Fuck I want "socialized medicine" and I want it now!

The BBQ Pit
321

I really can’t think of what the excluded middle could be here.

Also, most countries in the EU have UHC (all countries? I’m not sure.) In many ways the EU is one cohesive unit. Explain to me how administering different states would be more difficult than that?
It seems like people who are opposed to UHC are just adamant that America is some super-special place where common governmental practices cannot work. Personally I think that the automatic assumption of failure is a poor excuse not to do something that is otherwise a great idea. If every other country that has implemented UHC has found that it works (I’m not aware of any country going back to private health), then the burden of proof is on you to show why it wouldn’t work.

And no, stamping your foot and insisting you are right is not proof.

322

Also, it is true that most Canadians live within 100km of the US border, but there are many small cities and towns north of that and also cities in the west tend to be more spread out. It is true that medical facilities can be concentrated in cities to some degree, and people from outlying areas are flown or otherwise moved to those cities if they require specialized attention not available at home.
But, people in rural area are harder to access and cannot be denied the care they deserve. Getting a doctor to Nunavut or wherever is hugely expensive as the cost of living there and flying in and out is high, but these people must be provided care just like other Canadians. I’m not sure that there is anywhere in the USA more inaccessible than the Canadian arctic (parts of Alaska, maybe?). Still, we manage and I think with a more condensed population, it would actually be easier to provide care to most Americans at reasonable per capita costs.

323

Well, there is no EU law re UHC. There is a multi-party treaty including both EU and EFTA countries by which people who pay SS in one country get SS benefits in all others for a limited period of time (the “European SS card”) but there’s no central administration for benefits, nor a law stating minimum coverage for all members.

Spain is nowhere near as big as the US, but it has moved from a centralized system to a “federal” one as different autonomous regions (13 of them) got SS transferred. In general it works well, although the Catalans have had to piss in everybody’s water by getting a different computer system that they claim is incompatible with the ones used by all other regions. This makes getting your medical history transferred more complex if one of the parties involved is Catalonia. To change your doctor within the same region, you just go to any Medical Service offices and they change it in a few minutes; to change it between regions, you need a couple of days for the data to be transmitted electronically. If one of the regions is Catalonia, you actually need things on paper, which is a pain in the booty.

Most benefits are common, although administered locally. They are defined in the Social Security General Law. Regional additional benefits are, as the name says, additional. SiL’s Dad (ALS) moved from Aragon to Navarra shortly after being diagnosed. Since most regional benefits, specifically extra money on his retirement payments, have a “minimum time registered” before they kick in, he wasn’t entitled to those. He did have the benefit of experimental systems like “outpatient hospitalisation” which don’t have that time limit.

Navarra is a “middle of the heap province” for many things, and a single-province region. We’re at about the average province size, about the average population size. We tend to outperform many communities, for example in roads and healthcare; in those things where we’re only at number four or five, the communities consistently above us are Madrid (single province, 10% of the country’s population, tons of universities), Catalonia (four provinces) and Euskadi (3 very small but very rough-country provinces). When a reporter asked our regional president for possible reasons for this, Sanz thought it might be a joke, verified it wasn’t and answered “:confused: good management? Just my WAG, but I’m the President so don’t take my word for it.”

Compact size probably helps us over, say, Castilla-León, but it doesn’t explain why we get better results than Cantabria (a similar size and also in the North) or Murcia (similar size, south).

324

Thanks for digging out the WHO stats. That’s what I was pointing out when I said that both Canada (covering everybody) and the USA (not covering everybody) have tax-payer funded health care systems at roughly similar total population per capita costs, but on top of this publicly funded system, most Americans pay privately (out of pocket or through private insurance) for health care that they have already funded out of the public purse but are not eligible to receive.

325

Can you get treatment anywhere in Spain? If you have Elvisitis[sup]*[/sup] and the best Elvisology centre is in a different region, can you get a referral to there?

In the UK there are certain conditions where treatment is only allowed to occur at one or two centres due to the rarity of the conditions involved. You get much better outcomes for individual patients if the doctors get to treat 10 patients per year as opposed to 1 every 10 years.

[sup]*[/sup]Totally fictional disease, AFAIK

326

Yes, most Canadians live close to the border with the USA, so one can not hold out that based on geography the USA is so significantly different from Canada that UHC can not work in the USA despite working well in Canada.

Beyond the border strip, we also have a lot of very small communities that are isolated – for example, in my district/county and the district/county beside mine, there are quite a few communities that you can only fly into in the summer, or truck into in the winter along ice roads across frozen lakes. Providing health care for these communities is not cheap.

Even along the border strip, there can be distance problems. For example, my drive to work today to my satellite law office will be 240 miles, with there being a small community roughly every hour along the way. There are not any lawyers in any of these communities because there are not enough people. But there are doctors and hospitals in each of these communities. That costs.

327

Well, “can’t” isn’t exactly the applicable word. Not giving you that referral would be dereliction of duty on your doctors’ part, so they have to send you there. SS won’t cover transportation for relatives (although one will be able to travel with you in an ambulance if you do need one), or transportation for yourself if you can go there without an ambulance, or cost of non-hospital stay. There are other Social Services which will cover or offset those if eligible, though (these are based on economic need).

328

Sorry but no. Cuban doctors not only do not get a say in where they practice, they also do not get paid anywhere near the level that doctors in the host country do.

And also from the article you linked:

"The doctors and nurses left in Cuba are stretched thin and overworked, resulting in a decline in the quality of care for Cubans, some doctors and patients said. "

329

Sorry, over time.

Protocols are designed to check most-common similar illnesses first. So if Elvisitis shares symptoms with four other, more-common, illnesses, these will have been discarded locally before you get sent to the Elvisologist.

When possible, tests and treatment for non-hospitalized patients will be managed with your local services. If, for example, your Elvisologist wants you to get Xrays every year for followup, you get the Xrays done in your local Radiology service and they get transferred to the Elvisologist. This means both less costs for SS and less hassle for the patient and his relatives. Also, since your doctors back home stay in contact with the Elvisologist, your GP learns more about Elvisitis and its detection procedures, which means he may be able to refer his next case earlier. He may learn, for example, that your elevated QST* value, which indicates you don’t have Chuckberritis (that would be diagnosed based on a low QST), is an indicator of possible Elvisitis; therefore when he checks someone with those symptoms for Chuckberritis (phase 2 of the protocol) and gets a high QST, he’ll initiate contact with the Elvisologist (normally phase 5) while asking for your Quadgop-Smithsonian plaques (phase 3).

  • TLA taken out of my left elbow. Plaques taken out of the right one.

Procedures like “at home hospitalisation” which I mentioned off-hand earlier are part of this idea of having the patient and his family as un-bothered as possible. It’s been tested in Navarra for the last three years and has worked well, so other regions are adopting it. The patient stays at home, gets resources from the hospital and nurse visits with the same frequency as if he was in the hospital, but at home and with a much-lower risk of hospital infections. SiL’s Dad got, for example, a sling to transfer him more easily from his bed to his armchair, and one of those superarticulated hospital beds; some of his machinery (the respirator and heart monitor) recorded his vitals and would have sent a signal to 112 in a crisis, as well as rung a loud alarm. It requires investing in the materials, but those monitors would also have been needed if he’d been in the hospital, he would have been more likely to get infections, and his family would have had to take shifts to go to the hospital.

330

No problem - It’s quite amazing, isn’t it?

331

And an inability to unlatch a seatbelt.

332

The United States is in the midst of a nursing shortage that is expected to intensify as baby boomers age and the need for health care grows

You might want to see a doctor to get that plank removed from you eye.

333

If I remember correctly, lalenin is Cuban or of Cuban heritage and often has the data to correct misconceptions about Cuba on the boards.

334

… Sorry but I don’t get it, do you mind explaining?

335

I’d settle for HMO coverage again.

When I had HMO coverage at my former employer, I went to my GP with a $10 bill in my hand.

The receptionist took the $10, I went into see the doc, who fixed me up with a script for medicine that I took to pharmacist who charged me another $10 or the actual cost of the drug, whichever was less. Any tests or x-rays were included in the $10 visit co-pay.
I never saw a bill.

Now, I pay much more in premiums and get much less.

I have to pay the year’s first $400 out of pocket, 30% of the next $2100, and 100% of tests and x-rays above a paltry $250.

And the billing drives me nuts! I think I’ve paid everything, and then some bill for some lab service to read a test comes in months later, via a collection agency!

Of course everyone at the lab billing office swears that I got 3 mos. of bills that I swear I didn’t. And ,of course, I’M the liar here in everyone’s eyes. And WTF is up with NOT ONE phone call or email in 3 mos. to see if maybe the bills got lost in the mail. They had 3 ways to reach me, claim to have used just one, and the whole blame is mine.

And get this! I give the lab billing office my credit card info, ask if this payment constitutes everything I owe them and they call back 2 minutes later to say they found another billing dated 3 months prior to the billing they just sent to collection!!

This bill was for more than the bill they sent to collection!!

How come a 3mo. old bill goes to collection and a larger 6 mo. old one doesn’t?!!!

And government can screw things up worse than this? HOW?

336

Just a stupid joke about a Chuck Berry song. He complains about being unable to unfasten his girl’s seatbelt…

I’ll shut up now. :smiley:

337

Aaaaaaah. Thank you. See, Chuck Berry is one of those guys whose music I like but whose lyrics I don’t “catch” 99% of the time…

And lalenin is Cuban, yes.

338

They are trying to maximize profits. If they collect from you they make more. Even if you are covered. They do not care. They deny everything they can and dispute the rest. It is about money. Their mission is not to provide good coverage and a friendly system. It is to make money.

339

The World Health Organization's ranking of the world's health systems, by Rank We are 37th in medical care according to WHO. We pay the most.

340

I agree. Amazing things. Not always good things though (highest per capita rate of incarceration, as an example.)

Don’t get me wrong, I love America absolutely. I believe it has it’s heart in the right place and the culture is basically ‘a goal to aim for’, relative to the rest of the world. So much of what it does it gets right, and that just makes me all the more annoyed for the places where it gets it wrong. I don’t expect places like Burma to be held to the same standards, because they’ve got other shit to deal with right now. But I do expect the US to be a, dare I say it, moral leader (this is the pit and I’ll probably get slammed for saying that).

But I don’t claim anyone has the moral high ground here. You tried a healthcare system that, on paper, looked good. It still looks passable, on paper, with a vaseline smeared lens and a Protestant view. But my opinion is that private insurance companies shouldn’t, in an ideal world, be able to decide who gets healthcare and who doesn’t. I think most Americans would agree with that. This may sound hypocritical because I also pay for a form of private healthcare on top of the national healthcare, but the difference is that in my case it’s not to stop me from going broke and it’s not to ensure that I get treatment when I need it. I know I won’t go broke and I know I will get treatment no matter what happens because the system works. I pay a little bit out of my own pocket, above taxes, just to know that I and my family will have zero expenses when the worst happens. If I didn’t have the private insurance I might have to pay about 15% of the total bill (the exact percentages are unimportant here because they vary from country to country and on the medical problem).

I would like to add that I was a bit lost by Foxy’s posts about paperwork, because when I’ve been sick I’ve never had to fill out a single form. Not one. I don’t know what I would be filling out a form for anyway. To testify that I got caught a cold on Thursday? If it was claims that she meant, then, I’m pretty sure that claims paperwork would drop dramatically under universal healthcare. Why? Because you don’t need to claim anything under universal healthcare.

And also when she said she didn’t expect a little card that she could wave and it would take care of all her problems. That’s funny because that’s exactly what I have. Not a dig at you Foxy because I like to hear what you have to say, but I have exactly that. A single card which shows that I am insured buy the government and there’s not a single question or form to fill out before I see a doctor.