The end of universal healthcare?

I feel like in the EU, healthcare covers pretty much everything. So, those models where you only get to see a doctor if you pay for insurance—if you don't, you basically just die—that seems to be a uniquely American thing.

But, honestly, I’m more interested in something else entirely...
A few years back, I was scheduled for an ultrasound. It was September, and they had me booked for December 28th.😲
I mean... who knows who'll even be alive by then..

Anyway, I managed to pull a little stunt and showed up for my exam the very next day... while I was sitting there waiting by the ultrasound machine, the staff just wandered over to grab coffee and hang out...
And there I was, lying there for AT LEAST HALF AN HOUR..

In that time alone, they could have finished at least three other exams, helped someone else, or maybe saved some money by preventing complications through earlier treatment and stuff like that..

I really think the way things are organized is where a ton of money just vanishes... but I guess when everything comes straight out of the government budget, they can just do whatever they want.

Let’s be clear: healthcare isn't exactly "free" even now, considering how much is already being deducted from my paycheck. On top of that, I pay for supplemental insurance just so I don't have to shell out $167 every single month for my prescriptions.

If they are truly intending to scrap the current system, why not just stop taking that portion out of my wages too? Why should I be expected to pay twice—once to the government and once to a private insurance provider?

Megan Reed said:Even today, the Secretary gave an interview on the morning news suggesting that supplemental insurance premiums will increase specifically for smokers.

First, how exactly do they intend to prove someone smokes? 😁 If I simply deny it, what then? Are they planning to hire private investigators just to snap photos of me holding a cigarette? 😬

Second, if smokers are being forced to pay extra, shouldn't people struggling with obesity due to poor diets be held to the same standard? 🙄 What exactly are the criteria here? By that logic, both groups are actively destroying their own health, are they not?

Apparently, there is some kind of medical test used to prove you smoke—I saw it mentioned on TV once. Though, I am sorry, I cannot recall the specific method. I believe you have to abstain from smoking for at least a month to ensure the results don't flag you.

Personally, I’ve always had some reservations about what we call "protected" groups, specifically retirees, since they tend to be the heaviest users of our healthcare system. Looking at my own family, I see my grandparents heading in for medical checkups simply because they have the coverage to do so, rather than out of an actual necessity. For instance, my grandfather already has a perfectly functional hearing aid, yet he’ll go get a brand-new one just because he's entitled to it! It feels like waiting rooms are constantly packed with people who are just exercising their "rights," while those of us in the working population—who are actually keeping the economy moving—don't have months to wait for an appointment and end up having to pay out-of-pocket for private doctors. Doesn't it feel like we're essentially paying twice for the same services? And if this trend continues, what does the future hold for us? We will continue to have our taxes deducted from our paychecks, yet we'll still be forced to pay privately for our own treatments and orthopedic aids, all while this "protected" group continues to utilize the funds we've worked so hard to provide!

Sandra Hayes88 said:IS THIS HAPPENING EVERYWHERE ELSE... LIKE IN THE USA, YOU THINK?
That's our tax money we're talking about, not their damn cats... 👎

The government barely spends anything on music or culture. That’s exactly why our healthcare system is such a disaster...

electricwalker17 said:Personally, I’m not a fan of the idea of "protected" groups—specifically retirees—since they end up being the biggest consumers. Looking at my own family, my grandparents go in for checkups simply because they have the coverage to do so, not necessarily because they need them. For instance, my grandfather has a hearing aid that works perfectly fine, yet he still goes to get a new one just because he's entitled to it. As a result, waiting rooms are packed with people who are just exercising their "rights," while those of us in the workforce can't afford to wait months for an appointment and end up paying out of pocket for private care. We're essentially paying twice. And looking ahead, this is how it’s going to stay. We'll keep seeing deductions from our paychecks, yet we'll still be forced to pay for our own treatments and medical devices while this "protected" group continues to spend our money.

It's exactly because of people like you mentioned that there isn't enough funding for everything else; every single one of those unnecessary checkups adds up.
Once the health insurance system undergoes reform, even they won't find everything as accessible as it is today. There will likely be limits—for example, maybe three free blood tests a year, and anything beyond that, you pay for yourself.
Under that kind of model, there wouldn't be this issue of double-paying. It would work similarly to retirement pillars: one portion would be mandatory to fund emergency services and public health infrastructure, while the rest—much like the optional components of a 401(k)—would be contributed based on individual choice.

But what happens to people facing really heavy diagnoses, like cancer? They’re going to need way more specialist visits than everyone else. How on earth are they supposed to cover those costs out of their Social Security checks?
I find myself thinking about it more often lately... if something serious ever hits me, I might just be better off 🙂 because with the way this system works, I honestly have no idea how I'd afford the medical bills.

shadowraven96 said:What happens to people dealing with truly heavy stuff, like cancer? They have to see specialists way more often than everyone else. How are they supposed to afford all that on a fixed pension?
I find myself thinking more and more that if I ever get hit with something that serious, I might as well just 🙂 because with the way this system is headed, I have no clue how I'd cover the medical bills.

The government is still going to heavily subsidize certain groups, so trying to draw direct comparisons to the American system is honestly pretty foolish.
But I really think people need to wake up to what's actually happening here and where it's all leading...

nimbleskipper13 said:All the gear, the machines, the disposables, the surgical tools... it's all coming from global manufacturers at global market rates. There’s no haggling there.
The only thing that stays cheap is the labor—nurses and doctors. That’s unheard of anywhere else.
On top of that, drug prices are astronomical.

Medicare covers a specialist visit around $23. Or maybe stitching up a minor skin laceration near $33.
But just the suture alone costs maybe $8-$15, since it’s an import (usually Johnson & Johnson). Then you have to factor in gauze, antiseptic, bandages... if you use $50 worth of supplies but Medicare only reimburses you $100, you're looking at a deficit. You have to pay the supplier for the sutures, otherwise they won't ship them anymore. That's how healthcare losses happen.
Plus, even a basic ultrasound machine runs about $10,000...

There isn't an antibiotic out there that costs less than $33 (a pack of Amoxicillin is roughly $15, Klavate $36... and those are last year's prices; they're higher now).

And then we wonder where the money goes.
A system where everyone chips in a percentage of their paycheck, only for the funds to be spent however anyone feels like? It can't work.
If there were options—say, someone who contributes, I don't know, $33 per month has the right to spend, say, $667 during that year, while those who contribute more can spend more—then things might start making sense. Not before then.

Of course, certain groups (like seniors, kids under 16 or 18, people with infectious diseases, pregnant women) would be protected. For everyone else: you get what you pay for.

But the main thing is just throwing sand in people's eyes by claiming three-quarters of the budget goes toward healthcare worker salaries.
A specialist's net hourly rate is about $12, an RN's is about $6.75... so do the math.

I'll say it again: health is paid for everywhere in the world. Just like food—you die without it too, and if you don't have cash, nobody's handing you free bread at the grocery store.
And you can't drive a car without gas.

We've gotten used to paying for everything else, so we'll eventually have to deal with this 😈

Wait, where exactly is healthcare paid for globally???
It isn't paid for in Canada.
It's paid for in the USA, while elsewhere they dump massive amounts of money into weaponry and stuff...
The wealthiest country on earth, and they can't afford health insurance?
Is it that they can't, or they won't?
People pay their taxes, yet they don't have health 👎

Sandra Hayes88, where else in the world can someone just decide to head to a lab one day, see a specialist the next, and then follow up with physical therapy whenever they feel like it, just like how we usually do things here?
In the US, primary care doctors mainly just write the referrals, and about two-thirds of the population is essentially exempt from copays...

Even Saudi Arabia couldn't afford to cover all that...
But honestly, things are starting to shift...
Check out today's article in The New York Times 😈

www.nytimes.com

I honestly don't get why you're celebrating these legislative shifts, especially since you're a doctor. I haven't delved too deeply into the specifics yet, but this piece in The New York Times is genuinely unsettling; it makes a pretty blunt case that this reform is completely devoid of social empathy. They're even saying that children will have to pay for $3.25 based on a referral and a prescription. It’s just grim 👎

Betty Bennett10 said:I don't understand why you, being a doctor, are so happy about these legislative changes. I haven't read much about it yet, but this article in The New York Times is truly terrifying; it clearly states that the reform is completely socially insensitive. Even for children, they will have to pay $3.25 via referral and prescription! It's awful 👎

I’m not celebrating; quite the opposite. As a physician, I am acutely aware of how limited we are under the current funding model. Because of general wastefulness, we can't procure new equipment, and we face shortages of medications and medical supplies.
Above all, I see daily how much money is wasted—patients are issued referrals for things so senseless it breaks my heart.
For example: a patient was scheduled for inguinal hernia surgery six weeks out (in the meantime, he has to get an internal medicine exam, an EKG, a chest X-ray, and lab work). He has a minor hernia that isn't urgent. Yet, he comes to see me four separate times within ten days because it's causing him discomfort. Every single time, he arrives with an "urgent" referral from his primary doctor. Each time he is examined, his condition remains unchanged. During his last visit, I finally asked him: "Look, why are you coming back just two days after your appointment when everything was explained to you and nothing has changed?"
?
You know what he told me? "Well, my doctor said if I kept coming back enough, I'd 'annoy' you into operating on me immediately!"

And he isn't the only case... I deal with people like this every day. Because of them, those who actually need care and emergency services struggle to get seen.
The examination cost $23... the government ended up spending about $100 on this one patient alone.
Every single cent...

Furthermore, Muslim children are being issued referrals for circumcisions, which isn't a medical necessity and a cost that parents should bear themselves rather than Medicare... it's just more $233, paid for by all of us through our own contributions.

I could go on like this forever.
That is why I believe this might actually change something.
Though, I admit, the system being proposed isn't perfect either.
People need to realize that healthcare isn't free.
Unfortunately, there are always collateral victims whenever these kinds of changes occur.

nimbleskipper13 said:Sandra Hayes88, where else in the world can you just walk into a lab whenever you feel like it, see a specialist, and hop into physical therapy—it’s just how we do things here.
In America, primary care doctors mostly just write the referrals, and about two-thirds of the population is essentially exempt from co-pays...

Even Saudi Arabia couldn't foot a bill like that...
Though, even that's starting to shift ....
Check out today's piece in The New York Times 😈

www.nytimes.com

I agree that healthcare shouldn't be free. But I'm honestly floored by my own paystub—seeing $300 a month going toward healthcare, plus another $120 for a private insurance policy. It practically invites the gray market—I end up negotiating with my boss to report a lower salary, then putting those extra funds into private health and retirement plans....

Wouldn't it be more efficient to implement a baseline coverage mandate that every employer pays—regardless of what an employee's reported salary is—and then offer tax incentives to encourage additional private policies?

nimbleskipper13 said:And most importantly, I see the sheer amount of wasted money every single day—patients are being handed referrals for absolute nonsense, and it’s heartbreaking to watch!

Exactly.

When I was doing my internship last year, I saw firsthand how people will demand just about anything.

For instance, someone please explain to me why it felt like every other elderly patient was coming in specifically demanding tranquilizers? 🙄

Or take the grandfather who would polish off his entire monthly supply of Norvasc in just a few days, only to show up shaking like a leaf asking for more. Jeez... 😁 🙄

So, basically, my tax dollars are going toward keeping seniors perpetually sedated? 🤣

I experience the same thing when I visit my own doctor; I'll complain about something minor, and within five minutes, I’m walking out with two different referrals. Their first instinct is just to write the script and pass you off to a specialist so they don't have to actually bother thinking about what your... well, you know... 🙄

Betty Cox30 said:Wouldn't it be more effective to establish a basic coverage basket that every employer is required to fund—regardless of the salary reported—and then offer tax incentives for additional private policies to encourage better coverage?

I completely agree. This seems like the only viable way forward for everyone involved. It would provide patients with clear transparency regarding where their money is going, while also forcing primary care physicians to handle more cases themselves (in Canada, for instance, which was mentioned earlier, about 70% of patients are managed within primary care).
By doing this, more funding could be diverted toward specialist care for those who truly need it, allowing for better equipment purchases and significantly shorter waiting lists...

However, I'm afraid we might all be waiting a long time before we actually see that happen.

nimbleskipper13 said:I completely agree. It’s probably the only way out for everyone... at least then patients would actually see where their money is going, and primary care doctors would be forced to handle more on their own (in Canada, for instance, which was mentioned earlier, about 70% of patients are managed through primary care).
That way, more funding could go toward specialist care for those who truly need it, we could get better equipment, and maybe—just maybe—those waiting lists wouldn't be so long...

But, I guess we’ll all be waiting a long time before we ever see that happen.

Look, nobody wants to fully privatize healthcare just so the rich are the only ones who can afford a doctor.
A friend of mine lives in the US and doesn't have health insurance (she's a student).
Every single doctor visit costs her $100.
God forbid she actually needs a hospital or surgery...

😲

If we’re admitting that the primary drain on our healthcare budget is this endless cycle of redundant tests and unnecessary prescriptions, then shouldn't the accountability fall squarely on the shoulders of primary care physicians? A GP shouldn't essentially function as a glorified bureaucrat whose sole purpose is rubber-stamping referrals and filling out scripts. I’ve seen how patients can be—a friend of mine worked at a small-town clinic, and she dealt with a local man who had been cleared for a head CT, yet he spent months coming back in, complaining about headaches and demanding more scans; naturally, she wasn't going to just churn out dozens of unnecessary referrals for him. If the issue truly lies with the way general practitioners operate, then any meaningful reform needs to target that specific bottleneck. This current proposal, however, seems designed to penalize the very people who need support most: chronic patients, pregnant women 😲, children 😲 😲—I sincerely hope this legislation doesn't see the light of day.

General practitioners are stuck in an impossible bind. If they don't give a patient exactly what they want, that patient can just grab their files and walk right out the door to someone else. But if their patient count drops too low, Medicare won't renew their contract. On the flip side, if they're too lenient and overprescribe, Medicare just cuts their funding.

The entire system needs to be torn down.
The only real solution is a solid basic package that covers the most vulnerable populations along with essential diagnostics and treatments, plus supplemental insurance—private or otherwise—to pick up the slack for everything else.

Just to be clear, I’m paying nearly $1000 a month myself, and I have to buy all my medications (from birth control onwards) out of pocket because they aren't covered by Medicare.