I feel the health of the USA is being held hostage by the healthcare conglomerates for cold, hard, cash profits. Americans pay the most per person of any people around the globe, but receive far less for our money, not even counting those that have naught or limited access to health care at all. I consider healthcare a basic human right but I am in the minority here in Yankeeland. Talking to other Americans about socialized health care I've found there is a relatively pervasive belief that if the USA were to institute socialized medicine it would be a step towards the type of tyrannical communism seen in the Soviet Union or North Korea, and that any day the rest of the first world is going to go bankrupt on account of their government's taking on the financial burden of providing health care to their peoples or that health care will somehow be "rationed" and there will be shortages of all types, despite the fact that some of the worlds socialized medicine systems are going strong in their 6th decade of existence, like the UK's. What is the rest of the developed worlds take on how the USA approaches taking care of the health of it's citizens?
The U.S. has ~300 million people. The biggest first-world Western European country (Germany) has ~80 million. France has ~67 million.
You cannot even begin to compare the impact of the population disparity on socialized medicine and such things.
Is there some arbitrary population size that socialized medicine stops working at that I'm not aware of? Also who figured it out and how exactly did they do that?
Is there some arbitrary population size that socialized medicine stops working at that I'm not aware of? Also who figured it out and how exactly did they do that?
What he means, and what I'm inclined to agree with, is that you can't compare the US to other systems because of size disparity in both the population and geography.
germany's 80 million exist in a MUCH smaller area than the US's 300. You can't do a similar system because european countries largely DON'T have a problem of service availability (which is a huge cost driver in the states).
As someone who has lived under european systems and the american system (UK's and Poland's), I can tell you that I prefer the system in the states a thousand times over. With insurance (I can't speak for those that don't have it), the level of care you get is incomparably better - doctors are more attentive, better trained, and you have access to every treatment and technology medicine offers. I had some chest pain the other day - the doctor called me within an afternoon, and I had a checkup scheduled a few days later once no actual problems were confirmed. You just don't get that elsewhere.
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Although I may not be from the 1st world may I share my views here? I hope so.
I consider healthcare a basic human right but I am in the minority here in Yankeeland.
I disagree with this. It is more like any other service. You need to be able to pay for the service to get the benefit.
Talking to other Americans about socialized health care I've found there is a relatively pervasive belief that if the USA were to institute socialized medicine it would be a step towards the type of tyrannical communism seen in the Soviet Union or North Korea
Socialist fear mongering set aside the fact remains that socialized health care does cost a fortune. Are you willing to pay anywhere from 20 - 40 percent more tax to fund this drive? The money for this has to come from somewhere.
despite the fact that some of the worlds socialized medicine systems are going strong in their 6th decade of existence, like the UK's.
The ironic thing is that health insurance is a thing in Britain even with there NHS. Also there is real economic concerns that this huge social expenditure brings. They payroll tax in britain is just simply unfair to the working people and the large businesses are sometimes tax between 40 and 50 percent of there profits. Something which stymies there growth a great deal. So I'm not saying this is bad thing. Just know that there are real consequences for such social programs.
Is there some arbitrary population size that socialized medicine stops working at that I'm not aware of? Also who figured it out and how exactly did they do that?
Things cost a helluva lot more when you have more people to deal with. The basic European social system exists because of low population and incredibly high taxes. The U.S. simply cannot provide the same coverage without literally bleeding a good portion of the population dry and leaving them with nothing. And even when it's probably not enough.
DokuDokuH also brings up a very good point with geography. Indeed, this may be of greater importance than the population itself.
Another important thing to consider is the health requirement of the average populace. I know nothing about the average health of folks in European countries. I do know that 1/3 of the U.S. population is overweight, and a stunningly high number of people are obese. In other words, Americans are ******* unhealthy. This drives health costs up by a ton. We could reduce health costs simply by becoming a fitter country.
The point- You cannot simply say that, because it "works" in other countries, it will also "work" in the U.S. There are tons of variables involved in all those countries, and to take the principle and apply it without taking the time to look at the details is stupidity at its finest.
Another thing- I don't consider health care to be a basic human right. Why should it be a basic human right?
Edit-
In fact, let me ask you this- What else do you consider basic human rights, and why do you consider them as such?
I'll post more on this later, but there are a lot of factors that affect Healthcare in a given country. I've studied the US system and the systems of a lot of the 'Universal' healthcare systems, and the population affected matters. It's easier, for instance, to fund a healthcare system that is devoted to an overall healthy population.
The US has a number of issues related to healthcare, and while this is by no means an exhaustive list, it should give you some ideas:
The US has huge swaths of underserved areas. These places are so rural or undesirable, they literally can't pay doctors enough to work there.
The US is a very unhealth country. Compared to everyone but essentially Australia, we're incredibly obese, and have a much higher incidence of a number of chronic illnesses.
Hidden costs encouraged by insurance and medical equipment suppliers keep the cost of healthcare high, and markups of 10,000% aren't unheard of, especially when it comes to DME.
That said, the US could have a good Universal Healthcare System, it would just require a completely different approach from the ACA. The real problem is hidden costs, and so while exchanges help somewhat in that regard, we'd need some reforms on how companies that sell healthcare products can do business before the costs can be brought back under control, in addition to a dozen other things I'm forgetting right now.
My counter to your population issue is India, MUCH larger population than the states Universal Health Care.
India doesn't have a Universal Healthcare System, at least in the sense you're thinking. In fact, the population size and geography is a major barrier to any kind of successful healthcare system.
The dichotomy between Urban and rural healthcare is even more pronounced than it is here in the US. In urban areas, the healthcare can approach what we'd expect in the west. In rural areas, however, it's much worse than even the most underserved area in the US.
My counter to your population issue is India, MUCH larger population than the states Universal Health Care.
You're kidding, right?
I was in India on vacation a few months ago. There's a particular road in Varanasi where the "street dentists" congregate. If you need a tooth extracted, they'll happily pull it out with pliers for you. With the help of our guide, I asked one of them whether he had any training or experience in this field. He said "Yes, I used to work on motorcycles."
I say we avoid anything that looks remotely like India's healthcare system.
As someone who has lived under european systems and the american system (UK's and Poland's), I can tell you that I prefer the system in the states a thousand times over. With insurance (I can't speak for those that don't have it), the level of care you get is incomparably better - doctors are more attentive, better trained, and you have access to every treatment and technology medicine offers. I had some chest pain the other day - the doctor called me within an afternoon, and I had a checkup scheduled a few days later once no actual problems were confirmed. You just don't get that elsewhere.
Please. In New Zealand (with a socialised healthcare system), when I had chest pain, I went to the doctor immediately and was seen about three minutes later. (At least, it sounds like you were praising the US system rather than complaining.)
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I am willing to bet my collection that Frozen and Solid are not on the same card. For example, Frozen Tomb and Solid Wall.
If Frozen Solid is not reprinted, you are aware that I'm quoting you in my sig for eternity?
As someone who has lived under european systems and the american system (UK's and Poland's), I can tell you that I prefer the system in the states a thousand times over. With insurance (I can't speak for those that don't have it), the level of care you get is incomparably better - doctors are more attentive, better trained, and you have access to every treatment and technology medicine offers. I had some chest pain the other day - the doctor called me within an afternoon, and I had a checkup scheduled a few days later once no actual problems were confirmed. You just don't get that elsewhere.
Please. In New Zealand (with a socialised healthcare system), when I had chest pain, I went to the doctor immediately and was seen about three minutes later. (At least, it sounds like you were praising the US system rather than complaining.)
Yeah, Doku's comment is pure rhetoric. Socialized systems have their own strengths and weaknesses, but they still work. The idea of waiting weeks or months for an appointment is, at best, a mistake based on a poor grasp of the subject. I've had to wait weeks or months for an appointment with fantastic insurance.
I must say, I never looked that much into the US health care system, but I can say what the majority of people in Germany about the USA think: It's ridiculous.
And one thing many of us can't understand is the idea of freedom the Americans seem to have:
If I have more money than the average, I don't have to care about the problems of anybody else.
If this impression is justified or not, I cannot say. But this is overall the imagine we get through media and internet.
And the problem of huge swaths of underserved areas is not a problem of the US alone. In Germany we have a similar problem in more rural areas as wll, mostly in east germany.
But nonetheless, I really believe anybody should be have a health insurance. (For your information: In Germany many self-employed people have huge troubles to find an insurance, so we are not really there yet. Sadly, this will not change in the next couple of years.) Life is too short and too valuable to be dismissed for something as trivial as money as we only have one life for all we know. This is a lesson I have learned in the last few years. And it's a lesson, many still need to learn (I think).
And the problem of huge swaths of underserved areas is not a problem of the US alone. In Germany we have a similar problem in more rural areas as wll, mostly in east germany.
Yeah, but it's an issue of Scale. Red marks the underserved areas. We've got more underserved than you've got people, and many of our people in order to reach some healthcare have to travel half the length of your country to find it.
India is a good example of the issues with Universal Healthcare not solving all the issues out there. If there is no healthcare infrastructure to 'universalize', it's a moot point.
How does that make sense, really? You'd expect things to be cheaper per capita if the population is so much larger. Brazil has 200 million people and they have a national health system.
The majority of US citizens live in or near cities - in fact proportionally more than in France or Germany. If remoteness is really that much of an issue, it can be factored into the program as increasing the 'own risk' proportion.
Living close or near cities don't mean much when public transportation is poor and most people who the ACA is supposedly meant to help rely heavily on public transportation to get them to places.
Americans are always stereotyped as fat, but obesity is a rising problem in many European countries as well. I'd be very surprised if there were huge differences on this front. This too, could be tackled by adjusting the program for certain lifestyle diseases.
There are huge differences. I'm sure Jay13x knows a lot more than I do on this front (him being in the health business and all) and could provide you with a lot more information than I can even look up in a day.
It is silly to simply hand-wave it away in the manner you did here. Average Americans are THAT MUCH more unhealthy than the average European.
There are always tons of variables involved. It surprises me that on so many issues Americans say "we'll try it anyway" (i.e. the actually quite admirable American entrepreneurism), but not on healthcare. It supports my notion that opposition to a national health insurance system is largely ideological and has little to do with practical problems...
...and yes, it's confirmed. Do you accept basic human rights in general? And if so, why do you accept some but not this one? What do you think is the impact of poor health on poverty?
I personally don't care what the U.N. decides is basic rights or not, if that's what you're referring to.
And, no, I don't believe in the concept of basic human rights. It doesn't make sense to me.
[quote from="Mad Mat »" url="http://www.mtgsalvation.com/forums/outside-magic/debate/579904-an-american-asking-the-rest-of-the-1st-world-for?comment=7"]There are huge differences. I'm sure Jay13x knows a lot more than I do on this front (him being in the health business and all) and could provide you with a lot more information than I can even look up in a day.
It is silly to simply hand-wave it away in the manner you did here. Average Americans are THAT MUCH more unhealthy than the average European.
Europeans are catching up, but outside of England and Australia no one is even close.
And, no, I don't believe in the concept of basic human rights. It doesn't make sense to me.
Wait, basic human rights don't make sense to you?
Granted, there are no 'rights' in a state of nature, but in a global society you don't think cultures can agree on a bare minimum for how other human beings should be treated?
And the problem of huge swaths of underserved areas is not a problem of the US alone. In Germany we have a similar problem in more rural areas as wll, mostly in east germany.
Yeah, but it's an issue of Scale. Red marks the underserved areas. We've got more underserved than you've got people, and many of our people in order to reach some healthcare have to travel half the length of your country to find it.
India is a good example of the issues with Universal Healthcare not solving all the issues out there. If there is no healthcare infrastructure to 'universalize', it's a moot point.
The lack of access to primary care is huge in Texas. I'm extremely aware of this due to the fact that I've worked in rural counties with the nearest Trauma II center being 150 miles away, and I also was in a nasty car accident in a county that didn't have an ER. Doctors need to be incentivized to work in these counties. I think the current student loan reform program for doctors in rural areas is 10 years service, and I think it needs to be lowered to 3 or 4 and include all health workers and an expedited program for working in the IHS. The need is absolutely huge in these rural areas, and it's getting more dangerous all the time. It seems that every month some oil field worker is getting severely injured in the Eagle Ford or Permian Shales and they have to be taken via helicopter to a Trauma I center. The tax bases are growing but they're not building hospitals or getting doctors to work there because no one is expecting the boom to last.
Yeah, but it's an issue of Scale. Red marks the underserved areas. We've got more underserved than you've got people, and many of our people in order to reach some healthcare have to travel half the length of your country to find it.
India is a good example of the issues with Universal Healthcare not solving all the issues out there. If there is no healthcare infrastructure to 'universalize', it's a moot point.
I know the situations can't be quite compared, but I just wanted to say that the European Health System, which looks at itself as nearly perfect, is far away from that.
But: If there is no healthcare infrastructure to 'universalize', shouldn't you create one? If you have an atom bomb to kill many thousand people at once, shouldn't it be possible to create a healthcare infrastructure which saves the same amount of people per year? If there is no desire to solve the problem, then you will never have a solution. And it seems to me as German, that the Americans are too content with things being the way they are now. Again: If this impression is justified or not, I cannot say. But this is overall the imagine we get through media and internet.
Granted, there are no 'rights' in a state of nature, but in a global society you don't think cultures can agree on a bare minimum for how other human beings should be treated?
Clearly not, since in the U.S. alone you have a (very large) number of people who believe that the poor should be left to their own devices in varying degrees. I doubt you'll be able to the great majority of the populace to agree on what the bare minimum is.
In any case, it is one thing to strive for a certain standard of living for people and quite another to proclaim certain things as outright "basic rights". I can understand the former. I don't understand the latter.
I must say, I never looked that much into the US health care system, but I can say what the majority of people in Germany about the USA think: It's ridiculous.
And one thing many of us can't understand is the idea of freedom the Americans seem to have:
If I have more money than the average, I don't have to care about the problems of anybody else.
If this impression is justified or not, I cannot say. But this is overall the imagine we get through media and internet.
The American health care "system" is insanity, it's more than ridiculous. And you are spot on about many Americans having a very strange(I'd call it perverse) notion of freedom.
If there is no desire to solve the problem, then you will never have a solution. And it seems to me as German, that the Americans are too content with things being the way they are now. Again: If this impression is justified or not, I cannot say. But this is overall the imagine we get through media and internet.
It's not that Americans are content with things being profoundly messed up, they think the world can be no other way because we have been lied to for generations by the monumentally wealthy that any amount of wealth "redistribution"(slightly higher taxes) is the first step down the path to the USA becoming a communist despotism with no freedom or opportunity like Cuba or North Korea, when in reality it would be taking the USA down the path to becoming a true liberal democracy where the biggest factor in determining where you end up in life is how determined you are and how hard you are willing to work, not whether the family you were born into was affluent or poor, more like Sweden or Iceland.
The American health care "system" is insanity, it's more than ridiculous. And you are spot on about many Americans having a very strange(I'd call it perverse) notion of freedom.
It's not that Americans are content with things being profoundly messed up, they think the world can be no other way because we have been lied to for generations by the monumentally wealthy that any amount of wealth "redistribution"(slightly higher taxes) is the first step down the path to the USA becoming a communist despotism with no freedom or opportunity like Cuba or North Korea, when in reality it would be taking the USA down the path to becoming a true liberal democracy where the biggest factor in determining where you end up in life is how determined you are and how hard you are willing to work, not whether the family you were born into was affluent or poor, more like Sweden or Iceland.
I traveled around Boston for a time with public transportation. It took me roughly 30 min on public transportation to travel just a couple of blocks, iirc (been a while so I'm not entirely sure). It takes well over 30 minutes to travel from Boston to the outlying areas such as Cambridge, and an hour and a half to travel a distance of ~11-13 miles on the rail. And none of these are helpful because the ******* bus system only works on an AM/PM basis unless you're literally just traveling WITHIN the city and nowhere else.
I'm sure if you're a fit individual you can deal with this. But if you're sick? Not going to happen.
Apparently so, I stand corrected. Still, this is not a fundamental problem for a nationalized system.
Why? It means that it'll cost more per person by a significant amount, for one thing. That's why I keep bringing the population up. It is overwhelmingly more expensive to treat the average American than the average European.
If the average American was as healthy as the average European, then it might be an easier comparison. But they're not. The average American is really unhealthy.
And this drives up healthcare costs by a significant amount.
Innovation and risk-taking businessmen in general. In Europe, such things tend to be much more strongly discouraged if not shot down completely.
I think you're mistaking a couple of things. Individual risk-taking and innovation is one thing, a national one is quite another. The U.S. as a nation is not a big risk-taker.
When it comes to the social system, the U.S. has done something this big in only two other times- When we were in the midst of a Depression, and another when we were at our strongest and richest (speaking relatively).
During the depression, we had to do something, anything, in hopes to find a result. During our strongest and richest, we felt that we could actually solve the problem of poverty.
Both didn't really work out the way the architects intended it to, and have left some big and lasting effects on the country today.
I'm going to agree with magickware99 on this one. Can anyone point to a country with a population close to ours whose socialized health care system is a success story?
India is a good example of the issues with Universal Healthcare not solving all the issues out there. If there is no healthcare infrastructure to 'universalize', it's a moot point.
Agreed, and this is a detail people seem to miss with regards to the US: yes, the healthcare system clearly has issues, but we also have the best doctors in the world.
And really, I think it's pretty safe to say it's because of our non-socialized system that we have them.
Quote from magickware99 »
I traveled around Boston for a time with public transportation. It took me roughly 30 min on public transportation to travel just a couple of blocks, iirc (been a while so I'm not entirely sure).
Yeah... The T barely counts as transportation. Especially if it's the Green Line.
It needs to be said that a huge amount of the costs in American healthcare is the massive bureaucracy that comes with it. I receive a statement quarterly from Medicare and apparently they need specialized people just to code the services I received. There are probably 16,000 medical codes for stuff ranging from injuries from a snowboard accident to diseases you've never heard of. Instead of grouping the injuries with the injuries, they differentiate them. You shouldn't need a specialized bureaucrat to tell the insurance company WHAT EXACTLY you're getting treated for.
There's no reason why an MRI should cost $2k in the US and $700 in France except for the bureaucracy. And they hand out these MRIs to anyone because of the massive profit involved.
Not to mention the often perverse incentives that come with receiving certain types of healthcare. Instead of sending me to get some weekly massages and a gym membership after my car accident where I injured my neck, they just hand out hydrocodone like it's candy. I've seen it in the ER too, doctors going from door to door giving out prescriptions for Soma. 98% of the world's opioid prescriptions occur in the US and we have a ballooning prescription abuse and death epidemic going on. Apparently in other countries they'll attempt to treat you rather than get you hooked on drugs.
It's really about what I expected- Richer people get better services, poor people remain the same.
The issues that Jay13x and DokudokuH talked about (geography) is an incredibly important part of the article, and there should be no doubt it'll be an incredibly important in the U.S.
It's really about what I expected- Richer people get better services, poor people remain the same.
The issues that Jay13x and DokudokuH talked about (geography) is an incredibly important part of the article, and there should be no doubt it'll be an incredibly important in the U.S.
It's the same here in America. The people who are insured get better services while the uninsured go to the ER, die, or become permanently disabled. The counties that have indigent health care usually are overburdened and inadequately staffed.
I've sat on all parts of the continuum--I've been uninsured, went through the county system, was on Medicaid, and currently I have the best health care that money can buy. Both me and my mom ended up in the ER because we were uninsured. We were fortunate enough to go through the indigent ER system and didn't have to pay anything. Others don't live in counties that have an indigent ER where people don't pay. They just have to go bankrupt, and the last I checked 50% of the bankruptcies in the country are due to medical bills. When I got health care through the county system it took months to get a regular appointment, and often they would just forget about you. It would take years to get a dental appointment, and it took my mom 7 months to see an OB/GYN. If you're pregnant you're just screwed for prenatal care.
Medicaid is great...provided that there are providers in your area that are 1. accepting Medicaid, and 2. accepting new patients. I had to see a primary care physician nearly 2 counties away, and I live in a large city. Doctors in wealthy Austin don't want to see Medicaid patients. They don't get reimbursed and the bureaucracy is a nightmare. I had better luck getting a provider in Houston where 1/3rd of the population is uninsured. Damn near every doctor in Houston accepts Medicaid.
So I currently have PPO insurance and Medicare because I'm disabled, and I get the best health care money can buy. Endometriosis surgery that costs 35k dollars? Free of charge, everything was handled in a matter of days. Get in a severely disabling car accident and have to be rushed to the ER? Totally paid for, didn't cost me a cent. I've had three surgeries in the past 2 years and didn't pay a dime. I don't pay copays for doctors visits, can see a specialist without a referral. I don't pay for flu shots, my copays for medicine range from .35 cents to $1.75. I thank my stars every day that I have health insurance.
Because of this, I'm the healthiest I've ever been. I never get sick, despite the fact that I have a really bad habit of rubbing my eyes and my nose due to allergies. When I didn't have insurance I got sick all the time. Strep throat, flu, the works. People say I'm unhealthy because I have to see so many specialists. That's just because I'm disabled. I'd rather see the specialists and be considered sick than not see them at all and be in danger of getting catastrophically ill.
The organization I work for advocates for Medicare for all. There's still a lot of issues with Medicare, though, as a person who is on it. If I had Medicare alone my medical expenses would be hefty.
The U.S. has ~300 million people. The biggest first-world Western European country (Germany) has ~80 million. France has ~67 million.
You cannot even begin to compare the impact of the population disparity on socialized medicine and such things.
Is there some arbitrary population size that socialized medicine stops working at that I'm not aware of? Also who figured it out and how exactly did they do that?
What he means, and what I'm inclined to agree with, is that you can't compare the US to other systems because of size disparity in both the population and geography.
germany's 80 million exist in a MUCH smaller area than the US's 300. You can't do a similar system because european countries largely DON'T have a problem of service availability (which is a huge cost driver in the states).
As someone who has lived under european systems and the american system (UK's and Poland's), I can tell you that I prefer the system in the states a thousand times over. With insurance (I can't speak for those that don't have it), the level of care you get is incomparably better - doctors are more attentive, better trained, and you have access to every treatment and technology medicine offers. I had some chest pain the other day - the doctor called me within an afternoon, and I had a checkup scheduled a few days later once no actual problems were confirmed. You just don't get that elsewhere.
G MGC
WB Teysa Tokens
BR Wortsnort
UG 23.5-No Edric
URG Noncombo Animar
GUB Damia Stax
WBR Alesha Hatebear Recursion
WBR Daddy Tariel
UBR [Je]love-a Your Deck
GWU Almost Critterless Enchantress
WUB Sydri+Artifacts=WUB
WURG Glint-Eye Combo
I disagree with this. It is more like any other service. You need to be able to pay for the service to get the benefit.
Socialist fear mongering set aside the fact remains that socialized health care does cost a fortune. Are you willing to pay anywhere from 20 - 40 percent more tax to fund this drive? The money for this has to come from somewhere.
The ironic thing is that health insurance is a thing in Britain even with there NHS. Also there is real economic concerns that this huge social expenditure brings. They payroll tax in britain is just simply unfair to the working people and the large businesses are sometimes tax between 40 and 50 percent of there profits. Something which stymies there growth a great deal. So I'm not saying this is bad thing. Just know that there are real consequences for such social programs.
Things cost a helluva lot more when you have more people to deal with. The basic European social system exists because of low population and incredibly high taxes. The U.S. simply cannot provide the same coverage without literally bleeding a good portion of the population dry and leaving them with nothing. And even when it's probably not enough.
DokuDokuH also brings up a very good point with geography. Indeed, this may be of greater importance than the population itself.
Another important thing to consider is the health requirement of the average populace. I know nothing about the average health of folks in European countries. I do know that 1/3 of the U.S. population is overweight, and a stunningly high number of people are obese. In other words, Americans are ******* unhealthy. This drives health costs up by a ton. We could reduce health costs simply by becoming a fitter country.
The point- You cannot simply say that, because it "works" in other countries, it will also "work" in the U.S. There are tons of variables involved in all those countries, and to take the principle and apply it without taking the time to look at the details is stupidity at its finest.
Another thing- I don't consider health care to be a basic human right. Why should it be a basic human right?
Edit-
In fact, let me ask you this- What else do you consider basic human rights, and why do you consider them as such?
The US has a number of issues related to healthcare, and while this is by no means an exhaustive list, it should give you some ideas:
That said, the US could have a good Universal Healthcare System, it would just require a completely different approach from the ACA. The real problem is hidden costs, and so while exchanges help somewhat in that regard, we'd need some reforms on how companies that sell healthcare products can do business before the costs can be brought back under control, in addition to a dozen other things I'm forgetting right now.
India doesn't have a Universal Healthcare System, at least in the sense you're thinking. In fact, the population size and geography is a major barrier to any kind of successful healthcare system.
The dichotomy between Urban and rural healthcare is even more pronounced than it is here in the US. In urban areas, the healthcare can approach what we'd expect in the west. In rural areas, however, it's much worse than even the most underserved area in the US.
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You're kidding, right?
I was in India on vacation a few months ago. There's a particular road in Varanasi where the "street dentists" congregate. If you need a tooth extracted, they'll happily pull it out with pliers for you. With the help of our guide, I asked one of them whether he had any training or experience in this field. He said "Yes, I used to work on motorcycles."
I say we avoid anything that looks remotely like India's healthcare system.
Please. In New Zealand (with a socialised healthcare system), when I had chest pain, I went to the doctor immediately and was seen about three minutes later. (At least, it sounds like you were praising the US system rather than complaining.)
Yeah, Doku's comment is pure rhetoric. Socialized systems have their own strengths and weaknesses, but they still work. The idea of waiting weeks or months for an appointment is, at best, a mistake based on a poor grasp of the subject. I've had to wait weeks or months for an appointment with fantastic insurance.
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And one thing many of us can't understand is the idea of freedom the Americans seem to have:
If I have more money than the average, I don't have to care about the problems of anybody else.
If this impression is justified or not, I cannot say. But this is overall the imagine we get through media and internet.
And the problem of huge swaths of underserved areas is not a problem of the US alone. In Germany we have a similar problem in more rural areas as wll, mostly in east germany.
But nonetheless, I really believe anybody should be have a health insurance. (For your information: In Germany many self-employed people have huge troubles to find an insurance, so we are not really there yet. Sadly, this will not change in the next couple of years.) Life is too short and too valuable to be dismissed for something as trivial as money as we only have one life for all we know. This is a lesson I have learned in the last few years. And it's a lesson, many still need to learn (I think).
Yeah, but it's an issue of Scale. Red marks the underserved areas. We've got more underserved than you've got people, and many of our people in order to reach some healthcare have to travel half the length of your country to find it.
India is a good example of the issues with Universal Healthcare not solving all the issues out there. If there is no healthcare infrastructure to 'universalize', it's a moot point.
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How good is the Brazilian national health system?
Living close or near cities don't mean much when public transportation is poor and most people who the ACA is supposedly meant to help rely heavily on public transportation to get them to places.
There are huge differences. I'm sure Jay13x knows a lot more than I do on this front (him being in the health business and all) and could provide you with a lot more information than I can even look up in a day.
It is silly to simply hand-wave it away in the manner you did here. Average Americans are THAT MUCH more unhealthy than the average European.
What issues are you talking about?
I personally don't care what the U.N. decides is basic rights or not, if that's what you're referring to.
And, no, I don't believe in the concept of basic human rights. It doesn't make sense to me.
Europeans are catching up, but outside of England and Australia no one is even close.
Wait, basic human rights don't make sense to you?
Granted, there are no 'rights' in a state of nature, but in a global society you don't think cultures can agree on a bare minimum for how other human beings should be treated?
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The lack of access to primary care is huge in Texas. I'm extremely aware of this due to the fact that I've worked in rural counties with the nearest Trauma II center being 150 miles away, and I also was in a nasty car accident in a county that didn't have an ER. Doctors need to be incentivized to work in these counties. I think the current student loan reform program for doctors in rural areas is 10 years service, and I think it needs to be lowered to 3 or 4 and include all health workers and an expedited program for working in the IHS. The need is absolutely huge in these rural areas, and it's getting more dangerous all the time. It seems that every month some oil field worker is getting severely injured in the Eagle Ford or Permian Shales and they have to be taken via helicopter to a Trauma I center. The tax bases are growing but they're not building hospitals or getting doctors to work there because no one is expecting the boom to last.
I know the situations can't be quite compared, but I just wanted to say that the European Health System, which looks at itself as nearly perfect, is far away from that.
But: If there is no healthcare infrastructure to 'universalize', shouldn't you create one? If you have an atom bomb to kill many thousand people at once, shouldn't it be possible to create a healthcare infrastructure which saves the same amount of people per year? If there is no desire to solve the problem, then you will never have a solution. And it seems to me as German, that the Americans are too content with things being the way they are now. Again: If this impression is justified or not, I cannot say. But this is overall the imagine we get through media and internet.
Clearly not, since in the U.S. alone you have a (very large) number of people who believe that the poor should be left to their own devices in varying degrees. I doubt you'll be able to the great majority of the populace to agree on what the bare minimum is.
In any case, it is one thing to strive for a certain standard of living for people and quite another to proclaim certain things as outright "basic rights". I can understand the former. I don't understand the latter.
The American health care "system" is insanity, it's more than ridiculous. And you are spot on about many Americans having a very strange(I'd call it perverse) notion of freedom.
It's not that Americans are content with things being profoundly messed up, they think the world can be no other way because we have been lied to for generations by the monumentally wealthy that any amount of wealth "redistribution"(slightly higher taxes) is the first step down the path to the USA becoming a communist despotism with no freedom or opportunity like Cuba or North Korea, when in reality it would be taking the USA down the path to becoming a true liberal democracy where the biggest factor in determining where you end up in life is how determined you are and how hard you are willing to work, not whether the family you were born into was affluent or poor, more like Sweden or Iceland.
Why is it insanity?
Uh, what?
They don't. That was the point.
I traveled around Boston for a time with public transportation. It took me roughly 30 min on public transportation to travel just a couple of blocks, iirc (been a while so I'm not entirely sure). It takes well over 30 minutes to travel from Boston to the outlying areas such as Cambridge, and an hour and a half to travel a distance of ~11-13 miles on the rail. And none of these are helpful because the ******* bus system only works on an AM/PM basis unless you're literally just traveling WITHIN the city and nowhere else.
I'm sure if you're a fit individual you can deal with this. But if you're sick? Not going to happen.
Why? It means that it'll cost more per person by a significant amount, for one thing. That's why I keep bringing the population up. It is overwhelmingly more expensive to treat the average American than the average European.
If the average American was as healthy as the average European, then it might be an easier comparison. But they're not. The average American is really unhealthy.
And this drives up healthcare costs by a significant amount.
Theoretic doesn't mean much.
I think you're mistaking a couple of things. Individual risk-taking and innovation is one thing, a national one is quite another. The U.S. as a nation is not a big risk-taker.
When it comes to the social system, the U.S. has done something this big in only two other times- When we were in the midst of a Depression, and another when we were at our strongest and richest (speaking relatively).
During the depression, we had to do something, anything, in hopes to find a result. During our strongest and richest, we felt that we could actually solve the problem of poverty.
Both didn't really work out the way the architects intended it to, and have left some big and lasting effects on the country today.
Agreed, and this is a detail people seem to miss with regards to the US: yes, the healthcare system clearly has issues, but we also have the best doctors in the world.
And really, I think it's pretty safe to say it's because of our non-socialized system that we have them.
Yeah... The T barely counts as transportation. Especially if it's the Green Line.
There's no reason why an MRI should cost $2k in the US and $700 in France except for the bureaucracy. And they hand out these MRIs to anyone because of the massive profit involved.
Not to mention the often perverse incentives that come with receiving certain types of healthcare. Instead of sending me to get some weekly massages and a gym membership after my car accident where I injured my neck, they just hand out hydrocodone like it's candy. I've seen it in the ER too, doctors going from door to door giving out prescriptions for Soma. 98% of the world's opioid prescriptions occur in the US and we have a ballooning prescription abuse and death epidemic going on. Apparently in other countries they'll attempt to treat you rather than get you hooked on drugs.
http://www.theatlantic.com/features/archive/2014/05/the-struggle-for-universal-healthcare/361854/
This article paints a different picture.
It's really about what I expected- Richer people get better services, poor people remain the same.
The issues that Jay13x and DokudokuH talked about (geography) is an incredibly important part of the article, and there should be no doubt it'll be an incredibly important in the U.S.
It's the same here in America. The people who are insured get better services while the uninsured go to the ER, die, or become permanently disabled. The counties that have indigent health care usually are overburdened and inadequately staffed.
I've sat on all parts of the continuum--I've been uninsured, went through the county system, was on Medicaid, and currently I have the best health care that money can buy. Both me and my mom ended up in the ER because we were uninsured. We were fortunate enough to go through the indigent ER system and didn't have to pay anything. Others don't live in counties that have an indigent ER where people don't pay. They just have to go bankrupt, and the last I checked 50% of the bankruptcies in the country are due to medical bills. When I got health care through the county system it took months to get a regular appointment, and often they would just forget about you. It would take years to get a dental appointment, and it took my mom 7 months to see an OB/GYN. If you're pregnant you're just screwed for prenatal care.
Medicaid is great...provided that there are providers in your area that are 1. accepting Medicaid, and 2. accepting new patients. I had to see a primary care physician nearly 2 counties away, and I live in a large city. Doctors in wealthy Austin don't want to see Medicaid patients. They don't get reimbursed and the bureaucracy is a nightmare. I had better luck getting a provider in Houston where 1/3rd of the population is uninsured. Damn near every doctor in Houston accepts Medicaid.
So I currently have PPO insurance and Medicare because I'm disabled, and I get the best health care money can buy. Endometriosis surgery that costs 35k dollars? Free of charge, everything was handled in a matter of days. Get in a severely disabling car accident and have to be rushed to the ER? Totally paid for, didn't cost me a cent. I've had three surgeries in the past 2 years and didn't pay a dime. I don't pay copays for doctors visits, can see a specialist without a referral. I don't pay for flu shots, my copays for medicine range from .35 cents to $1.75. I thank my stars every day that I have health insurance.
Because of this, I'm the healthiest I've ever been. I never get sick, despite the fact that I have a really bad habit of rubbing my eyes and my nose due to allergies. When I didn't have insurance I got sick all the time. Strep throat, flu, the works. People say I'm unhealthy because I have to see so many specialists. That's just because I'm disabled. I'd rather see the specialists and be considered sick than not see them at all and be in danger of getting catastrophically ill.
The organization I work for advocates for Medicare for all. There's still a lot of issues with Medicare, though, as a person who is on it. If I had Medicare alone my medical expenses would be hefty.