I don’t think there is only one answer. I think there are many many varieties of health care reform that are possible. Ranging from entirely private but regulated all the way to completely public. I think the most important thing is that the United States find a way to ensure that everyone can be insured. That can mean having the government provide their insurance (like in Canada) or regulating the insurance companies to require them to ensure everyone at affordable rates (like in Germany where I had health insurance as a student for $60 per month).

The system in Canada isn’t perfect. But the great thing with regards to something like wait times is that if there is a problem, the government can pour resources into fixing it. Wait times have been significantly reduced in a lot of areas. For example, the average wait times for MRIs in Ontario in 2003/2004 was 22 weeks. By 2007 it was 10 weeks. The important thing to remember with “averages” is that they include the extremely remote areas in our country (something that the US doesn’t have much of). The wait times in populated areas for MRIs are generally a few weeks. If you are willing to go in at odd times of the day, you can often get in much earlier. The machines are sitting empty at 3am…

I am not assuming that quality of care would be lower – I am basing that on several things I have read/heard, including the video I linked to above. I have also seen several places where people make reference to things like having to wait 6 or 7 months to get an MRI in Canada… that seems to be inferior to what we have now, where in the US you can get an MRI scheduled much sooner, usually in less than a month. If certain procedures end up being delayed, wouldn’t this potentially cause higher rates of death and complications resulting from not receiving treatment in a timely manner?

I really don’t see my concerns as faulty logic. I am also not trying to cause any rifts here, but I am honestly looking for answers to my concerns, as are many Americans. I have posed these same concerns to people on Facebook when they have posted something about health care reform, and they have just ignored me – one even deleted what I had asked. I mean no harm – I am just genuinely concerned and so it is disheartening when people (like these ones on FB that I mentioned) insist that there is only one answer and therefore won’t even respond to your concerns. I am sure there are lots of different answers and compromises, but I would prefer one that does something to actually improve the *quality* of health care and also doesn’t further drive the US into bankruptcy. It is highly concerning to me already how much debt the US gov’t has.

In your husband’s case, if he wanted to maintain the high level of coverage he has today, then he would have to find a job that pays more in order to cover that cost. This is all basic economics.

When it comes to quality of care, I’m not sure why anyone would automatically assume a public option would be inferior. That is a huge assumption. But even if was inferior, just having a public (cheap) option out there is great for economics. It creates an entry point in the market. Private companies will see the lowest price offered by the government and then enter the competition, setting their prices just above the government. THERE! Now low-income families actually have choices. By introducing a low price point, the government is widening the market.

Similar to car insurance, there would be a range of providers and prices available…. more expensive coverage and cheaper coverage, too. Each family chooses what they can afford.

My main concern is that the gov’t option would become more widespread over time to the point that it was what most people used for their insurance. And if it is an inferior plan, then that leaves a majority of people with inferior health care. If it is free, then what incentives will stop companies from dropping all their employee’s insurance coverage? That could lead to most people needing the gov’t option. I would much rather retain my husband’s insurance now, and I would hope his employer would choose to keep it… but what if they decided to drop it? My husband does like his job, but without the good health coverage, it would probably be better financially if he found a higher paying one. The good health plan makes it worth a lower salary.

These are valid concerns that many Americans are currently raising. We are concerned that the gov’t option will end up being not an option at all, because it may well become the *only* option for many people if employers begin to drop employees’ health insurance.

With regards to his comments on Canada that: “Our Canadian and British employees express their benefit preferences very clearly—they want supplemental health-care dollars that they can control and spend themselves without permission from their governments. Why would they want such additional health-care benefit dollars if they already have an “intrinsic right to health care”?”

The Canadian public health care system covers basic health care, emergency health care and access to any specialists that you may need for diseases, conditions, etc. that you have. However, it does not cover things that are considered discretionary. Canadians can and do purchase additional insurance (either on their own or through their employer) for things that are discretionary and some of those things are covered through opt-in government run plans too.

This blog is not just about AP. It is about parenting issues. Access to health care is a parenting issue. If you cannot afford to keep your family healthy, that is an important parenting issue.

I don’t know where all of the ideas/thoughts in your comment come from, but let me tell you a little bit about Canada:

1) You said: “My husband works for a non-profit which has excellent health insurance… and, as I said it is a non-profit, that means that the pay isn’t so hot. The health coverage is one of the main reasons he can work there and I can continue to stay at home to raise our children. For us, health insurance is part of his pay as we see it.” Here everyone has insurance and it isn’t tied to our jobs. So no one is forced to stay in a job that they don’t like or leave a job that they do like because of the health coverage.

2) You said: “There is the concern of what the gov’t will consider essential health coverage and what it won’t. There is the concern of a one-size-fits-all policy, where people are not able to choose the type of coverage they want (based on their age, lifestyles, gender, etc.).” Why does that matter if the public option is just an option and if people can choose to purchase the services that are not considered to be essential? Here the public health system covers the things that are needed by people based on their age, lifestyle, gender, etc. There are national guidelines, for example, for when/who should get mammograms. However, doctors can also send someone who is outside of those guidelines to get a mammogram if they have a reason for doing so.

3) You said: “And there is the concern that once most people are on the gov’t option that competition between doctors will be killed, bringing us to a level of mediocrity rather than doctors trying to excel.” In Canada, doctors do not work for the government. They have private practices. As a Canadian resident, I can take my government health card and go to whichever doctor I would like to go to. There is a big difference between a single payer health care system and a single provider health care system. Read the link “not all socialist countries are alike” to get a better understanding of the differences in plain language.

4) You said: “My biggest issue is maternity care… how it costs 6 or 7K just to have a natural, vaginal birth in a hospital while at home with a midwife would cost only 2-3K. Of course, if you have insurance, it is cheaper to do the hospital birth for your own pocketbook, but the money is paid, and it is too much considering the very inferior maternity care given in most hospitals. Midwife-attended homebirths are far cheaper *and* far safer, and they are usually more personalized… the midwife might actually check up on you and offer bfing support, whereas the hospital certainly won’t.” I agree completely. In Canada, you can choose to have a midwife assisted home birth and it will be all paid for by your government health care. If you do give birth in a hospital, there are usually lactation consultants that you can access for free with your government health card while at the hospital and on an out-patient basis after wards. There are also home visits by a public health nurse to all newborn babies, regardless of where they are born.

5) You said: “So, bottom line for me, health care is already too expensive for the quality we get in many cases. Expanding the coverage of this without actually reforming the quality of the care is a bad idea. It will end up costing more for care that is of lower quality.” I don’t know much about England, but I’d be curious where those stats came from and how Canada, Germany, and other countries shape up compared to the United States. Also, Cuba fares better than the United States in a lot of areas.

6) You said “So, bottom line for me, health care is already too expensive for the quality we get in many cases. Expanding the coverage of this without actually reforming the quality of the care is a bad idea. It will end up costing more for care that is of lower quality.” Perhaps the reason it is too expensive for the quality of care you get is that the insurance companies are skimming off more than a healthy profit. In a public system, that money can be either (a) pumped into higher quality care or (b) put back into the pockets of taxpayers.

I think all of your concerns are important, but it seems like you have a lot of misinformation. I hope this reply helps to clarify some of my experience and position.

It also makes me feel good that somebody else who values natural/organic foods has non-liberal views.

I did want to ask, though, what health care reform has to do with AP? Your post was nicely written and not offensive, although i do see in the first comment that there is the potential for conservative-bashing. In my opinion, that does nothing to unite those of us who practice AP. There seem to be fewer conservative AP parents already… and many AP parents already feel very alone due to their differences, which makes it much harder for the even smaller minority of conservative AP parents to find comfortable places for ourselves. This is why I have personally had to leave some AP chat groups…. because they ended up being liberal AP groups, meaning they discussed AP but also went nuts over any mention of conservative viewpoints.

Again, I don’t think you have written anything inflamatory in this post, but the subject of it made me wonder. Personally, I am opposed to the health care reform as it is being presented by Obama because it really doesn’t seem to be actual reform. I think that reform should aim at improving quality of care while also reducing costs or at least making them more realistic. By having a government “option,” I worry about companies dropping their good health coverage plans in favor of the gov’t plan since it is less money out of their pockets. My husband works for a non-profit which has excellent health insurance… and, as I said it is a non-profit, that means that the pay isn’t so hot. The health coverage is one of the main reasons he can work there and I can continue to stay at home to raise our children. For us, health insurance is part of his pay as we see it.

I am concerned about the quality of care lowering… some statistics I heard on England’s health care showed that their rate of people dying from all kinds of cancers and other diseases was higher – because the health coverage was inferior. There is the concern of what the gov’t will consider essential health coverage and what it won’t. There is the concern of a one-size-fits-all policy, where people are not able to choose the type of coverage they want (based on their age, lifestyles, gender, etc.). And there is the concern that once most people are on the gov’t option that competition between doctors will be killed, bringing us to a level of mediocrity rather than doctors trying to excel. And… the gov’t has a pretty poor track record for doing things well. I don’t want them in charge of my health care based on the way they handle other entities. I want to be able to have some level of control and not relinquish that to the gov’t.

It seems to me that we would be lowering the overall quality – providing coverage to all, but coverage that is inferior. I think we can and should do better. I think that part of the problem is the rate at which people sue doctors – making their expenses higher. Another problem is that people are so drug-reliant and go to the doctor at the drop of a hat, rather than working on prevention by doing things such as eating healthier foods, exercising, and of course breastfeeding! Without people working on their health from the front end, then the gov’t option just perpetuates the cycle of fixing things rather than trying to maintain them before they break. I know that not all health issues are caused by things that could be prevented, of course… I am just seeing this as a part of the problem.

My biggest issue is maternity care… how it costs 6 or 7K just to have a natural, vaginal birth in a hospital while at home with a midwife would cost only 2-3K. Of course, if you have insurance, it is cheaper to do the hospital birth for your own pocketbook, but the money is paid, and it is too much considering the very inferior maternity care given in most hospitals. Midwife-attended homebirths are far cheaper *and* far safer, and they are usually more personalized… the midwife might actually check up on you and offer bfing support, whereas the hospital certainly won’t.

So, bottom line for me, health care is already too expensive for the quality we get in many cases. Expanding the coverage of this without actually reforming the quality of the care is a bad idea. It will end up costing more for care that is of lower quality.

I apologize for going on and on… I do look forward to perusing your archives some more as well as reading new posts on attachment parenting from you! AP parents need places to come for support sometimes, so you are doing important work!

Now I realize that private health insurance is EXPENSIVE. Which is why the public option makes sense to me — put something more affordable out there. Maybe the coverage won’t be as good but at least provide an option.

When looking for quotes on car insurance, there are cheap companies and expensive companies. But today in the USA, health care is just plain expensive and that’s it!