# Health insurance suggestion from a lay-person to cut down on unnecessary care **URL:** \ **Category:** Great Debates\ **Created:** [October 27, 2016, 1:31pm UTC](https://boards.straightdope.com/t/health-insurance-suggestion-from-a-lay-person-to-cut-down-on-unnecessary-care/769844 "2016-10-27T13:31:31Z")\ **Posts on this page:** 7\ **Page:** 3
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [October 28, 2016, 6:30pm UTC](https://boards.straightdope.com/t/health-insurance-suggestion-from-a-lay-person-to-cut-down-on-unnecessary-care/769844/41 "2016-10-28T18:30:39Z")
> [@Fotheringay-Phipps](#): > > What we were discussing was the comparison between the level of care that a poor person in the US would get from the Medicaid (or Medicare) and ER combination versus the level of care that a poor person in the UK would get from NHS services. OK, poor person (no income, on welfare or whatever your terminology) in the UK needs a kidney transplant. Their GP refers them, the specialist assesses them on medical need and they go into the relevant order in the queue. An organ becomes available, if a patient needs it and they are a good match they get it. Cost - £0 out of pocket (for all expenses and lifetime care thereafter) What would the cost be for an equivalent person with no insurance in the USA? ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [October 28, 2016, 6:33pm UTC](https://boards.straightdope.com/t/health-insurance-suggestion-from-a-lay-person-to-cut-down-on-unnecessary-care/769844/42 "2016-10-28T18:33:42Z")
> [@PatrickLondon](#): > > Class and private medical insurance in the UK: I suspect the range of employers who offer private insurance as part of remuneration is relatively limited, as are the classes of employee involved - basically senior managers. I worked to quite a senior level in university management and no-one would have thought of it, nor I suspect in any sort of public service: but that was before the days of widespread privatisation and commercialisation of public services (and rent-seeking top bosses, but don’t get me started). I don’t know so much, I worked through from very junior levels through to director levels levels in microelectronics and pharma and subsidised private healthcare was always offered as part of the packages. ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [October 28, 2016, 6:37pm UTC](https://boards.straightdope.com/t/health-insurance-suggestion-from-a-lay-person-to-cut-down-on-unnecessary-care/769844/43 "2016-10-28T18:37:59Z")
> [@Novelty\_Bobble](#): > > OK, poor person (no income, on welfare or whatever your terminology) in the UK needs a kidney transplant. Their GP refers them, the specialist assesses them on medical need and they go into the relevant order in the queue. An organ becomes available, if a patient needs it and they are a good match they get it. > > Cost - £0 out of pocket (for all expenses and lifetime care thereafter) > > What would the cost be for an equivalent person with no insurance in the USA? [Apparently](http://www.nationalkidneycenter.org/treatment-options/transplant/affording-a-transplant/) Medicaid coverage varies by state. But people with end stage renal disease (i.e. the cohort who needs transplants) would be covered by Medicare, including transplants. But I don’t know why I’m even getting drawn into this. You made an assertion in comparing the two systems, which implied that you were familiar with the US system. Are you? ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [October 28, 2016, 6:53pm UTC](https://boards.straightdope.com/t/health-insurance-suggestion-from-a-lay-person-to-cut-down-on-unnecessary-care/769844/44 "2016-10-28T18:53:03Z")
> [@Fotheringay-Phipps](#): > > I’m not looking at this in terms of earnings. But I know that the “typical middle class” person is a group that covers a lot more than 10% of the population. So unless you dispute that number, then your statement is clearly incorrect. not so fast, true, it was a “gut feel” for me as to where I draw the line but looking at recent figures regarding [household income in the UK.](https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/408470/365-2015.pdf)… (warning pdf) It looks like around 25% of households in the UK have an income of £48k or more. I wouldn’t be surprised if much of that 10% of private healthcare population overlaps with that group and I’m not sure that a £48k household income ($60k) is what I’d consider a middle class income, these are gross amounts as well, so no taxes or other deductions taken off. ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [October 28, 2016, 7:00pm UTC](https://boards.straightdope.com/t/health-insurance-suggestion-from-a-lay-person-to-cut-down-on-unnecessary-care/769844/45 "2016-10-28T19:00:00Z")
> [@Fotheringay-Phipps](#): > > [Apparently](http://www.nationalkidneycenter.org/treatment-options/transplant/affording-a-transplant/) Medicaid coverage varies by state. But people with end stage renal disease (i.e. the cohort who needs transplants) would be covered by Medicare, including transplants. That’s great. So they’ll get the work done and it wouldn’t cost them anything now or in the future…sounds wonderful if true. > [@](#): > > But I don’t know why I’m even getting drawn into this. You made an assertion in comparing the two systems, which implied that you were familiar with the US system. Are you? yes, I have friends and colleagues in the states who have excellent coverage but still struggle with bills and have nightmare interactions with insurance companies. Huge payouts for having babies, thousands of dollars per year for chronic ailments. They still consider themselves lucky but many of their families have a hell of a time. So…how familiar are you with the NHS and other universal healthcare systems? And which part of my assertion doesn’t stand up. I have provided cites so you feel free to show me opposing ones? ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [October 28, 2016, 7:41pm UTC](https://boards.straightdope.com/t/health-insurance-suggestion-from-a-lay-person-to-cut-down-on-unnecessary-care/769844/46 "2016-10-28T19:41:51Z")
> [@Novelty\_Bobble](#): > > not so fast, true, it was a “gut feel” for me as to where I draw the line but looking at recent figures regarding [household income in the UK.](https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/408470/365-2015.pdf)… (warning pdf) > > It looks like around 25% of households in the UK have an income of £48k or more. I wouldn’t be surprised if much of that 10% of private healthcare population overlaps with that group and I’m not sure that a £48k household income ($60k) is what I’d consider a middle class income, these are gross amounts as well, so no taxes or other deductions taken off. I’m not going to get involved in incomes. Again and for the last time, anything that 10% of the population has is not something that a “typical middle class” person has. That’s all. > [@Novelty\_Bobble](#): > > So…how familiar are you with the NHS and other universal healthcare systems? Familiar enough for the specific assertion that I made, which is that they cut back on unnecessary services by rationing healthcare. That’s all. For some reason you got all worked up about the greatness of the NHS system and decided to make a broader comparison, which you failed to support, but that’s not my issue. > [@](#): > > And which part of my assertion doesn’t stand up. I have provided cites so you feel free to show me opposing ones? You provided cites but no cites that supported the claims you were making. I myself am not making any claims here, so I don’t need any cites. I said I don’t know which is better. I’m sorry but the fact is that you seem overly eager to have a debate about the greatness of the NHS system, and I don’t think I’m up for it at this time, and that’s not the subject of this thread. I don’t anticipate responding further on that matter. ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [October 28, 2016, 8:15pm UTC](https://boards.straightdope.com/t/health-insurance-suggestion-from-a-lay-person-to-cut-down-on-unnecessary-care/769844/47 "2016-10-28T20:15:53Z")
> [@Fotheringay-Phipps](#): > > Familiar enough for the specific assertion that I made, which is that they cut back on unnecessary services by rationing healthcare. That’s all. And the USA rations healthcare in a different (and more unfair) way. > [@](#): > > For some reason you got all worked up about the greatness of the NHS system and decided to make a broader comparison, which you failed to support, but that’s not my issue. Never claimed greatness. It is good, certainly better, cheaper, more comprehensive than the USA, other universal systems around the world can make even stronger claims but certainly the affordability, universality and equality of access of all such systems is a key factor. > [@](#): > > You provided cites but no cites that supported the claims you were making. I claimed the USA was more expensive, excluded more people and drove more people to bankruptcy, my cites back that up. > [@](#): > > I myself am not making any claims here, so I don’t need any cites. I said I don’t know which is better. The evidence is out there that might help you decide if you are willing to explore it further. [Previous page](https://boards.straightdope.com/t/health-insurance-suggestion-from-a-lay-person-to-cut-down-on-unnecessary-care/769844.md?page=2)