The realities of socialized health care: share your experiences

[shredfreak]

reading about healthcare in the usa is just sad.

Last trip to the hospital i payed about 700$ total (give or take with the conversion rate),
Wich was tendonitis in the left shoulder (as a bonus i got artrose in the right joint for free...):
2 appointments with a specialst
2 examinations (mri scan & ct scan + contrast injection)
1 month of fysiotherapy treatment 2 days a week.

I should get that back at some point in the future since legally it's still listed as assault, although it's taking them painfully slow to be honest.

As for healthcare ensurance its a yearly fee of 50€. A large part is already getting deducted from my paycheck however & my employer pays a part aswell for that (wich is why employmentcost is hotly debated over here).

Im pretty safe to say that i pay around 800$ a month to taxes that get deducted already from my paycheck. Wich is the not so pretty side of the coin.

The pretty side is:
lots cheaper healthcare & some procedures are stupidly cheap (but only if they are deemed needed). My girlfriends breast reduction only cost her 50$ for example (yes they were that big...), cancer treatment is also a world apart from usa standards.

Education. Bachelor degree = 3 years = 3 * 550 = 1650€. for a master that would be 2200€.

Most people don't realize how money gets sourced from that but the darker side of the coin here is quite desastrous in some cases making it that bigger companies simply move to the lower wage countries.

The system we got does lead to a whole other set of problems though wich most people don't consider.

 

[MrWulf]

Reading this thread reminded me of an experience while i was in California with my brother. He had pain in his eyes due to dirty lens in the middle of the night, so I called up ambulance for him. I wasnt aware how absolutely .... the US health care system was until we were hit with 2k worth of bills for what essentially a 10 minute drive to the nearest hospital. And thats not to mention all the trips to an eye specialist afterward either. The worst part? The international student insurance we bought earlier in the year for him was a waste of money because the insurer did not want to pay for it.

When Americans complains about taxes and big government but then moans about falling infrastructure and expensice healthcare, I can only shake my head. You guys' idea of freedom is basically having your cake and eat it all at the same time.

 

[bostjan]

As I said before, I believe the crux of the problem in the USA is corruption in the insurance industry. As your anecdote pointed out, insurance companies deny valid claims. I do not believe that they do this to avoid fraud as much as they do it to make more money. This goes for health insurance, car insurance, flood insurance, etc. There are still hundreds of appeals in the works from claims that were denied after hurricane katrina, as if insurance companies are saying that there is some interpretation going on regarding where the hurricane caused damage and did not cause damage, on a large scale, even a decade after it occurred. I don't think that's right.

 

[Andromalia]

You guys' idea of freedom is basically having your cake and eat it all at the same time.

I'd add to this that this is usually someone else's cake too.

 

[vilk]

My idea of freedom is we all bake a massive cake so enormous that none of us could ever possibly finish it and then we all can eat as much as we want but try to help each other understand that there's no value in stuffing yourself.

 

[bostjan]

I like that analogy, so I'll roll with it:

Republican: We use our military to take the cake, then the richest people get to eat it.
Democrat: Let's borrow some cake and eat it now, then bake a cake later to pay it back.
Socialist: What's my cake is my cake and what's your cake is my cake, too.
Tea Party: The tax on cake is too high!!!!one!!!
Libertarian: Don't tell me how to eat my cake!
Green Party: Cake is too fattening and bad for consumers! We should grow kale instead.
Pirate Party: Arrr, take yer own cake if ye dare!
Communist Party: All cake is created equal. Except fearless leader's cake, less equal, therefore, fearless leader may eat much more cake.
Progressive Party: Poor people don't get enough cake.
Silly Party: Kake! F'tang f'tang f'tang!

 

[HeavyMetal4Ever]

My last significant medical procedure was having two wisdom teeth removed. It ended up costing me about $150AUD and the dentist was excellent.

 

[estabon37]

In your mind, where did the funds come from that paid for those procedures?

Answer: all taxpayers, with 80% of the funds scraped off for "administration."

You ALL paid so much more for those procedures than you will ever realize.

In the short term, governments like the US just print more money. Longterm, many people believe we are all fracked.



Couple that with the fact that EVERYONE will eventually need life-saving medicine... and there is NO WAY this ponzi scheme will work out.

You either need to reduce care cost overhead, or reduce doctor compensation in the long run for it to pan out.

Just shifting huge costs to the taxpayer saves NOTHING. You will see.

It's really as if you're not reading what people are writing about their knowledge and experiences. Sticking insulting names on social services and constantly muttering "wait and see" lends no credibility to an argument that is already disturbingly low on credibility.

Check out the numbers according to the World Health Organisation: http://www.who.int/mediacentre/factsheets/fs319/en/. For those that don't ever click links, here are the first five figures:

Total global expenditure for health per person per year (US$ 948)
Country with highest total spending per person per year on health United States (US$ 8362)
Country with lowest total spending per person per year on health Eritrea (US$ 12)
Country with highest government spending per person per year on health Luxembourg (US$ 6906)
Country with lowest government spending per person per year on health Myanmar (US$ 2)

The country with the highest government spending per person per year pays over $1000 less than the US. Furthermore, Fig 2 shows that the impact on health outcomes by amount of money spent stops increasing drastically at around the $1500 mark, so spending over $8000 is insanity.

Go to the OECD's 'Better Life Index' page, prioritise 'health' on the sliders, and then sort by ranking. US citizens aren't concerned about their health by a long shot, they're just paying an abnormal price to stay as healthy as some of the most 'socialist' countries on earth. So, what gives? Bring the 'health' slider down and push the 'income' slider up, and you'll see that US citizens, unlike almost every over member of the OECD, prioritises income over health, and prioritises income over every other standard of living.

In other countries we are essentially happy to pay more in taxes to secure the health and wellbeing of our fellow citizens without judging them. This philosophy has not ruined civilisation for us, and is somehow more cost effective than US's system by, on average, a factor of 8:1. When the damage caused by corruption in the private insurance industry in the US far outstrips the corruption in the public health industries in other nations, it's either ignorance or belligerence to claim that ...

Just shifting huge costs to the taxpayer saves NOTHING. You will see.

... without making even a half-arsed attempt at supporting the claim, particularly when the whole world's evidence points in the opposite direction.

So, which is it? Ignorance, belligerence, or both?

 

[vilk]

fckn pwned

 

[celticelk]

@estabon37: Well said. All the likes for you.

 

[bostjan]

It's really as if you're not reading what people are writing about their knowledge and experiences. Sticking insulting names on social services and constantly muttering "wait and see" lends no credibility to an argument that is already disturbingly low on credibility.

Check out the numbers according to the World Health Organisation: http://www.who.int/mediacentre/factsheets/fs319/en/. For those that don't ever click links, here are the first five figures:

Total global expenditure for health per person per year (US$ 948)
Country with highest total spending per person per year on health United States (US$ 8362)
Country with lowest total spending per person per year on health Eritrea (US$ 12)
Country with highest government spending per person per year on health Luxembourg (US$ 6906)
Country with lowest government spending per person per year on health Myanmar (US$ 2)

The country with the highest government spending per person per year pays over $1000 less than the US. Furthermore, Fig 2 shows that the impact on health outcomes by amount of money spent stops increasing drastically at around the $1500 mark, so spending over $8000 is insanity.

Go to the OECD's 'Better Life Index' page, prioritise 'health' on the sliders, and then sort by ranking. US citizens aren't concerned about their health by a long shot, they're just paying an abnormal price to stay as healthy as some of the most 'socialist' countries on earth. So, what gives? Bring the 'health' slider down and push the 'income' slider up, and you'll see that US citizens, unlike almost every over member of the OECD, prioritises income over health, and prioritises income over every other standard of living.

In other countries we are essentially happy to pay more in taxes to secure the health and wellbeing of our fellow citizens without judging them. This philosophy has not ruined civilisation for us, and is somehow more cost effective than US's system by, on average, a factor of 8:1. When the damage caused by corruption in the private insurance industry in the US far outstrips the corruption in the public health industries in other nations, it's either ignorance or belligerence to claim that ...



... without making even a half-arsed attempt at supporting the claim, particularly when the whole world's evidence points in the opposite direction.

So, which is it? Ignorance, belligerence, or both?

I think it'd be the argument of least resistance to retort to this by pointing out that most countries without socialized medicine (ignoring the fact that these are 3rd world countries) have the lowest per capita health cost. So, I would merely warn that correlation implying causation could be a weak argument in this case.

I am firmly of the belief that the US healthcare system could benefit from just about any kind of reform other than allowing it to descend into anarchy, as the Republican party seems to want to do. Maybe it's not fair to assume that's what they want, but, other than repealing Obama's reforms, I haven't heard a single detail on how they'd handle it.

In the USA, we have gotten stupid, as a mass. I don't mean to offend anyone individually by stating this, but it's true that we tend to vote for really stupid things and allow congress to vote for stupid things without repercussions. For example: the Iraq war was a stupid thing, but the majority here supported it. Bush even got "re-"elected because of it (Bush's first term was a result of being appointed PotUS by the SCotUS; his second term was by election). Repealing Obamacare, at this point in time, is a really stupid thing, yet, I fear a majority of Americans are for it. Hilary vs Trump presidential election..., well, you get the point. That's democracy, though, when the majority of people vote stupidly, everyone suffers...

Back to the corruption in US healthcare - why is healthcare here more expensive than in other countries? Is it better healthcare? I think that maybe one could argue that our top tier healthcare is the best in the world, but in reality, it's probably not, let alone, I don't think anyone would argue that the USA's average level healthcare is better than any other country on Earth. Our cost of living in the USA is certainly not the highest, nor is our quality of living. Ahh, but what about our medical innovation? It is very high by global standards, but it is also very highly subsidized by the government already, so that does not explain, rightly, why healthcare costs here are so damn high. I boil it down to corruption, by process of elimination, reinforced by my personal experiences with both healthcare workers in daily life and experiences dealing with the US healthcare system. A bureaucracy is an inefficient way to function, yet healthcare systems here seem extremely efficient when it comes to generating revenue, which is counter to the idea that simply bureaucracy in and of itself is to blame.

TL;DR - I agree with your conclusions, but not with your argument.

 

[celticelk]

I think it'd be the argument of least resistance to retort to this by pointing out that most countries without socialized medicine (ignoring the fact that these are 3rd world countries) have the lowest per capita health cost. So, I would merely warn that correlation implying causation could be a weak argument in this case.

A better comparison comes from further down the table: the average per-capita yearly health expenditure in the combined OECD member nations (http://www.oecd.org/about/membersandpartners/list-oecd-member-countries.htm) is $4380. Given that there are $30 member nations, and the annual US expenditure is $8362 per capita, you can back-calculate that the OECD average without including the US is about $4243 per capita per year. That's a pretty stark difference.

 

[vansinn]

We used to have very well working public health care here in Denmark.
We still per-definition have it this way; however, it has become halfways useless.

There are pros and cons to both mechanisms.
In general, I'd say any country should have a fully functional public health care system.
However, this is only possible as long as the country's state avoids too much privatization.
As soon as this dreadful mechanism starts rolling in, banks and, in this case, Big Pharma, will pervert the health care system based on desired revenues from drugs.
Doctors will get additional revenues based on selling pills.
I find it scary looking at how many are on prescribed morphines in the US, and it's being slowly rolled out here too.

An example of how our system has become much less useful than it used to be:
I had severe pain in my back. Doc send me to X-ray (which I knew wouldn't reveal anything). X pics looked ok'ish to the doc, that is, he said "you have a fine back for a man in your age (58 at the time). There is a little bending here, but that's no problem".
No problem? This is what I paid loads of money for in private chiropractics to fix (such damages never sully goes away); and what prevented me from entering military back then.
The doc ended up writing down address and phone for a shrink..

What I might see as ideal would be a well functioning public system, combined with the ability to have private treatment - but tax deductable.
I do realize that some/many may say that this will only benefit the ones who can afford the private mechanism.
But this I, at least partially, disagrees with. simply because those that do go private won't take up space in the public queue, and those who cannot afford private as such ought to get in faster.

There's of course a problem with this: The private sector tends to pay better salaries than the public system, so guess which sector gets the best doctors and such..?

There's another problem with privatization: Accountability and proper, unbiased research and documentation.
But hell, in some places, even the university research is biased due to Big Pharma lobbying and fundings..

Then there's the so-called alternative medicine and treatment sector.
I have some 25-30 years of experience with using this, incl having taken several training courses in various disciplines.
If I hadn't used alternative, I have no idea in which state I'd be in today..

This sector used to be laughed at here in Denmark, but over the years, despite resistance against it from the public old-school doctors, it has grown a lot, and is now largely covered by minimal requirement to how these educations are arranged.
I find this really good, as it adds some recognizable common standards to such treatments, and serves to de-mystify what it's really about.

 

[flint757]

The biggest medical problem in the US IMO is pharmaceuticals for sure. They find loop holes to keep generics from entering the marketplace, and no innovation has really occurred for this exact reason in quite some time. Many companies have slashed their R&D departments. Couple that with the bloat from insurance and you have really expensive healthcare. It doesn't help that lobbyist keep getting our politicians to right ....ty bills that pad their bottom line.

Frankly, the insurance game is ridiculous. My current insurance plan is pretty good, but a few people on the plan have had serious health issues which has made our particular portfolio for our insurance company more expensive. Mind you, insurance companies have tons of clients so realistically they could offset each other in a larger pool. So anyhow, now the company is either going to increase our monthly payment by over $500 or increase the deductible from $1000 per person and $2000 for family to $3000 per person and $9000 per family (for my family; the more people on your plan it just keeps adding up instead of stopping at 2). I can't afford either of those option, especially if I needed medical care, which means I likely just won't go to the doctor or get treatments done when I need them. I need a $6000 eye surgery done at some point and with the new plan I'll have to pay almost all of it myself (insurance won't cover part of it to begin with). I don't have that kind of cash lying around and I already have a mountain of debt from student loans.

The biggest failure of the ACA is how it went about making sure everyone is insured. Being insured isn't enough if people can't afford the services offered due to high prices and high deductibles. This may have changed, but getting on a different plan was pretty much impossible if your company offered one even if it sucked. Obama's optimistic speeches about the number of people insured and number of people off unemployment are about as meaningless as when Clinton talked about the number of people he got off welfare. People with insurance still can't afford medical care, people are working lower paid jobs and in some cases less hours or not looking anymore, and the people Clinton kicked off welfare were still in fact poor once he removed them from the program.

[EDIT]

To bring it back to my original point, because a few people actually needed to use their medical care they're essentially increasing the prices so high that fewer people will use it moving forward (essentially what the meeting sounded like). This is how insurance works in the US and it is why insurance IMO is not the answer to our problems. It's like when you get in a car accident and then your plan goes up. They don't want you to use your insurance, but they want you to pay your monthly premiums nonetheless. It's a joke. /rant

 

[estabon37]

TL;DR - I agree with your conclusions, but not with your argument.

My argument (at least in my head) was more about people dismissing the systems of a couple of dozen countries without attempting to support the dismissal with evidence or logic. I'll admit upfront that the figures I found were brought together inside of 10 minutes; but that's kind of my point again. I at least spent 10 minutes looking around to see whether or not what I was planning to say could be supported.

It's exactly what you did when you wrote this:

Back to the corruption in US healthcare - why is healthcare here more expensive than in other countries? Is it better healthcare? I think that maybe one could argue that our top tier healthcare is the best in the world, but in reality, it's probably not, let alone, I don't think anyone would argue that the USA's average level healthcare is better than any other country on Earth. Our cost of living in the USA is certainly not the highest, nor is our quality of living. Ahh, but what about our medical innovation? It is very high by global standards, but it is also very highly subsidized by the government already, so that does not explain, rightly, why healthcare costs here are so damn high. I boil it down to corruption, by process of elimination, reinforced by my personal experiences with both healthcare workers in daily life and experiences dealing with the US healthcare system. A bureaucracy is an inefficient way to function, yet healthcare systems here seem extremely efficient when it comes to generating revenue, which is counter to the idea that simply bureaucracy in and of itself is to blame.

That's the kind of thing I'm trying to draw out of people that insist on using catchphrases and insults instead of their brains. You've made a better argument than I did (in my opinion), using different premises and a different method to draw your own conclusion. Awesome!

Celticelk also used my sources better than I did, to make my argument better than I did:

A better comparison comes from further down the table: the average per-capita yearly health expenditure in the combined OECD member nations (http://www.oecd.org/about/membersandpartners/list-oecd-member-countries.htm) is $4380. Given that there are $30 member nations, and the annual US expenditure is $8362 per capita, you can back-calculate that the OECD average without including the US is about $4243 per capita per year. That's a pretty stark difference.

Awesome again!

If we don't support our claims, the conversation goes nowhere, and the opportunity to take action to support real solutions evaporates entirely. I feel a little bad for picking on Forsaggio in particular, but if you really do believe in a certain stance on an issue, you only harm it by spewing unsupported nonsense. I'm more than happy to have people tell me I'm wrong, but they at least need to tell me WHY, and back up the details of their argument. What I posted might have been inflammatory, but it at least progresses the conversation.

EDIT: The lack of a 'like' button really forces us to go to more trouble than necessary to say to someone "I like what you got!" (as opposed to "Show me what you got!"). Shit's fucked, yo.

 

[narad]

As an American who has lived the past many years in Australia and England, I have mixed thoughts on this. When I think of my US healthcare experience, the memories that come to mind are mostly of sitting in waiting lines. I never had any medical conditions that were too serious, but it was pretty apparent that most of the medical clinics I visited in upstate New York were way overbooked -- waiting rooms with like 35 patients sitting around to see 2 doctors. Awful.

In London things have been much better. When I've been sick enough to need to visit a hospital, the wait times have been reasonable (45 mins?) and the service very comprehensive: doctor + x-rays + antibiotics + follow-up. When they suggested x-ray some involuntary twinge in the core American part of me shuddered, ".... - does my insurer cover that? what will the co-pay be?" before snapping back into reality. It's great to not think about these things, and to just be handed antibiotics on my way out as casually as possible - no pharmacy stop or prescription involved.

However, when .... really hits the fan, when you need emergency life-saving surgery or cancer treatment, I'd much rather be in the US. The specialists in the US and the equipment they have access to just seem to be a notch above. This is quite anecdotal but I work in research wings of universities and what's going on at Johns Hopkins and Stanford just seems to blow the water out of what's going on at Cambridge/Oxford/Imperial.

Obvious we can have both though -- universal healthcare and more research funding to top university hospitals.

 

[flint757]

However, when .... really hits the fan, when you need emergency life-saving surgery or cancer treatment, I'd much rather be in the US. The specialists in the US and the equipment they have access to just seem to be a notch above. This is quite anecdotal but I work in research wings of universities and what's going on at Johns Hopkins and Stanford just seems to blow the water out of what's going on at Cambridge/Oxford/Imperial.

You won't be feeling that way when you get the bill.

I'd personally rather get just below amazing service for next to nothing than to get potentially better service, because medical care quality varies widely across the US, that saves my life, but I'll be paying it off until the day I die (or your family will).

 

[FEcorvus]

I'm not going to get in on this argument, but I would like to put up this article from Forbes
http://www.forbes.com/sites/rickung...-costs-are-so-artificially-high/#3f0d36605cc4

basically for those who don't want to read it, this source points to the prices of American Healthcare being due to hospitals overcharging insurance companies to make up the losses from people who can't pay for treatment and then the insurances propogating this as it leads to higher premiums and thus more profit for them and then the whole process snowballing until it got where it is now

 

[narad]

You won't be feeling that way when you get the bill.

I'd personally rather get just below amazing service for next to nothing than to get potentially better service, because medical care quality varies widely across the US, that saves my life, but I'll be paying it off until the day I die (or your family will).

I think they're pretty good with that kind of stuff? I never thought of my father as having particularly good insurance -- it was always a pain for me personally to do anything under his coverage -- but his heart bypass operation was covered all but a couple thousand. Similarly my friend's mom had a rather serious cancer and about a year's worth of treatment and IIRC that was about $8k out of pocket for almost $200k "worth" of treatment.

To continue with the anecdotes though, there was a kid in my high school whose parents didn't have insurance or didn't have a good plan for high cost treatment, and the family was forced to do these fundraiser dinners to cover the treatments. Pretty sure he died. And I can understand how it happens when you're a young dad, and your kids or teenagers and still quite healthy, maybe it seems safe to take on a more practical insurance policy.

Too many details unknown but I don't like the thought of considering a country "first world", let alone "the greatest country in the world", but young guys can still wind up not getting first rate treatment for fatal diseases. You have to give props to St. Jude and similar hospitals that won't turn away children with cancer, regardless of the insurance situation, but really the entire country should have similar values.

 

[flint757]

Agreed, but even if you end up only paying 3-10k for treatment that is a huge chunk of many Americans annual salary. More importantly, people who can't afford to pay their premiums or deductibles end up forgoing tests that could catch things like cancer because it's the difference between being able to pay rent and put food on the table. Sometimes that gamble works out and sometimes people end up dying.

I've had a wide array of tests done over the years and the cheapest one, aside from blood work, was about $600 (mostly CAT scans and MRI's which fell between $1000-$2000). When I needed a bone density scan and DEXA scan done last year it cost me $2800. It took care of my deductible, but I had to pay for it all entirely out of pocket and if I was having to choose between rent and those tests I wouldn't have gotten the tests done.

We shouldn't have to make decisions like that in regards to our health is all I'm saying and insurance offers no real solution to solve it.