You are still misunderstanding - so can I and always have been able to do.
Socailized Medicine?
- Thread starter Ed
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You are still misunderstanding - so can I and always have been able to do.
A doctor OF YOUR CHOOSING? Then what is the deal with your being told you can't see "Dr Geoghan", and having to go to "the surgery" and be seen in the "open session"?
You can go and see any GP in the whole of the USA at any time without paying a fee for something routine like an inoculation? I've never heard of an insurance policy like that before.
In the UK most of us have a primary health care point of contact - our GP. We choose what GP we wish (assuming they have room on their list) obviously though our GP can only deal with a certain number of patients every day. In the past the appointment system was such that it ended up being booked for weeks in advance - this was due to many reasons - mostly bad management however despite that I could still go and see my Doctor any day or (in the past things have changed now) called my Doctor and got a home visit that day. (Assuming my Doctor wasn't on holiday, ill or otherwise unavailable - if he or she was their surgery would be covered by a locum.)
I don't know if it is any in the whole of the USA. But I have a very large number to choose from. I am not committed to one GP, or even one Dr's office.
Even if I was committed to one GP or one Dr's office, I am never told that the person is too busy to see my in 36 hours or less. That is a difference between our systems. The GP that I prefer (but am not required) to see is more available to me.
ETA: I have one of the best private health insurance plans you can imagine. But I worked EXTREMELY hard to get it. Which is one reason I don't want to pay for other's care. I am willing to work hard to get what I need to take care of myself. I don't like my money being stolen and given to others who have not also done so. But I'm not sure if my libertarian rant is getting off-topic or not.
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Doesn't sound it to me - sounds like we have comparable access. Any time I need to see my Doctor I can and like you, most of the time I can get an appointment to see her within a day or two - like you.
ETA: I have one of the best private health insurance plans you can imagine. But I worked EXTREMELY hard to get it. Which is one reason I don't want to pay for other's care. I am willing to work hard to get what I need to take care of myself. I don't like my money being stolen and given to others who have not also done so. But I'm not sure if my libertarian rant is getting off-topic or not.
From the figures available it would appear you would pay less under a national health care system.
Then I am REALLY confused about the "Sorry, Dr. X isn't available for 3 weeks" comment. Seriously. You have totally lost me.
BTW...I'm not trying to be a d**k. I'm just actually confused. See this post, if you have any questions: http://www.internationalskeptics.com/forums/showthread.php?postid=1448657#post1448657
shecky
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Going to a "doctor of your choosing" sounds nice, but is it really that great if you can't get a appointment with your regular doctor? I used to have a plan that had a pretty extensive list of approved doctors, but I would have been reluctant, because I didn't know any of them.
And there are still plans like Kaiser, which sound like all the socialized medicine horror stories, weeks for appointments, travel to distant facilities for specialized care, indifferent doctors, so on.
One thing I've found is that good doctors are ALWAYS overbooked, at least around here. Getting a appointment within 48 hrs is difficult, unless you're really ill. And things like physicals and checkups need to be scheduled months in advance. In my area, I suspect this may be due to a relative shortage of primary care doctors (and overabundance of specialists), and the domination of a local university over running a majority of the medical practices (somewhat heavyhandedly, I might add).
Where I live these days, lots of the independent doctors operate as cash pay only businesses. This is a significant cost cutting move, as the doctor doesn't need the extra staff to hassle insurance companies into paying for service. A interesting thing about this is that there is some haggling possible over prices. Also interesting is that this approach doesn't necessarily keep insured patients away. Instead, it places the responsibility of insurance reimbursement on the patient. What used to be the doctor's headache of getting insurance companies to pay up now becomes the patient's headache. However, it keeps the actual medical bills lower, so there is some incentive for all involved.
I have a few doctors that I see, that I know well. There are other doctors even in the same office that I won't see. Being able to see one of these doctors, intead of "Go to the clinic and wait for an hour to see someone who is available, because your GP is busy for 3 weeks" is much preferable.
Bodhi Dharma Zen
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Completely agree. The politics of having to pay for health care are, well, I could insert here all kind of adjectives, suffice to say that I dont like that fact.
"Old system": In the UK the standard practice was to have an open surgery normally a couple of hours in the morning and sometimes in the afternoon. So if you woke up in the morning felt ill but didn't think you needed a home visit you would drag yourself down to the surgery to see your doctor. You could also attend the open surgery for any other reason - say an embarrassing but not life threatening boil on your nose. So you could always see your doctor the same day however if you wanted to make an appointment to get that boil seen to that was were the old system fell down the next available appointments would quite often be week or more away.
New system: See the doctor the same day if you are ill, appointments now available to get boil seen to before it engulfs your face.
(and thanks)
I see where some of the confusion has come from.
I was speaking of only wanting an appointment with my Doctor - for most of us if we are happy to see one of the other practice doctors then there is never any delay at all and even under the old system in most practices you'd have been able to see a doctor with an appointment within a day or two.
That's not true any longer although emergency treatment isn't withheld. (And we haven't had much money since we bankrupted ourselves saving the free world in WWII.)
Godmode
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I've never had to wait more then 24 hours to see a doctor in the UK. There may be areas where that's NOT the case, but I've personally never experienced it. And keep in mind, there ARE emergency centers and ambulances if you need somebody right NOW.That's a "win" for the US system, as far as I'm concerned.
I don't think I've ever not been able to see a doctor on the same day when I needed to, and I don't think I've ever not been able to see one in less than 24 hours for any reason. The exception being specialists, but we are talking about GP's here.
You can also call a nurse 24 hours a day to get any sort of advice, if you're not sure you need to see a doctor or not.
I've experienced healthcare in the US. It was not superior to the UK in any manner. Maybe if you're very wealthy it is, but health care should not be dependent on how wealthy you are.
That is an opinion. It is an opinion that I respect, but disagree with. But it is still an opinion.
brodski
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Absolutly, and thats why this debate will never be "won", the differnce is not with the application of logic, it is with the selection of premise.
And why not, why should every soceity be the same?
ysabella
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But private insurance companies don't have a monopoly on patients. If you don't like your plan, you can generally go get another one. If your job offers limited choices, you may be able to get a group plan from a professional organization, or you can contract directly with an insurance company. Personally, I am willing to pay more to have greater freedom to choose my own doctors and go directly to a specialist, so I choose programs accordingly. Plus, you can always call, say, the dermatologist who isn't on your plan but is really good, and ask what the cash discount is. Sometimes it's surprising what they charge in cash versus charging insurance.
Well, I haven't said anything about "hordes" and I haven't said our way is the best (and I wouldn't say I was a conservative, either); I openly admit our system has problems. My point is, I don't want to change from our way to "their" way. Certainly not on a national level.
It would be hypocrisy if I thought everyone should have to pay cash or suffer; I was briefly on Medi-Cal myself when I was about 18 and very poor, and I was able to go seek medical care at the nearby Stanford Medical Center (being a teaching hospital, they take coupons and so on, and no, I didn't live in pricey Palo Alto, but Fremont). I got that kind of stellar care for free when I really needed some help, so I can hardly talk smack about providing help for the poor and aged. I just feel we can do that better without nationalizing. I honestly think California did better by me than a USA health system would have. That is still "socialized" medicine, by the way.
I'm not totally talking out of my hat here; I lived in Europe for three years and I've received medical care in France, the UK, Belgium, and the Netherlands. I always had private insurance, though. I had American insurance so I would pay cash and get paid back a few months later. Except in the Netherlands, I was actually a Dutch employee and had a Dutch health plan. And I have to cut this off and go do some work but will come back later.
But switching providers due to poor service has its problems as well. The chief amongst them is that you don’t know whether or not your insurance company will put up a fight about payouts until you need the money, and at that point whatever is wrong with you becomes a “pre-existing condition”, which other insurance companies will refuse to cover.
ysabella
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It depends, Random. There are certain times when they aren't allowed to do that. If you lose your job and are paying out on COBRA (which means continuing that insurance by paying directly to that plan, and is usually pricey) and sign up for an individual plan, they don't have you fill out the health forms (at least, they didn't have me do it - my husband had to fill one out). It's complicated, I'll grant you, and not everyone has a lot of options.
One hideous problem that I can tell you we have here in my area is with "charity care." This is when some low-income person with inadequate insurance (or none) runs up a hospital bill. The hospital, any hospital that receives any kind of public funding, has a separate fund for helping these patients; they often require the patients to sign up for social programs if they qualify, but then the hospital forgives large chunks of the bill and works out a payment plan with the patient.
However, some hospitals are hiding this from patients, or at least not going out of their way to let patients know. If the patient doesn't know their rights, the hospital collections people may come after them with a vengeance and try to go after any property they might have. One local hospital used to have a small office dedicated to providing this service with a few posters up to help low-income patients know that they should ask about this option, but the office was closed and the posters taken down.
Private hospitals tend to make pretty good money, but they often hide it in ongoing construction and landscaping projects. Overpaid hospital administrators get sent to Tahiti for pricey health care conferences and things like that all the time. Meanwhile, poor patients get squeezed.
Despite the scare stories, I see that my local hospital has a web page all about charity care and payment options. It says they paid out over $10M last year on it.
Overall, most Western countries seem to have some form of a two-tier system, or are moving in that direction. Those who can afford it go private, those who can't get assistance. Canada was supposed to be a true single-payer program but more Canadians are pushing for more private options (and they want the options in Canada, which makes every kind of sense).
There are a lot of problems in American medicine, sure. If you ask me, the place to start solving them is actually with medical school. Medical school here is brutal and expensive. I'm not saying it should be easy and cheap, but to me it seems like an area that could use some changes. As it is, who would go through all of that if they couldn't make a seriously good living when they are done? If they don't they can't even pay their six-digit student loans.
One hideous problem that I can tell you we have here in my area is with "charity care." This is when some low-income person with inadequate insurance (or none) runs up a hospital bill. The hospital, any hospital that receives any kind of public funding, has a separate fund for helping these patients; they often require the patients to sign up for social programs if they qualify, but then the hospital forgives large chunks of the bill and works out a payment plan with the patient.
However, some hospitals are hiding this from patients, or at least not going out of their way to let patients know. If the patient doesn't know their rights, the hospital collections people may come after them with a vengeance and try to go after any property they might have. One local hospital used to have a small office dedicated to providing this service with a few posters up to help low-income patients know that they should ask about this option, but the office was closed and the posters taken down.
Private hospitals tend to make pretty good money, but they often hide it in ongoing construction and landscaping projects. Overpaid hospital administrators get sent to Tahiti for pricey health care conferences and things like that all the time. Meanwhile, poor patients get squeezed.
Despite the scare stories, I see that my local hospital has a web page all about charity care and payment options. It says they paid out over $10M last year on it.
Overall, most Western countries seem to have some form of a two-tier system, or are moving in that direction. Those who can afford it go private, those who can't get assistance. Canada was supposed to be a true single-payer program but more Canadians are pushing for more private options (and they want the options in Canada, which makes every kind of sense).
There are a lot of problems in American medicine, sure. If you ask me, the place to start solving them is actually with medical school. Medical school here is brutal and expensive. I'm not saying it should be easy and cheap, but to me it seems like an area that could use some changes. As it is, who would go through all of that if they couldn't make a seriously good living when they are done? If they don't they can't even pay their six-digit student loans.