My Experience With Socialized Health Care

Reason Online has an article up detailing California’s plan to institute a socialized health care system by making private health care completely illegal. If you can ignore the advertisement of a half-naked, homoerotic ape dry humping the floor, follow the link to read the article.

Link: Canadianizing the Golden State

I’m torn on this. Ireland has socialized medicine, and it sucks. When I first moved to Dublin, I took my Yamaha Superscooter out for a rush-hour drive and took a spill off it going around 55, breaking both my arms and one of my legs. Luckily, I was right around the corner from the hospital, so I got up from the mangled wreck of my bike, flagged down a taxi, and had him bring me here. When I got to the emergency ward, a scrolling sign chipperly announced that average waiting time was 8 hours. It was 9am on a Tuesday morning.

Near the door, a man with a board nailed to his face grumbled to his ashen-faced girlfriend that it was four hours since he’d arrived and he had a board nailed right through his fucking face, doesn’t that take some kind of precedence? I didn’t think I could compete with that. Thinking quickly, I hobbled back outside, flagged down another taxi, and had him drive me back to my superscooter accident. I propped myself up by the curb in a dramatic semblance of agony then called for an ambulance. When I got to the hospital, I bypassed the emergency room line entirely, was treated immediately — ambulances, apparently, don’t go through queues.

Read the rest after the jump.

The entire experience was an odd admixture of abject incompetence and occasional excellence. The good news is that my bill at the end of the day was only
75. I met some cute nurses. On the other hand, if I were to see a doctor for fifteen minutes in a follow-up appointment, I would have to take the entire day off work, just because of the lines. When I eventually saw the doctor, more likely than not he would merely rattle my arm around in the cast, put his ear to it and rap upon it with his knuckles, as if testing the ripeness of a coconut. When my casts came off (which I actually had done with a serrated knife in my bathroom that morning, not wanting to have to wait in both the cast removal queue and the queue to see a doctor), the doctor told me that despite breaking 75% of my major appendages, there was “no need for rehab or exercises” and swatted me away when I began pointing out the fact that I could not bend my wrists or knees at all.

Maybe it’s the American in me, but as nice as it was that the entire ordeal cost me only
75, I would have gladly paid just to be treated with some semblance of competence and sympathy. I’ve had my share of negative hospital experiences in the States too, but a long line in the States generally meant a couple hours waiting in the emergency room on a Friday night, not an eight-hour queue on a weekday morning. I never have had an experience in the privatized American healthcare system that can match the callous incompetence of my experience under Ireland’s socialized medicine system.

The bottom line is that money talks. Whether we’re talking about health care, cars or cellular phone coverage, you get better service the more money you pay. When no one’s paying any money, you as an individual become a statistic and receive the base minimum of care, competence and attention to maintain the aggregate. So making private health care out-and-out illegal seems like a disastrous move for the consumers of health care.

I’m not sure what the solution to the problem is — the negative side of the American system is that, all too often, people without insurance get reamed, and I’m liberal enough to believe that every person has an unqualified right to be cured when they are sick. But that’s a paradox: how can money talk when not having money guarantees you the same rights? Is the solution to make it the law that every company has to supply health insurance to their employees, regardless of full-time employee status and other mitigating factors? Those who are unemployed get taken under the umbrella of socialized medicine. But I can see that having extremely adverse economic drawbacks as well and I’m not nearly smart enough to know how to make that work.

Does anyone out there have any thoughts on the subject of universal health care, or know of any schemes that address the issues I’ve touched on here? I’d love to hear them. Drop us a line in the comments section below.

Comments

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  1. gunnk says:

    FYI: the same emergency room wait system exists here in the states as well. Take yourself to the ER and you can face a many-hour wait plus loads of paperwork before anyone sees you. Arrive by ambulance and you go straight in.

    As for callous incompetence, I can vouch for the fact that being a very well-insured professional won’t save you here in the states either. My daughter was about 5 when she needed to see a specialist due to some odd test results.

    First, the hospital rescheduled our appointment twice and simply mailed us a notice of when we had to be there. They didn’t ask us, mind you, they TOLD us. Twice. By Mail.

    Worse yet, the two notices arrived the SAME FRIGGIN DAY with no way to tell which new appointment was the right one.

    During the appointment (a PEDIATRIC appointment in a sterile, bland environment without ANYTHING for the children they were “serving”) my daughter was told they were going to draw a blood sample. The nurse left the room, leaving us to comfort my daughter (who was terrified because she’d just been told that the NEEDLE was coming).

    THE NURSE RETURNED FORTY-FIVE MINUTES LATER. My daughter was just about hysterical by that point.

    The specialist told us that my daughter was a likely candidate for a disease that would KILL HER by adulthood and suggested that we go home and learn more about it.

    Fortunately, I did, and discovered that the strange test results were likely due to a recent strep infection and NOT due to a deadly disease. Note that the strep infection was the latest item on my daughter’s medical history which APPARENTLY no one had bothered to read. At all. I called the specialist who said “yeah, that’s probably all it is…”

    And don’t EVEN get me started on my daughter’s birth… My wife was in the hospital for several days (c-section due to delivery problems). They forgot to tell me when they moved her to recovery. They forgot to bring her meals. The nursing staff always pushed my daughter’s weighings and such onto the next shift — so nurses would wake us at 2:00 a.m. nightly to take my daughter for measurements. EVERY staff member told us something different about feeding requirements.

    How much worse could universal coverage possibly be?!?!

  2. Jen says:

    I have to agree with gunnk. You can have just as horrible an experience in the US. The only difference is that you’ll have to pay a lot more to have it. I once spent four hours waiting in an ER to get stitches with a man who had fallen off a ladder and broken his ribs. When I broke my pelvis in a car accident, I spent ten hours on a gurney waiting for a room. My mom didn’t get to spend the night in the hospital when she had her 2nd mastectomy. I could go on and on. It’s just such a great system we have her in the US, and we pay more than any other country in the world for it.

  3. GenXCub says:

    My best friend passed away last month. Since August, we had been dealing with HMO Care in Las Vegas (a city YOU DO NOT WANT TO EVER GET SICK IN). Despite the fact that he had decent coverage for a person of his wages (not great, less than 40k per year), 2 hospital visits that didn’t even include surgery (cat scans, thorocentesis x3, and meds), AFTER his insurance paid their portion, he was left with $36,000 in bills. So, even if he recovered, he’d have been bankrupt.

    One thing that socialized medicine will fix is what caused most of this bill… If a doctor even sneezes within 100 yards of you, you’ll be billed for a consultation. There were about 25 doctors who had added a $800 consultation fee, EACH. about 3 of which we were aware of personally.

  4. Smoking Pope says:

    “The only difference is that you’ll have to pay a lot more to have it.”

    Really? The doctors in Canada aren’t working for free. They’re getting paid by the government, which is getting its money from… Taxpayers! And like any government program, you’re paying a lot more into the system than you’re getting back out of it.

    I have both American and Canadian citizenship, and I had cancer a couple of years back, and trust me, you’re paying for it either way.

  5. AppTechie says:

    GenXCub, there is a solution to that. Fight the bill. Never, ever, ever, ever pay a bill unless they have specifically introduced you to every doctor that has discussed your case. If they cannot present the doctor, and his findings, you can fight the charge and remove it from your bill. Both systems have issues. Socialized has a problem with people dying before they can even be seen, and privatized has a problem with overbilling.

  6. Smoking Pope says:

    Just looked up the numbers, and it seems that 22% of all taxes collected in Canada go towards paying the health care system. In that scenario, treating my cancer in 2004 would have been three times as expensive in Canada.

  7. AppTechie says:

    And there is the other side of the coin. I was wondering who would bring it up. Sounds like fun having socialized medicine and having up to 70% of our income tax out of our hides to pay for our government and our healthcare….

    Just be thankful you aren’t swedish…that’s all I have to say.

  8. Jen says:

    Actually, as a percentage of GDP, the US spends more than any other country per person on health care costs. I just finished Tim Harford’s book The Undercover Economist, and he says that, “The United States government alone spends more per person than the combination of public and private expenditures in Britain, despite the fact that the British government provides free health care for all residents, while the American government spending program only covers the elderly (Medicare) and some of the marginalized (Medicaid).”

    So we are actually paying for it with taxes, our current system is just so inefficient that those taxes only cover a fraction of the population.

  9. Fairytale of Los Angeles says:

    If you’re going to have a socialized system, you’ve got to have privatized alternatives as well, or you go straight to the “massive ER wait, lowered standard of care” scenario.

    Being uninsured in Los Angleles County generally means 10+ hour ER waits if they think you might need the ER– and being *sent home* to come back the next day if they think you can wait it out and just go to urgent care instead. You can’t just get an urgent care appointment by going there, you’ve got to waste the ER triage unit’s time first. The urgent care wait could be anywhere from an hour to four hours; if they need to refer you to another clinic inside the hospital, that’s another four to six right there. That’s not counting the hour or more you’ll spend sitting outside of urgent care with a take-a-ticket slip in your hand waiting to register.

    I don’t know who gave LA County the impression that uninsured people can somehow afford to miss two days of work for an ER visit that might take upwards of 20 hours to actually help the patient, but I wish they’d wake up and start implementing a better system.

  10. Smoking Pope says:

    @Jen: Yeah, I hadn’t taken my taxes for Medicare and some of the other programs into account. Still, I come out ahead in the US anyway.

    And if it’s costing less here, why would I want it to be like the Canadian health care system where the shortest wait to even see a specialist is 6.1 weeks (for oncology)? I went from first symptom to first treatment through my oncologust here in 4 weeks total (including a zillion tests, 2 surgeries, etc.)

    Anyway, my point wasn’t that one system was better than the other (although it kind of turned in to that), but rather that the so-called “free” health care systems held up as examples of what we should implement are never, ever free.

  11. Jen says:

    But it’s not costing less here for you or for anyone else. Per person we pay more than any other country by more than a third, and we don’t even live as long as people in Canada. You may get in for surgery quickly, but how easy is it to get preventative care? When I didn’t have insurance because the individual health insurance market crashed in Washington state, I couldn’t go see a doctor. I’d end up at urgent care and pay through the nose for 5 minutes with a doctor who I had to wait 4 hours to see.

    It may not be perfect in other countries, but it’s pretty much hell in this country if your employer isn’t kicking down for decent insurance for you or if you’re really, really rich.

  12. Smoking Pope says:

    @Jen: Well, I’m far from really, really rich, but my employer does offer decent-ish health benefits, and that does make a difference, as you pointed out.

    I ran the numbers (what my tax would be in Canada * 22%) as opposed to what I pay in witholding for Medicare, insurance, etc. and added my deductible, and I personally come out ahead in the US, but freely admit this may not be the case for all.

    Also, I have no problems seeing a good doctor here when needed. My primary care physician has hours from 7:00 AM – 10:00 PM and allows walk-ins (if you don’t mind waiting an hour or two). But again, this isn’t necessarily the case for everyone.

    While our system is not perfect (and I won’t even get into what should be done to “fix” it), I can’t help but object when people hold it up to Canada’s system because it’s some sort of fairy-tale medical wonderland. It’s not. It’s not free, and it has it’s own problems (like an average 3 month wait for a simple CT scan, for instance.)

    BTW, I noticed on your site the recent economics reading. Have you read Freakanomics? Intersting take on alternate uses for economics.

  13. Sallykat says:

    I want to know where the poster who has never waited more than 30 minutes goes! I have waited over 8 hours at Brigham and Women’s, one of the top-rated hospitals in the country. And even at that, they only took us in because we threatened to leave. I have wait 4-6 months for anything other than an emergency doctor’s visit.

    The best example we have for how socialized medicine might look in this country is the system we already have: the VA. Recent polls show the VA getting higher satisfaction rates than any private HMO in the country. And they spend far less per patient than Medicare, mainly because they are allowed to bargain with the drug companies. I work for the VA, and I see first-hand how people pay less money and get better service than I do when I go down the street to one the best private hospitals in the world.

    Every system has problems, but government-run healthcare isn’t an automatic evil.

  14. GenXCub says:

    I don’t know if it’s being completely branded as evil. Because so much of what the government controls is horribly costly and inefficient, it’s just going to be seen as another boondoggle. I think there should be a pilot program done, but not in the most populous state in the country. Compare a state-run healthcare system against paying out for Disability, Medicaid, Medicare, et al.. and see how much it REALLY costs in both time and money. Perhaps it should go state-to-state instead of federal. That’s just another good way to boost your state’s tax revenues if people WANT to move there. You can bet if Roe v. Wade is overturned and Abortion becomes state-based, that will only provide another reason to get people to come to your state for care.

    Like Bill Maher said on Real Time:
    “Every state will have a new motto: Massachusetts: “Where the country was born, but your baby wasn’t.”
    “What happens in Vegas, stays in Vegas. No, seriously!”
    And of course, California: “I just got an abortion and now I’m going to Disneyland!”

  15. Jen says:

    Smoking Gun, sounds like you have a good setup in terms of health care. I can’t complain about mine at the moment as I have a few docs I really like here and decent coverage through my employer. However, I have a genetic condition that predisposes me to emphysema. The treatment for the condition costs $1000/week. That doesn’t include doctor’s visits or monitoring. I’m young and not needing it now, but I know several people who are coming close to their lifetime limit on their medical insurance because of this treatment. Most people don’t think about reaching that point, but something serious could come up and next thing you know you’re weighing the pros and cons of going into bankruptcy to pay medical bills or of going without care. And it’s very much a potential under our system.

    I don’t know that the legislation mentioned above is the answer. I would be tempted to say that it’s something more along the lines of requiring that everyone carry a certain level coverage individually and mandating prices based on income like several other countries do in Europe. The government could kick in money like they do now for Medicare and Medicaid, but the money could support low-income people and those with chronic medical conditions who are more expensive to insure. We could also lower drug costs by negotiating lower prices with drug companies, and streamline billing to lower adminstrative costs. The whole thing might end up being cheaper than the current system.

    And I loved Freakonomics. It started my lasting reading kick on economics which led me to the Undercover Economist … very good, especially if you liked Freakonomics.

  16. geek 101 says:

    it kinda works in canada the way to go is two teir health care were you have privitization and socialized med together working in harmay and peacful coexistance

  17. reallycheeky says:

    I have hadthe rare ‘privilege’ of experiencing both socialized and privatized medicine systems and I would most definitely opt for socialized and here is why…
    Up until my mid twenties I lived in England and Ireland where I was entitled to free national health care. Whilst my experiences of the ER mirrored your own; long waits, off-hand attitude etc I found my GP to be an exceptional doctor who truly cared for the patients in his practice. When I made an appointment I was seen within 15mins of the appointed time.

    I had assumed when I immigrated, legally, to the States and had to pay for health care that the services would be superior, it was a rude awakening to make an appointment with the doctor and wait up to 1 hr before I actually saw the doctor. Here of course one must deal with an army of nurses and medical office staff who each take your details and symptoms and then plonk you in an exam room where you wait and wait for the doctor and then when the doctor finally comes you must relay the details and symptoms all over again.

    Both systems have flaws but for me the socialized system provides superior care over the long term. Most people here carry health insurance in part to avoid the exorbitant out-of-pocket expense of a major illness or accident. However as anyone who has ever gone through a major illness will tell you, the insurance companies find ways to disenroll or deny coverage. Health insurance seems to be only good as long as you are not sick. The facade of ‘we have all this available if you get sick, an army of specialists, doctors and nurses who will make you well’ crumbles. The private system works for the health of the system not the patient the social system works for the health of the individual.

  18. StevenAK says:

    I was in Dublin and had a stomach virus: dehydrated, sick, not eating, etc. I went to “casualty” and was given an IV, meds, and had a conversation with an RN regarding follow up and what to do next. They laughed when I asked them if they needed my insurance card. It was a good experience. There was a person there who was waiting longer than me. He fell out a second story bar window and broke his heel bone and needed surgery. The reason he waited is because the surgeon was fixing a life threatening pelvic fracture. They call that triage and it is done based on need, not insurance type.

  19. bodysnatcher says:

    Here is my expirience with socialized healthcare, And with the people who have it. Ive never heard anyone complain about it. I train fighters for a living and have traveled all over Europe and Canada. Never dealt with any long lines, none any longer than here in the US even though I was a Foreigner. Fact is in the USA we pay more than any other country in the world per person. As I have researched quite a bit, I would ask all to do the same. Not hersay, Ive always heard that they have long lines and out of control taxes. That is not the case, they go by urgency of the case. People arent dying waiting because all the countries who have Unversal healthcare live longer than Americans thats a fact. In Sweden a conversation about healthcare came up at dinner and the swedes argument was they do pay 50% taxes, now this includes healthcare which is many times better than ours, Free Education as far as you want to go. FREE, and it also covers that when your old you wont be thrown out in the street, you will live your dying days in a first rate nusing home. One other story is one of our older guys a Canadien while we were in Montreal had chest pains and was rushed to the hospital, he ended up having Quadruple heart surgery and all his recovery and physical therapy included. FINAL COST $35, why the $35 charge. He chose to have a private room in the hospital or it would have been free. So when Americans talk about universal healthcare DONT LISTEN, I would say do the research or ask people from the country you want to know about.