Twitter users answer the question: "When did you become radicalized by the U.S. health care non-system?"

boing
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One of the biggest things terrifying me about brexit is how hard the US government is pressing for the NHS to be opened up like chest cavity of recently slaughtered livestock.

Sure, the NHS has its problems but that is just the nature of the beast that is finite resources. I’m happy to wait 3 or 4 hours longer for my relatively superficial cut or minor broken bone to be seen to if it means someone else gets the care they need to survive whatever trauma they are going through, even at a fundamentally selfish level it means if you find yourself in their situation you’ll be triaged the same way.

The UK also has private healthcare, which still uses many of the same doctors and treatment facilities… the difference is essentially that between economy and business tickets on the same journey - they’ll get the better bed and the tastier food for their premium. The plan is that you’ll both arrive at your same destination.
And it’s a system that works, just look at how the worlds longest surviving ALS sufferer lived waaaaaaaaay beyond most people in the US with the same condition. That man was Stephen Hawking, who used the above system. Public for treatment, private for the palliative side.

The profit motive simply shouldn’t be there when it comes to the actual treatment for life-threatening needs. I’m fine with it being there for elective stuff such as cosmetic surgery and for “value-added” after-surgery care over and above a standard level, just don’t use it for fastpassing or even gatekeeping the attention somebody needs to either not die or to vastly improve their quality of life. It should all be judged on need, not economic clout.

Further to this, I find it equally as abhorrent for people to complain about others being treated by our system just because they happen to not live here or weren’t born here. This just feeds into the artificial “us vs them” bullshit that allowed brexit and Trump to happen in the first place.

We all deserve healthcare wherever we are, be it the country we were born in or currently live in or the one we are just visiting, because getting ill or injured doesn’t wait for you to be at home and do you really want to be in a situation where people simply tell you that there’s nothing they can do because you aren’t from 'round these parts?

We’re better than that.

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44

Don’t worry, it’s taken care of. Donny Two Scoops and Uncle Joe both say they’ll tell us all about their policies after the election.

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45

I’m not even American. It was Thirty years ago, maybe more, I was working in Louisville, Kentucky, and on one of my days off, visited the Humana building. Kind of in the way that you might visit a stately home in Europe. It wasn’t long before the sheer opulence of the place began to concern me. Then it began to disgust me. I can remember other visitors, other sightseers being puzzled by my looks of disgust. As I left I said to myself “If Americans could see the profiteering that’s being made out of health insurance, they would tear this building down brick by brick and dance on the rubble.” And that was thirty years ago.

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47

I think you’re exactly right, that in almost all measurements, the Canadian system is better than the US’s. My point was about countering comments I often hear in Canada (and in the US, when talking about Canadian healthcare) that we have no right to talk about or complain or fight for better Canadian healthcare. All we should do is feel smug about the fact that we are generally better off compared the US.

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48

When I had thyroid cancer, and with insurance still owed about $10k out of pocket. That included charges for an “assisting surgeon” who was not covered by my insurance … and whom I never met, nor was I asked if it was okay for someone “out-of-network” to assist at my surgery. I wasn’t even informed that it was a possibility; the hospital was in-network, so naturally I assumed all the doctors there were as well.

And $10k is chump change compared to what some people end up on the hook for.

The gulf between “good insurance” and “might as well be worthless” insurance is wider than the Grand Canyon. Right now, my insurance is spectacular. I had a pulmonary valve replacement via open-heart surgery in December. I have not seen a single bill. But Mr. Bells’ company went through a round of layoffs early this year so who knows what my insurance might be next year.

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49

That happened to me as well where some “surgery assistant” popped out of the woodwork and sent me a surprise bill for a couple of grand. I ignored it completely and still haven’t paid almost 5 years later. As far as I know nothing has happened to my credit.

Even “great” insurance is being constantly pushed downwards these days. I’ve switched jobs a few times in the past couple years and each new benefits plan claims to have excellent insurance while in reality every company I’ve seen is moving towards high deductible plans as the only available option.

While many firms are offering to cover most of the deductible with Health Savings Accounts or Flexible Spending Accounts, it doesn’t change the fact that plans are moving away from the $300-$600 deductible PPO options to $1500-$3000+ annual deductibles. It’s only a matter of time before companies start gradually reducing their contributions and leaving employees with higher and higher out of pocket costs.

It’s also becoming deliberately more confusing with indecipherable gobbledygook like co-insurance, annual spending limits, shifting deductibles and exempted procedures. I have advanced degrees and can’t figure out what’s covered and what’s not.

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50

Fuck. I feel their pain. A family member has had a liver transplantation at the age of four months. The mother is a teacher, and privately insured. She and the father are not married, the child thus is insured with the mother. They have to pay the bills themselves, but get a quick and unproblematic refund. The mother is on maternity leave, w/o payment since the child is older than two. She can return to her job any time - if they can manage.

However, the strain this medical necessity took on them is enormous, even tough the German healthcare insurance system works, the child has some of the best treatment in the world (the clinic is a European liver transplant hotspot) and until now, only minor problems occurred.

I can only imagine to what lengths your family goes. But I definitely feel their pain.

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52

Oh fucking hell. That’s something I hadn’t on my list. Any sources for that?

I’ve got friends in the UK (and Ireland), and the UK citizen among them could be eligible for several EU citizenships. If this is a real danger, they should apply for those dual citizenship ASAP.

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53

Absolutely. The thing about the US system that’s truly cruel is that, on top of the uncertainty, pain, and terror that comes from the thought of your baby undergoing this sort of thing, on top of the knowledge that this will be a lifelong battle for the child and the family, there’s the knowledge that there’s basically no way to come out of it financially unbroken. There’s no way to take off work to care for a profoundly ill child, because you would lose the insurance that’s guaranteeing their care. Even if you are dual-insured, there’s no guarantee that a parent leaving work could resume it, since the employer would be under no obligation. On top of all that, there’s the knowledge that every free penny and more is going to have to be funnelled into care.

(In the US, the billed cost of a heart transplant averages something like 1.4 million dollars. No idea how much of that insurance typically covers (if there is even a “typical”).)

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54

The two arguments that anger me most from the right about health care are:

  1. Do you want some sort of RATIONING (scare word). Yes, of course. My very first day in my very first econ class I was told that economics is about the allocation of scarce resources - ie, rationing. I’ve had a lot of econ courses since then (too many) but I have not lost sight of that very fundamental fact. We have rationing. We ration by money. Rich people get all the care they can use, medium-rich people get health care paid for by their employer, and poor people get fucked.

  2. “Do you want some expensive faceless government bureaucracy involved in your medical decisions?” We already have an expensive faceless insurance company bureaucracy involved in our medical decisions. Plus, that bureaucracy has a primary goal of making a profit, which means maximizing price and minimizing paying for care. Do you really think the government can do worse than that?

ETA: Let’s not talk about measuring how well the government does by some bullshit measure of “efficiency”. Let’s measure by success of health care delivery. And no fair inadequately funding health care and then claiming it’s not doing its job. If the added cost to the government of government run health care is less than the current cost of the health insurance industry and we deliver comparable care we are in the win category. If we can do better than that (and I think we can) it’s all gravy.

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55

One of the biggest things terrifying me about brexit is how hard the US government is pressing for the NHS to be opened up

I don’t have a source but somewhere I read that too.

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59

It’s things like this

and this

which just keeps on rumbling along.

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60

Will read later. Already gives me the creeps.

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61

Which, incidentally, is why there is a waiting list. The US likes to talk about how more universal systems ration health care, but the reality is that physical surgical space and qualified surgeons are a finite resource no matter what country you are in. The question is how those resources are rationed. In single payer or other countries where coverage is universal, it’s based on assessed urgency of need. In the US it’s based on ability to pay.

I much prefer the former, even if it means that I have to deal with a waiting list (which even happens in the latter).

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Nice follow up comment. Thanks. Yes, what you wrote about limited resources is exactly what happens. And I agree, would rather I wait because of limited resources rather than the CEO of HealthCareCorp needs a $5,000,000 bonus.

Also, if you have the resources, you can go private – something that the anti-universal-coverage people seem to forget, or seem to think that if we have universal coverage, then somehow, private healthcare will somehow be illegal. Which, of course, it won’t be.

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64

If there’s one silver lining, at least the United States serves as an example of how much worse things would be without socialized medicine to the developed countries who have it.

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Here’s one source for the whole “some people want the NHS to be more like the US”


From Jeremy Hunt, the walking spoonerism.

Personally I was radicalised by the Us healthcare system after I had appendicitis.
Because I live in the UK, the NHS took care of me, and it cost me £0. Then I had a look at what it would cost if I lived in the US and my appendix tried to kill me.

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66

Yup, similar here. Not American either but I can’t remember how long ago it was I became aware of the systemic horror that, I dunno, somehow seems less visible up-close? I’ve always wondered how those decades of hospital TV shows - ER, Elsewhere, Dougie Howser, Scrubs - sit with the general populace when, as I understand it, the shiny, clean high-tech private rooms depicted therein are (I could be wrong?) as remote from most Americans’ lives as the moon.

It’s kinda like people treating the environmental crisis as some fresh and pressing concern… I mean, heck, Marvin Gaye was singing about it in 1971. This is not news!

One other thing that always gloomily amuse-depresses me is when reformers point to European systems as shining paragons to aspire to - and you definitely should! - but having been treated, or had family treated, in various EU countries, I should warn that hospital care here can often be slow, scary, intimidating, mismanaged etc… but it’s still a million times better than some of the horror stories in this thread.

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It cost me more than money.

23 years ago, I’d had appendicitis 3 times already, all misdiagnosed as food poisoning. The fourth time, I was two weeks away from my insurance becoming valid. Four days into it, I couldn’t take it any more, and checked into a hospital further away for an emergency appendectomy.
Of course, I had to file for bankruptcy soon after – but the real kicker was being shamed in front of college friends by the attending doctor’s nurse/receptionist’s son for “skipping out on the bill”.

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I want to add fuel to the American fire here. I grew up there.

A friend of mine here in the UK was just released after treatment for bowel cancer. He didn’t pay a penny.

My daughter badly sprained her leg recently. A&E, consultant (very senior specialist) within 18 hours, follow-up this week with the same guy (he is US trained, btw, a New Yorker - although born and bred in Asia). No personal cost.

I could go on, obviously.

The hospitals aren’t pretty, and we have our issues, simple things like parking is a nightmare, and you risk MRSA in any hospital.

But when I’m in these hospitals, there are rich, poor, dumb, bright, purple people, green people and so on.

Everyone gets the same treatment. Private is faster, but for life or limb critical urgency, the National Health Service is the same speed, and the same doctors.

Insurance is, always has been, and always will be, a scam. I carry private insurance here as a backstop to my kids developing something rare that needs treatment in Tokyo, or NYC, or Zurich. About $5,000 a year.

But you cannot pay a company money and expect it to work like children’s promises. They must make a profit, and must show growth and increased profit, and the simple logic is that the millions of people paying in are the source of the revenue, and their treatment is the cost. Jacking prices up loses business (unless of course you all do it together …), so reducing cost is the Executive Medal Winner.

I don’t have a solution. But fuck, looking at the USA, I feel bad and myself cheated of the promise conveyed by my time there.

America is not meant to be a shithole.

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