Question for non-Americans - UHC and extreme sports?

Here in the USA we have private insurance and that insurance usually has a provision that they will NOT cover injuries sustained for certain activities like say scuba diving, hang gliding, auto racing, MMA, parachuting, etc… If you want to do those activities you take out extra insurance. If you play for a professional team or even in some amateur teams, the club has their own insurance.

In a country like Canada or the UK which has universal healthcare, would the government pay for an injury in those extreme sports?

Healthcare is not insurance in Canada, it is a public service delivered by private business, funded through provincial governments which receive their funding through taxes. If you are hurt you go to the clinic or hospital and get better.

A person’s private insurance, which you can have, may or may not cover you.

To the best of my knowledge, yes. In Norway. fundamentally, health care is a right sourced in law which says that residents have the right to medically necessary health care. There is no “unless” in the law. People are very negative to messing with that, or any kind of “Thin end of the wedge”

Also, we don’t want to pay for a gatekeeping system. Waste of money.

It’s been a couple years so I’m not sure if I recall this correctly, but a couple years ago I went on a 100 mile run (over 4 days) in the Cotswolds in England, and the web form when I signed up made it clear that I needed medical insurance if I was not a UK citizen (which I am not). Which implies that for British citizens, their insurance does cover long-distance runs, at least.

:dubious:

I think it’s standard for life insurance policies to exclude paying claims in the event that you die while engaged in such activities, but I haven’t heard of health insurance refusing to pay for health care under those circumstances. Unless you actually bother to tell your doctor how you got hurt, how would your insurance even find out?

UK: healthcare is free at the point of delivery. No qualifications for UK and EEA nationals : https://www.gov.uk/guidance/nhs-entitlements-migrant-health-guide

This. EU citizens may need to produce their EHIC at some point but that’s way down the list of priorities. You will be treated first and questions will be asked later.

Much the same goes for others: the NHS worries about healing you first and your insurance later. It’s not like the US where, if the last episode of Jack Ryan is anything to go by, insurance is the admitting nurse’s second question.

Well for example, scuba diving. If you get the bends that requires specialized medical care which requires special insurance.

Also if one needs airlifted from the scene of an accident that is not covered by insurance. Would it be under universal systems?

Yes. I can see the landing pad for the chopper from my office window. Or I could, but they are building a block of flats next to this building so not any more.

But it is much the same thing. The mechanisms and consequences of denying people healthcare would be substantially more expensive than covering it. Besides the ethical and political considerations.

Wait, what? I understand all of those words individually, but the way you’ve grouped them makes them unintelligible to Americans. Interesting, the differences between how the language is spoken here and in other parts of the world.

It’s covered.

The reason it doesn’t bankrupt the system is as one enormous province sized group, we have spread the risk out. Same with people with expensive to treat conditions or transplants etc. All covered.

I hate to ask this, Urbanredneck, but…cite? You’re making some blanket statements about U.S. health insurance – which may well be true – but not providing any backup to your statements.

Yeah, I have a pretty low-end HMO and there’s nothing in there about not covering sky-diving, bungee jumping, etc. If I have to go to the ER, it’s the same amount regardless of the reason.

The only thing would be if I got additional “accident” insurance, which does have restrictions on what it covers.

Scuba is extreme sports now? :confused:

In Spain the cost of medical transportation is part of the UHC system, and yes, you’re covered for it. And yes, you’re covered for any parts of the medical treatment which are considered “part of normal protocols” and “not elective” (where “elective” and “not covered” are treated as synonims): for the bends, since we have places to treat it, it’s a standardized process etc you’d be covered.

For someone who worked as a scuba monitor there’s a slight difference in that in his case any medical problems incurred as a consequence of diving would be a professional situation; some of his paperwork would be through his Mutua (the companies which handle work-related medical care, both preventative and not), but he’d still get treated at the same hospitals and for the same invoiced amount (zero).

As part of belonging to an archery club, I have sports insurance, but it doesn’t cover me from damage I suffer while traipsing around the mountains shooting plastic targets (that’s covered by the UHC system); it covers civil damages I cause to someone if I mistake them for a plastic bear (if things get to criminal levels, there’s no insurance for that).

There are some things which are not covered but they’re mainly things which are medically and socially perceived as elective; surgery for hare lip is covered, breast reduction can be covered, making yourself into a Barbie isn’t covered.

I believe this OP starts with a false premise – that health insurance has exclusions for certain activities.

It may have exclusions if you can be covered by someone else (liability insurance from a car accident or workman’s comp for workplace injuries), but I’ve never seen such exclusions for certain activities.

Life insurance often has those, but in my experience, they disappear after the first few years. That is, if you’re killed sky diving within, say, 5 years of taking out the policy, you’re not covered, but after that you are.

You can take out evacuation insurance - pretty important for mountain climbers and long distance hikers. An evac is usually pretty expensive and definitely not covered. I have friends who were choppered out of the Grand Canyon after he blew out his knee - that was not a cheap flight.

Most people get their evac insurance through membership in one of the big climbing associations either in the US or Europe. That’s where we get ours, and haven’t had to use it yet. :slight_smile:

AIUI, an air ambulance is covered by some health insurance policies, though certainly not all. Is the “evac” that you’re talking about different from an air ambulance because the injuries are not life-threatening (i.e. a blown knee just prevents self-extraction from remote places to where one can be driven to the hospital)?

If it’s just a blown knee requiring no immediate treatment, couldn’t you just take an ordinary helicopter? Still not cheap, but it would be far less expensive than calling in a genuine air ambulance.

The air ambulances in England are all charity run, none of them charge (they might hit you up for donations later, but it’s voluntary), but they’re actually not run by the government health service. Having said that, the onboard medical staff normally are paid for by the NHS, though the pilot and helicopter running costs are not.

Eta: You don’t get to call one in though, that decision is made by the operator based on location and severity of accident. If they reckon you can wait for a normal ambulance, which is run by the NHS and free at point of use, you do,

The basic point is that the NHS isn’t an insurance scheme to reimburse individual treatments. It’s done by tax-funded block budgets.

As for whether the individual should be considered responsible for the costs of the health consequences of high-rise activities - there might be some heavy tutting once the patient is on the road to recovery, but people do just as much damage to themselves on motorbikes or falling off ladders, and in total cost the rest of us a lot more.

Probably alcohol misuse is the most costly to the NHS, and in that case there would likely be some stern talking-to and reference on to your GP to get you into the appropriate harm reduction programme and keep an eye on you. People do occasionally suggest fining drunks who turn up in A&E, but as noted above it’s usually considered not worth the paperwork.

Per HIPPA, health insurance policies can exclude coverage for injuries from high-risk activities:

That said, I no policy that I have ever been covered under had those type exclusions. As always, check the small print!