Respectful Insolence

The only thing he’s left out is a takedown of Nazi analogies. After all, Nazis wanted universal health care, too, except that they wanted to guarantee the health of the volk more than any individual:

Comments

  1. #1 Zach Miller
    July 23, 2009

    I always love it when Lewis is on the Daily Show, and the other night was no exception.

  2. #2 Deafboy
    July 23, 2009

    Hilarious. Why is it the daily show is so great at making especially repubs look like idiots?

  3. #3 Autismnostrum
    July 23, 2009

    That was a classic.

  4. #4 Rita
    July 23, 2009

    What on earth is wrong with the idea of socialised medicine? We Brits were brought up on it, it’s great. Not an easy thing to run, these days, money being a bit tight, but better than that awful private health care nightmare – unless you’re rich of course……….but lots of people aren’t – what DO they do in your society?

  5. #5 The Science Pundit
    July 23, 2009

    I loved how he put Peggy Noonan in her place. As they say on the interwebz: PWNT!

  6. #6 Kristie McNealy
    July 23, 2009

    “What on earth is wrong with the idea of socialised medicine?”

    How about the part where your government, as well as Canada’s, regularly sends people to other countries to get treatments they can’t provide? In the US, we get a fairly regular influx of NICU babies from Canada, because in parts of Canada there are only open NICU beds about 50% of the time.

    Here’s a news story with some recent examples of this:
    http://www.thespec.com/News/Local/article/590540

    In the UK, people are sent to other countries for joint replacements and who knows what else.

    Not my cup of tea to wait months or years for necessary tests or treatments or be separated from my loved ones in a time of critical illness.

  7. #7 Tigana
    July 23, 2009

    yes, always find it difficult to understand *why* so many Americans are against universal care. Over the pond we went through this before I was born – yes, it costs lots of money, yes I don’t agree with every decision of what should be included (homeopathy *hello* – or IVF *my bugbear*) I know if I ever get seriously ill, I will be looked after, the drugs paid for. I am happy to pay higher taxes *now* for the reassurance, for me and my family. Not perfect, but a whole lot better than the national lottery that appears to be the case in the States.

  8. #8 Tigana
    July 23, 2009

    Kristie,

    can’t speak for Canada, but in the UK, when people have been sent abroad for treatment abroad it has been paid for by the NHS, to clear waiting lists for particular operations, or because it was cheaper to pay a surgeon abroad to do the same operation. The operation were for things like hip replacements – not generally a time *of critical illness* hence they were voluntary.

    Having said that, if I was critically ill & I had a choice of being with my family and having no treatment or going abroad and expecting my family (who live some way from me anyway) to travel to see me – guess which one i would choose? Plus without ending up with crippling medical debts.

    I don’t know what you are trying to argue. The hospitals in the States are happy to fill their surplus beds with Canadians because they refuse to fill them with poor American with no insurance. Is that fair?

  9. #9 Kristie McNealy
    July 23, 2009

    “I don’t know what you are trying to argue. The hospitals in the States are happy to fill their surplus beds with Canadians because they refuse to fill them with poor American with no insurance. Is that fair?”

    Actually, hospitals in the US cannot turn you away if you are actually sick, regardless of whether or not you have insurance.

    My argument is that if you need to send people abroad, no matter who pays for it, the system isn’t working.

    Perhaps you haven’t seen a family torn apart while their child is hospitalized hundreds of miles away. It’s a pretty horrible situation, especially with a tiny baby.

    In the US, the alternative is not to sit and die. I’ve spent enough time taking care of uninsured people at a county hospital here to know that.

  10. #10 Zach Miller
    July 23, 2009

    “Perhaps you haven’t seen a family torn apart while their child is hospitalized hundreds of miles away. It’s a pretty horrible situation, especially with a tiny baby.”

    At what point do the needs (or wants) of a few give way to the needs of the many? I wouldn’t call what you describe a broken system, merely one that’s different from ours. If the “tiny baby” gets the care s/he needs, what’s to complain about?

    I have Cystic Fibrosis, and if I had to travel to a distant land to get a lung transplant (and if it was paid for by the government), you bet your ass I’d be on the first flight.

  11. #11 genewitch
    July 23, 2009

    Kristie:
    They can decline you VOLUNTARY procedures without healthcare.
    County hospitals usually don’t, that’s why tons of county hospitals are CLOSING. because taxpayers don’t want to pay for everyone’s health, just their own.

    Healthcare reform will take place on its own when private healthcare becomes so expensive that only the upper cruft can afford it (which won’t take much longer with everyone waiting longer to acquire health insurance now)

    comparing the US to canada or england is apples and oranges, and i think anyone who does it should be forced to sit through several Logic and Critical Thinking courses at a junior college.

    Until a country takes care of the miscreants and poor and homeless, it can’t compare its health care system to that of a country that does.

  12. #12 Mike Haubrich, FCD
    July 23, 2009

    Hilarious. Why is it the daily show is so great at making especially repubs look like idiots?

    Posted by: Deafboy | July 23, 2009 5:01 PM

    It’s great material to work with. To be fair, the jokes pretty much write themselves.

  13. #13 Cthulhu
    July 23, 2009

    Hospitals can’t deny life or death care, but once you are stable their obligation ends. Back in 1991 Humana hospital told my grandparents that unless they signed a contract pledging to cover all my father’s medical bills (he had cardiomyopathy) they wouldn’t treat him.

  14. #14 Calli Arcale
    July 23, 2009

    “How about the part where your government, as well as Canada’s, regularly sends people to other countries to get treatments they can’t provide? In the US, we get a fairly regular influx of NICU babies from Canada, because in parts of Canada there are only open NICU beds about 50% of the time.”

    Just curious — do you kno how many of those are being sent to the US because Canada’s system sucks (which seems to be your contention) versus because no place has an infinite number of beds? I mean, babies get flown all over *within* the US for the same reason. There are whole charities which have sprung up to help parents whose families have been uprooted so they can accompany their children to remote hospitals. The Ronald McDonald House is probably the most visible of these charities.

    Bottom line is that kids get flown all over *anyway*. I’ve never seen a good breakdown of how much this is due to just the nature of pediatric medicine and how much this is due to lack of capacity abroad. (It is worth pointing out that I have heard of American babies being sent to Canadian hospitals, because that happened to be where the care could be provided. It happens less, though, because while Canada will pay for their citizens to get care in the US under these circumstances, the reverse is dependent on the restrictions of the patient’s insurer, assuming there is one.)

    And while at your county hospital you may not have turned people away with life-threatening illnesses, please don’t assume that that is what happens everywhere in the US. Most hospitals do a good job of balancing indigent care with other care, although in the end, the only way they can do this is by raising fees on those with insurance, which would not be necessary if everybody had insurance.

  15. #15 DLC
    July 23, 2009

    Hm… so if I am sick and go to canada they will take care of me ?
    I live 2 miles from a hospital. If I walk in sick and have no insurance they’ll tell me to go to the county hospital, which is some 20 miles away. The obligation is not “if you’re sick” but if you are in immediate danger of loss of life.

  16. #16 ebohlman
    July 23, 2009

    Kristie: Keep in mind that differences in the availability of highly specialized resources (e.g. NICUs or heart transplant teams) between the US and other countries can reflect lots of factors other than the system of healthcare financing, factors such as the US having a much larger population than other developed countries. From a purely medical point of view, you want such facilities to have nearly full utilization because the best outcomes are associated with units that see lots of patients per year. That means that in a country like Canada with a relatively small population spread out over a large geographic area, having such facilities close to just about everybody would mean having so many of them that most of them wouldn’t be treating enough people to stay in top form.

  17. #17 Tony P
    July 23, 2009

    To all you who say they can’t turn you away that’s utter and complete bovine effluent. They can and do turn people away.

    Not only that if they take you in, you’re left with a whopping bill afterward. Just as an example, when I had insurance I needed a strep test. My doc was out of town and I went to the local ER. The bill, which my insurance company refused to pay, $700 for a strep test.

  18. #18 D. C. Sessions
    July 23, 2009

    Most hospitals do a good job of balancing indigent care with other care, although in the end, the only way they can do this is by raising fees on those with insurance

    s/those with insurance/those without insurance/

    Insurance companies have the negotiating power to force down their reimbursement rates (generally to Medicare levels.) The result is that “full rates” are only paid by people with no insurance: the working poor. Going over the charges for some recent injury treatments, I find that the docs, hospitals, etc. were paid between 30% and 50% of the billed amount. Co-workers tell me that the ratio can go as high as 10:1 for some lab tests.

    Now you know why medical bills are the #1 cause of personal bankruptcy in the USA.

  19. #19 Travis
    July 23, 2009

    Is it really the #1 cause of personal bankruptcy in the US? Scary!

    I just had a circumcision performed last week (ouch, and no it was not a cosmetic choice so if you are very anti-circ please do not scream at me, I understand the concerns, but sometimes it is medically needed) and I am really curious how much this procedure would cost in the US. I had it done at a hospital under general anaesthetic, but it was just a day surgery so I was out the same day.

    I am in Canada and so far my out of pocket expense was something like $40, $15 to cover the painkillers, and about $25 for gauze, tape and polysporin.

    Is there some calculator out there that can estimate the cost of this?

  20. #20 Damian
    July 24, 2009

    Kristie McNealy appears to be confusing the fact that there are people with the necessary expertise to perform certain operations in the US that do not exist anywhere else (as there are in other counties), as well as the fact that it is sometimes preferable to send people abroad for numerous other reasons, many of which have been highlighted, with the quality of the care and the hospitals in other countries. That, as they say, simply does not follow. And those operations (and other services) are often not even available to all Americans, anyway, because they are deemed too expensive.

    If it is a choice between being denied certain medical procedures, being slapped with an enormous medical bill that takes years to pay off, or traveling on a plane for a few hours, which would you choose?

  21. #21 oscar zoalaster
    July 24, 2009

    In the US, the alternative is not to sit and die.

    Yes it is. Because you cannot afford to go to the doctor you wait and hope that things get better on their own. And then when you get to the point where you desperately go to the doctor you are often told that ‘if you had come in earlier…’ and ‘it is so advanced now’ that the only honorable thing to do is go home and die instead of wasting a bunch of medical resources on care that is now ‘too little, too late’, and providing your relatives with huge bills. Anyone who thinks that ‘charity care’ is the same thing as ‘health coverage’ has never been poor.

  22. #22 Militant Agnostic
    July 24, 2009

    Kristie – one cherry picked example proves exactly what? The Canadian Health Care System does have some problems with long waits, especially in the less affluent provinces but these are being addressed. Foe example, the Calgary health region reduced waiting times for hip replacements by applying Industrial Engineering methods to increase the rate at which they could do procedures. You should try talking to some actual Canadians – you will find that they are not exactly clamoring to change to a health cares system like the US.

  23. #23 Dianne
    July 24, 2009

    After all, Nazis wanted universal health care, too, except that they wanted to guarantee the health of the volk more than any individual:

    And had it to, having inherited a universal health care system from Bismark. The Nazi’s “contribution” was to exclude a bunch of people from their health care system (or systems since Germany has not only multiple insurers but multiple public insurers…it’s complicated but effective). Sort of like the way insurance companies in the US try to exclude certain people from their coverage. (Intentional Godwin…and a bit unfair. Health insurance companies in the US are rarely committing intentional genocide. Just death from neglect.)

  24. #24 Mark P
    July 24, 2009

    “How about the part where your government, as well as Canada’s, regularly sends people to other countries to get treatments they can’t provide?”

    Don’t argue with this. This isn’t the problem. The problem is that Canada’s system is SOCIALIST. Not to say Communist. The target will move, because facts aren’t at issue, but ideology.

    Anyone looking at facts will soon find that single payer systems are cheaper and more effective. You can go the New Zealand route and make them cheap, and the French route and make them really effective, but they always work out better value for money than the US method (which costs the same as the French system, but delivers the same as the NZ — basically half the value for money).

    But government directed health is SOCIALIST, and therefore impossible in the US.

  25. #25 Andrew Dodds
    July 24, 2009

    Mark -

    I get the impression it’s purely a case of US healthcare making huge profits for insurance companies, allowing them to spend a small fortune on lobbying to convince people not to change it.

  26. #26 Luis
    July 24, 2009

    I allways thought that the major problem in the USA was with non life threatening cronic illness. In Portugal it would be impossible to have that sort of medical expense covered by insurance, at least indefinetely, and certainly if you are over 65 years old!

  27. #27 D. C. Sessions
    July 24, 2009

    Travis:

    Outpatient minor day surgery, general anaesthesia? Very roughly $1000 US dollars. I’m comparing with a tendon repair of mine last year and applying windage for the fact that “general anaesthesia” in your case wouldn’t require a respirator, the surgery itself is simpler, and the postop is simpler (no cast, for instance.)

  28. #28 Jud
    July 24, 2009

    So Kristie, do you think we ought to get rid of Original Medicare (Parts A and B)? And what should we do with the tens of millions of seniors it covers?

  29. #29 Jud
    July 24, 2009

    One more thing, Kristie: I’ve read the article you cited from the Hamilton (Ontario) Spectator. In an emergency situation requiring NICU treatment, the nearest NICU bed to be found was in Buffalo, NY. As the article relates, the parents were barred from coming with their baby because of the U.S. government’s new policy requiring passports for Canadians wishing to enter the U.S., a (quite legitimate, IMHO) sore point for Canadians. (I’m a U.S. citizen who used to travel back and forth between Canada and the U.S. frequently between 1988-1994, using nothing more than a driver’s license and Social Security card for ID.)

    The article describes the parents’ anxiety at being separated from their baby, especially given the child’s medical condition.

    And you read this as a criticism of Canadian health care?

  30. #30 Dianne
    July 24, 2009

    If we’re going to talk about cross border health care, what about all those people who go to Canada to get their prescriptions filled?

  31. #31 Brent
    July 24, 2009

    I have no figures but I wonder if the Canadian health system figured when planning NICU beds that it would be cheaper to send babies to the US as needed. It is expensive to set up and staff a NICU. If there are plenty of beds just across the border then it is cost effective to contract for their use.

    I worked as a nurse at a Shriner’s hospital that contracted with a local pediatric hospital for surgery space and recovery rooms. They only had a few cases per week so it made economic sense to contract those services. Such a calculation may have been part of the Canadian decision.

    The problem of restricting parent visitation is a concern but could be resolved quickly if there is the will on the US side.

  32. #32 Kristie McNealy
    July 24, 2009

    OK, so if it is cheaper to send people abroad, what happens when the US adopts socialized medicine, and suddenly there is no place to send people from Canada when their intensive care units overflow? Or if European countries say no way do we have the capacity to do joint replacements for people from other countries?

    The babies I have seen transferred within the US, generally are transferred because they live someplace without a high enough level NICU. In Colorado, we take a lot of babies from rural areas in the surrounding states. We do not, however, send those babies to Canada or Mexico. If the premature baby was born near a hospital with a high level NICU, it would most likely stay there.

    Ronald McDonald House occupants are there for a variety of reasons. People move within the country to join clinical trials, to see the recognized expert in their field, or because they live somewhere that is too small to support specialists for a rare disease. They might just prefer another doctor. They do not get shipped to California because Ohio cannot do their knee replacement until 2012.

  33. #33 Michael Ralston
    July 24, 2009

    Kristie: Everything you are saying is rendered moot when one exampines the consequences of the simple fact that almost everyone in Canada lives near the border with the US, but almost everyone in the US does not live near the Canadian border.

  34. #34 Zach Miller
    July 24, 2009

    Kristi, again, I just don’t understand your objection. If travel is a viable means of getting care, why complain?

    And what’s with all screaming about SOCIALISM? It’s a specific governmental system with its own pros and cons. It’s not THE DEVIL or something. I really, really don’t understand the constant fear of socialism. It seems to work pretty well for those who have it.

  35. #35 Sid Offit
    July 24, 2009

    Orac, where’ve you been hiding this guy? He’s HILARIOUS!!!. A real Bozo the Clown. I thought I was gonna die laughing.

  36. #36 Astrofys
    July 24, 2009

    Kristie: Why do you assume that the default case is to be shipped away to a foreign city if medicine is socialised? This will only occur if the treament is unavailible at nearby hospitals, which could be due backloggs, rare form of treatment, etc.

    And why do you assume that there must be under-capacity in such a system?

  37. #37 Zar
    July 25, 2009

    Hospitals in the US are going under because of the current health care system. They have to treat patients, but many of these patients can’t—and don’t—pay the bill, so the hospital loses money. It’s a huge problem. No one can honestly look at the situation in this country and think that things are all right. I know there are lots of dramatic horror stories about Canada and England, but I have yet to see an English person or a Canadian who would prefer the American system.

  38. #38 Infophile
    July 25, 2009

    And what’s with all screaming about SOCIALISM? It’s a specific governmental system with its own pros and cons. It’s not THE DEVIL or something. I really, really don’t understand the constant fear of socialism. It seems to work pretty well for those who have it.

    In the minds of many Americans, the Cold War never ended. Socialism and communism are The Enemy. That’s really all there is to it.

  39. #39 dp
    July 26, 2009

    Kristie the fastest growing travel segment in the US is US citizens travelling abroad for medical procedures. So this is already happening in the US the only difference is that the cost is out of pocket. The vast majority of people travelling to the US for medical procedures are RICH. The wealthy don’t have a problem with health care and the US lives up to its billing as number 1 provider. Its the rest of us. Those that have seen premiums go up 20% per year when salaries are at 2-3%. Those that have seen companies cut the corporate match or eliminate coverage altogether. Those that have something happen to them and find out that they really weren’t covered for that ailment or worse somehow it gets declared pre-existing. Those that have chronic conditions (not eligable to buy insurance at any cost) who are one layoff away from bankrupcy. I’m afraid that you need to get out more and talk to the little people.

  40. #40 Roger
    July 26, 2009

    Just because a hospital can’t turn you away without health insurance doesn’t mean you get free care, FYI. By an error (story too long to get into) I was uninsured (unbeknown to me) and was sick recently. I went to the county hospital and was treated for about 48 hours, no questions asked, no financial counseling offered. I went home and received a bill for $9,800.00. I have said that I can’t pay and offered to pay $100 a month. They said no. My best offer? $3,500 down now then $500 a month for the next two years or so.

    The myth of the poor being taken care of by the public hospital is just that, a myth. I may have to declare bankruptcy.

    Oh yeah, and I’m a physician (1st year resident in Internal Medicine).

  41. #41 Barry
    July 29, 2009

    “Actually, hospitals in the US cannot turn you away if you are actually sick, regardless of whether or not you have insurance. ”

    Posted by: Kristie McNealy

    Just to add on to the pile up, because you deserve it – you’re wrong.

    And when we consider your other statement: “I’ve spent enough time taking care of uninsured people at a county hospital here to know that. ”

    You’re claiming knowledge, and making false statements. That means that you’re lying, not just ignorant.