Health emails from US voters overload fed website

The US debate of health care reform led to a flood of emails from constituents that swamped the House of Representatives' primary Web site, the AP reports. Sys admins issued a warning that the house.gov site might be slow in responding on Thursday, blaming a huge flood of webmails on Thursday. Traffic data is not immediately …

[OmniCitadel]

The media = Fail

Ok being a yank, All I want to know is how much does it cost me not every one... and If I break my leg, need a bigger dong, or I have the sniffles how much it costs me... I have yet to see this and that is frustrating. Just tell me how much... at $125 a month for health insurance right now I find it hard to belive it could get worse...

[Eddy Ito]

Typical politics

Here in the US, the right portrays it like Obama wants nationalized health care and the left says it is really private care and not much different from what we have. Comparisons to the UK health system are completely pointless because the Democrat plan is much closer to what we have here in Massachusetts which is a mandating of health insurance paid for by the individual. Where I am, you, your employer or both pay for the insurance or you are fined $1000. I don't know what the fine is for the employer but I shudder at the thought of the costs to a small mom and pop operation.

It's funny how much offense is taken at the smoke and mirrors generated by our two party political cartel.

[Jesse Dorland]

Windows NT at its best

This is why we should all switch to linux, or better yet save some money and buy OSX matte screen laptop.

[Michael C]

What?

The number was for ONE REPUBLICAN'S office, not the ENTIRE Whitehouse.gov email system...

[Anonymous Coward]

Grunting thoughtless morons

America yet again proves that it's the most backward and uncivilised country in the first world.

[Chris C]

Why don't they want national health care?

For those people (especially the Brits) wondering why those silly Americans don't want a national health care systems, I can only speak for myself, but here's my take. I live in Massachusetts, the only state (that I'm aware of) which has mandated that all state residents must purchase health insurance if it's "affordable". They do not define "affordable". Instead, they ask you questions and then tell you if you can "afford" health insurance. If they feel you can afford it, you are forced to pay whatever the insurance company wants to charge you (the rates are not regulated). The last time I checked, the State determined that anybody earning $32,000 per year (about $16/hr) could "afford" health insurance.

Now, let's discuss finances. At $32000 per year, you'll pay approximately $8000 in taxes, leaving about $24000 for expenses. Rent will cost between $8400 and $18000 depending on where you live, leaving you with $6000 to $15600 for heat, electric, car payment, car insurance, car maintenance and gas/petrol, rental insurance, food, phone, cable, and Internet access. That, of course, assumes no entertainment and no savings. As a single person living on my own ($1000 rent, no car payment, and no cable), my expenses are about $24180 per year ($2015 per month) -- again, with no entertainment and no savings. The end result is that I have literally no money available for anything, but the State says I can "afford" health insurance, so I now have to pay a private insurance company $3024 per year ($252 per month). To add insult to injury, the insurance companies are constantly decreasing the prescriptions they cover (they won't cover a prescription if a similar product is available over-the-counter, even if the active ingredients and/or dosages are different). Let me take this time to point out that it's a federal crime to use medications in ways other than the directions state. So in order to get your prescription strength from an over-the-counter medication, you need to take twice the recommended dosage (or more), which is a federal crime.

One of the reasons I'm so against this is because the Massachusetts lawmakers forced this through by saying it would get more people off of MassHealth (the State-funded insurance for low-income people) while the actual text of the law explicitly states that MORE people will be on MassHealth (thus draining the State funds even quicker).

Another reason I'm against it is that people on the State-funded insurance get BETTER coverage than I get. Their co-payments are less, their cost for prescriptions is far less ($3 for a brand-name prescription, whereas I would be charged $50), and more services are offered on their health plan. So why am I paying $252 per month to get FEWER benefits than someone paying ZERO?

But the primary reason I'm against this is that I don't go to the doctor. I can count on one hand the number of times I've been to the doctor in the past 20 years. And yet, because the State wants to give the private insurance companies more money, I'm forced to pay them for receiving literally nothing. And yes, the law explicitly states that the purpose is to force people who would not normally buy insurance to contribute to the risk pool, thus easing the burden on the PRIVATE, FOR-PROFIT INSURANCE COMPANIES' finances.

Actually, that last part is what bothers me the most. The State is using a State law to force me to give my hard-earned money to a private, for-profit insurance company. If this was a State-run or even State-regulated program, it might be different, but it's not. The State merely tells me that I have to give my money to the insurance company, and the insurance company is allowed to do whatever the hell it wants, and to cover (and not cover) whatever the hell it wants.

And THIS is the program that Obama wants to structure a national health care system after. I'm not opposed to a system such as that of Canada or the UK. What I AM against is the government forcing me to give my money to a private, for-profit company without sufficient reason. Some people may compare it to auto insurance, but it's not the same. If I fail to purchase auto insurance and I hit someone, then I have injured them financially. If I fail to purchase health insurance and I get sick, then *I* am the only one injured. If we have a national health care system, it should be run or regulated by the government instead of by private, for-profit insurance companies who can (and do) constantly raise their rates without justification (a 20% year-on-year rate increase is not uncommon).

[Anonymous Coward]

Why does Fox hate America?

It's a fake grass roots campaign run by rich Republicans allied to the Health lobby.

http://www.youtube.com/watch?v=Ct--N3hJfxs

This group (including 'Tea Party Patriots', the Fox' previous attempt to attack Obama with a fake grass roots campaign) is one of the major players.

They bus screaming Fox extras around to disrupt meetings. The company behind it has successfully run many such 'grass roots' campaigns.

Once again I ask the question, "Why does Fox hate America?" and why aren't the CIA and NSA taking a damn close look at Murdochs empire and the agenda he's running.

[Steve Cragg]

@OmniCitadel

To answer your question is rather difficult, as it's all based on taxes and therefore a percentage of your earnings. So it could be $50 or $500 - at least for the UK system. Though over the recent governments it's become more and more blurred (as in where the taxes actually go to). However, removing that issue, going to see a doctor under the UK healthcare system would cost you no money "upfront". Going to the hospital for a broken leg would cost you no money "upfront" - as in you have already paid for it.

There is also one thing which isn't talked about allot lately and that is with the NHS you simply turn up, get your treatment and leave. There is no paperwork to fill out, no justification either. You need it, you get it. Though there are some situations (mainly with regards to new drugs) where you don't always get what you want. Want being the operative word.

Also remember that we (UK) don't get the medical adverts like the US. We get Over the Counter adverts, but anything which needs a prescription is never advertised to the general public - so we are reliant on the doctors and not advertisers.

There's also that peace of mind that if we need health care urgently, it's there. People complain about waiting times, and it's probably true, but for anything serious you get the support you need.

You asked about breaking your leg etc.... Well, here's my experience with the NHS.

Mother wakes up one morning, walks down the stairs, promptly collapses in a heap. Step-father calls emergency services (999). Ambulance arrives in less than 10 minutes time. She's at the hospital in less than 20 minutes time. It's determined that she has just suffered a burst brain aneurysm and given drugs for treatment. She is placed in a high intensity unit and watched over for two weeks.

She gets worse and is transferred to a specialised hospital for treatment. She lapses and goes into a coma and is placed into a unit where there are 4 patients and four (always in the room) nurses and two doctors. She exits the coma - of sorts. She is then in surgery for an operation (coil placed at the point of the burst) which is carried out by the surgeon who invented this procedure.

She remains in the same unit for another 2 weeks and then placed in a general unit for another month for observation. She is released afterwards but given 6 months care support for rehabilitation.

Cost? Nothing (except obviously for the taxes paid).

Paperwork? None.

Peace of mind? Definitely.

Saved her life? Absolutely.

The NHS ain't perfect - no-one is saying it is. But having that safety net, no matter what situation you are in (either rich or poor) is something i would never want to have without.

[Anonymous Coward]

Oh boy

Hey, I am a 37 year old male with a wife and two kids. I pay $1,600 a month for my private health insurance. I've been told in the fall that because my wife weighs too much they are dropping us so I'll have no coverage. I am strongly in favor of ANY change!

[Anonymous Coward]

Health Insurance

One thing to note about the US health insurance system is that it is geared towards paying big bucks for big operations which ups the premiums and makes it more unaffordable for the poor. The UK system doesn't encourage big bucks for big operations and ensures that all can have an operation, not just those who can afford it (who can go private if they want).

[Anonymous Coward]

@Chris, lets crunch the numbers

http://www.william-russell.com/individualsandfamilies/global-health-insurance/compare/

This is a typical global nomad health care plan. We buys these because we are international workers and need global cover.

You'll notice that by default the US cover is EXCLUDED, this is because it's ridiculously overpriced for the same level of cover.

Lets try, a 50 years old, living in UK silver plan WITHOUT USA. US$439.92 per month

Now lets add 90 days visit to the US maximum limit $250k the quote jumps to US$1,018.33 a month.

Yes to add a 90 day cover for the US, would DOUBLE THE PRICE FOR INSURANCE! To add 360 days would presumably add $2000 PLUS to PER MONTH, just for US cover!

I get cover in Europe with it's excellent hospitals for $439, but the US, it would cost $2500!

So you see the problem with the US, you have piss poor healthcare and nobody can afford it. It benefits the health lobby, and they want to keep their prices 5x the rest of the worlds, even if it means disrupting meetings and straw men arguments (like the one you raised).

[W]

FUDathon

If Chris C's description is even anywhere close to the truth, all this talk of the US going for an NHS-lite seems like quite the red herring and I can see why the proposals haven't won everyone over. It sounds like such a half measure.

Though I'm not sure I want to see the GOP reaction to proposals for an NHS-lite if the current system of insurance is peversely being portrayed as a benchmark of freedom and liberty.

Based simply on Steve Cragg's anecdote, you'd think the NHS model would be an utterly easy concept to 'sell', eh?

The whole thing seems to have degenerated into a big, weird FUDathon.

[johnjgr]

Real Problem

In our debate the real problem is not addresses by our US Congress. They want to take over the Health business to control costs. The bills proposed do not do this, they hey just change who administers it. So why change other than to give power to the central government. It is a debate over power

There is one item that could be fixed but our congress will not even talk about it. This is the malpractice insurance each hospital, Doctor, drug company need to do business. The insurance takes about one third of a doctors income. People are sue happy because with our system they usually win large amounts or settle for large amounts of money.

Until there is true tort reform over here the cost of health care will be high no matter who runs it. .

Looking at the numbers posted I think they are about right. Our costs are actually less expensive than the European numbers I see when the necessary malpractice money is removed.

[Tom Paine]

@AC at 14th August, 21:45 GMT

> I've been told in the fall that because my wife weighs too

> much they are dropping us so I'll have no coverage. I

> am strongly in favor of ANY change!

>

Sorry, but am I the only one thinking the change you need is to trade in your salad-dodger? Paris is looking, I hear

[Chris C]

@AC 22:05

"So you see the problem with the US, you have piss poor healthcare and nobody can afford it. It benefits the health lobby, and they want to keep their prices 5x the rest of the worlds, even if it means disrupting meetings and straw men arguments (like the one you raised)."

Would you please kindly inform we what "straw man argument" you think I raised? I know the US health care system is piss poor and that few people can truly afford it. I know it has a lot of problems caused by over-inflated doctor fees, hospital fees, pharmaceutical fees, etc. I know that some of those fees are because of this country's insane payouts in malpractice cases, making mandatory malpractice insurance for doctors and hospitals outrageously-priced. I know that the current health care system only benefits the doctors, insurance companies, and pharmaceutical companies.

Personally, I find it ridiculous that an insurance company may cover a hospital but not all doctors located within, or that it may cover a doctor but not the hospital they work in. I find it ridiculous that when you go to the hospital, you get a bill from the hospital, from the doctor, and from the lab which did your blood work. I find it ridiculous that I pay $252 per month for insurance when my plan has a $2000 deductible, meaning insurance will only cover things AFTER I have paid $2000 out-of-pocket (in addition to the $252 monthly premium). I find it ridiculous that the insurance companies are allowed to raise their rates by any amount they want. Lastly, I find it ridiculous that an insurance company can refuse to cover treatment for a specific illness (such as cancer or HIV), claiming it's a "pre-existing condition".

In case you misinterpreted my point, I'm not against health care reform . Trust me, I'm FOR health care reform. My point was that the system this national plan is based on has nothing to do with reform, and everything to do with artificially propping up the insurance companies' finances by keeping the existing system, but forcing everybody onto it. My point was that any mandated health care system should not be run by private, for-profit insurance companies who only care about maximizing their profits.

[JohnG]

Private vs. NHS

As a Brit living and working in Germany, I have experience of both the NHS and private medicine with private insurance. For starters, the private route is expensive because the doctors charge more for private treatment. Whilst tax payers have to pick up the tab for the medical costs of those who aren't contributing, the costs in the private systems seem to be much higher.

I found the NHS to be better in that they have a view of my total healthcare whereas the private system sees everything in terms of each insurance claim (and whether or not a condition or treatment is covered). Under the private system, doctors are keen to run up the bills and may even "try" several treatments before hitting one what works. This not only results in bigger insuranc claims but also, more time off work - bloody useless if your are a freelancer. The private schemes seem to get flaky in the area of incurable conditions and long term care.

I think the NHS would be better if the costs were separated from general taxation i.e. run as a real state insurance scheme with NHS costs spread amongst tax payers in a distinct charge.

My personal preference is for NHS with supplementary private insurance - it offers everything the private systems in Germany have but costs less and doesn't have limitations for long term or incurable conditions.

I don't know what the best solution is for the yanks - maybe they first need to reduce the excessive costs of their healthcare (when compared to other developed countries).

[Anomalous Cowherd]

Astonished

As a UK-based outsider looking in to this debate in the US, both I and everyone I know are simply astonished. We just don't get it. Here, you pay taxes so if you get sick, you get treated. It's as obvious to me as the right to a fair trial or the right to vote - it's a right, not a privilege, and the odd newsworthy failure doesn't lessen that.

For me the lasting impression I have watching this debacle play out is how the more god-fearing christian you are, the more you're prepared to let your poorer neighbour suffer in the name of lower taxes.

[Eddy Ito]

RE: W

Chris C is pretty much on the mark. You can check his numbers yourself. Simply go here:

https://bluecrossma.inshealth.com/ehi/CoBrandHomeWelcome.ds

plug in 02110 for the zip code, Boston. Then on the next page select "male" and enter a birth date such as 07/04/1970 and notice the cheapest option is about $265 per month. Here is a shortened link to the penalty phase, http://tinyurl.com/kw83dn

In short, if Chris C makes $32,500 and doesn't get coverage or even has a lapse of coverage for about two months, he will be fined over $1000.

Chris C, do what I do, pay the $1068 to the state and assume that gives you state coverage since you are paying for it. It's a lot cheaper than the $3180 Blue double Cross charges.

[Andus McCoatover]

Gordon Bennett!!!

I used to work in Camberley, UK, with a mate. We went our separate ways, me to Finland, he to Irving, Texas.

Met up with him on a business trip to Irving. On chatting, he told me he'd been in hospital a couple or so days for some leg problem. Now, I don't have the exact figures, but his total hospital bill was something (IIRC) of the region of $100,000. With insurance, that got down to $20,000. Our employer's 'cover' (ex-employer who makes the occasional saleable mobile phone, and whose operating system name should not be misspelt*, lest it be mistaken for a sex toy) got it down to $2,000. Which he personally had to pay from his own pocket.

Funny, I said. "I had had tooth root canal dentristry§ in Finland recently, and it cost me eleven".

He commented, "$11,000 - that's fairly cheap".

"Nope", I replied, "€11. Paid from the coins in my pocket. Price of a couple of beers".

('course, getting a new crown fitted's gonna cost a couple of hundred, but as I have one foot in the grave, and the sex appeal of a roadkilled squashed frog, why bother...few more bevvies)

Now, THAT'S a healthcare system.

PS - ex-missus got both hips replaced recently. Nowt, nada, nothing (except the hospital food bill - few bucks a day)

Suck on that, Obama!

§ Alright, anasthetic is an extra, but being a Big Boy, I didn't cry. Pissed meself, tho'. Fuc*king agony!

*OK, Symbian. Toss (titter!) out the 'm' and - google's your friend...)

God, I should write for this rag, I crease myself up, I really do!

[Dave 3]

Storm in a thimble

Fraser Nelson points to a 2007 OECD survey that found 57% of Britons thought the NHS needed 'fundemental changes'.

http://www.spectator.co.uk/coffeehouse/5266698/why-we-need-a-proper-debate-about-healthcare.thtml

And did the 'we love the NHS' thing really give twitter a problem? Dizzy says it was planned maintenance:

"...I say alleged Twitter crashing, simply because I'm yet to see any evidence other than the British press simply saying it happened. Meanwhile Twitter's own status pages warn of system maintenance and service degradation during the time of the supposed “crash” inspired by an outpuring of love for the NHS."

http://dizzythinks.net/2009/08/grow-up-you-morons.html

[Anonymous Coward]

Can't think of a title

In the USA: Why is everything a crisis?

The poor and the old are already covered by gov insurance. It's the middle class who (think they) get screwed.

Car insurance is mandated in every state I have ever lived in, and your car insurance will cover you (for life), for any injuries sustained in a car accident.

If you are hurt on the job, workers comp covers your medical bills.

I was raised on public assistance and was covered on medicaid at that time. I spent my 20's without any insurance (was stabbed in the kidney, and spent 13 day in the hospital during this time, broke foot another time). I have paid for private insurance from the time that I had my own children. At all times, the quality of care that I received was the same. And that quality, always depended on the quality of the doctor.

They didn't ask for insurance when I was stabbed...

With or without insurance, I have never been turned away from an emergency room. Because the fact is, they can't turn you away. If I visited the emergency room with chest pain, and I were given antacid and sent home, but found later that I was having a heart attack... I could sue both the doctor and the hospital for millions (and I would).

"I'm paying $1600 per month":

1. Shop around man. I'm paying $442 per month for a family of 5 (30% copay, $2500 max copay per year, 50% prescriptions, prescriptions don't apply to copay).

2. You're doing a great job. You're spending $19,200 per year on your entire family. For medicare, medicaid and schip, the gov is spending over $15k per year PER PERSON.

This is savings? While a gov plan may appear to save you money "this year", in a few years you will be paying gst or vat to pay for it all.

Our health care crisis is: Medicare is going broke. It's a sinking ship. If you reduce benefits for old folks, you lose the next election. The political solution is to put more people on the ship, to give them an incentive to bail the water.

The comments I've seen from UK people seem to say: I had an emergency and I got free care; you are only declined if you do something bad, like continue to smoke when you're sick from smoking.

In the US, you will get emergency treatment regardless of insurance status. But you will get a bill for it.

You can smoke, drink, or be as fat as you want. You will still get full treatment anyway, but you will get a bill. If you are on a group/employer plan, medicaid or medicare, you're ok. On a private plan, you will get kicked from the plan.

Your doctor has full individual discretion regarding your treatment. If they think you need an ultrasound, an mri, a ct scan, etc. You will get it, today. There is no other criteria needed, beyond the doctor's opinion. You will get the test even if you don't have insurance, they will just bill you later.

Canada, a couple years ago

We have friends who live in Canada, but work in the US. At about 8 months pregnant, their doctor heard some problem with the baby's heartbeat.

So they were scheduled for an emergency ultrasound... next week.

To contrast that: My wife was recently pregnant at >35 yrs old. Once she reached 6 months, she had weekly ultrasounds and bi-weekly fetal stress tests.

The Canadian couple had to wait several days, wondering if their baby was ok.

Us? We could get an ultrasound if my wife had indigestion, and I could probably throw a rock from my home and hit a clinic that would give an ultrasound "right now".

While weekly ultrasounds seems like overkill to me, it's comforting to know that we would not need to wait several days for a test if the doctor thought the baby was in trouble.

That's all we Americans want. Complete comfort and piece of mind, and we want it right now.

P.S.

And a big mac. We want a big mac too.

[Kevin Campbell]

what I want to know is pretty simple

Yank here. Kinda on the fence. I hear a lot of pro-NHS and a lot of anti-socialized medicine talk. I'm not necessarily against socialized medicine except for one very important point: rationing.

The Republicans have made much hay about eventually being forced to ration care (to control costs). They frequently point to Canada's system wherein many near the border will actually cross to the US and pay out of pocket for certain tests (CT, MRI, etc) so they don't have to wait weeks in Canada. Is that true in Britain? I'm NOT talking emergency care, here. Rather what would be classed as "urgent". Not required for life-saving, but pretty darned important - such as an MRI or CT scan of a suspected cancerous tumor, etc.

Some Republicans have made much hay about the so-called "Death Panels." To anyone quick to poopoo this idea, rationing is exactly what they are talking about. If rationing of care comes to pass, eventually SOMEONE is going to have to decide what's "worth" treating and what's not. THAT is what scares the bejesus outta me. And the potentially crippling taxes.

If the UK NHS rations care, then I want no part of it. If the UK NHS costs an arm and leg in taxes, then I want no part of it. If, however, the UK NHS does neither of those then bring it on. This, of course, will NEVER work in the US because there are too many lawyers with not enough to do, but it IS a nice dream...

[Alan W. Rateliff, II]

The real problem, dear AC's

The primary problem with the health care debate, my dear AC's, is the lies. The lie upon lie upon lie trying to push the damned thing up our collective rectum. I have already gone over them in another post and will not waste the carbon footprint to do so again.

The bottom line is the elimination of our choice. I am self-employed, and I pay for my health care insurance myself. My premiums have just barely doubled in seven years and one age bracket. I have had two major medical events, as well as several MRIs and X-rays. I pay $50 co-pay for a few of my prescriptions, $30 for a couple others, and sometimes as little as $10 (depends upon name-brand, generic, and special "prefered" medication tiers.) I pay $10 to see a doctor. I pay nothing for my MRIs or X-Rays, blood work, tests, etc. My insurance provider reimburses me for health memberships, up to $150 per year for gym memberships, etc. I also get discounts from some memberships because of my insurance. I also have secondary coverage which pays me for my annual checkups, disability, hospital stays, emergency room visits, accidents and the subsequent doctor and physical therapy visits.

So what has that to do with anything? I made the choice for this plan over several others. Sadly, this insurer is taking no position on the whole mess, but it should if it wants to survive. It also employs a large number of people locally, which would be without a job if it folded.

Oh, but you can still choose after the new plan! Not true, and if you do not believe me, go back and read Obama's lips and hear his own words and the words of the people in charge of this health care reform.

Really, I fail to see the problem here. AC, if your wife is too fat (you did not state her weight, so I have to assume, sorry,) get her to lose weight or pick a new insurer.

Yes, there are approximately 12 million "chronically" insured, which include those who may be uninsurable for extreme conditions. Let us focus on taking care of them directly; do not touch my ability to choose.

Health insurance is not a right. In fact, I believe that preventative care should be paid out of pocket and insurance should only cover anything that is not routine. The whole Medicare and Medicare system has set up a perception of entitlement to health insurance, but not care itself -- we already have that. NO ONE AMERICAN IS REFUSED NECESSARY CARE IN AMERICA.

Read that again. Because it is not just true of American citizens, but non-citizens as well. You walk into an emergency room with a critical issue and you will get taken care of. If you cannot afford your medications, there are options. If you cannot afford surgery, there are options in the family, community, charitable organizations, and even some medical providers. If you cannot afford routine care, there are free clinics all over the place.

Frankly, we do not and should not give two shits about the quality, of lack of quality, health care in other countries. We should instead focus on the fact that once the government plan becomes law and we start getting the piss taxed out of us before it goes into swing in 2013, we will lose our private coverage and our choice -- that is what The People can understand. Why destroy what works (or mostly works?) It if is broken, fix it! Our health care cannot be approached with the Wal*Mart mentality of tossing something out and replacing it if has flaws.

For Christ's sake, people. Do not just buy into the words, look at what is backing up those words.

Paris, free to make her own choices.

[PT]

@ AC: Can't Think Of A Title (9:42)

While I'm happy for you, anonymous coward, that you apparently get such good service, the experiences you relate - if true - are far from typical.

Much more typical was the experience of a friend of mine, who went to the doctor with a severe headache. The doctor referred him for an MRI, as you rightly point out he had the discretion to do. However, before the local hospital would carry out the procedure, they wanted some assurance they'd be paid, so they contacted his insurance company (HMO). The insurance company in turn contacted the doctor, who filled out the proper forms in support of his referral and faxed them back. The insurance company sent it all to one of their assessors for a final decision.

All this took about a week. On the sixth day, my friend died at the age of 36 from a brain aneurysm.

[Anonymous Coward]

@PT - pick any two

PT, I'm sorry for the loss of your friend.

In an emergency room: if the headache was accompanied by something like having recently passed out, he would have had an mri before leaving the hospital. What you wrote about, sounded like a visit to a family physician. If that Dr had thought it was an emergency, he would have sent your friend to the hospital in an ambulance.

At the end of the day, what you are complaining about, is a layer of bureaucracy that delayed the mri from "right now", to at least a week later.

That layer of bureaucracy and level of delay is nothing compared to the level of delay in Canada. In other countries (like the UK), I have no idea.

UK people: if you went to your family (non emergency) clinic with a severe headache, would you be able to get an order for an mri? If so, how soon would it be done?

Canada: The Canadian friends with the baby... that was a clear emergency. It was called an emergency by the doctor. Yet the ultrasound was still delayed until the following week. For Canadians that require an mri for things like severe back, knee or hip pain, the delay can be several months (at least it was at that time). If your friend were in Canada, I have a feeling that a severe headache would have put him in with the group of people with back pain. He would have had no chance at an mri within 6 days.

Around the same time of the Canadian couple and their baby, I had seen an article in a canadian news paper regarding a private mri clinic in either Edmonton or Calgary. That clinic would give an mri to anyone willing to pay $400 cdn, bypassing the 4 month wait for an mri in the province. For things like back pain, you needed an mri to get on the list for back surgery.

The reaction to the private mri clinic? Calls for it to be shut down. Because it was unfair and provided an advantage to those who could/would pay, because they would get on the back surgery list sooner.

So how could a business even survive, where the competition is giving the same product away for free? By doing the same thing better or faster or cheaper, and people in pain are a motivated customer. But if you're the gov and the competition is making you look bad, you can crush them through legislation, regulation, or taxation.

While I'm sure that we would get the same 2009 level of care on a gov plan vs a private plan, my concern would be that on a gov plan, we would be getting 2012 care in 2020. Lack of competition drives out innovation and use of new tech and new drugs.

In IT there is a saying that is applied to data storage, and sometimes entire systems. You can have: Good, Fast, Cheap... Pick any two.

I'd say that this applies to health care too. Long term, no system can provide all three. And you have to have some companies/countries pushing the envelope on combinations of Good, Fast, Cheap. If you don't, everything stagnates.

Note: Search google news for the words: calgary mri private. You will see results with lawsuits, supreme court decisions, banning, complaints that the local hospital mri staff quit to go work at the private clinics, people willing to travel long distances and pay for medical services, the gov trying to compete by adding two mri machines, etc.

While you are looking, please note that Canada operates as a republic, much more than the US does. Provinces have much more latitude in their own laws and regulations. So one province could have had private mri clinics, while another province could have simultaneously had a total ban on private clinics. Then the provinces fight each other in federal court.

Note: The Canadian friends lived in Windsor, owned a business in metro Detroit.

Before 9/11, we had a pretty open border here. Typical question was Citizenship?, Where you headed?, Have a nice day... People were asked for ID, maybe 15% of the time. Sometimes you would get to the gate, and you would just be waved through. So it was very easy to commute to work.

Note: I never paid my bill from the time that I was stabbed (I couldn't have)... While it stayed on my credit for 7 years, the hospital never sued me, or pursued it very hard. I had several mortgages and plenty of credit during this time. Mortgage brokers would say things like "well, it hurts you, but we don't look at medical collections too hard".

But on the other hand: If i had stumbled into a doctors office rather than into a hospital, they would have sent it to a collection agency that would have pursued it to the ends of the earth.

Note to anyone with enough spare time on their hands to have read this far: The "-if true-" from pt gets under my skin a little, and I could throw the same thing back at pt... But I'm sure that it IS true. We all know of someone who has died of something like a heart attack at 30, 35 or 40. It's always shocking, and we always feel that more could have been done by the doctor/hospital/police/ family/insurance/gov. It's a shame that it happens.

Again, i'm sorry for your friend, and the loss felt by his family and friends.

A.C.

Because everything you write on the internet lives forever, and could cost you a job 10 years from now.

[Chris C]

@AC 6:29

"In an emergency room: if the headache was accompanied by something like having recently passed out, he would have had an mri before leaving the hospital. What you wrote about, sounded like a visit to a family physician. If that Dr had thought it was an emergency, he would have sent your friend to the hospital in an ambulance."

Don't be so sure. Here in Western Mass, my sister had sharp abdominal pains one night, too severe to wait until morning to go to her primary care physician, so she went to the emergency room. The doctor told her that he thought she had appendicitis. He then sent her home, without any follow-up, prescription, or antibiotics, telling her to call (phone) the next day if the pain got worse. That was after waiting 3.5 hours in the emergency room waiting room (in which there was only one other person).

Also, for those saying that your doctor determines what test you should have, that is not necessarily true, either. Many insurance companies now require you to get THEIR approval for any tests or referrals, and, of course, THEIR doctor's opinion overrides YOUR doctor's opinion. When there is a difference of opinion, you are not given approval because their doctor (who is hired explicitly to deny claims in an effort to reduce the companies' payouts) said you don't need that test or referral.

Another big problem we have in the States is that doctors, hospitals, and various other health care workers can charge whatever they want to whomever they want. They charge a different rate depending on who pays them -- each insurance company is charged a different price for the same exact test, and an uninsured person is charged the most. Yes, you read that correctly. An UNinsured person, paying out-of-pocket, is charged far more for a test or a visit then an insurance company is charged for that same test or visit.

As for the claim that a hospital cannot turn anyone away, that is legally true. However, it only matters if law enforcement enforce it, which they do not. People ARE turned away from hospitals and emergency rooms. At least one of the news shows (Nightline, 60 Minutes, etc) actually did a story showing how one hospital was sending people away in a taxi, to be dropped off on the street several blocks away. So no, you don't get to hide behind the "they can't turn people away" line. Using that logic, we wouldn't have any murders since murder is illegal.

The biggest problem we have is that nobody wants to deal with the real issues. By and large, the Republicans are against any reform because they don't want to pay for the low-income people, and the Democrats are against any system which reduces benefits for low-income people or requires them to pay anything, and neither side is willing to compromise or even enter a rational debate.

[Anonymous Coward]

@ chris

"Don't be so sure. Here in Western Mass"

I'm sure the law and local expectations varies from state to state. I hope that your sister sued.

"However, it only matters if law enforcement enforce it,"

That's what lawyers are for, punishing incompetent doctors with huge lawsuits. I would never want to see the right to sue restricted. It's the only real protection we have... I don't buy the argument that cost would go down, if hospitals could screw up without being sued. The credit card companies told us that rates would go down, if interest rate caps were raised, and bankruptcy law was reformed. We all see where that got us.

"THEIR doctor's opinion overrides YOUR doctor's opinion"

In my state, I could still have the test, then fight the insurance company to TRY to get it covered. I'm not sure why you would think that with gov insurance, you would be able to to get any test you want, any time you want. With gov insurance like Canda, there is still someone telling you "no", or "OK - but 3 months from now".

"can charge whatever they want to whomever they want. They charge a different rate depending on who pays them"

That seems to be the real issue to me... I have a prescription that costs $100 with insurance, then I pay half... If my insurance lapses for a few days due to a late payment, the store want to charge me $270.

Also, my wife recently had about a dozen blood tests. With my insurance, I pay 30% of the final cost. When the total bill came, it was over $900. Once blue cross had knocked it down to their rate, my 30% came to something like $3.72.

To me, it is obscene that people who do not have health insurance are the ones who get charged the most. It seems very wrong. Everyone should pay whatever the lowest rate is, that has been negotiated by company X.

I'd be completely in favor of rate leveling. But it doesn't seem like the politicians in either party have the stomach to go after doctors, hospitals, testing clinics, and pharmacies. Insurance companies are an easier target, because they tell people "no". But really, they are only the middleman. It's the hospitals and drug companies who set the asking prices.