Simple numbers for simple people...

[mijan]

I've heard people rant about the evils of "socialist" medicine - the high taxes, the long waits, etc. 

Well, for any of my fellow Americans who have needed health care, you KNOW that the waits are pretty damned long around here.  You've probably also experienced the ugly side of billing - that your insurance certainly NEVER covers everything, and that even with decent insurance, you're going to spend a small fortune.

But let's look at cost.  Nothing but cost.  Here's a REPORT from CNN Money:
"Employees' share of premiums for a family plan is up an average 14%, to $3,997, vs. just a 3% rise in the total bill, according to the Kaiser Family Foundation."

So... our share of the insurance cost is rising, the actual insurance cost is rising, and simultaneously, our co-pays, co-insurance, and deductibles are also rising.  In 2009, the average cost of healthcare, per capita, in the United States was $8,047.  And as a nation, we spent 17.3% of our entire gross domestic product on health care!  That's fucking INSANE.

Wow... Canada spent an average of $4,089 per capita in 2009 on health care.  And that's TOTAL!  Not "insurance"... TOTAL.  And that's about 10% of their GDP.

Why is this so fucked up?  Overhead, partially.  Inefficiency, partially.  Americans who don't take care of their own health, partially.  But LARGELY because after the insurance premiums in America are paid... we keep paying.  Oh yes.  THROUGH THE FUCKING NOSE.  Have you ever gotten sick?  Gone to the ER?  Gotten a bill in the mail for thousands of dollars?  Had to take out a loan, set up a payment plan, or sell a possession to afford health care?  Even with insurance, we keep paying.  And paying.  And paying.  Co-pays, co-insurance, deductibles, and so on. 

I've got damned good health insurance... for an American.  I still pay $100 to go to the ER.  $25 to see my PCP.  $45 to see my rheumatologist, cardiologist, ophthalmologist, dermatologist, ob/gyn, and neurologist.  Don't laugh - this shit could happen to anyone.  I've always been an athlete and if most American ate a diet like mine, we'd solve the type-2 diabetes crisis and turn the heart disease statistics upside down.  I don't smoke and I seldom drink.  And I STILL got sick.  And every time they say, "You need to have ___ checked by ____ specialist," there goes another $45, minimum. 

So... for my insurance alone, I just found out that the base cost to my employer (who pays 95% of my premium) is $5,760 per year.  That means if I NEVER get sick, I'm automatically costing $5,760 per year.  Think about that.  It's part of my employee benefits, so it's mine - and it means that I'm effectively shelling out that much before I even see a doctor.  Wow folks, that's ALREADY over what Canadians spend per capita.  My income is almost exactly average for an American.  Oh, and of course, I pay taxes.  My taxes cover all those people who can't pay for medical care because our economy sucks and people are losing their jobs or are under-employed.  So on top of my premium, and all the co-pays and co-insurance and deductibles I pay, I'm also paying in taxes.

Right now, spending a direct, average amount of $4,089 sounds pretty damned CHEAP, doesn't it?  And with longer life expectancies and lower infant mortality rates, that means the Canadian plan is more effective, too.

Oh, and when all is said and done... have any of you ever had to fight with an insurance company for approval, or a claim that got denied, or simply the filing process itself?  Keeping track of all that paperwork can be pure hell, on top of already feeling like shit.

So why are we still trapped in our insurance-based system?


EDIT:  I mis-read something in the CNN article, and I am changing a paragraph to reflect what I realize it actually meant.

EDIT AGAIN:  Another objection I often see to UHC is about the right of the doctors to earn a profit.  What's a profit, I ask?  It's a paycheck, right?  Adjusted for the exchange rate at the time this chart was posted, all based on 2005 data (recent enough for argument, as far as I'm concerned):

Specialty	US Average Salary	Canada Average Salary (n/1.212)
Family Medicine	$164,952	$167,064
Int. Medicine	$170,889/ $169,450 (hospitalist)	$248,721
Ob/Gyn	$253,160	$261,412
Gen. Surgery	$278,433	$247,375
Anesthesia	$309,019	$205,441
Urology	$317,778	$279,982

Comments

[kryptyd.livejournal.com]

You're preaching to the converted here. My dad (in Ireland) got a very serious genetic condition in his hands which untreated can led to the hands being unusable claws or even amputation. He got operated on the best surgeon for this condition in the country (without any long delay) and was able to play notes on the guitar after he healed that he hadn't been able to in years. He had no money so he paid something like €40.00 for the operation. It was a very serious operation which removed tendons etc. I dread to think what would have happened to him if he had to pay even a fraction of what that surgery was worth.

In Ireland I had to pay €50-€60 every three months for my Doc to write me my contraceptives prescription, then the stuff itself cost €14. Here in England, I pay zero for both visit and medicine! Yay!

Neither country is remotely socialist either, it's just that civilized countries treat healthcare as a right for all.

[lothy.livejournal.com]

As a Brit, the mentality of thinking that medical insurance is better than free healthcare is utterly bizarre to me. I honestly can't see one logical reason why somebody would believe that.

(But then, the right-wing American stance in general tends to make no sense to me and probably to most people in the UK. Handguns as a civil right? Huh?)

In the past few weeks, I have paid five separate visits to my doctor. I have been to my dentist. I have a dermatology appointment next week. I have had a flu jab and two prescriptions. The only things from that list I've paid for were the dentist appointment and the prescriptions, and they were all pretty cheap. I didn't have to fill in any insurance forms or make any claims. I'm not even ill. My family members are - my mother's in remission from cancer (and has had countless appointments, inpatient stays, medications, treatments and even wigs provided for free by the NHS), my sister has ME, etc. Nobody can tell me that medical insurance (which we'd struggle to even pay for to be honest) would provide a better service than the NHS.

To me, healthcare should be a basic human right. Maybe not absolutely everything available on the NHS would count as a human right, but when something's medically necessary it should be as much a right as the rights to food, water, shelter and clothing.

[mintcloud.livejournal.com]

Because America has gone to hell in a handbasket, and I'm fucking done with it.

I don't care what the cost is, how many nights I cry myself to sleep or how long I have to quarantine my cat. I am gone, and may this country get exactly what it deserves!

Barbara Havers thinks this shit is stupid.

[sphynxle.livejournal.com]

Insurance, or my lack of it, is greatly frustrating to me right now. I'll be honest, I don't know a lot about the Canadian/British/Everything Outside of the USA vs American Insurance, but what I do know I don't LIKE. After the post I made yesterday, I had several people comment going "As a Canadian/Brit/Whatever, your insurance thing is BIZARRE. Why shouldn't you be able to go to the doctor just because you don't have it?"

I wish I really had a good answer for that.

My cardiologist alone is a $40-$50 co-pay (it seems to change), and god forbid you don't have it - it's a $300 visit straight up. With my heart issues, I have to see him 2-3 times per year. More if there's something going on.

I'm frustrated.

[foldingstar.livejournal.com]

Good post. I am a Brit so in a respect take my healthcare for granted.

I mean of course we pay as well. We pay through our taxes and national insurance payments, however we will always get treated and have no extra sudden cost added in. If you are not working, on benefits you will get the same treatment too. There is no extra benefit to being wealthy when using the NHS. Everyone is treated the same. Naturally people who can afford private healthcare will use that as well. It is their choice.
The NHS is not perfect of course. They are always problems somewhere along the line and dentist treatment on the NHS can be a joke at times. Most people stay private for dental treatment, I do but there is good plans out there!
But the main gist of your point is interesting. Calling it the health care of socialism creates these terrible images in the heads of some Americans because of apparent associations with communism! It is a scare tactic of course and like you say, socialised medicine is not socialism. It is something for a civilised society.

[misscake]

So why are we still trapped in our insurance-based system?

Because the insurance industry is about making money (which they do - a lot!) rather than taking care of people.

[nightshadow-t2.livejournal.com]

I've heard good things and bad things about the health care system in Britain from friends I have over there. And I've had good things and bad things happen through the health care system here. I don't know which is better or which is worse. But I do know that there's no such thing as free. Somewhere at some point along the line a price is paid by someone. Even with free promotional coupons a price is paid in the loss of current profit, but its seen as a way to possibly increase future profit. And while the new system may be cheap, which considering my budget would be nice, that doesn't mean it will be better. It doesn't mean it will be worse either. I had an expensive little tote for my knitting, but the 50 cent curtain bag I picked up works better. Then again I bought a kiln for 200 and it died after one use and now I have to save up for a more expensive one. I'll wait and see what this price is, both the monetary one and the non-monetary one, and then I'll have an actual opinion one way or the other.

[abigail89.livejournal.com]

You don't have to convince me. I think is it positively *immoral* that families go bankrupt to pay for a child's leukemia treatment, or have to sell their house to pay for dad's heart by-pass surgery.

And the arguments against socialized medicine are outrageous. "Oh, we can't pick our own doctors." Bullshit. Your insurance company makes you pick from their list or ASSIGNS you a doc--so what's the difference here? "We'll have to wait months for surgery or appointments." Obviously, they've never tried to get an appointment with a specialist or a surgeon lately.

Like you, I have good insurance. It paid for all my well checks (except for the $30 co-pay), my mammogram and follow-up ultrasound. But I'm also paying $500 out of pocket per month for the premium. I have great doctors. I have a level 1 trauma center 10 minutes from my house. But I'm ready for this country to change.

[lothy.livejournal.com]

By the way, how does mental health care work in the US? Is that also covered by insurance or does that operate separately?

I work in a mental health clinic (admin) and I'm just curious as to what the difference would be.

[lilithilien.livejournal.com]

As a new Canadian (got my citizenship in 2005), I can say without a doubt that the healthcare I've received has been regularly on par with what I received in the US, and far better in the case of extreme conditions. Yes, it's hard to get an immediate appointment to see my regular doctor on the day I have a cold, but that was the case in Seattle and Austin as well. At least in Canada, I can go to any walk-in clinic and be treated without any cost.

But what is most impressive about Canada's healthcare was how they treated my uterine fibroids. I saw a doctor in Seattle about my extreme cramps and bleeding before leaving Seattle, said I was worried about endometriosis or some other condition, and could she check them out. I was dismissively told not to self-diagnose, and she wouldn't even send me for an ultrasound. Shortly afterwards, I moved to Canada, where I had to wait for 8 months before receiving medical coverage. Once I got it, I saw a doctor who immediately scheduled an US and discovered that I had huge fibroids. Had they been caught earlier, I might have been able to reduce them with meds; as it was, I had to have a hysterectomy (which was free, btw, and done within three months). I can't help thinking that my US doctor didn't want to incur the costs of the ultrasound, so I was left undiagnosed.

So yeah. I'll take the Canadian system any day!

[helenadax.livejournal.com]

I'm from Spain. If you're working a small amount of money is deducted from your salary (between 25-100 euros, I think, according with the money you earn) every month. If you're not working, you don't have to pay anything. And with our healthcare system almost everything is free, except medecines and some minor stuff.

And if you're an "illegal" inmigrant, it's the same. You just need to get the card of the healthcare system (we call it Seguridad Social) and that's really, really easy. And then, you'll be attended every time you need it with no cost at all (except for the medecines).

[foxestacado.livejournal.com]

I want to talk to you about this, but later. I am off to Old Pasadena now!

[georgeodowd.livejournal.com]

All I have to say right now is why the hell didn't I go to med school??

[hdluff4eva.livejournal.com]

I love being Canadian :)

I was in the hospital early this year for a kidney infection. What did I have to pay for? The ambulance ride. and I only had to pay 20% of that. I'm lucky that my school offers insurance that is included with our semester fees and that it is available to anyone who doesn't opt out. So basically, if you're at my college, you have health insurance for a low fee and can get dental 80-100%, perscription drugs 85% and ambulance 80% off. There are more but those are the ones that I remember.

It really is too bad that there are so many people who don't see how are system works, choosing to instead believe what they think they know.

[vector-nyu.livejournal.com]

I think as long as there is still some kind of incentive that pushes doctors to keep developing new procedures and whatnot that we'd only improve as a country for giving healthcare to all our citizens... but american medicine is some of the best in the world (if you can afford it >->), would it decline if no longer a part of the free market? The idea that the quality of medicine declining if it's socialized is a scary thought, but much less scary than thinking about how in four months I'll turn 26 and no longer have health insurance at all. :/

[mga1999.livejournal.com]

You already know what I have had to go through to keep healthcare for my chronically ill child, but I have to applaud you for your post.

I would say that I don't know how anyone could read this and have any common sense could still argue about it, but I know from working on HCR that there are.

Don't get me started. I honestly considered marrying a Canadian guy friend, he offered, before I did the drastic means I did. I just couldn't do it because I'm lame like that and think marriage is to sacred.

[tseecka.livejournal.com]

I couldn't resist this icon XD

This just...this sums up every reason why I, quite literally, thank God every day that I live in Canada. I look at news stories like this and it scares the shit out of me.

The fact of the matter is, I don't even know what's going on half the time with my health care. Because I don't NEED to worry about it. I don't have to count every penny and decide when I can go see a doctor and when I need to stick it out. I just...go. Yeah, I take the system for granted...but am I ever fucking grateful that I can.

/end Canadian thoughts

[coltdancer.livejournal.com]

SON of a biscuit...I'm too boggled to say anything other than, "I'm in the WRONG profession!" Here or there, they all make three, four, even FIVE times my teacher's salary!

But many, many valid points that even to the more conservative, make sense (and subsequently, are infuriating).

[kei-rin.livejournal.com]

Insurance is one of the most convoluted things to think about. I like the way Pratchett talked about it in his book "Color of Magic" (yes I know it's a fantasy book but the explanation makes sense), where it's basic a gamble that something bad is going to happen and if I lose the insurance company get my money.

Healtcare is double bind were I can't "win" for "losing". If I need health insurance I still have to pay and I don't need it well you showed the numbers on that pretty well.

I think more people need to go back to high school government class and revise the difference between socialism and communism. Yeah "socialist" healthcare isn't perfect but it makes more sense than the "capitalist" insurance-based healthcare that we're limping along with right now.

[ias.livejournal.com]

I've had multiple miscarriages (currently on pregnancy no. 9 and only got one sprog to shoe for the other eight) and I've had 7 D&Cs and one hysteroscopy plus a battery of blood tests including a full gentic kryotyping for me and the Spouse. I've not had to pay a penny.

It saddens me when I read of the experiences of US women on the miscarriage comm who had had to endure D&Cs under locals because that's cheaper than generals, and who are still paying off the cost of their D&C at the time their due date would have been. And yet they would almost all claim that their healthcare was better than mine (even 'though I bet you they didn't get hot, sweet tea and hot buttered toast after their ops) because they have swallowed the myth that the US healthcare sysem is the best in the world rather than just the most expensive.

Miscarriage isn't the be all and end all by any means but it is symptomatic of the whole system.