This is Just Smart - Socialized Medicine

[FakePigtails]

I don't think most of us who support some form of universal healthcare are under any illusions that it's free. I don't mind paying more taxes to know that anyone who needs it can get the care they need - even if they aren't paying in via taxes as much as I am if at all. Social contract and all. Everyone benefits when a population is more physically and mentally healthy and financially stable. The economy is affected when people go bankrupt because of medical bills, something that happens way too often and even to people with some form of health insurance.

I highly recommend anyone interested in this topic check out this PBS program: http://www.pbs.org/wgbh/pages/frontline ... dtheworld/ . You can watch it all online, read a transcript, or just read summaries of the different systems and issues covered in the program.

I like that other countries subsidize the education of doctors. In return, they get paid well but not over-the-top. It seems more conducive to getting doctors who are in it for their patients, not the high-class life (something I've seen IRL, though the person ended up not doing well enough in college to make it to med school *phew*).

[desertvixen]

Oh, we have death panels. They're called "insurance companies".

Pretty much.

while I think socialised medicine is better, I can appreciate that with the US healthcare system set up the way it is, this would be a very costly exercise - you can't just tell all the hospitals to suddenly function in a different way. It would probably also require a huge change in mentality in both healthcare professionals and patients to come to terms with using fewer resources.

This is very true. There would need to be more emphasis on getting preventatives, and less emphasis on doing whatever it takes to keep people at the end of life alive, no matter the cost. It would require more acceptance of death as part of the cycle of life.

Again, I don't see that as a problem of the healthcare system as such. It is more of a problem with the attitude towards that sort of thing. I do wonder if it is linked in with the whole pro-life ethos that the USA has, has it been extended to all human life (provided of course you can pay for it) whether or not there is no hope.

If you can pay for it, and if you're the right "sort" of people... but yes, I think it is absolutely tied in.

But insurance companies only care about profit for the next quarter. They don't care about saving money long-term because their hope is that these patients will simply be on a different plan (or none at all) before they start having these expensive problems. They don't care about financial responsibility; they only care about the bottom line for next month. We would save so much if routine preventative care were just completely covered, and we'd be healthier too.

This is one of the things that drives me nuts about the insurance companies and birth control. Birth control coverage would be more cost-effective, but women's health issues turn into a whole political football that makes me want to throw things and scream.

[desertvixen]

My theory is that the Republicans who were responsible for that just picked a woman at random, to try to appeal to the Democrats and moderates who supported H. Clinton in the primaries. Unfortunately, they seem to be so sexist that they think all women are interchangeable and that the people who supported H. Clinton only did so because of her gender and absolutely nothing else. Thus, they assumed that Palin would be an adequate substitute. I doubt that only one person was responsible for the decision; McCain probably had a team of advisers and publicists and probably had little say in the matter.

I think you're spot-on, and I don't think it hurt that Sarah Palin was a good-looking woman also -more appeal to the masses.

[2xx1xy1JD]

I'll share my views on the Canadian system, as both a patient and as a doctor's spouse.

1. Hubby has ONE billing system, ONE set of codes to learn and ONE payor to bill, except for those very rare cases where a visitor to Canada is paying out of pocket. The system is simple enough to allow him to do it himself, without a billing agent.

2. Hubby spends no time at all chasing bad debts. He also doesn't need to worry about charging other patients more to make up for bad debts or patients in the hospital who can't pay.

3. The government can often negotiate lower rates for procedures.

4. There is less reliance upon tests and technology. My hubby does not have an ultrasound machine in his office, while some of his American colleagues do. I have never seen a Canadian OB with their own ultrasound machine (not just a doppler), but the tests are generally available close by. During pregnancy, there is one standard ultrasound, and others are only ordered as needed.

5. There is almost no marketing. Doctors hang out a shingle, announce that they are open, and that's that.

6. Seeing a specialist requires a referral from a family doctor.

7. Where urgent treatment is required, you get urgent treatment. There can be delays, however, for some things that are necessary but not urgent.

8. Funding doctors and hospitals does not magically address every health problem. Clinics and health centres may be needed to hard-to-serve populations. You get a bit of a disconnect if someone is entitled to top-quality medical treatment, but can't afford physio or medications, or is living in a situation that doesn't allow them to be compliant.

9. There are some pretty big geographical issues. I can get top health care, because I live in Toronto. In other parts of the country, I might need to travel long distances or even wait for a fly-in doctor. I think this issue would exist, regardless of the medical system, simply due to the size of the country and the fact that the population is concentrated in urban areas.

[JesusFightClub]

NHS care isn't beautiful, but it works brilliantly without destroying my income. If I call in at eight any weekday morning I get a same day appointment which I'm not worried about being too broke to afford. I am Scottish and we do not pay for prescriptions here. We have a phone line we can call over weekend and get emergency referrals to hospitals or assessments over the phone or they send an ambulance (they did for me once). I hugely respect the NHS workers. They have saved my life and my family's lives.

What I mean by not beautiful is do not expect glamour. My work once sent me to a health assesment conducted by a private clinic. My God, the waiting room! It had a little fountain thingy, lovingly tended plants, the magazines were not dog eared copies of Heat but the latest Economist in little plastic binders. Soothing music. A water cooler with crushed ice. A fucking chandelier. I have never ever felt so much the scruffy punk I am.

Whereas at my local doctor's surgery, in the waiting room everything will be painted NHS green, the leaflets on the walls are about how to stop taking drugs and catching STDs, burly men may take out cans of Special Brew and stare accusingly around and there's always several people who you try to ignore because they are quite clearly psychotic and scary. I didn't feel out of place there (and I once stayed six hours in an NHS hospital bed in an accident and emergency cubicle with fresh blood all the way across the wall...)

I don't care about the less than wonderful surroundings if I get wonderful care and I can honestly say I have.

NHS care may not always be pretty, but it is fucking fantastic.