Looking Overseas Gives Us Reasons to Be Thankful for Obamacare

U.S. Adults Are More Likely to Skip Care and Struggle with Medical Bills Than Adults in Peer Countries

This Thanksgiving, a lot of Americans will be giving thanks for Obamacare.

By the end of this month, HealthCare.gov will be able to handle 800,000 users per day, enough to enroll everyone who needs coverage by the end of the year. Meanwhile, the state-run exchanges are reporting “a November enrollment surge,” precisely as the Obama administration predicted. (Massachusetts also experienced a late enrollment surge when they adopted an individual mandate in 2006.) Everyday, we hear new stories about Americans who are saving thousands of dollars on their insurance costs, including House Speaker John Boehner, whose new Obamacare insurance will cost pennies on the dollar of his six-figure income.

And not a moment too soon. Earlier this month, the nonpartisan Commonwealth Fund published the results of their latest survey of eleven industrialized countries, including the United States, where they asked people about their experiences with the health care system in the past year. Their findings are a sad reminder of just how bad the status quo is — and why we demanded health reform in the first place.

Many Americans don’t go to the doctor when they’re sick because they can’t afford it. Many don’t go to the pharmacy or take their medicine. Add it all up, and 37 percent of Americans had some sort of “cost-related access problem” in the past year.

That kind of problem isn’t nearly as common in the Netherlands, where it only affects 22 percent of the population. Or France, where the number drops to 18 percent. Or Canada, where it’s 13 percent. Or the UK, where it’s 4 percent.

Fair enough, you might say. More people have more access, but they also have to wait in line longer, right? Not necessarily.

In fact, in most countries, the majority of the population could see a doctor within a day of their request. The United States placed second-to-last in this category. A quarter of our population had to wait six days or more — a little better than Canada, but far worse than Australia, France, Germany, the Netherlands, New Zealand, and the UK.

But that’s primary care. The United States is known for its specialists, where 76 percent of the population got an appointment in less than four weeks and only 6 percent had to wait two months or more. That’s a heck of a lot better than Australia, where only 51 percent got an appointment in less than four weeks and 18 percent had to wait two months or more. Or Canada, where the numbers are 39 percent and 29 percent, respectively.

But it’s about the same as the Netherlands, where the numbers are 75 percent and 3 percent. And the UK, where they’re 80 percent and 7 percent. And even Germany isn’t far behind, at 72 percent and 10 percent.

So it’s a mixed bag, but we’re certainly not in the lead.

In most countries, it’s a lot easier to get after-hours care than in the United States. Only 35 percent of American doctors have an arrangement to take care of their patients after the office is closed — by far the lowest percentage of all the countries surveyed. In Canada, it’s 46 percent. In France, it’s 76 percent. In Germany, the Netherlands, and the UK, it’s 90 percent or higher.

And the doctors have a lot more problems in the United States, where the paperwork piles up. One in three — 32 percent — reported significant paperwork or payment problems in 2013, compared to 23 percent in France, 17 percent in Germany, 15 percent in Canada, and 4 percent in the UK.

No wonder everyone else is happier with their health care than we are.

Only 25 percent of Americans think their health system works well. In the other countries, that approval rating ranges from 40 percent in France to 63 percent in the UK.

Whereas 27 percent of Americans think the health system needs to be completely rebuilt, that disapproval rating ranges from 12 percent in Norway to 4 percent in the UK.

That’s a lot of numbers, but they all tell the same story: The United States has the most complicated, most expensive, and most frustrating health care system in the industrialized world — and none of that is due to Obamacare, most of which took effect after the survey.

In fact, Obamacare is moving our system closer to our international counterparts. Based on these numbers, I’d say that’s definitely something to be thankful for.

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An abbreviated version of this op-ed was published in Friday’s South Florida Sun-Sentinel. This version was published in the Huffington Post.

Happy Is Fast While Sad Is Slow

About twenty years ago, I attended a Tony Robbins event in Del Mar, California.

Tony spent a good deal of time discussing pain and pleasure and concluded that individuals will do whatever possible to avoid pain and have pleasure.

He had five poor individuals on the stage with him, and the subject was “time.” He was trying to determine what represented a long time and what represented a short time. He was making no progress, so he ambled into the audience.

As all six-foot-seven of him loomed above me, he glanced at my nametag and said: “Okay, Norman, we have never heard from you. What do you think is a long or short time?”

I thought for a second and answered: “A long time is any amount of time when you are having pain and a short time is any amount of time when you are having pleasure.”

Tony loved my reply, and we all discussed it for a half hour.

Very early in my career, I discovered that, when the staff was having a good time, we/they performed better, and the time at work simply flew by.

I once was interviewed by the New York Times concerning my departure from Columbia Pictures and my starting a television company for Polygram. I told the reporter that I had left Columbia because it stopped being fun.

My new German/Dutch management went nuts when they read it. They had absolutely no concept of fun at work. The head of the company (a lawyer) called me and asked what I meant. I was not proud of myself when I answered that perhaps it would be better stated if I had said “the gratification of success.” He was happy about that.

I wonder how they deal with that issue at Harvard Business School.

I recently came across a quote that I wish I had written: “Money in all its disguises is the religion of humanity.”

Those that maintain that money can’t buy happiness are correct to a certain extent. However, money can certainly provide a certain amount of pleasure…and yes, even happiness.

But, however you find (or define) happiness, I’ve always believed that happy is fast while sad is slow.

I will conclude with a poem I wrote just before Thanksgiving. I call it “Doggies”…

It’s Thanksgiving soon, and I remember so well
The sights, the sounds, the warmth, the smell.
We had big dinners, and kids came too.
When it was time to eat dinner, it was all so swell.
Dinner was liked by our dog Annabelle.
She was imported from London, all fluffy and white,
A Maltese so tiny, but she was a fright.
She barked at all doggies and wanted to fight
Them no matter how big, and she was so slight.
She was the same color as our living room rug.
She loved all celebrations, and she looked all around
‘Cause people dropped food there that Annabelle found.
She would sleep with my children and cuddle up snug.
She was so sweet, and she was so nice.
I think of her often, not once or not twice.
The years are all gone now; they sped quickly by.
I think of dear Annabelle, and at times I cry,
For things are so fleeting no matter I try.
She’s gone forever; it’s been sad for me.
Yet I found Valerie; she was such a love.
She had a big doggie, a gift from above.
The dog’s name was Jerry, a hundred pound Doodle, all fluffy, all white.
Jerry was also quite crazy but such a delight.
Now Valerie’s gone, and Jerry’s moved away.
I miss her and two doggies both by night and by day.
Happy is fast while sad is so slow.
I need to move on. I need to just go.

31 Days To Go: The Hypocrisy of Thanksgiving

You know the thing about compassion and generosity? Easy in theory, not in practice.

A week ago, we asked you to give. We specified three charities with an easy-to-follow donation button to PayPal. We are thus far disappointed with the response. We hope you will reconsider our request. To reiterate: We accept any amount. It is mind-boggling that our readership (and we know we have a strong readership because we see the daily tracking statistics) can’t even spare one dollar and one minute. We are also aware that many of you have spent hours decorating your houses and otherwise investing in your own holidays. And you should. Enjoy it. You earned it. But when we ask so little, we find little to respect in excuses like “too busy.”

We do not deny that this is a busy time of year. Many of us feel overwhelmed. But a small donation may be the solution instead of the problem. Yesterday, psychologist Susan Krauss Whitbourne wrote:   Continue reading “31 Days To Go: The Hypocrisy of Thanksgiving”

32 Days To Go: My Holiday Contribution…

My contribution to Trading8s for the Holidays has been to visit the most excellent video front-end and aggregator Clicker (which aggregates or indexes the popular content from a variety of sources) and posting various Thanksgiving, Black Friday, and Christmas-themed TV episodes.

FireShot capture #016 - Clicker Screenshot

I have not searched for Hanakuah episodes as of yet, and the Seinfeld ‘Festivus’ episode is not online – anywhere – to my knowledge.    No slight was intended.   Enjoy!