This is the Government that You Want to Run Health-care?

[Architect]

It comes back to the same point. Whether you believe that, as a society, you have a responsiblity to provide certain universal care standards, for example healthcare, education, and welfare/social security, at a consistent level regardless of each individual's ability to pay.

Europe, Canada, Australia, and NZ all say yes, and have dones so for some 60+ years. So far none of the countries have gone to hell in a canoe, much to Jermoe's surprise I suspect. I'm happy to stick with our system and work to iron out the bugs, but I'm damned if I'd swap it for the US system where - as far as I can tell - the least able to support themselves are kicked where it hurts.

 

[jimbob]

ETA for clarity:

Don't make me laugh. Do you know just how long ago the Opium Wars were? Are you aware that most of our colonies were essentially wholly devolved financial administrations prior to WW2, and that we gave them all independence from 1945 onwards, barring a few minor corners who wanted to stay British? Are you seriously suggesting that we've been sitting on some massive cash coffer for 63+ years?

You're just trying to avoid answering the question.

And Architect, he was talking to Blue Mountain, who lives in winnipeg, which is a part of the UK that I am entirely unfamiliar with...

 

[Architect]

Oh, I don't know, you can have anything you agree to pay for ...

We pay for lots of things out our NI contributions, which you will recall are generally less than the tax you pay.

Just to summarise:

• Generally speaking most UK and European employers will pay up to a month's full wages whilst you're on sick leave. Thereafter the state kicks in with SSP - a fairly modest amount, but cash nonetheless.

• If you're chronically ill and off work for a long time, then you'll probably get disability allowance and additional financial support to provide for personal care.

• If you are left with insufficient cash to survive then Social Security kicks in and you'll get state benefits. You also get these if you're unemployed. There is no time limit or cap on the amount, although if you are fit you will have to go on training courses, etc.

• If you are pregnant, then you are entitled to Maternity Leave. During this period your employer is required to pay you, thereafter the state kicks in with a modest allowance for (if I recall correctly) about 6 months. Maybe a year. And it's illegal to fire someone for being pregnant.

• Fathers are entitled to two weeks paid paternity leave.

• Both parents are entitled, by law, to up to 6 weeks unpaid leave during the first five years of a childs life.

In Scotland our welfare state further provides :

• Free nursing care (either at home or in nursing homes) for all elderly people who require it.

• Dental treatment is free for a substantial proportion of the population, focussing upon the young and elderly as well as the unemployed.

• Eyesight tests are free for everyone. Glasses are free or heavily subsidised for the same groups as dental treatment.

• Schoolchildren are about to get free school meals in order ensure a balanced diet for those in the poorest communities (the trials have just been completed and have been very successful).

Hey, perhaps you have the same in the US but did you know that in the UK there is a minimum wage?

 

[Architect]

ETA for clarity:


And Architect, he was talking to Blue Mountain, who lives in winnipeg, which is a part of the UK that I am entirely unfamiliar with...

When you answer what health-care the United Kingdom provides for all the people of its former vassals from which it raped and pillaged so as to provide the wealth to pay for the health-care for its citizens I will answer your question.

Aye, perhaps, but he was talking about us.

And isn't Winnipeg out the back of Bolton somewhere?

 

[jimbob]

Jeropme, is your argument that because historically there have been injustices, we shouldn't bother with attempting to ameliorate current injustices.

 

[JEROME DA GNOME]

Jeropme, is your argument that because historically there have been injustices, we shouldn't bother with attempting to ameliorate current injustices.

Not at all. My argument is that the system which provides your "free" health-care is only possible because of the wealth that was extracted by the empire and the wealth which is not currently spent because of American military protection of Europe. If the emotionally charged argument is to be made against the American system is that it does not properly care for its citizens in regards to health-care than it is proper to extent the argument to the circumstances of UK wealth. If I am to be asked how the American system is to care for particular cases than I want to know how the UK is going to care for the former colonies from which it extracted the wealth which allows its current system.

 

[jimbob]

But our government spends less on helathcare than the US government does.

 

[JEROME DA GNOME]

But our government spends less on helathcare than the US government does.

Only because your government is not providing health-care to all the people it has a responsibility to care for.

 

[balrog666]

[snip]

How is this better than the Canadian and European systems?

Did I say it was better? In any case, it's the system we have.

I issue you a challenge. Look up the welfare rates for your area. Assume you're eligible for food stamps, and that you can make a trip to your local food bank once a month, or as often as the food bank allows. If your house is paid for, factor in the cost of a low-rent bachelor suite, since the majority of welfare recipients don't own their own homes. Then live on only that amount of money for the next month. No credit cards. No bank balance. Begging in the street for spare change is allowed.

If you don't do that, I will remind you of this challenge every time I see you mention the word welfare in a post. I won't assiduously monitor your posts, just the ones you make in the topics we both participate in.

I've been there and done that and I wouldn't need to beg and I wouldn't need the food banks. Furthermore I would end up with more money at the end of the month than I started with.

The difficult arises when one tries to maintain the same lifestyle with reduced income (divorces also tend to produce such a problem) and/or little savings or other assets.

 

[jimbob]

Well Architect did say it earlier:

Don't make me laugh. Do you know just how long ago the Opium Wars were? Are you aware that most of our colonies were essentially wholly devolved financial administrations prior to WW2, and that we gave them all independence from 1945 onwards, barring a few minor corners who wanted to stay British? Are you seriously suggesting that we've been sitting on some massive cash coffer for 63+ years?

You're just trying to avoid answering the question.

Jerome posted his original comment to a Canadian; I am interested in the fundamental difference in the source of Canada's wealth compared to the US. Of course, slavery in the British Empire ended in 1834, so less Canadian wealth was built on slavery. Canada also fought all through WWII (without needing to). It would have been equally affected as the US by European geopolitics.

Canada manages a universal healthcare system.

American defence of Europpe was self-interested.

Not at all. My argument is that the system which provides your "free" health-care is only possible because of the wealth that was extracted by the empire and the wealth which is not currently spent because of American military protection of Europe. If the emotionally charged argument is to be made against the American system is that it does not properly care for its citizens in regards to health-care than it is proper to extent the argument to the circumstances of UK wealth. If I am to be asked how the American system is to care for particular cases than I want to know how the UK is going to care for the former colonies from which it extracted the wealth which allows its current system.

I am confused.

Firstly I do not see what the relevance a discussion about the origin of the wealth of the US and the UK has to do with the fact that the US government provides healthcare for about 37-million citizens, whilst a similar proportion of GDP, provides coverage for 60-million UK citizens. And this is from a population of 60-million and not 301-million.

My argument is that meidcaid is expensive, and ineffective compared to many examples of universal healthcare. What does this digression have to do with the effecacy of medicaid?

The British Empire brought wealth to the UK that should be spread around the commonwealth. American wealth arose in a fundamentally different fashion, and thus is 100% "clean". Britain should have paid the US for military aid it received during World War II (which it did). Europe should have contributed to the defence of Europe (maybe by taking part in a North Atlantic Treaty Alliance, or "NATA").

 

[D'rok]

Only because your government is not providing health-care to all the people it has a responsibility to care for.

Some descendants of former slaves who are living in institutionalized poverty in your country might want a word with you.

Good lord. Has it really come to this? The argument against universal health care is that Britain once had an empire? Pathetic.

 

[zooterkin]

Britain should have paid the US for military aid it received during World War II (which it did).

Indeed; didn't a significant proportion of Britain's wealth get transferred to the US as a result? So the US should be supporting the former Empire, by JDG's logic.

 

[jimbob]

Some descendants of former slaves who are living in institutionalized poverty in your country might want a word with you.

Good lord. Has it really come to this? The argument against universal health care is that Britain once had an empire? Pathetic.

Indeed it does win a non-sequiter award in the context of the efficacy of medicaid.

 

[Architect]

Not at all. My argument is that the system which provides your "free" health-care is only possible because of the wealth that was extracted by the empire and the wealth which is not currently spent because of American military protection of Europe. If the emotionally charged argument is to be made against the American system is that it does not properly care for its citizens in regards to health-care than it is proper to extent the argument to the circumstances of UK wealth. If I am to be asked how the American system is to care for particular cases than I want to know how the UK is going to care for the former colonies from which it extracted the wealth which allows its current system.

Isn't this sudden and wholly irrelevant change of direction a tacit admission that you can't answer the points put to you?

 

[Rolfe]

My thoughts entirely, Architect.

When I saw this from Jerome, my immediate reaction (when I got my jaw off the floor) was, Jerome's admitted he's lost the thread.

When you answer what health-care the United Kingdom provides for all the people of its former vassals from which it raped and pillaged so as to provide the wealth to pay for the health-care for its citizens I will answer your question.


Do you fell guilty when you receive your "free" health-care which was purchased through the poverty of the India and Africa?

You don't what to talk about the opium trade, do you?

Your "free" health-care is purchased from the blood of the raped.

Our healthcare, free at the point of need is purchased from the money we pay in taxes. Less money, as a proportion of our income or GDP or whichever way you want to slice it, than you pay in your taxes to fund your Medicare/Medicaid system, which covers only about half as many people as our universal system, that is only about 10% of your population (as opposed to our covering 100% of our population).

The system was set up shortly after WW2, when the country had practically run itself into the ground saving the entire world from Hitler.

It gets better. Anyone who comes here and settles here and pays their taxes can access the system. Including my former neighbour, who was American, and a friend who worked all her life for the American embassy in London, also American. Knee replacement she had on the NHS, I recall. (And yet she always paid her taxes in the US.... how did that work? No matter, she lived here and she was eligible.)

Many people from the former Empire did indeed come here and settle here and they and their descendents can and do benefit fully form the NHS. Now we're in the EU, any other EU citizen can come here and settle and work and access the NHS.

Jerome, I asked you to provide statistics showing what proportion of the British public has ever had to wait six months or more for any healthcare procedure in their entire lives. No answer.

I asked you what better care Abigail Hall would have had if she'd been in the US system. No answer.

I asked you whether Abigail Hall would have been assured of the standard of care she got, if she'd been in the US system. No answer.

All you can say is, Britain once had an empire? Is that it? As D'rok said, some descendents of slaves in your country might want a word with you.

Non sequitur of the century, that one. Translation? "Jerome has officially lost the argument."

Rolfe.

 

[Rolfe]

You mean someone elected not to buy any health insurance and later regretted it? Where's the problem?

You're quite happy that for some people, sufficient insurance to provide comprehensive healthcare coverage is simply unaffordable?

Well, in the USA, she collects welfare, Food Stamps, rent subsidies, and gets free medical care from MedicAid, in addition to other government supplied benefits, food banks, and charities. If she chooses to go to work, she also collects EITC, which can add 25% to her (tax-free) income; in addition, PIC's can pay half her salary to a prospective employer during any training period. Where's the problem?

The problem you yourself have frequently highlighted. The abysmal quality of Medicaid.

To digress. Reading today's newspaper, there was an article about Sir Menzies Campbell, senior politician, long-time member of parliament and former leader of the Liberal Democrat party. During the article it was mentioned that he had suffered from non-Hodgkins lymphoma, but was now in remission. He and his wife could not speak highly enough of the care he received from the NHS.

Another little news snippet. Yesterday Lady Margaret Thatcher was taken ill while dining at the House of Lords. She was taken to St Thomas's Hospital. NHS again.

When even the senior politicians themselves are content to rely on the NHS in their time of need, I think you can perhaps see what we've got here. You want to downgrade all your poor and disadvantaged to a substandard system your senior politicians wouldn't trust with their own health on a bet, and yet you still wind up paying more for that system than we pay for our universal one which even treats prime ministers.

He gets a job or he starves. Or, if he leaves home (officially, anyway), his wife and children collect welfare, Food Stamps, rent subsidies, and get free medical care from MedicAid, etc., etc. If not, in addition, he qualifies for both Unemployment Insurance (income) and medical benefits, as well as federally financed retraining to a new career. Where's the problem?

Free medical care from Medicaid? Where's the problem? See above. You yourself have castigated Medicare as being of very poor quality. But it's OK for your underclass I suppose. As far as you're concerned, anyway.

No emergency room in the USA is allowed to refuse such treatment. If they did, he would have the makings of a hundred million dollar lawsuit and he and his (remaining) children would be set for life. Where's the problem?

That afterwards the family is going to get a bill that will wipe them out? Don't you feel even slightly uneasy about this?

Didn't I just provide the most obvious of solutions? Every time I look there are even more benefits for people are who thrown out of work or needing emergency medical care - I don't see a problem here. Where do you?

Two places. One, that you have repeatedly stated how bad the quality of the medical care is that is given to those without private means. Two, that in order to qualify for even this poor-quality (and, for the state, extremely expensive) care, the family first has to lose everything.

Do you never see any possible set of circumstances in the future where either you or someone close to you could find themselves unable to afford high-quality treatment? Really? And assuming this is the case, do you care not at all for your less fortunate fellow-citizens?

Rolfe.

 

[Blue Mountain]

I've been there and done that and I wouldn't need to beg and I wouldn't need the food banks. Furthermore I would end up with more money at the end of the month than I started with.

The difficult arises when one tries to maintain the same lifestyle with reduced income (divorces also tend to produce such a problem) and/or little savings or other assets.

Your jurisdiction must have very generous welfare rates, or you really know how to spend frugally when you need to. Where I am, welfare is designed to tide you over until you can get back on your feet. Although I know one lady who walked out on her abusive husband and did a wonderful job raising four children on welfare. All four children, now adults, are productive members of the community.

 

[Rolfe]

Did I say it was better? In any case, it's the system we have.

So you're stuck with it? You can never aspire to better? What was that about the great American can-do attitude?

I've been there and done that and I wouldn't need to beg and I wouldn't need the food banks. Furthermore I would end up with more money at the end of the month than I started with.

The difficult arises when one tries to maintain the same lifestyle with reduced income (divorces also tend to produce such a problem) and/or little savings or other assets.

Hmmm. May I be allowed to be a little sceptical here?

Have you seen the "30 days" film by Morgan Spurlock? The one where he and his fiancee try to do pretty much that? I was struck by how well they were managing, and especially by how well served their area was by charity provision which got them furniture and quite a lot of help.

They would have managed to do it, I'm sure, if it hadn't been for healthcare costs.

Morgan injured his back doing the manual labouring job he'd secured, and it looked as if he might not be able to work without treatment. He tried to access a free clinic, but it proved to be impossible - the quotas for the day were always massively over-subscribed. His fiancee developed severe cystitis, and needed antibiotics.

I'm not familiar with the system so I couldn't say at this point exactly what they did. However, it seemed as if their situation forced them into quite expensive routes to treatment. It totally blew their budget and was the cause of their being unable to make ends meet.

So I would say that your chances of success in that endeavour would be dependent entirely on your health remaining good. If you were lucky in that respect then sure, I imagine it's perfectly possible. However, unless you can tell me what Morgan Spurlock and his fiancee were missing, the chances are that any requirement for healthcare would blow your calculations out of the window.

Rolfe.

 

[Rolfe]

Only because your government is not providing health-care to all the people it has a responsibility to care for.

Oh, I can't leave that alone. I'm going to regret it, but still....

Gnome, do you think any government has a responsibility to provide healthcare for people is has no jurisdiction over, and who pay their taxes to an entirely different jurisdiction?

If you believe that the British government has a responsibility to provide healthcare to people domiciled abroad, do you also believe that the British government has the right to tax these people?

You might wait until your govermnent is managing to provide healthcare for its own citizens before you start firing off at other governments' hypothetical responsibilities to people who contribute nothing to the common good and over whom it has no jurisdiction.

Oh yes, and until your government is providing all the necessities of life to all the descendents of those its own forebears mistreated in pursuit of 18th and 19th century wealth.

Rolfe.

 

[Rolfe]

The story about the kid with the appendix horrifies me. However, we have to remember that it's the bad news stories that make the papers. The cases where something went wrong.

What went wrong here was someone miss-selling healthcare insurance, trading on the lack of knowledge many people have of how much hospital care actually costs. Then for the family in the story, crunch time came when they actually incurred some very big bills.

It was pointed out towards the end of the article what bad value the policy actually was. Rather than say, we expect you to pay a large but finite sum, and after that we'll pick up the tab (which was the gist of the recommended policy), this one agreed to pay only a relatively small amount before leaving the claimant on their own.

No doubt we'll have the usual bunch of "stupidity is a capital offence" attack dogs declaring that the family brought their troubles on themselves by making a poor choice. Even the mother herself at the end of the article seems to be saying as much. However, I thnk you'd have to be quite sophisticated to realise what's being said here, especially off the top of your own head without any professional advice.

One policy says they'll start paying as soon as any healthcare costs are incurred. They seem to be offering quite a lot of cover. $6,000 is a lot of money, no? We're all young and healthy, surely that will be enough?

NOT WHEN IT COMES TO SURGICAL OPERATIONS IT'S NOT!!! But do the clients know this? No. Does the insurance salesman tell them? What do you think?

The other policy is saying, you're on your own for the first $12,500 for each member of the family. Only after that do we start paying.

That could easily sound like a much worse deal to anyone not really thinking through the details, or aware that they might end up with a bill for $34,605 for a whole six hours in hospital. In fact, if you're young and healthy and nothing catastrophic happens, then it is a worse deal.

This is just one of the horrors that universal healthcare avoids. The bent insurance salesman getting his commission by cheating families who know they need to get some sort of cover, know they can't afford what they really need, and are trying to get something in place on the cheap.

But something is being done about it.

MEGA Life and Health Insurance, an Oklahoma-based company that is being investigated by insurance officials in Washington and 34 other states. Regulators found that MEGA and two sister companies have misled consumers, denied legitimate claims and mishandled complaints.

A settlement with the states is expected later this year.

Regulators are intervening to stop the miss-selling. Good for them.

But in the Gnome's perfect world, no such intervention would be allowed to happen. There would be no regulation or control at all. Any crook with a glib line of patter would be free to con as many people out of their hard-earned cash for as threadbare a policy as he could write.

I'm glad I don't live in the Gnome's world.

Then we see something else distressing about the incident.

.... Theresa Devers pleaded with him to hang on until morning so they wouldn't have to go to an emergency room.

Then, ...., Devers asked without success if she could drive her son there instead of having him taken in an ambulance. And when they arrived at Seattle's Swedish Medical Center, Devers urged the staff to skip tests or procedures unless they were vital. [....]

Theresa Devers says she was upfront with nurses and doctors about her limited insurance, even though it shamed her to discuss money in the midst of her son's illness.

"Yet I was acutely conscious of what everything was costing," she said.

This woman had a child with a ruptured appendix. That is lifethreatening. That's enough worry for anyone to bear without being in a perpetual panic about money. This is another huge advantage of a universal healthcare system. Whether you're a senior member of parliament when you get your non-Hodgkins lymphoma, or a casual labourer on the minimum wage, you only have to worry about your illness. You do not need to worry about what it costs to treat it, and in particular you don't have to beg the medical staff to cut corners.

A third point is perhaps the most obvious.

When her youngest son, Cole, awoke one night last month writhing in pain, Theresa Devers pleaded with him to hang on until morning so they wouldn't have to go to an emergency room. [....]

Though it got serious, it wasn't until the third day that the family finally took him to the emergency room.

The kid had appendicitis. Of course the mother would have taken him to Casualty if she'd known. She did know he was ill and should be seen by a doctor, but she also knew the financial consequences, and she hoped it was just flu and would get better.

The result of the delay was that the appendix ruptured. Making the situation 20 times worse, putting the child's life in serious danger, and vastly inflating the eventual cost.

This does not happen in societies with universal healthcare free at the point of need.

However, accepting that the point of this story is that it's news, and an example of the system going wrong, does that explain everything? Would like have been just peachy if the family had purchased the other policy, recommended as being safer - certainly in hindsight that is?

I don't think so. Suppose the family had the $12,500 excess policy. Would that have encouraged the mother to rush the child to A&E at the first sign of illness? I doubt it! Would that have allowed her to be quite laid-back about ambulance trips and extra tests and so on? I think not! While, in the event of a really huge occurrence, which this was, there would come a point (once the $12,500 had been passed) when the mother could just relax and say, well, it can't get any worse, $12,500 is still a lot of money (really $25,000, because two members of the family happened to get expensive conditions). Looking at shelling out a goodly chunk of that is still going to act as a barrier to getting children with fulminating appendicitis into hospital.

I'm constantly amazed by the sanguine attitudes of people like G'Kar and the Gnome. It's pretty clear that the cost of premiums for good comprehensive healthcare coverage even for a young helathy family is simply more than many working people on relatively low incomes can afford. So they end up with poor, inadequate cover. Or in some cases simply trusting to luck.

Possibly G'Kar and the Gnome are in privileged positions where they are easily able to afford the cost of such insurance. However, are they quite comfortable that this will always be the case? Or that they'll never contract an expensive illness or suffer an expensive injry?

What are people in the Devers' situation actually supposed to do to prevent themselves being bankrupted by healthcare costs?

Rolfe.