I met a nurse during lunch earlier who's a contract manager for a health insurance company. We chatted over stuffs and one particular story that I'd like to share w/ ya'll. A couple went into the hospital for prenatal care. They had ultrasound done and the results showed that the fetus has tetralogy of fallot; no esophagus, and the arterties that deliver blood to the brain was below the aortic arch when it should be above. However, since the couple don't understand English, a medical intepreter was called in to do the translation. The sad thing here is that no one is sure whether the translation was accurate cuz the parents thought their baby was perfectly fine and carried him/her to full term only to find out that the baby will die at birth. There is no lawsuit file or anything but I thought it was a rather sad case and interesting discussion about personal and professional ethics as well as medical legal responsibility. Do ya'll think that it's the hospital/doctor's responsibility to make sure that the parents fully comprehended the conditions or is it the patient (couple in this case) responsibility?? I read online that according to research; some medical intepreter neglect to translate about abortion option or any sort of that due to religous reason regardless of circumstance. Whilst on that point, even insurance has refused to pay the medical bills claiming that the parents fully aware of the situation but ignored the the doc's order. Just when you think things can't get any worst, you're hit will a huge hospital bills??? SAD or what?? Personally, I feel the couple should file a lawsuit against the hospital/doctor for negligence. Whilst the doc is not directly at fault, the medical institution was the one that hired the medical intepreter. Because of mistranslation, the couple has to go through emotional, physical, and possibly mental pain. Cuz anyone on the right mind will not carry the baby to term if they know the baby will die at birth, correct?? suing in this case is not a choice but a must for damages and cleared up the hefty bills as well.
it should always be the doctor's responsibility to make sure the patient is fully aware of the situation... this case is sick... the doctor at the very least should have informed the parents that the baby would have little to no chance of survival once the baby was delivered... if there was even the slightest chance of something lost during translation, the doctor should have advised/guided the parents to someone whom they could better understand them...
It can go either way. It's the doctors fault for not making sure the patient understands the situation BUT it can also be the patients fault for not letting the doctor know that they did not understand.
I'm just curious how the translation can be entirely opposite of the situation. Could it even be possible that the medical interpreter could have translated so erroneously that a bad situation became a good one?? Nevertheless, I guess it is still the doctor who has to make sure that the couple really understood what they heard. Sad case.
I don't know the exact details about the case but I can be 100% sure that any intern; not doctor yet can see that the baby will not survive since it's very clear with the four heart chamber and the missing esophagus on the ultrasound. I don't think the doc had left out the survival rate. Since s/he doesn't understand the language, everything is down to the med intepreter. If anything, I believe it's the mistranslation. Whilst I think it's the hospital's job to ensure all patients are aware of their conditions and all but it's difficult. There are language and culture barrier; definitely hard to address all needs so at the end, I believe patients should always seek second opinion when in doubt. It's the patient's responsibility to look out for his/her own health. It's like when we cross the street. Driver knows that pedestrians have the right of way when crossing at the crosswalk when it's green light; however, you simply can't trust the light; you gotta look both way before you cross cuz who know, driver can miss the light. you gotta look out for yourself.
it could go either way but i think that the translator could be at fault, since the it was stated "whether the translation was accurate" right now, it's just a blame game between patient and doctor
everyone makes mistakes but then this is a serious one that CAN be preventable however things just didn't go right. of corse the couple can sue but then it will cost a lot of money and they may or may not win. I dont konw how people can go to chekups or doctors when they dont understand english? it just doesn't make sense
^ Actually there's a really interesting idea my Anthropology professor mentioned. It has do to with respect to authority. In this case, respecting the doctors authority and not questioning him.
I would believe the medical institution is at fault, the hired translator clearly did not do his job correctly.... he must have sugar coated or misunderstood the severity of the situation leading them to believe their baby would recover....
This one's a no brainer; the medical institution is at fault for failing to ensure informed consent. The ultimate responsibility is on the giver or provider of the profession, to always explain fully what they are offering to the patient, and at what risks for what benefits before the patient can legally be held to his or her decision of consent. That's clearly not what had happened here. Legally speaking, Swish... this one's all net. On the practical side though, I can see where shit like this can happen. I've seen plenty of "Chinese" interpreters often mangle a medical interpretation and explain or say things that are just outright lies or shit that's made up when they; a) either don't know what the words in English mean, or b) don't know how to say the words in Chinese. The former usually afflicts the relative brought along by the non English speaking patient, and the latter is usually the medical care giver who is an ABC that can't really speak anything but DimSum Chinese (ie just enough to go Yum Cha). With the internet, the doctors and interpreter could have easily provided pictures and diagrams of Fallot's Tetrology, the congenital malpositioning of the carotid arteries, and the esophageal atresia. While any one may not be necessarily fatal (and can be easily corrected), the combination of the three together would already consign the newborn to an extreme regimen of progressive surgical interventions where outcomes are highly uncertain. This is something that is so unusual and of such an extreme high risk that any doctor would have the presence of mind to ensure informed consent before allowing any patient to go forward with such a pregnancy. In other words, it should have been all over the patient's chart that "...she fully understands the risks of her baby being born with a heart whose chambers and tubes were wrongly positioned, who may already be severely brain damaged, and not have a food tube, along with the almost certainty of being still born; several interviews by multiple and different medical professionals who speak her language natively and used as translators were met with her steadfast insistence that the pregnancy be carried to term despite it being contrary to our judgement and that of the medical community at large..." As a total side bar, while Fallot's Tetrology can be easily detected by 23 weeks, esophageal atresia is not something easily seen on a prenatal sono (ultrasound). So I'm guessing this was really rather late in the game to begin with. Further, abortion is a medical procedure, not a religious one. If your religion does not allow you to fully and accurately translate, then get yourself another job. And finally; sue the bastards.
well, yeah i think they should sue .. of course, the med institution .. aftering the one w/ the $$$. but from a physician stand point, where do you draw the line as to know for sure that the patient fully understands the risk and benefits especially when you can't understand the language. ya'll know when you walk into a doc clinic and they would hand you a bunch of papers to sign before sending you to the waiting room. i bet 95% of the patients do not bother to read them cuz the front desk just simply say that it's general practice that if you're don't pay, we will bill you and this is our privacy statement obligated by law. we don't share your med information w/o your consent. GUESS WHAT .. READ CAREFULLY Why? my family and i go to a private clinic for med care and when i read through the privacy statement, there was two lines that said that whilts our medical record will not be released without our consent, our name and address will be added to the catholic clergy list of donors. i was like WTF and tell them NO, I will not sign it cuz I don't agree with the statement. I am not catholic, not gonna donate to the church, and definitely don't want my name to be added to any list. EVEN THE PRACTICE MANAGER HAS NO IDEA THAT such lines were included into the statement, so she has to confirm it with the docs there. It turns out that the founder of the clinic was a catholic and stuffs so they just told me to cross out those lines, initials and dated that I don't agree. The lesson here is to make sure you READ everything before signing anything. Even though this situation is not very serious but who knows .. just like when you think the church is safe for kids, children are actually being sexual molested by priests .. you gotta look carefully and out for yourself and not doing anything in a rush.
By having her explain back to you, using layman's language through another interpreter, what is going to happen to her and her baby; what the baby's life is going to be like, and the chances of the baby being able to be born alive at all. Ideally, both interpreters should be currently US certified and licensed medical personnel that have also practiced medicine in that patient's home country, so that you're sure that they not only understand the medicine, but that they've actually practiced medicine in that language too. Your other problem is not unique. Yours is not the first instance in which "God tries to play doctor" or in which church affiliated medical facilities attempt to strong arm people by using their offer of medical services to extort religious fidelity or compliance. This is one example of why the state should never be affiliated with ANY religious organ as the result can be coercive and manipulative. I really feel sorry for those poor bastards living in organized religious states like Iran and Israel, where their religious authorities extend into secular government functions. Another state where this effect is worth study would be Tibet, where religion influences life a tremendous amount. However, under Chinese military occupation, this question has become moot as the church and government there no longer holds any real power. Whether the impetus is from Islamic fundamentalists working to impose Sharia, or Christian fundamentalist working to impose the Ten Commandments (as the only civil and criminal authority); any religion controlled legal venues ultimately becomes easily tainted. And it's already public knowledge that the church can be as political motivated as the mafia. Just a look into their pedophile cover up history would provide ample evidence of this. We should only have one government, that which we vote for, and none should have any shadow organization controlling the agenda. Oh, and BTW, most lawyers agree that anything you are required to sign in an attempt to get medical treatment in and of itself is a matter of signing under duress, that is, you're only signing in an attempt to get medical treatment without regard to what was actually on the paper. Hence, the statement that you nominally signed and "agreed" with won't stand up in court. Still, you're right in that one should always read before signing anything. :ugh:
Let's play devil's advocate. I don't know where this case happened, nor have I read about the case other than what's posted in this thread. The doctor saw the patient, did the ultrasound, diagnosed tetralogy correctly, and informed the patient using a hospital interpreter. Now explain to me how this is any fault of the doctor? Did he not do his job? Did he not use a translator? Did he not tell the patient of his findings? If anything, it would be the translator's fault for not getting the message across correctly. And who's to say the hospital should pay? They probably will due to semantics that the interpreter is working for them. But I fail to see how it is the hospital's fault either. If the interpreter's qualification is checked and she had a license/diploma/certificate to perform medical translation, how is the hospital supposed to know that the interpreter would slaughter the translation? Again, at most I only see it as the translator's fault. All that aside, if one logically thinks about this, how could any patient with any shred of common sense not appreciate that there is something wrong with the fetus unless the translator did not even try. As bad a translation could get, one could probably simply say "the heart doesn't work, and the throat is missing, the baby will die at birth." Inaccurate translation....yes, but gets the point across .... absolutely. Latly, I'm sick of seeing doctors and hospitals being blamed for issues of language. If the patient didn't understand the medical terms, then yes, the doctor has the responsibility to explain it in a way that the patient will understand. What I don't get is, I live in the United States. English is the official language here. Unless you are visiting, then learn English. DON'T expect us to learn your language to conform to your needs. When I get sick in Europe or Asia, I don't DEMAND that the doctors there speak English, nor will they even try. So why should it any different in the United States? People are becoming ungrateful bastards. US hospitals are already blessed with language lines, and a very diverse multicultural staff....people need to stop pushing it!
Informed Consent and Respondeat Superior, are two legal principles that leaves little room for the doctor and hospital. Granted, if the translator trashed the translation, it is that person's fault. But the master that employs him will ultimately be responsible (ie. Respondeat Superior). Similar to this is if a cop shoots an innocent bystander by mistake, the city (his boss) will have to pay. The biggest hurdle against the language argument (I'll paraphrased here as "you're in the US, so speak English") is the Informed Consent clause that is printed in just about every patient Bill of Rights that I've ever seen. It requires that any doctor ensure that a patient understands the risks and benefits of any procedure beforehand, otherwise, their consent for treatment is meaningless. As such, providing accurate translation services would easily fall within the physician's purview. Frankly, railing on about the fact that people don't speak English is not going to change anything. If anyone really feels that this system is unfair, then they should entreat their congressional representatives to enact laws to better protect medical personnel from such lawsuits.
Like I said, "They [the hospital] probably will [pay] due to semantics that the interpreter is working for them." The hospital paying is one thing, however the main blame should still lie with the interpreter as well as the patient depending on whether it was a bad translation or whether the patient heard the translation correctly, but decided not to act on it and now is suing to make a buck. And as you said so correctly, informed consent "requires that any doctor ensure that a patient understands the risks and benefits of any procedure beforehand." Unfortunately, it does not apply to this situation. There is no procedure being done. The doctor is just providing information. Had he been an OB/GYN who wanted to operate and abort the fetus, he would then have been bound by this law to provide informed consent. And even if we pretend that this "rule" applies in their situation, the doctor would not have been at fault because he DID provide the information and he DID use a translator to ensure that the patient understood him. It still falls into the translator or patient's fault that the message didn't go through. Lastly, I respectfully but vehemently oppose to what you said about "railing on about the fact that people don't speak English." This is our country. We are the citizens who are paying taxes. We are the people paying for all the free medical care that is rendered. The official language is English. How would it be unreasonable and illogical that we demand those who seek our help and services to speak English? Am I to learn all the different languages of the people who come to my Emergency Room? If so, why don't they learn my language since they are the one's asking for my help? Try getting sick in Asia, go to their hospital, and demand that they find someone who speaks medical English fluently, I doubt you'll get any sympathy there. You are right, we should "enact laws to better protect medical personnel from such lawsuits." That's what tort reform is for, to protect those who serve us from frivolous lawsuits and those which are not the fault of the medical professionals.
I differ with your view vis a vis informed consent and the lack of a "defined" procedure; the issue here is whether the patient could successfully carry the fetus to term or not (with good outcome), and quite clearly (from the scenario given), had the patient been fully informed of the problems already detected in utero, she might have chosen to electively terminate the pregnancy. This line (from the OP): "...the parents thought their baby was perfectly fine and carried him/her to full term only to find out that the baby will die at birth" was what defined the argument of being less than fully informed, which is the patient's right. As for medical care being free? Not in the United States. Medical care is free only in countries with socialized medicine (like Canada and the UK), something that the American Medical Association and their allies in the pharmaceutical industry vehemently oppose. People who present themselves for treatment should not be held hostage to a requirement of being able to pay beforehand, nor should they be required to prove their allegiance through citizenship. Further, they need not be able to see, nor to even speak. Holding potential patients to an academic requirement of being able to speak English first before offering them the benefit of full care can be viewed as being unfairly selective and rather inhumane, IMHO. As for frivolous suits? You won't find any disagreement here. Tort reform is very much needed, but then again, so is better professional oversight. Bad caregivers just make the entire health care arena bad for everyone.
I agree with you that the parent's may not have been informed, however I still hold that there is no consent to be made. Consent to what? The physician is not trying to consent the patient to do anything, nor is the patient asking for any procedure to be done by this particular doctor. So as a compromise, I do agree that the patient was not informed, however the law of informed consent does not apply here. I routinely consent patients to procedures on a daily basis, after which they sign a document along with a family member's signature as witness signifying that I did inform the patient properly. However, I have never had to obtain an informed consent signature in order to have to tell a patient about their medical condition because I'm not asking the patient permission to do anything for them. You are right, medical care is not free in the US. Someone has to pay the bill. I am referring to those who do not have health insurance or who are illegal, come to the EMERGENCY room for something that's NON emergent, who subsequently does not pay their bill. I've seen everything from fake ID's, fake addresses, a man trying to use a woman's ID, to patients slipping away after they are treated without being processed. Those people are getting the free care at your expense via your annual taxes. I don't know about you, but I personally don't like to pay for another person's care unless it is life threatening. I can tell you that about 30% of the patients I see daily are of this type in the geographical area I work at, and 99% of the time they are here for completely nonessential and nonurgent issues. THAT is why health care professionals do not want to pass universal health care. THEY are the one's who have been dealing with this problem day in and day out, not the people barking for universal care who does not understand the in's and out's of the problem. Besides, every country is different, Canada and England do not have the same number of influx of illegal aliens as the United States, they have a smaller population to pay for, and their tax system is on the verge of being semi-socialistic. However I digress; that's a subject which needs to be dedicated to an entirely different thread. I absolutely agree with you that NOBODY should be denied EMERGENT health care regardless of race, nationality, or language. However health care is a privilege not a right. It is also a limited resource. Therefore, one should have the right to deny NON-emergent health care. For example, I see minorities all the time who call the ambulance because their kid coughed for 2 hours; they come to the ER, and their kid is screaming and running around playing with other kids. When I ask them why they called an ambulance, they say because they didn't want to take the bus. I ask them why they would do that when the ambulance cost $300, while the bus only costs $2. You know what they say? "Don't worry, I'm not paying for it. I have medicaid!" And this is not once in a while, this is every day that these similar situations occur. How can one not be bitter at this system? I'm glad at least we agree on the tort reform issue. And in regards to professional oversight, I think there is plenty of oversight already, to the point of being overwhelming. Do you know how many pieces of paper I have to fill out after seeing someone with a cold in order to get paid my $11 of medicaid money? Do you know how many oversight forms I have to check off for every critical patient to say I have given this medication and that medication within this time so that I conform to regulations? Do you know how many times a year some idiot non medical businessman who runs the hospital comes down telling me how to do my job? Or how many times JHACO comes by to make sure we're doing everything correctly? Do you know that I take a test every single year to stay up to date with the most current literature in order to keep my license? How many other professions can you name which has anything remotely as overbearing as the oversight for a physician? If I didn't have all this paperwork to go through, I'd probably be able to help out twice the number of people than I do now. Wouldn't that be swell compared to drowning one's own doctor in paperwork, bureaucracy, and red tape?
Thank you for your continued comments. We're both pointing at the same box but from various angles; we both had already agreed that the woman (for whatever rationale), was left with an information set that did not allow her to fully understand the fetus' dire clinical situation. We could label that as an error in communication, but it certainly wasn't based on misdiagnoses, but rather a breakdown in conveyance of information. That is, the patient was (for whatever reasons) not fully informed of the prognosis. Ultimately, who was responisble for conveyance of that information? IMHO, it is the health care professional who's opinion she sought. Hence, IMHO it would be the de facto spirit of Informed Consent that applies here, even if not strictly de jure (as you had pointed out). Whether my opinion withstands legal litmus would be up to a judge and jury. The problems vis a vis the pitfalls in delivering modern urban emergency medical care (so detailed by your impassioned response) is something that has been well recognized for years, and has been the subject of heated debate in both political and academic arenas. Patients presentations emblematic of the types of frivolous activity that drains already limited operational resources often become an easy target of professional frustration. One has to recognize though, that these patients have simply found accommodating features within a system already widely recognize as faulty; one which has obviously failed to anticipate many such contingencies. To shovel blame onto these social outcasts living out a marginal existence as if doing so alone would solve all of the emergency arena's problems may be emotionally fulfilling, but does little towards a genuine solution. I have no problem in believing that your frustrations are genuine, but I feel that you're misdirecting your anger. Your citation of the various cost impact of such activity, while poignant, doesn't come close to the savings that could have been realized had the nation successfully initiated a system of national health care. Instead, we as a people were bamboozled by scare mongering tactics of the health and insurance industry; in effect handing the reins of our entire health care delivery over to the insurance companies and their intermediaries. Needless to say, their bottom line is certainly not patient outcomes, but rather quarterly dividends (profits); I assume that it would equate to a lot more than all the excessive $300 medicaid bus rides the system can ever come up with. Imagine what the health care system could be like had all corporate profits been plowed back into the system instead? And I don't believe for a minute that social medicine cannot work in the US. If you really took the time to investigate the negatives (and I mean really assume that you know nothing and read up on it like you're doing so for the first time), you'll find that the bulk of all the reasons seems to point towards one thing and one thing only; the diversion of profits from corporate pockets. There are tremendous forces at play to prevent such a thing from ever happening. Like Michael Moore pointed out in his film Sicko, we already have many aspects of socialism based services (police, fire, sanitation, postal service). But health care was too lucrative a pie for many feeding at that trough to ever give up. Or to put it in a way that a medicine colleague once stated, "There are far more people living from AIDS than dying from it..." His meaning was that there is a system set up whose purpose is to perpetually support the system, never mind what the original intent of the system was in the first place; that then becomes relatively inconsequential. The health care system isn't really about health care right now, it's about maintaining profitable revenue flow to the keepers and overseers of health care. That's why we have people coming into our ER's instead of going to their own doctor, one which they cannot hope to afford under the current state of affairs. So, do these people stop getting sick just because the profit based system doesn't want to recognize them or their needs? Hardly. And it would serve no worthwhile purpose to get angry at them, they're just people looking to get help. So do we not care for these people until they get so sick as to then qualify for your EMERGENT care? I rather not let it come to that and take care of their problems beforehand. That is, their problem isn't going to go away, and in all likelihood it's going to get worse, so why not take care of it before we need to do something more drastic and costly? This is the idea behind such programs as Well Baby, and Immunizations. So why not extend it to the rest of medicine? What I'm talking about here is degrees and impacts. Like a bank robber who steals 20 grand from a bank, and gets a lot of press with a lot of jail time, how many of those do we need to lock up to equate to the impact of one criminal Wall Street executive? Res ispa loquitur, while the little guy is troublesome, the big guy in the suit is the one that is deadly. That is what I mean when I alluded earlier to your anger being misdirected. And I respectfully but fervently disagree with your assessment that health care be a "privilege" and "not a right." A nation as technically advanced as ours should have no problem setting up a system in which universal health care is the norm. However, it is the avarice and greed of people in high quarters that maintains the status quo. Oh, and BTW, many people assume that Socialized medicine is somehow "communist," it's not. To get a bit of perspective, in the People's Republic of China, people have to routinely pay for just about everything while they're in the hospital (much like the third world or United States). If they cannot afford to pay for a procedure they desperately need, they die. So that is communist medicine. Socialized medicine is the free medical service similar to our socialized service of police and fire protection. Much like we never have to get a bill to call a cop or pay monthly dues to be protected by the fire service, we get free health care provided by the government (just like our neighbors the Canadians, and our allies the Brits). And you might even wind up having to fill out less paperwork too. PS. And if you really want to get my back up about self perpetuating systems, just talk about the ESL (English as a Second Language) racket in the schools system., LOL...
Ralph, it's is refreshing to hear from a spirited debator such as yourself. I have not had such a thought provoking conversation on these forums for quite a long time. Thank-you and I want to express that I respect your opinions, whether they align with my own or not. You are correct in saying that I may have misdirected my anger. I can tell you that I tend to be much more critical than the rest of my collegues in the field. When I started out this profession, I truely was out to help everyone. But as time went by, the countless "less desirable" experiences have gradually eroded my compassion for those I serve. I find myself caring only for those who I feel truely deserve and require my specialty services. As wrong as that may sound, it is actually to the patients' benefit that I do not try to treat problems which I'm not trained to take care of. Therein lies my distaste and ambivalence for taking care of those who come into the emergency room for nonemergent treatment. Again, it's like someone with a broken car going to a boat mechanic to get it fixed. These people are going to the wrong specialist for care. I am not licensed to take care of primary care problems. I am trained to take care of those in extremis and at risk of dying or loosing a limb. What am I supposed to do when a patient comes into the ER with a rash that he's had for an entire year who clearly needs a biopsy when I don't know how to do one? They are wasting my time, their time, and increasing the medical insurance premiums for everyone under that insurance by using the wrong resources, or increasing the tax we pay for their poor judgment if they have medicaid. Now let's assume that my license allows me to treat everything, and I'm not restriced to conditions covered under my specialty. Even then I would not be able to take care of the nonemergent cases because there are more than enough people with emergent problems who need my help to occupy the entire time I'm working. So how is a physician who is trained to take care of problems under one specialty supposed to respond when they are forced to take care of a full load of emergent patients and have all the nonemergent patients shoved onto their lap? So while I wholeheartedly agree that (a) the system is broken, and (b) the uninsured patients should have someone they can see for nonemergent problems, I still fail to see how it is my responsibility and burden as an overworked emergency specialist to take care of them for free when I don't have time, license, or money to do so. And even if I have the time and license, am I supposed to work pro bono for the millions of patients who come in for free care? Do I not have a family to take care of, do I not need to eat, do I not have a home to take care of or bills to pay? Why should I work for free? Just because I'm a physician doesn't mean I don't need to make a living. I agree with you that the current system of private health care is unacceptable. However I disagree that putting it in the hands of the government will be any better. As you said there are already "many aspects of socialism based services (police, fire, sanitation, postal service)" However, how well do you really think they are operating and how much tax money do you think they are wasting? There have been many news releases about how the big wigs in those government orginazations take lavish vacations and buy themselves nice cars and gifts at the tax payer's expense. And even if we ignore that and say that's only a few people spending a small amount of money, let's look at the system, the postal sytem for example. They are so deep in debt and inefficient that private companies such as UPS and FedEx has outcompeted and outperformed them year after year. The only way the government postal service stays afloat is by raising postal rates almost yearly without rendering more services for those rate hikes. In regards to efficiency, there are at least 8 different personal occasions when I either didn't get my packages, or my packages were damaged in transit, or were delayed for over a week from the estimated time of delivery by the government postal service. That has never happened to me when I use UPS and FedEx. My point being, the private sector will always be more efficient and cheaper than the government to run anything because they have a profit incentive. Government is notorious for big spending. Their solution to almost every problem is to raise taxes. Another good example is social security, if government is that efficient and well run, our social security system will not be threatened with bankruptcy within the next 20 years as it stands today. So do I think the private health care is doing a good job? No! Do I think the government can do a better job? Absolutely not. How can we fix the problem then? By increasing regulation of the private sector, but let them continue to use their creativity to be as productive and efficient as possible. We need to pass legislation on the maximum % profit drug companies make on each medication, limit the % that goes into HMO executive officers' coffers (like we are doing to the finance industry), mandate a minimum % of profits be utilized in direct patient care annually, and of course limit bonuses, etc... Do I think it will happen, probably not before I retire. These industries have too much lobbying power and money at the current moment. What I predict is that the healthcare system will continue to deteriorate and eventually crash. At that point, there will be an uproar by the general public who will force their legislature to pass extreme laws to attempt to regulate or fix the problem, just like what happened to the financial sector. Last 2 points: I don't think Canada or England's system is communist, I said they are approaching "semi-socialist." Which they actually are; take Canada for example: their federal tax bracket maxes out around 30%, and their highest provincial tax bracket maxes out around 18% (New Brunswick) bringing the total tax of an individual in that bracket to a whopping 48% (not even counting GST on top of sales tax) !!! That's almost half that person's entire income. If the government steals, uh I mean takes that much money from their people, I should hope that they put out a little with at least some "free" and inefficient healthcare. (I'll tell you why I feel it is inefficient in my next post...fingers too tired to keep typing). So you see, the healthcare is not really "free." People just don't realize they are paying for it with higher taxes. Michael Moore does a good job of illustrating his point of an arguement, but that's all it is. It's his point of view. I feel his documentaries are too one sided. Once he fixates on who he think is wrong or is the enemy, he does a splendid job of vilifying that side. But he doesn't really spend enough time looking at the opposite perspective. But that's just my personal opinion. OK, until next post.....ciao! PS Just looked up the tax in Netherlands and Switzerland both of which have universal health care.....52% and 55-60% respectively via Wiki http://en.wikipedia.org/wiki/Tax_bracket And to put that in perspective, Switzerland's population is 7.5 mil, Netherlands 16 mil, Canada 33 mil, UK 60 mil, USA 306 mil !!!! So if it takes on average >50% tax to pay for universal healthcare in these nations, how much tax is it going to take to pay for universal healthcare in our country that's >10 times larger than most of these other countries, and with a disproportionately larger and exponentially growing elderly population as baby boomers are all hitting >65 years old? Government is definitely not the solution.
well i've only read about a paragraph about health care above but forgive me if i'm off, i'm speculating the american government and its big money maker (drug companies) and people in power do not want universal health simply because they are cash cowing in the private health industry. The reason is as simple as that, you're not a third world country in fact you're #1 economy wise and you can afford to spend trillions in iraq for nothing.. if you really wanted to you could and you would. I remember hillary clinton tried to do something about it in the 90's and it got turned down cold right away, i would rather have her for president then obama simply because of that reason.
