A Tale of Two Hospitals
Sharon August 10th, 2009
We spent a rare weekend away from the farm, visiting family near Boston, and just relaxing. It was lovely. Meanwhile, I was only half paying attention to the news, but couldn’t help noticing the millions of people all over Europe and throughout Canada who were rioting, demanding an American-style health care system to free them from the deep tragedy of theirs. Oh, wait, maybe I wasn’t 
.
What I was watching was the inanity of the protests against “socialized” medicine and the crazy objections to the idea that poor people shouldn’t die sooner than rich ones. The emphasis is mostly on a tiny number of examples, many of this false or based on incorrect assumptions, of people who are in some way unhappy with their European or Canadian health care systems. Now I’m pretty sure if we worked at it, we could find an equal or perhaps even greater (gee, how unlikely is that) number of Americans displeased by their health care system, but you’d never know that.
I was thinking about this as I sat visiting with my aunt, who had recently returned from a summer trip to Ireland, where she had sojurned with her 88 year old mother and 9 year old daughter. Now her daughter “Lucy” has epilepsy and a number of other disabilities, but hadn’t had a seizure in several years. While they were travelling in rural Ireland, however, Lucy had a sudden, severe seizure, and my aunt got to experience British medicine first hand.
My aunt’s commentary on this was fairly simple. She noted that in America, when you enter an emergency room, you are asked three things - your name, the nature of the complaint, and how will you be paying for this. When she and her daughter arrived by ambulance at the emergency room in Ireland, she was asked, again, three things. Her name, the nature of the complaint, and would she like a cup of tea?
The experienced with National Health, she observed, was hugely different from that of American hospitals after Lucy’s seizure - instead of doing dozens of tests on Lucy, they did one, the relevant one. As Lucy was showing signs of recovery that evening, they held her for observation and released her, rather than insisting she remain in hospital for several extra days, just in case, as has happened in the US. She was seen rapidly, the emergency room was calm and the doctors responsive, and despite the fact that they were not British citizens, there was no charge. Like everyone I know who has ever experienced any kind of national health system, my aunt’s reaction was that if we did half as well, it would be a huge improvement. My own observations on that front are similar.
And this, of course, is the clincher - I’ve never, ever, ever heard anyone, from any country with any kind of national health service suggest that they would rather live under the US system. Not one.
Contrast Lucy and my aunt’s experience in an emergency room with my last experience in an ER. My husband’s grandmother, a few months after the death of her husband, took a wrong turn in the dark while visiting her cousin for Passover, and fell down a flight of stairs. She broke her neck, her leg and her collarbone. When one says she “broke her neck” it sounds as though she must have died instantly, but that’s not the case.
What happened is this - her elderly cousin, sole caregiver for her husband who had had a stroke, rode to the hospital with her, after calling us to come. We were visiting my MIL across NY City, and I immediately got up in the night, dressed and took a cab to Queens from Manhattan. By the time I arrived at the hospital, Inge’s cousin had returned to her husband, because he could not be safely left alone. When I arrived, she’d been at the hospital for an hour, without a single person examining her. She was still strapped to the stretcher, in an ice cold room without a single blanket (she was wearing only a light nightgown, which was up above her waste, where she was completely exposed), and was weeping with pain and cold. When I finally managed to orient her, and asked a nurse to attend to the fact that she was in acute pain, the nurse said “Oh, yes, she had a fall, I’m sure she’s just sore.” This was in reference to an 80 year old woman who had fallen down a long flight of stairs, and who had a visible broken bone, as no one can keep their leg at that angle.
I finally got her warm (she was in shock, very easily recognizable, dangerous and totally ignored) and pain medication, and she became lucid. A doctor, coming to examine her (three hours after arriving) said that even though the CT scan machine was occupied and even though she was having head and neck pain, he thought she probably didn’t have any serious neck injury, and he sat her upright for her examination, even though that’s just about the first thing anyone learns when they do any medical examination - never jostle a head or neck injury about. He told her she’d just need light surgery for her broken leg (missed the collarbone entirely, along with the neck injury) and that she could be released to rehab the next day. I was the one who insisted that she have her neck scanned, and, of course, it turned out that she had a severe break.
We spent 12 hours in the emergency room with beds literally so closely crammed together that there was no room for a chair, and chairs were forbidden. I was 3 months pregnant with Asher, and I stood on my feet for 11 consecutive hours, until Eric’s father arrived to take over attending her. She was finally admitted, after the neck injury and collarbone were detected.
Eric’s grandmother was slightly deaf, and when forced to lie flat on her back, often couldn’t understand what was being said to her. When she realized her neck was broken and she would require massive surgery to repair it, she was very concerned that her wishes that no heroic measures be taken be respected if it seemed likely she would die. My husband and I were the bearers of her power of attorney, and asked that it be invoked, and she agreed - we asked the hospital employees to make absolutely sure they were familiar with her documentation (which we had on hand, sent over by her attorney), and that before any major medical procedure occurred, we be consulted. They agreed. Then, during the early hours of the morning, while my husband and I were asleep (and yes, they knew our number) during some action that a nurse took, her neck was jarred further and my husband’s grandmother went into spinal shock. Without our consent she was put on a ventilator and kept alive against her intentions, expressed will, every request, our request and all documentation.
Arriving at the hospital the next morning, my husband and I and her daughter spent the day trying to get the ventilator removed so that Inge could die in peace as she had always wished. The doctor who had put her on the ventilator against her consent had “ethical issues” with letting her do as she had chosen, and as we had asked, and was in surgery and would not deal with her. She was in a great deal of pain, and very clearly able to express her wish to let go. Despite the fact that surgery to repair her neck injury was admittedly now impossible, despite the fact that even before she was an 80 year old woman in mixed health and there was an excellent chance she would not have survived the surgery, despite the fact that the hospital had demonstrably contributed to her condition by handling her roughly and moving her neck without support before they were certain of the extent of her injuries, despite the fact that she lacked the will and desire to live as a quadrapelegic, they felt they knew best. I’ve rarely felt so much despair and anger at anyone as I did dealing with the hospital in this case. I felt we’d failed her - Eric and I had promised her that this would not be the kind of death she would have. I remember weeping hysterically in the hallway, after the fourth or fifth doctor came along to cover the legal ass of the hospital and showed absolutely no concern for Eric’s grandmother or her wishes.
Finally, after a very long, miserable day, Inge was removed from the ventilator on which she should not have been placed, and allowed to die. She had incurred tens of thousands of dollars in medical costs, received terrible care, and was kept waiting even for death, by the estimable American medical system so many people are fighting so foolishly to keep.
What’s notable about this story isn’t the story itself, it is that I could actually tell two or three other ones about the American medical system, but won’t, for lack of space. I could, for example, talk about why my son, at 6 weeks old, was admitted to a hospital to be treated for a disease he did not have, and for which the only evidence was a screw up by two separate lab technicians. In the meantime, he was tortured - he had 6 spinal taps in a matter of a few days, and we consented, because every time we questioned the doctors, we were told he would die if we took him out of the hospital, and it would be our fault. And no, I do not exaggerate here.
I could tell other stories, belonging to friends and family - but all of them are mostly the same - they talk about a health care system where doctors, nurses and administrators have been forced to be so fearful of a lawsuit that they run up costs beyond reason, but where competence and kindness cannot be rewarded. I could tell more stories of long waits to see specialists (we’re always threatened with waiting - but I’ve never waiting longer in any country than the US to see people), of bankruptcies, and early deaths, and more commonly, unnecessary suffering. I could tell you terrible stories that work in every direction - of doctors driven out of practice by escalating insurance costs and huge amounts of paperwork, of patients deprived of basic medical care, of desperation.
And I can’t tell you those stories in other countries, not because there are no horror stories, not because no one in any other country has ever had a bad experience with medicine, or wanted something they could not have - but because en masse, there is no one who would choose the American system over any other rational system. If you can name a large population from a developed country with national health care clamoring for an American style system, please, enlighten me. Instead, what I hear overwhelmingly from across the world (and have heard for decades) is Thank G-d we don’t have American health care.
The big question, of course, is whether we can afford it. Well, if you’ve been watching the news about Fannie Mae and Freddie Mac, you will see that they are slowly but definitely sinking into the sea, and about to create an economic crisis far greater than anything Bear Stearns or Lehmans ever could. We will certainly spend money we can’t afford on that. There will almost certainly be more stimulus we can’t afford. There will certainly be more bank subsidies we can’t afford. We are spending money in Afghanistan and Iraq we can’t afford, at huge cost to human lives and to the nation. Our whole world is things we can’t afford.
The difference is this - a reasonable health care system actually gets us something. It will save us billions in wasted ass-covering. It will give people access to a basic need - everyone gets sick or hurt eventually. It will create a society of greater equity and lower suffering. Of all the things we cannot afford, it is the only one proposed that’s really worth having.
Sharon
I would agree - the American system (that is actively promoted by the neo-cons here in Canada) is a shameful disgrace.
It is ironic, if there wasn’t so much human suffering involved, to see American healthcare as nothing more than another corporate welfare program for the financial (e.g. insurance) sector. However, with all the suffering it causes, it is simply tragic.
My question, then, is not how do we fix a system whose expenses have gotten out of control, but how do we fix the attitudes of those involved? How do you get folks in the ER to accurately triage patients? How do you get doctors to do their job and diagnose properly? How do you get folks to stop suing at every little thing that goes wrong (without preventing them from suing when it really is the right thing to do)?
It seems to me our government is currently trying to address the out of control costs of health care. Even if they’re successful in that, I don’t see how it fixes the incompetence and attitudes that leads to stories like Inge’s.
I am so sorry to hear the grandmother’s story. Happens all the time… Doctors even refuse to authorize hospice for the dying to keep them in the system… Sigh.
I have a more lighthearted experience of British health care, living in London as a foreign student. My IUD (Dalcon shield!) was giving me problems, so I went to see the local family doc. He told me to lie on the sofa, turn a bit, reached in and removed it. Ha! No referral to a GYN, no waiting, no humiliating “gowns”, no horrible table with stirrups, only kindness and a homey feeling, and no cost.
But I do have a question about going onto such a system here. The country is run by a pack of callous thieves. How can we believe that they would run such a system as well as Canadians or Europeans?
Yep, I’ve experienced the Great American emergency room myself on a number of occasions, most recently when I broke my leg (fell off the porch while watering plants. Yes, I am a klutz.) My husband came home from work to take me because I wouldn’t call an ambulance (been in a few of those, and they’re enough to send a person into shock! AND very expensive!) I sat for three hours in a chair waiting for x-rays, even though the bone was visibly broken. Even though there was almost no one in the ER, things proceeded very slowly. The doctor finally came in and assured me that x-ray would come soon (they didn’t). Now, mind you, I could hear the staff in the hallway, chatting and laughing, so they weren’t busy. After four hours of agony, I told my husband to grab one of them and make them do something (he’s a much more patient person than I am, and also, HIS leg wasn’t broken). Then in August of last year, my 81 year old mother fell on the stairs and broke her hip in three places. I live 4 hours away, and so wasn’t there for the emergency room, but the next day after her surgery, they overdosed her with painkillers, and she became unresponsive, her heartbeat slowed, and her heart and blood pressure dropped dangerously. If I hadn’t pointed these things out to the nurse that was supposed to be monitoring her, she would have died. As it was, she coded, they sent us out of the room, and thankfully brought her back. Now, maybe that would happen with socialized medicine too. Ineptitude and callous disregard can happen in any situation. But add to that the phenomenal expense of being
poorly treated!! Even with decent insurance, we spent a couple of thousand dollars on my broken leg. And yes, I am grateful for modern medicine, but if you can’t afford it, then it isn’t much use to anyone.
As a Canadian, now living in the States, I have been so angered by the misinformation that is being broadcast on various news networks about the Canadian health care system. The biggest problem that I’m aware of right now in the Canadian system is a lack of doctors and nurses, especially in rural areas. This does, on occasion, necessitate a waiting period to obtain treatment. But that is true of the US too.
As you mentioned, if you look hard enough, you can find cases in either country where the medical system has failed.
One very big difference between the two systems. In Canada, no one loses their life savings or has to file for bankrupcy because of an injury or on going medical condition.
Another big difference… no business owner has to make the decision, do I cut workers or do I cut health care coverage.
There is a huge cry about how health care will be paid for. Yet every American, every day pays a high and in my opinion, unacceptable price for the current system.
I’m an American who has the great fortune to live in the UK. I’ve been married to a Brit for over 20 years, and I thank my lucky star that I was able to emigrate. It is wonderful to see doctors who actually take an interest in my wellbeing, rather than just ticking boxes on a form so they can get on to the next case.
I’m very grateful for “socialized medicine.” As someone who has experienced both the US and UK systems, I believe that the UK system is vastly superior to the US one. I have told Brits about Americans being bankrupted by the need for medical care, and they have been shocked, never realizing that such a thing could happen in America.
It’s very sad to see America tearing itself apart over what looks like a minor reform of the medical system, while avoiding the real reform that’s needed. Perhaps the purpose is to distract y’all from how the banksters are robbing you (and the rest of us) every day.
Health care? No.
Death care? Yes.
As a child I went to public hospitals run by nuns that were supported by taxes and donations. Corporations and private companies were not involved-real people were. The attitudes of the people in hospitals today are a result of the system itself and the values that it espouses and calls worthy. It is like a child, the more we ignore the three year old tugging at our skirts, the more he whines and cries and the worse it gets. Stop and pick him up and comfort him and actually spend five minutes meeting his needs by listening and he will dry his tears and go play.
Ignore comes from ignorance. Got healthcare? Be your own doctor and you have a better chance of living. The third highest cause of death in America?
Death by prescription drugs. Third behind heart disease and cancer. Go figure.
Sharon, I’m very sorry to hear your husband’s grandmother’s story.
A few years ago, there was a show on here called The Greatest Canadian. The winner, as voted by Canadians, was Tommy Douglas, the founder of universal healthcare. Our system isn’t perfect, but, boy, you can’t say much more than that.
There’s been news here of a Canadian woman who has done an ad for an anti-universal healthcare group in the US. As far as I’m concerned, she’s doing a great disservice to the American people.
Speaking as a Canadian, universal healthcare is a no-brainer.
I can’t imagine having health care tied to a specific employer,or rely on an insurance company to decide my treatment as Americans do.
Forget the propaganda,nobody I talk to up here wants to change our system.
(my sister lives in England,same thing)
*Please do not confuse Bureau of Indian Affairs run hospitals (which are more like inner city clinics) with tribe funded and run hospitals.
I’m a fan of the health care system. Well, the Native American system. I live in a very poor and rural area. The number one employer in the area is the Choctaw Nation. At the same time the Choctaw Nation has a very large amount of money. Which they have spent building an enormous health care complex. In the middle of a town of about 5,000 there is a hospital, gym, pharmacy, diabetes care clinic, women’s clinic, ambulance service (and where it would otherwise take 2 hours for an ambulance to get to us, it now takes 20 minutes). The hospital is not misplaced. It serves a very large area, and a very appreciative population.
Everything is free. Here’s my most recent visit. I had a very painful ear infection (ahh…lake swimming). I didn’t have an appointment so I went to the emergency room. The woman who did my intake form asked after my mother and talked about knowing me since I was born (literally, she worked at the hospital then too.) I waited about 5 minutes. The nurse called my name and I saw the doctor. He looked at my ears, talked about his wife and handed me a prescription for antibiotic drops and painkillers. 10 minutes. I walked over to the pharmacy and got my prescription filled. 10 minutes.
Total Price: $0
Total Time:25 minutes
There is one major restriction which comes with the system. You have to be Native American to use it. In my area, that’s about half of the population.
So this entire post is basically one very long squeal about how awesome having a tribe is. But it shouldn’t be. Because a tribe is basically a government. It’s corrupt, leaks money, and scandal. But a tribe is my government. It pays for my education, Gardisil shots, a new roof, a storm shelter, a handicapped bathroom for my mother, it mails my prescriptions to me when I’m 2500 miles away, the tribal minimum wage is twice that of the state minimum wage, and there are no taxes.
I don’t really have a conclusion to this. Is this how all governments should work? Does it only work because the tribe makes money off of much larger population than its members? (Though arguably, the US does too) I don’t know, but there it is.
My sympathies to all to have had these bad experiences with the US health care system. Especially what you, Sharon and your family had to endure with Inge.
I want to say that my experiences in the past 6 years with our medical system has been quite different. I’ve been in an emergency room three times, twice for me and once for a friend. First of all, I did have insurance.
My surgery went splendidly in one hospital, the ER was a closer hospital and I was treated pretty well, I did have to wait but I got treated and everything turned out well. My friend seemed to think it took a long time, and to the injured or sick it is especially long, but she seemed to feel her treatment came out pretty well after she got out of there.
Actually, I was in an ER when my mother had trouble breathing last September, and she had to be admitted. It turned out to be her last illness, she was weakened by not eating much for several months by way of alzheimer’s, her Alzheimer’s had gotten much worse those months, she also had right side heart failure, her xrays of her lungs showed lots of scarring and they couldn’t tell what was happeneing in them. She had to have a staff member at the hospirtal with her 24/7 since she would pull out her tubes and try to get out of bed. She was treated for pneuomonia and it helped her fever some but not that much. The next step was a broncosscopy (a sample from the lungs to tell if it might be cancer) and/or a respirator. It was a calm conversation and I simply told the lung dr there would be no respirators and I did have the legal paperwork to show them. And actually I’m the one who said no brocoscopy. I have a brother in CA who I kept informed but he knew what was going on and agreed with me.
The drs, heart and lung, both agreed with me about this. They were not anxious at all to put her through the lung sample thing and the respirators. She was moved quietly to hospice the next day and died quietly about two days later. She always knew who I was and was pretty alert through most all of this until the last 24 hours. She had to have a staff member at the hospirtal with her 24/7 since she would pull out her tubes and try to get out of bed.
My emergency room visitis plus one surgery of mine all went pretty well. One visit at Christmas was a long wait with lots of sick children but then it was Christmas.
My broken arms earlier this summer went splendidly in a brand new redone ER and we got through pretty quickly before a crush of swine flu possibilities showed up.
All I can say is that I know we need to do something to have more medical care available to those who don’t have it and that I know Europeans who’ve had very good care and the idea of being sick in America frightens them.
I can’t listen to any of the health care debate at all, especially these ones screaming about socialism, calm or not. It’s just too emotionaly for me to listen to any of it.
and our own state employee/retiree open enrollment is right now except for some “procurement problem” whatever that is (?) that has completely delayed our whole new enrollment process. We have no info on plans, we know they are going to be completely different than what we’ve had for the last 4-5 years and no one knows when we’ll have any information. Our present plans will continue, and we’ve had a good selection of them in past years, but I knew some kind of crunch was coming with our various and affordable plans when this current contract came to and end. And apparently it’s going to happen this year, if I and my friends ever find out what they are.
And it’s Monday to boot!
I should say our present insurance plans will continue until this issue is settled otherwise they’re going to have about 45,000 people with no employement, current state employees and retirees.
shamba
Sharon, I’m so sorry to hear about the suffering you have gone through with your son and husband’s grandmother.
I was worried about being treated the same way with my son’s birth. There are so many stories here about unneccessary, unconsented episiotimies - sometimes against the expressly stated wished of the mother, and so many reports of women who were given pitocin because the birth wasn’t “on time” or a c-section because labor wasn’t progressing according to “the chart” or an epidural because the doctor won’t let mom turn on her side or get up and walk around to ease her pain. Wouldn’t want to disturb the completely unproven “fetal monitor”!! In fact, those stories aren’t unusual - those are the norm.
Of course, in emergencies OB’s are lifesavers. But I opted for a midwife rather than be put through that kind of treatment, and she was great. Couldn’t have wished for any more caring, attentive and respectful treatment.
My son and daughter-in-law own their own business and make ends meet — barely. They cannot afford health insurance and do not qualify for low-income plans as they have too much money in savings (hoping to put a down payment on a house someday). Recently, they were travelling in California when my daughter-in-law became quite ill — high fever, pain, nausea. They took her to the emergency room for treatment. After several tests, her problem was diagnosed as a kidney infection. She was prescribed an antibiotic and released. No surgery. No overnight stay. The bill? 10k. That’s right, $10,000 they don’t have for a kidney infection! They are contesting the bill but have already made payments of over $500 -and even that is a lot of money! But the scariest part is that they are now afraid to get medical help even in an emergency situation. And they are wondering if they will ever be in a position to afford the medical bills associated with having a baby.
In the meantime, we are getting angry emails from friends all over the US of A claiming that Obama’s bill is going to force the elderly to commit suicide. Bull shit!! The bill does recommend counciling for elderly to explain living will options and their consequences, but nothing about euthenasia — despite what Ms Palin may wish us to think.
We lived in Europe for over twenty years and their system has its imperfections — but no one is left out in the cold. How stupid can we be?
Keep in mind that the town meeting disruptions, “tea parties,” and all the misinformation and lies about “socialized” health care are intended not to defeat health care so much as to defeat Barack Obama himself.
They couldn’t do it in the election last November, so they’re trying to do it by disrupting the democratic process today. They’re the worst kind of hypocrites there are. Plus, as they are demonstrating their contempt for the American electoral system, they are certainly not loyal Americans.
we planned a homebirth 17 years ago, but my son ended up being born in the hospital. he nearly died and they saved his life. after 48 hours of touch and go, he stabilized, but they kept him another three and a half weeks to monitor him. we had good insurance, and copies of the hospital bills were sent to us along with the insurance co. the total bill was $40,000 (a huge number 17 years ago). we paid about $5,000 of that. the hospital settled with the insurance co. and paid $12,000. we said ‘wow, does that mean that if we didn’t have insurance, we could have negotiated and paid that same amount?’ they said no, we’d have to have paid the whole thing, that’s just how the system works. pretty messed up. i do believe he would have died without the hospital (meconium throughout his lungs), but i think they kept him excessively long out of legal fears. they apparently didn’t make any money off us.
I can’t believe how intelligent people, even doctors, allow themselves to read the hype and listen to the ignorance rather than find out the truth themselves.
To the person who thinks staff don’t know how to triage correctly: two things. First, at our hospital only qualified personnel are allowed to be in triage. Second, due to liability issues, even if we triage someone and we KNOW it’s ‘xyz’ we still have to triage them as though it’s ‘abc’ because the providers will TREAT them as though it’s ‘abc’ even though it’s obvious it’s not. What this means at least in our hospital is that people are getting what we call the ‘million dollar workup’ as lawsuit protection instead of the treatment they need.
Now, I can’t speak for Sharon’s experience. That is just beyond my imagination having worked in the system I do work in, in both prehospital and hospital, for the last 17 years. That would happen in a nursing home here, or in maybe a very rural hospital, but it would never happen in a city that I’m aware of.
If you want health care reform you HAVE to have tort reform. Doctors are already walking around with big red targets on them as the general public thinks they’re loaded with money (truth be told, they only LIVE like they’re loaded with money — most of them are drowning in debt) and that’s why the system is the way it is, at least partially. Doctors will treat patients more appropriately if they aren’t constantly looking at the patient with the eye of a lawyer, wondering what could go wrong, what are they missing, and how much money will that cost them in legal defense fees.
And what the h*** is wrong with socialized medicine anyway??? We have socialized police and fire services, socialized judicial system, socialized postal service, socialized medicine in the form of Medicare and Medicaid — and the Congressional medical system — anyway! Nobody bitches that police should be by private pay only, or that fire departments should be for profit. Why should medicine be any different????
Susan, it happened at New York Hospital of Queens. And the mistreatment of son happened at Beverly Hospital, 30 miles outside of Boston. I also used to be an EMT, and I’ve got to tell you, I’ve seen doctors do equally incompetent things at Mass General in Boston and other major hospitals. So no, I don’t think it is true that absurdist malpractice happens only in rural areas or nursing homes.
That said, I agree with you about tort reform - we also need educational reform for doctors - doctors can’t have to come out of med school with 200,000 in student loans - that’s not the way to get a decent medical system.
Sharon
A friend in Australia recently lost a new-born nephew in the “preemie” unit when the electrical cord fell out of the wall (not sure what the electrical unit was but evidently some kind of life-supporting unit).
I replied “Wow — I’ll bet there will be a huge lawsuit and settlement on that one — and whoever let the plug fall out, his head will roll!” A typical US reaction on my part.
My friend looked shocked to hear me say that and replied “No, of course ther won’t be a lawsuit — it was an accident. No one would sue over an accident in Australia!”
I am so thankful that I live in Canada, am Canadian, and am not afraid to go to the doctor, hospital, or whatever medical care I need. I know our system is not perfect, but contrary to my experience in the US, my sister in law in the states (previously Canadian but forced to give up her citizenship to be an American, ?) and her family, I don’t want to panic about healthcare everytime I hear a sneeze with my kids, climb up a ladder, or ride my bike, fearing some sort of injury. The stress alone would probably do me in. Cudos to my friends and family in the US who have made the system work well for you, my fear would be, what if I could not afford health care premiums or my surgery? Yikes!
No one disagrees that health care here in the US is pretty messed up, and everyone probably has a horror story related to a hospital or doctor visit. I could relate my five very different birth experiences from the c-section to the VBAC homebirth, and the incompetence of my care providers from baby #1 to bady #5, but I won’t. I could discuss the several unnecessary surgeries I’ve had, because the doctors wanted to “be sure,” but I won’t.
Unfortunately, however, the current bill before Congress will not solve those problems, as the goal is not to overhaul the current “system” of care and give us better treatment, but rather to make health care “more affordable.” The current discussions are not trying to find ways to make health care better for the patients, but simply shuffling the money around. The emphasis isn’t about making sure we’re all getting the treatment we need, but rather it’s all who is going to pay for the care. And as it stands, right now, the government is in negotiations with insurance companies (nine of the 100 top grossing companies in the US are health insurance companies), who will drop their “pre-existing condition clause” if the government will guarantee EVERYONE has an insurance policy, and I’ll spare you the long diatribe about how much money just the premiums would cost me as a self-employed individual - which does not even include any co-pays or deductibles, which are also considerable. Can I say it one more time with emphasis? It’s..all..about..the..money.
But it’s not just that the government continues to spend my money or attempt to dictate to me how I should spend it. There are at least three or four other clauses in the proposed plan that make me bristle (including the one that requires everyone to get vaccinations, including the highly controversial Gardisil, and the completely unnecesssary and potentially harmful Chicken pox).
I’m not for or against universal health care, but I couldn’t be more AGAINST this current proposal. The way it reads, right now, it’s just another one of those programs that erodes my right to choose for myself and my children.
People go bankrupt when they get sick??? A couple of thousand dollars for a broken leg??? You’ve got to be kidding.
I’m from Australia, bringing up 4 boys on my own, and I’ve never had to pay for a doctor’s appointment or a trip to the ER. The only thing I’ve ever had to pay for are medicines (and most of those are subsidised by the government.)
Sharon,
You tell a compelling story, but . . .
The problem I see is not moving to socialized, litigation-free health care. What I see is enfolding the rest of the nation into the corruption and mismanagement of Medicare and Medicaid - which serve very few people that don’t rely heavily on private “supplementary” insurance.
This nation doesn’t know how to do what you descrbe for Ireland.
The hospitals in the US were built to make money, many of them, and the owners and administrators aren’t interested in changing that.
Many American doctors rely on the cash flow generated by hospitals and pharmaceutical companies to make their chosen career “attractive”. Many have spouses and families embedded in the cash-flow lifestyle, and won’t be eager to assume a more moderate lifestyle.
Just like with Detroit, there are unions among them there hospitals and emergency services. And Obama has a history of rewarding unions.
If the government set out to start constructing county hospitals and neighborhood hospitals with on-demand care, if they intended to construct an infrastructure to empower national health care, that would make sense. A starting seed of clinics, hospitals, and associated facilities could provide care to the most-needed areas, and grow to cover the rest of the nation. I could wish the first one be built next to me.
Instead, B. Hussein Obama and Reid/Pelosi intend to nationalize today’s health care without first muzzling the courts and lawyers, without establishing a rational infrastructure, without providing for the research and incentives for advancement that the American system has actually produced.
I grew up in Clay County, Iowa. The hospital in Spencer was, I believe, built and run by the county. Over time costs grew, regulations increase, and the hospital was sold to private interests. Instead of care for the people of Clay County, there was a subtle shift of emphasis to care for the management of insurance cash flow. People were still cared for, but scheduling was done to suit insurance requirements for test results, for approval cycles - for the infamous lists of authorized payments for lists of covered claims. Yes, your story is quite common.
The ethical issues thing, though, I think is separate from the financial and infrastructure part of health care. I think the issues of avoiding heroic resuscitation, of unwilling support from staff and care givers, will be an issue with us for a long time. As long as we have significant portions of the nation more concerned about ethical treatment of animals, above and beyond community needs, we will face physicians and organizations refusing to allow the individual to choose for themselves. This is the essential liberal vs. conservative discussion, after all. The liberal contends there is no such thing as a life and death decision - the state’s choice (or the “right” choice that is the only option the speaker acknowledges) overrides anything the individual might prefer. The conservative assumption that the individual is responsible for themselves, until proven otherwise, has been demonized by this and previous liberal administrations and organizations. Note that we still send nurses and other caregivers to prison over questions about assisting mercy deaths. That sends a very strong message to the medical community. And that dichotomy over mercy, individual choice, and right to life might actually be another wedge to drive some of today’s caregivers from health care, should ObamaCare prevail.
In short, rather than gain a decent health care system with responsible health care for the nation, we stand to lose the hospitals, staffs, and doctors that now provide what health care is available. And be left with insurance companies that are no longer agile enough to serve as they are today. (I am thinking of the provision in the House bill that makes it illegal for insurance companies to write new policies - so much for B. Hussein Obama’s promise that “people can keep their current insurance plan”.)
As clumsily as the Obama administration and this Congress have blundered with stimulus actions, with bailouts, with using the Cash for Clunkers program to inflate the credit market and reward the car makers (and unions) they are now invested in, please forgive me if I am concerned that they haven’t yet come up with a responsible plan for health care. Administering the juggernaut that is proposed will require entire new battalions of bureaucracy, meaning newly hired officials, unwritten forms and procedures, and possibly an interesting cash flow to fund the bureaucracy and the health care, given the way the economy looks.
I am not forgetting that the real sign that the economy is improving will be an increase in demand - and price - of energy. Which will create another destabilizing factor in the economy.
Please pardon my concern, especially as this administration seems more prone to blackballing and demonizing criticism than to admit mistakes (Call someone stupid, they often expect you to say “I’m sorry for calling you a name when you didn’t deserve it.” Apparently apologies don’t apply to this administration. But control Czars and lists of radicals and dangerous persons suit B. Hussein Obama very well.)
In Australia we have things go wrong in our system - as in any system, but overall we have access to a high level of healthcare and universal coverage under the Medicare system.
If it wasn’t for our universal healthcare I would have had a hard time managing to pay for treatment when I was on a low income and had cancer a couple of years ago. I did have to pay a small amount of costs myself (about $500 out of costs totalling more than $10,000). I am so grateful for Medicare and the quality of our doctors and hospitals. I would love to see everyone in the world have this standard of care.
Every time I hear about America’s system of insurance and people only getting treated if they have enough money, it shocks me that a first-world country could have such an inhuman system.
Same goes for the NZ healthcare system - it’s far from perfect, but I’ve never heard of anything so appalling happening here. And if you have a simple infection, it’s probably not going to cost you more than $50 at the most. And if you’re low waged or unemployed you won’t even have to pay that.
Every time I have to travel to the US on business I get given a little card to wave about if I should have to be hospitalised. I’m thinking I’ll just drag my poor sick carcass onto the next plane home rather than face the US medical system
No government-based reform will cure the incompetence described in your story. I have a rare joint condition that carries a high risk of disabling osteoarthritis in middle age. At the young age of 18, when I asked the rheumatologist what I could do about it, he said “well, keep your weight down, but there’s not much you can do. Come back in 20 years when the damage is done, and we can treat you.” I have learned since that appropriate exercise, physical therapy, and lifestyle modifications could have prevented the damage in the first place! But medical doctors are trained to treat patients and not (with rare exceptions like childhood cancers) to cure or prevent disease. Unless they change the training paradigm, we’re just changing the payor from individuals who don’t have money to a government that does not have money. That won’t help us very much, and bears a high probability of crashing the system altogether when our bankruptcy becomes unavoidable.
Good comments by Brad and Wendy, among others, and naturally I agree with everyone who mentions the lawsuit crisis ( but good luck changing that in a system wherein nearly all elected officials are former lawyers). Obama seems to me to be focusing much more on expanding coverage ( to more people) than on controlling costs, the real problem for most of us. Those of us who are self-employed and paying for premiums out of pocket have no reason to believe the premiums will go down, or go up more slowly, under a “deficit-neutral” ( yeah, right) system that suddenly includes millions more people and the bureaucrats to support them.
“Everyone gets sick or injured eventually…” - true enough, but a certain class of people doesn’t KNOW that. I mean, of course, the under-30’s, most of them. Perhaps you were always worldly wise and mature, Sharon dear, but I who am a few years older than you can recall that invincible, invulnerable feeling very well. “Twas bliss to be alive then, but to be young and stupid was very heaven - twas no feeling like it!” ( No, the quote is not quite right - I was not an English major like you). I think very soon in this country there is going to be a very not-cool intergenerational fight, whether Obamacare passes or not. Medicare is paying out more than it is taking in NOW. End-of-life costs are rising much faster than inflation, partly because of newly available technology and partly because of stories like the one you shared with us. People assume costs can keep rising and ( shrug) SOMEONE will always have to pay them, if you pass enough laws. This has worked ( sort of) up to now because geezers outnumber and easily outvote whippersnappers, esp. when the codgers vote with the geezers as we generally do. But it can’t go on like this much longer. Ultimately when people CAN’T pay a bill/fee/tax, they DON’T - moral sanctions and legal penalties notwithstanding. The young whippersnappers aren’t going to like it when their hero forces them into a health plan they think they don’t need and requires them to help support geezers they don’t feel responsible for. Anyone else notice that the proposed health plan doesn’t take effect until 2013, coincidentally after the next pres. election?
Society as a whole is not emotionally or spiritually prepared for a new era when most of us will live longer than we dreamed possible and will spend more time supporting our parents than raising our children. We are also ( you may have noticed) a long way from becoming a Nation of Farmers rather than a nation of lawyers as presently. I don’t have the answers but when people do gradually re-assess their assumptions and priorities they are going to need a lot of practical, non-ideological advice such as you provide on how to grow food and medicinal plants and develop social support networks apart from government. That’s why I read your blog, Sharon, and I do aprreciate the vast amount of such info you share with us for free. Thank you.
If Canadian health care is so great, why did I take care of so many that came here to get their procedures done? Anyone with any education in economics says that this has to be paid for some way. That means higher taxes for everyone. It will have to be rationed as well. Are you ok with someone else saying who, what, when and where, taking away the right to choose? Are you also ok with the crash of one of the few industries (2) that are currently not getting bailed out - insurance and health care, and are still employing people? If so, universal health care is for you. Yes it will be rationed, it has to be. Yes, they will be pulling plugs, as long as you are not afraid of the here-after, that’s not an entirely bad thing. I agree poor people need health care. I do not agree that the government can competently run it, just like they manage energy and the economy, eh?
Here’s my take on the whole health care debate - and yes, I am a Canadian (who happens to live so close to the US border I can see it from my front porch).
A critic of our system will find a case where either the government wouldn’t pay for a “life-saving” drug, or someone was forced to go to the US for treatment, etc. - i.e., atypical cases that happen in ANY country. If I find news items like that focusing on American health care, I’m told I’m being biased.
A critic of our system will say that all governments are inherently corrupt, and if one is put in charge of health care, the costs will natural rise. If I find evidence of corruption in the insurance industry, I’m told I’m being biased.
A critic of our system will state that we pay incredibly high taxes to fund our heath care system. If I show what I pay in all taxes (provincial and federal), and compare that to what a friend in Ohio pays in taxes (local, state and federal), and add in her health care premium, and show that my cost are equal or less, I’m told I’m being biased.
A critic of our system will find some on-line stats (for example, colon cancer rates) that “prove” the US system is better. If I find stats that show that Canadians have a longer life expectancy, lower infant mortality, etc., I’m told I’m being biased. If I try to explain that one reason for the higher rates of death due to cancer may not be that we don’t treat cancer properly, but that we have a greater number of older people, who naturally die of something, I’m told I’m being biased.
I’ve been told that I can’t comment on the US system, since I’m Canadian, and have no basis of comparison - which is 100% true, but that fact doesn’t seem to apply to those who criticize our system. I’m told that I simply don’t see all the Americans who can’t get health care because their doctors are too busy treating Canadians (but I don’t dare talk about Americans coming here for cheaper prescription drugs). I’m told I simply don’t see all those Canadians crossing the border for health care - and it’s true, I don’t. I’m almost 40 years old. I have lived on the border for all but 10 of those years. I know of NO ONE that goes to the US for routine health care. I know of one person that has gone to the Mayo Clinic for teats/treatment of an incredibly obscure disease, but that is not because he was refused treatment here - and in fact, his treatment there was covered by Canada.
I am so tired of trying to debate with people who simply do not want to hear, learn, listen - they simply want to hold on to what they have because THEY aren’t suffering, and can’t seem to see those that are. And yes, I am so glad there was someone like Tommy Douglas (and all of his supporters) who showed us that there was a better way, and that as a community, we need to care for all, regardless of their income or employment status.
Sorry for such a long comment - and I love your blog!!
Coleen,
Where I can sign on for your insurance? With the insurance I get from work, I have a limited list of doctors I can see. My younger daughter has to see different specalists at hosptials in different states because the that’s where the insurace plan sends here. I’ve paid out of pocket more than once becuase while a doctor wants to see her every six month, the insurance would only pay for a vist once a year….
I could go on, but I’d rather sign up for your plan.
MEA
Another vote in favour of the Australian health care system.
I have just finished chemotherapy for lymphoma. This followed extensive surgery and even more extensive exploratory procedures, and has been followed by CT scans and ultrasounds etc.etc. Total cost $0. I cant speak highly enough of the care I received from all the surgeons, doctors, nurses, ward attendants etc. etc. I have reached the ’safety net’ as far as drugs use goes, which means that now I get my pharmaceuticals for free. The safety net means I have spent $600 (I think) in less that one year.
On the US NHL discussion board I check in on, this seems to cost tens and tens of thousands of dollars in the US. That is if you have the money or the insurance. And If you have the insurance, you seem to have to hope the insurance company will OK the scan the doctors want.
I just don’t understand the heated debate in the US over health care reform.
A brilliant piece.
Something forgotten in the “demonostrations” against the present debate on heath care:
Current Insurance Companies ration care, too!
Affordability of Prices ration care, too!
In the US, that is. This has been very interesting to read the responses from non US denizans.
cheers,
Shamba
Thank you, Sharon, for framing the issue so well. I am sick to death of people who rely on our currently socialized systems (Medicare, police departments, garbage collection, etc.) screaming about how they don’t want to have to pay for anyone else’s anything! Thank you also for sharing your stories.
Personally, I wonder how many of America’s uninsured are working on farms or in meat packing plants or slaughterhouses…do the current screamers really want these people to be without healthcare? Have they thought our what the potential ramifications on the food chain are if we continue to not provide health insurance to our neediest people?
Thank you also to the people currently using universal healthcare in their own countries who have commented. A good friend of ours in France echoes your comments that he much prefers the system in France to that of the United States.
As for Brad, I was reading his post until I came to the Hussein reference to our president and realized that he’s just another hater trying to incite racial problems. Not worth my time.
Brad K.
Now, wait a minute. You may have some valid points, but you also have some nonsensical ones. Caring about the ethical treatment of animals in no way prevents people from caring about the ethical treatment of human beings; that’s an absurd assertion. And so is your argument that being liberal prevents people from believing in personal responsibility for life and death decisions. Here in Oregon, we passed a very controversial, very liberal law to allow assisted suicide. Tossing off stereotypes does nothing to further this dicussion.
And what is with the constant repetition of President Obama’s middle name? Yes, it’s a common Middle Eastern name. What of it?
No doubt the bill is imperfect. Most federal legislation is. Well — make that all federal legislation. Unfortunate, but that’s how it goes. I, too, adamantly oppose mandated vaccines, for example. Still, it is at least a beginning. We could all write to or call our Congressional representatives to argue for improvements.
Diana,
Just saw your post after mine went up. Good point.
I love how oppnents of single payer health care can always say bravely “Yes…but…” I grew up with single payer in England and Italy and for all the shortcomings (which never affected me personally so what do I know?) I never heard anyone says they wanted change. But in this country? The brain washing makes me despair. My wife and I have insurance but we have had to deal with actual insurance claims and the endless paperwork, the denials of service, the arguing, the waits for treatment. My friends in Europe laugh bitterly at my stories.
Anyone who thinks “Yes….but…” is someone who hasn’t had to actually use our system, because when they do have to use it, they too will be converted to our point of view.
I read a fascinating article making the pint that white Americans who oppose universal coverage ar epeople who don’t want to share our medical system with the poor minorities who are currently shut out. It was a very provocative essay.
We do have a shortage of general practitioners in Canada because they know they can make more specializing or moving to the the U.S. The other major shortage is OBGYN because of crappy hours and fear of being sued for a child with a dented head or such.
Other than that I’ve heard many minor problems but never have I heard of service denied, people going bankrupt or the uninsured dumped in the alley still hooked up to an IV like cameras have caught in some U.S. states.
I think however that western society has to look closely at the invasive and expensive treatments that are being developed and ask the question is an operation that gives a 70 year old 3 more years of live worth the cost of supplying neo natal care to 1000s of poor, or feeding 1000s of malnourished. Drugs, machines and treatments are eventually going to cost more than society can support and front end, free preventive measures have a much greater utility. the story I heard last week about the boy who for the lack of an 80 dollar tooth extraction died of a brain infection costing several 100 thousand dollars, its just nuts.
Re: Brad’s use of Hussein - let’s let that one go here. I don’t love it either, but then again, I used to refer to GWB as “Dubya” all the time (and occasionally as “Chippy the wonder chipmunk”
) - Brad’s allowed to call his president anything he wants, and the guy’s middle name is one of the nicer options for any president 
.
Re:Colleen - health care is currently rationed. The average person without insurance who gets cancer has a shorter life than the average person who does not. Infant mortality among the American poor is a national disgrace, and in poor areas of the US, lifespans are *decreasing* - so let us actually compare objective information. None of that is true in Canada, where “rationing” and “plug pulling” still seem to result in lower rates of infant mortality, longer lifespans and a greater degree of satisfaction with their health care.
MD, I agree that we won’t fix the healthcare system by creating national health care, but there are ways that we can make it more rational.
Wendy, Brad, I don’t love the current proposal - I belive in single payor models. But the reality is that anything, at this point, is better than nothing.
As for raising your taxes, folks, we could have paid for national health care for decades on what we spent on the Iraq war - I do hope you were out protesting. We could provide health care for more decades on what we’ve already given the banks - I do hope you were as loud in your protests there.
Just sayin’
Sharon
During a visit to Queensland Australia three years ago, my son came down with what seemed to be strep throat. We had to take him to a clinic. Clinics are everywhere and abundant in that particular town. The one that was suggested to us by a friend was in a shopping mall. They gave us a 10 o’clock appointment (that’s right, not walk in but by appointment). We got there right on time, filled in basic paperwork and were seen by the doctor at 10:10. By the time we were in the examining room, my sons medical history was on the doctors computer screen. She did the full examination and a simple test, determined he did not have strep and sent us to the pharmacy for a specific throat gargle with instructions to come back if he worsens. The time we spent with the doctor? Nearly an hour. I have had full physicals that take less time here in the U.S. The cost of the visit was 60 dollars. If we had an insurance card it wouldn’t of been totally free we were told but it would of cost 35 dollars. The program is multi tiered but I don’t know the full details of how it really works. However, the experience completely destroyed any semblance of belief that our system is superior to socialized medicine. It was fully accessible, super efficient, paperless, affordable and the doctor was fully qualified. What else do we really need?
Everyone commenting here seems to see something that the politicians deny. I think we can all agree that this bill is a step toward a single payer health care plan (for better or worse depending on your perspective). The problem that I have is that the politicians pushing this legislation deny that fact. Call it what it is and be upfront about it.
Another problem is that they (the politicians) say that this legislation will increase coverage without increasing cost. Those seem to be mutually exclusive goals.
I agree that our current system does not function well. I do not believe that the proposed legislation is the correct way to go about fixing it.
Sharon, I don’t buy the argument that “anything, at this point, is better than nothing.” “Anything” is a dangerously inclusive word. I am surprised that you allowed that to slip through. You’re normally so careful in your word choice.
Also, I’m sorry to hear about the awful medical experience that you recounted in your post. I don’t wish that on anyone. I do however fail to see how the current plan would do anything to prevent a repeat of that situation.
Hi Sharon, As I know you know, Ireland is not part of the United Kingdom. Not unless you meant Northern Ireland, entirely possible.
My husband is English and lived there for the first 42 years of his life. I spent two years living in Canada. We both have extensive experience with the American farce of a medical system too.
In spite of all the lies you read and the propaganda issuing forth from the right wing and the insurance companies, the British medical system is better than ours in several very important ways: one of which, of course, is that the Brits do not leave 47 million people with no health coverage at all. The Brits, on the whole, are very happy with their system, by the way. There are other reasons why it is better too, and not least among them is that doctors in the UK get to actually *practice medicine* rather than being insurance clerks as they are in the USA. Our doctor in the USA speaks longingly of being able to actually spend his time treating patients rather than arguing with insurance companies and doing their paperwork.
I don’t think this plan will pass at the moment, and I think the reaction when the chaotic, wildly unfair, horrendously inefficient present system is left in place will absolutely ensure that the Republican Party will never again be in power. That’s the only good thing about it. The worst thing about continuing as we are, of course, is the people who will continue to die needlessly…and there are a whole lot of them. I personally knew a woman, 51 years old, who died needlessly.
Both my husband and I know absolutely, from personal experience, that we would choose socialized medicine in a heartbeat - any day and every day.
Pat Meadows
I’m an investigator for a state medical board, and I see these tragedies every day. A man injures his shoulder, goes to an ER, gets prepped for surgery, and has the IV pulled when it’s learned he has no insurance. A woman has an emergency colostomy, and when she returns to the surgeon to be put back together, he won’t do it because she’s lost her insurance. An eye surgeon tells patients they need cataract surgery - when they don’t -and brags because he can do the procedures in 5 minutes, one right after another - he makes millions.
The good physicians are stressed, depressed and burnt out. They can’t practice the way they want to. They are forced to limit their time with patients to a few minutes and are constantly afraid they could be missing something important. They don’t dare speak up for socialized medicine for fear of being criticized and reprimanded by colleagues and the AMA (a powerful political force).
I wouldn’t let a loved one stay in a hospital alone any more than I would leave a child alone on a busy street corner.
This is the first step towards single-payer? Don’t count on it. How likely is it that a large give-back to the health insurance companies ( as this appears to be) is the first step towards eliminating those companies? Again, what’s with the “pass this thing right now, before congresscritters have time to read it, but it won’t take effect until 2013?” THere’s no reason for either of those provisions unless “someone” thinks the public as a whole isn’t going to like the finished product, and i think that someone is right. Figure on your premiums going up, not someone else’s taxes, and plan accordingly.
( Cheer up, maybe the next Fannie and Freddie problem, or Gerald Celente’s long-predicted ‘bank holiday,’ will make this seem like small potatoes).
I’m a US citizen who now lives in the UK, and I can tell you, the health care system in the UK, for all its problems, is much better. Imagine being able to call a FREE service 24 hours a day, where a nurse will answer the phone and talk to you about your medical problem. She’ll then tell you what to do, what to watch for, or help you book a visit to the doctor or hospital. NHS Direct rocks.
In the US, even with excellent health insurance (I was a state employee), there were times I could not get an apponitment to see the doctor, once with a 103 degree temperature that was not going down. Out of exasperation, I just showed up at the clinic, marched to the desk with a thermometer in my mouth, took it out and said, look. I’ve been highly feverish for two days, my blood pressure is low, I’m coughing blood. I need to see the doctor. I had pneumonia.
We’re not ever going to be fortunate enough to get single payer in this country, I believe. The masses are too brainwashed to act in their own interests, and most Americans have never had access to anything outside their own system for reference so they are easy prey for mind-control via the flickering blue box. Having lived in France and in Canada for several years, I can say without reservation that America is a pitifully underperforming “developed” nation when it comes to our health care. We certainly do not come even close to having the “best health care system in the world,” as the propagandists would have it. I think what we forgot to develop on our path to riches was our humanity and our morals and our ability to critically analyze what we’re told — and we are paying the price now for our lapse and will continue to pay as the Empire crashes around us.
It really is kind of depressing to see the brownshirts-type behavior going on at these town meetings, though. Is anyone concerned that we’re in the first stages of a fascist meltdown? I’ve wondered for a long time where the anger of the middle class was going to go when it finally burst out, and it looks like it’s being channeled very effectively by the entrenched, shadowy corporate interests, as usual for the benefit of the corporate interests.
Great blog, Sharon. I really enjoy reading your passionate rants. Your fire is inspiring, and I wish I could hang on to some of your idealism in this area. I guess I’m jaded after seeing our populace fall for the lies over and over and over — and yes, I’ve protested and continue to do so, but with less and less zeal over time. I’m also jaded from seeing an insured friend and her husband go bankrupt after two newborns required the n.i.c.u. for long stretches and from going several years now myself in this country with no insurance because I’m self-employed and have a pre-existing condition that arose when I was quite young and yet which has not recurred in over 14 years. I simply can’t afford what they would charge (insane!) and they wouldn’t even cover the condition if I paid it. I’ve made it a policy to go with cash (you can often get lower prices from the doctors if you’re friendly and honest), to treat my body like it’s precious with rest, love, exercise and the healthiest food I can grow, barter, or buy, and to save for a worst-case scenario. But the reality is, I’d be sunk, with insurance or without, if my pre-existing condition were to reemerge.
Better to focus on personal and family and neighborhood preparedness — and your site and books are helping me to do that!
Sharon,
I completely respect your opinions and appreciate all of the information you provide. I even buy your books, but on this subject I can not agree - especially with the assertion that “anything is better than nothing.”
As I said, I’m neither for nor against socialized medicine. In fact, I was in the military and am familiar with “socialized” medicine, but, frankly, the level of medical care US soldiers receive in that government-sponsored system isn’t really superior to what minimally insured American civilians receive. If you want to imagine what we might end up with in THIS country (and make no mistake, the current bill is not modeled after those superior systems in other western countries) under the current bill, go visit a VA hospital or an Army clinic for active duty personnel.
The CURRENT proposal will not change the care people receive when they go to the hospital. It will only change who, ultimately, pays for it. I’m self-employed and have no “employer” coverage. To insure my family of five would cost almost $15,000 per year. The premiums alone constitute almost 25% of our annual income - and that doesn’t even include any doctor’s visits, never mind if we ended up in the hospital (at which time, we’d have a $10,000 deductible to deal with - in addition to the $15,000 worth of annual premiums AND any doctor co-pays). We make too much money to be eligible for government subsidies, but not enough to give Unum (or Aetna or Blue Cross Blue Shield or …) 25%.
Under the current proposal, however, I would have no choice. The CURRENT proposal would REQUIRE that *I* purchase a plan from a private health insurance company.
I am one of the 45 million currently uninsured people here in the US, but there is no way that I am for giving some fat-cat insurance company 25% of my annual income. Personally, I feel like we’d be better off with more doctors like these who don’t take insurance, and can, therefore, cut their costs. In fact, if this plan passes, I see a lot of people, like me, opting out of the “system” and using these sorts of doctors. The, unfortunate, result in this country will likely be that the “good” doctors end up not taking insurance and lowering their costs, and the ones who continue to practice in the system will be the ones who do what they want without regard to what the patient wishes.
In my opinion, that’s where this current bill will lead – kind of like all of the education “reforms” have created a very healthy and thriving homeschooling community. In both cases, “anything” was most certainly not “better than nothing.”
And, please, understand that I am not saying that we should do nothing. I’m saying that we should fight any bill that gives more of our money to private industry without our consent - as this bill will do, unless some huge changes are made.
As I’ve said before in a response on this forum, the Australia taxation paid health care system leaves no one without care and we can opt to pay for private health insurance which gives a few extra benefits like the choice of doctor. The fact that they are ‘competing’ with the public hospitals means that they keep their prices down.
A few other thoughts from a semi-oldy. In my opinion, hospital care has become worse since they moved nursing training out of the hospitals and into the universities. When young nurses were available in the wards to watch and learn, things seemed to be quite efficient and there were lots of nurses who worked, learned and were paid to learn. No shortage of nursing staff there.
In Queensland up until about 30 - 35 years ago, there was a legislative upper cap on what you could sue people for (personal injury). In those days it was $500K. Now even if you had an upper cap of $5mill it would make a big difference to the costing of the insurance that hospitals and doctors have to hold and free up the fear of litigation that is crippling the care industry.
Please don’t imagine that we here in Queensland are ’socialist’. We are collectively more conservative right wing than many of the countries you have talked about but we have always had free health care. It was previously funded by the state lottery.
Coming from Canada, I personally don’t have an issue with ’socialized medicine’. Is there problems? Absolutely. I couldn’t get a family doctor because our area had a shortage. One had to go to clinics. I still got more than adequate care. Do you have to wait for ‘elective’ surgery? Yes. My grandfather waited multiple months to get a hip replacement. But if I had to choose between waiting for elective surgery and knowing I wouldn’t die from something curable because I couldn’t afford the care… I choose knowing that I won’t die from something curable/preventable.
Having said that I have no issues with ’socialized medicine’, I have great fear of the plan that the govt is thinking of. I have no faith in the American govt and have a hard time believing that they will be able to implement a functional system that will be to everyone’s benefit.
One of the things that I find most disturbing about the health care bill and issues such as tort reform are that they do absolutely nothing to address the inhumane treatment and lack of respect and choice that many doctors and hospitals subject their customers to. I fell in my house hard enough to break the skin on my head and refused to go to the doctor because I was reasonably certain that I was fine. Money was not the primary reason that I did not seek medical treatment, it was the fact that I did not wish to put up with the way that the medical personnel have treated me in the past. It is very sad to say but I feel that my pets receive better and more respectful treatment at the vet’s than human beings do in a doctor’s office. Maybe that is because they have sharp teeth?
Another major difference is that veterinary care is generally on a fee for service basis and the insurance industry has not succeeded in infitrating it very thoroughly yet.
Just back from Robert Wood Johnson Hospital, were I was informed that I were uninsured, I’d be charged 115% of the going Medicare/Medicaid rate.
MEA
As a Canadian I am so grateful for our health care system. I am utterly astounded at the rhetoric I’ve heard coming out of those ‘town meetings’ about health care reform in the US, people talking about ‘death panels’ and who seem to mistake socialized anything for communism. Our Canadian system isn’t perfect, like others have said, but when I wrecked my knee falling out of my husband’s semi truck, my knee was repaired at no cost to me other than my monthly health care premiums (of which my employer pays half). I also received subsidized physiotherapy for months afterwards. My husband had hip surgery earlier this year, again at no cost to us other than the government regulated premiums. He’s still taking his physiotherapy now - he will get 20 free visits because he was a surgical patient. There were some wait times involved in both of our surgeries, but nothing ridiculous, and no onerous medical bills before, during or after the fact. We heal up and carry on.
I am sorry for your family’s awful experiences in your health care system Sharon. It’s just not right that people get treated this way. I hope that the rhetoric gets toned down and people there realize that providing a basic level of free health care for everyone is just the right thing to do. Way better than bailing out banks and car manufacturers.
Just added some numbers and found that here in Alberta, Canada, I pay $1969 CDN for health care for a year for both my husband and I. If we had kids the amount would be the same. That includes coverage for subsidized eye exams and corrective lenses, as well as for 80% coverage of prescription medication and most dental, and subsidized physiotherapy, psychotherapy and chiropractic services.
[...] care clamoring for an American style system, please, enlighten me.” Sharon Astyk relates an experience in an Irish hospital vs one in the U.S. [...]
I must run in vastly different circles than you do because I have met several people who have experienced health care in other countries as well as here who have said they would rather take ours. This includes people from France, Brazil and other such places. I don’t disagree that our system needs some fixing, but I really don’t think the current proposal is the answer. And regardless of what side of the debate people fall on, I wonder how many people spouting off opinions have actually read the entire bill.
Probably redundantly, I’ll add my voice to those in favour of the Australian (socialised) system. It is by no means perfect, but no-one is denied emergency care here. No-one. And the level of treatment is, on the whole, good. I’ve had a very, very sick sibling, multiple health problems of my own, three difficult pregnancies resulting in caesarian deliveries, and I cannot say I have any complaints (except, ironically, about the ONE provider I paid privately for - the anesthetist who gave me the spinal block for my last baby, and botched it up, giving me nerve damage in my thoracic spine). Our public health system is overloaded, a bit clunky, and sometimes annoying, but it works. We get treated, and treated like human beings, not cash cows.
Bit confused here. Is the National Health system receiving praise here in Ireland or the UK? It reads as if it happened in the Irish Republic but it might have been Northern Ireland. The UK and Irish systems, while both being ‘public’, are very different.
This is a very nice post and a great discussion (a little one-sided, but that is the side I am on…)
I grew up in Canada, went to medical school in Montreal, did my residency in the US and have practiced 20 years mostly in community health centers in the US.
I want to say something about emergency rooms and the difference between Montreal hospitals and the ones I became familiar with, first in Rhode Island, then in Massachusetts, San Francisco and finally in Colorado.
Life in the US, compared to Canada, is just more gnarly. One of my first ER patients as an intern had been beaten and thrown out of a car - fractures on both sides of her face - passed out drunk… In four years of medical school I had not seen this in Montreal. Honestly, I was so traumatized I never went to visit her once she got admitted. I could not deal with it, and no one was going to help me.
The next month I overheard a nurse casually ask a young man in a pediatric ER: “So, where else were you shot?” Another teen was sleeping off an alcoholic binge. Heck, Providence was so dangerous in 1987 there were yellow HELP buttons on the street lights in the hospital parking lot.
It’s a funny thing you might not expect, but there is a fair amount of post-traumatic stress disorder going on within the medical profession. I am still reeling from the night 2 years ago when I was called to admit a 17 year old in a coma from drug abuse. The grief at seeing his young body devastated in this way was almost unbearable. I think the best writing on this is by David Hilfiker (”Not All of us Are Saints”), who insists that medicine is about “service”, and that this must be embraced, or callous craziness like Sharon describes is the outcome.
Finally a point no one ever makes: the best way to decrease medical costs is to cut back on the number of people getting sick. So you start with the department of Agriculture, the department of Transportation, Education, and the department of Defense (you want to see PTSD - just wait a couple of years). Oh yes, and get rid of the television!! And did I mention Racism? Income Inequality? These are all underlying reasons for our high “health care” costs.
I haven’t read all of the above comments, so my apologies if someone has already stated this, but:
The Republic of Ireland (Ireland, Éire, the South of Ireland, whichever) is NOT part of the UK, it is NOT part of Britain. We don’t have an NHS here (mostly public healthcare supplemented by some private insurance).
If the first part of the story took place in the North of Ireland (Northern Ireland), then that IS part of the UK, and then the care given to your cousin was given by the NHS.
I just had to clarify this, firstly as an Irish citizen, and just in case anyone reading this story wanted to compare healthcare systems around the world and got confused.
I agree that there are rampant problems in our health care system, often spurred by malpractice fears.
The problems you give examples of seem to be spurred by malpractice concerns…which aren’t going to be fixed by the currently proposed legislation which actually *PUNISHES* states that dare to pass malpractice reform legislation.