I don’t consider health care to be something I am guaranteed by the government. In addition, I’ve seen what governmental programs are like, and I prefer the private sector whenever possible.
This is the current debate topic in California High Schools, so my kids have been researching this and arguing it since September.
Americans as a whole don’t expect it from their goverment, who are you to tell them why or why not? European countries may have socialized healthcare but none of them are bringing peace and democracy to the Middle East, are they?
You are asking for an opinion or a value judgment and there isn’t any answer. You probably feel that way because I presume you grew up in a place where there is centralized health care. Those of us that didn’t often don’t think of it that way. You probably hear about the horrors of our medical system when it comes to the high costs that can destroy a person financially if he doesn’t have insurance. Many people in the U.S. look at countries that have socialized medicine and are appalled right back when they hear that people sometimes have to wait 6 months to see a specialist and the government has a say in what treatments may be done.
We aren’t used to seeing government in that role so it doesn’t seem obvious to us at all. That is all there is to it.
Taxes are used for whatever the people, as represented by their government, feel they should be used for (theoretically). If the people want to use tax money to pay for free health care, it will be. If the people would rather use that money for something else, they don’t get free health care. It’s that simple.
This is not generally true. Most HMOs these days are basically the same as insurance companies. You may have to use their network, but the doctors in the network are not employed by the HMO. Kaiser Permanente in California is an exception, in that it both insures and provides care.
Silenus
I guess that’s where we differ. I *do * consider a basic level of healthcare to be something that a government should guarantee to its citizens. Granted, it will likely be a no-frills service, but if you’re not happy with that, be prepared to poney up the dough for a private hospital which would provide a better level of care and comfort.
Fair’s fair - I expect something decent for my taxes, but will be prepared to pay extra for a premium service.
I was putting it “simply.” You can view a “network” – a series of contractual relationships – as an associated medical practice.
Fair enough. That’s pretty much the way I saw US healthcare, but then again all I know is what I saw on TV, so I figured it couldn’t be quite as bad as all that, hence my appeal to the Dope for a bit of ignorance-elimination.
Maybe the problem is that when it comes to U.S. healthcare, there’s no such thing as “simply.” When you say “associated medical practice,” it seems to imply that the practice is joined at the hip to the HMO. Here in Massachusetts at least, and I think elsewhere, a given medical practice will take whatever HMO you have. And I seem to remember a court case (from Kentucky?), that basically established that any physician willing to accept the HMO’s payment rates can join the network. Plus these networks are often quite large, comprising multiple practices. I think for the average HMO customer, the HMO feels vastly more like an insurance company than it feels like a provider of healthcare.
Chill.
I’m not telling anyone to do anything, least of all in their own country. I’m simply trying to understand a system that made little sense to me based on what little information I had. I’m not judging anyone, so quit being so frickin’ defensive.
:rolleyes: Neither are you, dude. And WTF does that have to do with my questions on healthcare? Or with anything else in this thread for that matter?
Book Monster - Americans by and large pay less taxes than Europeans. We prefer to do that and use the extra money to foot the bill for things ourselves. The taxes we do pay go to subsides social programs, including health care programs for the elderly and indigent ; the military; the basic infrastructure (roads, schools, police, fire departments, etc.) of a country. If we decide that the government has the duty to provide healthcare for every Joe off the street, what’s next? Providing housing because you don’t feel like paying rent? Providing food because you don’t feel like getting a job, earning a paycheck, and cooking? We are not a Socialized country. We feel that, if you’re able, it’s your responsibility, not the government’s, to take care of yourself. Do people slip through the cracks? Certainly. As I’m sure they do in every country in the world. No matter how many safety nets you put up, it often comes down to a person’s desire and ability to take advantage of the programs offered to them.
There are homeless people who, when offered a clean, safe, warm place to sleep prefer the streets. Many may be mentally ill, but they can’t be forced to take advantage of what’s being offered. That would be no different than incarceration, even with the most benign of motives. All you can do is expect people to do their best, and be ready to help if they can’t make it on their own.
StG
American policy, especially in the last 30 years or so, has generally put less emphasis on social programs (especially at the federal level) and instead works with the private sector to provide basic needs to the citizens. Americans in general seem to prefer less government interference than those in Western Europe – this is probably due to our heritage of being uppity revolutionaries and the federal nature of our system which emphasizes de-centralization and balances of power.
There are advantages and disadvantages to this approach, of course. Personally, I prefer having the vast freedom of choice afforded me by private insurance, but I am saddened that people poorer than me don’t have the same choices. So that’s why I donate to certain medical charities, among others.
Everybody also pays medicare taxes, even though most people don’t use that system.
What we typically don’t realize is that there’s a horrendous markup on health services just because of the administrative burdens and cost-shifting inherent to our crazy system. So even though we don’t pay the costs as “taxes,” we pay them just as surely under another name. Plus, half of all healthcare spending comes from the government anyway. Given that we pay twice as much on a per-capita basis as many countries that cover everyone and get outcomes superior to ours, you might conclude that we do in fact pay enough in taxes right now to get universal coverage.
Thank you all for some brilliant and useful answers. I guess that alot of my confusion was down to my preconceptions of how things *should * work, rather than just an imfamiliarity with your system. I really had no idea that Americans felt that way about how their taxes ought to be used. I simply took it for granted that healthcare was part of one’s “contract” with the government and didn’t realise that people might actively decide that they don’t want it that way.
Thanks again. Ignorance takes another (minute) kick in the ass… 
No sweat. A lot of Americans would agree with you. Just not, so far, the majority. Soemetimes we’re just uppity that way. 
Just an observation: While we do have centralized health care here in Europe, at least in Sweden, we also have private health care. If you do have the money, you are able to make a choice.
What is apparent in this thread is that in the US you will be treated (or at least stabilized) by a hospital post-trauma (for instance), but what happens after that is dependant to the size of your income. What happens if you need a transplant because of the accident? What hospital would foot a 200,000 K bill? I’m sure most of you have seen John Q, and that illustrates this point (if it’s an extreme case, that’s not for me to say, but I think there is a certain validity in the plot).
I honestly would be terrified if I was living below the poverty line and one of my kids got hit by a car and suffered debilitating injuries. If I’m lucky, I could mortgage the little shack I preside in, sell my shitty little car, donate semen etc just to make ends meet, but what happens then. At some point cash flow will become a problem and you will feel shafted by a greedy (my lowly opinion) health care system.
Sure, in Sweden, there are lines to see specialists. If you don’t have money, you will have to wait in line, which in some cases translates to years. But when it comes to emergency medicine, it’s like it is in the US: immediate care, but also care that doesn’t end when the patient is stabilized.
For what it’s worth, this issue is highly politicised in the US. For example, it’s NOT generally accepted that our health care is better than everyone (most Canadians I’ve spoken to seem to feel theirs is just as good, and many Americans agree with the statement “superior medical care that’s not available to people who need it isn’t superior.”), and while “most people purchase insurance” is true, more than one person in six cannot afford it, and they ones that do will generally not be covered sufficiently for something like long-term cancer. Emergency room care is provided to everyone, but without follow-up care, outcomes for the poor are statistically much worse than outcomes for those with insurance. For anyone short of the very wealthiest in the US, a single serious medical problem that’s not covered or insufficiently covered will cripple them financially for decades. It’s not uncommon for treatment of some illnesses to run into the millions of dollars.
Why don’t our taxes pay for it? US taxes are some of the lowest in the world, and many Americans aren’t willing to pay higher ones. One of our political parties has as one of it’s basic platforms LOWERING our already very low taxes, particularly for the wealthy.
However, health care costs have been rising at vastly greater rates than inflation for a couple decades now, so something will have to break, sooner or later. The number of people who can’t affort insurance is rising by millions per year, and insurance as a benefit of employment is becoming less common, especially as more people become underemployed and can’t get full-time work.
All of these points are controversial, but I thought it was useful to point out the controversy. A tangential issue is the price of drugs in the US vs. the VERY SAME drugs elsewhere: the drug companies point to their research budgets, but the claim is often made (I don’t know whether it’s true or not) that those budgets are disproportionately allocated to “rich people’s ego:” i.e. balding, acid reflux, toenail fungus, erectile disfunction, and that sort of thing, rather than to the actual cure of real diseases. Certainly you’d think so if you watched TV ads.
Also, not to belabor the point, but the idea that we don’t have to wait in the U.S. to see specialists is false. I have waited four or five months to see a specialist on a non-urgent matter. Of course, your experience will vary – for better or worse – depending on the specialist, the medical issue, and the location.
I guess one underlying explanation for the US’s health system is that it reflects capitalism. US health care is big business, with a huge number of people make a profit out of the provision of health care. For that reason, there is a significant incentive to provide what is desired by those most able/willing to pay. And, for the “players” in the system, there is a significant incentive to keep the system set up in a manner that continues their source of income.
As many have said, your questions do not have a single factual “answer.” But I am not the only US citizen who considers our health care system an embarrassment in several respects. For us to consider ourselves among the most highly advanced societies, yet to have such a tremendous percentage of our workforce lack basic insurance. Or for such a disproportionate percentage of our healthcare expenditures to go towards the last weeks/days of terminally ill elderly, compared to basic preventative healthcare for the poor. For healthcare to be consumer driven, through the direct marketing of medicines towards prospective “customers.” For so many resources to go towards middlemen, gatekeepers, and overhead, instead of to actual care providers…
I just enrolled in a health care plan - my employer offers several different programs. Choosing which one to enroll in requires quessing “how sick” your family expects to be over the upcoming year.
It is hard for me to imagine anyone who has had to deal with US insurance/HMOs thinking ours is the best possible system an economically advanced society could come up with. But, in the US, if a bunch of people make money (with which they make political contributions and lobby) off of the status quo, it is tough to change anything.
Just look how far Clinton’s proposal to re-evaluate health care went. All it took was the charge of “socialism” to end any intelligent discussion. And I suspect Hillary’s association with that failed effort is the source of a significant amount of the disfavor she currently enjoys.
For so many resources to go towards middlemen, gatekeepers, and overhead, instead of to actual care providers…
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I absolutely agree. I feel this is where the system is flawed. The insurance companies are making big profits on health insurance and mal practice insurance while the providers struggle with paying overhead. People in the US still think that physicians make huge incomes and that simply isn’t the case. They would be much better off being an executive at Aetna than have patient’s lives in their hands every day. Salary Graph
That being said, physicians still make a comfortable living which is part of the incentive of chosing medicine as a career. If that incentive was taken away, would be still have the best and the brightest?