# In what ways are countries with UHC less free than the U.S.? **URL:** \ **Category:** Great Debates\ **Created:** [August 28, 2009, 12:06am UTC](https://boards.straightdope.com/t/in-what-ways-are-countries-with-uhc-less-free-than-the-u-s/507977 "2009-08-28T00:06:15Z")\ **Posts on this page:** 12\ **Page:** 6
**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\ **Post date:** [October 3, 2009, 4:20pm UTC](https://boards.straightdope.com/t/in-what-ways-are-countries-with-uhc-less-free-than-the-u-s/507977/101 "2009-10-03T16:20:20Z")
> [@Fear\_Itself](#): > > Some freedoms should be taken away by the government. The freedom to sell adulterated food. The freedom to commit consumer fraud. The freedom to abuse employees. All of these freedoms should be restricted by the government. I support restricting freedom. Don’t you? I would add to your list the freedom for individual doctors to set whatever standards of car they want should be taken away. If an electrician comes to put a new circuit in my house, he has to follow a building code which has been created by (horrors!) a government body. He does not get to just wire the house however he feels like. I also hope there is some oversight for the surgeon taking my gall bladder out. ---
**Author:** ![NajaNivea](https://avatars.discourse-cdn.com/v4/letter/n/22d042/32.png) [@NajaNivea](https://boards.straightdope.com/u/NajaNivea)\ **Post date:** [October 3, 2009, 8:15pm UTC](https://boards.straightdope.com/t/in-what-ways-are-countries-with-uhc-less-free-than-the-u-s/507977/102 "2009-10-03T20:15:19Z")
> [@Muffin](#): > > I hope you start feeling better soon NajaNivea, and that you don’t have to get medical care. Thanks for the kind thoughts, Muffin. ---
**Author:** ![jackdavinci](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackdavinci/32/3259_2.png) [@jackdavinci](https://boards.straightdope.com/u/jackdavinci)\ **Post date:** [October 8, 2009, 7:11am UTC](https://boards.straightdope.com/t/in-what-ways-are-countries-with-uhc-less-free-than-the-u-s/507977/103 "2009-10-08T07:11:28Z")
> [@Sam\_Stone](#): > > You may feel ‘more free’. In the same way you might feel more free if the government killed your neighbor and gave you all his stuff. You may have more freedom, but it sucked to be the neighbor. Yes and you may feel more ‘free’ to live in a crime free neighborhood because there’s a police force, but it sucks to be a thief. That’s a bogus argument and not really relevant to what was being asked. Your other statements are more interesting: > [@Sam\_Stone](#): > > In Canada, doctors are not free to set the rates they wish to charge for their services. Well they are somewhat limited in what rates they can charge in the US if they want to be paid by insurance, so that’s status quo. > [@Sam\_Stone](#): > > They are not free to pick their patients. OK I can see a possible objection to this on principle, but what is the practical downside? And on the other hand, what’s the rationale behind the policy? I do think that in a UHC system there should be some kind of public institution that can’t refuse patients, but I don’t see a reason to extend this to private doctors. > [@Sam\_Stone](#): > > They are not free to determine the standards of care they will apply. Between the AMA and insurance, seems like the current US situation. > [@Sam\_Stone](#): > > People on waiting lists are not free to seek out their own doctor and pay out of their own pocket. Thus the government feels justified in intruding into your private life to punish you for bad habits like smoking. There’s talk of a ‘fat tax’. I agree those are not good things. But they are adherent to particular implementations and not in any way inherent to UHC. There’s no reason we couldn’t have UHC and not implement those policies. > [@Sam\_Stone](#): > > People who don’t want health care are not free to choose to go without and save their money, because their pay is taxed to pay for it. I think anarchism is a nice idea, but in practice ends up being less cost effective than some set of government services. ---
**Author:** ![bengangmo](https://avatars.discourse-cdn.com/v4/letter/b/50afbb/32.png) [@bengangmo](https://boards.straightdope.com/u/bengangmo)\ **Post date:** [October 8, 2009, 9:16am UTC](https://boards.straightdope.com/t/in-what-ways-are-countries-with-uhc-less-free-than-the-u-s/507977/104 "2009-10-08T09:16:32Z")
> [@NajaNivea](#): > > Here’s a charming example of just how effed up this system is. NajaHusband is a post doc at a state university. He works for a lab but technically is employed by the state, so his insurance plan is really pretty good, comparatively speaking. > > Early on Friday I had a very mild case of the sniffles. Drippy nose, a little fatigued, a little sneezy, no big deal, could have been seasonal allergies. Starting around 6:30 I started coughing. By then my doctor’s office had been closed for an hour and a half. By 9:30 I was beginning to hack up wads of rubbery green stuff and breathing with what felt like about 30% of normal lung capacity. NajaHusband asked if I wanted to go to the hospital two blocks away for a prescription cough suppressant/expectorant and an inhaler. I pulled out the 1/2" thick packet which details our insurance coverage and start flipping through to find out what it might cost. > > This takes a half hour or so (cough cough, wheeze wheeze) by which time I determine that for hospital visits we pay 20% of the tab per visit, meaning that if they want to do a chest x-ray, breathing treatment, etc, we could be looking at hundreds or thousands of dollars. The upshot is we have a $2000 “in-network” cap, so at least we know we won’t be paying more than two grand for my cough syrup. There is an urgent care facility in the next town over, but it’s “out of network”, meaning our bill is 30% with a cap of $6k :smack: > > There were no other options to choose from, in terms of insurance plans. Six years ago when he first signed up, the fee for an ER/outpatient hospital visit was a flat $50. We get a new 1/2" thick packet every year. > > My doctor isn’t in again until Tuesday, so pretty much I’m Effed in the A unless it becomes such a crisis that we’re willing to empty our checking account and a chunk of our emergency savings to treat a truly “emergency” situation. > > Let freedom ring, baby :rolleyes: To Americans - is this a typical scenario? Not to say that the systems I have seen before are good (I have seen New Zealand and Singapore first hand\*,) BUT from my experience.. In New Zealand I would have paid maybe $80 to $100 for a 24 hour GP (high rate for after hours ya know) - if he couldn’t solve problem onsite it would have been off to the ER for free treatment. In Singapore I would pay maybe $50 or so for late doctor (they stay up late here) - if an ER visit / hospital stay was required I may have been up for an out of pocket expense of a few hundred dollars - unless I was having a full lung transplant. Note: New Zealand is a full UHC, Singapore is a hybrid UHC, user pays, you must save for your health costs system. In neither country does the health care system have any direct impact on my “freedom”. In both countries I am free at ANY TIME to pay the fee and go to a fully private doc. Both countries have got good reputations and well trained docs. ETA - In neither country would I be in any way concerned about costs incurred beyond having cash for the GP visit, the rest would not have been a major financial hurdle ---
**Author:** ![alice\_in\_wonderland](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/alice_in_wonderland/32/176_2.png) [@alice\_in\_wonderland](https://boards.straightdope.com/u/alice_in_wonderland)\ **Post date:** [October 12, 2009, 11:14am UTC](https://boards.straightdope.com/t/in-what-ways-are-countries-with-uhc-less-free-than-the-u-s/507977/105 "2009-10-12T11:14:35Z")
> [@Sam\_Stone](#): > > Of course, the very rich can simply skip down to the U.S. for better, faster treatment, or the middle class can mortgage themselves to the hilt to pay for U.S. care (while still paying taxes for Canadian care they can’t receive). This isn’t strictly true the way you’ve presented it Sam. As an example: my father received an unfavourable diagnosis and prognosis in Manitoba, headed to the Mayo clinic in the US. Paid the $16,000 to be reassessed by their team of doctors and took the results of that reassessment back to Manitoba where he received the surgery he had originally be denied, by a surgeon in Winnipeg fully paid for by the Manitoba govt. He was then able to claim the $16,000 as a tax deduction on his income taxes because the US assessment resulted in a substantially different outcome than the Canadian one. Now, that’s not a super streamlined process, and there was a lot of paperwork and hoop jumping, but the end result is that my dad was able to receive a procedure that was originally denied. FWIW, I don’t consider my parents to be ‘very rich’ - ‘comfortable’ perhaps, but not very rich in the Paris Hilton sense of the phrase. ---
**Author:** ![hobscrk777](https://avatars.discourse-cdn.com/v4/letter/h/a6a055/32.png) [@hobscrk777](https://boards.straightdope.com/u/hobscrk777)\ **Post date:** [October 12, 2009, 5:40pm UTC](https://boards.straightdope.com/t/in-what-ways-are-countries-with-uhc-less-free-than-the-u-s/507977/106 "2009-10-12T17:40:02Z")
> [@bengangmo](#): > > To Americans - is this a typical scenario? Yes, that’s fairly typical. Welcome to America, where you can have all the health care you want, so long as you don’t intend to actually use it. ---
**Author:** ![Xotan](https://avatars.discourse-cdn.com/v4/letter/x/278dde/32.png) [@Xotan](https://boards.straightdope.com/u/Xotan)\ **Post date:** [October 12, 2009, 9:19pm UTC](https://boards.straightdope.com/t/in-what-ways-are-countries-with-uhc-less-free-than-the-u-s/507977/107 "2009-10-12T21:19:05Z")
Living in France I am so unfree. When I moved here I had to file a document I got in my home country from a Health Office. Within 5 minutes I had a Social Insurance number. Within a few days this was followed up by a card. All my medical history is on computer and the chip on the card means it can be accessed wherever I am in France. I visit my doctor 4 times a year for whatever checks he reckons are apporpriate. I am on blood pressure medication. I pay the doctor Euro 22 per visit, and my 3 month supply of medication costs about Euro 33 to me. The state picks up the tab for the greater part of the cost… Of the 22, I get a refund of 14 Euro into my bank account from the state. The remainder is refunded by my personal insurance. I get a refund of the 33 Euro also. Personal Insurance is seen as a ‘top up’, and it costs me about Euro 1,000 a year. Should I need to see a specialist, I can do so normally within a matter of two days. Eye specialists take a bit longer. I need a blood test? Call without appointment to the laboratory. The results are ready in the afternoon or next morning. I read the results myself as the parameters are shown, and anything that is outside the acceptable range is highlighted. Call the doc and tell him is there is a problem. Simple. No waiting, inexpensive, insurance cannot be refused, regardless of pre-existing conditions… I feel so deprived of freedom that it’s painful to think about it. ---
**Author:** ![Muffin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/muffin/32/4341_2.png) [@Muffin](https://boards.straightdope.com/u/Muffin)\ **Post date:** [October 12, 2009, 10:21pm UTC](https://boards.straightdope.com/t/in-what-ways-are-countries-with-uhc-less-free-than-the-u-s/507977/108 "2009-10-12T22:21:26Z")
You’re in France. France does not have freedom fries, and is populated by cheese eating surrender monkeys. Therefore your are not free. ---
**Author:** ![Xotan](https://avatars.discourse-cdn.com/v4/letter/x/278dde/32.png) [@Xotan](https://boards.straightdope.com/u/Xotan)\ **Post date:** [October 13, 2009, 9:58pm UTC](https://boards.straightdope.com/t/in-what-ways-are-countries-with-uhc-less-free-than-the-u-s/507977/109 "2009-10-13T21:58:13Z")
True, Muffin. But we do have French fries, delicieux! Mmmm! 🙂 And no point in being vinegary because France refused to involve herself in a ruinously expensive war that was based on a GWB lie. Although I do agree that we are all ultimately descended from great apes. (Isn’t evolution wonderful!) Sincerely, I do hope the slide of the dollar can be stopped. And the troops are got out of Iraq and Afghanistan asap. And also that certain people can be asked to justify the reduction of their proud country from surfeit to deficit in 8 short years. BTW, some smallish adjustments to foreign policy might save the US lot of dosh that at present is being spent in an unwinnable situation. When I said ‘sincerely’, I meant it. France is the US’s oldest ally. It would be a mistake to forget that without her help the US might be just another British possession. It would be a bigger mistake to fail to realise that France is equally as proud as the US, and her friendship with your country does not require her to take idiotic action against the wishes of her people. Now back to my cheese and French fries. 🙂 ---
**Author:** ![Muffin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/muffin/32/4341_2.png) [@Muffin](https://boards.straightdope.com/u/Muffin)\ **Post date:** [October 13, 2009, 10:47pm UTC](https://boards.straightdope.com/t/in-what-ways-are-countries-with-uhc-less-free-than-the-u-s/507977/110 "2009-10-13T22:47:49Z")
Vive l’America libre! McDonalds has been installed at the Louvre. ---
**Author:** ![Attack\_from\_the\_3rd\_dimension](https://avatars.discourse-cdn.com/v4/letter/a/b38774/32.png) [@Attack\_from\_the\_3rd\_dimension](https://boards.straightdope.com/u/Attack_from_the_3rd_dimension)\ **Post date:** [October 14, 2009, 3:52am UTC](https://boards.straightdope.com/t/in-what-ways-are-countries-with-uhc-less-free-than-the-u-s/507977/111 "2009-10-14T03:52:21Z")
> [@Xotan](#): > > France is the US’s oldest ally. It would be a mistake to forget that without her help the US might be just another British possession. > > It would be a bigger mistake to fail to realise that France is equally as proud as the US, and her friendship with your country does not require her to take idiotic action against the wishes of her people. > > Now back to my cheese and French fries. 🙂 Very well said. America has a memory like a goldfish. ---
**Author:** ![Muffin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/muffin/32/4341_2.png) [@Muffin](https://boards.straightdope.com/u/Muffin)\ **Post date:** [October 14, 2009, 12:57pm UTC](https://boards.straightdope.com/t/in-what-ways-are-countries-with-uhc-less-free-than-the-u-s/507977/112 "2009-10-14T12:57:54Z")
> [@Attack\_from\_the\_3rd\_dimension](#): > > Very well said. America has a memory like a goldfish. And health care fit for a goldfish. [Previous page](https://boards.straightdope.com/t/in-what-ways-are-countries-with-uhc-less-free-than-the-u-s/507977.md?page=5)