Healthcare: universal or affordable?

"Affordable" healthcare is at no. 5 and is on its way up on the priority list over at whitehouse2.org.  Universal, single-payer, healthcare is at no. 11 and is on its way down.  Why?  I suggest it is because most people in the U.S. are familiar with un-affordable healthcare and have no experience with "socialized" (dirty word) care.

"Socialized" schools, police, fire departments and some other necessities are OK.  Does it follows, then, that healthcare is not a necessity?  I disagree.  Just removing the fear (stress) about not being able to afford a medical emergency will immediately improve health by a few points. 

I'm no expert, but I've experienced the Norwegian system for a couple of decades and want to tell you about it.

Prerequisites for a health care system like the Norwegian one include: 
--identification of each person (patient) -- Check.  We have Social Security Numbers.
--identification of each doctor, lab, hospital -- Check.  They’re licensed and registered.
--identification of each diagnosis and its approved treatment(s) -- Check?  The insurance companies, collectively, have that information.  They must be allowed, I think, to bid on government contracts.  Their expertise is needed, at a price -- but not at a profit.
How does it work in Norway?  Doctors who go into the system state how many patients they want on their lists.  I choose which GP’s list I want to be on.  The doctor gets paid a small amount a year for each patient, whether the patients ever go to the doctor or not.  The doctor also gets paid a certain amount each time I go to him. 
Starting in January, I pay around $20 for each doctor visit, including for specialists and tests my GP sends me to.  I pay a subsidized amount for each prescription drug on the essential list.  I keep the receipts on a wallet card.  When I’ve paid $300, I’m done paying for those things for the year.  Doctor visits and essential prescriptions are free the rest of the year.  Now, some people don’t bother to keep the receipts, as they never reach that $300 limit.  One parent and all the kids in a family share a $300 limit. 
Hospitalization is free.
Except for kids, dentistry is still outside the system, and it’s expensive.  Glasses are outside the system, though a doctor’s examination and prescription for glasses are free as outlined above.
Citizens and residents cannot opt out of paying their taxes for this system.  Doctors and clinics can opt out and charge what people are willing to pay.
If Americans can be cured of their allergy to the word “socialist”, shouldn’t this system be workable for them, too?
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Poll

Which healthcare system should we push for?
Universal, single-payer 90%
Affordable (insurance) 0%
No change: what we have now 9%

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--identification of each diagnosis and its approved treatment(s) -- Check?  The insurance companies, collectively, have that information.  They must be allowed, I think, to bid on government contracts.  Their expertise is needed, at a price -- but not at a profit.

by Scandinavian Chef on 11/12/2008 04:46:47 PM EST

Not sure what you are asking.  On a prescription for what I've called an "essential" medication (blå resept), the doctor states above her/his signature that the diagnosis is within "group X" and that the medication is within "group Y".  If in the government's lists, that medication is not a standard remedy for that diagnosis, further application/explanation will be required. 

by Arna on 11/12/2008 06:49:14 PM EST

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Sicko

Im all for socialized medicine .. the sooner the better.


by Chinese Democracy on 11/13/2008 02:07:37 AM EST

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--identification of each diagnosis and its approved treatment(s) -- Check?  The insurance companies, collectively, have that information.  They must be allowed, I think, to bid on government contracts.  Their expertise is needed, at a price -- but not at a profit.

Just unsure where insurance companies come into the picture. As far as I know, they can't get a hold of your medical journal without your approval.

-J

by Scandinavian Chef on 11/13/2008 06:37:56 AM EST

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Apparently I'm being quite unclear on this.  My point was that whether the expertise remains in and is purchased from the insurance companies or goes to the NIH or Medicare or whomever, there are tasks now being done by those companies which will still have to be done.  Statistical and control tasks and others.

I certainly don't want my doctor handing over my journal to anyone!  But when he writes a prescription, he signs off on what group of diagnoses this is for and that the medication is approved for the diagnosis.  There are controls on that (which do not involve my name), and if he wants to try some unapproved drug, he'll have to apply for permission to do so.

In some cases, the patient's name is required.  I do happen to use a prescription medication which isn't on any approved list.  My specialist has to write a new application each year, in good-old-fashioned triplicate, to get a prescription approved for me personally.  He believes that this medication should be approved and that it eventually will be, when the powers-that-be catch on to the newest (like 15 years old) research on my condition.  (The system is quite conservative.)  The only restriction for me is that I have to get this drug at the local pharmacy which has the approved application on file, and I have to wait a few days for them to get it in.

Am I clearer now?  I'm talking about system-wide controls and statistics.

by Arna on 11/13/2008 09:39:55 AM EST

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