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If you watch TV, the odds are that you have seen the advertisements from Conservatives for Patients’ Rights (CPR). In one ad, they have doctors and patients sharing their anecdotes about their terrible experiences with national health care systems. They speak of long waits, being denied treatment and so forth. The point being made by these ads is that national health care is a bad idea because it will hurt patients.
It is reasonable to assess the health care plans of other countries and see what has worked and what has not. If there are serious problems with certain aspects of national health care in these countries, then we would be wise to be aware of them so as to avoid them when (if) we reform health care. As such, the sort of cases that CPR presents in its ad should be duly considered and assessed.
It is also reasonable to properly assess such claims. First, while examples are relevant, to simply rely on anecdotes would be to fall prey to the fallacy of anecdotal evidence. While such unfortunate tales are worrisome, what must be determined if such problems occur at a significant level. Naturally, someone might say that any problems are significant. This is true-but there will always be problems in any system. This leads to the second matter.
Second, there is the obvious question of whether these problems also occur in our health care system or if they are specific to national health care plans. If our system suffers from comparable problems, then the fact that national health care systems also have such problems would not be a mark against them in favor of our system. In short, the question is this: does our system have its own comparable horror stories?
The answer is, sadly, yes. Even a cursory search of the web will reveal a plethora of problems within our current health care system: gall bladder surgery, misdiagnosis, waiting for care, botched surgery, and denial of treatment.
My own medical experience here in the US would fit nicely into the CPR commercial. When I went to the first doctor after my fall off the roof, I was x-rayed and told I did not have a broken leg. I was not given a referral or any additional advice. I went on the web and did research on my own. Based on my findings, I inferred that I had a quadriceps tendor tear. I then returned to another doctor, hoping to get treatment. After a quick look, the doctor did not make any diagnosis. He did give me a referral, though. A week after my accident, I finally got to see a specialist. As such, I was hobbling around for a week with a disabling injury. The specialist did the diagnosis in a few minutes, something I wish had been done a week earlier. I was lucky that there was an opening the next day for surgery. After my surgery, they did not have the right sort of wheel chair, so I left the hospital with my immobilized leg held up by a few pillows. Luckily, the person wheeling me out did a good job keeping my leg from flailing about.
I have good insurance, so I only have had to pay about $700 out of the $12,000 for the actual surgery and hospital costs (so far-but the bills keep coming in). I did have to pay $500 for my brace (not covered) and I have to pay for the PT as well. But, if I was like many Americans and did not have insurance, then I’d be in rather dire financial straits. After all, the leading cause of personal bankruptcy in the United States is medical bills. So, we have plenty of horror stories.
But, don’t take my word for it simply accept the few links I’ve given above. Google it yourself and see the results. This is, of course, an empirical matter and well documented.
My point here is that the horror stories presented by CPR seem to be the same sort of thing that happens in our health care system. As such, these hardly seem to be special problems for national health care plans and especially not a special problem for the plan Obama is working on. Rather, these problems seem to be part of our health care system as well.
I do agree that the problems presented in the CPR ad are problems-but they are problems within our current system as well. As such, they give us no reason to worry that things will be worse for us under Obama’s health care plan. In any case, the ad does not even really attac Obama’s plan-it is just a general swipe at the straw man of national health care.
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There is broad agreement that the U.S. health care system is broken on many levels and needs to be fixed. In my view the biggest problem is that health care is too expensive, and with the baby boomers set to retire the costs will be unsustainable.
Speaking for myself, I am willing to accept a single payer system and rationing if it can control costs and save the U.S. from financial ruin.
My main problem with Obama’s plan is that rather than saving money it will cost more money.
Eventually, entitlement spending and interest on the national debt will consume all of our budget and there will be nothing left for investments in the future, like R&D spending.
Very interesting chart of spending here:
http://perotcharts.com/category/challenges/medicare-and-medicaid/
By 2031, spending on Social Security, Medicare, and Medicaid alone will comprise 20% of GDP.
Assuming it is true: But is that a bad thing? If so, why? If not, why not? Even if they make up that %, this might be fine. After all, we pay into that when we work, so we certainly deserve to get something back. But, if we will be ripped off in 2031, then we need to do something. I have no problem paying to make sure that I have security and medical support when I retire. Nor do I have a problem helping out other people. But, if this 30% will stem from mismanagement, corruption, or such…then I’ll be concerned.
Alright; this will fall into the anecdotal category because it is based mostly upon my more then twenty years in emergency medical services.
Federal law in the United States says that you cannot be denied treatment for a life or limb threatening illness or injury, or imminent delivery of a baby. If the facility is not equipped to provide the proper level of care you are to be stabilized as best possible, and transferred to to an institution that is capable of proper care.
To that end I simply cannot tell you how many times I transferred patients that needed care beyond the capabilities of the clinic or hospital that they initially went to for care. Most often those would be patients needing a cath lab, or severe trauma. But it also included pediatric patients and other special needs patients.
Now, let’s contrast that a bit.
Several times a month I would respond out to Jefferson County Airport and take a patient from an aircraft that was from Canada. Those patients were not always what we would call “special needs patients.” But were in need of definitive care if mortality and morbidity were to be reduced. Inevitably I was told that there would have been a wait in Canada that was simply unacceptable. These were patients with serious problems, I’m not talking about a sore throat here.
Too that end I see our model as vastly superior, and I have not even touched on the various horror story’s that I have been told by people from Sweden and Britain etc. that have socialized medicine.
Then we have to address the economics of medical care. Just how much is a life worth? How do we come to that conclusion? Once that is achieved how do we parse out the limited resource? Is that resource sustainable, and at what level if it is?
I would submit that the American model is superior, and that with a few twists (Notably preventive health care, and I include dental care in that.)that the current model with the built in safety nets will provide much needed care at a cost that can be tolerated by society.
And now Professor! 😀 Learn a lesson from a retired Paramedic. The next time you take a fall that results in the type of pain that you endured call 911. That’s what we are there for after all. You could very easily have had a broken femur or pelvis. Or blown your spleen (referred pain)or a combination of those and other injuries. A quick trip to a trauma center could have ruled out those life threatening injuries, and sent yon a path to proper treatment in relatively short order. I certainly hope that the delay in treatment does not leave you with a lasting disability.
Patrick,
If the health care in Canada and other such places is consistently worse than our own, then it would be unwise to degrade our overall health care by adopting their approach. This is, fortunately enough, an empirical problem and one that can be addressed using empirical measures across the population. For example, we can look at life expectancy, recovery rates, rates of illness, average treatment time, % of treatments that are denied, and so on. We can then compare these indicators with our own health care system to see which is better for the population as a whole. With that data we can begin to see what parts of our system are effective and what parts we should change. After all, it is not like National Health Care is a pre-set package that we have to “buy” from the Canadians and install in the United States. If their system is inferior, we can do something better.
I would never deny that the United States has the best medical care that money can buy. Our professional athletes, top politicians, and rich people have access to some of the top docs and technology in the world. But, we also have to take into account the general population: can the average person expect to have affordable access to care? This is also measurable by empirical means. For example, the leading cause of personal bankruptcy in America is said to be medical expenses. If this is just bad planning, then that is one thing. But if this is because health care costs are beyond the reach of average people and it breaks them, then this should be corrected. As I mentioned, I’m lucky. I have a good job and am able to afford decent insurance.
As you said, we do need to address the economics of health care. It has been well established that money is being wasted and that much could be done to cut costs without cutting services.
Oddly enough, the pain wasn’t that bad. Other than the knee, I seemed to be fully functional-no signs of shock, no pain elsewhere, no bones sticking through the skin. 🙂 But, I do admit that I tend to lack good sense when it comes to injuries. Fortunately, I decided to be wise about my recovery-I am listening to the medical professionals and being very cautious. Naturally, my running buddies are shocked-they figured I’d be trying to run by now. I suppose that when I was younger…maybe. But some wisdom has come with age.
Yes, I guess the elderly will get the shaft in this system then. Doctor- “I’m sorry Ms. Smith, I have cross referenced all data on our medical assessment charts and because of your age the procedure would only be beneficial 49% of the time. It would only extend the life expectancy of someone your age by about an average of 1.5 years. Now that isn’t very cost effective now is it Ms. Smith? Now be a good patriot and suck it up for the rest of us please.”
My response was in reference to this….
“For example, we can look at life expectancy, recovery rates, rates of illness, average treatment time, % of treatments that are denied, and so on. We can then compare these indicators with our own health care system to see which is better for the population as a whole. With that data we can begin to see what parts of our system are effective and what parts we should change. After all, it is not like National Health Care is a pre-set package that we have to “buy” from the Canadians and install in the United States. If their system is inferior, we can do something better.”
Very interesting video. Lots of people out there choose not to buy health insurance even though they can afford it.
http://reason.tv/video/show/560.html
“Of people currently classified as uninsured, a conservative estimate says about 45 percent of them would be able to get health insurance right now if they wanted it,” says economist Glen Whitman. That estimate comes from a study headed by a Johns Hopkins University researcher, which separates those who could get insurance into one of two categories: Those who earn enough money to buy it, and those who qualify for existing government programs.
I do know some people who take that gamble-they figure that they are young and they will be fine. I didn’t take that gable myself. I was an adjunct my first year of teaching and could not afford insurance (lousy pay plus high cost of buying my own). But, when I was hired as a real professor I signed up for health insurance instantly. It really paid off this year-$12,000 in medical expenses from 45 minutes of surgery and 7 hours of waiting at the hospital knocked down to about $700.
However, even if 45% of those who lack insurance could get it, that would entail that 55% cannot. That is still a big chunk of the population.
Let’s not forget the 15% that are here illegally:
http://www.usatoday.com/news/washington/2008-01-21-immigrant-healthcare_N.htm
“Illegal immigrants represent about 15% of the nation’s 47 million uninsured people — and about 30% of the increase since 1980.”
So we are left with about 19 million U.S. citizens that cannot afford insurance. Still a large number, but considerably less than the 47 million we always hear about.
Folks in the media have a tendency to go for the “big stat” rather than break it down into the component parts (although, to be fair, sometimes they do a good job breaking it down). In some cases, it might just be sloppy or lazy reporting. In some cases it might be because the big stats sound more impressive and garner viewership. One classic example of this is gun deaths-most reporting just lumps them all together. Some might say that this is done to make guns seem more scary.
19 million is much more manageable. While I am concerned about the well being of illegal immigrants as fellow human beings, we have an obligation to take care of Americans first. After all, many of these people have paid into the system legally and are also, obviously enough, citizens. We do have moral obligations to all people, but our own people have to take priority. If the illegals want to go through the legal process of becoming citizens, then we would be obligated to help them out as fellow citizens.
Naturally, we also need to solve the problem of illegal immigrants. Ideally, we would find a way to get them within the legal system and also subject to being taxed.