Help me find a comment about an American in an Australian hospital?

March 27, 2012 6:24 PM

Please help me find a comment about an American who ended up in the hospital in Australia, and burst into tears when he/she realized that it would not cost them anything.

I'm having an argument with someone who insists that foreign countries with universal health care (or something close enough) won't cover non-citizens who are traveling in their country. I remember someone here recounting a visit to a hospital who was expecting a bill in the tens of thousands, and ended up owing nothing.

Can anyone locate this comment?

posted by tzikeh to MetaFilter-Related at 6:24 PM (314 comments total)

Ah I remember it, it was in the past few months, pretty sure. I'll dig around for it, it was not in the thread you'd think it would be in, iirc.
posted by jessamyn (staff) at 6:28 PM on March 27, 2012

Here you go.
posted by shoesfullofdust at 6:28 PM on March 27, 2012

Ahh - ok, I'll have to ask Empress if her friend had become an Australian citizen before that happened.
posted by tzikeh at 6:30 PM on March 27, 2012

It wasn't me, but I broke my arm when I was a kid, in England, and it cost nothing to be fixed. (I'm American.) Follow-up care in France was also free, or very cheap, I don't remember anymore.
posted by rtha at 6:31 PM on March 27, 2012

I'm having an argument with someone who insists that foreign countries with universal health care (or something close enough) won't cover non-citizens who are traveling in their country.

In Australia, access to Medicare (subsidised health and hospital care) requires you to be either or applying to become a permanent resident, a citizen (Australian or New Zealand), or covered by a Reciprocal Health Care Agreement.
posted by kithrater at 6:51 PM on March 27, 2012 [1 favorite]

FWIW, you generally do not have to be a citizen of a country with Universal health care to enjoy their Universal health care -- merely a legal resident.

So, tourists don't get coverage, but anyone with any kind of long term visa -- working, family, etc, will get coverage within a few months of landing. I'm not sure about student visas specifically, but most other categories will bring allowable coverage.

But the other upshot of Universal health care is that it tends to make all health care cheaper. So if you are an American citizen, and you happen to break your leg in Canada, you may be pleasantly surprised by the bill you get, even if you're paying full freight.
posted by jacquilynne at 6:52 PM on March 27, 2012

According to this page at the Australian Department of Health and Ageing site, US citizens aren't covered by the Reciprocal Health Care Agreement.

Check with Empress, certainly, but if her friend was a US citizen, it appears they wouldn't have been covered.
posted by malibustacey9999 at 6:56 PM on March 27, 2012

In general, non-residents of Australia are billed for the cost of medical treatment they receive here (unless they are residents of Finland, Ireland, Italy, Malta, Netherlands, New Zealand, Norway, Sweden or the United Kingdom), although the cost is nowhere near the astronomical figures that I've heard quoted for things like surgery in the USA.

If the person in question was a USA citizen, but had residency status in Australia, he would be covered by Medicare.
posted by dg at 6:59 PM on March 27, 2012

Also, if you are travelling to Australia on a student visa, Overseas Student Health Cover is a mandatory condition of your visa, regardless of citizenship/residency.
posted by dg at 7:04 PM on March 27, 2012

My family's recent birth / new member in Malaysia cost us a whopping $200 on the day of delivery. Extensive pre- and post-natal visits, vaccinations, in house visits by nurses, etc., have been either free or trivially cheap (like $5) along the way. We have work visas but are not permanent residents.
posted by Meatbomb at 7:24 PM on March 27, 2012

Oh, and just an interesting tidbit, Malaysia now has a (slightly) lower infant mortality rate than the USA. GO GO Malaysia :)
posted by Meatbomb at 7:26 PM on March 27, 2012 [8 favorites]

No, you idiots. We live in the greatest country on the face of the planet. There's no possible way that things are better in other countries. That's just crazy talk.
posted by crunchland at 7:27 PM on March 27, 2012 [22 favorites]

I'm having an argument with someone who insists that foreign countries with universal health care (or something close enough) won't cover non-citizens who are traveling in their country.

While I'm not the commenter you remember, this has happened to me. I am a US citizen. Four years ago, while visiting a friend in the UK, I took a tumble, and we were worried that I might have fractured my ankle. (While it turned out to be a sprain, it did, in fact, hurt worse than when I had previously fractured my ankle, so a fracture was a distinct possibility.) We were in Brecon, Wales, so we went to the Breconshire War Memorial Hospital. X-rays were taken, sprain diagnosed, a small amount of painkillers dispensed, and a soft cast was given to me. When I was told I was all set to go (and this I distinctly remember) I asked "So, since I'm not from the UK, do I need to pay for this?" and the nurse just laughed and said that if I wanted to fill the prescription for more painkillers I'd pay for that, but otherwise, no, I didn't owe anything.

It was amazing. I <3 universal healthcare.
posted by ocherdraco at 7:28 PM on March 27, 2012 [12 favorites]

The UK's NHS will cover everybody for an emergency of course and may or may not ask you to pay. All legal residents are covered not just citizens. They're not really supposed to be free to tourists, though. I think they are starting to clamp down on this.

My old clinic was right across the street from the British Museum so they were used to tourists. While waiting to see my doctor I saw plenty of Americans and other foreigners walk in and be asked to pay a nominal but small fee for a consultation.
posted by vacapinta at 7:38 PM on March 27, 2012

Ahh - ok, I'll have to ask Empress if her friend had become an Australian citizen before that happened.

I'm assuming she did, since she married an Australian national (he of the refrenced appendix).

I know there's been some other paperwork since, but even if she wasn't 100% a citizen, HE was by birth.
posted by EmpressCallipygos at 7:40 PM on March 27, 2012

and now that I'm seeing the rest of the thrust of your question:

* she was an American, but he was Australian. She'd just been dirt-poor for a while, and had had a couple of ill-health-while-uninsured-in-the-US issues for a while. She'd moved to Australia to marry her beloved, who was himself Australian.

So it wasn't a matter of "is Australia going to be nice enough to cover people who aren't citizens," it was a matter of her having the knee-jerk reaction of worrying how to pay for medical insurance and getting the shock of "wait...this country DOESN'T treat people like that?...."
posted by EmpressCallipygos at 7:43 PM on March 27, 2012

The emergency ward at Whistler is packed with skiers from other countries. You get fixed up right away, without question. If some insurance is available to cover the costs, that's great, but no one is ever turned away, or saddled with massive bills, post-visit. This includes dipsticks who ski out of bounds and fall down down cliffs.
posted by PareidoliaticBoy at 7:47 PM on March 27, 2012 [2 favorites]

Someone paid for it. It was not free. "At no cost to that person" does not equal free. There is no such animal as "free health care" even less than there is a free lunch.
posted by Carbolic at 8:16 PM on March 27, 2012 [3 favorites]

I've had several friends/girlfriends from overseas treated in the UK by the NHS and never paid a penny, even for stuff that required surgical procedures. No-one had any kind of residency.
posted by unSane at 8:17 PM on March 27, 2012

PareidoliaticBoy writes "The emergency ward at Whistler is packed with skiers from other countries. You get fixed up right away, without question. If some insurance is available to cover the costs, that's great, but no one is ever turned away, or saddled with massive bills, post-visit. This includes dipsticks who ski out of bounds and fall down down cliffs."

I don't know if you'd consider it massive but a basic ER visit will cost non residents $765 +fees for some supplies and drugs. More if you are admitted to hospital or need surgery. No one will be turned away but they'll eventually try to collect. It's a good idea to have travel medical insurance when visiting BC.
posted by Mitheral at 8:17 PM on March 27, 2012

Someone paid for it. It was not free. "At no cost to that person" does not equal free. There is no such animal as "free health care" even less than there is a free lunch.

Gosh. Really?
posted by unSane at 8:18 PM on March 27, 2012 [42 favorites]

Yes RLY
posted by Carbolic at 8:19 PM on March 27, 2012 [1 favorite]

Someone paid for it. It was not free. "At no cost to that person" does not equal free. There is no such animal as "free health care" even less than there is a free lunch.

THE TAXPAYER'S PENNY YOU SAVE BY DENYING SOMEONE'S CHILD MEDICINE MAY BE... YOUR OWN
posted by scody at 8:24 PM on March 27, 2012 [63 favorites]

I don't want to deny anyone healthcare but reveling in the irresponsibility of having someone else pay for it rubs me the wrong way.
posted by Carbolic at 8:28 PM on March 27, 2012

When I lived in Spain and finally managed to save up a decent sum, I decided to be posh and pay for health insurance, and braced myself for costly horrors. Instead, for 60 euros a month, I had better coverage than I have ever had in my entire life, including when I was on the executive family health plan of the vast multinational drug company my late father worked for.

our country is so stupid
posted by elizardbits at 8:32 PM on March 27, 2012 [15 favorites]

Someone paid for it. It was not free. "At no cost to that person" does not equal free. There is no such animal as "free health care" even less than there is a free lunch.

Well, yeah.

But who do you think supports the people impoverished by medical bills? (A: You.)

And how much do you think that costs? (A: More.)
posted by Sys Rq at 8:35 PM on March 27, 2012 [48 favorites]

I don't know if you'd consider it massive but a basic ER visit will cost non residents $765 +fees for some supplies and drugs ... It's a good idea to have travel medical insurance when visiting BC.

Of course it is. However an ER visit here is still less than a day of a Heli-skiing, and is a small percentage of what similar, uninsured care, costs in the U.S.. Naturally, insurance agencies, such as the one linked above, emphasize the potential liability, while ignoring that an inability to pay won't ruin you financially for the rest of your life, and you will still be looked after.
posted by PareidoliaticBoy at 8:41 PM on March 27, 2012

Sys Rq: I agree.
posted by Carbolic at 8:43 PM on March 27, 2012 [2 favorites]

Carbolic: "... reveling in the irresponsibility of having someone else pay for it rubs me the wrong way."

Think of it this way - today you are paying for someone else's health care. Tomorrow, someone else could be paying for yours. Civilised societies look after one another in this way, while those that are less so put in place systems that deny huge proportions of their population the level of care needed to sustain a basic quality of life.

The same process that makes universal health care not free (ie someone has to pay, somewhere along the line) is the process that makes it free (ie it's there when you need it and whether or not you have funds available at that time to meet the cost).
posted by dg at 8:53 PM on March 27, 2012 [60 favorites]

an ER visit here is still less than a day of a Heli-skiing

Not if an ambulance takes you to the hospital, and not if you need any additional services like a CAT scan, or an ICU visit, or surgery.

The idea that uninsured non-residents who need medical care while in Canada don't run the risk of large medical bills is a dangerous one, because it is not true.
posted by one more dead town's last parade at 8:53 PM on March 27, 2012

Back in the day, I did some supervisory stuff for American students on summer study in the UK, and invariably one or two of them would end up in A&E, whether it was a mistimed tackle on the football pitch or an unfortunate collision with the pavement after a night on the shandy. They were all gobsmacked that the NHS would patch them up without having to show or swipe a card. As vacapinta says, there are greater controls these days against obvious medical tourism, but the NHS is not (currently) structurally capable of billing you down to the last paracetamol, and overlaying that capability incurs costs that won't necessarily be retrieved through billing.

the irresponsibility of having someone else pay for it rubs me the wrong way.

The irresponsibility of thinking that healthcare is not a collective responsibility chafes me something rotten, but since I live in the US, I shouldn't admit that, as it may count as a pre-existing condition.
posted by holgate at 8:58 PM on March 27, 2012 [60 favorites]

I would start a brand-new, tax-paying business that employed people today if I lived in Canada, the UK or any other country with universal health care. But I'm hogtied to the job. It's a nice job and I like it very much. But still.
posted by Cool Papa Bell at 9:01 PM on March 27, 2012 [9 favorites]

My understanding is that it's generally a reciprocal thing; if government A agrees to cover government B's citizens, then the reverse is also true. Canada doesn't have any reciprocal arrangements, since the country we're tied to the closest doesn't have a universal health care system itself.

(For what it's worth, the last time I bought travel insurance, there were two rates; one for absolutely anywhere in the world outside the US, and a second, far higher, rate for travel to the States.)

My personal anecdata was from injuring my arm in Europe; I eventually went to the urgent care clinic in Slovenia. The nurses there told me that if I was from any of a very long list of European countries, that I would have been covered, but instead they had to bill me. The standard provincial health care coverage here would have reimbursed me for at least a portion of the cost; the whole visit was only €106.14 so I didn't bother going through the paperwork.

BTW, that link from Mitheral is (unintentionally) hilarious. "Outlined on this page are some sample costs taken from across Canada." From Vancouver, Burnaby, Richmond, and Surrey.

That's like the time I sampled the cuisines from across America, all the way from Central Park to Times Square to Greenwich Village.
posted by Homeboy Trouble at 9:19 PM on March 27, 2012 [2 favorites]

A philosophical quandary: is reveling in civilization the same thing as reveling in irresponsibility? Or is Carbolic simply really bad at spelling?
posted by jsturgill at 9:21 PM on March 27, 2012 [1 favorite]

the irresponsibility of having someone else pay for it rubs me the wrong way.

To make health insurance an earned privilege is to condemn people to physical suffering or even death because they failed to secure a job that gives them health insurance, or they don’t earn enough, or they happened to contract an expensive illness, or a member of their family did. [...] In every other advanced country, the provision of universal access to medical care is a public responsibility. In every other advanced country, this principle has been accepted by the mainstream conservative party. Only in the United States does the conservative party uphold the operating principle that regular access to doctors and medicine should be denied to large chunks of the population. This sort of barbarism is unique to the American right.

posted by scody at 9:27 PM on March 27, 2012 [71 favorites]

More medical tourism stories: I was in Shanghai about 6 months ago as a tourist from the US. My Shanghai-born girlfriend arranged for me to have a full physical there. We stayed in a nondescript neighborhood of the city, with nothing special around it, but there were two good-sized hospitals in walking distance (as well as dozens of schools, public parks, etc.).
On the day after I arrived, we walked over to the hospital for checks, and I had to come back eventually twice for follow-ups & results. Since I was a tourist with no Chinese relationship or paperwork, she/we paid about RMB100 for the whole thing.
Thank you, Mao.
posted by growabrain at 9:28 PM on March 27, 2012 [1 favorite]

Yeah, as has been described upthread, I paid cash money for medical services when I lived (a Canadian) in Australia, first on a working holiday visa then a few years later on a long-term business visa for a years, as far as I can recall. I was young and relatively healthy, and costs weren't exorbitant, but then again, this was a long time ago now.
posted by stavrosthewonderchicken at 9:28 PM on March 27, 2012

... a few years
posted by stavrosthewonderchicken at 9:29 PM on March 27, 2012

Homeboy Trouble: "(For what it's worth, the last time I bought travel insurance, there were two rates; one for absolutely anywhere in the world outside the US, and a second, far higher, rate for travel to the States.)"

Yeah, the last time I bought travel insurance (for travel to Vietnam), my policy specifically excluded any medical care provided in the USA, but covered anywhere else. I would have had to purchase a separate policy to cover this, at about four times the cost.
posted by dg at 9:35 PM on March 27, 2012 [1 favorite]

oh, and carbolic: if you really have the courage of your convictions, listen to this. You don't even have to come back here and respond publicly. Just listen to every minute of it. Then sleep on it. See if you're still thinking about it tomorrow. See if you really still believe that not being able to pay for medical care is indicative of nothing but someone's personal failure and irresponsibility. See if your eagerness to place blame really does override your empathy for another human being. See if you can still tell yourself that in the richest country on the planet in the history of the world, there's really no money and no will and no need for universal health care.
posted by scody at 9:40 PM on March 27, 2012 [29 favorites]

Just to clarify something about Medicare here in Oz: all taxpayers (except low income earners) pay 1.5% of their taxable income each year as a Medicare levy. So the vast majority are paying into the system... some of us don't need to use Medicare, some of us do. But all are charged a percentage of their income to fund it.

If you can afford to buy private health insurance - which a hell of a lot of people do, as far as I can tell - you can claim those payments as a tax offset.

I currently fall into the low income earner bracket, so my daughter's broken ankle and damaged ligament (and MRI's and blood tests and x-rays and multiple casts and god-only-knows-what-else) were paid for by the taxpayer. I appreciate that, particularly since reading on Mefi about the US health care system, sorry, excuse for a health care system. But I also was a higher income earner for decades, paying the Medicare levy every year with my tax return when I never needed to claim a cent.

I guess my rash generalisation is that it all balances out in the end.
posted by malibustacey9999 at 9:55 PM on March 27, 2012 [5 favorites]

I have always supplied heath care coverage to those for whom Im responsible, What bothers me are others who could just have well done the same but decided take an "alternative" job" that didn't provide health care but now feel it is an ENTITLEMENT. Maybe I could have been a fantastic potter and would have loved that life but I became a lawyer so I can pay the necessary expenses (its a burden and a choice to make the sensible job choice) Ive had a decent healthcare plan of my own since 19 and I was son my parents before then. Part of that was lucky part responsible Its not that difficult to end up with employer sponsored health insurance if you aren't set on living in a commune,.
posted by Carbolic at 10:06 PM on March 27, 2012

I'm not eligible for Australia's Medicare and I am legally obliged to carry 457 Visa Health Cover (health insurance), because I'm a temporary resident and American citizen. I pay for nearly everything out of pocket and if I'm lucky I get some of it reimbursed by my insurance. I fill out paperwork every year to prove I am exempt from the Medicare levy, which is fair. Basically, the system is pretty fair-minded.

My costs as a private patient don't seem to be as exorbitant as they do in the US when I've been uninsured.
posted by gingerest at 10:07 PM on March 27, 2012

Its not that difficult to end up with employer sponsored health insurance if you aren't set on living in a commune,. (Carbolic)

[CITATION FUCKING NEEDED]
posted by ocherdraco at 10:08 PM on March 27, 2012 [52 favorites]

malibustacey9999: "I guess my rash generalisation is that it all balances out in the end."

I don't think it's rash at all - it's the fundamental principle that makes Medicare work (for all its faults). I have paid into Medicare almost every year over the past 30 years or so and, in almost every one of those years, I have not needed to visit a doctor or receive any medical care. But then my son was born with a syndactly of the right hand. Since that time, he has had four rounds of surgery from one the country's most respected hand surgeons. He's had regular check-ups to monitor progress, including x-rays and consultations with the same surgeon, physical therapy, casts, various implements custom-made to help his hand stretch etc. We had a consultation with a geneticist to help figure out what may have caused the condition. The cost to me? Not one cent.

I guess that, if I lived in the US, he would still have got that treatment (or most of it, anyway). But the whole family would be living in poverty to make it happen. Denying basic health care to individuals doesn't only adversely affect the individuals - the impact flows to everyone around them.

Even after all I've read and heard about it, I still cannot comprehend a country that calls itself civilised and that dares to hold itself up as the leader of the free world and defender of the downtrodden treats its own people so shamefully.
posted by dg at 10:10 PM on March 27, 2012 [7 favorites]

"What bothers me are others who could just have well done the same but decided take an "alternative" job" that didn't provide health care but now feel it is an ENTITLEMENT."

Even in countries with a long history of universal health care for all citizens, you'd be getting awfully bothered about a vanishingly-small number of people.
posted by Pinback at 10:10 PM on March 27, 2012 [2 favorites]

Carbolic: " Its not that difficult to end up with employer sponsored health insurance if you aren't set on living in a commune,."

*gobsmacked*
posted by dg at 10:11 PM on March 27, 2012 [26 favorites]

That's like the time I sampled the cuisines from across America, all the way from Central Park to Times Square to Greenwich Village.

From Burger Joint to Veselka? Yep, that pretty much covers it.
posted by eddydamascene at 10:11 PM on March 27, 2012

Its not that difficult to end up with employer sponsored health insurance if you aren't set on living in a commune,.

You've got to think this is parody.

On the other hand, given that a significant number of Americans actually think people like Mitt Romney, Rick Santorum, Newt Gingrich and all the other fools and villains that have fallen off the clown-car are reasonable choices for presidential candidate, so you never know.
posted by stavrosthewonderchicken at 10:14 PM on March 27, 2012 [20 favorites]

Carbolic: "Yes RLY"

I'm picturing Carbolic as a giant owl sitting at a desk going HOO HOO HOO.
posted by dunkadunc at 10:15 PM on March 27, 2012

Even after all I've read and heard about it, I still cannot comprehend a country that calls itself civilised and that dares to hold itself up as the leader of the free world and defender of the downtrodden treats its own people so shamefully.

posted by dg

I know where you're coming from. I didn't know about the US 'health care system' until I learned about it on Mefi, and I can remember staring at the screen in amazement, stunned that such an arse-backwards system would exist anywhere in the first world, let alone in the US.

We really are the lucky country.
posted by malibustacey9999 at 10:19 PM on March 27, 2012 [10 favorites]

Its not that difficult to end up with employer sponsored health insurance if you aren't set on living in a commune,.

Never driven through rural Alabama have you?
posted by RolandOfEld at 10:19 PM on March 27, 2012 [13 favorites]

I would start a brand-new, tax-paying business that employed people today if I lived in Canada, the UK or any other country with universal health care. But I'm hogtied to the job. It's a nice job and I like it very much. But still.

I'm curious what specific problems you're having, and what you've tried.
posted by michaelh at 10:22 PM on March 27, 2012

malibustacey9999: "I didn't know about the US 'health care system' until I learned about it on Mefi ..."

I kind of knew about it, but I don't think I ever really believed that the stories were true. Even now, knowing the truth, I just can't reconcile it. Not at all.
posted by dg at 10:25 PM on March 27, 2012 [6 favorites]

Even in countries with a long history of universal health care for all citizens, you'd be getting awfully bothered about a vanishingly-small number of people.

Though it would include "alternative" jobs like working in restaurants, or singing in bands, or writing novels.

Still, if you decide to be a lawyer, you can represent the people screwed over by their health insurers, or if you're a particular kind of lawyer, the health insurers themselves, given that litigation is the final recourse with a shambolic healthcare "system" that will ruin you at the drop of a hat. One person's "sensible" job choice is made possible through systemic nonsense. Funny, that. Though not amusing.
posted by holgate at 10:30 PM on March 27, 2012 [6 favorites]

Being held hostage in the wrong job frequently has health consequences, s'all I'm saying.
posted by Trivia Newton John at 10:38 PM on March 27, 2012 [2 favorites]

I became a lawyer so I can pay the necessary expenses (its a burden and a choice to make the sensible job choice) [...] Its not that difficult to end up with employer sponsored health insurance if you aren't set on living in a commune,.

Objection: facts not in evidence. One in three Americans have gone without health insurance at some point in the past five years, and nearly 80% of them were either in the workforce or were in a family in which at least one member worked full-time. Your claim that people lack health insurance solely because they are just trying to live like hippies, man, is specious and demonstrably false. Either you are actually unaware of the data, or you are purposefully trying to obfuscate them. Which is it, counselor?
posted by scody at 10:56 PM on March 27, 2012 [102 favorites]

Something like one in six adults in the U.S. is uninsured. But I guess they're all just irresponsible jerks who decided to take "alternative" jobs in lieu of being good citizens by going into six-figure debt to get law degrees. Or something.
posted by rtha at 10:58 PM on March 27, 2012 [8 favorites]

I'm curious what specific problems you're having, and what you've tried.

Can't spend $2000/month on a family plan that will offer what my family needs on top of the risk I would take starting my own studio. It really is that simple of a risk/reward calculation.

Its not that difficult to end up with employer sponsored health insurance if you aren't set on living in a commune.

The U.S. unemployment rate has been north of 8 percent for the past three years.

Wow. I had no idea there were that many communes in this country.
posted by Cool Papa Bell at 11:17 PM on March 27, 2012 [9 favorites]

We've heard multiple first person accounts of someone that thought everything was peachy in the world because they had good insurance from their employer, only to get hit by a car or diagnosed with leukemia or some other expensive illness that reaches into 6 or 7 figures to treat. The employer's group rate increases on account of it, and soon after they somehow find the need to downsize, eliminating the position of this person that happened to have the very expensive condition, who is now royally and utterly fucked as no insurance under the sun will have them. After their exorbitant COBRA coverage runs out, they find that their only option is to slowly go bankrupt and lose everything until they qualify for Medicaid. Tell me, where is the personal failing in getting cancer?
posted by Rhomboid at 11:21 PM on March 27, 2012 [20 favorites]

I became a lawyer so I can pay the necessary expenses (its a burden and a choice to make the sensible job choice)

Allow me to introduce myself. I am a lawyer, and for a time I was working on my own, and making enough money to pay for health insurance, and yet I was unable to obtain coverage. You can't be a group of one. I applied, and was rejected, on the flimsiest of justifications. (Seriously, a healthy 31 year old, non smoker, wtf?) It was not until I went back to working at a law firm, and became part of their group, that I was able to obtain health insurance. But I spent 18 months pretty much holding my breath that I wouldn't get hit by a bus or anything.


Anecdotally, I spent a year in France as an exchange student, and the doctor in my little town actually made house calls when I came down with the flu. No charge.
posted by ambrosia at 11:24 PM on March 27, 2012 [12 favorites]

I'm a lawyer, too, and I support universal public healthcare.

Because people in a civilised society shouldn't be condemned to financial catastrophe as a result of illness. Even if they choose pottery.
posted by robcorr at 11:24 PM on March 27, 2012 [25 favorites]

I'm a lawyer, too, and I support universal public healthcare.

I'm a lawyer as well, and I also support universal public healthcare.

Because I don't want poor people to die.

And because a civilised society should take care of its weakest members.

And because having a heathy population makes for a more productive economy.

And because preventative healthcare is cheaper and more effective than reactive healthcare.

And because a socialised system like Australia's is actually cheaper than America's ludicrous system, and delivers better healthcare to boot.

And because, ultimately, the costs/benefit analysis says that universal healthcare is worth it - it's better for the entire society and everyone in it. And the countries that have implemented it prove that this hypothesis is correct.
posted by His thoughts were red thoughts at 11:41 PM on March 27, 2012 [80 favorites]

For curious Americans, who may wish to see what a (part-coverage) Universal Health Care system that costs everybody 1.5% of their income looks like:

• What Medicare covers
• An A-Z list of services covered by Medicare

Short version: Medicare in Australia covers 75~100% of the cost of most visits and procedures. The major exception for most people is probably dental, along with MRI & similarly specialist imaging procedures (although those are covered for both emergency & many diagnostic non-emergency cases). In addition, most pharmaceuticals are subsidised through the PBS.

Want full coverage, or your choice of doctor, or a private hospital room? Punch in your requirements at the website of any of the major private health-care insurers (e.g. here) and see what it costs. For me - single, 45yo - it costs around $200/month. Full family coverage is ~$430/month.

"Can't spend $2000/month on a family plan …"

Fuck me … this is why people in civilised countries can't understand why people in the US put up with their frankly ridiculous & self-evidently broken system…
posted by Pinback at 11:53 PM on March 27, 2012 [11 favorites]

(Oops - that should have been "… or your choice of doctor and a private room in hospital?". You get to choose your own GP &/or specialists for non-hospital purposes - none of the US-style farking about worrying if they're in-network or not…)
posted by Pinback at 11:58 PM on March 27, 2012

tzikeh, I'm afraid your friend is right.

I just read this today about an Australian premature baby born in Canada. The parents had travel insurance but the insurer won't cover. The bill was around 1 million, and the parents have worked out an agreement with the hospital to pay $300/month.
posted by lunaazul at 12:04 AM on March 28, 2012

Yeah, the Australian situation is a bit tricky. This: In Australia, access to Medicare (subsidised health and hospital care) requires you to be either or applying to become a permanent resident, a citizen (Australian or New Zealand), or covered by a Reciprocal Health Care Agreement.

is not quite right. New Zealand citizenship isn't enough, until you have resided in Australia for a while and can prove you intend to reside here long term (e.g. by buying a car, or a house, and by having ongoing bills in your name like 24-month phone contracts and a bunch more stuff). And then you have to hope that the people at the Medicare office are feeling friendly the day you go in.

I wasn't covered by Medicare for the first few years I lived here, and as a NZer also was not eligible for overseas student health cover. I basically fell between the gaps.

So did my husband, as a Swedish citizen with NZ permanent residency who had previously been living in Denmark before he came here. Sweden has a reciprocal healthcare agreement with Australia, but it requires you to have been living there for the year preceding emigration - citizenship is not sufficient. To have Medicare access on the grounds that you intend to reside in Aus, NZ residency is insufficent - you have to be a citizen. The Danish thing didn't help us one way or the other.

It was all very irritating, but I still remember calculating what accidents and emergencies would cost us without health cover, and even paying everything out of pocket, it wouldn't have bankrupted us the way the same situation in the USA seems it would. I don't entirely understand why that is the case, actually.
posted by lollusc at 12:49 AM on March 28, 2012 [1 favorite]

Rereading my comment, "fell in between the gaps" makes no sense whatsoever. In my defense: wine.
posted by lollusc at 12:50 AM on March 28, 2012 [1 favorite]

When I studied abroad in the UK, I got hit by a car while crossing the street.

Totally my fault. And while I was totally gob smacked, the look of horror on the face of the person who hit me doubled when she heard my accent, as if she thought I was going to sue her. All I got out to her was telling the crowd that it was totally my fault, and apologized to the driver. Then someone got me to sit down. Someone else found my shoes, which had somehow come off. A third person brought me some tea. And I waited until an ambulance showed up, and took me to the hospital, where I got xrays, checked out by a GP, and was put in a cab and taken home. Never got charged for any of it - neither did my insurance.

That's the day I realized how awesome universal health care was. Not perfect, mind you. But awesome. Because if anything like that had happened to me in the US without health insurance, I would have been the difference between barely making it, to financially being in the hole, and taking months to pay back of thousands of dollars. Now I could afford it, but at the time, I was barely making it, and even my international insurance didn't cover everything.
I am grateful to the folks who cared for me that day - and that no one got all "who are you to use our health services" about it.

The same way that I don't get upset about the fact that there is a post office, or a fire station, I wouldn't get upset paying into universal care. I see my parents benefit from medicare, and I am grateful. I see all the other people in the waiting room also benefiting from medicare, and I just hope they're doing okay as well. I don't get pissed when I pay my taxes. I get pissed when people insist that they don't want to help someone else, but then refuse the acknowledge everything they get from supporting communal services - like they are solely paying for all of the trash pick up service and police. Grar to those folks. Just Grar.
posted by anitanita at 12:51 AM on March 28, 2012 [17 favorites]

Someone paid for it. It was not free. "At no cost to that person" does not equal free.

I pay an absolute shitload in taxes. I'm giddy with gratefulness that I'm lucky enough to be able to do that. I have a shit-eating grin because a fair whack of it is spent on our health care system.

So no, it's not free. It's on me. You're welcome, mate.
posted by obiwanwasabi at 12:54 AM on March 28, 2012 [65 favorites]

tzikeh, I'm afraid your friend is right.

I just read this today about an Australian premature baby born in Canada. The parents had travel insurance but the insurer won't cover. The bill was around 1 million, and the parents have worked out an agreement with the hospital to pay $300/month.

tzikeh's friend is right in this specific case, but not in general. Universal health care countries cover non-citizen visitors from other countries where they have reciprocal agreements. The reciprocal agreements include all of Europe in one big agreement, recipocal agreements between Australia/New Zealand/United Kingdom, as well as other pairings, like Chile/Peru. Most people in countries covered by universal health care are covered in the other countries they are most likely to visit.

I hope that this unfortunate case leads to a reciprocal agreement between Canada and Australia, although the way our health care system in Canada is structured may make that difficult.

From the article:
But Evans [mother of the baby] says the Australian government or their insurers should cover the bill, not B.C. taxpayers.
"If we'd been in Australia, we've always paid for full medical and private medical insurance. It would have been covered, no questions asked," she said.
"So really, the only winner out of this is our private health insurer, because they've managed to avoid paying those bills for us in Australia."

Full points to the mother of the baby, for coming out of this with a good attitude. Half points to the hospital in BC, who wrote off at least 90% of the cost and negotiated a payment that's expensive, but not financially ruinous. Negative a million points to the private insurer, who somehow yet again privatized the profit and socialized the loss.
posted by Homeboy Trouble at 1:05 AM on March 28, 2012 [2 favorites]

In general, non-residents of Australia are billed for the cost of medical treatment they receive here (unless they are residents of Finland, Ireland, Italy, Malta, Netherlands

Ah, that was why I got 100% free surgery-type treatment in Holland once. I thought it was just because the Dutch were ultra cool with people on tourist visas, but it must have been a reciprocal agreement between the countries.

Still, it's pretty cool that Medicare down under extends to random overseas destinations as well.
posted by UbuRoivas at 1:25 AM on March 28, 2012

Here's an anecdote: my partner experienced moderate gastrointestinal distress when he visited me in Australia in 2009, and we made two trips to an ER in Sydney which included X rays. He's an American citizen, and he ended up paying about (US)$500 in total. Two years later, after I'd moved to the US, we ended up in the ER again, this time in California. He had a mild stomach flu but had begun to hyperventilate. It freaked him out a little, so we he headed to the nearest ER, where we waited for more than three hours before a doctor saw him. By then, his symptoms had mostly subsided. Like Sydney, there were X rays but no medication, and total bill came up to about $2000. He was fortunately insured, but we were horrified nonetheless.

I've told him on no uncertain terms that if I were to come down with an illness that required surgery, I'm flying home to Asia to seek treatment.
posted by peripathetic at 1:29 AM on March 28, 2012

As has been noted above, there's no such thing as "free" health care.

Americans in Australia, however, get the benefit of medical care because America saved Australia from invasion in WWII - this was part of the treaty of surrender to the US that Australian Prime Minister Daryl Somers signed in 1941. BUT to pay back this debt, Australia also has to help America if the Martians ever try to invade.

"Strewth President Obama, we'll save youse from invasion with our army of space-Kangaroo cowboys and cosmic Koala marines, I reckon!"

-- "Thank you, my Australian stereotype friends. May the force be with you always".

"Too bloody right your Presidentialness! Now taste the sweat of me thong, youse fucken Martian bastards!"

... etc. So, in reality, nothing is "free".
posted by the quidnunc kid at 2:06 AM on March 28, 2012 [11 favorites]

Americans, here's an idea for you: abolish state-provided education for children and introduce a new 'literacy insurance' to cover the costs. Don't worry, the children of the poor won't suffer, because they'll be provided for with 'Educare', where every child gets a free pencil and some ketchup for lunch.
posted by le morte de bea arthur at 3:30 AM on March 28, 2012 [26 favorites]

For the healthcare alone, the US is so broken. If I was American, and didn't have a big family, I would seriously consider emigrating. If I did have a big family, I wouldn't even hesitate.
posted by smoke at 4:03 AM on March 28, 2012

The same way that I don't get upset about the fact that there is a post office, or a fire station, I wouldn't get upset paying into universal care.

Small comment -- you don't pay into the postal service, the government does not subsidize USPS.
posted by inigo2 at 4:40 AM on March 28, 2012 [2 favorites]

I was visiting my (Australian) fiance's brother and sister-in-law in the UK last fall. Their youngest child was really uncomfortable and miserable with some coughing/chest/breathing thing going on, or something like that. So the parents shrugged and said "Well, I guess we'll just take her to the emergency room. brb."

My immediate reaction was horror at the expense of what they were about to do, and how unnecessary it seemed when in the US the parent would just go to the drug store, buy up all the anti-mucous stuff they could, and hope they helped enough to get the kid through the weekend to Monday when the pediatrician's office was open.

Then my fiance started laughing at the look of horror that was apparently on my face and reminded me that the NHS exists. What an amazing thing, that a parent can get their child care immediately, without a second thought.

It was also pretty enlightening when we got into a discussion of personal responsibility and private insurance and whether or not it was feasible to expect someone to buy it for themselves, in both the US and Australia. We realized the disconnect in the conversation when he found out that private insurance for an individual in the US is hundreds of dollars, if not close to $1000, a month (for a young person in good health who doesn't have a pre-existing condition) and private insurance in Australia is something like $60/week. The conversations about insurance people in nations with socialized healthcare have are just fundamentally different from the conversations people in the US are having and I don't think most people on either side fully realize it.

Moving to the UK this year. Got quoted better insurance than I have now for less than half of what I pay every month in the US for my employer-subsidized insurance. Booyeah.
posted by olinerd at 5:00 AM on March 28, 2012 [3 favorites]

I can't even wrap my head around the mentality down there. You can't call it a "premium" (or whatever) and force people to buy it, even though having enough people in the pool, is the only way insurance can remain affordable. And you can't call it a "tax" because then you're a SOCIALIST.

Fuck, in Canada, I'm in the highest tax bracket, and I do not, for one second, begrudge what I pay to the government. It keeps my country healthy, and I don't limit my use of that word to the healthcare system. Our higher taxes create far less disparities, which mean far less crime, better education system, less homeless people, good libraries, etc. In the US, I've always offered my employees 50% of their healthcare costs, despite the fact that I was under no obligation to do so. I find it so ironic that the US attempts to sell itself as a great place to have a small business, when healthcare costs are approaching prohibitive levels, and I actually pay more corporate tax in the States, than I do up here.

Yeah, I hate waste, and I know that some of my tax dollars are misappropriated, but I fuckin' cringe when I read that something like thirty cents on every dollar spent on healthcare in the US goes to executives' salaries, having a staff to figure out ways to deny claims, and other useless shit that doesn't need to exist.

My girlfriend's father passed away last month after more than a month in the hospital. He received amazing and compassionate care while he was in there, and for much of the time, he was in a private room in the ICU with his own nurse(s). I just can't imagine what it would have been like to leave that hospital after he passed, and be handed a bill for hundreds of thousands of dollars on the way out.
posted by gman at 5:04 AM on March 28, 2012 [8 favorites]

I was a (foreign) student in Australia, and I broke my leg. The insurance paid for everything (xray, surgery). However the insurance didn't cover dental or anything to do with eyes, and consequently when my tooth chipped, I went to the dentist I found out that it would cost as much as a ticket back to India AND getting it fixed there! So I had to wait a while before I got that fixed.
posted by dhruva at 5:17 AM on March 28, 2012 [1 favorite]

The post office has a weird public/private role in the US and has for most of my lifetime but it is a system created by and partially supported by the US Government

Unlike other private businesses, the Postal Service is exempt from paying federal taxes. USPS can borrow money at discounted rates, and can condemn and acquire private property under governmental rights of eminent domain.

The USPS does get some taxpayer support. Around $96 million is budgeted annually by Congress for the "Postal Service Fund." These funds are used to compensate USPS for postage-free mailing for all legally blind persons and for mail-in election ballots sent from US citizens living overseas. A portion of the funds also pays USPS for providing address information to state and local child support enforcement agencies.

Under federal law, only the Postal Service can handle or charge postage for handling letters. Despite this virtual monopoly worth some $45 billion a year, the law does not require that the Postal Service make a profit -- only break even. Still, the US Postal Service has averaged a profit of over $1 billion per year in each of the last five years. Yet, Postal Service officials argue that they must continue to raise postage at regular intervals in order make up for the increased use of email.

Fire stations where I live are funded entirely locally as a counterpoint.
posted by jessamyn (staff) at 5:24 AM on March 28, 2012 [2 favorites]

Surprised this was still going. I wanted to clarify that my initial comments about 8 hours ago had to do with people thinking it was so great (reveling) to be able to take advantage of a health care system they didn't contribute to. Then things went another way.
posted by Carbolic at 6:52 AM on March 28, 2012

Around $96 million is budgeted annually by Congress for the "Postal Service Fund." These funds are used to compensate USPS for postage-free mailing for all legally blind persons and for mail-in election ballots sent from US citizens living overseas.

I mean, it's wording it like taxes are being given to USPS, but really taxes are being used to pay postage. Semantics, I guess. And it doesn't mention the free postage congress gets (franking privilege). This write-up is mostly accurate, but it also neglects all the military pension benefits that the USPS becomes responsible for when a former military person joins USPS (unlike other federal agencies). (This was a large part of the "5 billion dollar deficit" claims in recent years.) But enough about USPS; sorry for the derail.
posted by inigo2 at 7:00 AM on March 28, 2012 [1 favorite]

I don't know what this has to do with anything, but I recently attended a lecture by a Harvard physician well known in acadamic circles who studies health economics and public policy. He told me of touring a Canadian hospital while collaborating on a research study and asked to visit the billing department of the hospital.

In the US, the coding and billing department typically takes up a floor of the hospital and employs 30-50 people. In this particular Canadian hospital, it was one room, and 2 employees who told him they spend the majority of their time billing American insurance companies for US citizens who got sick while travelling over the border.

If the Affordable Care Act is struck down, I swear to god this physician is going to quit medicine with a giant "Fuck All Y'All!". Either that, or I will spend all of my remaining time in practice trying to defraud insurance companies who deny my patients care until I'm caught and sent to jail.
posted by Slarty Bartfast at 7:22 AM on March 28, 2012 [12 favorites]

I don't want to deny anyone healthcare but reveling in the irresponsibility of having someone else pay for it rubs me the wrong way.

You're absolutely right. It's so heartbreaking to see the nightly news pieces on all of those countries that have chosen the path of irresponsibility, their citizens in wonderful health but otherwise destitute, begging for a crust of bread from the passing reporter. It's just so, so awful, how many stories you hear about their children, teeth perfect, maybe, but unable to afford even rags to cover their nakedness. Oh, the hubris! They thought they could fly too close to the healthcare sun, and how they have suffered!
posted by adamdschneider at 7:35 AM on March 28, 2012 [2 favorites]

"These days, dealing with insurance is a huge part of any medical practice. A recent Cornell study found nationwide it costs doctors $31 billion a year to deal with insurance companies. That's about 7 percent of all spending on physician and clinical services.

At Ortho Bethesda, an orthopedic practice in suburban Washington D.C., there are eight doctors on staff, and 14 people in the business office."

That Marketplace story is from 2009. I can't imagine the situation has improved.
posted by rtha at 7:41 AM on March 28, 2012

Can we close this up?
posted by schmod at 8:04 AM on March 28, 2012 [1 favorite]

Why, does the thread not have insurance?
posted by Brandon Blatcher at 8:07 AM on March 28, 2012 [7 favorites]

Someone paid for it. It was not free. "At no cost to that person" does not equal free. There is no such animal as "free health care" even less than there is a free lunch.

You're right. Nothing's "free," so there is no such thing as "free" health care. The idea that we're inexplicably missing out on a chance to get "free" stuff represents a fundamental misunderstanding of economics. But the post doesn't use the word "free." It just says that the American "burst into tears when he/she realized that it would not cost them anything." It doesn't say "he/she realized that it would not cost anyone anything."
posted by John Cohen at 8:22 AM on March 28, 2012 [1 favorite]

Why, does the thread not have insurance?

Are you kidding? With these known risk factors, and now a pre-existing condition as well?
posted by FishBike at 8:31 AM on March 28, 2012 [6 favorites]

Surprised this was still going. I wanted to clarify that my initial comments about 8 hours ago had to do with people thinking it was so great (reveling) to be able to take advantage of a health care system they didn't contribute to. Then things went another way.

Uh, yeah, because then you started to slag off on people who were so totally irresponsible they hadn't become lawyers in order to ensure their families had health insurance and denigrated everyone who doesn't have health insurance as a hippy who just wants to live on a commune. So, definitely, the thread took a slightly different turn at that point.

Here's a hypothetical for the masses:

If everyone in the USA became lawyers for the health insurance, could those lawyers then afford the cost of health insurance in a system beset by a mass influx of lawyers? Let's assume for the sake of argument that people who would have become doctors or nurses still became doctors or nurses.

But no hospital orderlies or security guards or anything. Because those people often work on contracts and have no health insurance.
posted by jacquilynne at 8:33 AM on March 28, 2012 [15 favorites]

Heck from a couple of the recent postings it appears many lawyers can't afford insurance as it is.
posted by Mitheral at 8:51 AM on March 28, 2012 [3 favorites]

Surprised this was still going. I wanted to clarify that my initial comments about 8 hours ago had to do with people thinking it was so great reveling) to be able to take advantage of a health care system they didn't contribute to. Then things went another way.
posted by Carbolic at 14:52 on March 28 [+] [!]

Who here has actually done this? I see a lot of people praising universal healthcare systems, I don't see anyone saying "haha I got healthcare abroad for free, suckers!"
posted by jonnyploy at 9:30 AM on March 28, 2012 [2 favorites]

Surprised this was still going. I wanted to clarify that my initial comments about 8 hours ago had to do with people thinking it was so great (reveling) to be able to take advantage of a health care system they didn't contribute to.

I may be missing something, but I don't see either revelling or people taking advantage of a system they didn't contribute to, at least in the original comment linked above. The person in that comment was crying with relief at not having to pay, and they had lived in Australia for a couple of years. So either she or her husband would be paying tax to contribute to the Australian healthcare system.
posted by Infinite Jest at 9:32 AM on March 28, 2012 [1 favorite]

The same process that makes universal health care not free (ie someone has to pay, somewhere along the line) is the process that makes it free (ie it's there when you need it and whether or not you have funds available at that time to meet the cost).

THANK YOU. Now I have another argument to pull out in discussions that turn into denials of the factual "I went to the pharmacy and paid nothing". I mean come on. I pay about the same amount of income taxes percentage-wise as Americans, a little more sales tax (but it's part of the advertised price, and whoa wouldn't you know, they set that price so it's about the same as the pre-tax advertised price in the US), employers pay more taxes, but... woot free pillz! :o) One-euro GP visits! Free sonograms and boob-smushings errr sorry breast cancer screenings!

I'm having an argument with someone who insists that foreign countries with universal health care (or something close enough) won't cover non-citizens who are traveling in their country.

This actually happened to me too, in Finland. And it saved my life. I honestly don't know if I would be here, writing this today, were it not for the Finnish health care system. Long story short, an ovarian cyst that had twisted around a fallopian tube decided to burst. I walked to the nearest hospital, about two hundred yards down the street, and it was the Helsinki Women's Hospital (hello coincidences working out in my favor). They were able to operate immediately; if they hadn't, according to them, I'd have bled out and died.

I was not a legal resident at the time, in the sense that my residency was still being processed by Finnish immigration authorities. The diagnostics, operation itself, 24 hours in a hospital, meals, pain medication etc. all ended up costing me something like 50 euros, I think. When I cried at seeing the bill, a nurse reassured me that social services could help if we (was living with my French ex at the time) weren't able to pay. I wasn't crying because of that. I was crying because of all the people I knew in the US who denied themselves health care because they had to pay 10, 100, even 1,000 times that amount.

A couple years later, my best friend's mother died after a year-long hospitalization for leukemia in Oregon. Despite having paid for health care, and a specific cancer add-on that she had started paying two decades before being diagnosed with leukemia, she died 2 million dollars in debt. So I can't help but raise an eyebrow very, very high at people who criticize health care elsewhere for not being ENTIRELY free and paying, say, 50 stinking euros for surgery when people who pay for private insurance in the US are not even able to benefit from their own insurance.
posted by fraula at 9:37 AM on March 28, 2012 [40 favorites]

"In the US, the coding and billing department typically takes up a floor of the hospital and employs 30-50 people. In this particular Canadian hospital, it was one room, and 2 employees who told him they spend the majority of their time billing American insurance companies for US citizens who got sick while travelling over the border."

This used to be my job. There were about 5–6 people. It would have been fewer were it a higher capital investment priority, as one person just spent their day typing provincial insurance information spat out by the medical computers into a 25 year-old billing mainframe. There were a few quirks. Because healthcare in Canada is provincial, one person had to spend their time punching numbers into provincial websites to see if they were valid, and calm Quebec residents on the phone about their $75 bills (Quebec isn't fully reciprocal, but it's more annoying than bankruptcy inducing). There were also quirks with students from other provinces who stick around after graduation and forget to apply for local health cards.

There were complications due to the fact that many homeless persons don't have health cards, so a lot effort was made writing things off. But since in-province insured are paid for via block grant anyways it's not the end of the world. Workers' Comp was fee-for-service, so it was worth investigating those, and one person dealt with fee-for service-clinic visits (both for the hospital's budgetary benefit, neither involving a bill for the patient), and also privately paid room upgrades (usually covered by work-provided supplemental insurance, which Canadians mostly use for prescription drugs). One person handled the foreign residents / medical tourism cases.

The department that paid the bills was much, much, larger.
posted by maledictory at 9:42 AM on March 28, 2012 [1 favorite]

Carbolic: I wanted to clarify that my initial comments about 8 hours ago had to do with people thinking it was so great (reveling) to be able to take advantage of a health care system they didn't contribute to. Then things went another way.

I assume that my initial comment in this thread is one of the ones you take to be "reveling" in receiving care from a system the reveler didn't pay into.

Let me clarify something: my excitement at having my sprain taken care of was not "Oh yay! I get this for free!" It was more along the lines of "Oh yay! This experience was not awful and didn't leave me in tremendous debt! This system is great! I hope my country adopts it so that I too may pay taxes such that I and my fellow citizens can get proper healthcare without it being an undue financial burden for any individual!"

While I admit that all of that thought about "Wouldn't it be awesome if I, too, could pay into a system like this, instead of having my worries about how I'm going to pay for healthcare be a chronic, anxiety-ridden nightmare" is not explicit in my saying "It was amazing. I <3 universal healthcare," that is in fact the background behind my delight at what transpired, not just "Yay! Free stuff!"
posted by ocherdraco at 10:30 AM on March 28, 2012 [7 favorites]

That's the day I realized how awesome universal health care was. Not perfect, mind you. But awesome.

This is a fact, my American chums. A fact. You need to persuade more or your good people to believe it. You uncomplainingly permit a proportion of your taxes to fund other emergency services and shared social facilities and benefits, do you not? Why on earth so many of you have this weird objection to doing so for something that almost every single one of you will need, and probably more than once, is as baffling to we socialistic nanny-state Europeans as your fondness for guns and religion. Heal thyselves. Or at least check your insurance policies to see if your covered for that.

Echoing those who say that if you are American and you get hurt or ill in the UK, you will be fixed up for nothing. You might have to pay about seven quid for some prescription after-care painkillers, but that's about it.
posted by Decani at 10:43 AM on March 28, 2012 [4 favorites]

Do medical staff get paid significantly less in other countries compared to ye 'olde US of A? I'm trying to reconcile things in my head and that's a data point I'd like to have/hear about first hand.
posted by RolandOfEld at 11:04 AM on March 28, 2012

You uncomplainingly permit a proportion of your taxes to fund other emergency services and shared social facilities and benefits, do you not?

Oh, they're busy complaining (and undermining) those shared social facilities and benefits, too!
posted by scody at 11:05 AM on March 28, 2012 [4 favorites]

I have seen two American girls cry with joy when they found out how much world class medical care costs in Mexico.

We used to have international students living in my house for many years. The Americans would be terrified every time they got sick. They would stay in their rooms taking OTC pills and feeling like dying.

Then we would explain that if they were scared of the public health system, our family doctor would do home visits for a hundred dollars, or they could go to the office and pay under fifty.

And if they did not want to go to the big scary public hospitals, the closest world class private hospital would charge forty dollars for a chest X-ray, and about five hundred for a CT scan. That little private hospital in Mexico was way better than all except one of the hospitals I have been to in San Francisco.

One of the students has laser eye surgery because the total out of pocket cost was lower than their deductible in the US. Another girl paid three thousand dollars for her first while body checkup, and the doctors found a weird metabolic issue in thw liver that could have killed her if she had waited.

Mexico will not give free healthcare to Ameticans, but it so affordable that it is hard to go bankrupt from a medical issue.
posted by Ayn Rand and God at 11:10 AM on March 28, 2012 [3 favorites]

Roland, I don't know how much doctors make in Mexico, but all the ones I know enjoy a pretty good standard of living compared to other professionals.

It may have to do with the size of their student loans.

Regardless, I think the idea that doctors should be rich is a dangerous one. In my ideal world, doctors, cios and teachers would make about the same and have the same high professional standards.
posted by Ayn Rand and God at 11:14 AM on March 28, 2012 [2 favorites]

Ayn, I feel the same way but it's often anathema to voice something like that. I don't know if it's because of the horrendous student debt incurred in medical training or in the 'prestige' of the position deserving salaries above and beyond that of a well trained master/expert in another field. They're interrelated of course, but it just pains me that our system is broken so badly here.
posted by RolandOfEld at 11:16 AM on March 28, 2012

And by cios I mean CEOs
posted by Ayn Rand and God at 11:24 AM on March 28, 2012

Last summer, my wife started bleeding profusely. After stubbornly refusing to go to the hospital for some days, she finally gave in when she couldn't even stand up anymore. She was rushed to the hospital by ambulance.

The reason why she waited until it was almost too late was, as a US citizen, she got so used to toughing it out rather than going to the doctor and having to pay a large sum of money even if she was insured (the deductible). Even after many years of living in Europe she still couldn't shake that habit. I almost lost her because of that.

In any case, her diagnosis was cancer. We have the 'deluxe' health insurance package, which costs 200 euros per month, for both of us. The health insurance has paid for everything, including a private room during two more hospital stays (that is the 'deluxe' part), a hysterectomy, several scans, all the medications, the dressings she has needed for her surgical scar, and the six week radiation therapy course she is in the middle of now. It's also paid for daily home visits by a local nursing agency to change her dressing (down to 3 times a week now since it's almost closed up; I change her dressing on the other days), and door to door daily transport by ambulance taxi to the radiology center an hour away. I thought our Swiss insurance was not bad but the French insurance is much cheaper and pays for a lot more.

The irony is that 3 years ago when we were both feeling a need for a change, we were discussing moving to the U.S. I don't even want to think of what might have happened if we had.

It is hard enough having cancer, let alone watching someone you love have fighting cancer, without having to worry about whether you will be pushed into poverty because of it.
posted by derMax at 11:42 AM on March 28, 2012 [15 favorites]

My friend's wife had insurance through his job. She had appendicitis and got an appendectomy. His insurance wouldn't cover it because they classified it as non-life-threatening.

I recently left my nightmare of a job, where I had insurance, to work on my own so that I could learn Revit (which is basically replacing AutoCAD as the standard program in my industry - my old job was still using AutoCAD 2004 and had no plans to change). Despite getting consistently high marks on my performance everywhere I've worked, I couldn't even get a callback for an interview while trying to leave my old place, and I applied for something like 10 jobs over the course of the last year. The only reason I was able to leave my job was because I can get insurance through my wife, and 6 months later, I just interviewed with my pre-recession job (who were hiring last year and didn't call me back after I applied) and will hear back from them this week. So, if not for my wife, I would have been stuck in a horrible job and not been able to improve my situation, whereas in pretty much any European country I'd have been out the door at my old firm much quicker. And yes, I've taken classes, but they're not same as practical experience or having the program to work with.
posted by LionIndex at 12:13 PM on March 28, 2012

a health care system they didn't contribute to

She did, too, contribute to it. As a resident of Australia, she paid taxes that were specifically earmarked for the health-care system.
posted by Sidhedevil at 12:16 PM on March 28, 2012

Can't spend $2000/month on a family plan that will offer what my family needs on top of the risk I would take starting my own studio. It really is that simple of a risk/reward calculation.

That is a huge amount of money. Is someone in your family nearly uninsurable?
posted by michaelh at 12:20 PM on March 28, 2012

Is someone in your family nearly uninsurable?

Have you not priced health insurance recently?
posted by entropicamericana at 12:40 PM on March 28, 2012 [19 favorites]

private insurance in Australia is something like $60/week

No, basic private health insurance is about $55/month in Australia. A ridiculous government rebate for the middle class (which is designed to weaken public health care system by moving as many people as possible out of it) has made private health cover trivially cheap.
posted by dontjumplarry at 12:59 PM on March 28, 2012 [2 favorites]

I used to work for a company that did third-party billing for a small insurance provider in Bend, OR. This was just in 2009/2010. The lowest monthly premium I ever saw was just shy of $500, for a single father and his toddler son. No pre-existings, no extras, ridiculously high deductible, $30 co-pay for office visits, and the prescription plan was so jacked that I couldn't make heads or tails of it.

Had it been a single mom and her child, it would have been easily $700. Because ladies can get knocked up.

I'm unemployed as of this Friday and will have COBRA coverage for two months... here's hoping nothing goes disastrously wrong!
posted by palomar at 1:00 PM on March 28, 2012

In the individual market, even if you have a family plan that's a step up from hit-by-a-bus, your premiums might be manageable but your deductibles?

Family Policy Data
-- In February of 2009, the average monthly premium for family policies was $383
-- In February of 2010, the average monthly premium for family policies was $392
-- Average premiums for family policies increased 2.3 percent over that time.

-- In February of 2009, the median monthly premium for family policies was $329
-- In February 2010, the median monthly premium for family policies was $336
-- Median premiums for family policies increased 2.1 percent over that time.

-- In February of 2009, the average deductibles for family policies was $3,128
-- In February of 2010, the average deductibles for family policies was $3,531
-- Average deductibles for family policies increased 12.8 percent over that time.

(emphasis mine)

That's fucking crazy. Anyone with a family who wants to start their own business had better have a very high risk tolerance - beyond what it takes to leap into entrepreneurship - before they quit their day job. Unless you are a genius and/or extremely lucky, your homegrown business is not going to see a 12% increase in net profits every year.
posted by rtha at 1:01 PM on March 28, 2012 [4 favorites]

Do medical staff get paid significantly less in other countries compared to ye 'olde US of A? I'm trying to reconcile things in my head and that's a data point I'd like to have/hear about first hand.

They're likely paid less in England than the US, but most jobs are still good money. A starting nurse gets paid about $33,000, but they can expect to earn $50,000 at their peak, but more if they do well. A doctor can expect to earn at least twice, if not three, four, or even more times the average salary in England. I read a story the other day where a top heart surgeon in the NHS was on about $200,000 a year. I'm sure greater pay can be had in the US, but it's pretty fair nonetheless. They're not starving for the greater good, no.
posted by Jehan at 1:04 PM on March 28, 2012

Why not just move to Vancouver? We need family doctors in Canada.

We've thought about this a lot, actually. I still have pretty crushing student loans, which would be a pretty big handicap in entering the Canadian physician market ($4000 a month comes right off the top of my salary for this) and I get some federal student loan repayment money. Also, my wife is a hyper-specialist at the House of God hospital and her job opportunites are somewhat more limited.
posted by Slarty Bartfast at 1:06 PM on March 28, 2012

Do medical staff get paid significantly less in other countries compared to ye 'olde US of A? I'm trying to reconcile things in my head and that's a data point I'd like to have/hear about first hand.

Ontario just published this year's 'sunshine list', listing public employees who earned more than $100K. If you sort by "Hospitals and boards of public health" you'll see that our clinicians probably don't make as much as they would in the states, but are certainly very comfortable.
posted by sevenyearlurk at 1:07 PM on March 28, 2012

Also, I work in public health right now, so I can provide health care to everyone regardless of ability to pay and I rarely have to deal with insurance companies (this career decision was driven mostly by disgust at how dysfunctional the US health care system is). But a lot of our funding is set to evaporate because everyone's anticipating universal coverage in 2 years.
posted by Slarty Bartfast at 1:09 PM on March 28, 2012

No, basic private health insurance is about $55/month in Australia.

$87/mth for a family of 3 here, for a mid level of cover including hospital, dental, etc.
posted by UbuRoivas at 1:15 PM on March 28, 2012 [2 favorites]

Its not that difficult to end up with employer sponsored health insurance if you aren't set on living in a commune,.

Right-o. I'll get right on applying for these not that difficult to obtain lawyer job----wait a second....

Carbolic, you have an incredible amount of privilege. You are a LAWYER. How do you not have the reasoning ability to understand that the vast numbers of under and unemployed folks in America today are not just looking to mooch "free" healthcare off of "hardworking" (but really just very very lucky) folks like you?

How? How?

I work 16 hours a week, which is more than my boss can afford to pay me. I just learned today that my workplace is closing. I've been applying hither and yon for jobs for quite a while now. Most want ads do not advertise benefits, and getting them requires a waiting period - usually 30-90 days, often a year. I'm at a point where having medical insurance would be awesome, but getting any type of work is challenging enough.
posted by bilabial at 1:17 PM on March 28, 2012 [8 favorites]

Don't worry, Carbolic is a mere puff.
posted by UbuRoivas at 1:28 PM on March 28, 2012 [3 favorites]

COME ON SHEEPLE. WON'T SOMEONE MENTION THE DEATH PANELS?
posted by MuffinMan at 1:40 PM on March 28, 2012 [1 favorite]

In the future, when they create holovids about the fragmentation of the USA into separate nations, among the many things that will stun people about the once proud country is how willing working class and poor people in America were to stay unhealthy and trod upon by insurance companies and large corporations because of last place aversion.

How insane is it to decide that you'd rather be sick than support a system that would care for people you feel are inferior to yourself? It's from a movie that is problematic in its treatment of the light=good/dark=bad theme, but Theoden's quote when facing the goblin hordes, ironically, applies here: what can men do against such reckless hate?
posted by lord_wolf at 1:52 PM on March 28, 2012 [2 favorites]

COME ON SHEEPLE. WON'T SOMEONE MENTION THE DEATH PANELS?

You laugh, but the March tracking poll from where I work shows that 36% of respondents believe that a government panel will be making end-of-life decisions for people on Medicare. 20% don't know.
posted by rtha at 1:56 PM on March 28, 2012 [2 favorites]

What percentage of the polled wanted the government to stay out of their Medicare?
posted by entropicamericana at 2:17 PM on March 28, 2012

That is a huge amount of money. Is someone in your family nearly uninsurable?

Yes and no. My son is autistic, but that is generally not a deal-killer for health insurance. Otherwise, there are no pre-existing conditions.

My employer (a large, publicly traded company with hundreds of employees) pays about $900 per month per employee for medical/dental/vision. I chip in about $300 per month to cover the family.

So, $1,200 per month for a group plan. An individual plan would be significantly more (although, you could futz around with deductibles and HMOs). I use the $2,000 figure as a round number.

But now we're just splitting hairs. Even half my round number precludes taking a cut-the-employer-cord risk. And I do pretty well, thanks very much, so while this is truly a first-world, white-guy problem, imagine what it's like for someone that can't even entertain the idea in the first place, and then imagine what that collectively does to a country of 300 million.
posted by Cool Papa Bell at 2:18 PM on March 28, 2012 [3 favorites]

an "alternative" job" that didn't provide health care

- Working in a group home for troubled girls
- Technical writer, mostly editing printer manuals
- Computer salesperson
- Census worker
- Working at a company that rents & maintains underground construction equipment
- Museum tour guide
- Office temping

That's the various employments that did not come with health insurance of two people of my acquaintance over the last 15 years. Not exactly commune-living jobs. (Curiously, both of them spent some time working at a bookstore chain that was known for really good benefits.)

FWIW, I also once worked with someone who was generally known to be staying in the job primarily because our health insurance was (relatively) inexpensive. It would have been better for the overall productivity of the economy if we had universal health care and she'd stopped dragging her feet (etc) around the office and gone anywhere else. I know historically why insurance is tied to employment, but damn it's annoying.
posted by epersonae at 2:22 PM on March 28, 2012 [5 favorites]

I love it when people assume getting a job = healthcare. The last time I had health insurance was in 2001. Oh, sure, I had the student health clinic in college where I could talk to a doctor for free, but any kind of lab work, x-ray, or medication came out of my pocket. I haven't been lying around the house since 2001 either. I worked my ass off, sometimes working three jobs at once trying to keep a roof over my kids' head, but not a one of those jobs offered any kind of health insurance. I made too much to qualify for any kind of subsidies and too little to afford insurance on my own. I guess we were lucky none of use got hit by a bus (but the middle child person did have her appendix removed, that cost me a pretty penny, even with the state's help). I'm what they call "the working poor."

I don't feel entitled to health care, I pay for it when I can and go without when I can't. I've mentioned before that I have a slew of physical difficulties and bipolar on top of them. I get my crazy meds through patient assistance (because society doesn't want crazy people roaming the streets and those meds are expensive) but I pay for my pdoc out of my own pocket. Everything else? It's wait and see. If it gets too bad, there's always urgent care and I'll deal with that bill when it gets here. I'd like to see universal healthcare here in the States. I'd trade higher taxes for not worrying about huge bills or a way to deal with my chronic pain.
posted by patheral at 2:22 PM on March 28, 2012 [5 favorites]

Well, without getting personal, I would say he's just blowing smoke.

Hey! Those are just rumours!
posted by smoke at 2:26 PM on March 28, 2012 [31 favorites]

I don't feel entitled to health care, I pay for it when I can and go without when I can't.

I'm so, so sorry that this is the case, you sound awesome and I hope karma has given you some awesome kids or a rocking, indie job that you love to go to on a daily basis, or something.... Because... you deserve the chance to be healthy and not go without. This sentiment is what I feel like alot of working poor that also don't support universal healthcare (because EVIL!) have been tricked into thinking.

*sigh*
posted by RolandOfEld at 2:27 PM on March 28, 2012 [3 favorites]

smoke: If I was American, and didn't have a big family, I would seriously consider emigrating. If I did have a big family, I wouldn't even hesitate.

I'd move to Canada or any number of European countries in a second (no spouse/kids), but as hard as it is to get a job in the U.S. (I just spent the day pounding the pavement to 10 different temp agencies), imagine how hard it is to get a work visa when you're not in a highly specialized field. I believe the term is "impossible."
posted by tzikeh at 2:42 PM on March 28, 2012 [6 favorites]

I'd move to Canada or any number of European countries in a second (no spouse/kids), but as hard as it is to get a job in the U.S. (I just spent the day pounding the pavement to 10 different temp agencies), imagine how hard it is to get a work visa when you're not in a highly specialized field. I believe the term is "impossible."

We should set up a refugee committee to spouse US folk.
posted by Jehan at 2:48 PM on March 28, 2012 [11 favorites]

We should set up a refugee committee to spouse US folk.

You don't even know how serious I am when I say I'd be on the next flight wherever.

(As long as my spouse would be ok with me getting a cat)
posted by tzikeh at 2:53 PM on March 28, 2012

Please add me to the list of potential refugee spouses. Please?
posted by brina at 2:59 PM on March 28, 2012

an "alternative" job" that didn't provide health care

In the US, this kind of job is most frequently "working at a large chain retailer fewer than 24 hours a week" and let me assure you that people don't generally do that out of a wish to follow their dreams let the chips fall where they may.

Many large chain retailers game the system (capping workers' hours at just under the health-insurance eligibility levels) so that they can provide the fewest workers possible with health insurance benefits as a way of cutting costs. Walmart is far from the only large retailer using that strategy.
posted by Sidhedevil at 3:00 PM on March 28, 2012 [5 favorites]

Dasein: "Well, without getting personal, I would say he's just blowing smoke."

Lay off, he's tired and emotional.
posted by dunkadunc at 3:02 PM on March 28, 2012

I mean, Carbolic, I get that everyone has piled on on you a lot already, but do you really think people "choose" to work 23 hours a week at Walmart, and thus not get health insurance, out of irresponsibility? That is one of the most "let them eat cake" comments I've ever seen here at MeFi.
posted by Sidhedevil at 3:03 PM on March 28, 2012 [7 favorites]

Dasein: "... reciprocal agreements that Australia has with 11 countries for free care; I'm guessing the U.S. is one of them."
It's hard to establish a reciprocal health care agreement with a country that has no health care system.

patheral: "I don't feel entitled to health care, ..."
You are entitled to health care, but your government refuses to provide you with this most basic of needs.

As far as Australian doctors' salaries go, based on a couple of sources, they aren't anything too grand, particularly when you consider the investment they make in training. I'm sure there are lots of outliers, but the figures in those links are pretty much what I had thought they would be, placing doctors well above average, but nowhere near rich.
posted by dg at 3:11 PM on March 28, 2012 [2 favorites]

Cool Papa Bell: Wow. I had no idea there were that many communes in this country.

They're everywhere. They're just really poorly run, in that they look remarkably like normal living situations.
posted by filthy light thief at 3:12 PM on March 28, 2012 [2 favorites]

Oh god another sad day and another sad Meta thread about Americans and health insurance. I have nothing new to add since the last few times we've had this discussion except that it just keeps on getting worse as we all may have noticed. The nonprofit where I used to work (I suppose being the communications manager is too commune-y of a job? How about bookstore clerk, as I am now?) no longer even offers benefits to its staff. It's not required, you know and more and more small businesses are just giving up on even bothering to offer them. Benefits are expensive and nowadays people fight to get any job, bennies and low salary be damned. Oh and yes, large businesses, like giant retail chains that are supposed to offer health insurance for full time workers? They would offer it for their full time people but it's totally amazing how their entire workforce is part time.

I don't have health insurance either. I live in fear of actually getting very sick and in the meantime I just don't go to the doctor. My self employed friend hasn't been to a doctor in 12 years; I'm not that extreme. I should probably get a mammogram but I went and had a pap smear last year and even at the charity Christian clinic - where, by the way, they will not under any circumstances prescribe pain or anxiety or depression medication - it cost almost $100 and I can't afford to ever go back. If I was younger or if I could figure out some way to do it I'd emigrate.
posted by mygothlaundry at 3:14 PM on March 28, 2012 [2 favorites]

Jumping into what's probably the end of an interesting thread, I'm a dual UK/US citizen and I moved my wife and new baby to London at the start of the month in large part because of healthcare. I have been in the US for ten years, and consider it my home. We would have loved to stay in LA, but even though we're solidly (as solidly as any American can be with the ever-present threat of medical bankruptcy) middle class, before we left, our healthcare costs were more than our rent payments. The kid and I were on an HMO Cobra from my last job at about $1100 a month, my wife had a plan from her employer that was free to us, but had a $2500 annual deductible and a lot of limitations and exclusions.

Last week we took the kid to A&E (UK ER) for some breathing issues. We were seen quicker than we ever were in the US, they were nice to us and it was free. It was such a massive relief not to have the fear of bills in the equation. I thought back to when I had just moved to the US and ended up in ER with an irregular heartbeat, and burst into tears when they wouldn't treat me until they got billing info. That visit (in 2004) cost $6000 and took us years to pay off.

I am so grateful we could move here. I will absolutely fucking dedicate myself to fighting the attempts to dismantle the NHS. It's not just about healthcare, but I didn't even realize how scared we were all the time until we left. We could never plan our lives in the long-term in the US with the healthcare risks looming over us, never leave our jobs or buy a home, when it could all just be taken away with one illness or accident. And I know far too many young people whose lives are already limited by chronic conditions they can't treat or untreated injuries that healed badly. All so rich people can have more. Disgusting.
posted by crabintheocean at 3:14 PM on March 28, 2012 [9 favorites]

This US citizen already has her Canadian husband, so back off. *waves pitchfork around menacingly*

Seriously, I am so glad to have Canadian health care. I have chronic health issues and have no idea how I would afford to have health care in the US if I hadn't left (dx'd after moving to BC). The mister also has chronic issues. We'd never get insurance in the US due to preexisting conditions.
posted by deborah at 3:21 PM on March 28, 2012

I will absolutely fucking dedicate myself to fighting the attempts to dismantle the NHS.

You picked a bad month to come home...
posted by Jehan at 3:22 PM on March 28, 2012

For some perspective on costs of insurance, my contribution to Medicare is around $1,800 a year. For that, I get access to free medical treatment (obviously, not elective surgery etc) for anything except dental and some restrictions on optical (pays for tests etc, but not glasses etc) for a family of five. If you want to find out how much you would pay on your current income under this system, have a look here. Warning - may make US citizens cry.
posted by dg at 3:27 PM on March 28, 2012

It always amazes me when conservatives, who claim that they're all for small business owners and job creation, are against universal health care. Health insurance is probably the main thing that stops people from starting their own business.

I'm a civil servant strictly because I like not being able to worry about getting sick. If I didn't have to worry about health care I'd be doing my best to work for myself doing something I loved.
posted by elsietheeel at 3:29 PM on March 28, 2012 [2 favorites]

Back when I was living in a tent with my commune without insurance for a couple of years after grad school in Chicago, I was working 60 hours a week through three different part-time jobs that didn't offer any benefits: waitressing at a bar at nights, office managing a photography studio during the day, and tutoring high school students on the weekend. I was able to get medical care because a doctor who I had seen once through urgent care (after managing to scrape together the $75 to walk in the door) agreed to see me off the books in the evenings at his practice. I had had thyroid problems for several years at that point, so I at least needed someone who could keep a basic eye on my TSH levels, etc.

Over the course of that time, the lump in my neck grew larger and larger, and the tests that he could run that I could afford were all inconclusive as to what was going on. Given multiple other symptoms, we started to suspect that I had thyroid cancer. However, because I didn't have insurance, and he didn't want me to get blackballed for having a really fucking serious pre-existing condition (as opposed to my just moderately serious pre-existing conditions that we knew of at the time) and neither of us wanted me to be bankrupted, we decided that we would have to stop pursuing a diagnosis until I could finally find a job with health insurance. This was a calculated risk that he was willing to take solely because thyroid cancer tends to be somewhat slow moving, and we thought that letting the cancer (if that's indeed what it was) progress for another year or two wouldn't necessarily be, you know, fatal.

And that's how it played out. It took another year to get the job with insurance (at which point my commume magically turned back into a shitty studio apartment!) and then the 3-month waiting period to qualify for benefits, and then about six months to get properly diagnosed with my first go-around with cancer. On top of that, my body was having such a severe autoimmune reaction (presumably to the cancer), by the time I was able to be treated I was so sick that I was having problems walking up and down stairs unassisted. Finally, after waiting more than two years from the time we first suspected I might have cancer, I was able to have the surgeries and the radiation to treat me.

I was 28, had put myself through college and grad school, and had been working since I was 15. The height of irresponsibility indeed.
posted by scody at 3:29 PM on March 28, 2012 [94 favorites]

This was a calculated risk that [my doctor] was willing to take... (scody)

And indeed, strange as it sounds, by delaying the diagnosis, even with all the awful things that entailed, like your autoimmune response to the cancer, he was only following the oath of "First, do no harm."
posted by ocherdraco at 3:38 PM on March 28, 2012 [2 favorites]

Oh yeah, and also? That Euro health plan I mentioned above? When I returned home to NYC for a visit one year via India and arrived with the most ghastly case of amoebic dysentery I have ever had the grave misfortune to experience, I stuck it out for 4.5 days (since I stupidly had neglected to activate the travel portion of my insurance) before I finally went to the emergency room. And I only even went because my tongue cracked down the middle from dehydration and barely bled, which I found supremely terrifying. Plus, hallucinations. The resulting bill was about 15k. So I could have traveled back home to Spain, first class, gone to the hospital for free and stayed in a lovely room in a posh hospital with a 1:1 nurse to patient ratio, and still had 10k to spare. Fuck, I could've chartered a goddamn plane both ways and saved money.

Instead, I waited idek how many hours curled in a whimpering ball on the floor of a dirty ER before being stuck in a quarantine room that stank of wee. And the only reason they even treated me without insurance was because I flat out lied and said I'd been exposed to cholera.
posted by elizardbits at 3:39 PM on March 28, 2012 [1 favorite]

If you want to find out how much you would pay on your current income under this system, have a look here. Warning - may make US citizens cry.

I think I will cry, and I make good money and have pretty decent benefits.
posted by epersonae at 3:43 PM on March 28, 2012

Someone paid for it. It was not free. "At no cost to that person" does not equal free. There is no such animal as "free health care" even less than there is a free lunch.

The cost was shared by those living in the country, rather than being borne by the hospital, the government and the creditors who get screwed in bankruptcy.
posted by Ironmouth at 3:49 PM on March 28, 2012 [2 favorites]

Don't worry, Carbolic is a mere puff.

Well, without getting personal, I would say he's just blowing smoke.

Balls to the both of you.

Neeeeeeeerds!
posted by His thoughts were red thoughts at 4:10 PM on March 28, 2012

dg, I wouldn't believe those figures for doctors salaries, not for one minute. I would expect a GP of several years experience in a suburban clinic would be on about $120 - $150k pa (or more), a surgeon in private practice in the city to be on about $250k + (up to +++). This puts them into the class of wealthy/rich.

Here are nurses salaries in Queensland (plus all sorts of loadings for shift work, + 9% super). Casual/contract nurses would be paid a lot more. A very solid middle-class profession.
posted by wilful at 4:19 PM on March 28, 2012 [1 favorite]

And Carbolic, the logical outcome of this comment of yours is that anyone who doesn't have insurance coverage in the US is probably just being lazy. That's where the strength of the reactions to your comments is really coming from. Because that is totally crazy talk, as others have said.
posted by His thoughts were red thoughts at 4:31 PM on March 28, 2012

Or at least extremely self-serving thinking.
posted by dunkadunc at 4:47 PM on March 28, 2012

We'd never get insurance in the US due to preexisting conditions.

This is one of the reasons I am white-knuckling the Supreme Court hearings right now, because if they don't keep the non-mandate portions of the ACA, I am fucked if my husband ever loses his job (or if I ever lose my husband, for that matter).

One of the best things in the ACA is forbidding discrimination because of pre-existing conditions. If that goes, I have no idea what is going to happen.
posted by Sidhedevil at 5:06 PM on March 28, 2012 [4 favorites]

But of course I should just take responsibility for my choice to have a complicated auto-immune illness. And depression.

Or for my choice to try to keep alive rather than just dying and reducing the surplus population.
posted by Sidhedevil at 5:07 PM on March 28, 2012 [2 favorites]

willful, I did think those rates were a little low, although not dramatically. My impression, though, is that they are still not generally in the 'rich' category, more 'comfortably upper middle class'. My impression is that doctors in the US would skew much more towards being in the rich category by default.
posted by dg at 5:10 PM on March 28, 2012

Sidhedevil, you should have been responsible and become a lawyer. No one to blame but yourself--especially since it's been proven over and over again that each and every one of us is equally capable of doing anything that anyone else does if we'd just try hard enough.

I'm amused (not really) at how, without any ridiculous leaps of logic at all, "having depression" and "taking up pottery" can be equated in this discussion. It's a shame my chronic depression doesn't net me any vases or bowls or anything.
posted by tzikeh at 5:15 PM on March 28, 2012 [8 favorites]

If I was American, and didn't have a big family, I would seriously consider emigrating

This US citizen saw the writing on the wall long ago, and decided to get serious about emigrating to Canada or Europe. Actually came close to achieving it, too. My ex was a software engineer in the computer games industry. He got a job in Vancouver, BC, and I got a spousal work permit. We left the States with glee, and started making plans to apply for permanent residency in Canada. I lived there with him for two years (2003-2005) and loved it. If I recall correctly, we paid $90/month for excellent health care coverage. It was like a huge burden had been lifted from my shoulders. Finally I could focus on my freelance writing work without the constant threat of the possibility of medical bankruptcy if I got seriously ill or injured! I even embarrassed some of the Canadian doctors with my effusive expressions of gratitude at the ease with which I received health care in Canada.

Then my ex took up with another woman, decided he wanted a divorce, and absconded with my half of the money from the sale of our house. I ended up back in the USA. I scrambled to get into a university post-bac program, in part so I could take advantage of the services at their student health center. That held me over for awhile. Graduated years ago; I've been single, unemployed, and job-hunting unsuccessfully ever since. I'm now part of the 'precariat.'

In the USA, people like me are only deemed worthy of receiving affordable, dignified health care if we are 1) married to someone with good insurance or 2) working for an employer that offers insurance. This shirking of our collective responsibility to care for one another angers me something fierce.

I am smart, responsible, frugal, highly educated, and capable of making a positive contribution to my community. Is there no place for me to live free of the constant threat of medical bankruptcy for me and my loved ones?

That refugee committee to spouse US folk? Sign me up. I'm dead serious.
posted by velvet winter at 5:23 PM on March 28, 2012 [14 favorites]

smoke: "For the healthcare alone, the US is so broken. If I was American, and didn't have a big family, I would seriously consider emigrating. If I did have a big family, I wouldn't even hesitate"

I did. I got out on a student visa, lucked into a work visa, and now I'm headed towards permanent residency in Australia. There's a lot I miss about back home, and it sucks being so far away from family, but whenever I think about the health care situation back in the US I have no regrets.

In my limited dealing with health care here, I've had various responses like those mentioned above. I've never out and out cried in relief, but it's come close. I've been absolutely floored by the cheapness of it, and I've despaired for friends and family who are being fucked by the situation in the US.

Health insurance in the US so so so daunting and just so ... well, abusive. It's the threat above your head that you better not lose your job, you better not try and strike out on your own, you better not risk anything to lose the lucky position you're in – and if you have the family, the threat is multiplied by all the people who rely on you for their insurance. But above all, the nature of the American system beats it into you that you had goddamned well better never have the gall to get sick.

I don't miss that at all.
posted by barnacles at 6:51 PM on March 28, 2012 [2 favorites]

I still remember calculating what accidents and emergencies would cost us without health cover, and even paying everything out of pocket, it wouldn't have bankrupted us the way the same situation in the USA seems it would. I don't entirely understand why that is the case, actually.

Producers prefer higher prices. Consumers prefer lower ones.

If you've set up a given sector of the economy so that most consumers do not pay producers directly but do so via middlemen, that gives those middlemen an enormous amount of power to influence prices.

If the middlemen are for-profit corporations that take a percentage cut of all the money they handle, then it's in their interest to handle as much money as possible. So the middlemen will do whatever they can to make sure that prices stay high. And since offering consumers a choice of middlemen would allow the kind of competition that lowers prices, quite a lot of what they do will be devoted to devising lock-in schemes to make sure most of their consumers don't get any such choice, and prices stay relatively high.

If there's a massively dominant middleman driven not by profit but by a political imperative to keep costs as low as possible and spread them as widely as possible, it has the raw market power to dictate prices to a very large extent, and prices stay relatively low.
posted by flabdablet at 6:57 PM on March 28, 2012 [5 favorites]

If I was American, and didn't have a big family, I would seriously consider emigrating


Always lovely when internet tough guy shows up.

Everybody likes to talk about it. Very few do it. Out of those who do, many return on the first adversity.
posted by falameufilho at 7:04 PM on March 28, 2012

But above all, the nature of the American system beats it into you that you had goddamned well better never have the gall to get sick.

I am a rich lady with excellent health insurance. But when my appendix went wonky in the middle of the night, and I had a fever of 105 Fahrenheit, I waited until the morning to go to the doctor because I didn't want to have to pay $100 to go to the emergency room, which is what my insurance's deductible for emergency room visits not previously cleared with a primary care provider amounts to.

Fortunately, the hours of waiting didn't put me at any further risk (though both the doc and the surgeon yelled at me, not to mention my husband, about waiting), but the $100 emergency room deductible did the job it was designed to do--it kept me from going to the emergency room. Even in an emergency. Even though I have $100.

It certainly opened my eyes to how much of a barrier this shit is to people who don't have my resources.
posted by Sidhedevil at 7:10 PM on March 28, 2012 [3 favorites]

Very few people emigrate from the US to other countries with universal health care because those countries don't have open immigration, to say the least, falameufilho. It's hardly being a "tough guy" to talk about wishing to do that while understanding that there are significant barriers to same.

My cousin is living in Denmark, has been married to a Danish-born Danish national for 20+ years, and has been going through immigration hoop after hoop for years. Immigration: not so simple.
posted by Sidhedevil at 7:12 PM on March 28, 2012 [7 favorites]

Everybody likes to talk about it. Very few do it. Out of those who do, many return on the first adversity.

I am American. I don't have a large family. I have emigrated.

Happy?
posted by one more dead town's last parade at 7:24 PM on March 28, 2012 [5 favorites]

Very few people emigrate from the US to other countries with universal health care because those countries don't have open immigration, to say the least, falameufilho. It's hardly being a "tough guy" to talk about wishing to do that while understanding that there are significant barriers to same.

Especially given that the kind of immigrants that tend to be welcomed with open arms -- the well-educated and readily employable in professional jobs and/or wealthy -- are, statistically speaking, not the kind of people who have the biggest problems with US Health Insurance. There are gaps there that some of those people fall through, obviously, and pre-existing conditions is a big one, but for the most part, the class of immigrants that Canada would happily accept from the US is very similar to the class of people who already have health insurance.
posted by jacquilynne at 7:28 PM on March 28, 2012 [4 favorites]

As an Aussie I pay $600 a year for my health insurance - and that's only because my income is above the line for the extra Medicare surcharge, so I'd be taxed 2.5% of my income rather than 1% for health care. I'm thinking about dropping it though, because I'd rather let that money go into the public system than a private insurer's coffers. I'm more than happy to go into the public hospital that is in my area.

This is totally being facetious, but maybe if you add together monthly mortgage + health insurance costs, US and Australia wouldn't be too dissimilar.
posted by trialex at 7:29 PM on March 28, 2012

This is totally being facetious, but maybe if you add together monthly mortgage + health insurance costs, US and Australia wouldn't be too dissimilar.

I think that's a false equivalence. Buying a house is not critical to life. Healthcare is.
posted by His thoughts were red thoughts at 7:34 PM on March 28, 2012 [1 favorite]

Everybody likes to talk about it. Very few do it. Out of those who do, many return on the first adversity.

I left. I came back. On balance I like it better here but the health care problem is one of the things I do not like. Everyone's got a lot of plates they're keeping in the air as far as what they need to make their life work for them and their loved ones. Deciding to leave town over a single issue may be principled but it is rarely practical. Totally can see why people decide to do it, but acting like it's an easy or simple decision is just that much blustering. You can actively dislike something and decide to work to change it instead of flee from it. Or decide you despise something but have other priorities that outrank it.
posted by jessamyn (staff) at 7:35 PM on March 28, 2012 [3 favorites]

This is totally being facetious, but maybe if you add together monthly mortgage + health insurance costs, US and Australia wouldn't be too dissimilar.

?? The average monthly mortgage payment in the US is $1,867 US ($1,795 AUS), and the Internet tells me that the average monthly mortgage payment in Australia is $1,990 AUS. $200 AUS wouldn't buy very good health insurance in the US even for a single person in great health with no pre-existing conditions.

The US health insurance system is a drag on the US economy no matter how you slice it.
posted by Sidhedevil at 7:35 PM on March 28, 2012 [2 favorites]

In fairness to our American friends, I was in hospital for a week recently and the food was pretty ordinary. I assume that hospital food in America is amazing. And there were only like ten channels on my little TV in the private room I had in the public hospital (not that private though, nurses and doctors were coming and going like they owned the place), and sometimes when I was finally able to get out of bed and walk I went into one of the little kitchenettes and microwaved my own gel heat packs. And when the nurse gave me a suppository because I was constipated for five days I was really embarrassed. In an American hospital I would be opening up my asshole non-stop to everybody who walked past.
posted by tumid dahlia at 8:03 PM on March 28, 2012 [2 favorites]

In an American hospital I would be opening up my asshole non-stop to everybody who walked past.

I believe it's the TSA who do that.
posted by unSane at 8:07 PM on March 28, 2012 [1 favorite]

flabdablet: "If the middlemen are for-profit corporations that take a percentage cut of all the money they handle, then it's in their interest to handle as much money as possible. So the middlemen will do whatever they can to make sure that prices stay high. "

This is an important point, I think. Not only do the insurance companies need to take their cut, the service providers need to increase their prices to cover the cost of dealing with the insurance companies. When the cost of providing the services becomes so high that significant portions of the population can't afford to pay for the service they've received, the providers also need to factor in a significant bad debt allowance, which increases the cost to consumers, which makes it unaffordable to a higher proportion of the population and so it goes on. Combine this with a highly litigious society that means malpractice and liability insurance goes through the roof, so providers have to factor that into their costs and it's hardly surprising that health care costs have spiralled out of control. You can't even really blame the insurance and legal companies, really, because they are working within a system. A deeply flawed, inhumane system, but a system nonetheless that allows them to operate within the law and line their own pockets quite thoroughly in the process.
posted by dg at 8:30 PM on March 28, 2012 [1 favorite]

?? The average monthly mortgage payment in the US is $1,867 US ($1,795 AUS), and the Internet tells me that the average monthly mortgage payment in Australia is $1,990 AUS. $200 AUS wouldn't buy very good health insurance in the US even for a single person in great health with no pre-existing conditions.

Australian anecdata - my monthly Australian health insurance premium, for a single person, is approx. $100 a month. It's one of the higher levels of cover.

Even if you factored in the %1.5 Medicare levy, I pay about about $2,500 a year in health care 'insurance', i.e., my taxes, plus my private insurance. But if I wasn't earning anything, I would still be covered by Medicare, which as discussed, covers most things.

In contrast, a colleague who went to the US, also a lawyer, in rude good health, and the same age as me, told me that his insurance premiums there were $14,000 a year. For less effective coverage than Medicare.
posted by His thoughts were red thoughts at 8:40 PM on March 28, 2012

The average monthly mortgage payment in the US is $1,867 US ($1,795 AUS), and the Internet tells me that the average monthly mortgage payment in Australia is $1,990 AUS.

As usual with this kind of thing, it's a little more complicated, because Americans can (for some hard-to-understand-to-me-at-least-reason deduct mortgage interest from their income tax.
posted by stavrosthewonderchicken at 8:53 PM on March 28, 2012

malibustacey9999: "Just to clarify something about Medicare here in Oz: all taxpayers (except low income earners) pay 1.5% of their taxable income each year as a Medicare levy. So the vast majority are paying into the system... some of us don't need to use Medicare, some of us do. But all are charged a percentage of their income to fund it."

That sounds great to me. I'm currently losing around 20% of my pre-tax income to health insurance, and that's only because I opted to not insure my kid with my company's plan. Instead, he's insured with CHIP which is awesome. Pretty decent coverage so far, low co-pays for office visits, and just around $80/month, compared to the $250+/month it would have cost on the company plan. Oh, by the way, interesting factoid: it's the same damn insurance company. Company plan is Aetna; we get our CHIP coverage via Aetna. Our co-pays, had we elected to have our kid covered under the company plan, would have been higher. So, you know, I guess this is what it looks like when government gets itself involved in controlling healthcare costs.

I've always been a fan of government healthcare. I'll be first to go for the public option (so long as its cost is reasonable compared to what I'm paying now). But my recent experience with CHIP has only strenthened my conviction.

I've commented on the issue of health care coverage before. Things have changed -- I'm married and have a kid -- but my feeling remains the same. Our health care system is broken. It's just broken. As long as people seriously bring the "I've got mine" argument to the table, we're not going to get anywhere. It needs to be brought to the forefront that fighting universal healthcare means you don't care if the poor or uninsured get sick and die. You can hide behind whatever excuse you want, but that's the end result of holding such a belief.
posted by Deathalicious at 8:53 PM on March 28, 2012 [4 favorites]

By the way, just for shits and giggles, I will say that having lived in Canada, Australia, and Korea for more than a few years apiece, I 'pay' the least by far here in Korea -- I don't even know how much my payroll deduction is, but under US$100 a month, I'm pretty sure -- and though I haven't had to have any major surgery or anything thus far, I'm fairly satisfied with the quality of health care. It's good enough by international standards for there to be a booming medical tourism business of mostly Americans coming here for medical care.

A clinic visit costs me like 5 dollars out of pocket, and drug costs are low indeed (A quick check online shows me that Combigan drops, which I use for ocular hypertension, cost in the range of $65 dollars from Canadian websites, but I pay about $8 for them here. God knows what they cost in the US.)

I guess my point is that if even Korea, which is a hot mess in so many ways, can get universal health care more or less right, then it continues to amaze me that America can't (and that so many scumbag Canadian politicians are so keen to dismantle it there).
posted by stavrosthewonderchicken at 9:03 PM on March 28, 2012

Yes, the US may be willing to accept being outperformed by Eurozone countries, but the fact is the US system doesn't even hold up to many many countries in the developing world.

Having universal public health care makes private hospitals cheaper too, it seems to me, since they have to prove their value for money over the government ones. Several of my children were born in a private hospital in Malaysia with Western-educated doctors and all the machines that go beep. Total average cost including a few nights stay in a private room = about 700USD. My last kid went elective Caesar for about 1500USD all in. Oh, and congratulations, Meatbomb.
posted by BinGregory at 9:25 PM on March 28, 2012

Dear potential US spouses: email is in my profile. I have two cats, so we might have to work around your cat(s) joining the household. I'm pretty easy about your gender, but you do have to like books and music--male, female, in-between, whatever, but the books and music thing is non-negotiable. If you have most of your own teeth, that's good too. :)
posted by jokeefe at 9:30 PM on March 28, 2012 [9 favorites]

Cool Papa Bell: "Can't spend $2000/month on a family plan that will offer what my family needs on top of the risk I would take starting my own studio. It really is that simple of a risk/reward calculation."

Fuck. $2000 a month? That's about how much my family MAKES.
posted by dunkadunc at 9:33 PM on March 28, 2012

Americans can (for some hard-to-understand-to-me-at-least-reason deduct mortgage interest from their income tax.

It encourages people to build, buy, upgrade and keep houses, which are good societal things for all sorts of other reasons. Affordable housing is important, but at the same time, you don't want a nation of renters.
posted by Cool Papa Bell at 9:34 PM on March 28, 2012

If the US is ever going to get universal health care, it seems to me that pitching it as an issue of fairness is not going to cut the mustard, just because WOOOOOOOO SOCIALISM WOOOOOOO GRAR WOOOOOO.

If I lived there, I would concentrate on hammering the point that real numbers available from the real world right now show clearly that universal health care would give you access to better care for less money than what you are paying right now.

Also: is there truly not one existing US bureaucracy that you could point to and say "See? They are easier to deal with than your present health insurer" and be pretty much guaranteed to be always right?
posted by flabdablet at 9:37 PM on March 28, 2012 [4 favorites]

I'm an American expat now living as a permanent resident in Australia, and I've had the exact experience talked about in the OP.

A few years ago I had a major injury playing rugby. In hindsight, it was a totally awesome injury, but at the time it entailed a lot of pain, five days in the hospital, and emergency surgery with a cardio team on call. Even while in my hospital bed, woozy from pain and morphine, I kept worrying about how much this was going to cost. I knew intellectually that Australia had this thing called "universal health care", but years of being uninsured in America, of stoically weathering illnesses and broken bones, of getting billed thousands for simple procedures -- all of this convinced me that even in a "universal" system, I was going to get nickel-and-dimed to death for every little thing, and hospital bills and insurance payments were going to dog me for years afterward.

When the nurse offered more shots of morphine, I asked how much it was going to cost. When they had to take me in for a complicated scan, I was convinced that it would result in thousands of dollars I couldn't pay, and asked if it were truly necessary. All of these queries were met with bemusement and reassurance. At some point it finally sunk in that -- really -- I could just lay there and worry about getting better, not about how this was going to ruin me financially.

My response: relief. Such major, intense relief as I have rarely experienced.

It's hard to adequately capture what a difference universal health care makes, psychologically. Sometimes I very much miss so much about America, but there is no way I can ever see moving back. And the health care system is, honestly, in the top three reasons for why. Living without the albatross of worrying about how I'll pay for health care or what I'll do if I get sick or lose my job is worth a thousand times what I pay for it in taxes.
posted by forza at 9:44 PM on March 28, 2012 [7 favorites]

It encourages people to build, buy, upgrade and keep houses, which are good societal things for all sorts of other reasons. Affordable housing is important, but at the same time, you don't want a nation of renters.

Well, yes, obviously, that's the idea -- that whole 'ownership society' thing of Bush's that went so well.

It's not particularly hard for me to trace the simpleminded logic behind that particular Big Idea, suspect and shaky as it is -- how does making mortgage interest tax deductible prevent 'a nation of renters', for example? -- what seems ridiculous to me is the specific idea of making mortgage interest income-tax deductible.

Hell, it seems to me like it's taking from the pockets of everyone who pays taxes to pay banks interest on money borrowed privately. It encourages people, as we've seen in the past decade, to try to buy houses that they really can't afford, by taking on mortgages beyond their actual means. It seems wrongheaded and stupid some kind of weird combination of OMG SOCIALIST (which in itself isn't necessarily a bad thing at all) and massively corporatist.

Actually, thinking it through, never mind. It makes perfect fucking sense -- a depressing, citizens-as-consumers, self-defeating, lobbyist-driven kind of sense -- given the way things are in America.
posted by stavrosthewonderchicken at 9:48 PM on March 28, 2012

If the US is ever going to get universal health care, it seems to me that pitching it as an issue of fairness is not going to cut the mustard,

Agreed, and moreover it will be the thinking that, if something bad happens to you, you did something to cause it or earn it. And that's not an American thing, per se, it's a human nature thing.

I happen to think it'll be a small state that, looking to attract business, will offer some kind of state-sponsored exchange. "Pay the state a premium, and we'll pick up the health care tab. All of it. But you have to have actual residency that we verify, and you have to use our HMO-style doctors and hospitals."

Pretty soon, the me-too-me-too psychology kicks in, and that'll be the tipping point. Right now, no state can justifiably claim that their state really does something demonstratively different than any other.
posted by Cool Papa Bell at 9:49 PM on March 28, 2012 [2 favorites]

that whole 'ownership society' thing of Bush's that went so well.

To be fair, the concept of interest deduction was created under a Democratic administration ... in 1913. With strong support from ... wait for it ... The American Socialist Labor Party. Seriously. You can't make this stuff up.

W was bad, but he wasn't literally the Antichrist. ;-)
posted by Cool Papa Bell at 9:57 PM on March 28, 2012 [3 favorites]

With strong support from ... wait for it ... The American Socialist Labor Party.

I had no idea it dated back to 1913. But like I implied with the OMG SOCIALIST thing, it does indeed have a socialist whiff about it, so not such a great surprise.

Using public taxpayer dollars to (in effect) pay the interest on privately incurred debt, though? Banks have to just love that shit. Bigger mortgages and more of 'em? Bring it on, peons!

W was bad, but he wasn't literally the Antichrist. ;-)

The jury remains out on Cheney, though.
posted by stavrosthewonderchicken at 10:07 PM on March 28, 2012 [2 favorites]

Oh, and for what it's worth in illuminating my perspective on this (continuing tangent, I know, sorry) -- I do not much care for banks, to put it mildly, and since I have been a teenager, have promised myself that I would never apply for a bank loan, let alone a mortgage. I am deeply averse to the idea of debt.

In my mind, it's a sign of broken system (broken at least from the perspective of ordinary people mired in wage slavery) when you have to indenture yourself to a bank for much or most of your working life in order to own your own home.

This has meant, predictably, that I've lived most of my life very simply, and never owned a home (or a new car) until this past year, when, at the age of 46, I finally bought my first of each. For cash.

To hell with the banks.
posted by stavrosthewonderchicken at 10:15 PM on March 28, 2012 [3 favorites]

Mortgage deductions, awesome as they are, don't cover what people in the US spend for health insurance even on the most subsidized plans.

I agree that the whole "fairness" thing isn't such a great strategy in US politics. I don't know why the whole "this is a huge drag on the economy because of the tremendous inefficiency and lost productivity" angle hasn't worked better. Some of the physician advocacy groups made a really good case for that, but it hasn't picked up traction so far.
posted by Sidhedevil at 10:20 PM on March 28, 2012 [1 favorite]

what seems ridiculous to me is the specific idea of making mortgage interest income-tax deductible.

This idea has, in the US, been part of the federal income tax code since its implementation. I cannot imagine a scenario where this would be changed after 100 years.
posted by Sidhedevil at 10:23 PM on March 28, 2012

though both the doc and the surgeon yelled at me, not to mention my husband, about waiting

I mean, my husband yelled at me for worrying about the $100--he was away on business at the time--not that the doc and the surgeon yelled at my husband.

I do not want to tarnish my husband's reputation here as a prince among men, which he is. I am the skinflint of the family.
posted by Sidhedevil at 10:28 PM on March 28, 2012

Someone paid for it. It was not free. "At no cost to that person" does not equal free. There is no such animal as "free health care" even less than there is a free lunch.

All free things are paid for by someone, just not the person getting it.
posted by delmoi at 11:22 PM on March 28, 2012

Just read through this thread, not word for word but fairly closely. And then called a kid that I mentor, because I wanted to get his story, line by line, then write it out here.

Don't have insurance? Do you have lymphoma? Are you a US citizen? Wonder what might happen to you? Read on.

Some of you might have read about my fun experience, which was brought about in large part because I didn't have insurance, and wouldn't go to the hospital, as I didn't have the money. In relating that experience, I referenced Mike, the kid I just spoke with; I'm going to call him back after I write this, make sure I've got this all correct, and in the right order.

(Okay, I wrote it out, called Mike, couple of corrections and here you go.)

Mike. 26 years old. Best health he'd ever been in his life; gym, trying to eat well, quit smoking, etc and etc. Making twenty grand a year but hey, he's young, life is ahead, he's in Austin and happy, so, hey, sweet.

But he had this thing on his neck. This swelling, this thickness, and it's just weird. So he went to a doc; Mike's grandmother had gone to an ENT (ear nose throat doc) for something at one time, Mike went there. The ENT had suspicions immediately, ran some tests to make sure, and then he had some interesting news for Mike.
(This ENT was the best, he cut Mike every kind of deal he could, he checked up on Mike throughout this entire process -- pretty unusual, that is -- he gave Mike the names/numbers of who to call, what to ask them, on and on. A stellar human being.)

Lymphoma. Blood cancer. Bad odds, horrific treatment, and the treatment kills some people in trying to kill the cancer. But you've got to try, esp since if you *do* make it through the chemo, and the radiation, and you do make it to your "CLEAR" date, well, then your numbers are great. It's just that kind of cancer. Most people don't live through to remission but if you do, that's good news.

So. Mike is resourceful. Mike is interested in living. Mike enters into the US health system without insurance.

No hospital here in Austin will help him. Nor one cancer clinic. Not one. Door shut in his face. Out of eight or nine, not one. No one will help him. He can't believe it, no one can believe it, but there it is. No one would help him. They did talk to him, on the telephone, long enough to make sure that he knew that they were not going to help him. One hospital -- this really is rich, a real knee-slapper -- one hospital will help him once it's in stage four. Ha Ha!! Isn't that great? Stage four!! Ha ha!! We laughed about it again as he laid this out for me, the conversation we had a few minutes ago -- these pricks will put an IV in his arm as he's dying, maybe rent him an oxygen tank and mask, but they won't help him until then. You couldn't write this stuff up. Who'd have dreamed?

So -- now what? In Austin, there is something called the Medical Assistance Program, you fit the criteria and they will give you a MAP card, use this card and you will be provided with health care, and scrips for a co-pay. (This is an amazing thing for a US city, Austin still does try, though I'd bet MAP is dying; I know they're buried, try to get an appt and it's a month or two out.) Anyways, Mike is all about it, gonna get him a MAP card -- hurray! Except twenty grand is too much; you can't get a MAP card if you are living a lavish life such as that. Had he been making ten grand, maybe. (I asked but Mike didn't know what the cutoff is, how much you can make and still get that card.) But he was out of the running. Off the record, a woman who worked there told him that to get a MAP card he'd have to lose his job, PLUS it'd have to be framed that he'd gotten fired -- not laid off, not quit, but fired -- from his job, and even then it wasn't a sure thing, as you just can't have people parading through the doors there and getting them this bounty, so they can then go lying about in those lands of splendor and beauty which MAP cards absolutely signify; you just know those people are having a great time!

And the ENT mentioned MD Anderson, in Houston, world renowned for their cancer treatment, and with good cause. People come there from everywhere, people for whom money is no object, just that they want to live, they are under a death sentence and maybe MD Anderson can help them. The ENT gave Mike the right number to call there, and Mike called it, and spoke with Monica and damned if Moica didn't tell him he qualified for their help. He couldn't believe it. This was after searching here in Austin for long, long weeks, and each day more danger, and then one call to Houston! Magic! He set up an appt the next day, called family members and friends -- this is huge.

But then Monica called him back. Monica made a mistake it seems, she read the wrong chart, and Mike was making just altogether too much money for them to help him save his life, and so Mike needed to buzz off.

And: Mike flipped fucking out. He was done. He teed off on Monica. Told her "Look, I'm coming there tomorrow, make this work, you can't just do this" etc and etc. And she told him to go and die, but Mike didn't want that conversation any more; he'd gotten angry, and he began to demonstrate that.

And Monica said "Hang on a minute" and she went and talked to her supervisor, and then came back with the happy news that they would give him this treatment at half price. Mike says "Um, how much is that?" and Monica says "$32,500, due in advance." Mike told her she's nuts, that she knows he's got nothing, his family has nothing, I'll see you tomorrow.

And he did show up that next day, and they told him to go die, and Mike said no, he didn't want to. And so Monica's supervisor then said "Well, let me go and talk to my supervisor and see if anything can be done." and she did so and came back and told Mike the happy news that they'd do it for half of the half price, due in advance. Mike laughed, "Look, you know who I am, you know I have no money, you know my family has no money, you know I cannot do that" and she suggested he go and die.

But Mike still didn't want to go and die, for whatever reason -- he kept on going on about it, he's just really incredulous but okay, considers it, maybe he can go and rob a bank, and then a bulb goes off, and he asks if there are any other costs involved and she tells him "Oh yes. You will need at least twelve of these treatments, and then radiation, and TONS of medications and tests" and blah blah blah and Mike literally laughed at her.

Except it's that kind of laugh that you don't want to ever hear from people, a Jack Nicholson in The Shining laugh, and Mike knew he was in deep shit, he *had* to leave that office, he was going blind with rage, literally going blind with rage. He walked out.

And he's outside. He knows the rules, you gotta talk, he calls Jason, and J doesn't know what to say, any more than you would, but he's there, he holds to it, exactly like he's supposed to be. After a few minutes, Mike's parents come out to get him, tell him that he's got to talk to Monica's supervisor again. She wants to talk to him. She had gone back in and talked to her supervisor again. And, easy as pie, her supervisor said "Okay, waive it all." And they did. Every penny of every expense at MD Anderson.

He had to know, Mike had to know -- what was the difference, what happened back there? And she told him that her supervisor had changed her mind, that's all, and said yes.

How much? $1.5 million there at MD Anderson. He got pneumonia and almost died when he was so weakened and was hospitalized here in Austin -- hospitalized through the ER, they *had* to take him, I'm sure they'd rather he died -- and he's on the hook for that, and of course tons of other expenses, he'll never, ever pay it off.

But he's alive. It's spring in Austin and it's beautiful and he gets to see it.

Why did I write all that out? A warning, maybe. You get a bad dx, you gotta strap on your boots and stomp some butt, call everyone, call their sister, too, and anyone else. But even then, even doing what he had, it came down to Monica giving Mike that wrong information at a time when he was done done done, and it came down to that supervisor waiving it that day -- if she had gas, or a hangover, Mike is dead.

He's a great kid. I meet with him once a week, sometimes more but always at least once, we talk it all out, life on lifes terms. I'm lucky to be in a role in his life where I get a window into it; I didn't have children (that I know of, the 70s and all) and I'm not lucky enough to be his father but I do get to be there, such as I can; it's very important to me and I'm pretty sure to him, too. He's a drug and alcoholism counselor, an addictions counselor, in a treatment center for drug addicted kids, he specializes in working with these kids, and he's great at it, he brings one hell of a lot to this show -- not everyone can reach the broken ones but Mike is a star, he knows all the games that they try to run but he's got these real steady eyes, they trust him, and they should. That would be gone, my Sundays would damn sure be a lot emptier, Austin be much less for it, the world would, really. I'm glad he's alive.
posted by dancestoblue at 11:46 PM on March 28, 2012 [73 favorites]

I'm Canadian with permanent resident status in the US due to having married an American. He's got a great job with good insurance. Every time people ask about our future plans, we say: "We're planning on moving to Canada because of the health care system." Everyone gets it.

The first time my spouse had an emergency, I'd been living with him in the US for two years but I didn't know much about the US system except that for the first time in my life I had to pay sizeable $$$ upfront (high deductible plan) before every single appointment. When his abdominal pain got really bad, I drove him to the nearest hospital (5 min drive). Turned out if we'd waited any longer, the bowel adhesion that was on its way to obstructing his guts would have caused serious damage meaning he'd have ended up with a colostomy bag for the rest of his life. But he got medical attention in time. They fixed him up and he came home some days later.

Shortly after, he got an furious call from somebody who must have been from the hospital's billing dept. After he hung up, he explained that this person had been demanding to know why we'd gone to HER hospital. "I'm sorry, what?" said I. "What? We're NOT supposed to go to the NEAREST hospital in an emergency? What the fuck kind of system is this? What the fuck is wrong with you people?" (Later I gathered that another hospital 20 min away was the one that his insurance would have reimbursed, more, for his care. Or something. I never grasped the details of what the problem was because my Canadian brain still stalls at "We're NOT supposed to go to the nearest hospital in an emergency?")

When we're out in public together, looking at "health care debate" newspaper headlines while standing in line at the grocery store, say, or standing in line at the pharmacy behind some poor bastard listening with head bowed to the pharmacist explain gently and repeatedly that the poor bastard's Rx costs $2/pill and that if that's too much then maybe you're eligible for this financial aid program...no? maybe this other resource? no?... I have no shame about remarking loudly to my spouse, "You Americans are crazy to keep a system like this that fucks over the people least able to afford it and don't people realize more people would open small businesses if they didn't have to worry about health insurance and what is it that makes some people think they'll always have the gold-plated insurance they have now and I'm so glad I'm Canadian cuz we'll have an easier time moving to a country that's sane about this issue..." (Harper's attempts to insanitize the country notwithstanding). I know it's wishful thinking that giving voice to these thoughts might make some people in earshot think. But maybe it'll help somebody who feels this way but is cowed by "Socialist commie!" rhetoric feel less like a freak, and plant a seed of Hey the way we do things in the US is not necessarily better and maybe not even normal. At the very least it makes me feel better, voicing it instead of raging inside.

I'd be delighted to spouse all youse Americans who need decent health care, if I were living in Canada and polygamy were legal.
posted by cybercoitus interruptus at 12:28 AM on March 29, 2012 [4 favorites]

I've written before about US health insurance costs being a big factor in deciding if we were going to move to Canada or the US.

The numbers just don't work. We lived in the States, loved living there, but when the opportunity arose to move back, we decided to move to Canada instead. I am a professional in a good industry, not a 1%-er but doing well enough, and the healthcare system is so broken that it didn't make sense for us to move back.
The US/State government has lost my tax revenue, my property taxes, my investments, my spending on goods and services - and the cost of health insurance is a key factor in this.

Universal healthcare is not only the moral thing to do, it's good financial sense. Until this comes about, I doubt we'll consider moving to the US.
posted by arcticseal at 12:54 AM on March 29, 2012 [4 favorites]

It encourages people to build, buy, upgrade and keep houses, which are good societal things for all sorts of other reasons. Affordable housing is important, but at the same time, you don't want a nation of renters.

Just for a different perspective, in Switzerland only about 10 to 15% of people own their homes, so it is indeed a nation of renters. Except for places like the city of Zürich, housing is generally fairly affordable. And I am not aware of any major social issues caused by most people renting instead of buying their homes. (There are some social issues associated with gentrification in places like Zürich, but that is a bit different.) A nation of renters means that since there is no stigma attached to renting, or much status to be gained from buying, suburban sprawl does not happen at an accelerated rate in the way it does in societies where that is the case. (I realize this is a derail, but I wanted to address the statement.)
posted by derMax at 5:23 AM on March 29, 2012 [5 favorites]

This comparison of Canadian and American healthcare systems is what sold me on single payer system. Not that I was against it previously, but this article really lays out how much better, morally, financially and nationally, a single payer healthcare system. Workers are free to move to between jobs; companies have lower costs; people aren't afraid to go to the doctor, so epidemics are more quickly noticed and combated; doctors spend more time doctoring and less time dealing with insurance companies.

Americans fighting against this are not only strangling all that they claim to love (God and country) but their fellow citizens.

The key thing for me personally, is having a nation's citizens invested in the program. Newspapers watch for fuckups, because everyone's taxes is paying for that fuckup. People encourage others to go to the doctor or hospital, 'cause hey, everyone is covered and there's is literally zero excuse to have a sick person around who could contaminate others. No excuse, everyone is covered, so it suddenly becomes immoral and self centered not to go to the doctor.

I've heard so many stories about Americans sticking with shitty job or boss, because "Hey, at least my family and I have insurance". That's insane and does nothing for the free market this the U.S. supposedly loves and champions.

America may be the most powerful country in the world, but it sure as hell isn't the smartest.
posted by Brandon Blatcher at 6:12 AM on March 29, 2012 [18 favorites]

(Later I gathered that another hospital 20 min away was the one that his insurance would have reimbursed, more, for his care. Or something. I never grasped the details of what the problem was because my Canadian brain still stalls at "We're NOT supposed to go to the nearest hospital in an emergency?")

This is a mind blowing thing for me too. I was down in Oklahoma storm chasing and one of the guys I was traveling with stepped out for a coke and collapsed in a service station (just dehydrated, he was fine). The attendent called an ambulance and when they got there and got him talking him they asked what hospital he wanted to go to; a question so surreal he thought he was having a stroke or something and his brain had shorted out. He mumbled something about the nearest one and was on his way but ya, an interesting glimpe into the absurdness of the system.
posted by Mitheral at 7:45 AM on March 29, 2012 [1 favorite]

Affordable housing is important, but at the same time, you don't want a nation of renters.

Yeah, um, why? It seems to me that the whole own your own home thing is just an accidental outgrowth of the era of cheap oil and plentiful automobiles, i.e. the suburbs. People who own their own homes spend so much time and money and energy maintaining, upgrading and talking about their homes that it really seems like most of them would be better off not worrying about it.
posted by adamdschneider at 8:08 AM on March 29, 2012 [3 favorites]

Going further down the rabbit hole, building/owning (possibly even maintaining) one's own home is a great thing and can save a ton of money in the long run. Plus you get exactly what you want if you design your own place and/or build it with heavy input.

That said, most of the homebuilding here in the US isn't of the sort that I approve of. Homes that are built willy-nilly, without proper consideration of local climate, without thought for the future inhabitants, with crappy stick frame construction methods to save money, with no thought of efficiency/envelope that are built with the sole purpose of stimulating the economy because they are being built and using resources are NOT, NOT, NOT a good thing in the long haul.

My familial experience has been more rural and DIY than urban, as if you couldn't tell, for what it's worth.
posted by RolandOfEld at 8:14 AM on March 29, 2012 [1 favorite]

What bothers me are others who could just have well done the same but decided take an "alternative" job" that didn't provide health care but now feel it is an ENTITLEMENT. Maybe I could have been a fantastic potter and would have loved that life but I became a lawyer so I can pay the necessary expenses (its a burden and a choice to make the sensible job choice) Ive had a decent healthcare plan of my own since 19 and I was son my parents before then. Part of that was lucky part responsible Its not that difficult to end up with employer sponsored health insurance if you aren't set on living in a commune,.

This lawyer's experience is completely different. Of course I have temporal lobe epilepsy, so that difference might explain it. Had coverage when I was in a firm, lost it when I went solo because I was bringing in more than the boss in a husband and wife firm and they had informally promised partnership. Didn't want to give up control. But hey, everything that happens to us is all our fault, right?
posted by Ironmouth at 8:22 AM on March 29, 2012 [6 favorites]

Its not that difficult to end up with employer sponsored health insurance if you aren't set on living in a commune.

Okay: I have employer-sponsored health insurance. I even sacrificed a dream of working full-time in theater to get it.

That employer-sponsored health insurance is currently fighting with my orthopedist's prescription of 10 sessions of physical therapy for my broken foot. They only want to pay for six.

Exactly what good does sacrificing my vocation for the sake of employee-sponsored health insurance do again?
posted by EmpressCallipygos at 8:28 AM on March 29, 2012 [4 favorites]

That employer-sponsored health insurance is currently fighting with my orthopedist's prescription of 10 sessions of physical therapy for my broken foot. They only want to pay for six.

Of course! Spending money cuts into profits. Oh sorry, does that mean a person doesn't get good healthcare? Not the companies problem, they are there for the profits.

That's the problem with the current US system. Companies can do great, but the citizens who make up the country? Screwed, unless they jump through the right hoops, in the right sequence on the right day.

What bothers me are others who could just have well done the same but decided take an "alternative" job" that didn't provide health care but now feel it is an ENTITLEMENT.

That is a problem. People should start thinking of it as goddamn human right.
posted by Brandon Blatcher at 8:37 AM on March 29, 2012 [8 favorites]

I'm an American citizen who moved to the UK. I'd be getting repetitive if I wrote how about how astonished I was that I could just meander into my doctors office anytime for anything, get seen and treated and then walk out. None of that insurance nonsense.

What also floored me was that my prescriptions are free. I take synthetic thyroid. I take it daily. I've taken it daily for 20 years and I'll probably need to continue taking it daily for the foreseeable future.

In the US, you have to get the prescription constantly renewed. And you need to get regular bloodtests to check your levels. For all those things you need to see a doctor. And of course you have to pay the doctor, pay for the blood tests and pay for your medicine. Its like an extra tax I have to pay to keep living a normal life.

In the UK, I still need the regular doctor and blood tests. Those are free of course.

When I first went to get my thyroid prescription, I paid for it. The pharmacist asks "Don't you have a medical exemption?"
"Uh..no, I say."
I don't know what that is and in the back of my mind I try to remember to ask my doctor.

When I see my doctor she says "Oh right! You don't have an exemption card? Let me give you one."
"Whats that I ask?"
"It means you don't have to pay for your medication."
"Why not?"
"Because you have a listed medical condition. You have to take these drugs, to live."

How civilized, I thought.
posted by vacapinta at 8:57 AM on March 29, 2012 [27 favorites]

A question for non-American mefites (whether you live or have lived in the U.S. or not): in discussions like these*, I'm always struck by how many of my fellow Americans express what seems to me to be an attitude that it's totally normal to think that people who don't have what you have (job, housing, access to decent health care) don't have those things because they just haven't worked as hard as you. That what you have - job, housing, health insurance - you got by dint of hard work and by gum, anyone who works hard can also have these things....and if they don't, it's their fault. I see this attitude expressed by my fellow citizens a lot.

This feels to me like a *very* American trait (I'm American, have mostly lived in the U.S., with brief stints in Western Europe a couple of decades ago), though it almost certainly exists everywhere. But does it exist in as culturally normal a way as it does in the U.S.? Or is this just all confirmation bias on my part?

* not just on mefi, but all over the place
posted by rtha at 9:06 AM on March 29, 2012 [4 favorites]

A question for non-American mefites (whether you live or have lived in the U.S. or not): in discussions like these*, I'm always struck by how many of my fellow Americans express what seems to me to be an attitude that it's totally normal to think that people who don't have what you have (job, housing, access to decent health care) don't have those things because they just haven't worked as hard as you. That what you have - job, housing, health insurance - you got by dint of hard work and by gum, anyone who works hard can also have these things....and if they don't, it's their fault. I see this attitude expressed by my fellow citizens a lot.

This feels to me like a *very* American trait (I'm American, have mostly lived in the U.S., with brief stints in Western Europe a couple of decades ago), though it almost certainly exists everywhere. But does it exist in as culturally normal a way as it does in the U.S.? Or is this just all confirmation bias on my part?

The doctrine of Predestination and the Elect.
posted by Ironmouth at 9:20 AM on March 29, 2012 [2 favorites]

But now we're just splitting hairs. Even half my round number precludes taking a cut-the-employer-cord risk. And I do pretty well, thanks very much, so while this is truly a first-world, white-guy problem, imagine what it's like for someone that can't even entertain the idea in the first place, and then imagine what that collectively does to a country of 300 million.

I don't pay anything like that and I'm on my own with a family that has routine expenses. You could pull this off if you wanted to.

I certainly don't like to see anyone pay mental tax because of regulation, of course. I see your point.
posted by michaelh at 9:20 AM on March 29, 2012

I wonder if I could get transferred to the London office. (Almost certainly not.)

I remember last year spending time on the phone with my insurance company, a millimeter away from sobbing "I don't understand why you're doing this to me" at the poor girl on the line, who had no idea why anyway. There was no reason my medication was denied - not even "it's our policy that you try X, Y, or Z first", it was just "No, not for you." I beat my head against that wall until I stopped functioning entirely. My attempt to get treated for depression resulted in one of the worst depressive episodes I've had as an adult.

I tried a different route and saw a doctor the other week. Apparently the drug I'd been asking for became a rubber-stamp approval a month after I gave up.
posted by Karmakaze at 10:03 AM on March 29, 2012 [1 favorite]

What bothers me are others who could just have well done the same but decided take an "alternative" job" that didn't provide health care but now feel it is an ENTITLEMENT.

You are absolutely goddamn right I'm entitled to it, and so are you and so is everyone else. What the hell do you think "society" means, anyway? The "social contract"? It's stuff like this that leaves the rest of the world speechless, America. And brokenhearted for the suffering it causes.
posted by jokeefe at 10:04 AM on March 29, 2012 [20 favorites]

Geez, at the risk of digging a deeper hole ...

I was reacting to a specific type of attitude. I was ticked off/irked and communicated what I was feeling poorly and knee jerk.

I don't feel that as a civilization we shouldn't try to provide food, housing, healthcare, etc. to those who can't provide it for themselves but, I think there is a significant difference between society as a whole wanting to provide such things and the people who expect they should be provided to them by society because they are entitled to them as a human right.

Society's act of providing those things to the individual is charity (a fine thing) but I just don't feel receiving them is a right.
(Someone take away the shovel).
posted by Carbolic at 10:06 AM on March 29, 2012

The doctrine of Predestination and the Elect.

Yes, absolutely. Somebody earlier in the thread commented on the idea that anything bad that happens to you is in some way your fault, and attributed this to human nature. No, not at all. The world's literature is full of capricious gods who lay shit on people all the time for no good reason, and meditations on how the unpredictability of life and event is just that: unpredictable. The idea that you deserve, or earn, your suffering seems to relate strongly to Calvin, the Puritans, and such religious ideologies. Perhaps somebody who is more conversant with the history of Protestantism could comment.
posted by jokeefe at 10:08 AM on March 29, 2012 [2 favorites]

I think there is a significant difference between society as a whole wanting to provide such things and the people who expect they should be provided to them by society because they are entitled to them as a human right.

Who exactly are these people, Carbolic? Are they like the mythical Welfare Queen? The lazy and undeserving poor? Who are they?
posted by jokeefe at 10:09 AM on March 29, 2012

And one more time: Yes, you are entitled to be treated like a human being and that in itself is a human right. It is beholden on a rich society to spend money on those who are compromised by circumstance and to strengthen that society by alleviating suffering where possible.
posted by jokeefe at 10:11 AM on March 29, 2012 [5 favorites]

Society's act of providing those things to the individual is charity (a fine thing) but I just don't feel receiving them is a right.

*facepalm*
posted by RolandOfEld at 10:12 AM on March 29, 2012 [2 favorites]

(Someone take away the shovel).

Take personal responsibility and put the goddamn thing down.
posted by rtha at 10:16 AM on March 29, 2012 [20 favorites]

I am a fan of "we should provide it".

Not a fan of "you (society) should provide it for me because it is my right to receive it from you".

It's not a group of people I have a problem with it is an attitude. (Not an attitude I'm saying is the prodominate one throughout society, just a certain attitude).

RolandOfEld: Did you read the definition I linked? (charity - : benevolent goodwill toward or love of humanity, 2 a : generosity and helpfulness especially toward the needy or suffering; also : aid given to those in need
posted by Carbolic at 10:19 AM on March 29, 2012

It seems to me that the whole own your own home thing is just an accidental outgrowth of the era of cheap oil and plentiful automobiles

It's been a huge priority of US public policy since the end of the US Civil War. Offering veterans good rates on mortgages has been a part of every veterans' compensation act since then. It was also a goal (not very well followed through on) of the Freedmen's Bureaus.

It's true that the US public policy and popular energy around how important it is to have a high percentage of homeowners doesn't make sense in the context of most other countries' political cultures. But it arises out of specific aspects of US history, from homesteading to an acknowledgement that sharecropping was an exploitative system to the roles that private banks play in shaping policy at every level from the local to the federal.

The whole "car suburbs" thing fit into an existing cultural imperative. Before car suburbs, there were streetcar suburbs and pushes to get people into their own farms and the like.
posted by Sidhedevil at 10:23 AM on March 29, 2012

I don't give a shit what somebody's attitude is. Someone who's starving and is an asshole still deserves to not starve. Someone dying of cholera in Haiti who's all "fuck you aid workers from Nepal who brought cholera!" still deserves treatment so they don't die.

Having to tug your forelock and smile before someone deigns you worthy of health care or food or shelter is bullshit.
posted by rtha at 10:26 AM on March 29, 2012 [15 favorites]

Carbolic, the difference between a social safety net and charity is that the latter is at the whim of the individual, and the former is a group expression of concern for the needs of the most vulnerable.

Having worked in both public social service providers and private charities, the former is a far more robust system. Private charities can and do deny people help on the basis of their religious orientation, for instance; public social service providers must provide help to all equally.

Even looked at pragmatically, public social services are more efficient than private charities. And "let's let charity take care of people" is a very un-American strategy; one of the ways the early Federal government staked out their differences from the English government was by providing public schools, public poor farms, and other public social services instead of following the English model of having these things run by Church of England parishes.
posted by Sidhedevil at 10:27 AM on March 29, 2012 [4 favorites]

This feels so similar (to me) to the kerfuffle from the Right over contraception - the attitude of "why should I have to pay for someone else's choices?" (ignore, of course, that no one was "paying" in the Fluke case). If we just HAD healthcare for everyone, and personal choice didn't necessarily dictate "who got what", you'd just have one less reason to stack-rank yourself and your own choices against everyone else and theirs.

I'm remembering someone's comment from a thread about conservatives being mad about health care, and why they were so hot on the savings account idea - Because it's one of the purest possible distillations of "Fuck you, got mine".

posted by ersatzkat at 10:28 AM on March 29, 2012

Look, I've said I think society should provide it!

I'm just irked by entitled attitudes. I'm also irked by slow drivers in the far left lane on the interstate.
posted by Carbolic at 10:33 AM on March 29, 2012

I guess if you're saying it isn't a right in the natural law sense of things, sure, duh, that's the trivial solution. Heinlein said it well when he said

"What 'right' to life has a man who is drowning in the Pacific?"

We get that health care isn't a 'right' in that sense of the word. However, in any functioning society that I'd aspire to be a member of it should be a right for someone to be able to sue for and receive decent health care independent of their income. If the society can provide it that is, but we can, that's the thing.

We can. We just choose not to.

On preview: Sure you've said it, but you've also said that you just don't feel receiving them is a right. That's what doesn't jive with me.
posted by RolandOfEld at 10:38 AM on March 29, 2012

But the worst, women in the grocery check out who, after their goods are rung up, start digging into their purse looking for their wallet and then they begin writing a goddamned check. Did you just realize you were going to have to pay for the shit?!!!! Have you never been through this process before?!
posted by Carbolic at 10:40 AM on March 29, 2012

Dude, if you don't put that shovel down, you're gonna end up in China. Then you'll have to deal with all those bad drivers you hate.
posted by gman at 10:47 AM on March 29, 2012

I'm a 51 year-old grouchy white male. I should mostly be ignored. I ignore most of my kind and I'm happier for it.
posted by Carbolic at 10:51 AM on March 29, 2012 [1 favorite]

"Women in the grocery check out ... "?
Imagine if you will: aggressive snatching of a shovel.
posted by de at 10:54 AM on March 29, 2012 [3 favorites]

So, Carbolic, you want people to be more grateful to you because you "chose" to be a lawyer instead of a part-time employee at Walmart?

I know who needs a visit from some ghosts this Christmas Eve!
posted by Sidhedevil at 10:58 AM on March 29, 2012 [2 favorites]

jokeefe: You are one of my favourite MeFites. It's too bad I'm allergic to cats.
posted by velvet winter at 10:58 AM on March 29, 2012 [2 favorites]

I'm just irked by entitled attitudes

I have an entitlement attitude about health care, because it's fucking health care and I don't care if you or anyone doesn't like, approve or feel all rosy about that attitude. The US spends half trillion dollars a year on the military, but making sure the populace has a basic level of health is like pulling teeth, but without insurance.

The situation regarding the US is completely ridiculous, immoral, wasteful and damaging. The 'lone cowboy, pull yourself up by your boot straps' mentality doesn't work on this scale. Companies, right now, right this minute, this very second are rejecting healthcare claims because it hurts their bottom line. They are treating citizens as profit centers and lowering the length and quality of lives an so the goddamn board of directors can have another 100K bonus or some create.

And here you are, pissing and moaning because people have an entitlement attitude for some basic human care. What the hell, man?
posted by Brandon Blatcher at 10:59 AM on March 29, 2012 [27 favorites]

Don't pull that "I'm an older white male" crap either. None of that precludes you from thinking rationally and realizing the game is rigged to literally screw people over.
posted by Brandon Blatcher at 11:03 AM on March 29, 2012 [8 favorites]

hahah people without money so fucking entitled thinking they deserve to be alive If only I can ram slow drivers off the interstate like the way we off sick people who happen to be poor my American dream would be made USA USA
posted by dustyasymptotes at 11:04 AM on March 29, 2012 [3 favorites]

I'm just irked by entitled attitudes

So on the one hand you think that society has an obligation to provide something, but on the other hand you think that the recipients should display sufficient gratitude?

Can you quantify the sufficient level of gratitude that seems most appropriate? Perhaps we can make it part of the application process.

Would the sending of a Hallmark card do, for instance? Maybe one with a ducky or a bunny on it?
posted by EmpressCallipygos at 11:06 AM on March 29, 2012 [5 favorites]

The United States will not have healthy people no matter how much free insurance they have. Our goal here, no matter who buys the insurance, is to string people along for as many years as possible, not give them healthy or happy lives. Let's not get confused by that silly word, "healthcare."
posted by michaelh at 11:08 AM on March 29, 2012

Society's act of providing those things to the individual is charity

And too often manifested in bake sales for $5 muffins -- 'charity' as a capricious, heavily-weighted and ultimately insufficient thing -- because there are only so many $5 muffins one can buy (or $5 muffins one can sell) before it gets uncomfortable.

If you dig etymologically down to caritas or agape (or mettā), the idea of a duty of care and compassion towards others that operates on a sufficiently encompassing scale, then too bloody right it is.
posted by holgate at 11:08 AM on March 29, 2012

I didn't ask anyone to be grateful to me.

I have no problem with working at Wal-Mart I just said lawyer because that happens to be what I did and it isn't particularly a lot of fun. I was a part-time employee for approximately the first ten years of my insured life.

Brandon: I don't disagree. I just expressed a feeling at around midnight a couple of days ago. It was grouchy, knee jerk and not exactly surgically expressed. I've just been trying to clarify that.
posted by Carbolic at 11:09 AM on March 29, 2012

Society's act of providing those things to the individual is charity

You know, something always puzzles me about this.

There is nothing stopping the well-to-do from giving more money to charity right this minute. At all. There was nothing stopping them from giving money to charity twenty years ago, or thirty, or fifty or a hundred years ago.

And yet, they don't. Giving the well-to-do tax breaks -- tax breaks which were paid for by cutting social programs -- also didn't lead to any kind of uptick in charitable donations sufficient to the needs of the needy.

So what do you do about the fact that society's way of providing things to the individual is charity, but yet charity is not forthcoming from the well-to-do?
posted by EmpressCallipygos at 11:11 AM on March 29, 2012

I didn't ask anyone to be grateful to me.

Of course not. However, you wish for them to not display "a sense of entitlement." Logically that gratitude must be expressed at the time they apply for their services so the caseworker can perform a proper assessment that they do not have this "sense of entitlement" of which you speak.
posted by EmpressCallipygos at 11:13 AM on March 29, 2012

*hands Empress a pitchfork*
posted by RolandOfEld at 11:13 AM on March 29, 2012

I am a fan of "we should provide it".

Not a fan of "you (society) should provide it for me because it is my right to receive it from you".

It's not a group of people I have a problem with it is an attitude. (Not an attitude I'm saying is the prodominate one throughout society, just a certain attitude).

The best fallback in this case is the Bismarkian view: if you don't provide welfare, people will eventually take what they can, and that's worse. Unless you have a wonderful plan for making the poor no longer exist, or holding them down forever, the long run ends in either welfare or a basement in Yekaterinburg. Everything else is just the journey to one of these points.

It's not the argument I would want to make, as it's more or less blackmail, but it's pragmatic and easy to understand. If you're better off than most, welfare is a great way to enjoy your wealth in a safe and peaceful society. Screwing over the poor is a great way of hanging like a kulak.
posted by Jehan at 11:16 AM on March 29, 2012 [4 favorites]

EmpressCallipygos: I don't know that society is obligate to provide for the needy but I think a good society would.

I never said anything about expressing gratitude. I said the entitled attitude "irked" me. "Hey society, where's that fucking healthcare I'm entitled to?"
posted by Carbolic at 11:17 AM on March 29, 2012

I'm just irked by entitled attitudes.

Tell me, EXACTLY AND PRECISELY, what part of my "entitled attitude" in my story about having to wait two years to get treatment the first time I got cancer because I didn't have insurance "irks" you.
posted by scody at 11:19 AM on March 29, 2012 [2 favorites]

Actually, scratch that. Tell me, EXACTLY AND PRECISELY, what part of Anthony Griffith's story conveys this sense of "entitlement" that irks you so. Is it the part where he thinks his daughter shouldn't have to die and he shouldn't have to go bankrupt to save her life?
posted by scody at 11:22 AM on March 29, 2012 [2 favorites]

Scody, he's talking I think about people who didn't get insured on purpose and easily could have and didn't have a good reason not to. You did what you could.
posted by michaelh at 11:22 AM on March 29, 2012

Do you also feel annoyed at people who feel entitled to walk on public sidewalks, or to enjoy the protection of law enforcement, or the legal system, or have the fire department turn up to put out their house when it catches fire?
posted by unSane at 11:22 AM on March 29, 2012

I don't know that society is obligate to provide for the needy but I think a good society would.

Can you quantify the difference between "obligation" and "would"?

I never said anything about expressing gratitude. I said the entitled attitude "irked" me.

Then what would you consider to be the opposite of entitlement, and how would one express that?
posted by EmpressCallipygos at 11:25 AM on March 29, 2012

Maybe this thread could not turn into a torches and pitchfork situation? This is getting a little weird.
posted by jessamyn (staff) at 11:26 AM on March 29, 2012

Moreover, do you believe a "good society" would allow itself to become "irked" at the tone its needy take upon receiving charity? Do you believe the charity befitting a "good society" is conditional upon the emotional response of the recipient? Is not charity a selfless act, one unswayed by whether the recipient feels "entitled" or not?
posted by EmpressCallipygos at 11:27 AM on March 29, 2012 [2 favorites]

"Hey society, where's that fucking healthcare I'm entitled to?"

*facepalm*

You realize that the frustrated message being conveyed in this thread, and the original comment you mentioned in the beginning, is occurring because people don't have health care and, all too often, can't get it.

Every person here who has received health care without crippling [pun intended] financial consequences has been exceedingly grateful.
posted by RolandOfEld at 11:28 AM on March 29, 2012

Maybe this thread could not turn into a torches and pitchfork situation? This is getting a little weird.

Fine, tarring and feathering it is!
posted by Brandon Blatcher at 11:32 AM on March 29, 2012 [2 favorites]

Scody: I didn't say you had an entitled attitude or that any specific person had an entitled attitude.

unSane: Only if they feel entitled to walk on the sidewalk really slowly in front of me and weave around so that I cannot pass.

EmpressCallipygos: It like I'm speaking another language. I think a good society, although not necessarily obligated to, would provide for their needy members.

As far as a society allowing itself to become irked? Not if it were a perfect society but if it were a human society some members might become irked.
posted by Carbolic at 11:35 AM on March 29, 2012

One of the errors every person in the world makes is to assume that their circumstances are universal. Carbolic, I know that I probably make that error way more than you, because I am an idiot, but you are making it here.

You had health insurance when you were a part-time worker not because of your foresight or prudence, but because that insurance was available to you then, because the situation and circumstances were different. Right now, that insurance is not available to tens of millions of people in the US, not because of their "attitude" or because of their failure to plan, but because the circumstances of how health insurance is provided in the US have changed dramatically.
posted by Sidhedevil at 11:38 AM on March 29, 2012 [4 favorites]

I think a good society, although not necessarily obligated to, would provide for their needy members.

What is the measure of whether a society is "good"?
posted by EmpressCallipygos at 11:39 AM on March 29, 2012

jokeefe: You are one of my favourite MeFites. It's too bad I'm allergic to cats.

Aww. As soon as I use packing tape to get rid of all this cat hair on every clothed surface of my body, I will give you a hug.
posted by jokeefe at 11:42 AM on March 29, 2012

"Hey society, where's that fucking healthcare I'm entitled to?"

An excellent question, and one that more people should be asking out loud and often.
posted by jokeefe at 11:43 AM on March 29, 2012 [13 favorites]

Fine, tarring and feathering it is!

Seriously, the interrogation stuff needs to wind down. If you want to have a discussion with the community here, feel free. If you just want to pepper Carbolic with questions and "What do you mean by THIS exactly?" stuff, maybe take that to email or MeMail?
posted by jessamyn (staff) at 11:44 AM on March 29, 2012

Dear MetaFilter,

A couple of nights ago it was getting late (there may have been beer involved) and I spouted off and made some comments that were unintentionally hurtful to some members. I may have made it even worse in my attempt to explain that. I apologize.

Sincerely (really),

Carbolic
posted by Carbolic at 11:46 AM on March 29, 2012 [20 favorites]

...Well, I think that apology took some guts.

Thank you, Sir Carbolic.
posted by EmpressCallipygos at 11:48 AM on March 29, 2012 [2 favorites]

If you just want to pepper Carbolic with questions and "What do you mean by THIS exactly?" stuff, maybe take that to email or MeMail?

If he's going to call people entitled for wanting a service provided by every other developed nation, then I think he should have to back up what he means.

If he's truly unable to back up his statements, I think that's something worthwhile for the participants in this discussion to see for themselves.

I'll bow out now.
posted by scody at 11:48 AM on March 29, 2012 [1 favorite]

In hopes of not being condescending (really), that's a pretty candid apology. Well said.
posted by RolandOfEld at 11:49 AM on March 29, 2012 [1 favorite]

I apologize.

Cool, thanks. Let's go have some pie.
posted by Brandon Blatcher at 11:51 AM on March 29, 2012 [1 favorite]

EmpressCallipygos and RolandofEld: Thank you.

Acheman: I been trying to explain that it was not a considered opinion and it was just a grouchy reaction to something that got my goat/irked me. That it, and I, should not be taken so seriously. A rant from a grouch. I can be a dick sometimes.

Brandon Blatcher: i like pie.
posted by Carbolic at 11:52 AM on March 29, 2012 [1 favorite]

Yay, pie!

Carbolic, you are a stand-up person to be so gracious. I think one of the things that you unwittingly walked into is that you expressed opinions here that lots of other people express in many other settings (Reason magazine, I'm looking at you!) and we had the chance for back-and-forth with you that we don't have with Thomas Sowell or Rand Paul or whoever.

Please believe that despite the profound disagreements I have with the opinions you expressed, I appreciate your good faith in discussing them here.
posted by Sidhedevil at 11:56 AM on March 29, 2012 [2 favorites]

I too would like to offer Carbolic some pie.
posted by jokeefe at 12:02 PM on March 29, 2012 [1 favorite]

I'd have pie. I can contribute some fancy donuts to the table.
posted by rtha at 12:04 PM on March 29, 2012

Seriously, Carbolic, my opinion of you just jumped about ten points for that pitch-perfect apology. Well done.

Sorry you had to be the proxy for my crazy Uncle. I suspect I'm not the only MeFite with crazy Uncles.

[not Uncle-ist!]
posted by ambrosia at 12:05 PM on March 29, 2012 [1 favorite]

If only the U.S. government could get it together the way Carbolic just did.
posted by tzikeh at 12:06 PM on March 29, 2012 [1 favorite]

This thread makes me cry every time it happens.

(thanks for apologising, Carbolic)
posted by batmonkey at 12:11 PM on March 29, 2012 [1 favorite]

I'm feeling warm and fuzz. Thanks all. (No Depends jokes)
posted by Carbolic at 12:16 PM on March 29, 2012

You wouldn't need Depends for warm and fuzzy feelings. Maybe something for a rash?
posted by tzikeh at 12:19 PM on March 29, 2012 [1 favorite]

I'd have pie. I can contribute some fancy donuts to the table.

Cake, is anyone bringing cake?! If you don't have cake, bring alcohol.
posted by Brandon Blatcher at 12:26 PM on March 29, 2012

Affordable housing is important, but at the same time, you don't want a nation of renters.

Yeah, um, why?

Because of a nation of renters means there's no investment in the nation. This has both micro- and macro-implications. On the micro level, renters have no reason to invest in the upgrade and use of real estate, which has been the primary driver of economics since Sumerian times. On the macro level, failure to encourage widespread ownership leads to negative rent-seeking behaviors. "Rent-seeking behavior is distinguished in theory from profit-seeking behavior, in which entities seek to extract value by engaging in mutually beneficial transactions."

You mention the development of suburbs as a negative, that making it easier to buy houses leads to sprawl. What you're arguing there is urban planning, and while happen to agree with you in principle, that's something different than real estate ownership policies.

Someone upthread mentioned Switzerland as a positive example of where a "nation of renters" has turned out OK. I think this is an apples-and-oranges comparison, as Switzerland is a small, economically and socially homogenous country. It didn't get to be the richest per-capita nation in the world because they rent their homes.
posted by Cool Papa Bell at 12:31 PM on March 29, 2012

When is someone going to make that startup that lets you send pie through the mail via API?
posted by michaelh at 12:37 PM on March 29, 2012 [2 favorites]

A nation of renters means the entire housing supply is in the hands of corporations and landlords. I think you can imagine how well that is likely to turn out in the US.
posted by unSane at 12:38 PM on March 29, 2012 [2 favorites]

it contains what I think may be one of the all-time great Metafiler comments about health care, namely this one by dancestoblue.

I flagged that comment as "fantastic," but it feels weird to flag something so painful as fantastic. There are sometimes heartbreaking, mind-bendingly awful stories told on this site, and I want to flag those comments as "notable" or "sidebar-worthy" or something, because it feels itchy to flag "here's how the American government killed my father" or the like as "fantastic."

A++++ WOULD WEEP FOR HOURS AGAIN not quite what I'm going for.
posted by tzikeh at 12:45 PM on March 29, 2012 [2 favorites]

Carbolic: "Dear MetaFilter,

A couple of nights ago it was getting late (there may have been beer involved) and I spouted off and made some comments that were unintentionally hurtful to some members. I may have made it even worse in my attempt to explain that. I apologize.

Sincerely (really),

Carbolic"

That might have been the most heartening things I've read in a while.
posted by dunkadunc at 12:46 PM on March 29, 2012 [1 favorite]

I make a kick-ass blueberry pie.
posted by patheral at 12:51 PM on March 29, 2012

You better make more than one blueberry pie because I will probably eat a whole one all by myself.

When is someone going to make that startup that lets you send pie through the mail via API?

No kidding. We need a version of the Alameda-Weehawken Burrito Tunnel for pie.
posted by rtha at 12:59 PM on March 29, 2012

I hope Carbolic comes back here for his pie. I make a kick-ass peach and blueberry.
posted by jokeefe at 1:02 PM on March 29, 2012 [1 favorite]

Cake, is anyone bringing cake?! If you don't have cake, bring alcohol.

I've got bannock; does that count or should I bring beer too?
posted by Mitheral at 1:07 PM on March 29, 2012

or should I bring beer too

No, just some heroin will be fine.
posted by Brandon Blatcher at 1:11 PM on March 29, 2012

a nation of renters means there's no investment in the nation.

That depends. Germany has about a nationwide 50/50 split, but with big differences on a regional level, and there's still "investment in the nation"; it's just that the rough correlation is between investment in public space and investment in private space. A city like Berlin, where nearly 90% of the population rents, functions on the basis of a tacit consent that investment takes place in shared spaces, and that's been the primary driver of cities as economic engines; in addition, renters have strength in numbers to demand secure, well-regulated tenancies.

That, I think, speaks to a paradox of post-WW2 America, because its growth was built on a foundation of shared sacrifice followed by shared reward, but that shared reward was largely distributed in an individualised fashion, via the GI Bill. Post-war western Europe, having bombed itself into bits, instead chose universal healthcare and social housing and the social-democratic safety net.

There are good arguments that both approaches are at points of crisis, but I think you can lay a very specific criticism at the American approach to both housing and healthcare, which is that those individualised benefits (the no-money-down mortgages and subsidised college education) cease to register as such over time. If your grandparents moved to the 'burbs in 1948 and your parents were able to get a good college education cheaply, then you are demonstrably the beneficiary of collective national social policy, but it's understandably easy to think differently, because all that stuff happened a long time ago. I'm not sure if the same applies if those policies are made tangible by being institutionalised in ways that they "belong to us".

I concur with pie for Carbolic.
posted by holgate at 1:15 PM on March 29, 2012 [3 favorites]

From pile-on to pie-on
posted by unSane at 1:57 PM on March 29, 2012 [4 favorites]

it contains what I think may be one of the all-time great Metafiler comments about health care, namely this one by dancestoblue.

dancestoblue regularly writes great prose, often hidden away in AskMe answers. It's worth adding him as a contact to try not to miss any of these gems.
posted by UbuRoivas at 2:08 PM on March 29, 2012 [2 favorites]

Carbolic: ". I apologize."

Well done. I was going to argue with you some more and maybe call you some names but, well, now I can't.

unSane: "A nation of renters means the entire housing supply is in the hands of corporations and landlords. I think you can imagine how well that is likely to turn out in the US."

A nation of homeowners means the entire housing supply is in the hands of bankers. Although, if 'homeowner' was not synonymous with 'suburban house owner' and if owning a home that reasonably accommodates a family and was within easy reach of public transport was the brass ring rather than an enormous house on your own piece of dirt that forces everyone to be dependent on cars because it's not viable to extend the public transport infrastructure that widely, housing would be more affordable and we wouldn't be shivering in fright every time interest rates are reviewed. He says, knowing that he owns just such a home that is far enough away from public transport that the family can't manage without two cars.
posted by dg at 2:11 PM on March 29, 2012 [1 favorite]

A nation of homeowners means the entire housing supply is in the hands of bankers.

That's really not true in a lot of senses, even if you buy the underlying premise. I have a decent sized mortgage but about 40% equity in my house. My parents paid off their mortgage. My wife's parents paid off theirs.
posted by unSane at 2:20 PM on March 29, 2012

Well, 'entire' might be a bit strong (with both examples). But anyone with a mortgage is at the mercy of interest rates and, while interest rates are not completely controlled by commercial banks (here, anyway), interest rates do have a huge part to play in controlling the availability of affordable housing.
posted by dg at 3:01 PM on March 29, 2012

anyone with a mortgage is at the mercy of interest rates

Only if your mortgage is variable or the term is shorter than the period.
posted by Mitheral at 3:09 PM on March 29, 2012

But that's true for rental accommodation too. Rents go up, eventually, if interest rates go up, because most rental units are held on commercial mortgages. You dig down far enough you always hit banks.
posted by unSane at 3:10 PM on March 29, 2012

Yeah, that's true, with the added bonus that rents don't go down when interest rates do.
posted by dg at 3:12 PM on March 29, 2012

But anyone with a mortgage is at the mercy of interest rates

That's one of the reasons the US Federal Reserve is so iffy about raising interest rates.

This is a long-standing historical thing (as I said, since the US Civil War). There has been a long impulse in US social policy to encourage homeownership for lots of reasons. For a long time, that policy jibed pretty well with the local nature of US banks (remember there is no national government bank in the US, unlike most other developed nations); banks were based in communities and made their money from encouraging home and business ownership in the communities, at least in principle.

In the age of megabanks, this system may be (in my opinion, is) out of stasis. But it's not a recent development, and unpacking a 150-year-old trend in public policy is going to be hard work.
posted by Sidhedevil at 3:21 PM on March 29, 2012

I can be a dick sometimes. (Carbolic)

We all can. But not all of us apologize after doing it. I think you deserve something special for stepping up like that. Let's see, what would do? Oh, I know, a citation for a gracious return:

[CITATION FUCKING AWARDED]

Now I feel better, too.
posted by ocherdraco at 4:48 PM on March 29, 2012 [2 favorites]

Metafilter: Hugs, pie and ponies for all!
posted by His thoughts were red thoughts at 5:26 PM on March 29, 2012 [1 favorite]

It irks me that some people feel entitled to pie.
posted by Ritchie at 1:43 AM on March 30, 2012 [1 favorite]

I came for the free healthcare, and stayed for the pie!
posted by blue_beetle at 3:22 AM on March 30, 2012

When I was in the US in school, I was within a day's drive (or overnight bus) back home so I could use my government supplied health care instead of the creepy "Oh, you have an ear infection? Take this pregnancy test and then you can see a doctor" and expensive school care.

I am also single and I have both cats and employer-sponsored insurance for things like dental work and prescriptions. Memail me if you want to reenact Green Card, just sort of in reverse.
posted by jeather at 5:44 AM on March 30, 2012 [1 favorite]

I was told that participation in this thread entitles me to both cake and pie.

*waits*
posted by elizardbits at 8:27 AM on March 30, 2012 [1 favorite]

It might also entitle you to a Canadian spouse.
posted by jokeefe at 9:32 AM on March 30, 2012 [1 favorite]

That's an acceptable tradeoff.
posted by UbuRoivas at 2:57 PM on March 30, 2012

I'd say trade-up, having already snagged myself a Canadian spouse.

Would still like pie though.
posted by arcticseal at 4:03 PM on March 30, 2012

What about poutine?
posted by tzikeh at 4:33 PM on March 30, 2012

I just said lawyer because that happens to be what I did and it isn't particularly a lot of fun.

Pie for thought
posted by flabdablet at 5:29 PM on March 30, 2012

Put. That pie. Down.

Pie's for closers only.
posted by Ritchie at 10:30 PM on March 30, 2012 [1 favorite]

Another account of an American (and a MeFite) getting healthcare in the UK: An Eye-Opening Adventure in Socialized Medicine
posted by homunculus at 4:29 PM on March 31, 2012 [2 favorites]

If we can find just one new thing to bitch about this can roll off the front page and into oblivion
posted by Carbolic at 6:16 AM on April 1, 2012

Not if we longboat it! Then it will stay in your recent activity forever! (Or until you remove it okay fine.)
posted by rtha at 7:39 AM on April 1, 2012

If we can find just one new thing to bitch about this can roll off the front page and into oblivion

Oh, don't worry. We can multi-task.
posted by His thoughts were red thoughts at 4:06 PM on April 1, 2012

I am fully insured. Over the past couple of years I have driven to Canada multiple times to pay privately for medical services which were not covered by my insurance and which cost twice as much to secure in the US.
posted by bq at 6:20 PM on April 1, 2012

Happy to be given a selection of potential spouses who would like to escape the US, please apply via memail.
posted by AnnaRat at 4:32 AM on April 2, 2012 [1 favorite]

with photograph
posted by unSane at 5:01 AM on April 2, 2012

See. Oblivion.
posted by Carbolic at 9:09 PM on April 5, 2012

Not quite.

Anecdata, from this week. Just after I finished my lunch last Monday, I was hit with a gallstone attack (like a sudden fiery sword of pain through my ribs, etc.) and was driven to the closest emergency room by a co-worker. I waited 5 minutes to register, then was seen right away. Mentioning that I might faint if I tried to walk brought immediate attention and a wheelchair. In another minute my history and blood pressure was being taken; I was put to bed and hooked up for a ECG, with many apologies that they couldn't bring out the drugs quite yet, until the heart tests were done. The drugs showed up, and continued being administered as the nurses checked in with me about my pain levels every half hour or so. I was sent home about 6 hours later with extra pain pills and instructions to wait for a call in the morning for an ultrasound appointment. I had the call at about 8:30 a.m.; had the ultrasound at 2:00 p.m.; was told I should come back the next day for a CT scan, which I also did. Within 48 hours I had all the tests and a diagnosis (gallstones), an appointment with a surgeon in three weeks time, and a follow up appointment with my family doctor upcoming on Tuesday.

The cost? Nothing, unless you count the percentage of taxes I pay, which is exactly comparable to the rates in America. I was supposed to be in Seattle this weekend, and all I could think, lying there in the ER, was thank god this didn't happen in America.
posted by jokeefe at 7:23 PM on April 6, 2012 [1 favorite]

Argh. I too, have anecdata from about two weeks ago, from the other side of the border. I had intermittent chest pains that continued for about 24 hours, were moderate to severe and focused on the left side. So I finally took myself to the ER, even though I know better. I was seen immediately; everyone was very nice. They gave me an EKG and a chest x-ray and as I was lying there hooked up to a heart monitor, they sent in the billing people. They needed $100 right there, they said. They were nice too. I burst into tears. "Don't worry," they said, "We're sure you qualify for financial aid. Just give us the $100 and here is a whole bunch of paperwork to fill out when you get home and mail back to us within 10 days and we're just sure it will be okay." So I gave them $100, which is a lot of money for me, and I went home with my unknown chest inflammation / pleurisy diagnosis and I filled out the paperwork and copied several of my paystubs and sent it back to the hospital.

Last week I got my first bill. It's for $619 and it warns me that this is only the very first, preliminary bill that covers only one of the doctors I spoke with. There will be more. Quite a lot more, I think. I should never have gone. I should have known better and I feel like an idiot and I'll be paying these bills for the next ten years. I could cry again when I think about it. I tell you what though, I have learned my lesson. I'm never going back to the ER. Medical care is out of my financial league.
posted by mygothlaundry at 7:08 PM on April 10, 2012 [1 favorite]

mygothlaundry: "Medical care is out of my financial league."

This just makes me weep. Your financial situation should not dictate your access to basic healthcare.
posted by arcticseal at 8:05 PM on April 10, 2012 [3 favorites]

Well, it didn't make me weep, but the statement 'I have learned my lesson. I'm never going back to the ER.' almost did. Taken in isolation, most people from civilised countries would assume that this was a tale of medical incompetence, poor customer service or something related to the level of care. The idea that an intelligent, rational adult can make such a statement because they consider basic medical care beyond their financial reach is just heartbreaking.
posted by dg at 8:34 PM on April 10, 2012 [1 favorite]

US healthcare has discovered a cheap and effective cure for everything, called death.
posted by unSane at 8:44 PM on April 10, 2012 [1 favorite]

Jesus, MGL, I'm so sorry. What a fucking parody of a health care system you Americans have to suffer with.

I wanted to update my story with a sort of for the hell of it counterexample to the stories and misrepresentations circulated down South about the Canadian system, and now it hurts to do so. I'll just say that my family doctor decided that three weeks was too long to wait to see a surgeon as the CT scan turned up a mass or growth in my gallbladder, so exactly two weeks and one day after having my first symptoms I was in a surgeon's office (fine firm handshake, in scrubs with addition of little hat, framed certificates of being a No. 1 surgeon on the wall, none even in crayon!) and after talking to him I had a date for the operation, another four weeks hence. Worth every cent of my very reasonable taxes, and not just for the financial aspect but for being treated like a human being who has a right to exist and be cared for, just as I in turn help to care for others by giving back to the pool. I can't imagine how humiliating and dehumanizing it must be to be asked to pay up front for needed medical care, and to be treated badly (or not at all) because you couldn't afford it. It's simply evil, this profiting from someone else's misfortune.
posted by jokeefe at 10:03 AM on April 20, 2012 [4 favorites]