 Why is 'socialised medicine' a bogeyman in America? For the love of God, why?
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Jul. 10th, 2009 @ 03:15 pm 
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So, I just read this: "How I lost my health insurance at the hairstylist's."
And it makes me feel a kind of sick horror. Even though it's not my risk. I don't live in America - I live in Australia, where my private health insurance (which I have even though I've been unemployed for a couple of years now, because it never had anything to do with employment) doesn't actually cost me that much, and where, if I didn't have it, I would still be able to get necessary medical treatment, because that's what Medicare is for. And Medicare applies to everybody.
My private health insurance, as a young, single adult, costs me about $40 a month.
Some time in the nearish future I'm going to be getting an MRI. My psychologist, having heard my history of severe head injury, and recognising that some of my problems may, in fact, be due to frontal lobe damage (which I'm trying not to find terrifying or horrifying, because if I have frontal lobe damage, I've had it for nearly twenty years), wants me to get one. (And is surprised I haven't had one before.)
Is this urgent? No. The head injury provoking this curiosity about the physical condition of my brain happened in about 1990.
Is it critically necessary? Not really. It would be useful information, but my health and survival don't really ride on it.
But I'll get it done anyway, and it will be covered by Medicare, just, you know, in case.
All sorts of screening and testing procedures are covered by Medicare, because it costs less money to prevent disease than treat it, as a rule. And because, in Australia, universal health care is considered a fundamental right of citizens.
In the last month and a half I've been to the Emergency Department about four times, for various reasons. I have paid exactly nothing for the treatment I received there, even when I had to get stitches, even when the doctor gave me antibiotics.
I have medications. Every month, I get my antidepressants and my dexamphetamines. A few days ago I got antibiotics for an upper respiratory infection as well. The antidepressants and dexamphetamines cost me around $30 each. The antibiotics cost me about $20. I can get them at whatever pharmacy is most convenient. The process goes like this: 1) walk into pharmacy 2) hand over prescription 3) wait 5-10 minutes 4) pay 5) leave, with medication in hand.
When I need to see a doctor, I see the doctor I want to see. Some people see different doctors every time, some people see different doctors for different things, which is weird to me. I used to see the doctor I'd seen since early childhood, now I see the doctor I prefer at the university medical centre.
My old family doctor, at the point when I switched, was the most expensive he'd ever been, as he'd moved to a new practice. Out of pocket, I was paying about $20 a visit. (Medicare was paying most but not all.) My new doctor I don't actually pay anything at all to see. The university practice bulk-bills students, which means Medicare pays for all of it. I go in, get seen, sign a form, leave.
I don't have to worry about who takes my insurance. In situations where I have actually made use of my private health insurance, I still went where I wanted to go, and my insurance paid - coverage is based on the service rendered, not the provider who rendered it.
I've always taken all this stuff for granted. It's how the health system works, and in Australia we still complain that it's not really good enough. If you need non-urgent medical treatment you have to wait for it, in a queue behind the urgent people, and the non-urgent people who've been waiting longer. (Private cover involves less waiting, it's true.)
I just can't understand how a modern, developed economy like America's is still labouring with such a broken system, one that kills people and leaves them struggling to survive if they manage to escape alive, and its politicians can still make analogies to countries like Sweden that make it sound like socialised medicine is a bad thing. I read about the debates in magazines like the New Yorker and it just deeply, profoundly does not make sense to me.
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| From: | ![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png) sqbr |
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July 10th, 2009 08:38 am (UTC) |
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Seconded.
coverage is based on the service rendered, not the provider who rendered it.
Well technically doctors have to register with the health funds, but yes.
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| From: | trouble |
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July 10th, 2009 04:16 pm (UTC) |
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My limited understanding of the OMG!socialist health care! issues coming out of the U.S. are that they're focused around a certain class of people. That class of people are not in a situation where they can't leave a job because they need the health insurance and they don't have a chronic illness that they need to pay out of pocket for.
They think that folks who develop chronic illnesses have done something to deserve it. Oh, if only you weren't fat/lazy/a smoker/a drinker/crossing the street at the wrong time/whatever. They think the hard-luck stories are either just stories, or far rarer than is presented. And really, it's very sad that children are sometimes born with chronic illnesses or disabilities, but really - supporting them would just drain money away from where it belongs: keeping the healthy healthy. You know that keeping alive PWD is just a drain on society, right? Right?
*sigh*
What I hate is when the discussions about socialised health care focus entirely on the needs of PWD. And I totally agree that PWD do "better" (for certain definitions of better, but let's leave that aside for now) in socialised medical care than they would in the US. But it ignores all the little health things that add up for the temporarily non-disabled. Right at the moment I'm in a bit of limbo in terms of my health care because I haven't received my Nova Scotia Health Care Card. And thus, I haven't gone to the doctor about the intense pain in my neck and shoulders which is being caused by sitting poorly at work. So instead, I suffer, I'm cranky, I don't want to talk to people, and I dread my job. Once I get things sorted, I'll go into the doctor, he'll give me a referral to someone who can unknot my back, probably give me some more powerful muscle relaxants, and I will likely stop spending my whole weekend trying to relax.
But this would be a waste of money. Or something. I don't know.
Your limited understanding is pretty much dead on.
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| From: | rainbow |
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July 10th, 2009 04:33 pm (UTC) |
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I'm right there with you at being disgusted by our system.
I think it has quite a lot to do with a) leftover Puritan values (and maybe "Protestant work ethic") that make illness and disability one's own fault (so why should anyone help you? You brought it on yourself and "As ye sow, so shall ye reap") and b) *very* heavy duty lobbying and massive spread of misinformation by the health care industry. Then you have the leftover of 50's socialism, which is hugely threatening to the folks on the top of the social strata -- they might LOSE some of their privilege, omg!
a) is a huge problem here and it's very cultural; it tends to be strongest in white families who came from the northeast and who've been in the country the longest -- the ones who descended from or married into the Puritan lines.
b) is another huge problem. The health care industry is huge and powerful and makes a lot of money. They don't want to lose that. They both lobby for political influence and spread misinformation (I don't have proof of that, but it's something that's been talked about for decades): "socialised medicine means more ppl will die"; "socialised medicine means you won't be able to get the care you need in a timely manner"; "socialised medicine will ruin the country because the poor, disabled, and immigrants will overwelm the system and bankrupt us"; "socialised medicine will mean you can't see your own dr"; "socialised medicine is a scarcity situation and must be avoided", "socialised medicine is communist", etc.
That's another big issue here: scarcity situation fear. And in the current economy it's worse that ever. (If you're not familiar with the theory it's basically that there's not enough of X to go around, so if you have X you need to guard it or someone will take it away from you and you won't be able to get more because there's not enough for everyone.)
scarcity situation fear
Huge component of this, I agree. Keep in mind that most Americans are insured and reasonably okay with their insurance, so they're terrified that if something changes they'll be as screwed as the people who are already screwed.
Exactly. Reading that linked story, the US "system" is even more broken than I thought. Nobody could lose by reform except the insurance companies, and they should lose, because they're stealing money. From everybody!
Recently I've had a variety of tests and consultations, new reading glasses, new orthotics (insoles, for fallen arches) and dental treatment (more to come). I had to pay for the glasses (but subsidised by the NHS), and I might have to pay towards the dental treatment but I'll get it back. To get prescriptions filled, I just sign the form.
If I wasn't on benefits I'd have to pay full-price for the glasses; dental charges (which have an upper limit) and prescription charges (set charge per item, but I get so many I'd probably get the annual prepayment certificate), and maybe for the eye test. Most of those charges were introduced by Mrs. "Privatise Everything" Thatcher. Everything else is covered, which means I paid for it when I was working, by paying National Insurance.
N.I. has problems, notably that the government wants people to work to greater and greater ages in order to balance the books, but basically they're running an insurance scheme, instead of an insurance scam. Isn't the US about due for some riots or something?
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| From: | sami |
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July 10th, 2009 04:57 pm (UTC) |
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For a country founded by revolution, the American people are ridiculously passive. (There's a whole other post I keep meaning to write about why the disappointments of the Obama Administration are, in fact, the fuckup of the American people, not Obama himself.)
Seriously, Australians, who are a nation of people who go with the flow because making an issue of stuff is hassle, would not stand for the American "system".
Odd thing with differences: here, eye tests are covered by Medicare, but glasses aren't. It's odd. But you can find out what your prescription is and get cheap pharmacy glasses, or if you have HBF* you can get the cheap ones they pay for completely, or you can get more expensive ones and pay for them yourself/pay the difference from your private cover.
* Or other private insurers, I imagine, but I've only ever been with HBF so I'm not that up on the benefits the rest offer; I have never had a single complaint about HBF, and have in fact had a number of good experiences with them, and have been with them since I was a toddler with no interruptions so get to rest in the happy knowledge that there is no such thing as a pre-existing condition as far as my HBF cover goes.
Recently-ish, an Australian politician suggested that we should revamp our health care system to be more like the American model. Apparently the Opposition don't want to be the Government again.
I know the NHS has some budget issues, but I suspect that's mismanagement, rather than the system itself being a fundamentally bad idea.
"...the US "system" is even more broken than I thought. Nobody could lose by reform except the insurance companies, and they should lose, because they're stealing money. From everybody!"
Yes, they are.
"Isn't the US about due for some riots or something?"
Yes, we are.
"I just can't understand how a modern, developed economy like America's is still labouring with such a broken system, one that kills people and leaves them struggling to survive if they manage to escape alive, and its politicians can still make analogies to countries like Sweden that make it sound like socialised medicine is a bad thing. I read about the debates in magazines like the New Yorker and it just deeply, profoundly does not make sense to me."
1) People on top, who don't have to worry about healthcare because they are rich or have good private insurance and not HMO shit, don't want to "share" what they have. They don't want longer wait times, they don't want to sacrifice walk in appointments, they don't want "dirty bums" hanging out in the same waiting room as them. They think people "deserve what they get", so feel no camaraderie or compassion for them.
2) Insurance companies make a LOT of money off this. Pharmaceutical companies make a lot of money off this. Companies that manufacture medical equipment make a lot of money off this. Hell, even a lot of DOCTORS make a lot of money off this and would rather it not change.
3) Politicians make a lot of money in kickbacks from groups lobbying for the groups, and more, listed in (2) and don't want to change it. They are descended from the people in (1) and don't want to change things.
etc etc etc
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| From: | willow |
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July 10th, 2009 09:21 pm (UTC) |
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I can't even talk about this. Every sentence and tact I start, ends up with me getting extremely angry, or saying something that might make your head explode.
But America is filled with people getting sick because of the slacking of regulations in the food industry and chemical industry. It is filled with an aging population. It is filled with people getting sick because they have to work three jobs just to make ends meet and that doesn't include preventative medical care.
But having the government care for everyone, not just the people that end up near death's door, if they're lucky and an administrator somewhere is feeling charitable or blessed by the heavens - is socialism/badness.
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