Healthcare controversy

by Richard on August 14, 2009

At the end of June I wrote a little piece Yay for the NHS! that got one or two of my American US readers hot under the collar. Now I see that has been repeated on a wider scale, with the American right-wing using the denigrating the NHS in an attempt to stymy President Obama’s healthcare reforms.

What surprises me about this debate is the extent to which the Right are prepared to lie to support their case. I wish it were possible to be more circumspect in my language about this, but it isn’t. When, for example, ‘Club for Growth’ claim that NHS patients can’t get treatments costing more than $22,750, that’s a simple, straight-forward and unambiguous lie. What’s more, they must know it is a lie.

Similarly, it is not true that 4 in 10 cancer patients in Britain don’t have access to an oncologist. Or that you can’t get heart treatment if you’re over 59. Or that Ted Kennedy’s brain tumour would have gone untreated because he is 77.

Just. Not. True.

I ask those inclined to support ‘Club for Growth’ and their ilk: why do you think they need to lie so blatantly in order to make their case?

{ 42 comments… read them below or add one }

1

Simon 08.14.09 at 4:43 pm

Some in-house right wing lunacy and much detailed rebuttal on this Ship Of Fools thread, and also this one

2

DH 08.14.09 at 4:49 pm

Richard, I know that there are some people who tell lies about but there is also many negative truths about the British health system that cannot be denied. I acknowledge the problems of the American system but I don’t agree that socialized or Obama healthcare is the right answer. Here is an unbiased video on 20/20 that shows people from Canada and the UK and medical people from those place that are negative:

http://www.breitbart.tv/abc-news-anchor-john-stossel-airs-blistering-dissection-of-socialized-medicine/

Is the group “Club for Growth” wrong like you mention Richard? maybe Is that terrible? yes Are there many negative aspects of the the Brit/Canada/Obama? yes and they shouldn’t be denied in light of the facts.

Also the problem with Obama healthcare is beyond just right or left. Many people who are not in the “right” have major problems with Obama or any form of Socialized medicine.

3

Kim 08.14.09 at 5:11 pm

Here is an unbiased video …

You’ll have to excuse me as, having just swallowed my tongue laughing, I’m heading up to casualty (the ER) at Morriston Hospital (as in “hospital”). I should be back in three or four days, if not with my my tongue, at least with a lottery ticket.

4

Steve 08.14.09 at 5:14 pm

Richard,

Don’t attempt to understand it. But the fact is that there is about 20 percent of the population in the U.S. which has gone completely off the rails and believes that they need to stop Obama’s agenda by any means necessary because:

1) He wasn’t really born in the United States, legal documents be damned.
2) He’s really a secret muslim. I mean, come on, Hussein? Obama? What more evidence do you need?
3) He’s actually a communist, because he wants to raise top marginal tax rates to below the level they were at under Supply Side Jesus, Ronald Reagan.
4) And he’s also a Nazi, ready to set up “death panels” for the elderly.
5) If we let him get what he wants, the terrorists have won.

5

Kim 08.14.09 at 5:21 pm

Richard asks: why do you think they need to lie so blatantly in order to make their case? Is it because

(a) they don’t do subtlety.
(b) they wouldn’t know the truth if it came up behind them and gave them an edema.
(c) they reckoned, “Well, it worked over WMD.”
(d) All of the above.

6

Tony Buglass 08.14.09 at 6:18 pm

DH, there are negatives about every health-care system, because they’re run by people, and sinful humans drop clangers and get it wrong.

However, despite the failings of the NHS, it is preferable to a system based entirely on private insurance. John Bell of the Iona Community was on BBC R4 this morning, and spoke very eloquently abut the issue - ending with a despcription of the US system as where “the powerful pay and the poor perish.” He’s been there, he’s seen it, he is one of the best and m0st perceptive Christian preachers and commentators I’ve ever heard, and that is his considered opinion.

Oh - and the Tory MEP who said his piece on Fox News is an utter idiot: he’s a Tory who has been disowned by his own party leader, he went on Fox News (clear evidence of insanity) and he talked through his backside.

7

DH 08.14.09 at 7:07 pm

Steve, you are just stating a bunch of red-herrings that have no bearing on the conversation at hand. I know many people even in the majority who do NOT adhere to what you think is adhered to by those who are against Obama’s healthcare system.

Kim, it IS unbiased. 20/20 is considered unbiased by even people I disagree with who happen to be liberal.

Guys, I agree that probably what Richard quoted by “Club for Growth” was not true but that does NOT mean that we can conclude that Obama’s healthcare or any socialized system is the proper system.

Tony, I do NOT believe it is the superior system. We have medicaid and no one I repeat no one is turned away for care. Also it is a fact that people with cancer have a longer survival rate than in the UK and Canada. Just because he is a good preacher or commentarator doesn’t mean that his perceptions are correct in light of other things that are important in a healthcare system. Do you want a system that will make for MORE people who are your children and grandchildren more poor due to higher debt and deficit than otherwise? No one talks about the “poor perishing” in 50 years due to the multiple TRILLION DOLLAR DEBT than otherwise.

The fact remains Obama’s plan will result in TRILLIONS of DOLLARS of more debt than otherwise and that is a known fact by the Congressional Budget Office and we all know which party controls the US Congress and it is NOT the Right.

8

DH 08.14.09 at 7:10 pm

‘Here is a picture of what ONE TRILLION DOLLARS IS: http://www.pagetutor.com/trillion/index.html

9

DH 08.14.09 at 7:14 pm

Simon, that is a “red-herring” I can find people on the left who are just as crazy in the opposite direction. Again not all people in the right are the same. If people are going to lump people like me in with lunatics then maybe we should lump (which I wouldn’t but for argument to make a point) we should lump you as a Communist? I don’t believe you are but now do you see how not all people in the right are the same?

10

Simon 08.14.09 at 7:36 pm

DH - The lunacy in that thread certainly does come from right wingers, hence “in house right wing lunacy”.

11

DH 08.14.09 at 8:08 pm

Simon, I can bring up left wing lunatics who support anarchy. Should we then call or imply that that is “in house left wing lunacy”? This and what you bring up really have no bearing on the conversation at hand because the “lunacy” comes from a minority within the right wing just as much as lunatic anarchists come from a minority within the left wing.

So the question remains: What is the point of your post?

However, tempting it may be, I never try to define those who I disagree with by those who are lunatics within the groups that those who I disagree with are. Hense the implication from your reply therein.

12

Simon 08.14.09 at 8:19 pm

The point of the post is to highlight a detailed discussion of the issue on another site. I would have thought that was quite obvious.

“In house” therefore refers to those posting on that thread, on that board.

13

malc 08.14.09 at 9:20 pm

I did laugh when I saw someone point out that Obama is getting stick for wanting healthcare for all US citizens. Is that really such a bad thing?? I mean, isn’t looking out for the people one of Obama’s jobs?? Surely making sure that ill people, especially those who might have trouble paying for healthcare, are looked after.

14

DH 08.14.09 at 9:52 pm

Simon, I see. However, when the term “in house” is used it is typically in reference to “within a group”. It is great that I was able to “catch you in your tracks”. I sense a definition from before you posted your first reply and your lastest reply with regard to the definitions of “in house”. I’ll be generous to you and take your latest definition as being the “thread on that board”. ;)

Malc, it isn’t about making sure that sick people are looked after, looking out for people, etc. that is the issue. I have never said that the American system is perfect. It is just the matter of how that is done and to not have systems which have the “law of unintended consequences” in effect. There are so many ways like tax incentives for individuals, tax incentives & credits for small businesses to offer healthcare, tax credits for poor people, getting people who are in the 15% tax bracket an opportunity to be in the 0% tax bracket to pay for health insurance, tort reform to lower costs, etc. as opposed to the government running it.

15

Richard 08.14.09 at 10:26 pm

DH, you’re missing the point. I don’t want to argue the relative merits of the US system versus the NHS. That isn’t the issue here.

The point of my post was to ask why, if the case for a system based on private insurance is so obvious, do opponents for change have to lie to argue their point? It isn’t just a question of a single example or of a different interpretation of complicated statistics. What we’re seeing is opponents of healthcare reform in the US telling the most outrageous lies about healthcare in other countries, specifically mine.

You might think it is acceptable to build a political case on lies.

I don’t.

16

Tony Buglass 08.14.09 at 10:46 pm

DH: “We have medicaid and no one I repeat no one is turned away for care.”

A friend who lives in the US, by email today: “We are the richest country in the world and there is no excuse for us to have such an abysmal system. So many people not covered. So many that cannot get the needed tests etc. Friend just got a Mammogram and has not been able to afford it, and could not get one with out the $$, had surgery the NEXT day because of the mass they found. She found it too, but could not afford to get it checked out. ER won’t work, because Breast Mass is not an emergency.”

Now, a friend in this country has just emailed to say tat his wife has discovered a lump, and has been given a hospital appointment in just a week or so to have a MRI scan, with a provisional appointment for surgery already booked for just a few weeks later.

So, not only is your claim “no one I repeat no one is turned away for care” empirically falsified, but the very case that was not treatable in the US without private insurance is being treated very quickly in this country without any payments being made at all. NHS, expert care, and free at the point of need.

I rest my case.

17

J 08.15.09 at 3:28 am

I’m not going to pretend I know any more about how the NHS works than I do about how parlaiment works, but there seem to be some misunderstandings in both directions. In your “Yay for the NHS” post you state that “If he’d been the other side of the Atlantic his treatment would have depended upon proof of an ability to pay”. In fact, emergency rooms in the US are barred by law from considering ability to pay in the delivery of emergency care (http://articles.moneycentral.msn.com/Insurance/KnowYourRights/KnowYourEmergencyRoomRights.aspx). As tempting as it is to go on about how that’s a lie, I’m actually pretty sure you sincerely believe what you said and are merely wrong, not a liar.

Likewise, “a despcription of the US system as where “the powerful pay and the poor perish” is inaccurate as well. In the US, the poor have health insurance (paid for by the government, of all people). It’s lower middle class adults too “wealthy” to qualify for medicaid who have troubles. Getting rid of restrictions on group eligibility would help them far more than any government program. No, there doesn’t seem to have been a significant amount of discussion of this issue in the debate over here, but I still have hope.

“NHS, expert care, and free at the point of need”

One thing I am certain of though - NHS care is not free.

18

Tony Buglass 08.15.09 at 8:14 am

“One thing I am certain of though - NHS care is not free.”

Nothing is free. But the NHS is paid for by the community, not the individual. And it is available to everyone, whatever their resources. So, as I said, it is free at the point of need.

19

Tony Buglass 08.15.09 at 10:10 am

“The brutal truth about America’s healthcare” - an article in today’s Independent (for non-UK readers - one of the intelligent British newspapers):
http://www.independent.co.uk/news/world/americas/the-brutal-truth-about-americarsquos-healthcare-1772580.html
I can imagine Earl and DH will find the title unacceptably provocative, but the content of the article justifies it, and it is backed up by figures from the WHO.

20

Tony Buglass 08.15.09 at 10:25 am

DH: “We have medicaid”

According to the Independent article cited above, California has axed dental care from Medicaid - is that true of other states? The article also states that under some private policies, some basic medical procedures aren’t covered. So how effective is a system based on the assumption of private health insurance if the policies don’t cover everything?

J: “In the US, the poor have health insurance (paid for by the government, of all people). It’s lower middle class adults too “wealthy” to qualify for medicaid who have troubles.”

Well, according to the testimonies in the article, it is also some of the working poor who can’t afford health insurance who are suffering. You can define your terms in whichever way you like (’middle class’, ‘working poor’, etc) but any system which leaves people without health care because they can’t afford it has gone badly wrong.

UK dentistry largely fell out of the NHS net a few years ago because of a new contract imposed by the Government. When a dentist in Scarborough began taking NHS patients again, there were queues right around the block - hundreds of people turned up who couldn’t afford the costs of private dentistry. Where we imitate US health care, we see the problems which you seem to be denying.

21

Wood 08.15.09 at 10:52 am

Don’t diss the American Right. They’re just protecting the fundamental right we all have to get sick and die in poverty.

(Seriously, though: it’s like they have no grasp on anything like reality. They’re so divorced from the way that things actually are, I can only conclude they’re naive, massively ignorant or complete… well, bad people. I wouldn’t trust them to tell me what colour grass was.)

22

Tony Buglass 08.15.09 at 11:19 am

Since I posted the piece about the Independent article, I’ve found this (very balanced) blog article about an American’s experience of the NHS:
http://potentialandexpectations.wordpress.com/2009/08/13/this-americans-experience-of-britains-healthcare-system/

It notes that there are problems in both systems, but that on balance the NHS is a much better and more flexible system for everyone.

23

J 08.15.09 at 12:23 pm

“You can define your terms in whichever way you like (’middle class’, ‘working poor’, etc) but any system which leaves people without health care because they can’t afford it has gone badly wrong”

“Lower middle class adults who cannot afford care” would generally be people whose income exceeded 120% of the poverty level for their family size, though some states go way above that level. These are precisely the people who would benefit most from easing or eliminating group restrictions.

Re the “testimonies” the Independent article:

“”I had a gastric bypass in 2002, but it went wrong, and stomach acid began rotting my teeth. I’ve had several jobs since, but none with medical insurance, so I’ve not been able to see a dentist to get it fixed”

I know our tort systems are different too, so I’ll give the reporter a pass for buying this nonsense; it’s safe to say there’s more to the story here. Likewise:

“others had brought their children for immunisations that could end up saving their life”

From http://www.cdc.gov/vaccines/programs/vfc/default.htm :

“The VFC program is a federally funded program that provides vaccines at no cost to children who might not otherwise be vaccinated because of inability to pay”

“In America, the offer of free healthcare is so rare”

Maybe so, but the offer of healthcare at no cost to the patient is pretty common in the US.

24

Richard 08.15.09 at 1:22 pm

>>“In fact, emergency rooms in the US are barred by law from considering ability to pay in the delivery of emergency care”

My experience is that the ER aren’t required to do more than the bare minimum. I have myself taken a young man to hospital in the US with a badly broken leg, to be met with signs warning that the hospital does not participate in medicaid. He got some treatment of a sort: the leg was strapped up and he was given some painkillers. But it was after the weekend before he was given proper medical attention. His foster mother told me of the very different experience she had taking her own children (covered by the family insurance) to the doctor compared with taking a foster child covered by medicaid. Dress it up anyway you like. That can’t be right.

Furthermore, my own little experience of an ER visit suggests that ability to pay is considered very seriously before treatment is given. I got nowhere near a nurse, let alone a doctor, until my insurance papers had been very carefully scrutinized.

But let me say again, my point here is not to compare the relative merits of our two systems. I’m just asking why the Right has to lie in its opposition to US healthcare reform. And ‘lie’ is the only word for what they’re doing.

25

Tony Buglass 08.15.09 at 2:39 pm

J “I’ll give the reporter a pass for buying this nonsense; it’s safe to say there’s more to the story here.”

Well, unless you can demonstrate that it’s nonsense, that really only says you don’t want to hear it. There is always more to any story, but the issue is whether the details provided are false or the interpretation put on them is false. Seems fairly cut and dried to me.

26

Dave Warnock 08.15.09 at 10:12 pm

J wrote “In fact, emergency rooms in the US are barred by law from considering ability to pay in the delivery of emergency care (http://articles.moneycentral.msn.com/Insurance/KnowYourRights/KnowYourEmergencyRoomRights.aspx). “

Last year my sister & family were in the US on holiday in Florida, my young nephew tripped and cut his head at the hotel swimming pool. They were so rushed off to hospital by ambulance that they did not have all documentation with them and so had to pay for treatment. Several hundred $ for a few stiches. I think there were later able to claim back on insurance. But not free care. This just would not happen in the UK. What if they did not have several hundred $ available at the time. Horrific.

27

Bene D 08.16.09 at 4:31 am

Why do they lie?

Because they can.
Because health care is not perceived as a human right.
Because the audience is incredibly ignorant.
Because the bottom line is capitalism not community.

We Canadians have put up with US lies for years and we’re fed up being the ’socialist’ scapegoat.

I hope our UK friends health care getting trashed gets some people educated.
To our shame, our government did not step forward and publicly demand US lobbiests tell the damn truth when the latest silliness started in the US.

Don’t think they can represent us however, because I don’t think most of this hysteria to the south is about health care.

When we head to the US we buy insurance up the wazoo. Bottom line; the family and friend travel rule is that short of imminent death, the agreement of the group is to pile the potential patient in the car, designate a driver and bee line it to the border.

I’ve had private care in Canada, it wasn’t any better or worse than public care, and the insurance companycarping led me call to the head of insurance at the Law Society. He happened to be my brother-in-law at the time and he shut them up long enough for me to be sick and start getting well. I still wound up leaving before I was well, didn’t need or want the stress of the insurance company starting up again, finished up my care in the public system.
The experience helped me understand the systems a bit better.

In one I’m free to be a patient, get treated and get on with my life, in the other I’m $$ signs. Both have their strengths and weaknesses but I’ve no complaints about public care.
Has served me and mine well.
I’d not pay for private again.

The ease of the lies being flung about in the US is disgraceful.
The ease they are swallowed is insane.

28

J 08.16.09 at 7:48 pm

Richard, Tony and Dave - an emergency room in the US is barred by law from considering ability to pay in the delivery of emergency care. That does not mean they cannot charge you once the care is delivered. If you’re unable to pay, they have to absorb the cost, but if you have the ability to pay, do they not have every right to collect?

I understand that you guys seem to have some inherent problem with private medicine, be it for-profit or nonprofit, but I suspect even hospitals in the UK expect reimbursement from someone.

29

Kim 08.16.09 at 8:27 pm

No, J, they don’t. And if you offered to pay for your treatment at a casualty (ER) reception desk, they’d look at like you were from another planet - America for instance. The NHS is funded entirely through central, national taxation, with some regional variations, namely in the delivery of optical and dental services, and in prescription charges. In Wales, for example, we don’t even have to pay for prescriptions. It’s awful, I know. Where is Joe McCarthy when we need him?

30

Richard 08.16.09 at 8:45 pm

>> “Richard, Tony and Dave - an emergency room in the US is barred by law from considering ability to pay in the delivery of emergency care”

Then why was my care delivered after my ability to pay had been assessed? Why was my young friend sent home with a broken leg only strapped up and not properly treated?

31

Tony Buglass 08.16.09 at 9:38 pm

“Richard, Tony and Dave - an emergency room in the US is barred by law from considering ability to pay in the delivery of emergency care.”

One of my church members was visiting Niagara last year when she fell and broke her foot. Her friends took her to the nearest (US) hospital, but although she had taken out comprehensive health and holiday insurance it was not accepted. They wouldn’t treat her unless she agreed to pay. So her friends took her 30 miles by car to the nearest Canadian hospital where she was treated no questions asked.

Sorry, J. It seems to me that you, Earl and DH will tell us what you have been told is the case, but we have experienced US health care, and we know from experience that it sucks. What you have been told is simply not true. And what Fox News and other rabid right-wing agencies are telling America about the NHS is just lies.

32

Kim 08.16.09 at 10:27 pm

… which brings us back to Richard’s original point: the lies, distortions, and smears, and the whipping up of fears, by people not just driven but (literally) possessed by vested and/or ideological interests. Which is the really scary thing here: the sheer scope and intensity of the hysteria suggests the demonic presence of Pauline principalities, led by capitalism, jingosim, and I dare say some racism.

William Stringfellow puts “the denial of truth” at the top of his list of “the tactics which the principalities mount against human beings.” He writes: “In the place of truth … are data engineered and manufactured, programed and propagated by the principality. The truth is usurped and displaced by a self-serving version of events or facts, with whatever selectivity, distortion, falsehood, manipulation, exaggeration, evasion, concoction necessary to maintain the image or enhance the survival or multiply the coercive capacities of the principality.”

Does US health insurance include provision for exorcisms?

33

J 08.16.09 at 10:48 pm

“The NHS is funded entirely through central, national taxation”

Which is paid to, among others, hospitals. That’s called reimbursement.

“In Wales, for example, we don’t even have to pay for prescriptions”

Yes you do. Read the third sentence of your post again.

“It seems to me that you, Earl and DH will tell us what you have been told is the case”

Actually, I’m telling you what the law is. The exact text of the US law covering this issue can be found here: http://www.law.cornell.edu/uscode/42/1395dd.html

If you believe a hospital violated that law, you can turn them in at 800-HHS-TIPS, and I would encourage you to do so.

I understand that you guys find it horribly unseemly for a hospital to discuss payment with a patient, but I really can’t help you with that one.

34

Richard 08.16.09 at 10:54 pm

>> “I understand that you guys find it horribly unseemly for a hospital to discuss payment with a patient, but I really can’t help you with that one.”

No. I prefer a health system that’s funded through taxation, but I understand that isn’t so in the US.

What I don’t understand is why, if it is against the law, does discussion about payment before treatment in the Emergency Room appear to be so widespread.

35

dh 08.17.09 at 1:41 am

Guys, I have never said that lying is good or that my view is based on lies etc. I have said tens of times that the US system is not perfect. I even gave my recommedations on how a sytem could work WITHOUT it being a UK or European system for healthcare. You continue to lump me and others with the extreme within the group that.

Richard, and that is why your unemplyment rate is higher and other nations outside of the US have higher unemployment rates. Higher taxes. I rather the government GIVE tax incentives to buy health insurance and for the poor to be able to afford it through tax credits as opposed tio RAISING taxes for a wacky system of long waits and rationing of care for particular services (that isn’t a lie but a fact).

36

Richard 08.17.09 at 7:31 am

Unemployment in Britain is higher than in the US. But is the difference worth crowing about? 4.6% in the US, 5.4% in the UK.
On a ‘wacky system of long waits and rationing’, see the article I linked in a previous comment

37

Tony Buglass 08.17.09 at 8:22 am

J -” “The NHS is funded entirely through central, national taxation”
Which is paid to, among others, hospitals. That’s called reimbursement.”

No, it’s called structural funding. Reimbursement suggests payment following expenditure; hospitals have budgets, they manage their budgets and do their jobs funded by money drawn from central, national taxation. Would you argue that a military unit is reimbursed for the fuel and ammunition expended in an operation? The word is inappropriate.

More precisely, Kim’s response to your comment about reimbursement implied money from outside the normal funding structures - especially payment offered by patients. Your comment now seems to be using the word in a different context - it’s not talking about the same thing.

38

Kim 08.17.09 at 9:31 am

Your comment now seems to be using the word in a different context - it’s not talking about the same thing.

J either knows that, in which case he is a knave; or he doesn’t, in which case he is a fool.

39

Beth 08.17.09 at 9:47 am

“a wacky system of long waits and rationing of care for particular services (that isn’t a lie but a fact).”

“Wacky”, of course, is a value judgement, not a fact. I consider your system immoral, you consider mine wacky. Given the choice, I’d vote for wacky.

40

John Cooper 08.17.09 at 7:32 pm

why resort to lies you ask?

Because someone wishes to redistribute power. The moment you try and move power away from an elite to the masses the elite raise merry hell/the contents of revelation to try and stop that.

In this case the power is the power of access to healthcare

a) Pharmicuticals etc only see it as financial buisness and worry about potential loss of income

b) Rich individuals worry about having to wait for someone poorer to gain access when in every other area of life money would steamroller over need

c) Hospitals can be concerned about lack of funds - an honesty worry when change occurs

The problem is - the number of people without access to healthcare is huge and it is upto the President to sort this out.

Free healthcare for all is a tax worth paying if it means the state delivers life, rather than officiates until death.

Oh yes that was it - tax.

Those with money can’t understand why those without can’t afford it. Therefore don’t wish their taxes to pay for others to be treated.

However they are happy for their taxes to be invested in killing people thousands of miles away, but that is a whole other story…

With Regards

John

41

Kim 08.17.09 at 9:18 pm

Ain’t it the truth.

42

PamBG 08.18.09 at 1:44 am

I understand that you guys find it horribly unseemly for a hospital to discuss payment with a patient, but I really can’t help you with that one.

I want a healthcare system whose reason for existing is to heal people.

What we have at the moment is a healthcare system whose reason for existence is to make profits.

I want to live in a society which thinks that healthcare is a basic human right and not first and foremost a money-making opportunity.

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