U.S. Healthcare vs. NZ and other nationalised programmes

[globetrecker]

I am curious to hear the Americans in New Zealand opinions on the health care issues that are in the media recently. More specifically, why are many Americans so vehemently against having some nationalized health care? I was born and raised in Canada and didn't have problems with the system, and my family who is currently there have not had problems either with supposedly high taxes, lengthy waiting times or poor care. It isn't as the U.S. portrays, from my extended family's experience. I have also lived in the U.S. for 10 years and have seen good things for people with great insurance and also very sad things happen to families there because they didn't have insurance or didn't have enough insurance or had pre-existing conditions. I am now back into a nationalize system here in NZ and work in a hospital, so I've lived on both sides and naturally know that there is no perfect solution. It just doesn't seem "so terrible" as is being portrayed and taught in the U.S. Yet the majority of my American friends are horrified and terrified (exact words) of a system (like Canadian, EU and NZ etc.) They have even brought in communism. The attacks on these systems are quite intense in America right now. I know this is a heated debate and I don't want to start a heated discussion, but I am interested in some more balanced views. Why do Americans have so much fear and disdain for national health care? Any explanations or similar experiences?

[BkyMonster]

Obviously I'm for it, but here are some of my thoughts on why people are against it.
The US lets whaargarbl (Definition here, one of my favorite words to come out of the internet) drive popular opinion. The idea that you might have to wait, or be denied service in a care rationing scheme (here is an article on the Oregon Health Plan, one of the US's socialized health care plans that has been used in media invective to foster incorrect ideas about how rationing doesn't work), is counter to 'popular media opinion' of fairness, when in practice even with privatized (PPO, both Blue Cross and Cigna) health care I routinely had to wait months for appointments. Generally 1 month for routine annuals, 3-6 months for some specialists.
Really there is a lot of worst case scenario scaremongering going on. America has a very vocal minority of media entertainers that many listen to seriously.

The scaremongers choose to highlight the cases in which people are denied care or receive delayed care, and ignore the cases in the current US for-profit system that underhandedly encourages people who develop serious illness to be fired from employment so that the insurer can keep a handle on costs. (Seriously, here are a few examples from googling 'fired for getting sick':http://www.nydailynews.com/news/2009...ting_sick.html ,http://www.progressivefox.com/?p=721) Or the people who do not have jobs that provide affordable health care (and even those that do) that medical issues bankrupt.


Another article I read stated that the US wants 2009 health care at 1960's prices and would be unwilling to settle for less. As the US is a corporation based country, the for-profit model makes it hard for people to visualize change (look up recision in relation to insurance providers finding ways to deny coverage). Considering people pay quite a bit for insurance as it is, this is a huge fallacy. At my last job my payment for medical/dental/optical was a fully subsidized $7-800/month(state worker), but at OH's last job he paid something like 6-700/month pre-tax. This does not include the co-pays (10-15 at time of visit) and the insurance bills that arrived months after the treatment.


Another thing is that federally funded bodies like the VA hospitals aren't well managed (either through poor funding or corruption) so people fear that a nationwide health care system would be similar to that.
The US form of corruption isn't necessarily in the form of bribes etc. My replacement for my last job(whom I trained) was a Canadian citizen and she commented on how plush our local hospital was. I realized that a lot of the hospital costs went toward maintaining designer carpets, decorations and paint. Not to say environment isn't important in some ways, but (to my view, unnecessary) things were refurbished every few years whether they needed it or not. I could cite a lot of other examples of state/federal money spending the budget to the max every year so it doesn't get cut and similar.

The communist label is dumb IMO as it kind of panders to the aging populations fears of when the Cold War was a scary thing. Most of the scaremongering is aimed at the aging population because they vote more.
In reality, it is fairly routine for people of working age to pay a large portion of one's monthly paycheck (may or may not be subsidized) to company insurance policies that...support everyone you work with. Which is basically the same thing that scaremongers warn against. The aging population is partially serviced by Medicare...which is a social program for medical insurance for people over 65. Again, similar.

[TJH]

I would love to hear the personal medical experiences of American's currently in NZ.

My wife and I have got into numerous arguements with my parents over this topic. They simply refuse to believe that there could be a better way of providing medical care than how the US does it. This is even in face of personal experiences from my cousin who lives in Canada and has spoke about how the system is much better there - and he has some health issues.

I am in complete agreement with BkyMonster in that "America has a very vocal minority of media entertainers that many listen to seriously". I can't even watch mainstream American news anymore as it is more propaganda and entertainment than actual informative news.

The fear of socialized medicine is the result of a small minority voicing their opinion on the matter to such a degree that it has eventually been regarded as fact - even in face of evidence to the contrary. The main problem with the system is that the US system is a "for profit" system for the insurance companies rather than "for the benefit of the people" system who are insured and receive the medical care. These same insurance companies have a lot of money to get their message out that socialized medicine is a horrible idea as it would be horrible for their profits.

Hopefully this thread gets a lot of discussion as I am very interested in this subject.

[BkyMonster]

I can share a few experiences, though nothing serious.
Accidents are covered by ACC and some other people have commented on various experiences with that on this board.

So far here, unless my Dr. is on vacation (which she does from time to time and then I can see someone else in practice for the same fee) I can get an appointment to see her the next day, sometimes the same day. As an adult registered with the practice I pay $32 for the visit. If I want blood tests to be done there I pay an additional $5. No insurance, we decided we don't need it right now, though have looked into it. Before we had PR I paid the non-registered fee of $59 per visit (not sure on blood work).
I had a surgical outpatient day visit a few months before we got PR and that ended up costing me about $2000--something that would have been $6000+ (what the insurer would have paid) in the US (possibly more without insurance, just listing out of pocket costs), and would have been free if we had PR. I was seen within a week of making the appointment, even though they delayed me from a Friday to a Monday for more urgent cases. I got a 10% discount for prompt payment to the hospital.
I haven't gone to a specialist yet (though was looking at into it, thankfully ended up not needing it) so maybe someone else can share on that, but there is the option to go private (still not the same level of expense as the US) for faster service. You can have insurance or pay out of pocket as well. There are rules on which medications Drs can prescribe, i.e. some can only be prescribed by specialists.
I'm sure it varies by region and services needed as well, so would also be interested in others experiences.

[globetrecker]

Excellent info so far, and I hope we have more insight from others on here. Keep it coming.

[stellachiara]

Just a few thoughts, because I am deep in a project with a tight deadline. I am not keen to get into an argument, heated or otherwise, and probably will not do so, but I just want to throw in 2 cents from the other side:

-- The US has an enormous population, many times greater than any of the countries you name with government health care, and a far more diverse population than any of the countries you name as well. This makes any kind of overarching government program a far different and more difficult undertaking than it would in, say, New Zealand.

-- The US government is not known as a benevolent, kind entity. I am disgusted by what I see when I read the news every day, and I certainly don't want these liars, cheaters, and robbers controlling what happens or does not happen to my body.

-- Although it may be fair to say opponents of government healthcare in the US "ignore" the downsides of US health care while highlighting the downsides of government health care in other countries, the exact reverse can also be said with a great deal of truth as well.

-- Some of us do not think our choices should be 1) keep everything as it is, it's great or 2) let the government take it over. Some of us think there should be a way where we don't have to ration health care (yes, it is certainly rationed in government health care systems) while at the same time we can provide a safety net and assistance for those who can't afford their health care.

-- Some of us also think that the stated reasons for the health care system not working efficiently (greed, big pharma, doctors ordering too many tests) are NOT the right reasons. There are other reasons, such as the ridiculousness of having to depend on your employer for healthcare, the disallowing of insurance companies to operate across state lines, and other number of government interventions that hurt, not help.

-- I and my family have never had any serious problems with the US health care system, and we are not rich and have not always had coverage. I know more than one person who did not have health insurance who received surgeries for free, birth control for free, and all kinds of other care for free. So, my anecdotal evidence for the goodness of the US health system is as good as your anecdotal evidence for the goodness of the Canadian system.

The bottom line is, some of us prefer not to increase government control over our lives, especially when it is just not necessary and we can get BETTER results by not doing it. I would also like to know where all the magic money is coming from to pay for it. I think the NHS is wishing it had some magic money right about now, and they're not the only ones who can't sustain what they've promised over the long haul.

I just met a lady who lives in the flat above us who has been waiting three years to be scheduled for a surgery for her heart. She has a condition that she could die from at any moment, but, she has to wait. And she tells us she is lucky, because if she were 65 instead of 50, the government might not even think she is worth paying for surgery for. This lady has been a nurse in New Zealand for the last 10 years, so I think she understands the system quite well.

Every system has its positives and negatives, and I am not disparaging either one, really. I just think it's a completely false dichotomy to think the US either has to stick with what it has or let the government take over. Some of us think people have and can do quite well when they are left alone to go about their business and do their jobs, and that that is what should happen. And some of us think that people should be looking to their friends, family, churches, and communities to support and help them, not the government, which possesses too much force and too much power, power and force which can turn on us in a heartbeat.

[Sam B]

The Health system in NZ is not as Nationalised and free as that in Britain, but so far it has worked slightly better for me. I have to pay for my visits to the GP, but I can always get an appointment the same day, and I get to spend more time with my GP as well and don't feel as rushed. For the sake of $30 it is worth it. Prescription medicines are cheaper.

I have had one specialist referral. I waited a month for the letter informing me that I had an appointment, and this appointment took place a month later - so a 2 month wait for a non-urgent condition that was not causing me any discomfort. The specialist doctor was excellent. This appointment was free. The wait was comparable to the NHS in Britain.

So far, no complaints at all. The doctors here seem more relaxed and of a very high quality. I am yet to see a Kiwi doctor however.

[unar]

I am not in NZ yet, but I am an American living in the UK. I love the NHS! I had a minor accident in London, had emergency treatment, then surgery, then physiotherapy all for free, and everything is done efficiently and professionally. The GP system works really well as well.

In contrast to my experience in the US, where I also had an accident which the ER doctor refuse to take a X-ray even though I fell on my face and broke all my teeth. I had insurance, but still had to pay $300 for a bit of saline solution and a bandaid. It is not until I went to dentist the next day where I found out my jaw was broken in three places. And this is with health insurance and an university hospital with a good reputation.

And my husband who had the best insurance money can buy in the US, he almost died in the ER because the nurse refuse to see him without the filled out insurance form. He was having a severe allergic reaction, can't speak and can't write because his face and both hands were so swollen. The doctor who rushed him into treatment, told him another 10mins he would of been dead.

Can't imaging what would be like to be without insurance. I am all for national health. Come Obama, be brave!!!

-Una

[Oregonkiwi]

Originally Posted by TJH

I would love to hear the personal medical experiences of Americans currently in NZ.

My (American) husband's thoughts - and a lot of discussion in the comments section:

http://spatulaforum.blogspot.com/200...what-ails.html

[sweetpea]

I do think its mostly a few American hypercapitalists and scaremongers who have gotten people riled up over the years. Socialism, until recently, made a good punching bag in the US.

It's been awhile since I've been back, but I get the impression things are changing. My parents (n=2, I know) are pretty staunch Midwest conservatives and they are very strongly for universal health care now. Shocked the hell out of me. I suspect that with the recession and more people losing their jobs and experiencing what having no health coverage feels like, we might find more acceptance of Obama's plans.