Ouch, I touched the third rail.
Maybe I should've used a different word than "right." Still, what we have here is broken and needs changing. I'm not saying the Canada model is our solution ..... although I don't see how it's worse than what we have right now. I stand by my claims that we have a lot of Canada's "problems" - down here, they're just cleverly disguised.
The two-tiered price structure (insurance-nego'ed lower prices) is unfair to those who lack insurance and are forced to pay cash. I say that even as I benefit from that, as one of the (lucky) ones who has a decent insurance plan. It's funny - the doctors and hospitals whine about the insurance companies and the insurers gripe about hospital charges. Instead of using this tension to craft a real solution, they keep up their profitable finger-pointing. Just like Coke and Pepsi 'pretend' to compete, while both work together to keep RC Cola shelf space as tiny as possible.
One problem which needs solving is the indigent situation. And as for cellphones, cable TV, etc. -- dropping all of those wouldn't get you anywhere near the average premium for an outside health plan! And even if one went for a policy that could be afforded, it would be a high-deductible major medical policy. Okay, fine. Let's say you have such a plan now. You've cut the cable, have no cellphone, no computer in order to afford it. You're being a good steward of what little you make. Well, you're covered just in case you have something really big, such as a major operation -- that is, after the $1,000+ deductible. Real money, whether you have a cellphone or not.
What if one of your children gets sick? What about an accident (they do happen, ya know)? ERs are overburdened because they're being used as a de facto "clinic" when people get really sick ... because they cannot turn anyone away. And that's when it gets expensive - ultimately sticking all of us with the tab.
One solution? Some time back, I read an article in
USA Today about some CVS drug stores adding 'mini-clinics' which take care of simple ailments, and have nurse practitioners on duty all the time. Best of all, the prices for everything ARE ALL POSTED. Just like at Mickey D's. In exchange for not having an actual MD diagnose you (NPs are just as good at the basic stuff, imho), you pay lower prices. And if it's a real problem, you get referred to the ER. That would help immensely with the indigent care problem, and free up ER resources for what it's really intended for in the first place.
The non-insurance walk-ins are still a bit steep (the one here in Savannah is $60.00 up front). That's quite a hit for many -- even for those who don't go out and buy bluetooth phones and X-Box 360s. No not everybody is genuinely poor, but not all poor are "Cadillac queens", either! And I won't go into the untold problem of underinsurance - where, after you have a hospital visit or doctor procedure done, you get hit with an ugly balance-bill. Sure, I have $350 laying around here somewhere, let me check between my sofa cushions.
If we could get ourselves to a system where basic, preventive care and simple illnesses could be covered for a low price ($25, maybe? Equal to an average HMO or PPO co-pay) ..... I mean, Wal-Mart, etc. now have many generic Rx drugs at $4.00 -- a start in the right direction!! Certainly that would be possible. Maybe at $25, the health system would take a loss at the beginning ..... but would ultimately win as the cost of unnecessary ER visits plummet. And it might get Mr. Moore and pro-Canada sentiment off their backs. Everybody wins.
Again, something has to be done ... only the AMA, insurance companies and the filthy-wealthy benefit from things as they are now. If we keep down this road, a kneejerk is inevitable. They should give a little for a sensible solution, or else risk a backlash.
Flame away...........
--Russell