Americans are not ready for socialized medicine
 

I think there are a lot of efficiencies to be gained by socializing medicine. However, I'm concerned that Americans just aren't ready for it. They've been spoiled for too long getting what they want, now. Wait until someone tells them no, you can't have your MRI of your knee because frankly, the government doesn't care if you're a future all-star of your city league over-40 basketball team. No, you can't have the newest blood pressure medicine because it costs 20x the amount of the old one that makes you a little more tired when you run. No, we're not doing another EKG today because you've been here 18 times this year for chest pain and it's never amounted to anything. No, we won't do a Vitamin B12 level to check out that tingling sensation in your toe. No, we're not going to keep your 80 yo father in the ICU for the next month hoping that he turns a corner.

I'm obviously talking about Americans with good insurance, but a lot of this applies to Medicaid patients, who in some cases, have the best insurance out there. But these Americans with good insurance are the ones in power and they're not going to stand for rationing. Any sort of socialized program akin to Europe or Canada is going to be extraordinarily expensive because of this.

If only we had monarchs.

Damn straight.

These is a key factor in "socializing" medicine, American penchant for consumption of medical resources. No proponent of socializing health care further will honestly discuss the rationing aspect because it is unpopular and every ninety year deserves quadruple bypass before the spine surgery, even though that ninety year has a drinking problem and smokes four packs.

Our consumption of health care far exceeds our ability to provide it to all. In France, the social cultural expectation amongst the populace is one of medications and avoiding surgery and expensive procedures.

For the US to experience the efficiencies of universal care will require a radical revolution of consumption and expectations. Obama and his kin are NOT purposefully educating the extreme changes which will be required.

I agree, on both points, but there's just no way Obama (or anyone else) can do a HillaryCare (or Canadian or UK) solution. It simply won't work in the US, not now, likely not ever.

The two biggest problems areas in US healthcare are insurance and Rx $$.

Competition between the private & public sectors on health insurance will help drive costs down, overall, and force the private insurers to become more efficient. No matter how successful the public insurance plan(s) might become, there will always be a market for private insurance, for supplemental insurance if nothing else.

Expectations in other nations of a completely egalitarian system won't be a problem here. Americans are used to the idea of paying extra for expedited or premium service. It's that way in air travel, sporting events, etc.

If you're the 40-something athlete & don't want to wait for your MRI, there's nothing preventing your from ponying up $$ to have it done sooner, or paying the supplemental insurance to get expedited service.

Regarding Big Pharma, why shouldn't the American public get the same price the Canadian public gets? If there is cost shifting on research funding, end it, make the Canucks & others share the costs. Right now Big Pharma sticks it to the American consumer because they can.

Wait til spring. They're migrating south this time of year.

Some of them migrate to the Pacific Grove area next to Monterey. It is very cool to see thousands of them wintering there.

I can't count the number of times I have said this. I see it all the time in my job. The military healthcare is essentially socialized medicine, and we have to ration healthcare (to some degree). We cannot provide all of the services that our beneficiaries demand so we have to send them out to the civilian sector for care. We can't support the demands of the American public.

I agree with you, ERCougar. I heard an academic cardiologist the other day saying that Medicare should start requiring proof that patients have failed a course of medical therapy for angina before providing coverage for angioplasty and stenting.

It's gonna go over really well when a patient comes in with chest pain, we identify a coronary obstruction causing the chest pain, we can safely fix the coronary obstruction at the time of the angiogram, but we can't open the obstruction because Uncle Sam is trying to save money. I can hear myself saying "Well, we found the blockage causing your chest pain. I could have opened up the blockage, but Medicare rules don't allow us to do that yet. Talk to your Congressman if you don't like it."

America's not ready for that.

Fear-mongoring • see: CardiacCoug's post