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Stephanos
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since 2000-07-31
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Statesboro, GA, USA

0 posted 2007-07-21 08:51 PM


Okay,

I'm a Registered Nurse.  So it's pretty obvious why Michael Moore's new movie would interest me, since it promotes socialistic medicine, or health-care reform if you want to drop the stigma of "socialism".  (Though that's what it is.  Any doubts are allayed after seeing Michael gaze admiringly at a statue of Karl Marx in the movie).  This of course would affect things dramatically, for me, and for many many others.  The question is still whether it would be positive or negative.  


Believe it or not I am open to many of Moore's observances, and ideas.  However this one thing irks me, and I want your opinion (especially if you are from Canada, Britain, or France).  Moore's descriptions of less-than-ethical Health Insurance companies are probably accurate, and I could feel that it was probably close to the mark.  But his depiction of socialistic healthcare in Canada, England, and France, seemed too good to be true.  The people he interviewed spoke no criticism in a kind of utopian affirmation of what Michael was trying to prove.  But frankly, to me, they looked like actors in those moments reciting lines, rather than the documented.  


My question is:  What is the downside (really) of healthcare in Cananda, England, or France.  Is everything free?  Are the medical services really up to par?  Are the healthcare workers all rich and happy?  Does everyone have exactly what they want, even picking their own doctors as easy as picking a sweater from a clothing rack?  No one can be as falsely chipper and content as those in Michael Moore's flick.  Tell me the truth ... the good, the bad, and the sicko.  


Stephen    

© Copyright 2007 Stephen Douglas Jones - All Rights Reserved
Not A Poet
Member Elite
since 1999-11-03
Posts 3885
Oklahoma, USA
1 posted 2007-07-21 11:33 PM


Well, for starters, sicko pretty well describes Michael Moore

Grinch
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since 2005-12-31
Posts 2929
Whoville
2 posted 2007-07-22 02:03 PM


I’m British and have recently had first hand experience of the healthcare system, I haven’t seen Moore’s film though so I’m not sure whether my comments confirm or contradict what he was saying, you’ll have to be the judge.

The first point of contact with healthcare in the UK is generally with your GP (general practitioner). In most cases your GP is the same as your parents, you get added to his list of patients automatically at birth and he gets paid based on the number of patients he has from a central government pot.

You can change your GP at any time, all you need to do is ask to be added to the list of the new GP and all your records are sent from one to the other.

Making an appointment to see your GP is easy, mine for instance guarantees an appointment slot the same day as long as you call before 08:30. GP’s deal with all the standard stuff like mumps, measles, coughs, colds, flu etc. Most of them also undertake minor procedures that don’t require a general anaesthetic. GP’s also make house calls, again mine guarantees a call the same day if you book before 08:30.

If you have a cough or cold the GP will prescribe medication, unless you’re exempt (pregnant, unemployed or receiving state benefit, on a low income, under sixteen or a student) you pay a maximum of £7.50 for any prescribed drug. If you’re on long term medication (like me ) but aren’t exempt from prescription charges you can pay a one off payment (£90) that covers you for 12 months, you get a nifty little card that you flash at the pharmacist instead of paying.

If you have an accident or are suddenly taken ill you can dial 999 and an ambulance will be with you ASAP, the maximum response time in my area is 15 minutes (the last time I called one it got to me in 10). The ambulance will take you to the nearest Accident and Emergency Hospital free of charge, the A&E run a triage system, if you are really ill you jump the queue if not you wait your turn. When I went to A&E by ambulance a month ago a consultant met the paramedics at the door, when I needed 5 stitches in a cut on my hand a couple of years ago I waited an hour.

If your GP can’t fix it and it’s not an emergency you get a referral to a consultant who’s an expert in that particular field, waiting time to see consultants vary again depending on urgency, I’ve seen one in three days and another in three months. Your GP can request that you’re seen as a matter of urgency and they can also short circuit the whole system by admitting you to a local hospital. If you need surgery your name gets added to a waiting list again based on priority.

If you want extra care you can join a private health care system (BUPA’s the biggest in the UK) for an additional monthly payment you get to see the same doctors at the same hospitals, or the same doctor at a different hospital, but you get bumped up the waiting list if you need surgery etc

So how’s it all paid for?

National insurance is deducted from your salary at a fixed percentage by your employer, the more you earn the more you pay. In return the government undertakes to supply every man woman and child with healthcare when and if they require it depending on need.

I think the NHS in the UK is absolutely amazing, the only losers in the system as far as I can see are nurses and trainee doctors who unfortunately work long hours for not enough money.

[This message has been edited by Grinch (07-22-2007 05:29 PM).]

Stephanos
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since 2000-07-31
Posts 3618
Statesboro, GA, USA
3 posted 2007-07-23 04:23 PM


quote:
If you need surgery your name gets added to a waiting list again based on priority.


This is the part I wonder about.  Does one's medical condition influence one's priority status?  In other words, if one has many diagnoses of health problems, will other "healthier" people always get the surgery first?  I have a friend who suggests to me that this is how it is in Canada (though she doesn't live there, and never has under their health care system).  It seems to me that if this is the case, then the ones who really need it don't get it.  Kind of a similar situation to what the U.S. has with Insurance companies not wanting to pay "pre-existing conditions".    


Oh, and in terms of U.S. dollars, how much would say, an R.N. or a Doctor get paid annually?  I'm curious.


Stephen.  

Grinch
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since 2005-12-31
Posts 2929
Whoville
4 posted 2007-07-23 06:19 PM


Stephanos,

quote:
Does one's medical condition influence one's priority status?  In other words, if one has many diagnoses of health problems, will other "healthier" people always get the surgery first?


Yes and no.

If I need an appendectomy I go on a list of people who need the same operation, my ranking on that list is based on three things.

First is the order in which I was added to the list.

If I were added to the list tomorrow and there were 16 people waiting for the same operation I’d be 17th on the list.

The second is the urgency of the procedure as determined by the consultant.

If I were added to the list tomorrow and there were 16 people waiting for the same operation but the consultant decided I needed the operation first I’d be 1st on the list.

The third is whether I paid private medical insurance.

This is where it gets complicated, and where all the confusion starts.

If I paid private medical insurance I’d be added to a separate list of private patients, if the operation was going to be performed by an NHS surgeon at an NHS hospital I might be the only person on the list. However the NHS surgeon might only work on private cases every 2nd Monday of the month and even then NHS cases deemed more urgent take priority.

If however the surgery is going to be performed at a private hospital, with a private surgeon the queues are smaller so the surgery gets done sooner.

This is the big problem with comparing private versus NHS healthcare in the UK, some say private is better but in some cases it simply isn’t. The deciding factor is whether the private healthcare providers have the staff and facilities to undertake the procedure. If they end up effectively hiring the operating theatre and surgeon for X days a month from the NHS the only advantage might be that you get a room to yourself instead of sleeping in a ward with six other patients.

Take me for example, I needed to see a specialist and was put on a NHS list and given an appointment date two weeks later, I enquired about ‘going private’ and was told for $200 I could see the same specialist at his next private surgery. The date of his next surgery turned out to be three weeks later!

As far as salaries go I can only give you rough estimates on the salaries based on a quick scan through some employment sites and data on the net.

A registered nurse can earn between $35,000 and $90,000 a year depending on experience and the field they work in. (I saw an advert for a scrub nurse (?) at $35k and an ICU nurse at 65K.)

UK general practitioners earn, on average, around $212,000 a year according to a report on a recent pay review I saw.

Consultants and surgeons are higher up the food chain probably earning $350,000 with another $100,000 or so for any private work they may undertake.

As far as NHS versus private healthcare goes I’m a firm believer in the NHS system and am quite happy to wait my turn, unless of course whatever ailment I have is potentially life threatening, in which case I’ll stump up the one off fee and go private (as long as it gets me fixed quicker).  



hush
Senior Member
since 2001-05-27
Posts 1653
Ohio, USA
5 posted 2007-07-24 02:15 AM


Hmmm... sounds pretty wonderful to me.

I actually really liked the movie, it echoed a lot of thoughts that I had had for quite some time. Not as keen on the politics that didn't necessarily need to be included... such as the potshots at Bush or the blatant admiration of Hillary Clinton... but the Guantanamo Bay bit was brilliant.

LeeJ
Member Patricius
since 2003-06-19
Posts 13296

6 posted 2007-07-24 10:20 AM


yes, it sounds great, but I'd like to hear from others who are actually using it and their pro's and con's.

To all of you who have offered your opinions and are using it...thank you...this is what we must do...and before we vote on socialized medicine, we have to find out what they're contract covers...we can't vote for something before we know what it entails and what it doesn't entail....

I mean, how ridiculous to walk up to a machine and vote yes for a coverage that we haven't had outlined for us?  

That is my concern with all of this...research first...

Local Rebel
Member Ascendant
since 1999-12-21
Posts 5767
Southern Abstentia
7 posted 2007-07-24 10:34 PM


So Lee-- have you read the fine print on your private insurance policy?

Speaking as one who is using the for-profit health care system -- it's at least as horrible as Grinch's description -- with the added ingredient of going bankrupt in the process!

Oh yeah -- and -- I waited for 2 months to see a neurologist -- saw him for 15 minutes -- and I get to see him again in another three months!  Oh, and, I still don't even have a diagnosis -- they're just throwing pharmaceuticals at me until I can see another specialist -- let's see -- how long have I been waiting to see him? I've lost track now.

Stephanos
Deputy Moderator 1 Tour
Member Elite
since 2000-07-31
Posts 3618
Statesboro, GA, USA
8 posted 2007-07-24 11:51 PM


Reb, no one is saying the U.S. system is great.  The question is, are other systems really better?  That, being a very subjective question, may take more than a few choice opinions (as given in MM's movie).  Come on Canadians, French, and English.  Tell us your stories.

I mean what kind of response would someone get if they took Moore's approach:

"Email with your horror stories about socialized medicine"

  
Stephen.

hush
Senior Member
since 2001-05-27
Posts 1653
Ohio, USA
9 posted 2007-07-24 11:55 PM


I don't think any candidate is just going to walk up to a microphone, say "socialized medicine, vote yes" and walk away without elaboration.

I just think it's wrong that we live in a society where, if you don't have insurance, you will simply have to go without healthcare (or food, or shelter) because you can't pay. My fiancee doesn't have health insurance, and he makes enough that medicaid wouldn't really help him much, what with the spend-downs and all... You know, last I checked, toget complete Medicaid coverage, you can only make 400 and some odd dollars a month. Ever tried to live on that? I have never lived on my own and made that little, and even when I was making about 600 bucks a month and splitting rent/bills with my boyfriend, who was making about the same... we lived in a crappy apartment, drove crappy cars, ate Ramen noodles, and we were still broke! I can't imagine having to pay a doctor's, or god forbid, a hospital bill on that... and if you make more than Medicaid's set amount, you have to spend X amount on healthcare before Medicad kicks in. So, let's say you make $700 per month. And, just for example, that the Medicaid set amount is $450. Your spendown would be $250- you have to spend $250 on medical bills per month before medicaid even kicks in. That's a lot of money.

So.. I guess I just hope my fiancee doesn't get sick... especially since he doesn't have a doctor (remember, he doesn't have $100 extra bucks lying around just to make an appointment to say to a Dr. "Hi, you're my new PCP!") and even if I could convince him to go to a doctor if he was sick (which he wouldn't, partly because of money and partly because he's a man), he wouldn't be able to because there are waiting lists for new patients. So he would simply have to, if sick enough, go to the ER. Which would easily cost him about 2 grand, since the itemized list I got from my ER trip was about that much. And I didn't even get any IV's or X-Rays... just some labs, one med, and some Vicodin to take home.

$2,000 is a lot of money... even if you aren't poor.

Stephanos
Deputy Moderator 1 Tour
Member Elite
since 2000-07-31
Posts 3618
Statesboro, GA, USA
10 posted 2007-07-24 11:58 PM


quote:
I just think it's wrong that we live in a society where, if you don't have insurance, you will simply have to go without healthcare (or food, or shelter) because you can't pay.


Hush, since I've been an employee in health care, rarely (if ever) have I seen this.  Doctors don't turn people away when they appear at the Emergency Room, nor do consulted surgeons turn people away.  They (even if begrudgingly) absorb the cost.  It's understood that non-insured patients don't really pay (anything substantial).


Stephen.

[This message has been edited by Stephanos (07-25-2007 12:00 AM).]

Ron
Administrator
Member Rara Avis
since 1999-05-19
Posts 8669
Michigan, US
11 posted 2007-07-25 11:03 AM


quote:
I just think it's wrong that we live in a society where, if you don't have insurance, you will simply have to go without healthcare (or food, or shelter) because you can't pay.

And see, to me, the tragedy is that we live in a society where people who can pay feel they shouldn't have to. Why is it almost everyone seems to believe that medical services should be essentially free?

hush
Senior Member
since 2001-05-27
Posts 1653
Ohio, USA
12 posted 2007-07-25 11:53 AM


Stephen, that's not what I mean. Of course, any hospital will treat an emergency condition... but even if the hospital absorbs the cost (sometimes they do, sometimes they don't), how does this person pay for their follow-up appointments? Their prescription meds? What if they broke their leg but their job doesn't pay disability and they can't afford to take the time off work? There are avenues to seek financial help- but the process is long and complicated, and at the end, someone can still tell you you are denied.

Ron-

What is your definition of someone who can pay? I have paid for doctor's appointments before, when my father's insurance quit paying for them altogether and left it as the patient's responsibility. And while I wasn't in the poorhouse, I certainly wasn't swimming in money, either- trying to juggle work and school. If I was sick, i would often put off going to see the doctor... because I didn't have an extra $100. And I had insurance!

I don't feel that healthcare should be free, per se- I think it should come out of taxes the same way we pay our police and firefighters. After all- does a cop ask you how you're going to pay when he comes to investigate a prowler? Should he? Is it right or wrong to arrange our police and firefighters and city workers the way we do- paid with taxes- or should it all be private pay?

I think that a person has a right to healthcare the same way we have a right to the protection offered by police and firefighters.

Susan Caldwell
Member Rara Avis
since 2002-12-27
Posts 8348
Florida
13 posted 2007-07-25 12:22 PM


I have a good job and good insurance (that I pay for) and I am grateful I do.  With that said here is my little story:

I had surgery, the doctor had an “accident” (not intentional) and left me with damage that took a minor surgery to put in a stint that was in for 3 months, a catheter I wore for 5-6 weeks, and finally when all that failed to allow the injury to heal on it’s on, a major surgery was done to go in and repair the injury manually.  This was done  by rearranging a particular organ so that the cut, and now shorter tube, would reach so it could be reconnected in a nice new spot.  
My insurance paid for roughly 98% of all the additional medical, lab, and drugs.  I was left with bills totaling approx. $1500.00, a sick leave balance of -105 hrs and a annual leave balance of over -200 hrs.  Yes, negative.  I was allowed to use advanced sick and annual leave.  I also had approx. 16 hours of leave without pay.  
Although I am lucky to have good insurance that paid most of my medical cost and the option of advanced leave, there is still a considerable cost to me for something that wasn’t my fault.  
To my understanding when the state of Florida passed the law putting a cap on malpractice suits there was another clause in there somewhere that also, essentially said, if a surgeon cause’s injury that another surgeon can fix and there is no permanent damage, you may not sue for a dime.  Not even the cost due to lost work time, or medical bills.  Nada.  That is what two attorneys told me.  Another attorney said I may find an attorney to take my case but only if I paid up front and that amount would probably be more than I received if I were to win.
I just wanted to recoup my losses, nothing more.  If this same doctor had hit me in his car, his insurance would have paid for my expenses due to the accident being his fault.  Why doesn’t it work that way for doctors?  Accidents happen, I understand that, but why should my insurance and I pay?  
And how does my insurance recoup?  They raise their rates, lower their coverage.  
The current system is in need of some revamping in my opinion.
And I don’t think it has to be a black or white solution.  Maybe the solution is a little of this and a little of that.  

"too bad ignorance isn't painful"
~Unknown~

Grinch
Member Elite
since 2005-12-31
Posts 2929
Whoville
14 posted 2007-07-25 02:12 PM



quote:
Why is it almost everyone seems to believe that medical services should be essentially free?


It always amuses me Ron when people talk about ‘free’ medical services, the UK system isn’t free you just don’t pay at the point you receive the service.

I pay $553 dollars a month in National Insurance Contributions, in exchange the Government agrees to supply me full healthcare, a state pension when I retire and state benefit if I’m unemployed. My 20-year-old son pays $96 dollars a month for the same while my wife pays $120 dollars (which is about the average).

Everyone pays a percentage of his or her earnings for exactly the same service whether they use that service or not and though there’s no payment when you do need to use the service it’s definitely not free.

I’m quite happy to pay my national insurance contributions, it gives me peace of mind in that I know I don’t have to worry about medical bills if I’m sick, that I’ll get a benefit payment to support me if I’m ever unemployed and I’ll have a pension (however meagre) when I get old(er).

An added benefit is that I know that I’m helping (by contributing more because I earn more) to ensure that everyone gets exactly the same regardless of the situation they find themselves in.

Not A Poet
Member Elite
since 1999-11-03
Posts 3885
Oklahoma, USA
15 posted 2007-07-25 02:39 PM


Thank you for sharing Grinch. It is enlightening to hear from one who actually has first hand experience with the system. I'm afraid what we hear from the mass media is subject to spin in one form or another. We do get some real horror stories from Canada but I have not heard much about England or France. BTW, I'm also glad to hear that it is working well for you.

It is also enlightening to understand that you do pay for the service through essentially a government operated insurance program. Actually, it sounds very similar to our privately run system, including the approximate cost. The main difference appears to be that there are people in the U.S. who cannot get insurance due to health history or other problems, not the least of which may be the cost.

The main problem I can see from your description is the government part. Governments in general, and ours in particular, have proven many times over that they are the ultimate examples of inefficiency. I suspect a private insurance company could provide the same healthcare for half the cost. I know, you can point out the greed of private enterprise as it seeks its profits. But don't think even briefly that politicians are any less greedy. To the contrary, they have a proven ability to all but suck the life out of the poor happless taxpayer.

Grinch
Member Elite
since 2005-12-31
Posts 2929
Whoville
16 posted 2007-07-25 06:56 PM



Pete,

Both systems have their good and bad points and yes they’re almost identical apart from over here those in employment pay and everybody gets the service and National insurance is compulsory for those that qualify.

The UK model wouldn’t go down well in the US though for one very good reason I haven’t mentioned.

Every employee pays national insurance and every employer when they deduct it from your salary has to cough up the same amount and hand it over to the treasury

Can you imagine how corporate America would react to that?


Local Rebel
Member Ascendant
since 1999-12-21
Posts 5767
Southern Abstentia
17 posted 2007-07-25 07:32 PM


quote:

The main problem I can see from your description is the government part. Governments in general, and ours in particular, have proven many times over that they are the ultimate examples of inefficiency. I suspect a private insurance company could provide the same healthcare for half the cost. I know, you can point out the greed of private enterprise as it seeks its profits. But don't think even briefly that politicians are any less greedy. To the contrary, they have a proven ability to all but suck the life out of the poor happless taxpayer.



I'd suggest Pete, that you do some investigation into the administrative costs of Medicare and Medicaid vs. private industry.  You'll be in for a huge surprise!
http://healthcare-economist.com/2006/07/27/medicares-true-administrative-costs/

Local Rebel
Member Ascendant
since 1999-12-21
Posts 5767
Southern Abstentia
18 posted 2007-07-25 07:38 PM


quote:

And see, to me, the tragedy is that we live in a society where people who can pay feel they shouldn't have to. Why is it almost everyone seems to believe that medical services should be essentially free?



Here and in another thread where you said private insurance was evil Ron, you seem to be suggesting that the market has made a huge error.  How is that possible?

Didn't private insurance come about because there was a market?  Why?  Because people couldn't pay for healthcare with chickens and green beans anymore.

How did towns get doctors back in the day?  Why -- they sent some kid to medical school -- at municipal expense -- under the guarantee that he'd come back and practice right there in the town.

Sounds like socialized medicine right from the start doesn't it?

I'm toying with the idea of private police and fire departments though -- sounds like just the thing for a gated community.  And -- what happened historically to cultures that gave rise to gated communities -- hmmm?  What happened to those cultures?

serenity blaze
Member Empyrean
since 2000-02-02
Posts 27738

19 posted 2007-07-25 08:12 PM


I am so disgusted...

After much protesting on the part of my family--we insisted that my brother was not well, the "experts" disagreed--my brother died one hour before his release.

After holding my brother's body for three days, emotionally hostage, my mother had to sign a legal release form to get his death certificate signed.

My sister was certified as a chronic alchoholic and prescribed anti-depressants for treatment of withdrawal. She slipped. She died. Don't think we aren't paying the cost.

My father, during the course of treatment for lung cancer, had a hernia. This hernia could not be treated while he underwent radiation therapy. He died, at home, after the doctors finally removed his hernia and his cancer was in remission. But the cause of death was still "lung cancer".

I have a list of at least twenty doctors--some of whom left the Greater New Orleans area, some are simply no longer in my healthcare network. The last doctor I saw told me I'd seen too many doctors to not have emotional problems.

I finally agree with one.

I'm not going back. It is madness to repeat the same actions over and over again and expect different consequences.

I'll buy my antibiotics off the street, as we did after the storm (five bucks a piece too, just like the painpills folks) and we now have a home medical kit that includes a scalpel, lidocaine, a syringe, surgical thread AND glue too. (I probably have the stomach to stitch somebody up but it wouldn't be pretty.)

But it's okay. I'm crazy.

I wanna know, what the hell is my husband paying close to a thousand bucks a month FOR? (And ironically, he works for a medical facility.)

I envy the civility of the UK, Grinch.


rwood
Member Elite
since 2000-02-29
Posts 3793
Tennessee
20 posted 2007-07-26 07:06 AM


Not seen Sicko but I've had plenty of go-arounds with insurance companies and doctors. Especially Champus, anyone remember them? Back in the military days.

My daughter cost around $60 grand. She was a preemie. Thank God we had insurance and I paid around $3 grand outta pocket. I think I finally got her medical bills paid off in 1999. She was born in 1988. They kept "finding" things that hadn't been taken care of. Talk about a stack of paperwork! I could have wallpapered a 5,000 sq ft house with all the civilian hospital forms. The military hospital didn't have a preemie unit.

Then, when she was about 14, she had an ingrown toenail. Her daddy had bailed years prior, though the state caught up with him on the job and made him enroll his daughter into his medical plan. Just so happens, he was recently fired and the coverage had just expired. Without any choice, I called a toe doc, knowing that she didn't have any current insurance (and even if I tried to get her some it wouldn't take affect, pre-existing conditions, deductible, blah blah) and I just wanted to make an appointment for her toe. This is how it went:

"Does she have any insurance?"

No.

"I'm sorry, the doc only sees insured patients due to the risk of high medical costs."

I was referred by one of his patients and I'd like to talk to him about treating my daughter.

"I'm sorry, the doc is unavailable right now, but I'll take a message for him."

Okay, great, but first let me ask a question. Worst case scenario: What's the cost for toe removal?

"I'm sorry, did you say toe removal?"

Yes, it's just an ingrown toenail, but yall are worried about risk, & depending on how BAD off the toe is, removal is the next step right?

"Well, yes, uh, hold on. (Muzak) Okay the fee might be around $2,000, worst case."

Okay, how's cash sound? I mean, I can remove the toe myself, but the authorities may arrest me for child abuse. She can't wear a shoe now, & flip-flops are not an option. So what do you say? Tell the doc I have cash and I'll bring it down there for him to look at if he'll take a look at my daughter's toe.

She put me on hold: More Muzak.

She came back and said that my offer wasn't necessary and kindly gave me an appointment. I took my daughter, the doc spent a few minutes on her toe, and voila! All better, toe intact.

$400 with insurance or $200 cash. I was upset. Not because of the price, but because if I'd had insurance I would have had to pay the $400 due to deductible. So I put the Why's to him. His answer? "Because insurance companies only pay a small portion of the bills and he must write the rest off."

[This message has been edited by rwood (07-26-2007 07:53 AM).]

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