I love when conservatives bring up high cost health care like transplants.
Here’s how it works in countries with UHC:
A patient requires a heart transplant.
He is prioritized based on need.
If he needs it right away he goes to the head of the list and gets it right away.
If he is not as urgent he may have to wait.
If he is very rich he may have private insurance or pay out of pocket to get surgery right away regardless of his condition.
Here is how it works in the US.
A patient needs a heart transplant.
His insurance is checked and his copayment and deductible calculated.
He is informed of what his payment will be and is then prioritized based on risk.
He desperately tries to scrape up the money for his portion.
He may be put at the top of the transplant list but if it is felt that he will not be able to afford his follow-up care and medications he may be deemed a bad risk and go to the bottom of the list.
Many of these people are those who have health insurance through their employers that have a high copay for specialty medications.
If he gets a transplant and cannot afford his anti rejection medication, he will die.
If he is rich he can pay more out of pocket and get the surgery immediately.
It’s similar for something more common like a knee replacement.
With UHC your surgery is scheduled based on medical need so you may wait if your symptoms are mild but you always have the opportunity to pay privately and get immediate care.
In the US your surgery is scheduled not only based on need but also based on whether you have the cash up- front to pay. If you don’t, then your surgery will be delayed until you get the money. You don’t have to worry about waiting because you are not an urgent case; even if it is urgent, you will wait until you can come up with the money, which may be forever.
The sad thing about SA, that we see in this thread is that he defines happiness as having a bigger, better car, a bigger house and my amenities. Unfortunately, people with these values can never be satisfied because somebody else will always have something more. I actually feel kind of sorry for people who define their self worth and define not just success but even happiness based on things they own. Trump may be the same, but it must be a miserable existence spending your life judging yourself compared to others and only feeling happy when you think what you have purchased is more or better than what others have.
@ Starving —
(1) Do you still think Trump has an MBA?
(2) If your answer to (1) is No: Do you think the rank of degree Trump received from Wharton just “slipped his mind”?
You refused to answer my earlier questions, even though I thought they were easy questions. Are these two questions, finally, easy enough for you?
“Everyone … enjoyed pre-Obamacare … healthcare”? Do you even know that some people didn’t even have insurance?
You’re misinterpreting dramatically, even if your cite is valid. Are you truly stupid enough to think that benefits and dividends to shareholders are the only “pay outs” an insurer makes? Your “3%” does NOT include the salaries of insurer executives, often paid tens of millions of dollars each; it does NOT include salaries for the 2.6 million U.S. employees of insurance companies (yes, that’s Million with an M) whose main “useful function for society” is to deny or impede care; and it does NOT include the insurance costs afforded in addition to premiums — some doctors need a full-time clerk just to interact with insurers.
Bzzzzt. Next contestant.
I can’t speak for rational or liberal Dopers, but I admit there’s an element of perverse masochism for me.
But I do wonder if it’s possible to get through to Starving. The harsh language I use is probably ineffective: only a confident open-minded man responds well to criticism. But there have been glimmers that Starving is more self-aware than typical Trumpists and Republicans; might there be a way to sledge-hammer away his ignorance?
Let me try one more time.
@ Starving —
(1) Do you still think Trump has an MBA?
(2) If your answer to (1) is No: Do you think the rank of degree Trump received from Wharton just “slipped his mind”?
You refused to answer my earlier questions, even though I thought they were easy questions. Are these two questions, finally, easy enough for you?
A few quick comments is all I have time for tonight, so pardon the lack of response to further comments.
At what point does the less urgent patient get moved to the head of the line? If new, more urgent patients are automatically and constantly given top priority, when does the less critical patient get to stop living a reduced, painful life and get the treatment they need? Are they simply kept in a waiting pattern until they become critical, and if so how do they make sure their newborn criticality gets caught in time? It’s conceivable that the guy I mentioned earlier whose mother’s cancer wasn’t treated for eight months had a slow-moving cancer and that’s why it took so long for her to get treated. As for me, I prefer a good, contract-based health care system where you get what you contracted for and you get it without having to await approval from some anonymous bureaucrat.
And no, I don’t define happiness by big cars, big houses, etc., as happiness must come from within. But having things that are more than ‘adequate’ are nice, and often fun. It’s nice to have a big, powerful car that will quickly get you out in traffic or up to highway speed to merge, that holds more people and carries more stuff. It’s nice to live in a big house where you have the room you need to move around, have extra rooms to fit certain purposes, can have more people over for dinner or to watch games on TV or enjoy a party. It’s simply nicer to have better things. That’s why when people can afford them, nicer things are what they buy.
Where a government controlled lifestyle that is just adequate comes into play is that it stifles people. It’s just that much harder to be happy when you’re scrunched up in a tiny house or apartment wth minimal and usually cheaply made furniture, and drive a tinny, underpowered little piece of crap that’s little better than a motorbike with a shell around it. Also people like to achieve things. it gives them a rewarding sense of accomplishment. It creates a great sense of satisfaction to look at the nice house your family is living in, and to look at the nice clothes they wear and the nice, big comfortable and powerful car they have to drive around in, and know that your accomplishments are what made it possible.
The sense that adequate is good enough seems to exist much moreso on the left side of the political aisle, but an adequate life is not one that is very pleasant or rewarding, and the stifling that is part and parcel of deadens one’s soul.
In short, capitalism rocks. It provides lots of good stuff for people to have, the great majority of which make life much more pleasant and rewarding. It drives creativity and innovation. When things are adequate and adequate is adjudged to be all that’s needed, where’s the motive to make anything better?
I’ve long noted the tendency of liberalism to take all the fun out of life. Drab and lifeless seems to be the order of the day and the more influence liberalism has over society the less nice things become. Look at the way people dress these days for example, or how nice things are criticized or mocked and portrayed as excess or the result of privilege. And of course life under communism, which is liberalism getting all it wants, is drabness, repression and lifeless personified. I used to think the deprivation communism was so famous for was the result of scarcity and poor central planning, but lately I’ve revised my thinking into believing that the communist ideology itself held the same view - “adequate is all you need, you would-be capitalist pig.”
Yes, I’m stupid enough to thing that corporate profits are what is left over after operating expenses. On the other hand, surely you’re not so stupid as to think the salaries of health care executives would make any sort of dent at all in covering the nation’s healthcare costs. As was recently pointed out somewhere around here, if all of Bill Gates’ $87 billion or whatever it is were taken from him and distributed to everyone else in the country, each person would only receive about $450 dollars.
And yeah, I’m glad all those evil insurance company employees have jobs. I’m generally of the opinion that it’s good when people have jobs. But since we’re asking how stupid each other is, surely you’re not so stupid to think that under government healthcare there wouldn’t be a similar legion of government employees (drawing largest salaries and with greater benefits and more days off, not mention being virtually impossible to fire) making decisions as to what the government will pay for? Ask anybody on Medicare if everything they want or need gets paid for without question by the government and you’ll soon learn how wrong you are.
I said before that I’d answer your questions when I returned since you had suddenly become nice and reasonable and shit. Now you’ve reverted to form so I won’t. End of story. Have a nice night.
Don’t be silly. The less urgent patient is queued up just after the previous less urgent patient and given an estimate of their waiting time. That time is calculated on the basis of available capacity, and a competent guess at how many critical patients that will come in during that wait time. IME I get a date for the non-critical operation pretty soon, but depending on how non-critical it is, I might have to wait somewhere between a couple of weeks and a month. I don’t get bumped up the line, I just wait until it’s my turn. If something catastrophic which puts an inordinate strain on the system occurs, I might be bumped back a week or so. I can live with that. I’ve had non-urgent appointments where I’ve had to wait four to six weeks, but it hasn’t affected my quality of life since loss of quality of life is one of the criteria deciding whether I’m queued for a month or treated next week. And if it’s potentially life-threatening, I’m treated immediately. Like the time I had acute appendicitis, or when I showed up at the ER with possible symptoms of a heart attack. I was admitted immediately, spent the necessary time in the hospital, thanked the nice nurses and doctors and went home. No worry about copay (zero), or whether all of the health personnel I’d met were in my insurance company’s pool. All paid for by my and others’ taxes.
It’s obvious that the scenarios you’re painting are pulled straight out of your ass, and that you have absolutely no experience with a single payer public healthcare system. Nor any knowledge of planning, logistics and coordination. What you claim to worry about is a simple logistics problem which both public healthcare facilities and private production companies handle every day.
And this “government controlled lifestyle” comes into play… where? I can tell you that it’s nowhere in any of the countries we’re discussing here (Australia, NZ, Canada or Western Europe). Are you really this ignorant, or are you deliberately building another strawman?
Which isn’t an issue in any of the countries we’re discussing, at least not for the middle class. Maybe for members of the poor working class, of which there are far fewer in our liberal hells than in your shining beacon of capitalism. And besides, even in the Nordic countries private enterprise is an important part of the economy. We just realize that a certain amount of government control is needed to protect the weak from being exploited too much, so we don’t allow the hardcore laissez-faire capitalism you seem to get a hard-on from.
Where do you find this so-called liberalism which “take[s] all the fun out of life”? At least not in Australia, NZ, the UK, the Nordic countries or continental Western Europe. I’d hazard a guess that you might find it up in your arse, where you’re obviously pulling these “facts” from.
Just so we’re on the same page, you think that the “operating expenses” of an insurance company are identical to what they “pay out in benefits.” Apparently because the salaries of 2.6 million (Did you notice the M in million, idiot? ) won’t make a “dent.”
And you can’t decide whether Trump has an MBA.
I’ve changed my opinion of you, Starving Artist. It’s become quite clear that you’re stupider than Shodan. AFAICT you are the Stupidest Doper of All. Congratulations!
What an astute observation. This is precisely why I asked how it worked. And like Martini Enfield pointed out, albeit probably with a different perspective in mind, government health care systems deal with more than one person at a time. I would assume that patients needing care when they aren’t governmentally adjudged capable of living through their pain and disease, illness, whatever, are entered into some sort of registry from which waitees are drawn when the time finally arrives that they can get care. So my question was, how do those at the bottom manage to get to the head of the list, given that, you know, new and more critical patients are entering the system all the time.
We’ve been speaking primarily of proudly socialistic Scandinavian countries (or so it’s been claimed in this thread by one or two of its residents), and if you live in a socialist country you by definition live a government controlled lifestlyle.
I found it primarily in every. single. communist country that ever existed. And secondarily here in the U.S. where over time every bit of glamor, style, and non-drug and non-sex element of human enjoyment is gradually being sucked out of American life. I touched on this before when I said “Drab and lifeless seems to be the order of the day and the more influence liberalism has over society the less nice things become. Look at the way people dress these days for example, or how nice things are criticized or mocked and portrayed as excess or the result of privilege.”
Just so we’re on the same page, would you care to point out where I said that?
[quote=And you can’t decide whether Trump has an MBA.[/quote]
I know perfectly well whether Trump has an MBA. But you know perfectly well that most of the things you’re ranting about which I said about Trump came early in his campaign and that I subsequently had a change of heart about him, and indeed did not vote for him. And yet, in your typically dishonest and underhanded way, you deliberately chose to cherry pick things I’d said prior to changing my mind about him in a deliberately dishonest attempt to make it look I still have those sentiments and beliefs today. So, since you’ve been dishonest about all this and are being a dick in general anyway, you ain’t gettin’ any answer. So stick that in your smipe and poke it! (But I mean that in the nicest way. )
I resent that! I may be the stupidest conservative on the board, which would still be a damn sight lower than Shodan, but that would still leave me about ten levels above a dingaling like you. (And I mean this in the nicest way too. I’m…what is it the cool kids say these days?..oh, yeah, I’m just bein’ real.)
That’s not how it works. The government doesn’t decide if your “need” fits a certain criteria; doctors do. And like I said before, hospitals can treat more than one person at a time, and there’s hospitals in pretty much every city.
Let’s say someone is having a heart attack and gets rushed to hospital where the triage staff determine they need an operation immediately. They will go into surgery right away and the person who gets bumped down the queue isn’t someone else having a less severe heart attack, it’s someone who maybe needed a battery changed on their pacemaker or something - ie someone who won’t drop dead immediately if they aren’t seen to. And they might just get slotted in the next day or something, depending how the surgeon’s bookings are going for that day.
The people who handle these things are professionals; they don’t draw numbers out of a hat like a bingo caller at a school fundraiser to decide who gets medical treatment and who doesn’t.
Imagine, if you will, a system where the government is everyone’s health insurer and they always pay out on claims, for everyone, with no exceptions, no deductibles and no co-pays. That’s what universal healthcare is.
I know a way for someone who’s relatively far down the triage list to move ahead:
indicate she’s willing to get a date in a vacation period or four-day weekend.
I do that all the time: my regular checkups always catch me out of the country, so when I’m going to be home I call SS. “Hi, I was supposed to have my boobs squished in July but I was out of the country, can we reschedule it?.. March? And if I’m OK with doing it over the Christmas break?.. Yes, December 27th at 8:15 am is lovely, thank you!”
When her doctors got tired of trying to fix my mother’s intestinal problems and go for surgery, one of the first things they asked was if she had any travel or vacation plans: no, nothing in the next six months. In fact, nothing until this gets fixed. Oh, would you be willing to have it next Monday then? It was a 4-day weekend, only another patient had agreed to be scheduled for that Monday.
Note that in the specific case of transplants from deceased donor, the biggest hurdle in UHC countries is getting the organ. If you’re at the top of the list but no compatible organs come up, the doctors can’t whip one out of their sleeves any more than those in the US can. But what gets someone in one position of the waiting list or in another is not related to their insurance when everybody has the same one (be it single payer or multiple-but-equivalent payers as in Switzerland).
This study (PDF) has information showing that, while not as bad as I thought, still shows wait times and efforts to improve them to be considerably more of a problem than posters are saying here.
I consider them evidence that there is a problem. If people weren’t complaining about wait times there wouldn’t be such a widespread effort to improve them. Or do you think up to 178 days to get a painful hip replacement is just peachy?
It occurs to me that someone afflicted with SA’s misunderstanding of how these things work would naturally conclude that keeping teh poorz from cluttering up the heathcare system is an act of self-defense. This helps explain both the content and the stubbornness of rightist positions on the subject.
I’m not the one who said they think adequate is best. Don’t know about you, but I’d think living in a country whose populace has been brainwashed into thinking adequate is good enough would be a pretty glum place to live.
Some organizations try to improve because that’s the right thing to do; it’s part of the general philosophy. Turns out that very often the improved methods end up being better in results and also in costs, yay, so it’s a win-win-win. But I guess that’s something which goes way above your head.
And adequate is, by definition, good enough. Since my small car fits my needs, why would I want a bigger one which would not? Since my small house fits my needs, why would I want more rooms that would just stand empty and need heating and cleaning?
Please. The study I linked to shows various UHC countries with wait times all over the map and nowhere near as timely as you people have been trying to claim. At least I admitted they weren’t as bad as I expected, but they’re still pretty bad.
Do you even know that some people didn’t even have insurance? 
) won’t make a “dent.”