US health care: waiting for Godot

You can't count on defenders of US health care for much, but you can always count on them to allege that in Canada and other "socialized health care" systems there are long waits for elective surgery. Wait times for a hip replacement in Canada have been alleged as long as 6 months, although I don't know if that is generally true or not. Whatever the wait times, most Canadians seem satisfied. From Statistics Canada:

The results for 2005 indicate that waiting for care remains the number one barrier for those having difficulties accessing care. Median waiting times for all specialized services have remained relatively stable between 2003 and 2005 at 3 to 4 weeks, depending on the type of care. There were some differences noted in selected provinces. Most individuals continue to report that they received care within 3 months.

Similarly, patients' views about waiting for care have remained fairly stable between 2003 and 2005. While 70 to 80 percent indicated that their waiting time was acceptable - there continues to be a proportion of Canadians who feel they are waiting an unacceptably long time for care. (Statistics Canada)

Three to four weeks is not instantly, but just try to get an appointment with a dermatologist in Boston or an ophthalmologist in Chicago. That can take 3 to four months even if you have good health insurance. That's because medical care is rationed in the US by lack of doctors or lack of money. If you don't have health insurance, well . . .

Adults with no health insurance face waits up to a year or longer for gallbladder or hernia surgery in Los Angeles County, a backlog that community clinic doctors say has worsened since the county downsized Martin Luther King Jr.-Harbor Hospital last year.

The elimination of most specialty care at King-Harbor, formerly known as King/Drew, has hit Harbor-UCLA Medical Center near Torrance the hardest, the doctors say. As the county-owned hospital closest to King-Harbor, it absorbed the bulk of that facility's displaced patients.

Community clinics rely on five county-owned hospitals to provide virtually all specialty care, including hernia and gallbladder surgery, for their uninsured patients.

With a quarter of the county's adult population lacking insurance, patients have always had to wait a long time. But delays are growing longer as the population ages and suffers complications from such chronic conditions as diabetes and obesity.

Still, clinic doctors were stunned earlier this month when Harbor-UCLA told them not to send any more nonemergency gallstone, hernia, orthopedic or neurosurgery patients until hospital physicians worked through the yearlong backlog for these surgeries.

"The bottom line is there's still a year's wait," said Dr. Karen Lamp, medical director for the Venice Family Clinic.(LA Times)

Gallstones or hernias are not usually emergencies (although they can lead to emergencies), but living with them can be painful, uncomfortable and risky. A blocked common bile duct or intestinal obstruction are emergencies and they are possible consequences of unattended gallstones and hernias.

So whether there is a longer wait time in Canada or the US depends upon who is in line. As Moore has pointed out, we make the lines shorter in the US by eliminating 44 million of our fellow citizens. Is that a health care system to be proud of?

Or a country to be proud of, for that matter?

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For those who believe the lobbyists...come to Canada...go top a hospital...and note the differences for yourself.

Most would say that universal healthcare is our proudest achievement even if it is not perfect.

Thanks for writing this because it's important for Americans to understand that tens of millions are waiting - forever - since they are denied care or don't seek it due to its unaffordablity or inability to access it.

Overall, I'm disappointed that the progressive blogosphere doesn't support healthcare blogs with more readership, attention and responsiveness. Sure, there's the usual complaining and agreeing that healthcare is a problem. But then, progressives go right back to dissecting the political scandal du jour. They are sensation junkies just as surely as the MSM caters to Hollywood sensation to garner entertainment sensation junkies.

Healthcare blogging is more akin to fresh vegetables - colorful, full of texture and good for you, but not exciting and sinful, as is rich chocolate and a 4 patty heart attack on a bun.

Or you can go to Boston where it doesnt seem to be working with the assertion being that its because the insurance companies are in charge.

Tom you and Revere I respect very much but when a system, a UHC system threatens to prosecute someone who has a suspected brain tumor for going to a private care physician that confirms the diagnosis then there is something that is wrong. In addition, when confronted with the problem the answer by the politicos of Canada they tried to make it non-elective, "YOU WILL PARTICIPATE." Seems that we have heard that before.... 1772 Boston, 1773 New York.

We are not little kids and this as I said before may work partially or mostly under the Canadian political system, but it wont here. It will destroy this country in under a decade. Healthcare at all costs insinuates that this is a right. It is not. It is a service and one that has to be paid for by someone.

Generally the people who can afford something are being asked/told that they have to pay for someone who cant. That makes it a taking under US law and its dead on arrival into the Senate as a result. Social Security used to be an elective too. Now if you dont pay it, you go to jail. Lets see, um I believe that was another lefty/lib/Dem trick. Only three Republicans I think voted for that when it came into being.

My dentist said that under TennCare he would have to go totally private practice to avoid the patients that would come in. No money in it and even if he joined a negotiated single payer group it wouldnt pay the bills. He said that he wouldnt be able to survive under it financially. I havent spoken to my primary care physician but their views are on record as they were voted the best doctors in Shelby County and that is that we are private practice and wont take TennCare or CoverTennessee. Emergency patients will be seen always.

Mass. just put it in and its a repeat of a broken record playing. The response of Revere was that they need to raise taxes (sounds familiar). The crush of people entering the system has already bankrupted it (sounds more familiar). The assertion is that there isnt enough money because of Iraq (they used the war on terror here as an excuse, but the noise is getting louder). Then as the monetary intake was far exceeded by the money outlays the number of providers left the system and the docs holding the bag. Then the docs all started pulling out of the system entirely (Sounds very familiar).

The answer in Tennessee was to try to implement a state income tax to pay for it. Why? Because someone who had access to health care and not health insurance pushed for it and indicated that they werent being afforded the same rights by the ....government? Fastest way to get into a big debate here is to bring it up. No, I'll pass on UHC even if I am on life support.

Remember, the government can now after you exceed your input into the SS system/Medicare take your home and assets after your death for repayment of the difference. How very nice. You work all you life as a tax slave and then they come in and take your slave house.

So for cradle to the grave it ensures that government gets complete and total control and you just become a number, a tax payer for the benefit of the government. The South is too poor to afford it as they will have to kick in what will likely be the majority of each states budget. To get rid of it will be like taking one of your kidneys out with a claw hammer. Nope...it wont and hasnt worked yet and the answer is always to either ration, or raise taxes. Broken record from the bleeding heart liberals.

With all due respect.

By M. Randolph Kruger (not verified) on 26 Jul 2007 #permalink

Randy: The Mass plan has barely started. It is based on private health insurers, so, in my opioin bound to fail. But you don't seem to realize you already are paying as a portion of your health insurance goes to the "free care" pool for the uninsured. So it's already happening. When someone without insurance goes to the ED for an emergency, who do you think pays? You do.

I am old enough to remember the AMA saying that with Medicare we will see the end of the US as we know it and before that it was Social Security. Now it is UHC. If our society is that fragile (which it isn't) it wouldn't deserve to survive. But we will. We are even surviving the colossal waste of our military expenditures that benefit no one except defense contractors.

With all due Revere, thats another one of those reverse posturings. Without the military of the US, we wouldnt be here and we wont if we go back to the days of Gimme Jimmy Carter. Lets watch across the next two years as the real weight of the Mass plan goes to the providers.

You want a government takeover of healthcare. I think it will be the biggest blunder in American history and I am not kidding, the South is going to let themselves be heard on it. Dixiecrats are coming out in every state house and its not on the side of the libs. They see financial disaster and a socialist state emerging. Each time we have done a 'Great Society" program it has cost us in the long run in ever running deficits and fiscal irresponsibility.

The free care pool here at least is not free. You freely admit that someone else pays for it someplace else. The County and State force Arkansas and Mississippi to kick in for their indigent care for those who are driven/flown in for emergencies. NO one is denied healthcare in those three states...period. They are either on Medicare/Medicaid or CoverTennessee. If someone is brought in and they dont have a job, or whatever they are seen. They do load up the emergency rooms though because so many are refusing to take that card unless its American Express. This is my point in entirety. It is a service. Not a right under our laws and Constitution. BUT no one is denied care. They just have to wait their turn when they cant pay for it. The docs here all donate time to the Memphis Interfaith system and everyone gets seen. Maybe not on the non productive citizens schedule that is on rent/food and healthcare assistance, but they do get seen. The also are not denied any procedures that I am aware of. But they do have to wait their turn. They also have access in every county to the county health department and they see patients every day. Thats in those three states. So as you say free health care to some is already here for some, but at someone elses expense.

By M. Randolph Kruger (not verified) on 26 Jul 2007 #permalink

Randy

You need to visit or comment on more than 2 countries. The lack of circumspection in these arguments astounds me.

The US does not need to bankrupt itself to pay for what Americans either call Universal Care or Socialized medicine depending on their viewpoint. Stop repeating the canard that 'taxes will have to rise' without also ackowledging that at the same time you won't have to pay excessive amounts of your income into insurance plans. The US healthcare system is a worldwide example of what not to do as it is both the most expensive and least efficient.

Your 'system' is about 1.5-2 times as expensive in terms of percentage of GDP as any other country in the world and yet delivers measurably less.

Caring whether you pay for healthcare through the government or through the private sector smacks of ideological entrenchment. The utilitarian interpretation clearly favours healthcare for all provided by non-profit means. It delivers better healthcare to the most people at the least cost.

'Socialized' is not a dirty word in the rest of the world. All of the humane systems in the world have massive problems but we can all look to the US and remark on how lucky we are on balance.

Randy: Your opinion about the military. Just an opinion. Not mine. I don't want a government take over of health care. I want government financed health care. I have no problem with being allowed to purchase health care if you can afford it. There is no such thing as free health care. All health care is paid for by someone. Just like the military. It isn't free either. I want to pay for the protection of people at home in the same way we pay for interfering with the lives of other people abroad. You don't seem to understand that health care protects everyone. It is a public good. Just like police and fire and education.

Randolph

Healthcare is an issue everywhere because, in my opinion, new technologies that often are 'solutions looking for a problem', that also happened to be overpriced...are foisted on our heathcare system by skilled manipulators.

There is more money to be made by lobbying in the healthcare system then by providing healthcare in the healthcare system.

I very much appreciated the healthcare I recieved in the 19780's and 80's...I did not feel that I missed anything.

Often today, life is extended minimally, quality of life is not...period.

Like the doctor said...'you won't live longer, it will just seem like you lived longer'.

I don't know where you heard the information but I can come across the border anytime I want and get healthcare...if I can afford it. Many Canadians are now going to India for joint replacements at affordable prices because they don't want to wait months for the surgery.

I think that you deserve the peace of mind that a universal healthcare system provides and I think we all deserve universal pharmaceutical coverage as well at affordable prices...

...the way we do that is by paying for others to be treated when you are young and healthy so that the less fortunate, which can be you in the split second of a car accident through no fault of your own...

...I can't think of a better present to US citizens...it just takes one representative with the 'balls' to do it...this happened for us in Canada in the early 1960's by a man called Tommy Douglas.

Last year in Canada, Tommy Douglas, the socialist minister from the prairies was voted the most important Canadian in history over many Prime Ministers etc.

Your day is coming, I hope sooner rather than later...it just takes one person with the courage of their convictions.

MRK: Let's talk about the insured. Some are being forced into bankruptcy, and many are going without needed services due to copays and deductibles, and at least 18,000 OF YOUR FELLOW CITIZENS are dying each year with the current system. The insurance plans with the "donut" where the patient pays all costs after a certain amount, then the insurance kicks back in after several thousand dollars out-of-pocket, keeps people from getting prescriptions and other health care they or their family members need. I know this because my recent job for over two years was with an insurance company, talking to people all over the country about their chronic diseases. It not just about the uninsured.
Also, many who work in the health field are finding the situation untenable, leaving hospitals under-staffed and our most gifted and caring health care professionals choosing other work. I am an example of this. I am still trying to recover from the stress of trying to help real people while working for an American health insurance company.
Have you seen Sicko yet? Seriously, I'm hoping you do because it would be good to discuss it with you.

We ALL pay for the uninsured. Our hospitals and clinics are full of them. The only way to save the cost is to refuse to treat those who cannot pay, or to make sure that they are covered. They are also less healthy and need more expensive care. All healthcare in the US is already rationed...just not rationally.
If you get a new job, you often have to wait 90 days to get insurance...if you don't get fired first. Many employers avoid keeping people long enough to get them covered.
I could go on and on, but wait times are plenty long in the US, and we are all paying for universal health care (no one gets turned away) whether we like it or not.

Even the insured are hurting and in a sense being "turned away". With the falling wages many people are facing, and increased costs of basics like electricity, food, and gas, the working insured postpone needed health services because of copays. It is truly sad that the discussion has to focus on the hardships of the insured in order to get this country's citizens to pay attention. It should be enough that people are dying needlessly. It is a lie that no one gets turned away. Does a woman get a mammogram for free? No, she will be "turned away" unless she pays or her insurance pays.

When my wife had a gallstone attack around 1990, she was whisked into a Vancouver hospital at once. If anything, she was treated too quickly, before she'd recovered from the attack, and she spent ten days in a very good hospital before being released.

Ten years later it was my turn, and I was told it would be a year or so after my attack before I could be dealt with. In fact it was more like six months, and I spent just one night in hospital. Gall-bladder removal had improved greatly since 1990, and they would have sent me home the same day except for some mild bleeding they wanted to look after.

Call it anecdotal evidence, but my family's 40 years' experience with the Canadian healthcare system has been a very happy one--from childbirth (cost: $35) to various accidents and then to the inevitable problems of aging. One reason why we Canadians seem so dull and laid-back to Americans is that we're not worrying about how to pay the medical bills--whether it's a soccer-playing child's dislocated knee or a mother's chemotherapy.

And emergency gallbladder surgery is likely to be open surgery. This means not only a much longer recovery for the patient, but a much larger bill, due to the week or more hospital stay required. Non-emergency (semi-elective) gallbladder removal is generally done laproscopically, and without complications, you can go home the same day.

Chances are good that a person without insurance will default on a bill for tens of thousands of dollars, an amount made even larger by the accounting that charges non-insured people more than for the same procedures. And then everyone else, through taxes or higher charges, absorbs that cost.

The American health care system is more than just inhumane. It's a classic example of penny wise, pound foolish.

Randy -

I'm uninsured. Were it not for the fact that I visited the ER a few years ago (not my only visit, just the very worse) I would not be here today, and social security would be supporting my fatherless child. The cost of that visit, before it was through, was over six grand. The cost, had I been able to see a doctor and had it dealt with, would have been around three hundred dollars and I wouldn't have lost almost three weeks of work, that I couldn't afford to lose.

So instead of seeing a doctor and getting it dealt with for far less, thousands of dollars more were wasted and I had to sling a bunch of marijuana to make up for the lost time at work, risking my freedom and my family in the process. Of course, I could have avoided that and gotten our utilities shut off and ended up homeless, but instead, I called in some favors from a less savory time in my life, took a risk and kept my family sheltered.

I'm doing a lot better now and it gets better every day. I'm almost to the point of getting an HSA, if I had to, I could afford to pay for a doctor visit. If I get a contract that I'm shooting for, I will be in an even higher tax bracket. You know what? I'm more than happy to pay it. Even though it's likely that under UHC, I'll be one of those lucky enough to avoid using it, I'll happily pay. Because I'm going to pay for it anyways, I would love it if it actually worked and provided reasonable care. UHC is more efficient than the status quo, which screws people with insurance, nearly as much as it screwed me - in some cases more.

I waited almost a year for my cholecystectomy (what the staff in the hospital called a "lap chole"), but on the other hand, I was younger and in better health than the average gallbladder patient (if someone figures that out, let me know). On the third hand, my surgeon told me specifically that if I started having problems I couldn't cope with, to call him directly and he'd meet me in the Emerg and put me in surgery right then...

I'm quite happy with my OHIP, but I also live in a city with not one but two teaching hospitals, and not in a rural area or in one of the places with the severe doctor shortages. (I attribute a lot of Ontario's problem with this to the neocon former Premier who deregulated medical school tuition, making doctoring a profession only trust-fund babies with altruistic streaks want to go into anymore. That cuts down on the candidate pool quite a bit, since almost no one wants to be $150 000 in debt when they start out, no matter what doctors' salaries are...)

By Interrobang (not verified) on 26 Jul 2007 #permalink

Peggy-I saw it and there are "some" things that are incorrect about it but not many. We do have a crisis here and it relates to costs and that is from inflated pricing for everything. We send pills to Canada, Germany, France at a cost we cant even buy them for here.

Regardless of what Revere says IMO this wll do us. I hear everyones complaints and yes I feel the problems you are having with your various states. But healthcare is NOT a federal problem, it belongs to each state to handle. The Federal Government is there to assist but not run healthcare. Thats pretty much how its done by law now and the reason that MA wasnt able to make it mandatory. The second they do its an automatic slam dunk by the courts. It is a service, plain and simple.

Every state has at least the equivalent of Medicaid and some have better. Do we pay more? Yep, no doubt about it. Fastest way to get it to drop is to create a maximum amount you can sue for. We have to have every damned test out there to make sure a doc doesnt get sued. Next is Peggy you have to understand that the doctors will bail out of the system. Just as they did here in Tennessee. By the time TennCare was dumped there were only 1000 doctors and 11 hospitals that would take it. It was a money commode. You drop it in, you pull the handle and you get nothing in return.

Reveres socialistic program will require more and more money from a society that will be so aged in 10 years that there is and will be no way to tax for it. They will be back to deciding likely not on health care but whether they want to eat or not. A hyperinflated economy is and will be the result. There will be nothing for defense, nothing for roads, nothing for anything but healthcare. We already know that SSecurity is going to account for every dollar taken in as taxes in 10 years and now many who arent thinking it through or dont care about the outcome want to start a whole new money pile. Its a cash flow scheme. The Dems will tax everything in sight to pay for it. That means jobs will go, the cost of living will increase and someone will finally stand up and say to hell with Michael Moore. Personally I think he is a communist opportunist and talks out both sides of his mouth. He wont debate the issue, he just makes statements and lets it ride. This is a debate we have here and I am about the only Republican here, so be nice.

You all make good and valid points. But they are based upon the one single premise and that is healthcare at all costs. Not your costs, spread risk costs. You also make an assumption that I and others want to assume your debts (incurred already by some, future ones for others). That is where the taking occurs and makes this the legal issue for the courts. They have held time and again that this kind of thing is and shall be always elective in the US and it would likely take an Act or or even an Amendment to the Constitution. It will never happen.

Yes, we are all already paying for some socialized medicine in the US. It hasnt worked out for us yet. It has been nothing more than a money pit. All told in taxes because it was a good year I paid local, state, federal almost 122,000 and frankly folks what in Hell did I get out of it? Oh, I am doing okay but I could be doing better. Its not greed in what I do, its some damned hard work and you can die very, very quickly if you screw up.

I pay 100% of my employees insurance. I am a little different than most employers of course and it ensures I get really good people. On the other hand you are looking at the high probability that all taxes would rise beyond the 50% mark and that includes retirees and people on Social Security. There isnt any other way to pay for it. The system will constantly require more and more infusions of money. It wont change a thing. But it will destroy the economy plain and simple.

There are those that say well it didnt happen here in ...... Okay a given. But you dont have a system like ours which demands that the individual have the rights of the many to obtain life, liberty and pursuit of happiness. But the system is a two edged sword and it also demands that you be personally responsible for your actions or lack of them in some cases. In other words you cannot expect that the government will provide you with life, liberty and pursuit of happiness. There is no provision in the Constitution for it. As with Canada, they will and would have to make it mandatory and then finally after many, many years and the jobs leaving and we get our asses whacked somewhere because the government couldnt defend our interests, the pols would dump it. Damage done though. I think the South would be gone within 10 years as their individual budgets would be tagged by DC for this. Its no longer a spread pool at that point and only DC gets to call what the FPL is. Its a giveaway and this one would indeed shut the military down or create deficit spending that would as I read it to be 4 trillion dollars in 10 years. Its 1 now.

Do we need to do something? Yep. But access to healthcare is there. It isnt cheap because of the copays but who is responsible here. Were I and others born to save someone elses butt and pay their way thru life? No, and that is and will be the reason that this will fall apart like a two dollar watch. IMO. Thanks for the time and bandwidth. So many libs, so many problems that their "progressive" minds want someone else to handle and pay for. Tell you what, I'll just stop by your house tonight and have you give me the 30K I spent on healthcare for my workers last year. Nope, you dont have the right to say no... Its UHC. We are now the UHC police. You dont pay your UHC taxes and we will arrest you and take your belongings to pay for some guy who plays basketball all night, an illegal, someone who cant afford it but thinks you ought to pay for him and family problems.

Strange concept.

Crawford... Very nice you have that. But its really not 35 bucks now is it? Its really about 50% or more of your income. I have been all over Canada and yep, they are about as laid back as they come. Kind of like cold air people in the south. But we have a major dilemma in that we do have to maintain a posture in the world and it pisses a lot of lefties/libs/Dems off to no end that we spend a lot of money on all these marvelous toys for the miltary. I am astounded myself with what they have come up with since I left and I was in on many things that were on the drawing boards ten years ago. Respectfully as I did serve on many NATO runs with the Canucks, it wouldnt take much to knock Canada over. Two provinces gone and its history. The US is the big dog on the block with so much power and sometimes not enough brains to use it correctly. But we are the Democratic party police in the world. We dont fight wars that could drop the costs back, we just keep having these little Koreas. That was the first one, Vietnam next and on and on. If you only have dead enemies, then you dont need too much of a military. We could come back from Iraq tommorow and we will be back into something inside of three years. This costs money. You cant have economic stabilty to pay for UHC without physical stability and that means the military. Sorry. I disagree. If we do this then the chances IMO and MANY others will be that the government will have to go totally socialist and take away all of your money as taxes to pay for SS, UHC and the military. Nothing left in between.

I-bang. You are already describing something that is happening here. Reason.... lack of doctors. Easier to become a lawyer to sue the government after UHC debaucles. Read some of the previous posts on it. This is a real deal here in Tennessee and if they need two senators and six congressmens votes to get it thru in DC, they'll be short by a box load on it that day.

And for a parting note folks. If you feel the need to take care of someone then go ahead and do it. I do it all the time too. But dont come thru my door and TELL me that I have to. Thats when the shit is going to hit the fan and the South is already rumbling hard about this. They will block vote no and then what? Back to the states rights and states problems issue.

By M. Randolph Kruger (not verified) on 26 Jul 2007 #permalink

Just chipping in with an Australian perspective.
Our system is a hybrid system: Everyone pays a Medicare levy through taxes but you can also choose to have private insurance. The medicare levy is scaled to increase with age (the cynic in me says that this is to push everyone into private insurance).
Now to coverage - if I go into hospital for non-elective treatment it is free, if I go to a GP it is free, if I buy prescription drugs it is subsidised. That is the Medicare levy side of things. If I get elective surgery, dental work, visit a specialist etc I will either pay full price (uninsured) or claim through my medical insurer.
Overall the system seems to work quite well.

Mr. (or Dr. if honored) Kruger, you are aware that your tax money is supporting a quasi-UHC in America right now, correct? Federal employees in the Executive Branch are universally accepted under the Federal Employees Health Benefit Program(FEHBP, approved under the Balanced Budget Act of 1997) which is an extensive program covering an absurdly high percentage of all medical costs and is paid for by taxpayer money. If you are interested in the plan, here is the link: http://www.opm.gov/insure/health/

What does "the South" have to do with UHC's approval in America?

By C. Porter (not verified) on 26 Jul 2007 #permalink

Re: SimonC's perspective of Australia's "hybrid UHC system" -- roight on, dude! Back in 2000, I pretty much was the only GenX gay male in Oz borrowing and attempting to understand hard science text books from the public library... Given this, I knew darned well transgenic pathogens were on the horizon and would be the death knell for many people. The gov powers that be were literally asleep during this time -- pre9/11!

One hot nite, I went out for a dance at a local gay club and drank a few too many beers cos, on the short journey back to my then apartment, I was chased like a dopey dawg and beaten into the ground by a group of angry twenty-somethangs.

I went to hospital emergency (without money) and was treated immediately -- stitches, etc. Thank God for UHC, cos there's no way in the world I could've paid for it. This year, on the other hand, I had the cash to pay for elective dental treatments not covered by Medicare (UHC)...

Life pretty much is a chi circle! Health care aint free. But balance is in Oz's UHC system -- I would not be able to do what I do now if the system hadn't fixed my wounds after getting bashed in the Oz Summer of 2000!

By Jon Singleton (not verified) on 26 Jul 2007 #permalink

Randy -

You also make an assumption that I and others want to assume your debts (incurred already by some, future ones for others).

You don't seem to get it. You already have. And unless ERs start turning people away, you're going to continue to, unless you decide to stop being a health care consumer. Yeah, I have some debt that I am paying, to cover care I got for pneumonia. But there are thousands that I am not going to pay, except as a consumer, because the debt's gone. Absorbed by the overhead, overhead that gets covered through increased cost to the consumers.

And I am far from alone in getting care this way. Every day, every ER in the country is providing care for probably hundreds of thousands of people, a fraction of whom will ever actually pay for it out of their pockets. More than one of my visits, including the most expensive one, were covered by the hospitals, through programs that they offer to people who are unable to pay for it. Who do you think pays for it?

You also seem stuck on the idea that UHC has to be some monstrosity that will inevitably fail. Where is the evidence for this? Where is the evidence that it has to bankrupt us? Every other industrialized nation in the world manages it. Do you honestly think that American's are so stupid that we can't manage to make it work? You also seem to suffer the misapprehension that it isn't inevitable. We have more than 45 million Americans without coverage, millions more who have dangerously inadequate coverage. Eventually, people are going to say enough is enough. You mention that you pay for your employees insurance, that's great, even better that you can afford to. Far too many businesses can't keep it up. Companies go bankrupt, not because they are bad at business or make a crappy product, but because they can't afford health care for their workers.

This isn't about liberals against conservatives. This is about what has become a serious problem that no one touches. Unfortunately, no one has touched it for so long that it's now broken beyond any easy repair. It is going to take a multifaceted, complete restructuring, that will include some form of UHC. You can either bitch and whine about the inevitable, and inevitably hate the results, or you can get involved in the discussion and help find a workable solution that won't destroy the country or lead to a totalitarian, socialist state. Given what I've read thus far, I assume you'll keep whining. To bad for you.

Does anyone really think the minimum wage uninsured worker will every be able to pay their ER bill? We ALL pay for not insuring them. Jeez! I see it every day.
And cutting doctors fees won't help. Already, it's impossible for me to get any of my residents to go into primary care like me...we all have enormous medical school debts and the pay we get now doesn't really cover that. If you want to continue to have the best doctors and best health care (not health care system) in the world, you gotta pony up the bucks.

When I fell and tore my rotator cuff, I was able to see my primary care physician a day later. The appointment with the orthpedic surgeon was about two weeks later. The surgery was about two weeks after that. So, my wait for non-elective (in a sense) but not emergency surgery was a month. I consider that neither too long nor especially quick. On the other hand, the cost was so high that some people could not have afforded it without insurance, and my own payments were so high that even some with insurance could not have afforded it. Getting really good health care insurance would cost me about double what I pay now for what I assumed was catastrophic coverage. It turns out what that means is that if you have a catastrophic medical event, even with this coverage it could be a financial catastrophe. It might save you from bankruptcy, but it could be life-changing.

I just talked to a good friend from Mass., yesterday. Her teen daughter had been plagued with headaches for over a year. They had done lots of visits with the PCP, lots of meds, all to no avail. She missed over fifty days of school, and didn't complete all her sophomore year as a result.

When the PCP finally decided it might not be migraine, one of the suggestions was that she go to a biofeedback doc. When my friend called in November, the soonest they could take her daughter would be March. Because we have to wait less time than other countries with socialized medicine.

Fortunately, a compassionate TMJ dentist knew the biofeedback doc and made a personal request to have the teen scheduled sooner. That moved her up, and the therapy has been largely a success. Still not out of the woods.

A few things: Pain is not treated as an emergent condition. I can understand this, but all too often pain interferes with day-to-day existence. People miss school, work, family events, and pretty much life because they are dealing with pain that does not respond to OTC meds, and maybe not even opiates.

To me, the idea of a kid not completing a grade or a person being fired from work because of absences is a serious issue that needs to be addressed sooner, rather than later. Too often, the pain sufferer has to reach rock bottom with a side of depression before anyone tries to treat the cause instead of the symptoms. There is a dollar cost when workers can't work, or people have to waste tuition costs, or pay for tutoring. It's a drag on productivity, not to mention a real social problem for families.

Pain can be hard to treat, which makes more than a few docs uncomfortable and unlikely to jump at the chance to take on cases. Then there's the criminalization of pain meds, even when legally prescribed. I've had docs who didn't want to prescribe stuff because it would require more paperwork, and maybe put them on somebody's watch list. WTF?

I have a whole host of elders in my family who have reached their 80s and 90s, and now have to wait months to see somebody to treat the pain they have from age, wear and tear. If they could manage their pain, they could still be independent and less a drag on all our precious precious tax dollars! It's a stone cold b*tch when you have managed to make it into the upper limit of human age by being healthy and then have to surrender your autonomy because you are just in so much frakkin' pain.

By wenchacha (not verified) on 27 Jul 2007 #permalink

Randy - as an employer, you seem to pay a great deal of money in order to keep your employees in good health, as well as a great deal of taxes yourself. Although its highly responsible of you to do that, doesn't it put you at a disadvantage? Your competitors don't have to provide healthcare at all, and although you might get better people, their bottom line might look better.

Now which would be cheaper, paying a bit more in tax, but no hassles with insurance, or continuing the way you are? You have enough to do running a business, without having to deal with the healthcare industry as well. I suspect that Ford GM and Chrysler would now prefer it if they had the system their subsideries enjoy outside the US.

I remember from another post of yours some time ago that you paid $470 a month in personal health insurance. Again, you could simply pay that amount in tax, and not have to worry about co-payments, etc.

You might object to having to pay for someone elses illness, but there could be a time when they might have to pay for yours - we all get old and we all get sick, and if it costs less to get treated as a group, then whats not to like?

As long as we continue to allow crap food, 80%, to be brought into the U.S. from China there will be health problems. And the problems will multiply if this ridiculous situation is not corrected.

I can understand both sides of this argument but I also was not born to save someone else's body and pay their way through life.
Unpopular concept at EM however, it's karmic baggage, and I didn't create your karma, you did.
We are labeled uncaring souls for not wanting to help other's with UHC. I help many people too, in ways that don't require taking my dollars. Sure, it's better to give than receive but not when the other one wants to take and take and take.

wenechacha: Yes, the issue of someone suffering physical pain weighs heavy on my heart also, especially since there are ways of alleviating the pain. The way we care for our senior's in the U.S. is disgraceful, and yet, the senior's who worked during the 40, 50, and 60's for one company for 35-45 years are in reality fortunate. My mom did just that and now has the dollars to cover her needs. That and the fact that she saved a dollar here, five dollars there and prepared for her old age.
My mom even asked me awhile back if I still smoked pot, I don't because it's illegal and I don't want to go to jail. I asked her why she asked and she said she wanted to try it, she heard it helps with pain.

C. Porter-The South cant afford it. Our portion now of Medicare backup is going to have to increase due to Federal budget cuts. Again, healthcare at all costs for citizens that are becoming less productive (old people). Yes we pay for it now. Its a disaster. Want to make it worse? People lose jobs and our ability to compete when we spend money. E.g. Gimme Jimmy with his socialist programs put the interest rate at 21% and unemployment arguably at between 7-10%. High taxes to pay for the social programs and high interest rates will kill an economy. The South has already as a group pretty much said, "Dead on arrival" for UHC. They can stop it in the Senate for sure. The House less of a chance. And yes, the total government subsidization of health care is at 50% I believe is the number already...And its already a disaster to boot.

Jonny--Hi! If you had been beaten up and were on the state plan you would have paid 20 USD. Dont know what to say other than that.

DuWayne-Human rights are not specified in the Constitution. It does define the rights of the citizens. and yes I do get it. Its socialism in a capitalistic society. If implemented we will constantly be pushing and shoving between what it will cost, what it will pay, what we will pay. Its currently illegal under the Constitution as for Revere's plan it gives basically all of the income of the citizenry to the the government. Its not going to be elective and anytime they run out of money, they'll just vote some more. Canada has unjustly been too much of a target on this one. I posted with links before that the Germans, Dutch and Swiss are having to reduce services and what is covered to prevent raising the rates any further. Full blown rationing is in effect in the UK because to cover the wait times they spent too much money.

Mark P. Hope you feel better. UHC will not save you from bankruptcy, it will just keep you in a constant state of it. Our wages are very high already and to cover the COLA they will just keep upping it. Gas is and will be nearly 6 bucks a gallon, you will pay thru the nose for everything as they will tax to cover it. The nearly mandatory system implemented in Tennessee resulted in a 750 million deficit in just six years. So you move that to the Federal government we will add hundreds of thousands of employees to account for it adding to the debt. The population will age to beyond 65 predominantly starting in 09-15. Social Security will already account for every tax dollar taken in and this will cost even more than SS.

I keep hearing about individual problems with healthcare that was obtained, for a fee. Does anyone really believe that because someone tells you its going to be cheaper that it really will be? NO. It will raise the taxes on everything else. They will just keep voting the system money until the economy collapses back to a third world nation status. But oh hell we got no jobs, we got no money but we gots healthcare. This will destroy the middle class, big dog money will move to the Caymans, and then once its in we wont be able to get rid of it without a revolution. The South though I believe will just opt out. Its all about economics. Everyone has problems in their lives and for someone to say that this will be "Just one less thing" is a crock. It will become the over and all encompassing "thing" in our lives.

Just as we did in Tennessee when the real bills for this started coming in. They were shocked in the first year, stunned in the second, crying rape in the third. Then they wanted an income tax. And then without it the call went out to drop it because we simply couldnt afford it as a state. Toyota is putting up two plants in Miss next year. Reason they didnt come to TN? CoverTennessee......

One last thing Mike. That last para, I already object to having to pay for other peoples problems and have for the last 20 years. They have never paid a dime into the system as a rule where I am and they arent under UHC. At least I get the right to bitch and try to change it before they put this disaster into place. There arent going to be enough doctors, but there are going to be plenty of lawyers to go around.

By M. Randolph Kruger (not verified) on 27 Jul 2007 #permalink

I am a fan of universal health care. I grew up in Australia, and their system, while not perfect, works pretty well.

However, I've recently moved to New Zealand, and due to lack of funding (small population, therefore small tax base) the system stinks. Private health insurance is available, but is expensive and covers practically nothing in comparison to Australia.

If you get cancer, you may get 2 or 3 weeks of subsidised chemo... then it's up to you.

My partner (who has anaphylactic attacks) recently had one, and was well cared for in the emergency department... but when it came to replacing his epipen, I was quite shocked at the lax situation. His just-used epipen, purchased in Australia at a cost of $25 (subsidised medicines), and easily obtained (all hospital pharmacies have a stash, as if you need one you MUST NOT leave hospital without a replacement if you've had to use yours), will not be able to be replaced for FOUR DAYS.

In the national capital, the largest hospital does not have even one epipen in stock. Neither does any pharmacy in the city. Estimated delivery time (due to the emergency ocurring lunchtime on a Friday) - four days. And, on top of that, the cost is market price ($150 or so). The cost, while an imposition, is not so much of a big deal.

However, how can any country call their health system healthy when potentially lifesaving medication is not available anywhere?

By attackrate (not verified) on 27 Jul 2007 #permalink

Randy -

You really don't get it. It already is happening, just very inefficiently. I don't buy for a minute that the law is going to change and ER's will suddenly be allowed to turn people away. And if you actually believe that ER's should turn people away, who are going to die if they do, then you're one evil SOB.

You also don't seem to get that UHC in some form, is inevitable. It is going to happen, whether you piss and whine about it or not. If you don't want it to be a system that forces people to use it, regardless of their ability to pay for better care, then you might just want to quit whining and get involved. The other thing you don't seem to grasp, is that while it's a challenge, the constitution can be changed.

The thing that people like you refuse to acknowledge, is that we have UHC of a sort. It's just brutally inefficient, with waste in the hundreds of percent more than it needs to cost. You also seem to glance past the fact that a lot of people who have insurance don't get remotely adequate care. They, or their employers, usually both, pay thousands, upon thousands of dollars, only to be denied care when they desperately need it. While the only response you can come up with is; "screw them." Sorry, it just shouldn't work that way and before too terribly much longer it won't work that way.

Especially as more and more big corporations start to jump on the bandwagon. I look forward to the day when the big money lobbyists in Washington, start throwing money at UHC - again, inevitable. Do you honestly think your pissing and moaning about it, is going to stand against that? Never gonna happen.

Well lets see we can take the comments above in many ways. UHC will put nearly all of the money into the hands of government thereby taking away the "limited government" proviso's of the constitution. Once its in, it will only go away when you suddenly realize that you no longer work to provide for your family, you provide for government.

The Constitution can only be amended DeWayne or tossed and rewritten and this might happen after a revolution. They will pump this handle and tell everyone its a good thing. I will tell my employees that they no longer have health insurance because they will tax the corporation at least at the 65% level. All prices will rise to support Big Brother and as I said the South just might say good bye to the Union. It will be all about the Federal Poverty Level and if implemented they will raise it to include all of the ethnics, illegals and people who cant afford traditional insurance. Oh, those people can and could be covered but the states run it now and their thresholds are a lot higher and thats the reason no one joins them.

Federalization of a situation. Hmmm sounds a lot like Katrina. Throw more money at the problem rather than just acknowledging that no one is responsible for you other than yourself. When it finally bankrupts the country then you'll get it. Just as we did under TennCare, just as Mass is starting to find out already and California when 3 million illegal aliens were registered to vote and filed for social services after getting their voter registration cards. It bombed their state budget (remember who Arnie replaced), it bombed our budget and it will Mass.

It will work only if the government takes over and Revere would have you think it isnt. It would and it will.

By M. Randolph Kruger (not verified) on 27 Jul 2007 #permalink

Randy: You are claiming that UHC is unconstitutional? That is the first time I have ever heard this. Exactly what is the constitutional grounds for this? If limited government is unconstitutional then the US military, the largest centrally planned economy in the world, is unconstitutional. Is that your claim? UHC works everywhere else (despite your claims to the contrary) and it will work here. And you and Lea will benefit hugely. And I'll be glad you will. Along with the rest of us. Meanwhile feel free to rant against the income tax and unconstitutional and all the rest of the fringe stuff. The courts have already decided this. That's the system.

Randy -

Umm, it doesn't take a revolution to amend (change) the constitution, there are actually several ways to do it - none that include the need for violence.

Also, I would have you read between the lines. The idea is not to throw more money at the problem. Indeed, with a more efficient system, we could throw far less at it. Especially if we don't pretend that UHC is the only necessary change that needs to happen.

And no, the government doesn't need to take over, just fund it. Revere is far from the only reading on this that I have done. There are a lot of very good ideas out there. I doubt that any single idea that's been mentioned thus far is the end all, but a lot of people are working on ways to fix the system. Even people who haven't started out with the premise that UHC is the answer. Yet inexplicably, most health care wonks, regardless of their starting point, end up at some form of UHC.

I would challenge you to start actually researching the issue. Get the sand out of your eyes and pay attention to what people are actually saying. Including a lot of conservatives and business leaders, few of whom started with support for UHC. Few end up not supporting it in some form, excepting those who, instead of actually seeking a solution, just complain about them libruls seekin' to ruin our great nation.

All you proponents need to come up with a way to pay for it. Revere its illegal when it becomes mandatory. DuWayne is either new here but I quit citing from the countries that have it last week on the last UHC entry. I quit at about 35 I think.

No one is going to go to violence. The process is already underway to ensure this never, ever comes into effect. You all worry about healthcare and that someone should pay for someone elses problems. This is the typical "progressive" program and its socialism at its finest. Suddenly you become a criminal by condition. You fail to pay your taxes and they come and get you and your things and haul both off. One for jail one for auction. Healthcare is out there and the guise is that "I" will save money. Bullshit pure and simple because our progressive tax system is that "I" will have to pay more than "someone else" even though I will choose not to participate.

It will down our companies and put all the money in the US into the governments hands and not in yours. Instead of earning it, they now force government to steal it. They didnt earn it, they just take it. Screw a bunch of stuff about this being elective. Thats another horseshit line. We are going to become cash cows for the government and its the last thing that we should ever do. Its a takeover just as sure as I sit here writing about it.

Duwayne, you just dont get it. The providers whether it be the USG or AIG are going to always never have enough money for it. You really need to do your homework, not me. EVERY country that implemented this in any form ALWAYS had to CUT, RAISE, OR RATION the services after implementation. I challenge anyone to prove me wrong.

The sellers of the services, or the materials always just raised their rates to insure their margins and thats where this bullshit heads south. The supposition that this will help poor people is the biggest lie there is. They will be out of a job because it takes away the spendable capital from the people and makes it the spendable capital of government. Tell me how you will be able to survive on 50% as a tax bracket. You wont. Tell me how corporations will be able to first employ and second compete with the world market where they dont have UHC? We cant and you wont.

Revere, the second it becomes non-elective its illegal.

http://www.cato-at-liberty.org/2007/06/27/announcing-the-anti-universal…
http://blogs.wsj.com/informedreader/2007/06/29/is-french-health-care-re…
http://www.iht.com/articles/1996/12/21/health.php
http://www.frost.com/prod/servlet/cif-econ-insight.pag?docid=77082735
http://content.healthaffairs.org/cgi/reprint/18/3/76.pdf

Here is one where they rigged it....
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=381359

Sweden begins rationing
http://www.nationalcenter.org/NPA555_Sweden_Health_Care.html

Note Peggy that they pay about 20 bucks as "copays" and about 40 to see a specialist. They also have a government tax, and allow local governments to tax for healthcare too. Sounds a lot like double jeopardy to me.

Sweden again
http://www.fraserinstitute.ca/shared/readmore.asp?sNav=pb&id=440

So the all encompassing systems in Europe are now straining, raising taxes, and rationing.

Here are the Dutch under their COMPULSORY HEALTH ACT.....
http://www.euro.who.int/Document/E84949.pdf

and here where they say now they have to cut spending for other things and force people to pay more from their pockets.

http://www.oecd.org/document/37/0,3343,en_33873108_33873626_36986213_1_…

The UK-No way out and the spiral is upward and rising out of control.
http://jobs.leaddiscovery.co.uk/resourcearticles.aspx?rid=53&t=Healthca…

Rationing in the UK system
http://www.rcplondon.ac.uk/pubs/ClinicalMedicine/0604julaug/0604_julaug…

Now boys and girls we can all read and write. When I see and hear that there is a boogeyman in a house I cautiously lean my head in and find out. EVERY country with UHC (including the vaunted Canucks) have raised prices, are cutting care, increasing copays, and rationing has started.

If you use Sicko as a broad example of what it might be able to do then fine. I will accept that. But Michael Moore is an opportunistic slob. He finds a subject that is a hot button issue, develops a program that fits the agenda then produces a movie on it. He absolutely denigrates everyone who says lets wait a minute and debate it. Of course he refuses to show up if anyone wants to ask him the hard questions. We DO spend more than any nation on the planet. Might it be because its the only place where there is any money to be made? Might it still be legal to call it a service rather than a right.

Oh and the Man of the People lives on Fifth Avenue and I guarantee he isnt on any state program healthcare.

Now read as I have. No where do I find "savings", I find Lyndon Johnsons "Great Society" which in the face of the costs of percieved necessary war but assured necessity defense blew the budget after introduction of the programs that still hang on today.

I would favor without question or much discussion vouchers that would make the coverage more affordable for a family by paying them to get onto traditional insurance or a state program but the bottom line is that UHC creates a system that cannot support itself and the answers are as everyone notes, taxation, limitation, rationing, and then another round that spirals upward ever endlessly.

They are leaps and bounds in systems ahead of us in the EU. None of which pay for themselves. We would join this and within five years it would absorb even the payments for Social Security as the budget for health care is expected to rise from 1 trillion to 4 trillion in the next 10 years. Might that be because our population is ageing. How in Hell will they pay any more than they already have. Someone is gong to just have to suffer Peggy, DuWayne. Brutal? So is losing your country. The end results would be worse than the cure. The South cant afford it and they will respond in a most devisive of ways.

By M. Randolph Kruger (not verified) on 28 Jul 2007 #permalink

Randy: You mean like Medicare? Social Security? Police? Schools? Fire? Military? Telephone tax? Gas tax (to pay for roads)? Numerous fees? Etc., etc.

reverte: how in the world are we going to sustain an ever growing population? This really needs to be taken into consideration when one wants to start prolonging people's lives.

Medical marijuana would go a long way in alleviating many problems. And I won't go into the proven benefits, although they are beyond numerous.
Here's a friendly reminder of the wonderful job your elected representatives are doing.

262 Members of Congress Vote To Prosecute State-Authorized Medi-Pot Patients
165 House members the most ever vote to end federal raids in California, 11 other states

The House voted 262 to 165 against the bi-partisan measure, sponsored by Reps. Dana Rohrabacher (R-CA) and Maurice Hinchey (D-NY). The 165 House votes in favor of the patient-protection provision was the highest total ever recorded in a Congressional floor vote to liberalize marijuana laws. Of those who voted in support of the Hinchey-Rohrabacher medical marijuana amendment, 15 were Republicans (a loss of three votes from 2006) and 150 were Democrats (a gain of six votes vote from last year).

Representatives that voted against the Hincher-Rohrabacher amendment

Aderholt - Akin - Alexander - Altmire - Arcuri - Baca - Bachman - Baker - Barrett (SC) - Barrow - Barton (TX) - Bean - Berry - Biggert - Bilbray - Bilirakis - Bishop (UT) -Blackburn - Blunt - Boehner - Bonner - Bono - Boozman - Bordallo - Boren - Boswell - Boustany - Boyd (FL) - Boyda (KS) - Brady (TX) - Braley (IA) - Brown (SC) - Brown, Corrine - Brown-Waite, Ginny - Buchanan - Burgess - Burton (IN) - Butterfield - Buyer - Calvert - Camp (MI) - Cannon - Cantor - Capito - Cardoza - Carney - Carter - Castle - Castor - Chabot - Chandler - Cleburne - Coble - Cole (OK) - Conaway - Cooper - Costa - Costello - Cramer - Crenshaw - Cuellar - Culbertson - Cummings - Davis (AL) - Davis (KY) - Davis, David - Davis, Lincoln - Davis, Tom - Deal (GA) - Dent - Diaz-Balart, L. - Diaz-Balart, M. - Dicks - Dingell -Donnelly - Doolittle - Drake - Dreier - Duncan - Edwards - Ehlers - Ellsworth - Emerson - English (PA) - Etheridge - Everett - Faleomavaega - Fallin - Feeney - Ferguson - Forbes - Fortenberry - Fortuno - Fossella - Foxx - Franks (AZ) - Frelinghuysen - Gallingly - Gerlach - Gillibrand - Gillmor - Gingrey - Gohmert - Goode - Goodlatte - Gordon - Granger - Graves - Green, Gene - Hall (NY) - Hall (TX) - Hastert - Hastings (WA) - Hayes - Heller - Hensarling - Herger - Herseth Sandlin - Hill - Hinojosa - Hobson - Hoekstra - Holden - Hulshof - Hunter - Inglis (SC) - Issa -Jefferson - Jindal - Johnson, Sam - Jones (NC) - Jordan - Kagen - Keller - King (IA) - King (NY) - Kingston - Kirk - Klein (FL) - Kline (MN) - Knollenberg - Kuhl (NY) - Lamborn - Lampson - Larsen (WA) - Latham - Levin - Lewis (CA) - Lewis (KY) - Linder - Lipinski - LoBiondo - Lucas - Lungren, Daniel E. - Lynch - Mack - Mahoney (FL) - Manzullo - Marchant - Matheson - McCarthy (CA) - McCaul (TX) - McCotter - McCrery - McHenry - McHugh - McIntyre - McKeon - McMorris Rodgers - McNerney - Meek (FL) - Meeks (NY) - Mica - Miller (FL) - Miller (MI) - Miller (NC) - Miller, Gary - Mollohan - Moran (KS) - Murphy, Patrick - Murphy, Tim - Musgrave - Myrick - Neugebauer - Nunes - Ortiz - Pearce - Pence - Peterson (PA) - Petri - Pickering - Pitts - Platts - Poe - Pomeroy - Price (GA) - Pryce (OH) - Putnam - Radanovich - Rahall - Ramstad - Regula - Reichert - Reyes - Reynolds - Rogers (AL) - Rogers (KY) - Rogers (MI) - Ros-Lehtinen - Roskam - Ross - Ryan (WI) - Salazar - Sali - Saxton - Schmidt - Schwartz - Sense Brenner - Sessions - Shadegg - Shays - Shimkus - Shuler - Shuster - Simpson - Skelton - Smith (NE) - Smith (NJ) - Smith (TX) - Smith (WA) - Snyder - Souder - Space - Spratt - Stearns - Stupak - Sullivan - Tanner - Taylor - Terry - Thompson (MS) - Thorn berry - Tiahrt - Tiberi - Turner - Upton - Viscously - Walberg - Walden (OR) - Walsh (NY) - Wamp - Wasserman Schultz - Weldon (FL) - Weller - Westmoreland - Whitfield - Wicker - Wilson (NM) - Wilson (OH) - Wilson (SC) - Wolf - Young (FL)
....................................................

Lea: If you are talking about the US, our birth rate is falling, as always happens when you prolong lives. But maybe a pandemic would be good, right? Reduce the population? Hope it's not me, though.

Reverte-Thats exactly what I mean. When government induces a program that could never pay for the outlay it requires that they increase their intake to maintain the program. I will auto-give it to Revere that this means the military too. On the other hand, you cant have economic security without physical security. Just throw down the rifles and lets just sit around the campfire and sing songs.

There are so many taxes where we are taxed already. Those will be upped, and then they will create new ones to pay for a program that will doom the economy. Oh-they will try to balance it but only after the damage is so severe that it wil put a generation or more out of work. What we are seeing in Europe right now is that they are the cash cows for their governments. The cows are mooing because the same set of services are in varying degrees still the same damned thing we have here. The rich get covered, the poor get shit. Its a two tiered system and cream always rises to the top. There arent enough doctors, facilities, equipment and to maintain the service levels that they do have it has to constantly find new ways to cut back. That is directly related to raising copays (we see this now), rationing (the poor see this here), and deletions of what is covered (we see that now too).

So whats the difference and the answers? The difference is that you have the choice for the time being here, later you wont. The answers. Sometimes its just better to do what you can with what you can and leave a big problem laying on the couch. You wake it up and you might have bigger one.

And honest to God for all, I cant see what we can do. No one had health insurance as a rule until the 1940's when it became a benefit. What did we do before then when it wasnt an employer provided item? I think its like 65% of the country that were uninsured. I know when I was born that my parents didnt have insurance. I know, because when I buried my mom I went thru the paperwork and I found that I cost 350 bucks to the hospital and 225 to the doctor.

So what are we really talking about here? Is it really inexcusable that 40 million Americans are uninsured, or is this another socialist program aimed at the takeover? You be the judge, the people will be the jury and the program if implemented will be the executioner.

By M. Randolph Kruger (not verified) on 28 Jul 2007 #permalink

Randy: I remember the days before Medicare and Blue Cross. You are right. People didn't have insurance. Medical care also cost a pittance, then. I know because my dad was a GP and he never in his best year made more than $10K. He worked 7 days a week. He went to the office on Sunday morning, too, and made house calls. He was a wonderful doctor but there were many things he couldn't cure.

But our new abilities to cure disease also cost a lot more. Medical costs have to be brought under control no matter how they are paid for. The best way to do this is to take payment away from the health insurance companies. They are a major part of the problem. You give them an interest free loan, which they invest, and then they don't pay you back.

I don't understand why you won't accord health care -- and being healthy to me is also a kind of physical security -- the same status you accord other things mandated by the government. If I'm not healthy, nothing much else matters. What is more basic than that?

revere, don't be angry just because I don't agree with you. It's just not productive to be angry, although it happens on occasion by everyone. Anger stirs up poisons in the liver and that's bad for your body.

But maybe a pandemic would be good, right? Reduce the population? Hope it's not me, though.

Is this something you've kept buried, only to bring up now because I've expressed that a pandemic might be good? I've expressed that sentiment because sustainability is going to be a very real issue if it's not addressed. Not because I'm cruel or heartless as you would like to believe, or so I'm led to believe by your statement.

Hope it's not you? Well, I've heard you're not preparing and that you'll be in the hospitals saving lives. That paints a picture, does it not?
Hope it's not you either, you're a good, loving, caring person with some rough edges just like the rest of us.

Lea: Believe it or not, I wasn't expressing anger at you, or anger at all. I am remarkably (some say pathologically) even tempered. But I am an academic and my natural mode of discourse is vigorous argument. I also did not remember you said a pandemic might be good (I often don't have time to read all the comments in all the threads) or forgot you said it. I inferred it as a logical consequence about what you said about over population without realizing you had actually said it. When I said, "Hope it's not me" this was meant to say that while there is the abstract idea that the earth is overpopulated few people want it reduced in poplation by elminating themselves or their families. Hence they come here to read about pandemics. The reason I don't prep is not that I don't care whether I live or die (I hae no choice in that a there are biological imperatives we must obey as living organisms) , but that a a matter of policy and principle I don't care. I know I'm going to die and I'm not afraid of it. I take it as a given. That doesn't mean I don't care if I die of a painful cancer or drop dead suddenly or die in a pandemic. I haven't prepped at all for reasons perhaps I['ll discuss here or perhaps not. It has nothing to do with my interest in preparing the community for what could be a very bad time in its history. I am concerned with the welfare of the community. It is part of that concern.

The sustainability issue is an important one. You could approach it by saying there are too many people so let's reduce the number of people. That can be done on the production end (reduce births) or the other end (kill off a lot of people or let them die). I am for the former method and will argue against the latter method. It's part of the argument. Please do not confuse argument with anger. For argument we try to use reason. Anger interferes with reason.

Wait times for a hip replacement in Canada have been alleged as long as 6 months, although I don't know if that is generally true or not.

I don't know if that's true or not either, but I wouldn't be surprised if it was. UHC systems typically focus on the young and working-age, productive people -- forget it if you're elderly (I'd guess the majority of hip replacements are done on elderly folks) or chronically ill (I know whereof I speak on that one). You will be down prioritized 'cause you're just not a productive member of society. Not everyone can be accomodated by limited budgets, so prioritations have to and will be made.

U.S. health care is by no means perfect -- I'd like to see all American citizens covered somehow -- but neither are UHC systems perfect (and I've lived in 3 countries with UHC -- all European). Far from it! Wait times are a BIG problem (4 years to remove a cyst?!) -- lack of or insufficient facilities -- lack of medicine (like the poster from New Zealand mentioned) -- the fact that one doesn't get the latest treatment and/or medication available ... I could go on and on.

I dunno what the solution is -- something in between UHC and completely private I guess. If allowed only one of the two options, though, I'd go for the U.S.'s system any day.

Reverte-I can think of a lot of things that could be worse than not having healthcare. Ask the Czechs, Poles, and Hungarians. Again, healthcare at all costs will put us on the one one option for defense...nukes. It also takes away the individualism of this country and every dollar into the hands of government. I say that part again. EVERY dollar in our system will enter the governments hands in some form or fashion. When the federal government has no more money to put it into it, they will force the states to up their input which will result in higher taxes for the states, which will in turn put more pressure onto the local economies. Putting money into a sinking ship is my best analogy. All based upon a premise that healthcare is a right.

By M. Randolph Kruger (not verified) on 30 Jul 2007 #permalink

Randy: I would rather not have government dollars fund the means of coercive force which can be used against me or other innocent people abroad, according to whoever is in power thinks it's a good idea. Money in the hands of gov't to make people well is a much safer bet (in every meaning of the word). I'm not going to argue with you whether Czechs or Poles would rather have cancer or Soviet overlords because that's not the choice. if we completely disarmed we couldn't be invaded and occupied by a foreign power successfully. Consider the fact we can't even do that in Iraq, so that's not even a possibility except in the fantasy world of Hollwood or the wingnuts. The Soviets couldn't do it in Afghanistan either, something we don't seem to have figured out. The US military counterinsurgency manual suggests it takes two troops per hundred resident, which means an occupying force in the US would require 6 million occupiers. Yeah, right. As for nukes, the best protection is international diplomacy and cooperation for anti proliferation. Military power is otally ineffective as we have seen. Waste of money and only lines the pockets of defense contractors and friends of George and Dick.

All things change Revere. You are right about the counterinsurgency manual, good you are reading. We have been occupied before if you recall by the British and under very harsh conditions to the people of the not then US of A.

UHC will end that debate because there will be no military to speak of. During Gimme Jimmy's days I could remember that trucks couldnt move, aircraft couldnt fly, air defense radars were sitting with their scopes out of the rack because there were no parts for them. And that negotiating thing really worked out. Might I remind you that the Russians invaded Afghanistan because they knew they could. They had the horsepower to do it. The Saudi's funded a lot of the military hardware to boot them out.

Successful invasion? I guarantee that if the Russians and Chinese got together they could easily knock a US of A over with a combi of tactical nukes and troop deployments. If you think not, then thats a bit dellusional. Plenty of Chinese to go around.

Afghanistan? It was a drive for the Persian Gulf and we started arming Osama to act as our proxy army. That didnt work out either. So really there arent any answers because diplomacy in the US relates to just buying someone off and dealing with terrorists. Thats what I do admire about the Islamic fundamentalists. They really believe in what they are doing.

Diplomacy for non-proliferation? Doesnt seem to be working out in Iran does it? Didnt in India or Pakistan. Korea? Got a fizzle rather than fission. But my how they are all working for it. The deterrent to that is conventional forces and fear of what a 1000 pound bomb can do.

But UHC would take all of the money up completely in the US and put us on the same level with maybe Pakistan economically.

The old B. Clinton joke 1040 income tax form comes to mind.

Line 1, Enter total earnings to include tips, wages, and other compensation.

Line 2. Send it in.

By M. Randolph Kruger (not verified) on 30 Jul 2007 #permalink

Randy: People keep telling you: you're already paying it and more and getting less. As for being occupied by the Chinese, give me a break.

And what would stop them Revere except for nukes if we had to pull back on our military? You have already commented that it would take 200 per single resident. There are 300 million of us, and how many billion of them? I think its plenty and especially if they tamp us down a bit with their own nukes. An old US military saying, "What does a 5 million man Chinese Army do? " Answer, "Just about anything it wants.

Know how you'll know? When they do something and we are unable to stop them. Art of War Revere, might want to read up on that one a bit. Afghanistan is a good example of what DOES happen when you cut the guts out of your military. Desert One is another.

It doesnt matter Revere if we are paying more and getting less. Europe is paying less and getting a lot less, but they get seen eventually. A lot of times in a pine box by family and friends. All this does is give government control of all the money in the country and they will do it by making it mandatory.

At least I have the option of choice right now. Yes I know they take the money and invest it in the stock market. Another reason that it will tank.... So whoever is sitting on top of stocks if and when it starts will see their value drop like a frozen turkey on Hillary's head. Pelosi will just say it only applies to people in the contiguous 48 states. Harry Reid will turn and say its because the Republicans have blocked them and that we need to get out of Iraq....even though we will have left two years earlier. Waxman will simply say, "We need to subpoena all Americans. How dare they say we dont have oversight on the Oversight Committee."

We end up where we began Revere. The people still dont get healthcare in a timely manner, or with the latest and greatest treatments, and with a Dem/Republican gnashing of teeth that will be pointing fingers. I dont call this progressive. I call it nuts

The difference here is that the USGOVT will be irretrieveably broke when they finally shut it down and healthcare except by pay as you go might be the end result.

By M. Randolph Kruger (not verified) on 30 Jul 2007 #permalink

Well, Randy, you're in the people moving business. Suppose you calculate how long it would take to move 6 million Chinese to the US mainland.

The communist chinese don't need to invade the U.S. physically, they're killing us with their tainted food imports. How clever!

Using both boat and aircraft, the Chinese could move just under 400,000 per month with their present capabilities. If they took Taiwan, the Phillipines and Indonesia then they could move if they didnt destroy the boats and aircraft doing it, almost a million a month.

To do it they would have to neutralize Pearl Harbor, Japan, Wake and Guam.
We wouldnt be able to stop them if the Navy was in mothballs. Kind of like just ahead of the first Pearl Harbor. We didnt move out of Pearl because there werent enough supplies to go around while the New Deal was still sucking the wind out of the economy.

Regardless of how this comes out. I hope we dont mortgage our futures. What is healthcare? Something that goes to the grave with you. Same if you dont have it.

By M. Randolph Kruger (not verified) on 30 Jul 2007 #permalink

NHS should not treat those with unhealthy lifestyles' say Tories
04.09.07
ThisisLondon.co.uk

David Cameron is considering NHS Health Miles Cards to reward clean living. Failing to follow a healthy lifestyle could lead to free NHS treatment being denied under the Tory plans. Patients would be handed "NHS Health Miles Cards" allowing them to earn reward points for losing weight, giving up smoking, receiving immunisations or attending regular health screenings. Like a supermarket loyalty card, the points could be redeemed as discounts on gym membership and fresh fruit and vegetables, or even give priority for other public services - such as jumping the queue for council housing.

But heavy smokers, the obese and binge drinkers who were a drain on the NHS could be denied some routine treatments such as hip replacements until they cleaned up their act. Those who abused the system - by calling an ambulance when a trip to the GP would be sufficient, or telephoning out of hours with needless queries - could also be penalised.

The report calls for a greater emphasis on the "citizen's responsibility" to be healthy and says no one should expect taxpayers to fund their unhealthy lifestyles. Yet while the Health Miles Card would award points for giving up smoking and losing weight, it could penalise those who are already fit and well because they would receive no benefits under the scheme.

Also, the NHS already demands that obese patients lose weight before receiving hip replacements."

No someone give ME a break. UHC is a disaster waiting to happen for the country and the people in the UK are starting to feel the pinch of a system going broke, rationing healthcare that they are supposedly paying taxes for. It aint free folks. Anytime they need a little more they'll tax a little more until all of the available capital is in the hands of government and not in yours. But all of those non productive people will have health insurance now wont they. This isnt about healthcare in the US, its about health insurance. You can get healthcare, but perhaps not health insurance. So everyone else gets to pay for your problems and no, they wont be paying for mine either even though thats the suggestion because below a certain wage, you wont pay a thing. Welcome to Romneyville and the Breck Girl Edwards big idea. You will be forced to go for checkups and that kind of thing. Now is that not the final definition of a takeover?

By M. Randolph Kruger (not verified) on 04 Sep 2007 #permalink

Randy: I would think you would like this kind of policy. Anyway, in the US we are ahead of all those you say are headed for disaster. Our disaster has already happened.

Randy: We also have a fairly severe doctor shortage. At least they can do something by increasing class sizes, which they say is the root of the problem, not UHC.

Shortage of doctors is one of the FIRST things that is noted in every UHC program. It becomes a rationed thing, controlled by government. The other thing they control without question is the GNP of the people as it goes into the governments pocket for dubious quality health care and care only given within the limits that the government establishes.

For example the UK UHC plan requires people who are fat to lose weight before they can have a hip replacement. Great... Get to be in unbearable pain while you try to lose weight on an exercise machine so you can have a hip replacement.

Our system is now where near perfect. There is health care available to everyone in the US, health insurance isnt. The system will collapse within five years and the economy with it if its implemented.

Its an experiment that I wouldnt want to try. Social Security is going to account for all tax money collected in five years. So we just raise taxes and more slip below the poverty line, the same line that will be established as the level at which no one pays into the system. Then the system taxes those who are able to pay and then they slip below the line. Then they try to raise the line and ups cant do that, now the line stagnates and they try to cut costs by limiting care and what is covered. Doctors go out of business because of the red tape. All of my doctors said they would have to raise their rates by two-threefold to make it as they write off so much now. That includes my dentist. The only way to make it work is to force EVERYONE to pay the same regardless and that simply will not happen. Just saying that someone is too poor to pay because they dont have a job is not going to work and thats where the divergence begins. It will start a spiral and inflation will go off the charts.

People in the UK have to drive miles just to get care because they cant a doctor to accept them. They can pick and choose who they see. Thats rationing too. These are all documented facts Revere. The assumption that healthcare is a right rather than a service is going to sink this boat. Its backdoor socialism and the US would have to shuck it within ten years else as a nation we will fail. Guarantees your 50 year fracturing of the country into regional sections. Healthcare will be completely gone then.

Then what? ?

By M. Randolph Kruger (not verified) on 30 Sep 2007 #permalink

Randy: Shortage of doctors is NOT the first effect or even a common effect. If an insurance company won't insure you because of prior condition, smoking, heart disease or some other condition do you object? At least with UHC someone is accountable. Who makes them accountable?

And with UHC everyone gets covered for someone elses lifestyles. Only difference is that the people that are productive are the ones that get the bill for someone elses problems.

There is another reason right there not to do it Revere. Suddenly I get 300 million family members to cradle to the grave support. As for the prior conditions, it is exactly what I said. They CAN get health care, they CAN get their problems worked on, but no health insurance. So what is it more than a takeover by government? Its a service and not a right.

If people get that right in this country then dont worry within a few years no one will get healthcare period. There wont be doctors, nurses or specialized anything other than lawyers. It will be a gold mine as people die waiting for a system to take care of them. Virgin Atlantic ought to be against it because of all the Brits that go to Orlando and Atlanta just so they can get themselves fixed. Wonder why they have jumped out of the UK to get fixed? Hmmmm......

I dont see US citizens hauling butt to Canada to get fixed... so whats really going on? Its the other way around.

And with UHC you have the right to sue, and sue and sue. And then you get a cash settlement that I and others had to pay for and then they go right down to the doctor who isnt in the system and get their asses fixed.

Its the same round robin. There is a round robin now of course in our system and that is the costs and that costs would be spread but they would rise and rise and rise. Pure bullshit of the masses. Socialism and Communism.

"We will destroy you from within", Nikita Kruschev.

By M. Randolph Kruger (not verified) on 30 Sep 2007 #permalink