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??

[Jstand]

The Medical School my daughter goes to gets (zero federal dollars), I have a son getting his Master's Degree, he is going to a state university, gets paid a TA position and graduating with 1/10th of the debt my daughter has. I know what I paid for my masters degree.

PGY pay is less than a nurse makes. The process of getting into medical school is so much harder than going to graduate school, you have to pay for each primary and secondary application. If you get an interview you have to pay all the costs. My son had his room and board covered for his interview and no secondary applications .

Are you intimately involved with a medical student ( I mean to have access to their bills like I have ? ). I have quoted my sources could you share your sources since I find them very different from what my family has experienced.

I know what I paid for my masters degree too. I'm not sure what either of us paid for our's is relevant or what relevance what your son gets paid for a TA position would have either. I would like to know how you figure that your daughter's medical school gets zero federal dollars? In 1927 student fees accounted for 34 percent of medical school revenues. Today less than 5 percent of medical school revenues comes from tuition and fees. Instead, medical schools rely heavily on federal and state support. In 1992 total medical school revenues amounted to $23 billion. State and local governments provided $2.7 billion. The federal government paid at least $10.3 billion to medical schools and hospitals for medical education and training. You can't argue with this.

I still don't feel sorry for your daughter because it is hard to get into medical school. If you are going to whine about it, then don't go through the process.

I don't see what relevance it has to the discussion that you are "intimately" involved. It doesn't give your argument any additional credibility to say that you have a daughter in medical school. All that does it make you more biased.

All of that being said, we certainly don't need to divert any additional dollars to medical education. What we need to do is use the additional money to find some more innovative ways of providing care to people at lower costs.

[Jstand]

THis is an interesting discussion, and I believe it brings out the pros and cons of the "socialized" system. My question is this:

If the government now provides health care (or pays for it), what do you do if:

1) a woman is pregnant, and tests show that the child is severely deformed and will most likely need care for most of their lives. This is expensive.

In a system w/ socialized medicine, what priority will be placed on coverage for this baby.

Some people may think that she should terminate the pregnancy, but if we all think this way, we are missing the entire point that 1) many times, these so called abnormalities diagnosed in the womb somehow fix themselves or end up not to be true. 2) some women firmly believe that terminating a pregnancy is wrong -- what then?

When resources are limited, there are people who will encourage that this life (and yes, it is a life, contrary to what some people believe) will be "selectively terminated". As rare as it may seem, it could potentially happen.

2) another scenario -- what if an elderly person would like to have some kind of surgery, but the surgery is expensive...would the system then tell that person that he/she can't have it becuase the benefits are few and the cost is high?

3) If everyone has to go to a GP (like they do inthe UK), what do you do if you can't get past the GP, or if they won't refer you to a specialist? Example: if you break a bone, it can be set and casted, but, if you cast it the wrong way, or do something bad because a GP is not an orthopedist, what would happen then? Do you still have the option of going to a specialist at your own expense or are you S.O.L. because nobody will refer you? I'm sorry, but I've been to a few "primary care doctors" who can't navigate out of a paper bag, I'm wondering how they got through med school. (but that's another issue).

While I am not against the fact that people should have health coverage so that it doesn't bankrupt them, I am not sure I am comfortable w/ so called "experts" defining algorithms and expecting everyone to live by them, and making it hard for people to get the correct care because it might be a tad expensive. (Translation -- Kaiser does that now don't they?)

I am not pleased w/ the direction of health care -- I think we will eventually find that this utopia of providing access to everyone might eventually backfire, as it does in many cases. But of course, it sounds fabulous to hear that anyone can go to a doctor and get medicine for their illness...what are we going to do when the insurance companies decide that it's no longer profitable, so they will just get out and leave everything up to the government...

All the promises that "your insurance will NOT be affected", and "you'll continue to receive your insurance" is bogus because we all know that if an employer says -- I can't afford to provide health insurance to my workers, there goes that plan and unfortunately, we will all be stuck w/ the government's plan, which frankly, probably won't be all that wonderful.

But it sure sounds good -- can't argue w/ that. Let's revisit this plan in 2014 or maybe 2018.

All of your arguments against the legislation are emotional responses to hypothetical situations. It sounds like the rhetoric that Republicans continue to spew about the law. I don't understand how they even equate this to "socialized" medicine in Canada and Western Europe. The new law bears almost no resemblance to those systems.

As far as your argument that insurance companies finding it "no longer profitable" due to rising costs, how do you explain that this can happen when it hasn't already in the previous two decades of costs rising in the range of double digits every year? You think that this new system is unsustainable, but the old system wasn't? The arguments just don't make any sense at all. It isn't adding up. You need to seriously rethink your stance on this and assimilate all of the facts before you go making some emotional post that is completely unfounded.

[Jstand]

Funny, the doctors I work with say working with private insurance is easier dealing with Medicare or Medcaid ( which does not pay it's bills).

Does not pay it's bills? Can you explain what you mean by that?

[Ginger's Mom, MSN, RN]

This isn't aimed at the poster I'm responding to but really? This kind of response drives me nuts - the idea that universal health care will result in some hideous slippery slope end product is pure scare mongering. Every Western country except the US has universal health care. While they're all different, and the program you (may) end up with will no doubt be different again, none of them has anything like enforced termination of potentially disabled babies. Though termination's an option, genetic counsellors are not allowed to influence the decisions of parents, even when explicitly asked.

That's not to say that support for parents is everything it could be - my godson is significantly affected by autism (admittedly not a condition currently detectable in utero) and though his education costs are state covered and his mother receives a tiny payment toward his care, at the moment knowing what will happen when he a) nages out of school, and b) is unable to be cared for by his family is still unknown.

But medical costs? Wholly covered - CF, cerebral palsy, microencephaly...

"Wopuld like" some surgery? Well that's going to depend on the kind of surgery and the need. Cosmetic surgery isn't covered, but pretty much everything else is. There are certainly waiting lists, but decisions about eligibility for surgery are made by the surgeon and anaesthetist not the government - if the patient is likely to have a good outcome then age isn't really an issue.

That's not to say you can have whatever you want - there was recently a high profile case here of a young woman who was rejected for a second liver transplant (original liver failure related to drug use, transplanted liver failed due to a return to heroin), but the WA government bowed to pressure and paid for a living-related partial liver transplant; she died today.

I've never heard of a GP refusing to write a referral, but I guess you could see another GP if that happened. IN Australia you're not limited to seeing one GP. Everyone I know who's fractured something has gone to ED for x-rays and casting, including me.

If you're happy to pay to go private that's certainly an option here, and prices are considerably lower than they seem to be in the US. I had a surgically-assisted maxillary expansion, which is a wholly elective procedure (ie not a Medicare funded procedure); I needed volume expanders post op and spent the night - including anaesthetic and surgical fees it was around $3,000 all up. Although not a Medicare procedure, because I spent over the annual threshold on medical expenses that year I got money back at the end of the financial year.

I have come to the conclusion, socialized medicine is not universal care. I really don't think the two can be compared.

In the USA, there are many different health care plans, based upon your income and employment, my understanding is that in other countries income or employment is not a factor.

In the USA, many unrelated issues such as student loans are tied to health care in other countries that is not true.

In other countries, doctors and nurses don't graduate with huge loans, in the USA students graduate up to hundred of thousands of dollars.

In other countries, your GP is located within your postal code, in the USA citizens can travel many different places and not tied to local postal codes.

In the USA - 85% of the citizens were happy with their health care yet, the government pushed through the bill, I can't comment if this happens in our countries.

So when I see people from the UK, Australia, and other countries comment how it won't be bad for us, I have to add, you can't compare the different systems. My understanding is that the healthcare works well in your countries and I am happy for you. But the USA healthcare even with Universal Health care it is not the same .

In the USA for veterans to get care from the VA - you have to contact your local government official, I don't want my health care being decided by local government official.

[Jstand]

I

In other countries, doctors and nurses don't graduate with huge loans, in the USA students graduate up to hundred of thousands of dollars.

In the USA - 85% of the citizens were happy with their health care yet, the government pushed through the bill, I can't comment if this happens in our countries.

So when I see people from the UK, Australia, and other countries comment how it won't be bad for us, I have to add, you can't compare the different systems. My understanding is that the healthcare works well in your countries and I am happy for you. But the USA healthcare even with Universal Health care it is not the same .

In the USA for veterans to get care from the VA - you have to contact your local government official, I don't want my health care being decided by local government official.

Most students in the US graduate with large student loan debts. I'm not sure why you single out doctors and nurses for purposes of the conversation. What you are saying is that it is okay for other students to graduate with large debts, but not doctors and nurses? That doesn't make sense.

Where on earth do you get your statistic that 85% of people were happy with their healthcare? Do you truly think that the only part of the population that was unhappy with the current state of affairs were the uninsured? Do you truly think that all self employed people out there are happy with the amounts that they have to pay to get coverage? The real truth is that this issue is about a 50/50 split at the time of the vote, with about 6-10% of people on the fence mostly because they are scared by the rhetoric spewed by doctors telling them that if this passes they will quit their jobs and people won't have access to care. If people knew the real truth, that doctors won't quit, there would be a huge majority in favor of it. Furthermore, they would be lining up to call their state legislators the next day to tell them they had better pass a bill to allow independent practice for nurse practitioners in their state.

Then they would have someone who really wants to do the job at the right cost and do it well. Primary care is a job that if done the proper way and done efficiently can earn a nurse practitioner in independent practice between $100,000 and $120,000 a year. Nurse practitioners are perfectly willing to do the job for that amount of money and to spend the time that it takes to do the job right. They are also willing to do it in a lower overhead business structure.

If you don't see people clamoring for this now, just wait until all of these younger people are forced to buy health insurance and they get on a high deductible plan with an HSA. Once that happens, they are going to start demanding lower cost alternatives. This is going to force most states to give them their demands in the form of an independently practicing nurse practitioner.

[ballerinagirl]

lamazeteacher, you got it wrong. The church doesn't TELL anyone to do anything. It's a choice you make and have to live with. I'm one who didn't have an amnio because the results would not have made any difference to me. The catholic church does not issue decrees like the govt does.

So no, nobody is under any obligation to pay for a disabled person's life, except now, the government will because they made it so.

[ballerinagirl]

Apples and oranges indeed.

• The new health care plan is not SOCIALISM. With a competing government for health care, the private insurance company can not dictate their price anymore, since there is now a competetion ....if the government health is cheaper, then the private insurance company will have to compete and go low w/ their pricing. I can understand the fear of the "gov't management " just by looking back into the past...... but some of the branches of the government are under a microscope, and looked at very closely, to eliminate waste and dysfunctions. Our health insurance is built under a profiteering bunch of organizations that spends money to lobby for their own interest of more profit, and nothing is enough and the greed can not be satisfied. all you have to do is to look at our woes in the fiinancial sector ----- they will bankrupt the cash cow ( tax payers) until dry. So the Obama administration is trying to fix some of this . Let us not argue , let us support him and the present administration. My own eyes and ears tell me that they are doing and walking the talk. so let us do our share by listening closely and not be intimidated by our own fears. Of course it may not be a perfect plan , but the current one is not working...so what would you do? Unless you are one of those rich families who can pay the astrocious medical bills.
  

A private company can always dictate their price. And that price will be HIGH because they can no longer deny anyone to keep their costs low.

Of course, if there's no money to be made, why stay in that business? I think they will get out and offer a plan to cover what the govt won't cover. that would be the way to go. That way, they can call it something else -- supplemental insurance (not health insurance).

And if competition is really what we're after to lower prices...we have just eliminated the competition. Smaller insurance companies will get out or be gobbled by bigger ones. (that's competition?)

And there's always concierge doctors for the rich. no insurance needed.

[ballerinagirl]

you hit the nail on the head. when you expect the govt to provide everything for you, then you also give up your ability to make a real choice. But I suppose that people haven't figured that out. all they want is that someone else pays. What they don't realize is that we are already paying and we will keep on paying for useless govt bureaucrats to make random decisions based on the whim of special interest groups.

[ballerinagirl]

All of your arguments against the legislation are emotional responses to hypothetical situations. It sounds like the rhetoric that Republicans continue to spew about the law. I don't understand how they even equate this to "socialized" medicine in Canada and Western Europe. The new law bears almost no resemblance to those systems.

As far as your argument that insurance companies finding it "no longer profitable" due to rising costs, how do you explain that this can happen when it hasn't already in the previous two decades of costs rising in the range of double digits every year? You think that this new system is unsustainable, but the old system wasn't? The arguments just don't make any sense at all. It isn't adding up. You need to seriously rethink your stance on this and assimilate all of the facts before you go making some emotional post that is completely unfounded.

the old system is unsustainable, but the new one is also quite unsustainable. Of course, you can always sustain it with higher taxes, I suppose. The new bill doesn't address the reason for high costs. What you are doing is replacing a system w/ another one that isn't quite likely to work either. If we really wanted to cover everyone, then just cover everyone that doesn't have coverage and don't try to fix what isn't broken.

Insurance companies have always been profitable. That's why they are in it. You think Blue Cross provides insurance so they can lose money? Obviously they are making money. They don't care how the cost rises. they already negotiated their lower rates. Next yr, they know they have to raise premiums to account for rising costs.

As a businessman, if you can't make money off one business, you usually get out of it. So costs are rising, but they are raising their premiums to maintain profitability. either that or cut benefits, which is what some of them will do. Either way, someone will pay. This is what I mean.

[lamazeteacher]

Today, President Obama spoke to people in Portland, Maine. It was another excellent speech intended to clarify what the Act was that he signed earlier.

Most people who slash the efforts made to change our corrupt former health care system, have no idea what the reform of health care Act is about. Some one spouting its dreadfulness to me last night, said after I asked him if he had read exactly what it is, told me, "I'm not going to waste my time reading it. It's going to be repealed." Well, I didn;t waste my breath telling him about it.

President Obama was quite funny as he related the normal things he saw upon waking up the day after he signed the Act, seeing that Armagedden hadn't occurred as threatened by opponents of the new legislation. Then he went on to say what wouldn't happen any more, asking individuals whose situations he knew to stand up for the appreciative applause of the audience.

After CNN aired the speech, they interviewed a staunch Republican, who obviously hadn't appreciated what had been said (as if , indeed his brain perceived the words that had been spoken). He dissed all that he thought was in the bill, claiming that only one idea that was any good came from the Act, and that thing had originated in the proposal by the Republican party. I think it was about insurance companies having to continue their coverage of those with preexicting conditions.

Then this senior Republican loosed what he stated was the Republican position for reform of health care. "Individuals should run their own health care", he said.

Can you imagine any program being run by 310,000,000 diverse people? Could anything be less planned, more chaotic or capricious? Anything that is unregulated is on a train toward fraud! This was a "respected" career politician, folks! How do such yahoos get elected, anyway? You guessed it, MONEY. In this country we get what someone else has paid for....... so how can health care reform fare worse than what's been accepted for many decades as our due?

I can't let post # 366, wherein med-surgRN32 wrote:

"In the USA - 85% of the citizens were happy with their health care yet, the government pushed through the bill, I can't comment if this happens in our countries."

I know that Canada's health care plans (different in each province) weren't subjected to public scrutiny at all. Each one was in place through governmental agencies with experts appointed to do that job. No vote was held, no big whoop, and no thought was given to whether health care was a "right". When I asked many Canadians I know as friends; and those to whom I am related

if they have misgivings about having to pay for others' health care they look puzzled and say, "Why would I?" They care about their fellow Canadians and feel responsible for their well being. Why don't we have that same concern for others?

[lamazeteacher]

Oh, and the 85% figure given as representative of those in our land who are content with the former health care they had, will still have it, at less cost for themselves and their employers. However that figure must represent those who were without insurance, as it's too high to be true, as 85% of those residing here, don't all have it.

I found it interesting that the stock market reported that all health care insurance companies' stock rose, the day after the passing of the reform Act.

So if people do put their money where their mouth speaks, there had to be few stockholders in disagreement with the passage of the bill!

[talaxandra]

I have come to the conclusion, socialized medicine is not universal care. I really don't think the two can be compared.

I suppose it depends on how you define the two terms, It seems as though many American members use "socialized medicine" to refer to any nationally-funded health care system, whereas the rest of the Western world calls this "universal health care".

So when I see people from the UK, Australia, and other countries comment how it won't be bad for us, I have to add, you can't compare the different systems. My understanding is that the healthcare works well in your countries and I am happy for you. But the USA healthcare even with Universal Health care it is not the same

I agree that the US system is different than the Australian system; we're all different. I don't think I've ever said it won't be bad for you - like most of us here, all I've tried to do in this discussion is tried to correct misrepresentations about universal health care from the perspective of someone living and working in a country that has universal health care. Like this one:

In other countries, your GP is located within your postal code, in the USA citizens can travel many different places and not tied to local postal codes.

That may be the case in the UK - it's not an integral part of universal health care. I've certainly seen GPs in my postal area, but for the most part the GPs I've seen have been in different areas, usually because I moved and wanted to stay with the same provider, or because a friend recommended someone.