Did you get this from Albion’s Seed: Four British Folkways in America? I’ve been meaning to read that.
The poor in the US have medicaid which is far superior to Canadian or British UHC. FAR FAR superior.
What do you base that assertion on?
What metric are you using that leads you to this conclusion? Heath outcomes? Quality of care? As has already been pointed out, the people who qualify for Medicaid are generally women and children who live below 133% of the FPL, or people in nursing homes with less than ~ $2k to their name. Qualifying for Medicaid is pretty restrictive (currently), which greatly reduces access. Comparing the US Medicaid population (people who are pretty destitute) to the population of other nations who qualify for UHC by virtue of citizenship seems like a pretty poor comparison.
What are you comparing Medicaid to in the Canadian and UK systems? Because Medicaid is government funded health insurance, not a government funded healthcare system like the VA or the NHS.
I make the comparison based on all the people I know who were treated for life threatening health issues. It was done in a timely manner under Medicaid. This is in contrast to the people I’ve known in Canada and what I’ve read about the delays in diagnosis and again in treatment for life threatening health issues.
And I’m aware of the qualifications to be on Medicaid. I stated that the near-poor and people with existing conditions are better off with UHC.
So, just to be clear, your proof is anecdotal observations you’ve made? It’s not based on a rigorous analysis or an independent study published in a peer review journal somewhere?
Just anecdotes?
we’ve been all through this before. The target minimum times for being seen and then treated in the UK are quite long. Those are the target minimums.
As for the Canadian anecdotal experiences they were the same problem in a different country. Stuff like basic medical exams with MRI’s or treatments for heart by-pass surgery. This is routine stuff in the United States. There is no reason for month long delays.
I’ve watched helicopters land at traffic accidents within eyesight of a hospital to take patients to the OPTIMAL hospital which was 10 minutes away by ambulance. We don’t fuck around with emergency care regardless of insurance. If I can’t get in to see my doctor on the same day or when it’s convenient to me I go to an urgent care. Call it anecdotal all you want but if the US goes to a Canadian system there won’t be any place close by to go to when Canadians need care in a timely manner.
I suppose one of the tests of the NHS in the UK is that we have a relatively high average income as an advanced industrial country. Very few people actually take out supplementary health insurance and the papers are full of reports about how such insurers try as hard as possible to limit all benefits.
I have a wide range of friends and struggle to think of any who rely on private health care for their entire health needs, and few who even carry private cover.
The best thing about NHS care is the preventative aspect- people of all income levels get good access and long term health care from the NHS compared with the previous US system where the non-privately insured get long term illness care!
Oh your, anecdotal interpretation then. Besides the fact that you are comparing a government run healthcare system (the NHS and the Canadian system =/= all UHC systems) to government run health insurance for the poor in the US.
The people ‘you know’ treated in the US for life threatening health issues were treated under the US healthcare system despite the care being funded by Medicaid.
Do you think Medicaid patients have equal access and outcomes compared to privately insured patients in the US? If no, then how can Medicaid be “vastly superior to UHC in other countries”, when the US population/system doesn’t rate much better than most other OECD countries with UHC?
International comparisons of select OECD countries:
Almost All Patients Can Get Same- or Next-Day Appointment
Quality Indicators in Select OECD Countries
Five-Year Survival Rate for Select Cancers
Mortality Amenable to Health Care
This is why so many posters are scratching their heads at your claim ridiculous claim. I noticed you changed the goal posts from: “Medicaid being vastly superior to countries with UHC”
to: “Medicaid being FAR FAR superior to the British or Canadian UHC”
then to: “people on Medicaid are treated in a timely manner compared to Canada” - based on your personal anecdote and what you’ve read about wait times in Canada.
I doubt the care “the people you know” received had anything to do with Medicaid picking up the tab. They probably would have received the same emergent care for ‘life threatening issues’ if they were uninsured or privately insured.
The US does well with emergency care - no question - but when it comes to preventing, treating and managing illness/ailments before they become emergent (particularly among the poor, who have less access to primary care) the US does NOT do so well. This has to do with incentives in the US system, where there is more money in specialized/acute care than in primary care.
Back to the OP: Reimbursement reform is the crux of the issue in US healthcare. The US reimbursement system incentivizes unnecessary procedures and diagnostic testing with little to no benefit to quality outcomes (sometimes leading to actual adverse outcomes). Reimbursement reform in the private sector and the public sector needs to happen before the US system can be sustainable and if the system is not sustainable then moving to a single payer system would be a financial disaster. Culturally, I don’t think the US will ever go to a system where the government is the sole payer, with government ownership of hospitals and clinics, where physicians and nurses are government employees (like the VA healthcare system or the NHS). Though, this is the common strawman trotted out anytime someone mentions reforming the US system.
No, from How the Scots Invented the Modern World: The True Story of How Western Europe’s Poorest Nation Created Our World & Everything in It.
Which uses “Albions” as a cited source.
The book is really excellent. DO read it!
It’s interesting that many people are responding that public education provides a clear public benefit (educated workforce) but public healthcare does not (healthy workforce). Both are textbook examples of economics externalities where the good received by one individual is beneficial to more people than the ones involved in the monetary transaction.
It’s simply American perception that public healthcare isn’t as important. For people who grew up with public healthcare, the concept of potentially not having access to healthcare simply doesn’t make sense, just as the concept of not having access to primary education makes no sense to us in America. You are looking at it through the lens of your experience. Empirically speaking, there are clear and major benefits to making sure that everybody has access to healthcare and preventitive medicine in terms of societal productivity and controlling diseases and disabilities. In America, people who fall through the cracks that don’t have access to physical and mental healthcare simply get dumped in the emergency room or in prisons, both of which carry staggering economic and social costs.
If you grew up covered by your parent’s insurance, then got a job that provided you with health insurance, then it seems like the system works, although you’re getting fed up with how expensive it has become at 5-20% cost growth per year. If you’re less privileged and have experienced what happens in the giant gap between “being employed full-time by a company that covers your medical care” and applying for Medicaid, then you have a more realistic view of exactly how miserable it can be in a country with no public healthcare system and staggering out of pocket medical costs. Currently going through a bankruptcy myself from medical bills. We are one of the only “modern” countries in the world where citizens routinely have to file bankruptcy due to medical bills, and we rank very low on all sorts of health measures. Numerous studies have shown how it’s impossible to pay for medical care on minimum wage if you are unfortunate enough to suffer a major injury or illness. That ain’t the sign of a system that works. The crushing cost of healthcare on the poor and lower middle class is just as big a weight in it’s own way as the old-school system of the poor and lower class not having access to public education. It’s just a class separation that we’re used to in the U.S., so it doesn’t seem strange to us.
I think the dichotomy comes from how healthcare is treated in this country. Health care has nothing to do with keeping you healthy and everything to do to with getting you well if you are sick. Thus while education is something everyone needs on an ongoing basis, health care is only needed if you break an arm, tear up you knee or get the cancer. I think that what the US should do is start changing public perception by providing free or low cost primary care for everyone.
NM
yes, they were treated by private healthcare covered by Medicaid. Your point?
yes.
I can go to 10 different extended hours walk-in medical centers in my area. These are not hospitals or private practice doctors but on-demand doctor centers. The greatest distance between any of them is 11 miles which puts anybody in my metro area within a few miles of one of them. There are 6 centers in my area with MRI’s. Scratch your head all you want that kind of availability doesn’t exist in Canada or the UK. So you can quote all the waiting statistics you want about people waiting for their private doctors in the but they have options.
Now lets look at the waiting time in the UK. It’s on the rise. Between 2010 and 2011 the average time for a knee operation went from 88.9 days to 99.2 days. Hernia operations went from 70.4 to 78.3 days. Gallstone removal time increased by 7.4 days.
Diagnostic test wait time increase:
Measure: Number of patients waiting more than six weeks for diagnostic tests
Change year-on-year: +364% (by patient numbers), or +330% (by percentage of patients affected) (May 2011 versus May 2010)
Treatment within 18 weeks increase:
Measure: Number of patient waiting over 18 weeks for hospital treatment
Change year-on-year: +11% (by patient numbers), or +24% (by percentage of patients affected) (April 2011 versus April 2010)
Cancer: treatment within 31 days
Measure: Number of cancer patients not treated within 31 days.
Change year-on-year: +15% (by patient numbers), or +10% (by percentage of patients affected) (Jan-Mar 2011 versus Jan-Mar 2010)
The last time I had a medical procedure (kidney stone removal) the wait time was measured in hours. Not days. Not weeks. Not months. Hours. I waited a week to see if it passed and got in to see the surgeon the next day I called. The surgeon gave me the option of taking it out the afternoon of the appointment. During the week I tried to pass the stone I saw a doctor twice to change pain medication.
”life threatening” is not the same as “emergency care”. I said life threatening as in “cancer”. And yes, it had everything to do with Medicaid picking up the tab.
It’s not the poor who have problems, it’s the near-poor and people with pre-existing conditions. That gap will covered by the recent healthcare act or so the politicians say. Medical costs were suppose to go down but my insurance rates have risen sharply so we’ll see.
Why don’t you ask some of those poor people if they were able to receive non-emergency surgical care at all?
I’ve been about as poor as you could possibly be, and Magiver couldn’t be more wrong.
Because freedom.
Or I could answer a question with a question: if we have state funded schools, and we should have state funded hospitals, then why shouldn’t we also have state-funded grocery stores? People need to eat, do they not?
Education is a necessity to be a productive citizen. Health care would be if access to health care beyond emergency services actually improved health. The recent Oregon study of Medicaid found that it does not, and I’ve never seen any other studies that show that access to health care does anything more than provide piece of mind and shield people from huge medical bills.
Providing free health care today is only marginally more useful in 2013 as it was in 1913.
You mean like operations for cancer and heart by-pass surgery? That’s what I was specifically referring to. Stuff that requires a doctors visit leading to specialist referral and then surgery. All paid by Medicaid. That’s what it’s for. People with no discernible wealth. Poor people.