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The Views From Your Sickbed
August 17, 2009 11:47 PM   Subscribe

The Views From Your Sickbed: Andrew Sullivan's readers share stories about health care in the United States.
posted by lalex (65 comments total) 18 users marked this as a favorite

 
Those have been really interesting reading.
posted by delmoi at 12:03 AM on August 18, 2009


Fuck you Dick Armey.
posted by ryoshu at 12:09 AM on August 18, 2009 [1 favorite]


I love accounts from inside hospitals and insurance companies. Thanks for the pointer to this. Also relevant to the conversation is this recent interview with ex-Cigna PR head Wendell Potter, who resigned in 2007 to start speaking out about the insanity of the for-profit health insurance industry and the PR firms who manage their message and spread scare tactics about a "government takeover" of healthcare. His Bill Moyers appearance a was linked last month, but it's worth sending folks his way again.
posted by mediareport at 12:09 AM on August 18, 2009


These stories, along with those on late term abortions from a few months back, have been powerful and moving. I think they've opened a lot of eyes and changed many minds, including Sullivan's.
posted by Auden at 12:16 AM on August 18, 2009


Christ, I can't believe that anybody thinks a system where stories like that are common is worth defending. It's like defending the brilliance of the Maginot Line from Vichy France.
posted by smoke at 1:22 AM on August 18, 2009


Or attacking the 'socialized' systems of Europe from the US? ;-)
posted by i_cola at 1:34 AM on August 18, 2009


Re: The Baby Isn't Insured. I was told that kids in the US qualified for free health care...or is this just a localised thing (e.g. NYC)?
posted by i_cola at 1:36 AM on August 18, 2009


Again, these stories want to make me cry.

On wednesday the 5th of August (just under two weeks ago), my father died after a 3 year battle with cancer. On the 12th my wife gave birth to our second child. Not a cent (red or otherwise) has change hands. I've posted before about the tax rates I pay. They are not onerous.

My Dad wasn't on some bullshit 'death list'. He had a couple of surgeries to slow the cancer and extend his life. He elected to go on a drug trial in the final months of his life in an attempt to help others. He had a blood transfusion 6 days before death, simply to make him more comfortable. His last two days were spent in a comfortable hospice, with a drinks trolley twice a day (wine, beer and spirits) for use by patients, friends and family.

This cost us nothing.

My wife had an elective ceasarean, due to an extremely difficult previous birth. We waited maybe 3 hours longer than our booked time, because an acute obgyn surgery case had come in just as we arrived. After the delivery, we had a private room, with a lovely view. Wife and baby spent four nights there, with continuous midwifery support and pain relief on demand.

This cost us nothing.

I'll return to work soon after this tumultuous time in my life. I have no additional stress. My finances are intact.

Public healthcare. You should try it sometime.
posted by pivotal at 1:38 AM on August 18, 2009 [48 favorites]


Like pivotal, I've spent a lot of time in hospitals over the past year. Both my parents have had life-saving surgery (one for bowel cancer, one for a strangulated hernia). Mrs Morte spent 3 nights in hospital and had a blood transfusion after a particularly unpleasant miscarriage. I had my gall bladder removed in March (I was out and walking about within four hours). We've had consultations, scans and check-ups for our new baby (due in December - third time lucky, yay!). At all stages the follow-up care has been excellent. Between the four of us we've paid a total equivalent to $12 (a prescription charge for my painkillers, because I earn enough money not to be exempt). None of us had to jump through any hoops to get this; it's our entitlement as citizens of a country where access to health care is considered as important as roads, clean water and agricultural subsidies. My tax burden may be a little heavier than the average person in the US, but hey, I didn't have to sell my house this year.
posted by le morte de bea arthur at 2:07 AM on August 18, 2009


The $10,000 cyst story is one I read with great interest, since it's a direct corollary to my own story. Background: I was born and raised in Oregon, then came to France to finish my degree in French language and literature. I met a French guy who got a job in Finland; I'd long wanted to see the country (had Finnish relatives and friends in the US), so went along and became a freelance English and French teacher. I'd been diagnosed with endometriosis in the US, but never treated for it — the Pill often helps — due to my parents' religious beliefs (long story). While in the US I'd had stabbing pains, passed out and asked to be taken to the emergency room a couple times; my parents refused since they didn't want to pay for it and partly due to their beliefs.

In Finland, the same thing happened to me as to the woman in that $10,000 cyst story. Stabbing pain, could barely walk, thought it might be appendicitis, so got myself to the nearest hospital, a block away; it just happened to be Helsinki Women's Hospital. The doctor took my blood pressure, looked concerned, examined my abdomen, then grabbed a sonogram scanner in his room and checked with that. He got a serious look and said, "you need surgery, now." A large-apricot-sized, twisted ovarian cyst had burst and caused internal bleeding. This is where my story starts to differ from the woman's; this is where I start to realize just how right I've been all these years to dread what might have happened to my financial future if I'd been in the US instead of Finland.

I had emergency surgery an hour later; the time it took for them to do the necessary tests, ask for my weight and when I'd last eaten for anesthesia — "it doesn't matter you ate two hours ago. If we wait for surgery, you die," the nurse told me with typical Finnish aplomb. They gave me a laparoscopy, removing other abnormal endometrial tissue and an even bigger, but more benign, cyst on the other ovary. The ovary on which the twisted cyst had been was so damaged, they told me they didn't know if it still functioned; but they wanted to let me keep it just in case, so I'd have a better chance at having children.

I spent the night and the next day in the hospital recovering, with at-will pain medication for the first few hours, then they released me.

Total cost to me: 300 Finnish markka, or about 50 euros. And I actually had surgery. The woman charged $10,000 in the US didn't.

In France my salary puts me in the 14% tax bracket (just barely, I'm a couple hundred euros beneath the cutoff): French tax brackets. Seems the highest bracket, 40%, is the one that always gets quoted in the American press, when in reality, the majority of people are in the 14% and 30% brackets here, and there are plenty of deductions for families, etc. Even as a single, childless woman, thanks to being a new homeowner, with my deductions I end up paying about 5%. The salaries might be lower, but we don't pay for health care (apart from optional 10 to 20 euro/month supplemental private insurance) — employer taxes do. And everyone is insured, not just employees. I never have to worry about health complications; I've had several sonograms due to cyst scares in the ten years I've been here. All free.
posted by fraula at 2:10 AM on August 18, 2009 [26 favorites]


The $10,000 Cyst story actually happened about three years ago to me and my wife (then girlfriend). Except that she didn't qualify for any sort of charity care - she made $50/quarter over the limit.

Luckily, my mother-in-law sent us a newspaper article that inspired me to take a closer look at my wife's medical bills. In doing so, I started to do Google searches for every part of her hospital bills that didn't make sense. One of these searches turned up something amazing: The rates that Medi-cal pays for every medical procedure. According to these rates, Medi-cal would have paid $2,000 for the procedures that my wife was being charged for.

With this knowledge, I was able to negotiate much lower rates for my wife. Without this knowledge, my wife would have probably had to declare bankruptcy.
posted by jpf at 2:44 AM on August 18, 2009 [4 favorites]


Well, policy by anecdote, that makes real good sense. None of it adds up to, "Let's make sweeping, one-size-fits all changes for the whole country, decreed hastily out of Washington, being paid for we-don't-know-how, and possibly stifling all the drug development and device innovation that allows countries with socialized medicine to offer laparoscopy for burst cysts, and other advanced care, at reasonable costs, and take credit for having better health care than the U.S."

Christ, I can't believe that anybody thinks a system where stories like that are common is worth defending. It's like defending the brilliance of the Maginot Line from Vichy France.

Who says "stories like that are common?" That there are stories "like that" is well known -- and no one knows it better than people who work in health care. But statistically, how common are they? Once you're inside the incredibly complex world of hospitals and medicine, you are amazed that any of this happens at all, much less that it should occur with the real efficiency and effectiveness that it does for 90 percent of the patients in the US.

Hey, here's a good idea, why don't we start an anecdotal thread of people's stories of horrible, life-destroying encounters with the IRS? How the IRS violated their privacy, stripped their resources, and left them destitute Does anyone doubt that you'd get thousands moving stories? Would that motivate the government to do anything about federal tax reform?
posted by Faze at 3:38 AM on August 18, 2009


Who says "stories like that are common?" That there are stories "like that" is well known -- and no one knows it better than people who work in health care. But statistically, how common are they?

Last I looked, there were at least 47 million of them.
posted by Happy Dave at 3:45 AM on August 18, 2009 [13 favorites]


Well, policy by anecdote, that makes real good sense. None of it adds up to, "Let's make sweeping, one-size-fits all changes for the whole country, decreed hastily out of Washington, being paid for we-don't-know-how, and possibly stifling all the drug development and device innovation that allows countries with socialized medicine to offer laparoscopy for burst cysts, and other advanced care, at reasonable costs, and take credit for having better health care than the U.S."

Yes, because nobody has yet figured out a system that preserves the human right to health care and costs less than 16% of GDP. The anecdotes are there for humanizing the real cost of a system in failure, just in case, you know, somebody tries to sell you 'medical innovation' as more important than the lives of real people.
posted by Sova at 3:48 AM on August 18, 2009 [3 favorites]


I'll remember the objection to policy by anecdote the next time I hear some apocryphal story about waits or denials in the NHS. Stephen Hawking, for example?
posted by miss tea at 4:01 AM on August 18, 2009 [4 favorites]


possibly stifling all the drug development and device innovation that allows countries with socialized medicine to offer laparoscopy for burst cysts, and other advanced care, at reasonable costs, and take credit for having better health care than the U.S.

German pharmaceutical companies spent €4.5 billion on R&D last year. I don't know about medical device research, but I know that Siemans has so much they're doing that they can't find enough qualified software and electrical engineers in Europe so they ship them over from around the world. Being in a country with a decent, compassionate health care system doesn't actually stifle, well, anything, although I guess they haven't successfully invented a device that would pull your head out of your ass, so maybe you have a point.
posted by cmonkey at 4:03 AM on August 18, 2009 [5 favorites]


It's not "policy by anecdote". The people responsible for drafting health care policy weren't inspired by Andrew Sullivan's blog, and they're not drafting policy to address the specific anecdotes on Andrew Sullivan's blog. This post is a collection of anecdotes, but the debate on health care reform has been going on for a long time, and there has been plenty of data-based analysis of the American system and the various health care systems available in other first-world countries. If you've missed all of this, you could start by searching Metafilter for "healthcare".
posted by creasy boy at 4:08 AM on August 18, 2009


possibly stifling all the drug development and device innovation that allows countries with socialized medicine to offer laparoscopy for burst cysts

According to this timeline, which I have no reason to distrust, most of the advances in laparoscopic surgery have taken place in Europe. The abstract of "History of laproscopic surgery"
(Surg Clin North Am. 1992 Oct;72(5):997-1002), by T.A. Stellato (Case Western) starts out:

"Laparoscopic surgery has a long and colorful history. Although most general surgeons, especially in the United States, have discovered this technology only recently with the advent of videolaparoscopy, extensive diagnostic and therapeutic laparoscopy has been accomplished throughout the twentieth century, especially in Europe."

I now return you to your regularly scheduled shouty healthcare thread.
posted by escabeche at 4:13 AM on August 18, 2009 [8 favorites]


None of it adds up to, "Let's make sweeping, one-size-fits all changes for the whole country

Because 50 separate state insurance programs will be more efficient and more conducive to the advancement of interstate commerce and the general welfare? You got rocks in your head?

decreed hastily out of Washington

hey man, they spent months on this. :)

being paid for we-don't-know-how

increased taxes on rich people.

and possibly stifling all the drug development and device innovation

The possibility of that is 0.0%. Got any more gross distortions to pull out of your ass?
posted by @troy at 4:19 AM on August 18, 2009 [3 favorites]


I have to say Faze, your troll a dozen comments into this thread is a work of art. You've managed to squeeze pretty much every right wing canard from 'the US does all the research' to 'there's no proof that socialised medicine is any good' into a single comment, and you even drop a tax rant in for good measure.

Bravo. You win at the internet.
posted by Happy Dave at 4:20 AM on August 18, 2009 [4 favorites]


None of it adds up to, "Let's make sweeping, one-size-fits all changes for the whole country...

I agree that we need a system that offers choices. Private insurance for those that want it, public for those that don't.
posted by DU at 4:24 AM on August 18, 2009 [2 favorites]


I am still totally gobsmacked there are corporations in the US who are against public healthcare after seeing GM brought to it's knees partly due to the burden it faced in paying for medical benefits.

Why do they not realise that a productive, healthy workforce who can take a few hours off and go to the doctor at the first sign of sickness instead of passing out on the factory floor and being rushed to the ER is a whole lot better? Oh that's right because employer health care in America is less about looking after your employees than it is keeping you locked in your job.
posted by PenDevil at 4:48 AM on August 18, 2009 [6 favorites]


I was told that kids in the US qualified for free health care...or is this just a localised thing (e.g. NYC)?

Yes, SCHIP programs (Children's health) are administered by the states in different ways. New York's income cap is pretty high compared to most places. (But then the cost of living here is high too.)
posted by fungible at 5:26 AM on August 18, 2009


policy by anecdote, that makes real good sense

Um, at least these anecdotes actually happened.

Fighting with facts didn't work, so maybe an appeal to emotion is what's needed now.
posted by JoanArkham at 5:30 AM on August 18, 2009


Private pharmaceutical research being guided by profit means that most big pharmaceutical companies are only interested in researching drugs for erectile dysfunction and depilatory creams. That is, ones that are profitable to sell in the West. They're not interested in developing or selling drugs that can help the many millions around the world who are suffering from diseases that we could easily cure or at least treat.

An example would be African trypanosomiasis, or sleeping sickness. Treatable with Eflornithine, the company that made that drug (Aventis) ceased production because it wasn't cost-effective. It became cost-effective with the knowledge that it is also an effective hair removal cream - notably in the Vaniqa product. Aventis now donate $5 million worth of eflornithine per year to treatment for sleeping sickness in Africa, while raking in cash from the multi-million dollar hair removal market.

I'd rather have 'inefficent' government research that does things on the basis of need rather than profit. Never mind the fact that most private research just builds upon what government research has already done. Sigh.

I know this isn't exactly relevant to these views from sickbeds (which are excellent reads by the way) but the never-ending reification of the market pisses me off.
posted by knapah at 5:44 AM on August 18, 2009 [8 favorites]


decreed hastily out of Washington

If by "decreed" you mean "grotesquely watered down and no doubt likely to end more so once at least 4 House Committees and the Senate get done arguing it out, partly due to a month of enduring getting yelled at and threatened by slightly off-kilter people who have been misled by the extreme dishonesty of the media and Republican leadership" and by "hastily" you mean "they wanted to do it before August but then didn't, and that's ignoring the fact that we've been having this fight since 1993," then sure, sounds about right.
posted by naoko at 6:07 AM on August 18, 2009


> Who says "stories like that are common?"

I think part of the reason American conservatives get so worked up about the prospect of public health care is because they don't like to be reminded that poor people exist.
posted by The Card Cheat at 6:07 AM on August 18, 2009 [5 favorites]


...that's ignoring the fact that we've been having this fight since 19933...

FTFY
posted by DU at 6:09 AM on August 18, 2009


> Um, at least these anecdotes actually happened.

I'm kind of surprised no-one on the right dusted off the one about babies being tossed out of incubators, which, like, totally happens all the time in Canada and France.
posted by you just lost the game at 6:10 AM on August 18, 2009


I think part of the reason American conservatives get so worked up about the prospect of public health care is because they don't like to be reminded that poor people exist.

...outside the penal system.
posted by gman at 6:13 AM on August 18, 2009 [2 favorites]


Conservatives don't necessarily want poor people in jail. They want them either in jail OR strapped to a chair at an assembly line, manufacturing money. For conservatives.

Which is another reason they are being typically short-sighted on healthcare. Poor people spending less money to stay healthy means lower manufacturing costs for longer total working years! It's win-win!
posted by DU at 6:19 AM on August 18, 2009


I think part of the reason American conservatives get so worked up about the prospect of public health care is because they don't like to be reminded that poor people exist.

...outside the penal system.


... and the ones that clean their house, take care of their kids, bathe their mother in the nursing home, mow their lawn, bag their groceries...
posted by Pollomacho at 6:19 AM on August 18, 2009


..that's ignoring the fact that we've been having this fight since 19933...

FTFY
posted by DU


No doubt.

"The health of American children, like their education, should be recognized as a definite public responsibility...About 1,200 counties, 40 percent of the total in the country, with some 15,000,000 people, have either no local hospital, or none that meets even the minimum standards of national professional associations. "


- Harry Truman, 1945


To the Congress of the United States:

An all-directions reform of our health care system--so that every citizen will be able to get quality health care at reasonable cost regardless of income and regardless of area of residence--remains an item of highest priority on my unfinished agenda for America in the 1970s.

In the ultimate sense, the general good health of our people is the foundation of our national strength, as well as being the truest wealth that individuals can possess.

Nothing should impede us from doing whatever is necessary to bring the best possible health care to those who do not now have it--while improving health care quality for everyone--at the earliest possible time.


- Richard Nixon, 1972
posted by vacapinta at 6:20 AM on August 18, 2009 [3 favorites]


Let's make sweeping, one-size-fits all changes for the whole country

It's not a forced policy.
It's not a forced policy.
Get it?
You don't have to take it.
Not forced.
Get it?
How about now?

Now?

Still haven't gotten it yet?

being paid for we-don't-know-how

Sure we do. Maybe the problem is you've had your fingers in your ears yelling LA LA LA I CAN'T HEAR YOU the whole time.

possibly stifling all the drug development and device innovation

Come again? How's that work? How does innovation get stifled? What... uninsured people get coverage and all-of-a-sudden the capitalistic will to innovate and make a buck suddenly shrivels like your testicles? Get real.
posted by Civil_Disobedient at 6:24 AM on August 18, 2009 [7 favorites]


> ...outside the penal system.

I also forgot the military. Now if only they could bring back debtor's prisons...
posted by The Card Cheat at 6:28 AM on August 18, 2009


Who says "stories like that are common?"

Thanks, Faze - they say that laughter is the best medicine, and you never fail to provide it in threads like these.
posted by rtha at 6:30 AM on August 18, 2009 [1 favorite]


I'm just laughing at the thought of some huge cadre of scientists, all toiling away, and then the news comes across the wire that a single payer system has been introduced.

"WHAT!" they yell, "well... well... that's IT!" And then they drop their instruments, rip off their lab coats and throw them to the floor, cross their arms and sulk with a big pouty face.

"I'm not going to do NO MORE SCIENCE until this gets overturned!"

Yeah, that's totally realistic.
posted by Civil_Disobedient at 6:32 AM on August 18, 2009 [7 favorites]


Look, it's very simple. When poor people are suddenly able to pay for life-saving advances, the demand goes up. When demand goes up, prices fall. It's economics.
posted by DU at 6:42 AM on August 18, 2009


To distill it down to one comment: "Your health care is already rationed, dumbass. It's just that you will have no idea until you actually claim whether you're subject to rationing or not."
posted by aeschenkarnos at 6:49 AM on August 18, 2009 [6 favorites]


Having found out a bit more about this new healthcare reform in the US, it's not even vaguely comparable to the NHS (now or 1948).

It's far more like the 1911 National Insurance Act. Guys, we did this before women had the vote, before we had decimal currency, while we still had an Empire for heaven's sake!

Nearly a century. People like Faze, do have a think about exactly how backward you are when you make Edwardians look progressive.
posted by Coobeastie at 6:51 AM on August 18, 2009 [8 favorites]


So, just in case the yelling, screaming, and lying doesn't completely intimidate healthcare reform supporters, it appears some folks are using other tactics.
posted by Thorzdad at 6:57 AM on August 18, 2009 [1 favorite]


I am fortunate now that I work for a company that provides decent health insurance, but going from one job to the next is highly dependent on the level of coverage I can expect to get.
~~
I’d like to get off that Gerbil Wheel and start a business of my own. (How supremely Republican, no?) There’s only one reason I don’t: healthcare.
~~
Without the medication, she could never get and hold a job. Without a job, she can't afford the medication.

I'm not going to say that single-payer healthcare would radically transform the labor market in the US, but...
posted by uncleozzy at 6:58 AM on August 18, 2009 [1 favorite]


i liked the ones illuminating the non-transparency of health care costs, i.e. "how can we expect the market to work when the consumers don't get to know the price BEFORE consuming?"

well: "the insurance companies don't have much of an incentive to bother"

in fact: "powerful institutions that dominate the health-care landscape ... are often looking to protect themselves from competition."

that's why: "Anyone following this issue closely can see each modest attempt at progress is quickly submerged by an inundation of non-coherent nonsense."
posted by kliuless at 7:01 AM on August 18, 2009 [1 favorite]



I'm just laughing at the thought of some huge cadre of scientists, all toiling away, and then the news comes across the wire that a single payer system has been introduced.

"WHAT!" they yell, "well... well... that's IT!" And then they drop their instruments, rip off their lab coats and throw them to the floor, cross their arms and sulk with a big pouty face.

"I'm not going to do NO MORE SCIENCE until this gets overturned!"

Yeah, that's totally realistic.


It's amazing how often neo-conservative theories that are supposed to rest on individuals as rational actors actually rely on complete irrationality, both in theory and practice.
posted by Happy Dave at 7:16 AM on August 18, 2009


Well, policy by anecdote, that makes real good sense.

Yeah,the "death squads" totally weren't an anecdotal thing.

Oh, wait.
posted by EmpressCallipygos at 7:24 AM on August 18, 2009 [1 favorite]


...possibly stifling all the drug development and device innovation
In the same way that a single-payer defense system has stifled weapons development and innovation?
posted by Thorzdad at 7:24 AM on August 18, 2009 [9 favorites]


... and the ones that clean their house, take care of their kids, bathe their mother in the nursing home, mow their lawn, bag their groceries...

Dude, those aren't poor people... they're entrepreneurs... they're millionaire seeds.
posted by Rat Spatula at 7:28 AM on August 18, 2009 [1 favorite]


I have a funny story - well, funny now - about being ill in France without insurance. I was working there at the time on a student programme. When I got there, I was issued with a temporary resident's card, which I would have to upgrade myself to a more permanent version for the princely sum of £15. I bought the £15 stamp necessary to do this but never filed the paperwork.

Which meant, unbeknownst to me until it really mattered, that I wasn't entitled to the free reciprocal healthcare that a UK citizen ordinarily gets.

Anyway, this doesn't matter because I can count on one hand the number of times I've been to a doctor. And then, one Sunday, I fall ill. I lived in a pretty hilly bit of town and my flatmates advise me the nearest hospital is half a mile up the hill. So off I trudge, only to find - this being France - that it is shut. Instead I get directed to a teaching hospital 3 miles away at the other end of town.

An hour or so later I arrive at the hospital, one of a pair of adjoining teaching hospitals. They take one look, check my temperature and tell me I'm going to be in for a couple of days. But I need to go to the next door hospital, they say.

No problem, I say. I'll pop over. They insist this isn't possible now that I'm officially in their care and I'm put in one of those old skool, very long Citroen ambulances. As I'm lying there, I can clearly read the price list. £35 or so for a journey of under 2km, double rates for Sundays and public holidays. A comically short 100m ride down a parking ramp, along a road and up another parking ramp costs me £70.

Still, it was a breeze compared to the £1,000 or the hospital stay ended up costing me.
posted by MuffinMan at 7:37 AM on August 18, 2009


Well, policy by anecdote, that makes real good sense.

You raise a valid point. Humans, being what they are, are sometimes swayed more by individual stories than by statistics. It's why "person killed by shark attack" makes national news, but "30,000 Americans killed in auto accidents this year" seems to be barely worth mentioning.

In fairness, it's a tactic used by both sides. Find a single person who had to wait hours for emergency room treatment in Canada, and you'll never hear the end of it from opponents of health care reform.

But you're right that policy should be based on the big picture, not a handful of heartbreaking anecdotes. So let's look at some actual numbers.

Once you're inside the incredibly complex world of hospitals and medicine, you are amazed that any of this happens at all, much less that it should occur with the real efficiency and effectiveness that it does for 90 84.2 percent of the patients in the US.

Fixed that for you. And even that is assuming that those who are insured don't have problems getting treated anyway, which some of the anecdotes might give us cause to doubt, but let's go with that for now.

So now we have an actual number for the US, rather than mere anecdotes. I eagerly await your presentation of the percentage of people unable to receive necessary medical treatments in Canada or France or the UK or Sweden or Ireland (which, you'll recall, McCain praised in the 2008 presidential debates for its low corporate tax rates) or whatever other developed country you want to choose.
posted by DevilsAdvocate at 7:56 AM on August 18, 2009 [2 favorites]


MuffinMan did you tell them you didn't have French health insurance? When I did, fully intending to pay (I had a similar experience my first month as an exchange student), they later shooed me out the door with a smile and a wink: "we never saw you, we don't know who you are." What they had done was, in fact, to not document me. If at no point you tell them you're uninsured, however, they start putting info into their automated system and indeed, they can't get you back out, and so you're billed because, well, that's how it goes. For someone enrolled in French health care, everything on your bill would have been covered 100%.
posted by fraula at 8:05 AM on August 18, 2009 [1 favorite]


But statistically, how common are they?

You know, I hear you. I'm one of the first to stand up and ask for data when I hear that everyone knows that X is true.

The current system does work for most people. But I still think it needs to be taken out back and shot, and replaced with something better that works for everyone.

Many of you feel bad for this lamp. That is because you're crazy. It has no feelings. And the new one is much better.

Your IRS analogy is a good one, and it made me think. But I still disagree. Money is mundane. Health care is qualitatively different. You can make me choose between cable TV and the tax bill. But I don't want to choose between cable TV and a tooth extraction.
posted by Cool Papa Bell at 8:06 AM on August 18, 2009 [2 favorites]


fraula - no, I didn't. I had vague recollections that I might not be insured, but still thought I could wing it. In the event, I couldn't submit the paperwork retrospectively and I ended up getting the whopping bill.
posted by MuffinMan at 8:09 AM on August 18, 2009


I try to stay out of the healthcare threads, because it isn't my fight. But I read some of those stories and damn, was really moved. The Australian Medicare system isn't perfect, but I've never felt like I was on my own when it came to consultations or getting treatment. If anything, I've been over-serviced: I'm currently dodging phone calls from my doctor who wants to schedule a check-up (I should go, but can't be assed driving over there).

Just do it. You'll love it. The cost of the program will be offset by the increased productivity of a workforce that can get the treatments they need when they need them, and the corresponding decline in the number of people getting a government disability check. If there's any leftover shortfall, just tax Faze.
posted by Ritchie at 8:12 AM on August 18, 2009 [3 favorites]


Look, it's very simple. When poor people are suddenly able to pay for life-saving advances, the demand goes up. When demand goes up, prices fall. It's economics.

Uh....did you fail econ, by any chance?
posted by nasreddin at 8:32 AM on August 18, 2009 [4 favorites]


Not to derail much. But, fraula and MuffinMan: I understood my European Health Insurance Card (provided free to me by NHS) would cover me if for example I had a medical issue while in France. So I'm not understanding why you had to pay at all...
posted by vacapinta at 8:47 AM on August 18, 2009


vacapinta - my tale of woe is from the mid-nineties: it predates the EHIC. At the time, you could take an E111 form abroad, which did roughly the same sort of thing. But which explicitly did not apply for residents (as opposed to visitors.
posted by MuffinMan at 9:00 AM on August 18, 2009


"Hey, here's a good idea, why don't we start an anecdotal thread of people's stories of horrible, life-destroying encounters with the IRS? . . . Would that motivate the government to do anything about federal tax reform?"

Clearly, we need to restore our country to the intent of its founders!

For example, Benjamin Rush, one of the signators of the Declaration of Independence, also founded the Philadelphia Dispensary, where he and many other doctors provided free medical care for the poor... with financial assistance from the local taxpayers!

Or Benjamin Franklin... who, like George Washington, was an early advocate of free public schooling, and who helped found Pennsylvania Hospital "to care for the sick-poor and insane who were wandering the streets of Philadelphia"... with the hospital's grounds and building paid for by the taxpayers!

Or, of course, we should look to Thomas Jefferson, the author of the US Constitution, for his sage advice on taxation and socialism, when he said:

"This . . . led me into a train of reflections on that unequal division of property which occasions the numberless instances of wretchedness which I had observed in this country and is to be observed all over Europe. The property of this country is absolutely concentered in a very few hands. . .

I asked myself what could be the reason that so many should be permitted to beg who are willing to work, in a country where there is a very considerable proportion of uncultivated lands? . . . I am conscious that an equal division of property is impracticable. But the consequences of this enormous inequality producing so much misery to the bulk of mankind, legislators cannot invent too many devices for subdividing property. . .

Another means of silently lessening the inequality of property is to exempt all from taxation below a certain point, and to tax the higher portions of property in geometrical progression as they rise.

Whenever there is in any country, uncultivated lands and unemployed poor, it is clear that the laws of property have been so far extended as to violate natural right. . . .

It is too soon yet in our country to say that every man who cannot find employment but who can find uncultivated land, shall be at liberty to cultivate it, paying a moderate rent. But it is not too soon to provide by every possible means that as few as possible shall be without a little portion of land.


Don't like public services and programs designed to help every American own a home, have a healthy family, a good education, a bit of money, and some dignity in life, paid for by a progressive tax system, as our Founding Fathers intended?

Then leave! Go to Somalia, you Libertarian!
posted by markkraft at 9:39 AM on August 18, 2009 [35 favorites]


Who says "stories like that are common?" That there are stories "like that" is well known -- and no one knows it better than people who work in health care. But statistically, how common are they?

Just out of curiosity, Faze - how many anecdotes does it take to make up a trend?

I'm just curious what the exchange rate is you're using.
posted by EmpressCallipygos at 12:48 PM on August 18, 2009


Seems the highest bracket, 40%, is the one that always gets quoted in the American press, when in reality, the majority of people are in the 14% and 30% brackets here

The highest tax bracket is the only one ever discussed in the American press, regardless of which country they're talking about. The modern press in America is a massive PR machine that works very hard to make sure people think their best interests are the same as the billionaires who own the media.

The USA has fully embraced feudalism, while publicly portraying it as capitalism. Those born into the aristocracy trade positions governing the large corporations and run them like fiefdoms, using their governorship to extract as much wealth as possible from their subjects. The difference between now and the dark ages is that public disinformation has been very effectively employed to keep the masses worshiping the aristocracy and defending their interests.
posted by heathkit at 12:57 PM on August 18, 2009 [10 favorites]


> possibly stifling all the drug development and device innovation that allows countries with socialized medicine to offer laparoscopy for burst cysts, and other advanced care, at reasonable costs, and take credit for having better health care than the U.S."

What a very ridiculous and insulting sentence. You'll be amazed, I'm sure, that medical innovation did not stop in Canada after the introduction of our current health care system in 1966. And even better, more of our population can actually, you know, ACCESS that medical innovation. What a concept!

Someone in another thread said that people who live in countries with universal health care must want to point and laugh when they read about the American system. Well, reading these stories definitely does not make me want to point and laugh. It makes me want to cry. The stories on that blog read like scary dystopian science fiction to me. I literally cannot relate to those experiences.

I spent some time the other day trying to wrap my head around the concept of a "pre-existing condition exclusion." I still don't really understand. Someone who already has a serious health problem is apportioned LESS help with their medical care, not MORE? That's just evil. It should be illegal.
posted by hurdy gurdy girl at 1:54 PM on August 18, 2009 [7 favorites]


I spent some time the other day trying to wrap my head around the concept of a "pre-existing condition exclusion." I still don't really understand. Someone who already has a serious health problem is apportioned LESS help with their medical care, not MORE? That's just evil. It should be illegal.

And not only is your specific pre-existing condition excluded, but any tangentially related conditions will usually also be excluded. For instance, my parents applied for a new health insurance plan years ago, and because my mother had uterine fibroids (benign tumors that 20-40% of women have), the insurer refused to cover not only the fibroids, but any "female" disorder, up to and including breast cancer.
posted by Blue Jello Elf at 4:00 PM on August 18, 2009 [1 favorite]


PenDevil: corporations in the US[...]Why do they not realise that a productive, healthy workforce who can take a few hours off and go to the doctor at the first sign of sickness instead of passing out on the factory floor and being rushed to the ER is a whole lot better
From an article linked from How American Healthcare Killed My Father (three threads up)

"he met with a coalition of large employers known as the Leapfrog Group. It included companies like General Motors and Verizon, which were seeking to improve the standards of hospitals where their employees obtain care. Within weeks, the coalition announced that its members expected the hospitals they contracted with to staff their I.C.U.s with intensivists."

Which doesn't dispute the lock-in argument (which I agree with and make me thankful for HIPAA's portability part), but does show that it's possible to be a conservative corporatist and not a short-term focused moran.
posted by morganw at 4:17 PM on August 18, 2009


> because my mother had uterine fibroids (benign tumors that 20-40% of women have), the insurer refused to cover not only the fibroids, but any "female" disorder, up to and including breast cancer.

Your poor mother! That is absolutely criminal. It boggles my mind.

I have those fibroids too. However, instead of being refused health insurance it means I'm eligible for precautionary ultrasounds every couple of years to make sure nothing's getting out of hand, and surgery if it gets serious. At no extra cost to me. I hope it doesn't come to that, but at least I won't have bankruptcy to worry about on top of everything else if it does.

I'm not mentioning this to rub it in, but rather to say to those who are being warned against Canadian-style healthcare--don't be afraid! Change is scary, but I promise, getting away from this awful private health insurance system you've got now can only be an improvement.
posted by hurdy gurdy girl at 4:41 PM on August 18, 2009 [1 favorite]


At free clinic, scenes from the Third World

Final day at free clinic
posted by homunculus at 8:51 PM on August 18, 2009


Man... seriously you guys, please stop replying to Faze. Every single comment I have seen him post, in any thread, has been such a blatant and deliberate troll that I think "No way is he getting away with that one." And yet people just feed him every time.
posted by rifflesby at 9:48 PM on August 18, 2009


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