I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: jollor on January 19, 2008, 02:13:33 PM
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I would love to know what everyone thinks about Universal Health Care. It's one of the issues that some of the presidential canidates are talking about right now. I would also love to hear from patients who are actually part of a universal health care system. It sounds like a wonderful idea but do you think the U.S. can manage to do it. I guess we'll see eventually depending on who wins.
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Another hot button with me! I believe single-payer Universal Health Care is the way, the truth, and the light to put it mildly. We have a chance to get it here in Colorado. There are five health care proposals here that are going to presented to the state legislature and single-payer is one of them - the only one that saves money and covers everybody as stated by this Lewin Group that was given the task of analyzing all the proposals.
Rather than go into it further, I can provide a link that answers a lot of questions:
http://www.pnhp.org/facts/singlepayer_faq.php
The above site also has articles from all over the country:
http://www.pnhp.org/news/articles_of_interest.php
This might get a rise, but Dennis Kucinich is the only presidential candidate I believe has the right idea for health care.
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I agree that the situation for universal public healthcare in the U.S. looks pretty bleak. I had to leave the United States and move to a country with socialized medicine because I could not survive financially in America, given my pre-existing medical conditions, so I keep a careful watch on U.S. politics to see whether there will ever be any chance for me to return to my homeland. Kuchinich has no chance of getting the nomination, and so if a candidate with a progressive healthcare plan is to be elected at all, it would have to be Hilary Clinton, whose plan is pitifully inadequate.
Any country which tells people with serious medical conditions that they will have to remain poor all their lives, no matter how hard they work and how much money they make, either because government healthcare benefits will be reduced according to their wealth, or they will be thrown to the sharks known as the private insurers, or left to pay for their healthcare privately (the four months I was having intensive treatment in Britain when I was first diagnosed with renal failure cost the British National Healthcare Systme nearly one million dollars, so how could I have paid for that privately?), essentially creates a new class of slaves, who are, after all, just people who cannot profit financially from their own labor. Not wanting to be a slave just because of some unfortunate genetic accidents in my composition, I had to flee the U.S. for Canada, just as people with Black genes had to flee the U.S. for Canada 150 years ago to attain a status where they could benefit from the income generated by their own hard work. I can't see any difference between the cruelties of the two systems.
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Single payer health system is the only way to go if we want coverage for everyone in the United States.
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Well it would be good for people that can not afford it, and it is needed..However even if a democrat gets in the Republicans wont let them pass it. But i'd really like to hear from the people on hear that live in Canada and other places that have universal healthcare do if you get it , how is it?? IS it good? Work for dialysis patients??
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I fully support Universal Health care and will be voting for a candidate that supports it as well. This allows someone like me who is still young and single to be able to afford other things that would allow me to step forward and make a life for myself. It's difficult to be able to afford mortgage payments and such when the majority of the money that comes in is going to pay for my health care bill. And with the way things are looking, I'll be penalized even MORE if I choose to marry and start my own family. I've been told that many politicians believe that universal health care is a socialist act and therefore we as Americans should not support it. However, with that said, I also see that there are MANY parts of the American society that follow a socialist format. Examples include the public school system and the law enforcement systems. I just don't understand how universal health care wouldn't HELP more than hinder.... Particularly when we've seen it work in other areas of our lives.....
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In reply to the question about how well public healthcare works, especially for dialysis patients, I have a mixed review based on having lived under three public healthcare systems, in Germany, England, and Canada. The major problem is that while people can be induced to spend a lot of money on healthcare if it is for their own benefit, the taxpaying public is highly resistant to paying for a good healthcare system which may benefit others more than them, and of course the majority of people assume they will never become seriously ill. The result of this is that while the United States spends 15% of its gross domestic product on healthcare, England spends only 7% of GDP and Canada only 10% of GDP on healthcare, and the result is that users have to 'pay' for their 'free' healthcare by tolerating longer waiting lists than would be acceptable for treatment in the U.S. In Canada as well, there is the problem that licensing rules allow Canadian physicians to practice in the U.S. with minimal formalities, so Canada is forced to pay them rates comparable with the huge salaries American physicians get, and this further wastes money on greed that should be going to save lives. In contrast, in Germany, the average doctor makes the same salary as an American high school teacher, so that measure of humanity allows for enough money to be available in that healthcare system to provide everyone with excellent care.
On balance, the public healthcare systems, despite their problems, are better, since no one has to live with the worry that some catastrophic illness, such as dialysis, will destroy them financially at the very moment they are most vulnerable because of the onset of a terrible disease. Because I live under a public healthcare system, I have no forms to fill out, no plans to sign up for, no financial calculations to make in relation to my healthcare as a patient with endstage renal disease. All I have to do for all the medical care I need is to show my little plastic healthcare card that I received for free from the government and that is all the formality there is to it, which is a great relief when there is so much else to cope with.
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It sounds like those Canadian doctors have it great! If I recall correctly, they also don't get saddled with the huge education bills U.S doctors do. But as you say, the Canadians do have the problem of waiting times - mostly for elective procedures though from what I hear. However I read it wasn't the U.S. that had the shortest waiting times: according to a Commonwealth study it was Germany winning three out of four categories (we didn't win the fourth by the way):
http://www.commonwealthfund.org/snapshotscharts/snapshotscharts_show.htm?doc_id=409110
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Universal Health Care is a great idea and would be wonderful if it could work for every American but how do you keep it fair and how do you pay for it? Its not altogether certain that working Americans who've payed mucho dinero into existing programs like Social Security and Medicare will ever see the benefits they were promised and payed for. I would want to see whats been promised and payed for safe and secure first before thinking about creating new or expanding other programs.
The United States has some of the world's most porous borders and coupled with birthright citizenship we are currently in the midst of an unparalleled demographic disaster. Universal Healthcare would add yet another inducement to jump our borders and hop aboard the American gravy train at the expense of every American.
How also do you pay for massive new benefits when government continues to spend like a drunken sailor on expensive wars that are without purpose or end? It seems that our government's priorities are pretty clear. Purposeless destruction and killing are at the top of their list.
We are either in or near to being in a recession. We are also a debtor nation depending on nations like China, Japan, those of the EU, and others to keep us financially afloat. We're bankrupt already. The money isn't there kids. We can't do it. And don't think about asking for more in taxes because they can't have it.
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Livecam!! Good to see you have found a new internet home! I remember our days at DialysisEthics - sort of like the wild west at times with some bang-bang shoot-em up when disagreeable types would show up; I remember you as one of the good ones.
Anyway, to get back to your question about where the money would come from; as Dennis Kucinich is fond of saying: "We are already paying for Single-payer Universal Health Care - we are just not getting it!" ~30% of our health care dollars is going to administration due to the insurance companies and all the people who have to deal with them; if more of that money was actually going to health care - from what I've been reading - we would have more than enough to cover everybody. I'll post some links later, but I've only got time for a drive-by right now.
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I don't think we would all benefit from a Universal Health Care system, unfortunately. I also don't think people who come to our country uninvited and against the law should receive ANY health care period of any kind in America. I guess I'm cruel like that, but that I how I feel about it all.
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Angela515,
I understand your skepticism, it took me awhile to believe it too. But about the only ones I'm seeing that wouldn't benefit from a Single-payer Universal Health Care system are the private insurance companies - who are basically middle men trying to keep as much of the health care dollar for themselves anyway, so who needs them. About every other civilized nation has Universal coverage and they pay less, and most have better health stats.
I also understand your concerns about illegal immigration, it is definitely a gray area for me. Many of the illegal immigrants are hardworking people just trying to feed their families - but they are here illegally. Anyway the way I see it, with single-payer it looks to me they would be paying into the system if they are on the books, if they aren't on the books an employer could be fined further for not paying into the medical system - just a thought.
Livecam,
Here are those administration costs I promised:
"Private insurers take, on average, 13% of premium dollars for overhead and profit. Overhead/profits are even higher, about 30%, in big managed care plans like U.S. Healthcare. In contrast, overhead consumes less than 2% of funds in the fee-for-service Medicare program, and less than 1% in Canada’s program."
http://www.pnhp.org/facts/why_the_us_needs_a_single_payer_health_system.php
"After analyzing the costs of insurers, employers, doctors, hospitals, nursing homes and home-care agencies in both the U.S. and Canada, they found that administration consumes 31.0 percent of U.S. health spending, double the proportion of Canada (16.7 percent)."
http://www.pnhp.org/single_payer_resources/administrative_waste_consumes_31_percent_of_health_spending.php
And as an added bonus here is a link to an organization I belong to - Health Care for all Colorado:
http://www.healthcareforallcolorado.org/
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Plugger..good to see you too! What became of dialysisethics and Arlene anyway? The site just seemed to fade away. Welcome here Plugger!
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Regarding universal health care, I'll use this analogy.
Let's say there is a pie to be divided in equal portions
Using a hypothetical figure, there are 10 people who
each receive an equal portion of the pie. When the
next pie arrives to be divided in equal portions, the are
100 people who will each receive an equal portion.
Obviously each person is going to receive a smaller portion
of the pie or some people will receive a smaller portion of
the pie than the others.
The only way each person could continue to receive an
equal portion of pie is to make the pie larger.
Now , the question is how large can a pie be made?
The pie in this case is the budget for health care costs.
If everybody would do the math on this subject, they
should be able to come to a logical conclusion.
The answer is the quantity and quality of health care
each person would receive would be less than what they
currently receive.
A few years ago, I met a Canadian man at the county
hospital where I live and he told me that he came here to
the U.S. to receive further necessary medical treatment that
the Canadian health care system (same as universal
health care) would not give to him.
He had a fractured skull and the Canadian doctors basically gave
him medication and sewed closed the open wound on head.
They then released him from the hospital even after he complained
of headaches an a lack of equalibrium.
So I'll let you people decide if universal health care is appropriate for you.
I would not want at all.
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There are many stories around about universal health care in countries like Canada and England that aren't terribly positive. They usually revolve around the subjects of substandard care and impossibly long waits for elective surgery and other procedures.
If I was going to offer up a cure for our problems here I would be looking more at draconian regulation of existing insurance companies and other providers by the federal government. They would be required to meet certain standards of service, couldn't redlist patients because of exising medical conditions, and their profits would be limited to a certain fair and reasonable amount.
We have a system in place that could work much better than it does now. Rather than tearing it down maybe an extensive renovation would work better.
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Well say Stuff and Highlite.
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Well I have universal health care.... its hard for me to imagine how healthcare is something that you pay out of pocket for, I had health insurance for years but about 5 years ago, I moved "back home" opened a little business, and the health insurance went by the weigh side.
Fastforward 4 years and I now have kidney failure and no insurance.... I would have no idea who has insurance in my dialysis unit, and who doesn't. It makes no difference in getting a transplant, because even the expensive drugs that I will need afterwards are covered (Kidney Foundation)
There is many things that are not working in Canada, wait times and so forth, but there is many things that are. We do not think twice about taking our kids to the doctor, I would assume that many things are prevented. I think in a perfect world you would be able to have our system for the poorer people and those that can pay wold have that choice, but we all know that the ones that pay the most would have the best doctors , hospitals etc...
Its a tough question, but I think I will take the Canadian way.
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There are many stories around about universal health care in countries like Canada and England that aren't terribly positive. They usually revolve around the subjects of substandard care and impossibly long waits for elective surgery and other procedures.
If I was going to offer up a cure for our problems here I would be looking more at draconian regulation of existing insurance companies and other providers by the federal government. They would be required to meet certain standards of service, couldn't redlist patients because of exising medical conditions, and their profits would be limited to a certain fair and reasonable amount.
We have a system in place that could work much better than it does now. Rather than tearing it down maybe an extensive renovation would work better.
I think putting limitations would work to a certain extent. However, insurance is a business...and the primary purpose of a business is to maximize income. They'd find ways around it all.... I'm sure universal health care wouldn't solve this country's problems, but I do know that it would be a great start. People who can't afford health care are already receiving substandard care and long waits. It couldn't be worse than it is now..... I truly believe that if we prioritize the goals in our budget, it can be worked out.... It just takes a politician who is willing to undergo the change and initiate.....
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The important point is that there are some healthcare systems at least which are public and universal and have very short waiting times for treatment and excellent standards of care -- such as is the case in France and Germany, where this is possible largely because the government limits doctors' incomes to the extent necessary that enough doctors can be hired for all the patients who need them.
In the United States, because the country is paying 15% of GNP to cover the healthcare costs of only 86% of the population, the cost to cover everyone would be about 17.4% GNP. Canada and England, with their coverage for everyone, spend 10% GNP and 7% GNP respectively, meaning they spend very much less per capita than the U.S. does. This and this alone is what accounts for the shorter wait times and better treatment in the U.S., not the fact that the U.S. is capitalist and other countries have socialist medicine.
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I love Universal Health Care - at least we call it the National Health Service. That is what we have in my country, Barbados. I am always amazed when I see or hear the prices that people pay for health care in the States and the horror stories of people being turned away or left to die because they don't have health insurance.
In my country, you have a choice. If you are a citizen or legal resident (you must have your ID card) you can go to the Health Clinics or the General Hospital and everything is free, if you want. However, you can choose to go to a private doctor. Of course the disadvantage with the public treatment is that you cannot choose which doctor attends to you, and the lines are longer. Medication, even if prescribed by a private doctor, is free from birth until 16, from 65, and for anyone with chronic illnesses - diabetes, high BP, asthma, cancer, etc. the only condition is that the doctor prescribes a medicine that is in our drug formulary which is regularly updated.
When I was diagnosed with breast cancer I was seeing a private doctor. After the operation, when I had to come for regular visits and tests, one of the nurses told me to tell the doctor that i wanted to be changed to a public patient. she assured me that the care would be no different. I did that and everything continued the same, only I was not paying $60 every time i came.
I always found it hard to understand the cost of health care in the US. We get our machines and supplies from the States and yet a dialysis session in any Caribbean island costs 3 to 5 times less. How do you explain that? And our equipment is new. Ask Livecam about our machines.
The only other thing is that we pay a health levy from our salaries - 1%, i think.
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As Plugger has commentedthat if the USA is spending 15% of its GNP on healthcare then you are being ripped off. If Britain can provide using only 7% of GNP a National Health Service free to all then what is the US doing with the money? I also think that Stauphenburg's comnents about as he calls it social medicine is not truly accurate as regards Britain. I know that he had a particular bad experience at Hammersmith hospital London and I think that that may be colouring his views. The National Health Service in Britain or the NHS as it is now called does have many drawbacks but the waiting times Stauphenberg talks of have been reduced drastically in the last few years since he was in Britain. I believe that our NHS in spite of all its flaws is a national treasure. A medical health system which is available to all on the basis on need not wallet size is the only decent and moral optoin in a civilised society. I can't understand why American citizens are not howling at their politicians from the rooftops in persuit universal healthcare.
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I entirely agree with you, Ken, that the NHS is better by far than any private healthcare system, since it is worth putting up with the deficiencies of an underfunded public system just for the sake of not having to deal with financial worries piled on top of medical worries, which is what the patient has to endure in the U.S.
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I went to a single-payer Universal Health Care march and rally at the state capitol in Denver last week. The state 208 commission that was looking at different health care proposals wimped out as expected and is proposing insurance mandates - good idea, give more power and money to the insurance companies who are creating the problem! A bright spot was some of our politicians are willing to put their careers on the line and it sounds like they are working on drafting a bill.
Anyway, you can read about our rally at the following website :
http://www.healthcareforallcolorado.org/
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The bottom line is GREED! The United States is run on Greed!
The insurance companies in my mind bring the bills DOWN! For a 45 minute procedure the hospital charges $12,000. My insurance allows $3,000 and that is what they get. What the hell kind of game is that? "Negotiated Savings"
I have private insurance and I get no priority for having it. I wait in line with the rest of the uninsured. Why? "Because we have to treat everyone alike"
OK! Why don't I just drop my health insurance and save myself some money? It makes no difference, I get the same treatment!
This is what needs to happen. We need a price list for everything right down to the band-aid. We need a price list for every procedure and have a panel of regular people (including myself) to decide what these outrageous prices should really be. What does Canada charge for the same procedure etc??
Our US docs aren't going anywhere! There is no where to go! They will stay right here and instead of making $600K they will make $200K. sniff
Greed has taken over this country. You can call it a recession if you want to, but the housing crash is due to greed. Everyone is blaming the lenders, but I blame the greedy Realtors who are LONG gone with their millions!
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Got it. Love it.
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Got it, love it, can't imagine life without it :)
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The German Health Ministry publishes a book just like Rerun describes, in which every single procedure a doctor could conceivably perform is itemized and the legal price for it is set. The doctor does that work as set out in the book and gets paid that amount from the government. The fee schedule is generous but does not fuel the monopolistic greed system of American doctors, with the result that German doctors earn about as much as American high school teachers, and yet German medical schools are still highly competitive to get into and overflowing with applicants. (The highest grade in Germany is a 1 and the lowest is a 4: to get into medical school, your average has to be around 1.3.) If high school teacher pay is all it takes to induce people to spend seven years getting a German MD (compared to 4 years undergraduate plus 3 years medical school in the U.S.), then why pay doctors ten times more than that as we do in the U.S., where it is doctors' salaries that most contribute to making universal health care unaffordable?
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I see that I'm one of the few in opposition to Universal Health Care and I'll probably get off topic....but while I believe every legal US citizen should be entitled to receive health care, I don't believe we have a government capable of running a Universal plan that would be adequate and affordable. In spite of stories we hear, I've never known anyone in real need of medical care to be turned away. I'm as concerned as most when it comes to how we're going to pay our out-of-pocket expenses, but believe all but the poorest of the poor should have to pay at least a small co-payment. I have a couple close family members who receive excellent health care at absolutely no cost because of their individual situations. Others I know, myself included, have received reductions from hospitals or in some cases, complete forgiveness of balances based on household income. Doctors are harder to deal with but there are sliding scale practices. I also know people who make a personal decision to not buy health care even though they could afford the premium. I wish I could take our monthly premiums and spend them elsewhere, but I know I can't. Mrs. Clinton has already said everyone will be forced to pay a premium under her universal plan, including garnishing wages if necessary! That will go over in a big way. I don't know what caused our health care system to get so out of control. When my children were small (in the mid and late 60's), our family doc who practiced out of his home with his RN wife, would have no part of insurance paperwork. I've forgotten alot of my history, but believe that was right after the beginning of our Medicare system. Our children only saw the dr when they had sore throats w/high fevers or a minor accident. His charges went up over the years from $4 a visit to $12 but this included all medicine. I don't remember ever going to a drug store until in the 80's after he retired. He delivered my first 3 children, charging $100 each time. My first was delivered in his office at his suggestion. He cancelled his Sunday fishing trip to spend Sunday with me in labor. We were 18 and 21 years old, had no insurance, and he told us "you don't want to start out owing a big hospital bill". He diagnosed me in 1980 with glomerularnephritis and referred me to a nephrologist and retired in the early 80's. Today most children see a dr with every sniffle, etc., and many are prescribed meds whether they need them or not. Parents demand it. Most practices have several drs, a multitude of nursing assistants, and administrative personnel on site, as well as separate billing offices. Insurance companies are huge paper pushers, second guessing doctor's decisions, making large profits, etc. I know the doctors of today would never go back to solo, cash only, patient friendly, competitively run practices, but this would be a step in the right direction. I hope our government thinks long and hard before implementing a Universal Health Plan. But if they do, it'll be a first for them!
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The advantage of the single payer healthcare system, when that single payer is the government, is that the government, acting for the people, gets to tell the medical profession, the private hospitals, and the drug companies how the system is run, because the government can mandate their cooperation by law. Under the present system, where the power of the people is not concentrated into the single fist of the government but scattered among 300 million individuals, the doctors, private hospitals, and drug companies are more powerful than the people and can dictate the terms of healthcare delivery to them.
For example, under the British National Health System, you register with a General Practitioner who has to provide the first line of defense for you if you have some sudden emergency. He has to team up with other doctors to provide 24/7 coverage for you when you need it, and yes, they even make housecalls! Do you think British doctors want to have to live like this? Of course not: but because in Britain the people banded together in the form of the government to tell the doctors what type of healthcare they HAD to provide, the doctors had no alternative but to practice medicine for the benefit of the people rather than in service of their own selfish interests.
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In your usual articulate way you hit the nail right on the head Stauphenberg :thumbup;
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As far as I can find the United States is the only industrial nation that does not offer health care to its citizens. And, I noted a comment about people not being turned away for health care. Well, my daughter works with the mentally handicapped population and her clients are not only turned away, but if they get in the hospital for an issue they are immediately discharged to the street or to a waiting taxi with lots of times no where to go except to the homeless shelter. Now, that is not taking care of our citizens.
The government probably and most likely is not capable of administering a health care system - but that doesn't mean we should give up on the idea because of our politicians running D.C.
Lots of times where I live only the people with private insurance get to have what they need. One of my friends could not get the necessary heart care because she did not have insurance. And, for example, if you are on medicare and get a transplant, medicare will only pay for the transplant meds for 3 years. Whats with that? You need the meds for the life of the kidney or other donated organ. Come on. And the current President has proposed a budget to cut our domestic programs????? What's with that?
Lots of discussion on this particular subject.
Sandyb
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Come on. And the current President has proposed a budget to cut our domestic programs????? What's with that?
All the more to squander on his senseless wars in Iraq and Afghanistan. You asked!
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Well, I did know the answer but I was afeared of posting an anti-war message....... ;D
I do know where a lot of the money goes and lots of times I wish I was a little less informed than I am. I try to give up current events but I've failed at my efforts every time. ;D
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I've been following the US primaries and didn't Hillary Clinton mention Universal Health Care. Is it going to be a big part of her campain or do you think she'll bottle it so as not to upset middle class Americans?
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The government probably and most likely is not capable of administering a health care system - but that doesn't mean we should give up on the idea because of our politicians running D.C.
More to the point the government could not handle running a system at all.
Want to see how the government runs a health care system just look at the VA and that will give a good idea on how they would run the system.