posted
I haven't seen all of Sicko by Michael Moore, but there was one scene I saw where he interviewed people getting free NHS health care where I live in the UK. Which seemed to be saying "wouldn't it be great if we were like this"
From working in a hospital here (which I loved), I picked up a leaflet about the positive aims for choice and access to care in an antenatal care unit for expectant mothers. After reading quite a lot of stuff on the net about private clinics over in the states and the general republican stance on choice I wondered whether a full american national health service would be pro-choice or not... I dno the answer but thought for a moment, "thank goodness they HAVE private clinics who will give mothers decent care and support"... and then had a moment of self-reproach "did I really think that!!?" as someone who really believes in public health care.
So what should I think? What does everyone think about the relationship between choice and "public vs private"?
posted
I may just be being daft, but I'm a little uncertain what you're asking.
In the states, we have both private and public healthcare, even though not everyone qualifies for public healthcare, nor will it always cover all services (and the system often sucks). As well, many people cannot afford a private doctor here or a private clinic (do you mean private or independent, btw?).
In terms of if your national health, if we ever got it, would be pro-choice, that may be a bit of a moot point. More often than not, those who would work to get us national health here are on the pro-choice side, and those on the pro-life or antichoice side are usually the same people obstructing or opposing national healthcare.
-------------------- Heather Corinna, Executive Director & Founder, Scarleteen About Me • Get our book! 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 Posts: 63261 | From: An island near Seattle | Registered: May 2000
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posted
I think I've realised that I asked this question a little ignorantly because I don't know what independent means in this context, it may have been what i intended... and you have been answering the question I was trying to ask.
I've made an assumption that when there is a smaller public sector there is a bigger/more varied private one. So perhaps, even if it had to be payed for... it may have been more likely that there would be at least somewhere in the system where individual flaws within the public system could be countered and an alternative be given...
Unfortunately to relate that to choice, I imagined an instant US national health system which would hold the views of the presiding government ie pro-life... but as you've said and I've realised this would be a paradox...and that for it to even exist the administration would be completely different.
One thing to understand here is how many of us simply cannot pay for private health care. And it's not even just an issue of having the cash anymore: many, many doctors and practices simply will not even see those of us who are uninsured anymore, even if we showed up with a wad of money in our hands. There are 47 million of us in the U.S. without insurance to date, many of whom also can't get into the public healthcare systems. So, plenty of us simply have nada.
OB/GYNs, public and private, are overwhelmingly pro-choice, period. But some are not, some are even anti-contraception, and my impression is that GPs doing OB/GYN and sexual healthcare can be where you start to see less and less honoring of choice, particularly in rural (and this is a biggie, given that folks who are rural have very limited access to a variety of care) and suburban areas and with certain populations (like with teens). We also have the HHS proposal in wait that I talked about in a post in this area a little while ago, which could have a really big impact on choice for federally-funded clinics, where you're mostly be talking about public healthcare.
The tricky thing is that when we're talking about if an NHS would be better for us here, it doesn't just hinge on reproductive health. In fact, I've found that's the easiest care for me to get through a life of being uninsured, since even indie clinics will often have sliding scale fees. I live without a lot of healthcare, but that's one arena where in any city I have lived in, I have found a way to get covered. Even if the rest of my body goes to hell, I'll have a healthy, beautiful cervix.
But my repro health can be as good as I want it to be, and yet, that's just a sliver of my whole healthcare picture. If I can't get the rest of my health taken care of...well. To give you an example, last December, I wound up with viral bronchitis. In order to get seen by anyone at all without waiting for two months for an opening at the free clinic to show up (I make a little too much for Medicare, but can't get insured, either), I had to go to the ER. The total bill when all was said and done was $2,000. All for just getting looked at, having a throat swab and one simple x-ray.
As well, know that a lot of insurance plans here for those who are insured limit what doctors a person can see, some really restrictively. So, even if there is big variance in private practice (and there is), it's not something even insured people get to take advantage of in many cases.
Not sure if that fills in the picture a bit more, or is the kind of thing you're asking about, but it's what I got.
-------------------- Heather Corinna, Executive Director & Founder, Scarleteen About Me • Get our book! 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 Posts: 63261 | From: An island near Seattle | Registered: May 2000
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posted
In Aus we have Medicare, which basically means any resident can get a cash rebate on their medical care (of course, most places don't bulk bill so you end up going to large clinics and waiting, but it's better than nothing). There's also the healthcare card which covers all costs for people under a certain income.
I've been lucky to be seeing the same doctor for almost my whole life, and she bulk-bills me every time I see her - even though she knows that I'm working fulltime now. Luckily, she doubles as my psych.
When I started working full-time I made the choice to get private health insurance because I didn't want to end up burdening my family with medical expenses. Although I haven't yet claimed on it, I went for the highest level of cover because it was the only one which included psychiatric care (I'm now covered for everything except cosmetic surgery).
It's really reassuring to know that if anything happens I've got cover, and I even got a tax cut because of it.
There's such a shortage of good GPs - or rather the doctor to patient ration is so bad - that very few of them are taking new patients, regardless of what kind of health cover you have. Although it's nowhere near as bad as our mental health system, but I won't go into that now.
Posts: 465 | From: Canberra, ACT, Australia | Registered: Jan 2001
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