Universal Single-Payer Healthcare

[bascule]

So, Michael Moore's new film Sicko is out in theaters. I saw it an greatly enjoyed it. I've been an advocate of Universal Single-Payer Healthcare for quite some time, and find it refreshing that someone is finally thrusting it into the public spotlight.

 

So, two questions:

 

1) For those of you outside the US who do have universal healthcare, what do you think of your system and what do you think of the USes? Generally people in America are under the impression that they are receiving the best care available (if you go to an in-network provider!) and are generally quite wary about the idea of a universal single-payer system.

 

2) For those of you in the US, what do you think about a universal single-payer healthcare system, and what do you think about other systems worldwide?

 

According to a WHO survey conducted in 2000, Americans rate their healthcare system as being #37 in the world in terms of satisfaction, while they pay the most as a percentage of GDP. (and with the largest GDP in the world, that of course makes America the largest healthcare spender in the world)

 

This means America ranks itself below every other first world country, and under many third world countries (Moore made this point by taking 9/11 aid workers to Cuba to receive healthcare). Colombia, Chile, and Costa Rica all rank their healthcare higher than Americans.

[ParanoiA]

What is the advantage to the system without regard to economics?

 

I choose people over money. If we simplify the funding process with a nifty universal healthcare plan, how does that serve people? Why does that simplified funding technique magically equal better care for people?

 

Why do the best doctors flee from countries with universal healthcare?

 

Why on earth would you ask americans how they rate their own healthcare? How is that response worth an ounce of chicken fodder? Might as well ask americans how they rate their quality of life. They'll cry and bitch and moan about how aweful we all have it while we enjoy the best quality of living on the planet - even our poor live rich compared to half the freaking planet, but they'll still whine about how terrible their life is...

 

That's about as insultingly subjective as an answer you'll get with a worthless application.

 

Maybe we're the largest spender in healthcare and maybe that's a good thing. Yeah, maybe we could save some money, but perhaps, just maybe, people are more important than money. Hey, maybe that's we provide healthcare to everyone regardless of insurance??

 

Just some thoughts. I like universal healthcare too - in concept. It sounds nice and neat. Simplifies a complex subject - or seems to. Perhaps Einstein had a point when he said everything should be made as simple as possible, but not simpler. I have yet to hear of a universal healthcare system that solves more problems than created. Why overhaul a system just so we can swap out one set of problems for another?

 

Let's keep thinking instead, and come up with something better.

[Sisyphus]

What is the advantage to the system without regard to economics?

 

Well, if you spend the same amount, and cut your administrative costs in half, doesn't that mean you spend more on actual medicine, and people get better care? Also, it means that people can actually afford to get treatment either at all or before it becomes desperate, and every study ever shows that prevention is infinitely better and cheaper than cure, meaning people are healthier and we all save money. Hell, I have health insurance, but it's crappy (like most people's), and I'm screwed if I don't get hurt or sick within the acceptable parameters, bla bla bla.

 

Of COURSE it's about people. It's MOSTLY about people. But it also happens to make great sense economically, which is how we talk to Republicans about it.

[ParanoiA]

Well, if you spend the same amount, and cut your administrative costs in half, doesn't that mean you spend more on actual medicine, and people get better care?

 

No it doesn't. Care to explain why you think it does? Numbers on paper don't say anything at all about the quality of care. That's what those who actually work in universal healthcare complain about.

 

I still think there's a better idea to be thought of and have yet to hear a compelling reason to trade one set of problems for another.

[Sisyphus]

Um, so what would convince you then...?

[ParanoiA]

Um, so what would convince you then...?

 

A better plan.

 

A mirror image or copy off of some other system that is just as "arguably" good or bad is not a positive step in any direction - rather just a great way to blow an ass load of money converting over. How is that better?

 

Let's do the american thing here and come up with something better. Since when do we require a ready made template?

[ecoli]

Here's what happens in Canada...

 

They spend a lot of money on administrators and bureaucracy costs, which greatly extends the waiting time, even for important, vital operations. The people who can afford it, travel to the US to receive their medical care, because they don't want to or cannot wait. People who have connections to the bureaucracy or medical establishment can avoid the wait by getting their names on the top of the lists.

Like many socialistic programs, the people who are rich or connected wind up getting the advantage, while the poor, who cannot afford the buy their way around the system get screwed. The people who the system was supposed to help wind up losing out anyway.

 

And it's an expensive system. My Canadian relatives pay ~50% of their paychecks in taxes.

 

And to reduce the waiting time, a new initiative proposes an investment of an additional 4.5 billion dollars. http://www.hc-sc.gc.ca/hcs-sss/qual/acces/wait-attente/index_e.html

 

In Britain's system, the target waiting time was 18 weeks.... all patients would be treated by that time. But, they're even failing at that. http://society.guardian.co.uk/health/news/0,,2097563,00.html

 

 

I think that the root problem with a nationalized system that, like any bureaucracy, it becomes about the employees, rather than the patient. If doctors and private heath insurance companies want patients, they have to offer them a quality product, or they'll go somewhere else. It's the supply and demand of a free market system.

 

When the government owns the system, the workers aren't as pressured to perform as well (due to tenure laws, etc) and there's really no where else for the patient to go, so there's no driving need to offer them quality care. The government can force an increase in quality by legislation, by this requires use of administrators. You wind up paying more in administrative costs, and less of health care, so the quality goes down. I remember hearing somewhere that a lot of the equipment used in Britain's system tends to be outdated, while the US usually has state of the art stuff.

 

Because investing in new technologies tends to bring patients into that hospital. People want the best medical care, even if it costs a lot.

 

With a national health care, instead you get wage control for doctors, so they aren't able to charge more for better skilled as a doctor. You take away the incentive to be an excellent doctor, which decreases the overall quality of care.

 

 

I, for one, would not support a system of national health care, unless it was perhaps an optional one... Why do I have to pay more for a substandard quality of health care, which is targeted to help people that aren't me?

[geoguy]

I'm a Canadian but have lived in 2 U.S. states...Nevada for an extended time. The quality of health care was more or less the same. Very good and the differences are probably more to do with experience with individual health care professionals than the system.

 

What I prefer about the Canadian system is the flexibility it gives in life. I've been able to move around, change employment positions, go back to university, take time off for a year, now consult in geology, without even thinking about health care. If I get sick I walk into the nearest clinic and if I need a test, MRI, hospitalbed, operation....it's just a given than it's there. My circumstance in life isn't a variable.

 

Yes, I do pay for the peace of mind in my taxes. In fact I pay more that I would for private care in the US. But, my 80 year-old widow mother is also fully covered and, more importantly, so is the anonymous single mother down the street with 3 kids. She receives top notch prenatal care, as good an obstetric delivery team as anyone else. She will receive a year's paid maternity leave after birth and her children will be scheduled for regular visits to the wellness clinic and pediatrician. She will receive counselling on stress, nutrition and other needs. The bottom line is she and, most importantly her children, will be able to enjoy a quality of life that has dignity. Her children will get quality education, be healthy and contribute in future years to raise the next generation of Canadians.

 

The exception? No. More less the same system, with a few tweaks, practiced throughout the western world except the USA. In Canada even the right wing party falls over itself to distance itself from an American-style health care because Canadians like our sytem. It has flaws but we can fix them. The 'fixing' is to make sure nobody falls through the cracks or is disadvantaged because of health related issues.

[Cap'n Refsmmat]

This means America ranks itself below every other first world country, and under many third world countries (Moore made this point by taking 9/11 aid workers to Cuba to receive healthcare).

Cuba is, erm, 39th. Behind the US.

 

[ecoli]

Since when has a Michael Moore movie reflected reality anyway?

[john5746]

2) For those of you in the US, what do you think about a universal single-payer healthcare system, and what do you think about other systems worldwide?.

 

My main concern is does this stall invention? My understanding of universal-anything is that everyone gets a stone wheel, instead of the wealthy getting a radial-tire and the poor getting nothing. But, no one ever gets a radial, just keep living with stone wheels.

 

I wonder if this is true. Does the US make the bulk of advancements in medicine or not?

 

Also, much of the US health problems are the people themselves(myself included) We eat fast food, drive everywhere, watch TV for exercise and work all the time. Factor in the cost of living etc and we should have to spend much more to live like that. Also, wages in medicine are not getting pressured by outsourcing like everything else. No wal-mart hospitals around.

[bascule]

What is the advantage to the system without regard to economics?

 

How about not having to battle with insurance companies over health costs?

 

Not having to go to exclusively to in-network healthcare providers?

 

Not having to worry about what happens to me in an emergency? Not having to worry about an insurance provider looking into what should be confidential medical records in order to disqualify me from care? Not having to sign away my medical privacy because otherwise I'm screwed?

 

Being able to get care whenever I need it without worrying about my insurance sending me a bill for something that I don't consider covered?

 

Being able to get effective antibiotics (e.g. levaquin) without $100 in copay? Or is that just a "cost" issue?

 

Beyond that... letting Americans be more competitive in the international marketplace because they aren't expecting a health package?

 

My main concern is does this stall invention? My understanding of universal-anything is that everyone gets a stone wheel, instead of the wealthy getting a radial-tire and the poor getting nothing. But, no one ever gets a radial, just keep living with stone wheels.

 

Do public grants stall innovation in other sciences? That's my view on health sciences. I'd prefer a publicly funded prize system spurring pharmaceutical research. I'd rather see medical science pursue cures for debilitating and terminal diseases rather than curing baldness or impotence.

[Saryctos]

I wonder if this is true. Does the US make the bulk of advancements in medicine or not?

Absolutely, and most advances are from the private sector.

 

 

The biggest problem with healthcare is the lack of competative pricing really. Noone's out there trying to get the lowest cost MRI service to get more customers. Insurance will just pay for it.

[ParanoiA]

How about not having to battle with insurance companies over health costs?

 

Not having to go to exclusively to in-network healthcare providers?

 

No' date=' instead the health costs will be determined by an entity who has NO incentive to control any costs...in fact, has incentive NOT to control costs at all. Kind of like how our school system begs parents to sign their kids up for "free lunch" whether they need it or not - so they can get the most federal money possible.

 

Not having to worry about what happens to me in an emergency? Not having to worry about an insurance provider looking into what should be confidential medical records in order to disqualify me from care? Not having to sign away my medical privacy because otherwise I'm screwed?

 

Not having to worry about suing anybody after they mangle your body in surgery huh? The government protects itself from lawsuits...with laws. You're actually arguing to lose power over accountability. Everyone gets taken care of in this country, in an emergency, whether they have insurance or not.

 

Oh, and I see you're hung up over privacy because you want everyone working on you to know exactly how to do their job, but you don't want them to have to know what the hell is wrong with you?? Nice.

 

Many of these laws come from people who love to make money litigating. Some of them are really freaking practical and don't make sense until you critically think them out a little further than their face value, or headliner effect.

 

Being able to get effective antibiotics (e.g. levaquin) without $100 in copay? Or is that just a "cost" issue?

 

Beyond that... letting Americans be more competitive in the international marketplace because they aren't expecting a health package?

 

Yeah I agree these things suck' date=' but I don't think universal healthcare is going to be any better. You may fix some of [i']this[/i] list, then you get a different list of problems - long waiting periods (yeah, trying waiting a week or two to see a doctor for the flu...work that logic out, who's going to still have the flu in a week?), no "care" incentive whatsoever, impersonal care - doctors "process" you, they don't really "see" you, the government decides what brand of medicine you will take, the government decides the methods to be used for healthcare with no incentive to please anyone.

 

You think it's bad being dictated to by the insurance companies? You can actually go around them - there are other options - but when the government is running it and THEY dictate your healthcare, there is no getting around it.

 

I don't think you're thinking this out very carefully. I used to be a strong supporter of universal healthcare, but my Dad has been exposed to this concept of medicine and it's horrible. All universal healthcare benefits is the money trail - not the people. It just simplies healthcare "conceptually" - but healthcare should NOT be simple.

 

It should be personal. You get better care when you're seen, not processed. You get better care when the workers have incentive to be excellent at what they do. You get better talent when medical professionals can compete with each other. You get better facilities when they have to compete as well.

 

There are problems with our healthcare system, but they don't need to be solved by exchanging them for other problems. We're americans, we can do SO much better without copying a socialist system that doesn't rid any more problems than we have now. We can do better. Why is that so out of question?

[waitforufo]

As a US citizen and resident, I suspect that switching to a single payer universal health care system would produce more problems that it would fix. I’m sure that universal health care would come complete with litigation reform. If litigation reform were implemented now, cost would be significantly reduced. Litigation reform won’t be implemented in our current system, since lawyers are suing individual doctors, not the government. Then the lawyers give contributions to politicians.

 

I travel overseas a lot with my job and this topic comes up often. Generally I find that people who don’t use health care often, or those who use only common procedures (e.g. child birth) think universal health care is great. Those that have uncommon procedures or “elective” procedures aren’t so happy. For example, if your rotator cuff is torn by a shoulder dislocation, having repair surgery may be considered elective.

 

I generally find the same is true in the US. Those that don’t use our health care system much think it’s the best in the world. Those that use it aren’t so happy.

 

I do however think our (US) medical system is significantly broken. When I was in high school (70’s) doctors made upper middle class incomes. My family physician lived within walking distance of my home. He made house calls. He drove a 63’ Ford Falcon. Yea, he made more than my family, and you could tell by other aspects of his lifestyle, but not obscenely more. When I went to see him, he seemed to be generally interested in my health, not about if I could pay. Often my family couldn’t pay, at least not right away. When I go to the doctor now, it’s all about money. When they recommend a test (X-ray, MRI, etc.), I always wonder if they recommended it because a) they don’t want to be sued for not running the test, or b) the machine is new and they need to pay it off.

 

Perhaps we could fix the problems with our health care system if we had a) universal malpractice insurance for doctors, b) full medical training reimbursement for medical students, c) build medical schools until class rooms are only half full, and d) let anyone go to medical school as long as they make the grade. Let’s face it we are paying for the malpractice cost anyway. Medical training reimbursement and more medical schools/students would produce an abundance of doctors. I would love to here that doctors in the US were leaving medicine to drive taxis because the money was better (Cuba).

[Severian]

Having lived in quite a few countries with quite a few different systems, I am of the opinion that a 'free' universal healthcare service (like the UK's NHS) is a bad idea. It breeds inefficiency and ends up providing a worse service for everyone. The only bonus it has is making sure that everyone has medical care should they need it. But this can be done in better ways.

 

In my opinion, the best system is to have a completely privatised health care system (hospitals, general doctors, pharmacies etc) but require everyone by law to have some form of health insurance.

 

It may seem draconian to force people to have health insurance, but what is the alternative? You would have to let people die who didn't have insurance. The current system in the US of allowing people to opt out of insurance but then still patching them up after their car-crash is a bit counterproductive because you reinforce their belief that they don't really need insurance. Since this option is probably not going to be tolerated by the public, health insurance needs to be mandatory.

 

In order to keep the price of health insurance low, the state should provide a subsidised health insurance. This should be a very basic service (basically emergency medical care and life threatening conditions) and would place a limit on the market preventing insurance companies from taking people hostage. It doesn't have to be a big expense for the state, since it can adopt the policy of charging enough to just about break even.

[CharonY]

In my opinion, the best system is to have a completely privatised health care system (hospitals, general doctors, pharmacies etc) but require everyone by law to have some form of health insurance.

 

Actually from what how I understand it, it is slightly similar to the German system. Essentially everyone is obligated to have some kind of health insurance. These come in two flavors, the private health insurers and the statutory health insurers. The latter have to take everyone in and those that cannot afford it are subsidized by the state. The private one usually offer more (e.g. you can get single bed rooms in hospitals or get to choose the senior physician over juniors. It is a rather expensive system, especially if unemployment is high, as all unemployed have to be taken in by the statutory insurers. However, if you income is at the lower end you will get all necessary treatments fairly fast. If resources are limited privately insured patients will get (unofficially) treated faster, though.

[Pangloss]

As a side comment about the movie, I'm actually looking forward to this one, after being disappointed by Fahrenheit 9/11. I don't mind ideological bias in a documentary, but I do mind intellectual dishonesty. I'm hoping this film gets back to the gut-wrenching honesty and brutal truth of "Roger & Me", one of my all-time favorite films.

 

As a further note about Michael Moore, I think he is at his best when he sets aside partisanship (but not his ideology, which would be impossible). When he focuses on telling us what we need, rather than telling us who's responsible for us not having it, he scores a lot more points with me. And, I think, with his target audience, which is not ideologues at all, but rather people who DON'T agree with him. That was his big mistake in F9/11 -- he forgot whom he was speaking to.

 

In terms of the larger issue of universal healthcare, we need it because this is the 21st century and it's the right thing to do, because it's the right investment in society's future success, and because we can afford it.

 

BTW, I heard Michael Moore make a great point in an interview the other day where he made the point that just because other universal healthcare systems have problems doesn't necessarily mean that we will have those same problems. They're not necessarily attached to the concept of universal healthcare, and in most cases they appear to be solvable problems. I know some of that stems from the repugnant, far-left ideological position that more government control is a good thing (unless it's about security or recreational drug use), but I think he has a valid point. Just because Canada has certain problems doesn't mean we can't address those problems and handle them better.

[ecoli]

I just finished Sicko, and I agree... it was much better than F 9/11. Some problems with the movie, I feel, are that his evidence is often anecdotal when displaying the bad things about universal health care. For example, statistically, there is (at least) an 18 weeks waiting period for health care... it just so happened the people he talked to didn't happen to have that. Perhaps because he was in an emergency room?

 

Also, I have Canadian relatives and, while they like their health care, they often complain about it. And my uncle works in a hospital, so he has direct contact with the medical care system.

 

I completely agree with Moore's overall point, that insurance companies are basically screwing people. And I understand and respect the fact that we shouldn't be allowing people to be profiting so obscenely off of the health (or lack thereof) of people.

 

What would happen, as a hypothetical discourse, if we made all the insurance companies not-for-profit organizations? This wouldn't exactly be putting them in the hands of the government (which I tend to be against), but it would take control out of the private sector, and profiteers.

[geoguy]

The issue isn't just 'which is better' but which system do you want in your own society. Canadians overwhelminglywant a universal healthcare system as do the citizens of most western countries (except the USA). Folks in western democracies are not 'stupid' and make their choices basedon their own life experiences. I like a public education system, a public library, public fire department, public police department, public military AND a public health care system. There is nothing sacred about it but any politician who preached otherwise in Canada wouldn't receive 2% of the vote. There are elements of private enterprise in the health delivery that would be acceptable to Canadians but not a systen in which some mother had to open her wallet when taking her child to the doctor or an elderly patient had to pay for a heart bypass operation.

 

Americans like their system and that's fine. An infrastruture has been set up in society in which trade offs have been made (as there has been in a universal system). Americans are intelligent and elect leaders through free vote and weigh the pros and cons of making health care an issue but don't demand a change. Their choice.

 

My brother is a prof in Kentucky in the USA and he likes the American system for Americans for a different reason. His reason is that any universal benefits that would be set up in the USA would be gobbled up by large minorities. Basically white middle and working class folks paying for benefits of blacks, hispanics and immigrants. In Canada (and europe) the society can afford to give an expectant mother paid maternity leave and paid time to raise her infant but a similar benefit in the USA would be 'gobbled up' by large minorites. The pot wouldn't be big enough and the system would become one of racial and ethnic tension. Americans start a lot of their criticism with 'why should I have to pay for....' and it would feed into the sentiment of intolerance and racism he sees around him. The way it is now a poor black mother is given the crumbs of the healthcare system and her child will probably perpetuate the same lifestyle. Americans have decided that a level of mediocre health for the poor, mediocre education and the resulting crime, drugs and so on is an acceptable level in society.

[ecoli]

In my mind, I keep going back and forth between two things.

 

I like the idea of not having to open up a check book when I go to the doctor. I also like the idea of being able to help the less fortunate. But, my selfishness kicks in, when I realize that, I'll be paying for health care I may not ever use, and I wouldn't have to worry about my premiums going up.

 

Couldn't this contribute to the wussification of America? Where we go to the doctor's for every cut and cold, just because it's "free." That's less resources we have to concentrate on the real problems. How do other countries deal with this?

[ParanoiA]

In my mind, I keep going back and forth between two things.

 

I like the idea of not having to open up a check book when I go to the doctor. I also like the idea of being able to help the less fortunate. But, my selfishness kicks in, when I realize that, I'll be paying for health care I may not ever use, and I wouldn't have to worry about my premiums going up.

 

Couldn't this contribute to the wussification of America? Where we go to the doctor's for every cut and cold, just because it's "free." That's less resources we have to concentrate on the real problems. How do other countries deal with this?

 

See, what bothers me is this "service" mentallity. Sure it would be great not to open a check book for a doctor visit. So would a 10,000 dollar check from the national treasury to my house everyday. Sure it's nice not to have to worry about switching health insurance when changing jobs...but then so would a mandatory 5 hour work week with 40 hours pay.

 

I think it contributes to the wussification of america in a different way - it validates the notion that the government should be a "service". I guess in some ways it ultimately is, but moreso I thought government was simply a necessary means of basic law and order for people to operate in. It's job should be basic, with the least possible interference in anything.

 

I think we've gotten wussified in thinking life should be so smooth and kind. How long before we see "working to make money for food" as cruel? I can see Michael Moore now..."this poor family has to work a job, just to feed themselves".

 

I don't see anything wrong with opening your checkbook to cure your sick baby. Universal or not, you're still opening your proverbial wallet to pay for medical care. We all have jobs to do and we all deserve to get paid, no matter how noble or self-less you've fantisized our jobs to be.

 

The cruelty would be, that when we're broke, no one would help us. That isn't the case. Instead, someone will help you, and like all FREE things in life, it won't be very desirable. Big whoop...

[john5746]

...

Couldn't this contribute to the wussification of America? Where we go to the doctor's for every cut and cold, just because it's "free." That's less resources we have to concentrate on the real problems. How do other countries deal with this?

 

My guess is... waiting time. If it takes 2 days waiting for someone to look at your cut, you will say forget it. Like Emergency rooms in America. Most people try to avoid them even if it is free, but some sit there for hours and hours for routine stuff.

 

How about incentive to live healthy? Would universal healthcare bring more or less incentive to live a more healthy lifestyle? That is the biggest problem for America, IMO. We live very unhealthy lives. It is a strange problem: The poor in our country can afford to eat themselves sick, but cannot afford the doctors and medicine to deal with the problems that come afterwards.

[geoguy]

In my mind, I keep going back and forth between two things.

 

I like the idea of not having to open up a check book when I go to the doctor. I also like the idea of being able to help the less fortunate. But, my selfishness kicks in, when I realize that, I'll be paying for health care I may not ever use, and I wouldn't have to worry about my premiums going up.

 

Couldn't this contribute to the wussification of America? Where we go to the doctor's for every cut and cold, just because it's "free." That's less resources we have to concentrate on the real problems. How do other countries deal with this?

 

In my city I can walk into the 2 clinics within a couple blocks of my home every day if I want to. the reality is the last time I walked into one was 3 years ago after stepping on a nail and my foot was 'a bit sore'. Doctor said it was smart to come in, gave me a tetanus shot, and sent me on my way but told me to come back at first sign of infection. Didn't have to. Case closed.

I don't know folks who run to the doctor because it's free but am not so naive to know there aren't a few who probalbly do this. Better to have a few folks abusing the system rather than some single mother hesitant to take their child in because it costs 50 for a visit. Perhaps the negligent mother has no money or perhaps a millionaire and a miser but that doesn't help the child. The same for those with 'sort of' chest pains, etc. Best to err on the side of taking care of those who need help than the rooting out few who are chronic hypochondiacs.

 

There's probably some truth to 'an ounce of prevention is worth a pound of cure'. Spend $25 on an oil change and eventually save $1500 on a new engine. Get your sore throat looked at and get some treatment before pneumonia sets it. I don't know where the 'balance' is. I just don't want any expectant mother not having regular visits to her doctor, getting an ultra scan if needed, blood tests, etc. and even thinking about costs of having her baby or financial 'what ifs'. Her child will get regulatar visits scheduled to the pediatrician and the mother will receive any help she needs at well clinics to cope with nutrition, stress and so on. If she's a crappy mother then that's all the more reason to be there to help the children and give them a step up in life.

[ParanoiA]

I just don't want any expectant mother not having regular visits to her doctor, getting an ultra scan if needed, blood tests, etc. and even thinking about costs of having her baby or financial 'what ifs'. Her child will get regulatar visits scheduled to the pediatrician and the mother will receive any help she needs at well clinics to cope with nutrition, stress and so on. If she's a crappy mother then that's all the more reason to be there to help the children and give them a step up in life.

 

The government already takes care of this, it's called Title 19. And they usually get something else, I forgot what it's called, but it gets free milk, juice and other stuff.

 

My sister in law used title 19 for 3 of her children. She got better care than my wife, using our insurance I get from work. We got ok care, don't get me wrong, but I was surprised how much her sister didn't have to worry about anything at all, while I had to worry about co pays and insurance claims.

 

I really don't understand the urgency or perceived problem with getting care for the poor. They are not turned down in an emergency, and there are lots of government programs for people who'd rather sponge off of the system rather than do work for it.