The American Health Care System/Sicko

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    Jul 09, 2007 12:15 AM GMT
    As gay men making an effort to protect your health, hopefully to never need the assistance of your insurance, what's your take on the American health care system as well as the population it's supposed to support?

    Michael Moore's "Sicko" is just out, I haven't seen it yet, but, I will, at least when it gets to video. I'm not rushing out to see it, because, he's probably preaching to the choir where I'm concerned. I'm convinced the whole thing is a rip off to benefit administrators and the pharm industry rather than providers and actual care for the needy is an example of collateral damage.

    I asked specifically as gay men who, presumably, are working pretty hard to avoid health problems.

    What's your take?
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    Jul 09, 2007 2:18 AM GMT
    I have not seen Michael Moore's "Sicko" ..I will when it comes out on dvd..

    As a CANADIAN, I am shocked at the fact that America does not provide equal access for ALL...Hospitals may say they do, however I know factually they don't.

    Once on a great trip to Florida, the women at the check-out was about 70 years of age and I asked her in a polite manner " I don't want to assume why you are working ..can you tell me why?" She replied that her husband had cardio surgery and they have to pay off the remaining $70,000.00; the empathy I felt for that women was extreme...I wanted to cry at what her country had done to her. She should be resting after giving all her life to her family/country.

    Canadians are blessed to have universal health care..is it perfect...NO.., but we at least attempt to provide health care for all; a basic HUMAN NEED in our eyes.

    The insurance industry...well there's the BIGGEST...fraud ever..that is NOT regulated enough by governments to protect the people for a PRODUCT they purchase...To appeal, takes more $$$$, thus limiting equal access to ALL to the JUSTICE SYSTEM: in my country and that of my American friends.

    MICHAEL has the right value-system and belief regarding the urgent need to provide HEALTH CARE TO ALL(we the people). After all the objective is to take care of one's citizens..is it not?
  • OptimusMatt

    Posts: 1124

    Jul 09, 2007 2:50 AM GMT
    I feel the need to point out that Ontario has been shipping our fat asses across the border for weight-loss surgery at a VERY high cost instead of funding the doctors that have already created/proposed the programs here.

    Canada may be great because we've got universal health care, but we spend those healthcare dollars pretty damn frivolously.
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    Jul 09, 2007 2:55 AM GMT
    BioMatty: Is it perfect NO..Did they get the medical attention they needed?
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    Jul 09, 2007 3:05 AM GMT
    I've seen it because I was assigned to write about it. Basically, the movie is an editorial cartoon --not a "balanced" examination, but very effective.

    I have been through a healthcare nightmare myself the last year because of emergency surgery on both my knees. I have the best insurance a self-employed person can buy in my state -- it costs over $600 a month -- and I had no problem getting the insurance to pay for my surgery and meds.

    But there were all kinds of extra costs, beyond copayments, that were, on top of lost income, overwhelming.

    Don't think that because the movie "preaches to the choir," it doesn't shock you with some of what it reveals. It's galling to watch people in that industry actually admitting -- before Congress and in conversations with Moore -- that HMOs give doctors bonuses for keeping care minimal, that insurance companies routinely deny claims on the argument that something was "pre-existing," etc., causing more sickness and unnecessary death.

    The film is getting some criticism because Moore idealizes the universal health care systems in Canada, Cuba, France and the UK, where, of course, there are plenty of complaints. But bottom line is that the residents of those countries are guaranteed care, even if it's not always delivered on time. (What's a one-month wait compared to no care at all?)

    I could not buy health insurance AT ANY COST for two years about a decade ago because I had a diagnosis of depression on my record. Moore also exhibits a mind-boggling list of conditions that can disqualify someone for insurance. Insurance is bad enough when you're on an employers' policy. When you have to buy your own, it's a nightmare.

    I've landed in hospitals in France twice and had to see a specialist in one case. I was amazed. The care was far more personal than here. My visits to the ER cost me about $20, billed me when I got back to the U.S., and a specialist cost me $10. Believe me, I was not expecting such good care, having subscribed to the myth of our superior system. My partner landed in a hospital in Rome after we spent a month in Turkey -- same deal.
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    Jul 09, 2007 3:18 AM GMT
    Dear obscenewish: Travel really does impose education upon one's perspective..Thanks for yours... Hope those legs heal...and the bills for surgery(@#$% extra expenses;jerks) are not too much for you...
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    Jul 09, 2007 4:42 AM GMT
    That's why I ususally see elderly people on the news gettin on a Grey Hound bus to Canada for their meds.
  • OptimusMatt

    Posts: 1124

    Jul 09, 2007 4:51 AM GMT
    Oh don't get me wrong - the idea of NOT having universal health care is almost...incomprehensible to me. I asked a friend in the states if he'd seen a doctor about something, and he told me he couldn't afford it at this time...I was like, uh..what? I just make an appointment...and go..to my doctor.

    And you're right, it's not perfect. It's just, when you read about ways the government could be spending our taxes to keep stuff in-country and spend LESS money...and they DON'T...it's slightly frustrating.

    Socially NDP, fiscally conservative. I don't know if that's actually possible, lol.

    Christ, if I REALLY wanted to go off the deep-end I'd go Green Party.

    Lol, sorry - provincial elections are coming up so I'm starting to determine who the hell I'm gonna vote for, and McGuinty's health care premium is..interesting. Though I WILL say that it took me 1.5 hours to get through the ER completely last week - I haven't been in a few years but it used to be brutally long. So there's definitely been improvement...but there's still room for more. I dunno. It's easy to be critical when you're on the outside, I suppose.
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    Jul 09, 2007 4:56 AM GMT
    Man-o-man, can you believe this country ?! We put all of the emphasis on consuming, but NOTHING when it comes to getting sick. I tell ya, fellow American browskis , ya better take good care of yourself, because the hospitals won't... unless you are very rich.

    My bf is from Australia, and is a doctor. It is amazing to me the stories he tells me, because it's hard for me to believe that people can have it so good. I have also spent a lot of time in Canada, and not only do they have it good, they are really nice !!!! Same for the OZ's ... I have noticed a HUGE difference in the attitudes of those who do have a good health care system, and those who don't... a kind of anxiety drives our culture, rather than a sense of ease and well being, as it should be - obviously ! We have to simply persevere and be optomistic, and take very-VERY good care of ourselves. It's a lot of work, but it's worth it.

    I'll wait for video for the film, btw - MM is well meaning, but a bit annoying.
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    Jul 09, 2007 5:24 AM GMT
    After reading your postings I have to say I'm so glad I live in the UK. Yes, we do pay high tax rates - almost 40% of our salaries go to the taxman - but we can see our doctors for "free" and hospital treatment in based on need not ability to pay.
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    Jul 09, 2007 5:27 AM GMT
    Australia probably has the best health care system in the world -- at least that's true, according to one of my editors, who is Aussie and keeps bugging me to do a series about health care there. (I can't face the trip.)

    The Aussies, as I understand it, can buy accelerated or private care for a minimal price.

    Mattie: I don't think people in other countries realize how bad it is here. Two years ago, a friend of mine, not yet 30, lost his voice. He was unemployed and didn't have insurance, but went to see a doctor who told him he had laryngitis and it would probably go away in a few weeks.

    It didn't and the doctor said he needed to get an MRI. My friend couldn't afford it but, after 3 or 4 months scraped together the money to buy insurance and then had to wait another two months before he could get the MRI. They found advanced cancer and he died a few months later.

    I don't know that earlier detection would have saved his life, but this kind of story is typical. Americans, and that increasingly includes the middle class, constantly make decisions to forgo needed health care because of the expense.

    I had many friends die prematurely from AIDS -- including my own first partner -- because of the indifferent attitude of the system and slow drug approval protocols (that have since been improved, thanks to ACT UP).

    It is also not uncommon for people to choose to die rather than burden their families with the astronomical expenses of prolonging life. My mother was a stroke patient for 15 years before she died and her care cost so much money I can't even utter the amount.


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    Jul 09, 2007 7:14 AM GMT
    UNBELIEVABLE !

    Thanks OBSCENEWISH for sharing that. YES, we really need to manifest MAJOR changes in how this land of opportunity is run... I'm affraid the system has produced nothing but greed and artifice - oh, and massive destruction to the planet. Don't even get me started on our education system. Most of my friends are teachers. I know...

    But we can @ least always be entertained by the goings on of Brad, Angelina and Jen at the check-out line
  • NickoftheNort...

    Posts: 1416

    Jul 09, 2007 8:01 AM GMT
    The health care system, such as it is, in the United States fails to protect its citizens and non-citizens, fails at supporting the overall society by not supporting individual residents, and fails to aspire toward any recognizable form of social justice.

    I am lucky and privileged to be a Norwegian citizen (as well as USAm. citizen) and to have grown up in Norway, which has had national health insurance and pension since 1967. Almost as important as the coverage provided by this insurance is how it frees me from worrying about what will happen to me should I fall ill; I am not as stressed by the thought of getting sick as I presume I would be if I did not have this coverage.

    (considering the correlation between stress and the immune system, I would call that a double benefit :-) )

    I associate a national health care system as being a necessity for any state attempting to be a democracy; I also associate a national health care system with social morality, as a component of a larger social justice system.

    This is partly why the debate infuriates me, because in the US I see (and do correct me to extent I am wrong on this) the same group that argues against national health as the same group of people that proclaim themselves as Christians. How one can reconcile a purported Christian faith with the continued hierarchical exploitation and suffering of one's fellow persons, without being seriously screwed up in one's head, is beyond me.
  • NickoftheNort...

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    Jul 09, 2007 8:17 AM GMT
    Personal experience: I had the misfortune of getting a concussion while in the States (judo-mishap) and went to a local hospital. I was informed them that I was insured with the Norwegian state; it was something I had to do, and yet it was a big mistake.

    They kept me there for three days, claiming that it was highly inadvisable for me to leave. They gave me three specialists, yet didn't do much other than take blood samples and an MRI. Beyond this technical portion (which seemed wholly unnecessary for a concussion), the service was lousy and I quickly realized that they were intentionally milking my insurance (pissing me off: I love my insurance, but I don't want for it to be ripped off).

    A few weeks after, we got the first bill. The cost: $16 000 plus some extra expenses. This was just the first bill of course and they wanted for me to return for checkups (which I ignored) and sent further bills.

    There is not much of a moral to this story other that the hospitals themselves play a role in this health care battle, particularly if they are more profit-oriented (akin to the insurers). It does not have to be this way, nor should it be this way.
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    Jul 09, 2007 2:43 PM GMT
    it is my personal belief that private third party insurers are destroying the medical system in the US. Not only do I feel like a bunch of businessmen/women that neither study nor practice medicine should be able to direct care and give orders to people who have had proper training. The amount of extra paperwork is a waste of good time and the fractionary nature of HMOs, coverage plans, preferred networks, etc is mind boggling. The fact that profits, not cost-saving measures (which are legitimate since you want to use finite resources as best as possible), have been introduced will do nothing but make health care as delivered crappier and crappier. Think about it- everyone touting the "free market" solution to this isn't considering tha fact that the free market works for cartain goods/services because you can always say "no, I don't want that at that price, I'll wait til it comes down," however if you don't have time to wait you'll pay whatever because your resources aren't any good once you're dead. This is only going to get worse and worse as western medicine is doing a good job of saving the lives of people that would have been killed by their cancer/stroke/renal failure 20 years ago, but they might need persistent medical treatment to keep them going, and good luck paying for a chronic illness nowadays.

    Oh and as for ability to choose? yeah, I can choose the only plan I can afford, then I can choose a doctor (and no dentist, and forget about vision) 20 miles away off of a list of 3 people accepting new patients.
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    Jul 09, 2007 3:21 PM GMT
    Don't forget that new industry called "medical tourism." Medical facilities in countries like Thailand and Cuba are booming with American trade.
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    Jul 09, 2007 4:06 PM GMT
    I probably came from a small countries. Certainly not a superpower like the United States. But all citizen of this country have a right to subsidised medical services in goverment hospital. All you have to do is show your indetification card to prove your are citizen and they take you to your hospital bed. However lately they start charging norminal fee , which I think is fair . When I got into accident in 2003, I spent 4 days in goverment hospital , go thru an operation to remove broken glasses from my injured hand and I only pay around 25 US Dollar for the whole thing (operation, lodging,meal). Of course the service are not as good as in private hospital that charge you more, but good enough for people that cannot afford it. However most employer in this country do offer medical benefit as part of the benefit of employment.

    Talking about medical tourism, well, just like in neighbouring Thailand, they are really big business here too. A lot of private hospital with excellent medical service is here. Their patient came from richer elite from poorer country (so sad) like Indonesia and India. My employer provided this benefit to me so if I fall sick (god forbid) I am entitle to enjoy this world class medical facilites.
  • MSUBioNerd

    Posts: 1813

    Jul 09, 2007 4:37 PM GMT
    Well, I'll weigh in on the other, unpopular side of the argument and say that there would have to be many utterly massive changes to move to a universal health care system in the US. And these changes wouldn't just affect the US--they'd affect much of the rest of the world as well.

    Medicines developed within the US are sold at higher prices here than they are abroad. There is a definite profit motive to the development of new medicines--and there pretty much has to be, as most medical trials fail due to either the drug not being very effective or, much more commonly, the side effects being too severe to warrant the use of the medication. Given the large amount of time, energy, and money that must be poured into the even getting a medicine to an FDA trial, let alone getting one through and to market, most companies will only take the risk if they can expect a hefty financial gain on the ones which do make it. Lowering the costs we pay for medicines here will either need to come hand in hand with raising the costs of medicine in other parts of the world, or a recognition that there will be fewer and fewer need medicines developed as the incentive for corporations to do so goes away.

    There will always be a shortage of medical care unless you're willing to push taxes well beyond the 40% or so that the countries with the most socialized systems of medicine have. In the US, rationing takes place largely based on financial ability to afford the treatment. In countries like Canada, rationing is more temporal. Last time I checked the stats on a heart bypass in Canada, waiting time averaged approximately 6 months, which coincides with approximately 50% mortality for those needing a bypass. In the US, if you can afford it, you get your bypass the next day..or maybe after a two or three day wait if there happens to be a holiday or a lot of other people getting the procedure done just then.

    Many people quote that money is the root of all evil. That's an incomplete quote--the actual passage is that love of money is the root of all evil. Money is an inherently worthless thing, and only has value for what it can gain you. That includes basics like food and shelter, luxuries like air conditioning (which I wish I had with this heat wave), and freedom from certain types of worry such as "how will I put food on the table next week". While I can see the argument that basic medical care is a right, much of what we think of as standard medical care is really something of a luxury. I don't see well on my own, so I go to the optometrist and get a pair of glasses, and I can see better. My head hurts, so I take an aspirin. A friend's joints hurt, so she gets arthritis medication. My father had a TIA a few years back, so he takes a daily blood thinner to lower the odds he'll have another one. Many of these things really are more of luxuries than necessities, and that gets even more true as we move into old age and our medications are fighting against basic biology. Why are these luxuries ones where it is not acceptable for money to determine who has them and who doesn't? People can certainly get into significant financial hardships, but most of the time when things are available for purchase, the consumer is making choices about how worthwhile it is to him/her to make that purchase as opposed to another one. Since people have different risk tolerances, some will opt to protect themselves against possible medical disasters, while others will gamble that they won't need such protection and will spend that money on a nicer home or more expensive food or whatnot--and it is their choice to do so.

    If we make a move to universal health coverage, we'll have three options: 1) Make a list of those treatments/conditions which are treated, and those which are not, based upon a cost/benefit ratio and an assessment of how common the condition is. Of potential note to this community--there is basically no chance of any AIDS treatment ever being covered this way (though research on a vaccine might still be funded), as even though antiretroviral cocktails have extended lifespan the disease is still virtually 100% fatal. 2) Massively increase taxes. 3) Accept a luck of the draw waiting system, where even if your treatment is covered you'll have to wait long enough to get it that there's a reasonable chance you'll die in the meantime, with basically nothing you can do about it. And these three are not mutually exclusive either.

    Universal coverage for children may be politically viable in the US, but I highly doubt people will be willing to make the sacrifices necessary for a full coverage of the adult populace.
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    Jul 09, 2007 4:53 PM GMT
    So, I was wondering... I have not seen SiCKO, but I probably.. well I probably won't. I'll be honest. However, I've been reading about the process a lot. And I wonder, really, what the benefits are of universal health care. I mean 40% in taxes? That's not a benefit. More government involvement in our lives? That's not really a beneifit. The government controlling our health system? In the US... SO not a benefit to anyone other than white, upper-middle class individuals.

    Of course there is Maine, with universal healthcare and people not being able to get sleep aids or diabetes medication because the state refuses to pay the cost of those medications that are developed by these large pharm companies. How is that a benefit?

    Plus, I was wondering if these people who cannot afford health care, do they own tv's? cell phones? or any of those other 'necesities' that people have. I mean, how can one complaine about not affording healthcare when they pay out the ass to watch tv? or use a cell phone? or buy new clothes often? Just wondering.

    I am also wondering how, when there are so many without healthcare, why they are not using the already existing programs put in place to help people in such a situation. I really know little about this topic, so I am just asking.
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    Jul 09, 2007 5:34 PM GMT
    And there you have it: Americans are reluctant to pay for social services that raise taxes or through more government involvement. I don't think that universal health care is a right, but definately a mark of how society functions and how willing people are to pay for things that benefit others and not necessarily oneself.
    ihrtnalgenes: Many of the programs have strict requirements, and there are many who earn enough to not meet those requirements, but don't make enough to purchase care. In California if you meet the requirements for medically indigent you can get great care through the county hospitals, and pay almost nothing for it -- pregnant women are also automatically covered as long as they are through pregnancy, delivery and post-partum follow up, and there are programs for children, so you may have to pay something, but there is not excuse really not to have your child covered.

    There are of course those who can purchase healthcare, but make other things a priority -- I have friends who combined make over 100,000 a year, but don't have health care. Granted they haven't always made that much, but have for the last three years or so. They talk about getting care, but don't get around to it.

    But the current system hardly seems admirable, and is a complex mix of highly regulated private providers and government coverage -- for better or for worse hardly a free market system. Definately as one of the richest countries in the world we could do better and learn from other countries in providing both better access to and quality healthcare.
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    Jul 09, 2007 6:26 PM GMT
    wrerick: you're ability to begin the statement with a blatant insult is reason enough not to continue a dialogue.

    As for my questions.. I have been here at "work", doing "work" and read a few things, and I realized... I don't care. Sorry, chaps. I think it directly relates to my having health coverage (that I pay out the ass for). Thanks for the thoughts though.
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    Jul 09, 2007 6:28 PM GMT
    It has been deeply shocking to me moving to Cleveland, which has an exceptionally good health service (Cleveland Clinic, University Hospitals) which a good fraction of the people here cannot afford. And they always seem to be black.... why are the Americans here blind to the ENDEMIC racism in american society?

    that said... I don't have much respect for MM's style of journalist and I do wish MM wouldn't idealise the situation in the UK. The NHS is good, but it is also virtually ungovernable and sketchy to say the least!
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    Jul 09, 2007 6:51 PM GMT
    ihrtnalgenes, that statement wasn't meant as an insult. But, as I see it, Americans are reluctant to have government run, and pay the taxes for government provided services, that other countries think think are the norm for government to provide. Or to put it another way, I think Americans, are much more suspiscious of what the government and what it should provide compared to say Canadians or Europeans. I'm sorry that you thought that an insult, but your views of not wanting more government involvement or higher taxes express views I hear all the time, and rightly or wrongly go a long way in explaining why the US does not have a universal health care system, but me stating that dosen't mean I'm slamming you.
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    Jul 09, 2007 7:10 PM GMT
    i see.
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    Jul 09, 2007 9:31 PM GMT
    MSUBioNerd: I don't know where you get your stats re: Canada's health care...I have two relatives that had cardio-procedures both completed in 1 week, but before being completed, they were medi-vacd...about 2000 miles (in private jets to receive their health care....under the care of a Nurse Practioner. They are fine today.

    Yes your right you, would have to pay higher taxes, but it is a piece of mind to know that you are covered.

    The population of Canada is close to the pop. of California......think about it! If our country can take care of our health care needs; yes not perfect....my friendly neigbours in the USA can use their HUGE population to their advantage, when it comes to tax increases...by in BULK.....

    I guess that this is an issue that
    MICHAEL MORRE, has had the GUTS and the vision to get people to move to ACTION and not rationalizing that the POOR just can't afford health care???? That is a poor excuse when it comes to taking care of WE THE PEOPLE!