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??

[Pistachio]

5) How much are taxes in [Australia] and how much goes to health care?

I earn mid-tier wages ($34,000 - $80,000 PA). My taxes are calculated at $4,200 + 30c for every $1 over $34,000, less salary packaging and deductable expenses, like those for work, self-education and charitable contributions. Tax is taken out of my pay every fortnight; at the end of the financial year I lodge a tax return with all my deductable expenses and either owe the government (has happened once in 20 years) or get a refund.

Healthcare funding comes from the Medicare levy is an additional 1.5% tax, calculated on my taxble income. If my annual salary were $65,000 that works out to $975. As I have chosen not to take out private health insurance, I would also pay an additional surcharge of 1%. which comes to another $325.

:)

This is a great illustration of a huge part of the problem, in the US we already spend more on public healthcare thna many countries that have universal health care. If we were talking about paying $975 per person we would not have this debate at all but the public option we're talking about is going to spend more per person than we probably spend now in private healthcare.

[MaritesaRN]

Lamazeteacher ....you hit it right on the head ! Well spoken and right on target !!! We need the change for a health care reform, because it is not serving all people, as it should . A lot falls right thru the cracks. The insurance company participates in the name of profit only ---that is it! So the government must design a plan wherein they could share the profit of the insurance as well as the loss. Medicaid is burdened heavily by a lot of people who can not afford health insurance, and this "loss" can be shared w/ the insurnace companies, in terms of less taxes on the insurance part if they participate in a program , where they are the "complementary" insurance from a public option plan. It is happening now, such as medicare beneficiaries having a suplementary private health insurance, if they can afford it. This will help spread out the "loss" widely instead of the government alone handling all the non insured people. For a rich country , all should be covered w/ a reasonable health insurance. We need to look at the other country's health insurance structure so we can learn and even copy......but of course private insurers and other profiteering group will do their best to get in the way. To be honest whatever name you call it -----socialism or whatever , we need a system that allows ALL to have an affordable health insurance for EVERYBODY. the current health system we are in right now is a joke .

We need radical changes in our health system.

[MaritesaRN]

Before we start the argument as to how capable the government is ...we need to study the health system of the Dutch, Switzerland and England -------------how come theirs work and ours do not? Have you watched what some of our senators are up to? It took a longtime to even squeeze the start of the health reform , because our nation is pretty much ran by very rich people who controls these scenarios, and and some of their money are invested in these " capitalistic " approach of the health system ...... then we talk about it ! I do not understand why some people are so againts the health reform ...what we have now is just not for the people but for the money , and I am talking about the big insurance companies among other things such as the drug companies and big time greedy investors purely for profit and do not care who they step on , as long as they get their money.

so why are some of you so belligerant in the health reform , unless you are one of those that got bought to say bad things about the health reform.

[talaxandra]

Thanks, Kim. Of course, the question is why US health care costs are so much higher than those in the rest of the western world while at the same time delivering care to a smaller percentage of the population.

Until now I think I have never thought about preventative health care measures. Is this seen as a priority in the US? I know our road trauma casualties have significantly reduced since the TAC introduced shock ads and the media began reporting the road toll, along with mandatory seat belt legislation, reduced speed zones and a nation-wide 0.05 alcohol level. There are similar campaigns for alcohol moderation, reduction of under-age drinking (which is 18), illicit drug use and smoking. At the same time there are positive health messages about healthy eating and regular moderate exercise.

[HelenofOz]

Talaxandra

according to the ATO site you would not be liable for the Medicare Levy Surcharge if you earned $65,000 pa

http://www.ato.gov.au/individuals/content.asp?doc=/content/7128.htm&page=4&H4

"a single person with no dependants and had a taxable income for MLS purposes greater than $70,000"

so that $325 is still yours!

Helen

[lamazeteacher]

This is a great illustration of a huge part of the problem, in the US we already spend more on public healthcare thna many countries that have universal health care. If we were talking about paying $975 per person we would not have this debate at all but the public option we're talking about is going to spend more per person than we probably spend now in private healthcare.

I disagree, Kim. The United States actually spends less on public healthcare than most other non 3rd world countries. The budget cutbacks have gone on for many years, and freezing new hires is common. I have been a Public Health Nurse for 48 years, and haven't liked what I've seen here. I came from Canada in 1963. That was before Canada's "universal health care" was in high gear, yet the public health programs there included school nursing; and much more was expected of public health nurses. We made many more home visits there, staffed clinics, and had scheduled meetings with the doctors in our communities to have "same page" objectives.

The "County Hospital" concepts practised until the past few decades in the United States were a disgrace! Only poor people went there, unless a patient was pregnant with a communicable disease. Medical students and interns/residence were responsible for patent care, getting occasional consultation from staff doctors. The judgments given on patients were abominable. I recall being told with a laugh accompanying the comment, that a patients weren't told that they'd undergone a procedure that sterilized them! "They've had enough babies!!" was said. "Who decides that?"

I asked.

When private companies bought the County Hospitals, a sigh of relief went up from the governing groups in the communities, and it was found necessary to place stringent controls on all the programs. The concept that patient care wasn't always the first objective at most facilities was new to me when I first arrived. I still feel that it should be, with research and education added when financially indicated; and if those programs don't interfere with standards of care.

[talaxandra]

Talaxandra

according to the ATO site you would not be liable for the Medicare Levy Surcharge if you earned $65,000 pa

http://www.ato.gov.au/individuals/content.asp?doc=/content/7128.htm&page=4&H4

"a single person with no dependants and had a taxable income for MLS purposes greater than $70,000"

so that $325 is still yours!

Helen

Thanks Helen, but for the last financial year (which was the one I was posting about), the threshold was $65K so the $325 belongs to the government!

[Rebel Yell]

With respect, madwife, this is not a Socialist country, and the majority of us don't want to be. We are already part way there, unfortunately. America was based on a different premise, and with it's study you find that a lot of this is unconstitutional. Do we need reform? Yes, but not in this way. I have read parts of the bill that they allow us to see. The control of the government is way beyond the scope intended by the Founding Fathers and our documents. Understanding our history is part of your answer.

The power given to the HHS Secretary is appaling, and thus this is considered socialism. Socialism is defined by Webster; ". . . social system in which the producers possess both political power and the means of producing and distributing goods."

We are supposed to be a Republic; " A political order in which the supreme power lies in a body of citizens who are entitled to vote for officers and representatives responsible to them." And with this, the anger rises in the American people as their constitutional republic is taken away. We have been trying to make the representatives listen to us, but it isn't working. This is not a solution to the health care problems, it is a power grab, convoluted with back room deals, buy-offs, lobby pressured legislation. And when it affects my country, my life, and my loved ones lives, I have an issue with it.

[madwife2002, BSN, RN]

Can I just say a huge Kudos for all who have contributed to my blog I feel we have all discussed this huge hot potato in a very professional manner and I am proud to be a part of it!

[lamazeteacher]

show me one, just one government program that is run efficiently and effectively! why do we think the government can make the situation better?

it's not exactly a "government" program wherein health care is part of its socialist lifestyle, but israel is the only place i know about, wherein socialism can be practised in its purest form privately, by a group believing in it. those who want that lifestyle choose to live in any kibbutz they want, there, and are subject to the decisions made about whatever they have, by an elected council (sort of like a board of directors). each kibbutz has its own policies and financial arrangements, assigning members to work they say they'd like. if a couple has children, they don't live in the same living space with their parents, visiting for part of each day, more on weekends. those whose aptitude is appropriate for caring for children does that, without cost for the parents. cooking is the same, and a com,munity dining room is used. money made by whatever businesses happen at the kibbutz, is assigned to the many programs there according to the wishes of its members, who get an equal share of what is left over and not saved, for whatever they want.

there have been some successes and some failures, mainly due to the honesty and trustworthyness of participants.

that whole country has "national healthcare" which has positives and negatives. they can choose their doctor and hospital (of course the choice of doctor usually results in what hospital is used, as it is here. fortunately, there are clinics and hospitals in israel that are subsidized by jewish people in many countries, through an organization called "haddassah" and others. the arabs residing in israel (including those who call themselves "palestinians", have equal access to health care). some very important research takes place there, with great advances made in stem cell studies since the demand of religion isn't an issue there.

i personally like being able to go to the doctor when i want and not have to wait months and months for elective non life threatening procedures. don't be fooled into thinking that you can get all the "free" health care you want. i have a friend who's mother died waiting for cancer treatment in canada.

that is sad, and there must be more to that story. just as it happens here, unless patients are assertive, they go to the end of the line. i've known of breast cancer patients here, who waited 6 weeks to see a doctor about their breast masses, when they were told by a non professional scheduler that was the earliest time they could be seen. i'm from canada, with many family members still there, and i know that saying you must be seen earlier and why, results in that.

doctors have "after hours" clinics there, and patients can go after work, although they may not always get the doctor they prefer due to scheduling, without waiting longer. there are doctors who have additional charges, over that which the government pays, so if you want to be seen by one of them, you get "supplemental" insurance for that. many do that, so anyone with enough money, usually pays for the additional coverage. otherwise, it would be as if the entire practice was composed of medicare patients. medicare here pays about 1/3 of the amount doctors charge (usually because the doctors charge higher amounts, knowing they'll get less).

aside from the inadequacies that national programs have, we also have to think about the cost. it might be "free" to everyone but not to the people who actually work. countries that have plans like this have enormous amounts of taxes taken out to fund these programs. that depends on people's incomes. no one complains about being responsible for others' medical care. in fact they have distaste for the usa, where many of those with more resources don't feel they need to contribute more for the good of all.

i personally rather pay for my own health insurance rather than everyone else and their brother too.

yes, there's the "i've got mine, jack" way of thinking that is pervasive here. it could be that there are too many people on welfare here, who might work if they didn't "take advantage of the system". in canada most of those born in that country are loath to be "on the dole", and work hard to avoid that.

[talaxandra]

This is a very interesting subject. Does anyone know anything about the healthcare in Australia and New Zealand?

Yep :) What would you like to know?

I do have a response to this:

I personally like being able to go to the doctor when I want and not have to wait months and months for elective non life threatening procedures. Don't be fooled into thinking that you can get all the "free" health care you want. I have a friend who's mother died waiting for cancer treatment in Canada. Aside from the inadequacies that national programs have, we also have to think about the cost. It might be "free" to everyone but not to the people who actually work. Countries that have plans like this have enormous amounts of taxes taken out to fund these programs. I personally rather pay for my own health insurance rather than everyone else and their brother too.

1) I can pick whatever GP I want, though not all of them bulk bill (which means some doctors charge a fee above the Medicare rebate level) and if I choose to have private insurance in addition to universal health care I also get to pick specialist and surgeons;

2) I waited a week to have semi-elective hand surgery and have posted previously on this thread about Australian waiting list times (which are collected and publicised).

3) I don't think anyone believes universal health care is free; clearly it has to be financed somehow - in universal health care countries (which includes every Western nation except the US) the funding is through taxes. As a person who actually works, I pay less than 2.5% per cent of my gross salary toward Medicare. If I chose to pay for private health insurance that figure would be less than 1% (because there's a salary cap below which no taxed are due) and I'd be able to claim the cost of insurance as a taxable deduction.

4) I think anyone who thinks they're not already subsidising the health care of others is fooling themselves - you pay in taxes and higher insurance premiums, and not providing inexpensive health care to lower-income and uncovered people before they get really sick just adds the total cost of treatment. Deciding not to subsidise preventative inhalers means paying for emergency treatment for an asthma attack, to give one example, and that doesn't even factor in less direct economic costs like lack of productivity.

[MaritesaRN]

Love this discussion ----because indeed this is the area that really needs to be improveds. Different arguments , different info and very different filters or response..... there really is not much for me to add except the fact of sensing some paranoia about socialism. We are a capitalistic nation for a long time and this serves the nation well as long as it is not abused ---but it has been. Just look around and see Enron , AIG, big banks, not top mention big health insurance who gets away making their own rules and doing business w/ more profits in mine and letting people have no coverage at all becaseu it was too costly or whatever...... So the government ends up handling all the cost that the insurance company do not cover...so there goes the medicaid budget. so bottom line is that if the private insurance company is profiting form this the government shoudl share their "loss" w/ the private insurance also.....for now those who do not have insurance or do not qualify for a private health insurance , is being carried by the government alone......why not spread some of that to the private health insurance? that is why it is important to have the public health option as a strong competetion for the private insurance companies ....so that the provate interest will be forced to lower their prices to compete!!!! All kind of lobbies out ther now to stop the public option ------this is only the true catalyst in the health insurance reform.

If it needs socialism to change something that is not working right now, then let it be!!! But we can all stop this by regulating these profit mongers , or bust !