You also obviously haven’t been bankrupted by a medical disaster, either.
It’s only in danger of collapsing according to the Right, who simply want to get rid of it and let the old starve.
As for people complaining, so ? If something exists, people complain about it. Try to take away, THEN you’ll hear complaints. Succeed, and you’ll have an outright disaster.
That makes sense.
Every plan in existence has financial limits. If my insurance company pays for more health care than UK’s plan than my insurance is better. Not only is less care available in the UK there are no options to circumvent it except to go to another country and pay for it. So while someone in the US might suffer financially they’re alive to earn the money to pay for it.
WTH are you talking about? Name one person who wants the old to starve. You constantly make hack political statements like this instead of contributing something to the discussion.
I’m not sure that either of our personal anecdotes represent statistically useful data, but clearly mileage varies. My wife had her eardrum ruptured while we were on holiday in Australia. We walked into a hospital and had it surgically repaired by a gracious and attentive staff at no charge and nearly zero paperwork (I imagine the bureaucratic savings were pretty studpendous). They just took care of her. On release they advised that we’d have to have the work amended in about 12 months as the graft may not heal perfectly. By then we were back in the states and it cost $8000 and a byzantine nightmare of paperwork and insurance company arm-wrestling. If I billed for the hours I spent coping with that episode the cost would double.
As a teen I suffered a pneumo thorax (collapsed lung) and recuperated at a hospital here in California. My mother’s insurance covered some of it, but she’s been paying off the balance ever since. A few years later I had a recurrance while working in Saudi Arabia. Not only was the care far superior but it cost me nothing and there were no desk jockeys involved. Just health care.
I currently have really good coverage with Kaiser and they really do attempt preemptive care. I’m impressed with the quality of care I’m getting. But they refused treatment of a ruptured bicep a couple of years ago, unlike the fellow in Canada on Michael Moore’s Sicko with the same ailment who got treated. Mileage certainly does vary.
Sam, other developed countries with universal care eliminate profit driven insurance and negotiates pharmaceuticals. There are many reasons health care is astronomically expensive in the U.S., but eliminating profiteering insurance and big pharma’s dictated drug prices is the only way a UHC can work. Otherwise, it will be too expensive. And why would tax payers want to subsidize large insurance profits? Anything is an improvement to what we have, which is pretty dismal and getting worse. I don’t mean the health care. I mean access to health care.
Magiver
Please explain from your view as an American, what a UK health plan is.
When you start to get into treatment for chronic illness, especially mental illness, the image we have in the UK of the US insurance system is that it can let folk dow very badly and at very high cost, since this is an image, and therefore probably only partial truth, I would expect that your reply will aslo be based on such suppositions.
Our NHS is not perfect, but, the politican that tried to take it away would be out of office in a matter of hours.
US healthcare has its own problems, but you shold not exaggerate the UK issues in order to improve the image of your own.
Developed nations, US, UK and much of Western Europe draws in foreign healthcare labour, must to the detriment of other nations healthcare systems.
We lose many staff to the US, and in turn there is a knock on effect.
This speaks volumes about problems in both the US and UK as neither can seem to recruit, train and retain enough staff to run their services.
One way or another, the US has to pay for its healthcare, at present it consumes more GDP per capita than any other Westernised healthcare system, and yet there are many US citizens who are unable to access care beyond first aid.
Citizens in other such countries look upon it as a mark of decent civilisation that everybody should have the opportunity of a certain standard of healthcare, and those wanting more are able to find their own way to access it.
Its just that the lower expectations of US helathcare seem lower than ours, whilst the higher expectations of US healthcare are somewhat higher.
It ulitmately means that should the US implement a UHS, there will be those who are pleased, and those who are not, and in the end it will come down to the politics of where those expectations will please the largest percentage of the electorate.
The costs ?
Well those will come later, and thats when the real politicking will start.
I think you posted some good examples of successes from around the world. I was most impressed by Japan’s system after watching a program on the subject but I have doubts it is sustainable. Your post reminded me I wanted to add standardized billing and also state board review of claims to my list. And by state I mean independent review within a state as I believe someone already mentioned.
When I was young my parents had health insurance, not an HMO, but insurance. Doctor’s visits were simply paid for as needed. By the time I got into the workforce it was HMO’s. The company I worked for (25 years) would always show the amount they paid for my care as part of my benefits package. It was disturbing how fast it escalated. I believe this is because people don’t see the costs involved up front and thus can’t make financial decisions based on cost comparison. In my earlier example I asked about the price of treatment up front and they could not provide any figures for me. While it is difficult to shop for health care when you’re in pain it shouldn’t be impossible to provide costs when asked. I basically signed a sheet of paper saying I would pay for services rendered. From a contractual standpoint that doesn’t make sense. I should be able to pick up a book and look at the cost of X-rays and other services. In Japan, there is such a book.
I don’t want to go line by line so I’ll answer as best I can.
My view of the UK is that it is a tax funded UHC system with no cost visibility and until recently little competition. All health care is covered and it operates on a gatekeeper system. Choice of doctor’s/hospitals has increased but still limited and the waiting period for routine procedures is a real problem. The waiting period situation is improving and it was associated with recent changes allowing competition among hospitals. But the improvements were in the nature of 2 months (down from 6 months) and this seemed to draw great applause from the House of Commons. While this is an obvious improvement it is not the standard I want to go forward with. From my readings on the internet there appears to be a shortage of both doctors and routine diagnostic and procedural equipment.
I don’t know if Canada’s system is identical but it suffers from the same delays in treatment. This is only one example but I worked with a lady whose father in-law had heart problems (he’s Canadian). His bypass operation was delayed by months and he ended up having 2 heat attacks.
My personal experience with American HMO’s ,including family and friends, is a much higher level of care. I can’t answer your question regarding mental health but it’s listed as part of my policy. We have a UHC system for both the poor and the elderly. We have a system for the children of the near-poor but what we lack is a system for adults in this category. There is also a gap in working families that don’t belong to a company large enough to front an HMO. It’s difficult to get insurance in this category and that problem increases with age.
So in comparison, I would say American UHC does a better job taking care of the poor than UK’s UHC but the lack of health care for the near-poor adult is a detriment. American HMO’s suffer from the same lack of cost visibility and have suffered because of a general lack of concern for costs. It is possible to fall through a medical crack and end up with huge bill. In the UK the medical crack is a delay in medical care which ultimately cannot be circumvented without leaving the country and creating the same huge medical bill.
I don’t mean to pick on the UK but there are lessons there to be learned. I would welcome a national insurance law that required people to purchase insurance, taking into consideration the poor and near poor. Government involvement should be directed at reducing costs and streamlining the process. The United States has the advantage of looking at all the systems of the world and picking out the processes that work the best.
So how much did you pay for your last doctor’s visit and your most recent prescription? How much is your insurance premium, including your employer’s share of the costs? Will you keep your insurance if you change or lose your job? Can your insurance company drop you from coverage based on a pre-existing condition?
One can argue about whether private or public health insurance is better overall, but it is absolutely laughable to assert that your insurance is better in every respect than the NHS.
The U.S. pre-Reagan. We should never have allowed Insurance companies to be publically traded.
$20 for the doctor, $4 for the prescription.
Roughly $8,000/year
Yes/no By law I’m guaranteed coverage options for 18 months.
Currently, no. changing insurance, yes.
I think you’re mixing arguments. I would say my health care is better. I have immediate access to a large choice of doctors, specialists and hospitals. I think the main difference in argument is cost and availability.
The goal should be affordable health care. People hear UHC and think it’s free. It’s not. Let’s put the cost on the table, make it affordable, and let people choose their policy. We have the whole world as a functional test market, for the love of common sense, lets avail ourselves of the opportunity.
As does every person in the UK. I don’t think watching a TV program, whose information has been filtered by whatever political biases the production team has, is any sort of solid foundation for a debate of this sort.
And as I do in Canada as well.
One consequence of the private system in the US is the inflated administration costs. Yes, private medicine does take more administration. It’s admittedly a bit old (2003), but this cite from the NEJM shows that per capita administration costs are 3 times higher in the US than in Canada. The conclusion is:
“The gap between U.S. and Canadian spending on health care administration has grown to $752 per capita. A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system.”
administration costs
Another fiscal problem with the US private system is “direct to consumer advertising” (DTCA) for prescription drugs. This study
Found that
“The difference in per capita expenditures on prescription drugs in the United States and Canada began to increase at almost exactly the same time that Direct To Consumer Advertising began to flourish in the United States”
In other words, all those TV ads you see that tell you what prescription drugs you need? Those ads cost you, the consumer.
That’s simply not true and you know it. You cannot go to the doctor and get timely diagnostic care. Something as routine as a colonscopy averages 26 weeks in the UK. The goal is to get it done within 13 weeks. That’s the GOAL.
Hip replacement in the UK averages 15 months. Not weeks, months. That’s unless your fat in which case you are denied the procedure regardless of pain.
Prostate operation - 14 months.
Any time there are more people looking for something than the something is available, there will be rationing. We ration by money and access to insurance. If we switched that to rationing by need, or severity of the problem, the poorer people would get access to critical care, while those of us with good insurance now might have to wait. It’s not surprising that those of us with E-tickets would like it the way it is. But don’t claim there is no healthcare rationing in the US. Do you object to getting slower response to noncritical needs if it means some people would get better access to critical care?
BTW, nationalizing healthcare would be stupid, and I’m happy that no one is proposing that. Nationalizing the payment for healthcare is another matter.
Didn’t we go through this argument in 2005?
We already take care of the poor, the elderly, and the children of the near-poor. Plenty of care to go around. If the near-poor are required to purchase insurance then the overall cost should go down which will benefit us all.
Yes comrade, I object to government allocation of resources. It leads to rationing which is completely unnecessary. There is no reason why I shouldn’t be able to purchase health care at market prices. The point of this discussion is really about the near-poor adults who have problems getting catastrophic health insurance.
You already have rationing; The US system rations on the basis of who can pay for the care. If you can pay, or if you have insurance through your employment, you’re OK. If you do not, you can wait for care (or in many cases, you can get no care) Other countries ration on the basis of medical need.
And this ad hominem: “Yes comrade”
has no place in a rational discussion. This is not the 1950’s and you don’t have to be afraid of a Red under the bed.
Oh, what an excellent link. Thanks!
I think I like the Japanese and German plans the best.
In British Columbia, An individual who needs emergency surgery does not go on a waitlist. (I know this from personal experience)
Among the non - emergency surgeries:
97% of Urological surgeries were completed after a 3 month wait.
Hip replacement? 47% completed after 3 months
Cardiac surgery? Half of all heart or cardiac surgery in B.C. is done on an emergency basis and without delay. For the rest, median wait of 7.9 weeks.
I wonder if you could point me a site listing wait times for patients in the United States who do not have private insurance? My google-fu does not seem to be helping me here. I guess that’s another benefit for having public healthcare - the public in BC TOLD the Government to post waitlists for all hospitals so they could be accountable.