Seems interesting to me that people occasionally berate the government for poor security practices, lack of tech knowledge, breaches of personal information but almost in the next breath support that government taking over a very large part of the US economy (health care) and providing that same level of “expertise” to such an important part of everyone’s lives.
Every country must decide for itself how best to deliver healthcare, so I have no opinion regarding the best way to do it in the US.
However, I will say that I live in a country where the government took over the provision of healthcare 75 years ago, and I’ve had excellent care throughout my life in local facilities with helpful and experienced staff, and the only formality required has been to provide my name and date of birth to identify me. No contribution required other than paying my taxes when I’ve been employed, which I regard as my part of living in a civilised society.
Other experience in a lengthy IT career suggests to me that government and private industry are about equal in terms of incompetence and ignorance of security, and we should subject them both to constant public scrutiny to make sure they achieve acceptable standards.
I have heard both the good and bad of such care…most of the good from either young or very healthy people who haven’t had to test the limits of the care yet. I agree that the bureaucracy of either government or business gets in the way of real performance. Too often politics get in the way of meaningful regulations.
That’s very true regarding politics.
To clarify, I’m neither young nor recently particularly healthy, and recent years have included routine age-based checks for serious diseases and a number of emergency admissions to hospital. I suspect I’m probably Mr Average for the retirement-age grouping.
I’m over 50 and the health care I received in the UK as a child and in Germany as an adult is all paid for through employee and employer contributions to a national health scheme - run by non-profits in Germany, they made such a surplus a while back that we actually received money back at the end of the year!
I had a problem a couple of years ago and drove myself to the hospital in the next town. They took one look at me and said I needed an operation and would book me in that day and operate the next morning. I was so unprepared, I actually had to put them off 24 hours, so I could get someone to drive me to the hospital (parking there for a week would have been very expensive). The care was good. I also had a couple of operations on my heels (calcium deposits rubbing against the Achilles’ tendon), again quick, professional, I was seen by a specialist within a week of talking to my doctor and operated on within a couple of weeks.
Medication costs around $5.50 for a prescription drug. Pensioners generally get it for free, as do people on low incomes or unemployment.
The grandmother of my step-children (86) had a fall last year, was operated on to fix her broken hip, during the recovery a heart condition was diagnosed, she was moved to a specialist unit, where they repaired the heart valve. Then sent to physical rehab and finally sent home. The Krankenkasse provided her with 6 weeks in a home to recuperate, then provided an electric hospital bed in her living room, wheelchair, wheelchair ramp, comode and twice daily homecare visits and physio a couple of times a week. All that at no extra cost. She also had 2 laser treatments for cataracts at the end of the year.
We do have the usual problems of not enough people wanting to work in health care and they are investing heavily to provide more carers and nursing staff.
I’m glad it works so well for you. I have talked to people in Canada and that were in Europe that weren’t so fortunate, but that isn’t a scientific survey. I also have talked to people about some Canadians coming to the US for some medications…always seemed strange to me that they would come here…
I work on the basis that all systems have failures, and they’re more newsworthy than business-as-usual. I do hear about failures in the US system, but I remind myself that tells me nothing about how well people are being served by the system overall. I think the same principle applies to tales of woe about other countries’ systems: they tell you about the outliers, not the core.
What we have to do is make sure that all our systems are as well run as possible, with checks and balances to make sure sloppy security is punished and no-one is milking money out of the system. From where I stand, the risks of those look about the same for government and private systems, and I figure we have to make sure our representatives don’t implement rubbish systems. (For the avoidance of doubt, in government systems I’d class milking the system as basically money being pulled out to shore up someone’s pet project instead of running the system).
You’re broadly happy with your system, and I with mine: I don’t think the important thing is which ideology is being followed, rather that it’s being done as honestly and fairly as possible. I guess I’m a classic fence-sitter, which does have the risk of splinters in the butt.
Good points, but I don’t necessarily trust government to run such systems, or big business either. I would rather have competitive systems, funded in part by government. Bureaucracies (government or business) too often tend to control based on what is better for the bureaucracy more than the people using the systems. This has been a good discussion, amazing that things can actually be discussed these days with out resorting to personal attacks!
Europe is a big place. France has a very different system, for example, especially if you are a foreigner.
My brother, who lives in the UK, was working in France and broke his arm (he was a sports instructor and his mountain bike “fell apart” as he was bringing a tour down Mont Blanc), he had to pay for the doctor and the x-ray out of his own pocket and later get it re-imbursed through his employer, once he was back home. But that was back in the 90s and he hadn’t taken the relevant form with him, so I’m not sure how it is today.
On the other hand, when I was in hospital in Germany, there was a Brit in the next bed to me, who was on holiday, he got the same treatment as everybody else, for free. Although he spent a lot of time arguing with the doctor - he was used to British doctors handing out anti-biotics and in Germany, if there is no need for anti-biotics, you don’t get them, because they aren’t necessary.
Most European countries have reciprocal agreements, but you have to provide a form from your health provider in the destination country to get free treatment. Non-Europeans aren’t covered under this agreement, unless they are working in Europe and paying local taxes and health insurance, I believe. They have to provide their travel insurance details when being treated.
As someone that worked in hospital care in the US until I retired 3 years ago, our healthcare can run from excellent to poor. Most people that have insurance are usually pretty well covered but there are still policies out there that may be affordable but have such high deductibles they cause severe problems when you have a severe or complicated illness. Then there are the poor and working poor that still aren’t insured. It’s frankly a mess. We could certainly do better but we’d have to drop the political partisanship’s first and that doesn’t seem to be happening.
I certainly don’t have a solution. I have some ideas but I have no idea what would work or not. So, I sit and hope I will be covered for whatever I have when I need it!
The US government cannot even run the medical care of the VA correctly, and that is just a small percentage of the US population. If they cannot do that without killing lots of people because they are waiting to see a doctor so long that minor ailments are killing them (because they wait so long and they get so bad due to the wait)… I do not want them running healthcare for EVERYONE. Sorry.
That is what I have never understood about the US system. Healthcare is a basic human right. There should be no barrier to entry. Looking at it from the outside the US system seems very old fashioned and barbaric.
I think Patty is correct, like most things that should be federally run, they must be run without partisan political interference. But that is hardly likely to happen, especially not in the USA.
I think one of the benefits Germany has is that there hasn’t been a majority party government for decades, if ever. It is always a coallition between 2 to 4 parties. They have to make compromises and they are not diametrically opposed.
That is one of the weaknesses of the US system, there are only, in effect, 2 parties and they always want what the other one doesn’t want and vice versa. And when it is constantly flip-flopping between these opposing views, it is little wonder that at the federal level they have lots of problems, there is no consistency, no continuity. By the time a new law is passed, the opposition is back in power and looking to change it, not necessarily because it was a bad decision, but because it was made by their predecessors and everything they did was bad.
Just look at Patient Protection and Affordable Care Act, the Climate Agreement and the Nuclear Proliferation Treaty that were signed under previous administrations, but have all been overturned by the current administration. How is federal government supposed to do any job well or be taken seriously, if they have to do an about-face every few years.
Something like setting up a reliable healthcare system needs a couple of decades of working in one direction, by constantly flip-flopping it, it will never work properly. You need to set up funding and rules that are in place for a long time and cannot be taken away or dramatically changed - fine tuning if needed, but a complete about-face is just contraproductive. And that just cannot happen in the current US politicial system.
[big_D] Part of the problem with Affordable Care Act was that it was shoved through without any input from the opposition, they famously even crowed about not reading the details of the act. Was not much more than a pandering for votes, as is the case of much of the legislation lately in the US. I agree that the effectively 2 party system in the US is very flawed.
Both parties have not done much for the VA. Does not matter who has been in power over the years… It is bureaucracy at its finest. I do not agree that it is only politics that has that system in such bad shape.
Government can do few things well, IMHO. And, the multiple, multiple, multiple VA horror stories are ridiculous. No way in hell do I want them in charge of my health care.
They cannot even run the post office without losing billions of dollars.
The recent change by Trump that allows veterans to pick their own doctor is the 1st big attempted improvement. However, there are steps that must be followed and criteria that must be met, in order to get them to pay for an outside doctor. It is not a super simple pricess. But it is the 1st step in the right direction. A first step that has taken decades to get. But, even with that 1 change, the VA still sucks for so many soldiers needing health care.
Once again, I do not want them in charge of my healthcare. I would rather leave things as they are now.
Ever see war games
I understand all the hesitations for having the government run our healthcare. I also don’t see what we’re doing now as effective at all. What we need is an independent health agency funded by government but run strictly for what is best for the patients. Yes, it’s Possibly another government agency or a non profit agency regulated by the government. Assurances of patient directed goals and no political interference would need to be established and there’s the rub. Politicians only want to support something they can take credit for.
I, for one, don’t have tremendous faith in government doing a great job but they are beholden to voters and private insurance is only beholden to shareholders. Is there a way to form an agency that isn’t directly governmental but not a private business? I don’t know, but we need to start thinking creatively. Bankruptcy due to healthcare costs should be our shame! The richest country has millions not covered? Shame, again!
Independent and funded by government is an oxymoron … Rather than force millions from private care paid for by employers into Obamacare, which many can not afford, it would have been more cost effective to provide assistance for uninsured, as some states have done. Problems are when ever government is involved that involvement becomes a ploy to get votes.
The USPS isn’t government run or funded.
“How about a nice game of chess?”