Some of my summer in France was spent listening to indignant outbursts about U.S. health care reform. The tone: “You must be kidding! What’s there to debate if 46.3 million Americans have no health insurance?”
I think the French are right. I don’t think there’s much to debate when France spends 11 percent of its gross domestic product on health care and insures everyone and the United States spends 16.5 percent of G.D.P. and leaves 20 percent of adults under 65 uninsured. The numbers don’t lie: The U.S. system is wasteful and unjust.
It’s not just the numbers. It’s the intangibles. Two of my children were born in Paris ”” a breeze. One of them got very sick on arrival in the United States ”” and my wife fainted in a doctor’s office from the anxiety of finding the appropriate care (when we did, at the eleventh hour, it was excellent). The American health system is an insidious stress-multiplier whose hassles, big and small, permeate already harried lives.
Let me tell you another French health care story. This is from a client who worked for a multi-national company in Atlanta. One of his colleagues got posted to France for two years. During that time his wife got pregnant. There was a complication with the pregnancy and to carry the baby to term she would need a caesarian section. The French doctors refused saying that was not allowed as it was too expensive. They gave her two options; have the baby premature and take those chances or they could get her an abortion. The woman instead opted to to come back to the US where she went to term, had a perfectly healthy baby by C-section, and today that child is getting ready to start school.
She had a choice, made her decision and obtained the result she wanted, not what some unknown and faceless bureaucrat dictated.
Our system is not perfect, there is room for improvement, but somehow Roger thinks having bureaucrats making our health decisions will relieve stress (actually the picture is much worse than that: it will be a computer that will spit out the decision for you—-grrandma will be unplugged by a machine!).
46 million? I thought the President said 30 million???
And people say that this is a hard, fast number! the real number once you take out the illegals, and the YUPPIES who don’t want insurance, and the number is closer to 10 million.
That is a poignant story #1; for many more stories, slightly more lighthearted because they involve a middle-aged man with diabetes and his American wife in the French system, see this blog: http://thyme2.typepad.com/thyme_for_cooking_/french-medicine/
Interspersed with very good recipes and reports on the hard work of their country house renovation, this woman from Wisconsin has revealed aspects of a thoroughly socialized medical system.
I have completely the opposite experience of Cohen’s in France, in the Australian national social medical system. And sometimes, as he said of the US, at the 11th hour we have had excellent care here. But the extreme frustration of having to follow the rabbit trail from GP through specialists (only by GP referral) and thoroughly outsourced med techs, the arcane-ness of having to pay all up-front and then waste part of a week-day filling in forms and standing in a line, er, queue to reclaim perhaps 1/3 to 2/3 of the total cost, the difficulty of getting a second opinion in tough situations like prostate diagnosis (see ‘rabbit trail’), and the lack of any minute amount of personal interest of drs. in their patients’ outcomes after, e.g., surgery, continually anger and appall me. The system is just that and is unrelentingly user-pays, set up for the protection and benefit of the practitioners of medicine and related work, including paperwork or the equivalent in computer-tending…..a big opportunity for job-creation there!
I rant and fume about it all privately; it would be very bad manners to do so publicly! I thank God every day that our very premature son was born in suburban Chicago and not here, as I think he may very well have been left to die of his RDS here, and instead he is nearly 19 – and just starting to learn his way around this system on his own. The solution to the health care provision problems in the US is most certainly not the kind of system in place in European countries, Oz or NZ or similar, and all the citizens marching and protesting the current administration’s treacherous attempts to enforce such are heroes.
TACit re [i] in place in European countries, Oz or NZ or similar [/i]
Leave NZ out of the list — there is no push here for us to shorten our lives by adopting an expensive system like in the USA!!!
And everyone — what is your response to this?
[i] I don’t think there’s much to debate when France spends 11 percent of its gross domestic product on health care and insures everyone and the United States spends 16.5 percent of G.D.P. and leaves 20 percent of adults under 65 uninsured. The numbers don’t lie: The U.S. system is wasteful and unjust. [/i]
He didn’t get onto the fact that on average you live significantly shorter lives as well …
MargaretG, here’s some comparative statistics on life expectancy at birth, from Infoplease (an unbiased source for compiling statistics); I include only the 2008 numbers, since this is the latest full year available, and focus on the British Commonwealth countries, the EU composite, and USA:
Australia: 80.6 years
Canada: 80.3 years
NZ: 79.0 years
UK: 78.7 years
EU: 78.7 years
USA: 78.0 years
I am not going to begin to argue for the adoption of a “US” system in NZ. Nor am I going to try to defame the NZ system, or for that matter the Australian system (or the Canadian, or UK…). I’ve worked with MDs from all of the Commonwealth countries, and have been impressed by their training and professionalism.
That said, when you cast aspersions on our admittedly imperfect system, please define just what you mean by “significantly shorter” lifespan. As of the end of 2008, you Kiwis were blessed ON AVERAGE with a whopping ONE more year of life than us wasteful, unjust, and benighted Yanks. And, applying the same measure, you could extend your life expectancy by 1.6 years by emigrating to Oz.
And, as has also been noted by my physician colleagues in many other postings on this topic, life expectancy and infant mortality comparisons across borders are skewed by how “infant mortality” is defined, vis-a-vis preterm vs. term infants.
I’m glad you’re satisfied with your country’s health care system. I’d appreciate a bit more fact-checking and precise definition of terms from everyone in this debate.
Okay, MargaretG, one more time. The 20% uninsured is grossly overstated. The reality is more like 4%, and we could solve that problem much more cheaply than this nightmare bureaucracy being proposed. And we don’t live significantly shorter lives, if you take out the murder rate in some very sad neighborhoods and also the fact that we report premature births as births and add those who don’t make it to the death rate, whereas Europe ignores live births with a death following. Medically speaking, an American who makes it past the delivery room does better than a European, especially when he gets cancer.
The only problem with Katherine’s analysis is that 60% of cancer patients in US are on Medicare, i.e. government health care, not private insurance.
The dramatic increase in life expectancy in the US over the last 40 years has largely been the result of access to Medicare. Before that if you were over 65 you were unlikely to have any insurance, and your treatment options for cancer, heart disease, or anything significant were very limited.
[blockquote] And people say that this is a hard, fast number! the real number once you take out the illegals, and the YUPPIES who don’t want insurance, and the number is closer to 10 million. [/blockquote]
I am really not sure of the source of that statistic, and why would “Yuppies” not want insurance? I think you mean they are not willing to pay the cost of insurance.
Unfortunately, not requiring people to have insurance leaves the rest of us holding the bag. Lets say you are a healthy guy with a low paying job and healthy wife. So you make the really dumb assessment that it is cheaper to pay for your health care than buy insurance until you get a job with coverage. Then your wife contracts cancer. It will cost hundreds of thousands of dollars to treat her and the rest of us have to pick that up by increases in our insurance and costs at the hospital as you will never be able to pay for her care. Also, she is now uninsurable and will never have insurance unless you can find an employer who can get her on a group policy, and if you ever lose that job she will lose her coverage.
My sister worked in France for a year. Her card to allow access to the French medical system was eventualy forwarded to my parents’ house a couple months after she returned. Took something like fifteen months to get processed. Happily she never got sick, one of her friends had to have cash wired from home for the doctors. But of course the tax deductions for medical care started from her very first check.
[blockquote] it will be a computer that will spit out the decision for you——grrandma will be unplugged by a machine!).[/blockquote]
While I think the hyperbole is silly, what are you saying? Republicans have been pushing for years to cut Medicare. Especially end of life care. Are you saying it would be better for grandma to never get in the door of the hospital? I guess that way she doesn’t get her hopes up.
I consider myself an independent. I am not sold on universal health care for those under 65; however, I think Medicare works unbelievably well for those over 65. For Republicans to allege Obama’s call to cut the cost of Medicare by reducing waste and fraud will lead to pulling the plug on grandma, is galling.
Republicans are the ones who want to really cut Medicare. This argument is simply dishonest. There is nothing in any proposal to reduce end of life care for seniors.
Oh, go read NEWSWEEK, Mitchell. The one with the big cover story THE CASE FOR KILLING GRANNY in nice big bold letters. Or, to save time, go here: http://www.newsweek.com/id/215291/output/print
Amazing how fast we are being moved to consider killing useless old boomers, but that could have its upside. There’s a lot of protein and calcium to be recycled in the SOYLENT GREEN.
#11 I think you are barking up the wrong tree with me. I have no desire to reduce Medicare benefits. I think it is a great program, that has extended the lives and improved the health of tens of millions of America’s senior citizens. But, that does not change the fact there is no plan to reduce end of life care for seniors, in any of the bills. I don’t care what some Newsweek reporter says about the benefits. The simple fact is Republicans are far more likely to vote for reducing end of life Medicare benefits than Democrats are. They have been fighting for years to cut Medicare benefits. So this argument coming from the right is dishonest.
Except of course that the main charge is we really have to ration care to control costs. Never mind. Somebody else will get the rationing, not (me, mine, my relatives). Yep. But the real believers in the initiative could offer themselves, I suppose. Altruism and all that.
I would love to see more of a focus on meeting people’s allegedly-medical needs that can be met in non-medical ways, like the nurse outreach program mentioned in the article. If doctors and nurses are the only people who ever visit or listen to you, of course you’re going to find reasons to see them more often.
More could be done to keep people out of the dr. office in the first place, too. I’m a Kaiser patient, and I can’t tell you how many trips to the pediatrician I’ve avoided because the scheduling is done through an Advice Nurse, who does some basic triage, gives me a virtual headpat and suggestions for home care, and then schedules an appointment for me only if it sounds like the beeb really needs to be seen. Advice Nurse is free, but an office visit is $35, so we’ve saved money as well as time, and avoided dr. office cootie-exposure (oh son, why must you lick every surface in the waiting room? whyyy?). I can also email my doctor and she actually responds within 24 hours. Love it.
[i]I don’t think there’s much to debate when France spends 11 percent of its gross domestic product on health care and insures everyone and the United States spends 16.5 percent of G.D.P. and leaves 20 percent of adults under 65 uninsured. The numbers don’t lie: The U.S. system is wasteful and unjust. [/i]
Population France, 2008 est.: 64,057,792
Population New Zealand, 2008 est: 4,173,460
Population United States, 2008 est.: 303,824,640
People forget that the United States has quite a bit of a larger population than European Countries, and a totally different form of government. It would take quite a bit more money to ‘insure everyone’ and entail a loss of more freedoms than we are comfortable giving up.
So comparing these three countries is like comparing apples, oranges and grapes!