Models of consumer behaviour

[Walsingham]

I know there are a bunch of psychologists and economists etc. on here. I'm interested in a speculative way about how the UK government is trying to turn government services into kind of consumer driven entities. They keep waffling on about it.

 

What I'm after is some academic (or indeed your own) perspectives on what actually defines being a customer of, say, a hospital. Rather than being, say, an employee.

[Raithe]

Lets see, when I had my part-time job at the hostpital, as an employee I had abuse hurled at me from the nurses, the members of the public, and my bosses would encourage me to break all the health and safety regulations to get the work done on time - as long as they never saw me doing it, in which case they'd come down on me like a ton of bricks. If I didn't, they'd come down on me for the job taking too long....

 

As the family member of someone who recurringly ended up as a patient at the hospital, I just got the odd moments of abuse from the nurses and doctors, and the rest of the public there pretty much ignored you.

 

Although thats probably just a wee bit snarky to the way the nhs has devolved over the last decade or two rather then a useful perspective.

But eh, its funny actually, I practically grew up spending months visiting the Hospital due to my mother going in for long chunks of time, then ended up with a part-time job there during my college and university years. My dad ended up working in management accountancy at the hospital after leaving the docks (yeah, dockie and cargo crane operator to management accountancy...), and for a chunk of time my sister was actually getting paid by the NHS trust.

 

 

Hm. As a customer (regardless of who with) you expect a certain level of service. - Ie; you expect the nurses to do their job and not ignore calls for them while they talk about the latest tv show and round of x-factor. You expect doctors to prescribe the right drugs, in the right amount and for them to be delivered at the correct times. You expect a certain level of hygiene and standards.

 

As an employee , you expect a paycheque, some form of time management of when you are and are not working, to receive the correct training for the job and to be kept to the standards required as set out when you were hired. Also, if it's a job involving the public, you expect to deal with a certain amount of abuse and stupidity.

[Cantousent]

Does it matter if our perspectives are from a US point of view, Wals? I don't have a psych or econ background, but I have spent a lot of time in hopitals with sick people, not as much as a patient as with family and as a volunteer. I don't want to bogart your thread talking about US stuff if you're only interested in things from within the national health service.

[Enoch]

I'd say that the defining aspect of a service being "consumer-driven" is that it is subject to the threat that the people using the service will choose to take their business elsewhere if an alternate supplier offers better or cheaper service.

 

It's tough to pull off for a government entity, given that funding generally comes from the treasury, rather than from the pocketbooks of the customers walking in the door.

[Gorth]

What I'm after is some academic (or indeed your own) perspectives on what actually defines being a customer of, say, a hospital. Rather than being, say, an employee.

When I applied for permanent residency here, I needed police records from all countries that I had lived in for more than 12 months the last 10 years. Danish police said sure no problem, they sent copy in an envelope. New Zealand police said sure no problem and sent an envelope with a printout. Australian police.... we can do that, but it will cost you $40. So I guess that makes me a customer of the Federal Police

[Walsingham]

:p @ Gorth's Oz experience. Yes. I guess that would make you a customer in a way.

 

Cant, your experiences in the US might be even morevaluable because theres a perception here that US medcare is more consumerist/free market.

 

~~

 

So far I'm picking up on two things:

 

1) service, with an element of responsiveness in that service. Even a degree of proactive standards

2) Pay on delivery, with Enoch implying the old concept of 'investment' (I think). If your customer is the state then the citizen isn't really the customer. They're like the nephew of a rich patron. Except the patron is old and insane. Mistreat their nephew and they probably won't even understand anything is wrong.

 

 

~~

 

My point really was to seek to describe the distinguishing features of a customer, as opposed to other roles we play in society.

[Guard Dog]

I had an interesting discussion in class with one of my professors back in college. It was in a Calculus class and I was having some difficulty with antiderivatives so I kept asking him questions that kept him on the subject longer than he wanted. He made an offhanded remark on my responsibilities as a student and his as a teacher. I explained to him that he was mistaken about the nature of our relationship. In my view I hired and paid for Miami Dade Community College to teach me the Calculus II class. MDCC then assigned him (as their employee) the task of carrying out their end of the agreement. That means I am not his student, I am his customer and he has an obligation to follow his syllabus and teach the material as agreed when I paid my tuition for his class. Not just "present it and move on".

 

Needless to say he was not pleased to hear that his august and noble profession was really just little more than a paid service provider just like any other person with a job. But, that is what it is.

[Tigranes]

But, that is what it is.

 

Is it? Absolutely, the relationship between professor and student includes that of a customer and service provider / employee. But your formulation implies that the latter is the true, essential component that defines the relationship - i.e. harp on all you like about academia, professors, tradition, education, but in the end all of that is fluff and the real truth of our relationship lies in this reductionist core of I pay, you deliver. (Note that I'm talking about your formulation, which might be different from what you actually believe, GD.) I find that obscures the reality just as much as some high-flying rhetoric about The Professor might do.

 

Hell, in the end, there is no relationship which can be reduced only to the economic transaction of give money, get X - unless, perhaps, we're dealing with nonsentient clerks such as self-checkouts or whatnot. Even if you are a simple shopkeeper at a local dairy a range of relationships develop through the process of your business. You could argue that in the end the economic transaction is the most important, without which the rest may not exist, but this doesn't mean the shopkeeper is reducible to a service provider. By the same token, I would argue that while it is sometimes necessary to bring self-important professors from their pedestal and remind them that they're not rock stars, it is equally absurd to tell them they are just service providers. Ironically, with your situation GD, one could argue that it is precisely when a professor thinks of himself as purely an employee that he might just 'present it and move on' - i.e. argue that he is being paid to deliver the material, not hold individual sessions over it. (Then of course, you would argue about exactly how much he is being paid to do.) Rather, it is when professors too internalize a sense that they are participating in something called academia and they have a moral obligation, that they might be prepared to say "I'll make sure you learn this stuff".

 

I won't go on about it, but essentially, I think it's dangerous to say "this is a customer/employee relationship and that is what it is" because in many cases, this leads on to an implicit discrediting of other moral, symbolic, traditional, etc. forms of relationships embedded in that as less relevant, disposable, or less essential in some way. i.e. "Don't pretend you care, psychiatrist, I know you're just doing this to earn a living." Writ large, I think that leads to a dangerous and frankly rather unpalatable vision of a particular service or institution. I'm not up to date on what the UK gov is doing, but I think in general, yes, if your institution/service is being run according to the laws of capitalist economics, at some point you need to find ways of integrating that reality into the way you talk about and practice what you do. Some good can come out of that. But not in a way that sets down such a binary and says "all we are is a consumer/employee".

 

(Again, I'm taking what you say GD as more of a starting-point; as a direct inquisition of your post it would be rather straw-mannish.)

[Guard Dog]

Point well taken Tig.

[Cantousent]

In keeping with what Tig said, customer service (or guest service or whatever term is in vogue right now) involves more than paying for something and then receiving it. This is true even if you're selling a widget in a warehouse store, but the dynamic is even more significant when you pay for a service and becomes increasingly integral as that service becomes more personal, such as a student/teacher or patient/doctor relationship.

 

That is to say, most folks will choose a store where the clerk greets them with a smile and the cashier engages in some sort of friendly banter rather than a store where the staff is unfriendly. I know I know. Some contrarians among us will assert that they prefer stores where folks completely leave them alone, and there are times where I feel the exact same way, such as when I shop for cars. Nevertheless, that's also part of the dynamic. On the one hand, customers prefer service staff to be friendly. On the other hand, the provider wants to sell more product or service. A good provider, whether it's the cashier at a grocery or a nurse at the doctor's office, picks up on non-verbal and verbal cues to assess the customer and tailor his delivery accordingly. It can be something as simple as the customer approaching the cashier, the cashier smiles and says hello. If the customer gives the impression he isn't interested in banter, then the cashier is still friendly, but limits himself to questions that are necessary for the transaction. At a dealership, the salesman gauges whether or not he can break down the customer's resistance to service in order to make a sale. As long as he thinks he can push the issue, he will. When he realizes that he's actually hurting his chance to sell a car, he withdraws (and often lurks around to be ready to jump in if things change). Like Tigranes said, there's a hell of a lot involved in human interaction for any reason.

 

For my part, I don't think there's a huge difference between how the patients see doctors in the US and Britain or in how they interact with them. I mean, in one case private insurance foots the bill for doctor visits, in the other, the state foots the bill. In reality, most insurance in the US, if I understand it correctly, is provided through employment. There might be a co-pay for services to some degree, but the interaction is not so clear cut as a private citizen going out to purchase a product from a private business. It's much more like a utility. You have limited options. Moreover, if you only pay a fraction of the amount due for any service, then you're going to be insulated from the typical consumer behavior of measuring the cost versus the benefit. That's why you hear some politicians talking about personal health care accounts. You shop more so you don't go in for every sniffle which lowers the cost while providing competition for the service. I'm not advocating anything because I don't want to turn your thread into a universal health care debate. I'm only saying that there's a lot of folks looking at stuff like this in order to improve the service while lowering the costs for society as a whole.

 

Getting to actual customer service, which is a big part of consumerism, I think most folks I've met in government bureaucracy have actually been friendly. Even in things like military processing, once you get out of training, folks are generally pleasant. Sure, you get rude folks and the bar for customer service is undoubtedly lower most of the time, but you still get a lot of nice folks in places where the influence of outright commercialism is limited and you still get nasty folks in service oriented industries.

 

I used to conduct a lot of customer service seminars a long time ago. in fact, of all the seminars I conducted, such as film development and prescription processing, I conducted more customer service seminars than any two or three others combined in any given month because it's the most important.

 

I don't know how much my rambling answer helps, but that's my take at least.

 

If we could find a way to make the patients in either the US or England feel more tied to the costs of their personal health care without reducing their vital service all the while putting more competition for service providers to lower costs and increase quality then we'd be in fine fine shape. Since we're talking about living in Fantasyland, I say we hold out for personal hoverjets also.

[Walsingham]

Very grateful for all your thoughts so far. I'm particularly struck by the (good natured) disjunct between the 'I pay you. You do what the contract says' approach and a more nuanced one.

 

I will need time to digest them.

[bigcrazewolf]

:lol: @ Gorth's Oz experience. Yes. I guess that would make you a customer in a way.

 

Cant, your experiences in the US might be even morevaluable because theres a perception here that US medcare is more consumerist/free market.

 

~~

 

So far I'm picking up on two things:

 

1) service, with an element of responsiveness in that service. Even a degree of proactive standards

2) Pay on delivery, with Enoch implying the old concept of 'investment' (I think). If your customer is the state then the citizen isn't really the customer. They're like the nephew of a rich patron. Except the patron is old and insane. Mistreat their nephew and they probably won't even understand anything is wrong.

 

 

~~

 

My point really was to seek to describe the distinguishing features of a customer, as opposed to other roles we play in society.

 

 

Here in the US the medical care is consumerist/free market but that also goes hand in hand with big business/greed/$>people so if you can stop your country's health care going down the same poop chute ours has, you will be doing a good deed for everyone.

 

http://www.cnbc.com/id/27087295

http://blog.aflcio.org/2010/03/03/greed-no...rance-costs-up/

 

On the other side of our wonderful health care system we have the pharmaceutical companies that advertise there drugs on everything from magazines to television so you can self diagnose and ask the doc for a script, while making billions a year just in profit. Another practice I find totally disgusting is they give doctors checks based upon how many prescriptions they give out for there products.

 

now that I'm sufficiently fired up off I go wwweeeeeeeeee

[Orogun01]

I had an interesting discussion in class with one of my professors back in college. It was in a Calculus class and I was having some difficulty with antiderivatives so I kept asking him questions that kept him on the subject longer than he wanted. He made an offhanded remark on my responsibilities as a student and his as a teacher. I explained to him that he was mistaken about the nature of our relationship. In my view I hired and paid for Miami Dade Community College to teach me the Calculus II class. MDCC then assigned him (as their employee) the task of carrying out their end of the agreement. That means I am not his student, I am his customer and he has an obligation to follow his syllabus and teach the material as agreed when I paid my tuition for his class. Not just "present it and move on".

 

Needless to say he was not pleased to hear that his august and noble profession was really just little more than a paid service provider just like any other person with a job. But, that is what it is.

You went to MDCC? Cool, now there is an up chance that i've bumped into you in real life.

[Cantousent]

Here in the US the medical care is consumerist/free market but that also goes hand in hand with big business/greed/$>people

 

This is laughable. Whatever the health care system is in the United States, 'consumerist/free market' is not it. Now, you could make the case that the health insurance market is consumerist or free market, but you'd still be completely wrong. Having lived overseas and having family who live in England, I don't think I'd trade my health care here for what they have there. On the other hand, I have good insurance and don't have any chronic illness that will take me over the cap. In other words, I'm like the majority of Americans. Yes, there are circumstances where the British system would be damned appealing, but the vast majority of us don't live in these circumstances.

http://blog.aflcio.org/2010/03/03/greed-no...rance-costs-up/

It's always good to find a good unbiased source for your information. ...And if you think the AFL-CIO isn't out for itself, you're delusional.

 

On the other side of our wonderful health care system we have the pharmaceutical companies that advertise there drugs on everything from magazines to television so you can self diagnose and ask the doc for a script, while making billions a year just in profit. Another practice I find totally disgusting is they give doctors checks based upon how many prescriptions they give out for there products.

It's always interesting when folks who have benefited greatly by that greedy 'profit' complain about it as if it were the worst of all evils. Let me guess, when the auto-workers negotiate sweet contracts that carve out better pay and benefits than the vast majority of Americans, they're just getting their fair share, but when the investors who actually created the company in the first place demand a healthy return out of their investment, they're those 'greedy fat-cats?' Yeah, right.

 

Now, as for our terrible system in the US.... I'm not a rich guy. Just an average Joe. I had some chest pain. My wife called my doctor and made an appointment for me. I went to the doctor and that day, in his office, they administered an EKG. He said there were abnormalities, but nothing that stood out but he wanted me to get a cardiolite stress test. Withing two weeks, I'd done the stress test. My doctor called me personally the next day to go over the results and said he's referring me to a cardiologist. Since I have one of those hate 'HMO' plans, I need a referal. Yep, I won't get to go to the cardiologist for an entire week. Of course, if the stress test had come out badly, then I would have seen the cardiologist already. Well.... that's cheating because I already saw a cardiologist at the stress-test because of a small abnormality in that. He cleared me to go and the reason my doctor is refering me to a cardiologist is because of that dreaded 'personal relationship' that we greedy assed Americans try to establish between patients and doctors. All of this is within a month.

 

If you tell me I should throw over my so called 'consumer driven' health care for the British or Canadian systems, I'll laugh in your face.

 

Sorry, Wals, I know there are many admirable things about the British system, but in most circumstances for most Americans the US system is simply better.

Edited October 30, 2011 by Cantousent

[Hurlshort]

If we could come up with a way to fix the entire malpractice suit system, I think the US Health Care would be great. Right now I pay way too much a month for insurance. It costs me $600 a month to cover my family, and that is only about 15% of what my district is paying to the insurance company. It's a fairly raw deal, we are all healthy and basically carry it in case an emergency happens.

[Orogun01]

Now, as for our terrible system in the US.... I'm not a rich guy. Just an average Joe. I had some chest pain. My wife called my doctor and made an appointment for me. I went to the doctor and that day, in his office, they administered an EKG. He said there were abnormalities, but nothing that stood out but he wanted me to get a cardiolite stress test. Withing two weeks, I'd done the stress test. My doctor called me personally the next day to go over the results and said he's referring me to a cardiologist. Since I have one of those hate 'HMO' plans, I need a referal. Yep, I won't get to go to the cardiologist for an entire week. Of course, if the stress test had come out badly, then I would have seen the cardiologist already. Well.... that's cheating because I already saw a cardiologist at the stress-test because of a small abnormality in that. He cleared me to go and the reason my doctor is refering me to a cardiologist is because of that dreaded 'personal relationship' that we greedy assed Americans try to establish between patients and doctors. All of this is within a month.

 

If you tell me I should throw over my so called 'consumer driven' health care for the British or Canadian systems, I'll laugh in your face.

 

Sorry, Wals, I know there are many admirable things about the British system, but in most circumstances for most Americans the US system is simply better.

Well I won't hold it against you if you like being bounced around because of bureaucracy all while paying money to have 3 guys tell you what 1 guy in 1 visit could had easily told you.

[Cantousent]

Well I won't hold it against you if you like being bounced around because of bureaucracy all while paying money to have 3 guys tell you what 1 guy in 1 visit could had easily told you.

Yeah... That's the lesson to be learned. Nice insight, Orogungutan. The fact is that I payed five dollars as a copay for my first visit and, in fact, the stress test did show something he couldn't see from the first EKG. The real lesson is that there were enough abnormalities, including reversible ischemia, to warrant further testing, all of which leads to a cardiologist who may or may not tell me not to worry about anything. Frankly, I'm not worried in the first place, but the process has worked pretty well so far. The whole experience cost me five bucks and I've gotten more information from every step. I wouldn't have bothered doing it if it weren't for my wife, but having done it I can't complain about the quality of the care.

 

You guys want to make this yet one more thread complaining about American health care, have at it. I'm not going to have a heart attack over it.

 

Still, the idea that introducing some consumer/free market principles to the British system might actually have some benefits, which is probably why it's an issue over there right now.

 

EDIT: Oh, and if you think that the bureaucracy is bad in the states, you should see the wait times in some of the other western countries. Which is worse, getting 'bounced around' over the period of less than a month to find out I'm not in any immediate danger or getting 'bounced around' over the period of months during which time my health gets worse because there was something wrong?

Edited October 30, 2011 by Cantousent

[Orogun01]

Yeah... That's the lesson to be learned. Nice insight, Orogungutan. The fact is that I payed five dollars as a copay for my first visit and, in fact, the stress test did show something he couldn't see from the first EKG. The real lesson is that there were enough abnormalities, including reversible ischemia, to warrant further testing, all of which leads to a cardiologist who may or may not tell me not to worry about anything. Frankly, I'm not worried in the first place, but the process has worked pretty well so far. The whole experience cost me five bucks and I've gotten more information from every step. I wouldn't have bothered doing it if it weren't for my wife, but having done it I can't complain about the quality of the care.

You seem awfully defensive, have I touched a nerve?

 

You guys want to make this yet one more thread complaining about American health care, have at it. I'm not going to have a heart attack over it.

Good, that's an expensive surgery.

Still, the idea that introducing some consumer/free market principles to the British system might actually have some benefits, which is probably why it's an issue over there right now.

 

EDIT: Oh, and if you think that the bureaucracy is bad in the states, you should see the wait times in some of the other western countries. Which is worse, getting 'bounced around' over the period of less than a month to find out I'm not in any immediate danger or getting 'bounced around' over the period of months during which time my health gets worse because there was something wrong?

I'm sorry, but weren't you the one who went to 3 different doctors over the period of a month? Which if you had been in real danger it may have been too late to properly deal with it.

I don't know why you think that a month timeframe is a short time.

 

Consumer market doesn't work for healthcare, because when you need healthcare you really need healthcare. I find the fact that someone can look at me; pretend they are doing me a favor, while they're making me bleed money on medication to which there aren't viable alternatives, disgusting.

I'll tell you what the alternative for us is, that if possible we get asthma medication for my grandmother from my old third world country that has socialized medicine and somehow still manages to produce the same medication and sell it at a lower cost. The "business" of saving people is an opportunistic scheme akin to watching a man dying thirst and charging him for all he has, while driving a truck loaded with a tank full of water.

They're constantly putting prices on the lives of people and on the quality of their lives and you expect me to believe they're good?

[Cantousent]

You seem awfully defensive, have I touched a nerve?

Nope, just keeping the blood pumping. Trust me, my nerves are right fine in this thread.

 

I'm sorry, but weren't you the one who went to 3 different doctors over the period of a month? Which if you had been in real danger it may have been too late to properly deal with it.

I don't know why you think that a month timeframe is a short time.

 

Don't be sorry. Just think harder. Do you believe, under the same circumstances, I'd go to one doctor in England and all of the sudden he's going to cure me so I don't need to see other specialists? Good God, man, you live in Fantasyland. I would have gone through by and large the same steps in any western health care system. Only here, I went through them a hell of a lot faster. The point isn't that I would go to one 'cure-all' doc in Fantasyland to do my one-stop health care shopping. The point is that there isn't a one stop shopping experience when dealing with specialties. To think otherwise isn't just naive, it's foolish.

 

Consumer market doesn't work for healthcare, because when you need healthcare you really need healthcare. I find the fact that someone can look at me; pretend they are doing me a favor, while they're making me bleed money on medication to which there aren't viable alternatives, disgusting.

I'll tell you what the alternative for us is, that if possible we get asthma medication for my grandmother from my old third world country that has socialized medicine and somehow still manages to produce the same medication and sell it at a lower cost. The "business" of saving people is an opportunistic scheme akin to watching a man dying thirst and charging him for all he has, while driving a truck loaded with a tank full of water.

They're constantly putting prices on the lives of people and on the quality of their lives and you expect me to believe they're good?

Who said anything about good? The US was, until recently, the best place to develop drugs and one of the best places to develop equipment. To be fair, the Europeans have been actually quite good about moving new medical devices through administrative bodies, and so I'll give them that. To your point, we need those greedy bastard drug companies to have incentive to develop new drugs because, at the end of the day, those altruistic third world countries couldn't get the drug unless the greedy R&D bastards develop it in the first place.

 

Look, I'm not saying that consumerism is the holy grail. I take your point about the need for immediate care to heart. I really do. In fact, I might even share my experience about my burst appendix because that shows the good and bad of American health care. At least in my opinion and experience it does. It also shows how dangerous consumerism can be, since I waited to go to the doctor because I hate it so much and then, when I was in absolute agony I waited one. more. night to go to urgent care because it's cheaper than going to the emergency room. I understand your point. But there's also a point where, both in England and the US, we need to find some way to break the cost curve of treatment without lowering the standard. If finding a way to make people feel like they have a stake in the costs helps do that, it's not bad.

 

EDIT: In my exhuberance, I sometimes type too fast and have mistakes. hehe Normally, I leave them, but in this thread I seem to be prone to accidently saying the opposite of what I mean due to typos. It's actually quite funny.

 

Oh, and I mean this in all sincerity, I think it's fun arguing about this stuff. Most people I know in real life just don't care enough to trade ideas before they go to the ol' "let's agree to disagree and head out to dinner" model.

Edited October 30, 2011 by Cantousent

[Guard Dog]

I had an interesting discussion in class with one of my professors back in college. It was in a Calculus class and I was having some difficulty with antiderivatives so I kept asking him questions that kept him on the subject longer than he wanted. He made an offhanded remark on my responsibilities as a student and his as a teacher. I explained to him that he was mistaken about the nature of our relationship. In my view I hired and paid for Miami Dade Community College to teach me the Calculus II class. MDCC then assigned him (as their employee) the task of carrying out their end of the agreement. That means I am not his student, I am his customer and he has an obligation to follow his syllabus and teach the material as agreed when I paid my tuition for his class. Not just "present it and move on".

 

Needless to say he was not pleased to hear that his august and noble profession was really just little more than a paid service provider just like any other person with a job. But, that is what it is.

You went to MDCC? Cool, now there is an up chance that i've bumped into you in real life.

Yep, I finished my AA there from 1996 to 1999, all at night. Then I got my BS from FAU, finished in 2003. When were you there?

[Orogun01]

Don't be sorry. Just think harder. Do you believe, under the same circumstances, I'd go to one doctor in England and all of the sudden he's going to cure me so I don't need to see other specialists? Good God, man, you live in Fantasyland. I would have gone through by and large the same steps in any western health care system. Only here, I went through them a hell of a lot faster. The point isn't that I would go to one 'cure-all' doc in Fantasyland to do my one-stop health care shopping. The point is that there isn't a one stop shopping experience when dealing with specialties. To think otherwise isn't just naive, it's foolish.

No, I don't expect you to go to England for treatment. Cuba is a lot closer.

 

The point of this thread its to discuss alternative models for the British system, because it doesn't work. But the American system is far from perfect, so I don't consider it a proper alternative. Also, short of a grave case there isn't a need for a specialist. Specialists I like for rare and grave cases, not to tell me that I've got the common cold.

 

Who said anything about good? The US was, until recently, the best place to develop drugs and one of the best places to develop equipment. To be fair, the Europeans have been actually quite good about moving new medical devices through administrative bodies, and so I'll give them that. To your point, we need those greedy bastard drug companies to have incentive to develop new drugs because, at the end of the day, those altruistic third world countries couldn't get the drug unless the greedy R&D bastards develop it in the first place.

Sorry that I didn't make this clear in my post THE ALTRUISTIC THIRD WORLD COUNTRY DEVELOPS ITS OWN DAMN DRUGS BECAUSE OF THE FREAKING EMBARGO

There you go.

Look, I'm not saying that consumerism is the holy grail. I take your point about the need for immediate care to heart. I really do. In fact, I might even share my experience about my burst appendix because that shows the good and bad of American health care. At least in my opinion and experience it does. It also shows how dangerous consumerism can be, since I waited to go to the doctor because I hate it so much and then, when I was in absolute agony I waited one. more. night to go to urgent care because it's cheaper than going to the emergency room. I understand your point. But there's also a point where, both in England and the US, we need to find some way to break the cost curve of treatment without lowering the standard. If finding a way to make people feel like they have a stake in the costs helps do that, it's not bad.

Had a similar experience with kidney stones, except that I laughed my ass off when after half an hour of waiting; during which I was sweating cold, pale, in pain, and the one instance where I went to the bathroom was to vomit, the first thing that they as me as soon as I get through the doors into the ER was an urine sample.

 

This is actually another issue, that because of the cost of medical care people are putting off visits making what could be an easy treatment a hospitalization. This is a matter where I believe in socialization, the other one being education.

 

Oh, and I mean this in all sincerity, I think it's fun arguing about this stuff. Most people I know in real life just don't care enough to trade ideas before they go to the ol' "let's agree to disagree and head out to dinner" model.

This is the Internet, it is meant for arguing.

 

@GD: I went from 06 to 09, so unless you're superfamous and have your pics on the walls I don't think I've seen you.

Still, kind of cool. We're probably six degrees of separation from each other. BTW some of coolest teachers I've had were in MDC

[Walsingham]

QActually, I wasn't angling for alternatives to the British system. I'm thinking there's something fundamentally awry with the notion that being a customer makes the relationship healthy. Even in situations where you - for example - buy a sandwich, you can end up shafted.

 

On the other hand, being a customer can be very good. I'm curious what the factors are at work.

[Cantousent]

Frankly, I detest the DoE also, but that's a different debate. I do, however, believe in public education run by states and counties, but I believe private education is a viable option and should continue to be so.

 

As far as the argument about consumerism, I think we should substitute a different word: competition.

 

I don't believe that substituting non-elected bodies for personal choice makes for a better system and I seriously doubt most Americans feel much differently. What we want is to make health care affordable and available, which I believe it is to the majority of Americans already. Now, the more hard-core among you, such as Oro, might desire a complete overhaul to the system, but I don't think it needs to be so dramatically altered. What it needs is tweaks, many of them actually going more towards a free market solution.

 

The free market is actaully excellent for providing new goods and services, driving down the costs of existing goods and services, and distributing those goods and services across a huge economic spectrum. Do I think capitalism or the free market are perfect? No. ...But I do believe that placing equality over freedom and calling efforts to level the playing field often hurt the poor and middle class far more than it hurts those greedy 'capitalists.' The system we have works. It doesn't work perfectly, but then again what system does?

 

If you really want to claim Cuba as the great example of health care, I say go for it. I'm a big Michael Moore fan. I've watched all his most popular propaganda films. In fact, I hope he comes out with one for the next election. I'd really like to see the Republican win and Michael Moore's track record is pretty good for Republicans in election years.

 

As far as going to the hospital, yes, separating folks from any financial consideration in going to the doctor encourages them to go more often. For that reason, some folks will go to the doctor sooner and catch things that are far more treatable early. However, you'll also get a lot more folks going for trivial things and then backing up the system. I don't advocate making folks suffer. I just don't think it helps provide better care when folks feel completely disconnected from any consideration of costs. There are costs to providing health care for people whether the government doles out the care or a system of private insurance does, and those costs work their way into the system no matter what you do.

 

As far as the appendix thing, I just hate going to the doctor. I don't trust them, which is irrational, but I go anyway when I have to. The problem with me isn't so much a cost/benefit disincentive. Five bucks for seeing my primary physician every now and then isn't going to have much impact. The larger issue for me is that I just don't want to go. Even now, when there appears to be some legitimate health issue regarding my heart, I'm resistant to spending a lot of time at the doctors. ...But I do have to admit that I'm enough of a cheapskate that I didn't go to emergency even when I decided that I was going to have to throw in the towel, after weeks of suffering, because the cost is $100 versus $5 for urgent care or my primary. lol You know, I had to pay the five bucks at urgent care, they ran a ct and sent me by ambulance immediately to emergency. I had to pay $95 bucks to make up the difference when I got to emergency, and the ambulance cost my insurance which wouldn't have been the case if I'd just gone in to emergency the night before. Meanwhile, I end up in the hospital for five days with iv antibiotics and then go home. Insult to injury? haha My insurance company reimbursed me the whole $100 for the emergency room visit because, if it's a real emergency, the visit has no copay.

 

When folks complain about healthcare services, I tend to agree that there are problems, but I just don't see any system that works perfectly.

[Orogun01]

Well them maybe you're particularly privileged or i'm destitute, because my costs have been heavy when it comes to doctors.

 

I still argue that there is no logic to leave medical care in the hands of private entities with little oversight, specially in a democracy. Haven't you played Resident Evil?

 

Because of competition and powerful entities that monopolize their fields great ideas have been lost. Remember Tesla?

Quite frankly, competition breeds corruption which is the rule of the free market these days it seems. I don't feel that such an important service such as medicine should be left in the hands of corporations without transparency or an oversight committee (although I don't trust those either) and since any fault by them is going to eventually reflect on the government, then the government should be responsible for what we hold them accountable for. After all we elect officials to protect our interests but we have no voice on the practices of corporations.

[bigcrazewolf]

It's always good to find a good unbiased source for your information. ...And if you think the AFL-CIO isn't out for itself, you're delusional.

 

Did you do any fact checking on this? Name a entity that's not out for itself.

http://www.ncsl.org/?TabId=14509 Have a look at the report about health care premiums, and how much they have gone up in a short time.

 

 

It's always interesting when folks who have benefited greatly by that greedy 'profit' complain about it as if it were the worst of all evils. Let me guess, when the auto-workers negotiate sweet contracts that carve out better pay and benefits than the vast majority of Americans, they're just getting their fair share, but when the investors who actually created the company in the first place demand a healthy return out of their investment, they're those 'greedy fat-cats?' Yeah, right.

 

You couldn't be more wrong about my opinion on the UAW union, and I have never benefited from that greedy profit as you say....so you guessed wrong. The majority of investors that have money in any pharmaceutical company, didn't create the company itself they're just on board for the cash. If you find it OK for a doctor to get "kick backs" for writing say 100 scripts last month for "drugX", I'm not the you're delusional one here.

 

I find it inherently wrong to profit on anyones health. The way big business(pharmaceutical companies) own our politicians, doesn't bode well for policy's passed in DC for our health as a nation.

 

Don't start with the R&D either that's already covered before profit.

 

 

If you tell me I should throw over my so called 'consumer driven' health care for the British or Canadian systems, I'll laugh in your face.

 

I'll bet lots of folks asked to trade the health care coverage they have for the American system would laugh in your face. People from these country's

 

1 Norway

2 New Zealand

3 Japan

4 Germany

5 Belgium

6 United Kingdom

7 Kuwait

8 Sweden

9 Bahrain

10 Brunei

11Canada

12 Netherlands

13 Austria

14 United Arab Emirates

15 Finland

16 Slovenia

17 Denmark

18 Luxembourg

19 France

20 Australia

21 Ireland

22 Italy

23 Portugal

24 Cyprus

25 Greece

26 Spain

27 South Korea

28 Iceland

29 Singapore

30 Switzerland

31 Israel

32 Cuba

 

I know there are many admirable things about the British system, but in most circumstances for most Americans the US system is simply better.

Again your opinion.

But another fact for you, According to the World health Organization, the US ranks 37th in health care quality. Cuba, a less developed nation ranks 39th

 

More graphs

A PBS report