Why would you buy health insurance if your country has UHC?

As one of many examples of what individuals can get for supplementary insurance, see Page not found | Alberta Blue Cross®. Note that this is non-group coverage in one particular province from one particular company; there are many sources of supplementary health insurance, and what you can get under group coverage as part of your employment benefits will vary depending upon what your employer chooses to arrange for.

I’m sorry to hear about what happened to your family, but the average person does not get private health insurance. (It was 9% in 1999, mostly provided by employers).

People get it because they hear horror stories like this and imagine that it’s actually common, and that private healthcare never messes up. Most policies also have the big advantage of paying you some money if you’re too ill to work; the government will pay you too, but not as much. I’m sure some of the private hospitals are nicer, too - especially the food.

It’s not due to prescription costs, because the most you can ever pay for prescriptions in the UK is £100 per year, and quite a few groups of people get free prescriptions anyway.

Not to get involved with a big UHC debate, but I had very expensive private health insurance when they decided my visual field defect didn’t require a retinal specialist until the opthalmologist had a look in three days. A detached retina is repairable, but only within the first 24 hours or so.

I haven’t seen anything out of that eye since 2002, so I’m not all that confident that private health insurance is all that much better.

I think my family and I must have just been very, very lucky with our medical care thus far, because none of the horror stories mentioned have ever happened to us.

My sister has a chronic disease; she was able to choose her doctor (who is even continuing to follow her case from Quebec in collaboration with another local doctor while she is in a different province for university). I have a non-urgent back injury - I was able to choose my doctor, and get an MRI within a month of referral, though I admit to using private insurance through my husband’s work for the physiotherapy. I saw a surgical specialist within 2 weeks of referral, and can now call his office directly in case things get worse and I think surgery might be the way to go (not likely at this point). My aunt had breast cancer - treatment started immediately and she raves about how great her doctors were. My husband severely dislocated his wrist in a bike accident; he saw a specialist a week after the injury, was scheduled for surgery two weeks later, had health-care provided physiotherapy for six months (it was covered indefinitely, but he’d recovered enough by then), had no trouble getting follow-ups from his doc (well, he did switch doctors because one was leaving the hospital, but that’s rare enough). I was in and out of the ER recently in the middle of the night on a Friday/Saturday in less than 2 hours. My husband was seen for his wrist within 15 minutes of arriving at the hospital.

We both go to a walk-in/by appointment clinic up the road for basic medicals: checkups, followups on my weak asthma, gyn exams, etc. Officially one of the doctors there is my family doctor, and although I didn’t choose him, there’s nothing stopping me from asking to see another doctor or going to another clinic. Wait times there can be long because of the mix of walk-ins and appointments, but I hear that’s the same in the US too. There is never any cost for any of these visits.

Our drug plan asks us to pay (I think) 10% of the cost of prescriptions (a little steep, but the coverage for private MRIs, physio, athletic therapy, etc is much, much more expansive than anything else we’ve ever had through employment). We can afford that.

I think the combination of a supplementary plan and the provincial plans provides very good coverage, but even when we’ve only had the provincial plan, we can’t complain about the services we’ve received. It is far from a perfect system, but I do personally believe that it is a better system than non-UHC.

Allow me to clarify: when I say “average people” I mean “people who aren’t rich”, not that the average person gets private health insurance.

My suspicion is that the vast majority of the time the reason people would get private insurance is lack of access or scheduling, not quality of care. I actually personally do not think that quality of care is the issue.

I pay almost double that per month, and that’s with a US$5,000 deductible and no coverage for vision or dental work. Prescription coverage is spotty. As an example, the anti-nausea medication when I had chemotherapy was $600 per treatment (every 3 weeks), and medical marijuana (legal in MT and highly effective for chemotherapy patients) isn’t covered at all.

On the flip side, when I need something, I can get it scheduled fast, and with a good, qualified doctor.

Our healthcare system in the U.S. is badly broken.

German here. I am insured under the statutory system but my income is sufficient to be able to opt out into the private system if I wanted to.

  1. Private medical insurance instead of statutory insurance

Available to: employees above a certain yearly income threshold; self-employed persons
Pros: premium is a set monthly sum rather than a percentage of wage (i.e. the higher the wage the more advantageous private insurance). Also doctors can bill higher rates than for statutory insurance patients which makes them keener to keep a given patient going to another doctor.
Cons: Private insurers are allowed to make premiums dependent of age and health status and to deny insurance, while the statutory insurance must take all comers regardless of age and health and insure them at the same rate. Statutory insurance covers children and nonworking spouse at no extra cost; private insurers don’t. Patients insured privately pay doctors’ bills out of pocket and get reimbursed by their insurance, while statutory insurance pays for treatment directly to the doctor/hospital. Rates climb with age and if you have opted out of statutory insurance and find that for any of the above reasons you are f*cked now it is impossible or hard to opt in again.

  1. Private medical insurance in addition to civil service benefits

For historical reasons Beamte (civil servants) are not covered by the statutory scheme but get reimbursed 50%-80% of their medical expenses by their employer (depending on their dependents, mainly). They usually get partial-rate private medical insurance to cover the difference to 100%

  1. Private medical insurance in addition to statutory insurance

The main important risk not covered by statutory insurance is medical treatment in foreign countries which do not have a reciprocity agreement between their UHC system and the German one. This is important because Germans travel a lot - in 2007 (latest figures available - source: publication Tourismus in Zahlen - Touristische Nachfrage 2008 by Statistisches Bundesamt) Germans made 70.4 million private and 11.4 million business trips to a foreign country).
Private insurance for short trips is pretty cheap - I have insurance for 15 €/yr covering trips up to 30 days without coverage for conditions existing before the trip.

Other popular additional private insurance options include

  • additional dental (statutory insurance covers part of non-cosmetic dental)
  • insurance against loss of income in long illness (employers only pay salary for the first 42 days of being off sick per year, and the statutory payments for people being sick for longer only cover part of the loss of salary)
  • insurance for getting a one-person or two-person hospital room (patients under statutory insurance usually are in a 1-4 person room, depending on the hospital - when I was in hospital this year I was in a two-person room. Not bad but for some days I had a copatient who snored badly).
  • insurance for being treated/operated on by the hospital’s head doctor as opposed to a junior doctor/resident.

Excellent post, Mops. As a minor hijack, I’ve always wondered if that one really is a good idea. Why not let the people do the job who do it every day? I seriously doubt that a department head who spends most of her time in meetings and on the phone rather than in the OR is the better choice for complicated surgery.

Francis Vaughan & Bluezooky have summed up Australia nicely.

I have private cover, and a couple of things I’d like to add.

If you have an after hours health problem, you can if you’re insured (or hell if you’re happy to pony up the cash) go to the “ER” of a private hospital, and you’ll generally be seen by a doctor in less than 15 minutes, whereas in a public hospital anything short of life threatening, expect to be sitting in the waiting room for hours.

(I put ER in quotations as many of the private hospitals don’t have an ER in the sense of catering to major trauma, it is more like an outpatients area. )

I needed a small elective surgery last year, and going through the private system I went from GP referral to an appointment with the specialist in a couple of days, and into surgery in a private hospital a couple of days after that. For a minor elective surgery in the public system I probably would have been waiting some months to get it done.

There is a vast array of types and levels of coverage available from many different companies. At a very basic level coverage is broken into two streams “Hospital” and “Extras”. Hospital obviously provides coverage for admittance to hospital, and covers you for things like room fees, surgery costs, etc. (Again depending upon your level of coverage, either ocmpletly covers, or provides certian levels of co-pay) “Extras” are things like Dental, Optical, Physio, etc and depending upon your level of cover and your chosen insurer, can provide partial costs on ‘health and wellbeing’ benefits like remedial massage, and even gym memberships.

In relation to paying for health insurance in Australia, as Francis mentioned, the government pays for 30% of your insurance cost as a carrot. The stick attached to that is if you earn >$77k per annum , and you are not privately insured the government taxes you an extra 1% as a “Medicare levy surcharge”. So personally I pay ~$1,500 a year for my cover which is mid range covergae for both hopsital and extras. And If I wasn’t covered I’d be paying ~$800 in extra tax, so I sort of look at is as I’m only paying 700 bucks for my cover :slight_smile:

I had private insurance in the UK, although I never used it - not once. It was there basically to jump the queue on elective surgeries and to get a private room in hospital. As I never needed either an elective surgery or a hospital stay, the NHS worked fine for all my actual needs.

You can go to local clinics (look them up on the net) . They take Medicare at 100 percent. Generic prescriptions are 4 bucks at Target and other places. Unless you have something exotic.
I get an Email from Medicare yearly telling me what tests I qualify for. They are trying to keep me healthy. It costs them money when i am sick. They save money by keeping my health monitored. It is a different attitude.

Wow the aussies have certainly covered off us so far but to put my little spin on it.

I have private hospital plus cover as it covers dental and few other things that i would otherwise have to pay out of my pocket.

UHC is a bit like basal power, it provides for our everyday needs.

One thing though private cover or not, you won’t go bankrupt having to pay for an operation!

Just to echo what Una said, I needed to have my wisdom teeth removed. Using the NHS, I would have had to wait 6 months - in ever-increasing pain - or more just for the initial appointment. Paying privately, it was all done within a few weeks. Best £1100 I ever spent.

But that wasn’t private insurance, it was a private procedure. My own LASIK was done through a private clinic (SS does not cover it except for people for whom it means the difference between “legally blind” and “can tell cars are coming”, such as my great aunt), but no insurance was involved. “Going to a private doctor” and “getting private insurance” are two different things.

True, but I was echoing what Una said, primarily about the wait.

Further to the Aussie situation, you need to be careful that your private health insurance will cover you for any conceivable complications. A friend of my wife’s ran in to trouble recently when she elected to use her private health insurance when having a baby. There was a complication during the birth and her insurance didn’t cover the resulting procedure. She was up for something like a $5000 bill. That wouldn’t have happened if she’d used the public system, and as others have mentioned public hospital maternity wards are pretty good.

I’ve managed to avoid paying the 1% medicare surcharge for the last few years because we have a single income and two kids so the cut-off is much higher. It’s also based on taxable income so if you have a lot of tax write offs you can avoid paying it. At some stage I’m sure it’ll be best financially to get private health cover, but at the moment I don’t see the point.

Spot on Richard, although my wife had private cover she gave birth to the kids in a public setting. She got a private room for a few days and out into the masses but as she said it made her want to go home faster rather than behaving like a bloody princess!

I think that depends on where you live. Round here, I can get an NHS dentist appointment within a day. Not just me, but my GF; she called my regular dentist, and he didn’t have one the next day, when she wanted an appointment, so she called another one, and they did. Both were within five minutes’ walk.

My local hospital also does dental care if you’re actually in pain (that is, it doesn’t do regular clean-ups or cosmetic dentistry, but you can turn up and wait for the day and be seen in order or urgency). All NHS trusts have at least one hospital that does this - but damned if I can find a cite! Still, if you have any more problems, bear in mind that you don’t have to go private.

I have heard (via the media, not in real life) of areas where it’s really hard to find an NHS dentist, but I’m surprised yours is one of them.

You aren’t comparing apples to apples. The folks in UHC countries here pay a lot more in tax than we do (or, if they don’t personally, someone does). They also have to suffer through living in a country where the public sector dominates the economy to such a degree that it is very hard to grow the economy–the solution becomes its own problem, demanding more of the same solution.

No, the thinking of some U.S. citizens (i.e., those who want UHC but don’t understand all of the implications) is badly broken.

Did you see the thread a few months ago in which Dopers who had lived under both UHC and the US system gave their preference? Not one voted for the US system.