US Healthcare rant.

The BBQ Pit
1

(These remarks don’t seem to fit into any of the other of the healthcare threads, so I’m gonna just put them here!)

This makes me very angry!

As a person living in a country with universal healthcare, I have to say it’s always interesting to listen to the dialogue as Americans struggle with possibly changing / upgrading their system. Passions run high, flames of fear get fuelled, rhetoric gets frothy, everybody has an opinion, and sides get taken.

An outsider looking in, is often left scratching their head over various aspects, and which things people find objectionable.

From where I sit, there’s a lot to be critical of; costs are through the roof, many have no coverage, health maintenance and prevention are ignored often, people are bankrupted etc, etc.

But something that often gets lost in the other pressing issues, and is now being illustrated by a member who’s husband has been taken very ill, is the fighting for coverage thing.

She has spent time and energy and worry, over several days, trying to get his coverage sorted. You often hear about people fighting with their insurer for months and months after their hospitalization, about coverage or payments, etc.

I’ve never had to file forms to get care and cannot imagine trying to address mountains of paperwork at the worst possible moment of my life, as my loved ones lies perilously ill!

It’s so easy to overlook this harsh and cruel aspect of the system. As your loved ones life hangs in the balance it’s almost a full time job, it sometimes seem, just to ensure they actually get the coverage they’re entitled to, etc.

I cannot imagine the stress it must add, for people facing the most crushing circumstance to pile on a lot of forms, phone calls, run around and red tape!

This seems like one of the cruelest aspects of your system to me. And I get angry whenever I hear about it. How can you subject people to this at such stressful times?

And I admire the patience and restraint that it must take to wade through such stuff when you’re already undone by the suffering of a loved one! (Because I think I’d lose my mind!)

My heart breaks for people forced to handle so much!

(Thanks for listening and feel free to add your thoughts or rants about aspects you feel get overlooked!)

2

Americans are fond of saying “We all make choices” as a way to pin the blame on individuals who find themeselves in fucked-up circumstances. If it all comes down to individual choices, then it is never the system’s fault.

Didn’t file the paperwork during the open enrollment period? We all make choices, and you made the wrong one. Sucks to be you. Better use your brain next time, dumbass.

You didn’t know you have to get approval from your insurer to have a particular procedure covered, and now you expect them to pay for it after you’ve already had it? Wow. Well, we all make choices, and you made a horrible one. What the fuck were you thinking?

It’s like Americans–at least the ones in power–want things to be as complicated as possible so as to weed out people who aren’t smart enough or patient enough or lucky enough to deal with the system. Simultaneously, we are told that Americans value life and liberty. That’s a lie.

3

I completely agree, the US system seems completely alien to me. The only stress I have in times of illness is from the illness itself, which is how it should be.
It is a terrible system unless you don’t have to use it or are comfortably well-off. How screwed-up is that?

4

There are many sad and infuriating aspects of the American healthcare system.

I want to mention an issue that annoys me; I hope others can put it in perspective.

In most of the developed countries, health care is regarded as a right. Police are public servants, paid for by taxes and providing protection to rich and poor alike. Public schools are funded by taxes; fire fighters are so funded, and so on. Why not health providers as well? One hears Europeans, both on the “left” and on the “right”, celebrating their healthcare systems, proud of its humane and charitable character.

Yet, right here on the SDMB, when American Dopers discuss ACA, the focus is almost always on "What’s in it for me?" They point out that such a system implies income redistribution, as though the fact that poor people cannot afford health insurance without assistance is some secret Gotcha nobody else has figured out. :smack: They don’t give a shit if millions more Americans have coverage; they only want to whine about “My premiums have gone up. MY premiums. MY Taxes. Me Me ME!!!”

And these are not low-income people who are whining. Higher premiums mean they vacation in 3-star hotels instead of 4-star hotels. The right-wingers brag about how they volunteer a few hours a week at a soup kitchen, but when Uncle Sam needs a few dollars to treat infected poor children, they rant about the injustice — Obama is extorting their money at gunpoint and using it to help the undeserving.

I hope I’m wrong. Are there millions of Europeans also bitter about doctors treating poor people on their tax dollars? Certainly many or most Americans are far more charitable than the whining assholes (most of whom voted for Trump). Is it just that the inhumane uncharitable Americans lack shame and are more eager to rant and rave loudly?

5

It’s very screwed up. The basis for it (IMHO) is the much-touted American individualism, which leads to the belief (by some, not to mention names) that it’s not the government’s job to do anything about people’s general welfare.

Wait, I take that back… in the Preamble to the Constitution, it says “we, the people” are there to (among other things) “promote the general welfare.” But the interpretation of “general welfare” is where the rub comes in.

For our conservative types, this means the gummint is supposed to just get out of your way so you can get fat, rich, and happy. And the assumption is that if the gummint DOES get out of your way, you WILL get there. If you don’t, then there’s something wrong with you. Let the charities take care of it, but don’t expect taxpayer money to pay for your lack of preparation (or lack of being born into the correct family).

If you get sick, get fired or laid off, are born with a chronic health condition, have a baby with a chronic health condition, lose everything in a catastrophic natural disaster, well tough shit. You should have been prepared for that. As **monstro **said, “It sucks to be you. Now get outta my way, I’ve got to tee up for the next hole.”

Never before has this been more blatantly exposed than with the election of Donald Trump, his stuffing his cabinet with billionaires, and the extreme priority that those twin devils Mitch McConnell and Paul Ryan have placed on dismantling the ACA just to prove that they won’t be bested by an uppity black man.

This country has turned into an embarrassment in front of the whole world.

6

I don’t have children. I’ve never had children, and I never will have children. And yet, I have to pay taxes to send other people’s children to school! How is that fair?

Well, I recognise that an educated population is good for people’s well-being, that it’s good for the economy, it’s good for national security, and it’s good for international relations. Since the United States was set up to ‘promote the general welfare’, the United States was set up to provide for social programs that increase the well-being of citizens and, by extension, of the country.

Similarly, a healthy population is essential for the well-being of the country and its population – just like public education. It’s astounding that so many Americans are incapable of thinking of the big picture.

7

During my career in Canada I have probably contributed $300,000 in taxes to support health care.

There’s no way I’ve personally used that amount, but I did father two children and their births and health care costs didn’t burden me.

Also, both my parents died of cancer, stomach and pancreatic respectively, and it didn’t cost an additional dime to them or any of us.

How the US can’t get behind a system like that is very unusual.

“I’m all right Jack, keep your hands of myyy stack.”

8

Part of the problem, from a foreigner’s point of view, is probably that the conversation is not about UHC. Our conversations, at the national political level, are always about how to tweak a fucked-up system. And when you tweak the fucked-up system, there are winners and losers. Naturally, the losers are not too happy and would just as soon we had the older, fucked-up system rather than the new, fucked-up system. Even if the newer one is better, on average, for Americans.

I don’t think it’s even possible to have a rational, political discussion about UHC (as it is understood in most countries) at the national level in the US. I’m actually surprised we don’t see more states trying to act alone on this issue. The average US state is roughly the size of the average Western European country.

9

If death is the worst possible outcome … then all of us will be greatly disappointed …

10

It isn’t going to get better. American voters are dysfunctional. It is a favorite past time here to blame politicians, but at the end of the day the voters here are messed up. America is a very divided nation, and any attempt at creating a working health system causes all the class and racial tensions in the US to flare up. White people don’t want to pay for non-whites to get health care. The middle class and working class don’t want to pay for the poor. People hate the state. Combine that with the fact that wealthy powerful industries do not want the system to change and it doesn’t change. The public hate each other too much to want reform, and the rich/powerful don’t want reform either.

There is no easy answer. And even in blue states, they can’t implement working health reform. Partially because the system has gotten so overpriced that nobody wants to take on the responsibilities of creating a medicare for all system. If our health system was 10% of GDP, then maybe a state would take it on. But ours is 18% of GDP.

We are basically fucked.

11

This is my new favorite thread on the Dope.

It lasers in on the underlying issue that prevents us from moving forward in our quest for a more sane health care system – and that issue is those who foster the selfishness of individual Americans.

Exploiting this more base aspect of our natures is the very purpose of much of the propaganda now rampant in our culture. Everything from the paranoid rantings of Alex Jones, Rush Limbaugh and Breitbart to Fox “News” and others, acts in concert and feeds on the notion of American “exceptionalism,” and how we must “protect our way of life,” or “fight them over there so we don’t have to fight them over here,” or “they hate us for our values,” or any number of mindless tropes that so many Americans now subscribe to as their reality. Every bit of it encourages selfish, paranoid individualism, distrust in others and hatred of anything that benefits anyone other than themselves or their “tribe,” whether based in their identification as a rural person v. an urban person or a Christian person v. everyone else, etc., etc.

Who benefits from this growing general attitude of fear and uncaring for “the other?” The wealthiest among us, of course. It contributes to the much overblown notions of the “self-made man” and “pulling yourself up by your own bootstraps,” among other unsupported memes, as well as the truly meaningless concept of “deservedness.” It causes otherwise rational people to act against their own best interests.

It doesn’t just affect our national conversation (if it can be characterized as such) about health care – although health care is a debate that reveals the schism between caring Americans and uncaring Americans in a particularly stark way. It affects discussions about everything. As it is meant to.

The Alt Right has taken a much firmer grip on our national psyche than many recognized prior to our recent election. I’m dubious we’ll ever be able to dig this horrendous cancer out of our character. It has been carefully nurtured and engineered by wealthy powerful corporate interests with whom we are all familiar (or should be). They have diligently worked for a very long time to undermine trust in our government, our scientists and anything else labeled as “librul.”

Until we address this massive assault on evidence-based reality, I have little hope we will ever get back to a sane system of government that actually exists for the general welfare of its citizens – including our health. Its purpose is to divert our attention away from the pillage of our national wealth into the pockets of ever-wealthier individuals. It’s working very well.

I hear people complain constantly about the extraordinary high costs of health care in this country. I seldom see people ask why. If you do ask that question and conduct some research, it’s a sad, predictable answer.

12

Due to the Cold War, Americans have been inundated with anti-solidarity propaganda for decades. If you talk to Americans about UHC many of them will flatly reject it as socialism. The ACA is denounced as a government takeover of healthcare. If you mention other countries they say it doesn’t matter because they’re not America. Someone can’t afford insurance? Better do a spaghetti dinner.

“When I give food to the poor, they call me a saint. When I ask why they are poor, they call me a communist.”
-Hélder Câmara

From what I can tell, most people don’t know drug prices, for instance, are often much cheaper abroad. People think America has the best system and that Canadians are flooding here to take advantage of it. Or they might say that America subsidizes the rest of the world’s medical research. How magnanimous!

13

I couldn’t have said it better, elbows.

Thank you.

14

That’s a hell of a generalization, Wesley Clark. I don’t care what color people are. I want everyone to have healthcare, and I’m okay with my tax dollars being used for it.

I grew up poor. We were on food stamps, and in government housing. And Medicaid. It’s because of Medicaid that my mother got the hysterectomy she needed to live another 20-25 years. It helped with therapy after her failed suicide attempt. It helped my brother stay alive after he - through some process I do not fully understand - stepped on an underground beehive. He’s allergic to be stings.

If it wasn’t for government healthcare, it’s entirely possible that they would both be dead now.

15

No, is the short answer. Absolutely no is the slightly longer answer.

We think of healthcare in the same way as we do schools, roads, police, army, judiciary, fire services etc. We all contribute taxes to a central pot and those services are then provided free at the point of use to those that need them.

Johnny L.A. captured our mindset quite neatly and for sure it is a mindset that is widespread within the USA populace as well regarding most of the above services, why it is such a leap to considering healthcare in that bracket I don’t know.

16

I happen to agree with him.

When most Americans think of “welfare”, they immediately think of black people with their hands out. When Republicans talk to and about black people, it is often in the context of “giving them free stuff”.

I have no doubt when people think of universal healthcare, the first image in their mind is not of people like them being benefited, but rather those people. The same those that always seems to get all the freebies.

Of course, few people are gauche enough to express this opinion out loud. But you better believe their beliefs are apparent in their actions.

17

But Obamacare fixed all the problems and lowered not only insurance costs but health costs are lower as well so we’re all good.

18

:rolleyes:

Someone hasn’t been paying attention.

19

True. I’m often infuriated hearing middle class type people complaining about how people take unjust advantage of unemployment benefits, low-rent housing, social benefits, etc…paid for by their tax dollars, but complaining that they’re receiving medical care for free isn’t something I ever hear. It is taken as granted that everybody would and should get that.

20

I’m totally on board with the OPs rant. When you actually have a hospital stay, the number of different things you get billed for is just insane. A few years back my wife had an extended stay. After it was all over I had to print out all the different procedures and tests and doctors and what not. It ran to over 5 pages, with 1 line per charge.

Granted a lot of them had a balance of 0 because insurance covered them. (good thing or I’d still be paying it). But a lot of them weren’t 0 so I had to go through it all and make sure they all got paid. Scattered across those 5 pages might be 10 or 12 charges from the same office, so I could combine them into 1 payment.

It was seriously, without exaggeration, worse than doing taxes. Anything that is worse than doing taxes is way too complicated.

There’s one aspect of healthcare that completely blows my mind and I don’t really hear people talk about it much.

When you go in for a procedure, or get admitted, or even an ER visit, you have no idea what it’s going to cost before hand. You don’t even know what all tests and procedures will be ordered for you. Sure the doctor will go over with you what tests they want to do. But I don’t know about you but I have no idea what an MRI or CAT scan or blood test will cost you. Imagine giving your car to the repair place and saying, “do whatever needs to be done and charge me whatever you like.”

Took my daughter in for an urgent care visit. Quick little 15 min visit, get some antibiotics prescribed, badda bing badda boom. Since I hadn’t covered the copay for her yet for the year I figured I’d just go ahead and pay the bill when I was leaving.

Nope. Even they don’t know what they’re going to charge you. Have to run it by the insurance company 1st.