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Thursday, May 29, 2008

Take off your shoes, the doctor will see you now

Our good friend Doug has a pretty bleak assessment of what life is going to be like under President Obama. Among his choice comments today was this: "The people who run your health care are going to be like the people who are running airport security."

Comments (31)

I doubt that assessment sounds so horrible to the 45 million+ Americans who lack any health care whatsoever.

Take off your shoes

Which is how they've done it in Japan for generations.

Airport security and/or DMV.

And they aren't already? With the long waits, extreme costs, invasive tracking of personal information and rampant malpractice we already have, how much worse could it possibly get?

With the long waits, extreme costs, invasive tracking of personal information and rampant malpractice we already have, how much worse could it possibly get?

for the over 50 million that have no healthcare, and the millions more who have only limited insurance, it already is worse than that.

in other words, those of us without health insurance should be so lucky as to get to wait in a doctor's office, knowing that insurance has got us covered.

i'm beginning to think Americans actually don't realize how few people actually have adequate health care coverage.

Doug?

Personally, I don't think it will be as GOOD as airport security - and I don't think much of airport security.

I went through a period where I had no health insurance; me and my child. I was having problems with my asthema and she ended up with an infection in her ear. We ended up going to a 'free' clinic that the county provided in the evening, two nights a week. The wait was LONG, we were two of about 5 white people, all the others (I guess about 40 went through the clinic that night) were hispanic.

This is NOT to say that I enjoyed the process, I didn't. The care was fine, I got my meds, my child got her meds, it cost me nothing (I was making $10 per hour with no benefits ... and this was only 4 years ago). Did I mention the wait was long? Almost 4 hours - but I knew I had to wait it out and I got served. I have every expectation that healthcare under EITHER socialistic (Hillary or Obama) program will be similar.

Bottom line, there are places other than the emergency room to get healthcare presently. The majority of folks who need it, find it.

There isn't 45 million+ Americans who lack any health care whatsoever.

There are milions without insurance and many people think the government should provide free insurance, but I'm not one of them.
Many of those millions can afford it but make the choice to not buy insurance.

Whenever we hear about the possiblilty of expanded health care coverage for people who can't afford it (and are evidently expected to die if they get too sick without it) we always get treated to the same FUD.

The only thing sadder is people keep buying it. Maybe not this time, but who knows.

Maybe it's time to revive the "Just Say No To Dougs" campaign?

Or ... abolish airport goons and the federal flim-flim INsecurity fearfest despot-ization, redirect that waste of federal taxes into health insurance appropriations, (call that a waste, too, if you want, but it's a less bad waste because it doesn't destroy as much life liberty and happiness as fear-stress disorder kills), cover the medical mess of 50 million fellow citizens, and get change back, (lower taxes), in the bargain. Who knows, but when some of those people get their health improved, they might even contribute labor and affluence in a stronger economy. ... the airport goon squads sure look like they could use some health club'ing.

Mainly, decrying universal health insurance coverage on account of its taxes cost, is ridiculous, against all the bigger costs paid for sickness- and death-making things and those costs can be stopped. now. flatline.

Hey Hal,

Been pricing healthcare costs for those not receiving discounts through companies, associations, etc. recently?

Thought not.

Ever wonder what sort of health insurance the people who cut yr hair, wash your car, cook & serve your food, and so on---can afford?

Probably not. Do you care? Doubtful.

People in this country need to stop buying the bullshit about the astronomical waits and abysmal care available in countries with "socialized" medicine. Simply not true.

Besides living in different countries and experiencing first-hand just how "terrible" their services were---I've worked with folks from most industrialized countries, talked with them about this issue and have never, ever been told they'd rather trade their systems for ours.

I choose not to have health insurance because, well, I'm the kind of guy who doesn't even go to the hospital with huge gashes and infections and stuff, unless it is really, as in no-BS, urgently life threatening. I've been to the hospital twice in the past 15 years, paid the bills out of pocket, and came out waaaay ahead...I've other things I'd rather spend money on than overpriced health insurance.

I mean, years ago, I hobbled around for weeks on a toe that had been ripped open by my room-mate's insane dog to the point where you could practically see the bone. Just bandaged it up tight and kept it clean.

Having said that, if naive leftist fools feel like voting power-hungry creeps into office who will use that power to seize money from those wealthier than I to provide for my healthcare, well, who am I to complain ? Only masochists refuse a free meal...

Has anyone here actually ever had ANY care in a "socialized" medicine scene?

I have, and I was duly impressed. As a tourist in Canada, I contracted a nasty upper respiratory infection while in Quebec. After deboarding the train in Halifax, my wife convinced me that I needed care. So, I was directed to the "community clinic" across the inlet in Darmouth, Nova Scotia. It took a short trip by ferry, a very short wait, completed two forms and paid $25 CDN. I saw the doctor, who diagnosed me as having pneumonia and prescribed a ten-day course of antibiotics, which I filled in the pharmacy next door.

The total trip took less time, had less bureaucratic bulls**t, and cost less than a visit to my doctor with my employer-paid health insurance. Plus, the cost of the antibiotics were 20% below the cost of the very same med here in the US.

Cheaper, faster, less trouble than US healthcare....what's not to like about "socialized" health care?

Besides, around here, you practically have to pay your share for the tram in order to get care.

Hey, Cabbie, I used to think like you and for years went without health insurance. That was when I was young--like in my 40s. I still hardly ever go to a doctor or hospital, but in January (thankfully it was January), I collapsed in my own bathroom. A friend finally convinced me to go to the emergency room, where they discovered I was slowly bleeding to death from a duodenal ulcer. I mean, when I staggered into Providence, there was no waiting. I was told later I looked as white as a ghost. The upshot is that with an ER visit and four days of treatment (some of which was unnecessary in my opinion, but not my doctors'), the bill came to over $20,000--more than half of what I earn in a year after taxes. So, yeah, I'm glad I got smart and bought health insurance, even though it is incredibly expensive and has an outrageous deductible.

Problem is, when that happens to you, and you don't have insurance, all the rest of us have to pay for your care. Even worse, younger people who don't choose to carry insurance shrink the pool of payers and make insurance even higher for the rest of us.

There are milions without insurance and many people think the government should provide free insurance, but I'm not one of them.
Many of those millions can afford it but make the choice to not buy insurance.

imagine, if you will, substituting "A Fire Department" for "insurance". fire departments are public goods, provided by the government via taxes and run by government employees. let's try it:

"there are millions without a Fire Department and many people think the government should provide a free Fire Department, but I'm not one of them. Many of those millions can afford it but make the choice to not buy a Fire Department."

I've always thought the perfect trade-off for the medical professionals who whine about malpractice costs is to give them their damages caps--in exchange for single-payer healthcare. In our "free market" medical system, it is absolutely socialization of medicine to limit doctors' damages if they screw up. For some reason, the wingnuts never talk about that. Why should this socialization of medicine be only a one-way street? If that's what it takes to reduce our percentage of gdp on healthcare from 15% to 7% (like Canada)--while having 100% insured, I'd be all for it. Why is paying more for less a conservative value? Please explain, righties.

The question of whether or not our system "works" is really a cultural one, because it's really about values. There is no doubt that France and England are both stuggling mightily to keep up with the costs of their social programs, but there is also a broad and deep cultural commitment to the institutions and the principles that inform those programs. If Obama is serious about reforming healthcare he'll have to address more than just the operational deformities; he'll have to construct the deeper rationale. In our culture we tend to express our concern for others in more unforgiving and individualistic ways and that's a reality he can't change.

But Doug's warning truly is specious: the government responsibilities for which there is deep cultural support here really are the best in the world: look at our military, for example, or our interstate highways, or higher education. Airport security is a joke because it is something people are accepting, not something they demanded. Nobody took to the streets demanding we take our shoes off and surrender our gun-decorated belt buckles. Not the same. If Doug wants to argue that people ought not have access to healthcare for some reason other than our inability to provide it, he may have a case. But if Obama's declaration is Yes We Can, it might be better to argue No We Shouldn't rather than No We Can't Because Look How Stupid Airport Security Is.

Some other things to think about:

1) Look at the Oregon Helath Plan - the state's first venture towards a type of universal healthcare. Did it work? Overall I'd give it a D- at best.

2) Check out the facts, Britain, France AND Canada are having a very difficult time keeping their 'universal healthcare' systems afloat. The funding is falling behind and the wait times continue to get longer. More and more decisions to 'not treat a patient' based on cost have to be put into their systems.

3) We are a MUCH larger population than any of the countries mentioned above. The cost of the government oversight alone will be staggering, then add the actual costs of the program.

My experience doing debtor-bankruptcy work has convinced me our healthcare system is a failure. Nearly two-thirds of my clients have some medical bills; roughly a third have medical debt as the primary motivator for the bankruptcy.

That's enough to convince me our present system is failing many folks. And the line of about "choosing" not to have health insurance is, at best, wishful thinking. I have to do these folk's monthly budgets in the bankruptcy; after food, rent, and childcare, there is not a lot left, especially now with the price of food increasing.

I would rather see the country going the route of reforming healthcare to make it more affordable then going for free govt. provided healthcare for two reasons.

One the jokers can't manage anything correctly. There are to many examples out there to count of poorly run/managed federal programs. What makes you think healthcare will be any different?

Second, if something is free people overconsume. With overconsumption comes long waiting lines, denied treatments due to expense and other restrictions. There is a reason Canadians, who can afford it, come the US for treatment.

Why don't we overhaul what we have instead?

-Take away state mandates so you can purchase a stripped down health plan if you want, a cadillac plan that covers everything or something in between. There is so many things in my current plan I don't use and never will its ridiculous but the state makes my employer buy that crap for me.

-Tort limits, someone has to pay for those big awards and it aint the Dr. you are suing. The rest of us pick up that tab in higher premium costs. I don't think there should be a limit on recovering medical cost, lost wages and lifetime care (if needed) but this multimillion dollar pain/suffering stuff has to stop.

-Either streamline FDA approval system (doubtful on this one myself since bad drugs are slipping through the cracks), extend drug patent life or allow the drug companies to write off R&D. They only have a short time in which to recover their cost so we get it stuck to us as the consumer.

-Take healthcare out of the hands of employers and put it in the employee's hand. Couple that with allowing you to write off your healthcare against income.

Just a few thoughts and I'm sure a lot more can be done to overhaul healthcare and make it more affordable.

Hal,

I make a little over $30K a year and if my employer didn't offer it, I wouldn't be able to pay for health insurance and I'm single. I can't imagine what it would be like for a single mother making even less. If I wasn't already covered, I guess I could "choose" to pay the premiums, seeing as how I don't really need things like shelter, food, gas, etc.

If the Canadian system is so great, why do so many come here? I read just a couple of months ago where a Canadian woman about to deliver triplets was airlifted to a hospital in Wyoming because nearby Canadian facilities lacked the ability to provide care. And it isn't uncommon.

1) Look at the Oregon Helath Plan - the state's first venture towards a type of universal healthcare. Did it work? Overall I'd give it a D- at best.

it covers a small fraction of Oregonians, is critically underfunded, and isn't "universal healthcare."


2) Check out the facts, Britain, France AND Canada are having a very difficult time keeping their 'universal healthcare' systems afloat. The funding is falling behind and the wait times continue to get longer. More and more decisions to 'not treat a patient' based on cost have to be put into their systems.

both countries you mention have heatlh care for ALL citizens. both countries have imperfect health care systems. both countries struggle to keep up with immigration and population growth. so what do *any* of those reasons have to do with who pays for the health care? and, you're wrong about "wait times." prove they're getting longer (with something other than an anecdote.)

3) We are a MUCH larger population than any of the countries mentioned above. The cost of the government oversight alone will be staggering, then add the actual costs of the program.

you mean, as opposed to the hundreds of billions health care already costs? the cost per patient in both countries you mention is, in fact, far *lower* than here--yet more comprehensive care if offered.

all of your arguments are routinely brought up by "small government" advocates, who routinely forget that in America, far more expensive public services are provided by the Federal and State governments; yet nobody's lining up to complain the interstate highway system is "a wasteful government project" that could be done better by private roadbuilding companies.

and so on. c'mon, folks. arguing that the government can't do it while the government builds your roads, funds your Police and Fire, builds public infrastructure, etc. is disingenuine.

Darrin's post reflects my sentiments perfectly. I'm so tired of liberals insisting on a government fix for EVERYTHING. There's SO much we can do (as Darrin outlined) in the way of reform, and we could make these things happen quickly, right here in our own state. But no, it has to be 'all or nothing'.

Darrin's post reflects my sentiments perfectly. I'm so tired of liberals insisting on a government fix for EVERYTHING.

i know. i'm tired of liberals spending my tax dollars on highways, police, fire & emergency, and especially a few trillion dollars on the military.

enough is enough, liberals. put the highways, police, fire and military defense back in the hands of the people. i'm tired of people "overconsuming" all that police and fire service. i'm tired of all that overconsumption of military services.

Eco, you're smart enough to know that I wasn't talking about basic services. Quit playing dumb. Health care is much more complex than 95% of the things the government deals with, and they only get those things right about a third of the time (I'm being generous).

I consider you intelligent, so tell me, what do you have against reforming the health care system before taking the huge leap to universal health care? Don't you think it'd make more sense for Democrats and Republicans to work together on health care reform instead of the two parties tugging at the rope, refusing to give an inch?

Eco, you're smart enough to know that I wasn't talking about basic services. Quit playing dumb.

no, "Joey", i'm saying we both are talking about basic services. we just disagree about what a basic service is.

Anecdote: my wife fell ill during a trip to France 8 years ago and we received excellent care at the Paris hospital we just walked into, blind. Blood and urine tests, ultrasound, consult with several doctors, sent home with antibiotics that knocked out the infection. Yes, the whole ordeal took 5 hours, but that's not significantly worse than anything I've experienced here.

I asked about payment when I left, and they kind of looked at me funny. I insisted on giving them my U.S. address. Two months later, back in the States, I received a bill from the hospital. Wincing, I opened it the envelope, and. . .about $35. I actually sent a letter of thanks to the French Minister of Health thanking them for their kind hospitality (so to speak).

The French pay about 2/3 as much per capita on health care as we do, for universal coverage.

It's long past time we 100% privatized health care and let the open market handle the issue in its infinite wisdom.

I can't believe we haven't privatized the police and fire departments yet, or emergency services, or our state parks. I mean, government is SO INEFFICIENT.

And I'm sure the less government interference we burden these industries with the more they will begin to emulate the other successful deregulated industries like finance and energy.

For example, I hate to think what could have happened to the electricity and mortgage markets if these were highly regulated or government controlled.

"If the Canadian system is so great, why do so many come here? I read just a couple of months ago where a Canadian woman about to deliver triplets was airlifted to a hospital in Wyoming because nearby Canadian facilities lacked the ability to provide care. And it isn't uncommon."

Exactly what I mentioned before--bullshit anecdotal evidence that could have come directly from insurance industry lobbyist lackeys. Scare tactic crap. Ask average Canadians whether they'd scrap their system for ours.

Yeah, that's what I thought.

Wyoming? It doesn't have a border with Canada. You mean they airlifted her hundreds of miles across the entire state of Montana to get her to a hospital in Wyoming?

If so, then you'd have to wonder whether Montana's health care capabilities aren't any better than Canada's.




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