Socialized Medicine Sucks – Post 2

I’m so thankful I live in the United States of America. I used to say this a lot when Gina was first diagnosed with breast cancer. Now I’m chanting it again.

Why am I so happy? I’m happy because we currently have access to the best healthcare system in the world.

I know…this is political territory, but please let me explain.

When it comes to healthcare you can have two out of any three of the following:

  1. Universal Access (immediate access to care regardless of an individual’s “coverage”)
  2. High Quality Care (the latest procedures, best standard of care and newly developed drugs)
  3. Affordability (Low cost, not dependent on an individual’s ability to pay and/or fully governmentally subsidized healthcare)

Unfortunately, you can’t have all three – as a society we must pick two of these and live with them.

Just like everyone can’t live in a world where everyone gets everything that they want all the time for free – that’s called a fantasy.

But why is it that we can’t have all three and must choose only two you may ask?

Economics. The basics of Supply and Demand along with human nature and our desire for excellent health and also remuneration for investment risk (investment of time and/or money) and services provided.

We have currently decided in the US which two we’ll take. We have 1 and 2.

In the US there is Universal Access to Healthcare, and it is of the highest quality on the planet.

If you don’t believe me then point me to another system anywhere in the world where poor people regardless of their ability to pay can walk in to Memorial Sloan Kettering Cancer Center and receive world class treatment immediately, while other poor people can go on Medicaid and receive world class gender re-assignment therapy (nearly immediately) at institutions like UCSF Medical center – all while we can pick our own gynecologists, orthopedists, internists and receive breast implants as long as we pay in cash or sign on the dotted line for the plastic surgery.

Is this a perfect system?

No. It is costly as hell. That’s one of the reasons why we keep spending more and more on healthcare every year at the federal level and why private health insurance premiums keep going up.

But it does work.

At least it works far better than foregoing number 1 and choosing 2 and 3 (like Canada).

Let’s look to our neighbor to the north where they have chosen 2 and 3.

But you say, “Bill. Canada has Universal Healthcare. Doesn’t that mean that they also have Universal Access?”

No. It does not.

In Canada you have to wait in line while your cancer goes from Stage I to III and beyond before you can actually be treated.

Just ask this young, 33-year-old mother with anal cancer.

If Canada’s system, choosing numbers 2 and 3 isn’t the right choice, then how about picking numbers 1 and 3?

That’s what places like Cuba have.

In Cuba there is absolute Universal Access to healthcare. But the solution for many people’s illnesses like cancer in Cuba is Ibuprofen and morphine. They’re not interested at that point in curing you. That is expensive. They can’t afford to use high quality (and high cost) drugs like we have in the US.

Instead, in Cuba they make you comfortable while you die.

Options 1 & 3 and 2 & 3 really end up being a life and death choice (the choice of death for any serious illness) over the choice of 1 & 2 (what we have in the good ‘ol US of A).

I thank God that I live in the US every day, and now more than ever.

The cost of our healthcare will mean that Gina and I may lose our home.

We already have lost our savings. But…that’s ok.

Gina and I CAN LIVE with that outcome.

What we can’t do without is Immediate Access to High Quality healthcare.

Without that she and I would be leaving Will, Andrew and James all alone.

Tomorrow’s blog post will pick up the story from here.


7,207 Replies to “Socialized Medicine Sucks – Post 2”

  1. I Love that while you are fighting for your life… you do research to help the rest of us understand things like this . You are amazing Bill McDade. Always have been . Thank you for this uplifting blog. I’m sending you all the positive energy in the world. Love you ❤️

    1. Thank you for your reply, Tami. You are the first!!! Extra gold stars for you. I really appreciate the love and support.

  2. Cancer does not discriminate, whether you are a Republican or a Democrat, cancer is the true enemy. We must all come together and use all our resources to try and combat this horrible disease. Bill my thoughts and prayers are with you, Gina and the kids. You got this, cancer stands no shot against McDaddy!

    1. Thank you so much, Dean. I know that you’ve had your own direct experience with this.
      I’m not sure what’s coming, but i’ll Do my best. Cheers, -Bill

  3. Bill – good luck with your fight! Hugs and prayers. However I have to say that people in the United Stares are turned down for care frequently for lack of ability to pay. If you are having an emergency then you must be treated but if you have a long term chronic disease like cancer there is absolutely no obligation for hospitals and doctors to treat you. My uncle is a doctor my mother was a nurse practitioner and I have many friends who work in the medical industry. It is a sad testament to our system. I don’t advocate universal access but our system is broken. There are many reasons for high costs and many of them could be fixed but won’t be because of political power.

    1. Hi Natalie, Thank for for the good wishes.

      You are both correct and incorrect when you say that people are turned down for care in the United States.

      Let’s be clear about how our system actually works, because there are many many more opportunities for excellent care in our system than there are in any other system or country.

      In order to receive care in the US, the provider has to agree to see you. One of the major stumbling blocks to getting seen is how you plan to settle your bill.

      This isn’t that different from how we handle food in this country. In order to get fed, everyone needs to pay first.

      If you’re wealthy and have plenty of money then you can feed yourself and your family almost any way you want. You can buy groceries or even organic food. You can take the kids out to fast food (if you can handle the guilt). You can drop by your local church’s fish fry on Lent. Or you can make a reservation in a fancy restaurant. Your options are limitled only by what is being offered.

      If you are among the poorest of the people in the country, then your options are restricted by what you decide that you can afford, but you still can get fed. You can go to a soup kitchen. You can get on food stamps and buy groceries. You can spange (beg for spare change) for an hour or two and then use that money to purchase food. You can collect bottles and cans in return for cash (in big cities I notice many older Chinese immigrants doing this). Or you can sell your food stamps and buy fast food. It’s all up to you. But you will not starve.

      Access to Healthcare in the US works much in the same way except that we’ve even included a law that forces fancy restaurants to serve anyone in an emergency. – EMTLA.

      Under EMTLA no hospital, public or private, can refuse the same high quality care that they would give to a paying customer in an emergency to any poor patient that can’t pay.

      This is why we don’t see (thank god) cripple poor children permanently relegated to using crutches for the rest of their lives because they broke an ankle that no one would fix/set without a cash payment.

      But not everything is an emergency. Private hospitals are allowed to refuse care to individuals who can’t or won’t pay. Instead those patients must go to a public hospital where sometimes care is not as good and sometimes care is even better for treatment.

      BTW – in moving from the private hospital system over to the public hospital we are seeing, essentially, a switching from a system run for public benefit, privately to a governmentally run system.

      If you don’t like the idea of having to use the public hospital, then this supports my argument for NOT moving to a single payer universal system as that system would only have the Public Hospital as an option. The government would run everything. We do have one of those systems in the US, it’s called the VA and not very appealing.

      But in the US we also have Medicaid that picks up the cost of non-emergency healthcare for the poor that are not covered either by a private health insurance policy or our system for the elderly, Medicare. This system is not perfect, but public doctors may not refuse care to those on Medicaid. This does NOT mean that those people are always seen in a timely fashion or that they always get the highest quality of care, but the system does provide care.

      That’s why our system continues to be the best in the world. For the millions and millions of people covered by Medicare and private health insurance, care is not refused, but people need to advocate for themselves in order to get the best care. For the poor who’ve fallen through the cracks in our society, we provide Medicaid (and also a lot of other charitable contributions) and for the most part those people receive as good care as you’d get in a place like the UK or Canada or better care.

      What we don’t want to do in the US is screw up our system completely by following one of the failed models of socialized medicine. That would literally halt innovation in drug research for the world and ensure that we would all receive much worse healthcare.

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