Support for national health insurance

[Ken H.]

Making health insurance much less expensive or "free", whatever that means, will unleash a huge increase in demand. The aggregate cost to the taxpayers will increase proportionally.

The experiences of other countries with UHC doesn't bear that out. We (the USA) has the highest cost per capita spent on health care in the westernized world. Yet we trail in a lot of key care areas. The most depressing one being in infant mortality.

[Tourbike]

The experiences of other countries with UHC doesn't bear that out. We (the USA) has the highest cost per capita spent on health care in the westernized world. Yet we trail in a lot of key care areas. The most depressing one being in infant mortality.

 

You're incorrect. If you check the data, you'll learn that:

1. the US spends the most per capita because there are no controls on services, including defensive medicine costs, and high drug costs because we do the drug research for the entire world. For example, name the drugs that have come from Canadian research.

2. Infant mortality is not the best; true. But, drill down into the data and you'll learn that it's more of a social issue than an issue of unavailable care and resources. Unwed children having children where the mother first sees a physician when they are in labor doesn't bode well for the baby. Substance abuse is a big player in this issue also. Prenatal care is available and free in most states. You just can't pick a number without analyzing it.

3. The westen European countries manage what kind of care you get for what disease. Euthanasia is allowed in Holland.

 

Since I mentioned Canada, I hope you realize that the individual pays only a part of health cost directly; the rest comes from general taxation and the two combined are not much different than the cost in the US.

It's also interesting that Canadians come to the US in large numbers for medical care because they will not tolerate the long wait times. And, recently, the court in Quebec ordered the government to allow citizens to purchase private health insurance which had been against the law. Many people are not satisfied with the single payer system in Canada. But remember, most people are healthy and need little or no care. So, for them, the overwhelming majority, the system is good.

It isn't a simple matter to say let the government do it and quote the Democrat talking points. We need efficiency and rational delivery of care with some regulation to improve what we have. Efficiency and rationality are not hallmarks of our government processes a lot of the time.

[marcopolo]

It's also interesting that Canadians come to the US in large numbers for medical care because they will not tolerate the long wait times. And, recently, the court in Quebec ordered the government to allow citizens to purchase private health insurance which had been against the law. Many people are not satisfied with the single payer system in Canada. But remember, most people are healthy and need little or no care. So, for them, the overwhelming majority, the system is good.

 

You say Canadians come to the US in "large numbers". How do you define "large". There are over 33 million of us, BTW.

 

Principles that govern healthcare in Canada are established in law by the federal government. It is then up to individual provinces to deliver health services to their citizens that meet those legislated principles. One's provincial health card is valid in any province.

 

Many Canadians have supplementary private insurance, but it's pretty inexpensive, relatively speaking. As I said in an earlier post, my wife and I spend more at Starbucks each month than we do on our supplementary health insurance. Our supplementary insurance is available through my wife's employer, and it continues as long as she wants it after she retires.

 

Finally, you say that "many" people here are dissatisfied with the single-payer system. That's interesting, as I'm 57 and I've never run into one. That includes me who had a son in his 20s who suffered total kidney failure three years ago, but who now is healthy after two kidney transplants (first being unsuccessful). We thank our luck stars every day for our national healthcare system. Also, from articles I've read, major foreign companies consider our system a major incentive when considering whether to locate their businesses here.

 

Just one person's perspective up here. I'm not trying to convince anyone down there.

[hootowl]

Just one person's perspective up here. I'm not trying to convince anyone down there.

 

No need to convince me, I've been convinced for a long time.

Why is it that we don't have a health care system based on people's needs like every other developed (and some undeveloped) nations instead of corporate profits?

 

GLENDALE, Calif. - The family of a 17-year-old girl who died hours after her health insurer reversed a decision and said it would pay for a liver transplant plans to sue the company, their attorney said Friday.

 

Nataline Sarkisyan died Thursday at about 6 p.m. at the University of California, Los Angeles Medical Center. She had been in a vegetative state for weeks, said her mother, Hilda.

 

Attorney Mark Geragos said he plans to ask the district attorney to press murder or manslaughter charges against Cigna HealthCare in the case. The insurer “maliciously killed her” because it did not want to bear the expense of her transplant and aftercare, Geragos said.

 

Complete story here: http://www.msnbc.msn.com/id/22357873/

There are many stories similar to this.

 

Its been interesting to read the comments from people who are adament in regards to government involvement in health care.

While I'm not a fan of government, I'm less of a fan of corporations, particularly the ones who's business is health care and health insurance.

What industry has the most lobbyists' in DC, who spends the most money getting what they want from congress such as the medicare prescription drug plan??

 

The same industry hires the person who railroaded the medicare drug bill thru congress at a salary of millions of dollars/year.

 

Why do the american people put up with some fat cat CEO of an insurance corporation determining who will get what coverage?

 

The situation is a national disgrace and embarrassment

[Matts_12GS]

No need to convince me, I've been convinced for a long time.

Why is it that we don't have a health care system based on people's needs like every other developed (and some undeveloped) nations instead of corporate profits?

 

The good news is that this is still the land of opportunity. You can always start that health insurance company yourself and tend to people's needs and not worry about profits.

 

If it's really that bad here in the states, you'll have more business than you can handle and should be able to buy a fleet of HP2s giving you one for each day of the week.

 

Let me know when you get that started!

[Tourbike]

Anecdotes are a poor substitute for good data but if you like them look at these:

 

http://www.cbsnews.com/stories/2005/03/20/health/main681801.shtml?cmp=EM8705

 

http://www.city-journal.org/html/17_3_canadian_healthcare.html

 

There are many more. The US system is very good for most of us and costs more because you get more. And, large numbers = bus loads. BTW, MSNBC & NBC for that matter report thir news based on their own political agenda.

[MikeRC]

I'll agree that "News" outlets - paper, electronic and digital - are largely in the business of selling things and their stories are suspect.

 

I prefer statistics from the World Health Organization, CDC, and Stats Canada. But it seems many don't even trust them ...

 

So I'll address the two stories you linked to.

 

In one, the issue of a Canadian wanting a particular cancer chemotherapy drug was the primary issue. It was denied because the data didn't support it's use in her situation. She actually got the drug covered after an ombudsman review. The article stated "Erbitux (cetuximab) is standard treatment, covered by insurance companies—in the United States. Aucoin lives in Ontario, Canada."

 

So I decided to do a little search for US company coverage for the same treatment. Cigna has an eight page coverage position of cancers covered and not covered. Humana requires pre-authorization. Bristol-Meyers even has a patient financial assistance request form if your insurance company won't cover the drug. Anyway, you get the idea. By the way, cetuximab actually cures no-one and extends life by an average of only 1.7 months at a cost of $40,000 per treatment per the Journal of the American Medical Association.

 

The CBS story was from 2005 and the statistics were way off (as far as tax rates and percentage of provincial budget spent on health care).

 

In both stories long wait times for procedures and/or tests were the issue. But, depending on who your coverage is with in the US, those wait times can be similar on either side of the border.

 

An earlier point was about profit based medical systems being essential to innovation, discovery and development of procedures and drugs. Most of the important developments arise from work done under government and university (NIH) grants. In the US, Canada, Europe, South America, Asia, Japan and Australia. Commercial companies often the rights to the discoveries and then develop them for commercial purposes. The profit making companies are not in the business of doing "bench research" - they are in the business to develop a commercial product.

 

The health care delivery system in Canada is far from perfect. But don't make it sound like it's a disaster from a couple of anecdotes. As in Mark's case, it delivers services pretty well. Mostly in a timely manner, and serves the population well. And major diseases do not lead to personal financial ruin.

 

Mike Cassidy

[jdaniel2]

BTW, MSNBC & NBC for that matter report thir news based on their own political agenda.

 

which is why I never watch FOX!!!

[jdaniel2]

I really love this thread. And I am so happy we have members on this forum from Canada that take the time to debunk all the myths about their NHI. Thanks.

 

I'm 56 and if I'm lucky just might have a pension that lets me enjoy my retirement. But the way I see healthcare costs rising in the US and the increasing complexity of delivering that care without reduction of cost I fear my pension will largely go to paying for coverage. I am solidly in favor of National Health Insurance i.e., single-payer, because I'm convinced it is efficient, effective, proven and provides the most good for the most people. I won't vote for anyone who promises anything less. Don't try to sell me "Universal Health Care" because I see it as lipstick on a pig!

[Matts_12GS]

Good points Mike, but I have one question for everyone in the thread.

We hear a lot about wait times for care/procedures.

 

The last time I experienced any kind of wait for anything other than ER care was while I was in the military. That said, it was largely an issue of supply/demand which created those wait times. Too many patients, too few providers. That has colored my images of any kind of NHI/UHC.

 

In my most recent incident, I tweaked my knee in Sept, went to my a couple weeks later when I decided there was something wrong. So, 1 October'ish I went to see the NP in my GP's office. She agreed something was wrong and sent me for an xray (taken the next day). After review I did a month prescribed physical therapy to see if that would help the issue.

 

Mid November I went back in because I still had issues. An MRI was recommended. I held off on doing that because of travel schedules and the holidays. Come January, I did my MRI on a Sunday morning on my way to church. Thursday afternoon I was in the Orthopedist's office and two weeks later I was wheeled out of recovery after having it scoped.

 

So, the only delays I experienced were really ones that I caused... I've a PPO so I'm sure that likely has something to do with it, but are those experiencing those delays all HMO patients? Or?

 

JD2, not meant as an insult, but do you think your opinion on this is because of your point in life? At 56 your needs and short term expectations are much different than mine at 44 and ours are different from those on the low side of 40. Just curious.

[jdaniel2]

JD2, not meant as an insult, but do you think your opinion on this is because of your point in life? At 56 your needs and short term expectations are much different than mine at 44 and ours are different from those on the low side of 40. Just curious.

 

no insult taken.

 

Sure, my opinion is shaped by my stage in life. My question for you and those younger is, "do think this will be better for you when your my age?"

 

Most of my life I have enjoyed health coverage provided by my employer which was absolutely second to none. At no cost to me. But those days are rapidly coming to an end. For everyone.

 

I've watched for a long time now all the attempts to control costs. The HMOs, the PPOs, the HSA etc, etc. The consultants, consultants, consultants that come up with this years new trick to reduce cost and it just doesn't seem to work.

 

So yep, you bet, this stage of my life shapes my opinion, by what I've seen and what I think I see coming.

 

Thanks for asking. Good luck to you and yours. -JD

[MikeRC]

Matt:

 

I've got a few answers for you. Luckily I have time this week - I'm on a "flex week". Originally supposed to work 2 days but cancelled on short notice.

 

In your situation with the knee, if you had a family doctor you would get in in a week or two and go roughly the same route. If you didn't have a family doctor you would go to a walk-in clinic with a 2 to 4 hour wait. Xray immediately, physio for a while then referral to a sports medicine clinic (one to three month wait). One or two month wait for the MRI in a public facility or one week in a private facilty (cost about $500). Then about 3 months for an arthroscopy if indicated.

 

But remember this was an elective knee injury where you weren't disabled. If (for instance) the knee was "locked" due to an acute cartilage tear you would have the arthroscopy within a week. If you had an unstable knee with anterior cruciate tear you would probably have it repaired within a month of the original injury. These wait times are NOT proven to affect recovery. There is actually lots of evidence that waiting for the inflammation of the acute injury to settle improves long term recovery.

 

What if you had broken your leg and couldn't walk instead? Well, the ER wait might be pretty long depending how many other people are waiting and how sick they are. Not unlike the TV ER shows. Sometimes only an hour, sometimes 12 hours. Then you would be admitted to the hospital and booked for surgery. You would have the same surgical treatment as in any US hospital and it would probably be done within 48 hrs - again depending how long the OR Emergency list is.

 

By the way, twenty years ago you would have had the leg casted for 2 to 4 weeks and the decision to put in metal would have depended on the Xray at that point.

 

Acute gallbladder attack with fever? Admitted to hospital, painkillers. Gallbladder out in one to three days. Home.

 

Abdominal aortic aneurysm? If more then 5 cm then surgery or stent within one to two months. Is that reasonable? Sure, the aneurysm has actually been there a long time and only has a 10% chance of leaking in the next 12 months. Heck, you have a 3% chance of dying of a heart attack in 6 months. What if the aneurysm is painful or more then 6 cm? Surgery or stenting within 7 to 10 days.

 

Show up to Emerg with chest pain and an abnormal EKG but no acute evidence of heart damage? Exercise stress test and/or thallium scan within 24 hours. Surgery or stenting within 72 hours if indicated.

 

Breast lump? Mammogram within a month, biospy within a week if indicated. At the breast cancer clinic within a week. Treatment started immediately to within a month as indicated. Are those times reasonable? Probably not if you are the patient (stress etc), but the evidence is that they don't make any difference.

 

And therein lays one of my major issues with the Canadian system. You can't buy faster care without going south of the border. The national psyche is that we are all the same and that buying faster access is evil. We still allow it to some extent (like private MRI and arthroscopy services) but turn a blind eye to it if it occurs outside our borders. I would rather see a parallel “complimentary” system that employs Canadians in Canada to allow access to faster care if I feel it is worth it to me.

 

Doctors (and other health care professionals) fight very hard in the Canadian system to try to deliver the best care we can. There are limits, but the reward is that it actually works pretty well 90 to 95% of the time. Without financial ruin and with pretty good results for health, longevity and productivity.

 

Remember, the US has used the "unfair competition" claim in trade disputes with Canada arguing that we have a competitive advantage from our universal health care.

 

Mike Cassidy

[awagnon]

Most of my life I have enjoyed health coverage provided by my employer which was absolutely second to none. At no cost to me.

 

Actually it did cost you. A number of studies have shown that employers reduce wages that more than offset the cost of providing health insurance.

[hootowl]

On Tuesday April 15 PBS stations are showing a documentary about health care in several other countries.

 

Taken from the press release:

FRONTLINE teams up with T.R. Reid, a veteran foreign correspondent for The Washington Post, to find out how five other capitalist democracies--United Kingdom, Japan, Germany, Taiwan and Switzerland--deliver health care and what the United States might learn from their successes and their failures. In Sick Around the World, airing Tuesday, April 15, 2008, at 9 P.M. ET on PBS (check local listings), Reid turns up remarkable differences in how these countries handle health care--from Japan, where a night in a hospital can cost as little as $10, to Switzerland, where the president of the country tells Reid it would be a "huge scandal" if someone were to go bankrupt from medical bills.

 

Go here: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

to see a preview and get viewing times in your area (top right)

[Ken H.]

Thanks for posting that. I hope everyone watches.

[Mark K]

[snip] Canada is par, and depending on the mix, even slightly lower total tax burden that in the USA. And they have UHC, paid college education (in some providences) and more.

 

That's not so. Canada's economy is significantly more heavily taxed than ours. Their tax revenues amount to 37% of GDP versus 27% for the U.S. On the plus side, they don't have our outrageous agriculture subsidies.

[Mark K]

From the same stats.......this explains a lot to me.......young people don't need or want health insurance.....or at least they are not willing to pay for it.(My experience enforces this conclusion)

 

 

21% of the uninsured are below age 18 and 63% are under age 34.

 

 

The Uninsured by Age

 

 

 

 

......as I suspected......not as big a crises as I was lead to believe.

 

I will no longer spend any time worrying about it.

 

Have a nice day.

 

Whip

 

 

Too bad I'm so late to this party........

 

 

That was to be my response as well. I don't want to hear any uninsured numbers until they are reported as unemployment numbers are tallied, for example. Uninsured is a choice by many (myself as well for many years).

[awagnon]

On Tuesday April 15 PBS stations are showing a documentary about health care in several other countries.

 

This was an excellent show. I hope many who have contributed to this thread saw it with an open mind. Thank you for bringing this program to my attention.