Rationing Health Care - it's a lie!

[Architect]

He said this: Where should health care funding go to more: A dieing man who needs a liver transparent, or a man who wants a sex change?

Are you suggesting that, under UHC, both can't happen?

Incidentally, surely in any fair system priority would always go to Mr. Liver?

 

[Darat]

I was just talking to some guy in Starbucks over politics:

He said this: Where should health care funding go to more: A dieing man who needs a liver transparent, or a man who wants a sex change?

I know, its OT, but i just wanted your opinion.

Apparently many people wanting gender reassignment surgery in the USA go abroad for it - because that is where the expertise (and lower costs) are to be found.

Make of that what you will.

 

[makaya325]

Apparently many people wanting gender reassignment surgery in the USA go abroad for it - because that is where the expertise (and lower costs) are to be found.

I consider gender reassignment as much as a necessity as getting a face lift. Liver transplant focus's on a life-threatening and tricky situation

 

[jimbob]

Here's a story from an ex-pat american, living in London:

He is a professor, so pretty highly paid either side of the Atlantic.

In the US, my credit card saved my life

The relationship between doctors and their patients at every level is different from that in the States; here money does not change hands. An American friend of mine with five children was terrified when he became unemployed, fearful that one of them might become ill. I became ill when I was briefly back in the US some years ago, attending a meeting. With an acute urinary obstruction, the first person I saw, and the only one who could admit me for treatment, was the woman in charge of payment. My credit card probably saved my life.

There may be delays, frustrations and bureaucracy with the NHS, but the system delivers outstanding healthcare at no cost to the patient and far less of the GDP that the US system consumes. Being over 60, all prescription drugs are free. Perhaps it is that absence of fear of becoming ill that is the most important aspect of the system.

 

[BeAChooser]

40% is not a "majority".

You want majorities, Kelly?

http://www.quinnipiac.edu/x1295.xml?ReleaseID=1357

August 5, 2009

... snip ...

American voters, by a 55 - 35 percent margin, are more worried that Congress will spend too much money and add to the deficit than it will not act to overhaul the health care system, according to a Quinnipiac University national poll released today. By a similar 57 - 37 percent margin, voters say health care reform should be dropped if it adds "significantly" to the deficit.

By a 72 - 21 percent margin, voters do not believe that President Barack Obama will keep his promise to overhaul the health care system without adding to the deficit, the independent Quinnipiac (KWIN-uh-pe-ack) University national poll finds.

American voters disapprove 52 - 39 percent of the way President Obama is handling health care, down from 46 - 42 percent approval July 1, with 60 - 34 percent disapproval from independent voters. Voters say 59 - 36 percent that Congress should not pass health care reform if only Democratic members support it.

http://www.rasmussenreports.com/pub...ressional_health_care_reform_falls_to_new_low

August 11, 2009

... snip ...

Public support for the health care reform plan proposed by President Obama and congressional Democrats has fallen to a new low as just 42% of U.S. voters now favor the plan. That’s down five points from two weeks ago and down eight points from six weeks ago.

A new Rasmussen Reports national telephone survey shows that opposition to the plan has increased to 53%, up nine points since late June.

More significantly, 44% of voters strongly oppose the health care reform effort versus 26% who strongly favor it. Intensity has been stronger among opponents of the plan since the debate began.

 

[kellyb]

American voters, by a 55 - 35 percent margin, are more worried that Congress will spend too much money and add to the deficit than it will not act to overhaul the health care system, according to a Quinnipiac University national poll released today. By a similar 57 - 37 percent margin, voters say health care reform should be dropped if it adds "significantly" to the deficit.

By a 72 - 21 percent margin, voters do not believe that President Barack Obama will keep his promise to overhaul the health care system without adding to the deficit, the independent Quinnipiac (KWIN-uh-pe-ack) University national poll finds.

American voters disapprove 52 - 39 percent of the way President Obama is handling health care, down from 46 - 42 percent approval July 1, with 60 - 34 percent disapproval from independent voters. Voters say 59 - 36 percent that Congress should not pass health care reform if only Democratic members support it.

That still shows majortity approval, unless I'm reading that wrong.

 

[Ziggurat]

Here's a story from an ex-pat american, living in London:

With an acute urinary obstruction, the first person I saw, and the only one who could admit me for treatment, was the woman in charge of payment. My credit card probably saved my life.

This is simply not true. As an emergency case, this guy would have been given treatment regardless of ability to pay. Anyone with any real familiarity with the US system would know this, and so would the good professor if he had paid any attention to the prominently displayed signs indicating this in every emergency room. The woman who admitted him was legally obligated to do so regardless of his ability to pay. Since he's an expat, this shouldn't be arcane knowledge to him. So either he's too ignorant to be commenting on affairs here, or he's just a liar.

There may be delays, frustrations and bureaucracy with the NHS, but the system delivers outstanding healthcare at no cost to the patient

This too is a lie, and a transparent one at that. There's no cost at the point of service, but there sure as hell is a cost.

So for him to complain about "the outrageous lies that are being promulgated about the British health service in the US" while he turns around and lies about the US health system in Britain is, well, slightly ironic.

 

[Architect]

Ziggy, there may be a cost by way of Income Tax and NI contributions (arguably not the latter), but it's still half of what the US is paying. And, given that (for example) BAC's gun and accident statistics are looking a bit shoogily, I think we can stick with the general agreement amongst the other posters that this is all for healthcare which is at least on the same standard, looking at key clinical indicators.

 

[Architect]

On a lighter note, boys and girls, Matthew Best posted this article over on another thread.

I thought you might like both the "skip" and the "hair" comments.

 

[Ziggurat]

Ziggy, there may be a cost by way of Income Tax and NI contributions (arguably not the latter), but it's still half of what the US is paying.

But that's a completely different argument, so it doesn't change the fact that this guy was lying.

Furthermore, it's actually a very weak one. On a per-capita per-GDP basis, we're not paying close to twice as much. Countries with higher per capita GDP's generally spend more. Furthermore, that relationship may not be linear. Without a better understanding of what that GDP/spending curve SHOULD look like, you can't fit points at the far ends with any real confidence. And since we're well above the countries we usually get compared to in terms of per-capita GDP, it's not actually clear that we ARE spending more than should be expected compared to everyone else.

 

[BeAChooser]

That still shows majortity approval, unless I'm reading that wrong.

 

[Skeptic Ginger]

No there isn't. There's a certain segment that can't access health insurance, and can't pay for healthcare. But everyone has access to healthcare. Not any healthcare, and possibly not all the healthcare they might need, but everyone has access to healthcare.

IE, everyone can go in a drug store and buy a bandaide therefore according to your semantics game here, everyone has access to health care.

If you are referring to the fact EDs cannot turn patients away, that is not what the rest of us are talking about when we say access to health care. They aren't going to do a biopsy in an ED. They aren't going to do a colonoscopy unless you are bleeding significantly, they won't remove a metastatic tumor or administer chemotherapy. They won't become your diabetes heath care provider, and so on and so on.

 

[Skeptic Ginger]

On a lighter note, boys and girls, Matthew Best posted this article over on another thread.

I thought you might like both the "skip" and the "hair" comments.

That's actually pretty close to the truth. It goes with the poll that found 14% of the Fox News audience are certain Medicare is not a government health care program.

 

[Skeptic Ginger]

The usual right wing attack on anything that might benefit the Democratic Party politicians is mind boggling. Not only do the facts not matter one bit when people are echoing the absurdities (death panels and supposed Obama goal to make the nation totally socialist) but voting against their own best interest is again the knee jerk reaction.

Think about it. Our country is at a capitalist economic disadvantage in the world markets because our manufacturing companies are burdened with health care costs for employees that companies in other countries are not burdened with. Single payer would eliminate that capitalist economic world trade disadvantage.

And just because you can't see the tax, doesn't mean you aren't paying it now if you are someone who has health insurance. YOU ARE CURRENTLY PAYING for all those deadbeats via your health insurance premiums right now if you pay for your own health care or you pay insurance premiums or your employer pays those premiums as part of your benefits package. Why don't the right wingers want everyone to share that tax burden more equitably? As it is now, the insured are paying for the uninsured. It's expensive, inefficient care, and the cost is unevenly distributed.

 

[Ziggurat]

IE, everyone can go in a drug store and buy a bandaide therefore according to your semantics game here, everyone has access to health care.

No, skeptigirl. This is a strawman, and you know it is, as your subsequent argument demonstrates.

If you are referring to the fact EDs cannot turn patients away, that is not what the rest of us are talking about when we say access to health care.

That may not be what you meant, but you don't get to invent the meaning of words. It is still rather plainly access to health care.

They aren't going to do a biopsy in an ED.

Like I explicitly said, it's not access to any health care, and it may not even be access to enough health care, but it sure as hell is access.

 

[Rolfe]

Forgive me if you've answered this already Ziggurat, but it's a general question in any case to those making the point you just made. Do you think it's acceptable that private businesses should be compelled by law to provide their goods and services to people who have no hope of ever being able to pay for them, in the name of "access to healthcare for all"? Do you think it's acceptable that the only way for these private businesses to recoup the losses they sustain in complying with this law is by overcharging their paying customers?

It seems to me that the USA has made the moral decision that all residents are entitled to "some" healthcare, and cannot simply be left to suffer and die if they have been improvident and unlucky. However, it also seems to me that it is in a complete flat spin when it thinks about how that should be paid for.

In just about any other country, it would be accepted without even saying that if such a law were passed (about private companies having to give away their goods and services to people who could not pay for them), then the government would at the same time pass a law enabling these businesses to be reimbursed for this expense out of the public purse. It is a matter of utter amazement to me to realise that this is not the case.

Rolfe.

 

[Ziggurat]

Forgive me if you've answered this already Ziggurat, but it's a general question in any case to those making the point you just made. Do you think it's acceptable that private businesses should be compelled by law to provide their goods and services to people who have no hope of ever being able to pay for them, in the name of "access to healthcare for all"? Do you think it's acceptable that the only way for these private businesses to recoup the losses they sustain in complying with this law is by overcharging their paying customers?

I think that's a poor way to finance such care.

In just about any other country, it would be accepted without even saying that if such a law were passed (about private companies having to give away their goods and services to people who could not pay for them), then the government would at the same time pass a law enabling these businesses to be reimbursed for this expense out of the public purse. It is a matter of utter amazement to me to realise that this is not the case.

Actually, a number of states do indeed provide funding to help cover such mandated services.

 

[GreyICE]

No. I'm not sure what got you confused, but nothing I've said has anything to do with manufacturing costs.

Then if manufacturing costs aren't a factor, there is no reason that a drop in drug price would cut back the amount of drugs out there.

You can't have it both ways, Ziggy. You're just throwing whatever nonsense you think of off the top of your head at the screen, in the hope that somehow it will make that nazi-hitler-deathcamp-satan health care plan go away.

 

[Ziggurat]

Then if manufacturing costs aren't a factor, there is no reason that a drop in drug price would cut back the amount of drugs out there.

You can't have it both ways, Ziggy.

You have completely missed my argument. A drug whose price was lowered through negotiations would not be less available. But in order to get price breaks on that drug, one needs leverage, or the drug companies will not drop prices. After all, why should they, unless you have leverage against them? And the only way to get a large amount of leverage, which is what you need if you want large price cuts, is to have a credible threat of walking away from purchases. And the only way to make a credible threat is to actually, you know, walk away from some purchases. Which means some drugs will go unpurchased. But those will, rather logically, be different drugs than the ones you got a price break on. What does manufacturing costs have to do with this argument? Nothing. They appear nowhere within my argument at all.

You're just throwing whatever nonsense you think of off the top of your head at the screen, in the hope that somehow it will make that nazi-hitler-deathcamp-satan health care plan go away.

Why did you decide it was necessary to poison the well of this discussion with this absurd mischaracterization of my views? Why isn't such behavior beneath you?

 

[jimbob]

Here's a story from an ex-pat american, living in London:

With an acute urinary obstruction, the first person I saw, and the only one who could admit me for treatment, was the woman in charge of payment. My credit card probably saved my life.

This is simply not true. As an emergency case, this guy would have been given treatment regardless of ability to pay. Anyone with any real familiarity with the US system would know this, and so would the good professor if he had paid any attention to the prominently displayed signs indicating this in every emergency room. The woman who admitted him was legally obligated to do so regardless of his ability to pay. Since he's an expat, this shouldn't be arcane knowledge to him. So either he's too ignorant to be commenting on affairs here, or he's just a liar.

And if the emergency isn't immediately obviously life threatening, how are cases assessed as to whether they are life threatening?

Various americans made this point in the original article.

There may be delays, frustrations and bureaucracy with the NHS, but the system delivers outstanding healthcare at no cost to the patient

This too is a lie, and a transparent one at that. There's no cost at the point of service, but there sure as hell is a cost.

So for him to complain about "the outrageous lies that are being promulgated about the British health service in the US" while he turns around and lies about the US health system in Britain is, well, slightly ironic.

It was obvious that this comment was referring to no direct cost to the patient. Nobody claims that the communism fairy makes the NHS free...

There are a few other contributions in the guardian by Americans with experience of the NHS.

American healthcare is in truth already rationed

I grew up in the US with a series of mysterious health problems, not least two different kinds of cancer. Everything in my life – education, choice of career, job mobility, decisions to marry or divorce, where I lived, who I knew, what I wrote or talked about – all of it – was determined by the paramount need to maintain health insurance.

In the United States there is no basic protection for working people. My fully employed, doubly insured parents were pushed to the brink of bankruptcy four times before my 15th birthday. I exceeded the "lifetime maximum" coverage before I was old enough to vote. My family paid huge sums for insurance, then 20% of the cost for treatments, without assistance from any public entity.

I am healthy now, yet my background means that US insurance companies can refuse to cover anything related to events that happened over 20 years ago. Because I take prescription drugs every day, and because I need blood tests a couple of times a year, this will never change. The last quote for insurance I got exceeded my salary.

And this blog in new scientist:
Socialised medicine and death panels: business as usual

And this comment on the blog:

My bff may very well die of cancer for want of a simple test that she couldn't get because she didn't have health insurance because she's partially disabled and can't get a good enough job to pay for it.

Back to the guardian

In defence of the NHS: I'm glad I didn't break my leg in the US

Which does highlight some of the problems with the NHS (remember it is prettty cheap)

and then this comment:

"Bare minimum health insurance costs 60-100 bucks " .. where do you live ?
I live in the US, and in June my employer terminated the health insurance benefits, with three days of warning. After 19 years of health insurance I saw the monthly cost going from $350 to $1200 for a family of 6., and now with 3 days of warning, I was with no insurance and 4 kids at home. While shopping around for a private health insurance, on June 15th I was in a car accident, I was not at fault, the other guy lost control and hit my car. In the ER, as soon as they found out I was uninsured, they "stabilized" me, pumped me up with heavy-duty pain killer, and released me the same afternoon. I had three broken vertebrae in my neck. After a few days, of agonizing pain, I went to see a doctor. To make it short, urgent surgery was needed to avoid being paralyzed for life. $60,000 dollars later, I am at home, partially healed, in debt for $50K ( friends and family pitched in and loaned me the $$, surgery could not be postponed, now I would love to pay the money back, but I do not have that amount of cash on hand. Auto insurance will come into play, but it could be up to two years before they pay, and even then it will not be for the full amount. The other guy had minimal insurance, and my insurance added up does not cover the total amount I spent, so far in excess of $60K. And I will probably have to hire an attorney for the legal fight, and that alone will cost me about 40% of anything that will be recovered from the insurance. In the meantime I have been making calls to finally acquire health insurance, but all the company I called so far, either refused to insure me or priced me out of the policy, because of the injuries in the car accident. So, now I am still uninsured, not of my own will, still somewhat hurt, $50k in debt, spent $10k of my cash reserve, and mad as hell.

Originally I am from Europe, one of those "socialistic countries" that have universal health care. Yes, those systems have their own share of issues, and there is often a genuine attempt to fix them. They do, however, produce an overall good quality health service product, to a wider segment of the population, and at a lower cost than we have in the US. I had to go to the ER overseas, and it's a whole different experience. No one asks for your American Express before they stop the bleeding from your son's head. (True story, happened to me in California.) America deserves better. Americans should rise up and DEMAND better from their leader.

The first highlighted bit sounds like a potentially life threatening situation.