Mythological Healthcare

Following up on Melissa’s post below…

Paul Krugman on the myths of health care:

Being without health insurance is no big deal. Just ask President Bush. “I mean, people have access to health care in America,” he said last week. “After all, you just go to an emergency room.”

Yes, where you pay $300 to have a cut sewn up if you get treated at all before dying. It’s not the fault of the emergency rooms, however; they’re just not ready to be the first responders for the health care needs of the nation, and it’s also one of the reasons why health insurance is so expensive; someone has to pay for all those people who can’t pay when they show up at the E.R.

The claim that the uninsured can get all the care they need in emergency rooms is just the beginning. Beyond that is the myth that Americans who are lucky enough to have insurance never face long waits for medical care.

Actually, the persistence of that myth puzzles me. I can understand how people like Mr. Bush or Fred Thompson, who declared recently that “the poorest Americans are getting far better service” than Canadians or the British, can wave away the desperation of uninsured Americans, who are often poor and voiceless. But how can they get away with pretending that insured Americans always get prompt care, when most of us can testify otherwise?

A recent article in Business Week put it bluntly: “In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems.”

The myth that the British and the Canadians wait longer for health care is persistent and pernicious; someone will always come up with an anecdote about a friend who had an aunt or a cousin or some such that waited three years for a hip replacement in Sault Ste. Marie and finally ended up going to some place in Michigan where they got surgery the next day. And Saddam Hussein bought significant amounts of uranium from Africa.

On the other hand, it’s true that Americans get hip replacements faster than Canadians. But there’s a funny thing about that example, which is used constantly as an argument for the superiority of private health insurance over a government-run system: the large majority of hip replacements in the United States are paid for by, um, Medicare.

That’s right: the hip-replacement gap is actually a comparison of two government health insurance systems. American Medicare has shorter waits than Canadian Medicare (yes, that’s what they call their system) because it has more lavish funding — end of story. The alleged virtues of private insurance have nothing to do with it.

Of course Mr. Bush can take a “let them eat cake” approach to health care; he’s never had to worry about it himself. Given his family’s history going back to his grandfather, he’s been on government-paid-for health care since he was a kid.

Cross-posted from Bark Bark Woof Woof.



Filed under 06_bobby

13 responses to “Mythological Healthcare

  1. How many Americans have delayed seeking needed medical attention due to concern about cost?

    ’nuff said.

  2. “In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems.”

    Not to mention that the people with universal health care system live longer, have lower infant mortality, and have lower disease rates across the board than americans.

    Speaking as someone that grew up with nationalised health care, and fully intends to go back to such post study, if the choice is waiting a short time and being incredibly in debt, or waiting a little longer, and having it all for free, I’m picking the latter.

    You Americans have the potential to really have one of the best national universal socialised health care in the world, and yet you are all pissing it away like so much piss. It’s incredibly saddening and maddening to watch. I can only imagine how much worse it appears to an actual American.

    The value of a health care system is not in how it treats those with the most recources, but in how it treats those with the least.

    Oh, and this?

    Mr. Bush or Fred Thompson, who declared recently that “the poorest Americans are getting far better service” than Canadians or the British

    Is so much bullshit it’s not funny. The poorest of the poor in Canada and England get better health care than the majority of Americans … maybe that comes from focusing on the actual care, and not on ‘service’.

  3. Brynn

    Given his family’s history going back to his grandfather, he’s been on government-paid-for health care since he was a kid.


  4. puellasolis

    How many Americans have delayed seeking needed medical attention due to concern about cost?

    And not just the uninsured. I have insurance, but I’m skipping my annual physical, pap smear, etc. because I can’t afford the bill that my insurance company sticks me with after they’ve “paid their share.”

    In a few years I’ll have finished my thesis and presumably gotten a real job, one that will allow me to pay for preventative health care regardless of whether or not I have insurance. But I’m the exception, not the rule–most people in my current situation don’t have that kind of light at the end of the tunnel.

  5. To be honest with you, I do worry somewhat about the hip-replacement thing, being a fatass and having to hear that countries like Great Britain routinely deny hip replacements to anyone with BMI > 30. IOW, they’re telling fat people “lose bunches of weight even though you can barely walk, let alone work out like a gerbil, before we allow you an operation that alleviates your excruciating pain.”

    Don’t get me wrong, I do think our system is very, very broken and that some form of universal care is necessary. But it does seem like nobody wants to talk about either the potential issue of rationing according to age or weight, or whatever other procedures or meds people will balk at “financing” with their taxes because they oppose them morally (abortion, birth control, etc.). Are we really going to be able to create a system that pays for absolutely everything, for everyone, always? It would be nice to think so, but I don’t know of any system in the world that actually does that now, and I can certainly imagine an effort to create a system like that here stymied at every possible turn. I would love it if someone could convince me that I’m wrong, though.

  6. In 1989 when I broke my ankle, the school where I taught had to back-date the insurance application to a week before I had the accident because Blue Cross “lost” my original application. That’s basically third-degree fraud.

    Then, one day when I was at the orthopedist’s office in the middle of having my cast changed, the nurse interrupted the doctor to tell him that because of a glitch in the system they couldn’t get authorization to proceed. The doctor stopped, put on an air cast, and sent me into the waiting room until the glitch was fixed. Two hours later he finished applying the new cast…and charged me for the air cast.

    And I count myself lucky that I have insurance.

  7. Having lived in various countries with universal health coverage I can only tell you how it is done here in Spain as I have lived here so long I’m out of touch with the other countries, healthservice wise. But here, when I want to see my Doc. I crank up my little ol PC, go to their web site and then choose a date and a time. Max possible wait 24 hours. If it were an emergency then I would pick up the phone and call the emergency number and in no more than 15 minutes they would be here to pick me up in an ambulance. Cost 0€. If meds are involved the cost is 0 also as I am a pensionist. In fact the only thing I pay for are the needles I use to puncture my finger when I do a blood sugar test. (I am a diabetic.) Why I have to pay for these no one has ever been able to explain. But seeing as how 100, approximately a 3 months supply, cost about 8€ I can live with it.

    And I am also very fortunate as part of my control is done by a RN and if I haven’t been to see her for a couple of months she stops me in the street and gives me a bollicking. She takes her job seriously!

  8. Pingback: Let them eat cake? « Notes from Evil Bender

  9. Lee Ann

    I’ve been living in Canada for over three years now, and I believe that American liberals are a bit starry-eyed in their view of Canadian health care. It has its problems, believe me.

    Everyone has health insurance, it’s true, but insurance doesn’t always equal access. Some provinces are better than others; Quebec and BC are good, Ontario (where I live) is abysmal. I waited over two years to get a personal physician. Before that, if I had an illness or needed a prescription, I would go to a walk-in clinic, take a number, and wait my turn. I’ve always received very good care at the clinic, mind you, but it is much like going to an ER.

    There is a wait of six months for an MRI. Most people will make a trip into the States and pay out of pocket rather than risk the wait. We did just that with my partner’s daughter. Waiting for referrals to most specialists also requires many months; again, I’m speaking from experience.

    Prescription costs are not covered under the health care provisions, although many employers will cover them in their benefits package. For the rest of us, it’s an out-of-pocket expense. Most aren’t all that terrible, but the last time I needed refills I shelled out over $70. I have gone without filling all of my prescriptions because I wasn’t sure that I could afford them all.

    There is a dangerous shortage of doctors and nurses; hospital beds are not easy to come by. My partner is a survivor of two strokes, each of which brought her to the edge of death; she has a shunt that runs from her brain, and she lives with many neurological problems. When I rushed her to the ER because she thought she might be having a heart attack (and believe me, the woman is a nurse herself, she doesn’t panic), we waited six hours in the waiting room because there were no available beds. Fortunately for everyone she turned out to have pleurisy rather than heart problems.

    Private clinics are springing up across Canada, because people are tired of waiting, and because, in truth, the wait can kill you. Canadian health care frequently works on a “worst come, first served” basis. They’re not much on preventive medicine, and I think that is in part because they don’t have the resources that the US has. I think it’s also old-fashioned thinking.

    I have no illusions about the US system, either. I was poor, I was homeless; I know what it’s like to be ill and uninsured. I do believe that the two countries can learn from each other when it comes to how to get good medical care to each and every one of its citizens. But the truth has to be told about both systems before the real learning, the real exchange of ideas can begin.

  10. jahf

    Insurance premiums are not collected for the benefit of “the insured.” (A shameless rip-off of Heinlein’s ,”Taxes are not levied for the benefit of the taxed.”)

  11. jahf

    Oops. Hit ‘enter’ too soon; meant to add:

    With this bedrock principle of insurance firmly in mind, do we still wonder why people pay ever more money to INSURANCE COMPANIES for ever less care from DOCTORS?

  12. cfrost

    Just ask President Bush. “I mean, people have access to health care in America,” he said last week. “After all, you just go to an emergency room.”

    Yo, George, even a meathead like yourself, especially a meathead like yourself that enjoys vengeance, ought to realize what goes through people’s heads when you blurt that kind of stupid shit. I’ll spell it out, since you’re clearly too fucking stupid to get it: When you say that kind of shit you get at least fifty million or so people thinking maybe it’s time you took a trip to the emergency room.

    But, never mind, it’s a hopeless cause. These morons can’t learn any more than a cabbage can learn. After Reagan was shot, his administration defunded the emergency medical centers of which one was where he was treated. I’ve got chickens with more common sense and more compassion than your average Republican. A dipshit like Dubya who has never paid his own way, and has the imagination of a barnacle can’t be expected to understand why people are revolted by the pus that drips out of his mouth.

  13. The_Quilter

    Hi There!

    Universal healthcare is a subject I am very passionate about. I am a Canadian and I am very proud of our healthcare system. Canadians got universal healthcare in the 60’s. We got it because a third party (the NDP) who promised universal healthcare, began to take significant numbers of votes away from the two main parties who were not willing to commit to universal healthcare. The Liberal party The main federal aprty at the time)took on the NDP’s stance on universal medicare, rather than risk more lost votes. I think you guys need to vote for a party who is completely committed to universal heathcare.

    Take Care

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