running a high fever when sick.

Not only did I find this practice horrible but heartless. I did work for an insurance company at one point in my career and the insurance company often flew patients home since they felt the care rendered in Australia was below par. It was the insurance company's policy not to fly people home sick to air vac home was more expensive than treatment abroad but the care had to be equal to local care.

Also in my 30 years of professional practice I have never seen a patient turned away. I have never seen another nurse or doctor turn a patient away this is 3 times more evidence my 3o years verses your ten.. Using your logic since YOU find it hard to believe my story, the this does not happen is the US or are you implying you are reliable than me ?

Back to the issue of socialized medicine, for this not so bright family, who probably should never travel , I think I can say, my family is average intelligence for an American. That Americans would not be able to use Socialized Medicine the Australian Version.

[talaxandra]

As ghillbert clearly pointed out, s/he wasn't doubting your daughter's account, just puzzled by how it happened, because it varied so widely from her/his personal and professional experiences here. I certainly get that this is a sensitive subject for you, but reading into it that there was some kind of attack on your daughter's intellect, veracity and/or ability to function out of America is a massive reach.

Like ghillbert, I'm puzzled and surprised by your daughter's experiences in Melbourne and Sydney. My first response when confronted with something I don't understand and that conflicts with my experience is to find out more about it, and thereby work out how it fits into the picture I already have of how this aspect of my world is built. If ghillbert's mind works the same way then that post serves a similar purpose - to seek information, not cast doubt.

As I hope I posted before, I'm also sad to read that the injury was so significant and had such major and long-lasting consequences. I know that makes no difference at all, but it's true nonetheless.

[MaritesaRN]

mindless sheep huh?? so now if i dont agree with this govt plan i'm considered a mindless sheep...well thats rather arrogant. if half of the united states population has some speculations about this govt back plan its not because we are a bunch of damn mindless sheep. how insulting.

:cool:No insult was intended-- just want to get people to really pay attention

I simply said that I am disappointed that some people do not understand that without the public plan , there is really no competetion ---and this is the main factor that will actively encourage competetion --- otherwise it remains to be a monopoly market and soon even you and I will struggle w/ the premiums ! Even the non insured will be given a chance to get one that is affordable .

Now they are talking about a coop plan --whatever that is, hope it works , for all our sake!!!

Remember the reason for the health reform is that we need a drastic change because it is not doable anymore !! People have no insurance, due to unemplyment, poverty and pre existing diseases, the Medicaid/Medical can not bear this burden of patients that the private insurance is not accepting. I do not know about you , but even I with an insurance ( my employer changed us from HMO to PPO --- the 20% of this , even I can not afford just a simple , routine tests, costs me a lot , from outpocket ! I am a single mother and grandmother, and in the old days , nurses can support their whole family , well I do not think this is true anymore. Now think of the single mothers who have a minimum wage law, and forced to use medicaid and welfare to feed their family. ( Women and children free fall to poverty after a divorce. They are getting to #1 in the poverty list) .

I have a personal thing w/ this health reform --- all must be covered , especially children ( those that can not qualify for Medicaid and caught in between ) . These issues are very personal to me.................my daughter and my grandaughter will be in the streets if not for me.................... so pardon me for the word "sheep" ,it is just difficult not to be passionate when you have seen and experience the inefficiency of our health system , among other things !:stone

[MaritesaRN]

My experience living through a life threatening illness, is that I could call my insurance company and ask questions. My dealings with US Government officials have not been that open. You can't even talk directly to a Medicare official. W

ith an insurance company you have the option to choose another, how do you change a government plan? After reading the cancer survival rates in the UK, I am glad I lived in the USA.

My state has done way with pre existing conditions and waiting periods. I would be happy if all states had the same.

What State are you in? First time I heard of this. I bet , very few insurance companies there? I know we need to improve some of the government offices efficiency grade, and I know this is where some of the fears of the "government" comes from. the point is , we now have a chance to change something that was highly dominated by powerful and rich people or rich industry, and historically resistant to change. change for this people and industry is cancerous to them considering they will not be able to gauge the public or people exorbitant amount of premiums and endless limitation and restrictions of care....and yet, they will take your premiums --------this has to be regulated , or a better way to do it is to put a competetion of which will help bring prices down for the private insurance to compete against the public. that is why there is so much commotion and desperate lies all over to distract this attempt to reform .

[ghillbert, MSN, NP]

All I know from my very credible( Phi Beta Kappa, Honors Graduate, Masters degree in Clinical Research, and now Medical Student) daughter is she presented herself to several emergency rooms and was turned away from the person who sits at the desk. One did tell her a place to buy crutches ( without any instruction). She was in Melbourne and she was originally staying in Sydney. I believe she went to one in Melbourne and the second in Sydney. I would not know how I would find a GP in Australia, obviously She didn't I guess she and I are not as smart as you Ghilbert. I know when she was sick with a fever and I had the University intervene it took them half a day to find a GP to see her. I guess the University is not as smart as you either. As I had posted previously she had access to the credit line on my credit card and we could have transferred money in a minute.

I have to add my daughter prior to this had traveled to Europe, Asia, and Africa alone as a teenager to visit my sister, so she is well traveled and not naive but obviously stupider than the average Australian according to you. She is a healthy person and has no medical issues other than running a high fever when sick.

Not only did I find this practice horrible but heartless. I did work for an insurance company at one point in my career and the insurance company often flew patients home since they felt the care rendered in Australia was below par. It was the insurance company's policy not to fly people home sick to air vac home was more expensive than treatment abroad but the care had to be equal to local care.

Also in my 30 years of professional practice I have never seen a patient turned away. I have never seen another nurse or doctor turn a patient away this is 3 times more evidence my 3o years verses your ten.. Using your logic since YOU find it hard to believe my story, the this oes not happen is the US or are you implying you are reliable than me ?

Back to the issue of socialized medicine, for this not so bright family, who probably should never travel , I think I can say, my family is average intelligence for an American. That Americans would not be able to use Socialized Medicine the Australian Version.

Miaow! You'd better add reading comprehension to your list of challenges.

In case you missed it, that means that all the bolded sections are complete fabrications by you that bear no resemblance to anything said, implied or even THOUGHT by me. There appears to be a chunk of wood of some description on your shoulder that requires attention.

[Grace Oz]

I realized Australia has socialized medicine, but for my family it caused permanent damage to a family member, my daughter.

She went on a 6 month student exchange program to Sydney. I has world wide health insurance covered, but ensured that she had enough funds to pay cash for any treatment she could need. I also paid $500 to the Australian government to entitle her to reach health care there.

To make a long story short, she sprained her ankle was refused treatment several times, and she tried to nurse her ankle.

By the time she made it home she had to have an reconstructive surgery and now has permanent nerve damage. At least if this happened in the USA she could sue the hospital who turned a foreign girl away ( Same on the hospital in Melbourne and Sydney). So I am a bit bias when is comes to socialized medicine.

Also according to the Lancet , US has better survival rate than Australia or the UK.

It is with regret and disappointment that I read of your daughters experience. I would however have liked to be able to know the full and inclusive details of what actually transpired here during her endeavour to access treatment.

Not to deny you - or her- her reality of what transpired, but I find it almost incomprehensible that she would have been denied/refused treatment in any Australian hospital. It's against the law here to do so.

That she chose to not pursue attaining treatment from a source other than the one she initially sought help from, was her decision/choice. According to your post; an unfortunate one, since she required surgical intervention after returning to the USA.

I wish both you and your daughter good health in the future.

[Ginger's Mom, MSN, RN]

It is against the law in the USA too, and in my life I have never seen a person denied care in the USA. I have never read it in a local paper, heard it from a neighbor, or seen it in professional practice. I doubt the denial of care is as big an issue in the USA as the media has it. But I accept that it does happen.

That being said, while I was not in Australia with my daughter I have no reason to doubt her story. When she had the fever it was due to a parasite in the water ( something I have never worried about in the USA), it took the University's contact in Sydney half a day to find a doctor to see my daughter. The contact was a native.

That being said, my son when is England when he had to access care it was a piece of cake. It was told to go to a local clinic and was seen.

I just got off the phone with my daughter, this is the details.

Initial injury at beach, some one call the rescue squad and they gave her first aide, they told her that she did not need to go to the ER but drove her home since she was not mobile.

Few days later the pain was horrible, went to ED was immediately asked for money ( forget the fact I paid over $500 to the government for her to access the health system) and was told that she would have to wait at least 12 hours and even then they would not guarantee that she would ever be seen and suggested that she leave.

Those are the details doesn't seem like too much access to health care to me.

Lessons learned ( I learned, when my son went to England, if he could not access a MD, get on a plane home ASAP). When I travel I stay in a hotel or place which has a clinic. Do not count on what you read, basically you are on your own.