This is a stream of consciousness post, so I’ll apologize in advance for rambling. As I read through the post, it jumps around a bit, but it really does get to a point … eventually.
I’ve resigned myself to the idea that our medical system is going to become “socialized”. People want change. Our medical system needs change. President Obama has already stated that we’re going to get change.
As I work my shifts in the emergency department, I see a rather perverse distribution of health care in this country. People who work all of their lives contributing to our economy have little or no access to medical care because it is too expensive and they cannot afford insurance premiums. They make too much money to be covered under Medicaid, they don’t have a disability to qualify for Medicare or disability insurance, and they are too young to meet Medicare’s age limits. In an emergency, the people who sustain our economy worry about how they will be able to pay all of the medical bills. Just being in the emergency department and knowing that soon they will receive a huge bill is as traumatic for them as their illness is. I will never forget about one patient complaint I read that said “As soon as I saw the bill for your services [meaning the hospital ED charges], I almost needed your services again.”
Meanwhile, I see many perfectly healthy people who do not work and who contribute little to the economy who are fully entitled to walk into an emergency department and receive millions of dollars in medical care. Expensive evaluation for coughs, runny noses, pregnancy tests, work excuses, prescriptions for Motrin (so it can be picked up a the pharmacy at no charge), sometimes even follow up care – all at no cost to them in the emergency department.
I dislike the idea of a “socialized” system, but I dislike even more the lack of access to medical care that occurs with so many working families solely because their situation isn’t deemed “dire” enough to receive government handouts.
So socialized medicine, you win. We must take care of our own better than we are doing so now.
Then I sit back and try to imagine how future medical care systems in this country will operate.
I mentioned previously that once socialized medicine arrives, we’ll have to change the way we think about medical care in this country. Here’s another article about how our values affect medical care. I foresee a system in which futile care won’t be provided unless the patient pays for it. I don’t think that’s a bad thing … except we have to come up with a definition for what care is and is not “futile.” It won’t stop there, though. A lot of expensive care will have to be rationed. If patients want expensive care, they’ll have to pay out of pocket for it. Cancer treatment will be limited. Kidney dialysis will probably also be limited. Advances in HIV treatment will be curtailed – if you want expensive medications that have only a small benefit in outcomes, you’ll need to pay the $12,000 per year out of your own pocket. Ditto for the MRI to find out what’s causing your shoulder pain – just go to a government physical therapy program instead.
One good thing about such a socialized system is that once the government stops paying for expensive testing and treatment, market forces will kick in. If there’s no demand for a service because of high prices and lack of government reimbursement, then the entity providing the service either maintains its high prices and caters to the rich few, goes out of business, or lowers its prices to sell more of its product to the masses at less of a profit. Walmart created billionaires with high volume and low prices, not high profit margins.
A socialized medical system will also restructure the insurance industry. Who’s going to want to pay $1000+ per month for insurance to cover routine medical care when you can get routine medical care for free? Maybe boutique practices will become more common – there patients can pay cash for routine medical care rather than endure the wait for free medical care. Cash-only practices will also give patients a greater chance of maintaining their anonymity if they so choose.
Those who want insurance can purchase it so that they have faster access to major surgeries or more access to specialist care. Everyone will get all their care for free, but in the “fast care, quality care, free care” paradigm, people should be able to purchase a right to faster and higher quality care.
Socialized medicine will inevitably bring up new inequalities and new issues. There will be a fundamental unfairness in access to medical care that is not unlike the system we have now – only in the next iteration, everyone will have the same access to some level of government-sponsored medical care … the care will just be time-rationed. The focus of people’s angst will be on the speed at which those with insurance can access their care while those without insurance are forced to wait.
Civil rights groups will complain, but just as with every other private industry in this country, there is not and should never be an entitlement to the best of any product, whether it is luxury dining, luxury autos, luxury housing, or luxury medical care.
I also think that there will be another shift in focus – one that gives me hope, but that also concerns me.
Doctors and hospitals will no longer play the “bad guy” role. Instead, in almost every scenario, the government will take over the role as the “evil villain” that limits care. If a socialized system will pay hospitals and doctors for everyone’s care, providers will have no incentive to limit testing or treatment. Similarly, if patients are getting the care for free, the patients have no incentive to limit their demands. That leaves the government as the source of cost-containment. No longer will patients become outraged at hospitals and doctors. Instead, patients and the healthcare providers will fight the uncaring government.
As in …
The government wouldn’t pay for treatment and let him die.
The government says that the treatment “isn’t supported by evidence.”
The government “couldn’t afford” a costly cancer medication.
My guess is that the system will pit patients and doctors versus the government bureaucracy. Hopefully doctors and patients will be able to work together more as a team.
“Us” against “them”.
When you think about it, though, just like the identical twins in the picture, “us” and “them” are pretty much the same people. “We” will be fighting against a government comprised of “us” who are there to protect “our” interests.
Who really is the “them” part of this equation, then?
Those who use the most medical resources. The chronically ill. Those with severe illnesses.
All that separates “us” from “them” is a serious medical illness.
This is where “we” have to be very careful in designing a medical system for all of “us.”
Those in the “us” camp want to limit payouts from the system – keeping money away from those sickly “them” people who are disproportionately using the system resources.
The care that “we” agree to provide to “them” now will be the same care that “we” receive if we become one of “them” in the future.
Just how well will “our” new system take care of “them”?
That concerns me.
Well, the upside is probably no more malpractice worries for you guys. What a tradeoff!
[...] over. You may feel a little prick*” WhiteCoat addresses the upcoming shift in medical care in the US. His thoughts are definitely worth a [...]
“Doctors and hospitals will no longer play the “bad guy” role”
I would disagree with ya on that. People always blame those that are right there in front of em’. That why ya see em’ yelling at clerks instead of the managers that make the rules. Nurses and doctors will always get the abuse because they are the ones who see the irate customer.
I work full-time, and am a student. As my job does not offer health insurance, I decided to look for individual coverage. As most traditional plans were quite expensive. I decided on a HSA. I thought, “Cool! At least if I have an accident or something, then my max out of pocket will only be $7000ish.”
I applied, and was rejected, due to a prescription I had filled 7 years ago, which interestingly I did not disclose to them.
What gets me is this- I can afford the (HSA) premiums, and the ins. company is getting a pretty sweet deal in return; however, I make a little too much in my state to qualify for single Medicaid, and do not have children (another qualifying factor where I live). I kept getting rejected for what basically amounts to catastrophic health insurance.
So you know what? Fuck it. If I get shot or ran over by a truck, society can foot the fucking bill now, and I am NOT sorry to say so, because I tried my damnedest to get some kind of coverage.
Highly doubtful, Matt.
The hole in WC’s reasoning is that there will not be med-mal reform to the level of, say Canada. In Canada, if you die in the waiting room it is unlikely there will be a successful lawsuit, if there even is a lawsuit. And the payout, if the lawsuit was successful might be better that half if most malpractice caps here. If the case is particularly compelling.
All that is going to happen is that the Government will take the lead over insurance companies in denying payment by the use of “effectiveness committees”. As WC says, it will be my patient and me against the government when payment for a life saving test is denied. However, it will be my patient and you, Matt (or your brethren) , against me if I do not order the test in the first place because a government utilization committee deems it inappropriate.
I can see Docs demanding protection from the med-mal system if not as a condition of accepting the system, then to remain in the system. And the government will cave in on that one.
Face it Matt, it’s going to change for all of us. The public will get what it asks for, and probably not what it wants.
You’ll likely get a workers comp style no-fault system. But really, the claims will go down because people won’t have to worry about the cost of care going forward, which is often the largest part of a malpractice claim. The only ones who will still have incentive are your high earners.
You physicians, on the other hand, will be dealing with some federal agency or another when you commit malpractice. Or at least filling out a lot of forms when things happen out of the ordinary.
It is going to change for all of us, but of all the stakeholders, it seems the physicians are doing the least to stop it, or at least change it to their benefit, despite the fact their lives will probably be affected most on a daily basis.
I’m puzzled why you equate socialized medicine with free medicine. I worked in Japan for 4 years, payed for my health care there – which was very good and efficient – out of my paycheck just like we do with social security and medicare.
Every other OECD nation has some sort of socialized medical system which is far superior to ours in term of cost-benefit.
That’s 29 models vs. 1. We are the outliers here, and it’s hard for me to believe that here in the US we’re on to something so much better than the rest of the post-industrial, democratic world.
However, despite the excitement for reform, I don’t agree we will have socialized medicine anytime soon.
The transition to whatever system is chosen will be difficult, and I’m not sure that those currently receiving free dialysis and other free government-sponsored services will think that our new cost-saving system that reduces access to those services will be “superior”.
Just throwing my thoughts out there.
We’ll have to see.
Very interesting and thorough post regarding the current situation (AKA, the health care crisis or the health care mess).
Regarding this comment: “My guess is that the system will pit patients and doctors versus the government bureaucracy.”
Currently, patients and doctors are pitted against insurance company bureaucracies, which are far more ruthless than the federal government, IMHO.
The devil you know is sometimes better than the devil you don’t know.
You can sue insurers under many circumstances. Not so with the government and medical care.
Large companies with self-insured health plans are covered under ERISA – pt has little or no recourse outside of Federal court.
Agree – that’s why I said “under many circumstances”
Patients can still sue any insurance company for the cost of services denied – just not for medical damages.
Some states/courts have made it easier to sue insurance companies despite ERISA exemptions:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1449155
http://www.braytonlaw.com/practiceareas/hmoliability.htm
I thought physicians didn’t believe in lawsuits as a means of receiving compensation for what’s owed them?!?!? Was there a caveat about if they were the plaintiff?
I wonder if you’ve considered that the most likely outcome is that instead of the 5% of hardworking people who fall into the current ‘coverage gap’ currently getting screwed by the old system, under the new system we’re all going to be getting screwed.
What reformers fail to understand is that the problem with healthcare isn’t a structural problem or an institutional problem, it’s a human problem. Corruption, incompetence, greed, and abuse of free service are inherent to human nature and cannot be solved by government intervention. In fact government intervention inevitably makes such things worse, the government being the largest source by far of waste, graft, and bureaucracy.
You really think all the people who are abusing the current system for profit are going to just let that money go? Don’t be naive. Like every other threatened industry they’re going to spend 10% of their ill gotten wealth on lobbying and outright bribes to keep the other 90% flowing; all that will change is the path the cash takes to their pocket.
The same holds at the bottom, if the 1% of ER abusers can’t get million dollar work-ups once a month then they’ll come in for ten thousand dollar work-ups every day. Why not, it’s free? And once it’s free for us all that 1% is going to balloon very, very quickly.
So the bureaucrats won’t take a pay cut. The administrators and managers won’t cut their own pay. The consumers are getting something for free, so they’re going to want more and more and more of it… yet, somehow, we’re expecting to squeeze some spare change out of this system. Hmm, where could we find it? Who is powerless?
Oh, yeah, the doctors. If we don’t reform the educational system for physicians at the same time that we reform the insurance system we’re going to break an entire generation of doctors and in fifteen years we’ll be a lot closer to the Greek system, where your family better bring the doctor something ‘on the side’ if you expect to ever see him, than the Canadian one. That’s not change I believe in.
No system of government has ever willingly surrendered power once gained. Be very, very sure you want to give ours this power because we won’t get it back without blood.
I’m not advocating a socialized system. I personally think a free market system with mandatory insurance is the best approach. Maybe subsidies get paid to patients, but consumers have to control healthcare in order for the system to work.
The government already provides a limited socialized system in the form of Medicare and Medicaid. Why can’t a private system run in parallel with the current programs?
I bet that Uncle Sam would love to get out of the health care business. He’ll keep taking that 15.4% out of everyone’s paychecks, but he’ll be happy to pass some more unfunded mandates to get someone else to provide the care.
I hope your wrong about socialized healthcare. I don’t think it will be as popular as the utopian give everyone everything free chanters make out free healthcare to be. Americans hate to wait for anything and they also don’t like the word no. I do like the thought of curbing the ridiculous amount of medication and treatments thrown at the nursing home patients that can no longer speak for themselves. Does anyone really want to live longer to sit in a nursing home? Recently placed a tube feed on a major CVA 90 year old. It seemed wrong.
What if government pays your premiums, but you have to pick a high deductible plan. Perhaps the plan could contain one free well check/physical per year from your PCP. Perhaps a $250 ED deductible and $1000 hospitalization deductible would encourage folks to chose wisely. Or maybe the government can offer multiple plans: a Pinto, an Accord, a Lexus, and a Bentley, with each one tiered starting with no premium/high deductible to high premium/low deductible plan. John Q Public can then decide what he/she wants. Of course, plans would still be out there for the indigent and the elderly (although, they’d need to be refined to prevent waste and abuse)
The second article mentioned Anthony Wilson, who dies on 10 August 2007. I guess the government was right…. The treatment did not work.
I dont know if you are joking or not, but your reasoning is totally invalid.
Its like saying that since some people survive being shot in the face, being shot in the face must not be bad for you.
You note that “If patients want expensive care, they’ll have to pay out of pocket for it.”
I’m not sure about that – I expect supplemental insurance of some form to be available for care the basic system won’t pay for. The socializers don’t like that, but I think they’ll have to swallow hard and accept a two-tier system.
I think that health-care reform #1 should be to decouple health insurance from employment. Currently, if one loses one’s job (as millions have) one loses health coverage (not to mention the situation of those who work for really small businesses that don’t provide insurance to begin with.) That stste of affairs is indefensible.
You are probably honest, so I doubt if you recognize how much cost provider fraud adds to our system. I used to work for that insurance company whose name consists of a color and a symbol. Along with our own coverage, we also administered Medicare in our area under contract to the federal government. Our small fraud and abuse unit was overwhelmed and could only handle the most egregious offenders, but we had psychiatrists who billed for providing more than 24 hours of service in a day, we had surgeons who billed multiple times for the same surgery, and we had doctors who would submit various claims for the same service at different rates, pinging to find our usual, customary and reasonable payment rate. Not to mention that when Medicare began covering medical transport, everyone with a car became a transport provider. There are a lot of stupid or dishonest patients scamming the system; fortunately there are relatively few dishonest providers. But the few dishonest providers cause as much or more damage as the dishonest patients.
Of course, we could talk ALL DAY about the damage caused by the insurance companies.
Our current system is broken. There’s so much blame to go around, there’s hardly any use even trying to assign it.
Obama needs to convene a council of scholars to study OTHER health care systems around the world, not our own. That council needs to pick the best aspects of other health systems and put together a plan that incorporates them, an ideal health care plan. And then we need to hope that even a portion of that plan survives the savage attack the insurance companies and health care providers are certain to mount. Otherwise we’ll be stuck forever with a system that serves no one but a few insurance, pharmaceutical and health care CEOs.
This issue has been on my mind quite a lot lately. I agree with the poster who mentioned that insurance coverage needs to be decoupled from employment.
However, the more gov’t gets involved, the worse it is going to get. When someone can give me some glowing examples of routine, efficient, CORRECT, and timely service from any government entity (DMV, IRS, …), THEN, I might believe this would work.
Looking at the comments, the case against socialized medicine is already lost.
This was very sad to read [both the post and the comments].
No medical system is perfect [just like no government is perfect] so we usually end up settling for the lesser evil.
I grew up the US, covered by my parent’s insurance while I lived there, then I moved to the UK. I have duel citizenship, so I get to use the NHS. I have a rare auto-immune condition, if I’d got sick in the US I would have lost everything and ended up living with my parents again. Thankfully though, I got sick in the UK.
I have all of my treatments paid for, I have a pre-payment card for all my prescriptions [£102 per year] and if I ever have a problem with my doctors [haven't before, I love them all] I can follow the chain of command to resolve the situation without paying a lawyer’s bill.
Plus, because I was working when I got sick I am entitled to incapacity benefit and a little disability living allowance. These two payments mean the difference between my wife and I just surviving and being able to have a little savings.
I look at my story and I listen to friends and family in the US suffering under the current system and I cannot help but think that socialised medicine is so much better.
Obviously though, the unfamiliar is scary and changing such a mammoth system is going to take time and money. My heart goes out to all of you and I hope something changes for the better soon.
Well, if you’re disabled in the US, you’d be in about the same place as you are there. You’d have disability benefits and Medicaid would pick up your expenses. If you don’t like your doctor, there are plenty of others to choose from.
I don’t see how the UK system really improves your situation, other than your drugs might be cheaper.
Matt… I don’t think you comprehend what you are saying — this blythe “[w]ell, if you’re disabled in the US… You’d have disability benefits and Medicaid would pick up your expenses.” Most people don’t think to get disability insurance (I must be prescient) and Medicaid pretty much requires that one become destitute. Check out what is involved in “spending down” to qualify! This is the situation common to most hardworking people who are suddenly hit with severe and costly disability, as well as to seniors who need placement in a nursing facility. You’re ineligible for Medicaid if you’ve over $2,000 in liquid assets. I am pretty sure that, in the UK, a person does not have to completely lose their quality/standard of living, as is required here, in order to qualify for assistance.
“If you don’t like your doctor, there are plenty of others to choose from.” Oh. My. Goodness.
No… there… aren’t!
Anyway, this is a good discussion and I appreciate WhiteCoat’s post. If any of you out there have the chance to purchase private *longterm* disability insurance, please do so. Yes, it can happen to you! Even with the waiting period such policies usually require before paying, you are much more likely to see about 60% of your salary (what is normally provided) before your application for SSDI will even be looked at.
Socialism doesn’t scare me in the least, and were this country actually headed that way, I’d be thrilled… but it isn’t. Lots and lots of scare-and hate- mongering, yes. Socialism? No. When the diverse parties gather at the table with their needs, wants, and dreams, I think there will be much more unity than opposition.
Why aren’t more people talking about this!!!!
The Obama Administration announced Thursday a plan to start billing private insurance companies for war and service related injuries of their subscribers who are veterans.
http://www.bio-medicine.org/medicine-news-1/VFW-Against-VA-Collection-Increase-Proposal-38578-1/
That’s great. The economy is bad enough as it is. Veterans have a high enough unemployment rate. Who is going to want to hire them if their insurance premiums are going to be more expensive for employers? Are they going to be in a higher risk pool? If they have to pay for their premiums how are they going to afford it? This is totally unacceptable!
These men and woman sacrificed for their country, the mission of the VA as envisioned by Abraham Lincoln was to provide for those that “bore the brunt of battle”
Should we be forced into UHC, then it will be the same for all patients being treated. They will be subject to what I call “the protocol nazis” who know nothing about treating patients. The only concern will essentially be rationing health care and cost containment, period. To decide who is treated for what ailment or not is simply bad medicine.
And it will come to that, if the current admin, (who is setting out to stiff our injured vets) has his way. I’d like to believe stuff like this is DOA, sadly, Obama has zero concern for the troops and in my opinion is a lousy Commander-in-Chief.
Bianca, agree with quite a bit of your last paragraph. Well said.
Also agree with the reality of ascertaining entitlements in the US. Applying for and receiving disability benefits usually takes anywhere from 2 to 6 years, with or without a lawyer after numerous denials. Folks go down the financial tube waaaaaay before the cavalry arrives.
And yeah, the spend-down process is incredibly stressful on the already overburdened working Joe/Josephine American.I wish I had a dollar for every working Joe/Josephine who cried in pain and frustration when their value system came up against the reality of healthcare costs. “I don’t understand, I’ve worked hard my whole life. How can this be happening?” All this fueled with the awareness of a culture of “entitled” others who get a full ride on Uncle Sam.
Life is unfair. Reality.
I work hard to help those in need and effort as hard to limit system access to individuals whose real intention is to play the game to collect the green. I might be left-leaning but I’m no bleeding heart. Clearly, “them” is a personal button-pusher.
Signed,
Low Threshold of Tolerance for Mendacity
“this blythe “[w]ell, if you’re disabled in the US… You’d have disability benefits and Medicaid would pick up your expenses.””
Nothing blythe about it. It’s called Social Security Disability, and you are paid a sum based on what you paid in. It’s not high living by any means, but it’s at least sustenance. And if you didn’t pay in, there’s SSI to give you basic living expenses. Maybe you get paid a lot more in the UK, you didn’t say. And yes, it can take awhile, but why should it be quick?
““If you don’t like your doctor, there are plenty of others to choose from.” Oh. My. Goodness.
No… there… aren’t!”
Where do you live that there isn’t at least 3 doctors that will take Medicaid patients within, say, an hour drive? Or do you think you’re entitled to get one right around the corner for every need you have?
Socialism doesn’t scare you because instead of being grateful that the taxpayers are willing to fund your care, you think it’s perfectly natural. Except it isn’t. There is no constitutional right to all the care you want, when you want it, at no direct cost to you. Socialism with regard to healthcare doesn’t offer that either. There will still be limits, or you will bankrupt the country.
” Check out what is involved in “spending down” to qualify”
Why shouldn’t you have to spend down to qualify for care in your old age? You going to have a U-Haul behind your hearse? You want services, you should have to pay for them.
Matt, I am not in the U.K. For purposes of this discussion, assume I live in the States. Should you wish to come visit us, though, you’ll have to book a trip to:
Marlinspike Hall, Tête de Hergé
We’ll leave the lights on, and the bridge down over the moat. Don’t even *think* about staying at The Hotel! We have over 40 bedrooms.
That SSDI exists is a good thing — and you’re right that it is not a form of welfare, but essentially the return to you of your own money. I was only trying to say that it is an incredibly slow process, with often inexplicable backlogs that can last years, and that the SSA’s decision-making is often equally inexplicable.
“And yes, it can take awhile, but why should it be quick?” Because efficiency is a virtue, and at the end of the application is a person without income who is also actively ill or disabled. I have helped walk applications through for other people who ended up no longer having a freaking address by the time the decision was made — and when SSDI or even SSI came through? For LACK OF AN ADDRESS, they no longer qualified.
Just for the record, I don’t get SSDI — I fall between the cracks. I worked for 22 years as a university professor and then as a high school teacher. Every education system that employed me used a pension fund, which required investiture of 7 years before you could have access to what really was a piss-poor investment of my money. I never vested — so the four different school systems(3 state-run, 1 private) kept my money.
You’re spot on (oops, it’s the wannabe Brit in me trying to out!) about no pay out for no pay in, though. Taking into account the work I did as a student (private tutoring, late shift at the 7/11, stuff like that), it turns out that, according to the SSA, I only lack ONE work credit, worth $830, and that is what caused my SSDI application to be denied, as I was exceptionally qualified, medically. Exceptionally! (Oh, damn me with faint praise!)
Much easier, but much less sure, and therefore quite angst-ridden, has been my private disability insurance. I had no trouble qualifying for that, as it was a benefit offered through my last employer, a large urban school district. And again, I encourage anyone who has read this far to take advantage of that sort of insurance.
Fewer and fewer doctors accept Medicaid — but thanks for setting me straight on the rules. So if I *were* one of the ingrates sucking you dry, I would need to find a very specialized neurologist within an hour’s drive (in what car?) because that is the kind of doctor I need — as well as very specialized orthopedic surgeons (who handle complicated repeat revisions).
I love your little rant about how I am not grateful (and for something I don’t even get! I bet you were absolutely stewing that I was using YOUR MONEY to pay for the internet access by which I blog and respond to blogs, as well as waste my everloving time in any wasteful way I please! “The gall of that freeloading shifty Bianca! It’s all ‘gimme, gimme, gimme’ and a sky high sense of entitlement with her, and all the scum like her…”). Of course I am grateful.
I don’t know what the answer is to prevent the horror and degradation that spending down often brings down on seniors in America. I don’t think it would be terribly hard to make the system more socialized — and for that demographic, making old age easier and less stressful doesn’t seem like all that ridiculous a notion. I bet you could even swallow letting them get a bit of a wee free ride, so long as you could then continue to stick it to some less favorable group, eh wot?
Your friend,
La Bonne et Belle Bianca Castafiore (filling in for the Retired Educator who was inexplicably stricken with nausea)
My fortune cookie from dinner gave a message I’ll pass on to you, from the Good Seuss:
If you
never have,
you should.
These things
are fun,
and fun
is good.
Ta ta!
” So if I *were* one of the ingrates sucking you dry, I would need to find a very specialized neurologist within an hour’s drive (in what car?) because that is the kind of doctor I need — as well as very specialized orthopedic surgeons (who handle complicated repeat revisions).”
I don’t think you’re an ingrate sucking me dry. I have no problem with a basic social safety net, but the sense of entitlement. As for the inconvenience of having to be near certain specialists, that’s life. It sucks sometimes, but we all make adjustments due to our particular circumstances.
“I don’t know what the answer is to prevent the horror and degradation that spending down often brings down on seniors in America.”
What is this “horror and degradation” nonsense? Of course you don’t think it would be terribly difficult to make the “system” more socialized, because you believe that 1) government will do a more effective job, and 2) you haven’t considered the costs.
But I am glad you’re happy. We should all be!
I started typing a very long reply with too many anecdotes. But, I think we’ll just have to agree to disagree.
I prefer socialised medicine. It is better for the lowest people in our societies and in my opinion, when you bring the lowest people up, everyone rises.
Socialized medicine seems to work fine in countries with a lower overall population and/or relatively well-controlled borders. (Canada, UK, Australia, Japan)
I just don’t think the US would do quite as well in this regard. We can’t control the flow of people in and out, and our population is larger that most, and a significant portion of said population pays little to no taxes.
Thought this was cool submitted it to TRANSPARENTVOICES.COM
Hopefully they’ll post it for others to read!