One patient in Oregon got a letter that made this all too clear, when in the same letter rejecting her request for life-extending chemotherapy, Oregon offered her “physician-aid-in-dying”. In other words, Oregon offered their customer a heapin’ helping of death:
Yikes, *sorry, no drugs for you, but we can help you commit suicide*. I think this is what Obama was talking about when he said maybe a pill is best?
When it comes to health care reform, I have listened to both sides of the debate, and can agree with portions of both arguments. Living in Italy, where we have socialized medicine, I also see the good and the bad with this type of system. For the most part, I have stayed out of the health care reform issue. I believe the American people should be *the deciders* on this important issue. But, I am pissed when the Senate scoffs at reading the bills, and I worry about the attempts to pass this so quickly.
I have had a lot of discussions with family and friends, and hear opinions from all points of view. I think the most important thing is that people fully understand what these changes mean - financially and as far as actual coverage. And when members of Congress, and Obama don't even know what is being proposed, that worries me.
Supporters of the health care reform like to say that people go to Canada for healthcare, and deny that people travel to the US for care. People travel to the US ALL the time seeking better care. Some Americans may travel to Canada for healthcare, and I would bet those would be the uninsured Americans, or someone who was denied care by their insurance company. But I bet most would be people without insurance, and want to get some free care in Canada. Also, to take advantage of the cheaper drugs in Canada.
But, people from ALL over the world do travel to the US to receive the best care.
So, what do I think about socialized medicine? Well, for starters, it is paid for with taxes. Europeans pay +50% of their income in taxes for the socialized care. It can work efficiently and can be a great system. It can also be a nightmare. It depends on the area, the actual doctors and medical personnel. Socialized medicine seems to be great for caring for massive amounts of lower income people, people who just want the bare minimum in care. When I say bare minimum, I mean be prepared to supply all of your own comforts/supplies in the hospitals (from tvs to maxipads.) There are no private rooms, no fancy birthing suites. Yes, it's cheap (not considering the taxes you pay), and perhaps you may not care, but it is a no frills system.
Patients are responsible for their own health history, and carry around their own x-rays, samples and files from doctor to hospital, to doctor. (This includes all biological specimens, etc.) Also, you have to give yourself your own shots.
There seems to be very little funds for maintaining the hospitals, and I have seen hospitals with conditions as bad as those we saw at the Walter Reed hospital. Most are old, and in all stages of decay.
You also have to be very pushy with your health care provider. My BIL was suffering from what I thought was an aneurysm due to his symptoms, loss of balance, slurred speech, unable to walk straight, loss of vision in one eye, strange taste in mouth, upset stomach. The doctor wanted to test him for GERD... My FIL got very assertive, and went to the hospital and found his doctor, and explained his sons condition. The doctor ordered an immediate CAT scan and they found a huge brain tumor. Now, the Dr. was awesome, and he got great care. But, had the family not pushed, he would probably be taking Pepto Bismal or something.
My MIL was misdiagnosed for three years, and given steroids which destroyed her bones. She waited four months for a knee surgery to repair the damage to her cartilage caused by the roids. My FIL was diagnosed with prostate cancer, and received fairly quick care. Overall, expect for a few bad experiences, I have personally witnessed a pretty good system in Italy.
Another strain on the system is people use the emergency room as a doctors office. Doctors office visits are *private* but you pay ~150 euro. So, many people prefer to just go to the emergency room, where it is *free* (there is usually a small fee for tests, though).
Private doctors and dentists will send you to the hospital for tests, including blood tests, and e-rays, (since most don't have the capability/expensive machines in their office), where you take a number, and wait. If you are in line at the hospital before the doors open, your wait is only a couple hours. If you arrive there late, you can wait many hours.
When my brother in law was diagnosed as having a tumor with the CAT scan, he was then transported to another hospital for the MRI. He was then transferred to another hospital for the surgery, where the surgeon for tumors worked. The hospitals can't all afford to have all of the many machines that are needed for diagnosis. These machines are very expensive. Now, I assume a hospital in Milan or Rome would be fully equipped, but from my experience, the smaller ones where I live are not.
There are advantages and disadvantages. A big plus is you do not go in debt when you get ill. But, you have to pay a lot of taxes, and the health industry does suffer. And from what I have seen, there is a big difference in care depending on location, and the quality of people working.
One thing someone pointed out to me is small business owners who provide health care are at a disadvantage when bidding against companies that don't provide insurance. The bids by companies that have to factor in their health care expenses are at a disadvantage because their job bids are usually more expensive because the competitors aren't paying health insurance. So, mandates on companies that don't provide insurance will help level the playing field with small business owners.
Although, I wonder if, when cutting costs, small business owners will choose to drop insurance all together, knowing there is a government option available? (Why is it required that businesses provide insurance, anyway? I can see the benefit of say, a Microsoft, to offer health care to their employees as a benefit, and they probably get a great package, based on the number of employees they have, but for a small business? Do they get more of an advantage, or are they strapped paying for the healthcare?)
I have heard horror stories in Europe and in the US. I hear about long waits, denied care, and botched surgeries in both Europe and America. I hear about people dying, and people being cured in both places. As I said, you won't find yourself strapped with hundreds of thousands of dollars in dept in a socialized system, but you may find yourself denied care.
One nagging thing that worries me about moving to a government run system is that the US currently has the system in which people from all around the world turn to. How would a government run system affect the system as a whole?
And, as I brought up below, how will the Health Care reform reconcile the costs of Medical School with the new govt. subsidized Doctor salaries.
In American, doesn’t med school run upwards of $100,000+? My husbands cousin spent around $3000 - $4000 for her entire university and med school in Italy. Doctors graduating in America, with massive debt, I would assume expect to earn salaries that will allow them to repay their loans. Under a gov run plan, I don’t see that happening…?
I think there is definitely a need to fix parts of the system - the insurance companies denying/determining care, not your doctor. We need tort reform. The price of medicine is crazy. They need to examine what doctors charge insurance companies for their services/tests. My husband, a dentist, is stunned sometimes when he finds out what dentists bill for procedures in the states. Let's just say, it is a wee bit more pricey than in Italy.
So, what do you think about the health care reform? And if you are an expat, what are your experiences with health care in Europe vs. America? I have had a good experience with the system here. My husband has some doctors in the family, and friends, so we know the quality of doctors is excellent. :O) But, as I said, we also hear the horror stories.
My point in all of that, is that I do believe the goal of the Obama administration/Democrats is to get to a single payer, government run universal health care system.
I am not trying to influence one way or the other, just offer my personal experience, and opinions.
I think the American people need to demand the facts, educate themselves, and figure out what they believe is the best system for America, and be the *deciders*. For every article I read about how great healthcare is in Canada, I can find two that talk about the horrors. Same goes for the current care in America.
Whatever type of care you think may be best, at least find out the facts of the proposed reform. And demand that members of Congress read the bills! And be prepared to expect your taxes to go up. I can not imagine this system having any chance at success without raising taxes.
Thanks for this post, Sara.
ReplyDeleteFrom another post about this exact issue:
"Public option is nothing more than a back door to single payer.
That raises the question “Is the public option a back door to a single payer health government health care system?” Because many Americans are happy with their current health care, moving immediately to a single payer option is too radical a change to be politically tenable. But for those who see single payer as the ideal, a public option that uses taxpayer funds to tilt the playing field may be an attractive second best. If the subsidies are big enough, more and more consumers will be induced to switch.
You might think that bludgeoning private insurers like this will create a better health care system, but all I need to remind you of is how your similar plan to stimulate the economy has not worked at all. This would be fine if we had a government we can trust, but so far, you have given us absolutely no reason to trust your judgement. That is, save for blind faith in a politician whose only strategy is “hope” and “change”.
Hope and change, huh? More like the same old BS, if you ask me.
There is no such thing as a free lunch.
I lived in France for 7 years, and the healthcare was excellent. Taxes for healthcare alone are about 21%, but the care is very good. If we here in the US want socialized medicine, we have to be prepared to pay for it. I don't have a problem with that, providing the care is good.
For those who think they're going to get a free ride: Be prepared for your taxes to rise, rise, rise
I have had terrible healthcare in Italy, and I could write a long boring list about my experiences but they were not nearly as bad as my FIL who would have died waiting for an operation to remove his mestastisizing tumor if he didn't have connections. I was very glad that he did know the right people to get the help he needed but on the other hand I found it sort of ludicrous. Had he not known any doctors or surgeons he would have died while waiting for a spot in the hospital/OR. I don't think healthcare should be based upon who you know. That's very elitist.
ReplyDeleteI don't know about the healthcare bill in the US as it is very long and Pelosi wants to rush it through and no one has the time or inclination to read it and little has been said about it. As you say, even Obama has not read it in detail but commented on a few cases.
I do seriously wonder wny the exact same medical test done in Italy and the US costs so differently. I mean I went to a private clinic in Italy, had a blood test for one thing and it cost $20. Can you imagine a bloodtest without insurance in the US costing $20? Somehow the prices need to be lowered to make these tests more affordable. Either whether the US taxpayer or the individual foots the bill.
As an ex-expat I would like to describe the care I received in a socialized medicine state.
ReplyDeleteA few years ago I lived in Belgium. I was able to get health care the second week of my stay. I lived in a small village that had it's own doctor. It cost me 10 euros to see him. I could make an appointment but it wasn't necessary. And if I was too ill to see him he would come see me. And he would call me to make certain the medications were working and I was getting better. When I ran into problems with some workers that harassed me because I was an American, he told me I was being discriminated against and called the company doctor to let her know of the incident. This was right after Bush decided to invade Iraq. The company doctor informed the director of the company that discrimination was not to be tolerated and had him write a letter to my supervisor informing her that such behavior would not be tolerated.
So my experience with socialized medicine was a very good one. Of course there were quirks that would probably make most Americans paranoid. When I missed a day of work because of illness, a representative of the insurance company would stop by to make sure I wasn't faking it.
So where does this leave me in my opinion of the US health care system? A little perplexed. Once I had injured my back severely and was receiving treatment 3 or 4 times a week. The company I worked for was pressured by their insurance company to try to reign in costs. My employer attempted to get me to cut back on the care I needed and finally laid me off for no good reason. I went to see my doctor as usual and while he was examining me I told him that I had just lost my job and would need to make payment arrangements. He literally stood up and walked out of the examination room without a word. A few minutes later a nurse came in to inform me that the doctor could not treat me because I didn't have insurance and I would have to leave.
So do I think we have the best health care system in the world? Hell no. It's screwed me over big time. The lack of care messed me up for life.
The system in America is good for some people and not so good for others. Personally, I would support a single payer system where there was a basic standard of care that ALL CITIZENS received. If we wanted more enhanced care we could buy into a plan with our own money. But it wouldn't work unless the insurance companies were REQUIRED to allow all citizens to buy into it equally. That would lower the cost of it immensely. And if someone wanted elective ego surgeries to enhance their breasts (or penises), tighten their faces, change their gender or whatever, then people could pay for such a plan out of their own pockets. That type of system seems fair to me.
I totally disagree with how the current Administration is going about things. They are trying to rush through something most elected representatives haven't even read. And they are being prodded by an Administration that is imposing artificial deadlines merely for the sake of Obama's ego. It's all political, that much I am sure.
I don't know that I have answered any of your questions. But this is how I feel about it.
Well-written. I enjoy reading your perspectives.
ReplyDelete