to wonder why any American's are against Obamacare?

[lowfatiscrap12]

Please, if you're an American, or if you're not American, tell me.
It's driving me insane.
What's wrong with proper healthcare for everyone?
I've got a few American's on Facebook, who happen to live in trailers, so not wealthy people, and you'd imagine they'd be more supportive of Obamacare than anyone.
I don't get it.
What's the problem?
Why would anyone want to keep the current system where one illness can bankrupt a family?

I have an fb friend who moved to the state - I have seen more than one set of collections for her friends to get money for operations they need as they can't get the operation without the money. Not sure how common this is? Not sure if it is valid but she is in Texas

Have skim read so may have already been said but, I know the NHS is not perfect, but it seems massivey preferable to a system where:

1. The first thought of the ambulance crew that arrives to scrape you up off the road is 'have you got insurance'?

1. The US spends more per captia on healthcare (medicaid etc) despite the fact that many people pay $000s for health insurance

1. healthcare system costs seem to make doctors and insurance companies rich at the expense of its users

1. You can be made bankrupt (and lose your home?) because of healthcare costs

I am perfectly happy to pay taxes for a universal healthcare system and am equally happy that I don't have to use it very often (touch woood!)

Thats the thing Lizzie. You are not describing the US system:

1. If you don't have insurance the ambulance crew either charge the town (as what happens in our town when they respond to calls from Newark which is why our taxes are so high) or Medicare.

1. Yes they do and if you saw the level of service you would understand why. I loved having my own room after having a CS with DD. I had a lacatation consultant available to me 24/7. I waited all of 5 mins for an epidural because there is someone hired by labour and delivery just to give epidurals. This all costs money.

1. No it makes lawyers rich. Most doctors are making around $300-500K a year once they are specialists but they have debts of $300+K (I have seen debts as high as $500K) when graduating from medical school. Pharma companies make an awful lot but this is spent on research or on lowering the cost of drugs in other countries. The insurance companies are not making huge amounts of money either. This is why premiums have gone up so much.

1. Not true as medicare step in before this happens.

I am a UK Dr and have talked to a few US docs at conferences etc about this.
The bottom line for me is that I am not comfortable at all about access to healthcare being linked to ability to pay whilst US Drs find nothing shameful at all in this.
A lot of Americans seem to think that more medicine = good whereas in fact their system causes a lot of perverse incentives to do unnecessary tests and interventions which can actually harm patients (eg having lots of X-rays increases the risk of cancer).
NICE does limit access to certain treatments on grounds of cost-effectiveness but actually very few mainly cancer drugs which are incredibly expensive and don't cure but extend life often by a few months.

Not true around our way Want2beSuoermum.

1. here they bill you for the ambulance, and keep billing eventually sending it to collections.

2.yes they do spend more. Level of service isn't that superior. I shared a pokey room both times I delivered via C-section.

1. Definitely Lawyers get rich, Dr's don't do too bad out of it and the Insurance companies who sell the Doctors their malpractice insurance are the ones making the most it seems.
2. Yes it does happen and way too often. Dh's best friend from high school fell off a motorcycle and had a back injury, medical bills finally resulted in him and his wife going bankrupt. Medicaid never kicked in at all for him.

My friend who was a fitness instructor, developed Kidney disease, ended up having a kidney transplant, used her lifetime medical maximum allowance and lost coverage eventually, before medicaid kicked in they lost their home and business. They finally got her healthy and are renting a house, and she's sick again, needs another kidney, no idea if she'll get one, but she has medicare still but it's limited. Also I worked till recently as a home visit nurse here. Medicaid drags their feet, loses paperwork and files, denies coverage when people are obviously qualified and by the time they approved they are at bare bones, I had many patients like this. Also the friend of Dh that fell off his motorcycle (18 years ago) eventually did buy a home then had three children with his wife. three years ago he has osteoporosis in his spine from the original accident, his practically bed ridden, nearly lost it all again, but medi-Cal (California Medicaid) finally kicked in and he;s on Social security disability at last, but it's hard to raise three kids from you bed, they are 11, 14 and 14. I used to ask the doctors office for sample of drugs for patients who were out and had no money they had to choose food, rent or medicine, they were not life long lay abouts either, they were hard working people who worked at low paying jobs their whole life, and once unable to work and living on small Social security retirement payments couldn't afford a basic lifestyle. I've seen more bare bones poverty here in the US than I ever saw in UK, and I was raised on a council estate and people didn't have much back then. Here it was bare floors, hungry bare foot kids, freezing in winter and sweltering in summer and me trying hard to stop flies getting into open wounds so I could clean and dress them. Teaching patients how to wash out urinary catheters cause they couldn't afford more and they only got allotted a few each month and this was MS patients who had to use them to go to the bathroom every time to pee. It really sucks and makes me glad I can go home to UK. Makes me feel guilty that others here can't do that.

I don't get it either.

I can't understand how people can be happy with a system which can ensure you get blue lighted to hospital and brought back from the brink, yet hand you a bill at the end of it.

If you are referred to a skin specialist, for example, in the US you see a reputable skin specialist. Not his trainee or registrar. Or a 'specialist' nurse.

A couple of weeks ago I got a pain in my eye. I've had the pain before and thought it might be iritis so I took myself off to A and E.

My local A and E has specialist nurses who triage eye problems. If they can treat you they will, if not they send you to the the Opthalmolagists in the acute eye clinic. So faster treatment for both patients the nurse can prescibe for and for the ones who need the Dr.

I was seen, my eye pressure taken and drugs prescribed and dispensed in about 1.5 hours - this was Saturday afternoon so it was busy.

I was also given an appointment to see the opthalmologist on the Friday.

Specialist nurses are trained to do a specialist job. If it had been the first time then I would have seen the optho Dr.

"If you are referred to a skin specialist, for example, in the US you see a reputable skin specialist. Not his trainee or registrar."

And how do you think they became a skin specialist? Oh yes by seeing patients under supervision!

So many problems with American healthcare. One of my bosses was on holiday in the States with his child who ended up in intensive care. He said it was terrifying watching someone whose entire job it was to walk around with them and scan the barcode of every packet that was opened to bill them for it. They had insurance. Imagine how scary it would be if your child was taken to hospital and you did not? If you had the choice of letting them die or bankrupting yourself?

I listened to a scary program and a girl was talking about how she had rheumatoid arthritis. Her insurance through work (she was a waitress) would cover something like $400 for her drugs per year. Her normal, basic RA drugs cost $40,000 a year. She is 24 and can't use her hands because she can't afford her basic treatment.

Surely it is about equality? If you are lucky enough to be born healthy, never have an accident, never catch an infection or develop a disease then it is great. Or if you work for a big company with amazing insurance and don't lose your job when your child gets sick and you take too much time off then brilliant. It is very hard as a medical person to get my head around the idea that people should NOT get the best treatment because they have the wrong job or are unlucky. I do my job because I believe everyone deserves healthcare as a basic right. If people want to pay a little more and get a private room then fine- I can understand that having been in hospital. Or if it is that important to you to have the morning papers delivered to you then go ahead.

And similarly I am very glad I am not pressurised to order extra investigations with risks involved or over treat people just because my hospital will make more money

Oh and we are not talking about small numbers here. It makes you realise why the NHS struggles when you think a hip replacement costs a good 10000 pounds (and there are several done every day in every hospital) and it is why I get so FUCKING angry when people moan about it! It is not perfect in any way but it could be much much worse

Sorry rant over

I think universal healthcare is a wonderful thing.

That being said, a person who has worked hard all their life and who has a good job, gets taxed a fortune to pay for the medical treatment of those who choose not to work at all. Is that fair?

And often, those hard working people put their best efforts into maintaining good health; eating healthy food, exercising and so on. Yet they have to pay for what could be argued to be self-inflicted ailments of the people who eat themselves into obesity or who drink/smoke/use drugs. Is that fair?

Some parents are poor, yet still decide to have 5 or 6 children and then cannot work because they have to look after them, so the person who works full time but does not have any children gets taxed to pay for their treatment. Is that fair?

How about the t-total hard working person who has to pay for the medical treatment of the piss head who fell over after binge drinking? Is that fair?

I think that's where most of the people against universal health care are coming from. Everybody's treatment will need to be paid for through taxing the whole, and that means some people are going to be paying for more than they will ever need themselves, whilst others will be recieving more treatment than they will ever pay for. The extreme examples of unemployed people who are reckless with their health and employed people who live healthy lifestyles highlights this.

Cog- I know where you are coming from. But I think it probably all balances out in the end.

I do work hard and pay a lot of tax. But I also eat too much and I will hopefully live for long enough to benefit from healthcare in my old age. And I am grateful for all the services I get for my taxes, not just healthcare.

The tea total person who works hard may like to go climbing in the Peak District on a Sunday morning and fall off, be retrieved by a helicopter and require major surgery. And that is fine. I am glad they will get that for free. It makes up for the fact that some people take no responsibility for their health or get themselves in silly positions. And the drunk person may have actually tripped over a paving slab and would have done it even if sober. I am the first to be driven mad by some of the idiots I treat on a Friday night but unless I was perfect I could not really complain!

Everyone takes something from society and by being part of society we accept that some people take a little more, some give a little more. Hopefully karma has some part in it somewhere! Maybe those 5 or 6 children will go on to have jobs and pay taxes and will pay for our nursing home when we are old. No system is ever perfect or even close but it is about making the best we can of limited resources and giving everyone the opportunity

I think the thing about Obamacare is that Obama did the most amount of reform that he thought he could, and narrowly got away with it (Supreme Court has just upheld a part of the legislation that was challenged). The current political climate just won't allow anything else. I really do think that what the US needs is a (possibly Republican) LBJ figure, who will say to hell with my own electoral vanity, I'm going to use the presidency to push through massive healthcare reform because it is the right thing to do. Neither Romney nor Obama will be that figure.

Everybody's treatment will need to be paid for through taxing the whole, and that means some people are going to be paying for more than they will ever need themselves, whilst others will be recieving more treatment than they will ever pay for.

Those who are paying for insurance but are never ill are paying more than they need themselves. It just goes to make the profit of an insurance company higher.

An example of someone who recieves more treatment than they ever pay for, anyone who dies before they are 18. So a baby in PICU, a child who is involved in a car crash.

Two things that happen in the UK that don't in the NHS. Employers son't often offer private health care to anyone who is below a ceertain level. That means the cost of employing someone is cheaper.

The other is if there is malpractice, the payouts are much less as there is no component for ongoing treatment, treatment is assumed to be the provision of the NHS.

sashh that's what I find unfair, not enough of us have private health care here. It is unhealthy to depend on government so much, why could we not have an efficient graduated system? i.e. tax-funded healthcare only below a certain level?

I hope to see President Romney signing this out of law under a GOP-controlled House and Senate... and passing PRENDA, H.R.3 and all the other pro-life bills blocked by the Dems. If anything would make me take off to the USA it would be taxpayer pounds funding abortion in this country, which I'm fed up with. Their Hyde Amendment ensures that federal dollars go to life-affirming medical care, never foeticide or embryocide.

melbie that sort of left-wing view is what irks individualists, and especially those against Obamacare. To some degree "we're all part of society" is true. Does that justify the other statements though? "equality"- that is paid far too much attention in British medical formation, almost enough for it to cross the line to deformation professionelle if you ask me. The liberal-politicised "biopsychosocial" model is pushed in a couple of important texts, which itself discriminates against conservative medical students and doctors.

So does talk of "health inequalities" which can be pervasive: for me, the problem is the total amount of ill health, not how equally distributed it is. This approach risks seeing the poor and vulnerable as a group to be socially engineered against their will to force them to be healthy, which I see with minimum-price alcohol plans, anti-smoking fanaticism and the like. I support treating the poor like human beings with agency of their own, let them CHOOSE if they want booze and cigs. If that leads to them being less healthy than the rich so be it.

Hi all. Interesting discussions and I hope some Americans can start to see why we find their system so bizarre and some Brits appreciate their wonderful NHS (well it is until Lansley and friends have finished with it ) a little more.

I've worked in both health systems and agree with melbie that one reason the US system is so expensive is the perverse incentive to do more work, more treatments to be able to charge more $ to medicare/insurers.

We were due to return to the US this year. DH is American and had got his dream job, well paid, health insurance. But then fate intervened and DS got a life threatening infection. The NHS saved his life. The quality of the PICU care was an eye opener to lots of my American family (previously "the NHS leaves windows open to kill old people" etc,etc). I have even convinced my FIL that Obamacare is a good idea as it covers kids with pre-existing conditions.

BUT. We can't return to the US now. If I were an insurance company I wouldn't cover him! He needs specialist follow up until he's 18, and more operations on top of the one next month and the 7 he had before he was one. We can't risk Obamacare being repealed. We can't afford (despite insurance) the co-pays. It's ridiculous, DH and DS are Americans! But there it is.

47to31, I don't understand why you find it unfair that not enough of us have private insurance. We pay National Insurance.

I would like to see a system where we could choose to pay less tax if we chose to buy private cover.

The NHS is only great if you live in the right area and have the right illness. Otherwise it can be truly awful.

In contrast to Sashh, I have found eye care to be one of the worst bits about the NHS. If my dh had stuck with NHS treatment for his eye problems, he would have lost a significant amount of sight by now. So I'm really not comforted by the fact that we would get hip replacements should we need them. We would probably have to wait in pain for months before hand anyway.

President Romney.

Thanks for giving me the first laugh of the day. Never going to happen.

why not?

I'll tell you what.

I'll give you £20 if he does get in, ok?

"Some parents are poor, yet still decide to have 5 or 6 children and then cannot work because they have to look after them, so the person who works full time but does not have any children gets taxed to pay for their treatment. Is that fair"

That really doesn't bother me. Those children are human beings and did not choose to be brought into the world. I would hate a child to die of an easily treatable illness, just because their parents were poor.

In the UK we spend quite a lot on problem families and paying for their healthcare is a minor cost. I would hate a parent not to take their child to the doctor because they were scared of the bill. In fact I think adults should be encouraged to go the doctor if they are ill without worrying about the bill.

Good healthcare reduces the benefits bill. It stops people becoming disabled and a drain on society. It makes economic sense to have universal healthcare. Afterall you can't make a seriously disabled person costs a lot in benefits.

Prehaps in the US people are happy for entire families to starve to death like happens in third world countires. However the UK (I hope) is a more compassionate country.

Oops.

"Afterall you can't make a seriously disabled person costs a lot in benefits."

That was a badly worded sentence. I wish mumsnet had an edit facilty

What I mean is that the cost of untreated illness costs the country more in benefits. There are mercenary reasons for having a health service as well as compassionate reasons.

It is inevitable that disabled people are expensive for the country. Healthy people pay tax.

Its ironic that many american states are very anti abortion, yet do nothing to keep existing people alive.

Disabled people are not a drain on society. The vast majority of disabled people can contribute to society, if not through their working taxes, then in other equally important ways. They may also have already contributed financially to society before they became disabled.

I know you probably didn't mean to sound that negative about the contribution disabled people can make to society, but I just want to make the point that everyone has something they can offer.

Anyone of us at anytime could become severly disabled and unable to pay taxes. You are very fortunate, for now.

SoleSource: "Anyone of us at anytime could become severly disabled and unable to pay taxes."

Indeed. One of the injustices of the American system has been that, for example, if you're in a job and you develop a condition like diabetes, it's near impossible to become self-employed because insurance companies wouldn't take on people with pre-existing conditions.

I know people get upset when they see people in this country who have never worked or who don't take good care of themselves getting free healthcare. I know it doesn't seem fair. But the alternative, to my mind, is far worse. I am hugely grateful for the NHS, for all its flaws.