To be really shocked by the Panorama show Poor America

[MrsHeffley]

I just can't believe that Americans don't care how their poor get literally no healthcare or help at all ie no job no food,home,benefits or healthcare what so ever.

I love America and we have American family but dp and I were appalled and totally shocked.

All those families living in drains and tent cities,schools sending kids home with food and worst of all zero healthcare and all those hundreds of desperate people queuing up in cars on the off chance of free medical care,the girl whose mum ate rats.....

The complete utter lack of hope.I just don't get how such a rich country can justify in all these years not voting in free healthcare for the poor at the very least.

Elaine
but the USA is the richest country in the world - on average
it has NO EXCUSE to be other than at the top of league tables of personal welfare.

I agree! Completely. Just saying it goes way deeper than the healthcare system.

Just wrt infant mortality rates -- though rates are not good in the US, there are different standards as to what constitutes a live birth in the US than elsewhere. Any baby born with any vital signs at any stage of pregnancy (outside of elective abortion) in the US, is classified as a live birth. Obviously a lot of very pre term babies will not survive and would not survive anywhere. In many other places however, those babies would not be classed as live births and their deaths do not count for the purposes of infant mortality stats. Many European countries do not record as live births infants weighing less than 500g or before 22 weeks gestation (Ireland, France, Poland, Netherlands, Czech Rep). In Japan and HK, there is a suspicion that a lot of reported female stillbirths are not in fact stillbirths.

Probably more instructive as an indicator of quality of life is the fact that the US has a lot of pre term births and low birth weight babies compared to full term births and average weight babies, just using US stats alone.

Thta's very interesting Math. Didn't know that

Its horrific. I lived in the states for six years and witnessed some truly appealing poverty. So sad how far removed the country has become from its original ideals. Interestingly, its the only western country where becoming seriously ill will likely bankrupt you and leave you homeless.

Just wanted to say, I'm from the US, and I haven't seen this show but the situation there is not as black and white as it sounds the show made it seem. Most people are good people, but they may just not know how the other half live--it's easy to live your life there and never really meet or deal with truly poor people. It's not just the fear of socialism; I genuinely think most people have no idea how hard some people have it.

When I lived there a few years ago, I had a full time job and private health insurance. It cost about $300 per quarter but I still had to pay $35 every time I visited my GP, and my BCP was $50 per month! My dad is an allergist and his receptionist spends tons of time dealing with insurance companies. It's a nightmare. If you get health insurance through your job and you lose your job, you're screwed.

One thing to keep in mind with all this is that the USA is effing HUGE. California is the size of the UK (by population and area). I can imagine individual states creating a NHS but for the entire country to do it, well that is a massive admin and logistics task.

The problem is that the people in government are all in bed with big business, and are not held accountable to the people. There is also propaganda in the media and the education system, and lack of reporting on the stuff no one wants to know about.

Regarding emergency care, if you call 911 the emergency services have to come. If you turn up at A&E, they have to care for you. People will wait until their illness is an emergency because of this. You will receive a bill afterward that you can pay off in installments. There are also some free dental clinics. Pregnant women and children up to the age of 5 also get some free care but it is not ideal.

Healthcare is one big reason my English DH and I still live here.

missuswife is right: the US is huge. Don't forget that the population is almost 400m, which is close to the population of the whole EU. Imagine if an American documentary film team came to document Europe's 'socialist' nightmare (in their eyes!) and lumped in people suffering austerity in Greece with post-communist change in Poland along with the welfare state in the UK, France and Sweden. It's a big area to cover. California is a different world to Tennessee and that's why it's so hard to get any consensus on political reform.

The biggest issue I can see with US healthcare is that it is an immensely complicated and convoluted attempt to avoid a single payer system like the UK/ Canada. The US has tied itself in knots to avoid single-payer when it's half-way there already via Veteran care, Medicare/Medicaid, COBRA and legislation that obliges ER rooms to treat the uninsured. Why not just admit defeat and stitch together the gaps so no-one falls through the safety net anymore? Obama's original plan for healthcare reform was intended to achieve that and let's hope it does but there is so much opposition to any kind of action at all from the Republicans, it's hard to see how the Democrats can progress anything, especially with the election this year.

missuswife:
The problem is that the people in government are all in bed with big business, and are not held accountable to the people. There is also propaganda in the media and the education system, and lack of reporting on the stuff no one wants to know about.

Yes, this point really needed to be made. There are many, many people in the U.S. (who elected Obama, who supported his healthcare bill and/or objected to it because it didn't go far enough) who want universal health care because it's a basic human right and the only decent arrangement for a civilized society.

Then there are people who oppose it. And while I find it impossible to understand the mindset of opposing the provision of health care for anyone, I think that it's important to note that the majority of people who oppose it don't do so because they think that poor people are all lazy and don't deserve to live.

Most people who oppose it do so because they are bombarded with scare-mongering (from politicians in bed with insurance companies, from drug company ads on television, from Fox news et.al) about what socialized health care would mean: that if they have a heart attack, they will have to wait six months on a waiting list for an emergency by-pass, and then travel 10 hours out of state to be operated on by a doctor they've never met who has probably not read their file.

That is the view that many Americans have of socialized medicine, and I think that for most of those who oppose it, that's the reason why. Not because they're heartless, but because they're terrified.

I don't think that excuses anyone's opposition to universal health care; I don't think there's any excuse to see health care as anything other than a basic human right. But the lobbyists and propaganda machine are a very important part of the story, and that's been largely missed here.

'Why not just admit defeat and stitch together the gaps so no-one falls through the safety net anymore?'

Because the system is not conceived as a safety net.

The system is conceived as a business enterprise that exists to make a profit for hospitals, and a very good living for doctors and insurance company employees and shareholders and equipment manufacturers and pharmaceutical companies and their shareholders. It is not called the healthcare industry for nothing. It operates on a profit model, not with the aim of providing any services as of right. Patients are 'consumers'. There is no conception of a right to medical care in the US, whether individually or universally. It is seen as a commodity to be bought and sold.

While there is public provision, it is generally shunned by anyone who can afford any alternative; using the public facilities is a matter of shame in the US because to do so is to admit that you can't afford to pay. There is great shame associated with being poor in the US.

The system is conceived as a dog eat dog triumph of capitalism where the sturdy succeed and no-one wants to know about those who do not, who are assumed to be 'different' anyway, mostly by virtue of being black/poor/recent immigrants.

It's not just the practical aspects of how so-called socialised medical care would be delivered that scares off Americans. They are genuinely still very much brainwashed to believe in the Red Peril, a hangover from the Cold War. What the word 'socialism' means to Americans is ducking under school desks to take shelter from a Soviet hydrogen bomb. Even hit shows like '24' capitalised on this; Russia is overwhelmingly portrayed as Enemy Number One in popular media, even as China slowly takes over the world.

math, you wrote "In Japan and HK, there is a suspicion that a lot of reported female stillbirths are not in fact stillbirths"

did you mean China and HK? any sources?

just that I cannot imagine something like that happening in Japan?

I have not seen this programme, but it doesn't surprise me. As mentioned upthread, Michael Moore's documentary Sicko is enlightening.

another thing to think on .Wheelchair in uk that around £4000 in the Us it is not unnormal to see it at $40000 which is shocking the companies presume people insurance will pay out

Friend of mine in Us with a good job and insurance till has to co pay and dreads being ill

I think the most quoted researcher in this area is Ansley Coale, an old hand in the area. I meant China, yes . Chinese births have been studied since the 1930s.

I meant Chinese births since the 1930s have been studied....

thought so...

have a and a

sorry, not a biscuit in a MN bitchy way...I meant a proper nice biscuit with your nice cup of tea

My (American) mother (would have been 72 today! :)) started to identify herself as a socialist in the 1970s. I can't begin to explain to Europeans how incredibly radical a statement that was in our culture. She was always having to explain that she wasn't a communist, becausein the American mind there was no difference between those -isms. We have no concept of respect for the welfare state, only contempt for those who need it. :( That said, my relatives who are living on welfare seem to have okay medical care, but very patchy cover for dental care.

There are positive flip sides to this, childcare in the USA is incredibly cheap compared to the UK because it's not so regulated, so it's easier for parents to both stay in work. Sometimes the UK Nanny state gets me quite down. Living in the UK has made me more suspicious of government interference than living in the USA ever did.

2010 California population was only 37million, still quite a bit less than the UK :).

ragged
does that include the estimated 11m illegal immigrants though .....

Am in tears just thinking how much debt my family would be in now if we were like America...

I watched this with DH and we both felt incredibly sad and angry about the fact that American governments past and present are so quick to adopt the role of 'caretaker' of the world and a stalwart paragon of "democracy" yet they are happy to allow their poor to live in inhumane conditions without access to basic human rights such as healthcare. Being from a "third world country" myself (Argentina), I know what abject poverty looks like but the one thing that the state has always guaranteed (apart from the times when we were ruled by the despicable military juntas) is free education and healthcare for everyone. It is not a perfect system by any stretch of the imagination but there is no way that someone would not receive a much-needed operation due to lack of money. If you have a job, you get either private healthcare (paid for by your salary and the company) or a social plan (if you work as a public servant) which are both excellent.
If you are unemployed or a very low-earner, you are entitled to free, public healthcare. You will have to queue up and it will be patchy but you will not go without and won't need to pay for it.
For some people to even bring the "free market" into it is frankly disgusting and to imply that taxpayers should not be responsible for the welfare of those who are most vulnerable is simply scandalous. I feel for Obama and his seemingly genuine attempts at reform but I fear it will be too difficult to implement although I am hopeful that the 'Occupy' movement will help to raise awareness about the deep-seated social inequalities and the lack of opportunities for an increasing sector of the population.

Math I'd be interested (that is a genuine interested as opposed to a PA "prove it" ) to know where you get the evidence that the numbers of births of babies less than 500g or less than 22 weeks showing vital signs are sufficiently significant to affect IM stats.

I don't think they impact the stats significantly, but the US does have a higher prematurity rate than other developed countries and that in itself is significant. 1 in 8 babies in the US is born before 37 weeks -- this compares with 1 in 18 births in Ireland and Finland even when births before 22 weeks were excluded. Even excluding those babies born before 22 weeks/below 500g the US rate of prematurity is higher than elsewhere.

This paper shows that the US has a higher rate of preterm births (far higher) than other developed countries and also has a higher rate of infant mortality for term infants - both those figures seem to indicate that there are sections of the community in the US where consistent medical care for pre-existing conditions (diabetes, asthma, blood pressure and kidney problems, obesity, substance abuse during pregnancy) is not being delivered, that maternal diet and general conditions of life are not conducive to healthy pregnancy and good pregnancy outcomes, and that the same conditions result in poor outcomes even for babies born at term. Where massive medical intervention takes place, the US does well compared to other developed countries - for instance in the case of many preterm infants. But the US fails to address the issues that lead to the pre term problem and also the issues that lead to the higher mortality rate for infants born at term. There is a correlation between being black and being poor in the US, and being black and being at risk of a pre term birth -- indicating that health care for the poor is horribly substandard.

Thanks math

Comes back to the issue that although the US is a first world country much of its inhabitants live a third world life.

OK, I've now found a 2009 BBC article on the privatisation of welfare via the creation of the Insurance Industry Working Group, chaired by Alistair Darling and the chief executive of Aviva. (I've seen Tory involvement since - this isn't a party issue.)

"The report suggested that the insurance sector had the capacity to play a much bigger role in providing benefits like jobseekers allowance and money for those on long-term sick leave."

Apparently this would save the Treasury billions of pounds. Uh-huh. That only works if the Revenue continues taking National Insurance premiums off us, while declining to make NI payouts.

And the insurance industry doesn't have unlimited capacity. Any incident which causes a lot of simultaneous payouts (hurricane, mass redundancies, etc) can bankrupt an insurance company. The policies will usually be taken over by other companies - but if the incident impacts the whole economy that may not happen. And the government ends up as social security provider of last resort.

Just like it's been lender of last resort to the banks.

As the saying goes: Privatise profit, socialise risk.