The Cellar - Come and Get it! Free Healt Care for All!

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From a keynote address from the President of the University of Michigan 2003, based on the findings of the Committee on the Consequences of Uninsurance:

Quote:

Let’s start with the myths:

Myth #1: People without health insurance get the medical care they need.
Reality: Over and over, studies show that those without health insurance are less than half as likely to receive needed medical care.

They are much less likely to have a physician visit within a year, have fewer visits annually, and they are more than three times as likely to lack a regular source of care. They also are less likely to receive preventive services and appropriate routine care for chronic conditions than those with insurance.

Myth #2: The number of Americans without health insurance is not large and has not been growing.
Reality: The Census Bureau estimates 38 million to 42 million people in the United States lacked health insurance coverage in 1999.

That is about 15 percent of the total population of 274 million persons and 17 percent of the population under 65. Unfortunately, this intractable problem has persisted for many years.

Myth #3: Most people without health insurance decline coverage offered in the workplace because they are young and healthy and do not think they need it.
Reality: Young adults are more likely to be uninsured mostly because they are ineligible for workplace coverage. Only 3 million workers between 18 and 44 are uninsured because they decline workplace health insurance. Eleven million workers between 18 and 44 are uninsured because their employer does not offer them coverage.

Myth #4: Most of the uninsured do not work, or they live in families where no one works.
Reality: More than 80 percent of uninsured children and adults under the age of 65 live in working families.

Myth #5: Recent immigrants account for the increase in the number of uninsured persons.
Reality: Immigrants who have come to the United States within four years comprise a relatively small proportion of the general population [SLIDE 14]. Non-citizens represent less than one in five uninsured persons.

Let me summarize for you the principle ways that people living in this country gain or lose insurance coverage:

Employment-based insurance is by far the most common type of coverage available.
Some of us are able to purchase insurance on our own, if we can qualify, but the premiums are very expensive.
Insurance can be acquired through marriage to an insured person.
Or, it is possible to qualify for public insurance, such as Medicaid and Medicare.
But because most insurance is employment-based, families who have enjoyed excellent health insurance coverage for years may suddenly lose this safety net when a working parent changes jobs, is laid off, dies, or divorces.

Money may not buy love, happiness, or good health, but there is a strong correlation between family income and having health insurance. In lower income families, only 59 percent are able to obtain insurance for the whole family.
You are less likely to have insurance for some family members if your family is headed by a single parent, or you recently immigrated to the U.S., or you are a member of a racial or ethnic minority group.

So, who are the uninsured?

As I noted earlier, many of the uninsured are employed.
The uninsured are likely to have at least one wage earner in the family, but to earn less than 200 percent of the federal poverty baseline, and to lack a college education.
They also are likely to be self-employed, employed by a small firm of fewer than 100 workers.
In terms of life stage, the uninsured are most likely to be adults and young adults, unmarried, and members of families that include children.
The probability of being uninsured varies vastly by geographic region. You can see that Michigan ranks among the states with a high level of uninsurance.

In our work, we evaluated the literature about the health consequences of uninsurance, because establishing this link is critical to shaping public policy and gaining support for widespread health care financing.

Let me give you the “punch line” first:

The committee finds a consistent relationship between health insurance coverage and health outcomes for adults.
Coverage is associated with having a regular source of care, which promotes continuity of care. The ultimate result is improved health outcomes.
We concluded that health insurance is associated with better health outcomes for adults and with their receipt of appropriate care across a range of preventive, chronic, and acute care services. Adults without health insurance coverage die sooner and experience greater declines in health over time.
Let me provide a sense of some of the many findings that have led us to this conclusion:

Long-term, well-controlled studies of mortality reveal a higher risk of dying prematurely for those who were uninsured at the beginning of the study than for those who initially had private coverage.
These studies have shown that adults who are initially uninsured have a 25 percent greater risk of dying prematurely than adults with private insurance.
Follow-up studies have shown that black men and white women who were uninsured had a 50 percent greater risk of dying prematurely than their insured counterparts, and uninsured white men had a 20 percent higher risk.
Because of delays in diagnosis, uninsured persons are more likely to die prematurely than persons with insurance. Tragically, uninsured women diagnosed with breast cancer have a 30 percent to 50 percent higher risk of dying than women with private insurance. Uninsured women are more likely to receive a late-stage diagnosis of cervical cancer than are women with any kind of insurance.
Adults with diabetes who are without insurance are less likely to receive recommended services such as foot exams or dilated eye exams.
Among adults with HIV, having health insurance has shown to reduce the risk of dying within a six-month period by over 70 percent. Uninsured adults with HIV infection are less likely to receive highly effective medications that have been shown to improve survival.

http://www.umich.edu/pres/speeches/030519vodi.html

Quote:

they also never mention what percentage of those people are willingly uninsured, like both my brother and my father.

And me. For two years, ending last month. I could have afforded it. I enjoy gambling. I continued to purchase healthcare and paid cash. Sometimes it didn't work out so well

Just because some people choose not to be insured, doesn't mean there aren't millions of Americans who cannot afford insurance.

And, what about all those people whose insurance refuses to cover treatment? Okay so you get treatment and argue later. That works for emergency procedures. Doesn't work for a long course of chemotherapy. The treatment will cease if the cover isn't there.

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Originally Posted by DanaC (Post 375977)

And what percentage of an equivalent American contingent had to wait indefinately whilst they argued with their insurance providers? What percentage of an equivalent American contingent were not able to access treatment at all, because they had no insurance cover?

These arguments against socialised medicine only really stack up if the alternative system results in treating a higher percentage of people faster and better. If, as is the case in America, many millions of people are without health insurance, and several million will go without needed medical care because of a lack of insurance, or a lack of co-operation by the insurance companies, then pointing at the much smaller percentage of Canadians or British who go without needed care (or have to wait several months for operations) is a little disingenuous.

They don't wait, they get the care and then get hammered with a bill.

Some get care. Many do not.

Dana srsly, we freakin live here, don't you think we have some clue about how things work here?

Quote:

Originally Posted by DanaC (Post 376016)

Some get care. Many do not.

Wrong. No one is actually turned away from care that they have to have. I work in health care. I have never seen anyone turned away. Ever. I have seen people lose their shirts over hospital bills though, and seen insurance companies send the payment to the patient who then turns around and buys a new car, not paying the hospital or providers, who in turn have to take them to court, where in the end they can't pay the bill. Happens a 3 or 4 times a week where I work.

From the 193-page report, "Care Without Coverage: Too Little, Too Late"
as reported in USA Today 2002 : http://www.usatoday.com/news/health/...nce-deaths.htm

Quote:

the second in a planned series of six reports by the Institute of Medicine (IOM) examining the impact of the nation's fragmented health system. The IOM is a non-profit organization of experts that advises Congress on health issues.

Overall, the researchers say, 18,314 people die in the USA each year because they lack preventive services, a timely diagnosis or appropriate care.

The estimated death toll includes about 1,400 people with high blood pressure, 400 to 600 with breast cancer and 1,500 diagnosed with HIV.

"Our purpose is simply to deliver the facts, and the facts are unequivocal," says Reed Tuckson, an author of the report and vice president for consumer health at UnitedHealth Group in Minnetonka, Minn.

Among the study's findings is a comparison of the uninsured with the insured:

Uninsured people with colon or breast cancer face a 50% higher risk of death.
Uninsured trauma victims are less likely to be admitted to the hospital, receive the full range of needed services, and are 37% more likely to die of their injuries.
About 25% of adult diabetics without insurance for a year or more went without a checkup for two years. That boosts their risk of death, blindness and amputations resulting from poor circulation.
Being uninsured also magnifies the risk of death and disability for chronically sick and mentally ill patients, poor people and minorities, who disproportionately lack access to medical care, the landmark study states.

"The report documents the immense consequence of having 40 million uninsured people out there," says Ray Werntz, a consumer health expert with the Employee Benefit Research Institute. "We need to elevate the problem in the national conscience."

Calculating the cost in human suffering, he says, "is one way to get there."

Presumably the people writing these reports and conducting these studies also live in America. You tell me you should know what it's like there. But who do I believe? You? The people conducting the studies? The President of the University of Michigan? You all live in America, you all know what the country is like. There does seem to be a great deal of evidence that the system fails a significant number of Americans. You all point at my healthcare system and say it limits access, yet I tell you I live in this country and have never had my access to medical care limited. And that's with several long term chronic conditions that I've had my whole life. My family haven't had their access limited. When my niece went into febrile convulsions and the local hospital saved her life, her parents weren't faced with a crippling bill afterwards. Most of my, and my family's and my friends' experiences of healthcare in the UK is positive.

There are exceptions. There is a drug which should be available and isn't and the consequence of which is that a friend of mine is losing her sight (we did eventually manage to persuade her to buy the treatment: she is a political activist, and ex member of parliament, who has campaigned all her life for the values expressed in the NHS. She used her situation to launch a campaign to try and make the drug available under the NHS for people with her condition. As someone who has fought against privatised medicine she did not feel in good conscience she could spend thousands on treatment that most could not afford.) There are a handful of drugs where such problems of access, or getting NICE to approve them are the case. Usually these are fought over for a while and eventually they get adopted. These are the exceptions, but they are numerous enough to make me realise that we have work to do to improve the system. It works for most people most of the time without creating financial hardship.

But you tell me that nobody is ever denied the treatment they need under your system?

Oh, as a side note, Alice was successful in her campaign to get the drug into the NHS. But, it will take a while for the Primary Care Trusts to finish wrangling over the details. There are already people receiving these injections. The campaign took about a year and a half and was related to a fairly new treatment for this condition.

Dana I don't doubt their findings based on their extrapolated data. What I doubt is how they collect their data and then turn it into blanket statements about what actually goes on on the ground and at the door of the hospital.

The problem of the un or under insured is a real one.

Healt care? I don't need no stinkin' healt care!

What's that?

huh?

OH!

Nevermind! :)

Quote:

Originally Posted by Cloud (Post 376027)

Healt care? I don't need no stinkin' healt care!

What's that?

huh?

OH!

Nevermind! :)

Yea, sorry about that, I tried to fix that but apparently you can't edit stuff after a few days. :neutral:

Quote:

Originally Posted by DanaC (Post 376016)

Some get care. Many do not.

We should separate the care we need and the care we should have?
I'm of an age where they say I should have yearly exams for this and that, regular checks on that and the other... and I have very good health care insurance.
That said, I get medical attention when I have to call an ambulance because I can't crawl to the car.
So where do I fit in the statistics. Do I balance out the, go to the ER for a sliver or the sniffles, but doesn't have insurance? Do I show up in not getting the care I 'should have', because I don't cooperate with the 'should have' program?

People show up at the ER to get help for the Low back pain they have been having for 3 weeks because no doctors office will see them because they have no insurance. The stats are completely wankered.

I can only assume that your healthcare system is not as fucked as it looks from the outside, because you guys don't strike me as a doormat nation. I can only assume that if it was as bad as it looks from over here, you'd have kicked up an almighty stink by now.

This thread started with a characterisation of social medicine, which to my mind, demonised such a system entirely. You would have me accept that the picture that's been painted of your healthcare delivery system is skewed, inaccurate and probably wilfully false. Okay, I'll accept that as a possibility. I would suggest to you that your picture of socialised medicine is likewise skewed, inaccurate and wilfully false.

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Originally Posted by DanaC (Post 376039)

Both of those premises are possible. Both have truth and falsehoods. The fact is that we cannot take a system that works well in a country the size of Southern Calif and easily dump into one that is 50 times the size and expect it to work as nicely.