Qwitcherbitchin', Crybabies

Burning Platform has some whiny rant (and coming from me, that's really saying something) about a guy billed $426 for an $8 can of OTC pain spray.

Well, gee, no shit, Sherlock, and if you'd seen the report from MIT on the topic, or drove by Homeless Depot any time since 1986, you might have noticed those 200 Julios standing outside their branch in Greater Aztlan Assland, which heritage Mexican homeland apparently stretches all the way to Anchorage AKand Bangor ME. (Who knew?) And unlike whom, you have actual insurance.

Oh, and back awhile, your congressweasel voted in EMTALA, mainly in response to anesthesiologists passing gas for docs doing C-sections on pregnant migras who were crowning, and getting sued by them afterwards, but never actually getting, y'know, paid for their twelve years of higher-education services or their $1M expertise. Those bastards!! Doctors should work for free, amIright??
Occupy!

Short story long, if you show up at the ER, yours, mine, anybody's, you get to play, but you don't have to pay. At least, not up front. Unlike, say, your doctor's office, Urgent Care, or - waitaminute - every other commercial establishment in the flipping country, including the DMV and the Post Office.
Well-played, Fucktard Minions of Stupidity.

So, by the by, exactly how long d'ya suppose Mickey D's or Burger King would be open as a business anywhere, if tomorrow Congress passed the WAAH! My Tummy's Rumbling Active Hunger And Deadbeat Wimpy Act of 2018, dictating that anyone who wanted a hamburger now could get it now, solely on the promise to pay for it next Tuesday?

And if you worked at a business similarly burdened, how long would you have a job when that enterprise subsequently went tits-up, in about a New York minute??

And if the pharmacy at Wal-Mart had to hand that spray out for free, how much d'ya figure they'd start charging for kettle corn bags and underpants to subsidize that largesse? Say, somewhere around $426 dollars, just mebbe?

Anyways, they go on to knee-jerk call the price of the pain spray to government regulation and socialism(!), rather than all y'all getting the system you pissed and moaned for, and now finding out you're getting it good and hard.

Then, a couple of comments down, this nugget:

"Husbands bill was over $2000 to tell him his arm wasn’t broken.
Xrays were separate, about $50.
$256.00 for a tetanus shot.
For comparison, i can get a tetanus shot for a horse at tractor supply for $4.00
Tetanus boosters have been around for decades. Not like they’re rare or anything.
This is after sitting there for 4 hours among a couple dozen non English speaking persons."

Some people cannot put two and two together, and come up with the answer.
Let me help:

And that's why you're paying $256 for the shot.
You're paying for all the Julios and Marias and Wangs and Achmeds and Crazy Homeless Alcoholic Eddie guys with no insurance.

And of course they get a bill too (despite another idiot commenter suggesting we don't bill them).
Which we can't make them pay.
If they gave the right address.
If they gave the right name.

And also, because if your husband got an infection from poor injection technique, or they hit a nerve or blood vessel, or the sun was in your eyes, it was $256 to offset insurance premiums, because you'd then sue the hospital for a gazillion $$$. So you have a doctor ordering it, a pharmacist stocking it, and an RN giving it, rather than you grabbing a dose at Tractor Supply, and doing it yourself.

And of course, if he'd just gone to your doctor and gotten the booster himself, on time, months ago, it could have been had for maybe $20 co-pay, or even less than that, right?

Make your congressweasel pass tort reform, stop suing everybody for everything, build the frickin' Wall at the border, start throwing people back over it, get your annual checkups, and quit using the ER for drive-thru Urgent Care.  Now, how much of that is within the hospital or ER's control, and how much is within yours?

Otherwise, pony up. Walking in the door at any ER worth the name starts at about $1500.
If it was open, depending on day of the week/time of day, you could've gotten the same X-ray and treatment at any competent Urgent Care for a few hundred bucks.

People will price-shop for a ten dollar difference on a cell phone, but they won't use common sense about an ER bill of $2K vs. one at Urgent Care of $500.
Genius, right there.

(And if Urgent Care wasn't available for you, for any reason, then let's be reasonable. You had no choice about the ER, that injury hurt - a lot, and you wanted to know now. Fair enough. You want care now, you pay now.
We take cash, check, almost any insurance, and VISA/MC. Tell me they do things different at Burger King and Target when you want a Whopper or a pair of jeans.)

But don't bitch when you got the gold-plated care you demand, at prices your insurance company mostly pays, while you rarely see 10-20% of that cost.

This is the system you wanted, and now it's not so bitchin. I get that.
Now go fix it, as outlined.

I'd chat further, but I'm on duty at the ER tonight.
Where, if someone comes in with a heart attack, and we save their lives via the Cath Lab and first-world medicine that should be the envy of every Swinging Richard in human history since Adam, the only thing they'll remember afterwards, and go online to bitch about afterwards, is that the baby aspirins we gave them were billed at $20@.

So don't take this the wrong way, but as someone who couldn't have made two car payments in their life if they received $100 for every "thank you" heard from patients or families in 20 years of saving actual lives, if you complain about anything but gross negligence or egregious harmful malpractice, like having the wrong leg amputated, please, I beseech you most humbly and sincerely, go and fuck yourselves up the ass with a lit flamethrower, m'kay?

Because If I gave you that enema, I'd bill you for it at the price you deserve, and laugh while I did it.

Maybe when the shift is over, if I feel like it, I'll tell what you ought to be doing, and bitching about.
Knowing full well the odds of you taking such concentrated experiential wisdom is about as good as the odds of you listening to the discharge instructions you get.

The Waiting Room Channel - PSA #1

Hi there, and welcome to The Waiting Room Channel.
Are you here for abdominal pain?
If so, then NO, YOU CAN'T EAT OR DRINK ANYTHING.
You can come here for our world famous turkey sandwiches, or you can come here for treatment of your abdominal pain, but not both.
Did you bring your child here for abdominal pain?
If so, then NO, HE CAN'T HAVE THE BAG OF FLAMING HOT CHEETOS, UNLESS YOU WANT THE DELUXE "Discharged by MD from Waiting Room" TREATMENT PLAN.

This is because your abdominal pain could be caused by something that requires surgery. If you eat, you can't get anesthesia for 6-8 additional hours, during which time your potential surgical emergency could kill or seriously afflict you. Which our Risk Management Department, and your insurance company (unless you have ObamaCare) really frowns upon.

And if the abdominal pain is accompanied by nausea/vomiting/diarrhea, we really don't think it's in your best interest (or ours) to load the catapult for the next launch.

But if you'd really like to come here and throw up anyways, could you please do it in one of the boxes pre-addressed to Press-Ganey, so we can ship it right out to them?

Thanks boxloads.

This message repeats in Spanish in 10 seconds.

The Red Cross

In response to a notation over at Whitecoat's weekly update, where he noted "no more donations to the Red Cross".

For context you can read the whole thing, but the gist is that the Red Cross are being sneaky about where the money goes.

For context about my response, I was (note the past tense there) a volunteer with the organization for over a decade, including running multiple first aid stations within shelters immediately after the Northridge Earthquake, as well as working gratis on everything from rodeos to the Rose Parade, and was one of several monthly coordinators of event coverage for a group of nearly a hundred active medical providers. In addition, I was a certified instructor in Basic and Advanced First Aid and CPR, and took the gamut of courses for Disaster Operations, all before, during, and after attending nursing school and getting my RN license. So I have a wee bit of experience with the organization.

So, in the context of "Red Cross doesn't want to tell how they spent money collected from Big Disaster XX", allow me to furnish some insight.

When there's a metric crapload of human misery, and it makes national news, the pitch machine and collection apparatus at ARC goes into overdrive. This is because they are a completely NON-governmental organization, entirely funded through charitable donations. (Biomedical Services, AKA blood donation, is a separate financial entity, for good and for ill, going back to the early 1990s. It brings in a good chunk of change, and also a ginormous financial liability, both from fines, and from lawsuits, and the intent was to keep them in the Red Cross tent while splitting off the liability, to prevent the entire organization going under from lawsuits, esp. those from before the blood supply was tested for a host of previously unimagined nastiness.)

So far, so good.

People, most particularly Americans, really are human about seeing others getting raked over the coals of life. Even if people decided to build their houses in flood plains, tidal estuaries, or tinder-dry forests, they don't like to see anyone's whole life go up in a moment, and then watch them suffer and shiver. So they give.

Like numerous other organizations, the Red Cross funnels those contributions to help where it's needed. And now for the "But...".

BUT...sometimes certain disasters are more...photogenic, and TV-friendly, than others. Little kids with their toys strewn around the uprooted trees, along with their parents and siblings, and sitting on the curb crying, after some devastating tornado, tugs at heartstrings.

Kids sitting on the curb because the next door neighbors were meth-heads whose illegal lab burned down their ghetto tenement and made 40 people of limited means homeless, not so much.

But both need a helping hand just as much as the other.

So, in their wisdom, the Red Cross looks things over, and decides how much a given disaster will be funded. If donations are wildly higher than this, well and good. The extra money goes to pay for the little disasters that don't get donations rolling. And to funding the Red Cross itself, from staff members, to buildings, to materials for training, and hopefully, to keeping some stock of supplies prepositioned in places in every chapter in case something really earth-shattering, like a 8.0 earthquake, Cat V tornado or hurricane, or the Mississippi flooding to 500-year flood levels happens.

Anybody with a lick of common sense knows why this is both prudent, and necessary.

Now for the back of the coin.

The Red Cross is a charity. It's driven by volunteerism, of which there is no shortage, and a certain amount of organizational altruism, which documentedly exists.
But it is, let's face it, a business that has to pay rents and meet payroll, and exist next year, thankyouverymuch.

And some number of the sort of folks who go to work for well-below-market salaries at a charity, rather than take any number of much better and better-paying jobs, are not your Bill Gates', Donald Trumps, or Jack Welches. Or even anything remotely like it, by and large, even allowing an occasional exception to the rule of gravity.

So even though the people who make the organization work are the sort of people who can do high finance in their day job at a Fortune 500 company, and still find time to show up to teach a Saturday class, or roll out at 3AM when a twister levels a neighborhood two zip codes away, the people who run things day to day, decide what gets done, plan, and administer all the functions of the organization are far too frequently people who'd be woefully under qualified to be even assistant night managers at Party World or McDonald's.

And yet, they see that they have The Clipboard, and are In Charge, and so they foolishly assume that makes them smarter and more talented than the volunteers who make their responses and programs possible, both personally and financially.

And I'm here to tell you, it just ain't so.

Organizationally, the Red Cross has been living vicariously off of goodwill engendered by the organization since Clara Barton's day, and the fumes in that gas tank are getting pretty thin.

So it's certainly well within the realm of possibility that senior management (which generally comes from local management, which as Will Rogers noted are simply the town bandits send to raid HQ) may have decided that the peons out from somewhere beyond their offices don't need to know how and where the organization spends their money. IMHO, that's a jackassical choice, and without tying personal salary to names, everybody and every expenditures from the top down should be publicly available on their website 24/7. That it isn't is very likely either a sign that they think themselves beyond such an open accounting, or the truth would embarrass the organization. Or both. I don't know which, but I have my suspicions based on past experiences.

But it's their ball, and their rules.

I'm not saying don't donate to them. They do a tremendous amount of good work, and generally in a way far superior than government minions do so. They do decent training, the costs are a bargain, and hordes of pool lifeguards and medics got their start there. Hell, I worked for them for years learning the healthcare business long before I got to where I could get paid for it, and I'll always hold a warm spot in my heart for an organization whose emblem I wore.

But you should know what you're dealing with, and what you're getting for your money.
And eventually, if they don't knock off the silly stuff, they're going to wake up one day and find out that somebody else, say, the Salvation Army, has started doing first aid and lifeguard training, and that the S.A. already does feeding and sheltering better, and has done so 24/7/365 around the world for 100 years, and Red Cross will be out on the curb with the other unfortunates in a New York minute, wondering what happened to them.

Jerry Pournelle's Iron Law of Bureaucracy - In every organization there are two kinds of people: those committed to the mission of the organization, and those committed to the organization itself. While the mission-committed people pursue the mission, the organization-committed people take over the organization. Then the mission-committed people tend to become discouraged and leave.

PSA: Trolling

Astute observers, or now anyone, will note the appearance of a new box to the right., entitled "Comments"-->

It will intimidate something less than 1% of anyone who reads this or any other blog, or comments thereon, based solely on my own research.
The terminally stupid less than 1% who most need it will completely ignore it.

I blog for my entertainment, and a sanity release valve. That it elicits anything from a laugh to an "amen" from others is icing on the cupcake. That it may occasionally cause someone to disagree surprises me not a whit.

But if you haven't got the balls to identify yourself, even with an Internet alias (seriously, did you really think my parents named me "Aesop"??), and a trackback to yourself, but still think you can run in here, crap the floor, scoop it up, and fling it on the walls or at me with all the glee of a spider monkey on crack, think again.

If something I write twists your tail, have at it. I rarely lose a debate on the merits, but feel free to have a go, if you can stay on topic, rather than go all ad hominem. I recognize on most of what I write here, I'm handicapped by only having nearly twenty years' experience doing what I do and seeing about a paltry million patients, out of eight billion people on the planet, so it's inevitable that somewhere someone may have learned something beyond my ken. I'm not omniscient.

But when someone chooses to start with rudeness and insulting comments, any possible intellectual validity has just been sacrificed. So has my toleration or patience. Any screed that follows will thus be shipped out with all the warm and tender feeling of Ripley sending the titular foe out the airlock of the Nostromo's lifeboat in Alien, and with all possible dispatch. Take bets on this.

When you start out by being rude and/or insulting, and as a bonus are demonstrably retarded and ignorant, you may possibly hear the word "Fore!" just before the #3 iron arcingly descends into your ass and sends it straight down the fairway of Life.

In all the known universe, this is the one corner of it where I am entitled to wave my magic wand and send refugee flunkouts from Etiquette School where they belong, with a pull of the handle of the Internet's flush tank.

Happily, in a year, I doubt I've had to do that even five times. I'd be even happier not to improve those stats, but not to the point of foregoing the pleasure when the need arises.

I fire abusive patients and eject jackassed visitors all the time in the real world; if you came here from under a bridge, I will return you there faster than you got here, and you won't even elicit a tiny internet virtual tear. It may come as some shock to learn I, like 500,000 of my ER colleagues, tolerate none of anyone's bullshit whatsoever.

If five minutes reading what I write here hasn't made my glee at using the "delete" option apparent, "Go ahead, make my day." 

And of course, if I'm bored, I reserve the right to make you an example, because even steak knives need sharpening from time to time, and sometimes I appreciate you volunteering to be the cadaver for today's anatomy lesson.

The 99+% of you to whom this note doesn't apply, go back to having a pleasant day.

Dear Miss Management

Once again, it's time for your semi-annual review. We continue in our hopes that you may someday achieve a grade of barely adequate, but we won't hold our breath or get our hopes up. Based solely on your documented performance to date, flying pigs and a winning powerball ticket are more likely to be in the near future for me.

First, we need to correct a mis-impression on your part: when it was suggested to you (and if we find out by whom, the phrase "heads will roll" won't be melodramatic hyperbole as much as an anatomical description of fact) that Nietzsche had suggested God has died, and left you in charge, it was a metaphysical jest. Yes, we do note that you are possessed of a shiny clipboard, and a disposition that would pucker a sour apple tree, thus perhaps leading you or any number of guidance counselors to think they had directed a round peg into a round hole, but we note with some firmness that as observed by John Cleese, the first prerequisite for a lion tamer isn't "Has he got a hat?" Thus mayhap you could rethink your career choices, or at least notch down your delusions of personal competency at this one.

For your rather bankrupt fund of personal information, all those rather curious-looking and odd-speaking folks down on the lower floors moving to and fro rather rapidly are what we in the trade refer to as "medical professionals". They all have advanced training and degrees which, unlike yours, required actual passing grades in actual scientific fields of study, in things like physiology, chemistry, and such. They have all sorts of rather specific functions, none of them interchangeable to any great degree, arrived at by literally thousands of years of trial and error in the medical arts. (Stop me if I'm going too fast at any point. I realize that when I'm talking to you about science, history, and medicine, I'm speaking ancient Greek to you; in no small part because the ancient Greeks had a lot to do with, well, science, history, and medicine, thus this is the first time you've heard any of it.)

Consequently, we tend to look at what we do with a certain bit of prejudicial pride, because we have this quaint notion that the measure of our success is two-fold:
how many of our patients we don't kill; and
how many of our patients actually improve when we do what we're supposed to do.

Shocking as it may seem to you and your colleagues, neither of these things (I believe you refer to them as "metrics", yes?) has any remote relation to how long they waited outside, how distressed they are at having to wait, their personal emotions about anything, nor their feelings about how well we do our jobs (which, once again, are not to kill them, and to make them physically better to the limits of our powers. Perhaps you're noting a trend here?)

Hereabouts, there's an additional complication, because in its wisdom (owing to no small number of 2x4s applied to the back of the state legislators' heads, both serially and liberally), one small subset of medical professionals known as "nurses" (perhaps you've heard of them) are limited by the state's nursing practice act (we call that "the law"; by a strange coincidence, so does the state's Attorney General, and every court from Oregon to Mexico in between. Perhaps someone in Risk Management could catch you up on this concept another time?) regarding how many, and of what severity, patients we are allowed to assume responsibility for at the same time. Just as a refresher, here in the ED, that would be 4 regular patients, or 2 serious ones, or 1 critical patient. (Funny, huh? It seems that both legislators and people with medical degrees and nursing Ph.D.s came to the incredible conclusion that someone who's a 1:1 patient when they go to ICU isn't somehow less serious before they get there. Close your mouth, dear, flies will get in.)

Consequently, in a colorful turn of phrase, we really don't give a damn about how that makes people outside with hangnails and kids with runny noses feel when they have to wait longer while we foolishly chose to save the lives of the acutely critically ill or injured. (That was acutely, not cutely. Don't worry, it happens all the time in your department.)

We also don't tend to give a damn about meeting farcical illusions about how long a visit here takes, or how long the wait is to be seen. We observe daily the overwhelming number of persons who elect to leave before being seen should have made that decision before coming in the first place, borne out by years of not finding their decomposing corpses littering the freeways they drive to get home, ever, at any time in history. (Curiously both the police and fire departments have told us the same thing about a lack of cat skeletons in trees. Crazy, huh?) We further note that most of their histrionics occur once placed in a room, mainly to fulfill their inner child's need for attention before they huffily depart in their bid for the award for Best Actor Or Actress In A Dramatic Departure.

Personal anecdote here: among a baker's dozen (sorry, that would be thirteen for you. Public school grad too, huh?) of eclectic hobbies, I enjoy competitive shooting sports. Coincidentally, one of my best friends is a world-class shooter. And he's even younger than you are. The way he got good, was to get fast, then work on accuracy. It worked, to the point that he's faster than everybody, and he doesn't miss much now. Hardly ever, even on multi-day competitions. It's rather scary to behold. Thing is, that's a fine way to learn shooting, when you're talking about wasting a few rounds outside the target's bullseye. They hit the dirt with a thud, rather than the target with a clang, so nobody minds all his previous misses in practice.

But (pay attention, this is where that literary meander hits the target, so to speak!) that method of improvement doesn't work nearly as well with actual lives, unless you apprenticed under Dr. Mengele. (M-E-N-G-E-L-E. You should look it up on Wikipedia, 'kay?) Because the optics of those metrics - a little management lingo I've picked up - are a truckload of corpses, and a courtload of lawsuits. Good for Risk Management's job security, but conversely, less money for management bonuses. (Got your attention there, did I?)

So it's far better that we focus on getting everything as near to flawless, and then slowly increase speed, to just short of the point where we start making any mistakes, rather than listen to you and your clipboard, and try it the other way around.

So let's talk turkey: You have the exact same staffing matrix in place in terms of nurses and doctors now as you had here ten years ago. Conversely, we see every 24 hours some 300% of the number of patients as we did ten years ago. (And by the way, they're one helluva lot sicker, person for person.) I've been watching my paychecks, and yet strangely, I don't seem to be making 300% of the money you paid me when you hired me a decade back. In fact, you can't even be bothered to fully staff the nursing positions such that there is a nurse everywhere we're supposed to have one any night in living memory, and the lowest paid workers in the department, the techs, without whom patients don't get to such petty things as X-ray, CT scan, ultrasound, or admitted to surgery or the wards, are so short-staffed we could count them on our thumbs most nights.

So here's another historical anecdote, and a wee suggestion:
In 1864, General Ulysses Simpson Grant, Commander of all Union Army forces, and future president of the United States, noted that cavalry saddles chapped his ass. Which occasioned him to do nothing but tolerate the distress. I bring this up because if a great man such as that could bear up under adversity, perhaps the folks crybabying to you on the surveys could sack up and learn to tolerate their petty inconveniences like something other than offended oil sheiks at a strip club. (Who, unlike a respectably large number of our patients, actually pay for the services in question, and reportedly tip better. Just saying.)
And instead of feeding those pigeons by polling about how they feel when their whiny little complaint (that should have seen them in an Urgent Care or their doctor's office during business hours, rather than the ED when we have enough patients for 10 hours out of every 12 to fill 320% of the available beds) isn't seen as fast as they order fries at the Burger King drive-thru, how's about you stop responding to your Press-Ganey happy gas imperative, reach down between your knees, and pull really hard until your head pops out?

Think of trying it as leaving your personal comfort zone.

When the oxygen rushes to your head, and the light breaks because your eyes are outside for the first time in several years, maybe you could toddle over to Human Resources, and ask them why, with EMTs by the score within the range of me swinging a dead cat are looking for better jobs, you can't find us an on-call pool of 40-80 folks with excellent work ethics and a functioning brain who'd like a 50% pay raise over what they get paid to ride on an ambulance, a shot at benefits and normal hours, and an employee assistance program that would help them transition to becoming nurses, physician assistants, and doctors. You know, the one you pimp on the company website, that I have to listen to for hours on end while I'm on phone hold as my ear goes numb, trying to get one of the over-worked floor nurses to take report on my sick-as-hell ED patient, so I can help keep the meat moving down here in the hell you never visit until the JCAHO clipboard commandos dither by every few years with more stories about the Tooth Fairy and the Easter Bunny, and demands so ridiculously irrelevant to actual patient care as to be unthought of nor unseen by Florence Nightingale amidst a war in the Crimea when nurses still had to boil the patients' linens themselves.

Failing that, you'll perhaps understand why getting your head out is going to get a bit harder if you're still talking to me five seconds from now, after I shove that clipboard so far up your ass it impinges on your cardiac preload. I'm sorry if that negatively impacts on your workplace karmic harmony, but perhaps you would be better served by a transfer to either the retail sales or fast food service industries, where things like how long it took to get your Whopper, whether you liked the toy in your Happy Meal, or what color things come in, are all far more germane to what's important than they are anywhere within shouting distance of the Emergency Department.

Are we clear?
M'kay, B'bye until next time!



{Also, my apologies if I used too many "S"es in your title, to the same degree that the hospital's board of directors seems to put too many "asses" in your department. My mistake is because I was raised by people who were both courteous and wise, whereas the board manifestly was not.}

Dear Anonymous Troll

"Anonymous (troll) December 3, 2013 at 7:56 AM

I have a question: if subsidized health care is so bad (it is), how come it works so well in other countries?(It doesn't.) Take the Scandinavian peninsula countries for example, Sweden, Denmark, and especially Norway (who by the way have about the highest standard of living in the world)(actually, they don't), have all subsidized health care - and education btw. How come it's good for them but so abysmal for us? (It's abysmal for both; they just have a better track record of rolling over for nanny-state government.) Does it have to do with the "anti-socialism" brainwashing of Americans (they call that comparative government here) and failure to understand how this type of health care has to be organized in order to be made efficient?"(No, it's a success at understanding how this has to be organized, and recognition that it's contrary to our founding principles, our Constitution, and pretty much everything in American life and culture prior to about 1934.)

 

But out of fairness, Anny, let's check the videotape on your assertions:

 

Sweden    

Pop. 9.5M   15,765 immigrants annually

GDP 399B  35th world/26th per capita

AIDS deaths <100/yr

Denmark

Pop 5.5M    13,600 immigrants annually

GDP 213B   55th world/32d per capita

AIDS deaths < 100/yr

Norway

Pop. 5M        8,400 immigrants annually

GDP 281B    46th world/9th per capita

AIDS deaths  <100/yr

United States

Pop 317M    1,153,880 immigrants annually

GDP 15,940B   2d world/14th per capita

AIDS deaths  >17,000/yr

{So as not fry your delicate grey cells, I left out the number of Nobel prizes in chemistry, biology, and medicine respective to Scandinavia vs. the U.S., the number of patents for medical devices for Scandinavia vs. the U.S., and the fact that the total amount spent on healthcare in the U.S. annually is more than the entire federal budget for any year prior to 2004, because clearly things like medical innovation are unimportant trivia, and I'm sure you think the federal government is doing such a great job on running itself in every other way already that the best choice in healthcare is to just hand it over to them too, right?}
 

Wow, this is quite a poser.

If I understand you correctly, you're asking how we, a country that takes in more immigrants annually than Sweden, Denmark, and Norway and 150 other countries combined might have different health care needs?

 

How our nation's needs could possibly differ from the needs of three countries whose combined population is surpassed merely by the number of folks living in the greater NYC area??

 

And why a country whose non-socialist output exceeds them in total by a mere 16 times  might not be so enamored of socialism as they (and apparently you) are? (And BTW, Norway doesn't have "about the highest living in the world", they're eclipsed by Qatar, Liechtenstein, Bermuda, Macau, Luxembourg, Monaco, Singapore, and Jersey, just for your rather sparse fund of information.)

 

Or why we, caring for an AIDS population almost 60 times larger than all three Scandinavian states combined, might just maybe have some different healthcare priorities than a miniscule, mainly white protestant homogenous bunch of countries with essentially zero population growth?

 

You realize, right, that more people live in Los Angeles County than in Norway and Denmark combined?

That Norway's largest city isn't even the equivalent size of merely San Jose?
That Copenhagen and Stockholm, their largest cities, are eclipsed by Dallas and San Diego, and that our top 6 cities have more people than all three of those countries?

Or that the number of 0-14 year olds in the United States is three times larger than the combined population of the three countries you mentioned, combined??

And that none of those nations would even make the Top Ten if they were U.S. states, ranking behind California, Texas, New York, Florida, Illinois, Pennsylvania, Ohio, Georgia, Michigan, and North Carolina. That'd be Sweden; Norway and Denmark would actually be down around 22nd, just ahead of Alabama. In more ways than one.

And when you touted that sort of system, of course you knew that the average Swede pays >50% of their annual income to the government for that "free" subsidized healthcare, right? And that a Swedish-style single-payer health insurance system would cost the median income household in the U.S. $17,200 per year in new health care taxes. Please, extoll the virtues of doubling income taxes on the 46% of Americans who are actually paying any, because that'll really play well in Peoria. That'll be great news to the 91 million American unemployed at the moment, because it means folks like you, Anny, are going to get three new Mcjobs to help pony up all that cash. All for someone else's kids! Thanks, dude!

Gosh, sign me up, I can't wait to give Uncle Sam another 20% or more of my annual take-home, because I'm not eating enough PB&J and bologna sandwiches now, I can look forward to adding ketchup sandwiches to the menu! Thanks for the suggestion, Anny!
And then to contain costs, we'll cut staff and facililties, so that in a few years, procedures will be shoved down to lower and less-qualified staff, if they're performed at all, and in un-updated facilities with more antiquated equipment and technology. Welcome to U.S. Medicine 2015 1935.

If your message is that we should first helpfully eject all non-whites, and enforce a level of ethnic and social diversity - like you find in Sweden, Denmark, and Norway - that would do a Klan rally proud, you'll have to get your own blog. Good luck with that. I think they tried it in Western Europe starting around 1933.

 

We experimented with socialism in this country. But adhering to it almost caused the Pilgrims to starve to death, until they threw it out entirely, switched over to unrestrained capitalism, and were so inundated with bounty as a result that they paid off all their debts to their English sponsors, and had enough left over to hold a huge feast, and even invite their neighbors over. We call the remembrance of that "Thanksgiving". As Casey Stengel used to say, you could look it up.

The only subsidizing that's going on is at gunpoint, as healthy people are coerced under threat of growing fines to buy healthcare they don't need for exorbitant prices, in order to help cover the cost for those who get it for nothing. Try that at the interpersonal level, and see what the local District Attorney calls it.

I would have been all for government just letting anyone who wanted it sign-up for Medicare. But then, when they saw the exorbitant price they'd be asked for, and the substandard care they'd receive, if they could find a doctor worthy of the name who'd actually take that card, they'd run from government care like scalded cats. The idea would have been crib-strangled by everyone who experienced it firsthand in weeks. Pretty much the exact same response you're seeing now for HopeyDopeyCare, even from media talking heads who usually can't get their lips off his buttcheeks long enough to cover actual news.

But don't worry, I understand how socialism-philes love to chirp about "organizing things to be more efficient", because they're sooooooo good at making the trains run on time. Perhaps you could Google "Soviet health care" and get back to us. Unfortunately for your ilk, some of us also studied history, and we remember where the train tracks in your Worker's Paradise always lead: glorious barbed wire enclaves sitting beyond signs that promise all who enter, "Work Makes You Free". Right after a helpful post-train ride shower, eh? Last I looked, overt Socialism only killed - as in personally murdered, we're not even including the wartime casualty lists - about 65,000,000 people worldwide in just the last century alone, courtesy of Hitler, Stalin, Mao, Fidel, and Pol Pot. It would actually be less harmful to disseminate bubonic plague in grade schools.

So pretty much all your assumptions are wrong, the lack of familiarity with the basic differences is breathtaking in its totality, and the conclusions you draw, from the dearth of information about...well, anything you brought up, are almost totally wrong. Other than the fact there there are three Scandanavian countries named Sweden, Denmark, and Norway. Which probably puts you barely ahead of most current 12th graders in geography.
Sorry if reality stings when it smacks you where you sit. Maybe try an ice pack?

 

So seriously Sparky, as Bill Murray said to the innkeeper in Groundhog Day, "Did you really want to discuss the weather, or just make chit-chat?"