Bring On National Healthcare
The US needs to join the rest of the developed world and institute a single-payer healthcare system. There, I said it.
Forget the statistics on uninsured Americans. Forget the fact that Americans, despite repeated proclamations to the contrary, do not have the ‘best medical system in the world.’ Forget the skyrocketing cost of care.
Forget all of that.
I’m a very well insured American and I want a single-payer system if for my own convenience alone. I realize how that sounds. But the fact is, people do not respond to logic when it comes to topics like this. That’s why simply stating the fact that there are 47 million uninsured US citizens (many of whom are children with working parents) doesn’t move people to action. You have to break it down to a personal level and that’s why I’m saying this.
How did it come to this?
So why am I saying this now? The fact is, I’ve believed in the idea for some time, but recent personal events have just solidified my belief. What happened? We, as a family, have had to deal repeatedly with ‘the system.’ And I use that term loosely.
The back story is that my wife had minor surgery. Now the bills have started coming. Nothing unusual about that, you say. The thing is, we shouldn’t be getting any bills. Recall that we are very well insured (by which I mean we pay a modest copay and any reasonable medical expense is covered without deductible).
The parade of idiocy begins
First, when we check in for the surgery we are asked to pay a copay four times what we expected. This despite our checking several times on the particulars of the copay, coverages, and networks. Ok - what are we going to do, cancel the surgery? We pay, assured we’d “get a refund if it is determined this amount was incorrect.”
Thankfully, the surgery went well and everything is fine.
The first bill to come was from the anesthesiologist. I sort of expected this because they sometimes don’t have the insurance information to bill. The hospital and/or surgeon doesn’t share this with them. Ok - we call and straighten it out.
Then the surgeon sends one. What the??? Turns out they have billed insurance, but haven’t received a response, thus the bill to us. Is this delay (about a month) unusual? Not at all, the doctor’s billing person tells us. So why the bill? They send them out (reading “Pay this amount now”) even when insurance has been billed.
Back to the anesthesiologist. They send a bill again. My wife calls. “What’s up with the bill?” she asks. Oh, the hospital hasn’t billed the insurance company yet, so they (the insurer) has no idea why an anesthesiologist is billing them. What? You mean people don’t just go and get put under for fun?
It’s not unusual
This sort of thing is typical in the American healthcare ’system.’ This is how it’s supposed to work! This is ridiculous. I don’t know medical billing. I can’t read billing codes. I don’t know the forms and rules. And I actually don’t entirely blame the doctors’ billing offices. Think about it. How are they supposed to keep track of the billing codes and regulations for dozens of medical insurance plans?
Would there be headaches in a government plan? Absolutely. Would it solve these problems? Not completely. I don’t care. At this point, I think the positives of such a plan outweigh the negatives. Perhaps naively, I look to the next Congress and President to do something about it. Too bad they probably won’t.
July 16th, 2008 at 8:01 am
Wow! I would not have expected this from what I have read from your site. I understand the problems you have run into, but to think that a national healthcare system would make things any better is scary. I still feel that a big part of the problem with what it is currently is that the government is already to involved. Everytime the government starts to take control it will make things more difficult and convuluted.
Have you been to the DMV anytime lately? Gone to pay a ticket? Those are government run organizations and it is horrible! I do everything I can to avoid going into those places. Then on top of that they nickel and dime you worse than anyone else. I just changed my address on my drivers license. You could either pay $2.00 for the convenience of submitting and changing it online, or pay $1.00 to mail it in? What is up with that.
Sorry but national healthcare would go to crap and patients and doctors alike would get screwed.
July 16th, 2008 at 8:45 am
Philip, I don’t know what kind of crack you’re smoking, but have you ever been to a hospital in Canada?
Here’s how it goes:
1) I break my arm
2) I go to the hospital
3) I show my medicare card (If I don’t have it they can look me up if I know my number or they can find me by name/address/etc . . . you won’t be refused if you are a Canadian)
4) I’m triaged depending on severity
5) They set my arm and cast it
6) I go home
I never see bills, I never see costs, I never see the ‘difficult and conv[o]luted’ process. I just get health care.
Now, I know that the programs have it’s share of problems. But one of those problems is not people will be turned away if they need assistance.
July 16th, 2008 at 9:16 am
Also, I recently had to do an address change on my drivers license which means in my area you have to go in to the local office as only renewals can be done online.
I showed up, I pressed a button to take a number, I waited 15 minutes, I signed a form and paid, and then went to the ID printing area . . . the total wait time was at max 25 minutes.
Maybe it’s just a USA thing to have difficult government offices.
July 16th, 2008 at 10:31 am
It is amazing how blind people are to the facts. The USA health care system has poor outcomes and costs a fortune. It costs hundreds of billions more than any other countries system would cost here (based on how much they cost in their countries). It has long been one of the huge costs Americans and American businesses have to overcome.
International Health Care System Performance - USA Healthcare Costs Now 16% of GDP
Will there be problems with some alternative to the current system? Yes. Will it cost less and provide better health and economic results. Almost for sure - since we have the by far the costliest and one of the worst (compared to somewhat similar economies), for health and economic outcomes, currently.
July 16th, 2008 at 10:46 am
I couldn’t agree more.
My wife regularly has stuff done by the local hospital, we always get bills that only list as the line item “Billed Balance”. That’s the sum total of information they give us as to what the bill is for. You have to call to find out what the bill is for. Then they will only talk to my wife about it, and not me.
It’s extremely hard for someone who is on top of the situation to know who to pay, what to pay and when to let the process take over. But make one small mistake and it’s not long until your bill gets sent to collections and your credit gets dinged!
July 17th, 2008 at 6:27 am
Philip, I’m not going to argue that government is good at everything. And fighting bureaucracy is never fun. But from what I’ve read, the Canadian or UK models are reasonably well run and complaints are few. If that isn’t to your liking, you could look to the Singaporean model. I just think there should be a true ’system,’ not a hodge podge of different plans, uninsured people, and confusing billing.
July 17th, 2008 at 6:59 am
I am all for some change, but I am still not really convinced that it needs to be government controlled. It sounds like it works in some other places decently.
Just out of curiosity, what would happen to current doctor’s wages? Would they get cut so low that nobody with a decent education would want to go into that field? I like to think when I am heading to the doctor I am going to see someone that is the top of the class? How will education for doctors be handled then if they can not pay back their student loans? Just cut the education costs to them by reducing class work and time?
Even outside of the DMV, take a look at NASA, have you seen how they fight for funding? I am an engineer and I know that the pay that they receive is significantly less than what you get working in private industry somewhere. I am using the private industry to increase my ability to save and pay off some loans.
Finally, what would happen to all the research that is done into new medicines, machines and operation procedures? Will the government start cutting those out as “unnecessary expenses”?
July 18th, 2008 at 6:34 am
Philip, you pose some very important questions. I’m certainly not an expert on this subject and I haven’t studied other countries’ systems in depth as I’m sure many other people have. I don’t have all the answers for you.
July 18th, 2008 at 7:15 am
I was not really expecting answers, more of just wanting to give some points to be considered by people beyond the front cover of the idea.
July 18th, 2008 at 8:47 pm
I don’t have hard data, so I don’t want to argue one way or the other, but let me give some anecdotes, which are admittedly a terrible way to argue, but still fun to rant about.
I’ve renewed my license and car registration at the DMV. Every time I’ve done it it has been a 20 minute process. The DMV Web site told me exactly what documents I needed to bring to the DMV office.
I’ve received many medical bills. The explanation of benefits from the insurance company rarely matches up with what I get billed by the medical provider. Sometimes lab fees aren’t billed. The cost of the labs are around $20, insurance payed 90% ($18), but there’s no bill sent for the remaining $2. Guess it’s not worth the lab’s time to send a bill for that little amount.
Then there are the claims that medical providers send to the insurance company, but are miscoded, or the insurance company ‘forgets’ that you’re insured by them, so the claims get sent back to the provider. The provider resubmits the corrected claim so now you get two explanation of benefits, one that says you owe the entire cost of $6,000, and the correct one that says you owe $200. But the insurance company never takes the incorrect claim off your account, so the claim still shows up on the insurance company Web site in the list of explanation of benefits to confuse the heck out of you.
Then there are the bills that are for the wrong amount. The hospital says it just bills what the insurance company says to bill. The insurance company says it told the hospital to bill a different amount. Both promise to send documentation to back up the bill, which never arrives.
Yep, health care billing and payment in this country is an absolute joy.
July 22nd, 2008 at 12:49 pm
Amen. Not to mention the significant portion of the population that are under-insured. Company paid health care plan contributions continue to decrease, while plan out of pocket limits increase at a rapid pace. This is a real concern, and I personally feel that many go untreated even with insurance due to high copays and deductibles.
August 13th, 2008 at 4:59 am
@Philip
Hi Philip. I sort of understand your “concerns” but in my opinion they mostly stem from “fear of the unknown”. I don’t know how hold you are but I’m 40 and 4 years ago I moved to the UK (my wife’s English). I grew up in California and for years, especially when I was a student, I PRAYED I didn’t break a leg or get seriously ill.
This nonsense about “what would happen to current doctor’s wages”….UK Doctors make well over $100k as far as I know.
And “I like to think when I am heading to the doctor I am going to see someone that is the top of the class”…how in the world do you have any idea what level your doctor graduated AND more importantly how good they are now? Forget university(party) days, what about now buddy?!
“what would happen to all the research that is done into new medicines, machines and operation procedures”…dude, c’mon. You think “socialized medicine” is full of half-witted idiots who don’t know the difference between a femur and a lymphatic system? Get real dude. This is what annoys me about American’s views on medicine outside Blue Shield or some other HMO.
So, basically you’re cool with millions of people being un- or under-insured? You have an engineering job right? So, most likely your company forks out the bill for you to see some HMO doctor (you only get a couple choices right?). Be sure to ask the if they were at the top of their class next time you are hurt/injured and have a huge deductible to pay. HMOs are billion dollar businesses with friggin’ lobbyists and all that aren’t they? So, what’s the bottom line? The health of a nation or lining the pockets of those who own these major cash cows? Exactly!
I will say, I DO have complaints about the NHS (UK health system) but overall, it’s been far better than the US (in terms of service, not saying one’s better than the other in terms of research, etc.). And, speaking as a loyal American who loves where he comes from, if you think the US has got all the right answers and every other country is simply a “follower” and not as “evolved” or “intelligent” is once again why the stereotype of “Dumb American” exists. Not calling you one, just saying that stereotypes exist for a reason.
My mother is almost at retirement age and she doesn’t have a lot of money. I’m scared sh**less if she ever gets seriously ill.
So, before you make all sorts of inane, unfounded and fearful assumptions, try and open your mind to what could make the US even BETTER. Before I moved here, I too thought like you, assuming OUR system was the best because Americans think they’re the best at everything lol. Once again, it’s a stereotype.
Lastly I don’t see any socialized health care happening for a long time if ever in the US. Not because it wouldn’t make for a happier, healthier nation (because it would), but there are too many pockets to be lined and you folks are the ones footin’ the bill making “them” richer.