Antigen, want me to put you in touch with some doctors?
Why on earth were you given antibiotics for a virus?
Anyways, I’m a Canadian living in the U.S., and my experience is pretty similar to Ginger’s, but I think my wife’s employer has a better health care plan than hers, because my pregnant wife had to make one $10 co-pay on her first visit, and that’s it for the length of the pregnancy.
In Canada, only B.C. and Alberta split the cost of health care out of the general provincial tax rolls, although I understand Ontario is about to do the same. And the bitching some people have mentioned about finding a family doctor is true. In most of the country, 30% of people can’t find one-- this is mostly because G.P.'s have found it easier to hook up with a clinic rather than set up their own office. At least, that’s what my MD friends up north do, and they like it because it gives them the chance to have some variety in their work-week.
In Canada, you generally see a GP (either your family doctor, or in a clinic or emergency room if you don’t have a family doc) as your first step in the treatment ladder, then you get referred to whatever specialists are judged appropriate. You do NOT just show up at a dermatologist or a cardiologists office without a referral. Most offices hold onto some appts daily in case of emergencies (kids with high fever, etc…), but I’ve never had to wait more than 2 weeks for a generic appt.
In my own case, I’ve been able to get into elective surgery fairly quickly (removal of a ganglionic cyst from my hand)-- about 1 month total from seeing my GP, seeing a surgeon two weeks later, and then getting into surgery whenever that doc had hospital days.
There’s some diagnostic stuff that can wait a while-- I’ve never heard of a GP in Canada having an EKG unit sitting in his office, but it seems commonplace in the U.S., and Canada does have delays in getting MRIs because it has less units on a per capita basis.
But much as the system is criticised, it is working, and everyone in Canada is covered, without ever having to pay a doctor first (or ever).
UKer here …
I had a pretty eventful year healthwise in 2003. Without going into *too *much medical detail …
Jan: I use a wheelchair (NHS provided) and have no transport, so Diabetes Specialist Nurse visits me at home for check-up - switches me from tablets to insulin, and gives me a more up-to-date blood sugar monitor. Later in the month call GP - he arrives at my home within a couple of hours, and packs me off to hospital - admitted immediately.
Jan - April: Thirteen weeks in hospital (non diabetes-related), with two major operations. MRI scan. Another scan - can’t remember what it’s called - dye injected and followed through kidneys. Regular physiotherapy, and visits from Occupational Therapist. Food was good, and nursing staff were friendly and hugely entertaining. 
While there, I mentioned (in passing) that I thought my hearing was deteriorating - full hearing tests same morning, all clear. Annual diabetic check, including eyes. Contracted MRSA :rolleyes: - two courses of IV Vancomycin knocked it on the head.
April: Sent home with hospital bed and air mattress for rest of year, to use downstairs - couldn’t access upstairs. Twice-daily visits from Care Assistant for two weeks, followed by weekly visits from District Nurse for rest of year. GP pops in monthly “just to see how I’m doing”. Three visits back to hospital for check-ups, transport provided by hospital.
Antidepressants throughout.
All of the above was free.
Oh, and I’m fine now.
I don’t have first-hand experience on “the other side” - I only once accompanied my brother to a hospital ER on vacation in the US, and it seemed strange to us at first about a hospital requiring a credit card…
The system in Germany that I have experience of is
[ul]
[li]private suppliers (doctors in private practice; hospitals for-profit or non-profit; reimbursed by insurance companies in both cases)[/li][li]almost everyone covered by statutory not-for-profit medical insurance corporations (you can choose which one you sign up with, and they can’t refuse unless you had opted out before, in which case you can’t opt in again)[/li][li]premium to these statutory schemes is a percentage of salary (for my insurance at the moment 13.7 %, of which half is paid by the employer and half by the employee)[/li][li]dependents without own income are also covered[/li][li]medical services are free at point at consumption, with some co-payment - 10 EUR for first doctor visit in the quarter, 5-10 EUR for prescription meds, circa 10 EUR per day of hospital stay)[/li][li]basic dental care and preventive exams covered; most dental reconstructive/prosthetic work not or only partially.[/li][li]above a certain income threshold (at a “highly paid professional” level) you can opt out of the statutory scheme and take private insurance instead. These persons get billed by the doctor/hospital and are reimbursed by insurance.[/li][li]sick pay: Employed persons get their normal pay from the employer for the first six weeks of doctor-certified inability to work; after that a payment from medical insurance kicks in. Self-employed persons have to take out their own sick-pay insurance or take the risk.[/li][li]Apart from medical insurance, the statutory pension insurance pays for three-week rehabilitation treatments at a hospital run by the pension insurance scheme, designed to prevent disability before reaching the normal pension age (e.g. I have got an application in the works ATM for a weight-loss treatment). Applications for this are subject to medical and budget restraints and to a limit of once every four years for the same condition.[/li][li]most statutory insurance schemes offer financial incentives to their members for participating in preventive sports courses, posture training courses (for back pain prevention), dietary advice courses, etc.[/li][/ul]
My experiences to date:
- emergency
[ul]
[li]some common or garden bone breaks - get X-ray, cast within an hour or two[/li][li]pneumonia (medium severe - could breathe but was very relieved when I got oxygen) - showed up at my usual doctor, got examined after 15 minutes (did not say it was emergency), doctor called for ambulance, was in emergency room fifteen minutes later, got oxygen, emergency room exam finished after half an hour. Stayed in hospital for one week, got certified unfit for work for two more weeks. (Note: this was when hospitals got reimbursed for actual medical services plus per day of hospital stay. Beginning with this year they get a lump sum for specific diagnoses and treatments, with a schedule of some eight hundred different diagnoses and procedures).[/li][/ul]
- non-emergency
[ul]
[li]general practicioner (non-emergency): walk in, wait ten to forty minutes. Or make an appointment for next week or so.[/li][li]dentist (non-emergency): make appointment 2-4 weeks ahead[/li][li]foot surgeon, foot X-ray (for moderate foot pain): appointment on the next day[/li][li]orthopaedist (non-emergency): 4 hr wait or appointment in 2-6 weeks’ time (orthopaedists generally have abnormally long waiting times because back pain is our ‘national disease’). X-ray if needed usually made immediately at the orthopaedist’s.[/li][li]stomach exam, test for H. pylori: make appointment 2 weeks ahead[/li][li]liver ultrasound exam: make appintment 1 week ahead[/li][li]sports medical exam (history taken, lung function, ergometry with lactate curve and ECG, heart sonography): make appointment 3 weeks ahead[/li][li]physiotherapist: make appointment a few days ahead.[/li][/ul]
I very much agree. This is a point that needs to be considered more carefully in the US when they look at health care costs.
I’m in favour of the UK’s National Health Service. One misconception I’d like to point out is that despite the existence of the NHS, there is a thriving private health sector, which you’re welcome to use if you have private insurance or the money to pay.
My NHS experience - never any problem, except once when I broke my wrist and was constrained by time - the waiting list for minor ER was 2 hours and I only had one. But that’s my problem.
One thing I should say is that going to an NHS GP is free in the UK. Prescriptions are subsidised. The consultants are free. Hospital treatment is free. The GP can treat you or refer you. You can’t go directly to a consultant unless you go private.
Of course you do pay for it in income tax, but from what I’ve seen, US health insurance is way higher than the equivalent NHS budget would be. Yet the overall tax burdens aren’t that different between the two countries.
People do bitch about it, and there are a lot of flaws, mainly to do with waiting time and underfunding. Having said that, the amount of bitching about HMOs I’ve heard in the US makes me think “swings and roundabouts”. Of course the difference is that in the UK, if you’re very poor, you can still get the same treatment as anyone else.
Great.
Bout 5 minutes at the local, maybe need to book a couple of hours later with the uni.
Having been to the ER twice (both in a “rural” town, as it may) it took me 5 hours to set a broken arm, and I think it may’ve been less than 5 minutes to get in the next time.
That would explain a lot :eek:
I like our healthcare system. Some people bitch and whine about it, but I’ve never had a problem.
About 6 months ago I got referred to a psyche, after a short walk down the hall I was seen just after he’d had time to go through my referral. After that session I think I was given an appt. 1 month later, and he gave me his card so that I could call if I needed him in the mean time.
Depends on where you go I guess.
I only had brief run-ins with the NHS when I was in London, but fortunately I had asked for near-identical services through my health plan in the US a few years prior.
US experience: I was planning to move to China, so I called my health plan about six weeks prior to leaving so I could get updates on all the vaccinations I’d need. The first available appointment was three days before I planned on leaving town.
I get to the doc’s office, and my regular doctor was out, so I get whoever was around the office that day. I explain that I’m moving to China and I need any jabs that might be recommended. I get a blank stare. I pull out a printout from the CDC website, and the doc looks at it, reviews my record, and says that the only thing I need is a Hep C shot, but that they didn’t have it. (This appointment was at George Washington Medical Center in DC, where Reagan went after he was shot – certainly one of the two or three largest hospitals/medical centers in the DC area, military excluded – I was extremely surprised). So the doc writes me a scrip for me to go to a pharmacy, buy the vaccine, and return for the shot. I buy the vaccine (It was like $150 because my insurance didn’t cover it), and can’t get an appointment for the jab before I left town. A Chinese doctor did it for me.
UK experience: I was taking a trip to SE Asia. I call my doc about two weeks before leaving, say that I need some shots or pills or something. Doc looks it up in a travel health book. Gives me the Hep C booster and something else I needed… can’t remember what it was. No charge.
The doctor wasn’t sure which kind of anti-malarial she should give me, so she referred me to the Institute of Tropical Diseases (or something like that, can’t remember the name exactly). Got an appointment within a couple of days, saw a doctor, got the right pills. It cost 15 pounds, IIRC.
Now, I have no idea if emergency medicine is a different matter, but in my limited experience, the NHS beat the living pants out of US HMOs for these more routine sorts of things.
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Congratulations! I didn’t know.
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I am not covered by an employee health plan. I would have much better coverage if I were.
Thats not really true. My understanding is the US spends almost as much as a % of GDP on state paid healthcare as the socialized systems. Here in the US we spend about $750 billion in state/local/federal government funds on healthcare out of a 10 trillion economy, so 7.5% of our GDP is spent by the government for healthcare. Places like Canada spend about 9% of GDP in state sponsored healthcare, so we already are almost on par with the socialized countrys and may even surpass a few like the UK, Italy and Japan in regards to how much of the GDP we spend in gov. paid for healthcare (they pay closer to 7%).
I don’t know why i’m adding this, this may throw this post off from its original intentions. I was just pointing out that the belief that taxation rates would be higher here isn’t necessarily true.
Another Brit here (and one with children):
The NHS is a real mixed bag. It manages to be both outstandingly good and positively third world, often within the same building.
As has been explained for the usual coughs and colds and childhood illnesses the GP is the main point of contact – often the only doctor you will ever see, as they now will do small surgery too.
If you are hurt you can go to casualty which is a horrible ordeal. You will have to wait a couple of hours for non life threatening stuff, but you will be seen and treated and if necessary kept in.
Where the NHS is good is in children’s health care. It provides all the jabs and check-ups you could possibly want, and also things like specs are free for kids, as are all their prescriptions (adults pay about £7 for drugs, whatever the actual cost of the drugs). They are also very good at antenatal care.
However the hospitals are shameful – dirty depressing places that actually make you sick. This is why I have private medical cover (as do lots of people here – usually as an employment perk). That provides for private hospital care on top of standard NHS primary care for me and my immediate family…
I was actually just about to ask about that, so thanks! Any information on how much (percentage-wise or dollar amount) of each citizen’s pay goes towards the socialized medical system?
I pay $365 plus change *every month * for myself, husband and one child. This includes maternity coverage. Our deductible is $2500.00, and after that we pay 20% of the bills. We make less than $3000 a month, so that’s a huge percentage of our pay. The prescription coverage is lousy, and our insurance company (one of the biggest, “best” ones) is no longer “in-network” at over 50% of the hospitals in the area (all owned by the same parent group). It’s absolutely insane, and as soon as I have this baby, we’re switching to a catastrophic or medical savings plan. Even though we’re technically “covered by insurance,” it’s simply too expensive to go to the doctor for any but the worst conditions.
I’d gladly pay even 15% of my paycheck to socialized health care and avoid huge deductibles and obscene co-pays.
I’ve never sat in the ER for less than five hours before being treated, so it sounds like we’re on similar ground here.
Well, here’s my experience during my stay in the UK.
I came down with something nasty and, not knowing the health system at all but having some money from my parents, I went to see a private GP. He diagnosed me with flu, gave me some medicines, took my money and sent me on my way. A few days later I was much worse and phoned him again - he had to come out to see me this time because I was too sick to visit him - and all he said was “That’s just your flu. Keep taking your medicines and you’ll be fine.” And he took more money from me and left.
Remember, this was a private GP.
A couple days later I was so sick I could barely sit up and finally my flatmates called the paramedics (who were part of NHS). They took one look at me, immediately recognised I was in an advanced state of pneumonia, and checked me into hospital.
My care from the NHS doctors and nurses was superb and, contrary to owlstretchingtime’s post, the hospital wasn’t really that bad. I didn’t have a private room, but I was too grateful to be alive to care. I was there for eight days and didn’t pay a penny. Imagine what it would have cost me in the US?
That’s a really good question. Maybe it wasn’t a flu. I vaguely remember them telling us that his white blood cell count was a little high and that they had ruled out meningitis.
Hrrm… I’ll have to go back and look at his records.
Actually, I would really, really appreciate it. Thank you.
My e-mail should be in my profile, if not, let me know.
I haven’t had a “family doctor” for 15 years (I’m 27).
Like you, I have little to complain about. I once had a long term rash on my back that my GF wanted me to get checked out. I walked into a small clinic in Scarborough on a Saturday, showed my health card (not the photo one, the old red and white one) and got looked at. I also had a referal to see a dermotoligist 3 weeks later. No waiting in either place.
My GF’s brother is a nurse at Scarborough Gen. I know it can get really busy there so unless I’m missing some serious bits, I wouldn’t consider a hospital as my first choice for medical care.
People who complain about medical care in Canada tend to be in small towns/cities. I can get looked at within 20 minutes from where I live but I’ve heard stories of clinics who won’t accept you at all. In Scarborough I can see one of at least a dozen clinics that I know of.
The last two experiences I’ve had with the UK’s health service have been appalling, last time I was stuck in casualty for eight hours solid waiting to be seen, during which the bandage had fused itself to the wound.
Anyone who claims that the UK health service is in a good shape needs to descend from their ivory towers and take a trip to Wigan Infirmary.
Are you talking just about the US?
http://www.ncpa.org/~ncpa/w/w3.html
As Table I shows, in 1992 national health care spending was equal to $8,821 for every U.S. household. This burden was largely disguised, however:
This was in 1992, its probably closer to $15000 now.
http://reclaimdemocracy.org/articles_2004/us_recordhigh_healthcare_spending.html
The Department of Health and Human Services said that health care spending shot up 9.3 percent in 2002, the largest increase in 11 years, to a total of $1.55 trillion. That represents an average of $5,440 for each person in the United States.
I don’t know how much you pay in taxes. There are rougly 200 million wage earners in the US and about $750 billion is spent on healthcare, so it comes out to abouve $3750 per wageearner per year.
You also have to consider your wage reduction, your employer must withhold several thousands of dollars a year of your income to pay for your insurance. There is also the fact that goods and services are more expensive due to employer healthcare. I remember reading a while ago (I can dig it up but I’m short for time right now) that $1000 of the cost of each new Ford car went to pay for employee sponsored healthcare.
So how you pay for healthcare is multifaceted. You pay with all your taxes, you pay with wage reductions, you pay with higher costs for goods and services, you pay for insurance and you pay your deductibles. Overall it comes to about 16% of GDP.
My employer doesn’t pay for any of my health care or insurance, we’re on an individual policy. I’m sure I’m paying for other’s health care coverage (like the Ford example) but they’re not helping with mine. I pay into Medicare, of course. That’s a fixed but small percentage of earnings.
I guess what I’m wondering is if each individual person in Canada or the UK is spending more or less on health care than I am. It seems obvious that for each doctor visit, they’re paying less, but is that because a large chunk is taken out of their pay in taxes earmarked for the health care system?