To those opposed to a single-payer, national health care system....

[Kitty Herder]

If you think that it would be less effective, less efficient, are scared of long waits to see doctors, or any of the other horrible things we hear about the health care systems in other industrial nations, please listen to my current, personal health care nightmare.

I'm sick. I have a sinus/ear infection. I've had it since December. I have no insurance. I've been to the local clinic four times and each time they send me away with an antibiotic. Each time, I start to feel a little better towards the end of the course of antibiotics, but the infection returns within days. Also, I have some other health issues (PCOS, frequent migraines, low-thyroid ) which they won't even listen to me about. I have another doctor, a primary-care physician, who is wonderful and has treated my chronic conditions in the past, but who is also expensive and hard to get an appointment with. So I decided to see her about my infection and other issues this time. I made the appointment last week. The soonest I can see her is the 22nd. It's not like she's a specialist, just a family practitioner.

Now I'm sitting here, my infection worsening, starting to get chills and fever, knowing that I'm going to have to return to the shitty local clinic as soon as they can see me.(Probably tomorrow or the next day. At least I don't have to wait forever for their inadequate treatment.) I could also go to the emergency room, but that would involve sitting in their waiting room for hours and would cost a fortune. But I'll still need to see my doctor to deal with the other issues and probably to get effective, well-considered treatment for this damned infection. So that's two appointments that I can't afford.

And guess what. My good doctor is now branching out into cosmetic surgery because it pays better, so as she spends more time doing that and less time treating the sick, she'll be even harder to get an appointment with.

So my question is, how could a European or Canadian style system be worse than this?

(I apologize for bitching and moaning, but I'm pissed off about this issue right now. I also apologize if this is a bit incoherent. I have a fever. )

Edited to add: All the other actual doctors in my area(not P.A.s or Nurse Practitioners) are just as hard to get an appointment with. (P.A.s and Nurse practitioners are just fine, but I'm sick of the ones that keep under-treating my ear/sinus infection and won't even listen to my other problems because they're too much for them.)

[nadinbrzezinski]

1. First off try to take it easy

second off, the nightmares that forty plus million americans go through every so often because we do not have a healthy system, no pun, are unconscionable. What is more, the system as it exists right now is bound to collapse. My brother is an MD, he gives it ten years... I give it less

Third, even with shitty insurance our health care is substandard and that has shown up in life expectancy and other indicators... so those who are opposed to national health care, are either ignorant of the reality or blinded by propaganda

Oh and so you feel a little better, try the tylenol or the cool, not cold, just cool bath

[Kitty Herder]

2. Thanks.

I already took some tylenol and a cool bath sounds lovely.

I hope you and your brother are right that our system will collapse as long as that leads to a recognition of the need for substantial change in the way we deal with health care in this country.

[nadinbrzezinski]

6. It will but the suffering short term will be incredible

but the system is unsustainable and the choice will be you will get care only if you pay first, or we get national health care, no in-between

I have seen both a good national system (Canada, and yes there are examples of nightmares), and bad national systems, (Mexico)

If we go to the Canadian system (mostly) we will be ok. If we go to something like the Mexican system... it will make the current system look like heaven

[Kitty Herder]

9. I'm unfamiliar with Mexico's system.

I've read quite a bit about Canada's and it seems pretty decent. Of course, no system is perfect.

How does Mexico's system work?

[nadinbrzezinski]

13. First off you have several national systems

for example the Social Security has hospitals for all workers who work in private industry. The system is ok, but underfunded, severally underfunded, and understaffed. There is also quite a bit of graft, and boy could I tell stories

PEMEX has its own medical system, (which is pretty good actually)

ISSTE, which is parallel to the IMMS, (Social Security) for state workers, pretty good in some cases, but also mostly understaffed.

And of course the military system, which like here is independent... some, like the Military Hospital in Mexico City, are excellent, but some army bases, not so good.

Then you have the Red Cross with its own national trauma and disaster service, which also runs EMS for the country. (I was a medic with the Red Cross for ten years. Some hospitals and regions are world class, others are not)

Of course there is the public indigent hospital system, which is anywhere from bad to oh my god... if you want to die, you go to the General Hospital

And then the Private system, some hospitals are world class, but others are not. Usually they take money up front or health insurance... some even American companies... (and I kid you not Blue Shield Blue Cross now has a program here at border town to have US Citizens go to the humana hospital in TJ, instead of the US)

The problem is that in paper the system looks very good, and if all the inefficiencies and graft were taken out, then the system would work very well. There is a network of primary doctors, that in theory refer patients to specialists when needed, but they don't have time to eval patients. My pediatrician, he's dead, been some decades, he used to have his private practice and work at the IMSS. He had all but five minutes per kid at the IMMS. You cannot even say hi in five minutes, let alone do your job as a doctor.

Now it has its shining programs, like the National Vaccination campaigns, that have reached over 98% across the nation... which also means the death rates in infancy have gone down by orders of magnitude and actually are far better than the US... but then again, so is Cuba's, not hard either. And right now the President has enacted a system where all children born during his sexenio (six years in power) will be covered for life... my question was...ok, that's nice, where's the money coming from? Bear in mind, less than 15% of Mexicans actually pay taxes every April.

There are days I wonder why the let's scare muricans crowd doesn't use the Mexican system, since it is a very good example of how not to run a federal system

[Liberty Belle]

3. See a dentist, you could have an infected tooth. I did,

and when I finally got it treated my recurrent sinus infection went away for good. Not even sinus surgery had helped.

Of course affording the cost of root canal and a crown is another story...I think dental care ought to be included as part of healthcare!

One more piece of advice: Go to your local healthfood store and buy XClear, a natural sinus spray product that works much better than any over the counter or prescription sinus products, is far safer, and not habit forming.

[Kitty Herder]

7. I had thought of that.

But I can't afford dental treatment right now, and I know for a fact that I have at least one major cavity, so I don't even want to know what's going on in my mouth. Pathetic, isn't it?

Yes, I agree that dental care should be included. Problems with teeth and gums can make a person very sick, and can affect your heart.

[nadinbrzezinski]

8. A COMPREHENSIVE health care system

will include, medical, dental and eye care

[Selatius]

14. Agreed. It's sad we have to look to the others instead of our own system for models to emulate.

But I'm sure industrialists in Europe are thinking of ways of dismantling their system and replacing it with a copy of our crappy system here that puts profits ahead of people.

[nadinbrzezinski]

16. See Italy for that leading edge, now that they have open Fascist

in power

[Selatius]

17. Actually, I heard the Netherlands did push through health care privatization.

Predictably, costs have risen. Gee, I guess it's because private health insurance companies tacked on fees and other profit mark-ups to make more money.

[nadinbrzezinski]

18. Color me surprised

granted the cost of modern medicine is high indeed, and most folks don't realize just how high

One day we were seating at the station oh about ten years ago

We had implemented a modern Trauma Standard, and we started to calculate the difference in cost

Before that was implemented and we had a pure scoop and haul a critical trauma patient ran oh 300 bucks... worst case, for the prehospital phase... don't ask how bad care was.

After we managed to get those through that same patient ran close to 3000 in equipment, meds et al

Never mind that survival rates went up, and complications, or life altering sequelae went down (like not walking), but our million + annual budget started to look thin indeed.

Not that you can place value on human life... but boy I saw the increase in cost in the flesh....

So it is not only privatization... but privatization will increase cost anywhere from 10% to 150% depending on how much you tag on

[Selatius]

4. According to the World Health Organization, France has the world's best health care system.

They measured each nation according to 5 criteria, and overall France came out on top.

France utilizes single-payer health insurance. It doesn't pay for everything (something like 75 percent of costs are covered), so people are also free to purchase private supplemental insurance. However, it covers everybody and at roughly less than half the costs per capita compared to the US.

You can go to any doctor you wish.

[Donnachaidh]

27. it's so good, in fact, that a neighbor of my family flies home to france

when she's sick. She gets cheaper BETTER care for the cost of a plane ticket.

[NaturalHigh]

5. Without getting into the debate on single-payer healthcare...

let me just say that I can sympathize with your ear problems. Mine were so severe that I ended up getting a shot of demerol in the emergency room. The last time I had the infection, I ended up going through three different courses of three different antibiotics.

I hope it clears up for you soon.

[Kitty Herder]

10. Thanks.

I'm going to go off soon and take a cool bath. I hope it will alleviate the fever.

[Spiffarino]

11. If you haven't done it already...

Contact your local hospital and find out if they have a Pharmacy Outreach program. They know how to take advantage of Big Pharma's free or reduced cost drug programs and can save you the hassle of having to deal with Pharma directly.

Good luck. I was uninsured for seven years and nearly died. We need USP healthcare yesterday.

Edit: Somebody mentioned a tooth infection as one possibility. My hospital has a program called "Tooth Bus" that provides dental care for folks who need it. Some hospitals do great work helping folks who need medical care and can't afford it. Contact your local non-profit hospital's foundation or look in the phone book for any Outreach programs they may have. It could save you lots of money and get you the help you need.

And may the deity of your choice bless you!

[Kitty Herder]

12. Thanks for the advice! nt

[Jane Austin]

15. You've gotten some good advice here.

I pray that you find a solution soon.

[1]

19. and you think this will improve under national health care?

do you think your health care providers will suddenly step up and "get it right" when we go all "single payer"? like that is some sort of magic solution?

don't get me wrong. it sucks to pay for substandard treatment. but fucked up health care is fucked up health care.

how do you see this getting better when it is "single payer"?

[Hissyspit]

21. Apparently you didn't see "Sicko"

For one thing, health-care delivery is better when there is less bureaucracy to deal with.

I would add more, but I'm tired and need to go to bed. See Post #20, rent "Sicko" and then learn from the people here who have been posting and reading about these issues for years before you post generalized right-wing talking points.

[1]

22. of course it will be...

i defer to those most wise who have rented "sicko" before me...

that's the answer. that's how we fix this problem. rent "sicko".

that's how we solve this.

so simple...

[magellan]

30. For one, no one will have to suffer because they can't afford treatment

There are millions of Americans who have a pre-existing condition that prevents them being covered by health insurance, and millions more who have inadequate coverage -- or none at all -- because they can't afford the premiums.

I was one of the latter when I got appendicitis a few years ago. I didn't know what was wrong and didn't go to a doctor because we couldn't afford it. It would have been a routine operation and cost much less to fix if I'd had access to a doctor when the pain first started. Instead, I got worse until my appendix RUPTURED and then I needed more expensive care, all of which was written off by the hospital.

IOW taxpayers, including those like yourself who oppose paying for other people's care, paid a premium to save my life.

Under single payer, everyone -- EVERYONE -- has access to health care. That means few will put off seeing a doctor because they can't afford it. This is how minor ailments are caught before going critical (which costs more than catching things early). It also keeps people healthier, at work, and in a situation where they never have to worry about losing everything over medical bills; and that's good for the country and the economy.

[JDPriestly]

20. I lived in Europe for years -- had two babies there.

We were very poor, but we always had excellent health care. I support single payer insurance 100%.

I have a daughter who is a doctor. The reason doctors have to worry so much about making money is the enormous debts they have to take upon themselves to get through medical school and their residency in this country. To be fair, if we switch to single payer, we should forgive the enormous debts that young doctors have to take on to get through medical school. My daughter like many others who sacrifice to get through medical school was born to be a doctor. She loves her patients more than anything. But she is a responsible person and has to repay her education loans. She spends very little money. Her biggest expense is those enormous loans.

I wish you good health. Have you tried a nasal spray of salt water with aloe vera?

[Segami]

23. The Canadian Health care system for what its worth

Hi,...this is my first post on these discussion boards so please bare with me as I feel myself around. There are a lot of myths being promoted about the Canadian Health Care system and how Canadians are dying while waiting for critical life-saving surgeries. This link might help dispel some of these myths:

Excerpt:

"....I'm both a health-care-card-carrying Canadian resident and an uninsured American citizen who regularly sees doctors on both sides of the border. As such, I'm in a unique position to address the pros and cons of both systems first-hand. If we're going to have this conversation, it would be great if we could start out (for once) with actual facts, instead of ideological posturing, wishful thinking, hearsay, and random guessing about how things get done up here.

To that end, here's the first of a two-part series aimed at busting the common myths Americans routinely tell each other about Canadian health care. When the right-wing hysterics drag out these hoary old bogeymen, this time, we need to be armed and ready to blast them into straw. Because, mostly, straw is all they're made of."


The reality here is that it would probably be next to impossible to find a single Canadian who would welcome swapping their Health Care system with ours.


http://www.ourfuture.org/blog-entry/mythbusting-canadian-health-care-part-i

[Prophet 451]

24. I live in England

Under our socialised NHS, even with all it's admitted faults (mainly caused by underfunding and mismanagement for the last twenty-five years), here's how it would work:
You call your doctor, you get an appointment (probably on the same day), they either refer you or give you a prescription. You take the prescription to a chemist and pay £7 (roughly $15) as a contribution to the cost of the drugs. If you're old, poor or young, you're exempt from that charge.
If you have to be referred, you'll get an appointment probably within the next day or two, either with a hospital or, in some areas, a specialist. You're condition doesn't sound like it needs surgery but if it was needed, you'd be booked in sometime in the near future (contrary to popular rumour, waiting lists of months are rare and considered scandals. Waiting times are more likely to be a few days as the system prioritises urgent cases first), have the operation, stay in hospital until you're able to look after yourself (although being released into your family's care is very common) and then go home. A short time later, you'd get a follow-up appointment to check on your recovery and while you were incapacitated, you'd get provided with sick pay (not a fortune but designed to meet basic needs while you're unable to work).

All of that is funded directly from your taxes. The average family on the average income pays roughly twenty-two percent tax. Of that, slightly under a quarter (around 5% of your income) goes into the NHS and provides complete health coverage for absolutely everything except dental (due to a loophole in the legislation). Assuming an average income of around £24,000 a year, that means your personal contribution to the NHS is around £1200. That covers you for everything, under any circumstances. No suits deciding if you live or die, no questions about whether to withold care. Of course, people still die anyway but not for lack of money and your out-of-pocket expense is limited to that £7 contribution to the drug cost. Because it's collected as part of a progressive tax system, even the long-term unemployed and disabled are covered because everyone is covered by the same system, no exceptions. A few people still choose private care for various reasons but they have that care in addition to the NHS, not instead of it.

Now, don't get me wrong. The NHS is far from perfect, there are big problems in some areas but whenever some maniac MP suggests privatising it, they're shouted down and voted out of office and the general attitude of the public has always been that if ther are problems, you fix them instead of scrapping the system. Of course, the NHS is not the only way of doing universal care. The French are generally held to have the best system, the Germans have a very good one and I'm told that the Swiss system is quite something as well. Since the US is coming to this relatively late, you could easily do a study of the existing systems and then mix-and-match parts until you come up with something worthwhile.

[Vinca]

25. I feel for you, Herdin. No insurance here, either, and I live on Aleve.

A 3 year old muscle injury (untreated - who's got money for surgery?)causes me chronic pain. I've been intentionally avoiding seeing anyone about this just in case we ever get affordable coverage of any kind. I don't want a pre-existing condition on my chart. It's very sad that after a life of working hard, paying taxes, obeying all the rules and doing everything "right," we get swept off to the side of the road because big insurance is greedy and Congress is wimpy.

[Justitia]

26. You have to see an ENT. I got Meneire's Disease from repeated ear infections.

Of course, I have no idea how you do that w/no insurance, so I know my post is less than helpful....

Can you call some ENTs (Ear, Nose, Throat docs), explain your situation (repeated & persistent ear infections) and see if they will take you on a pymt program? Even if only a few dollars a month? I have to believe (or hope) there is an ENT out there somewhere who will see you.

I had repeated ear infections which were treated by my general practitioner w/antibiotics over and over. I finally saw an ENT who cleared those up, but I was left w/Meneire's Disease, which is a permanent condition.

You have to get in w/a specialist, please try calling some about a pymt program, I'm worried for you - those infections are miserable (so painful I would cry!) and permanent hearing loss could be the result.

Best of luck to you!

[Donnachaidh]

28. Herdin -- what sort of antibiotics did they give you?

The last really bad sinus problem I had I was prescribed Biaxin, which is VERY expensive but it cleared up everything. Luckily we have insurance to cover that. What sort of antibiotics have they been giving you?

[elias7]

29. Couple of things

First, if your antibiotic courses have probably been 7-14 days, that is often not long enough to treat a sinusitis. If your symptoms were improving, then worsened after ending antibiotics, it is not the antibiotic choice that is the problem , but the duration. For bad sinusitis, 2-4 weeks is appropriate.

Second, complicated sinus infections can have further complications themselves, with spreading of infection into deeper tissues. Usually this is not the case, but the point is this: If a typical sinus infection is not behaving typically, then it is time to see an ENT specialist (this was already mentioned above). You can have your local clinic refer you, your PCP refer you (demand it over the phone), or call ENT's from the phone book and tell them you were seen in the ER and they told you to follow up with them if not improving.

It is a tough call to come down hard on that local clinic. You may have seen 4 different practitioners-- i.e. no continuity of care-- and those types of clinics treat common things commonly. You probably should have been advised to make a follow up appointment with your own PCP after that 2nd visit to that clinic (the first recurrence of infection). That way, after 10-14 days of antibiotics failed to clear things up, you would have had a previously scheduled appointment with your doc, and an ENT referral would have probably been given at that point.

The current system is not perfect, but if you use your PCP as your guide, that works best. Maintaining a good working relationship with a PCP you are comfortable with is the best way to get doors open fast. Repetitive visits to a local urgent care facility, though expedient, is inviting the type of problems you're having.