Soviet-Style Medicine, North American-Style
A Canadian's tale of what it's like to try to get care under socialized medicine. Cathy LeBoeuf-Shouten, of Hudson, Quebec, writes:
Imagine that you and your spouse, and three children under the age of six move to a new city and must find a family doctor. You are told at the local clinic that the doctors there are not accepting any new patients. (Canadian price controls have created shortages of everything when it comes to healthcare). The receptionist suggests that you go through the yellow pages and try to find a physician whose practice is not "full." You spend days, and weeks, doing this, and are repeatedly told "Sorry, we are not accepting new patients." You put your name on several waiting lists and persist in calling doctors' offices.Finally, a receptionist tells you that, while the doctor is still accepting new patients, he requires a full medical history and an interview with each family member before you can be added to his roster of patients. Based on the questions asked during the interviews, you come to understand that he is screening out sick or potentially sick people. You are all healthy, fortunately, so he takes you on as patients. Others are just out of luck.
There is a chronic shortage of doctors in Canada because price controls on doctors' salaries have resulted in a "brain drain" where the best and brightest practice medicine in the U.S. and elsewhere, after being educated in Canada. In addition, the Canadian government cut medical school enrollment in half in the 1990s as a "cost-cutting measure," making the problem of doctor shortages much worse.
Next, her son gets an appendicitis attack:
You tell the nurse that your son must be seen by a doctor immediately - it's an emergency! - as his condition is worsening by the minute. The nurse tells you, stone-faced, to go and sit in the waiting room to wait for a triage nurse. Having no choice, you do what you are told and join twenty or so others in line in front of you. You are given nothing to help make your son more comfortable - no damp facecloth, no bedpan for the vomit, nothing.When a triage nurse finally strolls in a half hour later your son is too weak to respond to her and you begin to panic. Finally, a doctor appears and says it's just a "bug" and that you should not be playing "armchair doctor" by "diagnosing" appendicitis. He orders some time-consuming tests anyway, because you have shown him that you are very, very angry. Six hours later the test results come back positive for appendicitis.
Your son is whisked away for an emergency appendectomy, after which the surgeon tells you that, had the surgery been delayed by another few minutes, he would probably have died. Your son's appendix was gangrenous and on the verge of bursting. It reminds you of reading in the local news of three other people who were sent home from the emergency room, only to have their appendices burst and die. You are grateful that you were much more persistent and ornery than they apparently were.
It's naive adult children who think government is going to provide some sort of medical utopia.
Yes, we need health care reforms -- like untying health care from the workplace and lifting prohibitions on competition that keep people across a state line from saving large sums of money every month simply because they're on the wrong side of a state border.
In case you'd like a preview of what's to come under Obamacare, here's a bit of Canada down here in the USA: Washington state Walgreens refusing to fill Medicare patients' prescriptions as of April 16.
I know, I know, there's a simple solution: The government will pass legislation to force them to do this.
And they will either go out of business or pass the costs on to the rest of us:
"Can of Diet Coke? That'll be $13.50, sir."
Canada link via Dr. Eades
As time passes, it becomes more clear that the goals of the business and of the government are not those of the people.
Time to beat this drum again!
Radwaste at March 18, 2010 2:43 AM
There are a lot of full dentist and doctor's office in Philadelphia, too...
NicoleK at March 18, 2010 5:32 AM
Not that this makes this situation any less fucking absurd, but if you're vomitting and need a Dr asap (esp at the ER) just make a mess. Ditto with bleeding. Messy people get seen before non-messy people, other things being generally equal.
I'm always amazed by the stupidity of people who bitch about Drs not accepting new medicaid patients, who assume somehow that when we're all basically medicaid patients it will all be magically better.
momof4 at March 18, 2010 5:37 AM
On a local newspaper column, someone made the comment that "Americans want the government to fix the healthcare mess." I read this on the same day:
http://www.independent.org/blog/?p=5309
People who want the government to fix our problems are part of the problem.
Pirate Jo at March 18, 2010 6:31 AM
"People who want the government to fix our problems are part of the problem."
This. 100% this.
"Yes, we need health care reforms -- like untying health care from the workplace and lifting prohibitions on competition that keep people across a state line from saving large sums of money every month simply because they're on the wrong side of a state border."
I also agree with this. Less govt involvement is the answer in my opinion, not more. If these regulations about competition that they have right now were lifted, they would likely see that the cost would actually go down. I like to liken indsurance to a business (it kind of is anyway right?). The general public determines how well a business does. Competition for that business forces businesses to provide better service at reasonable prices. The public will not support a business that provides subpar service for a high price and that business will eventually buckle. It is actually pretty simple.
Sabrina at March 18, 2010 8:13 AM
I think allowing the insurance companies to compete for our money would do a lot to fix this mess.
I've been saying from the beginning, if the gov't wants to run health care, they need to prove they can by fixing Medicare first.
Since we all know THAT'S not going to happen...
Ann at March 18, 2010 8:32 AM
Allowing doctors to compete for our money would also drive down costs.
Misplaced expectations are another factor. When I get my car fixed, I pick the mechanic and deal directly with them. I pay for routine care and maintenance myself, even when it's something big like engine repair. My insurance is just there in case disaster strikes - a tree falls on my car, or someone runs into it (or I run into something). Since I am expected to pay for most things myself, the cost of fixing most things is driven down by competition and my insurance is affordable. Auto insurance is also not tied to my place of employment. But guess what, I cannot expect affordable car insurance AND expect my insurance company to pay for every damn oil change! And guess what else, I have an incentive to take care of my car.
Maybe this would be a good time to point out the difference between "health care" and "medical care." Take care of your OWN health care, and maybe you won't need so much medical care.
This would work for medical insurance, too. I believe it was even discussed on this blog before, but the price of lasik surgery plunged within a couple of years, probably because no ones insurance covered it. When providers negotiated directly with consumers, prices were driven down.
Pirate Jo at March 18, 2010 8:55 AM
Last weekend I drove down San Diego to visit my sister in law who had just had a hip replacement. She had flown all the way from Spain to have the procedure done.
There is a reason why patients from all over the world come to the US to have medical treatment. And, you never hear about patients going to Canada,England or any other country with a socialized medical system.
belle de ville at March 18, 2010 9:05 AM
So odd that the Israelis, Danes, Germans, French, Italians, Spanish etc etc etc all stick with this horrible socialized medicine--and providing health care to all citizens (while getting six weeks off a year).
When will these Euro-Mideast morons get a clue?
And those French--when Alkon goes there, like an overage exchange student she gushes about their suave ways---and even they are so stoopid as to stick with socialized medicine? WTF? I mean, WTF to the moon!
We have it better in the USA. True our cities look like crap next to Rome or Paris, and our internet download speeds are glacial, and our food or literature or television or education system is inferior but we are the best at everything always.
Really Flustered at March 18, 2010 10:00 AM
Amy Alkon
http://www.advicegoddess.com/archives/2010/03/18/sovietstyle_med.html#comment-1702434">comment from Really FlusteredThere's an article I just read in the WSJ about how France's system is in financial trouble -- they all are. And my friend M, who earns about 250K in France, pays 65 percent of his income in taxes.
Amy Alkon at March 18, 2010 10:03 AM
This post is full of...well, a$$. I mean, what the heck is your point? Replace any word referring to Canada with "U.S. Emergency Room" in your quoted articles and you would have the same inflammatory indictments of our current system.
Keep it simple will you? Yes, we need serious reform. Free-market lovers like to talk about competition, but we all know the insurance companies are in the business of generating profits, not keeping everybody healthy.
This: "Yes, we need health care reforms -- like untying health care from the workplace and lifting prohibitions on competition that keep people across a state line from saving large sums of money every month simply because they're on the wrong side of a state border" was all you had to say.
All the rest is just taking a frustrating and scary experience and blowing it up to indict the entire system. And that's just lazy writing.
LV_P at March 18, 2010 10:15 AM
Ah, springtime, when the trolls are in bloom.
@Really Flustered: England's health care system (which I notice you carefully omitted) is collapsing. The rest of the social democracies in Europe are funded by virtue of not having to pay for their own national defense.
If we pull our troops out of Europe and dissolve NATO, that free health care and six weeks of paid vacation will be the first thing to go.
@LV_P: News Flash - EVERYONE IS OUT TO MAKE A PROFIT. EVEN YOU. Anyone who tells you otherwise is lying.
But there's this little thing that happens in a proper market - competition. It's not just about the lowest price, it's about the best perceived value.
A lot of people seem to be under the impression that the government has some kind of interest in the well being of the citizenry. They do not. We are simply money fountains to them. Giving the government the power to decide who lives and who dies is always a bad idea. And it's far worse when they regard the herd as a profit center to be maximized.
brian at March 18, 2010 10:35 AM
Another thing to think about... So when the govt. does your healthcare, and they botch something, like they did with making the kid wait?
Who're you going to sue? The Government? They have immunity to that.
SwissArmyD at March 18, 2010 10:49 AM
You will have your voter medical services. And federal employees and congress with have their own.
Guess which one you will want to access, but cannot?
Spartee at March 18, 2010 10:51 AM
"Free-market lovers like to talk about competition, but we all know the insurance companies are in the business of generating profits, not keeping everybody healthy"
Yes. Profit. And the problem is...?
The food you eat? Grown by farmers with a profit motive. The clothes you wear? Profit motive. The education you received? Again, look at the *people* involved (those are who really give you what you have, not institutions) and what do you find? Profit motives! All of them (unless you were taught by naked, starving teachers who asked for nothing in return). The brakes you use in your car, that protect your kids? Fixed for profit. /gasp
Adam Smith raised this point hundreds of years ago, noting how we depend on the butcher's self-interest, not his charity, for our meat. Why is health care different from food?
But hey, if you can structure a health care system where capital, doctors, nurses, administrators, underwriters, and other vital economic inputs will work without profit motives, let me know. I will eagerly short health care stocks right before proclaiming you the greatest economic thinker since Hayek.
Spartee at March 18, 2010 11:00 AM
The US Postal Service is cutting services and hours because it cannot make a profit given its current cost structure (especially union-mandated salaries, benefits, pensions, and work rules). Government run healthcare is going to suffer from similar cost structure issues once the public employee unions take over.
Given that UPS, FedEx, DHL, etc. are capable of and ready to take over delivery of first-class mail, and can do it at a profit, why is there still a taxpayer-funded financial black hole called the USPS?
Insurance companies in a true free market system that fail to provide the insurance promised end up broke and out of business. You generate a profit by selling a product and, with that product, customer satisfaction. Unsatisfied customers = bad reputation = no customers.
Conan the Grammarian at March 18, 2010 11:55 AM
Company Paid Health Insurance is Part of Your Salary
Here is the central confusion of the healthcare debate. People think that their employer-paid insurance is a gift of employment. They correctly compute that they can't pay for that insurance out of their current take-home pay. So, they want either more rules on employer-paid insurance, or insurance provided by the government.
People are already personally paying for their "employer-paid" insurance. They don't buy it directly so (1) it doesn't attach to them when they change jobs, (2) and they can't shop for the insurance they might want. The employer writes the check with part of the money earned by the employee.
Healthcare is now tax-free when purchased indirectly as an employment benefit, but mostly taxable through personal insurance or when purchased directly.
Untangle the tax mess, remove employers from the middle, and salaries would go up in the amount of the "free" healthcare benefit through employers. Then people would have enough take-home pay to buy their own health insurance. That is what healthcare reform should be about, along with removing anti-competitive rules from the insurance market.
Most people already pay for their health insurance, but currently have little choice about what they buy. True reform could put that money and choice into their hands.
Andrew_M_Garland at March 18, 2010 1:07 PM
Wow, you sound just like a Fox News broadcaster. Straight old Republican talking points. Seriously, what has the Republican party given us as solutions in the past four decades? Laissez-faire capitalism and "free enterprise". Bunch of bologne. All you folks who think that buying insurance across state lines will somehow magically fix health care are delusional idiots.
Jay Pipes at March 18, 2010 1:08 PM
And this new Obama-care legislation will just magically fix healthcare Jay Pipes? Uuuuhh...no...
Sabrina at March 18, 2010 1:15 PM
Interesting. But don't cherry-pick too much. An overwhelming majority of us Canadians would not trade our country's universal health care system for the United States' current system. It doesn't mean ours is better than yours. Only that in this case (among others), we definitely don't think your grass is greener.
Alan in Canada at March 18, 2010 1:28 PM
Amy Alkon
http://www.advicegoddess.com/archives/2010/03/18/sovietstyle_med.html#comment-1702490">comment from Jay PipesThese aren't anybody's talking points, and if you had valid cricitism of them, you'd surely make them. You don't, so you name-call.
I'm neither a Republican nor a Democrat but a fiscal conservative, libertarian, and personal responsibilitarian. I have affordable health insurance -- through Kaiser Permanente. I got it in my 20s because I needed affordable insurance that wouldn't rise in cost, and that would give me catastrophic care if I need it. I've been paying into the system for decades, and rarely going to the doctor. Why should I pay for somebody who's not paid into the system when, at 46, they discover they have some expensive condition?
Amy Alkon at March 18, 2010 1:34 PM
Or, you can be like me and my husband.
Husband develops severe pain in his groin. We trundle to the ER of our local hospital. He checks in, and asked a couple of initial questions to see if he's in imminent peril of death. Finding him to be likely to live a while yet, they ask us to wait for the real triage nurse. That takes approximately 4 minutes.
His OHIP card is scanned, he's put into a room, put on a drip, checked out carefully, and monitored til a doctor comes over... maybe 10 minutes. He's diagnosed tentatively as having a kidney stone, and some tests are run. Morphine is offered.
We move to a waiting room for test results to come back. Fluids are replaced as needed. All staff is friendly and courteous. Tests confirm kidney stones, prescription and instructions are provided, and we are sent home with all the information we need.
We are not sent to the poorhouse as a result.
Want another? I'll make this one shorter: father has a lump. Gets it removed, tested, found cancerous, and removed within a few days. Starts chemo and radiation once the incision has healed enough. Followups and specialists galore, negligible turnaround. Father can still afford both home AND food.
I've got more, if you want 'em. I've got very little bad to say about the Canadian system.
Is it *perfect*? Of course not. But anyone who thinks *any* system, be it government-run, profit-oriented, or any other option, is just plain delusional.
Lauren at March 18, 2010 1:37 PM
Oh I forgot to say this. The case mentioned in the article is very misleading. In Canada where I live, numerous walk-in clinics are opened everywhere for those of us who still don't have a regular family doctor. That's where my family and I go for our visits to the doctor anyway: it's faster and convenient since you don't need an appointment. Myth busted.
Alan in Canada at March 18, 2010 1:38 PM
So, Jay Pipes, what is you "Solution"?
Or maybe better, what is the PROBLEM we are trying to solve?
Where is it written that healthcare is a "right" that the government should provide? That would seem to be a question. As Alan in Canada might say, and Amy mentioned above, you don't get healthcare witout paying for it. It's a SERVICE. It doesn't matter if you pay taxes and get it, or you pay salary to get it, it isn't FREE. So the question is, is it a fundamental RIGHT, that the government and by extension all the people of the US who make it up, need to provide every individual, or is it not? Through Medicaid we have already provided for the impovrished, Medicare the elderly, so now what are you trying to say?
What is actually broken that we are trying to fix here? I've noticed that the people who campaign for this the hardest, also seem to be the least likely to pay for it, top or bottom. So taxpaying guy in the middle thinks, "sure, it's no skin off their nose." why wouldn't they be pushing it. Don't kid yourself that it is all self interest.
SwissArmyD at March 18, 2010 1:48 PM
Amy Alkon
http://www.advicegoddess.com/archives/2010/03/18/sovietstyle_med.html#comment-1702496">comment from Alan in CanadaA close friend of mine is from Canada, and regales me with horrendous stories of what she's been through. She's now in the US and grateful as hell for the medical care here. Furthermore, appendicitis is not the stuff of the family doctor visit.
Furthermore, it's important to have consistent care from a provider so they can know your situation and not be new to it every time. My doctor knows what to look for in me -- I don't have to give her a full medical history every time, and what if I forget something? Things are often not charted perfectly, either. We have a relationship, my doctor and I, and I can trust her to give me prudent (but not crazy) care -- meaning the tests I need vis a vis my family history, even if they aren't the standard tests of a person my age.
Note that I also don't want to be overtested. There's something called "iatrogenesis," a term I learned from my epidemiologist friend, and it's when medical care messes you up. Medical intervention often comes with risks and side-effects, and it's important to be mindful of that.
Amy Alkon at March 18, 2010 1:49 PM
Posted by: brian at March 18, 2010 10:35 AM: "A lot of people seem to be under the impression that the government has some kind of interest in the well being of the citizenry."
And those folks absolutely baffle me. They are completely ignorant of history and truly on the road to serfdom. Oh, but they get good service at the DMV! So, I have too usually but I also make sure to go at the right times to minimize the hassle etc.. Corporations aren't saints but to put full faith in government? I'd sooner put my full faith in the Catholic church and I am not a fan of organized religion.
Spartee, clearly you are an ignorant whelp. Hayek was a fool. Paul Krugman says healthcare is different. Regular economic rules don't apply and Mr. Krugman has a PHD AND a Nobel prize. ;)
"Another thing to think about... So when the govt. does your healthcare, and they botch something, like they did with making the kid wait?
Who're you going to sue? The Government? They have immunity to that.
Posted by: SwissArmyD at March 18, 2010 10:49 AM"
Which will lead some folks to flip their lid in grief and anger after watching their kid die (didnt Denzel Washington make a movie about this recently?) thus pulling a Lethal Weapon cliche response to the "Soverign Immunity!" claim with "Its just been revoked!" as they go postal on the IRS worker sent to audit them after filing a complaint.
As for it being hard to find a doctor while on medicare or in Canada. That already exists here in the US. Last year needing to see a doc, most clinics had waiting lists and one instructed me to "call next week" at 8am or so to see if any Docs had openings for new patients. Now that I have insurance (self funded) I still have yet to sit down and find a general internal med doc. Its a royal PITA to find one. I had no trouble thankfully a few years ago getting an ear test done and since I paid cash, got half off the insurance price (so they said anyway).
The clinic I did go to for emergency care as it were is now after me claiming I owe them $150 via a bill collector. Which seems odd because considering any bill I got went to a credit card they made me give them to secure payment/see a doctor back at time of service, I should have paid the bill.
FP at March 18, 2010 1:51 PM
Here in Canada we actually take care of people who don't have money for healthcare. Here's a scary word for those south of the border in North America, SOCIALISM!! It works and is what is needed in this world. Not Capitalism!! The U.S. is completely fucked up by there aggressive attitudes towards the almighty (sometimes) dollar. Unfortunately many countries are following suit and are going down the toilet as well. When you have finally beaten the masses and taken all of thier money it's only a matter of time before those masses will revolt!! Revolt now so you will have a future. Money burns just as well as cities or farms.
J. at March 18, 2010 1:59 PM
Conan The Stupidarian:
The US Postal Service does not make money due to cross-subsidies to our weakling rural economies.
I can live in Taos, NM, and drop a letter in the box, and for 45 cents the USPS will take it to Red Bluff MT. or the tip of Florida, or even to the lesser Hawaiin islands or some turdlet in the Alaskan boonies.
No private carrier will reach into the hinterlands (remote rural areas are not served), or deliber a letter for under $6.
You are a myopic poltroon to take such a stance
Really Flustered at March 18, 2010 2:22 PM
@Amy Alkon
"Why should I pay for somebody who's not paid into the system when, at 46, they discover they have some expensive condition?"
Because it's the right thing to do. It's called social justice and collective good. All you "libertarians" and "fiscal conservatives" are so good at saying that *you* don't need no stinkin government programs. Of course, then when sh*t happens and you get ill and go broke because your "solution" of a for-profit health insurance company dumps you.
Also, as for "not having talking points", your point about buying across state lines is 100% pure Fox News.
@SwissArmyD
My solution? Medicare for all. Single payer systems get, on average, better care for less cost.
"Or maybe better, what is the PROBLEM we are trying to solve?
Where is it written that healthcare is a "right" that the government should provide? That would seem to be a question. As Alan in Canada might say, and Amy mentioned above, you don't get healthcare witout paying for it. It's a SERVICE."
I didn't say health care was a right. Not sure why you would say that.
England's (I am British, but have lived in the US for decades) health system is a single payer system but it is not a right. In fact, in the legislation for the NHS, it specifically states the national health service is not a right. It's a responsibility of every citizen to pay, via a tax, for the socialized health system.
And Brits aren't trying to get rid of the NHS because overall, it *works*. Same in Canada. Same in France. Same in Germany.
But, whatever, think what you will, I really don't care. Just keep watching Hannity at night.
Jay Pipes at March 18, 2010 2:26 PM
um, J.?
d'ya realize that you are conflicting in your terms?
"Here in Canada we actually take care of people who don't have money for healthcare."
"When you have finally beaten the masses and taken all of thier money it's only a matter of time before those masses will revolt!!"
It's the MASSES, that are not liking the whole healthcare gig, because it is THEY who will be funding it for everyone else. Or perhaps you didn't know that the TOP 50% of all income earners pay 96.4% of all taxes... meaning that the bottom 50% pay MUCH LESS.
Where do you think this money you speak of comes from? We dont have VAT like you do... try and tone down your revolutionary rhetoric and think for a minute...
SwissArmyD at March 18, 2010 2:27 PM
I always thing that there is something wrong with people who can't get a family Dr. in Canada.
I have my Dr.and my wife has hers. Our children have their Drs in different cities. Emergency rooms suck for waiting but unless you come by ambulance it's the same in the U.S.
I had a tumor removed from my back.It took them a year to find it hiding behind the spine but when they did it was Dr to specialist to OR and out,10 days.
As for being in crisis, yes it is.Always has been always will be.Going broke? The same. No matter what anyone says I prefer the 2nd class system here to the 1st class system that all Americans enjoy.
What did I say something funny?
Dax at March 18, 2010 2:31 PM
65% in taxes? Jesus, I pay almost 50% of my income in taxes and all I got was an invisible bomber attacking mud huts in Iraq.
I also got a bill for $5,000 for a ride to the emergency room for pneumonia -- and a notice that my $580 monthly health insurance will most likely take a 30%+ jump if Anthem/Blue Cross get their way.
Meanwhile, my insurance won't let me get an annual physical for my $40 co-pay with a doctor who has been treating me for 10 years and is in their system. I have to go to a total stranger in one of their Anthem clinics or pay $200+ for a checkup.
I'd say that yes, things are getting broken here and could use some changes.
As to foreigners coming here for surgery, I'm glad to see they've got enough money to fly halfway around the world for surgery. I wonder what their less-wealthy neighbors are doing. Dying, I suppose. Well, screw the poor, as King Louie used to say!
Gog_Magog_Carpet_Reclaimers at March 18, 2010 2:31 PM
Where was this guy's money and concern for social justice and the collective good until age 46? He paid nothing to help anybody and now decides he needs help.
Conan the Grammarian at March 18, 2010 2:36 PM
"Where was this guy's money and concern for social justice and the collective good until age 46? He paid nothing to help anybody and now decides he needs help."
That's the whole point of single-payer. Everyone pays in and everyone is covered for less cost.
Congratulations, you've missed the entire point of collective good.
Jay Pipes at March 18, 2010 2:40 PM
The USPS delivers mail (what they don't lose or mis-route) to most of the US at an enormous cost to the taxpayers.
You want the rest of us to subsidize your remote location daily mail service using a money-losing entity because you don't want to bear the real costs of your geographic choices.
A private entity will figure a way to make a profit delivering mail to the hinterlands. Perhaps not on the daily basis the post office is trying to weasel out of, but on a regular basis nonetheless.
Who's being myopic now?
In the meantime, you're not bereft of communication options. Ever hear of e-mail?
Conan the Grammarian at March 18, 2010 2:45 PM
So Jay Pipes, where are your stats that it costs less in the UK. There certainly isn't better outcomes for cancer treatments:
Cancer Rates UK vs. Europe
SwissArmyD at March 18, 2010 2:48 PM
Amy Alkon
http://www.advicegoddess.com/archives/2010/03/18/sovietstyle_med.html#comment-1702520">comment from Jay PipesI work my ass off seven days a week. My friend Ruth wants to drop by the coffee shop where I'm writing today, but I keep telling her I have to keep working. I'd LOVE to see her -- and I've been working all day and will work until I drop at the end of the day. I'll be on Doug McIntyre's syndicated radio show tonight at 10, so I can't go out tonight, either. I'm going to go home and read some studies if I have the energy, then nap for half an hour and go on the radio.
So...why should I pay for somebody who takes it easy? I paid for health care when I could barely afford a can of beans, because I couldn't leave it to my parents if something catastrophic happened to me -- who might choose to dump me off at Bellevue instead of mortgaging their life away, who knows.
Personal responsibility -- try some on, sometime.
I just love the notion that it's "social justice" to take the money I earn and finance somebody else's life. I choose to volunteer my time to people -- probably more than many people, if you count all the advice I give to people whose questions will NEVER be fodder for my column...in addition to the volunteer work I do in my day-to-day life.
My choice. You don't get to enslave me on behalf of the lazy.
Amy Alkon at March 18, 2010 2:48 PM
The Masses as in those with money like the top 10% of the U.S. Oh that's convienent. How about the 50 million Americans who don't have healthcare? Only in the U.S. where they preach equality and that's only if you have money. The poor have no say. And they said Communism was an evil!!
J. at March 18, 2010 2:56 PM
The deterioration in quality is not worth the cost. It will not cover everyone for less. No country that has single payer has lower overall costs. Taxpayers simply pick up the cost of an inefficient service, like the post office in my earlier example.
Health insurance in this country needs an overhaul - it needs to be disconnected from employment, freed to operate across state lines, and made more competitive.
Healthcare in this country is not a problem. Most people are satisfied with the quality of healthcare. They're concerned about the price - which is heavily influenced by the health insurance system which pays for it.
A single payer system means no choice in healthcare delivery. What the provider will pay for is what is offered, nothing more. And the provider is motivated to reduce costs. That's not going to lead to "social justice" or provide for the "collective good."
And your hypothetical 46-year-old? Maybe if he'd had a competitively priced healthcare option available, he'd have gotten health insurance at an earlier age and contributed to the system before he needed it - you know, chipped in for the "collective good."
Conan the Grammarian at March 18, 2010 3:01 PM
"You don't get to enslave me on behalf of the lazy."
Nice. I'm going to use that one.
Conan the Grammarian at March 18, 2010 3:03 PM
"It's called social justice and collective good. All you "libertarians" and "fiscal conservatives" are so good at saying that *you* don't need no stinkin government programs. Of course, then when sh*t happens and you get ill and go broke because your "solution" of a for-profit health insurance company dumps you."
Which is why I posted the solution.
Maybe you should read it.
Meanwhile, there is no "justice" in abetting the criminal and irresponsible.
Radwaste at March 18, 2010 3:05 PM
That number was an erroneous estimate. Even Obama's dropped that figure to the more realistic 30 million. And he's still counting people who are between jobs (who will get healthcare again when they're employed), people who are covered on someone else's medical insurance (college students), and people who simply choose not to spend their money on health insurance.
Conan the Grammarian at March 18, 2010 3:08 PM
nice to see butthole re-emerged
ron at March 18, 2010 3:18 PM
Politician: There is so much need in the world, and among the poor voters and future voters of the United States. So much need, and I am willing to devote my life to serving that need. I need a contribtuion to do this.
Taxpayer: How about $100?
Politician: (pulls out and points a gun) How about $10,000 for now?
Taxpayer: (unhappy, presents the money)
Politician: (takes the money) It would be much better if you were cheerful about helping the poor, you greedy, capitalist bastard. Be happy that you are contributing to a good cause.
Taxpayer: Could you put the gun away now?
Politician: OK, but remember that I have it.
Andrew_M_Garland at March 18, 2010 3:19 PM
" ... what has the Republican party given us as solutions in the past four decades? Laissez-faire capitalism and "free enterprise"."
Gee, I *wish.* If that was the case, I would actually vote for Republicans!
Pirate Jo at March 18, 2010 3:29 PM
Amy Alkon
http://www.advicegoddess.com/archives/2010/03/18/sovietstyle_med.html#comment-1702542">comment from Pirate JoThanks, Pirate Jo. Missed that.
And my sentiments exactly.
Amy Alkon at March 18, 2010 3:35 PM
hey J... Medicaid covers poor people, care to try again? I ALREADY PAY FOR THAT. PLUS I pay for myself. Notice that I said top 50% paid for everything. Not Top 10%. AND? Who are you to say that the top % should have to pay more, just because they make a lot of money? Wouldn't that just mean they they stop making that much? We already have a progressive tax system, that is why the top 50% pay thirs and the bottom don't pay as much.
SwissArmyD at March 18, 2010 3:42 PM
My solution? Medicare for all. Single payer systems get, on average, better care for less cost.
Um no. It actually provides lesser quality care, offering no choice of who your caretaker is, for a low cost to the GOVERNMENT. But, it is not a low cost to ME. I will be the one paying into it. Not the poor that are actually the ones this is benefiting. ME. And for what? Oh right? The "Collective Good". Well, if you care so much about the collective good then you should write a damn check. Me? I would like to keep *my* money that *I* earned. I am not going to pay my money to the same system that allows welfare mothers to keep poppin out babies and get a free ride on my dime. Uh uh. If they want insurance, then they should go out and get some. It's called personal responsibility. I am so sick of this "the govt needs to take care of the people" crap. No. You need to take care of yourself.
I am fortunate enough to have a job that provides decent health insurance but I wasn't always that lucky. When I didn't have insurance in my early 20's, I went out and got some out of my own pocket. I skrimped and saved for it and got the very basic coverage because I knew that my health was MY responsibility. I sacrificed for it, because it was important to me.
Sabrina at March 18, 2010 3:59 PM
J. & Jay & Dax trolls -- thanks for showing your ignorance, eh. Please don't think these fools speak for all Canadians. It scares the hell out of me that someone from my country will actually speak the word Socialism as if it were a good thing!
Hopefully they're very young. Socialism seems like a brilliant idea when you're a young, middle to upper class student, because you can't understand why anyone wouldn't contribute their best to the "greater good". You do it within your gang of friends, why wouldn't it work in the bigger world?
But as you get into the real world you start to ditch the friends that NEVER pay their share, because you learn how hard you have to work to EARN it and how they don't. You don't get to pick the bigger world. And you don't get to decide the definition of the greater good. Once you've accepted the IDEA of the greater good, you can't really argue when it shifts to encompass things you don't believe fit.
moreta at March 18, 2010 4:02 PM
If health care is so great in Canada, why did Premier Danny Williams come down here to get treatment for his heart condition J, Jay, and Dax?
The argument put forth by the supporters of govt run healthcare is that he "is considered a privileged person" and "had a very special condition." He also has the money to get treated wherever he wants. And of course, since Mr. Williams has lots of money, and can afford the very best in healthcare, which is not the case for most people, he should not be criticized for coming to the US to get a procedure that would "safe his life".
I won't argue that Mr. Williams is free to spend his money and visit whatever doctor he likes. That is a given.
Apparently though, Mr. Williams had a very very special condition that required the best care that could only be provided in the US. Well, that right there says it all doesn't it. He couldn't get the best care in Canada because it wasn't available. Apparently, only ONE doctor in the whole Northern American continent could treat him for his very special heart condition. Really? You want us to believe that this one stop shop healthcare program provides better quality care for all of it's citizens, yet, you can't get the kind of treatment in Canada that Mr Williams, one of it's own members of govt needed?
And, lets just go with the statement that there really are no specialists that can perform this very special procedure that Mr. Williams needed. Could it just be that the highly skilled specialists will not work up there? Why should they? They won't get paid at the rate they should for the service they provide. I have to wonder though, if there was a specialist for his condition in Canada, and he/she was part of the network of doctors provided by the govt healthcare system, would Mr. Williams had gone to them instead of flying here? Doubtful. Because, Mr. Williams is very important and deserves only the best care... which, by his own admission, he can't get in Canada.
I guess what isn't good enough for the Goose is good enough for the gander after all.
I am not knocking Canada as a whole. I think it is a beautiful country (with great gambling), but the free healthcare for all citizens thing just ain't workin. If it isn't working there, why in the hell would we want it here?
Sabrina at March 18, 2010 4:44 PM
I meant was is apparently good enough for the Goose ISN'T good enough for the Gander.
Sabrina at March 18, 2010 4:54 PM
"And they said Communism was an evil!!"
Yeah, who could argue such a thing based only on the tens of millions killed by Stalin, Mao, Pol Pot, etc. But hey, if we put those deaths aside--along with that whole slave camp and totalitarian tyranny thing, too--sure, maybe we can then discuss whether communism is evil or not.
After all, communism is still really working out well in places like North Korea and Cuba. I hear the health care there is primo too!
Spartee at March 18, 2010 5:52 PM
"That's the whole point of single-payer. Everyone pays in and everyone is covered for less cost.
Single payer is where the government says "We will spend x amount of GDP on healthcare. No more." And then govt distributes that funding according to government fiat, with little input from consumer feedback.
That does not make health care "cheaper", that method simply makes the first x amount spent on health care each year a large government program. It does not, by itself, make anything more efficient, better spent, more productive, or "cheaper" in this fellow's vernacular.
There certainly are things government can provide more efficiently than can be done safely and effectively via private action. Me seeing a doctor and getting treated is probably not one of them.
Spartee at March 18, 2010 6:02 PM
Amy Alkon
http://www.advicegoddess.com/archives/2010/03/18/sovietstyle_med.html#comment-1702580">comment from SparteeI'm all for "everybody pays": I pay for myself, and you pay for yourself. Same as at lunch. If I want the steak, I'll pay more than you do if you want the quesadilla.
Amy Alkon at March 18, 2010 6:09 PM
"Only in the U.S. where they preach equality and that's only if you have money."
No I am not young. I have had to show what the word "responsibility" means to the next generation by standing by my spouse and kids. We have never had benefits but have managed to pay for all our needs and some of our wants during 17 years of marriage. If we had lived in the States we would have never made it this far and paid off school loans, a mortgage, and basic dental care, etc... Some people have hereditary issues to deal with and are always sick. They want to work but can't.
Capitalism in North America is slowly destroying the masses all for those who want everything. Good luck taking all your stuff with you when you die! Small s socialism means working together not plotting against others. I'm 42 and not a millionaire but I am part of the 2% of people who are the richest humans on the planet.
J. at March 18, 2010 7:03 PM
Amy Alkon
http://www.advicegoddess.com/archives/2010/03/18/sovietstyle_med.html#comment-1702604">comment from J.Small s socialism means working together not plotting against others.
Ah, but don't you mean forcing others to work for others' benefit?
I am a very giving person, and just saw the teacher who brings me in to the inner city school, and to my dismay, found that they can't bring me in till after finals. I CHOOSE to volunteer my time, and I'm trying to figure out how to get this program funded across the country. I will never make a dime from it. But, it's my choice to do this, and if somebody else's choice is to never give a moment of their time in some volunteer position, that is their choice, and I do not have the right to force them otherwise.
Amy Alkon at March 18, 2010 7:30 PM
moreta
No not a troll.I do pay taxes and lots of them.Not a wide eyed innocent either.And I have used the U.S. system. A medical procedure I was going to have done here and a new work project conflicted so I went south and paid. If it had been urgent it would have been done here. I hope your premiums don't increase as you age. Mine won't
Dax at March 18, 2010 7:42 PM
Although it's been stated elsewhere, I'm going to repeat it.
Socialism kills. Whether directly by liquidating undesirable populations, or through bureaucratic neglect by leaving a boy to die of dehydration.
There is no such thing as "Social Justice". "Social Justice" is a euphemism for "forcibly separating the productive class from the fruits of their labors for the benefit of the freeloaders."
You know when this country saw its biggest improvements in productivity and growth? Before we started allowing creeping socialism to run shit.
Get rid of the federal Department of Education. No federal regulations of health insurance. Sure as shit no single-payer system.
What I don't get is why so many people want socialism in this country when it's failed everywhere it's ever been tried before. Are they just stupid? Or are they hoping that they'll be the ones in the Party who get the good shit and all the rest of us will be standing in line at GUM to see what kind of meat they don't have today?
I'm going to go out on a limb and state that anyone agitating for a single-payer system simply wants to become a freeloader, but can't do it because they need a job to either provide health insurance or pay for medical services.
@Dax - I'll bet you a million dollars that your premiums increase every year of your life. Unless you've never gotten a raise, that is. THERE IS NO SUCH THING AS A FREE LUNCH. Your benevolent government is pointing a gun at your head and forcibly extracting money from your wallet with one bureaucracy while another bureaucracy is pointing a gun at your head and telling you what level of medical care you'll accept.
Why are you willing to let someone else make these decisions for you?
brian at March 18, 2010 9:26 PM
"Why are you willing to let someone else make these decisions for you?"
Because they were so wise in Vietnam, Grenada, Watergate, Irangate, the JFK investigation, the invasions of Iraq and Afghanistan, the management of our southern border. Brilliant decision-making all round. Huzzah for the well-meaning bureaucrat!
Gog_Magog_Carpet_Reclaimers at March 18, 2010 11:05 PM
"That's the whole point of single-payer. Everyone pays in and everyone is covered for less cost."
Wow. Do you really think that? How do you have control over your money once you hand it over? Answer for me this big question:
Why should you pay for something you do not receive?
When you get used to this, you then fail to notice that your money is used for other things. It has already happened to you in tax programs and in medical care.
Radwaste at March 19, 2010 3:30 AM
Sabrina: "If health care is so great in Canada, why did Premier Danny Williams come down here to get treatment for his heart condition J, Jay, and Dax?"
Actually, his heart condition was very solvable up here. Turns out that he went South because he decided he wanted a version of the surgery that's *higher* risk, but when successful leaves a smaller scar.
Most Canadian doctors don't much approve of doing a more dangerous procedure primarily for vanity's sake, and don't do it. Though some would, apparently, consider it for young women (presumably, unsightly boob-regions are a Terrible Thing and more important than the risk of a stroke...)
In short: Mr. Williams could have had the standard *recommended* (by the Society of Thoracic Surgeons, no less) procedure up here without a hitch.
Lauren at March 19, 2010 2:43 PM
Lauren... fair enough. Then why didn't he just come out and say that? Why all the damn secrecy about it?
But I still stand by my sentiment. If he could have gotten the surgery up there, then he should have. I What's good for the Goose, and all that...
Sabrina at March 19, 2010 2:58 PM
I support healthcare reform and the insurance companies have no one to blame but themselves for this. The CEOs did not get into insurance out of the goodness of their hearts. They did it for the mansions, yachts and limousines. If the law allows them away to have you pay in for years and years so they can cut you off when you need them most, they're going to do it. And they do. A friend of friend became HIV positive and predictably lost his insurance..."Gee...HIV is expensive to take care of. We didn't want to...like...pay for anything. Sheesh. What's up with that?"
He now has insurance with the state and pays 1000 a month for it.
I have to hand it to the insurance companies. They did a good job on their shills, instilling fear in them. Here are the scumbaggers...er, I mean "teabaggers"...calling our elected representatives classy names, like "nigger" and "faggot."
Such class acts these teabaggers are! Our Founding Fathers, whose name the teabaggers appropriated, would be so proud.
Patrick at March 21, 2010 4:52 PM
Sorry forgot the link to HuffPo.
Patrick at March 21, 2010 4:53 PM
Patrick -
I've got $100 that says that both of them were plants or were never their and just made up by the media like the person (that was never there) who (didn't) yell "kill him!" at some Palin event.
When the HuffPo/DKos/FDL types can't get their enemies to cooperate with being as evil as they need them to be, they send in the plants.
You know this is true because every time one of their own shoves a shoe store in his face they start accusing Republicans of a false flag operation. And we both know the iron-clad law of liberalism: whatever a liberal accuses you of is something they either did or intend to do to you.
brian at March 21, 2010 8:13 PM
Oh, and Patrick -- once we end up with the progressive's wet dream of universal health coverage merely getting AIDS will be a felony, as will being obese, not wearing a seatbelt, or having sex without a condom.
If you think 20 years hence if the socialists get their way anyone with AIDS is going to get anything but a reserved suite in hospice, you're dreaming.
And I'll be classless shitheel just like those worthless shits on CNBC and ask you this: if I'm a teabagger, how's my balls taste, bitch?
Get used to it. Because the Democratic Party just signed it's suicide letter with this insane bill.
brian at March 21, 2010 8:18 PM
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