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Discussion Forums » General Discussion
Obama's Health Care Bill
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16 Aug 2009, 06:29
~RedFraggle~
Post Count: 2651
They're given emergency treatment, yes. But surely illegal immigrants aren't given full long term care for chronic conditions? That is what really costs money.
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16 Aug 2009, 15:48
Fiat
Post Count: 288
Actually, I hear labor and delivery is a common treatment, and we all know how much that costs...
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16 Aug 2009, 16:03
Transit
Post Count: 1096
Well, it is emergency treatment!
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16 Aug 2009, 16:07
Fiat
Post Count: 288
Very true. Can't exactly turn away laboring women!
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16 Aug 2009, 21:36
~RedFraggle~
Post Count: 2651
I was going to say the same as Transit. It IS emergency treatment.

I'm talking about people who require treatment for cancer, for diabetes, heart disease, high blood pressure etc. I doubt very many illegal immigrants would be given that sort of care. But correct me if I'm wrong.

And while I sympathise with your feelings on the system being abused by illegals, in reality, this group of people is the minority (and their treatment is likely limited to emergency treatment only). There are many many hardworking AMERICANS going without healthcare as a result of the unfair system you have at the moment.
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17 Aug 2009, 00:08
Fiat
Post Count: 288
I totally agree that the current system is flawed. Health care is very expensive and if I didn't have insurance through my husband's work, I don't know how on earth we would ever pay for Abby's birth out of pocket. And like you said, that was a relatively inexpensive procedure compared to cancer treatments, chronic conditions that require lots of medication, etc.

At the same time, I have a hard time wrapping my mind around the idea that health care is a right. This might make me sound like a monster, I know. But isn't health care a service? Shouldn't we pay for the services provided to us by doctors such as yourself who went to school for years and paid hundreds of thousands of dollars for their education? Now if we had socialized health care, everyone would pay through their taxes and then access health services at no extra cost. But there's a lot of room for abuse there too. I mentioned the illegal immigrant problem, for one. And though you think it's silly, I DO wish to choose my own doctors. I MAY wish to have an elective procedure done sometime that the government might deny me after deeming it unnecessary. I might have issues with seeing the doctor in a timely manner. I've heard many arguments to the contrary, but honestly - the government programs we already have are a mess. Anyone been to a Department of Motor Vehicles (DMV) lately? I don't know my health care to run in a similar manner.

Anyway, the bottom line is that if I'm going to be hugely taxed for health care, I want quality health care with options to choose doctors and elective procedures. I do NOT want those decisions made for me by a government that hasn't even mastered an efficient postal service yet.
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17 Aug 2009, 06:36
~RedFraggle~
Post Count: 2651
A monster? No. But I do think refusing to pay into a system which will save others lives (and from which you'll likely benefit yourself) seems a tad selfish to me. But the problem lies in the difference of opinion over whether health care is a right. I will always believe that it is.

The people who suffer under a pay-for-care system are mostly people who've been unfortunate enough to be born into low income families... who've gone on to have little education and work very hard most of their lives in low paid jobs (earning just too much to qualify for medicaid). I cannot see how it can be justified that those patients be denied life saving treatment (e.g. cancer treatment) just because they've been unlucky in life.

Yes, health care is a service, and yes it should be paid for. I don't think it should be paid for (and it is paid for, by taxes). I do not believe it should be refused to those who just cannot pay. I do not think you should be required to use your own life savings to pay for your cancer treatment. It is absolutely insane and cruel to me to imagine my caring for someone in ICU for months and then handing a bill to them when they get better for thousands of pounds, to pay me for it (worse still, they die and the bill gets handed to their grieving family!). I do not do my job because of the money. I do it because I want to help people. I'm not sure the same can be said of all American doctors. The biggest supporters of the NHS in the UK are the doctors and nurses who work within it. I'd probably earn far more money working in the US, but I would feel absolutely terrible then billing my patient for the treatment I've just given them.

Yes, the system is open to abuse. Any system is. Your current system is already being abused! I really think the illegal immigrant argument is being blown out of all proportion. As you say, illegal immigranta can already access emergency medical care. It is unlikely that a public health care system would change that (and in my opinion it shouldn't). But a public health care system would still NOT provide free long term treatment to illegal immigrants. Yes, it would still be abused by illegals, but the abuse is unlikely to be worse than it is now.

And I STILL don't see how concerns over abuse by illegal illigrants is good enough justification for punishing hardworking Americans, who have worked (and paid taxes) all their lives, in minimum wage jobs, but cannot afford treatments which could save their lives. Why punish the majority to hit the minority (the illegals)?? And ultimately the punishment is death or disability, so it's not one to be taken lightly.

I need to go to work, so will reply to the rest of your comment later (but none of the issues you've mentioned are an problem under the UK system).
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17 Aug 2009, 21:11
~RedFraggle~
Post Count: 2651
I meant to say I don't think it should be paid for by the individual patient (and it is paid for, by taxes).
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17 Aug 2009, 09:21
Transit
Post Count: 1096
I don't know about other NH services, but in the UK you can see any doctor in the entire country who works for the NHS, you can have elective procedures as well, which is why our c-section rate is similar to the one you stated about the US.
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17 Aug 2009, 15:31
starsmaycollide
Post Count: 408
Given all the problems they are having with the debate, I won't be surprised if the Democrats give up on the public option part of the plan.

If it does go through, it is an option that you would not be required to use. It extends coverage to people who don't have it with the public option available to them , but insured people like yourself can keep what they already have. It has to be done that way , because we can't manage a single payer system like the UK, since most people here get their insurance through their employers.
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17 Aug 2009, 21:09
~RedFraggle~
Post Count: 2651
To respond to the rest of your points...

I won't personally understand how getting to choose your doctor can be more important to people than having easy access to good quality care. :P But in the UK SOME doctors (surgeons for example) do do some private work in addition to their NHS work, so you could choose to pay to attend a particular surgeon privately. But only of course if that surgeon does private work. The thing is though, I don't really think that the public are in a position to judge who the best doctors are. Patients are more likely to recommend a surgeon to a friend because they've found that surgeon is friendly and put them at ease, and while those are very important qualities for doctors to have, I'd say that the surgeon's technical skills are far more important. I know some incredibly rude but HIGHLY talented surgeons. One of the most skilled anaesthetists I've ever worked with (who is speciaialist in difficult airways) had a reputation for being so blunt with patients that he recieved complaints. But if I had a difficult airway I know he'd be the one I'd have wanted intubating me! So I wouldn't say wanting the choice is silly... but I don't see why it is SO important that it takes priority over other issues.

In the UK the government do NOT decide if a medical treatment is necessary or not. Doctors decide. Doctors decide if a treatment is clinically appropriate for that patient. The government do not get a say in it. And as doctors are not paid per treatment they are less likely to carry out unnecessary procedures (which I believe happens more commonly in the US where if the patient is willing to pay, they'll often get a treatment regardless of if it is actually medically the best thing for them).

The exceptions to this are restrictions on certain expensive drugs. Often these are new cancer drugs for which there has not yet been shown to be a clear clinical benefit. However, these are the same drugs that insurance companies would probably refuse to pay for also. AND there is the option to pay for the drugs privately for those who wish to do so.

Also, your healthcare is restricted in the US too. By your insurance company! American health insurance companies have far more restrictions on what they will and will not pay for than the NHS does here. At least in the UK, the DOCTOR decides on the best treatment... not the insurance company.

Yes, one problem with a public healthcare system is waiting times, but this has greatly improved in the US, and suspected cancer patients for example are mostly seen by a specialist within 2 weeks of seeing their GP with the initial symptoms. Furthermore, if you didn't want to wait, you would still have the option to pay privately and be seen sooner.

I don't know what the Department of Motor Vehicles is... but I highly doubt that a national healthcare system would be run like any sort of car business. :P
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17 Aug 2009, 21:15
~RedFraggle~
Post Count: 2651
You can also usually see a GP within 2 days of phoning for an appointment, so there's rarely much of a wait to see a doctor. The wait is just slightly longer if the GP needs to refer you to a specialist.
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17 Aug 2009, 21:16
Fiat
Post Count: 288
The DMV is a government-run agency that oversees vehicle registration, road testing, etc. It is notorious for it's unacceptably poor service (four hour wait times are common) and disgruntled, underpaid government employees. But I digress - just an example of a shoddy American program.

When it comes to choosing doctors, what happens if a patient wants a second opinion? Are they allowed to seek another specialist? I'm thinking about how socialized health care will affect my next pregnancy. Given my preferences for prenatal care (which you know all about), how would I deal with an OB who insists I need a c-section (for example) and I simply don't trust their opinion? I'm not trying to throw you for a loop here - I'm just wondering how things like this run under your system.
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17 Aug 2009, 21:20
Transit
Post Count: 1096
You can see any doctor within your surgery, mine has 9, so I can get 9 opinions. If you don't like your midwife or OB (generally you don't see OB's in the UK unless you are high risk, I know Scottish women see OB's more often than English and Welsh), then you can ask to be transferred onto an others list.
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17 Aug 2009, 21:24
~RedFraggle~
Post Count: 2651
I was about to say, every pregnant woman here sees an obstetrician antenatally, but if the labour and delivery are straightforward, they are managed by a midwife usually. Doctors only get involved if there's complications.
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17 Aug 2009, 21:27
~RedFraggle~
Post Count: 2651
I'd totally forgotten about GP practices. My mind went straight to secondary care (hospitals), and that's where the delays can occur. But most patients don't need to attend hospital anyway, as GPs can manage most things. And you can choose your GP, and see them within 2 days! Can't complain at that!
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17 Aug 2009, 21:29
Transit
Post Count: 1096
Ours is within 4 hours :) Go Wales!
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17 Aug 2009, 21:23
~RedFraggle~
Post Count: 2651
Yes, you can ask for a second opinion. Anyone is entitled to that.

I think women are actually far less likely to be pushed into a caesarian, because there's no monetary gain for the doctor to push you into such a treatment, under a system where they are salaried. But I also think very few doctors would push a woman into a caesarian unless it was absolutely necessary for the sake of your life or your baby's life. I've NEVER seen an obstetrician push a woman into an emergency section that wasn't necessary. But then, that's in the UK where medical decisions are made based on what is best for the patient NOT money.

I really don't think you can compare the DMV (which sounds like the same as our DVLA, which doesn't provide the best service either!) with the NHS! Highly trained and highly caring doctors and nurses working within the NHS are NOT the same as 'disgruntled, underpaid government employees'. Most doctors and nurses here strive to produce a service of high quality, and the vast majority of patients are extremely happy with the treatment they recieve as a result. You just cannot compare that to people working a low paid, unskilled job, just because they need to earn money somehow, but who couldn't care less about the service they provide.
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17 Aug 2009, 21:36
Fiat
Post Count: 288
I didn't mean for my DMV example (which admittedly was made in sarcasm) to imply that doctors like you are disgruntled and unskilled. However, I do wonder how our government, which has managed to screw up every other program we have, can possibly manage health care for all.

Anyway! Thank you for the info. Maybe we can look forward to less corruption in the area of prenatal care. We have lots of it here!
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17 Aug 2009, 21:14
~RedFraggle~
Post Count: 2651
Oh, I forgot about GPs. Patients in the UK DO get to choose their GP. And unless you require specialist treatment, most problems are treated by GPs. You can walk into any GP practice and register, and you can phone up and ask to see a specific doctor. But when it comes to specialist treatment the GP refers to the relevant specialist, and that is who the patient sees.
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19 Aug 2009, 15:01
Kate.Monster
Post Count: 113
Yea, I thought on Obama's plan you'll be able to continue to see the same doctor you've always seen, if you wish. I'm sure it does depend on the plan you get though because if you work for a business that needs to change their plan to fit the government standards, you *might* need to switch, but I'm not positive on that.
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17 Aug 2009, 00:48
Hope Rising
Post Count: 42
Many times, they come through the ER and are admitted for whatever reason --- it is money the hospital never sees. I worked at a public hospital for almost a year, the amount they had to write off all the time was amazing.
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17 Aug 2009, 00:51
Hope Rising
Post Count: 42
Also, at the public hosptials you can't turn people away period. If they come in for labs, xrays, etc ... they MUST get treatment. We could never refuse to send someone back to xray/lab/chemo/etc because they couldn't pay -- so in turn yes, they are getting that sort of treatment free as well. It's not just emergency treatment.
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17 Aug 2009, 02:46
Lauren.
Post Count: 885
Really? I work in a public hospital and by law you cannot turn down someone for emergency treatment, however we are more than entitled to turn them down for any non-emergent procedures including outpatient services such as radiology services, lab work, etc. Thats the laws of Georgia, but I'm sure they change state-by-state. I also find it weird that the hospital wrote off amounts! My hospital NEVER writes off unpaid bills (which is odd considering the sheer amount hospitals write off due to contractual rates with insurance companies!), but they go through two collection agencies and then to court. I suppose this could also be state variances, but my hospital is also part of Community Health Systems which is one of the biggest hospital health systema in the US.
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17 Aug 2009, 12:04
Hope Rising
Post Count: 42
Yes, the hosptial I was at wrote off large amounts. The hospital offers a sliding fee scale to self pay patients. If we could get a patient to fill out the paperwork, their bills would be covered by grants. However, most times the patients would refuse to fill out paperwork. Patients are also notorious for giving false addresses, etc so it makes it impossible to reach them once they left the hosptial. In those cases we would normally end up writing the amount off. My hospital did use collection agencies/courts too, but eventually the amounts would be wrote off -- especially when we couldn't reach the patient.

I will be the first to tell you the hosptial was/is poorly managed fiscally. It went under new management about 6 years ago and has went down hill fiscally ever since.
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