Different Perspective on Healthcare?

[freejoytoo]

I was looking at an article earlier about a proposed bill which would bring serious change to our UK NHS service, which the majority of the country are opposed to, mainly because it threatens to bring the NHS closer towards being a business. Conversely, I've noticed an attitude in the states that you should be solely responsible for paying towards your healthcare and that 'socialised healthcare is dangerous healthcare', whilst here we see it as a general right. I've seen a debate about whether contraception should be covered by insurance, and it shocks me that it is not - here it is covered by the NHS. Do you think healthcare is viewed differently in America than in other parts of the world? Do you think America's attitude is changing? Any thoughts on the article?

http://www.guardian.co.uk/society/2012/ ... ealth-bill

[AudreyE]

It's not just healthcare where are attitudes differ. I've heard some people joke that it's our Puritan work ethic. The basic ideals are every man for himself and poor people are lazy. The myth of the American dream is strong, and for a long time a white man really did have a good chance of improving his lot with hard work. I read a study suggesting that the potential for social mobility is lower here than it's been in 60 years, but still the myth persists.

A big part of it is PR. The health insurance companies are amazing at distorting the facts to convince people that private health care is in their best interests. Even when former executives come out and say, "Oh, man, we spend a fortune of time and money 100% focused on being lying sacks of crap to manipulate you," people still don't get the message.

The GOP is also way better at communicating conservative values in a convincing way than the Dems are at communicating what they want. The Dems are too... well, liberal... to put forth a single coherent message. (I even heard a Dem strategist complaining about this, and then the reporter he was speaking with asked whether he was prepared to get on board with daily party memos about talking points - the way the GOP does - and the Dem said, "Hell, no. Nobody is going to give me a script for what to say. Sigh!)

[BravaAmica]

Health care in the US is viewed, by most, as a commodity. Since you're paying for it, you have every right to expect "good customer service" and have everything your way. And if you can't afford it, you shouldn't expect others to pay your way.

I find those attitudes obnoxious and selfish. You're going to see a doctor because you need help- you need help getting your ease of body back. That's nothing to do with "good customer service" or paying someone else's way.

[genericJname]

Yes, absolutely its viewed differently. I am for "socialized" health care, but I know that it is going to take some dramatic changes for that to ever be palatable here. There is such a "individualism" mentality and I just don't get how they are able to keep conservative low-income people from seeing how strict capitalism is hurting them. I work as an RN (newly graduated) and while I don't deal with much of the financial side of things, our health care system in the US seems incredibly inefficient. I work at a non-profit pediatric hospital that I am pretty happy with where the majority of patients are Medicaid/uncompensated, which would not be sustainable without outside donations.

My story where healthcare financing became so important happened when my son was born with a severe congenital heart defect. He needed several surgeries, and months of hospitalization and eventually a transplant. My husband and I did the "right thing" and had steady jobs with health insurance. Until the new healthcare bill (evil Obama care :lol: ) private insurance usually had a cap of how much care you could get in a lifetime before it "maxed out." We decided to pay the extra premiums to cover our son with both of our insurance plans, just in case, which was a good idea, because my husband's insurance ran out in less than a year of my son's life. My insurance was through a company that went out of business (before I got into nursing), and they ended up not paying on several claims (luckily only a few.) We ended up getting through on a loophole that allowed us to get our son Medicaid to pay for whatever insurance doesn't, so we are safe for the next few years, until he catches up developmentally and doesn't look disabled enough to get Medicaid and then we have to start stressing again about being 100% sure we always have good enough insurance.

I have gotten involved in a lot of online communities for parents of "heart kids" and those from places like the UK seem so much better able to focus on their children when they are not full of stress about how to get the surgeries paid for.

Anyways, I think healthcare as a commodity is a horrible thing. While there are lifestyle ways to prevent some disease, illnesses and injuries can happen to anyone at anytime. I would rather health care be based on evidence for what is the most effective/ lowest cost than on who's insurance covers what. I would rather give up fancy private rooms and good "customer service" than think that somebody is left to die because they can't afford care.

I really do hope that the NHS is able to stay intact and that someday American attitudes will change. [sorry for the rant!]

[freejoytoo]

No, the rant was interesting!

I still can't get over jericho comparing healthcare to giving out free iphones. Wtf x infinity.

[YPestis]

Healthcare is seen as a a commodity to be purchased. It's not viewed as a right per se, but most people acknowledge we need a system that allows those who need it to receive it. The difference here is that we view it as the individual's responsibility and something that you get as a benefit of your job. In other developed countries, it's universally given with varying degrees of individual supplement. Contraceptives is a whole other can of wholes. Most (men) don't realize it's not just for preventing pregnancy, but that women use it for health related issues. Unfortunately, the people most opposed to BC are men, and their voices are heard most loudly.

I guess I blame both these attitudes on our Puritan background (oh hey, didn't they come from England originally ;)). I also think it's the individualistic ideals of the old pioneer myth. The idea that each man got a piece of land and eeked out a good life from it or whatever.

I also blame it on the heterogeneity of the country and our racial history. Our attitudes of the evil of socialism and such was generated through the racial divide that mirrors our class divide. It's much easier to think of socialism as evil when "the poor" encompasses mostly black people. I don't think modern conservatives are racist but I think that attitude of "individualism" and 'every man for himself" stems from the old days when racists saw that social programs would predominately benefit blacks and other undesirables. I think while the racist attitudes has been lost, the 'every man for himself" was passed on. I also think upward mobility has traditionally been much easier for white males than for any other group, so it's easy to see they believe less help is needed than other groups.

If we lived in a country with a composite like Japan, where people are predominately homogeneous, universal health care and other social programs would probably be more welcomed because it's seen as helping your fellow neighbor.

[shesinsane]

On one end of the spectrum are countries with nationalized healthcare, on the other end are the countries where people drive past car accidents because bringing the injured to a hospital would require the transporter to pay the hospital to care for the injured. America is somewhere in the middle, where we consider ourselves world leaders, yet people die from medical conditions that could be treated if they could afford it. As long as Americans think that goverment run healthcare is automatically awful (I know someone in Canada who came to the US for cancer treatment because they didn't want to wait 6 months blah blah), they will keep health care private... which is a problem because private usually means for profit. Medicine shouldn't be for profit, it should be for healing, but Americans aren't ready to accept that.

[emmiedahl]

If we lived in a country with a composite like Japan, where people are predominately homogeneous, universal health care and other social programs would probably be more welcomed because it's seen as helping your fellow neighbor.

That is an excellent point. Americans have little group solidarity as a whole, and we are especially divided along class and religious lines. We tend to think rather ugly things about the people outside our little groups, which is why everyone wants to privatize. So they only have to help insiders. This viewpoint is especially evident in calling taxes "theft". The assumption is that we personally get no benefit from that money and the person who does is unworthy of it.

Very few of the people against national healthcare even care that it would cost them less. All they care about is their money going to help one of those dirty lazy people.

[freejoytoo]

It does come across as a really selfish attitude. I'm not that fond of every member of the public but I'd hate to think that they wouldn't go to the doctor because they couldn't afford it. I'm happy to pay taxes for it because it's my duty as a member of society and it benefits me as well as them. Our country is by no means perfect but we are very proud of our NHS and think we have a duty to uphold it (sadly people are less benevolent about those on benefits).

[shesinsane]

It does come across as a really selfish attitude. I'm not that fond of every member of the public but I'd hate to think that they wouldn't go to the doctor because they couldn't afford it. I'm happy to pay taxes for it because it's my duty as a member of society and it benefits me as well as them. Our country is by no means perfect but we are very proud of our NHS and think we have a duty to uphold it (sadly people are less benevolent about those on benefits).

Denis Leary's wife Ann was 6 or 7 months pregnant when they went to London and she went into labor, she later wrote a book about her experience of having her first child prematurely in a foreign country. She mentioned being in the maternity ward and others being rude to her, finally one of the women told her they were annoyed that a greedy American was taking advantage of the NHS. After she told them about a meeting she had with a hospital staffer that was entirely about submitting the Leary's bills to their US insurance carrier, everyone got nicer to her.

[Constance Vigilance]

I think while the racist attitudes has been lost, the 'every man for himself" was passed on. I also think upward mobility has traditionally been much easier for white males than for any other group, so it's easy to see they believe less help is needed than other groups.

The racist attititudes really, really have not been lost, and are a large (mostly unspoken) part of the conversation about welfare queens, taxes as theft, poor = lazy etc.

Denis Leary's wife Ann was 6 or 7 months pregnant when they went to London and she went into labor, she later wrote a book about her experience of having her first child prematurely in a foreign country. She mentioned being in the maternity ward and others being rude to her, finally one of the women told her they were annoyed that a greedy American was taking advantage of the NHS. After she told them about a meeting she had with a hospital staffer that was entirely about submitting the Leary's bills to their US insurance carrier, everyone got nicer to her.

Not sure what this has to do with the bit about benefits that you bolded? Benefits are our equivalent of welfare. Nothing to do with foreign people using the NHS (which is a whole other thing the Daily Mail likes to rage about).

[Creaky Mom]

Canadian here.

I've always thought it interesting that many American Christians are so against social healthcare. It just seems so incredibly at odds with what Jesus taught and the historical Christian response of establishing hospitals, orphanages etc.

I worked in a border city health clinic and we frequently had Americans coming across to Canada for healthcare. Some was legit, some not (most of them knew one of the doctors.)

I also knew an American preacher who specifically moved here so his disabled child could receive free healthcare, otherwise he generally thought social healthcare was not a good idea. :roll:

[Little Miss Alien]

I have to say I'm not thrilled by the changes, but as I work in NHS commissioning I understand the changes that are going to happen.

There's a lot of worry that people are going to have to pay for their healthcare here, and that's just not true. What the government are doing is encouraging competition between NHS and private companies, who will bid for services to be outsourced to them. If they are the lowest bidder, the commissioning body passes on funds to cover their costs as set out in their bid. The end result will not be much different to the consumer, especially as the companies will be answerable to and strictly regulated by the commissioning trusts (as the various frontline trusts are already).

No, it's not ideal, it's a slippery slope, but the aim is that it will inject more funds back into the NHS, and actually improve services for the taxpayer (whose taxes will still be funding the commissioning bodies to commission and regulate services). By and large. it may also boost the economy because tax revenue may be freed up to spend elsewhere.

You may well know all this, but I'm breaking it down more for those not so well versed in UK healthcare. Don't get me wrong, I'm against it, not because it's change, we all have to get used to that, but because it means that many NHS frontline staff are/will be losing their jobs over this. I kind of have job security guilt over it, actually.

[desertvixen]

I just don't get how they are able to keep conservative low-income people from seeing how strict capitalism is hurting them.

Never underestimate the power of the "American dream" myth...

Even for people who have insurance, getting health care can be a painful experience.

[freejoytoo]

I don't understand how healthcare correlates with a work ethic. If you suddenly fall ill and need major surgery (or even minor surgery) surely it has nothing to do with how hard you've been working if you can't cover the cost.

[Bella99]

It doesn't and I would argue that public health care that keeps people healthy enough to work is better for everybody financially in the long run.

[freejoytoo]

It also gives off the sense to me that the more money you have the better you are and you deserve better treatment than some poor guy down the street.

edited for riffles

[AudreyE]

It also gives off the sense to me that the more money you have the better you have and you deserve better treatment than some poor guy down the street.

In America, you do.

[Nesomja]

I have to say I'm not thrilled by the changes, but as I work in NHS commissioning I understand the changes that are going to happen.

There's a lot of worry that people are going to have to pay for their healthcare here, and that's just not true. What the government are doing is encouraging competition between NHS and private companies, who will bid for services to be outsourced to them. If they are the lowest bidder, the commissioning body passes on funds to cover their costs as set out in their bid. The end result will not be much different to the consumer, especially as the companies will be answerable to and strictly regulated by the commissioning trusts (as the various frontline trusts are already).

No, it's not ideal, it's a slippery slope, but the aim is that it will inject more funds back into the NHS, and actually improve services for the taxpayer (whose taxes will still be funding the commissioning bodies to commission and regulate services). By and large. it may also boost the economy because tax revenue may be freed up to spend elsewhere.

You may well know all this, but I'm breaking it down more for those not so well versed in UK healthcare. Don't get me

wrong, I'm against it, not because it's change, we all have to get used to that, but because it means that many NHS frontline staff are/will be losing their jobs over this. I kind of have job security guilt over it, actually.

But my understanding is that services will change, because the cheapest option is not necessarily the best and it is cheaper to employ less well qualified staff. In my area (mental health) there is s huge push to get rid of senior staff and to use unqualified graduates who won't provide as good a service. In my trust we are all losing our jobs and being reinterviewed, with most of the senior posts having gone.

[genericJname]

It also gives off the sense to me that the more money you have the better you are and you deserve better treatment than some poor guy down the street.

This is a point that I can't even seem to get across to my conservative father. He got laid off a few years ago right after getting diagnosed with cancer and now has to pay huge premiums for scanty coverage through the state's high risk pool insurance.

Still, he goes off about "What we need in healthcare is more of a consumer" and he boasts how he called around one time and got the cheapest MRI available in the area, which most people wouldn't do because they just let insurance pay.

I just cannot get behind the "consumer" concept, because that boils down to deserving more healthcare if you have more money and not investing in preventative care if you can't afford to.

[shesinsane]

Not sure what this has to do with the bit about benefits that you bolded? Benefits are our equivalent of welfare. Nothing to do with foreign people using the NHS (which is a whole other thing the Daily Mail likes to rage about).

I misunderstood. In America, a frequent talking point is "illegal immigrants are using up all the social services", and I thought that's what you meant in the UK.

I just cannot get behind the "consumer" concept, because that boils down to deserving more healthcare if you have more money and not investing in preventative care if you can't afford to.

Replace "deserving" with "receiving" and I think you've summed up US healthcare.

[Little Miss Alien]

But my understanding is that services will change, because the cheapest option is not necessarily the best and it is cheaper to employ less well qualified staff. In my area (mental health) there is s huge push to get rid of senior staff and to use unqualified graduates who won't provide as good a service. In my trust we are all losing our jobs and being reinterviewed, with most of the senior posts having gone.

Yes, you're right, I worded it poorly. What I was responding more to is the commonly held belief by many (including the old lady who shouted at Andrew Lansley) that suddenly we're all going to have to pay for healthcare and only those who can afford it will get it. That's not the case.

As you point out though, the outsourcing is going to result in less qualified and cheaper workers, which is why I said I don't agree with the bill as people are going to lose jobs. The biggest concern is that there will be an influx of cheap healthcare workers from outside of the UK. There will be cultural and language barriers, not to mention potentially less qualified personnel.

However, the commissioning trusts remain the same, and I have to say, in my trust at least. where there are already some private companies operating, standards remain as high as ever. When the private companies cock up, we're on them faster than me on chocolate cake.

There will be problems. Hopefully only teething problems, but we will have to wait and see.

[Austin]

Never underestimate the power of the "American dream" myth...

Even for people who have insurance, getting health care can be a painful experience.

In response to this year's State of the Union speech, delivered by GOP Indiana Governor Mitch Daniels, he said that in American, we are not a country of haves and have nots, but rather haves and soon-to-haves.

Clearly, the myth of the meritocracy is alive and well.

[bananacat]

There's also a whole lot of "personal responsibility" going around in the U.S. So many people think that diabetes is punishment for eating food. How many people were mad at Paula Deen for getting it? Very, very many people believe that bad health is mostly caused by personal choices such as smoking or eating cake. The public just does not have a good understanding of the many factors that contribute to obesity, heart disease, and diabetes so they really like to focus only on the aspects that they believe people have control over. I bet that most people in the U.S. aren't even aware that half of people with Type II diabetes aren't obese. So there's this petty, childish attitude that paying for someone to not die is rewarding them for doing "bad" things. They think that if all those bad people could just live perfect lives, then they wouldn't need healthcare except in the tragic and un-blamable cases of breast cancer and a few other diseases. It's like if you could have avoided the disease by just being a better person, you don't deserve coverage for it.

[desertvixen]

In response to this year's State of the Union speech, delivered by GOP Indiana Governor Mitch Daniels, he said that in American, we are not a country of haves and have nots, but rather haves and soon-to-haves.

Clearly, the myth of the meritocracy is alive and well.

All you have to do is work hard and Think Positive!