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» Scarleteen Boards: 2000 - 2014 (Archive) » SCARLETEEN CENTRAL » Bodies » The Pros and Cons of Universal Health Care

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Author Topic: The Pros and Cons of Universal Health Care
Karybu
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Since this thread was getting slightly derailed with discussions of the benefits (or not) of having a universal health care system, here's a place to discuss the topic.

What are your opinions on universal health care (that is, health care paid for largely by the government)? Do you think there's a difference in the quality of medical care in a privatized system versus a universal health care system? And, something I've been wondering about - in a country like the United States, with a privatized health care system, do you think that the high cost of care for the uninsured (or the fact that it may show up on a parent's insurance) prevents teens and young adults who might otherwise do so from seeking things like regular STD screens, yearly gyn exams, etc?

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Heather
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I'd also be interested, when users discuss this issue, to hear about what your personal experiences have been per if you've paid for/accessed healthcare yet on your own. For those in countries where universal health care is available, we'd be talking about paying taxes.

I insert that, because it tends to make a big difference per how people view these systems, especially for those who haven't done bucketloads of bipartisan research on the subject.

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-Lauren-
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Myself, I entirely support universal health care in the United States.

The 80 billion dollars (I think more has been spent since then) spent on the war in Iraq could have made universal healthcare entirely accessible to every person in the United States.

I haven't done any research, but it seems to me that every country on earth that has a universal healthcare system is in better overall health than the United States. I speak with people from other countries, and they're literally shocked when I tell that my mom has to pay 50 dollars to let me see the doctor, or pay up to 100 dollars in prescriptions.

And that's with her healthplan from work.

The cons I can see are cost.. but like I said, the war budget could really cover a hell of a lot of this. It would put a heavier burden on taxpayers, but without medical expenses to worry about, I think that would be doable. It could also be strained if used by illegal immigrants or non-taxpayers.

But in general, I think it would be much, much better than the current system.

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origami_jane
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By non-taxpayers, do you mean perhaps..... Pepsi Co.?

(I'm excited, we just talked about this in class today!)

Because the tax code has so many loopholes and is pretty biased towards the wealthy, the government doesn't get as much as it needs and we're continuing to take out loans from China (part of the reason why we rarely/never act on the major human-rights abuses there). I mean, even Visa cuts you off if you don't pay your bills on time!

Plus there are definitely programs in the budget that should be reevaluated if not cut. The "EPA" is obviously not doing its job (sometimes I feel like all it's doing right now is making excuses for big companies to kill the planet), and I've read that a lot of problems are caused by toxins pumped into the environment. Plus the horomones pumped into our food, or the artificial colors and flavors that make up more and more of what we eat every day?

(These effects, I think, are unfairly skewed to harm low-income families more. They may happen to live in an area near factories or where the environment has been heavily polluted.... Artificial things are MUCH cheaper than "natural" and "organic" products, etc...)

Anyway, I just read somewhere that the countries with the longest life span or something also happen to be the blondest: Sweden, Norway, Finland. We're something like #10.

Our insurance changes a lot, but I think we've almost always had a $10 co-pay for doctor's visits. I'm not sure what my dad's insurance from work covers, or if we buy extra.

I think that if we had an actually competent government that wasn't puppeted by corporations and actually worked for the benefit of its citizens.... then this might work. People need to not be so afraid of higher taxes, and they need to trust that they put good people in office.

......I'm going to go rant myself into a corner somewhere about how James Madison is rolling around in his grave right now....

I guess what I was trying to say is that universal healthcare isn't going to solve problems. We need to start worrying about where health problems start and corporate accountability before we try to nationalize healthcare.

[ 05-17-2006, 05:41 PM: Message edited by: origami_jane ]

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Gwaihir
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I do not believe that ANYTHING provided by the government other than their definitive tasks (legislative, executive, judiciary branches) can be good for us. Health care paid for by the government means the government pays the doctors. . which, if we know the nature of governments, means that the doctors get paid barely NOTHING at all, and the rest of our taxpayer money goes into the beurocrats' pockets.
The Canadian government for example, has been blatantly stealing from the taxpayers for so long and no one has ever called them on it. Having lived in Canada myself, I have to say that that universal health care for all is actually a really good idea in theory, but they haven't employed it very well. My own personal experiences with friends and family friends who have needed medical services are such that in most hospitals, there is never enough room, the doctors are underpaid, and the nurses being such as well, can be harsh and often cruel. People working in hospitals often seem to be out of touch with each other, aren't effecient at employing tasks and really don't seem to know what the hell they're doing sometimes.
A highschool friend who suffered a spinal injury kept getting shuttled back and forth between hospitals because they didn't know what was wrong with her on one occasion (she'd gotten a bloody nose) when taking care of her, such as bathing her and such the nurses were often very rough and harsh with her untill she was in tears. Another friend that had suffered a snowboarding accident got similar (mild) verbal abuse from nurses tending to her.
A family friend had to wait TWO YEARS for his hip replacement surgery.
But anyway, these examples are just in Canada, and I don't know how much better or worse it is than in the states, but I know that it's certainly NOT a utopia as far as medical systems go.

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LilBlueSmurf
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I agree with a lot of what you've said, Gwaihir.

As a nurse, i can defineatly attest to the crazy workload put on doctors and nurses (especially in the emergency rooms and on medical/surgical units). And yes, though it is certainly unintentional, the patients do suffer.

However, i like to think that patients are still better off for having this healthcare at all. SO many people could not afford it otherwise. Waiting too long in the ER? Without universal healthcare you may not even be seen at all, nevermind having to WAIT. Can't get services in your area? You might not be getting services at all if it weren't paid for.

And believe me, i've been on both sides. I had to have a surgical procedure a few years ago that had me traveling 45mins from home (w/ no car, mind you) for care (the procedure itself as well as pre and post op appointments). And 45mins is nothing. I've waited in the ER for hours upon hours waiting to be seen ... for an ear infection ... because i don't have a family doctor. I'm not trying to minimize the issues currently being dealt with at all, i'm just trying to put it into perspective. It IS better than nothing and i totally believe it is worth fighting for.

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Boldly Obscure
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Well, yes, the Canadian government has been blatantly stealing from its tax payers, but they have actually been called on it resulting in a huge scandal and the downfall of the Liberal government. (and another huge amount of money wasted on an inquiry)
However, despite the flaws of universal health care, I feel better knowing that if I do get injured or sick that I won't have to pay an unexpeccted amount of money just to get treated. The waiting lists are ridiculously long here, but the government is (supposedly) working on that. And I don't think that it is safe to say that the doctors and nurses in Canada are severely underpayed, harsh and cruel. If they are harsh or cruel, I think it is most likely due to the fact that they are overworked because of the shortage of healthcare professionals not because they don't think that they are getting enough money.

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LilBlueSmurf
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(Thank you, Aranel. While i'm not sure that that is what Gwhaihir was getting at, the doctors and nurses certainly aren't 'harsh' or 'cruel' due to wages. Those doctors and nurses that want the 'big bucks'? They go to the United States.)

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Heather
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I may as well add my two cents while taking a break from photoediting so as to keep from going blind. [Smile]

I grew up very poor, but I also literally grew up in U.S. hospitals, because I had a single mother who was (then) a nurse. (She's now an epidemiologist who is in charge of implementing infectious disease protections for an ungodly number of hospitals, and has also worked as a general administrator for several hopsital systems in the midwest.)

Setting aside my academic and practical knowledge of both privatized and public medicine, and just addressing the personal, I've used NHS systems while abroad. I've used private US doctors. But most of all, I've had to mostly make do with the U.S. public clinic system. Once, I even used a -- I kid you not -- secret underground healthcare system immigrants had organized in Chicago, because I literally had $20 to my name and had been walking around with a mouth full of blood for a week, but due to being in an internship, I couldn't qualify for Medicare at the time, despite the fact that I was working 60+ hours a week in that internship. I've also done a decent bit of volunteer work with mothers on WIC and in the Medicare system.

I have to say, I have yet to ever see or hear some of the monstrous things I've seen and heard, and experienced, in the public clinic system happening in most NHS systems, or happening with insured healthcare privatized systems. These are also docs who, I can assure you, are getting paid even less than docs and nurses working under most NHS systems are. And usually, they're NOT jerks: generally, in my experience, they're incredibly generous people, who find themselves horrendously limited in how much help they can actually be because of the low-income healthcare system.

(Though I've known and experienced plenty of jerky docs and nurses in the private for-pay system, and those working under HMOs who are no kinder than you're expressing, either. I think the long and the short of that is that being a jerk is pretty equal opportunity, for all people, period, and for docs and nurses, being people themselves, in any setting.)

Don't even get me started about state-run psychiatric hospitals here. That's a nightmare too scary for really anyone.

And there's the rub, really: ANYONE who cannot afford healthcare, in most systems, is not in a good spot: in private health, they're justb plain screwed, and in national health, they're more challenged. But.

Someone in a private system may NEVER be able to get surgeries they need, rather than a two-year wait, because hospitals and doctors won't let you pay as you go for surgeries that cost tens or thousands of dollars, sometimes even mere thousands. I have a homeless parent who needs healthcare, direly, he can rarely get. Last time he only ended up getting some because he got assaulted and landed in a state hospital: due to that circumstance, he didn't have to be asked about billing. (Which isn't to say he won't be billed, he will be, but at this point, his healthcare bills are so out of hand, and his situation such that it hardly matters: he's financially %$#*ed so bad, with nothing left to lose, that there's little they can do to him).

It took me three years to find a dentist in Minnesota who would just do basic dental work for me on a monthly payment schedule. A two-year wait for surgery really sucks. But never is worse. (I know that story, too.) And in many NHS systems, a person who didn't want to wait two years could still usually get private surgery on their dime, just like in private systems. In an NHS system, you will not find yourself suddenly faced with a hospital bill for thousands of dollars from a one-night ER visit that was unavoidable, then find yourself being sued because you cannot pay it in a month or two and THEN being sued, and having legal fees put on top of that. Dealing with that in your first few years of adulthood? Not a good time. Neither is trying to come up with a few hundred bucks when you're already living on rice and beans or PB&J, just so you can get basic, non-crisis care. I have rarely (actually, I never have, but I assume there are a few folks out there who differ from what I have heard/discussed) met anyone who would argue for continued privatized healthcare who has lived with it even as a lower middle-class person, let alone someone who has lived in poverty.

The big difference generally is that in NHS systems, almost EVERYONE can get basic, preventative health care (and not getting that often is a big part of where problems start), as well as some crisis care. Almost everyone CAN get surgeries they need, treatment they need, and NOT wind up homeless due to hospital bills. And that's a HUGE difference: almost everyone vs. less than half the population or so.

[ 05-17-2006, 08:28 PM: Message edited by: Miz Scarlet ]

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Heather Corinna, Executive Director & Founder, Scarleteen
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Gwaihir
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These are all good points, and I do agree with a lot of what people are saying that free healthcare for everyone is best. I want it to happen and that everyone, no matter who they are, how rich or poor they are, etc, deserves good health care. . I just don't know how a good solid system of such could be constructed. The thought of my healthcare (or most anything, really)---and basically my life being in the hands of something government funded just sends chills down my spine.
I hold an immense hatred and distrust (which I inherited from my dad. .heh.) of most forms of government and authoritarians.

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Heather
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I hear that. And with many governments, it pays to be wary, and it also often pays to separate yourself to varying degrees.

Heck, if you HAVE the means to choose what kind of healthcare you get, great. And I think that's great. Ideal, obviously.

Where things get sticky is that relatively few people worldwide do: most, especially globally, though, wouldn't be/aren't able to pay for any other sort of healthcare, though.

And that's where -- again, obviously -- the real crux is. For those of us who doesn't or haven't had the means we have no other choice, nearly always, than whatever public healthcare we can get or no healthcare at all, and in many situations, most really, no healthcare is a whole lot scarier.

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Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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Bobolink
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In the last 5 years, both my wife and I had gall bladder surgeries, mine with almost fatal complications. I hade major eye surgery just over a year ago and will have more this winter. My wife had brain surgery about a year go from which she did not recover. But in ALL cases neither of us was denied medical care because of inability to pay. I was not forced into bankruptcy. Look at bankruptcy notices in U.S. papers, in most cases the major ceditors are medical facilities. And the present U.S. administration has now denied bankruptcy protection to its most vulnerable citizens in a deliberate and malicious attempt to increase the level of poverty in your country.

If I were an American, I would have joined my wife in the grave by now as I would have been denied treatment. I am neither wealthy nor middle class.

I have diabetes that requires constant and regular treatment. I also need regular psychiatric counselling. Under Canada's health system, I can get the treatment I need to stay alive and contribute to Scarleteen. If I lived in the United States, I would now be dead and my son shackled with my medical expenses and driven into poverty.

[ 05-17-2006, 11:32 PM: Message edited by: Bobolink ]

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-Lauren-
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Couldn't have said it better myself, Bobolink.

It seems that most opposers to universal healthcare in the United States, on the political front at least, oppose it simply because they themselves have access to excellent care.

While I currently have access to the care I need, I'll be dumped by my mom's insurance on my next birthday. I guess I really will get a feel for what it's like to be subjected to the high costs of healthcare.

Another train of thought here. I'm sure all of us are very familiar with the notion that some doctors are payed lavishly to distrubute certain brand-name drugs; I'd bet almost all are badgered to. My doctor's office is FULL of free pens, notepads, clocks, the works, supplied by companies promoting expensive brand-name drugs. Do you think that universal healthcare would have an impact on the insane profits of pharmeceutical corporations, thus reducing the number of paid-off doctors?

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-Lauren-
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Couldn't have said it better myself, Bobolink.

It seems that most opposers to universal healthcare in the United States, on the political front at least, oppose it simply because they themselves have access to excellent care.

While I currently have access to the care I need, I'll be dumped by my mom's insurance on my next birthday. I guess I really will get a feel for what it's like to be subjected to the high costs of healthcare.

Another train of thought here. I'm sure all of us are very familiar with the notion that some doctors are payed lavishly to distrubute certain brand-name drugs; I'd bet almost all are badgered to. My doctor's office is FULL of free pens, notepads, clocks, the works, supplied by companies promoting expensive brand-name drugs. Do you think that universal healthcare would have an impact on the insane profits of pharmeceutical corporations, thus reducing the number of paid-off doctors?

The government, after all, would be far less willing to pay as much as citizens are being forced to for medicines.

[ 05-17-2006, 11:54 PM: Message edited by: Miss Lauren ]

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Karybu
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Well, at least in Canada, Lauren, prescription drugs are NOT included in the health care paid for by the government (and that isn't usually completely free - here in BC I pay a certain monthly mandatory fee to be covered by BC Health Care). I'm on a couple of different medications, and if it weren't for my student health plan, I would pay full price for all my prescriptions. Basically, that's a very roundabout way of me trying to say that universal health care doesn't necessarily eliminate the influence of pharmaceutical companies. It may reduce it, but I'm not sure the influence of those companies is gone. I had to argue with my doc to put me on the generic form of my antidepressant rather than the brand name; there is still a price difference.

All that said, though, I love Canada's health care system (and I grew up in the U.S., so I've had a chance to compare) - I think giving the majority of the population access to basic preventive health care is a great thing. It's wonderful to be able to go to the doctor for my yearly physical, show them my health care card, and not have to pay a cent. I've been having some health issues for the last year, and it turns out that I'll need to go to Vancouver at some point this summer for treatment - my travel expenses are covered because it's the only clinic of its kind in the province, and I don't have to pay anything for the appointment itself. If I need surgery, that won't cost me anything; should I ever end up in the ER, that will also be free. And people here, if they have the means to do so, are perfectly free as well to seek out treatment at private clinics to avoid waiting for things like knee surgeries.

[ 05-18-2006, 12:12 AM: Message edited by: karybu ]

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diamonds4lucy
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My guess is that no one against universal healthcare has ever spent the night crying because she was dropping out of school and didn't know if she'd be able to stay on her parents' insurance.

My parents found a way to just pay a little more by using cobra, but they were preparing to pay out of pocket for my psychiatric medication. Thank god we're pretty well off- three more years from now, and I'll have to either have a job with healthcare, be a student, or...I don't know.

It's a catch-22 with our insurance plan- I can't register as disabled because I'm able to hold down a job and make a little money, but if I wasn't able to have a job, I would still have to figure out a way to afford the co-pay.

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September
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I hear all of ya on saying that a little bit of free basic care is better than no care at all, but the truth is that (at least in Germany, but also in other countries I am familiar with) the parts that are for free are getting less and less. I have a friend in England who can no longer take care of her teeth because dentists were just dropped from the list of things the NHS pays for. I have a friend in Italy who is suffering from debilitating anxiety attacks but cannot see a doctor about it because psychologists/psychiatrists are not covered by the free healthcare. I myself suffer from a chronic disease that requires daily medication, but my disease is not a common one so in the near future it will no longer be covered by my health insurance that I pay for on a monthly basis - meaning I'll have to budget out an extra 100 Euro a month just for medications.

Another thing is that, due to the fact that all of the pays for doctors and nurses at state hospitals is coming out of government funding, we've got doctors working 36 hour shifts, with no breaks, and then when we send 'em home, they're still on call. I don't fancy being the patient that is seen by a doctor who was just called back into the hospital after nearly two days of work and no sleep.

Honestly? I am not sure I can advocate private health care only, simply because I am aware that lower-income people will be falling through the cracks then. But the same thing happens with a system of universal healthcare that is as overworked and underfunded as most of those systems in Europe are.

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Gwaihir
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I'm really not sure how to compare the USA's medical system with the Canadian one, since I haven't needed any serious operations or have any condition that requires medication, but I'm still fairly wary and distrustful of both country's medical systems.
It's just that when someone says to me, "Free healthcare! You don't have to pay a dime for services that will save your life and keep you in good health."
I'd say, "Yeah. . . what's the catch?" There's always a catch. I just can't shake the feeling that something's going to pop up in the end. Sure, we don't have to pay for medical services in Canada but the money has to come from somewhere. . .seems the only logical place is from out our wallets. . which means we're still technically paying for it.
When I was a teenager the Canadian government decided to drain 15,000 dollars out of my trust (my family lives on a trust fund) for God only knows what reason. I think they gave most of it back, too, which perplexes me even more. Basically I think my complaints aren't so much about healthcare as they are personal ones between me and the Canadian government. It's such a confusing system and I don't understand it at all, and therefore I'm extremely suspicious of it. .. but I digress.

"And the present U.S. administration has now denied bankruptcy protection to its most vulnerable citizens in a deliberate and malicious attempt to increase the level of poverty in your country."

This present administration? Part of me is not surprised. . but that they actually openly WANT people to suffer and die? They actually want the poverty level to be higher?
I dunno, I don't think I'm pessimistic enough to believe that. . .yet, at least. [Frown]

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Bobolink
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There is no "free" healthcare. It is paid for by taxation revenues or manatory premiums. Bu the point is that everybody gets health care. A doctor can oder tests on a patient and know that the patient will have the tests done ecause they are done at no additional charge. He can prescribe drugs that most provinces will cover by one method or other, In Ontario, it is called the "Trillium Plan" which is for people who do not have presciption drug benefits from another source. During a period of unemployment, I was able to draw upon the Trillium Plan. To the best of my knowledge, no province pays dental benefits but many citied inclued dental benefits for welfare recipients.

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I do not feel obliged to believe that the same God who has endowed us with sense, reason, and intellect has intended us to forgo their use.

- Galileo

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KittenGoddess
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I've always found universal health care to be a difficult topic. On the one hand, I do agree that everyone should have access to at least basic health care at an affordable price. You'll get no argument from me about that. There are far too many people who need help right now who are not able to access that for a variety of reasons.

Yet, on the other hand, I also have concerns what happens when universal health care is implemented in the US. Our current system is just not set up to deal with that. In terms of personel and facilities, massive infrastructre changes would be needed. And even if taxes were increased, many small communities would still have difficulties. Having worked in health care, I think it's also valuabe to recognize that no all doctors are as "rich" as we often stereotype them to be. While some specialties pay more (plastic surgeons, for instance), many doctors (especially in small communities) don't make nearly as much as we often assume that they do. And they (and nurses as well) have malpractice insurance that they have to carry and other costs and concerns that accompany being a part of the medical profession. So any discussion of universal health care coming to the US also has to address those concerns.

I'm also concerned about how a universal system would impact innovation within medicine in the US. Right now, it pays to be innovative here. If there is an influx of general use, how do we make it worthwile for practicioners to be innovative? How do we make sure that there is time and resources available to study new or less well known problems? Further, I know that people complain about the cost of prescription drugs, and I agree that some of the advertising is over the top, but I think that many don't take into account the actual cost of studying diseases and developing drugs to treat them. The process takes many many years, and many scientists and doctors. Plus you have the testing and trial phases...where not only do you have the costs of production but also you pay subjects. In short, it's not cheap by any means. So with brand name drugs, you're paying for the development costs as well.

Also, I have concerns about how well it will go over should a program be enacted where taxes and manditory premiums are used to pay for care, but if you want to be seen or treated sooner, you still have to seek private care that you pay out of pocket. Paying twice is not likely to go over well with many.

Honestly, I'm not against universal care. I just think it warrants consideration about how the structural and cultural changes necessary could and should be implemented. A great many people are more than happy to say that things should be done or should be changed, but the ones who get things done are those who come to the table with plans for implementing change.

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Sarah Liz

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LilBlueSmurf
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A great many people are more than happy to say that things should be done or should be changed, but the ones who get things done are those who come to the table with plans for implementing change.

I totally agree. Unfortuneatly, with not enough people fighting for this change (or status quo, if you have universal healthcare -- because yes, they've been stripping what's covered bit by bit), plans don't matter. Those who CAN afford their own healthcare tend to have the loudest voices anyway, and tend NOT to want to this kind of system. Go figure.

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-Lauren-
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Canadian doctors being overworked or underpaid is definately something I haven't heard before.

I even consulted a Canadian friend of mine whose father is a pediatrician. I don't know how many hours he works, but his salary is 450,000 a year.

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Karybu
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It's largely doctors working in hospitals, and nurses as well, who are overworked in Canada (and underpaid). Those with their own practices don't tend to have that problem.

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"Another world is not only possible, she is on her way. On a quiet day, I can hear her breathing." -Arundhati Roy

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LilBlueSmurf
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I think doctors and nurses are overworked in other areas of healthcare too, but it is usually in crises situations (as in hospitals) where it becomes more evident.

I also think that, on the whole, doctors and nurses are very overworked and underpaid. If this weren't the case, i think we'd have more doctors and nurses to go around, but the fact is that we're not attracting any new doctors and nurses to the area and many of the ones we're training here are leaving.

I've been without a family doctor over six years now. I'm a relatively healthy 22 year old, so i suppose i don't really need one right away ... But this is typical.

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Bobolink
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About docTors incomes. I remember a Toronto GP saying that after Medicare was instituted his income went up because he was no longer having to do "pro bono" work as he was paid by Medicare for every patient he saw including those patients that he had been trating for years for free because they were unable to pay. I'm old enough to remember canada before Medicare.

I also remember my father going into debt for 25 years to pay for necessary surgery for me when i was a child before there was Medicare. He took out a mortgage.

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I do not feel obliged to believe that the same God who has endowed us with sense, reason, and intellect has intended us to forgo their use.

- Galileo

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