I wonder what the cost of universal health care would be in the US compared to other wealthy countries like western europe ones, since in the US people live in a less healthy way?
Anyway to answer the question, maybe china? he’d need to go to some shitty developing country.
I’m not sure what Rush and the caller were going on about in that link.
Canada has UHC, as opposed to the compromise abortion the US is arguing over. Nothing prevents a Canadian doctor from doing roughly what the caller described, and Rush said could not be done.
In Canada, a doctor is either in UHC or he and his patients get no reimbursement for his work from UHC. (YMMV, it’s a provincial thing with Federal guidelines) Good luck making a living if you’re out.
If you are in the Medicare system, you can only charge what the provincial fee structure says for a procedure or consultation. No extra billing.
If a procedure is not approved to be paid for by the provincial system (or the patient is not covered IIRC) then you have the same free market system - the doctor can charge whatever he wants.
Generally, this is about cosmetic procedures. Some basic stuff - accident reconstruction, cleft palate, and extreme problems are covered (i.e. tummy tuck if you’ve lost over 100lb.) Vanity and optional stuff is covered.
So in the caller’s scenario - no, the physician and patient cannot simply decide in the moments before anaesthetic - “sorry, we’re doing A instead of B”; I’m not sure doing medicine off the cuff is a good idea anyway. The physician can’t simply “abscond” with the government-paid nurses and OR facilities to do a free-lance for-profit operation. (I suspect the same held true in Asia, but nobody reported them and it happened all the tim, and I bet the nurses and hospital administrators got a cut of the proceedse.)
However, the paitient and doctor could do the same consultations, prepare and arrange a private clinic pocedure, and do it.
Also, I suspect there are not too many “better procedures” in Canada that are not covered.
My wife had a tummy tuck from a surgeon who also does (UHC covered) reconstructive surgery. It was done in a private clinic, and we took her home a few hours later, and it cost IIRC about $3000.
The big difference is that in less rich third world or recently first world countries, medicine has not reached the point where the better off labourers cannot afford it. UHC became a necessity (yes!) when it got to the point where a few days stay in hospital, or an operation, could bankrupt a family. If a childbirthor fixing a broken bone cost a couple of hundred dollars, if a heart operation (once in a lifetime) cost a few thousand, health care would not be the issue it is today.
There was a joke a decade or more ago that it would be cheaper to hire round the clock nurses and stay in a five star across from the hospital, than to stay in a hospital while recovering from an operation.
It’s a huge step forward toward UHC.
Im sure in Rushs case, some company would set up a health bond system. Pay us $X a year, and you can pay for all your own health care since you are filthy rich. We simply guarantee to the government that we will pay for any procedure should you suddenly fail to have enough money to pay for it. Then you are on your own.
Of course, that would probably cost as much as regular insurance. In which case, he`s free to get the cheapest minimal coverage and then not claim against it, while paying private doctors out of his own pockets. Or, pay the penalty - sorry, tax - which again should be peanuts for him.
Universal does not necessarily mean government funded.
Section 5 (1) of the Health Insurance Law 2005 sets out compulsory health insurance for all residents. That is universal health care. http://www.hic.ky/UserFiles/file/Health%20Insurance%20Law%202005%20Revision%20(June2006).pdf
The elephant in the corner is the question of who pays for the health insurance. Employers (and self-employed) pay for the health insurance of employees and their dependants (s. 5 (2)), with a time limited extension of coverage following termination of employment. The government pays for the health insurance of indigents (and politicians ;)) and uninsurable people (s. 5 (3)).
That suggests to me that there are great gaping holes in Cayman Island’s health insurance system, for although on its face there is universal coverage (by s.5 mandate), it fails to address the issue of affordability for the self-employed who earn more than the cut-off ($40K per family), which I expect would lead to uninsured persons despite the law, and I wouldn’t be surprised if it fails to adequately address the asset cut-off for indigent persons (which I expect would lead to people losing their life savings if the trigger is too low), and it has a two-year exclusion for pre-existing conditions for people who earn less than $40K per family which to me is a huge hole. http://www.cinico.ky/portal/page?_pageid=3141,6625660&_dad=portal&_schema=PORTAL
In short, it has universal health care, but given that it is a tiny nation (under 10K in ’60 and under 60k in ’12), its health care is provider driven through private insurers with a government funded plan to catch those who fall through the cracks, so I wouldn’t be surprised if it leaks like a sieve. IMHO, a much better approach to universal health care is for the government to cover everyone and fund via taxes. By being provider driven, CI’s universal health care has a lot in common with Obamacare’s “compromise abortion” as md2000 aptly puts it.
Not everyone has insurance in Germany or some other European countries either. They to only have an “attempt” to ensure universal coverage. So I’d say if they can be said to have UHC, then so can the US under the ACA.
Again, I think the most meaningful definition of UHC is simply a gov’t requirement that everyone have health coverage along with some method of ensuring that everyone can meet that requirement.
Apparently there is nothing wrong with this (and the other BS) in this GQ.
He can always relocate to Gingrich’s moon colony.
Just a couple of further points about md2000’s description of how UHC works in Canada with regard to non-covered items being done privately. Yes, a person can purchase top-up insurance from private providers to cover such items, the most significant being common prescription drugs taken outside of the hospital, and dental care outside of the hospital. Yes, doctors’ fees are tightly regulated, but there is no shortage of people trying to get into med school to become doctors, for despite the caps, they still make a bucket load of money.
I do hope that we all are well aware that having a particular country wave around a piece of legislation that decrees health care for all does not mean that as a matter of facts-on-the-ground there IS even close to health care for all, or that you don’t end up with a parallel (formal OR informal) tiered system where money=quality dominating over the “universal” one. (Taking the broadest definition, one could say that since by law nobody in the USA can be turned away in an actual life-threatening emergency, then **that **is our rock-bottom tier of Universal Care.)
But then again Mr. Limbaugh is not really referring to that, is he? What Rush means is he does not want to be told that he has to pay into any system to benefit anyone but his own blowhard self.
For instance, to use the example from one of Muffin’s posts above, ther are those who would pose that if there are great gaping holes in coverage in a system that leaks like a sieve, excludes PECs and fails to address the issue of affordability outside of employer plans, then Caymans resident Iggy has a point in saying they don’t really have “Universal Health Care”, if taken to mean that you need not fear lacking health care due to your financial/employment status, any more that the USA would. Now, however, it may be that the average resident probably has better access to health care than those in a whole lot of the neighboring countries, yet Limbaugh would still object anyway since there is a mandate that insurance must be bought if the person or the employer has the resources to buy it, in order to achieve a policy goal of eventual full coverage.
I agree. Wholeheartedly.
An employee can refuse to accept the employer’s sponsored insurance. In fact many do. Not really a problem if he/she is covered under a spouse’s policy that might better.
But if an employee declines coverage and then has medical expenses that should have been covered by insurance but are not then the employer is on the hook. The employer then has to sort it out with the employee.
If a person of independent means lives in Cayman but does not work then they don’t really have to have insurance. The mandate falls on an employer. So long as such a person pays his medical bills no one will care if he doesn’t have insurance.
The benefits under the minimally acceptable insurance contract (SHIC1) are pretty low. US$32,500 maximum per incident for inpatient care, US$125,000 maximum per year, US$1,250,000 per lifetime. US$18,750 per year for emergency care per incident. Easy to blow through the per incident limits with one car accident. (The law lists the limits in Cayman Islands dollars (KYD). 1KYD = US$1.25)
It is becaue of such holes and limits of coverage that I would not say Cayman has Universal Health Care.
Since this thread was about where Rush could move where there is not Universal Health Care, I say to come on down. We have a billionaire or two or three residing here. We’ve got the Dart brothers who gave up their US citizenship for tax purposes. Might be Rush’s kind of place.
There is even a tertiary care hospital under development to focus on medical tourism sector, particularly cardiac care. A free market delight.
Then it’s decided. Cayman Islands gets Limbaugh.
Aw, fuck. My dad is a physician in the Caymans, and I like him.
LMAO!
OK, I guess we’ll have to find somewhere else for Limbaugh, out of consideration for your dad.
That whooshing sound you hear may be the wind blowing through your skull. Libertarians are to anarchists as nudists are to naked people.They’re just middle class & organized so they appear less crazy.
SS
I agree. Mods will transfer some threads out of here in a blink of an eye, and let others stay in for an inordinate time.
Mods, please get this shit out of GQ.
ahem
i don’t think they have the authority to send Limbaugh to another country.
I added to the thread of responses that really, really, belong in GQ, and nowhere else but GQ.
Don’t forget, he likes other excrement much better…