Health Care Stories: Azusa, CA

Jeanne wants to know what you will do against the madmen.



We’ve all read about madmen who wanted to rid societies of the sick, the infirm, the crippled, the mentally ill. It’s easy to point these madmen out in history books, and it’s easy to be outraged about the horrors they inflicted on the world because those events are over. Any coward can shake his fist at those who have already been tried and convicted. It is much harder to have the strength to challenge the perpetrators while the horror is in progress.

Our current national horror (some might say one of many) is health care. The sick, infirm, crippled, mentally ill cannot get equal, affordable access to quality health care. Historical madmen would have been thrilled: what a great way to get rid of society’s rejects! Force them to pay for health care, which bankrupts them, and then deny them that health care. Brilliant. Why, if I didn’t know any better, I’d think that our system is a thinly-veiled, economically-based genocide that successfully purges the country of those who can’t care for themselves.

But I don’t know any better. Instead, I know a single mom who had to drop her employer-based health care plan because she couldn’t afford the co-pays. I had a friend who couldn’t afford to insure her son because her employer only paid to cover her, and the cost of adding her son was too prohibitive. I’ve got a coworker who can’t get the root canal she needs because she can’t afford the deductible. I have a friend who had no health insurance and almost died from neglect at the hospital when her appendix burst.

I am lucky. My husband, kids, and I are insured through my husband’s employer. And, if my husband lost his job, we would have the option to pick up insurance through my employer. We have a small safety net. However, I feel no sense of security. If our fortunes change for the worse, we could lose it all, too, just like so many other Americans. I have bipolar disorder. My husband had a heart attack a few years ago. Our “preexisting conditions” make us immensely uninsurable. The madmen would be very glad to get rid of us.

Even worse than the madmen, though, are the ones who, against their best interests, stand with them. I’m thinking of a woman who once complained bitterly to me about single moms “getting government handouts.” “But you were a single mother,” I pointed out, “and you had it so hard—-why would you deny these people the help that you desperately needed?” She gave no answer, but her body stiffened as she glared at me.

Why do people go against their best interests? Perhaps they haven’t thought things through. Perhaps they’ve bought into glistening lies like the ones about death panels, lies packaged by health insurance companies and politicians who viciously want to keep the status quo. These are the madmen. Like the bank executives who greedily took bonuses while the banks failed, these madmen keep stealing profits as their industry absolutely fails in providing customers with the most basic care.

We need to do much more than shake our fists at these monsters. We need to stand together and demand that all have access to the health care that all of us need. If we as a people do not work to radically change the current health care system, then we are tacit accomplices in our own suffering and death. The madmen would be pleased.


--Jeanne
Azusa, CA

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Health Care Stories: A Canadian Thread

Here's an interesting "conversation" started among our neighbors to the north after I sent one of my millions of solicitations for this project.



I am so grateful to live in Canada. One year and three months ago, I was diagnosed with Uterine Cancer. I received treatment at Sunnybrook Cancer Center, from one of the top Oncologists. The treatment, tests, and radiation were all covered by the government. I have friends and acquaintances in the US. One or two have had cancer and weren't able to get testing done because they were laid off their jobs and had no insurance.

I have another friend, who even though he's in a union with health benefits, gets no health covereage when he's between construction jobs. There have been times he's had to go months without his heart medication or high blood pressure meds. When his BP acts up, he can't go to the doctor. Even the so-called "free" clinics are about $200 per visit. He even had a "minor" heart attack a few months ago and didn't seek treatment because he couldn't afford it.

I personally believe there is a concerted effort to get rid of the "middle class" in North America (specifically the US) What's even more angering is that any illegal alien (from Mexico, etc) can get health coverage for FREE, yet US citizens are left to die in hospitals, or at home because they can't afford to be treated for conditions.

Those stories are few and far between, of people dying while waiting in the emerg room, for treatment or to be seen. Does it happen? Occasionally. No system is perfect.

In Canada, no one is refused treatment. No one is standing by your gurney waiting for you to sign papers, before they treat you. That's not the case in the US.


Anne-Marie



In many areas in Canada, it's hard to find a family doctor willing and able to take new patients. I've been living in Nova Scotia for almost two years and still can't get a doctor for myself.

When I lived in British Columbia, I was fortunate to have had a family doctor. When my sister came to visit here, thinking of staying, she was unable to get one either. So she moved back to Ontario, where she still had a doctor.

A few days ago a young man (22) went to an emergency room in Halifax with his mother. He had asthma. It appeared that his wait to be seen would be many hours - overnight. He decided that, feeling as poorly as he did, he'd be better off at home resting.

His mother called him the following morning to see how he was doing and, getting no answer, called the police. The young man was found dead in his apartment.


Anne



That's sad about the 22-year-old. But, straight up, if he was still at the hospital, more than likely he would have been taken care of, once his medical issues became serious. Unfortunately, he chose to leave the hospital. It was an error in judgement. As for doctors not being available in many smaller areas, you are right, to some degree. I know many people who basically just use the local walk-in clinic as their main Doctor's office. But by and large, it's a good system. Unlike my American friend, who had a heart attack and can't even get himself checked out because it would cost thousands of $$$ to do so.


Anne-Marie



The 22-year-old would not have been seen. The following days the emergency set up a triage. The hospital had more than they could handle, and it's now being investigated. He should have been assessed on intake, but the story goes he wasn't able to even get to intake for the paperwork. That was a wait. Hospitals also routinely close their emergency departments for a day or two each week because there are no doctors available to work.

Also, there is no such thing as walk-in clinics around my area. The closest one is a half-hour drive.

I still believe, however, that things will improve.

But I agree, I wouldn't want the system to become Americanized, and I think the Americans are on the right track to try to change things making it accessible for all.


Anne



Good recollections to both Anne and Amanda and Anne Marie.

Um, I have to say...it's very difficult for us to get or teach young people patience. I can't help but believe if Paul Cleaves had had a friend with him...or had been encouraged to stay in emergency and wait his turn he would still be alive.

I think it's not a bad thing if we have some waiting periods in hospital emergency rooms. I've waited many hours when emergencies occured...with my daughter. That is part of life...waiting one's turn.

When we have fast food joints, drive-through banking...I believe we have forgotten that a large part of being a social animal...of being human and part of a community is ....


...waiting.

If the young Cleaves with asthma had stayed inhospital...I believe he would still be alive. Of course, a hospital staff is going to prioritize its patients. People giving birth, people bleeding will always be treated before others. But if someone had problems breathing...they would be rushed ahead of line.

We should be polite and patient. We have forgotten how to share. We have forgotten how to let somone else in line ahead of us...and we have forgotten how to wait our turn. So what if it takes 6 hours to see a doctor in hospital?

At least we are in the right place if we are ill. That poor boy who had asthma should have stayed waiting for care.

But you can't put an old head on young shoulders...therefore, the youth got impatient and left the hospitial.


Candy

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My Doctor Felt Used? What the Heck Does That Mean?

I had an odd experience at my doctor’s office on Thursday. First I have to give some background story so you can understand the context of both my mindset and, perhaps, why I found his reaction so strange. I’m putting this out there on the Web, so that if this odd doctor reaction happens to anyone else, they’ll know they aren’t alone if they do a search to see if it’s happened before. I’d also like to hear peoples’ thoughts on my Doctor’s behavior.

Last May, my dental hygienist was concerned about how much my gums bled when she jabbed them with sharp metal pointy tools. I may have “perfect teeth” in the words of my dentist, but my gums suffer from some gingivitis despite my good brushing and flossing habits. She suggested I talk to my doctor about it at a general physical exam, since it could indicate some potentially serious health problems — some which should not go untreated for months.

I phoned Doctor A, the doctor I see most frequently, and who I consider my “family doctor”. I was told that they were booking physicals in November, 6 months away! I couldn’t believe it — actually I believed it, but I wasn’t going to settle for it, so I booked that appointment and figured I’d check with other doctors in the city to see if I could get checked sooner. I phoned the office of Doctor B, who I’d seen a few times before, and they had an appointment for July. Still, July was 2 months away, but I figured I’d made my best effort to thwart the health system’s attempt at euthanizing me by putting me in a long waiting line, and left it at that.

I saw Doctor B, and the check up was pretty normal. I got some drugs for my mouth (which didn’t seem to help, I thought), and some standard blood work, etc. I got a phone call a week or so later asking me to pick up a form to get more blood drawn because they wanted to verify some tests on liver enzymes were correct. I got the blood drawn for that and phoned Doctor B back a week later asking if there was anything wrong on the test, and the office said there must not be, because the lab report “was filed”.

Fast forward to October, when I get a phone call from Doctor B’s office, asking for an appointment with me to discuss a problem on the blood test. “What the heck?” I’m thinking, because they told me before there was nothing the matter. I asked for them to fax me the blood tests, and they did. There were obviously high numbers for a few enzymes, highlighted by “up arrows” and boldface print. “It wasn’t nice of them to miss that two months ago,” I thought out loud to myself. I assumed whatever it was couldn’t be too serious, because the appointment they wanted to set was about a month later, on November 21, 2006!

My physical exam with Dr. A that hadn’t taken place yet was scheduled for November 16, and it was going to happen before I got the [bad] results explained to me by Doctor B – two months late. I reasoned if there was something wrong with my liver, I couldn’t get too many physical exams and blood work done, or too soon, so I didn’t cancel my appointment with Doctor A and figured I’d take him the July and August blood test results so he could explain to me what my liver was doing wrong.





It’s all about the smile.

I put the test results on the desk in Doctor A’s office while I waited, and, when he got there, he looked at them and I told him that they were from that summer and I had an appointment later to have the results explained to me, but that I’d like his opinion on the results. Big mistake on my part, apparently.

...

He got this strange look on his face and asked if I’d seen Doctor B because it was an emergency and Dr. A wasn’t available. I had a feeling that answering “no” was the wrong answer, but I told the truth anyway, and said, “no, not really.” Then he looked at me with a pained expression on his face and said he wasn’t feeling comfortable with what I was doing. He said, “Perhaps I shouldn’t tell you this because maybe it will just chase you back to Doctor B, but I’m proud of my work, and won’t allow myself to be used. I work until 8 in the evening some days, not until just 5 like some places, and appointments are given quickly. You have to understand, it’s not right to use me just when you think I’m good enough. I am nobody’s ‘doormat’.”

I sat there stunned for a moment, not really able to speak because I don’t have a steady voice after just being scolded. But I squeaked out that I wasn’t trying to misuse either Doctor A or the health system, and maybe that he felt that way because I did something not really typical, but it wasn’t my intention to abuse anyone. I was trying to get an appointment sooner than November, and that seeing Dr. B wasn’t personal, and I had confidence in Dr. A’s abilities. I asked if he thought we shouldn’t proceed with the exam, but he said we could, just that I should keep in mind what he said about him not letting people walk on him.

He didn’t seem to completely get the point that I had no real clue as to what he found insulting, but he calmed down some, and tried to get the appointment back on track. I decided to go ahead with the appointment too, since I was already in a hospital gown at that point, and even though I was questioning the mental stability of my doctor, I still trusted his physical capacity to examine me properly.

He left the room for a couple minutes, came back and conducted the exam, and left again for a bit to compile some information before returning to give the results. He explained them, and identified and explained the common liver disorder I apparently have (Gilbert’s Syndrome – which is so minor they don’t even bother treating it). There was the other standard stuff, with more follow-up and drugs to come.

After the prescriptions had been written, and the appointment was over, I made a point to try and bury the hatchet, and explain my intentions once again. I explained my actions from my perspective. “In May, my dentist told me I had potentially serious medical issues that needed to be detected and diagnosed through a ‘physical exam’,” and when I was told by Dr. A’s office that November was the soonest time available for one, I thought that wasn’t soon enough. I hadn’t considered then that they could make room to see me for a shorter exam, or considered that anything other than a “complete physical exam” would be able to find the issues suggested by my dentist. I said I was sorry if I made him feel used. He half-heartedly accepted my apology, because he still brought up that he would not be used inappropriately, and something or other about “loyalty”.

I just can’t get my mind around his reaction to me seeing another doctor four months ago, when his office would have had me wait four months longer. Are patients really supposed to remain so patient as to wait half a year for a particular doctor to look at them? Is it “disloyal” or just proactive healthcare for a patient to seek a waiting time that’s 66 percent shorter than their regular doctor’s line? I guess I was deluded to think that he’d take the blood tests I’d thought enough to provide him with – tests from the same lab he’d order results from normally – and interpret them without a lecture on doctor-patient loyalty. I can understand some people get sucked into brand name loyalty, but hasn’t he ever heard of getting a second medical opinion?

I can’t know if it’s because Dr. A hates Dr. B, or is desperate for fees collected by seeing more patients, but I remain a little weirded out by the encounter and have to decide if I should be chased back to Dr. B, or grin and bear Dr. A since he’s otherwise competent. In this tiny city, in this small province where a town is lucky to keep General Practitioners or get new ones to take new patients, can I really afford to alienate one of the five or so doctors available to treat me?



Saskboy




Check out Saskboy's blog, Abandoned Stuff by Saskboy.

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Health Care Stories: London, UK III

Harry gives us his point-by-point assessment of Britain's National Health Service.



I don't have any stories for you but i can tell you a few things...


1) The NHS does mean that anybody can book a GP appointment, or receive a heart-bypass, or whatever, for 'free' (it's everybody else's expense!)

2) This does mean that, since it's funded from general taxation, that it becomes a political issue

3) So everybody gets heathcare based on need, but the NHS can only supply healthcare based on politician's assessment of need and consequent funding. (supply has to be pre-planned top-down)

4) A body called NICE (National Institute for Health and Clinical Excellence) does a cost/benefit on drugs. Those that cost too much are banned from the NHS. You either get free treatment in the NHS for the approved drugs, or, if you want to pay for life-saving drugs, you have to go completely private. The NHS wont contribute at all, you can't top-up your healthcare. Equality is apparently more important than saving lives!

5) There used to be long waiting lists caused by the necessary 'rationing'. There is no market incentive for supply to increase. These have been greatly reduced due to massive taxpayer investment.

6) 1.3m people work for the NHS, vs 29m employed in the whole country. It creates a client state, with voters owing their living to government. They will vote for a pay increase at the expense of taxpayers!



However, some 'good' points...



1) There is no disincentive to pack in your job and set up in business for fear of losing your family's insurance cover. So labour flexibility is perhaps improved.

2) There is no bureaucracy from having to process insurance claims. It doesn't exist.

3) The focus at all levels is on health of the patient, not on whether they can pay (i.e. very altruistic culture where commercial realities don't exist)


The NHS persists, because no politician has ever been brave enough to propose an alternative system. The debate has always been around the level of investment (we want more doctors, nurses, etc., or we need to cut bureaucracy and make it efficient, etc.). Any time a politician talks about the NHS, it generates an emotive response. It has contributed to people feeling that the state is maternal and good. We have surrendered our self-reliance, largely, and voters seem to expect help from 'the government'.

The NHS could be reformed with market incentives to improve the situation a lot. It still forces taxpayers to foot the bill, but that is less of an issue than having people die because there is no market to drive up efficiency.



Harry
London, UK

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Health Care Stories: Oslo, Norway

David explores the differing European and American attitudes towards universal health care.



I’ve lived all 58 years of my life in countries with some form of National Health system: the United Kingdom, France, Holland and now Norway. In all of these countries, a publically-subsidized healthcare system is something that is pretty much taken for granted. If you have something wrong with you, no matter how trivial it is, you go to your doctor. You don’t worry about how much it will cost you, because it will cost you little or nothing. And even if you have nothing wrong with you – if you simply want your health status monitored as a precautionary measure – you can still make regular appointments with your doctor and again it will cost you little of nothing.

I think I’m reasonably accurate in saying that the average Brit, Frenchman, Dutchman or Norwegian regards the debate that is now taking place in the United States with a mixture of incredulity and amusement. We find it incredible that the richest country on earth has no effective system of social healthcare. We find it incredible that there’s even a debate going on about something that we regard as an inalienable right – the right to be healthy. And we find it amusing that so much hysteria is being whipped up and that government-subsidized healthcare is being branded as socialism.

And, as we all know, a large section of the American public is scared of anything that even remotely smacks of socialism. From an outsider’s perspective, it would seem that the Cold War mentality is not entirely dead and neither is McCarthyism.

However, this does not seem to stop 15.4 million Americans from being members of labor unions. Let’s get one thing straight: a labor union is an institution based on socialist principles. Unions were created to protect the interests of working people – to give them adequate salaries and working conditions, among other things. Yet, as we know, modern unions are not necessarily socialist, or even left-wing, in their political leanings.

Similarly, adopting a healthcare system on socialist principles does not mean that democracy is under threat or that there will be parades of tanks and missiles down 5th Avenue on May 1st. In fact, a national health system finally has little to do with politics – it is simply a way of ensuring that EVERYONE in the country receives adequate healthcare irrespective of their income level.

And it is income level that is the important point here. For the roughly fifty percent of the U.S. population that can roughly be defined as “haves”, the concept of a national health system is irrelevant. They may or may not feel that it is important to have an efficient and socially just health system but, on a personal level, they have no need of it.

But let us turn our attention to the “have nots” (bearing in mind that 58.5% of Americans will spend at least one year below the poverty line between the ages of 25 and 75). These are the vulnerable people, the people who prefer to risk their health rather than seek medical attention that they cannot afford. The people for whom a serious illness will also mean increased deprivation.

There are people living below the poverty line in all of the countries in which I have lived. But in none of those countries does poverty need to mean ill-health. Affordable medical care is available for all. It is not always perfect, and in the U.K. for example, there have often been long waiting lists for interventions that were considered non-essential, or at least not life-threatening. There are cases of misdiagnosis and there are some medical professionals who are clearly sub-standard. Yet, these are situations that can equally occur just as frequently in private systems. And the general quality of service that I have experienced has been uniformly high.

In Europe, the actual structure of national health systems varies from country to country. In the United Kingdom, for example, the health service is free for all, with a flat-rate prescription charge that covers all prescriptions – everything from aspirin to the latest and most sophisticated drugs.

One thing that you will never get in any of the European countries I have mentioned is unpleasant surprises. Should you be unfortunate enough to have an accident, you will be taken to the nearest hospital. Treatment, of whatever nature, will be thorough, effective and free. Treatment costs will be either covered by the state and/or by a form of private health insurance that provides a standard level of cover set by the government. Everyone in all of these countries benefits from some form of total health insurance. By contrast, in 2006, 16 percent of the population of the United States were without health insurance for at least part of the year.

You are free to choose your own doctor in all of the 4 countries I have mentioned. You are also free to discuss your best options for medical treatment. You will never find either a national health system or even a private health insurance company refusing a form of treatment on grounds other than its suitability as a remedy to the medical problem concerned. And, contrary to some of the propaganda put forward by opponents of healthcare overhaul, insurance companies in Europe – even those specializing in healthcare – continue to make very healthy profits.

Surely, the issue should not be about the so-called political implications of a form of national health system (non-existent) or the damage it might cause the private sector (negligible) but of how such a system should be best implemented.

Article 25 of the Universal Declaration of Human Rights states that: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”

As a signatory of the 30 articles comprising the Declaration of Human Rights, the United States of America is committed to implementing their provisions. If it wishes to occupy the position of leadership in the world to which it aspires, it would do well to ensure that each and every one of those 30 articles is rigorously observed. Then, and only then, will the United States be morally justified in persuading other countries to do likewise.

Free or low-cost healthcare for all is not an option but a moral imperative.

David
Oslo, Norway




Check out David Wray's blog, The Opposite.

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Health Care Stories: Quick Hits

Here are some emails I've received over the past month concerning the Project.



I really don't know how people in USA manage without a civilized health care system. In UK it does not matter who you are, you get treated. You do not need to make a private deal with a health care provider - you just get treated. My mother died five years ago and was cared for first in hospital and then in her own home. We had excellent domiciliary services - nurses, doctors, medicines, pain management, equipment - on tap throughout whenever she needed them. Nobody ever even thinks about 'does her policy cover this?' - no delays, no exclusions.

--David
Narborough, United Kingdom





In February 2005 I married an American citizen living in Seattle. On March 8 2005, I went to Summit Radiology in Seattle for a TB examination/chest x-ray as required by U.S. Immigration as part of a physical to allow me to live in the U.S. I was told that there was a "scratch" test for this or an X-ray, and when I requested that I’d rather not have an X-ray, I was told they didn't do the scratch tests. I agreed to the X-ray, thought I was having the X-ray, and when it was done, the person who took the X-ray realized she hadn't had film installed. So, I had to have a second X-ray. The impression showed "No apparent active disease in the chest. Specifically, there is no evidence of active TB." I was furious at the carelessness of the technician or whatever title/qualifications she had, but I wasn't in no position to make waves. I don't have TB, but I sure had a lot of exposure to radiation.

--Francine
Vancouver, Canada





Really quick story. My husband's back went out, and we ended up in the ER where they did take an X-ray and transferred it to a CD, which was useful later at the chiropractor, and gave pain meds which were useful at the moment. The hospital has so far billed us for over $1000 and been paid around a third of that. The chiropractic care had to be paid in cash since it is not covered by insurance. A wise investment since it actually got my husband walking again, and a bargain compared to "regular health care," which did not offer any real solutions to the problem, yet was covered by insurance.

--Nunya
San Diego, CA





My personal experience of the Swedish system is that, in general, it works well, in basics, when it doesn't it usually has something to do with overall budget cuts, system restructions not to mention the human factor.

We all want to meet, and depend on, professionals that are competent, caring and skilled in their respective field. That's unfortunately not always the case, and of course a universal problem not linked to the specific health care system per se, be it health care or other areas.

--Pia
Sweden





In general, I am content with the healthcare in Quebec, Canada. I don’t have to worry about the cost of emergencies, and I generally feel safe and secure. There are times though there I wish the healthcare system were more efficient.

One word: waiting. The story that best exemplifies this is one where my cousin was not feeling well, so she went to the emergency room. She had been waiting for a few hours, and other people kept being examined before her.

Eventually, she passed out in the waiting area. The next thing she knew, she was being examined by a doctor, and they had moved her into the emergency room. “If you ever need to get in faster,” she told us all later, “just pass out. It works wonders!”

Now I don’t think it’s necessarily always like this in hospitals here in Quebec. Though we all seem to have our share of “long wait” stories.

In terms of patient care, I’ve met many nurses while visiting my grandfather in the hospital, and they are all very caring and attentive. They are lighthearted and great at lifting the mood of the patient.

Overall, I’d have to say that I’m content with the healthcare system here, but the waiting average at hospitals can be trying at times.

--Nathalie
Quebec, Canada





You should remember that the Americans have far more ethics than the UK management systems. The NHS is in turmoil--not because of its principle but because of bad management for many years. The death rate is fairly high in the UK but not featured anywhere. I doubt you can compare the UK system to the proposed US system because the ethos of the UK is completely different. Nevertheless, care here is much like the lottery, I doubt people die on streets, but they definitely die in hospitals with a high rate of errors. While the US system appreciates whistle blowing, even appreciates the need for high quality healthcare, the UK government does not.

--Simon
United Kingdom





Sadly, or perhaps thankfully, I've only ever had to use the NHS a few times. Thankful only because I've not been very ill very much not because I think the NHS is in any way unable to
help.

The times I have used them I have been treated quickly, efficiently, and pleasantly. There has never been any trouble with them prescribing any drugs needed, or offering any form of treatment (which seems to be the problem many Republicans have with the idea of a public healthcare system).

I was born in an NHS hospital, my brother and sister were born via IVF treatment partially funded by the NHS. The NHS has been there whenever my family and friends have needed it, be it a visit to the emergency dentist on Christmas Day or treatment for leukaemia.

My other half, who has private health insurance with his American employer, recently found a tumour in his hand and found private hospitals were great for the kinds of amenities one associates with a five-star hotel (multi-channel television, room service) but found the NHS ended up offering him a better style of aftercare for his (privately) botched surgery than the private hospital were prepared to give him. They basically refused to fix the mess they had made of his hand because his insurance wouldn't cover it! Thank God the Attlee Government for the NHS.

Basically, though, I've got nothing much of use to your fight, but certainly want to offer some moral support. Private healthcare will always be around for those who want it, but there should always be a public health service for those who NEED it.

--Jae
United Kingdom





I'm originally from Britain, but have been living now for over 40 years in Canada. Hence my health costs have always been covered. Sure, there are problems with health care and with the costs for providing it: the system's not perfect. But I couldn't conceive of being without coverage.

The only time, thank God, I had to have medical service in the USA was after a skiing accident. I was lying on a stretcher with a torn Achilles tendon and the doctor wouldn't even see me without an upfront payment. Fortunately, I had enough in my wallet (It was before the days of credit cards), but otherwise what would I have done?

I'm also fortunate in that I had a good plan for drugs from my employer until I retired and, now being over sixty-five, I have drug coverage from the province and have to pay only a minimum amount. But what of those who can't afford adequate care? I am only too happy to support them in whatever extra taxes I may have to pay.

--A. Colin
Canada





When my father was 94, he was diagnosed with stomach cancer. He was operated on immediately and received all the health care he needed and didn't spend a penny, thanks to the British national health system. This was the same UK NHS that, according to Sarah Palin and her colleagues, organises 'death panels' for people over 60. If that were the case, my father would have been left to die. As it was, he had another seven years of rich and fulfilling life ahead of him because of the NHS's prompt, and excellent, treatment.

--Charles






I am a mid-level health care provider and have worked in ERs for about the last fifteen years. Regardless what your feelings are on the subject of reform the system is on the verge of collapse. ERs are operating above capacity with volumes unthinkable only five years ago. People are using facilities designed as triage for long term care. This cannot continue. Physicans, nurses, technicans and therapists are working beyond compentency levels due to sheer numbers. Anyone who thinks that there is no 'Problem' has no idea what they are speaking of....

--Eric


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At Least 52 Million Americans Have No Healthcare ... I Am Just One Person Who Truly Needs the Public Option. NOW.

I am an RN of 20+ Years. I have worked to take care of hundreds, maybe even more. I have never ever refused anyone care for anything, I have worked it all from community health, to AIDS to ER to hospice ... home care to hospital care. I took an Oath to care for people, to deny No One Care and to do No Harm.

As a Nurse I have always tried to teach others to be proactive and take good care of themselves. I never thought I would be UnInsured or not able to have access to care I need. I have been Uninsured since 2006, this is my story of why and how it happened ... and it is personal, and I am sharing it because it matters ... it is Reality. It is a Reality for me and 52 Million other Americans. Below is merely a piece of my Healthcare-Less story...

In 2005 I went through a Divorce, and therefore needed to find Insurance on my own as a single mom. My son still did and does have coverage, and that was my top priority. I set off to find a job that would offer benefits and also to find Health Insurance. The Cheapest Single Payer plan I could find was $480/month. I contacted more than 14 companies, and only ONE would take me. I was denied coverage by 6 of them for having MVP (Mitral Valve Prolapse-a simple heart valve deformity that millions of Americans have and it is a structural issue).

That was the beginning of seeing the dimensions of the ability of Insurance Companies to deny care. I called the Insurance Company and learned that many conditions are Exclusion-worthy. It was a long list. Even someone being ordered for an EKG or an Echo or other test that indicates Heart Monitoring would have people be cancelled.

Doctors cannot properly monitor for Heart Disease without restrictions and being overpowered by the Insurance Companies. So people with Insurance could also be cancelled at any time for a test or X-ray being ordered, without warning or notice. What bothers me about this process is that Insurance companies don't have to follow or abide by any HIPAA laws, they can do demand access to your Health History and records BEFORE they agree to accept you. It is like a Club that does not have to follow ANY laws ?

(By the way-that is just part of the Heart Story ... but it was the beginning of learning about being Denied care ... I do have valve issues, BUT the bigger picture is that I take good care of myself, I walk everyday, use a treadmill, and don't smoke or drink ... I am proactive, but no one ever asked me that. Bottom line: someone with an enlarged heart and valve issues SHOULD have Monitoring and Regular Screening, ie EKGs, etc.)

So that was the beginning of the struggle. Finally, after many months, I found a company that would cover me, and I was willing to pay the $480/month until I could get a job with benefits. So I paid for the insurance for 3 months, then I went to get my first Breast exam in many years, thinking I was going for a routine mammogram.

I got there, and there was a lump--actually a cyst the size of a small plum. Ultrasounds were done, and the cyst was aspirated ( 9 cc's...). And I was sent to a follow-up to a Breast Expert. He was very thorough. He did a History, he asked about my family. I explained that my grandmom had died of Breast Cancer and Lung Cancer. I also explained because he encouraged me, that before I had gotten pregnant with my son, I had had the BRCA test when I lived in another state. He asked me to try to get those records, so I did, and could not--they were archived or lost by the Institution. So he did what any doctor would do and ordered the important blood work be redone. It is important for monitoring and screening for breast cancer. I asked him not to. I told him when it was ordered that it would cause me Insurance Problems. He said it was worth the risk.

So within weeks, I was Cancelled for not providing a FULL Medical History, and ALL of the care for the Breast Appointments I had to cover myself, over $1500.

Now it is 3 years later. I am underemployed, with 3 part-time jobs. The One job that is not even a Nurse job is at a market. I took it because I was told that, within a year, I could be Eligible for Health Insurance.

NOW for the Truth, the Market Job will review my situation at one year and submit my name and start paying in. But that is a Probation period, and THEN the Actual Plan review is Not Until Spring 2010 (though I have worked there since 2008). And then, at that time, I can and still could potentially be denied, even after paying in during the Probation period.

The Nursing work here is all part-time or per diem with NO Access to ANY coverage--so that is my ONLY Option. (The Hospitals here have a hiring Freeze or only are hiring per diem or part-time, if at all, and this has been the case since 2007).

So here is where it gets very interesting.

For the past year I have been battling 98% of the Symptoms of MS. Thankfully, my Brain is fine and working at its usual speed. BUT my muscles are failing, and I am losing strength and coordination. I have constant pain and muscle spasms and stiffness and my gait is effected. I have NO meds for this. I have received some free medical "advice" and guidance about what I "need", (which vitamins and supplements to try).

I need a Neurologist, but cannot find one, single one that is willing to take me Without Insurance. I have contacted all the right people and organizations. I even found one group willing to donate a $2,000 MRI for me, but without a doctor or someone to offer me care, it is a meaningless gift.

MS means that, for work, I get up 3 hours early so that I can get "Unstiff" . I do have a Doc in the Box I go to when I am desperate for care, but I cannot go there for this. I have only been there this year when the Recalled Cookie Dough left me so sick and dehydrated, but I had to pay out of pocket for everything.

Another time, when I needed antibiotics for a respiratory infection, I ordered Fish Antibiotics from a Pet Company. And this winter I had a stress fracture in my foot. I used Duct tape to treat it. And, about the Breast Cancer Risks and History, there was never a follow-up or another test done. I did try to get care at the Free Clinic and was denied because they are not taking ANY new patients. Other low-income clinics would not take me without Insurance or MediCaid. I am out of Options.

So there is a Piece of my Medical Story ... Beyond Broken ... and I am just one of 52 Million that has such a Story ... I am one of 52 Million Americans that Needs a Public Option ... Now.



This piece was originally posted at Enigma4Ever's blog, Watergate Summer. Check it out.




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Health Care Stories: Malmö, Sweden

Mark has lived in Canada and Britain and currently lives in Sweden. He is here to give us his comparison of the three systems.


I'm a 44-year-old British-Canadian living in Sweden. To elaborate: I was
born and raised in Montreal (Canada), moved to London (England) in 1990,
and to Sweden in 2002. I currently live in Malmö, in southern Sweden, where I'm a freelance copywriter/editor.

As someone who's happened to live his whole life in countries where healthcare is either free (Canada/UK) or highly subsidised (Sweden), I find this issue a no-brainer, and it surprises me enormously that so many Americans are seemingly up-in-arms about the whole thing.

Before I continue, I feel I should point out that most of the people I hang out with here in Sweden are either American or British, so please don't think that I hate Americans. I have dozens of American friends, both here and in the States.

As I mentioned, healthcare in Canada and the UK is free. All you need to bring with you is the appropriate card (possibly some other ID as well, I'm not sure).



CANADA


I haven't lived in Canada for over nineteen years, so I don't know if much has changed there; I can't really comment on that. But I know that when I was growing up, whenever I needed to see a doctor - from what I can remember - there were never long waiting times.



THE UK


The UK's healthcare, the NHS (National Health Service) is a bit of a mixed bag, in my opinion. I've never personally had any problem with the standard of healthcare there, but the media are always reporting on botched surgeries, unacceptable waiting times, etc. But, while scandals of these types obviously exist, shining a spotlight on them--and adding a slight sensationalistic spin--will sell more newspapers. I'm sure many
tragedies and stories of incompetence also exist in the USA.

Incidentally, I saw Michael Moore's film Sicko. He definitely portrays the UK's system as idyllic, and, if you ask me, it's not a very well-balanced picture. It was all a bit too rose-tinted. But that's his type of schlock journalism ... but I digress.

I would say that problems do exist within the NHS (too many, in fact, to list here), but all in all, it's a system in which the majority of people can generally receive a very good level of healthcare free of charge. Prescriptions are also a standard price, regardless of the type of medication.



SWEDEN


In Sweden, healthcare isn't completely free. If you need to see a doctor, you pay up to about 200 Kronor (about $28) per visit. But the costs are capped at 900 Kronor (about $130) for the year. This means that if you need to see a doctor several times over the course of a year, you'll never need to pay more that about $130.

I went to see a dermatologist to get some nasty moles removed. I had to go several times over the course of a few months. The procedure entailed applying some ultra-freezing stuff with a cotton swab to freeze the moles, and they would eventually fall off. I think I had to go about seven or eight times. I was pleasantly surprised when I turned up once and was told that I don't have to pay anymore. I'd thought that I would always have to pay about $28 every time.

It's the same deal with prescriptions. I don't remember the exact amounts, but there's an annual cap of - I think - about $270.

Here's a bit of a horror story, though. Someone I know in Gothenburg - a Swede, in fact - broke his hand and went to a hospital's ER to get treated. There was no receptionist; just a ticketed queueing system. He waited about three hours before being seen. When it was his turn, he was told that they didn't treat broken bones at that hospital and that he had to go to a different hospital. So it's not all rosy here, either.



WHAT I THINK


I don't believe that free healthcare is perfect anywhere. But nor do I believe that it's something one should have to pay for.

People always have the option to "go private" (i.e. get private health insurance), but most people I know don't bother. I think most people who do choose this option are either quite well-off, or have had a bad experience with the public system.

The argument many American have about illegal immigrants milking the system is bullshit. When visiting a doctor, you need to present your Medicare card in Canada, your NHS card in the UK, and your National ID (with your unique "person number") in Sweden.

Arguing for keeping a system in which people are left to die, or suffer horrendous pain, because they haven't got insurance - or "the right kind of insurance" - is sheer ignorance.

Without wishing to come across as anti-American, as I definitely am not, I just look at those opposing this great step towards making healthcare available to all, and think "Yep, typical Yanks."

I think many are afraid of the word "socialized", thinking that this will be the first step towards a communist regime, led by Comrade Obama. It also appears that many are opposed to having Obama as a leader, and would oppose anything he would try to initiate.

I have never lived in a country without free healthcare. I should point out that I (like pretty much everyone I know) rarely need to see a doctor, so I think it's fair to say that the majority of people don't run to the doctor when they have a runny nose, just because it's free. Yes, there are hypochondriacs, but they exist in every country.

As for the "more taxes" issue: Yes, the cost has to come from somewhere. But the amount per citizen is negligible. From what I've heard, most people are happy to pay a little bit extra to keep themselves and their fellow citizens healthy.



BOTTOM LINE


Wake up, America. Keep your private insurance if it makes you feel safer, but don't deny your fellow citizens basic medical care because you decide to pay extra for yours.



Check out Mark's blog, Helsingbloggin' - Malmö.


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10 Things You Need to Know About Health Care Reform

Paula, who gave us the Western Mass. story, has returned to tell us what happened to her beloved state once it adopted universal health coverage.



My husband and I live in a state that already has health care reform. We live in Massachusetts.

On April 12, 2006, our state legislature enacted a law requiring all residents to have health insurance.

They could buy it themselves, they could buy it from their employer through a group plan or, if their income was below a certain level, they could buy it from the state at a reduced rate. This is the so-called public plan. If people are totally disabled and therefore unemployable, and have no assets to cover the costs, the state pays for it. Very few people fit the last category.

Employers – even small-business owners – are required to provide basic minimum health care plans. If they do not, they are fined (a whopping) $295 per employee, per year.

To date, the vast majority of employers – even small-business owners – have found a way to provide health insurance plans for their employees. Few have paid the fines. In fact, the number of small-business employers in the state that do offer insurance rose from 88% to 92% from 2007 to 2008, according to a recent story in Investors Business Daily.

This program has been in effect almost three years. As far as we can tell, the world has not come to an end.

When the law was enacted, my husband was already enrolled in Medicare and I was buying my own individual policy (a high-level HMO) from a business association group I joined specifically to buy insurance at a discount. The last year I had it, I paid $620/month, plus $175/year for association membership dues.

Today, we’re both on Medicare, but buy a mid-level Medicare supplement HMO plan from Blue Cross/Blue Shield of Massachusetts. The supplement includes a drug plan and costs $119 a month, brining our total outlay for health insurance to $216 a month/per person.

Thanks to Medicare and the supplement plan, we’re saving about $800 per month for the two of us. Thank you, US taxpayers and government bureaucrats.

We weren’t sure we liked the idea of mandatory universal health care when it was first presented to the people of Massachusetts. We worried about reduced care, higher bills, and all the other things you worry about when you’re facing change.

Here’s what has happened to us as a result of mandatory, universal health care:

1. We still go to the same doctors.

2. We’re still on the same medications.

3. We still use the same pharmacy.

4. All other medical facilities we use – imaging labs, hospitals, blood testing labs, physical therapy -- have not changed.

5. As far as we can tell, our insurance premiums have not changed or have changed slightly ($5, maybe, per month).

6. Our co-pays are lower, but we’re on Medicare.

7. If I had stayed in the same HMO plan I had before Medicare, some of my co-pays would have increased for things such as substance abuse treatment and prosthetic limb fittings, not that I used any of those benefits.

8. I have greatly reduced my drug regimen and we both have increased our weekly exercise, in part, because our insurance now encourages prevention by paying a nice benefit for going to the gym.

9. We feel more comfortable being in crowds at the grocery store, movie theaters, or in close quarters at the barber shop and hair salon, knowing everyone there has access to health care. That means everyone we deal with is less likely to be spreading infectious disease than they were three years ago.

10. We’ll feel even better when this year’s flu season comes around, since school children, teachers, bank tellers, store clerks and others dealing with the public can get the necessary vaccines or treatment to contain this year’s flu, no matter how rich or poor they may be.

And that’s the truth.




This post originally appeared on Paula's blog, Birds on a Wire. Check it out.


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The Angry Black Woman on Health Care

For most of my adult life, I’ve had to live without health insurance. Because I was a freelancer for many years, or because I did not have a fixed residence for a while, or because my skills and career interests often meant that the best jobs available to me were with small companies or non-profit organizations that did not offer benefits. I spent something like 6 years without health insurance.

Whenever I caught bronchitis (about once a year), I had to wait it out and hope that it wouldn’t develop into pneumonia. I constantly worried that the cancer I’ve been free and clear of for years would come back. If I ever broke a bone? I was screwed. Once I caught a severe bacterial infection and lived with it for over a week before finally breaking down and going to a doctor though I knew I couldn’t afford it. Forget about managing my high blood pressure, or getting advice on avoiding the diabetes and heart disease that runs in my family.

My situation was hardly the most dire. I may have been one emergency room trip away from missing my rent payment, but I have a large and loving family, so I have a net. Many people don’t. Many people do not have the benefits of education and skill that I have. Many people are like me, with skills that are useful and sought after, but not always by companies that can afford to bring them on full time, or offer benefits to any staff. There are dozens, maybe hundreds of other reasons why a person may not have access to health insurance, and are therefore barred from regular access to health care.

Any time I hear someone going on about how horrible socialized or universal or government-run health care is, I think back to the many nights I would go to bed worried that my heart palpitations meant the onset of a heart attack, but I couldn’t afford to go to the emergency room just to be sure (the last time I had done so it cost me $250 for a doctor to look at me for 5 minutes and say I was fine). So I’d fall asleep, heart racing, probably in the midst of a heart attack, partially convinced I might not wake up in the morning. I also think of my friend with asthma who would suffer through particularly bad attacks which the over the counter spray did not alleviate, hoping that it would pass, or that breathing techniques would work, and calculating if she had enough credit on her Visa to pay for the emergency room again. Or that little boy who died because of an infection in his tooth that would have been simple to fix except his mother couldn’t afford to take him to a dentist.

Every time I see protesters or blowhards on television I wish I could infect them with 5 minutes of the terror a person without insurance feels when they know that something is seriously wrong but don’t know if it’s wrong enough to warrant possibly missing a house or car payment. I’m willing to bet that most of these people haven’t spent very much time without an insurance net. Certainly not with a serious or chronic illness, either in themselves or a family member. Certainly not while having just enough money to get by. It’s so easy to protest and condemn when you’re comfortable, well-off, and secure, isn’t it?


Check out The Angry Black Woman. You won't be sorry.


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Remote Area Medical in the USA

You may remember how, a few weeks ago, thousands of people flooded the LA Forum to get free medical care. RAM got their start by airdropping medical equipment and staff into the remotest areas of the Amazon. Now, they feel the greater need is in large American cities and our rural areas. Apparently, we Americans and the Yanomami have "the best health care system in the world!"

Anywhere, here's a report 60 Minutes did on RAM awhile back. Definitely check it out.











Thanks again, Nadije.
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Health Care Stories: Wolfville, Nova Scotia, Canada

Wolfvillewatch thinks we Americans should tread lightly before we think about going with a public healthcare plan.



If you want my opinion off the top of my head I would go with a good, affordable insurance (either private- or government-managed) system rather than a completely government-run system. Once you have a government system, if you don't like it, you will be stuck with it. Singapore, I believe, has a mixed system; everyone has to pay into their own medical account that they draw upon when needed, but there is also some subsidised care. This seems a sensible plan to me, which hasn't been talked about much. This kind of system would be easier to tweak/fix until it fit people's needs well.

Here in Canada everyone knows our system needs reform, but no one dares dismantle what we have. Soon, however, it will become unsustainable; our demographics are already straining the system as there are fewer young taxpayers and more and more (longer-lived) elders drawing on the system. Once governments are involved, they have an interest in directing lifestyles to control costs. Instead of individual responsibility and choice, you will get the government telling you first not to smoke and then not to eat the wrong food and then not to drink. A system which has a measure of user pay makes everyone at least partially responsible for their own lifestyles. If they have ill health because of actions they take, they have at least some cost to themselves.


Wolfvillewatch
Wolfville, Nova Scotia, Canada

Check out the blog, Wolfville Watch.

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Private, For-Profit Health Insurance Companies Are Self-Contradictory

Private, for-profit health insurance companies are self-contradictory. They cannot pursue profits - try to make as much money as possible - and support necessary health care. I know this from first-hand experience.

Years ago, when our son was a little boy, he contracted a type of pneumonia that did not respond to the usual courses of antibiotics. After several rounds and weeks of fever on and off and on, his doctor decided to admit him to the hospital. You can imagine how upset my wife and I were. As we were talking about this, in the doctor's office, we heard him talking to our insurance company - Empire Blue Cross Blue Shield. "No, no, he's a professor. They're not those kinds of people. This is legitimate, I can assure you." (I was professor then not at Fordham.)

This went on for about 10 minutes. Finally, our doctor got Empire's agreement. By this time, we had walked out into hall, and he saw that we had heard the conversation. He shook his head sadly, and said, this is what you have to go through....

And I couldn't help thinking - let's say I hadn't been a professor. Let's say we were "those kinds of people" - people who had been paying premiums, but for some reason were not held in high regard by the insurer. Our son's hospital bills would not have been covered?

Our son did finally get an antibiotic that worked in the hospital. But my wife and I learned an important lesson about health insurance that day: the companies that provide it it are mainly in for the money. Accordingly, they do anything they can to limit their expenses. That's just good business.

I had actually learned this about insurance companies (actually, a car company that provided warranties) years earlier, when I was driving a new Oldsmobile to another school. The car up and died on the highway - the engine expired. When I got on the phone, later that day, to the car warranty company, I was treated to "do you have any proof that you were driving your car safely"? I replied that unless Oldsmobile which had happily taken my money for the car and the warranty now paid for the car's repair, and I was assured within an hour that this would happen, I would go to the media and tell them about their shoddy way of doing business. And I would have - but some supervisor called me back 10 minutes later and apologized for the first conversation. "He was only doing his job," he said of the first guy I had talked to. Exactly. Of course he was, and that was the problem. Just good business. Limit expenses.

The car was aggravating. The repairs were just about money, for me as well as Oldsmobile. But health coverage obviously can be a matter of life and death.

We can no longer afford to leave such matters in the hands of people and companies whose main goal is not to protect health but make a profit. I'm all in favor of making money. Profit and capitalism continue to do great things. But they've failed in this country to give adequate health care, even for people they accept in their plans.

It's time to break loose from these hopelessly conflicted, oxymoronic for-profit health insurers. And vote out of office anyone who opposes this long overdue, humane, clearly rational reform.

Government programs are certainly not flawless. But at least they don't work against their own stated goals.



Paul Levinson
New York, NY


Check out Paul's blog Paul Levinson's Infinite Regress.

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Health Care Stories: Los Angeles, CA II

Glennis recounts the troubling tale of what happened to her son when he was a baby and wonders how it would've turned out if she'd had to worry about her insurance as well as her child's fate.




Mine is a story with a happy ending, but every time I hear about someone who is uninsured, or who has inadequate insurance, I think of how it could have ended up horribly wrong if I hadn't been so lucky. And it's not so much about having NO insurance. It's about the pressure of costs that forces you to make decisions based on so-called "free market" issues during times when you can easily make the wrong decision.

In the late '80s, my husband and I both were lucky, because we were public employees and had great health insurance. The kind of "gold-plated" plans you hear about.

When our son was 9 months old, he choked on a twig - actually a small bit of juniper, that had been tracked into our daycare provider's home on someone's shoe. Our daycare provider saved his life performing infant CPR and had him checked out by paramedics, who urged us to take him to our doctor.

In the next couple of weeks, our son developed a cough. Our daycare provider nagged us, but when we took him to our family practitioner, they said things like, "Oh, there's a cold going around," and it was winter, and yes, every kid had a cough, and that's how it went.

He kept having a cough. So we kept taking him in. Our daycare provider swore that the piece of twig that the paramedics got out of his lung was too small for him to pick up - so it must have been a bigger twig and part of it was still in him.

I took him to the doctor - maybe 5 - 6 times in two months, and finally our doctor scheduled us for a "forced exhalation" X-ray - she was reluctant to do this earlier because it is traumatic and painful and also exposes babies to X-rays. But between me being a pest and our daycare provider's nagging, she finally agreed. Also, to be fair, she was concerned. He had stopped gaining weight, he wasn't thriving, and at one point he was crawling on the floor and collapsed as if too weak to continue, frightening me.

They discovered that over half of one lung was completely blocked. They rushed him into surgery. They took a huge chunk of juniper out of his lung.

He is now a strapping 21-year-old, with no health problems.

But I had a "gold-plated" policy. I could afford to make an appointment once a week, even when the doctor thought I was being alarmist. My co-pay was only $10. I had a good doctor, who knew our son's history, who balanced between not over-treating and taking a frightened new mother's fears seriously.

I always think about this when I think about our healthcare dilemma. No matter how good a parent you are, you can't help but rationalize when you worry about cost. If I had had to worry about cost, I can't imagine what would have happened to my son.

Perhaps we would have discovered it later, when it was far more serious. Perhaps he would have been a sickly child with respiratory problems all his life. Perhaps he would have weakened and died. Instead, he lived for two months with one impaired lung, had two surgical procedures - all of which fill me with guilt, thinking of the two months of pain and suffering he must have gone through. But he is a healthy young man, now, thanks to a nagging daycare provider and a good health insurance policy.

I didn't have to nickel and dime. I didn't have to rationalize, "Oh, it's just a cough, it's winter, babies catch colds." I didn't have to worry about paying for each office visit when the doctor just advised "Wait and see". I didn't have to decide whether that $40, $60, $80, $100 should have been spent at the grocery store instead of at the doctor's office. I didn't have to argue with myself, my husband, my mother-in-law whether that office visit was money well-spent. I also didn't have to go to a random doctor at an acute care clinic or an emergency room, who didn't know his history and would have just advised me to "Wait and see."

Shitty insurance is just as bad as no insurance. You shouldn't have to decide whether you can afford to have your child go to the doctor. I was lucky. Another mother and child might have had a tragic ending to this story.



Glennis
Los Angeles, CA


Check out Glennis' blog, Doves Today.

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Health Care Quotes of the Day

"If I hadn't been involved in this process as long as I have and to the depth as I have, you would already have national health care."


"It's not where I get them to compromise, it's what I get them to leave out."

--Sen. Mike Enzi (R-Wyoming)



Read the entire story here.
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Health Care Stories: Singapore

In Singapore health care is good. We have a system called CPF (Central Provident Fund) and Medishield, where the government takes a portion of your salary and gets your employer to pay for an additional amount, which will go to this fund. This personal fund will be used should you require medical attention. The Singapore government further subsidizes the medical fee although that would vary based on your salary. It's quite "socialist" here. But it works well, and we Singaporeans have been receiving good health care attention in general.



Kah Wee
Singapore
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Health Care Stories: New Milford, CT

Boy, can Stephen roar! Read and learn.




I lived in Canada for about 28 years.


I can't begin to list how much better everything is in Canada compared to the health care disaster we all suffer from south of the border. Cradle to grave, there is never any question about whether they will do everything they can to treat you in a reasonable amount of time.

I could walk in to my primary care physician any time he was open. If it was his golf day or something like his vacation time? I would go a couple of blocks down the street to another doctor. I chose those doctors based on my level of comfort with them.

My primary would even do house calls (probably still does?) if you or your kid were too sick to make it in.

If you had something so severe as to need more than what your typical primary could provide? Walk into the emergency room (or take the ambulance - they don't ask if you have insurance first because that would be inhumane). It is my understanding that they now have CLSCs in Quebec to cover the less severe emergencies like breaks, sprains, stitches, etc., that might just need the basics or to use when your primary caregivers office might be closed. This alleviates pressure on emergency rooms at hospitals so they can concentrate more on the serious emergencies.


My father was diagnosed with cancer not too long ago and given about six months to live.


He was treated by the best medical staff he could find for his specific problems. He also had a good backup for second opinions. He chose them based on how he wanted and needed to be treated based on consultations with many caregivers. He lived 3 more years after that original dead end diagnosis and died in his 70s.

No healthcare or treatment is perfect but had he lived in the USA he very likely would have been uninsured because of previously existing health conditions. In the USA he wouldn't have even had that "six months" diagnosis.

And never, not even once, did he have to make any healthcare decisions based on whether or not he could afford the treatment. He decided (as do all Canadians) in conjunction with and on the advice of his doctors. There was no insurance company in between them to turn him down.


The American system is as cruel to the poor and those that really need the medical help as it is profitable to the insurance companies.


Those are just some of the things I can say about the Canadian system.

Americans, in surveys, appear to be "more satisfied" with their healthcare providers than Canadians do. Maybe you don't understand this, being that you have had a crappy healthcare system all of your life...


That is because Canadians expect a lot more from their healthcare system than Americans do.


Never mind that the polls I have seen always point to satisfaction with providers BUT rarely address the cost and the mode of payment directly. Why? Because the few times we hear the voice of the people on this, for the most part, they say they hate their medical insurance companies.

My primary doctor in the US is great. He supports Single Payer. Most of the hospital people I have dealt with are great at their jobs, too. I always ask them and they support single payer by a large margin. My children have a great pediatrician and, yes, he supports single payer as well. Nothing to complain about the actual service providers. That side is pretty much equal to the Canadian providers. Some are better and some are worse, but competent and caring nonetheless. They want to give you the best service possible. And, for the most part, the majority of those providers want to give you single payer.

I am among the few that has half decent insurance. For how long, who knows? In this economy corporations are stripping workers of higher quality insurance for less costly junk plans. Our family's plan was changed to add higher co-pays and more restrictions on usage AGAIN, this year. And that is if these cash strapped corporations and small businesses aren't laying people off people all together so they have no insurance at all. If our family lost our source of health insurance we know that our budget would eliminate any possibility of keeping coverage regardless of government's provision of the costly Cobra plans. On unemployment, we would struggling to keep a roof over our heads and the kids fed. Regardless of that, I expect more from my healthcare AND I expect it to cost a hell of a lot less. But that is because I have seen and lived with a better healthcare system than the one we have here.


I expect nothing less than Single Payer!


Of course, that does not mean I am completely rigid on this and unwilling to compromise. It is just a higher standard that could be attained in this country. More recently we have seen a lot of discussion on the public op[tion, since single payer has been banned from the political discussion and the medias dcoverage of helathcare.

Fine.

Most recently some morons are saying that is the "Left of the Left" that are pushing for the public option and this supposed to be shocking news to be breathlessly reported on in the traditional media... As they continue their twisted and contorted takes on reality, let us look at who really supports the public option, OK?


67% of conservatives support having the choice between a public option and private insurance.


71% of Republicans support having the choice between a public option and private insurance.


77% of Americans support having the choice between a public option and private insurance.


For those of you that have a problem with reading comprehension I took a moment to annotate this Survey USA graphic. There is your "Left of the Left" in RED and BLUE...





The black ink in the ledgers of insurance corporations is being balanced by the red blood of Americans.

Right now about 22,000 Americans die every year because they are under or uninsured. This has got to stop. Now... You could do nothing at all about this issue OR you could contact your Congress critters and hammer them to bring some semblance of real reform to healthcare. Americans are literally dying waiting for something to be done. And a public option, at the very least, will allow for the uninsured to get insurance and give the underinsured the opportunity to choose better insurance.




Stephen
New Milford, CT

Check out Stephen's blog, Drinking Liberally in New Milford.




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The "Death Book": Fox News At It Again

According to Fox News's Chris Wallace, the Obama Administration wants to euthanize our nation's veterans, and they've come out with a "Death Book" to tell them how to commit "assisted suicide":






According to Daily Kos, here are some of the facts behind what the "Death Book" really is:


1. Fox's alleged "death book" is actually a guidebook on preparing living wills

The thing Fox is calling a "death book" is actually a guidebook called "Your life, your choices" initially developed in 1997 to help veterans understand issues relating to advance directives and living wills should they ever experience a medical condition (such as a permanent coma) where they cannot communicate their treatment preferences. Although the guidebook can be downloaded, it carries a disclaimer noting that is currently being updated and revised for a 2010 release. (See this article for more information on the revisions.)

Despite Fox's claim that the guide encourages assisted suicide and euthanasia, it is solely focused on helping veterans determine what type of care they wish to receive if they should ever became incapable of making their wishes known. The guidebook specifically makes clear that it has nothing to do with assisted suicide, which is illegal.

2. Although Fox said VHA practitioners must give the guidebook to each of the 24 million vets they serve, there is no such requirement

According to a directive issued in 2007 under President Bush, the guidebook is merely an example of the type of document that VHA practitioners should give to patients who ask for help with living wills.

3. The Bush administration, not the Obama administration, included the guidebook in the VHA handbook.

In February 2007 the Bush administration's VA issued a directive listing the guidebook as an example of the type of documents VHA practitioners should give to patients who want help drafting living wills. In July 2009, the Obama administration issued a minor update to portions of that directive, but did not language on the guidebook at all.


Click here if you want to read more.

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Happy 100th, Prez!!!

For those who don't know the life and music of the First Black President, here ya go.





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Health Care Stories: Gothenburg, Sweden

Désirée gives us the pluses and minuses of the Swedish system.


There is a saying in Sweden that goes "The health care is for free but not for free," meaning that the health care for the individual is for free (almost) but for the population it is not, since it is financed by taxes.

It costs a small fee for visiting a doctor if you are 20 years or older, the visit costs nothing for children and teens. Staying at hospital and treatment there is free apart from a small sum that is supposed to be what it would have cost to be at home, healthy, again if you are adult. Children always get free healthcare.

Pregnant women also get care for free. We have a very well-developed care for future mothers and birth care.

Medicines, however, are not free, but there is a limit on how much you need to pay a year for essential medicines.

One interesting thing that is often joked about is that Swedes' teeth don't belong to the body. Dental care is not included in our system. The idea is that you can affect your teeth negatively very easily (with sugar, smoking, etc.). Again, children get dental care free.


This sounds great, but there are some negative issues with the system. You often have to wait to get medical care, unless it is a question of life-and-death, emergencies like broken bones or birth care. There are also treatments that are considered too costly to offer, but might make life easier for an individual. Sometimes the doctors do not even know that there is a treatment to be found.

It is possible, however, to seek treatment abroad if sufficient treatment can't be found within the country and then get your money back covering your expenses. But you do have to be able to pay, because you don't get the money in advance. There is also, of course, an issue if it could be found within the country and the need of the treatment.

We have private care as well. Companies might offer healthcare for their employees through private actors, and individuals with finances can get the care they want when they want it.

The government sometimes buys the services from private actors, but the common people do not need to pay more for that. Private actors simply get the same money as the governmental organization would get for the same number of patients. Sometimes they do a better job, sometimes not.

Over all, I think we have a great health care. It has it down sides, but nobody is excluded from qualified care due to lack of money.


Désirée
Gothenburg, Sweden



Check out Désirée's block, Me, a writer of movie scripts.




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Can We Really Complain About Our Health Care System in Canada?

Two days ago I headed to the hospital in Owen Sound for some surgery. Being a typical man, I had ignored some pains I had been having for well over a year, but finally broke down recently and went to the hospital to find out what the problem was.

My first trip to the hospital was back in April, and what I discovered then was that I was having gallbladder attacks. Great, now I knew the cause of the intensely painful attacks I was having every month or so in the middle of the night.

I was told that in order to correct this I would need to have my gallbladder removed. Removed? I didn't like the sound of that at all. I tend to believe that if there are parts in your body, they are there for a reason, and rather than remove them, perhaps you can find a way to fix them.

I went to see our Naturopathic Doctor, and she advised me to go through a series of cleanses in order to flush out the troublesome gallstones which were the source of the gallbladder attacks. These cleanses went very well and I did pass several gallstones. Total cost including a couple of trips to my Naturopath was about $400.
At the time, I canceled the surgery that was booked for May in order to give the cleanses a try.

I think that this would have worked very well and fixed the problem IF I HAD CONTINUED TO FOLLOW THROUGH. Instead, once I started to feel better, and I was no longer having attacks, I went back to normal routine and stopped doing the cleanses.

BIG MISTAKE. I certainly can't fault my Naturopath as it was I who dropped the ball. She has done wonders with other problems that I have had that regular doctors just couldn't fix, or wanted to fix by loading me up with chemicals (drugs) which I am not a big fan of.

Fast forward to August and I have another gallbladder attack. My first since April (when I had been having them monthly for over a year). This gallbladder attack resulted in a stay in the hospital for a few days. Once released, I went home pretty certain that I would have to start taking a serious look at surgery. Two days after I got home, I had the most painful event I have had in my entire life- and I have had a few painful events. My spouse took me to the hospital, and the emergency department rushed me directly in to a doctor. This time it wasn't the gallbladder, it was acute pancreatitis. Now things are getting serious as pancreatitis which was brought about as a result of my gallbladder issues can kill you. I was kept in the hospital for several days until the doctors deemed it safe for me to go home and I was strongly advised to have my gallbladder removed as soon as possible.

Which brings me to two days ago, and my surgery which has cemented my high regard for our health care system. I am far from a socialist, in fact my political views can mostly be lumped into the libertarian philosophy, but there are certain services that I do believe should be provided by and administered by our governments- education and health care being the two highest on my list.

In the last few months I have had the following tests and procedures:

* X-rays

* Two Ultrasounds

* CT Scan

* Upper GI Scan

* ERCP Scope

* Countless blood tests

* Gallbladder removal surgery

Unfortunately, the gallbladder removal surgery did not go as well as had been hoped, and the laparoscopic method had to be ditched in favour of the traditional 12” incision full open surgery as the acute inflammation of my gallbladder (a result of ignoring the problem for so long) had made it impossible to remove with the newer, less invasive laparoscopic method.

With all of these procedures, and ultimately the surgery, I always felt that I was receiving top notch care. During my hospital stays they even accommodated my vegetarian and dairy-free diet.

What did all of this cost me? Nothing. Aside from paying for parking at the hospitals several times, and some prescribed medications, there was no out-of-pocket expense for me.

If I was in a similar situation in the United States as a self-employed person, unless I had some really good (expensive) insurance, this would have cost me thousands of dollars (I've seen price tags in excess of $8,000 for the gallbladder surgery alone).

While there is always plenty for people to complain about, and I even hear complaints about our health care system--emergency room waits are too long, the waiting lists for certain surgeries are too long and so on--at the end of the day, we have it pretty good in this country.

I for one love living in a country where no matter if you are rich or poor, you will receive the same care when you are ill at no out-of-pocket cost to you. Yes, our taxes are high in this country, but if you were to add what Americans pay for their health care out of their own pockets to the taxes that they pay, we are pretty much even.


Article & Images © Stephen Vance 2008


This post originally appeared on Stephen's blog, Mr. Writer: Musings from Meaford. Check it out.




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