Socialized Medicine

Continuing somewhat from a thread twist here, I am curious about how folks already in countries with socialized medicine feel about it.

Do you find it adequate? Exemplary? Sub-standard?

Do you get you money's worth?

Or is it that once it becomes available to everyone "for free" that the demand goes up, so...

• Then so does the cost, and so then goes the taxes?
• It eventually gets to a maximum point where the price has gone up via taxes, so then the quality suffers?

Disclaimer: I'll lay 50-50 odds on some hotly-argued bit about political systems breaks out. I'm not trying to provoke that, this thread is hoped to be about the opinions of folks living in countries that have socialized medicine already, and their opinions of it.

I'm also curious if anyone has lived under both systems and what their feelings are.

Well, I haven't had to do without socialized medicine before, and I really can't imagine it any other way, since it's the only way I've known my whole life.

Quote:

---

Do you find it adequate? Exemplary? Sub-standard?

---

Adequate I guess. Just by comparing average life expectancy across various countries, those with socialized medicine generally outlive those without it. It's not a perfect system, but it works quite well IMHO. The only real problems with it that I know of, are the long wait times. It probably varies from province to province, but AFAIK waiting times can get pretty lengthy. In a private hospital (wording?), I guess it's more like buying a product. You pay, and then you recieve what you bought. With public health care, everyone is basically paying, through taxes. So the only way to decided who gets the "product" first, is to go on a first-come first-serve basis. Although not strictly first-come; it is also heavily based on urgency, and the patient.

Quote:

---

Do you get you money's worth?

---

Definatly.

Quote:

---

Or is it that once it becomes available to everyone "for free" that the demand goes up, so...
Then so does the cost, and so then goes the taxes?
It eventually gets to a maximum point where the price has gone up via taxes, so then the quality suffers?

---

I think that because it's "free", people are probably generally more inclined to make use of it even when not totally necessary. But I also think it's not enough to cause any major problems, and I also think that allowing everyone to have an equal chance to have proper health care far outweighs the (relativly small) added cost of the general "overuse" of the system.

Quote:

---

Originally Posted by psychopath

Quote:

---

Do you get you money's worth?

---

Definatly.

---

Do you have a fairly accurate gauge of the amount you paid in versus the cost of the services?

For example, in a recent circumstance a health insurance option was about $1100 per month for my family [edit]of 4[/edit]. I chose not to, figuring it was unlikely for us to need $13200 worth of services for that year. During the 4 months of this situation, I believe actual costs were about $2500, roughly saving me $1900.

In some simple hypothetical case, if this were the cost per year forever and I lived 72 years, that would be $950400. Now given co-pays and such, let's round it off to a cool million. Is that a reasonable guess for the average case?

Since this stuff is built into salaries and taxes and such already in confusing ways, how great do you think the likelihood that you paid $20 for a...

• $5 item
• $10 item
• $15 item
• $20 item
• $25 item
• $30 item

[edit]Obviously I've rather tipped my hand as to which side of the fence I'm on, but I'm trying my best to inquire about this as open-mindedly as I can.

Also it's probably useful for you to post where you're from - I'd imagine it's different in every country.

The public health care system is definately not a perfect one, it has its holes (such as doctors being payed on a per-patient basis), and many (especially in Ontario) are considering private health care, but there is one thing that can never be qauntized or compared: the feeling that you are "covered" in the event that you experience a fatal or near-fatal injury and require some extensive/expensive medical surgery. There's nothing worse than having to worry about money while you are worrying about your life.
The only other remedy for this is an equivalent "Health Insurance" policy, but once you buy into that, whether or not your paying for health care through taxes or insurance bills is really moot.
So I think any form of subsribed health care (whether through taxes or insurance) can never really be debated about as to cost for service. It shares a lot of its dynamics with many forms of public or private "services", like the taxes you pay for public services that you may never use, or car insurance, which is notoriously and historically poor for its the cost vs. services report, yet it remains a necessary evil.
I believe public health care in its perfect form subscribes to a more utopian, almost communistic society, in which it would thrive under a society of people who only use services when they need them and service-providers who administer services based on quality rather than private gain.

There is data on per-capita health care spending on this page. Some info on health care outcomes on this page. Some speculation on the reasons for the disparities on this page.

America does have one 'socialised' health care system.

Quote:

---

I think that because it's "free", people are probably generally more inclined to make use of it even when not totally necessary.

---

In terms of health care, 'overuse' can be a good thing. Treating the pre-indicators of heart disease with aspirin and statins can be significantly cheaper than treating heart disease with bypass surgery.

One item I've heard regarding Canada's health care system is that it works well because a very high percentage of its population lives within 100 miles of the American border. So Canucks, feel free to comment on that as well.

Quote:

---

Originally Posted by Dave_Sinkula

One item I've heard regarding Canada's health care system is that it works well because a very high percentage of its population lives within 100 miles of the American border. So Canucks, feel free to comment on that as well.

---

What difference does that make?

Quote:

---

Originally Posted by anonytmouse

There is data on per-capita health care spending on this page. Some info on health care outcomes on this page. Some speculation on the reasons for the disparities on this page.

---

Apologies, I haven't visited these on a quality level at this point.

Quote:

---

Originally Posted by anonytmouse

America does have one 'socialised' health care system.

---

Is Walter Reed an applicable example, pro or con?

Quote:

---

Originally Posted by anonytmouse

In terms of health care, 'overuse' can be a good thing. Treating the pre-indicators of heart disease with aspirin and statins can be significantly cheaper than treating heart disease with bypass surgery.

---

But the more common, "my kid has a cold" shouldn't be overlooked IMO. We already know it involves bed rest, clear liquids, etc. But should this cost $150 per visit by 10 million per year to be refactored into your share of income? [Made up numbers.]

Again, I'm not trying to induce an issue. I'm looking at clarifications for my original question.

Whether or not I'm succeeding, MMMV.

Quote:

---

Originally Posted by Govtcheez

What difference does that make?

---

That those in Canada that have the means circumvent the their own system may skew the statistics by opting for an available US system.

Quote:

---

Originally Posted by Dave_Sinkula

That those in Canada that have the means circumvent the their own system may skew the statistics by opting for an available US system.

---

Gotcha. I was just making sure.

FWIW, I work with someone from Windsor, ON. He and his wife recently had a baby, and they made sure it was born in Canada so it'd qualify for their health care. I've spoken to him about it and they refuse to use US services, even though he works in the States and lives just across the border. Just an anecdote.

In my country, we have this glorious entity referred to as the NHS. This means that medical care is available to all completely free in emergency cases, while secondary needs, prescriptions and dental care is offered at a subsidized cost.

The main advantage to this system is, as already described, knowing that if you get injured or become gravely ill you can head down the hospital and will be seen. Eventually.

The problem is that so many people take advantage of this that the scales have long broken and it's bleeding money. For example, we know that peeps come from other parts of the world to receive treatment for whatever condition they have (like pregnancy) and then return home, leaving us to pick up the costs. They're supposed to track and manage this, but more often that not the people in charge either say "Their country's not developed enough to allow us to persue this" or they're a bleeding-heart liberal that shouts "Oh, but they deserved it!" :rolleyes:

If we made sure that treatment was only available to UK citizens (and European citizens with the appropriate papers) then we wouldn't be laying off clinical staff so much.

Quote:

---

Originally Posted by Dave_Sinkula

Do you have a fairly accurate gauge of the amount you paid in versus the cost of the services?

---

Not in dollars, no. When I say that I get my moneys worth, I'm talking more about the fact, that it'll be affordable should I really need it. IMHO, it's a little hard to guage socialized medicine in terms of cost paid vs cost of services, because while I myself may never "get my moneys worth", I'm helping pay for the next guy who might not be able to afford a procedure on his own.

Quote:

---

Originally Posted by Dave_Sinkula

But the more common, "my kid has a cold" shouldn't be overlooked IMO. We already know it involves bed rest, clear liquids, etc. But should this cost $150 per visit by 10 million per year to be refactored into your share of income? [Made up numbers.]

---

Yeah, that's the sort of overuse I was talking about. But again, I think it has little impact on anything.

I'm from Canada, BTW.

Quote:

---

Originally Posted by psychopath

Yeah, that's the sort of overuse I was talking about. But again, I think it has little impact on anything.

---

On the contrary, isn't that one of the major issues? That overuse diminishes quality and availability while increasing cost? ...

Quote:

---

Originally Posted by psychopath

because while I myself may never "get my moneys worth", I'm helping pay for the next guy who might not be able to afford a procedure on his own.

---

...Such that by making the care available to many makes it so that when your time comes you get the care you seek in 6 months rather than 2 weeks? And so that both you and the other guy receive lesser quality care?

Quote:

---

Originally Posted by Dave_Sinkula

Continuing somewhat from a thread twist here, I am curious about how folks already in countries with socialized medicine feel about it.

Do you find it adequate? Exemplary? Sub-standard?

Do you get you money's worth?

Or is it that once it becomes available to everyone "for free" that the demand goes up, so...

• Then so does the cost, and so then goes the taxes?
• It eventually gets to a maximum point where the price has gone up via taxes, so then the quality suffers?

Disclaimer: I'll lay 50-50 odds on some hotly-argued bit about political systems breaks out. I'm not trying to provoke that, this thread is hoped to be about the opinions of folks living in countries that have socialized medicine already, and their opinions of it.

---

My employer is awesome when it comes to benefits. When I started I was only paying $16/month for health insurance and $5/month for dental. It's gone up some the 3 years I've been there; not quite sure how much. But it's pre-tax and still low enough for me not to really notice. Plus we have an Employee Health Clinic with free laboratory testing. Think ya may have AIDS? Well, just go down to the Health Clinic and have them check for ya. FOR FREE!

I don't know if that has anything to do with the question. :)

Quote:

---

Originally Posted by ethic

I don't know if that has anything to do with the question. :)

---

I think it does.

Quote:

---

Originally Posted by ethic

My employer is awesome when it comes to benefits. When I started I was only paying $16/month for health insurance and $5/month for dental. It's gone up some the 3 years I've been there; not quite sure how much. But it's pre-tax and still low enough for me not to really notice. Plus we have an Employee Health Clinic with free laboratory testing. Do I think I have aids? Well, I think I may just go down to the Health Clinic and have them check for me. FOR FREE!

---

Another part of this that I don't fully understand is related to the FOR FREE part. Since nothing is for free, is it that your salary is actually reduced by, say $10,000 per year, and it's just that you never see that?

That is, absent employer-paid health care, the market value of your position there would be that much more? So by not using it you accept essentially accepting a lower salary for the same position? But that if you had no government or employer provided health care, you would have the funds to get it privately?

Quote:

---

Originally Posted by Dave_Sinkula

On the contrary, isn't that one of the major issues? That overuse diminishes quality and availability while increasing cost? ...

---

I'm not sure if it diminishes quality at all, but probably availability. Now that I think about it, I'm probably underestimating the problem.

Quote:

---

Originally Posted by Dave_Sinkula

...Such that by making the care available to many makes it so that when your time comes you get the care you seek in 6 months rather than 2 weeks? And so that both you and the other guy receive lesser quality care?

---

The wait times are an issue, but I don't see how the quality of the care itself would suffer. As far as the waiting goes though, I'd rather wait longer and get care, than not be able to get care at all because I can't afford it. And if I have a problem that requires quick attention, I'll get in before someone who, based on condition and such (I don't know all the criteria), can wait longer.

Quote:

---

Originally Posted by psychopath

I'm not sure if it diminishes quality at all, but probably availability.

---

I think I'm thinking of this, but at the moment I'm going from vague recollection.

I'll be attempting to listen in when not distracted.

[edit]Yes, I believe that was the one. Audio, 35:14.

Quote:

---

Originally Posted by Dave_Sinkula

I think it does.

Another part of this that I don't fully understand is related to the FOR FREE part. Since nothing is for free, is it that your salary is actually reduced by, say $10,000 per year, and it's just that you never see that?

That is, absent employer-paid health care, the market value of your position there would be that much more? So by not using it you accept essentially accepting a lower salary for the same position? But that if you had no government or employer provided health care, you would have the funds to get it privately?

---

I work for a medical testing laboratory. A lot of doctors and medical technologists work there. Most employees are required to have yearly TB tests, anyway. The company pays for the clinic to be staffed. It's budgeted for and is a benefit to employees. Free lab tests is the same thing as getting free corndogs if I worked at Dairy Queen,. Or so I would assume. :)

The company is just a really great company. The execs really care about their employees. We also get quarterly bonuses of up $500, depending on how well the company did for that quarter. Not to mention 75% tuition reimbursment (100% for Clinical Laboratory Science degrees) and 50% reimbursement for dependents and spouses. One of Fortune's top 100 in 2003 and 2004.

After listening to that audio, I believe that I have been derailing this thread. I will try to leave the financial burden arguments out of this.

I think the ideas expressed in the audio better represent some of the issues involved, and in a much better way than I have expressed.

Quote:

---

Originally Posted by Dave_Sinkula

I think I'm thinking of this, but at the moment I'm going from vague recollection.

I'll be attempting to listen in when not distracted.

[edit]Yes, I believe that was the one. Audio, 35:14.

---

No comments? Or is the audio too long? Or the breaks/intros/quirks unfamiliar and/or too long? Or are there other technical issues I do not see? [Especially non-US folks.]

Quote:

---

Originally Posted by Dave_Sinkula

No comments? Or is the audio too long? Or the breaks/intros/quirks unfamiliar and/or too long? Or are there other technical issues I do not see? [Especially non-US folks.]

---

When I click on that link, IE tries to download the MP3, but gives up and displays one of those broke placeholder picture things. Maybe no one else can get it to download either. Which is sad, because I sorta liked following along until now. I have a lot of interest in the health care industry. Sorry for butting in.

Quote:

---

Originally Posted by citizen

When I click on that link, IE tries to download the MP3, but gives up and displays one of those broke placeholder picture things. Maybe no one else can get it to download either. Which is sad, because I sorta liked following along until now. I have a lot of interest in the health care industry. Sorry for butting in.

---

No that's most helpful.

It was originally gleaned from here:
http://www.ktlkfm.com/cc-common/podc...jasonlewis.xml

Quote:

---

4/11 - 6p
Jason talks with Dr. Albert Schumacher from Ontario. Is Government Health Care really for the best, we talk to someone who lives it.

---

I hope this might produce better distribution.

Otherwise I'll try to figure out another way to host the ~12MB file.

[edit]A little birdie told me...

Quote:

---

It will work fine as long as they read, and don't speed on the information highway:

Quote:

---

To download the podcast, right-click "Listen" and select "Save As" from the menu.

---

---

FWIW, I tried the link and I didn't have issues; the audio came right in.

I downloaded it fine. Haven't had a chance to listen yet though.

Well that radio talk certainly puts things into perpective, and I can't say that I disagree very strongly because trhe system we do have does work reasonably well. I've always been well taken care of and I think it's fair to assume that any number of us represents the average American household.

One thing that irks me is that I feel most Americans don't realise that health insurance is a necessary expense. Health insurance does go a long way in helping you pay for quality care but I've met a lot of people who struggle with payments, prescription bills and things like that. Rather than go for full-blown reform though, I think the economy should get itself straightened out or another minimum wage increase could help. It could be something as simple as not being able to afford it right now. My family has personally been in that position for a while now, but I don't blame the system.

I blame the fact that my mom earns $14/hr and how it wouldn't be prudent to get insured while I'm unemployed.

As a disclaimer, I haven't listened to the audio. I also realize that I might be drifting off-topic.

I'd pretty much agree that health insurance is a necessary expense. I know that when I was self-employed, health insurance costs were way too high. I decided to chance it and went for five years without insurance. For me, it worked out. For some people, it doesn't.

To me, the problem is the cost of health insurance in the US. States regulate what must be covered under insurance plans, which sounds all fine and dandy except that you get really expensive health insurance. Why should an elderly couple be forced to pay for maternity insurance since they don't plan on having kids? Heck, why should I be forced to pay for drug rehabilitation insurance since I don't plan on doing drugs? If government would just get out of the way and let the private sector handle things, I think it'd work out.

Quote:

---

Originally Posted by Dave_Sinkula

Another part of this that I don't fully understand is related to the FOR FREE part. Since nothing is for free, is it that your salary is actually reduced by, say $10,000 per year, and it's just that you never see that?

---

My employer pays for my health insurance. While it technically comes from my pre-tax salary, my salary is adjusted to account for the cost. It might be more accurate to say that it's 'free to me'.

Quote:

---

Originally Posted by Govtcheez

FWIW, I work with someone from Windsor, ON. He and his wife recently had a baby, and they made sure it was born in Canada so it'd qualify for their health care. I've spoken to him about it and they refuse to use US services, even though he works in the States and lives just across the border. Just an anecdote.

---

I loved that anecdote. I've got a friend that lives in Canada. Her husband is from the States, and they live in Canada. However, their personal doctor is in the US. They're not wealthy by any measurement, but they prefer to fly down here, visit family, and see the doctor rather than wait. I'm sure no small part of that is that she has quite a few health problems.

FWIW, this would be my summary of the interview with a former president of the Canadian Medical Association.

Topics such as

• decreasing the number health professionals and equipment as cost control
• wait times of 70+ days vs 1 week
• limiting the number of people allowed to enter the medical profession, cutting medical school enrollment
• physician-to-population ratio now 2nd worst in western world
• neonatal/maternal mortality rate going from #1 (best in the world) to #21
• investment in medical equipment is diminished
• 10% of Canadians have no access to a family doctor
• people of means are not allowed to get care if they can pay for it -- unless they can get outside of the system (US, etc.)
• drug reimportation and the effects on drug prices in Canada if the US adopts thieir system
• slow introduction of drugs to Canada
• greater efficiency in adminstration
• frivolous lawsuit less likely in Canada and its influence on cost
• second opinion not really an option due to delays

Quote:

---

Originally Posted by Dave_Sinkula

people of means are not allowed to get care if they can pay for it -- unless they can get outside of the system (US, etc.)

---

AFAIK, there's some movement now towards combining the public and private healthcare systems here, so if you have the means to pay, you can. Those who can't afford will still have to wait on the public healthcare.

I just wanted to say that the arguments about financial cost that I've seen here don't make much sense. The reason that you get health insurance, is not so that you can get a $20 item cheaper. It's so that you will be insured against a catastrophic accident, that could ruin you financially for the rest of your life. Sort of like car insurance, in that sense.

Also, an argument that I've often heard, is that we are actually paying more for a private system. Because ER can't legally turn someone away, and the cost of ER treatment is higher. The rationale goes, that someone with no insurance will wait until they are very sick, then will be rushed to the ER, and will receive "free" treatment that is more costly. This "free" treatment is billed, indirectly, in the form of higher insurance premiums for everyone else (read: you and me). This is usually the argument that is put forward for universal healthcare, and how it will be less expensive in the long run.

And in terms of merging private and public healthcare, I don't know if I like that idea. I mean the idea that I pay through taxes for public healthcare, which involves a large wait time before receiving service, and the option of paying a premium for faster care. Something tells me that this will amount to me receiving the same health care coverage that I receive now, except I also pay higher taxes.

I think what it comes down to is, people who make less money will find universal healthcare more attractive, because it comes closer to "something for nothing" for them. And it will be less attractive to middle-to-high earners because to them it comes closer to "just another tax" and possibly (likely?) worse service than they currently receive. So the "bleeding heard liberals" try to sell the idea to the middle/upper classes, as this noble thing that they should support, because after all everyone deserves basic health coverage. I call this the "What about the children" argument.

You definately don't hear: "it's going to cost you less than HMO/PPO that you already have, and on the plus side the service is going to be much better."

Sort of a rant. Sorry.