I often see conservative writings about Democratic proposals warn about how they risk making the United States more like Europe. To conservatives, Europe is a mass of socialism as described in an old Ayn Rand novel with economies doomed to forever fall behind the economy of the United States.
This is one conservative meme which should be retired. This also provides an amusing landmark to be reached under George Bush. The conservative Times of London reports that living standards in the United Kingdom has surpassed that of the United States:
LIVING standards in Britain are set to rise above those in America for the first time since the 19th century, according to a report by the respected Oxford Economics consultancy.
The calculations suggest that, measured by gross domestic product per capita, Britain can now hold its head up high in the economic stakes after more than a century of playing second fiddle to the Americans.
It says that GDP per head in Britain will be £23,500 this year, compared with £23,250 in America, reflecting not only the strength of the pound against the dollar but also the UK economy’s record run of growth and rising incomes going back to the early 1990s.
In those days, according to Oxford Economics, Britain’s GDP per capita was 34% below that in America, 33% less than in Germany and 26% lower than in France. Now, not only have average incomes crept above those in America but they are more than 8% above France (£21,700) and Germany (£21,665).
“The past 15 years have seen a dramatic change in the UK’s economic performance and its position in the world economy,” said Adrian Cooper, managing director of Oxford Economics. “No longer are we the ‘sick man of Europe’. Indeed, our calculations suggest that UK living standards are now a match for those of the US.”
Although many people will be surprised by the figures, Americans have long complained that average incomes have been stagnant in their country. One often-quoted statistical comparison suggests that in real terms the median male full-time salary in America is no higher now than it was in the 1970s.
Plus, even though the system might not be the model I’d advocate, they all have access to health care.
You’re kidding about the healthcare, right? The NHS is telling women they aren’t giving out pain medication for labor because it’s too expensive. They don’t have the newest cancer medications. Waits so long for procedures that the British invented the “surgery holiday” (I guess that’s what they are doing with all that extra time off they get). This isn’t to mention the other inconveniences associated with the NHS. If that’s a higher standard of living, they can have it.
The UK doesn’t have a massive illegal immigration problem to deal with. No doubt, illegal immigrants were included in the survey and vastly skewed the results.
Plus, we share a border with Mexico. Border towns like Calexico, McCallen, Brownsville, and Chula Vista, have massive poverty centers, which also could have greatly skewed the results. There are whole towns now in extreme southern Texas and southern Arizona and California, made up entirely of illegal aliens. They are greatly impoverished. They’re like mini-Mexicos on this side of the border.
No doubt they were included in the surveys.
Eric,
Spoken like a true conservative, blaming everything these days on illegal immigrants. I’m not sure which way the skew the results. They could also skew the results by inflating the standard of living of Americans who use illegal immigrants for cheap labor.
Sharon,
“You’re kidding about the healthcare, right?”
That’s why I said “the system might not be the model I’d advocate.” It still says something that they could afford any system which covers everyone without it creating a tax burden which cripples the economy so badly that that they have a lower standard of living than us. It is particularly impressive that they could create any type of system while still rebuilding from World War II. As we have a much stronger system in place to begin with, we can work towards making health care affordable for all without resorting the the UK model.
The problems in Western Europe come from adapting a system different from both US and USSR systems to the US model. A Soviet victory in the Cold War, ironically, might have been better for Europe in that regard.
Unfortunately, Eric, you are wrong about the illegal immigration problem in Europe. They have a huge problem, as well as problems with those from the newer EU countries like Poland and Romania coming in. They also have problems with Muslim immigrants who are increasingly fundamentalist. Entire areas of England are almost a “no go” for non-Muslims, acording to the Pakistani born Archbishop of the Anglican Church,Michael Nazir-Ali in today’s BBC online.
In addition, mainy medical services we take for granted in the USA are unavailable in the UK due to cost cutting measures. I suffered from breast cancer 10 years ago and was on tamoxifen for 5 years thereafter. In England, women are fighting for and being denied these life saving drugs by the NHS, and having to pay for it out of their own pockets. they also pay a huge amount of taxes. The NHS is not “free” by any means. Someone has to pay for it, and it is YOU who pays for it.
So Eric Dondero doesn’t think the UK has an illegal immigration problem. That kinda proves the sub-text of the article: US conservatives just don’t know what they are talking about. Look at Sharon’s urban legends about the NHS!
It’s a bit rich coming from the land where a teenager recently died after being denied a liver transplant by her private health insurer because it was seen as ‘experimental treatment’.
Sharon… please explain how these problems are worse than a young woman dying because the health insurance company denied her treatment but finally capitulated when it was too late.
Ron… when backed into a corner and a ll else fails, blame the brown people.
[I assume you meant to say Eric, who made that argument, not me–Ron]
Wingnuts are running out of excuses for supporting failed and destructive policies.
“The UK doesn’t have a massive illegal immigration problem to deal with.”
Er…. WRONG!!!!
Sorry Ron… I meant Eric in my previous post.
Sharon… please explain how these problems are worse than a young woman dying because the health insurance company denied her treatment but finally capitulated when it was too late.
Eric… when backed into a corner and a ll else fails, blame the brown people.
Wingnuts are running out of excuses for supporting failed and destructive policies.
in the UK, people pay up to 40% of their income to taxes. Is that free? I think not. Undoubtedly, the Cigna liver transplant case was not fair. However, the young womaan had been in a vegetative state for weeks prior to their denying the claim,and it is not at all clear she would have survived. Was it cruel and cold hearted on cigna’s part? Perhaps. I am not willing to say until i know all the facts. What I do know is, she might not have gotten that liver transplant in the UK under the NHS (or “socialized” system of medicine), either, as the NHS often turns down treatments based on cost and risk. that’s why many people who need transplants, both from the USA and the UK, go to places like India to get it done. And, ultimately, again, I say, it is NOT FREE. You, the tax payer, pay for it, and they pay a huge amount of tax. in Austria, they pay even more, almost 50% of their income in taxes, to support their social services.
The entire intellectual trajectory of the conservative movement has been on a steep downward slide since the GOP bought into David Horowitz’s model of cultural warfare…. which is basically a retooling of outdated radical marxist tactics.
The whole party bought into that opportunistic huckster and now are suffering miserably because of it. Considering that Horowitz used to be committed to the destruction of the USA… it makes you wonder if his dreams haven’t come true in a perverted sort of way. He was a jackass in the sixties… and a jackass now.
His theory: You just scream your ideology loudly and aggressively… cry discrimination when someone challenges you… and then discriminate against everyone who disagrees.
Mags,
High taxes if viewed in a vacuum are not desirable. I’m certainly not calling for an imitation of everything done in the UK. However it is worth noting the overall standard of living.
Nobody likes paying taxes, but what really matters in the end is how much money you have left and the standard of living you can have on it. (That’s looking at life from a purely materialistic view for the sake of discussion–obviously on other levels other things matter too). From a purely economic point of view, I’d rather pay a higher tax rate if it meant having the benefits of a higher standard of living.
Just a note about cancer. In America, cancer is one of thee most heavily subsidized areas of research and treatment. That is, America is good at cancer treatment because we put so much tax money into it.
However, the young womaan had been in a vegetative state for weeks prior to their denying the claim,and it is not at all clear she would have survived. Was it cruel and cold hearted on cigna’s part? Perhaps. I am not willing to say until i know all the facts.
Gee, I wonder what your stance was in the Terri Schiavo case, and if it was so non-commital then….So much for valuing all human life…
I’m not sure what Mags’ point is. Yes, the top rate of tax in the UK is 40%. Though most pay less. Nevertheless, survey after survey shows that the UK public would be willing to pay 1 or 2% more if that money was hypothecated for health.
Much as we Brits are grateful for Mags’ concern for the welfare of our wallets, we are more concerned about the welfare of our health system.
Mags,
Considering that 1 out of every 4 health care dollars in the US goes to insurance companies, that tired old “more tax” argument just doesn’t hold up. It’s what you get for your money that counts. Medicare only takes 2-8% in overhead, not 22-27%. Plus if everyone was covered, businesses would no longer have to pay for Workman’s Comp and and medical awards in lawsuits would be greatly reduced.
Plus, ever notice how the majority in Europe like their system of government? Capitalism and socialism are tools to be applied for the best solutions to any given situation and not meant to be dogmatic religions run by rabid ideologues.
Needs to be said again:
“America is good at cancer treatment because we put so much tax money into it.” MrWebster
Rick,
Right or wrong, the political realities are that we are likely to continue with our non-government insurance system–and hopefully will fix some of the problems. Unfortunately many will look purely at Mags’ numbers and the tax rate, but simultaneously ignore how much money our current system costs when this money isn’t paid out of tax dollars.
Ron, one problem is that if the pound falls significantly against othe currenies, it would push britain’s living standards back down the ladder. They are assuming, accordinging to the Times article, that the exchange rate is $2 to the pound, and in recent days it has slipped below that level.
In addition, Americans spend less in general, as prices are cheaper, so you have to adjust this for “purchasing power”. and in terms of purchasing power, well, Americans do far better, and they pay far less tax.
However, the British typically have significantly longer holidays than Americans as well as access to “free” healthcare, if you want to call it “free”.If you call paying up to 40% of your income “free”, then fine. its free.
i doubt the increase in standard of living is going to be noticeable to most British people who are already paying record amounts for gas and heating bills this year, in addition to being taxed to death to pay for all these services. Finally, its almost impossible to sue in the NHS and you don’t have a choice of which doctor you go to or which hospital. You take what they give you, and if they deny you a drug or a procedure (be it a liver transplant or, in my case, a proven life saving drug treatment for breast cancer, tamoxifen), that’s that. you can’t fight it. yes, our private system has serious problems. I don’t deny that. But I think we should fix the system we’ve got, not switch to socialized medicine.
“America is good at cancer treatment because we put so much tax money into it.”
It would certainly be inaccurate, as some conservatives do, to portray it as a choice of a free market versus government system. There is certainly a lot of government involvement in our system, and a tremendous number of people already are covered by government programs.
I’m just wondering, are any of you know-it-alls actually interested in hearing from someone who suffered under the dreaded ‘socialized medicine’ for 30 years?
I lived most of my adult life in Canada before returning to the United States 4 years ago. My totally subjective (based on personal experience, nothing more) take is that you’d have to have rocks in your head to prefer what passes for “health insurance” in America over the Canadian system. There are no co-pays. There are no ‘pre-existing conditions.’ You don’t make insurance claims or deal with insurance companies in any way, you simply go to the doctor (or the hospital) and get what you need.
Are there waiting lists for surgery? Yes. For ELECTIVE surgery. If I’ve suffered a heart attack and need a bypass, I go to the top of the list and the surgery is tomorrow at three. If I need some varicose veins fixed, I go on a waiting list (I had this done and had to wait three months). If I want a face lift, that’s coming out of my own pocket.
Waiting lists for specialists? It takes me longer to get in here than it did in Canada. An appoinment with my Canadian GP was usually the next day, sometimes same day.
Choose your own doctor? Sure. I can’t choose my own doctor HERE! I have to pick from my HMOs ‘in network’ list.
For this I paid $54 a month. If I made less than $22,000 a year I paid nothing.
Were my taxes higher? Sure, but not $329 a month higher, which is what I pay for ‘health insurance’ here so inadequate it would get any Canadian politician run out of office.
Is the system perfect? No. But if you suggested to Canadians that they switch to the American one, they’d burn you at the stake.
The thing that annoys me the most about this issue is the amazing, pigheaded ignorance some of you people display about how these things are done in the civilized world. There is not some monolithic “socialized” system, where the government controls everything and doctors work for the state. The British come closest, which is why the NHS sucks (although it still beats what we have here, unless you’re upper middle class or better). The rest of the world uses various combinations of public/ private partnerships. In Canada, the system works much like it does here, with doctors as independant businessmen running their own practices and a combination of federal and provincial (state) governments picking up the tab. In other words, the government doesn’t RUN healthcare (as the scaremongers would have it), the government PAYS FOR IT.
The big difference is, we’re the only country in the world that allows private insurance to deliver basic, primary care. This is a blaringly obvious conflict of interest, since the best (and easiest) way for insurance companies to maximize profits is to deny claims.
Putting up with that is insane.
Mags,
“its almost impossible to sue in the NHS and you don’t have a choice of which doctor you go to or which hospital.”
Again, that’s why I noted that the British system isn’t the one I’d advocate. However, being almost impossible to sue sometimes doesn’t sound so bad when we look at the malpractice problem here. That’s going to far in the other direction, but it sounds like something conservatives would support.
I don’t mean this to argue that the system of government is better in the UK or that they necessarily are even better off. It is simply a matter of looking at facts as opposed to the meme that is too frequently repeated by conservatives that any government program is bad because it will make us like Europe. This shows that perhaps being like Europe isn’t an argument against a program. Even if conservatives are right that a particular case of government action is bad, the claim that it risks making us like Europe is a weak argument.
Good point, Ron. But do you know anything about our veterans administration? perhaps you should look into how well our Veterans Administration hospitals, all government run, are doing. You might be shocked to find out our government isn’t doing such a hot job, and that’s with our veterans! (as the recent incidents with Walter Reed Army hospital have brought to light). I’m not arguing definitively for or against one system or another, just positing the question.
Mags wrote:
” Finally, its almost impossible to sue in the NHS and you don’t have a choice of which doctor you go to or which hospital. You take what they give you, and if they deny you a drug or a procedure (be it a liver transplant or, in my case, a proven life saving drug treatment for breast cancer, tamoxifen), that’s that. you can’t fight it. yes, our private system has serious problems. I don’t deny that. But I think we should fix the system we’ve got, not switch to socialized medicine. ”
Please note my comment above. Most people in America don’t have a choice in these things as well.Our hospitals and doctors are chosen for us by our HMO. You can argue that we have a choice if we’re rich enough to pay, but what kind of choice is that? If the queen had balls, she could ‘choose’ to be king.
And once again, you haul out the old monolithic “socialized medicine” trope. The NHS is but one of a wide variety of systems in the world, and probably the worst of the lot (though debatably better than ours, depending on your income). Until you educate yourself on these matters, your arguments will continue to have no merit.
Mags,
Yes, there are problems with the Veterans Administration, but, like the UK’s system, this is not a model I’d advocate. In many ways the VA comes closest to the UK’s system. On the other hand, many people are covered by Medicare, which provides care far more economically than private insurances. One advantage of Medicare, as compared to both the VA and the UK, is that the government handles the financing but doesn’t attempt to directly provide medical care.
Once agin I have to question Mags’ knowledge.
First, Brits are not paying “record amounts for gas and heating bills this year” on the contrary, it’s been reasonably cheap. One supplier (privatised, I hasten to add) has just announced a 15% increase. Others are likely to follow.
Secondly, we are not “taxed to death”. Might I assume that Mags is a UK conservative? Bevause that is a conservative talking-point.
Our system is that your own local Doctor (who you choose) will refer you to a specialist and a hospital. Usually it is the best person. So choice is ephemeral.
Finally, tamoxifen may not be the most appropriate treatment. Both my mother and wife have suffered from breast-cancer. Neither have been given tamoxifen. But they have been given all possible help, assistance, and treatment. Tamoxifen is not a magic bullet and I refuse to believe that it would not be prescribed for someone who needed it and would benefit from it.
Mags wrote:
“Good point, Ron. But do you know anything about our veterans administration? perhaps you should look into how well our Veterans Administration hospitals, all government run, are doing. You might be shocked to find out our government isn’t doing such a hot job, and that’s with our veterans! (as the recent incidents with Walter Reed Army hospital have brought to light). I’m not arguing definitively for or against one system or another, just positing the question.”
Good questions. Here’s a couple of answers:
1. Not all ‘socialized’ medical care systems (that would be “everybody but us”) feature “government run” hospitals.
2. I’m old enough to remember when the United States did things like run VA hospitals very well indeed, before the small-government ideologues got their hands on things.
Here’s a question for you. Canada is a democracy. If their system of “socialized medicine” is such a disaster, why has no Canadian politician ever run on a platform of scrapping it for an American one?
Answer: It would be political suicide. Canadians can see what a brain-dead disaster we have, and they want no part of it.
John,
“Most people in America don’t have a choice in these things as well.Our hospitals and doctors are chosen for us by our HMO.”
This varies. HMO’s are stronger in different parts of the country, and HMO’s vary based upon how much choice people effectively have. Most people, including most on Medicare, can either chose their doctor without any restrictions or can choose from the vast majority of doctors in an area.
Per your previous comment, the use of denials by insurance companies to save money also varies. The vast majority of claims are not denied for such motivations, which is why there isn’t a massive public outcry against the insurance companies. However it still does happen way too often, which requires some action.
“The NHS is but one of a wide variety of systems in the world, and probably the worst of the lot (though debatably better than ours, depending on your income).”
Yes, it is probably among the worst (again the reason for my qualification in the post.) Our system is better for most people who can afford private care, but the NHS system is definitely better than the status quo for those who are uninsured, as well as a significant number of people’s whose insurance coverage is extremely poor.
“Yes, it is probably among the worst”
It absolutely is not. For most people most of the time it is everything they need. No whistles, no bells, but good, honest treatment.
Some recent problems, such as hospital infections, can be directly traced to the (C)conservative policies of privatising services such as laundry, food and cleaning and ending up with the lowest-tender bids being accepted, regardless of quality.
Can it get better? Yes. It’s far from perfect. But recent innovations, such as drop-in clinics have made a big difference.
Now, as a USian in Europe (and thus happy to hear the result), I’ve still got to say in name of honesty, that these ‘living standard’ comparisons are basically pointless. Take an American and a Brit and go see who can buy the most stuff on the Ginza in Tokyo.. It doesn’t quite work due to the currency fluctuations.
E.g. when the dollar goes down, Americans can’t afford to buy as much imported rice. Thus they’re supposedly ‘poorer’ even though they can afford just as much domestic pasta as before. Is that a big change in their quality of life? Hardly.
Personally, I’ve got my own metric. Take your average middle-class Joe and move him to Europe. Or vice-versa. Let them live there for a year or two, then ask ’em if they think they’ve experienced any major difference in their overall quality of life. And I assure you, the vast majority will say ‘No’.
In my experience, there Americans that are convinced Europe is somehow fundamentally flawed usually haven’t even been there.
Svendem,
Agree that the numerical comparisons aren’t the real issue, but they do point out that the conservative argument against Europe doesn’t hold up very well. Your example is in a way more meaningful, but is not something we can do. At least we can compare the numbers to debunk that point.
@Mags,
Stop with the “up to 40%”. We’re not innumerate and that type of hack disingenuousness fools nobody.
You’re also comparing tax rates in the UK, which include the cost of health care, to tax rates in the US, which don’t. Consider that the average US family of four pays 2,800 dollars in health care premiums and out of pocket expenses a year. The same family pays about 7,500 dollars a year in taxes. That means a health care system funded by taxes even 30% higher would be a good deal for the average family. Not to mention the 40 million americans without healthcare.
@Ron Chusid
I’m willing to defend the VA. Here’s why:
http://content.nejm.org/cgi/content/abstract/348/22/2218
also
Link
The VA does a pretty good job. It gets a lot of bad press for largely ideological reasons, but when it comes down to emperical, testable metrics it shows its worth.
Ron Chusid wrote:
“Per your previous comment, the use of denials by insurance companies to save money also varies. The vast majority of claims are not denied for such motivations, which is why there isn’t a massive public outcry against the insurance companies. However it still does happen way too often, which requires some action.”
That’s a very America-centric viewpoint. It may happen here “way too often” but it doesn’t happen anywhere else at all, because private insurance is ot involved in the equation. Some people try for equivalency by pointing out that government funded healthcare is sometimes rationed by money shortages, and that’s true, but the arguments against single-payer heathcare are almost always ideologically based (hthey can’t be results based, because our comparative results suck). Somehow a denial of care due due lack of resourses or funding is ‘evil socialism,’ but a denial of care for the sake of profit is simply the ‘wisdom of the marketplace.’ There’s a big difference of course. In the free enterprise model, denial of care isn’t a bug. It’s a feature.
There isn’t a ‘massive outcry against insurance companies’ because most Americans buy into the scaremongering, misinformation-peddling “Harry and Louise” propaganda, and are terrified of losing what little coverage they have. To paraphrase the commenter above, let most Americans live under any other civilized nations healthcare for a year. Very few would come back.
John,
If there was really this widespread a problem with insurance, then the Harry and Louise commercials wouldn’t have had any effect. The majority of people don’t have this type of problem with their insurance. The vast majority of insurance claims I deal with are promptly paid without any problem.
Both sides use over-generalizations. The conservatives who attack any plan as being European, and exaggerate problems there are incorrect. However you are making the same type of mistake when you exaggerate the frequency of problems here and over-generalize them as representative of the system.
Both systems have their pluses and minuses, and it doesn’t help discussion of them to exaggerate them (or to deny them).
“To paraphrase the commenter above, let most Americans live under any other civilized nations healthcare for a year. Very few would come back.”
Or to look at another comment here, as Svendem writes, despite the differences in systems people going from one to the other aren’t going to see a vast difference.
Adam,
That’s a flawed analysis. Measurements of quality are currently very primitive and those of us who actually work with them know they are full of errors. Measurements of quality currently really measure who can best provide data to show some good things. As the VA has computerized they have been in a situation to make their system look much better than it really is. Those who us who are actually involved in health care and see what the VA does are not going to be fooled by such numbers when they conflict with the reality we see.
I wouldn’t put much stock on anything Krugman writes about health care. He’s a columnist without personal experience in the field and takes the facts which support his political views. He often makes errors in writing about health care.
Ron Chusid wrote:
“The majority of people don’t have this type of problem with their insurance. The vast majority of insurance claims I deal with are promptly paid without any problem.”
Unfortunately, I seem to be standing outside the ‘vast majority’ then, since I suffer from a ‘pre-existing’ condition which my insurance company refuses to treat.
You’re again missing my point, which is that problems which exist in the rest of the world as glitches in the system (denial or delay of treatment due to lack of funding and/or physicians) are in fact built in features of the private insurance based model. There is an inherent conflict of interest between the interests of the patient (health care) and the insurance company and it’s stockholders. You seem to be suggesting that if insurance companies act in good faith this would not be a problem. I’m suggesting that removing them entirely eliminates the temptation to weasel out of paying claims.
The argument we’re having is one of perspective, and since yours is an American one I’m not surprised that this is difficult. You seem to be suggesting that with a little fine tuning and good will, these problems will be less severe. For me, having lived for years with a system where they don’t even exist, it’s hard to understand why you would want to keep them around.
A ‘reasonable’ discussion about health care reform in America always looks to me like putting lipstick on a pig. The idea that we might want to cherrypick ideas from countries that spend fewer overall dollars and get better outcomes than us (but, strangely, do not include private insurance companies in the delivery of basic care) is apparently ‘politically impractical.
Any ideas on why that might be?
“The argument we’re having is one of perspective, and since yours is an American one I’m not surprised that this is difficult. You seem to be suggesting that with a little fine tuning and good will, these problems will be less severe. For me, having lived for years with a system where they don’t even exist, it’s hard to understand why you would want to keep them around.”
Maybe these problems don’t exist, but others do. Regardless, elimination of the current system isn’t going to be accepted politically, largely because the majority of people are happy with their coverage. Preexisting conditions is one problem, but this is dealt with by current proposals which still maintain the private insurance system.
Today’s Uk Daily Mail has an article about exactly the situation I found myself in 7 years ago while living in Sunbury on Thames, England with my English husband (i’m American). My radiation treatment and masectomy were covered, and I had excellent care in the NHS hospital. But the drugs that could prolongue my life were denied. I am still alive today, and I thank our US system, which didn’t hesitate to provide me with tamoxifen. these women are now suiing the NHS, as they have paid into the system for years and years and fully expected to get the best care and the mostcutting edge treatments if they ever got sick. This is well worth a read, especially for the comments of the English readers who live under this system and have to deal with its inadequacies.
Link
Other than for cases of preexisting conditions I doubt anyone would have any problems having tamoxifen covered in the US. That assumes they have prescription coverage, which many people do not. For whatever its worth, the cost of tamoxifen used as adjuvant treatment (currently recommended for five years) is $16.99 per Epocrates. Local pharmacy prices vary tremendously. The cost is also higher when used for other indications at higher doses.
For people on Medicare we also have a strange system with regards to chemotherapy. Even before Medicare included prescriptions they would pay for IV medications, including chemotherapy. There were probably many people who received coverage for IV chemo but not tamoxifen. (Even before Medicare included prescriptions, which is done with a system of private insurance plans, many people had secondary insurance which may or may not have included prescription coverage. (Most people over 65 and as well as some who are disabled, are on Medicare.)
Hey, I’m new to this forum/blog, but I read the article and all the responses.
Lots of good points made (not by the conservatives), but I feel I should comment on one particular thing. The argument about VA is misguided. If I hear one more person claim that the “Walter Reed” scandal proves ANYTHING about “VA” system, I will have to, I dunno, get mad or something. Walter Reed is NOT a “VA” hospital. It is an Army Medical Center. It is part of the Active Army medical system. The victims of the scandal were not “veterans”, they were still active duty soldiers, subject to Army control. They were being HOUSED in bad conditions and being treated badly in their medical holdover type unit, NOT receiving bad medical care itself. And as a vet myself, I can tell you that the Army is notorious for housing soldiers in sub-standard conditions with no qualms at all. So, the Walter Reed thing proves absolutely NOTHING.
That being said, I can also tell you that the VA itself, from personal experience only, was EXCELLENT. I had ZERO complaints. They treated me better than I’ve ever been treated by the private system. They gave me more treatment than I even thought that I was legitimately entitled to. I don’t use it much anymore, as I now have employer provided healthcare and don’t feel like I should use taxpayer provided healthcare when others could use it so much more than me, but if there are new problems popping up I can guarantee you it is simply that the idiots in power didn’t plan for this war properly and are being overwhelmed with the numbers of wounded vets. That is NO argument against the system itself.
I’ll end with this. One of my doctors at VA actually told me – and this guy was an old Navy doc, very military, probably Republican – that he preferred the system because he himself liked the idea that he could just treat patients without the interference of insurance companies. He also said, when I asked him why I was getting such good care, that as much as he hated to admit it, he gave the credit to Bill Clinton for pushing for better funding, etc.
Bottom line all of you conservatives: healthcare is a human right. Let capitalism decide what kind of car or toothpaste you get, that’s fine. But healthcare is a right.
Peace.
Lisa,
As is the case with so many matters which get politicized, the truth about the VA is somewhere between the attacks from the right and those on the left which cite it as a perfect example based upon some quality measures.
I’ve had patients experience a number of different VA hospitals and, not surprisingly, it does sound like there is variation from place to place.
One problem is that patients often do not realize whether they are getting good care or not. If you receive treatment at the VA you might not realize any deficiencies if they did exist.
My impression of the VA has fallen from a number of experiences. This includes their unwillingness to cover statins for patients with a history of diabetes and heart disease to lower their LDL under 100, but the standard of care is to lower the LDL to under 70 to achieve regression of atherosclerosis They are also reluctant to cover glitazones in diabetics who require them. When they do cover them they cover Avandia as opposed to Actos because the cost is lower, but Avandia appears to carry cardiac risks which Actos does not. They are also often unwilling to cover other medications which I have no problem getting for patients in private plans when indicated. Unfortunately patients do not realize when they are being denied the best drug for their problems in favor of a less expensive one.
For someone without health insurance in the U.S., the chance of getting care at the VA would look pretty good.
In any case, whoever quotes waiting times, etc. in the U.S. without taking account of the fact that we have 47 million who (conveniently) remain uncounted, is a complete charlatan.
Regards the VA: comments regarding them not providing statin drugs to diabetics – that is hooey – I am a diabetic and on simvastatin – covered by VA. I am not using “pills” but insulin for my diabetes.
However, it is not the VA’s complete fault with some drugs – the VA, unlike Medicare, can negotiate with drug companies for prices – and since they will purchase very large quantities – they should get good prices. Unfortunately, some drug companies refuse to negotiate and will provide these drugs only at regular market cost – which the VA will not do. So don’t blame the VA.
If you really need to blame someone – blame Congress – since the VA gets a single pot of money each year – they have to work within that budget. If it is short – then yes, cost-cutting does go into effect. And with all the lack of planning and preparation for the inevitable casualties of the GWOT, the system is currently strained in several areas.
I have received care at several VA hospitals, as well as private ones when I had insurance. I must say that I have had different levels of care in both. I have had bad care in a private hospital, and I have had bad care (many years ago) in a VA hospital.
Under Clinton, the entire VA system was overhauled, and clinical research studies have recently been done that show that the VA is substantially improved, and in fact does as well or better than most large famous private hospitals.
For instance, MRSA (Multiple Resistant Staphylococcus Aureus). The CDC’s recommended that all hospitals test patients when they are admitted and when they are discharged. Admitted to isolate carriers of this bad bug and prevent transmission to other patients, and on discharge to make sure that isolation has worked and patients not positive have not become positive.
The VA is the ONLY system in the country that has instituted this policy, and their new case rate of MRSA has dropped from 27% to less than 7%. I don’t know about you, but if I don’t have a bad bug when I go into the hospital, I sure would prefer not to have one when I come out!
“Regards the VA: comments regarding them not providing statin drugs to diabetics – that is hooey – I am a diabetic and on simvastatin – covered by VA. I am not using “pills” but insulin for my diabetes.”
No, it is not hooey. You are demonstrating my point. I didn’t say that they don’t cover statins. I said they are using them suboptimally to save money. Simvastatin is a generic which they will cover, but they won’t cover the newer, more potent statins which many diabetics require. Are they getting your LDL under 70 with simvastatin? If they are, would they pay for a more expensive medication if your LDL did raise over 70?
Insulin is far less expensive than many other medications used for diabetes. Will pay for Actos, Januvia, or Byetta if one of these is better for you? Many people on insulin don’t even need insulin if treated with the newer medications. Others on insulin have their sugars much better controlled if combined with Actos to reduce insulin resistance. How tightly are they controlling your sugars. I’ve yet to see anyone from the VA whose diabetes was being treated properly. Of course patients are in no position to realize this, or to know that medications they are not receiving would do a better job.
Yes, this is largely because they can’t get a low enough cost, but people in other plans have access to many medication that people in the VA system do not.
The VA does do a good job in some areas, such as with MRSA. That is partially why some of the studies give them an exaggerated ranking. The problem is that they do a good job in some areas, but a terrible job in others that are not measured by the quality measures used in the study above.
By far the biggest investor into US medical research is the US Government; taxpayer money. The pharmas take the drugs to the market, and that costs a bomb too. But that bomb is still insignificant compared to the money spent by the NIH and the NSF.
The US is already spending huge tax dollars on health, it’s just that (mostly) only the rich have the privilege of access to the results. If you are talking cancer, this is unequivocally true.
It always gives me a good chuckle when i see americans deride the UK’s public health system and they always use such wonderfully loaded terms, “Socialised medicine”, which of course sounds like its run by Stalin and Kim Jong Il, and “40% tax rate” which is such a grossly unhelpful way to put it.
The fact is that if i get ill, and i do occasionally, i get an appointment the same day or the day after, i get drugs prescribed that day or if its something serious, i get the treatment i need quickly. I suffered from a cancerous growth in my sinus back when i was in college (thats 17-18 year old education to you), i got access to the specialist within a week, i had my first op the next week, the whole thing was sorted (benign growth, they just yanked it out) within the month. And i paid not a penny, money simply doesn’t come into it. I never have to fill in paperwork for insurance, i don’t have to sign up to anything, i get ill, and they fix me.
And yeah, there are queues for elective surgery, and yeah i can’t choose my own surgeon, big deal, i’d take this system over yours any day.
So tax. I pay tax so that my government and council can make nice shiny raods for me to drive on, so that i have street lighting in my street and so that if i get sick, i get healed quickly. I don’t pay anything like 40%. And i’d happily pay more if it went to health and education. You call it socialism, putting money into a collective pot to help out the community, but really its a sensible idea. Better than getting gouged by private companies.
As the UK’s system is government run, it isn’t so bad that it is referred to as socialized medicine. What I find much worse is when conservatives in the US refer to any plan with any government involvement as socialized medicine, even when they preserve the current system of private medical practices.
If Mags wants to be seen as anything other than a conservative partisan, she would do better than suggest that we all read the Über-conservative Daily Mail.
It’s like suggesting your British readers should get a balanced view of the US from Fox News.