Archive for the ‘health care’ Category
I just finished watching the third presidential debate. Admittedly, many people will be swayed by what he said. However, any thinking person who has a modicum knowledge of economics and national security as well as respect for all people, regardless of race, creed culture, gender or religion can upon reflection agree with him.
By and large, Trump repeated over and over that he would make America great again but without ever delving into how he would do so. On trade, he said NAFTA was bad, but the completely failed to explain how or what he would do to create better trade policies. Throughout his campaign, he has repeatedly called for isolationist trade policies which would be an economic disaster. The USA relies upon our exports for jobs and economic growth. Granted the TTP and other current proposals fail both the American people and other countries by putting too much power into the hands of major corporations – the reason Hillary Clinton does not support them – but international fair and free trade policies are needed worldwide, especially by mature economies like the US. To put it simply, US full employment cannot be supported without international trade.
On tax policy, Trump doubles down of supply side economics. His tax policy, outsourced to Steven Moore, a penultimate supply-sider who consistently ignores the demand side of the economic equation and is no economist, would increase the national deficit by trillions. Some say as much as $5 trillion. Since the financial melt down in 2007, the US has had an overabundance of supply but not enough demand. In other words, there’s plenty of product but not enough buyers. When wages are low or lowered (as has been the case since 2009 when companies lowered wages in the face of an oversupply of qualified candidates) wages, the demand side of the economic equation has gone down. If people can’t afford to buy, demand goes down regardless of the supply quantity. Thus, continuing the feed the supply side, i.e. Wall Street investors, does nothing to increase GNP (Gross National Product). The only way to increase GNP and, thus, GDP is to build up the demand side of the economic equation. Moore’s tax and economic policies, which Trump bought lock, stock and barrel, utterly fail this test.
On National Security, Trump sounded smart when when you delve into what he actually said but yet again failed to propose any solutions, he’s frightening. Does he want an all out war in the Middle East – a la the Crusades? If so, that is one sure way to push moderate Muslims into the freedom fighter camps of ISIS and the Taliban. Imagine if you will an invading force in the US (intent on stealing our national resources to pay for the invasion). Would any American stand by and let that happen, no matter how moderate they were? Of course not. The same principle applies in the Middle East. Throughout history all over the world, people have always fought against a foreign invader, even when they strongly disagreed with their own government. It would be no different in the Middle East now. Moreover, Trump and his neo-con allies have chosen to make his foreign policy about a clash of civilizations – a clash of religions much like the Crusades. And much like during the Crusades, Muslims would come together, regardless of their internal conflicts, to fight off the invaders. Smart policy, which Clinton advocated, is separating the moderates from the extremists…and backing the moderates who see a better way forward for Middle East countries than a 12th Century ideology in the 21st Century world.
Additionally, the idea of Trump denying or ignoring Putin’s spying and hacking and interference with this election shows his incredible naivety. Of course, his financial records prove, as Newsweek and other legitimate media outlets have shown, he has a huge income stake in protecting the Russian (and thus Putin) oligarchy. Do I think Trump would take his order from Putin the way Mussolini did from Hitler? I don’t know; but I’m not willing that that chance, given that Trump is all about himself and his ego and his fortune even as he sells out other and stiffs his suppliers. Trump’s entire career has been one long running steam of conning and lying and cheating others including failing to pay his suppliers. Believing him is like believing in Hitler’s promise to not to invade the restof Europe after stealing Austria.
On issues of his personal morality and how he think about woman and minorities, what more needs to be said other than that he has offended everyone with his misogynist and xenophobic mindset. Even the uber conservative Utah-based Mormon (Church of Latter Day Saints) has come out against Trump in a public statement.They consider his words and ideas…and his behavior…highly toxic. No matter how much he denies his behavior, the numbers of people coming out against him for how he has behaved and what he has done keeps growing. As a result, he’s proven himself to narcissistic megalomaniac who refuses to accept responsibility for his own behavior. In his words, everything is the fault of someone else…and he is totally innocent. That may go over well in the modern Republican conservative movement, but it doesn’t necessarily sit well with a majority of people who have been raised to believe they have to take responsibility for their own behavior.
On border control and minorities, polling shows that the list of minority voters switching from the Republican side of the ledger to the Democratic side ha gown dramatically since Trump became the Republican nominee. Beyond his polling numbers though is the fact that to implement his wall across the US Southern border and round up & deport every non-citizen (i.e. alien) would cost multiple trillions of dollars. Are you willing to agree to a major increase in your taxes to pay for it all…or are you going to shut your eyes and ears and put it on the national credit card and blame someone else for the outrageous deficit once again?
I could go on ad infinitum on the disastereous affects of Trump policies (or lack of coherent policies) but there is little doubt that committed Trump voters will change their minds. To far too many of them, the world is made up of “us against them” which the GOP has pushed, in various and sundry dog whistles, for over 50 years.
Nevertheless, regardless of how reasonably sounding Trump came off sounding in this third debate, the fact remains that all of his ideas, from every perspective, are extraordinary expensive and a national disaster. Moreover, the fact that the national GOP supports and endorses this caricature of a human being shows the party has descended into the bowels of hell.
Clinton may not be everyone’s favorite candidate…and granted she’s been vilified and lied about by the GOP in the national media for nearly 30 years…but compared to Trump, she’s an angel. Her policies are reasonable, well-thought out, progressive, equitable, and fiscally sound. But, of course, that won’t matter to die-hard Trump supporters who choose to ignore the reality of the man and his ideas by focusing only on his fantastic rhetoric as a way out there circumstances.
I object to many of the points in this article published by the American Conservative Magazine…and many of its comments.
According to PEW, I’m a liberal. However, I do not believe in taxing hospitals and providers at extraordinarily (75%!) high levels as the American Conservative article claims all liberals want. Nor do I believe in making all doctors/practitioners state workers. I find these notions shocking and antithetical to our democratic principles. In addition, I do not agree that liberals want someone else to pay for our health care needs. All of my liberal, Democratic friends agree with me on these points. Conservative talking points about what liberals and Democrats is long out of date, thus making them no longer relevant.
I agree that more money should and could be put into health cure research. Curing diseases, as in eliminating them, does bring down cost of health care. However, contrary to what some people posted in the comments section, the fed government via the NIH has provided much of the needed funding for basic research. Health care companies, in general, have reduced their R&D budgets by billions as more me-too drugs and generics hit the market which means the NIH grants become all the more important. I realize this flies in the face of the oxymoronic notion that government cannot do anything right. Would those thinking this way say the same about the DoD and DARPA over the last 30-plus years? Tremendous research is being carried out all across the country by leading research labs and universities as a result of NIH and allied federal research institutes’ funding.
Third, regarding costs. When people talk about how much cheaper it was to get medical care back in the ’50s they fail to note how much medical care has changed since the ’50s. Technologically driven advances drove much of the increased costs. Comparing 1950s medicine to today is like comparing the Model T to today’s automobile. Ain’t gonna work! It’s why a comparison of the 1950s costs to today are totally worthless at best and deceptively ignorant at worst. By the way, health insurance was instituted by companies, as an employee recruitment draw, during WWII. You know, back in the early ‘40s. So, the ‘50s argument about costs is ludicrous on its face as most large companies already offered health insurance to their employees.
The author correctly states in his analysis that hospitals shift cost losses from ERs to all other areas of the hospital. If hospitals failed to do so, they’d go broke rapidly since EMTLA (since Reagan signed the law, hospitals cannot deny treatment to anyone without insurance, regardless of ability to pay cash) is the law for the land. Thus, ERs have become loss leaders even while being necessary as public/community services. But the medical establishment, in conjunction with politicians, has divided up hospital territories upon which, all too often, none shall intervene.
But more to the point is that medical costs are opaque. Even when you ask about costs, most of the time you cannot get an answer. Either the provider refuses to give an answer or says that different insurance negotiating policies provide different pricing so they cannot/will not provide you an answer regarding pricing. In Taiwan, which has a single payer system and a private practitioner system, all prices of all the different providers are printed and posted in every provider’s office so patients can see the prices and can make their decisions accordingly. We don’t have that same transparency here in the US. How can you know you’re getting the best bang for the buck if pricing and comparative quality remain a mystery?
In addition, regardless of emergency needs, how many of us are capable of telling our doctors, “Sorry, I don’t want to do that test you demand I take or take that expensive medicine you prescribe”? Medical care is not like buying shoes or cars, regardless of the libertarian arguments simply because health care consumers – patients – understand they are not medical experts. If the doctor says do x, y, and z, we tend to do it because we believe the doctor is the expert and knows best. And all too often, as I’ve discovered, when you argue with the doctor, he angrily pulls the argument that he’s the professional and you’re not…do it or else! Free financial markets, to work correctly, depend upon access by all to the same information. That doesn’t occur all too often, and most particularly does not occur in the health care market because we’re not all equal experts in health care.
In addition, current regulations preclude the ability of Medicare from negotiating RX prices which means this country subsidizes other countries. We in the US essentially pay higher costs so those other countries can obtain lower prices. As a free market advocate, I object to that subsidy to other countries.
Finally, let me say that I and my liberal friends look forward to the day when health insurance is completely separated from the current employer based system to one that enables a group of like minded individuals to buy insurance on an exchange at market competitive prices. We recognize, as realists, that health insurance is not going away…it’s been around too long and has a huge hold in the mindset of too many people as an appropriate way to spread costs a la all other insurance policies. In addition, many of us liberals hope that once the exchanges are up and working well, a la Reihan Salam, that Medicaid, Medicare and VA outpatient systems can be moved into that singular system similar to Switzerland which spends approximately 11% compared to our almost 18% (17.9% in 2012). Currently, our health care systems are so fragmented that the most needy in those systems cause the highest cost. Moving everyone into the same system spreads the cost across a greater market – which the rest of the insurance market essentially does – to decrease costs for any individual or family.
Further, it should be noted that PPACA, aka Obamacare, does go a long way to fund pilot projects that looks at other health care funding models. Some 27 provisions in the PPACA legislation provide state approved or organizationally approved experimental models. The goal of these 27 provisions is to determine what works to provide the best heath outcomes at the best prices. Many of them are showing such remarkable results that large private companies like Boeing have signed up for.
For the libertarians out there, might I remind you of two things: 1) Friedrich Hayek said he was not a conservative because conservatives look to the past while he looked to the future, and, second, that he believed it was necessary and vital to provide a strong social safety net, including national health care, as societal goods because they promoted social and political stability.
What I believe most conservatives, including many social scientists like Prof. Heidt who claims to lean liberal, get wrong is that modern, post-Clinton Democrats are not adverse to capitalism but rather see the difference between laissez-faire capitalism which never worked for the masses (see Adam Smith, the Irish Famine & British Parliamentary history, early 1900s in the US, Robber Barons, Progressive Movement, TR’s autobiography) and long held Jeffersonian – Jacksonian values of opportunity regardless of the social and economic class into which one was born and regardless of race or ethnicity or wealth. What we liberals don’t demand is equality of outcomes, but rather equity of beginnings, i.e. education.
As a result of our modern belief system, liberals want a medical care delivery system that is fair to all providers while using the best technology and gathered data available to lower delivery system costs including using data from other OECD countries.
Rather than being ideological, we seek pragmatic answers to our modern challenges. Can today’s GOP and its libertarian allies say the same?
Everyone, not just today’s seniors, need to understand that Obama, through the Affordable Care Act, did not rob Medicare of $716 billion.
First of all, most of that money came from ending a very lucrative subsidy to Medicare Advantage insurance companies.
Here is what happened.
When Medicare Advantage was set up, insurance companies were lured into the program with a guaranteed no-loss, tax-free subsidy. What that meant was that if an insurance provider lost money, the government would pick up the loss and that tax-payer money was given to them tax-free to cover that loss. In other words, these insurance companies could reduce their tax bill by writing off the loss and receive a tax-free handout to cover that loss. A no-loss situation for health insurance companies…and it made them lots and lots of money. It was a pretty good deal: Medicare Advantage insurance companies got to write off any loss and have the government pay for the loss tax-free too.
Think of it this way. Say you make an investment, but it loses money. Naturally, you write off the loss on your taxes which reduces your Adjusted Gross Income and, thus, your tax bill. But then on top of having your tax bill reduced, the government turns around and hands you free of charge whatever amount your investment lost.
Well, that’s exactly the deal Congress made with health insurance companies. It was an absolutely great deal for health care insurance companies but not so much for taxpayers.
I don’t know about anyone else, but I find that deal a waste of taxpayer funds that should have ended. Obama and the Democrats were absolutely correct in ending it. Anyone who supports putting that free subsidy back in place is no fiscal conservative.
Yet, that’s what Romney is now saying should occur. Wrong, wrong, wrong.
Every taxpayer should be incensed by that guaranteed give-away of taxpayer dollars. If taxpayers were incensed by the possibility of helping underwater homeowners – as the original Tea Party was – they should be even more incensed over the deal the Republican held Congress made with insurance companies on Medicare Advantage.
No longer paying for waste, fraud and abuse
The rest of the money comes from tightening up on Medicare fraud enforcement as well as changing how hospitals are paid.
Prior to ACA, hospitals were paid for every readmission, regardless of how poorly those hospitals did their job. ACA now requires hospitals to do a better job of caring for their patients by stopping payments for re-admissions that should not have occurred. Since the Hospital Association agreed with this action, why do so many Republicans now want to continue to pay for poor care and waste? That’s not fiscally conservative, in my view.
At the same time, ACA strengthened the benefit side of Medicare by closing the costly doughnut hole and providing for annual check-ups. Essentially seniors, and all Americans, got a better deal for $716 billion less. That’s fiscally conservative!
So what are Romney and Ryan really saying?
That they want to return to the waste, fraud and abuse in the Medicare system prior to ACA?
Of course not. They don’t believe what they’re currently saying. It’s all campaign spin and garbage. They’d take that same money out of the system but use it differently…to help lower tax rates for the most wealthy. Furthermore, by overturning ACA, they would return the wasteful subsidies to insurance companies as well as end the provision that makes hospitals more accountable for outcomes. Ryan’s plan, which Romney said he would sign into law, makes that absolutely clear.
The next time you hear a Republican, or Romney and Ryan, expound on that $716 Billion, remember you’re being conned.
The new Washington Post-ABC News Poll show 50% of seniors view Paul Ryan’s Medicare plan favorably.
I’m not sure if they really understand what he proposes or if they just don’t care about making sure their kids and grandkids have the same benefits they have. Are they ignorant of what he really proposes, and which both Romney and House Republicans approved, or are they just selfish? I don’t know.
What I do know is that Ryan’s plan has been analyzed by dozens of non-partisan groups. All of them say the same thing. Under Ryan’s plan, people now 55 and under will be given a voucher – a premium support payment – based on nominal GDP growth plus .5% pegged to regular inflation. As we all know, health care inflation has been nearly 4 times higher than regular inflation. What that means is that health care delivery costs will rise faster than the value of the voucher. That’s where that $6,0000 number that’s been thrown around comes from. This number may not seem like much, but it gets worse when you look more closely at it. The Center for Economic and Policy Research/ (CEPR) summarized a CBO analysis, saying
In 2022, the projected cost of purchasing a Medicare equivalent plan is equal to 35 percent of the median 65-year-old’s income. By 2050 the cost is projected to rise to 68 percent of the median 65-year-old’s income…[The projected payment to buy a Medicare equivalent policy] would be equal to 200 percent of the income of the median 85-year-old.
What Ryan does is sift the costs for seniors’ health care expenses from the government to seniors. Yes, it will reduce the budget deficit because health care spending is huge, but his Medicare plan does not save any money in the health care delivery system, i.e. health care providers and suppliers. It does nothing to bend the cost curve, apart from expecting seniors to become more rational buyers of health care.
In other words, he’s telling future seniors to shop around more, or to tell doctors they won’t get that test the doctor wants done, or to question their doctor’s judgement. Good luck with that!
But that is not all. Ryan also sets up Medicare exchanges – exactly the same type of exchanges that the GOP rails against as part of the Affordable Care Act – from which seniors can review and pick their private insurance. Overall, that’s fine. Having been a shopper of private health insurance, I approve of exchanges where people can review different plans (apples to apples comparisons) and choose one that best suits their needs; but as we know, seniors oftentimes don’t choose the best plan for themselves, and evidence suggests from recent studies that some seniors are often misled on costs and benefits so that they ending up paying far more than they would under traditional Medicare.
As we all know, too, a private insurance market currently exists under the Medicare umbrella. It’s called Medicare Advantage. However, what too many don’t know is that Medicare Advantage costs the Medicare program 14% more than traditional Medicare for a variety of reasons. One of the biggest reasons for this differential is because of traditional Medicare’ size: the program’s size enables it to use its massive buying power to lower costs far more than a variety of private insurance companies can. In addition, Medicare’s administration costs are much lower, around 3% compared to 20% to 30% for Medicare Advantage.
So, here’s the point: health care, especially for seniors, costs all of us far too much. We all agree on that point. Currently, the U.S. spends 17% of GDP on health care while other developed countries spend between 3% to 11%. So, I’m not saying Medicare should not be reformed, but I believe any reforms must be targeted at reducing the overall costs inherent in the delivery system rather than just shifting ever increasing costs to seniors.
If current seniors believe this is a good deal for their kids and grandkids, then I have to wonder what they’re thinking. As a senior myself, if his plan were put in place next year, I’d be flat broke in a decade or so, rather than lasting 20 some years. Every dime I saved for 30 years for my retirement would be gone, forcing me to move in with my kids. Is that the scenario 50% of seniors today want for their kids?
Wendell Potter, senior analyst for the Center for Public Integrity and former head of public relations at CIGNA, joined Eliot Spitzer to analyze Paul Ryan’s plan to restructure Medicare and to put states in charge of Medicaid.
“You almost would be taking us back to the days before we had Medicare to start with,” Potter says of Ryan’s plan to replace Medicare benefits with vouchers that are pegged to the rate of inflation. “Over the past 10 years, health insurance premiums for people in the private insurance market have increased 113 percent — this is by the Kaiser Family Foundation, which tracks this. And that’s far and away more than inflation.”
Watch the interview to hear what this former health insurance company executive has to say about Ryan’s (and now Romney’s) health care plan.
I came across an except of this post by an American very conservative woman who moved to Canada with her family. I think the entire post is worth reading and passing along to others, especially to conservatives who fear a national health care system. The author makes a number of points, backed up by data and personal experience, that should appeal to economic and social conservatives alike. Hers’ is a powerful story that should be read by everyone.
I’ve chosen not to edit the post for length as I believe the entire post is relevant to our national discussion on health care as well as its economic and freedom costs to families, individuals, businesses and the government.
When I moved to Canada in 2008, I was a die-hard conservative Republican. So when I found out that we were going to be covered by Canada’s Universal Health Care, I was somewhat disgusted. This meant we couldn’t choose our own health coverage, or even opt out if we wanted too. It also meant that abortion was covered by our taxes, something I had always believed was horrible. I believed based on my politics that government mandated health care was a violation of my freedom.
When I got pregnant shortly after moving, I was apprehensive. Would I even be able to have a home birth like I had experienced with my first 2 babies? Universal Health Care meant less choice right? So I would be forced to do whatever the medical system dictated regardless of my feelings, because of the government mandate. I even talked some of having my baby across the border in the US, where I could pay out of pocket for whatever birth I wanted. So imagine my surprise when I discovered that Midwives were not only covered by the Universal health care, they were encouraged! Even for hospital births. In Canada, Midwives and Dr’s were both respected, and often worked together.
I went to my first Midwife appointment and sat in the waiting room looking at the wall of informational pamphlets. I never went to the Dr growing up, we didn’t have health insurance, and my parents preferred a conservative naturopathic doctor anyways. And the doctor I had used for my first 2 births was also a conservative Christian. So I had never seen information on birth control and STDs. One of the pamphlets read “Pregnant Unexpectedly?” so I picked it up, wondering what it would say. The pamphlet talked about adoption, parenthood, or abortion. It went through the basics of what each option would entail and ended by saying that these choices were up to you. I was horrified that they included abortion on the list of options, and fact that the pamphlet was so balanced instead of “pro-life.”
During my appointment that day, the midwife asked her initial round of questions including whether or not I had desired to become pregnant in the first place. Looking back I am not surprised she asked that, I was depressed at the time, (even though I did not list that on my medical chart) and very vocal about my views on birth control (it wasn’t OK, ever.) No wonder she felt like she should ask if I was happy to be having this baby. But I was angry about the whole thing. In my mind, freedom was being violated, my rights were being decided for me by the evils of Universal Health Care.
Fast forward a little past the Canadian births of my third and fourth babies. I had better prenatal care than I had ever had in the States. I came in regularly for appointments to check on my health and my babies’ health throughout my pregnancy, and I never had to worry about how much a test cost or how much the blood draw fee was. I didn’t have to skip my ultrasound because of the expense. With my pregnancies in the States, I had limited my checkups to only a handful to keep costs down. When I went in to get the shot I needed because of my negative blood type, in Canada it was covered. In fact I got the recommended 2 doses instead of the more risky 1 dose because I didn’t have to worry about the expense. I had a wide array of options and flexibility when it came to my birth, and care providers that were more concerned with my health and the health of my baby than how much money they might make based on my birth, or what might impact their reputation best. When health care is universal, doctors are free to recommend and provide the best care for every patient instead of basing their care on what each patient can afford.
I found out that religious rights were still respected. The Catholic hospital in the area did not provide abortions, and they were not required too. I had an amazing medically safe birth, and excellent post-natal care with midwives who had to be trained, certified and approved by the medical system.
I started to feel differently about Universal government mandated and regulated Health care. I realized how many times my family had avoided hospital care because of our lack of coverage. When I mentioned to Canadians that I had been in a car accident as a teen and hadn’t gone into the hospital, they were shocked! Here, you always went to the hospital, just in case. And the back pain I had endured ever since would have been investigated and cared for with whatever X-rays, Physiotherapy or even Surgery that was needed, which would have been at no cost to me. In our particular province, even chiropractic care was provided after a car accident by the provincial care insurance.When I asked for prayers for my little brother who had been burned in an accident, they were all puzzled why the story did not include immediately rushing him to the hospital. When they asked me to clarify and I explained that many people in the States are not insured and they try to put off medical care unless absolutely needed, they literally could not comprehend such a thing.
I started to wonder why I had been so opposed to government mandated Universal Health care. Almost every western country in the world has Universal Insurance of some kind, except the USA. Here in Canada, everyone was covered. If they worked full-time, if they worked part-time, or if they were homeless and lived on the street, they were all entitled to the same level of care if they had a medical need. People actually went in for routine check-ups and caught many of their illnesses early, before they were too advanced to treat. People were free to quit a job they hated, or even start their own business without fear of losing their medical coverage. In fact, the only real complaint I heard about the Universal Health Care from the Canadians themselves, was that sometimes there could be a wait time before a particular medical service could be provided. But even that didn’t seem to be that bad to me, in the States most people had to wait for medical care, or even be denied based on their coverage. Depending on where one lived and how rural the area was, one’s access to care could be limited, and that was regardless of what country one lived in. The only people guaranteed immediate and full service in the USA, were those with the best (and most expensive) health coverage or wads of cash they could blow. In Canada, the wait times were usually short, and applied to everyone regardless of wealth. If you were discontent with the wait time (and had the money to cover it) you could always travel out of the country to someplace where you could demand a particular service for a price. Personally, I never experienced excessive wait times, I was accepted for maternity care within a few days or weeks, I was able to find a family care provider nearby easily and quickly, and when a child needed to be brought in for a health concern I was always able to get an appointment within that week.
The only concern I was left with was the fact that abortion was covered by the Universal Health Care, and I still believed that was wrong. But as I lived there, I began to discover I had been misled in that understanding as well. Abortion wasn’t pushed as the only option by virtue of it being covered. It was just one of the options, same as it was in the USA. In fact, the percentage rates of abortion are far lower in Canada than they are in the USA, where abortion is often not covered by insurance and can be much harder to get. In 2008 Canada had an abortion rate of 15.2 per 1000 women (In other countries with government health care that number is even lower), and the USA had an abortion rate of 20.8 abortions per 1000 women.
And suddenly I could see why that was the case. With Universal coverage, a mother pregnant unexpectedly would still have health care for her pregnancy and birth even if she was unemployed, had to quit her job, or lost her job. If she was informed that she had a special needs baby on the way, she could rest assured knowing in Canada her child’s health care needs would be covered. Whether your child needs therapy, medicines, a caregiver, a wheelchair, or repeated surgeries, it would be covered by the health care system. Here, you never heard of parents joining the army just so their child’s “pre-existing” health care needs could be covered. In fact, when a special needs person becomes an adult in Canada, they are eligible for a personal care assistant covered by the government. We saw far more developmentally or physically disabled persons out and about in Canada, than I ever see here in the USA. They would be getting their groceries at the store, doing their business at the bank, and even working job, all with their personal care assistant alongside them, encouraging them and helping them when they needed it. When my sister came up to visit, she even commented on how visible special needs people were when the lady smiling and waving while clearing tables at the Taco Bell with her caregiver clearly had Downs Syndrome.
I also discovered that the Canadian government looked out for its families in other ways. The country mandates one year of paid maternity leave, meaning a woman having a baby gets an entire year after the birth of her baby to recover and parent her new baby full-time, while still receiving 55% of her salary and her job back at the end of that year. Either parent can use the leave, so some split it, with one parent staying at home for 6 months and the other staying at home for 6 months. I could hardly believe my ears when I first heard it. In America, women routinely had to return to work after 6 weeks leave, many times unpaid. Many American women lost their jobs when becoming pregnant or having a baby. I knew people who had to go back to work 2 weeks after giving birth just to hang onto their job and continue making enough money to pay the bills. Also every child in Canada gets a monthly cash tax benefit. The wealthier families can put theirs into a savings account to pay for college someday (which also costs far less money in Canada by the way), the not so wealthy can use theirs to buy that car seat or even groceries. In the province we lived in, we also received a monthly day care supplement check for every child under school age. I made more money being a stay at home mom in Canada than I do in the States working a part-time close to a minimum wage job. And none of the things I listed here are considered “welfare” they are available to every Canadian regardless of income. For those with lower incomes than we had there are other supports in place as well.
If a woman gets pregnant unexpectedly in America, she has to worry about how she will get her own prenatal care, medical care for her child, whether or not she will be able to keep her job and how she will pay for daycare for her child so she can continue to support her family. In Canada those problems are eliminated or at least reduced. Where do you think a woman is more likely to feel supported in her decision to keep her baby, and therefore reduce abortions?
Since all of these benefits are available to everyone, I never heard Canadians talking about capping their incomes to remain lower income and not lose their government provided health coverage. Older people in Canada don’t have to clean out their assets to qualify for some Medicare or Social Security programs, I knew older people who went in for procedure after procedure, and we never heard about dwindling resources, kids paying for their parents medical expenses, or being forced to use up life insurance or funeral savings in order to get the health care they needed. I heard of inheritances being left even amongst the middle classes. Something I had only heard about in wealthy families in the USA.
And lest you think that the Canada system is draining the government resources, their budget is very close to balanced every year. They’ve had these programs for decades. Last year Canada’s national debt was 586 billion dollars, the USA has 15.5 trillion dollars in national debt. Canada has about one 10th the population of the US, so even accounting for size, the USA is almost 3 times more indebted. And lest you think that taxes are astronomical, our median income taxes each year were only slightly higher than they had been in the States, and we still got a large chunk of it back each year at tax time.
In the end, I don’t see Universal health care as an evil thing anymore.
Comparing the two systems, which one better values the life of each person?
Which system is truly more family friendly?
This young woman’s advocacy provides a powerful message of the blessings that Universal Health Care provides to families, businesses and the country. In a later post, she writes:
First of all, when I describe myself as a die-hard republican, believe me I was. For my first election in 2004 I voted for Bush, and a few weeks before moving to Canada I voted for McCain. I believed that abortion was always wrong in every case, I believed that “gay marriage” was wrong, I believed that welfare programs were unnecessary because if every woman just got married to one man and he supported her and her kids there would never be a need for welfare, I believed that Christian rights and privacy were being violated by the government on a regular basis, and I believed that public schools were bad scary places. 4 years later, I am no longer a Republican.
I remember being on a mommy chat board during my first and second pregnancies and someone started a thread on costs of prenatal care and childbirth. I mentioned that my uninsured home births had cost between six and seven thousand dollars each and felt proud that my costs were so low compared to many people who spoke of struggling to pay bills even higher than mine which their insurance did not cover, such as for anesthesia and hospital stays. Others were uninsured because they were self-employed, or had to pay over thousand dollars a month for their private health insurance. People in Australia and Europe chimed in, shocked that anyone had to pay for anything. I felt sorry for them, I had been taught to not listen to anyone else who was not like me, I believed that those people were part of an evil system that they had no control over. In other words, I believed the lies I had been told rather than the stories of people who actually lived every day with Universal Health Care.
I was afraid of Universal Health Care, because I knew nothing else but what I had been told by religious propaganda and conservative think tanks. They repeatedly spread the idea that Universal Health Care took away all choice. I was told that people were assigned doctors, and were not free to choose a different doctor. I was told that older people were denied health care and left to die because they were not a priority to the national interest. I was also told that abortion was pushed heavily on any woman who had an unwanted pregnancy or women who were pregnant with a child with disabilities. I was told that people with disabilities would be eliminated by government encouraged abortions or possibly even killed at birth (they wouldn’t want those people on the federal dole since they would “waste money” and “drain the system.”) Universal Health Care was often tied in my mind to places like China with their one child policy, places where the choice to have a large family would not be tolerated.
When I moved to Canada at the age of 23, and was forced to experience Universal Health Care and found that it was actually a good thing for pretty much every person I came in contact with, I began to question what else I had been told could be misinformation. Even the very conservative people I came in contact with in Canada were happy with their Universal Health Care. In Canada large secluded religious sects had all their health care needs met by the government and had no problem with that. The stuff I had been fed was purely propaganda. There was no cap on how many children you could have, no older people left to die, no forced abortions or elimination of special needs people. Even when Canadians complained about wait times and talked of maybe running to the states to get a service faster, after finding out that it would cost them tens of thousands of dollars out of pocket, most chose to wait instead. (And yes I am aware that optical and dental care are not covered, I wear glasses myself. And since I wasn’t spending years paying off emergency room visits or the leftover costs of my children’s births, I could actually afford to take my kids in for dental care every 6 months.) The system wasn’t perfect, but it was a decided improvement on what I had observed and experienced in the USA.
I live in a rural, Republican favored district so I’m something of an outlier. However, I’m always interested in what my neighbors and local businesses say about national policy and politics.
This afternoon, after getting my hair cut, I got into a discussion of Obamacare with my hairdresser after she remarked on the large rheumatoid arthritis caused lumps on my left wrist and hand. The truth is she wanted to know why I had not had them removed to which I replied that the reason why my right wrist looks like I’ve contracted some horribly disfiguring disease is because of money. The surgery could cost thousands…and since my right wrist causes no pain, the extraordinary cost of surgery is just not justified. I’d rather have surgery on the middle finger joint of my right hand where another major lump has appeared, pushing my middle finger to the right, and on my left wrist which continually aches.
In any case, we began discussing on health care costs…and Obamacare.
Using a disparaging tone that I’ve learned is common regarding President Obama in this neck of the Republican woods, she said Obamacare was socialism. So I mildly asked her did she not like Medicare or Social Security or Medicaid because they were certainly socialistic. Her reply was, “No, I don’t because they won’t be there for me.”
So, essentially, her argument against Obamacare was not, in reality, against socialism but in response to her belief that she will have paid into these systems for decades all for naught. That the federal government, as a result of self-absorbed, self-centered, self-greedy Congressional action, would bleed her of the hard-earned money she had made and contributed while giving nothing in return for her dollars.
My hairdresser is a hard-working sole proprietor. A mom with two kids in college and one graduating from high school. She needs to believe government won’t be taking advantage of her. But she doesn’t.
As we talked, I told her how much health care costs today – 17% of GDP – and if left alone how much health care is estimated to cost in 2025 – 25% of GDP. Her face sagged and took on an odd shade of gray as she absorbed those figures…and what they meant for her pocketbook. Like me, she admitted that this country must do something restrain and lower actual health care delivery costs.
I told her about the many provisions in Obamacare that seek to reduce costs and the numerous pilot programs across the country that ACA partially funds. She asked were those programs were actually working and where were they so I told her about TR Reid’s PBS program which discussed the many pilot programs across the country where doctors, insurers, Medicare, Medicaid, and company insurance programs came together to create programs that provided optimal health care at much lower costs.
The message across the board in TR Reid’s PBS program: healthy people, regardless of income and status, cost everyone less so everyone can pay less.
Providing quality health care at a lower cost when communities and health care providers come together can reduce costs and increase healthy outcomes. 27 provisions in Obamacare (aka ACA) provide funds for pilot programs and assist funding for new programs where the main objective is reducing delivery system costs while increasing healthy outcomes.
If this nation basically returns to the system that dominated the last 60 or so years, health care delivery costs will only continue to rise. Pushing those extraordinary, opaque, unknown costs onto patients, as Paul Ryan and the GOP advocate, will not reduce costs. It will only cause more bankruptcies.
Once my hairdresser grasped the overwhelming and nationally bankrupting costs we are paying for our health care delivery system which other nations are not, her opinion changed. She began to see the need to make a real change in health care before we all go broke.
Regardless, one thing is certain: returning to the same old “pay for service” system that dominated US health care for the last 60 years is a certain fiscal loser for the nation…moreover, the “socialism” argument among voters may have less to do with ideology than with the fear or belief, as my hairdresser stated, that Social Security and Medicare – and ACA – won’t be there in 20 years when needed because politicians will have given away yet another pot of taxpayer money to corporations or otherwise shifted their benefits’ money elsewhere in the budget. The real fear may be less about socialism and more about lack of political trust.