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??

[JessicRN]

I'm Canadian. The best thing about our health care system is that in your daily life, you never have to think about affording care or not. You see your doctor or receive hospital care and you never get a bill. Our health care covers us no matter what province we are in when we need the care.

Catastrophic injury or illness? Same thing--you receive the care and no bills.

As nurses, we are paid well. And we don't have to worry about our patients' insurance covering this or that--we just look after them.

No system is perfect--there some community services that should be covered, especially for the elderly who need help with ADL's but I think that will come eventually. We could use better coverage for dental and drugs than we currently have, but people can get private insurance plans for that at relatively low cost.

Where health care is FOR PROFIT, that's when it becomes exclusionary and expensive. That's when it becomes an expense like any other in daily life. I would be so afraid to live in the USA where my coverage was a matter of ongoing concern.

I know it has been awhile since I was in Canada but in Ontario you use to pay for medication outside the hospital. Most people have work insurance which pays for the two things Medicare does not and that is anesthesia and outside medications. My sister was not one of the lucky ones as she did not have insurance so she did not take her medications and she has crohns. as a result she ended up with a iliostomy. In hospital however, with the exception of anesthesia everything is covered. The cost of procedures even if you are from another country is really inexpensive in Canada. We had a friend who was hit in the face with a baseball. He was taken to the Hospital ED where he recieved an Xray and had his nose packed as it was fractured and recieved pain medication. he was self pay so he paid a grand total of $300 and that was 7 years ago in New Brunswick. Here in MA USA if you are self pay they chargwe you 3x what it costs those with insurance. They say it is to help pay for all those that are illegal (we are the safe haven for illegals) or those with Mass health.

[talaxandra]

This continuous referral to socialism, and now a "socialist system," is bizarre to a non-American reader. I can't speak for Canada but Australia and the UK have had long periods of right wing government in power and maintained univeral health care, and none of the countries discussed in this thread have had socialist parties as a significant component of government, let alone in a position to direct policy.

The flip side to negotiating higher wages based on individual strength is lower wages based on arbitrary and subjective criteria. In Australia wages are determined by experience and qualification. That said, my hospital and many others pay managers above award wages. More important, at least from my perspective, is that there is no room for bias or favouritism, or for management to attribute changes in wages or conditions as being performance related.

ETA: I can't remember whether Italy, which has had ultra-left wing politicians has been directly mentioned in this thread. If so I so modify my response

[quezen]

I love this site where we call all discuss our views. I don't go on it a lot, but when I do I see the thoughts and experiences of so many 'real people', not just knee jerk political views, (well, with maybe some exceptions!)

We (in the USA) invent the drugs!!???

Numbers 3 to 8 of the leading 'Big Pharm' compainies are:

Bayer, GlaxcoSmith Kline, Novartis, Sanofi-Aventis, Hoffman-La Roch, Astra Zeneca. None of these are US companies.

Did the 'poster' citing achivements of Australian medicine even mention the doctor who risked his career to prove that ulcers can be caused by a bacteria?

Where is the US listed these day in efectiveness of health care- isn't it somewhere around #7, or #12?

No need to ask about cost of health care. The USA is ALWAYS #1 in this ranking.

Has no one noticed that we DO have free health care here in the USA.

Medicaid is FREE health care, for some-the rest of us pay for this care that only 'some' recieve. The 'Indigent Funds' that some States have (how many States have these, where does the funding come from-does anybody know- I would like to know this), pays for a lot of health care. I have seen illegals get a lot of care paid for by that fund. After all, the 'EMTALA' laws do not allow the ERs to turn these people away-who picks up the bill for an emergency surgery?

This is FREE health care in the USA.

The VA system is a sort of 'Universal Health Care' system, that provides free, or reasonabally priced care. Not everyone getting this VA health care served with distinction, some did their time, but spent as much as they could get away with on 'sick call'. (I am a veteran who worked in military health care- I knew the regulars at sick call, we all did- ask any vet.) Some managed to get 'medically retired', back in the day of Regans 'million man army', because they were smart actors who figured out how to 'use the system',ask any vet. (Nowdays, with all our guys, and gals, with 'real' wounds it is not so easy for these 'shamers'.

Do you think the VA system wants to go away by 'merging' into Universal Health Care?

Native Americans get FREE health care. They have their own department in the United States Public Health Service. The federally funded 'Indian Health Service' runs dozens of hospitals and hundreds of clinics. These are staffed by federal employees who's livelyhoods are vested in the continued existance of this system. This system is funded by over 4 Billion dollars a year of your money, dear middle class American. Do you think the Indian Health Care 'system' wants to go away by 'merging' into Universal Health Care?

By the way, for both of the above systems, if the Veteran, or Native American qualifies for Medicaid, guess who gets to pay the bill for the care? Yes, YOU, dear middle class American, these people DO get free health care in the USA, and YOU are paying for it! The VA, and the Indian Health Service, went to court and won the right to collect the $$$$ they put out for health care given by their systems from the Medicaid if an individual qualifies for Medicaid.

I am not questioning the 'right' of any members of the above groups to health care.

I am asking, "is health care a 'right' for some groups and not others?"

I think this question must be answered in a persons own mind before they can join in a discussion about 'Universal Health Care'.

I don't believe that "so many Americans are oposed to Universial Health Care". It seems to me that most would like to have 'Universial Health Care', but just LOOK at the power and money of the opposition! And this opposition does not just come from health care corporations.

Why should a smart person on Medicaid try to 'achieve' something? So they can 'live to work' and pay taxes?

The health care corporations get their money no matter who pays the bill. And you, dear 'sucessful' American who has 'achieved' and 'made something of yourself' are paying for the health care that is provided FREE to many who have outsmarted you and are sucking up on public assistance.

I just don't understand this. The middle class is the backbone of a developed Nation.

An iron clad rule of economics is 'you get more of what you subsidize'

The current system=more corporations+ more deadbeats+higher costs for those stupid enough to pay in.

This equation needs to change.

Is health care a 'right' of certain groups, or is it a basic right of all members of our society?

[ghillbert, MSN, NP]

I am not questioning the 'right' of any members of the above groups to health care.

Well, you clearly are. You basically stated that many of the people eligible for free healthcare are leeches, deliberately abusing the system (and therefore the average american taxpayer).

Why should a smart person on Medicaid try to 'achieve' something? So they can 'live to work' and pay taxes?

What a ridiculous argument - have you ever seen any data on this? Neither have I. But most people I know who end up on assistance for the POOR are not proud of it. Of course there are idiots in any society, but don't tar everyone with the same brush.

You, dear 'sucessful' American who has 'achieved' and 'made something of yourself' are paying for the health care that is provided FREE to many who have outsmarted you and are sucking up on public assistance.

I just don't understand this. The middle class is the backbone of a developed Nation.

This attitude is what I just don't understand. Many of the poor's healthcare problems are because THEY ARE POOR,, not because they felt like going and getting diabetes etc. Have you ever studied the WHO determinants of health? Try it sometime.

Is health care a 'right' of certain groups, or is it a basic right of all members of our society?

In a first world, civilized society, how can that even be a question? Particularly from a healthcare provider?? Wow.

Do you support the right to bear arms? If so, how can you support someone's right to have a gun, but not to be able to afford healthcare? It's just incomprehensible to me.

[talaxandra]

Did the 'poster' citing achivements of Australian medicine even mention the doctor who risked his career to prove that ulcers can be caused by a bacteria?

Yes, I did. Why do you ask? This seems like an unusual question in the context of the rest of your post.

[dlatimer]

I don't mean to beat a dead horse, but if a society wants all (or most) of it's citizens to be productive, then should healthcare be a right? If quality healthcare is only for those who can afford it how can anyone who doesn't have employer provided healthcare afford to work for anyone who doesn't supply it? There are lots of these people out there: mowing your lawn, washing your car, doing your laundry. If they get sick, tough. I hear of lots of people who don't work because they would lose their health benefits provided by taxpayers. They sometimes have a chronic illness (eg: diabetes) or they have children. Anyone have a solution?

[quezen]

Wow, did I post in English? I am pretty suprised at the vehement misinterpretation of what I was trying to say.

"Is health care a right of citizens of this country, or is it the privilege of those who qualify for it by virtue (??) of being on the low end of the economic scale, being members of a particilar ethnic group, having served in the Uniformed Services of the USA, OR having enough $$ to afford health insurance?"

I would say that asking this question is the basic starting point of any discussion about health care reform in the US.

I would ask any person in political office to give a clear answer to this question, before they said another word about health care. The answer to this question pretty much will tell you where a person is comming from on the health care debate.

I, myself don't have health care in the US, except the VA. Are you calling me a leech? I have been called worse, it doesen't upset me, just surprises me. ( I know that I am not the only soldier who discovered that a Stars and Stripes folded in half fit nicely in ones medical record folder). I am not calling anyone a leech, I am trying to point out that there is plenty of 'free' health care in the US, you don't see too many of the people who recieve this 'free' health care participating in these discussions, but you do see a lot of misinformation out there about 'poor people don't get health care in the US'. The people who don't get health care in the US are the middle class who cannot afford insurance premiums, and who do not fit in one of the above categories.

It is my personal opinion that everyone in America should have health care.

Sometimes an examation of 'Systems', can point out problems with existing systems. I don't think that anyone has any doubt that 'health care corporations' make big bucks in the USA. I am just trying to point out that 'corporations' are not the only enity that will put up a fight to maintain the 'status quo'. There are entrenched areas of health care that serve certain segments of the population in the US that would not like it at all if we would all be on an "equal footing" with regards to rights to health care.

I am not hurling accusations against any group of people. I am not saying that anyone 'goes out and gets' any paticular disease. I am a nurse, and except for when I was active duty I never had health care in my adult life in the US. I personally usually just 'self diagnose' and go to Mexico and get some medication the very few times I feel like I might be really in trouble health-wise.

I think I am a fairly good nurse, I have my strong points and weak points , like everybody else. I can say that because I have had so few chances to use health care services for myself personally I am at a little bit of a disadvantage when I deal with people who use the health care system for every little thing. In my area of the country, these are usually people with no insurance or people who have their health care paid for by the "Indigent Fund" (what IS this anyway, no really, is this a political slush fund, if you 'know' the right people you get your health care paid for?). I do know that doctors (Hospitalists) have told me that they feel much freer to provide adquate care to Medicaid and Indigent patients, "the government just pays the hospital for the care we feel the patient needs when it is a Medicaid patient, if the patient has insurance we must be very careful because insurance companies have offices full of people who do nothing but check over the bills to see if they agree with our treatment"

This is kind of a long post, I apologize, but I just am trying to explain myself. I am still asking the question, "is health care a right or a privilige?"

( I didn't mention guns, but then who is talking about guns-I wasn't!)

[talaxandra]

Maybe that is the difference between universal and user pays health care systems - in the former health care is a right and in the latter it is considered a privilege.

[lamazeteacher]

"Do you think the VA system wants to go away by 'merging' into Universal Health Care?

Native Americans get FREE health care. They have their own department in the United States Public Health Service. The federally funded 'Indian Health Service' runs dozens of hospitals and hundreds of clinics." excerpt Quoted from Quezen's post # 41

I believe all those medical programs need to be part of the new "free" health care program, so that expensive duplication of services will be prevented. I know the VA has a need to control their "general issue" (=GI) people.

When I've discussed with armed services personnel, the possibility of combining systems, the reasons of needing to "know where the soldiers are" was mentioned by an officer. Well, computers find all sorts of people. I'm sure patients' locations coud be available through that resource, in a hand held device issued to those with a "need to know".

Military doctors, nurses, and auxilliary personnel paid by the armed services would be an economic way of staffing all facilities, along with the staff already there. Then the ratios would look much better! It would also allow deployment of stateside medical personnel, if need be.

Having specialized health services is a form of differentiating certain groups, which may have been appropriate in earlier times, but not now. The point of having them, was to assure that permitted procedures/medications/services would be available for native Americans, that might not be known to every doctor/facility. Including them in the universal program would assure that every American has them.

I have a hunch that the anger between them and other Americans long ago was such that putting them together in a waiting room was a risky thing. Not so, now. Isolating them is not condusive to equal opportunities.

Soldiers returning from assignments which caused their injuries/illnesses, would have the benefit of being included with civilians so that acclimation to their homeland will occur more quickly; and association with others who appreciate the sacrifices they made, will increase their self esteem.

[MaritesaRN]

I love this site where we call all discuss our views. I don't go on it a lot, but when I do I see the thoughts and experiences of so many 'real people', not just knee jerk political views, (well, with maybe some exceptions!)

We (in the USA) invent the drugs!!???

Numbers 3 to 8 of the leading 'Big Pharm' compainies are:

Bayer, GlaxcoSmith Kline, Novartis, Sanofi-Aventis, Hoffman-La Roch, Astra Zeneca. None of these are US companies.

Did the 'poster' citing achivements of Australian medicine even mention the doctor who risked his career to prove that ulcers can be caused by a bacteria?

Where is the US listed these day in efectiveness of health care- isn't it somewhere around #7, or #12?

No need to ask about cost of health care. The USA is ALWAYS #1 in this ranking.

Has no one noticed that we DO have free health care here in the USA.

Medicaid is FREE health care, for some-the rest of us pay for this care that only 'some' recieve. The 'Indigent Funds' that some States have (how many States have these, where does the funding come from-does anybody know- I would like to know this), pays for a lot of health care. I have seen illegals get a lot of care paid for by that fund. After all, the 'EMTALA' laws do not allow the ERs to turn these people away-who picks up the bill for an emergency surgery?

This is FREE health care in the USA.

The VA system is a sort of 'Universal Health Care' system, that provides free, or reasonabally priced care. Not everyone getting this VA health care served with distinction, some did their time, but spent as much as they could get away with on 'sick call'. (I am a veteran who worked in military health care- I knew the regulars at sick call, we all did- ask any vet.) Some managed to get 'medically retired', back in the day of Regans 'million man army', because they were smart actors who figured out how to 'use the system',ask any vet. (Nowdays, with all our guys, and gals, with 'real' wounds it is not so easy for these 'shamers'.

Do you think the VA system wants to go away by 'merging' into Universal Health Care?

Native Americans get FREE health care. They have their own department in the United States Public Health Service. The federally funded 'Indian Health Service' runs dozens of hospitals and hundreds of clinics. These are staffed by federal employees who's livelyhoods are vested in the continued existance of this system. This system is funded by over 4 Billion dollars a year of your money, dear middle class American. Do you think the Indian Health Care 'system' wants to go away by 'merging' into Universal Health Care?

By the way, for both of the above systems, if the Veteran, or Native American qualifies for Medicaid, guess who gets to pay the bill for the care? Yes, YOU, dear middle class American, these people DO get free health care in the USA, and YOU are paying for it! The VA, and the Indian Health Service, went to court and won the right to collect the $$$$ they put out for health care given by their systems from the Medicaid if an individual qualifies for Medicaid.

I am not questioning the 'right' of any members of the above groups to health care.

I am asking, "is health care a 'right' for some groups and not others?"

I think this question must be answered in a persons own mind before they can join in a discussion about 'Universal Health Care'.

I don't believe that "so many Americans are oposed to Universial Health Care". It seems to me that most would like to have 'Universial Health Care', but just LOOK at the power and money of the opposition! And this opposition does not just come from health care corporations.

Why should a smart person on Medicaid try to 'achieve' something? So they can 'live to work' and pay taxes?

The health care corporations get their money no matter who pays the bill. And you, dear 'sucessful' American who has 'achieved' and 'made something of yourself' are paying for the health care that is provided FREE to many who have outsmarted you and are sucking up on public assistance.

I just don't understand this. The middle class is the backbone of a developed Nation.

An iron clad rule of economics is 'you get more of what you subsidize'

The current system=more corporations+ more deadbeats+higher costs for those stupid enough to pay in.

This equation needs to change.

Is health care a 'right' of certain groups, or is it a basic right of all members of our society?

A lot of the above that you mentioned is real, and I agree w/ you in most of the cases. Although I believe that health care must not be discriminating and will treat those that needs treatment, no matter who, what and where you come from. Illegal immigrant issue is something that this country needs to deal and finalize----if they give out green cards for temporary work in the USA, the employers will have to put in some health insurance. One of the blocks of getting this done are employers who want to pay dirt cheap wages to the illegal workers. Same with the health care reform-- there are those who do not profit from the Universal Health Care, and will block this reform thru powerful lobbyist and feeding the public lies through the media. You have no idea how brainwashed this generation is. Maybe thinking out of the box is what we need. After all our present health system is obviously not working....so why not try something different? There is no disagreement inthis, is there?

[Saúde]

Great discussion! I’m an American and my wife is Brazilian. In Brazil, we have a 2 tiered health care system. Those who can pay for private health care, (usually provided through an employer, 20% of the population) and a system called the Sistema Unico de Saude or the SUS for those who are too poor to pay, (approximately 80% of the population). The SUS is based on 3 fundamental Catholic principles; universality, comprehensiveness, and equity. As a RN and a Christian I feel these ideals are what any country of high morality should be striving for. But Brazil’s government funded health care has been a miserable failure because in real life these principles are not attainable. In Brazil, our Physicians and Nurses do not control the care they provide. The government controls it and patients are given preferences and better treatments based on their statistically determined survival rate. Terminally ill patients and those who have a smaller chance of survival are discarded which is very upsetting and perplexing to me because it betrays the core principles on which the SUS was originated.

[Saúde]

When considering whether or not America should adopt a Canadian style government funded health care system I am VERY concerned about the government control of and it's impeding of the physician and nurses plan of care for patients. For example, the care performed is ultimately limited to the resources available, resulting in patient prioritization and scheduling delays. As demand continues to increase over time resources will continue to decrease, remedied only by more taxation or an incremental decrease in care provided.