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Forums > Social Discussion > Why we need NATIONALIZED healthcare.

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:So I have now worked as a physician in two different countries with nationalized, single-payer systems. These are the U.K. and Spain. In both countries, the system has its drawbacks and faults. There are delays to receive care, there is bureaucratic run-around, but one thing there is NOT is denial of service. The NHS and the Spanish healthcare systems have nowhere to punt their patients and thus have to take care of them.

I have been told that my healthcare was "inactive" three times this year. I have been charged an inordinate amount of money. I have been denied essential medicine. And if there is more than one payer, they are going to try to punt their expensive patients.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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hamamelis
BRONZE Member since Jan 2006

hamamelis

nut.
Location: Bouncing off the walls.

Total posts: 756
Posted:If we didn't have the right to refuse medical treatment then possibly you'd have a point, Stone, but we do-
unless we're unconscious, in which case that goes to the next of kin. It is also possible to leave instructions to refuse treament in a situation where you would be unable to at the time, for example in cases of terminal illness, you can request to not be resuscitated.

I'd see it as much more of a threat to my liberty to be refused medical treatment because of my personal situation than to be offered it regardless.. I really don't get your logic.


THE MEEK WILL INHERIT THE EARTH!


If that's okay with you?

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Stone
GOLD Member since Jun 2001

Stream Entrant
Location: Melbourne

Total posts: 2830
Posted:Lightning, if Im making no sense then what is the current AMA stand on universal health care? The have opposed it in the past. Do they support Obamas universal health care policy?



Since you bring up the military, Im wondering what the reaction would be like in the US if conscription was introduced in response to the continued wars in Iraq and Afghanistan.





hamamelis, I never suggested that people should refuse medical treatment. The point was about the nanny state argument (socialized health care). And, regardless of whether people think this is a myth, the loss of freedom it is a real issue in the "USA" universal health care debate.



For example, Contrary to claims that government-imposed universal health care would solve Americas health care problems, it would in fact destroy American medicine and countless lives along with it. The goal of universal health care (a euphemism for socialized medicine) is both immoral and impractical; it violates the rights of businessmen, doctors, and patients to act on their own judgmentwhich, in turn, throttles their ability to produce, administer, or purchase the goods and services in question.

EDITED_BY: Stone (1215437968)


If we as members of the human race practice meditation, we can transcend our fear, despair, and forgetfulness. Meditation is not an escape. It is the courage to look at reality with mindfulness and concentration. Thich Nhat Hanh

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:OK, Stone. I give up. You're not listening to me. You aren't reading my posts. You're just arguing for the heck of it.

-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Dom
BRONZE Member since Dec 2001

Dom

Carpal \'Tunnel
Location: Bristol, UK

Total posts: 3009
Posted:OK, Stone, if you're quoting then please give the source as quotes give only a small part of an argument and with the full article we know more where you're coming from. The source is this article in The Objective Standard magazine by Lin Zinser and Paul Hsieh.

As somebody who has worked in publicly funded research units within public funded hospitals in a publicly funded universal heathcare system I read that quote and laughed at the blinkered, pro-insurance, anti-liberal, knee jerk statement it leapt out as being.

It's a long article but the editor of the magazine sums up the argument in an interview thus:
 Written by

...a recent article titled "Moral Health Care vs. 'Universal Health Care'" shows that so-called "universal health care" is factually immoral, that health care providers have a moral right to use and dispose of their products as they see fit, that the government has no moral right to coerce them in any way, and that the recognition of these facts is good for everyone.



The article first slams the current US system and works on then works on the basis that a universal health solution dictates the miniature of management from central government, finally concluding that a fully free market through health insurance is the only answer. The article looks a lot at Canada's seemingly strict system, and only pays passing attention to Sweden and the UK, quoting only one Swedish case and a one BMA statement, leaving out many of the salient points of the statement. Which is a shame. It also refers to these systems as "allegedly ideal", which anyone in the UK knows not to be the case.

In the UK there's been a campaign against the centralised control until recently enforced on NHS hospital, with the doctor and patient led movement leading to the more localised control systems we used to have. Centralised control is one of the main premises of Zinser & Hsieh's arguments against universal healthcare but it needn't be a deciding factor. The health minister shouldn't be deciding what colour the plasters are.

The article does touch on what Stone's referring to on health care being on the slippery slope to the limitation of rights, but I don't get it:
 Written by

A final (and often unacknowledged) consequence of government interference in medicine is that it leads to violations of individual rights in other areas of life, such as violations of the right to free speech and mandates regarding what people may and may not eat.


I don't get it, there's no direct and proven link. Interestingly the US has some of the tightest controls of food produce in the world, from unpasteurized cheese to artificial trans fats.

I think Lighning's original post was frustration at the current US system of insurance controlled access to healthcare, not a call for a particular universal health care plan. But as a doctor he's probably best qualified of all of us to outline what such a system should allow.

On the topic of the US health system, just looking at the numbers there does seem to be something wonky. The US healthcare system takes up 15.3% of GDP, but leaves 47 million people uncovered (source). Nobody else spends that much, the UK covers the entire population on 8.4%, which is a $6714/$2760 per capita difference. At the same time that the government is spending so much money and millions can't afford to get treatment the insurance companies are making vast profits (surely the presence of the medical insurance layer to almost the entire US system soaks up a lot of cash). The pharmaceutical companies can probably afford to buy countries with their profits. I'm sure most people see this imbalance as fundamentally injust and in need of balancing.
Figures from 2006: source

Me, I'm a fan of the public/private hybrid system we have in the UK today. I've used both systems and both worked well for me and people I know for conditions both minor and chronic.


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Stone
GOLD Member since Jun 2001

Stream Entrant
Location: Melbourne

Total posts: 2830
Posted:OK Dom, for a start Im not arguing against mandatory health care. I agree with nationalized health care, and Ive said that a number of times. Perhaps you need to read the whole thread. And the helmet thread, where it was stated (not by Lightning, but in the same nanny sate argument) that any legislation that could increase the general health of the population, was one of the scariest statements ever uttered on this forum. Then you might see where Im coming from.

 Written by Dom

I think Lighning's original post was frustration at the current US system of insurance controlled access to healthcare, not a call for a particular universal health care plan. But as a doctor he's probably best qualified of all of us to outline what such a system should allow.



The title of the thread is Why we need NATIONALIZED healthcare. Nationalized healthcare is also referred to as universal health care in many sectors. Perhaps that was misleading.

My point is if people use the nanny state argument, the slippery slope to the limitation of peoples rights argument, the pro-choices argument if you like. Then it seems rather incongruous to me, to then turn around and suggest that its a good idea to start nationalizing things. And I agree nationalized healthcare it is a good idea, no problem. However, Id suggest you are either pro-choice or not; not pro-choice when it suits. Furthermore, Id suggest that its the whole nanny state argument that is the cause of the problem in the first place. So, you are either part of the problem or part of the solution. Not part of the problem one day, and then part of the solution the next.


If we as members of the human race practice meditation, we can transcend our fear, despair, and forgetfulness. Meditation is not an escape. It is the courage to look at reality with mindfulness and concentration. Thich Nhat Hanh

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted: Written by :Stone


My point is if people use the nanny state argument, the slippery slope to the limitation of peoples rights argument, the pro-choices argument if you like. Then it seems rather incongruous to me, to then turn around and suggest that its a good idea to start nationalizing things.



You have yet to demonstrate one right or choice that people will have removed from them if everyone has healthcare.

What, the right to not have health insurance? You can cut up your health card. You can steadfastly refuse to go to the doctor even if your arm is hanging off by a thread. You can walk around happily with a blood pressure of 300/200 and not know it. Nobody's forcing you to do anything.

You haven't addressed that argument and that's why I'm not responding to anything you say until you do.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Dom
BRONZE Member since Dec 2001

Dom

Carpal \'Tunnel
Location: Bristol, UK

Total posts: 3009
Posted:And nationalised health care isn't a limitation of choice, it's adding a choice for those who can't afford, and for those who can there's still a choice.

So, like Lightning, I don't really logically see how you equate nationalised health care to a limitation of rights, or along the same lines of a seat belt ban, which is there to protect people, especially minors (people not wearing seat belts can kill other people). They seem to me to be 2 seperate issues dealing with different ideologies.


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dream
SILVER Member since Jul 2003

dream

currently mending
Location: Bristol

Total posts: 493
Posted:While my sentiments are entirely behind Dom and Lightning here... I think you're technically wrong.

When the NHS was announced by labour politicians it created extreme hostility amongst doctors. They were livid that were going to lose their freedom not to treat poor people. Their individual freedoms were being restricted so as to grant collective freedom to millions of people who previously could not afford medical care. So I guess nationalized heath care comes down to which set of rights you feel are more important.

1. The right of everyone in the country to receive medical treatment - the principle behind this being that all citizens should be treated equally.

2. The right of doctors to only treat those who can pay them handsomely

3. The right of rich people not to pay taxes which are spent on treating the poor

If you were to abolish all private medical practice in favour of socialized healthcare then you could add

4. The right of rich members of the community to receive a superior service to poor people.

Both 2 and 3 clearly violate the principle behind point 1. If you believe in inequality of opportunity then you don't also believe in equality... If you believe that everyone should have equal opportunities in life, then you'll struggle to maintain ideological consistency within capitalist models such as privatized health care...

For me making sure that everyone is looked after, in terms of health care, education, public transport systems, social security and access to art, culture, and public spaces are way way more important than making sure that a select few people are able to continue to live at ridiculously high and ecologically unsustainable standards.

...and there's my answer to Lightning's question from earlier... If we want universal (rather than national) health care it could be achieved; although it would be a massive undertaking which would encounter stubborn resistance - much like the founding of the NHS 60 years ago... However it would have to be predicated on a system whereby many of the extravagant luxuries enjoyed by the global rich; private yachts, numerous homes spread across the globe, sports cars, jet set lifestyles and other things, in order for everyone to have access to free health care.

Personally I feel it is morally wrong that we live in a world where treatable diseases like malaria and tb kill over a million people a year each while the wealth that could be spent eradicating these maladies is frittered away on luxury consumer goods and (my old friend) the international arms trade.

Medication not Bombs

In the UK we about to spend 75 billion pounds (about $150billion) replacing our nuclear weapons capability. This breaks down as 25 billion for the design and build and then 50 billion maintenance and disposal over the next 50 odd years. Given that the only apparent purpose of these weapons is to threaten other countries with annihilation I would gladly scrap the project and see all that money poured into international (or national) health care.

If the US followed suit then maybe the rest of world would stop hating us both... Instead of being seen as imperialist bullies who're responsible for murdering millions across the globe in order to maintain our economic dominance we could be states which provide life and good health to hundreds of millions.

The chances of this happening while the US refuses even to treat all of its own citizens however seems slim.


He who fights with monsters might take care lest he thereby become a monster. And if you gaze long into an abyss, the abyss will gaze back into you.

Nietzsche

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted: Written by :dream


 Written by


2. The right of doctors to only treat those who can pay them handsomely




Which doesn't exist...


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Stone
GOLD Member since Jun 2001

Stream Entrant
Location: Melbourne

Total posts: 2830
Posted:Dom, I think you got it.


Seat belt laws good, nationalized health care good.


If we as members of the human race practice meditation, we can transcend our fear, despair, and forgetfulness. Meditation is not an escape. It is the courage to look at reality with mindfulness and concentration. Thich Nhat Hanh

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:No, seat belt laws=nannying people

Mass education about the importance of seatbelts=educating people

Nationalized healthcare=taking care of people


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Dentrassi
GOLD Member since Apr 2003

Dentrassi

ZORT!
Location: Brisbane

Total posts: 3044
Posted: Written by :dream



1. The right of everyone in the country to receive medical treatment - the principle behind this being that all citizens should be treated equally.



2. The right of doctors to only treat those who can pay them handsomely



3. The right of rich people not to pay taxes which are spent on treating the poor



If you were to abolish all private medical practice in favour of socialized healthcare then you could add



4. The right of rich members of the community to receive a superior service to poor people.









Point 2 - so doctors shouldnt have the same freedom to do as they choose? Im no doc, but I can certainly refuse work if someones not going to pay me as much. Rights of doctors who have worked there ass for 10yrs to get qualified i suppose dont count.



Point 3/4 - ahh the entire rich vs poor debate. i pay for private health - cos its my life and i consider it worth it. Am i rich? not really - i work hard and earn a good wage - but im not darting off to my superyacht every weekend or anything.



I work hard and earn money so i can travel, buy a house, buy nice cheese, dance till 5am, occaisionally juggle, and drink lots of wine. Is spending some dough to increase the standard of my health care any different from the other things i do to improve the quality of my life?



Im all for a decent public hospital system - but also for the right to choose how i earn my money and how i spend it.



peace out.

D ubbrollsmile

EDITED_BY: Dentrassi (1215652105)


"Here kitty kitty...." - Schroedinger.

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted: Written by :Dentrassi


Point 2 - so doctors shouldnt have the same freedom to do as they choose? Im no doc, but I can certainly refuse work if someones not going to pay me as much. Rights of doctors who have worked there ass for 10yrs to get qualified i suppose dont count.



Actually, in an emergency situation, a physician may not refuse to treat a patient on the basis of inability to pay. And this is one reason why doctors get paid as much as we do. Or used to, anyway.

However, for elective/preventative care (which can often prevent said emergencies) the physician may refuse to treat without renumeration.

Now, there is a major difference between healthcare and emergency care. Healthcare is, to a large degree, about preventing emergencies.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Dunc
GOLD Member since Aug 2003

Dunc

playing the days away
Location: The Middle lands

Total posts: 7263
Posted:I completely agree with Doc, nationalised health care is an important part of a nations health. We pay texes for police/fire/ambulance rescue to protect us, for army/navy/air force to protect us, we pay taxes for nice roads that are safe to drive on and for the cleaning of streets and taking away our rubbish, we pay taxes for buying things and we pay taxes even when we inherit the riches. Why not pay taxes for a health care system that helps look after us/protect us/keep us in a clean state of health and so we can survive longer for our children to inherit our riches (financial or otherwise lol).

I'm glad I live in a country with "free" national health care, I feel very privilaged.

If people want to pay for special private care thats fine, I still feel I get value for money from my tax smile


Let's relight this forum ubblove

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:Yup, and I'm still waiting for Stone to explain how this compromises individual liberty in any way.

-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Dentrassi
GOLD Member since Apr 2003

Dentrassi

ZORT!
Location: Brisbane

Total posts: 3044
Posted: Written by :Doc Lightning


Actually, in an emergency situation, a physician may not refuse to treat a patient on the basis of inability to pay. And this is one reason why doctors get paid as much as we do. Or used to, anyway.

However, for elective/preventative care (which can often prevent said emergencies) the physician may



hmmmm interesting info. make sense of course when you explain it. out of curiosity are there any other type of professions where legally you have to do something or is its restricted to the medical field?


"Here kitty kitty...." - Schroedinger.

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dream
SILVER Member since Jul 2003

dream

currently mending
Location: Bristol

Total posts: 493
Posted:Firefighters...

They don't drive up to your door in a fire engine, see your house is on fire and then decide not to put the blaze out... Although they used to... In days gone by if you hadn't paid for fire brigade insurance the fire engine would turn up at your house, see that you didn't have the badge which denoted that you were a member and then drive off leaving your house to burn down. eek

A while back (in the UK at any rate) people decided that it was more important to stop people's houses burning down then to maximize the amount fire fighters could charge. So the fire service became a socialized service which would help everyone when their house was burning down.

...and I'm pretty sure I pointed out how nationalised heath care infringes on doctors civil liberties in my last post. The thing is it's a toss up between the 'rights' of a doctor to charge as much as he can in a free market (which will be a lot as people will pay whatever they can to ensure they are healthy if they are sick) and the rights of all citizens to receive health care.

Either way someone loses out... But in my eyes making doctors (who aren't badly paid people over here) treat poor people seems reasonable. Leaving poor people to suffer because they aren't rich doesn't seem so reasonable. When the NHS was founded in the UK the government was shocked at how many people needed glasses, dentures and other fairly straightforwards treatments for ailments they had often had for years but could not afford to have treated. Additionally within a few years of its launch contagious diseases were down about 80% in the UK as people actually went and got treated instead of passing the disease around to a bunch more people who also couldn't afford treatment. Trading the freedom of doctors not to treat poor people to sort these problems out seems like a fair trade to me - there are numerous situations where you have to weigh up this kind of situation where both decisions involve a certain loss of liberty, and in this one I think the freedom of doctors to choose rich patients is less important than the freedom of poor people to get treated.

The average GP in the UK earns over 100,000 pounds a year. That's not exactly bad money. If you don't think that's enough money to live a comfortable life with then you have issues... Besides which... If you want to be a doctor you ought to do it because you want to save lives and help people become/stay healthy, not because you want to make as much money as possible by only treating rich people.


He who fights with monsters might take care lest he thereby become a monster. And if you gaze long into an abyss, the abyss will gaze back into you.

Nietzsche

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Nee
BRONZE Member since Jul 2008

newbie


Total posts: 15
Posted:I'm in Australia and I cannot believe that the most powerful country on earth and possibly the richest doesn't have nationalized health care. What's more, it's not even a very hot topic (from what I've seen from the coverage of the presidential candidacy). In Australia, if your income is under a certain amount (basically, if you don't earn a small fortune), all of your hospital needs are covered, most of your general practioners, and many essential medicines are covered by a pharmaceutical benefits scheme. Whenever I hear people complaining about the long wait for in the E.R, I think of the US and feel greatful.

The problem with the user pays system of the US, where you pay for everything, is that it assumes that everyone has the same ability to look after themselves. The minimum wage earners (and let me tell you, US minimum wage is just laughable, its SO bad) of the world are just as important as everyone else and without them, no economy could function. They work just as hard as everyone else so why shouldn't they have access to essential medical care? The idea that if you can't look after yourself, you go without is ridiculous in my opinion - if that were the philosophy to adopt, we'd be leaving the elderly, disabled and even children on the street to fend for themselves! Doesn't make much sense, does it?


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natasqi


natasqi

addict
Location: Perth

Total posts: 489
Posted: Written by :dream


The average GP in the UK earns over 100,000 pounds a year. That's not exactly bad money. If you don't think that's enough money to live a comfortable life with then you have issues...


100,000 pounds??? Isn't that $300,000AU?
*starts packing*
You sure thats average??

 Written by :dream

Besides which... If you want to be a doctor you ought to do it because you want to save lives and help people become/stay healthy, not because you want to make as much money as possible by only treating rich people.


ARGH! I hate this! I really really do.
An accountant doesn't have to want to 'save people from financial hardship'
A physicist doesn't have to want to save the world with science.
A receptionist doesn't have to do it because she wants to be so efficient that her company rules the world.

I don't see why a doctor isn't allowed to be a doctor because he like science and is interested in how the human body works. Why can't you be a doctor because you like the travel opportunities that a medical career brings you, or because you like the variety.
Or why can't you be a doctor for the financial security?

Nearly all doctors would have the choice of working at X place and saving 10 lives a day but only working for accomodation, or working as a GP in Y and practising preventitive medicine, maybe saving one life a month but getting $100,000 a year (apparently).

I completely agree that healthcare should be nationalised.. I like Australia's system, and I don't believe people should have to pay huge amounts to get treated.

But I don't like the attitude that most people have that doctors have to be superheroes and only think of other people.

Anyway.. If I earnt $300,000 one year, it would mean I could go work in place X for 3... then come back, earn $300,000, then go work place N, helping amputee victims or something.
Not everyone who earns a lot of money is using it to buy a private yacht.

*end rant*


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Mr Majestik
SILVER Member since Mar 2004

Mr Majestik

coming to a country near you
Location: home of the tiney toothy bear

Total posts: 4693
Posted: Written by :natasqi


Not everyone who earns a lot of money is using it to buy a private yacht.




actually.................. my gp did. that and holidays to greece.

although i dont see why they shouldnt be able to spend their money doing whatever pleases them.


"but have you considered there is more to life than your eyelids?"

jointly owned by Fire_Spinning_Angel and Blu_Valley

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted: Written by :dream


Besides which... If you want to be a doctor you ought to do it because you want to save lives and help people become/stay healthy, not because you want to make as much money as possible by only treating rich people.



I became a doctor for many reasons. Some of them are private. But only I know all my reasons. Nobody else.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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