Still think we have the best Health care in the world?

[HM2VikingRN]

i heard this woman's story on npr http://thestory.org/archive the other night. read the diaries and make your own decision about whether our system needs reform. this patient had an 8 day wait to get in to see a us gynecologist on an urgent basis.

http://www.dailykos.com/story/2006/7/15/132936/405

in april 2005, when i was still ignorant of endometriosis and living in the us, i was lucky enough to have health insurance (bad as it was) and decided to find a us doctor who could prescribe something for my nasal allergies. in singapore, my doctor had prescribed me "flixonase" (the foreign name for flonase) and i could buy it there for us$17 a bottle. without insurance. i would find out later that a bottle of flonase in the us would set me back us$70 a bottle with insurance.

.....

me: "how soon would you be able to operate on my cysts if i decided to have it done immediately?"

he: "anytime also can.* you want tonight, or if you want tomorrow, it can be done."

(* some singaporean style english for you. it just means "anytime.")

me: "what? really?"

he: "yah." at no point did he exhibit any expression on his face except concern, and he looked me in the eye.

me: "you'd be able to do it anytime i ask for?"

he: "ya, anytime. the sooner the better of course. just tell me, we can arrange it."

when i told my husband about the conversation, he was amazed, even with the other personal singapore healthcare experiences he's heard from me. among other things, my gynae's practice in singapore:

- is "private", as opposed to a government clinic in singapore, but still affordable. i can also get appointment with the doctor really quickly, within the same week whenever i call, if not the next day.

- never made me feel rushed. my first appointment with dr o lasted an hour. all my appointments with dr m in raleigh had never gone over 10 minutes.

- was the one who gave me a pelvic ultrasound on my first visit to him, and showed me my sonogram images, on screen during the ultrasound, and on paper after. this never happened with dr m.

comment: no waiting time for care or needed surgery.

cost for laprascopic ovarian cyst removal us: 16000

singapore: 2000-5000.

lupron us: 682 dollars

lupron singapore: 250 dollars

- quality of medical attention? as a female, and as someone who has had to get check-ups regularly for visa requirements, i haven't had the quality of healthcare in us that matches what i get in singapore yet.

if you explore the singapore ministry of health's website, read their mission statements. one thing i've always liked about their approach to health: when government is partly footing the bill, that government has a lot of incentive to keep its people healthy, and to educate the population on how to do so. singapore costs are kept affordable in two ways - the moh put it in their mission to keep healthcare affordable in singapore (and then they do it), and singapore has both public hospitals and private hospitals. both types offer competitive quality and price. competition can work - done right.

...

but the biggest tragedy i see here in the us is failure of education, philosophy and vision - many people still think, despite all worldwide numbers to the contrary, that american healthcare is the best the world can do. what perpetuates the failed system is the spoonfed bs is that no one can afford a system that tries to take care of everyone, not just the rich. and of course, the neocon myth that free market will make good healthcare system. as long as sheeple believe these falsities, bad legislation follows.

[pickledpepperRN]

I don't doubt that, at all.

You just won't GET what you want by the means of gov't. I don't doubt your veracity, simply your means.

Free markets have given the most people the most opportunity to move up in the world. Period.

I'm not against your proposed safety nets nearly so much as I'm opposed to the cost you intend to impose on ME to achieve it. I'm not talking about increased taxes, which are bad enough, but decreased care and decreased access to care.

If this were merely a discussion about 'safety nets', it would be a different discussion. Instead, this is about creating a socialist utopia. Such a beast doesn't exist. It never has. It never will.

I'm not opposed to your goals, per se. I'm staunchly opposed to your means because they WILL NOT WORK. And I don't intend to have that proven on the backs of yet another failed socialist system, a system that gov't stormtroopers require me to take part in.

If your utopia is so grand, then why do you need the full and coercive force of government to make it so? Why is because, in order to bring it about, you intend to take away from the many in order to give to the few. And you don't intend to take away a little. You intend to take everything away but what Uncle Daddy will allow us to keep.

Uncle Daddy doesn't have the RIGHT to make such determinations. And, neither does anybody else. I am a free man, with God given natural rights that not incidentally, are protected by the Constitution.

THIS is what Jefferson said about gov't that feel that THEY hold the rights of the people at their command, instead of those rights being Natural Laws:

"That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or abolish it, and to institute new Government, laying its foundation on such principles, and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness."

And, that is just what we did, organizing said gov't in a way so as to deny it the power to do what you suggest.

~faith,

Timothy.

No one is advocating "uncle daddy" or "storm troopers"

I do believe that it is the right of the people to alter our government as we did when we created Social Security insurance and Medicare.

I hope all people live a long natural life but am glad SS survivers benefits help provide for the children who don't.

I am not discussing taking away your money or choice in healthcare provider.

I just think those who take millions and provide NO CARE need to be doing productive work.

I am not interested in debate. I care about action because our healthcare is a disaster.

[ZASHAGALKA, RN]

See now it is easy for a corporation to declare bankruptcy but not an individual.

On at least THIS point, we agree: the gov't was wrong to tighten bankruptcy law. THAT isn't a case of free market, but of neo-mercantilism: companies using the power of gov't to get a competitive advantage off the backs of the people.

If credit card and home lenders REALLY want to reduce bankruptcy, they'd stop handing out candy easy credit and then wonder why people get overloaded.

I'd stop getting 10 credit card apps in the mail a week.

No, they didn't want to tighten the front door into debt, only the back door out.

But see, this does tie into this discussion. Be it socialism or neo-mercantilism, those that wish to use the gov't to do their bidding against the people do NOT have the people's interests at heart.

~faith,

Timothy.

[ZASHAGALKA, RN]

You had opportunities. Others may not have had these things.

This is the LAND of opportunity. Others have the SAME opportunities as I do. There is NO reason why an able bodied person in this nation cannot be successful, unless they will not.

Me? I graduated H.S. with no money and parents unable to support me and a step father that greeted my diploma with the following: "So, when are you gonna get the bleep out of my house?"

I did. I joined the military. And I made my way from there.

I understand your sentiment. But you take away from me a long string of hard effort for me to get to my point in life by simply dismissing it as a 'lottery' of life.

There but by the Grace of God do NOT go I. The Grace of God: YES! But added TO THAT is alot of sweat and tears. I earned where I am at. Nobody has a right to blithely dismiss that.

And here's a secret: the more you press that such is the case for the majority of Americans, the more they will tune you out.

Oh, it's easy to make a case for class envy of the rich. But the more you go to reach down and make that case for anybody but those that don't work, the more you lose your argument.

And THAT is why gov't restricted healthcare will not happen in this nation anytime soon. It's NOT because you can't convince people of a safety net. No. It IS because you will not be able to convince them they deserve to feel guilty for their hard work and effort. Guilty enough, to let the gov't take it away from them.

It's a losing argument.

~faith,

Timothy.

[Gromit]

Yes, I still say we have the best overall healthcare in the world. I have no idea how well regulated docs are in Singapore -and I'm sure they have some fine ones -so do we. Few weeks ago, I went into the ER c/o tachyarrhythmias. I was advised that I should have a defibrillator (ICD) and three days later, I was undergoing said procedure.

My wound has healed, there were absolutely no complications, and I can tell you what it feels like when the bloody thing "fires", too.

Yes, I have pretty good insurance. But when everyone is so keen on comparing costs here vs. elsewhere, do they bother to figure out what the average salaries are in the super-low-cost-countries? What good is it to say it only costs a hundred bucks, when it takes forever to raise that kind of scratch? Numbers that aren't weighted, cannot be compared.

And as for universal healthcare, before you get so excited about waiting lists, check out what the Fraser institute has to say on waiting lists by comparrison.

http://www.fraserinstitute.ca/shared/readmore.asp?sNav=pb&id=801

You don't get 'cadillac care' on 'volkswagen' prices. Lambaste the corporate system all you want, but advancements aren't cheap, and innovation isn't free.

[Gromit]

I understand your sentiment. But you take away from me a long string of hard effort for me to get to my point in life by simply dismissing it as a 'lottery' of life.

There but by the Grace of God do NOT go I. The Grace of God: yes! But added TO THAT is alot of sweat and tears. I earned where I am at. Nobody has a right to blithely dismiss that.

And here's a secret: the more you press that such is the case for the majority of Americans, the more they will tune you out.

THAT is why socialism has such a bad name that it now has to be disguised with phrases such as progressive. THAT is why 'liberal' became a negative word in mainstream politics.

Oh, it's easy to make a case for class envy of the rich. But the more you go to reach down and make that case for anybody but those that don't work, the more you lose your argument.

And THAT is why universal healthcare will not happen in this nation anytime soon. It's NOT because you can't convince people of a safety net. No. It IS because you will not be able to convince them they deserve to feel guilty for their hard work and effort. Guilty enough, to let the gov't take it away from them.

It's a losing argument.

~faith,

Timothy.

Couldn't have said it any better myself. My folks WERE very supportive, but didn't have the resources to put me through college (and when I graduated highschool, I didn't have the drive to do so anyway -I went to work in the printing trade, hand-setting lead type.

NOTHING has been "GIVEN" to me -and to insinuate that I've won lifes' lottery is to insult me. I worked hard for what I have -and I'm STILL working hard to improve myself and the life of my wife and myself.

I am the kind of person who makes America run. The hardworking joe who isn't looking to the government for handouts or programs to take care of me. I may not have a lot, but what I've got is mine -and I got it honestly -through a lot of effort and hard work.

I've been uninsured, for years I pulled fuel for an outfit that didn't offer insurance, and didn't pay enough to buy insurance. But the thing is, EVEN WHILE I WAS UNINSURED, I felt the same way on that subject as I feel today.

Less government = more freedom -and possibly more risk, but THOSE two go hand in hand. I'll take freedom. My great grandfather didn't trust the government. My grandfather wanted nothing to do with them, my father was the same way and I'm proud to echo their sentiments.

[ZASHAGALKA, RN]

No one is advocating "uncle daddy" or "storm troopers"

I am not discussing taking away your money or choice in healthcare provider.

YOU'RE not advocating that. I agree.

But that doesn't mean 'nobody' is advocating that. Many on this thread, in fact, are.

It's not that I'm all that concerned about it though. Higher taxes is a dirty phrase in this nation. Walter Mondale said it, and came within 3800 votes, in his home state, from giving Reagan a clean electoral sweep. Hillary said it, and Bill spent the rest of his Presidency trying to put 'healthcare' behind him.

The most liberal politicians in office dare not breathe those dirty words: higher taxes. They bend over backwards to submit that they ONLY want to tax the rich, and not joe worker. But, gov't restricted healthcare requires joe worker to have a hardy tax increase. Try convincing the average American that huge tax increases are just a 'transfer' from insurance. Shoot, try convincing joe union worker that he should feel guilty and just give up his hard negotiated 'cadallac plan'.

In reality, what many advocate here will not just require new taxes, but a much greater phase of taxation. To accomplish that goal, they have adopted an attitude that Americans should and deserve to feel guilty about the hard work and effort they have invested in being successful. I just don't believe that is a winning formula.

See, YOU: you advocate a safety net. THAT is an idea that could be sold to the American people. In fact, I'm all for it. I just advocate that such decisions, of necessity - Constitutionally and practically - belong at the State level.

For others: they are advocating socializing our economy. Healthcare is just the next major step and merely a proxy argument, one they feel carries the most moral weight. If that safety net doesn't come with the attached string of socialism, then the argument, and opportunity, is lost.

Look at how many times in this discussion, over several threads, a few of the posters have widened this argument into a stated case for massive redistribution and equalization of wealth. THAT is the real agenda, for some.

But to MAKE that argument, they subsequently MUST argue that Americans should feel guilty about what they have earned. And so, the baby of safety nets goes out with the dirty bathwater of guilt-ridden, socialist driven politics.

I'm willing to entertain the idea of safety nets. I'm NOT willing to give the federal gov't dangerous powers to do so. I'm not willing to sacrifice my 'natural rights' to freedom and liberty. I'm not willing to destroy the economy to prove a well known fact: socialism is a failed ideology.

If that's what it takes to create a healthcare safety net, then the price is too high. For rich and poor alike.

~faith,

Timothy.

[RNfaster]

I traveled to Singapore in the last couple of years and was very impressed. It is a very safe, clean, and advanced city. I hadn't known until my visit that it is a stunning example of a third-world country risen to a powerful first-world status just in the latter decades of the 20th century.

It does not surprise me that the OP had a great healthcare experience there. I think it would be wise for the U.S. to look around at other countries to see what works, what doesn't work, and what might work better.

[TrudyRN]

I don't doubt that, at all.

You just won't GET what you want by the means of gov't. I don't doubt your veracity, simply your means.

Free markets have given the most people the most opportunity to move up in the world. Period.

I'm not against your proposed safety nets nearly so much as I'm opposed to the cost you intend to impose on ME to achieve it. I'm not talking about increased taxes, which are bad enough, but decreased care and decreased access to care.

If this were merely a discussion about 'safety nets', it would be a different discussion. Instead, this is about creating a socialist utopia. Such a beast doesn't exist. It never has. It never will.

I'm not opposed to your goals, per se. I'm staunchly opposed to your means because they WILL NOT WORK. And I don't intend to have that proven on the backs of yet another failed socialist system, a system that gov't stormtroopers require me to take part in.

If your utopia is so grand, then why do you need the full and coercive force of government to make it so? Why is because, in order to bring it about, you intend to take away from the many in order to give to the few. And you don't intend to take away a little. You intend to take everything away but what Uncle Daddy will allow us to keep.

Uncle Daddy doesn't have the RIGHT to make such determinations. And, neither does anybody else. I am a free man, with God given natural rights that not incidentally, are protected by the Constitution.

THIS is what Jefferson said about gov't that feel that THEY hold the rights of the people at their command, instead of those rights being Natural Laws:

"That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or abolish it, and to institute new Government, laying its foundation on such principles, and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness."

And, that is just what we did, organizing said gov't in a way so as to deny it the power to do what you suggest.

~faith,

Timothy.

While I too am reluctant to totally trash what little bit remains of our precious, already gasping-their-last American freedoms, I think it is ironic that Jefferson, whom you quote, was a slaveholder. He and so many of his compatriots didn't mind compromising the rights of their slaves so that he and his pals could live in freedom.

About your fear that you would have to relinquish your own freedom so that others might have a fair shot - I'm not sure just how it would all work, how a universal health care program would come about. Taxes, I guess. How do other countries do it? But I can't help but think that you are in the strongest group right now, i.e., those who are healthy enough to provide for yourselves by the sweat of your brow. You might think differently if you were less healthy, weaker, less able to keep the wolf from your door, Tim. Some people are born with better health than others, they avoid illnesses and injuries that cripple and lay others low. So many of my patients have illnesses, for instance, that render them basically shut down as early as their teen years. They can no more fend for themselves than can an infant. Same with those who, like yourself, work hard, build up their lives for years and years, then find that advancing age or a sudden catastrophe, not necessarily even of their own making, cuts the legs out from under them, so to speak.

As for you being a free man - just try not paying your taxes and you'll learn just how free you really are. I trust you have studied up on the alternative view of taxation, the Federal Reserve, our fiat paper money system, the pharmaceutical industry, the AMA, Vince Foster's so-called suicide, the magic JFK bullet, and 911 being an inside job. That is a fascinating study - alternative news views.

[TrudyRN]

This is the LAND of opportunity. Others have the SAME opportunities as I do. There is NO reason why an able bodied person in this nation cannot be successful, unless they will not.

Me? I graduated H.S. with no money and parents unable to support me and a step father that greeted my diploma with the following: "So, when are you gonna get the bleep out of my house?"

I did. I joined the military. And I made my way from there.

I understand your sentiment. But you take away from me a long string of hard effort for me to get to my point in life by simply dismissing it as a 'lottery' of life.

There but by the Grace of God do NOT go I. The Grace of God: YES! But added TO THAT is alot of sweat and tears. I earned where I am at. Nobody has a right to blithely dismiss that.

And here's a secret: the more you press that such is the case for the majority of Americans, the more they will tune you out.

Oh, it's easy to make a case for class envy of the rich. But the more you go to reach down and make that case for anybody but those that don't work, the more you lose your argument.

And THAT is why gov't restricted healthcare will not happen in this nation anytime soon. It's NOT because you can't convince people of a safety net. No. It IS because you will not be able to convince them they deserve to feel guilty for their hard work and effort. Guilty enough, to let the gov't take it away from them.

It's a losing argument.

~faith,

Timothy.

Your stepfather was a stinker, true. What a jerk. And yes, you did get where you are by the sweat of your brow. Many of us have done it, as best we could. And those of us who were taught that we weren't supposed to work outside the home, those of us who were taught that we were supposed to be homemakers, wives, mothers, volunteers in the community, transmitters of culture to the next generation, and helpers of our husbands, those of us who have had to spend our entire adult lives working AND homemaking know the schizophrenia of having to do, every damned day, something that, after all these many years, is still foreign to our self-concept.

We have worked and worked, saved and lived frugally, stayed within our budget, not gotten so far into debt that we could not get out. We have been the pillars of our community, the cornerstone of our families, the reliable, sturdy employees of our hospitals. We have sacrificed sleep, family time, holidays, even our health so that we could provide for our families and ourselves. We care for aged parents, we live the way we were taught was upright and honorable. We provide for our retirement years so as not to burden our children. Don't think, Tim, that we don't know where you are coming from.

But there are others of our fellow citizens who are less capable of self-care because of physical and/or mental infirmities, some self-inflicted, some God's decree. I don't think anyone is dismissing your accomplishments. We can probably relate to you pretty well, as we have done the same thing - we faced up to being poor and we did something about it. We worked, we lived honorable lives.

BTW, I want to thank you for your military service.

[ZASHAGALKA, RN]

While I too am reluctant to totally trash what little bit remains of our precious, already gasping-their-last American freedoms, I think it is ironic that Jefferson, whom you quote, was a slaveholder. He and so many of his compatriots didn't mind compromising the rights of their slaves so that he and his pals could live in freedom.

About your fear that you would have to relinquish your own freedom so that others might have a fair shot - I'm not sure just how it would all work, how a universal health care program would come about. Taxes, I guess. How do other countries do it? But I can't help but think that you are in the strongest group right now, i.e., those who are healthy enough to provide for yourselves by the sweat of your brow. You might think differently if you were less healthy, weaker, less able to keep the wolf from your door, Tim. Some people are born with better health than others, they avoid illnesses and injuries that cripple and lay others low. So many of my patients have illnesses, for instance, that render them basically shut down as early as their teen years. They can no more fend for themselves than can an infant. Same with those who, like yourself, work hard, build up their lives for years and years, then find that advancing age or a sudden catastrophe, not necessarily even of their own making, cuts the legs out from under them, so to speak.

As for you being a free man - just try not paying your taxes and you'll learn just how free you really are. I trust you have studied up on the alternative view of taxation, the Federal Reserve, our fiat paper money system, the pharmaceutical industry, the AMA, Vince Foster's so-called suicide, the magic JFK bullet, and 911 being an inside job. That is a fascinating study - alternative news views.

You have missed several of my points.

First, I disagree with the necessity to trade freedoms for 'a fair shot'. This nation provides every able-bodied person with an inherent 'fair shot' and those that aren't able bodied already have gov't programs designed to assist them (to the extent those programs fail, remember, gov't restricted healthcare will be run by the SAME people). In fact, because I understand that the best 'fair shot' for anybody is a free market, I am against socializing the economy BECAUSE it would deprive far too many from that 'fair shot'.

2nd, I'm not against a safety net. I'm against the idea that a safety net can only be brought about by socializing the economy.

3rd, I don't know why you think that stating that Jefferson and the founding fathers held slaves disables the social contracts that are our Constitution and Declaration of Independence. However, and since a thread was closed down after I brought this up in the past I have been reluctant to mention it again. But since YOU brought up the issue of slavery: forcing some, by threat of coercion, to labor for the benefit of others IS slavery. You seem to acknowledge this by stating that the necessity to pay taxes is an abrogation of freedom (while that IS partly true, I won't quibble over the point at this time). Should we therefore ADVOCATE slavery, so long as it brings about noble intentions? Maybe, it's a 'necessary evil'? Or, maybe, turning the tables, ala Sen John Calhoun, it's a 'positive good'?

I'm not saying this above is your intent. However, even YOU acknowledged that this concept is reflected within the thinking that gov't can tax at will, and should. Money is only a reflection of the labor that produces it. A gov't that believes itself free to tax at will is a gov't that believes that it 'owns' my labor.

4th: my problem with government restricted healthcare is not my current, relatively healthy situation. My problem with it is that for those that NEED that care, gov't restricted care is a worse solution. Equal access to a dismal system of restricted healthcare is not a good deal if you need those services.

You have to wonder why Canada had to come up with the maxim, "Equal access to a waiting list does not equate to equal access to care".

Castigate me if you like. I can live with that. But I have not dismissed the goal of providing better or even, more comprehensive care. I have just dismissed the goal of socialism disguised as morality. It's not. And it won't be. No matter what noble goals can or should be accomplished by 'necessary evils'. You can't make a deal with the devil and call it an answer to a prayer.

I think we all are better served leaving the concept of 'necessary evils' on the ash heaps of history.

~faith,

Timothy.

[ZASHAGALKA, RN]

I don't think anyone is dismissing your accomplishments.

Oh, but they are. You are coming into this debate late. It has taken place over several threads over the course of weeks.

Many have asserted that anybody over the poverty line has 'won life's lotto' which is a complete dismissal of the effort to attain that station. Many have tried to suggest that anybody not sleeping on the streets should feel guilty about their 'largesse'. Many have argued that, without complete redistribution of wealth, any relative better off person is guilty of unChristian uncharitableness if they don't submit to a level of taxation that equalizes outcomes.

Many have tried to argue that government restricted healthcare would be better and cheaper - but only attainable by the coercive hand of gov't.

Many have tried to argue that I am somehow mean spirited because I disagree that socialism is a better solution for the poor, or for healthcare. It's a neat sleight of hand. If I'm not for socialism, I'm immoral because of the poor children.

For the record, I made peace with the man before he died. He had his own demons, I hope he's found HIS peace.

~faith,

Timothy.

[justme1972]

The point of the original post was that she was able to receive high quality prompt care in Singapore. A careful reading of her diary reveals that her original Dr. in NC spent a fair amount of time on the phone essentially begging a gynecologist to see her on an urgent basis. She waited 8 days. In Singapore she was able to be seen almost immediately for a recurrence without the hassle of referral or prior approval. One of the usual objections to Universal Care is "waiting times." This persons experience showed that waiting happens in the US under our current system.

The thing is...she didn't have to wait 8 days, she could have went to the emergency room or she could have called to other OB's.

It was a CHOICE she made to not seek advice of another doctor, and that can happen in any country at any time. I am sure another one would have been happy to accept her insurance card if she had made the attempt, but she didn't do that.

Your post makes it sound like that is the "norm" in US Healthcare...and it is not. That is why doctor's carry malpractice insurance...because not all of them are good doctors and some of them make poor decisions.