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The last thing I did before leaving this morning was post a debate in booju_newju asking if the U.S. should socialize their health care system. As a result, I haven't read much of my friends page - I've been replying and managing discussion over there ever since I got home.
I'm wondering about the perceived connection between long wait times and socialized medicine. There is a connection, certainly, but it's not, "Oh no! If the government is paying for it, we'll have to wait!" From my point of view, it appears to be mostly about infrastructure. We do not have enough doctors or other specialists, and if we did, we would lack some of the operating theatres, hospital beds, and other necessary things to reduce wait times. This is a systemic problem, certainly, but it is not one that would appear immediately upon instituting socialized medicine. The U.S. already has the infrastructure, and they certainly have enough doctors. (They could send back a few of the ones they've borrowed from us, actually. We need them ourselves.) There might be some shortages when all the currently-uninsured suddenly had access to the whole system, but they'd be manageable, and probably much of it would be absorbed by the current system. After all, everyone would have a lot more time to see patients if they weren't filling out dozens of forms and attempting to getblood from a stone payment from people who have no money.
Also, what's with this idea that "The government will tell me which doctors I have to see!" That is totally, categorically false. In fact, I have more choice of doctors than many insured Americans whose insurance companies tell them which doctors they're willing to pay for. I can see any doctor in Ontario by presenting my health card, if I have a referral. And, while I know many people who have to wait, I never have. It depends on the specialty how long you'll wait, and once you're on their patient roster, you won't have to wait again to see the doctor - though you may have to wait for your surgery. See previous comment about infrastructure.
Last complaint I have little patience with - "Our taxes will be too high for us to afford to eat!" Okay, maybe your taxes would go up - though it should be possible to do it for the amount already being paid for Medicare - but your health premiums would (almost) disappear, and the savings would be rather greater than the increase in taxes. No, the rich are not going to flee to places where they don't have to support the poor. There aren't a whole lot of those places left, at least not places where the rich would actually want to live.
Okay, I'm done now.
I'm wondering about the perceived connection between long wait times and socialized medicine. There is a connection, certainly, but it's not, "Oh no! If the government is paying for it, we'll have to wait!" From my point of view, it appears to be mostly about infrastructure. We do not have enough doctors or other specialists, and if we did, we would lack some of the operating theatres, hospital beds, and other necessary things to reduce wait times. This is a systemic problem, certainly, but it is not one that would appear immediately upon instituting socialized medicine. The U.S. already has the infrastructure, and they certainly have enough doctors. (They could send back a few of the ones they've borrowed from us, actually. We need them ourselves.) There might be some shortages when all the currently-uninsured suddenly had access to the whole system, but they'd be manageable, and probably much of it would be absorbed by the current system. After all, everyone would have a lot more time to see patients if they weren't filling out dozens of forms and attempting to get
Also, what's with this idea that "The government will tell me which doctors I have to see!" That is totally, categorically false. In fact, I have more choice of doctors than many insured Americans whose insurance companies tell them which doctors they're willing to pay for. I can see any doctor in Ontario by presenting my health card, if I have a referral. And, while I know many people who have to wait, I never have. It depends on the specialty how long you'll wait, and once you're on their patient roster, you won't have to wait again to see the doctor - though you may have to wait for your surgery. See previous comment about infrastructure.
Last complaint I have little patience with - "Our taxes will be too high for us to afford to eat!" Okay, maybe your taxes would go up - though it should be possible to do it for the amount already being paid for Medicare - but your health premiums would (almost) disappear, and the savings would be rather greater than the increase in taxes. No, the rich are not going to flee to places where they don't have to support the poor. There aren't a whole lot of those places left, at least not places where the rich would actually want to live.
Okay, I'm done now.
(no subject)
Date: 2009-03-08 05:06 am (UTC)Here's the kicker, though: the people who care enough to vote, the people who pay the taxes and make contributions to politicians? They're in the group for whom access would not improve. All of a sudden, approximately 20% (more, depending on which stats you believe) of the population would have access to medical care, and in dealing with the influx, the people who used to get same-day service and surgeries in two weeks might find themselves waiting a bit. If their surgeries weren't urgent, they might find themselves waiting more than a bit. (I just waited two months for a hysterectomy. Mind you, that was fine with me - I needed that time to get things together for an extended absence at work, and I was expecting a wait for an elective surgery. Would I have been so accepting of that wait if I'd known what I'd be going through in February, or if I'd expected to be squeezed in the following week? Probably not. It's about differeing expectations.)
When you're less than two decades out of a massive social upheaval, you can expect things to not be functioning quite smoothly. Hungary (and yes, I CAN find it on a map) has European ideals but a struggling second-world economy, and I would have been surprised to learn that the medical system ran smoothly in that situation. It's interesting to get the perspective on it, though.
Thanks for stopping by.
(no subject)
Date: 2009-03-08 05:28 am (UTC)I'm glad you can find Hungary on a map. :) I'm not surprised to learn this, though.
You're right about Hungary. A lot of people here don't realise that, though. With the change over in 1989/90 and the brand new democratic government, people were bright and hopeful for the new system. When the newly elected government did not succeed to get us out of debt (it was a huge debt and we're out of it now. Kádár, the communist politician who was in power for the last few decades of the communism borrowed a lot of money from foreign banks to increase the standards of living, which was good in the short term and people were pleased with him, but it was a problem for the government that inherited the debt), when homelessness appeared (it was unheard of before), and inflation and the problems of privatisation and all the stuggles of massive social upheaval... when that wasn't fixed in four years, people were upset and elected a different party. And the elections swing back and forth each time, since it's too big a problem for anyone to fix in four years, but things have been steadily improving.
Still, we're not there yet and things take time, and many people I know talk nostalgically of communism, when they had enough to eat, but my friends who see the bigger picture understand that it's a process.
Hungary's in the EU and we want to be part of Western Europe and we have taxes like in Western Europe (59% is the tax bracket most people are in) but we have wages like the Balkans.
(Don't get me wrong, I love the Balkans. I speak two Balkan languages (Serbian and Macedonian) which means I can make myself understood anywhere in the former Yugoslavia, except, perhaps, in Kosovo because I don't speak Albanian (yet), but their economies, level-of-living, and crime rate are worse than ours. Health care is much better in Serbia, though, than in Hungary.)
I don't know, give us another 20-50 years. We'll get there. We were occupied by Russia for 40 years, and before that it was Hitler, and before that was about 30 years of golden age with Austria-Hungary (before that we were part of the Hapsburg empire but were just one of many minorities) and before that it was the Turks... :)
(no subject)
Date: 2009-03-08 05:37 am (UTC)Meanwhile, I love the optimism of North America. We believe that, if we work at it, we can accomplish anything - because we have. To some extent, we gave that back to Europe after Europe had long since lost it under centuries of, "It's always been this way."
I tend to take the long view, too, and I tend towards optimism in my politics. I think Hungary will come into itself as a modern nation within my lifetime, because it's already most of the way there.
(no subject)
Date: 2009-03-08 06:03 am (UTC)Szeged, my city, was rebuilt in the late 19th century by Franz Ferdinand (who was loved and adored by the Hungarians, especially after this, but before that too), after a flood destroyed the city. Our main...circle street, boulevard is what the dictionary says but I'm not sure that means "a street which is in the shape of a ring that goes around the city", has six names, one for each of the cities that helped rebuild the flood (Vienna, Moscow, London, Paris, Brussels, Rome). Moscow didn't give money, actually, but a section of the street was renamed by the communists. :)
So, all of the architecture is in the Art Nouveau style. The whole city was rebuilt, with circle-streets and ray-streets, because Szeged is the Sun City (we get 2000 hours of sunlight a year, the most of any city in Hungary). But there are some older buildings left, churches mostly, and the ruined castle. My favourite is the church in King Mátyás (Mathias) square, built in the 15th century. It's pretty.
I like history a lot. There's so much of it here. March 15th is coming up, which is a national holiday, commemorating our uprising against the Hapsburgs (1848-9), which was put down. Franz Ferdinand was only 18 at the time. Thirty years later Franz Ferdinand's wife, Elizabeth, was sympathetic to the Hungarians and changed his mind, thus beginning our golden age. :) We have a lot of holidays celebrating uprisings that were put down. We celebrate 23rd October as well (1956).
North America has a lot of history too, but most of the history is that of the native Americans, who did not build castles.
I admire North America's optimism as well. Hungary could use some of it. Hungarians are happiest when they have something to complain about.
And you're right about our traditions keeping us back. Many of our traditions are beautiful, but it slows our progress and makes it harder to make changes for the good. Christianity, for example, seems very different in the Americas. In Hungary, it was surpressed during communism but most people are Roman Catholic by name, but a lot of things are just rote and ritual. In Serbia, Orthodoxy is a very important part of the culture and I've tried to learn about it as much as I can. I see people who are very religious and love going to their churches and listening to the chanting and looking at the icons and feel a very deep, personal connection with God -- yet, they've never read the Bible. It's interesting to me, because I don't understand it.
Hungary is my third country. I lived in the Carribean till I was three and a half, then I lived in the states with my parents, and I moved to Hungary alone when I was seventeen for a year abroad, but I liked it here, so I stayed and got my citizenship and have made a life for myself. My mother is Hungarian and my father is American. I've tried to make myself as Hungarian as possible and can usually pass as one when speaking. It gives me an odd view of things. I can see beyond the borders of Hungary, and I can see things about Hungary that those who have lived here their whole lives don't see or notice, because I have more to compare it to. I've been back to the states a few times, but I feel like a foreigner when I'm there, and get homesick for Hungary.
(no subject)
Date: 2009-03-08 06:15 am (UTC)She was living with an American family who were evangelical protestants. She never said that, but I knew, because I recognized so many things she talked about that could easily have happened at my church. They asked her to come to church, involved her in the youth group, lent her a Bible, etc, etc. She went along with it all because exchange students are supposed to please their host families, right? Well, eventually, they took her to an evangelism meeting, where she was offered the chance to "accept Jesus into her heart." To the American family, this was the single most important decision she would ever make. It was life-changing, earth-shattering.
For her, it was something she did to please her host family. End of story. Eight months later, I sat in a Rotary Club meeting in France and listen to her wax eloquent - and very, very confused - about why her host family had been so excited.
I could have cleared up the mystery for her, but my French was good enough to understand her but not good enough to express those concepts, so I didn't. But it was one of several events that shed new light on my own faith that year. Sixteen years later, I'm not a Christian anymore.
She saw religion as rituals people went through at points in their lives, and as an element of cultural history. Her American host family saw it as a defining feature of their worldview. I think the European way is healthier, personally.
(no subject)
Date: 2009-03-08 06:25 am (UTC)I'm not a Christian, and I'm not from a Christian family, but I'm friendly towards Christianity and interested in learning about other people's beliefs (and have read more of the Bible than many Christians I know personally).
I'm not sure what my opinion of rituals are. I'll have to think about it some more.
(no subject)
Date: 2009-03-08 06:27 am (UTC)(no subject)
Date: 2009-03-08 06:42 am (UTC)But I'm still figuring things out.
I've done a lot of looking around and stayed with what I was raised with, deciding it was what fit me the best, all things considered. And I'm happy here, for the most part. I deal with religion is a fairly cyclic fashion. I'll work on my God issues for a while quite intensely and then I'll make peace with things or at least give it a rest for a while. Right now I'm more working on other issues, and I can't muster the energy to iron out my relationship with God too (most of my God issues have nothing to do with religion, luckily), so I'm sort of in an accepting place, where I don't think too much about the things that bother me, and when I do, they don't bother me all that much.