Yes, that gosh darn ‘caring for other people’ is whats wrong with America.
The fact that we don’t have a mass exodus of people to countries with UHC is not proof that we don’t have a health care crisis. Yes, hospitables will give emergency care to whom ever walks in the door but you get far more than a call 3 months later. Your credit score is dinged and in the US, your credit score is now one of the most important things about you. If you have a bad score then you will have a harder time buying a home. (you know, the American dream? remember that?)
Now if you had a chronic condition, well, you are screwed, because pharmacies don’t have to fill prescriptions for anybody regardless on your ability to pay. But, if you really think that people would ‘simply’ move to another country, I’ve been wasting my time typing this as you are an IDIOT.
People don’t change countries lightly. It’s not like a restaurant burns your food so you go to the one across the street. And if you haven’t noticed, people do take trips to Canada to get the drugs they need.
Same thing here. I had surgery here and didn’t have to wait. OTOH, my younger brother in America can’t aford insurance and has to live without treatment.
If it means no one will ever be crushed by medical bills ever again, I will gladly wait four months, heck, eighteen months, for non-urgent medical care. I don’t understand why anyone wouldn’t.
I wouldn’t, because I’m selfish. So are you. You could easily sell all your belongings so that a hundred starving kids in Africa can live, but you haven’t, and you won’t. I could give up getting prompt health care treatment and being able to choose my doctor so that millions of people I don’t know won’t be crushed by medical bills, but I won’t. I could give you a nice, long economic and philosophical justification of why UHC is a bad idea, but I have a feeling it’ll be wasted in the Pit. How about just a link? Should Medicine be a Commodity?
But I didn’t say I would give up anything in order to bring greater benifit to others.
Rather, I said I would wait several months for non-urgent medical care if participating in the system which requires this is participation in a system which renders it unnecessary for anyone to be crushed by medical bills.
My assertion of the latter does not generalize to an assertion of the former.
I can understand why one wouldn’t give up all they own to benifit starving kids in Arcia. I can’t understand why one wouldn’t wait for non-urgent care in order to insure no one has to, for example, spend their entire life paying for a single medical incident.
It’s just a matter of degree. There are some who do indeed give everything to help others, and those who give nothing at all. Most people fall somewhere between the two extremes, and it seems presumptuous for anyone to tell me that his chosen level of generosity (as well as its nature and recipients) should be mandated by law to apply to everyone else. If you don’t want to read all of Friedman’s article (it is somewhat long and technical), make sure you at least read the 5 or so paragraphs on mint toothpaste. It’s an eye opener that deals with this very subject, in an even more exaggerated form.
Just for clarification, we also have a private healthcare system in this country. If you can afford to pay, and don’t want to wait for non-urgent treatment, you can get it done straight away.
The real problem with this is that it is often the same doctors, in the same hospitals, that take private clients. By being able to pay (as I have done in the past) I am depriving someone who can’t afford it a place on the waiting list, somewhere down the line.
It should be borne in mind that we all (as long as we’re working), in the UK, pay for healthcare for everyone out of national insurance contributions. From my salary that’s about 10%.
When I studied in the US for three months, I was horrified to find that when I had really bad toothache, 3 dentists wouldn’t see me as they didn’t want to claim on my insurance. That, at least, doesn’t happen too often over here I think.
I’m not going to get into the broader issues here, but it’s worth noting that the situation is not as crazy as it sounds.
The problem is to do with the perverse incentives you get when insurers (public or private) try to control costs by means of budgets at a hospital or department level. Within such a system it can make sense to get doctors to sit on their arses. Say a region has a particular global budget and some hospitals are trying to minimise waiting times for non-acute cases within their budgets and some don’t care about their budgets. Unless you stop the latter you end up rewarding the hospitals who don’t care about the budget and punishing those who are least competent in controlling costs.
The problem in hospital funding (to reiterate, whether public or private) is that the people who pay are not those who decide on treatment. You want to give doctors and hospital administrators (and to a lesser extent, patients) the incentive to minimise costs. Having a hard budget constraint is a crude way of doing this. (The real UK system is less crude.)
You will note in the article that hospital in question is in the red. What the fund-holder system is trying to do is reward hospitals and administrators that achieve certain standards within their budgets and put pressure on those that do not to get their shit together.
