I use to have a Bookie in the family and he would say, "I don't gamble, never have and never will...gamblers loose and the house always wins...And I'm the HOUSE."

Gambling is a disease...I've seen it first hand...I've seen people shake looking at the sports section. I've seen guys ruin their lives and the lives of their families. Gambling can be horrible.

If socialized health care would give that lotto gambler health care..I'm all for it. Some things are not meant to be a business, some practices have to come from the heart first and foremost. I may not know what addictions are and how they really feel or how it is wasting my money...But I know what it's like to be poor, I know what it feels like to have no hope...We can't have 40 plus million people not medically covered. We can't have people denied coverage for any reason. It's not right. Morally it's not right.

David,

Do you offer your employees health care coverage?

Gary,

I just remembered that the last time I was in Aruba, my Uncle broke his wrist and had experience with there Health care system.

My Uncle jumped off a rock, landed funny and broke his wrist in more then one place. We drove 45 minutes to the only hospital on the island. All three of us went to the emergency room and waited.

Were you treated in a timely manner? Yes, but citizens were considered before foreigners. Although, I'm sure a life threatening illness would have been taken first. It seemed that everyone in the emergency room was there for scrapes, burns or a broken bone. There was a small child not feeling well--obviously sick, he went first. More then one person came in really bruised up from the "Tunnel of Love" LOL...Funny, my Uncle and Dad were born in Aruba and I've been to Aruba several times and none of us had heard about the "Tunnel of Love" but it wasn't kind to men.

Was your pain managed well? The bone was set, cast put on, surgery was recommended but could wait until we were back in the States, pain pills prescribed. Doctor said a hundred bucks would do...we gave it and he put it in his pocket. We left. When we got back to the states my Uncle had to have the arm operated like they told us.

We have very good friends who live in Aruba, they are not exactly poor. Where do they go for the basics? They get treated in Aruba. Where do they go for any major illness? The United States...I know they've been to NY, Florida and Europe. In Europe our friends are from the Netherlands one of the founding members of the E.U., so I don't know how health care works for them. Well, the husband was from the U.S. and his wife was from the Netherlands..I suppose they had the best of both worlds. Just a long plane ride.

I remember the hospital looking very old and deserted compared to ours. We saw one very tired looking doctor and two very young interns from Holland. They were very nice, but I wouldn't want to be treated for cancer there...at least at that time in 2002.

No, we have looked into it but it's very expensive and believe me restaurants, especially the mom and pop type that can't enjoy the savings of a chain restaurant environment, are not big profit makers. Being a CPA and having a large percentage of my practice devoted to the Hospitality Industry and I consult even the chains on profitability issues, I pleaded with my wife not to open a restaurant but like most husband/wife debates I let her win (lol).

You also have 2 basic types of restaurant employees; one, the servers who make mega bucks, like $40 an hour and two, the rest that are hourly/salaried that make very low wages. The first group is typically high turnover young, single, going to school and spends everything they make before they come back to work the next day. They also could care less about medical insurance. The second group is much more stable but has more debt issues and can't afford medical insurance on top of everything else.

Restaurants also have some very strange Labor Laws that we have to deal with that pretty much creates our 2 tier wage force and if we try to equalize the pay to the 2 groups, we can and will be severely penalized. My perfect restaurant would be where every employee would be paid the same hourly rate because in my opinion every one is just as important than the next but to do that I would have to be a maverick and all my top servers would migrate to all the non maverick restaurants.

It is also a shame that we can't offer a group policy to only those that want it and achieve the benefits of a group without having to pay 50% of the premium.

I assume all health care plans don't include vision, prescriptions and dental. Or are scripts included in all plans?

I work for a large company and our plan choices are determined by location and whether the employee is union or non-union. I often wondered if I was transferred to another area and had to change my plan, how that would affect my precondition with the new provider...If I moved to another county that alone could change coverage. It sure is complicated and scary. Am I stuck in my area due to cancer?

Too bad coverage wasn't determined by a whole industry or county or state or something like that...I suppose that would be socialized health care.

If small companies can't afford health care and large companies are having trouble affording the ever rising costs and as self-employed Gary proved having everything covered is very difficult. If it was socialized health care and we all paid through the form of taxes...Then who makes up the premium difference? Costs just don't drop. What happens to the industry as a whole? Is everything just regulated that much more? More red tape? Forms to fill out? It's complicated now and I can't see it getting easier other then everyone is covered...which I consider a major accomplishment.

I'm sorry I'm going off subject from what Gary originally asked but this subject has a lot of questions within itself. It's huge. Yet, other countries have been successful. within the U.S., SS, Medicare, and Medicaid are all socialized and they are a mess...maybe the whole system has to be one way or another not a mixture of both. Maybe if there wasn't so many choices...it's very confusing, I don't see how it can be fixed. Buying the wrong car is a horrible mistake, buying the wrong health care is deadly.

How long has socialized medicine been around? And was it better before or after the change?

Gary--you have my head spinning with this subject...LOL

Until recently most medical practices consisted of at most three partners, a receptionist and a nurse or a nurse/receptionist. An office visit was within range of the average person and doctors were able to allow a patient to "payout" a bill over time, even for conditions requiring hospitalization. The average person could afford to pay out of pocket and used medical insurance for big expenses thereby not driving up his premium.
Today most medical practices have more categories of employees than a military regiment. Malpractice insurance rates and frustration with insurance and governmental regulations have led to early retirement for many physicians. Diagnostic testing has become increasingly expensive. Hospital costs have risen astronomically. Today only a wealthy person can pay for most medical expenses. When medical treatment can rise into the tens and hundreds of thousands of dollars and even more even the wealthy can not afford the costs.
However, We all benefit from the increasingly effective diagnostic and treatment advances of the past few years. The only aspect of medical care which has not changed is the human. There are still more gifted, caring, well educated and observant medical professionals than the other kind. It is unfortunate that the cost medical care has become so regulated by insurance companies and governmental regulations. It seems to me that the best answer would be to have physician peer approved practices for every specialty with latitude for physicians judgement in certin scenarios. Every physician should be required to participate in at least one specialized "board" and receive on going information about his specialty. There has to recognition that the patient/doctor team is the best source of evaluation of treatment.
No one should be forced to undergo any examinations or treatments (such as mammograms, prostate checkups, etc.) no matter how obvious it is that by so doing money would be saved down the line. Likewise no one should be denied treatment he or a physician feels is neccessary. We have to recognize that not only "medically neccessary" options are important to a patients well being.
How to pay for this?? I am afriad that there is no good answer. It is foolish to believe that any party paying the bill should give out blank checks to doctors, hospitals or patients for every treatment without some determination of standards. The problem is that there will always be bureaucracy and associated red tape.

Ray: Costs do drop when no one has a profit requirement. Some would argue that the profit expense is replaced by bureaucracy expense, but there is already huge overlapping bureaucracy expenses with all the various insurance companies and hospitals performing the same function.

Great thread - love the discussion.

Donna

My last experience with UK healthcare was a few years ago.

My mum had a ruptured bowel which ended with a permanent stoma.. She also had a stroke during surgery.
During the time she was hovering between life and death my father (80) had a complete breakdown in which he stabbed himself 6 times.
He was placed in a treatment facility for 3 months.
Between the two of them I was in the UK for 5 months.
The treatment they received was amazing.. they were they both hospitalized for months. The aftercare, from folk coming into the home to make sure they were both managing, eating properly, making sure their home was suitable for disabled persons, given any aids they needed ...I could go on.
All this at no charge to them.
I know that a big part of that system I would not like e.g waiting for non-urgent care, but, I dread to think how much debt they would have been in had they lived here.
I am firmly of the opinion that healthcare is a right not a privilege.
We are, or were, one of the richest countries in the world, our people should not have to go into bankruptcy because of medical needs.

Medicare can be screwed up but like everything else it's all about understanding how the system works. I am enrolling in Medicare Senior Advantage though Kaiser and it includes Medicare A, B and D it has a vision plan and limited dental for $86.00/mo (that doesn't include the $93.00/mo deducted from my SSDI. The deductible for doctor visits is $25.00 and prescription drugs in the Kaiser formulary, as long as they are generic is $12.00. It is an HMO plan, unforunately some states, like Arizona don't allow HMO's. Then a supplemental plan, like AARP offers, can cut the expenses way down, pays for what Medicare doesn't cover. My dad had both, broke a femur, had cancer and I don't remember paying a dime for his healthcare, even the ambulance rides or PT.

I worked mostly high paying jobs and have been fully vested in Social Security for quite a while and that has helped a lot.

There is some truth to what David says about spending priorities and it's not just on lottery tickets. In the US people buy all sorts of stuff they can't afford at the expense of medical insurance. We have truly become an entitlement society and that in itself is a sickness. I am sure that like the gas crisis, if we ALL share the pain a little then health care premiums can be brought down, much like auto insurance rates have been in California (you can't get a license without proof of insurance). If all small businesses offered health insurance maybe the rates would come down to a manageable level for the rest of us. Maybe a shared responsibility between small business and Social Security, similar to Medicare would be a possible solution. (I'm sure starting to sould like I'm for socialized medicine aren't I?).

People under 40 can get catastrophic care coverage for pretty cheap. When it starts to get expensive is when you go over 40 and really ramps up in the 50's when many chronic illnesses amd self abuse start to take their toll.

I have always love the saying "If I had known that I was going to live this long, I would have taken better care of myself".

There are no simple solutions. Obama is simply not going to be able to reform the system overnight - it might take his whole term if ever...