Should health care be a service or a business? I believe it should be a service. The two big pillars of our society should be Education and Health care. Free universal health care, in my opinion. We do have it, in Spain, but I think our country is slowly going the American way in this field. People are encouraged to pay for private health care, less money is invested in public health... I'd rather pay more taxes and make sure every citizen can be properly taken care of when sick, than have people fend for themselves... As you alredy know, we had a medical problem at home last december. My husband had a seizure (I think they used to be called grand mal). I had no idea what was going on, he never had one before, and I thought he was dying. I called emergency and had an ambulance home, with a doctor in 5 or 10 minutes (can't remember exactly). He has no medical insurance, but that was no problem, he was taken to the hospital for tests. We waited for a long time. Anyway, he was finally diagnosed as having juvenile myoclonic epilepsy. Now, this is a benign form of epilepsy, and he's fine now, but I realize what we take for granted now (free health care) may be slowly drifting towards the American system...
I leave you with a scene of Michael Moore's new movie (Sicko). I have the feeling none of my American friends don't like him but I think he raises some good questions...
Monday, June 11
Sicko...
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8 comments:
This issues has pros and cons to it.
A few years ago, I took an 84 year old man with a hip problem for an MRI, which found he an abdominal aortic aneurysm, ergo immediate surgery was necessary. The MRI was performed the same day the Rx was written. In the Canadian system, he would have had to wait several months for the MRI... he would have died from the aortic before he got the MRI.
WM
I'm not particularly fond of Michael Moore - never have been and I encountered him (his work) long before he came to be demonized, and perhaps rightfully so, by the conservatives.
Health care is a growing problem in the US. I am coming to believe that health care is one of the essential services that should be made available to all by the government - just like education and libraries. Problem is, the government screws up everything they stick their long noses into.
I understand the popularity of the idea of government-provided healthcare, and I also understand the criticism that many heap upon the U.S. healthcare system. Actually, the term “system” is a misnomer; the U.S. does not have a healthcare “system” per se.
When I grew up, doctors made house calls. Anyone, nearly, could afford to pay for their own healthcare, because prices were much lower, with the exception of surgery and long hospital stays.
I have served on the board of directors of a local not-for-profit hospital since 1989 (except for a four-year period), chairing the Quality Assessment and Improvement Committee and the Physician Recruitment Committee, and served on the Executive Committee. For approximately three years I worked in the hospital as Director of Communication and Marketing and Administrative Director over physician recruitment and physician continuing medical education. Each year I attended the convention of the state hospital association where healthcare issues were addressed. I tell you all of this so that you will understand that I have a good bit of experience with and knowledge of the healthcare industry.
Through that experience I have learned that in the United States it is the increasing involvement of the federal and state governments in healthcare that is most responsible for the prohibitive cost of medical care. It is much too involved to explain in a few sentences, but please believe me when I tell you that government intervention through regulation and its idiotic reimbursement system, which pays doctors and hospitals less for their services than it costs them to provide those services, is a major factor in raising costs.
A second factor is the increasingly litigious nature of our society, where patients expect to be cured of the most serious diseases, and made normal from the most serious injuries, and are willing to take medical care providers to court if they are not happy with the results.
I don’t know about the situation in Spain, but I warn you to be careful what you ask for, because you might just get it. The healthcare system in Canada and in France and in Great Britain are good examples of the shortcomings of socialized medicine. As a physician recruiter, it was easy to find doctors wanting out of Canada because of the healthcare system there. And long waits for diagnostics and surgeries are legendary.
I know that a lot of people look down their noses at capitalism and businesses providing health services. But the U.S. private sector, left mostly alone to do its best, can provide far better healthcare than our government, and do at an affordable cost to many if not most Americans.
Ok, our system is not perfect either but at least everyone can go to a doctor or a hospital and get diagnosed for whatever illness and get treated for free. Waiting lists are a problem here, and doctors are underpaid, so that's why they tend to try to work for the private hospitals too or open their own practice.
James, you said
"Through that experience I have learned that in the United States it is the increasing involvement of the federal and state governments in healthcare that is most responsible for the prohibitive cost of medical care", why is that??
And, wouldn't you rather have a system that allows all the citizens of your country to be treated?
Any person in the United States, citizen or legal alien or illegal alien, must be treated in an emergency room for emergency medical conditions. The country also has free clinics that address the needs of many indigent persons.
But given the government's inability to do much of anything well--consider the postal service and Veterans Administration hospitals--I'm not comfortable with a government-run healthcare system.
A government-run healthcare system would inevitably be inefficient, requiring ever more money to operate it, meaning higher and higher taxes to support it, and then doctors that used to come here from Canada would be joined by American doctors looking for somewhere else to practice.
It would not be a better system.
The reason that government intervention is a major problem is that the government believes that it knows best how to deliver care, and imposes many regulations on providers that demand onerous record keeping and the implementation of policies and procedures that add to the time and materials needed to comply, adding additional personnel and related costs.
Our hospital has a medical records department of 15 people, three or four of which are necessary due to the demands of federal and state governments. This adds at least $100,000 to the cost of that department every year. The government sets standards for all manner of equipment that raise the cost of that equipment.
What do you suppose a stretcher/gurney costs? That is essentially a bed on wheels with certain features, like posts on which to hang IV bottles, and which can be raised at the head and foot. You might expect that to cost a little more than a king-size bed, maybe about $1,500. But in reality such a device costs nearly $15,000, mostly as a result of the standards the government insists upon for the manufacture of this equipment.
Many of these requirements really add nothing substantive to the level of care of hospitals, but do raise the costs of providing that care.
I could go on for a long time about this subject.
Very interesting, James. I have a question, you say anyone must be treated in an emergency room. Let's suppose I'm American, I've been feeling sick, have no insurance and go to the emergency room. They tell me it's cancer. Will they provide treatment or are they just supposed to diagnose me??
Or another example, I'm pregnant and go to the hospital to deliver the baby. Will they make me pay?
Also, WM, I believe if you have some life-threatening condition, you go first in the waiting list... they wouldn't let you die. Part of the reason is you could actually bring charges against the hospital (It's happened here in Spain, when sometimes, the government has faced charges due to cases like that). But still, we need a lot of improvement. A cardiologist told me not very long ago that the 25th best hospital in the US had the same budget as our entire community of 6 million people (Catalonia). Unbelievable!
Nuri,
It was the MRI that showed he had the AAA. In Casnada, he would heve been put on the waiting list and waited several monthws for the MRI. He would never been diagnosed there due to the 24 week wait period there.
WM
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