Socialized Medicine: Pro and Cons for residents of nations with such systems

[jspun]

This question is directed to people who live in countries with government run health systems, insurance plans, ect... Especially those who have experienced the US system and have a basis to compare it to there own?

 

[bit_pattern]

We've had universal health care since the seventies, paid for through a medicare programme where patients can get a rebate for accessing the public healthcare system covering a large % of tour costs. Everyone had access to the system regardless of income. Since the late ninties our conservative government at the time introduced a two-tiered system that actively encourages people to take up private health insurance by way of a $500 p/a levy on people who don't take up private cover..

Quite frankly, you are better of without health insurance if you require hospital treatment. The insurance companies will lure customers by providing 'extras', the most attractive being dental coverage because we stupidly don't have a public dental health scheme, but their actual standard of care if you are unfortunate enough to end up in one of their hospitals is really quite poor. We have excellent public health facilities that rival and excel beyond anything the private sector has bothered to invest in.

An extended family member was involved in a car accident a few years back and had the misfortune of having both private insurance and having had the accident in an area serviced by a private hospital. Not only did she get inadequate care, because private hospitals are more interested in turning a profit for their shareholders than they are occupying a bed and providing thorough care, she was stung with thousands of dollars in fees that simply weren't included in her coverage.

When my sister-in-law had a minor aneurysm she spoke to another family member who is a registered nurse before calling the ambulance, her advice was to call an ambulance, go to a public hospital and don't tick the 'insurance' box. The sister-in-law was admitted to public hospital, received worlds-best standard of care, was sent home with a clean bill of health and it didn't cost her a cent, other than what she and the rest of us contribute in tax. It would have cost thousands had she gone private. It's when I think about stuff like that that I am happy to be paying my 18% income tax, and for the state to charge its various business and property tax, so I know that the people I know and love have the ability to access worlds-best standards of care without it bankrupting them.

In my experience, and the anecdotal experiences I hear from family members in the industry, I honestly can't see any 'pro' side for private health. The whole thing is a sham, a persons health and well-being should never, ever be turned into a commodity and any developed country in the world should have the means to use a progressive tax system to fund and run a universal healthcare system that discriminates against no one, regardless of their socio-economic situation, and is actually a benefit to the economy through better standards and better productivity.

 

[scottodoit]

Bit pattern hit the nail on the head, I don't see how any so called civilized nation can turn away anyone with a medical need. Money should have nothing to do with whether someone lives or dies, or even suffers or not. I feel quite proud that my country puts peoples well being above profit.

 

[kong]

I'm getting off topic, but it can't be paid for. As advanced countries we may have amazing medical technology, but everyone can't have it. It doesn't matter what system we use.

Lets frame this discussion in honest terms. Under any system some people cannot get the care they need. It doesn't matter how "civilized" the country is.

 

[scottodoit]

Simply not true. While even in Australia those with the means may have access to some experimental or "best of the best" care. The average person still receives extremely good care with access to most mainstream care and medicines. The waiting lists for non critical surgery can get a bit long, but no system is perfect. Probably our weakest point is care for indigenous people in remote area's some of the care there is dismal. Dental care is hideously expensive , though there have been signs that this could be socialized in the future.

 

[bit_pattern]

Yes you can afford to, we manage it, you just need to restructure your tax system and make some hard ethical decisions about the level of private interest that is acceptable and at the same time practical. for your particular economy, I'd recommend a complete paradigm shift in the way you people think about health car, personally. And the way that a society takes care of its citizens really is a mark of civility, something that all "civilized" countries to aspire to. Don't forget, the OP is asking for opinions from people with a public health system, not for people to try and impose the narrowly defined scope of the American debate on the thread.

 

[jspun]

I know a country without one- Mexico. If you are injured and can't pay after being assessed, I have heard of someone put in a wheelchair with a broken pelvis wheeled to the curb and gently lowered to the curve. He crossed the border, needed surgery and his Hg was 6.5. Survived. In greece there is socialized medicine. My cousins wife was there in the mid 90s. they were americans with land in Greece (of Greek decent.) She had a GI bleed. On the way to the hospital, the ambulance driver would pull over and empty the bloody bedpan. She's a doc in the US. She needed to be scoped. A professor of Gastroenterology happened to be vacationing in that part of Greece. He didn't want to do the procedure. The local cop (had much family in the area) got the whole village together, a mob, and "persuaded him to procede." He scoped her, cauterized the bleed, did it without sedation like a dick. Her stay in the hospital was nightmarish. The nursing staff had to be paid off for good care. Money was given to the primary and other consults, my cousin didn't know who to bribe, what was appropriate, he would play a game- give the docs $100. bill, they would give it back- she's a collegue, he would insist, of course finally they'd take it. This was a small med center in peloponesus. They have socialized medicine, and there are well trained physicians, but then, in the 90s, the equipment was antiquated, and I don't know if it was because they were Americans, but to get good care bribes were required and maybe fees. I would imagine if they were in Athens or Thesalonika would get assistance from the embassy. Have no idea how the level of health care for locals is. My other cousin lives in a village, and they don't go to the hospital very often and see the doc from time to time, but physicals, CT scans, ect....cardiac caths- they haven't needed anything nock on would. Inspite of the economic problems recently, the health care standards I'm guessing has improved over the last 15 years. So it depends on what country your in or if your a citizen I would imagine too. In my hospital, we get lots of illegal aliens from mexico mostly come through the ER and have the same care as others- if they need a cath they get a cath, ect... They might be in debt the wrest of there life but they get treated according to accepted standards of care. This is US law before health care reform.

 

[marsmellow]

Pros: It's much cheaper than a privately run system. Everyone gets treated. Nobody is discriminated against because of wealth. No pre-existing conditions or dropped coverage. No ten thousand dollar hospital bills and medical bankruptcies. People don't get to get rich denying care to sick people. No deductibles and co-pays and other fees.

Cons: Slightly higher taxes. Fewer billionaires.

That about sums it up, I think.

 

[kong]

^Lol that does sum it up.

To everyone thinking I'm framing things in American terms I'm not. Everyone can't have as much healthcare as they want or need. It doesn't matter what country we are talking about.

 

[marsmellow]

What's your point though? That healthcare needs to be rationed, no matter if it's a private or publicly owned system? I agree. But the way it's rationed matters. It's sickening to do it by wealth. Instead, the resources should go to the people who have the best chance of recovering.

 

[kong]

^See what you said is exactly what I'm looking for. You have an opinion that take reality into account.

I may not agree with it exactly, but its a valid opinion.

This pie in the sky everyone gets what they want view of socialized medicine on the other hand is not valid.

 

[static_mind]

Aus- I think our system is quite good. It can take a while to get stuff done but iv had a severed arm and had to go under a general anesthetic and have the tendons stiched up and I don't think it cost anything except what it is to fill out scripts at the local chemist and they are subsidised under the PBS anyway.

I see it the same as a police or fire service. They are socialised and so should health.

 

[scottodoit]

^See what you said is exactly what I'm looking for. You have an opinion that take reality into account.

I may not agree with it exactly, but its a valid opinion.

This pie in the sky everyone gets what they want view of socialized medicine on the other hand is not valid.

Exactly what do you mean by that?. I have lived in both Australia and the United Kingdom, both having Universal health care. If it's Universal - no one by definition misses out. Obviously it must be paid for, and thats where progressive taxes and cost cutting measures come into play. Are you suggesting that the care in our systems must somehow be less?. Those with specialist needs can't just walk in, they must be referred. But it is still free. I just don't quite get what you are trying to point out. Universal health care is not only possible it is the reality for many countries.
Don't get me wrong no system is perfect, I have had to wait 3 hours in a A&E ward as my condition wasn't life threatening.
Last time I had to go to hospital was because I had severe gastro causing dehydration and withdrawal from 90mg methadone maintenance. I waited in a bed for about 30 minutes before a drip was given and some drugs to settle my stomach, about two hours later they came took some blood and did an xray on my stomach, found nothing. gave me something to settle my stomach enough to take my methadone. Two hours later they released my with a letter for my doctor and that's it. No bill, No question of money whatsoever.
Efficient, thorough and free. (no counting tax)
(This was on a Busy Saturday night in large city Hospital too)

 

[scottodoit]

Aus- I think our system is quite good. It can take a while to get stuff done but iv had a severed arm and had to go under a general anesthetic and have the tendons stiched up and I don't think it cost anything except what it is to fill out scripts at the local chemist and they are subsidised under the PBS anyway.

I see it the same as a police or fire service. They are socialised and so should health.

That's an interesting thought. Those that see Universal health care as an over extension of government. What about other services. Maybe the police should charge to show up if you need help. Or the Fire brigade send out a bill after saving your house.

 

[kong]

Exactly what do you mean by that?

That healthcare needs to be rationed, no matter if it's a private or publicly owned system? I agree.

Regardless of the anecdotal evidence suggesting otherwise there will probably always be more need than supply. I'm haven't said this makes socialized medicine a bad idea only that the same rules apply no matter what system is used.

Its wrong to speak of socialized medicine in such grand terms, "no civilized country would turn anyone away for care". Well they have to and do, its life. There is nothing any politician can do about it.

 

[jspun]

problem in the US: People can't get it through their head that people won't live for ever, and that keeping them vent dependent or brain dead at $10,000 a day plus even though they are 80s-90s just because family won't let them go- no health care coverage- the hospital eats the cost- passing it on to everyone else, what estate are they going to go after to recoup their loses. Health care- they eat the cost raising premiums- so we all suffer. I've seen cops, having patients that can't break out b/c there too fucked up wait to arrest them because then they don't have to pay for the cost- the hospital has to eat them up. Last staff, current staff has to pick up slack. Family doesn't realize there are other patients, you do your best, give heart and soul, there is no resources to give quality health care. Then there are the assholes that sue for bullshit reason- and take away from everyones care resources, more hospital workers lose jobs. Already, falls are a major problem because management can't afford sitters. As an RN, you cary a cell phone. You have 3 ours of charting thnks to frivolous law suits. Get call from family members saying they want their family members face washed, interupting the reults of the MRI or lab results your trying to access, or the treatment plan you are going over for appropriateness- you would be shocked at mistakes docs make- leave out DVT prophylaxis in post op patients, order IV fluids with K+ and forget to order BMPs (have potassium levels), ect... by the time you get back to address problem A family B has a prblem with the TV remote control or they sent the wron kind of jello with lunch. By the time yoy work it out with dietary, patient D's pneumothorax is getting worse and we have increased respiratory distress, then you can tell A, B, C to have a emergency and they are understanding. If a family sees you at a terminal- they think you are playing on the internet. I have a 12 hour shift. For lunch, I clock out. I tell everyone I'm going to lunch and they will be a problem. Atleast 1-2 patients have a major problem- need tea warmed up before i leave. Started taking lumch at 1430-1500. Less issues. Were required to take full 30 min but sometimes I eat fast but chart because i know there won't be interuptions from cell phone- charge has it. When they have a prblem- they tell patient your nurse should be there in 10-15 minutes, unless its an emergency then send CNA (who are horribly abused and over worked.). In spite all all my efforts, I am usally at work 30-60 min overtime which will eventaually cause a reprimand. What is the solution- don't have time to hear about our patients problems, talk with people that need someone to talk to. More and more, family members will have to learn to get stuff like water, tea, and towels, or do a freshen up with families. This should be the families job anyway, unless contraindicated. Our job is to coordinate there care, implement treatment plan, make sure they are not the victim of a fatal mistake, manage pain, communicate new results with the doctors on the case. Charting- thats time away from bedside care. The system is broken and fucked up- people are greedy, see the old ase a burden, not with respect, and sometimes forget they are in a hospital, not a hotel, depite the rediculous cost of health care.

 

[satricion]

Australia also has what's called the Pharmaceutical Benefits scheme. Under this scheme, prescription medication is heavily subsidised by the government so that even the most expensive medication is easily affordable by even the poorest people, including those on unemployment benefits. This scheme is run by a government authority which employs scientists, pharmacists etc to assess the efficacy of new drugs on the market, and only subsidises drugs which are proven to work better than existing medicines. In this way, the public has access to cutting edge medication, and the influence of advertising and marketting by large pharmaceutical companies is reduced.

And as others in this thread have said, here in Australia I can get free treatment for any illness, for as long as I am sick, no questions asked. Socialised health care works. It does not reduce freedom, it increases it.

 

[scottodoit]

Australia also has what's called the Pharmaceutical Benefits scheme. Under this scheme, prescription medication is heavily subsidised by the government so that even the most expensive medication is easily affordable by even the poorest people, including those on unemployment benefits. This scheme is run by a government authority which employs scientists, pharmacists etc to assess the efficacy of new drugs on the market, and only subsidises drugs which are proven to work better than existing medicines. In this way, the public has access to cutting edge medication, and the influence of advertising and marketting by large pharmaceutical companies is reduced.

And as others in this thread have said, here in Australia I can get free treatment for any illness, for as long as I am sick, no questions asked. Socialised health care works. It does not reduce freedom, it increases it.

My understanding is that advertising for prescription drugs is not allowed in Australia. I do believe doctors get allot of "incentives" to prescribe a particular drug over another though.

 

[satricion]

^^
That's right, advertising for prescription drugs is illegal in Australia, a policy that I completely approve of. I was shocked when I saw the advertising for prescription medication when I was in the States. If it were up to me I would make marketing of drugs which went beyond direct reporting of bare facts that were backed up by peer reviewed scientific evidence illegal. Doctors in Australia are a part of the pharmaceutical industry, just like America, but they don't get incentives to prescribe a certain drug. Drugs are marketed at conferences and the like, and doctors are no doubt influenced by these decisions and what not. But they aren't directly given stuff to prescribe a drug.

 

[Cyc]

Canada is similar to Aus. We pay for or privately insure dental and eye care, and everything else is covered.

Nurses don't come and fluff your pillow and check to see if the colour of your Jell-o is to your liking, because you're not staying at a hotel, it's a hospital. Our hospitals are clean, professional, well equipped, and efficient. You don't get preferential treatment, and if your procedure can wait, chances are it will.

If rich people want to buy five-star treatment, they can go to the US and blow wads of cash there. Some do, but in my experience, most are happy here.