Public and Private Medicine. "Is health care a right?"

[blondbeauty]

I am starting a new thread on this same subject because I find it very interesting, but I would like to point out a few things.
The quality of public health system and private medicine is the same. In fact the Drs. are the same in both systems. At least it is this way in Spain.
Prestigious Drs. work in the mornings for the public health system and in the afternoon they work in private hospitals or in their private offices.
For example, the Dr. that treated my fatherīs cancer works for the public hospital "12 de Octubre" and also has his private office called "Oncocenter".
All Drs. have the obligation by law to work in a public Hospital for 4 years before obtaining their university degree.
The difference with pulic Hospitals is that they donīt want to attract new patients because they do not obtain any profit. New patients mean more work and more waste of money. Private Hospitals want the opposite because the more patients they have, the more money they earn.
Another difference is equipment and facilities. Public Hospitals always have the latest and best equipment because the govenrment pays for it even if they donīt need it and replace it as soon as a better one comes to the market.
Private Hospitals try to obtain the most profit possible of their equipments before buying new one.
Comfort is the field in wich private hospitals win. But in case of accident ambulances always take you to emergency rooms of public hospitals.
Even if you have the best private insurance in the country or are the richest person in the community you always have to visit a Dr. of the Public Health System when you have to justify your absence to work for any health issue. An evaluation in a private clinic has no value for the employer and for the social security that pays you for the days you donīt go to work.
Public hospitals are usually crowded. That is the main concern of Public Health Systems. It took me one month to  have my first appointment at the Hospital after my diagnosis. But after the first appointment everything went really fast: two days later I was tested again for HIV and all other possible infections, had an electrocardiogram and X-rays. I entered the Hospital at 9.30 and left at 11.00 with all the tests done.
Two weeks later I had my next appointment were HIV infection was confirmed (they never trust medical reports from other clinics and always repeat all the tests).
On my last visit I had my check up with another Dr. because Dr. Yebra was completely booked till the end of February. He always makes me wait 45 minutes but this time I did not have to wait for a second. I approached the nurses desk and was sent immediately to the Drīs office. Much better than in any private clinic.
Ok...The hospital is old (from 1964) and a bit depressing, but everything is perfectly mantained, equipment is always the latest technology, nurses are wonderful and work brilliantly.
The Pharmacy department (where I collect my meds) is always fast. Never more than two people queueing. They really care, and always have a protocol that controls when are you going to run out of meds. If you donīt show up to collect them 3 days before you run out of them they phone you or send you a telegram (if you donīt pick up the phone).
Before being HIV+ I had never been to a public hospital. Burocracy is complicated at the beginning but once you are in the system everything is smooth and fast.
For Hospitalization a private clinic is much better. Private and more comfortable rooms wich are not available at public hospitals. But private insurance companies always send you home as soon as possible because you are costing them money...
Public and Private Medicine are not enemies. They are both needed. They complement each other. Without private medicine the national health system would be even more overcrowded.
Fortunately the National Health System is building 8 new hospitals in Madrid. Mine will be closed this year and I will have a new one 2 km away from home. No more half an hour drives.
Two links so you can compare the comfort of public and private medicine.
Hospital 12 de Octubre (a classic public hospital): http://www.h12o.es/
http://www.h12o.es/nuestro_hospital/galeria/index.php?img=hosp_insta
http://www.h12o.es/nuestro_hospital/galeria/index.php?img=hosp_panor
Onconcenter (Nice private Clinic):
http://www.oncocenter.com/

[blondbeauty]

A picture of my hospital...

[attachment deleted by admin]

[Cliff]

The quality of public health system and private medicine is the same. In fact the Drs. are the same in both systems. At least it is this way in Spain.

I don't think this is true of all countries.  But if people are paying extra for private health insurance, they must be paying for something...either better quality of care or reduced waiting times.  Otherwise, why spend money on having private health care if you are going to get the exact same service you would get from the government?

The benefit, I'm told, of my UK private health insurance is...

1.  Faster service (NHS is slow in referrals and has waiting lists for many types of treatments)
2.  Access to more up to date treatment options (particularly in terms of cancer) and better technology (NHS often does not update its infrastructure in order to keep cost low and stay within operating budgets)
3.  More privacy (NHS sticks you in wards, whereas private care gives you a private or semiprivate room)
4.  Sometimes, access to meds that the NHS has not approved or does not pay for, but are shown to be effective (for example you can get access to certain types of expensive cancer meds that the NHS will normally not approve as a first or second line treatment option because of costs)

But private insurance doesn't cover certain illnesses (such as HIV).  So I suppose it's not really appropriate to compare it to US insurance, because US insurance is (usually) comprehensive and by law companies can't routinely exclude certain illnesses from coverage, like they can in the UK.  I don't know if the same is true in Spain.

[blondbeauty]

Of course Cliff. I absolutely agree with you in all the points except in one: access to meds. In fact here is quite the opposite. When my father was diagnosed with tongue cancer he went to his private insurance clinic in Madrid. The treatment was going to be cutting off his tongue. He would never be able to talk again. It was the Public Medicine the one that had more advanced treatments.  Private insurance wouldnīt pay either for the medication needed to protect his salivary glands that would have been damaged with the radiotherapy. If he had been treated privately he would have no tongue, he wouldnīt have any saliva in his mouth and would be probably dead. 8 years ago PET was only available at the social security hospitals. His private insurance hospitals that belong to BUPA have bought this machines this year! An 8 year delay...
For minor things I prefer private clinics, of course! They ALWAYS give you private and nice rooms for you and a relative to spend the nights with you. In public hospitals this is usually unavailable. New ones have private rooms.
I still keep my two private insurances. I use to go to the dermatologist, to have my flu vaccinations, etc. It is much nicer. Having the possibility of both choices is great.

[koi1]

Sadly the reason we don't have higher level of care for the masses in the United States, is because we have not invested in an effective public healthcare system. This because of scare tactics used by Republicans who say that it will bankrupt this country. Of course much of what is bankrupting us has to do with Republican corporate welfare, corruption, and the high cost of exporting war to our economic interest areas.

Since there is no realistic attempt to make public healthcare a priority, relying on it means mediocre care at best, and a stigma that you have to go where the poor go. I have HMO coverage and so far it has been pretty good. But HMO waiting rooms are starting to resembel public hospital waiting rooms, because the government allows the level of care to deteriorate in all but the elite sector.

My employer pays 600 dollars a month for me to have this benefit. I find it hard to believe that healthcare cannot be had for a fraction of this if we had Universal healthcare. The sorry ass excuse that it will bankrupt this country needs to die, because we can all become wards of the public healthcare system, as most Americans live paycheck to paycheck. The sad thing is that our health is something we all need to live socially and economically productive lives.

Once again it is all about priorities, and as far as healthcare, education and the environment, we are failing miserably in this country.

rob

[Boo Radley]

I don't care what anyone says, the USA needs to adopt real universal health care like most of the other countries in the civilized world.   As a nation we pride ourselves on our high standard of living but allow such a large number to exist in severe poverty with all the problems it brings.  It's a disgrace.

This year my HIV meds are covered under my Medicare prescription plan for a $25 copay.  Last year there was an annual cap of about $3000 on coverage of such meds, forcing me to apply for Ryan White funding.  Since my SSD check is about the same amount as a month's supply of HAART meds out-of-pocket would be rather tricky.  I don't know if the new prescription coverage will last but if it does it's certainly a step in the right direction. 

As one who used homeowner's insurance to pay for the damage done by Katrina I was unpleasantly surprised to see about $800 of surcharges on my homeowner's policy for 2007.  All private insurers in the state are required to pay the state's  insurer of last resort based on claims paid by the state plan.  The private insurers are, of course, allowed to recoup the money from policyholders.  Why can't the administratively swollen bureaucratic private health care insurers be required to do the same thing?  Pass laws limiting the remuneration of top level administrators who make obscenely large salaries while ever-increasing the costs and reducing benefits to policy holders. 

Providing universal healthcare is a unique challenge in the USA but I fully believe there are feasible options that could be implemented with re-allocation of existing funds and a minimum of new taxes.   Let's start with the military budget, for instance.

Boo

[blondbeauty]

One of the things I hate most...waiting rooms...

[attachment deleted by admin]

[libvet]

Providing universal healthcare is a unique challenge in the USA but I fully believe there are feasible options that could be implemented with re-allocation of existing funds and a minimum of new taxes.   Let's start with the military budget, for instance.

Boo

Good luck with that.  That idiot in the White House wants to take 70 billion dollars AWAY from medicare and funnel it into his stupid little "must have a legacy" war.

It seems to me, that bastard and his cronies in his administration and his supporters care more about Iraq than America.

But you are right, given that we already spend more per capita than countries that already have universal health care, there is absolutely no reason we cannot find a way to do so.

As I have said before, the only thing stopping it is unwillingness to do so, greed on the part of the insurance companies, and the invertebrates worried that if they support universal health care their money pot from the insurance company that they use for re-election will dry up.

[northernguy]

There are many different forms of public healthcare.  The Canadian one is quite strict.  While private hospitals are allowed, they cannot charge patients for care.  All payments must go through the gov't funded system.  So the hospital where I have my labs is owned by a Catholic charity but all the care they do is paid by the gov't.  Every so often some clinic tries to set up a user pay system, but is quickly jumped on by the provincial gov't which doesn't want to risk losing their federal funding through the Canada Health Act.

The danger of a two-tier system can be seen in the first post: lack of investment in public infrastructure, and the leaving of docs from the public system to the private.

You can find some interesting info on comparisons here:
http://www.canadiandoctorsformedicare.ca/myths.html

[pozniceguy]

I have followed this thread in both runs.......I feel that there is some real misinformation floating around......I have lived in Europe and had extensive dealings in Asia where people who worked for me used the "local " Health systems.....In England  the NHS is available to anyone..we used to have a virtual boatload of young women come  from France on Friday so they could have an  outpatient abortion  go shopping in London and go home on sunday......a real abuse of the system, but one that can be expected with "no question" healthcare....the good part is that even if you were a tourist and had an accident you were sent off to a hospital for emergency care without question... There was also the "private " parallel system...some of us were privileged to have access and the Dr's were the same as the ones on the NHS ( they were required to take a portion of their patients as NHS)  but the service was much better., we could get an appointment almost immediately but the NHS patients may wait weeks or more for one.
Similar situations seem to exist all  over the "civilized" world....Since I primarily dealt in "Industrialized countries" I really cannot comment on places like central Africa,parts of So.America, and many of the countries of SEA.....which don't seem to have much health care at all
The point I am very slowly getting to is you can have any system of "healthcare" you want to support.....I read the threads about problems in Canada, Australia, France  & Germany plus all the moaning about USA  which just highlights the issue of you get what you accept......
If you ( primarily the USA moaners) want different methods of delivering healthcare then there is only one rational solution...VOTE...get involved...be sure that is a topic at every appearance of anyone who is running for anything..national as well as local...be sure your voice is heard....Make that THE topic at whatever political gathering is happening anywhere near where you live...election year is coming up ...YOU GET WHAT YOU ACCEPT...... stop moaning about what is being spent on Military( these people are volunteers trying to implement official policies) , forest protection( the tree huggers have done well) , global warming( no takers so far ), protecting the whales, drilling for oil in Alaska( the Moose are now well protected ) , or any of the other political hot potatoes and go out there and get your your issue at the top of the funding priorities..

one note of caution...be sure you know what you want...you may get just what you ask for....  There are no "entitlements" only those programs that were fought for by a concerned group of citizens ( OK sometimes by some crooked pols)..there is no infinite budget..if you get some then someone else will get less....let your conscience be your guide  ( OK just be totally selfish) 

Nick