American Health Care

I'm sure this may well have been done somewhere else, but being bone idle and a bit thick, can someone help me and explain to me why so many Americans are so vehmently anti any sort of universal state health care provision?

I just don't get it

socialism init?

I would guess it's to do with the necessary taxation, I don't think they're too keen on that.

Simple, those that have (or can afford) cover don't want riff-riff in their hospitals, and also don't want their access impeded in any way.

people who have already shelled out loads of money to pay for healthcare don't want a 'communist' system where they will have to shell out more to pay for all the 'work-shy poor people' to have equivalent care 'for free'.

Plus most of the people at government level who oppose it have strong ties with the medical insurance sector who make a fortune from the status quo.

Personally, I think it is a great move forward for America… lets hope they manage it. I won't hold my breath though, their political system seems to be built entirely with the purpose of stopping progressive thinking and reform.

Dave

As I understand it, it's to do with the belief that people should be self reliant and not look to the government for help as well as an ideological belief that government (and by implication taxes) should be kept as small as possible.

even the hicks who would benefit from it are against it as they think it reeks of communism. the insurance/medical industry has poured huge funds into propaganda campaigns to ensure that poor people don't get treatment

My opinion is that its a backwards step .

But folk need to be educated better……

Healthcare insurance is a necessity a new tv is not …. Much like folk here whining about flood damage and no insurance…..standing infront of 40 inch plasmas …..there are excepions and i accept that – and provision does need to be made for that but a full nhs system is not a forward step,

Even the US runs public spending at 41% of GNP.

Their Medicare system actually costs more than our NHS to run (per head of population) – but ours covers everyone, even visitors – whereas in the US 30-50 million are without, and another lot are on insurance.

Their big problem is cost of service, its way more than any 'socialised' system.

20 years ago a friend of mine was hit and run-d whilst out training near Colorado Springs (USCF and US Olympic Training Centre attendee) . She was found at the side of the road, unconscious and was eventually taken to hospital. Whilst the initial emergency treatment was carried out free, her medical insurance had a $20,000 excess in order to make it affordable. When I was cycling with her in 2002/3 she had pretty much recovered from her injuries but was paying the excess back at $500 a month.
I think I much prefer the UK system, however, obviously the "haves" in the US would much prefer their current system, but it does seem a little iniquitous for most.

Is the NHS not the most cost-effient health system in the western world (heard that once).

Healthcare insurance is a necessity a new tv is not …. Much like folk here whining about flood damage and no insurance…..standing infront of 40 inch plasmas …..there are excepions and i accept that – and provision does need to be made for that but a full nhs system is not a forward step,

There was never any question of the US adopting an NHS type model. Obama's reforms are basically aimed at ensuring that people do take out private insurance (and stopping insurers from not insuring ill people).

I'm a bit perplexed why everyone is so bothered about the American health care system

I'm a bit perplexed why everyone is so bothered about the American health care system

'coz my holiday insurance is way more expensive when I include travel to the US.

It signals American aspirations to become a civilised society

I'm a bit perplexed why everyone is so bothered about the American health care system

What apart from the fact that it emphasises the idealogical differences between us and our so called special relationship partner?

Seems to me that it is also an interesting comment on their perception of democracy and how that gets applied fairly frequently to logic behind their foreign policy, which I think gives us a straight line relationship between their health care attitude and its impact upon us.

My brother (D) is married to a lovely American girl (J) (they live in Leeds), but her mother suffers from various mental and physical illnesses. J's sister has suggested their mother comes over to the UK and goes into a hospital here "because it's free". This was disputed by my brother and the sister was under the impression you could walk into any NHS hospital, tell them what you wanted done and they'd do it (including cosmetic surgery!). Well, I laughed ( a lot) and this story has now been retold umpteen times.

But this is an example of what American (generalised) believe our system is. Personally, I'm for it (lots of cousins and friends over there) and the cost crippling to those on a low income.

My 2 cents over… Back to work, the lot of you! 😀

I'm a bit perplexed why everyone is so bothered about the American health care system

Same reason people are bothered about poor people dying in third world countries.

Except with an added sense of it being a complete waste, because the USA is one of the (is it the) richest countries in the world, and spends way more than pretty much anywhere else on healthcare, yet has health outcomes way worse than the other first world countries (which all have universal healthcare). Even rich people who get seriously ill don't get good treatment, which is crazy.

They also get bad treatment due to over-cautious medical staff worried about being sued by insurance companies, meaning people get tons of invasive procedures that they don't actually need (and that carry a risk of harming them).

Oh and they waste vast amounts of money on lawsuits, where insurance companies sue people to try and avoid a cost – which is one of the biggest sources of the crazy litigation culture that they have in the USA.

Not to mention having the largest percentage spend on administration of pretty much any healthcare system.

Oh and it also being depressing because it is basically a pointless ideological argument (supported by a bunch of insurance company lobbyists), where people put attach way less value to the lives of their fellow Americans than to trying to shore up their stupid ideology.

It's also interesting to see the depressing state of the US health system, because there is some chance we'll have a Conservative government, some members of which appear to think that it would be great if we went to a US style insurance backed system, where only the very richest would get decent healthcare, and everyone else would be pretty much left to die (or in an emergency, would be treated and then presented with a £20,000 bill).

Joe

why so many Americans are so vehmently anti any sort of universal state health care provision?

It's because Americans have over the years been whipped into an anti-socialist anti-communist right wing frenzy. Why? Because in the US, money talks louder than anywhere else in the developed world, and the people with the most money want to protect their ability to make tons of it at the expense of everyone else. Americans are taught that anyone can make their dream and become wealthy; the problem is that no-one seems to have considered that in order to have winners, you have to have losers. And since having more money allows you to make more money, wealth inequality snowballs, with few very rich people, a very large number of people on middle to low incomes and a sizeable chunk of people in destitution.

Remember, America is a project in progress. It was created as an experiment in nation building and to make it succeed it was SOLD to potential immigrants as a place of freedom, liberty and the potential for wealth. Consequently, personal freedom is something of a mantra in the US still, and people are very adverse towards anything that might detract from that. EVEN those that are suffering at the hands of the current system still believe in it, because they are constantly indoctrinated from all sides about the righteousness of the 'American Way'

obirobkeno – you can get cosmetic surgery on the NHS. You can go to your doctor and get anything you want as long as they think you need it, and they think it'll do you good – and they are fairly generous in all honesty.

Just to counter the 'flat screen tv' argument – this is a straw man. There are probably SOME folk who spend their health insurance money on rubbish but they are in the minority. Most people work hard and scrimp to make ends meet, and there's not a lot left over. Health insurance can be $300/month, and cover is always limited unless you have fabulous job benefits. So if your operation goes over $60k (which isn't a lot) they you have to meet the difference yourself. Stuff like birth control is often not included, nor is actually having a baby. If you want kids you need to save up about £3000, and if you are unlucky enough to need a caesarean, you'll be £10k out of your own pocket. Plus you only get so many GP visits a year and so on.

When this debate was going on, people in the US were told that nationalised healthcare leads to terribile facilities and horror stories of bad treatment and care. I think a lot of people unconciously wanted to believe this, because they want to believe their country is the best place in the world…

They also get bad treatment due to over-cautious medical staff worried about being sued by insurance companies, meaning people get tons of invasive procedures that they don't actually need

Being sued isn't the only reason – the more procedures a doctor carries out, the more money the hospital can bill the insurance company for.

My sisters in law had their babies (without complications) in an operating theatre with 5 nurses and a doctor.. so 6 salaries plus all the prepping, equipping and maintenence of a theatre. We had one midwife and a student in a room. Apparently they really encourage you to have epidurals even if you don't want one.. presumably because it's another line on the bill.

molgrips – Don't get me wrong, you're right. J's sister thought it was like ordering a car… whether you needed it or not…

and stopping insurers from not insuring ill people

It's important to remember that the insurance companies aren't charities and they should be perfectly entitled to decline coverage in certain circumstances. In those situations there should be another mechanism in place to provide coverage for those people.

It's unreasonable to expect an insurance company to take on a known risk when the expected claims cost for that risk will far exceed the premiums collected.

For example, if you phoned up for house insurance today and were quoted £500, then you told the insurance company your house was going to be burnt down tomorrow and you'd be claiming a a couple of hundred thousand pounds from them, would you still expect to get coverage from them for £500?

It's the same with medical insurance. If you approach an insurer for a quote you can't expect to pay a few thousand dollars in premium in exchange for the insurance company paying for hundreds of thousands of dollars in claims for you that you know you'll incur.

If you are currently insured and you fall seriously ill or develop a chronic condition then your insurer needs to take that on the chin but for new entrants or those that left their insurer, they can't expect a private company to pick up their claims.

cynic-al – Member

Is the NHS not the most cost-effient health system in the western world (heard that once).

Certainly its efficient and absorbs a smaller % of its income in management and administration than many- we get very good value for money. The most? I am not so sure. Japan does well

NHS is around 9% of gdp for universal coverage. US is around 12% of gdp and leaves a significant % without any cover at all

It's important to remember that the insurance companies aren't charities and they should be perfectly entitled to decline coverage in certain circumstances. In those situations there should be another mechanism in place to provide coverage for those people.

It's unreasonable to expect an insurance company to take on a known risk when the expected claims cost for that risk will far exceed the premiums collected.

For example, if you phoned up for house insurance today and were quoted £500, then you told the insurance company your house was going to be burnt down tomorrow and you'd be claiming a a couple of hundred thousand pounds from them, would you still expect to get coverage from them for £500?

It's the same with medical insurance. If you approach an insurer for a quote you can't expect to pay a few thousand dollars in premium in exchange for the insurance company paying for hundreds of thousands of dollars in claims for you that you know you'll incur.

If you are currently insured and you fall seriously ill or develop a chronic condition then your insurer needs to take that on the chin but for new entrants or those that left their insurer, they can't expect a private company to pick up their claims.

A perfect explanation of why it cannot work

A perfect explanation of why it cannot work

The reforms?

It's important to remember that the insurance companies aren't charities and they should be perfectly entitled to decline coverage in certain circumstances

Well that's yet another ideological point. Health insurance, along with education and transport amongst other things SHOULD NOT be run on purely commercial lines. Health insurance is not a new car or a big house, it's a basic necessity. So care should be subsidised at the very least for those who cannot afford it.

Market forces and capitalism work perfectly as long as you don't give a crap about poor people.

There's another issue though besides this. It seems to me that not only is it a flawed system by being purely commercial, but IN ADDITION providers and insurance companies are on the make. By that I mean giving you stuff you don't need so they can charge for it. Which is EVEN MORE disgraceful than the insurance system in the first place.

It's important to remember that the insurance companies aren't charities and they should be perfectly entitled to decline coverage in certain circumstances.

It's important to remember that regulation can force providers to cross subsidise some less profitable activities with other, more profitable activities. As long as all providers operate within the same regulatory framework, it's still a competitive market in which providers can make a profit, just one that better serves the community as a whole.

The above is true whether talking about public transport, television, insurance, etc. etc.

Well that's yet another ideological point. Health insurance, along with education and transport amongst other things SHOULD NOT be run on purely commercial lines. Health insurance is not a new car or a big house, it's a basic necessity. So care should be subsidised at the very least for those who cannot afford it.

Market forces and capitalism work perfectly as long as you don't give a crap about poor people.

There's another issue though besides this. It seems to me that not only is it a flawed system by being purely commercial, but IN ADDITION providers and insurance companies are on the make. By that I mean giving you stuff you don't need so they can charge for it. Which is EVEN MORE disgraceful than the insurance system in the first place.

Point 1 – So care should be subsidised at the very least for those who cannot afford it.

It is already subsidised. Those that never claim still pay substantial premiums.

Point 2 – By that I mean giving you stuff you don't need so they can charge for it.

US doctors practice "defensive medicine" i.e. giving you every test under the sun to avoid malpractice lawsuits. In addition the insurers will be getting discounts of around 40% on the treatment. The insurers will also be case managing in-patient stays to ensure the insured is in hospital for the minimum required time and no more.

I worked on a kids summer camp in the US when I'd finished my nurse training, and witnessed a 20 minute debate about whether or not they should call an ambulance to take a 14 year old lad who had collapsed to hospital.

In the end, they decided to take him 60 miles in the back of a car to a state hospital rather than call one to avoid having to declare an ambulance trip to their insurers.

Taking healthcare decisions on the basis of $$$$$$$ rather than need is not a sensible practice.

A lot of Americans have a totally different way of looking at things

We had 5 of them over at work & over a beer or two the talk got around to people being evicted for non payment of mortgages rent etc.
They appeared to [genuinely] have no sympathy whatsoever for their plight
Seeing it as a problem they had brought on themselves

This didn't come across as selfishness or lacking any compassion, it just seemed to be the only way of thinking they knew.

It is already subsidised. Those that never claim still pay substantial premiums.

That's insurance. Subsidy would be external money input eg government.

They appeared to [genuinely] have no sympathy whatsoever for their plight
Seeing it as a problem they had brought on themselves

I firmly believe that right wing ideologies go hand in hand with lack of empathy. If you can put yourself in the position of someone who is disadvantaged you might realise that it wasn't their fault and how unpleasant it would be to effectively force them to live worse lives.

My father in law is an example of this. He thinks that if anyone is disadvantaged then it's up to them to work their way out of it, and if they don't it's their fault so they deserve what they get. He doesn't seem to realise that a) not everyone is born with the ability to do that and b) there have to be SOME people on the bottom of the pile by definition, otherwise you don't have a pile. Which woudl be communism. He also happens to be one of the least empathetic people I know.

I guess it boils down to lack of knowledge. If he actually knew people who were really suffering he might gain insight into their plight.

My father in law is an example of this. He thinks that if anyone is disadvantaged then it's up to them to work their way out of it, and if they don't it's their fault so they deserve what they get. He doesn't seem to realise that a) not everyone is born with the ability to do that and b) there have to be SOME people on the bottom of the pile by definition, otherwise you don't have a pile. Which woudl be communism. He also happens to be one of the least empathetic people I know.

Sounds like my kind of guy 😆

US is around 12% of gdp and leaves a significant % without any cover at all

It's apparently a staggering 16.2%

So its basically because they are a bunch of knobbers then?

Bimbler – you are right – I quoted the wrong figure.

Isn't it the case in some/many European countries that you pay for the cheap things but the state pays for the biggies? So you pay for a trip to the doc to ask about your sniffle but if your arm falls off you don't have to worry about the cost of getting it fixed. That all sounds very sensible to me.

we laugh at obirobkeno's story, but there are numerous posters on here whose impressions and understanding of US healthcare system(s) are just as lacking in detail.

Just read this article on the BBC, and it exemplifies one of the reasons why American healthcare is relatively more expensive:

BBC story

Synopsis — the NHS decided that a particular drug, which extends life significantly for people with aggressive bone marrow disorders, isn't worth the money, so you won't be able to get it in the England and Wales.

How much is you wife's last 9 months worth to you? Your daughter's?
I'm forking out for private insurance just like in the States, thank you very much. And with a smile on my face.

And if you can't afford it, get a job FFS.

Crikey: Making decisions on the basis of $$$$$? Here you go.

I'm forking out for private insurance just like in the States, thank you very much

You sure you can find a policy which you can afford, AND will cover you for that drug?

I'm forking out for private insurance just like in the States, thank you very much. And with a smile on my face.

Except this is the misleading thing about "Death Panels" (as NICE has been referred to by various hyperbolics): insurance companies in the US will also cut off funding for certain drugs and treatments when there's no point any more, just like NICE will recommend to trusts.