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Author Topic: too expensive
lilykitten
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So, what would you do if you think you need a doctor visit, but can't afford it?

could use some advice, here...


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ErinK
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I would look for a free or sliding-scale clinic in my area, and call them and ask them about payment options and payment plans.
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leafy
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I live in England where we have a National Health Service and therefore visits to the doctor are free although for a percentage of people perscriptions are not. How do the posters here feel about having to pay to go the doctor and for contraception etc? I feel as though I've taken the benefits of the NHS for granted.
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kythryne
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Personally, I think I'd love to live in a country where health care wasn't a money-grubbing industry. I've had a lot of bad problems with the medical industry here, and I've had to go without proper healthcare on a number of occasions because I simply didn't the money to pay for the specialized care I needed. (I have a neuroimmunicological disorder.) I've only had health insurance once, for a few months, and it was expensive and utterly useless, as by that time I already had a full bag of "pre-existing conditions." Ugh.

On the other hand, I've had some lengthy discussions about this with people who live in England and Germany and Canada, and we always came to the conclusion that socialized medicine has its own set of problems. Personally, I still think I'd prefer it over what we have here in the States.

In fact, one of the many reasons I'm so terribly excited about my upcoming move to NYC is that for the first time in my life, I'll have good access to affordable medical care, in the form of free/sliding scale clinics. That's a concept that people around here just don't get. There are two free clinics in a city about 75 miles away -- one only serves residents of that city, while the other only offers a handful of not-particularly-useful services and it's nearly impossible to get an appointment. It's sad, really, because there are a lot of people living well below poverty level around here, and the doctors are exhorbitantly expensive if you don't have insurance.

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Kythryne Aisling
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DarlingBri
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The grass is always greener...

The NHS is great for routine care. Break an arm? No problem. Need cervical smears or birth control? Again, no problem.

Have cancer? Big problem. Your wait for treatment in may areas of the UK will be lifethreatening. Need infertility treatment? Good luck. You'll get one or possibly two rounds of IVF -- and we have a shortage of sperm donors as well.

Private health insurance is increasingly popular here, and for good reason.

Thar said, given the choice between "pay for everything and get a pretty high standard of care in the US" and "pay for nothing and get a wildly variable standard of care in the UK" I'm not sure one is really better than the other.

--Bri


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leafy
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Also with the NHS there is still private health care available so the 'the more money you have the better healthcare you receive' situation is still an issue. Stil, I believe that the concept of a national health service is a fantastic one.
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Rizzo
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I agree, leafy. The problem with having a two-tier system is that it seems to put a value judgment on the lives of human beings, based on the amount of money that they have. Also, if too many people opt for private care, politicians start getting ideas that they can cut funding for public health care.

Or maybe I'm just paranoid. We have both public and private schools, and the public ones, for the most part, are just fine.


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Gumdrop Girl
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*desperately fighting urge to argue*
can't ... fight ... much ... longer!

okay, i'll throw my two centavos in.

Yes, I know the system of HMOs in the US sucks. But the idea of handing health care over to the government is an idea I find absolutely repugnant. It's taking one bloated and dysfunctional bureaucracy and handing it over to a more bloated and dysfunctional bureaucracy. Then again, one of my political credoes is, "If you want something done right, don't let the government touch it." Like Bri pointed out, it's not perfect in the UK. Last year, the NHS sent some high-up mucky-mucks to Oakland to observe how Kaiser Permanente operates. Kaiser Permanente is, imho, one of the most hideous examples of everything that is wrong with the HMO system. Can't choose your own doctor. Can hardly ever even see your doctor. Patients usually examined by nurse practitioners instead (not necessarily a bad thing, but when you want to see a doctor, sometimes you really want to see a doctor).

I think HMOs are horrid. They charge the patients, pay doctors on a per capita basis regardless of procedures (wart removal? vasectomy? it's all $36 a head) and then take the rest of the money. but overall, the patients pay less than they did with regular insurance. And you know what? You get what you pay for.

Around the early 90's, HMOs became more prevalent. My dad had to sign on as a provider to some of them otherwise he'd lose a significant portion of his clientele. He saw his annual income decrease by 25%. Some doctors in more affluent and better populated areas are rebelling by refusing to accept HMOs. Their practices might have fewer clients, but the ones they do keep are better able to pay for services rendered. But where does this leave the patients? Limited to the doctors who accept their HMO.

So where am I going with all of this? Toss out the HMOs. Go back to insurance. Maybe make it more like auto insurance -- have some providers that can sell it super cheap at higher volume. Not a bad plan to be on if you're young and relaatively healthy and low maintenance.

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"In God we trust. All others must pay cash..." faw-choon kookie say.


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Beppie
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In Australia, every citizen is eligiable for Medicare, which covers doctor's visits, non-elective surgery, and optomistrist appointments once every two years. If you are on low income, or if you have private health insurance, you pay less, or no levy for this when you do your taxes (it depends on a few different factors as to whether or not you have to pay and how much).

I have never had any trouble going to the general practitioner that I want. I've never had to see a nurse instead of a doctor. If my doctor's appointments are all booked out for the day, then of course I'd have to wait, but I imagine the same would occur no matter how it was paid for. I like this system, and I wouldn't change it, except to make it cover dental appointments again, which it used to do. It's good to have the security to know that if you get really sick, which is something you can't exactly help, you can get the treatment that you need to go on being productive in your life. Its good to know that people who don't have health insurance aren't going to die from a serious injury because the hospital wants to see their insurance plan before they'll do anything for the patient. There are some problems with the system- certain things are considered "elective" that people don't really have a choice about, and there are waiting list problems- but this is about poor management rather than an indication that the system itself cannot work.

I personally believe that if we want to have productive members of society, people need to have the basic tools to be productive, and good health is definitely one of those things. After all, if someone is sick, they can't turn up to work and earn money for themselves and their families.


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Gumdrop Girl
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Would I be wrong to say this might be better suited for Ethics and Politics? I mean, we're having a jolly ol' time politicking, aren't we?

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"In God we trust. All others must pay cash..." faw-choon kookie say.


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Beppie
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It may well be- since lilykitten has gotten the answer she was looking for, how about we move it on over?
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Confused boy
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Moved to this forum and I suddenly notice this topic...

The NHS is, at the moment, pretty poor. I haven't had any problems with it myself but for many long term illnesses it is supposed to be quite dreadful. I would argue that this is not simply because it is run by the government but by the kind of government that has been running it. For over 20 years a right wing government of some form has been in power here, making the NHS look like an anachronism because it demands so much public investment. Mainland European countries which are generally more left wing spend far more on health but as a consequence tend to have higher taxes. Their systems are superior to the current British one.

Personally I would gladly lose some "spending power" if I could be sure there was a free hospital that was clean and efficient near me.


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Whatsthatmommy
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Personnally, I am against free health care. Becuase if you don't earn enough income for a doctors visit, I'm sorry to say that is your problem.Also, if the doctors are paid less they will perfom worse. I do think that children and seniors should have free medicare though. But if you are over 21, Go earn the healthcare your self instead of raising the taxes for everone else. If this were a socialsist nation that would be fine. But we don't stand for re-distrubution of wealth.

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"I believe everyody in the world should have guns. Citizens should have bazookas and rocket launchers too. I believe that all citizens should have their weapons of choice. However, I also believe that only I should have the ammunition. Because frankly, I wouldn't trust the rest of the goobers with anything more dangerous than string."
-Scott Adams


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Zanney
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quote:
Originally posted by Whatsthatmommy:
Personnally, I am against free health care. Becuase if you don't earn enough income for a doctors visit, I'm sorry to say that is your problem ... But if you are over 21, Go earn the healthcare your self instead of raising the taxes for everone else.

There are many reasons why a person may need assistance with health care - it is rarely just because they are "too lazy" to go and work and make money. Sometimes it is just unfortunate circumstances - low employment in the area, family situations etc - that mean these people need financial assistance. And they are human beings too, and have the right to access care from a competent professional. Their own bad luck should not disqualify them from it.

quote:
Also, if the doctors are paid less they will perfom worse.

Doctors take Hippocratic oaths etc when first registered, where they swear to do their best to care for a patient - and this is regardless of how much they are paid. Admittedly, there are some selfish doctors out there who may do a shoddy job if the money isn't forthcoming, but generally most doctors are in the profession because they want to help people, not because they want money.


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lemming
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Well said, Zanney. If healthcare costs were fairly priced - and one look at a hospital bill or a G.P.'s standard visit can tell you they aren't - that might be an attitude that you could afford to have.

But people's circumstances can change quickly, too - if I were to get married, say, and lose my parents' insurance coverage, there is no way I would be able to cover my healthcare as a student. My partner currently cannot afford the cost of a good dental exam, and I can tell you that that makes me sad and angry when I see the insurance cost and copay of mine.

I feel that part of the responsibility of a government is providing for its citizens, and preventative care is much cheaper than emergency care.

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Laurel Lemming
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"Ooh, I'll settle down with some old story/About a boy who's just like me/Thought there was love in everything and everyone, you're so naive!"-Belle and Sebastian, "Get Me Away From Here I'm Dying"


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Whatsthatmommy
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But that will raise taxes for the working class, that not fair. I can understand if you cant go to work becuase you have some mental or physical detriment, but hey I dont want to pay for your healthcare. If some areas have high unemployment rates then why did you move there in the first place? Let me refrase this. If your out of college then you should earn your own healthcare. I was making a bad guess at age of graduation of college. And trust me, you lower a paycheck a big difference happens.

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"I believe everyody in the world should have guns. Citizens should have bazookas and rocket launchers too. I believe that all citizens should have their weapons of choice. However, I also believe that only I should have the ammunition. Because frankly, I wouldn't trust the rest of the goobers with anything more dangerous than string."
-Scott Adams


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Zanney
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quote:
Originally posted by Whatsthatmommy:
But that will raise taxes for the working class, that not fair. I can understand if you cant go to work becuase you have some mental or physical detriment, but hey I dont want to pay for your healthcare.

The thing is, that is how the system works. We pay taxes to keep the country running, to maintain and build infrastructure, and to help support the citizens of that country. Healthcare subsidies are one very good way to support the citizens who aren't as well off. Some people, I repeat, cannot help their bad circumstances, and as human beings they have the right to health care. The government has recognised this right, which is why it collects taxes to help these people out.

quote:
If some areas have high unemployment rates then why did you move there in the first place?

Some people don't have the choice of "moving anywhere". Some people are born into unfortunate circumstances and have little hope of getting out. And very few employed people move anywhere without first checking out their employment prospects, as moving anywhere without already having a stable means of support lined up is rather foolish.

I repeat, for some people poverty is most certainly not a choice, nor a result of their own choices. Why should the better-off punish these people for their own bad luck by witholding subsidies, without which many would descend further into crisis? It truly is one of the more compassionate outcomes of the whole taxation system.


[This message has been edited by Zanney (edited 09-12-2002).]


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Dzuunmod
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Thumbs up is for Zanney.

To look at it another way, why should I pay for highways or roads that are built in the Gaspésie region of Quebec, if I live in Montreal? I've never been to the Gaspésie, but still, any taxes that I pay which go to the province are pooled, and go to projects all over the place.

I live in a poor neighbourhood, and everyday I see hundreds or thousands of young people who've been born into poor families here. Is that their fault? Certainly, it is not. Do they have any less of a right to live than someone living in a penthouse downtown? Certainly, they do not. Unless health care is government-run, or heavily regulated by the government, you're always going to have people who simply can't afford the care, because in the capitalist societies that we (or at least most of us, I presume) live in, inequality is inherent. There are always going to be poor people (relatively speaking) so you can't say that everyone who is poor is so because of their own choices, or laziness. Logically, it simply doesn't make sense to say that.

I think I should help pay for those roads just as I pay for roads in Montreal, because we're all in this together. That's the general philosophy behind medicare systems, as well.

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"Isn't it amazing what you can accomplish/when the little sensation gets in your way/no ambition whisperin' over your shoulder/oh, isn't it amazing you can do anything"
-The Tragically Hip, Fireworks

[This message has been edited by Dzuunmod (edited 09-12-2002).]


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melimelo
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quote:
Originally posted by Whatsthatmommy:
Also, if the doctors are paid less they will perfom worse.

or some doctors who are paid more would not really care since they get paid anyway.

or some doctors who get paid depending on what treatment their patient have could want to perform not-so-good so they could "take care" of their patients longer and then ask for more money...

the way the doctor works depends on the doctor him/herself and what you can do is to choose one you can trust.


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Confused boy
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I believe Whatsthatmommy may be pointing out the rather blunt nature of direct taxation that penalises everyone, including some who already struggle to balance their budgets. This is quite a good argument for introducing more targetted taxation. For example, in England, smokers not only pay for their own increased healthcare cost but also some non-smokers too through the high tax on tobacco. It is is also possible to introduce different levels of taxation according to income.

In many western countries where wealth is so plentiful, to me there seems little need for anyone to go without a basic standard of healthcare. How this is integrated with private medical care is up to each society, though it cannot involve pure reliance on the private sector.

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'An Anarchist is a Liberal with a bomb' Trotsky


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Heather
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I feel the need to chime in here. I don't mean for this to come off as antagonizing or snotty, but.... I have to say that talking about the realities of working, moving, staying employed and paying for healthcare are often VERY different than the average young person thinks they are.

Why doesn't someone who can't find employment just move? Well, because if they've been unemployed, they likely can't afford to. Moving can cost big bucks, especially if you're talking about moving out of state or country.

Lower-class people in the states also pay taxes that take care of those who live WAY above their means, too. Personally, I find that to be the greater inequity. I've been high and I've been low as making money goes in my life (though always below the average-middle class person, and I grew up very poor) and I don't mind that my taxes pay for medicare and welfare for those who need it who have trouble. I would mind that it pays for those who CAN afford their own, save that as Dzuunmod and Zanney said, we are all in this together. When it's equitable, what someone does or doesn't make shouldn't make a whit of difference. Redistribution of weath really is a misnomer for what is being discussed here when in fact, the very wealthy pay the lowest tax rates.

To boot, talking about college grads who should be able to pay is also tricky, since many college grads cannot get good job placement AND have the added burden of heavy student loans. Some of whom were medical students.

Lastly, not providing healthcare for people impacts everyone. Greatly. Look at countires where there is little to none and note how riddled by disease they are. Look at the crime rates, at the quality of life for all the people there. In other words, we all pay for that lack one way or another. personally, I'd rather pay for it with my taxes, thanks, and work to make things better rather than suffering the consequences of things getting even worse.

I'd be willing to guess that is asked what a good HMO or general healthcare costs would cost the average woman of childbearing age annually (whether she pays for it on her own or it is deducted from a paycheck), most people in their teens would be off by a highly substantial amount of money, simply because they have not looked, nor paid it themselves. Don't even get me started on what hospital bills can cost if you aren't or can't get insured.

So again, I don't mean to sound like a louse or to talk down. But discussing economic realities before having dealt with them independently and on one's own for at least a handful of years -- if at all -- has limited mileage.

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Heather Corinna
Editor and Founder, Scarleteen

My epitaph should read: "She worked herself into this ground."
-- Kay Bailey Hutchinson

[This message has been edited by Miz Scarlet (edited 09-13-2002).]


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