Universal Health Care - Liberal fantasy?

[Damndifino]

A series of threads on UHC has focused on the issue of selling the concept on the basis of "hard-headed bean-counting" rather than compassion. It is deemed impossible to persuade a majority of the nation that UHC is desirable on compassionate grounds. For example:

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=104&topic_id=1009316&mesg_id=1009316

My suggestion, based on the history and operation of free universal health care on this (i.e. the other) side of the Atlantic is that this is a hopeless fantasy. The National Health Service in Britain was introduced by a socialist government brought to power on a landslide election victory at the end of the Second World War. The Attlee government owed its support and its direction on welfare policy to a generation of people who were determined that the country they had fought for would not be seized back by the traditional ruling class, as had happened to their fathers on returning from the First War. The grounds for introducing universal health care were thus based on social democracy and compassion.

I further suggest that a scheme as complex and grandiose as a national health service can only be conjured into existence by the sort of desire for social change which occurs naturally at the end of a long, all-devouring conflict.

The National Health Service currently finds itself in a state of crisis, as do healthcare systems in other European countries. Personally, I can't remember a time when the NHS was not in crisis, and despite the Blair government's attempts to introduce creeping privatisation, I have a feeling it will survive. Why will it survive? Because of compassion, essentially. Preserving the NHS is regarded as a national moral imperative. Even the wealthy subscribe to the principle.

Looked at from this point of view, informed by the previous threads on UHC, the chances of a free health care system being introduced in the United States seems about as likely as the wholesale repeal of the Constitution and re-submission to the rule of the British Crown.

It ain't gonna happen.

[KissMyAsscroft]

1. I said the same thing about a lot of Bush's policies...

and it happened.

If enough people want it to happen, and we elect enough Dems it could very well happen.

[Damndifino]

2. I can see that some have the desire

I'm sure that many (though apparently not all) Democrats and other liberals want universal healthcare, and I don't mean to suggest that Americans are universally uncompassionate. However, is it realistic to imagine a sufficient (i.e. colossal) Democratic majority in Congress, plus a Democrat White House, plus the political willpower to fight against not only a substantial percentage of the population, but also the vested interests of Big Pharma and the insurance giants? That's a whole heap of willpower.

Even in the British case I cited, the Attlee government had to fight against vested interests (including the British Medical Association). In my view, they only won because of the unique circumstances of the period.

[GreenPartyVoter]

3. It'll happen slowly, state-by-state

we're already finding ways to make sure everyone is covered here in Maine. We basically have a state-run HMO now.

[Kanary]

4. 62% of the population want one-payer system

according to a recent poll.

There is also a physicians organization pushing for it.

So, the interest and will is there.....it's a matter of making the leaders lead.

Kanary

[Nederland]

5. until they see the details

The devil is always in the details.

[Kanary]

7. What a good reason to just give up

[Silverhair]

6. I think it can, but we have to allow the conservatives on board

too. As a compassionate program, it won't fly. Dead on Arrival. That's because most compassion based programs refuse to acknowledge limits and think bean counters are evil. But I think that if we accept the brutal fact that there are limits and that bean counters are vitally needed, then we can get the conservatives on board. The main problems most conservatives have with liberal programs is the runaway costs.

Show conservatives a program that will deliver quality care for all and at a lower cost, and we can get enough of them on board.

Obviously I can't prove that, but Hillary's approach was a monsterous disaster.

[Kanary]

10. Conservatives back the insurance companies

and think that Big Business is needed in health care. It "provides jobs".

I know, I've been down this road with conservatives. They don't yet buy your realization that it's the companies that are making the mess.

In the meantime, if we kill our *own* compassion to appeal to the conservatives, then we really *are* dead. Compassion is already endangered in this society.

Kanary

[Terwilliger]

22. Hillary wanted to save managed care

the idea of single-payer was alien to her

http://www.prorev.com/indexa.htm

Despite the contrary evidence of public opinion polls, the concept of Canadian-style single-payer insurance was dismissed early. Tom Hamburger and Ted Marmor in the Washington Monthly tell of a single-payer proponent being invited to the White House in February 1993. It was, he said, a "pseudo-consultation;" the doctor was quickly informed that "single payer is not politically feasible."

When Dr. David Himmelstein of the Harvard Medical School pressed Mrs. Clinton on single payer, she replied, "Tell me something interesting, David."

In other words, write Hamburger and Marmor:

"Fewer than six weeks into the Clinton presidency, the White House had made its key policy decision: Before the Health Care Task Force wrote a single page of its 22-volume report to the President, the single payer idea payer idea was written off, and "managed competition" was in.

[Kanary]

27. Yes, her proposal was bandaids on a broken system

In retrospect, I'm glad it didn't pass.

There is so much better that can be done.

Kanary

[flaminbats]

26. The approach proposed in 1993 wasn't a disaster...

the lack of any coherent legislative strategy was what led to disaster. First Clinton introduced the bill in September of 1993. This gave the interest groups months to demonize it. This scared away moderate Republicans like Danforth, Duranburger, Cohen, and Jeffords..who co-cosponsored the bill.

A majority of votes were available to pass the bill, but because the administration wasted months on passing unpopular legislation like NAFTA..this gave the re pukes plenty of time to organize a last minute filibuster to kill the bill just before the 1994 mid-term elections. The mistake was wasting time on NAFTA, again...why pass legislation with hardly any public support while failing to pass universal coverage for which there is widespread support?

Finally, remember that re pukes sunk health-care reform not by convincing those already opposing national health care that it was wrong, but by convincing swing voters that Clinton's bill would deny them of necessary healthcare. The argument that widespread opposition to universal healthcare is what has stopped it from becoming a reality is another fiction being sold by neo-conservatives and DINOs.

[denverbill]

8. British whiners.

Just kidding, but seriously, you pay 10% of your GNP for health care, and we pay 15% of our GNP for ours. Yours covers everyone, cradle to grave. Ours covers many people, most of the time. If you increased your health care spending by 50%, how many people would be griping about a 'crisis' in the NHS?

[Damndifino]

15. I agree

This is what I meant when I said that I can't recall a time when the health service was not "in crisis". This is because Britons, having grown up with free health care expect very high standards. Not only the quality of care, but the extent of cover.

Take an example. Part of the health service's revenue comes from prescription charges. The amount is fixed: regardless of whether you are getting a 10-day course of antibiotics or a three-month supply of heart pills, the charge is (at present exchange rates) about 13 dollars. People who are unemployed or otherwise on very low incomes are exempt from the charge. Nevertheless, Britons regard the fact that the charge exists at all as an outrage.

Whining or high expectations? I'll let you decide.

[Kanary]

20. I'm glad you clarified about expectations.

I wasn't sure from the initial post, but now I get the picture much better.

Hadn't really thought of it from that angle, and I'm glad now that you brought it up!

We're also told that there is a lot of waiting for "non-emergency" care. Would you say that's true?

Kanary

[Damndifino]

29. Yes it's true

There is a lot of waiting. In Britain, under the NHS you can typically expect to wait, say, 3 months to be given an appointment to see a consultant or receive non-emergency treatment, plus a further 6-9 months to the appointment itself. I'll explain that better:

First you see your doctor in January. He or she arranges for you to see a specialist. In April you receive a letter telling you that an appointment has been made for you in October. (Note: these figures are based on personal experience and anecdotal evidence - I don't have official statistics to hand.) The purpose of the time-lag between the initial doctor's consultation and the letter is to give the appearance of minimised waiting times, since only the time between the letter and the appointment is counted officially as 'waiting' time.

[sable302]

28. All I know

is that my wife kept coming home utterly amazed that Brits were complaining so much about having to shell out eight quid for something that would cost them $100 or more back in the states.

Is it high expectations in the UK, or simply that our expectations are just that low?

[Damndifino]

32. It's high expectations

We expect it free at point of delivery. How would you react if your government decided to charge you (say) $13 a month to breathe?

[Mairead]

37. It used to be 10%. Under the Tories it was strangled to 6%

I don't know what it is under the New Tories -- is it back to 10%?

[sable302]

9. Ok, I gotta say this just once

I recently moved back to the US after having lived 2 years in the UK. While there, of course, I used the NHS, my wife even had our first child while we were there, and she worked in the health care industry.

But, you are right. Every week there was some report on tele or in the papers about some new 'crisis' brewing in the NHS. I gotta tell you, though. I never once felt that health care there was really in crisis. We received excellent care, much better care than we had ever had in our LIVES! The NHS is not in crisis folks.

So, why does the British public get to worry each week about some new crisis? Is it just to sell more papers? 'Man dies as NHS hospital in Leeds' or something. Imagine that.

You want to see a crisis? Come to the US and experience healthcare our way. Where you get to see your doctor 7.5 minutes as prescribed by your HMO (in the UK we always got a full half hour... a f**king hour every time we went to the doctor, or even *gasp* when the doctor or nurse would come to our home). Where you have to show proof that you can afford care before they even let you in the door. Where the uninsured have to rely on the goodness of some doctors that will agree to see them, while most most are forced to cope with ever expanding patient loads to counteract the ever tightening reimbursement rates offered by insurance companies. So, even if you have some crappy health insurance plan, that still doesn't mean you can find a doctor who will be willing to see you.

As for rationing or wait times for certain procedures (the usual gripe), we have that too, and according to my wife, the waits are worse here in our 'capitalistic god on earth better than anything else in the whole world' healthcare system. Since she has worked in both systems, I have no reason to doubt her.

We do have insurance her, good insurance. It costs our employer on our behalf $12,000 per year. Twelve f**ckig thousand dollars a year, and I still think care was better in the UK. Minimum wage full time only makes someone $10,712 before taxes. Piss on us that we live in the richest country in the world, but to have good health care for your family, you have to spend more than a person can even make in a whole year on our crappy minimum wage.

We are fortunate, but many are not. I say, go NHS. If it were possible, I would have taken it back with me.

Thanks for listening.

[Kanary]

12. Thanks, sable!

I have heard so many of those scare stories about rationing of care in one-payer systems. I'm glad to hear anothe view.

Given that the UK system isn't seen as good as some of the others, that is still an improvement!

Kanary

[Damndifino]

16. Again, I agree

I refer you to my post at #15.

[Screaming Lord Byron]

11. So, on what side of the Atlantic is Canada, then?

Yeah, I know, i'm being picky.

[Cleita]

13. Well, if we don't get national health care

because of compassion and because it's the right thing to do, we should do it for the fact that social ills and plagues are introduced into the population by an untreated underclass of people who do not have access to health care. Tuberculosis, typhoid and more recently AIDS, ebola and now SARS could have been contained if the initial population who acquired these diseases would have been treated as soon as the symptoms appeared and before they had spread into the population before being noticed.

[JanMichael]

14. Everything is in crisis, OUR system is in crisis.

At least they cover 100% in their "crisis" whilst we do not.

Bad argument, period.

Look at the international rankings. We, I mean the US, do NOT rank well.

It will happen eventually. You know why? Because it's the right thing to do.

It's the Civilized thing to do.

[Damndifino]

17. I think you've misunderstood

I did not argue that the so-called "crisis" in the NHS is a reason for not introducing universal healthcare. Rather, I cited it to emphasise the strength of cultural will which exists around the service and which will ensure its survival.

Regardless of the comparative situation vis-a-vis the US, the NHS is regarded as being in crisis, for the reasons stated in post #15. Some of it is media scaremongering, some of it is the inevitable result of growing up expecting to get all the treatment you need, when you need it, completely free. And that is how it should be in any civilised society. Universal Healthcare. Quite Extensive And Better Than Our Neighbours' Healthcare isn't good enough.

[bobbieinok]

18. Germany got health insurance for workers

AT THE END OF THE 19TH CENTURY!!!!!!!!!!!!!!!!!!!!!!!!

It was implemented by Bismarck as the chancellor of the Empire in the hopes it would defuse the increasing appeal of the socialist party.

[Kanary]

19. Question for you

Regarding what is expected.... when I tried to bring up this topic on another forum, one of the things that people kept coming back to is that in the "socialist" countries, there are no such things as private rooms. All hospital rooms are 4-bed or more. Is that true? I suspect not, but having never experienced a hospital in a "socialist" country I have no data to add.

I tried explaining that just because that's how it was in another country didn't mean that the US would go that way. also said I couldn't imagine the gov't coming in and bulldozing all the hospitals with private rooms just so a medical warehouse could be built, but they were so stuck on the lack of private rooms that I couldn't get anywhere with them.

Thanks for bringing up this topic. There was someone here from Norway a while back, and I wish he'd chime in, also.

Kanary

[Damndifino]

33. It's not true

In Britain, private healthcare exists alongside state provision, for those who wish to pay for extras (like private rooms, instantaneous consultation, hotel-style facilities etc.). NHS hospitals do contain private rooms. Some are for patients who are paying for their treatment (in cash or through private insurance), but some private rooms are maintained for NHS patients who require them (e.g. critical or terminal cases). Otherwise, wards typically contain 4-8 beds.

[Kanary]

34. British hospitals

Thanks for responding about the private rooms.

Another question relating to that..... are these hospitals newly built, or from a long time ago... like built after WWII?

I'm asking because it occurs to me that if the hospitals were built before the advent of NHS, then it wouldn't have anything to do with whether that is part of National Health care.

Thanks for all the info!

Kanary

[Damndifino]

35. Modern hospitals...

...have multi-bed wards as standard, the typical ward being about 4-6 beds. This is one aspect of the NHS I've never heard British people complain about. If you go into hospital, you expect it to be a communal experience. It's expected and accepted. Of course, they put screens around you if you need a bed-bath or have to fill a specimen bottle...

And yes, it is to do with cost-saving. It saves space, and it saves on staff.

[flaminbats]

21. People like you only account for a third of the vote!

I don't think Democrats are going to win back power by turning off 2/3's of voters...

"With an estimated 43 million Americans without health insurance and sharply rising costs each year, there is a new openness to undertake fundamental changes in the nation's healthcare system. In September, 10,000 doctors publicly endorsed the creation of a government-run, single-payer health care program in the pages of the prestigious Journal of the American Medical Association. And in a Washington Post-ABC News poll released in October a majority of Americans, by a 2 to 1 margin, now prefer the establishment of a new universal national health insurance system over the current privatized healthcare structure."

<http://neworleans.indymedia.org/news/2003/11/595.php>

[Damndifino]

30. Huh?

By "people like me", I presume you mean people who are opposed to universal healthcare. If so, I wonder what proportion of the vote is made up by people like you - people who burst into flames without bothering to read what's placed in front of them.

For the record, and in the simplest possible terms:
1. I am not opposed to universal healthcare.
2. I am strongly in favour of universal healthcare, in all countries.
3. I believe America needs universal healthcare.
4. I believe that a country without universal healthcare has no right to call itself civilised (on the basis that a civilised society looks after all its members).
5. I am not convinced that America will get universal healthcare.
6. My reasons for believing this are stated in my original post and posts passim

[cryofan]

23. your analysis is a little weak, isn't it?

You basically just said that the NHS was born out of great traumatic change. Implied (I would hope) is that the USA will not undergo such trauma, and so therefore will not have a version of the NHS.

Well, first, the USA is now undergoing great change via globalization and immigration. So don't rule out upcoming trauma for the USA.

Second, there are countries, such as Canada that instutited socialized medicine without trauma (it happened there only a couple of decades or so ago).

Second, the socialized medicine schemes in Europe, Oz, Canada, et al, all work better than teh American system, IMHO. All we have to do is sell the idea to the public, which basically consists of showing them how it works elsehwere.

Just one catch--we need to get into office politicians who really want it. I see only one in this race--Kucinich.

[Damndifino]

31. I wish you luck

Though in what sense I'm not sure: good luck in getting UHC, or in avoiding major trauma. Whatever trauma America has coming, I hope for the world's sake it doesn't compare with World War 2.

Can't speak about Canadian trauma. Anyone from Canada care to comment?

[Snappy]

24. Plans

Since Dean will most likely be the candidate check out his Health Care Plan.

http://personalinsure.about.com/cs/healthinsurance1/a/aa091503a.htm#b

All the candidates have one. One can go to any search engine type in candidates name & "health care".

[Kanary]

36. yes, he still wants the corporations involved... $$$$$ n/t

[stevebreeze]

25. cowpuckey! it's only a matter of time until we have UHC

The crises state of health care in the US is ALMOST ENTIRELY a result of our "market" based system. In a recent poll 62% of Americans would prefer...taht's right prefer universal health care to what we have now.
This is my idea of how this can be and will be accomplished. First Health care will become a right in a few states, then the nation. In these places first there will be a state run health care system for those not covered by private health care. Business will soon figure out that inclusion in the state run umbrella health care plan if cheaper then private insurance, and soon all will be in a state run single payer plan. This is essentially how Canada got it's current health care system. Canada's and all other health care systems are cheaper and most provide better health care outcomes then the US currently can.
:kick: