A constituent asked me, since you are a doctor-in-training, you must know a lot about healthcare. Yes, I do. My experience in healthcare is not only limited to my experience as a doctor-in-training, it comes from my experience as a volunteer at Stanford Hospital and then the Pacific Free clinic that provided healthcare services to the poor and uninsured in East San Jose. My living experience in both the U.S. and then Europe further shapes my thought on healthcare since I have the opportunity to contrast between the different systems of healthcare that I have experienced. In my years volunteering at Pacific Care, I had never seen a politician (local or national) at the clinic. To them, a clinic that serves poor and uninsured Americans doesn't exist in their world. It’s no wonder why the politicians like Congresswoman Zoe Lofgren is clueless on the healthcare issue that her constituents have to face everyday. The Pacific Care clinic is located in East San Jose that is part of Congresswoman Zoe Lofgren’s district, but it resembles a medical clinic in a third world country (actually it reminds me of the medical clinic in the refugee camp in Thailand where I used to stay before coming to the U.S.) I am not talking about the equipment or the doctors, medical students, and community volunteers who work there; they are fantastic. I am talking about the very long line of uninsured patients waiting to get healthcare each day often exceeds the available resources. There are so many Americans who are uninsured and who cannot afford basic healthcare. It’s unthinkable in a country as rich as the U.S. When I lived in Europe, I never saw such desperation for healthcare services since countries in Europe have universal coverage. Going bankrupt in Western Europe due to health problems, except in Greece, it's unheard in Northern European countries like France, the Netherlands, Germany, and Scandinavian countries. The last job I had in Silicon Valley was with a well-known and well-funded startup that offered me a health insurance plan at Kaiser Permanente with a $5000 annual deductible and $300K lifetime coverage which means I had to pay out of pocket for every single item. Kaiser charged me $120 for a doctor visit, $350 for lab tests, and hundreds of dollars for prescription drugs. All of these fees are on top of the hundreds of dollars of monthly automatic deductions of my paycheck in addition to my company's contribution to my health insurance plan. Then I went to medical school in the Netherlands that requires me to have health coverage before they even let me in the country. I went to see a doctor and they charged me the full cost of providing health service -- $30 for a doctor visit and $4 for the medications and provided me with receipts to get reimbursements from my insurance in the U.S. (I have a good laugh after getting the receipt -- I said to myself -- good luck with that) since they don’t accept American health insurance. And I hadn't contributed a penny to the Dutch healthcare system. When I came out of the doctor office, I said to myself, Wow, this is interesting. I basically had no health insurance in the Netherlands but I paid out-pocket a whole lot less than what I paid in the U.S. with my "supposedly good" health insurance. I remember paying similar low prices while I was living in France. The same drugs that you pay through the nose are selling in a Parisian pharmacy at 80% off of U.S. prices. When I told a relative about my experience in the Netherlands, he wondered how a Dutch doctor could live on a $30 per visit. He actually lives quite well. His salary is taxpayer -supported rather than fee-for-service. Doctors in Europe are very well paid (unlike the propaganda coming from the Republican party about the horror of socialized medicine in Europe). Both he and my French doctor take long annual vacations – a luxury that American doctors don’t have and they don’t have huge educational loan to pay either (it’s another important issue that I will write in a different article). Another lie from the propaganda that makes me laugh is choice. Somehow it is implied that the single-payer will limit choice. Not so in my experience with the single-payer system in Europe, I can go to any doctor there; not so in the U.S., I am severely limited to the doctors in the network of my insurance plan. With many companies in the U.S. moving in the direction to provide just the bare-bone insurance plans similar to mine at Kaiser in order to satisfy the requirement of the Affordable Care Act, I don’t think Americans are getting enough coverage for their healthcare. Even with health insurance, health problem is the major cause of bankruptcy in America. I do not think Affordable Care Act is enough. The New York Times wrote in its article on JAN. 5, 2016 “Here is the surest way to enjoy the peace of mind that comes with having health insurance: Don’t get sick.” Even Insured Can Face Crushing Medical Debt, Study Finds Most people with health insurance don’t know about the risk of going broke due to health issue. They may not even aware of how expensive drug prices are in the U.S. compared to other countries. For example, Hepatitis C is a common disease among Americans. The new drug for Hepatitis C costs $100,000 annually in the U.S. So if your lifetime coverage is only $300K, you can only afford 3 year of drug; that doesn’t include other healthcare expenses. Some cancer drugs can cost as much as $300K-$400K per year. In medical school, I learned a number of drugs and the professor said "You can prescribe this drug in Europe, but you cannot prescribe it in America since it will cost your patient $300,000 per year and many insurance plans won't cover it." Can we afford it? Of course we can afford universal coverage and a single-payer healthcare system if we don’t waste trillions of dollars in foreign wars like the war in Afghanistan that Congresswoman Zoe Lofgren voted for. More likely, I think it’s going to save us billions of dollars a year because based on the experiences of other industrialized countries, a single-payer is much cheaper than the fragmented private healthcare system that we currently have in the U.S. Compared to other advanced countries like Western Europe, Japan, Canada, and Australia, the U.S. spends twice as much on healthcare as other countries and gets much worse results. Having universal coverage and a single-payer system will also allow talented people to pursue their entrepreneurial dreams that create more jobs and improve the quality of American lives instead of being tied down to an employer so he can get decent health insurance coverage. Contrary to Congresswoman Zoe Lofgren whom you never hear her talk about healthcare issues (the only thing she seems to work on in Congress is the H-1B and support for migrants who choose to violate American immigration laws), I support universal health coverage and a single-payer system or at least a public option and I will push for it. It’s one of the highest priority things I plan to do in Congress. It’s the right thing to do for Americans and particularly my constituents based on my experiences at Pacific Care and living overseas in more “enlightened” countries. Testimonials
ScottWChapel Hill, NC 1 day agoYou should come back to the States. Student debt at $1.2 trillion with no end in sight. We have billionaires building their fortunes on contract labor (formerly known as employees) who receive no benefits. Healthcare costs at least $300/month (for the young & Healthy) for an admission card and then deductibles/copays add even more costs if you get sick. We don't live in a society.
RMis a trusted commenter Vermont 12 hours agoThe rest of the first world countries can have universal health care at a lower cost per person than incurred in the United States. But trying to achieve that would be unrealistic and unachievable in the USA.
RobNYC January 5, 2016 Long story short: Went home once and mother told me that my parents received a bill of $130,000 for my father's cancer treatments. He's fully insured, so I asked, "Why do you have a bill for $130,000 if dad has insurance?" Mom didn't have an answer. What wound up happening is a game of back and forth between the insurance company and my parents. They questioned the amount, and insurance company said they'll check on it. Weeks go by and they agree to lower the amount to only $80,000. More weeks go by and eventually after not only having to deal with cancer, they had to spend countless hours also dealing with the insurance company whose bills were killing them. Eventually, the bill got lowered to the thousands instead of the tens of thousands. But why did they have to play this game in the first place? "Funny" side
story: one of the charges was a $6,000 bill for a doctor who came to see dad at
is bedside after a surgery. My dad remembers the visit very clearly. Went like
this: · 840Recommend CharlesMichigan January 5, 2016 As a dying breed of physicians ( solo, private practice), it has become clear to me that the elephant in the room is the private insurance industrial complex. They are responsible for the high co-pays and deductibles, which is putting folks on the brink of financial demise. Additionally, they are a pain in the rear to deal with from the standpoint of a practice owner. Medicare is much more straightforward to bill and receive payment. The private insurance companies, like to play games to make payment difficult, so that they may hold onto their money. After all, they have to pay their CEOs, egregious salaries and make the shareholders happy as well. To quote the patron
saint of the GOP, Ronald Reagan, "the private health insurance companies
are not the solution, the private health insurance companies are the
problem". And....... " the scariest words in the English language
are, I'm from the private health insurance companies and I'm here to help
you". · 594 Recommend Timmy Providence, RI January 5, 2016 This has been a very underreported characteristic of the ACA, and an aspect of the American healthcare system that is too often ignored. Yes, the number of Americans with health insurance is increasing, but those numbers do not equate to adequate healthcare. High deductibles, as noted here, often provide a powerful disincentive to seek medical care. As long as the US political system is dominated by corporate interests and Wall Street, we will continue to have a system that is more concerned with profits than it is with the well being of citizens. Those of us who have lived in countries with government-provided healthcare systems know it that it doesn't need to be this way, and in a country with a functioning democratic system it wouldn't be this way. · 253 Recommend Ken Fabert Bainbridge Island, WA January 5, 2016 I am a 62 year old primary care physician. When I moved to per diem work to scale back prior to retirement, I ended up paying $23,000 in annual COBRA fees to my nationally regarded non-profit health system in order to provide medical and dental for my healthy family of 3. I also had the opportunity to work in New Zealand a few years ago, and in comparison, it was a medical dreamscape. Taxation was progressive, care went to those who needed it, no one went bankrupt as the result of getting sick or injured and the perverse incentives to medicalize life and death, simply didn't exist. The freedom FROM financial insecurity and willful bureaucratic obfuscation was obvious. The freedom TO be an independent citizen—a student, an artist, or self-employed-- was clear. And every time I heard a complaint from a Kiwi, I jokingly offered to swap systems. No takers. US healthcare is an international laughingstock. Healthcare via private
or "non-profit" insurance is the cornerstone of our chuck-and-jive,
gotcha healthcare economy. Will we ever join the ranks of all other OECD
countries and free ourselves from the tyranny of an unfettered, inhumane,
insurance driven healthcare "system"?
· 128 Recommend Ken Fabert Bainbridge Island, WA January 5, 2016 I am a 62 year old primary care physician. When I moved to per diem work to scale back prior to retirement, I ended up paying $23,000 in annual COBRA fees to my nationally regarded non-profit health system in order to provide medical and dental for my healthy family of 3. I also had the opportunity to work in New Zealand a few years ago, and in comparison, it was a medical dreamscape. Taxation was progressive, care went to those who needed it, no one went bankrupt as the result of getting sick or injured and the perverse incentives to medicalize life and death, simply didn't exist. The freedom FROM financial insecurity and willful bureaucratic obfuscation was obvious. The freedom TO be an independent citizen—a student, an artist, or self-employed-- was clear. And every time I heard a complaint from a Kiwi, I jokingly offered to swap systems. No takers. US healthcare is an international laughingstock.
Healthcare via private
or "non-profit" insurance is the cornerstone of our chuck-and-jive,
gotcha healthcare economy. Will we ever join the ranks of all other OECD
countries and free ourselves from the tyranny of an unfettered, inhumane,
insurance driven healthcare "system"?
· 128 Recommend american abroadGermany January 5, 2016As a U.S. citizen living abroad, but wanting to visit my homeland periodically and sometimes for more than two months at a time, I then have to pay my German health insurer a premium of around $10 per day for every day I spend in the U.S. because the Germans automatically expect to have to pay (reimburse me for) such high prices for my medical care, should it be necessary. Some German insurers even provide hotlines to "mediators" who try to talk down the high U.S. medical bills issued to people insured in Germany but travelling to the States. Thus, I strongly agree with the statement in your article: "These financial vulnerabilities reflect the high costs of health care in the United States, the most expensive place in the world to get sick." When will elected officials get the guts to attack the high costs of medical education, liability insurance, fee structure, insurer coverage, etc.?
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