State shackles as healthcare solution
One of the topics I am keen to avoid with my new friends here in Cincinnati is healthcare. It is hard to listen to people who have never lived in a country with socialised medicine tell you how wonderful it would be to do so. I have often thought of printing up a one-page list of bullet points to hand out when this topic comes up, just so I can save myself some hassle. It strikes me that it would not be terribly polite. If I did create such a document, this - along with all the stories of loved ones who have needlessly died at the hands of the NHS (or nearly did) - would surely be included:
Observation 1) Less than 40% of NHS workers would want to be treated in their own NHS hospitals.
Observation 2) Less than half (45% compared with 50% in 2003) think “patients are the top priority.”
Observation 3) Stress-related problems at work have fallen among nurses and other staff (39% to 33%).
Conclusion: NHS nurses and other staff have stopped giving a shit.
And before you say that this guy is just harshing on nurses and medical staff, I’d add that this conclusion was drawn from the Health Commission poll by a man whose wife has been a senior nurse in the NHS for many years.
Filed under: Life
so what are your thoughts on the current American system?
Well, for starters: That it is hampered by ridiculous regulation. That people who complain about not being able to afford health insurance, but can afford cable television, are not deserving of much sympathy. That people who, as I did when I stopped being covered by my father’s insurance, choose not to prioritize their healthcare and do not purchase insurance do not deserve to have their coverage paid for by others. That I’d take it over socialized, nationalized healthcare - which you pay for regardless of how well it performs, regardless of whether or not you use it - any day.
Like I said, for starters.
Maybe you haven’t noticed the prototype for the American Healthcare system… Its been in operation for a long while, and everyone is talking about it.
That is the Veteran’s Admin I’m talking about. Well, everyone is talking about it these days! They just love it at Walter Reed.
I absolutely agree that people who’d rather pay for cable, or live as starving artist/waiters, than get health insurance don’t deserve much sympathy. But the fact is that when that unsympathetic uninsured person has, say, appendicitis, goes to the emergency room at the last minute because he doesn’t have a doctor, and then doesn’t pay the $37,000 hospital bill — you are paying for his treatment.
My parents have lived in the UK for 13 years. They pay for private health insurance from BUPA. I am not as starry-eyed aboutnational health insurance as many Americans are because, like you, I have known people who were in terrible pain for years and even died because of the NHS.
But I do think a system that combines coverage for everyone, so people can get more effective, cheaper regular care rather than making expensive emergency room visits that are never paid for, with the option to purchase whatever additional coverage their hearts desire, would be better than the situation in the US right now, where 15% of people don’t have health insurance and consequently are making it much more expensive for those of us who do.
But the fact is that when that unsympathetic uninsured person has, say, appendicitis, goes to the emergency room at the last minute because he doesn’t have a doctor, and then doesn’t pay the $37,000 hospital bill — you are paying for his treatment.
I am fine with other people paying that person’s bill on a voluntary basis, but not under threat of violence, as is currently the case.
not under threat of violence, as is currently the case.
huh? care to explain that one?
also, as for paying on a “voluntary basis” - wouldn’t that be nice? thing is, everyone who has insurance pays for the treatment of the uninsured, in the form of higher premiums.
Well, I was talking about programs like Medicaid, which are funded involuntarily by taxpayers. (If you don’t pay your taxes, you quickly find out what I mean by threat of violence.)
The problem with insurance, as I said previously, is the hideous regulation to which the industry is subject. For example, not being able to sell the same policy across state lines. Forcing everyone to take insurance has its own bad consequences - just for starters, a lack of incentive to compete on price or service.
I think the US health care system is the most UNDERRATED in the industrialized world.
On the other hand, the steep bills and worse, the threat of rapidly increasing co-pays and premiums are one of the biggest worries for any US household.
Any attempt to fix the problems of healthcare in the USA by introducing a national universal provider will be a disaster, unless you’re a trial lawyer or a union boss. At least the litigation costs in the UK are low, but for mostly bad reasons.
In the UK, it is routine for patients to die on waiting lists for treatment (I can personally quote examples), or from an infection received in a medical facility (one person I knew just this past week). The best drugs are simply not available for ordinary people, and it is illegal to tell patients about new drugs, all prescription drug advertising is outlawed (so patients don’t know what the government is refusing to pay for).
We have all the “benefits” of central planning: this bipartisan report in the UK talks of massive increases in spending, followed by hiring thousands of staff, who are then made redundant because the budget is not sustained. In London, hundreds of trainees doctors who have spent at least five years in training (at taxpayer expense) are guaranteed to have no job at the end (so they can’t even get the experience to practice privately), because of a screwup by the regional health authorities.
So let’s talk about improving the situation in the USA, by limiting tort law suits (just a cap on damages and forcing unsuccessful claimants to pay the full legal costs of defendants), by having more competition from insurers (private and non-profit) by allowing say French, Indian, British and interstate insurers. Let’s look at drug prices (including generics), restrictive medical practices, gold-plating etc. Let’s also look at ways of encouraging some form of health savings account, so people can set aside tax exempt savings for hospital bills and long-term residential care.
My criticism of the Democrats’ position at the moment is that there is an assumption that government officials know better how to negotiate than consumers and pharmacy benefit managers do. I don’t know the details of the Republican plan for Health Savings Accounts, but something along those lines is the only way I can see to avoid creating bigger problems for the future. Instead of a “Grand Plan” just doing a few little reforms to make it easier for people to pay for cheaper insurance would be good. Can Democrats live without tort lawyer donations? I don’t think so, but I’d love to see the Party turn around and refuse their donations. I’d join them myself, if they’d have me!
Disclosure: I sent the link about the NHS survey to Tim Evans.
I also write about the pharma industry for a living, though I do not depend on drug firms for my income. I am not eligible to vote in the USA.
People have a tendency to think that having something paid for by the government makes it the same, but free. This belief is resistant to quite an astonishing amount of experience.
I spend about $45 a month on cable. That won’t buy much health insurance in the U.S.
You’re about 29, right? Wait another 20 years, lose your insurance, and see what private health coverage costs then, especially if you’ve been treated for something like hypertension or some other common “pre-existing condition”.
The problem with American health care is not the health care. It’s the cost and the way we pay for it. Long-term care for relatively common ailments can easily cost enough to bankrupt anyone lacking a 7-figure income, with or without insurance. I’m cynical enough to believe there is essentially no direct relationship between the price of many medical services and the cost of providing them.
I don’t know how to fix things. But, I do know that it won’t be fixed if we allow those people and those institutions with a vested interest in maintaining the status quo — the insurance industry and the health provider industry — to continue calling the plays. They are the reason the system is broken in the first place.
The “socialized” NHS model might not work terribly well, but the existing corporate American system has failed, too. The lesson to draw from that is not that socialized medicine is inevitably bad. It is that any attempt to engineer societies according to any — any — ideology is doomed to failure.
If we get beyond the bogus notion of assuming corporations have the same rights as people and decide to focus on making people healthier rather than trying to score points for one ideology or another on the backs of people needing health care (and that would be all of us).
If we get beyond the bogus notion of assuming corporations have the same rights as people and decide to focus on making people healthier rather than trying to score points for one ideology or another on the backs of people needing health care (and that would be all of us).
Bill, I have no interest in “making people healthier”. Individuals should be free to be as healthy as they wish to be. I do not wish to contribute to any attempt to coerce people into smoking cessation, ‘healthy’ diets, or any other collective health efforts.
Bottom line: Do you honestly think bringing politicians into the mix is going to improve a damn thing? If so, why?