Can we all just agree to put the whole "America has the best healthcare in the world" argument to bed already?
I have a friend from back home, a dyed in the wool, Sarah Palin-loving right-winger, who I jostle with often about politics via email and on the phone. Our little debates are often funny and entertaining, but at times can be frustrating. In the run-up to the election, we fought over a number of things, healthcare being one of them. The 60 Minutes story that I posted earlier today got me to thinking about one of the exchanges we had over reforming healthcare in the US, so I went back and dug it up in my email. Here's the crux of what he said, something that I think is the universal argument amongst people in this country who are against the idea of a nationalized health system...
I agree that everyone needs access to affordable healthcare but the reality is, there is no way to do it without sacrificing quality. There is no one in the world who has done this without gigantic tradeoffs. The U.S. has the best healthcare system in the world yet it is very far from perfect. A perfect solution does not exist. If it did, I guess it would be available to anyone, anywhere, anytime and the Doctors and Hospitals would earn the big money they deserve because of the hard work that they put in.
And this was my retort to his "best healthcare in the world" argument...
about healthcare: i've mentioned to you previously how one of the biggest things for me in changing my feelings about gov't healthcare has been meeting and becoming friends with people from canada and europe where they have nationalized health care, people who not only find little fault with the systems that are in place in their home countries, but who are overwhelmingly enthusiastic about it, so much so that they often cite their government health care as a big reason they'd consider moving back home when it came time to "settle." in fact, i can honestly NEVER recall hearing any of them bitch about their healthcare. i've come to believe even more that the "socialized medicine is scary" is just propaganda from the pharmaceutical companies looking to maintain their through-the-roof profit margins (don't forget that i do have some insight into this having worked in the industry). we've been brainwashed into thinking we're all gonna die on the sidewalk if a national healthcare system is initiated and this is total bullshit.
and i do challenge your "best healthcare in the world" notion. that, my friend, is a cliche, something that was once true but no longer is, but something still used as a tagline for the propaganda machine. it's so off that it's a bad joke. just about every organization that rates such things using vital health statistics ranks us in the middle of the pack, even though we consistently lead the world in money spent on healthcare. the top two in the rankings are france and italy, two "socialist" nations. here's a quote from a BBC article on the last study done by the W.H.O.
"The study echoes the findings of opinion polls carried out in France, where people consistently register a high degree of satisfaction with their level of health care. By and large, hospitals are clean and efficient, waiting lists are short, general and specialist doctors are in plentiful supply and, above all, in a country that prizes its spirit of solidarity, the benefits are universally available."
the US ranks 37th in the same study, two spots ahead of cuba.
i suppose the reason this "best healthcare in the world" thing perpetuates is the "rich people from other countries come here for care" argument. the reason for this is not because we have the best care, but because they can use their money to get instant access here, where in other places they are no more important than the average citizen. but that is even changing...more and more people from the US are seeking treatment in places like India and Dubai, because it's affordable and the quality of care is just as good or better than it is here.
the fact is man...and i mean this truthfully as someone who has spent a lot of time digging into this...you have been lied to repeatedly. stop trusting the things you hear repeatedly and question everything. do your own research. the answers are out there. you just have to take the time to find them.
Now, this was sort of a simple exchange that just covered the basics, but is there really any more that needs to be said? I mean, is there even a valid argument that exists for not radically reforming the system, because I sure haven't seen it?
14 comments:
Yes, there's more. The Cuba canard is absurd on its face.
I think this is more fair to say:
The US could potentially benefit from government health healthcare INSURANCE, not government provided HEALTHCARE.
@nick...on the face of it that seems entirely reasonable.
I'm a British chick living in Canada and have enjoyed free healthcare my whole life. I don't feel the quality of my healthcare has ever been affected by the fact that the system is nationalised.
I lived in NY for a year and a half and spent the whole time hoping I didn't get sick - I didn't want to have to try to figure out the system there. It all seems terribly confusing.
Nice post CB. I have been thinking quite a lot about the health care system recently as well. Not that I think we have a perfect system here, but I would like to bring up a few points:
-Is it worth considering that the vast differences in the diversity and size of population in the US (in comparison with, say, France) will make it much more difficult to achieve success with a similar universal health care program? I tend to think that the larger role of government in European countries works better due to the fact that the countries have smaller and more homogeneous populations.
-What will be the effect on innovation in the medical field by moving towards universal health care in the US? Is it not reasonable to think there could be some downsides in this respect?
Don't take these questions as me saying I think our health care system is perfect. I am not nearly foolish enough to buy into the rhetoric that "America has the greatest health care system" and simply take that for granted. I think there is definitely room for reform but I am not quite sure how to do it in a way that is best for the US. I am very skeptical of simply taking some vanilla system that works in another country and pushing it to work here.
I took my 10 year-old to the ER last week (104 fever). They took her temperature and ran tests for strep and mono, then sent us on our way. I got the bill today, $1,800.00...I think that says it all....
Actually as a Canadian, who has enjoyed free healthcare all my life, I must say there are some flaws in our system.
The waiting time for some things can be incredicbly furstrating.
As someone with an ill parent, over the years I've had to deal with how backed up our system truly is. It's not a big deal for simple things, but the more complex your illness, the more complex getting proper care gets.
I think our health care system has gone down (at least in Ontario) over the last decade, but that has been due to cuts and improper government policy I think. Our system isn't perfect, and you should be aware of that.
But I much prefer it to a system where I would have to deal with an insurance company to get medical procedures. My mother would be uninsurable at this point, and we would be broke.
I'm pretty grateful I don't have to deal with that stuff.
there are a lot of potential solutions, which we can and will debate endlessly - but there's no question that major changes are needed. it would be one thing if only our health outcomes/health status overall were bad (and they are) because they're influenced by many other factors in addition to health care access. but the quality of our actual health care services is objectively, ON AVERAGE, not very good, despite having a large number of health care organizations and providers that are leaders in their fields, even globally. quality of care just varies in the extreme.
no one is proposing government-provided health care, or anything that could accurately be called "socialized medicine." really, seriously, no one. we will always have a mixed private and public insurance system and probably similar health care provider organization to what we have now. we can get to nearly universal access within that, but we have to figure out how we want to structure and distribute the economic, social and political tradeoffs that it will inevitably require. that has been a world of hurt ever since FDR and it's not gonna get easier, but it's not impossible.
oh, and can we get rid of the whole, we dont want anyone coming between a patient and his/her doctor?
cuz the insurance companies do that already
ok...lets not have single payer
but lets pass a law that says health insurance companies can no longer make profit...
i just fixed the system
@Nick, uuughh 'government healthcare insurance' = medicare and medicaid, correct? Last time I checked those systems still left a lot of people out on the sidewalks. So in the event that a larger system was created to include a wider range of people - not just the poor but those with 'pre-existing conditions' turned away by insurance companies - then sure, maybe it would work.
*ahem*
However ...
As someone who studies this for a living, is surrounded by our horrific healthcare system EVERY.SINGLE.DAY. and as a future provider, the ever-important component that people need to consider is THE PROVIDER! 'Providing access to care' doesn't magically make 5000 clinicians pop out of the sky. All those retiring baby boomer docs? Yeah, they'll need to be replaced. So when you magically provide care to 14 million new people (or hell, even 100 more people in small towns), we have a simple PEOPLE SHORTAGE issue that needs to be addressed.
What a 'nationalized' system MAY do is help pay for medical school OR provide livable salaries for people working in primary care.
While debating our great healthcare conundrum, there is very little discussion as to how we address the 'brain drain' of clinicians going into specialized care because primary care simply can't foot the 200k medical school bill. Becoming a clinician is a very long, expensive path and those who chose to go that route are insane, not talented (present company included). So IF we are going to go national, we need to look at medical school entrance processes, the way the insurance companies reimburse for specialized care and private practices, the structure of malpractice insurance and every little mundane detail that goes into this process. This is NOT as simple as just creating a safety net for all the poor auto workers in Detroit.
Our system is fractured because our practice of taking care of the ill is based on economics, not HEALTH and WELL BEING. Once we move to a preventative 'model' of treating people, we may have a chance at not only tackling our economy, but also getting a hold of the simple things that are killing us.
*sigh*
Sorry for the hijack
CB, you may like this medical blogger, Dr. Hebert. He's a Katrina evacuee, resettled from St. Bernard Parish into Mississippi. (when you get a chance, read his Katrina blog, and get angry/sad all over again).
One of his more recent posts was quite enlightening. He argues - convincingly - that Wal-Mart has done more to reform health care than any government program could do. He's not opposed to real legislative health care reform, saying "I know this argument makes me sound like a free-market libertarian, but this is not the case. I want the government to be more active in bringing about universal health care, and I don’t care if it has to raise my taxes to do it." He uses Wal-Mart's affordable prescription drug pricing as an example of how reform can be done, and where to start. Check out his post:
http://tinyurl.com/cp244q
Can't wait to get care like this! You're so right Cajun Boy, what lies.
http://apnews.myway.com/article/20090407/D97DGFH00.html
As someone who has suffered through serious illness and has been thoroughly through this country's health care system, I can attest that I never once received anything close to top-notch care. Over a period of several weeks, 6 physicians misdiagnosed my early symptoms until I was very seriously ill, and even then, I was treated with patronizing dismissal. They wouldn't even run tests to find out anything when I would ask. They'd just look at my "history" and parrot what previous doctors were saying. Until I was nearly dead. Once the tests finally started, I was frightened and frail, yet still endured abusive and cold treatment from technicians, including being yelled at for vomiting during a scan. Through this entire two-year long struggle, the first question was always how I'd be paying. The first thing I'd face every day was medical bills. The bills piled up, and I can say with 100% certainty that way more time was spent on billing and extracting money from this patient than was ever spent caring for my health. There is very little about this country's health care system that I would salvage, with the exception of Nurse Practitioners.
I am NOT alone in my story. Everyone else I talk to has a similar story or knows someone who has been through something like this. The medical care industry in America desperately needs an overhaul. Right up to the pharmaceutical companies, who apparently are the only companies left that can afford to run 60-120 second spots during prime time television.
topical, and an argument that needs to be made more often in non-wonkish contexts: http://www.latimes.com/news/opinion/la-oe-klein7-2009apr07,0,3092824.story
"Is it worth considering that the vast differences in the diversity and size of population in the US (in comparison with, say, France) will make it much more difficult to achieve success with a similar universal health care program? I tend to think that the larger role of government in European countries works better due to the fact that the countries have smaller and more homogeneous populations."
Not particularly. The thing about having a large population is that you have large tax revenues. This is actually more of a problem for SMALL countries than large ones, because there are economies of scale involved. Even a very large country probably only has one or two labs which deal with things like vCJD, for instance, but a small country needs one, too. Take Japan, France and Germany, all of which have good or excellent systems, and you more or less have the US population.
I don't understand what you mean about diversity. Something to do with race? People of different 'races' (the word has poorly defined meaning in a health context, anyway) don't really present a great healthcare problem (possibly a lesser one, due to hybrid vigour; countries like Ireland with a small gene pool have a big problem with things like MS), and most European countries are fairly multicultural these days anyway.
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