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Mama Deb
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Mama Deb [userpic]
Rant - healthcare

sraun wanted a rant on US Healthcare. Please note that this *is* a rant, and thus more opinion than anything else, and I might get things wrong.

US Healthcare is...huh. We have some of the best and some of the worst healthcare in the world. We have cutting edge, groundbreaking research and techniques. We're also #36 in terms of infant mortality, with countries like Malta and Slovenia ahead of us. Not to mention the UK and Canada.

If you have the money, or decent insurance, the US is...less than it used to be because of the rise of the HMOs, so you might not have consistency of medical care even if you can afford it, but it's still excellent. You'll get quick and effective treatment and surgery, even cosmetic surgery. Except that things are deteriorating even then - one of the most effective tools medicine has is nursing, but nursing is not a place to be anymore. Hospitals are hiring fewer of them and working them longer hours, and using cheaper aides, who may not have the skills to notice real problems and who cannot give the same care that nurses do.

But the worst of it is for those who cannot afford medical care. They can't afford the routine checkups, both medical and dental, that catch problems when they're small and treatable, as opposed to big and either only treatable with more expensive and drastic means or untreatable. If the choice is dentist or food, doctor or rent, there isn't a choice. And then it costs them more money and drives them deeper into debt, or, with no other choice, they have to go on public assistance. Yes, of course, there are those who take advantage of the system, but mostly it's there for what it should be - backup.

It's galling to me that people in what was the richest country in the world die of treatable illnesses because the treatments cost more than they have. Yes, I know that in countries with socialized medicine or national health insurance (not the same things), one might have to wait a longer time for non-emergency surgery, and that there are other problems or abuses. However, it means that even the poorest person has access to a decent level of care, and the wealthy can, if they wish, pay for more immediate care.

An example - my sister-in-law lives in Tel Aviv. She has, unfortunately, a rare form of cancer, although, thank God, she's doing very well. She was ready and willing to pay for private care, but the physician she wanted to use was able to take her on as a subsidized patient. Her care will be identical,except that the taxes she already pays will pay for that.

And yes, I know that that's the downside - much higher taxes. But the countries that pay these taxes seem to accept this. I don't know.

ETA: My information about infant mortality came from here.


And yes, I know that that's the downside - much higher taxes. But the countries that pay these taxes seem to accept this.

They accept this, at least in part, because though they pay higher taxes they have lower health care *costs*. In particular, we pay an enormous amount for health care administration -- perhaps 20-25% of our total health care costs -- and we also pay for insurance companies, etc., to make profits.

Yep. I have lived outside the US as a transient with no health care, and every time we needed medical care it was far cheaper than in the US, even in small island countries with high costs of living.

That is because of the enormous insurance bureaucracy. They are all on the take--LEGALLY. And the drug companies don't help.

I agree. I'm Canadian and I've always said I'd rather pay slightly higher taxes and wait a little longer for non-emergency procedures, if it means that I won't have to pay. No way could I afford to pay for medical care, especially some of the things I've had to have done in the last year due to my accident in 2004.

I need fairly important knee surgery, and likely I will end up waiting until about May for it, but there's no way I could afford to pay for it myself, even if than meant I could have it tomorrow.

Non-emergency things DO take longer, but emergency care here is as good as anywhere else, completely free (although there are insurance premiums if you can afford them), and for that there is no wait.

Motherfrelling WORD.

Pay a bit more in taxes to know that when I need to I make an apointment, get in the car and GO and sign in and don't have to deal with paperwork? HELL YES!

And for all those people who worry about abuse of the system. We already have a subsidized medical programs, and believe you me, the healthcare system has ways of weeding out/deflecting over 90% of the "frequent flyers".

I'm currently uninsured. I wouldn't even know where to start at looking for individual health insurance. Routine checkups do not happen. My teeth are deteriorating. I was able to afford my last dental work through the good grace of my parents.

I've lived in the US without insurance, and in the US with excellent insurance, and in Canada. Canada is better. Canada is much, much better. I don't even notice the higher taxes because *none* of my paycheck goes to insurance premiums or out-of-pocket expense. I've had no trouble at all getting excellent, speedy treatment for minor and routine stuff, despite what you hear about wait times, though to be fair I live in the richest city with the best health-care institutions in the country, and I know it doesn't work so well elsewhere all the time.

A couple of things I think people who have been in Canada their whole lives might not notice but that, to me, are HUGE:

Knowing that everyone I pass on the street, from the guy with the pushcart full of recyclable bottles to the persons whizzing by in their SUVs, has the same access to the same level of treatment that I get makes me feel good, and makes everyday encounters in the city less tense. Toronto is a happier and more peaceful place than Chicago (comparable size, weather, population) and health care is part of the reason why.

The minimal or non-existent access to health care for poor people in the US means that people who live in poor places -- rural Pennsylvania, in my case -- get crappy health care even when we have high-end insurance, because supporting good hospitals and clinics and, hell, even dentists, requires a large population of people with insurance nearby. Otherwise even with insurance you can only get what poor people can afford, and it is lousy. Part of the argument for not having a single-payer nationalized health care system has been that Canadians don't get as much "choice" as Americans who have insurance. But many people, even with good insurance, still have very limited options.

The more time I spend in Canada the less sense the US health care system makes to me.

Ooh! Nice Rant! Thank you.

I'm hoping that someone can get a campaign going to get corporate support for some kind of nationlized health care in the US on the theory that it will be cheaper overall for the corporations. My current insurance was costing my employer about 15% of my salary (and my contribution was about 3% of my salary). Ouch! I'm currently paying the whole premium myself (COBRA - I'm hoping that I'll find a position with benefits soonish!) - and it's still a good deal for us! My wife's monthly prescription medicines have a list price almost equal to our total premium - add in my monthly prescriptions, and our doctor visits, and we're definitely ahead of the game. But that's just medical - we currently have no dental coverage, and we aren't seeing the dentist. Now, we've both got pretty good teeth, we care for them, and we made certain we got current on our dental needs in the two months before I was laid off. But we aren't going to be going to the dentist for anything other than emergency needs until I get a new job.