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Sonatavarius

1,322 posts

Farmer

Posted May 9, '12 8:49pm UTC

First off, I apologize if I leave out information or misrepresent an idea/philosophy. My knowledge is limited and I often times forget key points.

We all have our opinions of how the medical field should be run, ie. socialized medicine, obama care, the laissez-faire approach (or how the US is now... don't remember the actual proper term for it), etc. I would like for us to present our opinions and then discuss why an area should or should not adopt a certain policy on medicine.

I lean more towards the way that healthcare in the US is, for the most part, run now. There are those that frown on this policy, but I'd argue that it can sometimes provide better treatment (not at the level of the actual physicians and what they do, I'll get into that now) than a socialized medicine setting.

I've talked to a few people from different areas of the globe and they all have varying opinions. I'm pretty sure that Jeffreysinspiration (you might know her as Shona) is all for the free social system. (Kiss her, She's Irish!)

A middle aged gentleman from England that I talked to with some of my dorm friends on chat roulette seemed pretty torn over different aspects that come with free healthcare (you pay for it with your taxes, but you don't pay more to go see the doctor). He enjoyed the fact that paying into the system covered you for whenever you had an accident or needed work done, but he didn't like that he knew some people, whom had never payed anything into the system could show up and get all sorts of work done (expensive work too) and then leave without having ever supported the system themselves.

I have another English friend who claims to get urinary tract infections a lot. The waiting list to see the doctor had her weight something like 2 to 3 months before she was seen. Now that she has been seen at the clinic she's had to wait another some odd months before she'll have a procedure done to try and help her out. I'm not altogether sure what it is that they do for cases like this when it involves lady parts...

It's free, but is the wait really worth the wait?

I had a conversation with the dean of the medical school I'm trying to get into and he is a DO, for those of you who knows what that means, and he also has his MPH... Masters of Public Health. He compared Canada and the US when speaking to my group of interviewees, at least mostly those two entities. He said that there are instances where Canadians will come across the border to pay for certain preparatory procedures for a major surgery and then go back to Canada to have the surgery. It would for whatever reason help them speed up their waiting period. Another thing he told me was that at one point he was working in one of the northern border states and in that state alone there was something like 15 MRI machines located at different parts of the state. He then turned around and said that there was, at least at that time, only 15 MRI's in all of Canada. (the actual numbers may vary, but the basic concept I'm trying to get across is the same)

Now, for my story... A few years ago I used to be a 70+ mile a week runner until I slipped, fell, and really screwed up my shoulder. The whole motion of the arm swing that comes with running would agitate the area so bad it would make me want to vomit. I stopped running and tried to wait for over a year to see if the pain would ever go away. It never did. It would just hurt constantly, even without me running it hurt. I got an appointment to see the family orthopedist, and I only had to wait a few days to see him. I've shadowed the man before, and it isn't that he just isn't very busy... he is constantly seeing patients. He got me to do physical therapy to see if that would help the problem at all. I went to PT for something like 2 months and saw probably 0 results. He told me that after PT and a cortisone shot (forgot to mention he gave me one of those) that I'd probably need surgery, but he was more of a knee and elbow guy. He referred me to the regional shoulder specialist (another busy busy man). I saw the new guy the next week and we went through the list of events that had already taken place. He agreed that if I'd not seen any results then the next course of action was surgery. I explained to him that I started a summer term Organic Chemistry class in two weeks, and that the regular school term soon followed after that... and this meant that I wouldn't be able to be back home for something like 3 or 4 months. He said I could wait or he could expedite the process and squeeze me in the next week. So... I had surgery that Thursday and was in class with a gimped up arm the next Tuesday (pain pills out the wazoo, and I still got an A... don't know how that happened)

Which system actually provides the better medical care? To me, it seems like the system that my area goes by has the potential to provide the a sometimes more immediate treatment to the problem and to also sometimes be able to procure more resources with which to treat people (the MRI issue). I can see how this system could possibly leave out those who can't afford it, but I think with policies like medicare and medicaid we can help alleviate that problem. I think some of those policies need to be revised because you can have a void where there are people who can't afford healthcare/insurance and they also make too much to apply for some of the aid programs.

I see helping those who cannot help themselves as different from carrying the dead weight of someone else who just wants to piggy back on the system and have the system take care of him/her (like the English gentleman described)

Again, I'm not calling into question the quality of care a devoted doctor that's in a socialized setting will give to their patients... They pour their hearts and souls (I'm sure you can understand the figure of speech if you don't cater to the notion of an actual souls) into their jobs just like physicians everywhere.

If you have an opinion, I'd love to hear it (read it >_&gt. Maybe you will my mind.

First off, I apologize if I leave out information or misrepresent an idea/philosophy.  My knowledge is limited and I often times forget key points.\r\n\r\nWe all have our opinions of how the medical field should be run, ie. socialized medicine, obama care, the laissez-faire approach (or how the US is now... don't remember the actual proper term for it), etc.  I would like for us to present our opinions and then discuss why an area should or should not adopt a certain policy on medicine.\r\n\r\nI lean more towards the way that healthcare in the US is, for the most part, run now.  There are those that frown on this policy, but I'd argue that it can sometimes provide better treatment (not at the level of the actual physicians and what they do, I'll get into that now) than a socialized medicine setting.  \r\n\r\nI've talked to a few people from different areas of the globe and they all have varying opinions.  I'm pretty sure that Jeffreysinspiration (you might know her as Shona) is all for the free social system. (Kiss her, She's Irish!)\r\n\r\n  A middle aged gentleman from England that I talked to with some of my dorm friends on chat roulette seemed pretty torn over different aspects that come with free healthcare (you pay for it with your taxes, but you don't pay more to go see the doctor).  He enjoyed the fact that paying into the system covered you for whenever you had an accident or needed work done, but he didn't like that he knew some people, whom had never payed anything into the system could show up and get all sorts of work done (expensive work too) and then leave without having ever supported the system themselves.  \r\n\r\nI have another English friend who claims to get urinary tract infections a lot.  The waiting list to see the doctor had her weight something like 2 to 3 months before she was seen.  Now that she has been seen at the clinic she's had to wait another some odd months before she'll have a procedure done to try and help her out.  I'm not altogether sure what it is that they do for cases like this when it involves lady parts... \r\n\r\nIt's free, but is the wait really worth the wait?\r\n\r\nI had a conversation with the dean of the medical school I'm trying to get into and he is a DO, for those of you who knows what that means, and he also has his MPH... Masters of Public Health.  He compared Canada and the US when speaking to my group of interviewees, at least mostly those two entities.  He said that there are instances where Canadians will come across the border to pay for certain preparatory procedures for a major surgery and then go back to Canada to have the surgery. It would for whatever reason help them speed up their waiting period.  Another thing he told me was that at one point he was working in one of the northern border states and in that state alone there was something like 15 MRI machines located at different parts of the state.  He then turned around and said that there was, at least at that time, only 15 MRI's in all of Canada.  (the actual numbers may vary, but the basic concept I'm trying to get across is the same)\r\n\r\nNow, for my story... A few years ago I used to be a 70+ mile a week runner until I slipped, fell, and really screwed up my shoulder.  The whole motion of the arm swing that comes with running would agitate the area so bad it would make me want to vomit.  I stopped running and tried to wait for over a year to see if the pain would ever go away.  It never did.  It would just hurt constantly, even without me running it hurt.  I got an appointment to see the family orthopedist, and I only had to wait a few days to see him.  I've shadowed the man before, and it isn't that he just isn't very busy... he is constantly seeing patients.  He got me to do physical therapy to see if that would help the problem at all.  I went to PT for something like 2 months and saw probably 0 results.  He told me that after PT and a cortisone shot (forgot to mention he gave me one of those) that I'd probably need surgery, but he was more of a knee and elbow guy.  He referred me to the regional shoulder specialist (another busy busy man).  I saw the new guy the next week and we went through the list of events that had already taken place.  He agreed that if I'd not seen any results then the next course of action was surgery.  I explained to him that I started a summer term Organic Chemistry class in two weeks, and that the regular school term soon followed after that... and this meant that I wouldn't be able to be back home for something like 3 or 4 months.  He said I could wait or he could expedite the process and squeeze me in the next week.  So... I had surgery that Thursday and was in class with a gimped up arm the next Tuesday (pain pills out the wazoo, and I still got an A... don't know how that happened)\r\n\r\nWhich system actually provides the better medical care?  To me, it seems like the system that my area goes by has the potential to provide the a sometimes more immediate treatment to the problem and to also sometimes be able to procure more resources with which to treat people (the MRI issue).  I can see how this system could possibly leave out those who can't afford it, but I think with policies like medicare and medicaid we can help alleviate that problem.  I think some of those policies need to be revised because you can have a void where there are people who can't afford healthcare/insurance and they also make too much to apply for some of the aid programs.  \r\n\r\nI see helping those who cannot help themselves as different from carrying the dead weight of someone else who just wants to piggy back on the system and have the system take care of him/her (like the English gentleman described)\r\n\r\nAgain, I'm not calling into question the quality of care a devoted doctor that's in a socialized setting will give to their patients... They pour their hearts and souls (I'm sure you can understand the figure of speech if you don't cater to the notion of an actual souls) into their jobs just like physicians everywhere.\r\n\r\nIf you have an opinion, I'd love to hear it (read it >_>).  Maybe you will my mind.

4 Replies

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Avorne

3,085 posts

Nomad

Posted May 9, '12 9:15pm UTC

To be honest, I've heard it said that until a country has an at least partly-socialized healthcare system, that it can't truly be considered a civilized society - hence why my Government and Politics teacher views the USA as not being civilized. I'm partially inclined to agree with that. I'll admit that the NHS has flaws but so does any other healthcare system, something as massive and far-reaching as the NHS has grown to become will obviously have problems such as people leeching off of it or extended waiting times, but it still revolves around basic principles that I'm sure we can all agree are (at least in part) very well-intentioned. The NHS is, and should be, free at the point of delivery regardless of ability to pay - whether you're suffering from flu or a broken leg or a chest infection there will always be that net of service there to ensure that you are nursed back to health without having to worry about what could be tremendously high bills.

Better quality healthcare is available to those with the ability to pay for it, private hospitals and the like can be found in abundance and offer the full range of services that the NHS does, they're just a secondary source of healthcare rather than the primary one.

Anyway, I kind of wrote some stuff up on the NHS reforms that the coalition has put through recently, so I'll post that here as well - forgive me if any of the facts are wrong/out of date:

The NHS is currently organized in such a way that GPs and local/community Doctors act mainly as referrers, being the ones who pass patients on to Hospitals after diagnosing the problem rather than treating the problem in the community. Primary Care Trusts operate within communities and use both primary and secondary care as commissioned from providers. They also have their own budgets and priorities in order to accommodate this and do, in fact, fund general practitioners and medical prescriptions. However, Primary Care Trusts are seen as taking power out of the hands of GPs and overcomplicating the health service for patients and doctors alike, which led to plans to abolish Primary Care Trusts in favour of giving greater power to the GPs - allowing a GP-led consortia to do the commissioning of services and care rather than the PCTs.

The main changes that are proposed by the Government are:
-Establishing the independent NHS Commissioning Board
-Establishing new local authority health and well-being boards
-Developing Monitor as an economic regulator.
-The abolition of Primary Care Trusts and Strategic Health Authorities

The planned changes to the Health Service received widespread criticism and disapproval from many sides including the British Medical Association, the Liberal Democrats, numerous Health-care professionals and the general public - this criticism forced the Government into engaging in what David Cameron called a "Listening exercise" with the critics during which time (as from April 4th 2011) the plans were 'aused' to allow for discussion. Changes that have come about as part of this 'listening exercise' include the removal of the April 2013 deadline for the changes to the NHS and changes to the health regulator Monitor that will give them the purpose of promoting patients rather than competition.

Competition between health care providers is seen as being another important part of the plan for reforms - this includes the private sector contributing more to the provision/delivery of Health Care. The cap on Trusts income and how much they can take from Private patients is being lifted to accommodate this greater competition in the hopes of sparking 'Health Care Wars' between providers who will seek to present their Health Care at the best prices.

As you can see - there is going to be a much greater inclusion and reliance upon Private healthcare which could be seen as leading to a system like the one in the USA. Perhaps a mix of the systems of the UK and the USA is what's best though?

To be honest, I've heard it said that until a country has an at least partly-socialized healthcare system, that it can't truly be considered a civilized society - hence why my Government and Politics teacher views the USA as not being civilized. I'm partially inclined to agree with that. I'll admit that the NHS has flaws but so does any other healthcare system, something as massive and far-reaching as the NHS has grown to become will obviously have problems such as people leeching off of it or extended waiting times, but it still revolves around basic principles that I'm sure we can all agree are (at least in part) very well-intentioned. The NHS is, and should be, free at the point of delivery regardless of ability to pay - whether you're suffering from flu or a broken leg or a chest infection there will always be that net of service there to ensure that you are nursed back to health without having to worry about what could be tremendously high bills. \r\n\r\nBetter quality healthcare is available to those with the ability to pay for it, private hospitals and the like can be found in abundance and offer the full range of services that the NHS does, they're just a secondary source of healthcare rather than the primary one. \r\n\r\nAnyway, I kind of wrote some stuff up on the NHS reforms that the coalition has put through recently, so I'll post that here as well - forgive me if any of the facts are wrong/out of date:\r\n\r\nThe NHS is currently organized in such a way that GPs and local/community Doctors act mainly as referrers, being the ones who pass patients on to Hospitals after diagnosing the problem rather than treating the problem in the community. Primary Care Trusts operate within communities and use both primary and secondary care as commissioned from providers. They also have their own budgets and priorities in order to accommodate this and do, in fact, fund general practitioners and medical prescriptions. However, Primary Care Trusts are seen as taking power out of the hands of GPs and overcomplicating the health service for patients and doctors alike, which led to plans to abolish Primary Care Trusts in favour of giving greater power to the GPs - allowing a GP-led consortia to do the commissioning of services and care rather than the PCTs.\r\n\r\nThe main changes that are proposed by the Government are:\r\n-Establishing the independent NHS Commissioning Board \r\n-Establishing new local authority health and well-being boards \r\n-Developing Monitor as an economic regulator. \r\n-The abolition of Primary Care Trusts and Strategic Health Authorities \r\n\r\nThe planned changes to the Health Service received widespread criticism and disapproval from many sides including the British Medical Association, the Liberal Democrats, numerous Health-care professionals and the general public - this criticism forced the Government into engaging in what David Cameron called a "Listening exercise" with the critics during which time (as from April 4th 2011) the plans were 'paused' to allow for discussion. Changes that have come about as part of this 'listening exercise' include the removal of the April 2013 deadline for the changes to the NHS and changes to the health regulator Monitor that will give them the purpose of promoting patients rather than competition. \r\n\r\nCompetition between health care providers is seen as being another important part of the plan for reforms - this includes the private sector contributing more to the provision/delivery of Health Care. The cap on Trusts income and how much they can take from Private patients is being lifted to accommodate this greater competition in the hopes of sparking 'Health Care Wars' between providers who will seek to present their Health Care at the best prices. \r\n\r\nAs you can see - there is going to be a much greater inclusion and reliance upon Private healthcare which could be seen as leading to a system like the one in the USA. Perhaps a mix of the systems of the UK and the USA is what's best though?

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Sonatavarius

1,322 posts

Farmer

Posted May 9, '12 11:16pm UTC

Your healthcare system is funded off of (at least partly) sales taxes, correct? Do citizens have the liberty of opting out of the system if they'd rather keep their money and take their chances?

What does it mean to be civilized? Is it making everyone pay certain taxes for the greater good, regardless of whether or not they want it? Is it allowing freedoms that will invariably have two separate parties tearing at each other's throats? (freedom of speech allows for racism and the Westboro batptist's hateful words)

Beautiful concepts like free healthcare and freedom to say what you want don't manifest in a vacuum. There are certain things that have to be allowed and/or done that are arguably not very civil. If a civil society allows for freedom of speech, then I guess civilized people go around spreading unpopular sometimes hateful ideas. If people never did that, then there'd be no reason to even proclaim that there is freedom of speech. Do civil societies force you to submit to taxes for things you don't want to fund? That doesn't sound like civil from my perspective. That doesn't sound very different in contrast to times past.

QUICK!!! One of you artsy forumers draw a scene with a bunch of monkeys dressed up in suits at a social event (don't want to say tea time, b/c that'd sound like it was directed towards our English viewers and not just a stab at civilized life in general) flinging poo at each other, saying mean things, while having chains on them that say "taxes" and "not truly free."

The definition of civilized that I found (taking AG's usual approach to a concept... Resort to the dictionary for the literal interpretation!) is -Bring (a place or people) to a stage of social, cultural, and moral development considered to be more advanced: "a civilized society". I would think that a civilized society that has transcended archaic times would take into consideration socialized medicine, but I don't think that they would have to decide on it to remain civilized. If most of history had the masses subject to whatever their ruler wanted to do or have done at the time, then I'd think that a civilized society would be one where the people have the option of deciding regardless of their decision.

Civilized life is overrated anyway. Poo on that. 'Murica!!!! F-yea!!!

I has question... Do the physicians that are part of the free healthcare system over there get paid well enough? I know the UK isn't nearly as large as the US land mass wise, but does the UK have an issue with medically under served areas? I'm just curious, because there might be an issue with motivating people to spend roughly 12 or more years of their lives to become a physician (getting into all kinds of debt), when the pay off is only the smiling faces of their cured patients... smiles are great, but they don't make the people you owe money stop calling. If they're not paid well enough, then in a culture where the All-mighty dollar reigns supreme, you might have smaller and smaller amounts of people who want to put up with the hell of med school. The US has medically under served areas as it is. I don't see how the government could support paying for doctors on top of all of the other crap it is spending its money on... especially not at the level that doctors are making now on their own. If I get into this one school, then it's going to cost me (living, tuition, and all) roughly 70,000 Dollars a year for four years to afford it. That's slightly over shooting it, because I'm not going to need some of the stuff the budget accommodates... but it'll be close. Would I be able to pay off my bills, a quarter million (if not more), on a socialized pay check? There are a lot of med schools in the US and each one is pumping out 100-200ish doctors a year. I'm not sure that the government really has the money to pay all of the ones we already have... let alone the ones that get added to the system each year.

How much of a sales tax (and whatever else it influences) do you have to pay?

Your healthcare system is funded off of (at least partly) sales taxes, correct?  Do citizens have the liberty of opting out of the system if they'd rather keep their money and take their chances?\r\n\r\nWhat does it mean to be civilized?  Is it making everyone pay certain taxes for the greater good, regardless of whether or not they want it?  Is it allowing freedoms that will invariably have two separate parties tearing at each other's throats? (freedom of speech allows for racism and the Westboro batptist's hateful words)\r\n\r\nBeautiful concepts like free healthcare and freedom to say what you want don't manifest in a vacuum.  There are certain things that have to be allowed and/or done that are arguably not very civil.  If a civil society allows for freedom of speech, then I guess civilized people go around spreading unpopular sometimes hateful ideas.  If people never did that, then there'd be no reason to even proclaim that there is freedom of speech.  Do civil societies force you to submit to taxes for things you don't want to fund?  That doesn't sound like civil from my perspective. That doesn't sound very different in contrast to times past.\r\n\r\nQUICK!!! One of you artsy forumers draw a scene with a bunch of monkeys dressed up in suits at a social event (don't want to say tea time, b/c that'd sound like it was directed towards our English viewers and not just a stab at civilized life in general) flinging poo at each other, saying mean things, while having chains on them that say "taxes" and "not truly free."\r\n\r\nThe definition of civilized that I found (taking AG's usual approach to a concept... Resort to the dictionary for the literal interpretation!) is -[b]Bring (a place or people) to a stage of social, cultural, and moral development considered to be more advanced: "a civilized society".[/b]  I would think that a civilized society that has transcended archaic times would take into consideration socialized medicine, but I don't think that they would have to decide on it to remain civilized.  If most of history had the masses subject to whatever their ruler wanted to do or have done at the time, then I'd think that a civilized society would be one where the people have the option of deciding regardless of their decision.  \r\n\r\nCivilized life is overrated anyway.  Poo on that. 'Murica!!!! F-yea!!!\r\n\r\nI has question... Do the physicians that are part of the free healthcare system over there get paid well enough?  I know the UK isn't nearly as large as the US land mass wise, but does the UK have an issue with medically under served areas?  I'm just curious, because there might be an issue with motivating people to spend roughly 12 or more years of their lives to become a physician (getting into all kinds of debt), when the pay off is only the smiling faces of their cured patients... smiles are great, but they don't make the people you owe money stop calling.  If they're not paid well enough, then in a culture where the All-mighty dollar reigns supreme, you might have smaller and smaller amounts of people who want to put up with the hell of med school.  The US has medically under served areas as it is.  I don't see how the government could support paying for doctors on top of all of the other crap it is spending its money on... especially not at the level that doctors are making now on their own.  If I get into this one school, then it's going to cost me (living, tuition, and all) roughly 70,000 Dollars a year for four years to afford it.  That's slightly over shooting it, because I'm not going to need some of the stuff the budget accommodates... but it'll be close.  Would I be able to pay off my bills, a quarter million (if not more), on a socialized pay check?  There are a lot of med schools in the US and each one is pumping out 100-200ish doctors a year. I'm not sure that the government really has the money to pay all of the ones we already have... let alone the ones that get added to the system each year.  \r\n\r\nHow much of a sales tax (and whatever else it influences) do you have to pay?

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MageGrayWolf

9,462 posts

Farmer

Posted May 10, '12 1:45am UTC

I can see how this system could possibly leave out those who can't afford it, but I think with policies like medicare and medicaid we can help alleviate that problem.

I'm on medicaid and I still can't get treatment for my arthritis. The number of doctors who accept it are very limited and there simply aren't any rheumatologists in my areas who do.

I see no reason why a system couldn't have both a publicly funded socialized system and a privately funded system to pick up the slack where the public system might fail.

The point that some might very well leech off a socialized system seems trivial to me. As for the wait, for many it's a matter of a long wait or no treatment at all. Given a choice between the two, the lesser of the two evils seems like the long wait.

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Sonatavarius

1,322 posts

Farmer

Posted May 10, '12 5:45am UTC

On the subject of carrying other people's weight...

If resources were infinite and we could actually carry everyone without worrying about the system, then I wouldn't have any misgivings about this system. As it turns out, our resources are not infinite, and free rides drain our already limited resources. This sentiment can be best seen in the similar parallel situation our social security problem. Rumor has it that it is running out, yet the working aged people who will most likely never see a dime of it (not unless something drastic happens) still have to pay into it. Just like with free healthcare, what happens to these people who have supported this system once it fails? They've happily and readily supported something that is to take care of everyone... but, if it fails it won't protect them and their families. They've spent their lives paying a crap ton of money (it eventually adds up), and when they need to fall back on it... it might not be there to catch them.

I agree that those who have not the means to take care of themselves should be helped. I agree that people who are here for whatever reason that have an accident should be helped... I'm not a fan of setting up a system that will allow people to show up and leech when they have never and don't ever plan to support the system when they most certainly have the means to. I'm trying to make sense, but I'm probably not... :/ If medical care would still cost upward of thousands of dollars for certain procedures, then even a small number of leeches could drain a large amount of the system's life blood.

For a country in as much debt as we are, is this not a valid fear? A similar system is in its death throws right now. ....In hindsight, I think they just restructured it. But, that shows we might not be able to maintain it. What happens if the government ever defaults? Is that going to affect the money available for the healthcare system? I'm not as caught up on the US politics, legislation, and the like, as I should be, and I apologize for that. If we had a ton of resources and could easily live in this utopian society without fear of it coming back to bite us in the *** later, then I might be able to back it more. If it goes for a while and then crashes, then I've paid a large sum of money into the system only to be left out to dry later on.

On the subject of carrying other people's weight... \r\n\r\nIf resources were infinite and we could actually carry everyone without worrying about the system, then I wouldn't have any misgivings about this system.  As it turns out, our resources are not infinite, and free rides drain our already limited resources.  This sentiment can be best seen in the similar parallel situation our social security problem.  Rumor has it that it is running out, yet the working aged people who will most likely never see a dime of it (not unless something drastic happens) still have to pay into it.  Just like with free healthcare, what happens to these people who have supported this system once it fails?  They've happily and readily supported  something that is to take care of everyone... but, if it fails it won't protect them and their families.  They've spent their lives paying a crap ton of money (it eventually adds up), and when they need to fall back on it... it might not be there to catch them.  \r\n\r\nI agree that those who have not the means to take care of themselves should be helped.  I agree that people who are here for whatever reason that have an accident should be helped... I'm not a fan of setting up a system that will allow people to show up and leech when they have never and don't ever plan to support the system when they most certainly have the means to.  I'm trying to make sense, but I'm probably not... :/  If medical care would still cost upward of thousands of dollars for certain procedures, then even a small number of leeches could drain a large amount of the system's life blood.\r\n\r\nFor a country in as much debt as we are, is this not a valid fear?  A similar system is in its death throws right now.  ....In hindsight, I think they just restructured it. But, that shows we might not be able to maintain it.  What happens if the government ever defaults?  Is that going to affect the money available for the healthcare system?  I'm not as caught up on the US politics, legislation, and the like, as I should be, and I apologize for that.  If we had a ton of resources and could easily live in this utopian society without fear of it coming back to bite us in the *** later, then I might be able to back it more.  If it goes for a while and then crashes, then I've paid a large sum of money into the system only to be left out to dry later on.

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