(sigh) I had kinda sworn not to get back into this..
The worries of MKLD's MDs are not entirely founded. From what I know of the Socialized Medicine countries, they do not PROHIBIT either private practice or private insurance. So just calm down on the "enslavement" front, would you please?
MKLD, it's a matter, certainly, of philosophy, but when you say, essentially, let 20% of the population rot in hell, it's their poor luck.. because it's "better than EVERYONE having poor care in the LONGRUN." I'm not so sure (even if that were the case, which it's not... since most countries with UHC allow for parallel private options).
Inherent in this declaration is:
if there's $10,000 in health care dollars available from whatever source, it is better spent on ONE whiz-bang $8000 treatment (we certainly can't forget the ins. co. infrastructure/CEO /investors and deny them their min. 20%) than on ten random $1000 treatments bereft of markup. Is this credible?
In these discussions, we've heard:
-blame on the average person
-putative blame on the government
but I've heard scant blame on the ins. companies.
Tell me, in God's good graces, what the health insurance companies ADD to the equation. I can easily see how they SUBTRACT their CEOs' salaries, how they SUBTRACT the 10% or 20% they need to report to their shareholders (above and beyond what they SUBTRACT for their employees and brokers), but for God's sake, tell me what they ADD.. besides confusion and strife.
I understand that ins. co. bean-counting and gov't bean-counting will, to some extent, be similar.. but gov't. bean-counting won't have the profit motive to satisfy. If that's even a 20% savings right there, isn't it worth it? To bring those 47+ million into the fold of getting a baseline of some basic health care, no strings attached?
Hark to this: I am surely a capitalist, but when it comes to Dr. Durante's "hats, " he is Off His Rocker. "Hat" production can never be an example for health care delivery and WE ALL KNOW IT.
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Let me talk a bit about my BIL (not the one with the dry goods store.. this is another one).
BIL is an Italian radiologist. A good one, from what I can understand. He was the head of radiology in a major Italian hospital. There was a recent Italian law (with which I don't necessarily agree) that said doctors had to choose whether to operate solely in the public sector, or solely in the private sector. He chose private. That means he drives hundreds of miles back and forth from one private clinic to another, making somewhat more $ but without the stability of showing up in the same place every day and certain other protections. Fine.. Does that mean he can name his price? Not exactly, because the private structures have their own limits, based on profits, as they do in the US. Before, he may've complained about the stinginess of The State; now "it's personal" because he sees the 2 Porsches (one street model and one racing) that the head of the private structure concedes himself at the expense of the doctors and everyone else. He said to us a few days ago: "I earn 20. The nurses and support staff earn 10. And the big boss earns 70."
At an unrelated point in time, I'd asked him what percentage of health care in Italy was 'private'' and what percentage 'public'... he said about "50/50".
But that STILL means when you fall off a ladder and you need stitches (as happened to our friend), when you have painful kidney stones that need breaking up via lithotripsy (like DH, now approaching round 2 of 'bombardment'), when you are, like my MIL, 80 years old and can't walk because you 'need' (could benefit from) 2 knee replacements.. these things get routinely taken care of in public structures.. with a minimum of decency, without contestation, without filling out endless forms, and without paying more than a type of co-payment. In these cases, yes, you may wait a bit for non-emergency care, and you won't have a private room. You may be (gasp!) on a ward! You won't have five different choices of provided meals (your family will possibly bring lasagne, and a portable TV, either of which you are free to share -or not- with your ward mates). Impromptu card games of tre-sette and briscola may break out, and patients freely wander outside (across the street) to the local bar to take a coffee (or drink, or smoke) in their robes and jammies.
Meanwhile (in the US) an 80+ y.o. friend of my mom's fell and dislocated her shoulder and had to wait for 6 painful hours to be seen in a local US hospital. This had nothing to do with what level of insurance she had; it was just the way it was. If we'd heard this story from Italy, we'd say "oooo..socialized medicine", but when the profit motive is invoked it's somehow more acceptable for us to wait like sheep? Why? To immolate ourselves on the altar of capitalism to ''insure' that someone ELSE profits from it?
Insurance companies insure themselves first; while you are the vehicle, you are also utterly the minority interest in the affair.