Well, if we were to compare actual costs ala carte versus taxation rates, I think we’d find that health care costs in the US are substantially higher per capita.
Feel free to look through all the numbers, but I’ll pull some out for you:
Country 2006 2007 2008 2009 2010 (est.)
Australia 4.80 4.40 4.20 5.60 5.70
Canada 6.30 6.00 6.10 8.30 8.80
Denmark 3.90 3.80 3.30 6.00 8.20
Italy 6.80 6.10 6.70 7.80 9.30
United Kingdom 5.40 5.30 5.60 7.60
United States 4.60 4.60 5.80 10.20
The highest number on there is the USA at 10.2% unemployment for 2010. But more to the point, I’m not noticing any indication from the unemployment numbers of those other countries with subsidized health care that they have long term unemployment problems.
You left Sweden and France off the list. Withthe exception of Denmark, every single one of those countries has hadhigher unemployment than the US for theyears in question (except for the last year, when the worst recession in recent history caused the US’s rate to skyrocket). Your own cite supports my post. Remember, I’m talking abohthistoric unemployment, not the rate right now (ie, while we are kn a recession).
But so’s the rest of the world (bar Australia thanks to their exports to China). And being unemployed in a universal healthcare system is nowhere near as bad as being unemployed in the US in health terms.
Personally I’d take the extra percent or so unemployment rate for universal health care if it came down to that choice.
{Corrections mine} You’re stating those like they’re facts, but since Canadian healthcare (for example) costs less per capita than the US American healthcare system, I think your facts might be debatable.
It is curious. I read among those reviews one person’s experience in Switzerland. Totally different from mine. My son was born over 45 years ago (thus long before the Swiss medicare was set up). My wife was kept in the hospital for seven days. They billed us at CHF 50 per day so a total of CHF 350. This included all the prenatal care (five months worth) and there were no other costs. BTW, in those days CHF 350 was about USD 80.
I grew up in the US, but was in a hospital only once for about a week. But that was in 1950, before the current system really took hold. My father had Blue Cross insurance through his work and they paid about 80% and the rest was small. When my MIL died in Florida in 1988, we eventually got a bill from her final stay in the hospital that was the size of a small book. I still remember two things. A $5 charge for an aspirin and a similar charge for a nurse looking in at her.
When I broke my ankle in Montreal seven years ago, I got excellent care. I presented my medicare card and was admitted with no further paperwork. I spent six days in the hospital (four waiting for the swelling to subside and then an operation and then two days post-op) and went home. There was no exit procedure, none at all. I informed the nurse at the station I was leaving and that was that. The doctor who operated on Saturday said I could go home on Sunday, but why not stay an extra day–which I did.
The only potential problem is that there are very few GPs and when mine (who hasn’t taken a new patient in over 15 years) retires, I will be up the proverbial creek. This is the result of deliberate gov’t policy to restrict the number of doctors allowed to set up practice in Montreal. This policy originated in a shortage of doctors in the sticks, but has mainly resulted in a glut of doctors in the off-island suburbs. This is exacerbated by the fact that voters in Montreal cannot be moved (east end is all separatists and west end all federalists and that is the only issue that motivates the two parties) while the off-island suburbs vary their votes.
I’ve experienced the Canadian and American systems, having moved to Maryland from Montreal about 5 years ago. Both provided me with good care. I haven’t had similar medical issues in both places - back home I had a few emergency visits for kidney stones and appendicitis, and here it’s been mostly preventative stuff and mental health visits.
Problems with my (and my family’s) experience in Canada: hard to see a specialist. Very crowded hospitals, leaving you in the ER for days sometimes, waiting for a bed. No real hospice care. Very long waits for elective or non-urgent procedures like orthopedic surgery, MRIs, etc. I’m not sure how most of that compares here in the US but seeing specialists has been a breeze, except for having to wait for an appointment. Not needing a referral is great (although I guess that varies depending on your insurance plan?)
Problems with the US: I am completely freaked out by the concept of health insurance being tied to my job. I’ve got great insurance, but costs keep going up and less is covered. And what if I actually get sick enough to need some serious medical help, but I’m also so sick that I can’t work for a while? I’m currently thinking about having a baby, and I get worked up into a panic attack because back home I’d get a ton of time off, and if I wanted to be a stay-at-home mom, I’d have no income but at least we’d be covered for medical care, so it wouldn’t be as big a hardship on the family as it would be here, where my husband is self-employed and adding me and a baby to his insurance would be extravagantly expensive. I also am seriously bothered by the fact that we’re “healthcare consumers” instead of patients. I mean, I get it, because it’s a business, but it seems cold to me.
Good stuff about the US: Mental health care is covered to a greater extent here, at least from what I’ve seen. Also, from what I understand, there is better end-of-life care available, although I don’t know the details.
Maybe it’s just in Quebec that it sucks, or my family’s having bad luck. I’m glad it was better for you (but sorry that you needed it in the first place).
I’m sorry that your family is having a problem with it - I guess that’s one of the dangers of talking about universal health care - not everyone’s experiences will be the same with the same system.
FWIW, I’ll echo Cat here–we just did the same with my aunt in Toronto, and I can’t fault the care at all. She was comfortable and cared for until the end.
It’s important to remember that, in Canada anyway, health care is delivered on a province-by-province basis. While there are many similarities between provincial plans, there are also a few differences.
Childhood and young-adulthood with US health care. Three operations in Thailand since 2001: One removal of a salivary gland and two shoulder operations.
The US health care was good, of course. It can be just as good in Thailand, but the Western-style hospitals are more expensive than the regular ones. And while still cheaper than in the West, they’re not such a good deal anymore. For example, my salivary-gland removal in November 2001 in a first-rate Western-style Bangkok hospital was less than US$1000 all in, including operation, doctor’s fee, two nights’ stay, food, medicines, everything. (Closer to $750, IIRC.) My shoulder surgeries in 2008 would have been in the neighborhood of $10,000 to $12,000 each! Granted, the latter possibly required a bit more technical skill – I won’t go into specifics – but they would have been down closer to a couple thousand had I had them a few years before. As it turns out, I had them done instead at the main teaching hospital here by the exact same doctor. (Almost all of the doctors in Western-style doctors here also have hours at the teaching hospital, but it’s a very Thai setup. Many if not most support staff do not speak English, and it looks rather Third World-ish.) Doing that dropped the cost down to the aforementioned couple of thousand, which my insurance company was happy to pay (it would not have covered most of the cost at the private hospital).
But local hospitals are not always bad. My dentist sent me to a colleague of his at the Naval Hospital for dental surgery a few years ago. It looked like one level of Hell. However, the dentist – a rather high-ranking naval officer as it turns out – was very skilled, his patient area sterile, and my complicated surgery came in at about 25 bucks American. And no physical pain during the procedure whatsoever. But I think the sight of that place would have scared away many Westerners. I don’t like the dental services at the Western-style hospitals, because they’re always trying to sell you unnecessary dental work and are expensive nowadays too, to boot.
The worst part of Spain’s current system, right now, is exactly that it has gone from a centralized model to one where each Region manages its own.
People pay into the centralized funds,
Some of those funds are sent to each region according to a formula involving previous years’ costs, population, etc, while others are kept by “Madrid” for programs which are still centrally-managed
If you need to see a doctor in a region that’s not where you’re a registered resident, procedures can vary from “the first appointment with the visitors doctor is in half an hour” to “are you bleeding? no? Ok, then you need to ask for a doctor to be appointed to you and then you’ll need to go to Treasury because we can’t find your records with both hands and a squad of archivists, then you’ll be able to ask for an appointment”.
Standards of care vary by region. There are occasional variations in terms of which procedures are considered non-elective, but in general once a procedure is considered non-elective in a region the rest take it up in a matter of months (next time their own regs are up for revision).
Usually you can get a same-day or next-day appointment for a GP or nurse; waiting times for specialists can go from a few days (urgent but not requiring hospitalization as far as the GP can tell) to three months (routine checkups, you’re told to ask for one three months before it’s due). I usually try to get my appointments during vacation periods, when you can pretty much pick your day and time. There is currently an epidemic of minor respiratory illnesses that’s got the system collapsed; my mother called for an appointment on Tuesday and got it for today (Friday).
My experience in the US was that I needed to spend as much time on the phone with the insurance as I’d spent in the waiting room, that appointments ran later than in Spain, and that they tested a lot more. Until I’d gone to the doctor in Andalusia I would also have said they were a lot ruder to the patient and treated us like we were idiots… but one of the Andalusian doctors was like that too, although she was better than my bad American experiences when it came to informing patients. The Americans would give you a paper to sign and get huffy when you insisted in reading it and asking questions, in Spain they give you the information verbally first and in writing once they think you understand.
I have had some bad experiences here in Troll Country. There was, for instance, the time I had to be physically restrained from going all Mama Bear on an emergency room doctor who implied that my teenage son, who had fallen during an epileptic seizure and had facial injuries, had probably taken drugs and not had a seizure at all.
But mostly, my experience has been positive. We’ve gotten care when we needed it, and it has been good care, delivered by good people. I can’t praise Norwegian nurses and nurses’ aides enough, although their belief that the way to deal with a mother’s anxieties is to offer her a cup of coffee is a bit puzzling. And I don’t even like coffee…
My experience with the American medical system essentially ended when I married and moved away in 1990, but I remember it as being about the same, except with considerably more paperwork and emphasis on how the bill is going to be paid. I’m sure there’s a ton of paperwork here, too - This Is Norway - but the patient hardly sees any of it.
Well, I’ve had experience with the Norwegian; US and UK systems. However, my US experience was equivalent to a skinned knee, and I work in health care in Norway, so my experience here was popping into the next door office and asking the doctor “Does my leg look broken to you?” “Yes” (true story). Not representative.
Partially. Long waits was a feature of many health care systems back in the 60s or thereabouts. They have been tinkered with considerably since then. But a lot of impressions from 50 years ago remains in the national memory.
Also, there is triage. Urgent problems will be treated before non-urgent ones. This means that waiting lists will be longer the less urgent a problem is. (Also, some things like the wearing out of hip joint replacements are very predictable, and can be scheduled years in advance if desired). Someone wanting surgery for his mild snoring problem may indeed have a long wait. Also, non-urgent problems are the majority of problems.
I don’t think you’ve fully realized what a special-case the US system is, and how much more expensive it is than the norm.
A US citizen** pays a lot more in taxes for government health care than a Canadian, Brit, Swede, etc. National health care costs signifcantly less tax moeny than the US system does. An American pays taxes for Medicare, Medicaid, VA, IH, etc, and all the redundant bureaucracies associated with them. Then pays privatly for insurance and all the bureaucracies associated with that. Other nations citizens pay for a system they can use themselves, and one bureaucracy whitch is a lot smalle due to the lack of profit in cheating the system.
The Wall Street Journal has a good article on the subject.
While on holiday in America I accompanied my friend to her hospital appointment, she pulls up in front of a very glamorous (to my eyes) building, I followed her in to what looked like a plush hotel with a fancy reception desk, ‘velvet’ carpet, decent art on the walls and lush sofas and armchairs… wait, this is a hospital?!?!?
When we were in a small town in Germany, my 10 year old son dislocated his knee. We spent time in the pediatric orthopedist’s office and in the hospital. Care was top-notch, waiting times were short, and everyone tried their best to speak English. We had no insurance, and were dreading a high bill, but in the end the only thing we had to pay for was rental of the crutches, about 10 Euros.
