On Saturday Kate and I saw Michael Moore’s documentary on the health care industry, SiCKO. As predicted, I left enraged at the situation in this country. Not that I didn’t know about the issues at hand — overpriced drugs, systematic efforts to ensure coverage is rejected and services withheld that end up killing sick people, patients who cannot pay dumped on Skid Row, the insane profits being generated by the insurance industry, the pharmaceutical companies and what is spent by them on lobbying your representatives on the Hill.
The bureaucracy, chaos, corruption and lack of any sense of conscience toward the health of our nation’s residents is appalling. While the universal health care depicted in the U.K., France, Canada and Cuba isn’t perfect, the critical difference that those cultures believe every person is entitled to free health care — and the fear of obtaining it or losing it or having it tied to one’s employment releases a burden that we live with here every day. No one has to worry about being bankrupted or made homeless, or in one instance in SiCKO, having to choose which finger out of two lost in an accident can be reattached because of the medical price tag.
The Americans living abroad in countries with universal care are the most powerful voices in the film because they have seen both systems, and know what folks living in the U.S. are missing, and the misperceptions (and misinformation spread by the industries with the most to lose) about what health care for all is really like.
That said, could this country ever successfully switch to a universal health care system? I have my doubts. We are very much a “me” culture, with an acceptance (as well as envy and disdain) of the ability of those with money to be able to buy services they want and need. We also have a history of watching our government fail miserably in terms of administering programs that citizens are dependent on (look at FEMA). For whatever reason we accept that government can do some things (the military, build roads, the mail), but not others, such as health care — privatization is always seen as the better option.
More below the fold.
Most Americans seem to want universal health care. It depends on how the poll question is framed. [In the same breath, it takes a leap of faith that our government could do it right, and that’s what the GOP spin machine preys upon.]
Republican rank and file want it. From the Hill (6/28/07):
A March CBS poll:The survey of 2,000 self-described Republican voters, titled “The Elephant Looks in the Mirror 10 Years Later,” showed that 71 percent consider themselves conservative, a 16 percent increase over the 1997 numbers.
Fifty-one percent of the GOPers said universal healthcare coverage should be a right of every American, and 49 percent favored allowing gays and lesbians to serve openly in the military.
Those two issues continue to divide the party, though, with more than 40 percent opposed to both. Fabrizio emphasized that “the devil is in the details” on healthcare, and that providing a plan that pleases the entire 51 percent would be difficult.
Although most Americans say they are generally satisfied with the quality of their own health care, including 41 percent who say they are very satisfied, it’s a different story when it comes to the cost of care.But ironically, most are ready to let the government take a crack at it in some way. I guess the issue is whether it’s a gov’t/private partnership or fully government run.Just one in five are very satisfied with what they pay for health care, while a majority (52 percent) are dissatisfied, including a third who are very dissatisfied.
…Less than one in three, however, say the government would do a better job than private insurance companies at actually providing medical coverage. Forty-four percent said the government would be worse as a health care provider than private companies.
When the bottom line is profit and the maximization of it, it means cost cutting where it is feasible and making judgments to please shareholders that have a direct impact on health and well-being of individuals, decisions made by highly paid doctors employed by these insurance companies who are rewarded by cutting costs with the stroke of a pen, not saving lives.
Jon Perr at Perrspectives has a great roundup of background information on the state of health care in the country — a good primer.
But before the inevitable discussions about the accuracy of the film’s portrayal of the U.S. health care system and the plight of insured middle class American come to dominate the airwaves, you can make up your own mind. Perrspectives has reached into its archives and combed through other recent research to produce a quick look at the U.S. health care morass by the numbers. The summary below includes comparisons of the American health care system relative to other countries and between the states, data on the uninsured, rising health care costs, the woes of Medicare and Medicaid and more.
59 Responses to “Seeing SiCKO”
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Pam: That said, could this country ever successfully switch to a universal health care system? I have my doubts. We are very much a “me� culture, with an acceptance (as well as envy and disdain) of the ability of those with money to be able to buy services they want and need. We also have a history of watching our government fail miserably in terms of administering programs that citizens are dependent on (look at FEMA). For whatever reason we accept that government can do some things (the military, build roads, the mail), but not others, such as health care — privatization is always seen as the better option.
But when privatization is so blatantly and evidently the worst option, couldn’t this just be “American exceptionalism” - the belief that because the American health system is American, it’s got to be the best possible way to do it?
You get people seriously arguing that they don’t know if a national health service would work, who honestly don’t seem to be aware that every other developed country has a national health service and in all cases they work much better than in the US.
I think it entirely plausible that the rich and powerful in the US who will never personally suffer from the lack of a health service could continue to deny this to everyone else: but that’s like the weird way it continues to be popular to campaign for the abolition of the estate tax. I also consider it entirely plausible that, if a US government wanted to institute a national health care system, the corporations who profit massively from the US’s present health care system would throw all their resources into propaganda that the US just doesn’t want it.
But it’s no more plausible that people accept placidly that a decent standard of health care is something that only the richest deserve, than it is plausible that the thousands who stayed in New Orleans after they were told the city was at risk, did so because they really looked forward to being drowned.
It’s not because the US is a “me” culture that people think like this: it’s because people honestly don’t realize that it’s entirely possible for their country to treat them better, and have swallowed whole without choking the myths it is profitable that they should believe.
I agree that we’re unlikely to see a truly socialized health care system in America. I think that we’re much more likely to get something like the Edwards or Obama plan passed, where people are simply provided with health insurance or made to purchase it. Of course, that doesn’t solve the problem of huge co-pays, refusals of coverage for certain conditions, exorbitant prescription drug prices, etc. The problem is, most Americans don’t really seem to seriously even recognize the option of truly socialized medicine– it’s like they can’t imagine a world outside of health insurance companies. So I’m really hoping that Sicko has a chance to engage the country in some real debate about truly socialized medicine, instead of the universal health care-lite discussion that we’re currently having.
One quick bone to pick–I wish people on the left would stop referring to universal health care as “free.” As the member of Parliament in SiCKO read from the NHS pamphlet, Britain’s health care “is not charity, it is paid for by your tax dollars.” Characterizing it as “free” just gives the trolls something easy to pounce on and distracts from the actual conversation. Let’s not make it any easier for them.
I watched a clip of Moore on the View just before I watched that movie. What he said has really stuck with me. It was in response to the OMG BUT TAXES! thing that “conservatives” like to roll out when the idea of getting something through the government comes up. And Moore was like “Dude, these other countries pay more to the government than we do, but they get ALL OF THIS in return, and for far cheaper than we get it paying directly to private corporations.
And you know, even if the US government was too inept to handle it the best way, how can they really do any worse than 47 MILLION AMERICANS UNINSURED?
I, too, saw the movie Saturday. I think one of the best things the movie will do is give people a more realistic view of the national health care provided in other countries and reduce the fear factor created by politicians and insurance companies over socialized medicine. The old demonization tactics that were used to attack universal health care 15 years ago won’t work anymore.
Also, I think the film drives home just how mainstream these concerns are. These are not concerns that can be marginalized and very, very few people can afford to stay in an “it-couldn’t-happen-to-me” bubble. Even upper income people are aware of their vulnerability, aware that a job loss or an extended illness in the family could be devastating financially. In other words, even those most invested in the “me” culture realize they can get screwed.
Ultimately, I think there’s no way to avoid some major changes. The current system is a train wreck. Given the political-corporate forces in power, I doubt we’ll wind up with a full-blown nationalized system, but we at least have to provide some baseline care nationally. I suspect it will be a hybrid system, and I don’t doubt that money will still buy a person better care, just like money can buy a kid a better education, but still, there will be some level of government funded health care. I honestly don’t see how we’ll survive as a nation if we don’t do make the changes.
I have lived both in a country that provides universal health care and now, in the U.S. The quality is about the same: often long waits for non-emergent issues, but eventually reasonable quality of care. I’m pretty sure that my taxes plus health care insurance premiums here are significantly more than the taxes I was paying at home.
I think we need to frame it as a bottom-line issue. Countries with universal health care pay much less for their health care, period. Large companies are moving operations to other industrialized countries, because the tax difference is much smaller than the health-insurance cost difference. I would love to see someone do the work to list how much the median company pays, in taxes and health-care for its employees, in a series of countries.
I spent the better part of four years, on and off, sitting with a young friend during her in-hospital chemotherapy. Meanwhile her equally young husband had to continue going to work every day because without that employment she wouldn’t be covered by insurance.
Until you’ve stood in the hallway and listened to two 20 year kids sob because she was diagnosed with an agressive cancer three days before and he has to leave Right Now or lose his job- well, let’s just say it’s something I would hesitate to wish on anyone. But I’ll make an exception for people who oppose universal health care.
My partner was off work for the better part of a year after a reconstructive surgery. Almost every cent of his unemployment had to go to cover the Cobra payments or he would not have been able to get the physical therapy, and without *that* the surgery would have been a waste of everyone’s time.
I spent hours wrangling with the insurance and the hospital over the long delay in the insurance company’s disbursement for the pre-approved procedure. After several months I had the following conversation:
Hospital Billing: Your account is now seriously past due.
Me: We have insurance. You have the information.
HB: They still haven’t paid. You are responsible for the bill. If they pay out after you pay us we will cut you a check.
Me: We have insurance. The surgery was pre-approved. Why aren’t they paying?
HB: Oh this isn’t unusual. But YOU are responsible for this bill and we will have to send it to collection if it isn’t paid at once.
Me: Huh. Okay, before you take me to court, do me one favor. Call the insurance company one last time.
HB: Ma’am, we’ve billed them repeatedly.
Me: No, take this down and read it to them. We have paid them an obscene amount of money each month to continue our coverage. In return for that money they agreed to cover our medical bills. If they do not, and you take me to court I will sue their asses the very same instant you serve me. I am fed the fuck up and I will report them to every agency remotely connected to the insurance business. I will sue for fraud and for their breaking our contract and for mopery and dopery if I can, and I will sue for emotional damages for the stress. I will sit in front of a jury and wail and beat my breast and I will give interviews to the TV and the papers. I will go and sit in my Congressman’s office and pour out my story of their evil. I am DONE playin’ now. It’s not like I have anything else to do.
HB: (long silence) I’ll call you right back.
And she did. Twenty minutes later she called me to say she had a payment disbursal number I might want for my records.
My wife has had health insurance for only about 6 out of her 28 years. It was very surreal talking to her about getting on my plan after we got married as she described very accurately the experience we were both going to have when we did finally need to go to the doctors: long lines, ridiculous fees, and insurance hassles, and in the end just flip a coin whether or not we’re actually better than we were before we went in.
As far as I’m concerned, America has no real health care system anymore. We’d be just as well off pretending that we live in the Civil War era of medicine and hospitals are merely the last stop on the way to the cemetary.
The nice thing about the Edwards plan is it allows for single-payer to emerge eventually, through competition. For-profit insurers simply can’t compete with Medicaid, and they’ll have to. They’ll be killed off one by one as people opt into Medicaid over insurance, until we all have Medicaid.
FEMA actually worked great once, under the Clinton administration. Why? Because they made it a priority, and professionalized it. Bush dismantled it and turned it into a patronage graveyard. Katrina was the inevitable result.
I’m trying to figure out how you sell (for lack of a better word, sorry) the general population on supporting federal universal healthcare. What did it look like in the 1960s, getting the Great Society off the ground? What did it look like in the 1930s with the CCC et al?
bbrugger: “No, take this down and read it to them. . . ”
Are you willing to copyright that whole speech? Because I think we should print it on stickers, copy it in emails, post it on every Internet website, and make generally damn sure that it’s in front of everyone who has to sit on the phone and beg these criminally corrupt companies to honor their agreements.
zuzu’s point is crucial, and not just about FEMA. One of the truly brilliant accomplishments of this administration, from a crony-capitalist point of view, has been to give most of the citizenry nothing for their taxes except death and international dishonor, and then to push “privatization” (aka giveaways to business). They’re using our money to fund a huge object lesson in how government can be made to suck.
(Spoilers ahead)
OLOD: I agree he could have made the idea that it’s not ‘free’ a little more explicit, but he did seem to recognize that it was primarily about who pays and how. He posed thhis question to the Canadian who suffered a torn bicep while golfing in Florida. “But why should you pay for everyone else’s healthcare? Wouldn’t it be cheaper to just take care of your own expenses?” The response was “Maybe, but that’s just not how we’ve decided to do things”. The French Muslim doctor also made that point “Everybody pays according to their ability, everybody receives according to their needs.”
I have a few nitpicks with the movie. He oversimplified the Health Care systems in Canada and England, ignoring the fact that Canada doesn’t have one health care system, but actually has 10, since each province runs it’s own medical plan; he didn’t mention the difference between a Single Payer setup like Canada, where delivery of health care is largely privatized but the government handles the payment and a system of direct government employment like the NHS; and he didn’t mention that there are private hospitals in england, not everything is run through the NHS.
That said, I was horrified by the movie. Which was probably it’s intention, and wondered why there hasn’t been a major terrorist campaign waged against the private insurance companies in the US. You’re telling me there isn’t anyone who’se been denied cancer treatment and gone Unabomber on us?
It also made me realize how smart Moore actually is, and how brilliantly calculated this was as a call to action. He was constantly playing on racial tensions in this film, but only explicitly mentioned it once, when the woman said “If my husband was white would you be denying him”. The contrast of the black woman who’se child died in the US, versus the white woman living in France who received prompt, free medical care for example. The scenes of people being dropped off in front of a homeless shelter, and generally just the visual choices he made in his examples from people in this movie, they all seemed perfectly designed to underline the class and racial issues without ever having to make them an explicit part of the movie (and leaving him open to GOP attacks from that angle). Using administration talking points to establish the level of health care in Guantanamo, and that it was being administered to Al Queda, for example, then contrasting it with the care that 9/11 rescue workers were getting. That was a brilliant rhetorical trap for the right wing.
Moore really works because he presents himself as basically being this big dumb lug with a camera, but he has a razor sharp instinct for hitting the soft spots in people’s rhetoric, and exposing contradictions and hypocrisies.
Bbruger: That was inspiring.
I was in a similar situation some years back: insured for my procedures but insurance wouldn’t pay, so the hospital insisted that I (a 19-year-old college student living month-to-month just to pay my $300 rent and eat something) come up the with few thousand dollars owed. I lacked your strength, the account went to collection, and I faced six months of being phoned every day by the most horrible collection agent ever– one who asked me things like: “Why won’t you pay? Didn’t you want your kidney stone removed? Aren’t you thankful? Don’t you think those doctors deserve to be paid?”
I start getting anxiety attacks every time the phone rings, which persist to this day. I moved and the calls didn’t follow, I (foolishly) assumed the insurance had finally come through.
Fast-forward to two years ago– I’m trying to close the mortgage on my home, and am told: “There’s just this one matter of a few thousand dollars to this collection agency…” At the point when you’re buying a house, money is flying around in unseemly amounts anyway. I freaked out, went into a total anxiety fit. Then I paid the bill. Then I bought the house.
It still makes me angry that, in the long run, the insurance managed to get out of that bill.
Any good ideas out there about health care reform won’t happen unless there is a movement willing to fight for it. IMO that movement isn’t strong enough at this point to make a strong reform happen and there is way too much belief that the democrats are just going to do something.
However, like this post mentions a large majority of Americans support universal care. The bodies for a movement are already present. A union I was in was nearly in a strike last year and many other unions are also conflicts with the employers over coverage issues. In SF there was a large hotel workers strike, that was largely over health care coverage.
IMO we need to be organizing for direct action. Strikes, pickets, organizing the uninsured, civil disobedience, whatever it takes. I read an interesting article in the American prospect comparing various countries health systems. France had the best IMO. And guess what, every time France’s government tries to attack working class living standards people hit the streets, protest, go off the rails and tear shit up.
I think there’s a connection between how hard you’re willing to fight and what you get.
I live in a country with a mostly public funded health care system, I can think of several people who I know who would be dead if they’d had to rely on a system like that in the US.
But my main point of argument for considering guaranteed universal health care is something I didn’t really properly think of until after I saw SiCKO.
My uncle is part of a small bio-tech company which has developed a test for genetic markers for a chronic and eventually life threatening condition which leaves people eventually dying slowly and painfully.
Coincidently my grandfather on the other side of my family is suffering from said condition right now…this test has the potential to be really valuable to me and to most other people living in countries where health care is publicly funded.
The downside is that a positive test would likely render people uninsurable in the US, I’m slowly coming to grips with the idea that what is supposed to be medicine may actually kill people and it’s creeping me right the f*ck out…
Moore was playing to his audience when he said “free”. From the perspective of an end user of health care, tax-paid health care is free in the same way that education and driving on (most) roads is free. I guess I”m picking at your nit.
Anyhow, I saw the movie and propose we write Moore and ask permission to mass produce dvds of it and distribute it in poor and working class neighborhoods. Just a thought…
I seriously considered seeing Sicko, but I punted. I’m seeing Transformers instead tonight. ^_^
Perhaps this is addressed in SiCKO (which I have not yet seen), but how do women’s health issues fair under “socialized” medicine vs. what we have here?
I know it’s pretty awful here. Even some “health insurance” doesn’t cover OB/Gyn visits as primary-care visits. And forget about having an actual problem like fibroids or ovarian cysts — they’ll say those were “pre-existing” and not cover them. I have a friend who is now un-insured (and who was previously under-insured): she’s been having abnormal bleeding off and on for quite some time now, and if she could manage to afford a decent Gyn. she could probably have whatever it is cured in a jiffy … but she can’t afford that kind of treatment (because of various physical and mental health issues, she can barely hold down a job).
It still makes me angry that, in the long run, the insurance managed to get out of that bill.
I had a similar situation, though probably for less money: I ended up with a $2,000 hospital bill for a one-night stay after my appendix flared up but (thankfully) went down again without requiring surgery.
I’m a stubborn bitch, so I just told the collections agency, “I’ll be happy to pay my part as soon as Aetna pays theirs. Until then, I’m not paying.”
After about THREE YEARS of reiterating this over and over, both on the phone and in writing, suddenly the $2,000 bill they kept sending me magically transformed into a $300 bill, which I paid promptly.
It ruined my credit, but I wasn’t going to be buying a house in my 20s anyway. In Los Angeles, you’re lucky if you can buy a house by the time you’re in your 50s.
I think my biggest pet peeve about my health insurance is that when you DO get hit, you’re so thankful that it’s only $2000, and not the $10,000 for the hospital stay + $5000 in other related bills that you see on the insurance statement (and your heart nearly stops when you mistake it for a bill).
I hate having to utter the phrase “Thank god for insurance”.
You know, the other thing that I always think of when people bring up, “OMG, TEH TAXES!” is that honestly, we’re already paying for each other’s health care. When Ford Motor Company’s single largest expenditure is their health insurance bill, what do we think we’re buying when we buy a car from them? It’s not just parts and materials and the labor of making the car, it’s the health insurance for all the folks who work for Ford.
The same is true all across the board, and that’s a big part of why companies like Wal-Mart are able to offer such low prices - they either don’t offer health care, or make it too expensive or otherwise impossible for the vast majority of their employees to be able to get, and thus their prices are lower.
But overwhelmingly, we’re already paying for our fellow citizens’ health care. It’s just wrapped up in the prices of everything we buy, and so we don’t notice it like we might when we looked at our paychecks and saw a big chunk taken out for taxes.
Oh, you guys. Don’t you know that basic economics informs us that people will get more broken legs and heart attacks if they know they can just toddle over to the hospital and get them taken care of for free?
(Seriously, I’ve found a gaggle of people saying that like it’s an established fact on the level of the law of gravity. Come join the fun.)
I have lived and grown up in a country with nationalised health care (New Zealand), lived in another country with nationalised health care (The Netherlands), and now live in the US.
One of the reasons I am leaving this country virtually immediately after my studies finish is because the health system here is AWFUL. I cannot believe I had to travel on the subway for 45 mins in order to get to a hospital that my grad-school insurance would cover while bleeding after being attacked by a dog.
I cannot believe that an HMO would just decide to stop covering a certain drug that I have needed since my teens, even though everyone including my doctor thought it was the best one for me, so I had to go on an inferior version, before the HMO decided to cover it again, which did fucked up things to my metabolism.
I cannot believe that if my job gets cancelled then I will not just not have access to this drug, but I won’t have access to health care at all.
I cannot believe more Americans aren’t ashamed of their health care system, and I can’t believe more don’t hear the laughs coming from the rest of the developed world when it is claimed that
This is what irritates me when people say, “But, waiting lists!!!”
Which is faster: waiting list, or never? If they start averaging in the time Americans spend just not getting care because they can’t, I’m sure our “waiting list” times will far exceed those of Canada or the UK.
I’ve said it before, I’ll say it again: insurance is a racket. I had coverage when I worked at Big Giant Financial Firm. Broke my elbow in a fall, had a few surgeries, my arm is damaged for life, and I sued the place where I fell. I won my case.
Guess what happened next?
The insurance company went after me to get reimbursed for everything they’d paid out on my behalf.
So in other words, they get to collect ALL the large sums of money my former employer gave them, and then they get to get paid back for doing nothing at all when I went through a multi-year lawsuit. They didn’t pay my lawyer’s retainer. They didn’t take time off work to deal with the suit. But they got my money twice anyway.
It’s as if they have absolutely no business risk at all. They get paid, or they get paid.
Based on my experience with the Japanese NHS, I’d say they were damn good about nagging us females into the regular gyn checkups, etc.
Also, if you’re a government worker they really make sure you’re getting all sorts of tests–some of which have been written into the system and are pretty silly in retrospect. The supposed preponderance of stomach cancer in Japan is why they push the barium cocktails so much (bleah).
Turns out one of the main reasons for the rise in stomach cancer wasn’t so much the present diet, but during WWII a lot of the uncooked rice was fluffed out with pretty nasty things like asbestos…..
*nods* totally Denise, and most of them don’t actually understand what a “waiting-list” actually is. As soon as it is determined you need a procedure, you’re put on the list for it. If you’re urgent, you’ll get it quick. If not, there will be people ahead of you that need it more than you getting it first. You’ll move up as time goes on, and if your status changes quickly, then you get jumped up the list.
Sometimes things don’t react as quickly as they should and people don’t get access as quickly as they need, but those are rare occurances. Unfortunately those are all you hear about when it comes to nationalised health care when it is talked about here in the US.
Shannon - a similar thing happened to my father-in-law. His foot was injured in an accident at his union headquarters. His health insurance paid most of it, but he was stuck off work for months and although he healed pretty well, it still causes him pain on a semi-regular basis. My in-laws sued for those damages, and eventually won, at which point the insurance company did exactly as they did to you - went after my in-laws to be reimbursed for the money they spent fixing up my FIL’s foot.
They didn’t do a darn thing with the suit, just stood back and watched this whole vicious thing go down, but they were ready and waiting as soon as the judgment came down in my FIL’s favor.
As you say - it’s such a racket. But they’ve got us, and they know it. If my FIL hadn’t had health insurance at all, they’d have been screwed and he probably wouldn’t have been able to get the kind of care he required in order to recover even as well as he has.
It’s fucking sickening.
Oh, and one of the big advantages of having a nationalised health care system is that it encourages PREVENTATIVE health care. In other words, if you don’t have to worry about paying too much each time you go to the doctor, you’re more likely to go for check-ups, nor wait till things are insanely serious before going if you are sick.
Whereas paying out of pocket encourages the kind of health system of the “ambulance at the bottom of the cliff” approach, which is always an inherently more expensive system.
DAS: Perhaps this is addressed in SiCKO (which I have not yet seen), but how do women’s health issues fair under “socialized� medicine vs. what we have here?
In the UK:
1. It’s actually quite difficult to escape getting an ob/gyn checkup at least once every three years whether you need one or not, because every family doctor practice is practically hounded to hound us to come in and get one. Likewise getting a mammogram.
2. Most prescription medications are charged for - a flat fee that can, in some instances, mean it’s cheaper to buy it directly. (It’s just under ÂŁ10 at the moment, I think.) You can claim free prescriptions if you’re under 18, over 60, pregnant (and for 12 months after childbirth), on a low income, or if you have one of a whole bunch of long-standing conditions that mean you’re going to need to get regular prescriptions. (Diabetes, for example.) But all women’s contraception is absolutely, completely, no questions asked, free. Whatever contraception you opt for: no woman pays a penny. (Men can get free condoms with just a little more difficulty: they’re available via most health clinics or safe sex projects, but if you get them from a shop, you pay.)
3. Abortions are available for free on the NHS, though you need to get two doctors signing a form that says you need one. (To be reduced to one doctor soon, for abortions before 13 weeks.) Admittedly there are some parts of the country where it’s easier to get an abortion if you go private, but there’s no part of the country where it’s impossible.
4. You can buy emergency contraception over-the-counter. (One of the major chains in the UK, Lloyds Pharmacy, has a “conscience clause” to exempt pharmacists from providing women with emergency contraception: I’ve only heard of it being exercised once, though.) You can also get emergency contraception at any hospital casualty or emergency department: there’s a helpline to help you figure out where the nearest one is. I’ve never heard of a rape victim being denied emergency contraception: the NHS guidelines for doctors say that emergency contraception should be offered to any female victim of rape or sexual assault, as well as if barrier or ordinary contraceptive methods fail.
What else?
I would caution anybody who thinks that Obama is going to solve the health care crisis. I went to his website yesterday after his campaign announced that they had raised $32 million. I read his take on this issue and was shocked by this quote:
What the heck does that mean? It sounds like he trusts businesses, including the insurance industry, to deal with the fact that 47 million Americans are uninsured (and a whole lot more are under-insured). I don’t think giving the insurance and Big Pharma companies a seat at the table is a great idea, when their greed is the reason we are in this mess. They are the reason Congress won’t touch this issue. They are the reason Americans can’t buy their own affordable insurance today.
Insurance companies, I would argue, are a key reason our workers have a reduced ability to earn higher wages (their yearly cost increases give employers a reason to “justify” smaller cost of living increases, and their ability to deny you coverage for pre-existing conditions if you try to switch jobs keeps people from job hopping - which is a grand way to work your way up the ladder faster). And what about small businesses and the American dream of starting your own new business, not if you or a dependent has a pre-existing condition, you can’t afford the self-insured rates for health care.
I have found that doctors and those who’ve actually worked in the health care industry are the best equipped with the big ideas to help solve this problem. In Oregon, the best ideas for trying to solve this problem at the state level have come from people like Gov. Kitzhaber and Representative Mitch Greenlick (my rep in the Oregon House), because they have worked on the inside of the industry and know how we could best manage the care - but they don’t pay their mortgage by profitting on high insurance costs. Nurses, would be amazing indivduals to invite to the table, as well.
I can’t think of a single drug company or medical insurance proffessional who would serve Americans well by being involved in this discussion - unless your end goal is to NOT create a true National Health Plan.
I have to say that I have had one good health insurance experience lately: worker’s compensation. I fell off a stepladder at my job and ripped my ACL (the anterior crucitate ligament, one of the two ligaments that holds the knee together — football players rip it all the time). Or, as my orthopedist said to me while showing me my MRI results: “See that little ball of mush? That used to be your ACL.”
I didn’t have to sue, because worker’s comp took care of everything, including the emergency visit, the MRI, the crutches, the medications, and the surgery. It got a bit annoying to be nickel-and-dimed, especially on physical therapy, but at least I didn’t have to worry that getting it taken care of would bankrupt me. I even got a little compensation during my three-week recovery from surgery (though my job at the time paid me some disability payments as well). And, no, it wasn’t “free” — the state has been taking SDI (State Disability Insurance) payments out of my check pretty much since I started working in California — but I didn’t have any kind of co-payment because I’d essentially pre-paid in case I needed Worker’s Comp someday.
And this would be a bad system to implement because …. why, again?
okay, so horror stories of insurance companies aside, what needs to be done to present to the US public the value of federal universal healthcare? What does a presidential candidate or the congressional leadership need to do to get the society excited about doing this? The only thing I can think of is to make it a national dream, like going to the moon or some such. How would you set it up? Is it possible to make universal healthcare inspiring? We all foresee some fairly drastic changes, but what mindsets and ideas need to change to make it happen?
Going to be a bit of a rant, sorry. So, a few months ago, I had this mild cardio-thing and ended up spending 3 days in the hospital (it ended up being some sort of bubble). After the pain’s gone and they’ve run a boatload of tests, I end up thinking to myself that I sort of wished that it had been a heart attack, because I doubt that the bubble was really “life threatening” (hey, I wasn’t seeing a tunnel or anything, but the pain was unreal and I was starting to go a bit numb). See, if something isn’t “life threatening” then the coverage drops to jack (they’ve got this really messed up list).
Hey, it wasn’t life threatening! I’m alive (or in the Matrix, which is cool too), woo-hoo! Oh, wait, you mean that since I didn’t assume room temperature now I owe you $7500? Neat. Yeah, I got it, but I sure hope Social Security doesn’t get “privatized” anytime soon (401K’s are great, until you need to sort of suck them dry so you can pay for being alive and all).
Look, its not “socialized” health care, its UNIVERSAL health care. Its for all of us: You, me, the people that we’ll never meet. We’re all in this together, okay? Love the person you don’t know, drop the pretentious bullshit and help us out, we’re dying here. I’ve got coverage and I don’t even want to think what would have happened if I didn’t.
I’m sorry I don’t have the same bank account that you do, and I guess that can make you better than me, but just help me live another day.
FEMA has been stripped of its funding and leadership under Bush, esp. since the re-org. of the government into the bloated monstrosity known as the Dept. of Homeland Security. Folks, like myself, who have worked in disaster recovery like to wax nostalgic of effective government response after the Northridge earthquake in CA in ‘94 and Hurr. Georges in Puerto Rico, also during Clinton’s time. Northridge was the model FEMA and Bush chose not to adopt post-Katrina, which was one of using HUD vouchers to re-house all disaster victims as quickly and efficiently (and cost-effectively) as possible. According to my post-Katrina colleagues, after Georges, HUD Secretary Cuomo basically stalked other branches of the government - there was even a lawsuit filed (though by who against who I forget, but basically it was some form of politically wrangling) - to have PR re-built within a year or so’s time.
Post-2005 hurricane season damage in the Gulf is virtually unprecedented, but we’ve had enough experience in this country to get a lot of it right in terms of providing housing and healthcare and empowering people to come home. It’s been the systematic de-funding by Bush of FEMA, and the distinctly political choice to channel all the long-term housing solutions (i.e., $75k trailers) through short-term oriented FEMA (indeed, emergency relief is the agency’s mandate) rather than the pre-existing, far-more-effective systems that exist in HUD (and also Medicare/Medicaid for the health of the displaced). Relying on our social welfare system might just indicate that we have a use for it in this country, and we wouldn’t want that now, would we?
As I mentioned re: the recent SCOTUS decision last week, it’s time for change:
http://www.newvisioninstitute.org/foresight/index.php/2006/07/18/dispatch-from-new-orleans-the-next-social-movement/#more-66
So this is the first time that I’ve ever posted here - heck, to any blog at all… so here goes:
As a left-progressive, I’m 100% for universal health care. After seeing SICKO, I’m 200% sure. Heck, my partner & I want to move to France now.
But as a feminist, I have reservations. What would the state of women’s health, specifically reproductive rights, be under a single-payer plan? For example, how would a federally-funded universal health care plan rub up against the Hyde Amendment, which bans federal funds for abortion services? It seems to me that if we switched to a French-style plan tomorrow, there goes Roe v. Wade…
Blimey, I don’t want to give Leslie Unruh any ideas, but, it seems like a legislature, judiciary, and bureaucracy mobbed by antis or only-lukewarm supporters of choice (like it is now) would guarantee that universal health care would spell doom for abortion services, and even contraception.
Please tell me I’m too pessimistic!
Rumors On The Internets: And People Call Me Traitor To My Face…
Tom Tancredo will use the Internet to embarrass us, himself. [Election Central] Blah Blah Michael Moore blah blah traitor. [Pandagon] John McCain trims his campaign staff but stops short of firing himself. [Political Wire] Looks like we’re havin…
As a brit working in Philly as a physician I’m appalled by the way some insurance companies almost go out of their way to deny basic services to their patients - things that would save them money in the long run. Don’t want to pay for this medicine for diabetes? OK well you’re going to have to pony up for the amputation 10 years down the road.
And my little anecdote, when I was a medical student I passed out in the OR and was rushed to the ED. I received fluids, an EKG, and an assessment by the doctor. My short stay ended up costing me $995 - which I as a medical student simply did not have, and my insurance refused to cover it because it was my own damned fault I passed out apparently. Grr
Contrast with, the year before, I had the most horrendous chest pains which had me doubled up in agony for most of the night - driving me to my local A&E in Norwich. I was admitted, received an EKG, fluids, a chest Xray, assessment by a doctor, a bed for 24hour monitoring and a prescription for pain meds. Cost me nothing.
And I waited both times for 3 hours before being assessed.
My 2 cents.
1. It’s actually quite difficult to escape getting an ob/gyn checkup at least once every three years whether you need one or not, because every family doctor practice is practically hounded to hound us to come in and get one. Likewise getting a mammogram.
[Scratches head]
Never happened to me.
(And here we see the dread hand of matriarchial assumptions yet again dominating Pandagon. Help, help - I’m being oppressed!)
(Actually, I like the idea of all females getting these sorts of check-ups regularly and cheaply/free, given a recent cancer scare with a beloved relative)
Speaking of ER care, too — a friend of mine, born American but married to a Canadian now, was back in the States on a visit and got put into the ER with a wickedly painful exploding cyst or something like that. Hours in the ER, tons of pain… she was really glad she had traveler’s insurance or she would’ve been out thousands.
As a brit working in Philly as a physician I’m appalled by the way some insurance companies almost go out of their way to deny basic services to their patients - things that would save them money in the long run. Don’t want to pay for this medicine for diabetes? OK well you’re going to have to pony up for the amputation 10 years down the road.
The gamble that they’re taking is that the patient will switch insurance providers in the next 10 years, whether voluntarily or involuntarily (such as their employer deciding to switch plans), and they’re most likely correct that it will happen. So they won’t be paying for the amputation — the next insurance company will. And if they’re not going to have to pay for the amputation, why should they pay to prevent it?
These are the incentives that are set up in our current healthcare system. Pass the hot potato to the next guy and hope you’re not the one caught when someone’s long-neglected health problem finally manifests itself in an expensive emergency.
One of the things that got me was the couple who had insurance but still went bankrupt paying for their medications and had to move into their daughter’s basement. They probably paid insurance premiums faithfully for 30 years, but it means nothing. There’s no relationship there, no “we’ve been paying so that we’ll be taken care of”–they ceased to be profitable, started costing the company money, and they’re out.
I’ve always hated the insurance system, and seeing that movie just makes me hate it more. I don’t even have any horror stories, it’s just so obviously a rigged system. As my stepdad said, look at the big, handsome buildings where they have their headquarters! Look at their CEO’s salaries! You can tell who’s winning this game.
In Canada, going to the doctor is going to the doctor, OBGYN’s included. Things vary province to province (i.e. British Columbians pay a $50/month premium, though this is often covered by employers) but doctor/hospital visits are all covered by your provincial plan. You flash your health card to the reception. Things get paid for. It’s like magic! (I kid.) As noted above, the most advantageous thing about our health care system is that it’s very good at preventative care; things often get caught earlier, and are therefore less severe (and less expensive) to treat.
I should also note that I grew up with severe asthma, which lead to a whole host of lung and sinus problems, and spent a lot of time in hospitals and emergency rooms. I’ve never experienced waitlist issues or any of the other horror stories that get told about universal healthcare. I’ve always gotten what I needed.
Abortions are considered medical procedures and are covered by provincial healthcare. There is no cost to the woman involved. When I got pregnant in university I freaked out, after being exposed to American television, somehow thinking that I would have to find the money in my tight budget. A pleasant surprise that my government valued my rights to bodily integrity to the point that they covered the procedure.
I’m chagrined that you buy into the ‘government can’t do the job as well as the private sector’ meme. Sorry, load of crap, that. The media have bathed america in this hogwash for so long that it’s become a reflex response, like jerking your leg when the tendon below the knee is hit. The reason government as it currently (well up until rethugs came to power) exists derives from the last time Robber Barons owned the country and in response Americans demanded non-profit non-partisan govenrment institutions that would act in the Public’s interest. The goal of conservatives for the past century, despite protestations of protecting tradition or other such nonsense, has been a return to the ‘gilded age’ of privilege for the few at the top. BushCo is the culmination of that drive restore the prerogatives of the favored few. It was accomplished by allowing conservative quislings to convince americans that not just their government, but all government is inept. If government is inept, it’s because we put people in power who wanted it to be inept.
For those asking about women’s health under a socialised plan, it’ll depend on what the US culture will allow, I suppose, but here in Ontario it’s fantastic. If I need an abortion, I can either go to the Morgentaler clinic or the hospital and it’s covered by the province. I can see an OB/GYN, and I’ve always had female doctors. I suppose one of the huge pluses for women’s health is that we’re able to choose our own doctors based on whatever doctors are taking patients - the choice isn’t limited by who your insurance will allow.
We saw SiCKO yesterday afternoon. There were about 40 people in the theatre, many muttering or gasping during parts of the movie. The entire audience applauded the film at the end.
In at least one state (WA), if you had continuous prior insurance coverage and change jobs, the new insurance company is not allowed to deny you coverage for “pre-existing conditions”. There *are* no pre-existing conditions, by law, if you were covered for the three months just prior to the new insurance coverage. The old insurance company must provide you with an affidavit of continuous coverage if you drop insurance with them, so you can show it to the new company.
That doesn’t mean that Washingtonians are any less screwed over when it comes to high rates, ridiculous co-pays, insurance companies denying people prescribed medications, the virtual impossibility of getting private coverage through anyplace but your large-enough employer (especially if you have one or more “conditions”, like me), etc. I have six very serious chronic conditions including diabetes and kidney disease. Nobody wants to touch insuring me. But because of this law, since I have had continuous coverage via my husband’s former employer and COBRA, they *have* to cover me with no exclusions or waiting periods for pre-existing conditions.
I’ve had no problems in Canada with women’s health - got STD testing without a question, didn’t have to even have a discussion about birth control, my doctor gave me a free three month trial followed by putting me on good pills that were of a lower cost because I was low income at the time, all sorts of things.
My partner has a chronic health condition that requires huge amounts of drugs every month, or so it seems to me. I loved it when we lived in the UK because we could totally budget for them without a problem. Right now we’re in a different province in Canada and he’s paying a lot for the drugs again, but we’re jumping through the hoops to get him on income assistance as he’s unable to work.
I honestly think he’d be dead by now if we had lived in the US. There’s no way I could afford to keep him in the necessary doctor’s visits.
Lord, just the mental health aspect - being able to see a doctor and talk about those issues without having to deal with a huge bill…
Perhaps this is addressed in SiCKO (which I have not yet seen), but how do women’s health issues fair under “socialized� medicine vs. what we have here?
—————————————————-
Sweden: all healthcare is healthcare. Most women I know go every year to their midwife (licensed nurses with a special degree in midwifery) to get checked, pap smear and get contraceptives. Free of charge. Midwives do most of the women care. Doctors are only called in if there are some complications.
There are special sex-ed clinics for young folks, up to 25 yrs old. Free of charge. Check-ups, info about STD’s and psychologists to talk to if needed.
All pre-natal care is free of charge. You do pay a small fee for the delivery and after-care at the hospital. (very small fee, like 30$ per day). And all post-natal care is free of charge until you’re 18. (or maybe 15.)
Abortions, of course, are healthcare and also considered emergency medicine, you’re not supposed to wait more than 2 weeks. Actually you pay a small fee to see a specialist, a whopping 25$.
You never pay more than 180$ per year for any prescription drugs you may need. for me, a migraine sufferer this is really a win-win. Even though I pay a lot in taxes, the meds are a life-saver.
And younger women/girls over 13 can get contraceptives, or an abortion, and professionals are not allowed to tell the parents.
Some clinics are private, some are not. All sponsored by the Govt. Or rather by all of us.
Might I suggest that some Americans look into the history of HOW other countries instituted universal health care, be it single payer systems like Canada, or nationalized health systems like the UK?
It absolutely was a battle. The whole country didn’t just wake up one morning and decide that healthcare should be available to all. The first government (provincial) to offer a version of universal healthcare in Canada was fought tooth and nail by doctors, insurance companies, and the Canadian federal government. As social democrats, they were accused of being communists. Banks and other governments refused to lend them money. Doctors threatened to go on strike or quit altogether.
The government raised money by taking personal 28% pay cuts and doing everything they could to diversify the province’s economy - without selling out to business interests. (Remember, this was during the Depression and Saskatchewan was a farming province - and they managed to do all this without either borrowing or going into debt. In fact, they paid off a lot of the debt introduced by previous governments.) They brought in foreign doctors to offset the local doctors who refused to work. They endured death threats and violence against themselves and their property.
And we’re damned lucky they did.
Anyway, the point I’m trying to make is that they a) started small. They picked a province which is perhaps the equivalent of Idaho or Massachusetts to start in. They were genuinely grassroots. They did not fall into the lucrative traps sprouted by big business and lobbyists. They did not buckle under when opposed by big money.
I don’t know if Tommy Douglas and the CCF could do today what they did then. But it starts by choosing the right people to lead you - people who want to serve, not wallow in money and power.
http://www.saskndp.com/history/douglas.html
http://www.saskndp.com/av/douglas/mouseland-high.mov
Perhaps the powers that be have decided to keep in place this sick system not just because it brings the insurance companies and pharm companies profits, but because it makes the little people (including the supposed “middle class”) toe the line. Not just corporate workers who are afraid of losing their jobs and their health insurance. Students who decide that they should get medicine, law, or business degrees instead of following their hearts. Women who get married for the spouse’s health insurance (in denial that husband won’t pull a Newt Gingrich should the wife develop cancer). I learned that I have thyroiditis and it is forcing me to plan for a legal career, even though practicing law under the present Supremes is soul-killing, because I expect to get thyroid cancer later in life. The present health system makes cowards out of most people, and the brave die young. (Sorry — I just learned about Rittenhouse.)
Excellent points, Deanna. However, I’d just point out that Premier Tommy Douglas (a.k.a. Jack Bauer’s grandpa!) brought universal health care to Saskatchewan (against fierce opposition) during the 1960’s, not the Depression.
The question of women’s health is a good one, but honestly, when I lived in the UK, I was impressed. Birth control free. Women’s health exams every three years, free (which is in line with the evidence anyhow - though they did have to fend off us Americans who insisted on Pap smears every year ‘cause that’s what we’re used to).
The abortion question, from what I learned there, was tightly intertwined not with government-sponsored health care, but with government-sponsored care for poverty-stricken families. Understanding the financial risks that unwanted children put on strained welfare budgets, and understanding that the health care pot and the welfare pot are basically one and the same, goes a long way toward making the abortion question a pragmatic one rather than a pie-in-the-sky woo-woo moral one. Or so I was led to believe when I was taking health policy classes over there: abortion laws are firmly liberalized because everyone understands the social consequences of unwanted children on the system that everyone believes in and relies on to get by. I’d be happy to take argument from anyone who’s actually from the UK on that point, but that’s what I was led to believe from a policy stand point when I was there. It’s a stand point that the US would be wise to buy into.
You’re right Sara - I had a much longer post that I chopped that included more information, including how what he saw during the depression affected his political career - and I edited poorly.
Thanks for the correction.
And crap, that should have been thanks to RainCityGirl. D’oh! See what I mean about bad proofing?
You can watch it six parts here.
grendelkhan:
VoxDay and his cronies say that, do they? I am not surprised that they’d conjure up such idiocy in the face of actual facts. Vox’s modus operandi, from what I’ve seen, is to tell boldfaced lies and then impugn the intelligence and character of anyone who dares question him.
[…] Pam Spaulding over at Pandagon had some similar thoughts, noting that “We are very much a “meâ€? culture, with an acceptance (as well as envy and disdain) of the ability of those with money to be able to buy services they want and need.” […]