Ah! More failure to understand the issues by claiming the point of my post was self-treatment.
Hint: it's not.
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Health care - administrative incompetence
- Thread starter bigred
- Start date
Ah! More failure to understand the issues by claiming the point of my post was self-treatment.
Hint: it's not.
Disclaimer: The following might sound like American Arrogance, but I assure you it's not. I'm married to a Hungarian citizen. My former mother-in-law was born and raised in Cuba. My grandparents came here from Greece. I have lots of friends who are citizens of other nations. We all have our strong and weak points. The following is just my rant about what I thought was a strong point about America, and it's not a reflection on any other country.
I'm 44. I grew up at a time when the USA had decided it wanted to accomplish some things, and they did. They wanted to put a man on the moon, and sure enough they did at a time of rotary dial phones and vinyl records. They decided that measles and polio needed to be completely wiped out. They did it.
What happened to this can-do attitude? If America wants efficient, nationalized health care, they can do it. We can do it. If our good friends and neighbors like the UK and Canada can do it well, then there's no reason we can't. We're a lot alike. They don't have anything special on us, so this excuse-making about how it can't work is nothing more than rationalization to support an ideology.
And from where did that ideology come? People join together to form governments for the greater good. We pool our resources to provide a better environment for all of us to have the best chance of individual success. We value entrepreneurship, yet health care is a huge barrier to small businesses and the self-employed. We value competition in the marketplace, but health care is a huge burden for anyone trying to get a business going. The costs greatly favor larger businesses, so even if a company can make a better widget more cheaply, their labor costs in the form of health insurance are a prohibitive barrier. It's out of their control. From an economic standpoint, it makes better sense to nationalize health care.
And then there's the issue of watching out for each other. We like to talk about how it takes a village to raise a child. We forbid foul language and <gasp> nipples from being shown on TV, yet we're unwilling to pay for dental and medical care for children? If a child is in a bad situation at home, we'll intervene and break up families, but if Dad breaks his leg and the kid has a congenital heart problem, the family is on its own. Sure, if they are near death, we'll stabilize them in the emergency room and send them back home. They aren't denied emergency care for lack of money, but they still owe it.
It just makes no sense to me.
I'm 44. I grew up at a time when the USA had decided it wanted to accomplish some things, and they did. They wanted to put a man on the moon, and sure enough they did at a time of rotary dial phones and vinyl records. They decided that measles and polio needed to be completely wiped out. They did it.
What happened to this can-do attitude? If America wants efficient, nationalized health care, they can do it. We can do it. If our good friends and neighbors like the UK and Canada can do it well, then there's no reason we can't. We're a lot alike. They don't have anything special on us, so this excuse-making about how it can't work is nothing more than rationalization to support an ideology.
And from where did that ideology come? People join together to form governments for the greater good. We pool our resources to provide a better environment for all of us to have the best chance of individual success. We value entrepreneurship, yet health care is a huge barrier to small businesses and the self-employed. We value competition in the marketplace, but health care is a huge burden for anyone trying to get a business going. The costs greatly favor larger businesses, so even if a company can make a better widget more cheaply, their labor costs in the form of health insurance are a prohibitive barrier. It's out of their control. From an economic standpoint, it makes better sense to nationalize health care.
And then there's the issue of watching out for each other. We like to talk about how it takes a village to raise a child. We forbid foul language and <gasp> nipples from being shown on TV, yet we're unwilling to pay for dental and medical care for children? If a child is in a bad situation at home, we'll intervene and break up families, but if Dad breaks his leg and the kid has a congenital heart problem, the family is on its own. Sure, if they are near death, we'll stabilize them in the emergency room and send them back home. They aren't denied emergency care for lack of money, but they still owe it.
It just makes no sense to me.
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Rolfe
Adult human female
At least Emet is medically qualified, which you are not. Despite frequently posting as if you are.
Rolfe.
Tatyana
Illuminator
- Joined
- Oct 23, 2009
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- 3,701
Even though the NICE recommendations are for levothyroxine (T4) by itself as the clinical trials do not demonstrate and advantage to adding T3, my GP has prescribed me T3 and T4.
I prefer it.
My chemist had to start getting T3 in as it is so rare for it to be prescribed.
Again, NICE recommendations are recommendations for best medical, evidence based medicine, however, the individual patient is always considered.
As I have a life-long condition (hypothyroidism), I have a medical exempt card for prescriptions, which means I no longer pay for any of them.
Pregnant women are also exempt from prescription and dental charges.
Please stop posting reasonable things I agree with. You're screwing with my zen thing, man.
Thanks. I realize that. I also know about the patients who don't do well on T4 alone, which is usually covered by insurance, but had problems getting T3/T4 covered by their insurance companies.
Tatyana
Illuminator
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It hasn't even been a year. The first tabloid reports began this June, 2010.
One anecdote does not equal evidence that the drug even works.
If you accept this one case, then you also have to accept anecdotes about homeopathy, acupuncture, prayer, etc.
http://www.badscience.net/2010/08/in-praise-of-anecdotes/
That was a special case. This week the newspapers were filled with stories about NICE’s recommendation not to fund Avastin, a bowel cancer drug that costs £21,000 per patient, in draft guidance. This drug has been studied in a large randomised trial of 1401 patients receiving either chemotherapy with Avastin, or chemotherapy with placebo.
The trial isn’t perfect – no trial is, you can read the details online - but it gives the best estimate of the true benefit of this drug, and overall, it shows that Avastin extends survival from 19.9 months to 21.3 months, which is about 6 weeks. Some people might benefit more, some less. For some, Avastin might even shorten their life, and they would have been better off without it (and without its additional side effects, on top of their other chemotherapy). But overall, on average, when added to all the other treatments, Avastin extends survival from 19.9 months to 21.3 months.
The Daily Mail, the Express, Sky News, the Press Association and the Guardian all described these figures, and then illustrated their stories about Avastin with an anecdote: the case of Barbara Moss. She was diagnosed with bowel cancer in 2006, had all the normal treatment, but also paid out of her own pocket to have Avastin on top of that. She is alive today, four years later.
Barbara Moss is very lucky indeed, but her anecdote is in no sense whatsoever representative of what happens when you take Avastin, nor is it informative. She is useful journalistically, in the sense that people help to tell stories, but her anecdotal experience is actively misleading, because it doesn’t tell the story of what happens to people on Avastin: instead, it tells a completely different story, and arguably a more memorable one – now embedded in the minds of millions of people – that Roche’s £21,000 product Avastin makes you survive for half a decade.
You'll find much of what you say in the many other threads where the USA and UHC has born discussed but the strange thing is that it is most often by "us" "Europeans" who for the life of us cannot understand why many folks from the USA think that a universal, well funded health system is beyond their ken.
It is especially frustrating when we see many folk just unable to accept the evidence that such systems can and do work and have been doing so for generations.
The UKians amongst us tend to talk about the NHS but that is simply just because it is the example we know best however there are many other systems in place (and working), from mixtures of government taxation and compulsory private insurance, to just private insurance and pretty much every combination you can think of. The one thing these systems all have in common is that they (generally) work at providing everyone with very good health care irrespective of means.
And none of these systems are perfect and can always be improved on. In the UK we tend to be very protective of our NHS, and that "our" is a crucial word - it is ours not "the government" not any "them" but ours - we own it and we demand it works but it certainly could be improved on, especially if we started to spend as much in terms of GDP that the USA does!
The argument against NHS or other systems because they have problems or can be improved upon bothers me because of several reasons:
1) It's not addressing the fact that the problems seem to be less detrimental the populace as a whole than the problems in America. I am not unique in my situation and in sheer numbers more are either massively in debt, bankrupt or go without in this country than other countries with a universal plan. I would not have to shut down my small business due to health care costs in other countries, and fostering small business is an extremely important part of a healthy economy.
2) It's head-in-sand thinking. Never will fallible men create an infallible system. That doesn't mean there aren't better answers to the problem now and here in America. In fact I would say we have allowed this system to become so bad that most universal plans if thoughtfully crafted in funding would be a better answer than what goes on now.
As with any other topic, the answer of "Well your answer has problems too" is nothing more than dismissal by the arguer to avoid having to admit they may have an untenable position or need to compromise their position to allow for facts.
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Rolfe
Adult human female
All drugs that have passed NICE (or equivalent) scrutiny as being cost-effective are covered for all people. The sort of things that make the headlines as being "denied" are what you're talking about - something that might extend the dying process by about six weeks, at the cost of tens of thousands of pounds.
If you're going to go on clinging to your terminally broken system until you can find something that will unquestioningly cough up millions for almost no benefit for whatever wizard wheeze the pharmaceutical companies just thought up, you'll have a long wait.
Meantime, back in the USA, when someone says "some drugs are not covered", they're talking about quite ordinary, well-established things that are available to others with no trouble. For God's sake, Accutane???
Your system denies treatment to thousands of people, more or less on the whim of the insurance company. Insurance loss adjusters regularly over-ride the doctor's advice and deny something as "not medically necessary". Not brand new, eye-poppingly expensive drugs that won't stop you dying anyway, but ordinary, standard care.
So you find the extremely high ceiling on "rationing" in the NHS, and point to an exceptional case or two that made headlines, as if that weighs against the routine denials of basic care that go on all the time in the USA.
Hypocrite.
Rolfe.
FattyCatty
Picky V. Nitty
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- 2,338
Well, I'm an American, too (and probably for a longer time than you, as I think I am older than you). I don't agree that UHC is "socialized medicine." This is a basically meaningless phrase used by some people as a derogatory term when any government-funded (i.e., taxpayer-funded) and/or government-administered health program is mentioned. And, as has been shown previously in this thread, our existing "socialized medicine" programs (e.g., Medicare, VA) are cheaper and more efficient than your "free market" programs.
I agree that American values are germane. And the basic premises of the country were and are the safety, happiness, and general welfare of its people. The specifics of American values evolve over time. From only whites can be citizens and only males can vote to not discriminating on the basis of race, color, religion, sex and national origin.
I think evolution in the concepts in safety, happiness, and general welfare now encompasses a right to basic human needs: food, shelter, and health care. From the Declaration of Independence:
From the Preamble to the Constitution:
From Article One, Section 8, of the Constitution of the United States:
Universal Health Care is in the best interests of American human beings and of American society as a whole. How could this not be the case? All citizens have health care vs. many citizens have no health care. Duh. No brainer choice in terms of overall well-being, productivity, control of epidemics, having a better next generation, and common decency.
You say "get a job" to all the people who are trying to get jobs. Don't you recognize that "getting a job" is not that easy? Why not try instead to bring some of the jobs lost overseas (by your "free market") back to the U.S.?
Pursuing happiness for an individual becomes harder when most legislation seems to favor businesses who are making obscene profits. How does their sending jobs away from the U.S. contribute to the "opportunity" to pursue happiness or even survival? How is maintaining basic standards of health, housing, and nutrition in the citizenry having "happiness handed to you on a silver platter"?
I'm not sure what the right to vote comment is about. There are many people in both parties who lack the sense, smarts, and compassion to understand it benefits the whole country when its citizenry have housing, food, and health care.
Lucky you to have family to help out. Not everyone does. Lucky wife to be brilliant enough for a full scholarship. Not everyone is.
Temporary for how long? Until the economy improves and there are jobs? An arbitrary time period established by people who have none of these problems? How do you improve your life while you are trying to keep your family together and trying to find work?
And suffer the consequences? You mean live on the street or in a local riverbed? How do your children go to school? How do you eat? How do you get health care.
You throw around phrases such as "work hard and succeed" and "get a job" and "don't or suffer the consequences" pretty easily. Plenty of people have worked hard and still don''t have the basic needs; plenty of people have tried to get jobs and haven't found them; and plenty of people are suffering the consequences of the lack of concern for their welfare.
Ours edged up to 9.8% in November. Yet "across the pond" they still manage to give their citizens the basic right of health care. I don't know the statistics for the other developed countries on malnutrition and lack of housing, so I don't know if they beat us there, too.
Rolfe
Adult human female
Maybe it is. But in that case you probably have to accept that what society thinks these people are worth is not what you think they are worth.
The day your wife can do one operation, and that magically fixes the problem for a couple of million people with the same condition, or does one consultation which magically results in six million people being correctly diagnosed and prescribed, is the day she might get paid what top entertainers get paid.
Of course when that day comes, you'll need as few doctors as you need top entertainers.
You misunderstand. Health care is a basic right in our society, because that's what we voted for and keep voting for. Health care is not a basic right in your society because you're all so hung up on the "evils of socialism" and "personal responsibility" and "I don't want to pay for anybody else" to make it one.
Your loss.
Yes, we do deny that. You can find hysterical tabloid articles about patients who have had bucketloads of care but didn't get yet another fortune spent on them just so they might stay alive another couple of weeks all you like. That doesn't mean that people who need care are denied. Only that there is a very high limit on that care, so high that very few people ever see it in their lifetimes.
You're the one who doesn't want to spend anything on anybody. Then when you find out that the NHS's cheque isn't quite blank, you throw up your hands in horror.
We cover everybody to an extremely high standard. When the US gets anywhere close to that, then come and start complaining because we baulk at spending tens of thousands to keep someone on their deathbed for an extra few weeks.
And individuals could do that if they wanted to. If someone in Britain is afraid that they might be one of the tiny minority who might derive marginal benefit from an extremely expensive drug that is not deemed effective enough to gain NICE approval, they are entirely free to forego football and fags and save up for it.
What is your point, caller? We already tax cigarettes till their pips squeak, to fund the NHS (among other things). You want we should ban people from spending their money on what they want, and confiscate it instead?
You're no making any sense here, you know.
I think you just drowned in your own ideology, and have lost touch with whatever point you thought you were making.
Rolfe.
xjx388
Penultimate Amazing
- Joined
- Dec 1, 2010
- Messages
- 11,392
I don't see many facts from the other side either. Plenty of name calling ("repugnant," "stupid") but no actual evidence that a free market system won't work. The fact is that the free market works just fine to distribute our food and shelter which we all agree are basic rights. They are both accessible for pretty much everyone in America. Healthcare, which is heavily regulated, is not. Things that make you go, "Hmmmmmmm..."
Rolfe
Adult human female
What is basic food? What is basic healthcare? No one has defined these things, except for "Prime Rib" is not basic food, but "Liver Transplants" (but not life-extending breast cancer drugs) are basic healthcare. Be more definitive about what these things are, then we can argue it.
Basic food is what you need to satisfy your basic nutritional requirements.
Basic healthcare is what you need to stay alive.
Liver transplants are basic healthcare because they will literally save the patient's life. Life-extending breast cancer drugs are also basic care. Breast cancer patients in Britain get pumped full of the bloody things.
You agree that resources are not infinite. There is a limit to "life-extending". Another ten years, absolutely. Another ten months, almost certainly. Another ten weeks, possibly, but you're getting close to the question of "is it worth it?" Another ten days, probably not. Another ten minutes, frankly no.
So don't come and accuse the NHS of refusing life-extending breast cancer drugs when every woman with breast cancer in Britain gets the appropriate treatment right up to the point where you're asking for tens of thousands of pounds to be spent on the chance of a couple of extra weeks.
When uncounted numbers of breast cancer patients in America are routinely denied even the highly effective, routine treatments that British women get simply for being legally resident in the country.
Rolfe.
Rolfe
Adult human female
Let me see. Food, which everybody needs every day to a predictable (and not prohibitively expensive) degree. Shelter, which everybody needs every day to a predictable (and not prohibitively expensive) degree. Medical treatment - which most people don't need at all for an unpredictably long period of time, but then may suddenly need an amount costing more than their entire accumulated income for all their working lives.
Hmmmm, no, I can't see how these things are different at all....
Rolfe.
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Rolfe
Adult human female
Well, as we saw, food and shelter are not the same sort of thing as healthcare.
Healthcare, as you observe, is not accessible to everyone in America.
Healthcare is accessible to absolutely everyone in Britain.
Why is that, do you think?
Rolfe.
MatildaGage
Muse
- Joined
- Jan 25, 2010
- Messages
- 799
Me too. WWJD? Where's the ethics?
If society really believes people's unexpected health bills should not be paid for by society pooling resources....then society should put its money where its mouth is and exert a lot more pressure on people causing preventable illnesses.
Example ~
A couple conceives a baby even though they know they're probably going to pass on a genetic illness or the mother is over 35 (more likely the child will have developmental disabilities)....
Why aren't the neighbors will picketing the house and throwing rotten eggs at them instead of throwing them a baby shower and praising them for being good parents/good Christians?
Rolfe
Adult human female
Thank you, my mother was 37 when I was born. Her mother was 42 when she was born, in 1916. We are both very well, thank you very much.
Way to derail the discussion.
Rolfe.
Way to derail the discussion.
Rolfe.
Tatyana
Illuminator
- Joined
- Oct 23, 2009
- Messages
- 3,701
Erm, no.
Are you reading all of the evidence people are posting and/or their posts?
While I assert that the US health care is a monopoly, it is already based on a free market system.
Maybe it would help if you distinguished what you mean by evidence if none has been provided thus far.
There seems to be some sort of communication issue.
http://en.wikipedia.org/wiki/Homelessness_in_the_United_States
http://news.bbc.co.uk/1/hi/programmes/world_news_america/8513771.stm
Homelessness in America is becoming increasingly educated, middle class and often with a family according to a United Nations report.
http://feedingamerica.org/faces-of-hunger/hunger-in-america-2010.aspx
http://www.mathematica-mpr.com/nutrition/hungerinamerica2009.asp
Findings from the 2009 survey include:
* More than 37 million low-income people received emergency food assistance through Feeding America’s network in 2009, an increase of 46 percent since 2005.
* Recipients represented a broad cross-section of America, including 14 million children and 3 million elderly. Approximately 40 percent were white, 34 percent were African American, and 20 percent were Hispanic.
* Thirty-six percent of recipient households had at least one adult who was working.
* Ten percent of all recipients were homeless.
* Seventy-five percent of Feeding America's clients were food insecure.
* Most recipients made difficult choices between food and other necessities, such as housing or medical care.
* Only 66 percent of people eligible to participate in government support or food assistance programs are currently doing so. More than 40 percent of those deemed food insecure are not eligible for the Supplemental Nutrition Assistance Program.
* Private charities were providing high-quality services to emergency food recipients.
* Most of the organizations providing assistance in the network were faith-based.
* Volunteers were crucial to food pantry and kitchen activities.