Health Care

[Destroit]

I found the following article on MSNBC. It's about a girl who has received care in both America and Britain. It isn't from some politician or anything, and seems fairly unbiased.

SO...I ask that AFTER YOU READ IT (please don't just start spitting crap out without reading the article. If you don't have time to read it then you probably don't have time to get into an intelligent debate about it either. Kthnx.) I would like to hear everyone's individual and well thought out answer to the following dilemna:

What would you think is better: Free-market capitalist based health care (US) or socialized medicine (UK)? Why do you think so? Does this woman's viewpoint change your current stance or reinforce it?

No fighting please people, just DEBATE and YOUR side of the story. Kay, here's the article:

A tale of 2 sickbeds: Health care in U.K. vs. U.S.

A journalist's treatment for same condition in two countries is worlds apart

LONDON - A few weeks ago I found myself curled up in a hospital here in London, my feverish body shaking violently back and forth. The pain in my side and back made it hard to straighten my torso, and I’d thrown up in a friend’s car on the way to the hospital.

The hospital couldn’t find an extra hospital bed, so I spent my first night hooked up to an IV on a gurney in the middle of a row of men and women, my sweaty skin sticking to the plastic. A shriveled woman in the bed to my right issued loud and largely unintelligible commands to nobody in particular. A steady flow of patients visited the bathroom right in front of my bed. A shouting match broke out between some of the nurses and nurses aides until a man at the other end of the room yelled, “Could you please take it outside? I’m trying to rest.”

Sometime in the midst of this I was diagnosed with pyelonephritis, a severe urinary tract infection that had spread to a kidney, and ended up in the hospital for three nights. I had already been on two courses of antibiotics, but that hadn’t cleared up the initial infection. Finding myself sick and alone thousands of miles away from my mom was bad enough, but scarier still was just how familiar the illness felt.

I’d been sick with the same thing almost 10 years ago when I was in my 20s and still living in the United States, where I’m from. In both cases, my side and back hurt and fever shot up. And each time, I recovered after serious doses of antibiotics and lots of bed rest. But apart from that, my experiences were a world apart.

The biggest difference: Money. Getting sick in New York City decimated my bank account. In London, I didn’t pay a penny. I should note, however, that a full 9 percent of my gross pay goes towards the equivalent of a health tax. (For comparison’s sake, according to the Commonwealth Fund, in 2007 about half of working-age Americans spent 5 percent or more of their income on out-of-pocket medical costs and premiums.)

And while I recovered fully in both cases, the care I received felt quite different. In New York, I never feared that I would be overlooked. At my doctor’s office in upscale Gramercy Park, he and his nurses took their time seeing me, and were always at pains to reassure me. On my first visit, the receptionist let me sit in an empty consulting room so that I wouldn’t have to weep in the waiting room. She checked in on me and brought me water.

But unlike the personal care I received in the U.S., in London, I felt like I was on a vast and often creaking conveyor belt, and there was a big risk of falling through the cracks. British care is socialized — and feels that way.

Affordable, but at what cost?

Amid the fever and pain, and the crushing boredom of my London hospital beds (I spent each of my three nights in different wards of the huge Royal Free Hospital), I couldn’t help but compare my two experiences and think about the presidential campaign happening back home and the growing impetus for health care reform in the United States.

Would the elderly woman in my ward in London who repeatedly pleaded “Can someone help me please?” after being left on her dirty bedpan for almost an hour, recommend a version of the National Health Service to Americans? What would British patients who are denied certain drugs because of funding constraints or because they’re deemed too experimental say about it?

And how about Professor Paul Goddard, one of the England’s senior doctors, who said recently that thousands of hospital patients are “starving” because over-burdened nurses don’t have time to feed them?

I saw what he was talking about. In the third ward, I spent a day next to an ancient-looking woman who refused to touch her food. A few times the harried nurse tried unsuccessfully to get her to eat. Mostly my neighbor sat with her eyes closed, her chin resting on her chest.

Being mouthy and mobile, I felt confident that I could cajole the hospital workers into paying attention to me. As it turned out, I had to be very, very patient. Nurses paced the corridors all the time and we could call them from our beds, but doctors were a bit harder to come by — unless there was a real emergency everyone had to wait their turn. And about twice a day a pack of lean and well-dressed physicians clutching clipboards would lope into the ward, pull the flimsy green curtains around our beds and ask us to share intimate information within earshot of the other patients. Being shameless and forthright, I got along OK — I pressed the doctors for answers and they sent me for a battery of tests to make sure that there wasn’t anything else wrong with me.

But I wasn’t so confident for some of my companions. One of my three roommates in the second ward was a woman who said she had a dislodged stent in her chest and was waiting for urgent heart surgery. She gasped for breath when hobbling across the room to the bathroom, and rarely spoke to the doctors except to say “thank you.” She confessed to me through tears that she had tried to kill herself a few weeks earlier. At one point the nurses left her in a corner in a wheelchair for about two hours as they looked for a bed for her on the cardiac ward.

Going broke to pay for clean bill of health

Complaints about health care straddle both sides of the Atlantic, of course.

With both Republican John McCain and Democrat Barack Obama devoting time to the issue of reform, politicians in the United States are responding to the feeling that something fundamental has to change when it comes to taking care of Americans’ health.

That’s because “the system is breaking down,” says Jacob Hacker, a professor of political science at the University of California, Berkeley, whose work on health care reform influenced Obama and his former rival in the Democratic primary, Hillary Clinton.

“We have people who are facing financial ruin even if they have medical insurance,” says Hacker, the author of "The Great Risk Shift: The Assault on American Jobs, Families, Health Care and Retirement — And How You Can Fight Back.”

Ten years ago, while living in New York, I was out of work and paying more than $200 a month out of my meager savings into a group plan for health insurance. Still, I put off going to the doctor until I was quite sick, fearing that things could get out of control and I would end up paying for something I couldn’t afford. By the time I did go, I was in a waiting room doubled over and weeping from the pain.

During the first consultation in a small, neat but spare clinic on the West Side of Manhattan, I asked the nurse to call my insurance company. She informed them of my condition and there seemed to be no payment concerns so they were able to turn their attention to my health. My fever was very high and the doctor wavered on whether to send me directly to the hospital, but instead decided to send me to a specialist downtown. Unlike the clinic, with its plastic seats, cramped waiting room and harried-looking staff, the specialist’s office in a brownstone was warm and inviting. A fleet of nurses busied themselves with paperwork and smiled at the patients in the waiting room.

The doctor immediately put me at my ease with his twinkly eyes and a hand on my shoulder. After an ultrasound, the doctor sent me home, armed with prescriptions for painkillers and a potent antibiotic. It was good to be at home instead of a hospital but I was knocked out and slept much of the time. I soaked the sheets as I sweat through my fever.

I saw the doctor two times during my convalescence and he called my home several times to check on me. After several ultrasounds, he determined there was no permanent damage to my kidneys.

After I recovered, I was hit with another shock: my insurance company refused to pay the roughly $4,000 I owed. There had been a mix-up with the nurse in the first clinic; my insurance company now said they would have paid for a hospital stay, but not at-home care. The company also blamed the mix-up on me as I did not call them directly when I was first diagnosed.

Had I been older and more self-confident, I wouldn’t have dropped the issue after a couple of incredibly frustrating calls.

Unable to pay the bill, I felt guilty for years that the doctors who had cared for me had been left holding the bag. With my family’s help, I finally was able to pay what I owed, but by that point my finances were a mess and my credit record had taken a hit.

I was far from alone. Americans are hemorrhaging money into the health care system. According to the World Health Organization, the U.S. spent 16 percent of its gross domestic product on health care in 2005, almost two times that spent in the United Kingdom and other wealthy nations. And Americans are not healthier for it. By many measures, in fact, we are markedly worse off, something widely agreed on regardless of where you fall on the political spectrum.

“If you ask Americans if they are in favor of reform, you get everything from diehard Republicans and diehard liberals saying yes,” says Robert Moffitt, the director of the Center for Health Policy Studies at The Heritage Foundation, a conservative think tank.

A 2007 Center for Studying Health System Change study showed that one in five Americans surveyed reported going without or delaying health care in the previous 12 months, up sharply from one in seven doing so in 2003. The cost of care was the main reason for not getting medical attention, the organization says.

In my case 10 years ago, I ignored the initial illness and just drank a lot of water and cranberry juice and took over-the-counter painkillers. If I had gone to the doctor with my initial complaint — a simple urinary tract infection — it may have cost me around $200 for a visit and drugs, even if insurance hadn’t paid. Waiting for it to get really bad ended up costing me thousands instead.

U.K. the way to go?

Most agree there’s a problem with health care in the U.S., but is the United Kingdom’s system the way to go? Certainly, the U.K.’s health care system has been held up as an example of how to go about things.

Polemical documentary maker Michael Moore took on the issue in his 2007 movie “Sicko” and gave the NHS, established in 1948, a glowing review. He interviewed a number of people to show that the NHS is in good shape, with everyone from brand-new parents to family doctors giving it rave reviews.

My take was more mixed than Moore’s. The good part was that my local doctor is part of a cooperative that allows patients to see someone after-hours instead of resorting to the emergency room. The doctor who saw me first seemed to take a real interest and helped admit me to the hospital within minutes. The obviously over-worked nurses treated me gently, calling me and everyone else on the wards “dearie” and “love.” When they saw me, the doctors focused on me intently and made sure I underwent a series of tests to make sure nothing was overlooked.

But as I was being rotated through different hospital wards, it didn’t always feel like I was benefiting from a gold standard of care. I had to be alert to any opportunity to talk to a doctor and nurse about my condition — it wasn’t that I felt the staff didn’t care, only that they had so much to do and so many people to look after.

So, I looked out for myself. I made a point of showering, washing my hands often and getting a clean gown every day — nobody else seemed to be paying very close attention to my hygiene or anybody else’s. I thanked God every day for lovely friends who visited and made sure I ate properly.

The wards were always noisy, making it impossible to get a good night’s sleep. Visitors wandered in and out throughout the day and late into the night. On my second night, I woke up to find that the woman across from me had fallen out of bed. She lay on the ground moaning while I dragged my IV down the hallway to look for the nurses.

The NHS is relentlessly picked apart in the media here, and the government is under enormous pressure to fix its problems, such as high cancer death rates, deadly infections flourishing in some hospitals and alleged understaffing and incompetence.

Medical care is extremely variable across the service, says Vanessa Bourne of the Patients Association, an advocacy organization, with the care and treatment highly dependent not only on what part of the country the patient lives in but also on the quality of individual family doctors, or general practitioners, as they are known here.

These highly independent professionals wield enormous power because they’re responsible for referring patients to specialists and tests. If yours is good — and mine is great, for the record — then your health is in safe hands. But if she or he is lazy or incompetent it can have a serious impact on your health. And there is very little recourse if you have a complaint because you’re pretty much stuck with whatever GP practice is in your neighborhood.

One friend here refuses to visit his GP’s office because they don’t listen to him and assume he is only there to get a pink slip off of work. He has tried raising a number of issues to deaf ears. This cannot be good for his health in the long run.

The NHS is often criticized for being unresponsive to the regular user and instead largely answerable to its own enormous organization.

And we are talking humongous: The NHS is the largest employer in Europe, with about 1.3 million people on its payroll. It has an annual budget of around 90 billion pounds, or roughly $160 billion dollars.

Another criticism is the practice in some parts of the country of stopping care if a patient pays out of their own pocket to get a treatment that is not on the NHS. In other words, if you have cancer and can afford an experimental drug that has not been approved for general use, the NHS will force you into totally private care.

The system’s problems, real and perceived, are such that the best jobs in this country offer private insurance. A few of my friends have paid thousands of dollars extra to get private care when they gave birth. For this private care you get your own room instead of sharing a ward with other new mothers and their babies, and extra care from doctors and the nurses.

This frightens me. Certainly, I’m nervous about depending on the over-stretched and arbitrary organization if I have a baby or when I get old. I can still hear one old woman next to me in the hospital crying “Mummy, Mummy,” when she realized no one would come to comfort her. Still, even if the system here is riddled with problems, I’ve come to appreciate the U.K.’s efforts to care for the health of all of its people, including me.

When I got sick I wasn’t afraid to call the doctor because of money. I was run through myriad tests and attended to by a fleet of nurses and doctors. I am now fully better. I can and do make appointments at my neighborhood doctor’s office a five-minute walk from my house, without ever having to worry about being bankrupted.

Brinley Bruton first came to Great Britain to live and work as a journalist in 2002. She had previously lived in New York City. Earlier this year, she became a dual citizen.

Link: http://www.msnbc.msn.com/id/26794291/

[SaGa]

a mixure. basic needs social health care wins.

preventive care, seeing the doctor just to get stitches, or to get drugs to fix the infection you already know you have.

surgery. i cant see amarica wanting to front the bill in taxes for that. and i cant see doctors accepting that huge of a pay cut to make it affordable

realistically free-market could still work for hospitals. if they ever compete on price and quality. but its more oligarchy health care. there very little to compete for the cheapest price when they know they dont have to if there IS no competition for under cutting the other hospital in price while keeping a high quality.

heck we probly whouldnt need social healthcare if prices didnt skyrocket to unaffordable levels, at ALL levels of healthcare. paying out of pocket without insurence is like paying the doctor a good some of gold

on a side note. i dont know if they have cracked down on this. but the ammount a uninsured pays out being higher then what insurence whould pay and the insuree payed. iv heard a few stories on this.

[n0Mad]

Sure, socialized healthcare looks great on paper but do you really want the same government who fucked up Social Security, Medicaid, and other programs taking care of your healthcare?

Don't quote me on this, but I've heard that in Japan, healthcare runs on the free market economy like in the US, but if you have no insurance or your insurance drops the ball, then the hospital foots the tab for you.

[freydis]

If you think government health care is a good idea, just talk to someone from Canada.

I have.

No fuckin way.

Never work.

People in need of major surgery can end up on a waiting list.

That's some scary shit.

[SaGa]

to bad theres no HUGE compitition with price, health care as a buisness model has some nice advantages. location is everything. but the pricetag does not matter. they build it and charge whatever they deem is a decent return and profits to build a bigger and more expensive city hospital. i find it sad that the genesis hospital that can be seen going to flint, lights up the sky for a few miles. and looks like a stadium. with the inside looking like a 5 star hotel.

[Gaf The Horse With Tears]

We need to get rid of HMOs. Prices sky rocketed and the medical bureaucracy grew as soon as those damn things were invented.

[Destroit]

a mixure. basic needs social health care wins.

preventive care, seeing the doctor just to get stitches, or to get drugs to fix the infection you already know you have.

surgery. i cant see amarica wanting to front the bill in taxes for that. and i cant see doctors accepting that huge of a pay cut to make it affordable

realistically free-market could still work for hospitals. if they ever compete on price and quality. but its more oligarchy health care. there very little to compete for the cheapest price when they know they dont have to if there IS no competition for under cutting the other hospital in price while keeping a high quality.

heck we probly whouldnt need social healthcare if prices didnt skyrocket to unaffordable levels, at ALL levels of healthcare. paying out of pocket without insurence is like paying the doctor a good some of gold

on a side note. i dont know if they have cracked down on this. but the ammount a uninsured pays out being higher then what insurence whould pay and the insuree payed. iv heard a few stories on this.

Very true, we do have quite an oligarchy of our health care system...

The reason, I believe, doctors penalize people who don't have insurance by charging them more is because when someone doesn't have insurance the doctor can't charge frivolous shit to their coverage. For instance, my grandpa went into the hospital a long time ago and when they got the insurance bill they charged him $8 for one Tylenol pill. There was also something that said in very technical sounding terms along the line of Phlegm Depository or something crazy like that that they charged his bill $25 dollars for. We called the insurance to see what the hell it was and why it was so high....it was a fucking BOX OF KLEENEX! Not only did they get away with charging $25 for a box of Kleenex the insurance company said they didn't care and it happens all the time.

That bullshit needs to stop.

[TitsMcGee]

I've been fortunate enough to have insurance for most of my life, and I loose that in April after my birthday. However, a good friend of mine has never had insurance, other than when she was pregeant. I have seen how hard it is for her when she gets sick to go to the doctor because it costs so much for her. I agree with SaGa, there should be a meld of both types. Just the thought of having to be on a waiting list if I need surgery for something rather important scares the daylights outta me.

[Rev.Reverence]

Very torn... I have to go with a well thought out split... a compromise... England & Canada don't seem very well off... but what we are into now... dosn't work any better... too many scam-artists in this country.

[Ice Queen (1)]

Warning: Bias view and somewhat uneducated as to what a socialized system would actually entail and only privy to what it seems like it would entail from what I have heard here and there.

Yes, the system needs to work better, but socializing does not seem like it would accomplish that. There are alternatives available to those without insurance within the current system. Most counties have a free insurance for the uninsured. Contact your local health department for information. In the county I live in, I simply had to fill out my name and address and say I was uninsured (maybe my SSN#). There were no complicated forms or income verification. I immediately got a card. Sure, I had to call around to see who accepted, but office visits were maybe $10, and prescriptions were cheap too. There are some as well that do sliding scale fees, like for paps/birth control and such as well as dentists. It takes a little effort to find, but well worth it.

Based on that story: Being in direct patient care, it brings fear to my heart what would happen to patient care standards, safety and nurse to patient ratios in a socialized system. As a parent and consumer I would worry that my children and I would not get there services we needed at all or in a timely fashion. At least in the current system, I know that if it is needed, it will be given. No need to wait and hope for an approval to be put on a waiting list.

Of course, we need to talk $$. Health care is a major industry, employing a great amount of people. It is one of the very few industries in this state that people can find and keep a job in. And yes, I am bias, because it allows me to support my family. It scares me to think about what would happen to all those people whose livelihood, like mine, depends on health care. Not to mention, the nursing shortage. There is already a nursing shortage. Increasing the workload and stress and lowering pay (which seems to be indicated in a socialized system), will only worsen the situation. Nurses are already stretched too thin at some places that do not have strict nurse to patient ratios, or asked to work too many hours, or given more and more responsibility and less help in the form of unlicensed personnel. Having a good nurse that has time (this does not mean they are not extremely busy) to actually know their patient and what is going on versus one who is spread way too thin and overworked, can make a huge difference not only on the patient experience, but also with what kind of outcome the patient has. Sometimes, it literally makes the difference between life and death. The description in the article of the wards scares the hell out of me.

Another problem here: Frivolous law suits, they drive the cost up for everybody. Doctors are closing doors due to high cost of professional insurance. This is not to say that all law suits are frivolous. Some are warranted and should be pursued. It seems, many are not. People are upset because things did not turn out the way they wanted, or they are told things they do not want to hear. Procedures have risks, outcomes are not guaranteed, and medical intervention can only do so much.

[Msterbeau]

Socialized medicine basically benefits the poor and the middle income brackets that can't afford insurance. What"s their option if the government doesn't assist them?

[Gaf The Horse With Tears]

Their pride. They have to swallow it and sign up for Medicaid.

[n0Mad]

Their pride. They have to swallow it and sign up for Medicaid.

Medicaid was a blessing when I needed it. I was between jobs and ended up in the ER without insurance and I was glad to take any state's aid I could but found a job with health insurance as soon as I could. In situations like that, I am grateful. Those lazy asses who live off of welfare and don't care about bettering their lives, they're the ones that fuck up the system for those who really need it. And all those people who use the ER as their own personal physician because it's the only thing the state will pay for need to stop, get a job with insurance (have you seen McDonalds, Starbucks, Walgreens, WalMarts, etc. healthplans? Quite nice), and get a family doctor. Our current system would actually work quite well if people stopped pooping on it.

[n0Mad]

A few of my customers in line at Walgreens today were discussing the idea of national healthcare. One was pretty neutral on the idea but the other (wearing an "I Am Union") t-shirt was all for it and saying how we're the only industrial nation that doesn't have it. After those two customers left, the next person shook his head and said:

"My father is dying because of national health care. My whole family is from Italy. We can't get shit over there. The wait is forever and the technology is pathetic. The rest of Europe is not better. You get what you pay for and when health care is free, you don't get quality any more. There is no incentive for doctors to work or do a good job past half-assed just getting by. No need for science and technology to develop any breakthroughs when it's no longer funded. So, my family packed our bags and came to America. Mom and I are working jobs that aren't all that great, the hours are long, the pay is poor, but it's better than what we had in Italy and even our mediocre health care plan after 90 days is phenomenal compared to European socialism. You really have no idea how good you have it in America until you try living somewhere else. Your doctors saved my father's life. I read the papers, yes things are bad right now, but they were bad 70 years ago too and 130 years ago. You will bounce back, this is America. Well, as long as you stay America you will bounce back. Don't become socialist. It doesn't work. I know, I lived it."

It was amazing. The look in his eyes. I could really feel his emotions. He loves this country as much as he loves his father and it pains him to see our citizens spit on it. Yes, I think we have an immigration problem. But with people like this customer, we can learn a lot from immigrants and if they were all like him, I welcome them for they are often better citizens than we are.