If anyone is still posting in this thread I have a few comments:
When you live in a country with UHC, in my case Norway, you never think about health insurance. No forms, no brochures, no thick books from an HMOānone of that. (One of the major surprises of coming to the United States was to be exposed to the highly bureaucratic health care system here.)
- You notice a certain government effort in preventive, aka social medicine. They run campaigns: donāt drink, donāt smoke. Work out. Eat right, and so on. Social medicine goes a lot farther than that of course with institutions akin to the CDC, FDA, etc. trying to keep food safe, illness outbreaks under control etc.)
Your GP calls you in for a physical now and then to see whatās going on with you, as part of the preventive program.
- When you are sick, you go to the doctor. As there is no eligibility (everyone is eligible) there is no paperwork, except to document your medical condition and treatment. If itās a minor, simple thing there will be a small amount of co-pay, say in the twenty-dollar range.
- The doctor takes a look at you, and decides whether you need further treatment. The doc does so according to medical standards. There is no insurance company to askāno adjuster who has never seen you can deny you treatment because you are not covered. You are covered, no matter who you are, no matter what your illness or problem is.
- You undergo treatment. Sometimes you have to wait, although I never experienced anything over a week or two. Your life continues. There is no bill that ever shows up in your mailbox. There are no collections, no bankruptcies, no financial worries should you, your kid, or a family member come down with something serious.
- If you change jobs, your health care stays the same. Same doctor, same everything.
End of story.
The essence of my experience with health care in Norway was that I simply never thought about it. It was never or rarely discussed between my parents or their friends either. If someone got sick, the discussion was about them: whether they were getting better, what their prognosis was, etc.
When my mother needed a stent due to a clogged coronary artery while visiting me in California we got a bill for $43,000 for the procedure and one night in the hospital. The Norwegian Government picked it up. When she needed a quadruple bypass in Norway at age 74 she was taken to a private clinic and had the procedure done. She waited for two weeks to get in, as the procedure was not based on an emergency. She was home after three days. No bill ever showed up.
The experience is so far different from what my life is like now that itās not even funny. Iāve been working for startups in California for the last three years. None have offered health care (too small), and my paycheck has been too meager to afford it on my own. Iām 49 and healthy, but Iām not cheap to insure. When I was laid off four years ago I had just had a physical. I was not given the results, as the HMO felt it could be a liability for them if I took it to another insurer.
Maybe Iāll have health care again. In the meantime I can only say this: I look at people around me, and notice that they are using a fair amount of time and energy on negotiating the health care system. No one in UHC countries are except when they have a problem. Problems happen there as they happen here. Then they too are exposed to a bureaucratic administration that can be difficult to deal with. I will guarantee anyone who cares to listen that itās nowhere near as cutthroat and uncaring as the U.S. health insurance industry. In spite of its shortcomings the system in a UHC country does not try to deny anyone care.
The difference between the two countries has demonstrated something to me: health care is not a product, and providing health care is not a market. It is a necessary service for a human need that varies between different people, and the variability does not coincide with financial wealth. Poor kids get expensive diseases just like rich kids.
To put private industry in charge of it introduces the profit motive into medicine. This is diametrically opposed to the Hippocratic oath. The two can simply not coexist. Patients do not have the information and knowledgeānot to mention foreknowledgeā they need to make sound decisions about the medical care they will need in the future. Therefore, none of us are informed consumers abouth health care.
When we do get sick, we do not have the tools to make sound āshopping decisionsā in any meaningful way. This is an area where we have to rely on the professional, by and large. Of course we can educate ourselves, and many of us do, but if your kid comes down with a melanoma on her neck, or with a raging case of E Coli infection , would you like to take over the treatment, or would you rather have a doctor do it?
I have read all the arguments on the private health care side. They all are blind to the elephant in the room. Weāve tried private health care. It doesnāt work, and it doesnāt work because publicly held corporations have a fiduciary responsibility to maximize shareholder wealth. It is an iron-clad rule for a corporation to do so. As a matter of fact, itās the law. That means to minimize and deny care whenever possible. Itās as simple as that, and insurance companies do it every day. As a matter of fact they reward their employees to find reasons to deny care.
This is the difference with the two systems: universal, public health care has its problems, but it is a basically sound and correctly structured system from the point of view of public welfare and medical integrity.
Private health care does not work and cannot work, because it intermingles the corporationās fiduciary responsibility to turn maximal profit with the Hippocratic Oath. Itās oil and water.
Large numbers of
insured people going bankrupt (50% of all personal bankruptcies) due to uncovered medical bills is part of the problem. 50 million uninsured Americans, among them 10 million children, are living proof of it. I am one of them.
Respectfully,
Tor