Abigail vs The NHS

[Aggie1]

 

Abi dropped a new philosophy tube about her struggles to get service through the NHS and puts a couple of cherries on top with a philosophical analysis of dysphoria and the laws of large organizations. Fascinating stuff.

 

[Ivy]

I'll have to watch it.  I'm a big fan of her.

[Susan R]

This was so worth watching. I’m always impressed with the amount of creativity, logic, and ability she has to tell her story and tel it well.

 

After watching this, I realized just how lucky I’ve been transitioning here in the US but specifically in Washington State. Washington is probably one of the top places within the US to accomplish this . Sure there’s some red-tape but nothing like what Abigail and others over the pond have experienced. The transition process there needs a serious overhaul and soon.

 

Incredible video…thanks for sharing @Aggie1,

Susan R🌷

[awkward-yet-sweet]

Interesting.  Makes me glad to live in the USA, even though the system here has high costs and the similar pain of being subjected to large institutions. 

 

When I needed to see a LGBTQ+ friendly doctor in another city, making an appointment was fairly easy.  It took a couple of weeks...not 18.  I received my prescription once the doctor figured out some of my medical mysteries.  Got cash or credit or the illusion of such?  Come right in.  Got an uncooperative doctor?  Fire the turkey and get another one.  Trouble with "Permission?"  Like the old song says...bring lawyers, guns, and money.  Insurance is a PITA, but my husband and GF seem to get things arranged quickly enough.  Charges too high?  Don't pay the bill, and argue until it gets adjusted.  

 

This video should serve as a warning for anybody who advocates for socialist medicine, "single payer" system, or similar schemes.  The US system may be bad in places, but it could be a whole lot worse. 

 

 

[Ivy]

6 hours ago, awkward-yet-sweet said:

This video should serve as a warning for anybody who advocates for socialist medicine, "single payer" system, or similar schemes.  The US system may be bad in places, but it could be a whole lot worse. 

There is no denying there are serious problems with the NHS in the UK.  Apparently gatekeeping for trans-people is a big one.  I am not convinced that some form of "socialized medicine" could not work.  The problem is, as with most things, the implementation.  For one thing, it would need to be adequately funded.  So money is involved as usual.

In the US things can work pretty well - if you are covered by adequate private Insurance.  Some here have even had their GCS covered.  

For me personally, that is not the case.  I am fortunate to be in the VA system at this time - which it could be argued is kinda socialized.  It has worked well for my hernia surgery, and cataracts; less so for my trans-care.

But I do know a lot of people in crummy jobs with no health Insurance, or huge deductibles that make it practically useless.

Sometimes I fear that the attitude here is "I've got mine - screw the rest of you."

[Diana Stone]

NHS works fine from cradle to grave. I w

 

1 hour ago, Ivy said:

There is no denying there are serious problems with the NHS in the UK.  Apparently gatekeeping for trans-people is a big one.  I am not convinced that some form of "socialized medicine" could not work.  The problem is, as with most things, the implementation.  For one thing, it would need to be adequately funded.  So money is involved as usual.

In the US things can work pretty well - if you are covered by adequate private Insurance.  Some here have even had their GCS covered.  

For me personally, that is not the case.  I am fortunate to be in the VA system at this time - which it could be argued is kinda socialized.  It has worked well for my hernia surgery, and cataracts; less so for my trans-care.

But I do know a lot of people in crummy jobs with no health Insurance, or huge deductibles that make it practically useless.

Sometimes I fear that the attitude here is "I've got mine - screw the rest of you."

  

That's the impression I get talking to many from the USA that many oppose social medicine because they simple don't want fairness. I don't get the if you are  poor just crawl off and die attitude, that some have. We pay into our system our entire working life as part of our taxes in the UK, so if we are unfortunate enough to get cancer we get treated and  not billed or told our insurance doesn't cover it.  If your are wealthy you can get private medicine in the UK but it will be the same medics that give you the treatment.
GRS  is slow in the UK but usually works out OK.  

[awkward-yet-sweet]

7 hours ago, Diana Stone said:

That's the impression I get talking to many from the USA that many oppose social medicine because they simple don't want fairness.

 

Perhaps we have a different definition of what fairness looks like.  I agree that the US system isn't fair, but social medicine doesn't seem fair either.  To me, it isn't fair to tax others heavily and have them pay for me.  There's an attitude that people who have money don't deserve to keep what they worked for... "just pay more taxes."  To me, that's theft, not fairness.  Its even more repugnant because it is enforced by the state.  A burglar at least runs the risk of getting shot, which makes him more honest and likeable than the tax man.   

 

This video clearly shows that a national healthcare system won't work out.  Handing something over to the state just makes for inefficiency.  That's what's happened in the US to a certain extent.  60/70 years ago, it was possible to stay in a hospital, have an operation, and pay for it out-of-pocket with no insurance.  Why?  Costs were kept low, and medicine was treated like a small-town business.  It isn't that way anymore, and it is no coincidence that government involvement in healthcare has simultaneously increased.  For several decades the big players (who are backed by the government) have made it unaffordable... and over-regulation has reduced what people can buy on their own without prescriptions and expensive appointments.  When I know what I need, I shouldn't have to pay somebody for the privilege of being able to purchase it.  Its like some weird medieval guild.  

 

In social medicine nations, they haven't reduced the cost...it just gets spread around.  They haven't reduced the power of the medical establishment, but have actually increased it.  That's not the answer.  We just need to have things cost what an average person can pay, with prices listed up front in a way average people can understand. 

 

What other business can you think of that doesn't tell you the prices up front, and sends you a huge bill later?  What other business (except lawyers, perhaps) talks its own specialized half-Latin language?  What other business can you think of where there is ZERO customer service, and the provider tells you what you can and can't have?  In what other business do the service providers have such massive egos, acting bossy like they own you?  What other business has such a small amount of competition? 

 

The big point of this video is to show that social medicine is NOT working for trans people, and that the system has serious issues.  

 

 

 

 

[Aggie1]

I suppose you have to pick your poison.

 

100% state controlled? Quotas. 
 

100% free market. Only the “rich” survive.

 

Hybrid system. Tweak the definition of “rich”. 
 

I guess I’m in favor of any system that offers choices. Too many choices can complicate the administration process and increase costs. Too few choices can leave people underserved. 
 

There’s a Goldilocks Zone there somewhere. Not too hot, not too cold. Not too expensive. Not too complicated.

 

 The problem is that every election cycle the extremists on both sides take up the megaphone and drown out reasonable voices.

[awkward-yet-sweet]

What we have now is not a free market.  Not even close.  It is a state controlled market, and the number of players is limited.  Big Pharma and Big Hospital makes the same profit everywhere... its just a matter of how tribute is squeezed from the people.  Elections don't make a difference because the oligarchs in every nation enable this.  

The Goldilocks zone must include removal of those who strangle us, rather than merely changing the method by which the criminals get paid.  

[Ivy]

I suppose there is a tension between the absolute freedom of the individual, and society as a collective.  As much as we - especially in the US - want to believe otherwise, most of us are dependent on society at some level for our survival.  

[Vidanjali]

Thanks for  the video, Aggie. I was not previously familiar with Abi. She's brilliant. 

 

There is intersection between stats on wealth gap among nations and "best healthcare systems" rankings. Digging a bit deeper, nations with market economies and smaller wealth gaps are less prone to be market societies. A market society is such that market economy bleeds into many/all aspects of civil life. We see that in the US where money will get you access to better education, healthcare, access to the justice system, etc. In market economies there is some central regulation by government, and various schools of thought differ on what optimal intervention should look like. There are myriad and dynamic factors to consider - none of this happens in a vacuum. I don't think it's reasonable to expect all folks in the US to bootstrap themselves into wealthy conditions else they get what they deserve. There have been massive inequities in the US, for example, from the very beginning which were partially enabled by society, economy, and government. It would be naive to believe we can simply reset conditions and assume all things are equal. I think it is equally naive to believe government will make regulatory decisions wisely when so much market economy has bled into all three branches, effectively privatizing it. 

[Aggie1]

3 hours ago, Vidanjali said:

Thanks for  the video, Aggie. I was not previously familiar with Abi. She's brilliant. 

 

There is intersection between stats on wealth gap among nations and "best healthcare systems" rankings. Digging a bit deeper, nations with market economies and smaller wealth gaps are less prone to be market societies. A market society is such that market economy bleeds into many/all aspects of civil life. We see that in the US where money will get you access to better education, healthcare, access to the justice system, etc. In market economies there is some central regulation by government, and various schools of thought differ on what optimal intervention should look like. There are myriad and dynamic factors to consider - none of this happens in a vacuum. I don't think it's reasonable to expect all folks in the US to bootstrap themselves into wealthy conditions else they get what they deserve. There have been massive inequities in the US, for example, from the very beginning which were partially enabled by society, economy, and government. It would be naive to believe we can simply reset conditions and assume all things are equal. I think it is equally naive to believe government will make regulatory decisions wisely when so much market economy has bled into all three branches, effectively privatizing it. 

It’s the guns and butter problem. There has to be a safety net but also incentives. There have to be rules agreed to by a majority and some way to enforce them. Not too harsh and not too lenient. Having said that, sometimes you have to rock the boat to get people’s attention. If the status quo gets too comfortable people become resistant to change and the rights of minority groups get trampled. But you can’t live in a state of upheaval for too long. 
 

The system has to allow people to fight for their rights.  it’s good to have choices. And the right to choose needs to be protected. 
 

one of the unifying principles in the military at least when I was in, don’t know about today, was “I may strongly disagree with what you believe but I will fight for your right to say it.” I remember this advice being offered to me when the military was coming under intense scrutiny. Police forces are facing the same dilemma today. The problem with force is how do you police the police? Even those opposed to the use of force will resort to the use of force to protest the use of force, and justify it.

 

Trans rights and trans healthcare is no different. It has to be fought for and defended and justified. And then we struggle to get back to the Goldilocks zone until the next battlefield emerges. And the battle we fought is forgotten. 
 

wash, rinse, repeat!

 

I’m starting to wax philosophic. LOL 😆 

 

[Diana Stone]

20 hours ago, Vidanjali said:

Thanks for  the video, Aggie. I was not previously familiar with Abi. She's brilliant. 

 

There is intersection between stats on wealth gap among nations and "best healthcare systems" rankings. Digging a bit deeper, nations with market economies and smaller wealth gaps are less prone to be market societies. A market society is such that market economy bleeds into many/all aspects of civil life. We see that in the US where money will get you access to better education, healthcare, access to the justice system, etc. In market economies there is some central regulation by government, and various schools of thought differ on what optimal intervention should look like. There are myriad and dynamic factors to consider - none of this happens in a vacuum. I don't think it's reasonable to expect all folks in the US to bootstrap themselves into wealthy conditions else they get what they deserve. There have been massive inequities in the US, for example, from the very beginning which were partially enabled by society, economy, and government. It would be naive to believe we can simply reset conditions and assume all things are equal. I think it is equally naive to believe government will make regulatory decisions wisely when so much market economy has bled into all three branches, effectively privatizing it. 

 Many people I know in the UK have gone down the private medicine route to transition and that's fine if they can afford it. But many others simply cannot. A few have basically put themselves in a position where they will be working until they drop to pay for GRS.  I started work at 15. The first job I had that paid a decent wage, I only got when I was in my mid 40s, then due to health issues I had to quit that which is how I got into making a living in music but that's been pretty much hand to mouth.  So my only route would have been via the NHS and that's usually a long wait.

[Davie]

The US comes in last in health care rankings of high-income countries. The US is the only one of the 11 countries surveyed not to have universal health insurance coverage. And concerning transgender healthcare, we rank just behind Saturn and Mars.

https://www.cnn.com/2021/08/04/health/us-health-care-rankings/index.html

[VickySGV]

A serious issue that we have to overcome is the reluctance to trust the governments to administer a universal health care base for the country.  The old socialism motif is still very much at play and so is the idea that "I am paying for the other no-good, lazy alcoholic junkie child molester who got AIDS <any social disease> who needs to die quickly and get off the rest of the public dole that I am paying taxes on."  That POV is largely held in areas where medical practice is very sparse BECAUSE the underemployed and underinsured do not USE medical services that are preventative, and will not support medical improvement because circularly the subcompetent and time frozen doctors there who are not making close to the industry level of income and status and ones who have no incentive to provide better service.  Trans care in too many places is actually out nearer to Uranus. 

[awkward-yet-sweet]

4 hours ago, VickySGV said:

A serious issue that we have to overcome is the reluctance to trust the governments to administer a universal health care base for the country.  The old socialism motif is still very much at play and so is the idea that "I am paying for the other no-good, lazy alcoholic junkie child molester who got AIDS <any social disease> who needs to die quickly and get off the rest of the public dole that I am paying taxes on."  That POV is largely held in areas where medical practice is very sparse BECAUSE the underemployed and underinsured do not USE medical services that are preventative, and will not support medical improvement because circularly the subcompetent and time frozen doctors there who are not making close to the industry level of income and status and ones who have no incentive to provide better service.  Trans care in too many places is actually out nearer to Uranus. 

 

I disagree.  I don't want universal healthcare, and I absolutely will not trust the government to provide for my needs.  COVID was all the evidence I needed to figure out that the "public health officials" definitely do not have my best interests in mind.

 

75 years ago, medical care was affordable on a laborer's salary with no debts.  Appendicitis?  Fixed.  Broken bone?  Easy.  Minor infection?  Take these pills and you're good.  My husband's grandfather was a carpenter, and paid for major operations for his family out-of-pocket.  Now apparently we have all kinds of computers and gadgets, but giving somebody a basic cast or a few stitches costs 3 months' pay???? 

 

My husband's mother is now the main physician for our rural county.  She's the coroner, and also runs the clinic at the county seat.  She's been in practice since the early 80's, and maybe she's one of those "time frozen" doctors 😏  But her philosophy is that "common things are common," and common things should have common prices.  She and her nurses (one of whom is a trans friend of mine) have been doing stitches, prescribing basic medication, and other easy things that are 90% of the medical care our people need.  No surgeries yet, but maybe in the future.  Lots of people in our rural area don't have insurance, and they are able to pay for these services out-of-pocket.  The clinic runs at-cost.  This is a new thing, but over the last few months it has been working!  I'd rather not have Uncle Sam come in and mess it up, because it would be nice if we could export our model to surrounding areas. 

 

We HAD a good, affordable, private system in this country years ago.  We CAN have it again.  But to get there, we need less government rather than more, and less Big Pharma rather than more.   And I would suggest complete elimination of the CDC, the NIH, and the USPHS commissioned corps, along with repudiating all ties to the WHO, and dissolution of the AMA.  I would also favor vigorous prosecution of health "officials" who have ties to Big Pharma.  These things would be a nice start. 

 

[LoRez]

I agree with @VickySGV. While I understand @awkward-yet-sweet's viewpoint, what awkward seems to miss is the fact that the cost of healthcare in the States is the result of capitalism and bought-politicians. If the States had a universal healthcare system like that of Japan, the prices for standard care would be affordable even to high school graduates working minimum-wage jobs. It's one of the reasons I expatriated to Japan. I've had medical events in both the States and in Japan. At least with Japan, they don't care to ask if you have insurance before calling the ambulance. The ride to the hospital is free! Everyone lives longer in Japan because the preventive healthcare is far more comprehensive than in America. (And the fact that most Japanese walk/exercise almost everyday too doesn't hurt...)

 

In Japan, the government ensures that approved clinics are given the subsidies to ensure they continue to function. Much like the schools here. Japan is notorious for its bureaucracies - for good or worse. It will keep a school open (on tax payer money) for as long as it has at least one student. Similarly, clinics are kept open as long as the city has residents. I'm not trying to sell Japan's system as somehow superior, but attempting to point out that without government, people in underserved areas would not benefit from the system designed to serve all. Japan's system sets the prices for all standard life saving medical procedures.  If it were left to the insurance companies and hospitals, the prices for "standard care" would be as bad as that seen in the States.

[awkward-yet-sweet]

9 hours ago, LoRez said:

I agree with @VickySGV. While I understand @awkward-yet-sweet's viewpoint, what awkward seems to miss is the fact that the cost of healthcare in the States is the result of capitalism and bought-politicians. 

 

Actually, I don't believe that I miss that part at all. What we have in the USA is crony capitalism with a bureaucratic oligarchy rather than free market capitalism in a truly representative republic.

 

Of course things go sour when a certain group of people is exempt from legal repercussions and gets sweetheart deals with the state! The more control the government gets, the more of that we will see.  The system itself is not going to change just because universal healthcare shows up.  I believe that having greater access to the public purse will increase the corruption, as the underlying issues won't be fixed.

 

[gemmalouise]

I went through the UK system.  My observations are its the same as before, but the waiting is many many times worse.  I went private for the surgery to speed it up.  But NHS for the rest.  As for gatekeeping I was briefed on what to say by the folk at a group I attended.  I am not going to say I lied but I did say all the right things they were hoping to hear to get through quickly. From GP visit one, to post op holding a Gender Recognition Certificate in two years.  I'd have no chance now to do it that quickly. 

 

I have absolutely no regrets (except maybe of surgery quality issues, not of having it done at all).  What I am perturbed about is that once you're done you're done, there is no opportunity to feed back success and be counted as evidence that the changes are good and the system works.  We just sort of disappear and have no way to lead the way for those who come later.  I guess they count no complaints as a success?

[gemmalouise]

PS love most of Abis shows but wish she'd occasionally wear clothing.  Nah, I made that last bit up.

[LoRez]

8 hours ago, awkward-yet-sweet said:

 

Actually, I don't believe that I miss that part at all. What we have in the USA is crony capitalism with a bureaucratic oligarchy rather than free market capitalism in a truly representative republic.

Indeed, this is what happens in late-stage capitalism. 
 

Quote

Of course things go sour when a certain group of people is exempt from legal repercussions and gets sweetheart deals with the state! The more control the government gets, the more of that we will see.  The system itself is not going to change just because universal healthcare shows up.  I believe that having greater access to the public purse will increase the corruption, as the underlying issues won't be fixed.

Sadly, I must agree with you here. It cannot be simply fixed at the highest levels but from all levels. Unfortunately, I don’t see enough motivation to push for a comprehensive reform that covers the entire system from top to bottom. As you said, “crony capitalism” prevents people from mobilizing. 

[Ivy]

2 hours ago, LoRez said:

this is what happens in late-stage capitalism. 

Kinda looks like this to me as well.

But this discussion could get messy, and I'm not sure I want to go there in this place.  

I'm kinda tired, and probably go to bed anyway.