When my wisdom teeth were giving me problems I got a same-day appointment with my local NHS dentist, and an appointment within two weeks to sort the problem*.
Best £46 I ever spent.
*I wasn’t in lots of pain so was happy to hold on, if I had been in pain they’d have sorted the problem on the same or next day.
Same for me - I have cover through work which costs £20 a month as a taxable benefit but I’ve never needed it.
My parents have had cover for 25+ years and I don’t think they’ve ever used it either.
A few people at work have used it though - one girl ruptured a knee ligament skiing and got that sorted privately.
I get BUPA coverage as part of my employment. It’s a perk that wasn’t really an incentive for me, but is standard to working here.
I have used it once, when I was worried about something that could potentially have been serious. My NHS GP referred me to a consultant and I was seen the next day and reassured that everything was fine. Had I gone with the NHS I would have had the same treatment, but have waited a few weeks.
Ultimately it bought me peace of mind, nothing more.
Oh, I’ve lived under both. I’d’ve voted for the US system. I must have missed that thread. Even now in a complicated UHC system, my employer was wise enough to provide us with private health insurance. And if my employer didn’t provide it, I’d probably think really carefully about securing my own (or not, private health care is cheap here and for anything really catastrophic we also have airlift coverage to get back home).
Here in Mexico there’s constitutionally-guaranteed health insurance. Employees of companies are all forced into a system called IMSS, run by the government. Employees of the government, meanwhile, are in a system called ISSTE. The self-employed buy private insurance, or can participate (along with the unemployed and otherwise uninsured ) in another government program called “Seguro Popular.” Now, these are all great programs for people that need really, super basic care and don’t mind red tape, limited treatment options, and public hospitals and clinics. Private insurance (or cash out of pocket) is the only way to go for US style health care.
Now before CBEscapee comes along and tells me I’m dumping on his health system, I’ll say that there are good attributes to the public system. Need a transplant? You’ll get on the organ list and eventually receive your transplant, regardless of “who you are,” for example.
This is incorrect. You pay more per capita for public healthcare in the US than we do in the UK. So it’s quite fair to directly compare private healthcare costs.
This, however, is just insane. I went to [LINK REDACTED] and tried to find an expensive policy, but even pretending I was a smoker, choosing the Platinum insurance, and specifying zero excess, I couldn’t pay more than £75 (~$115) a month - and could have paid £50 (~$77).
Could you do me a favour and go and check that site yourself and see what it charges? If you need a postcode, SW1A 2AD is a valid London one.
To clarify the Canadian system… The big fear is that we will end up with a system like the US public schools - that in many cases, people who can afford it will go private and the public system will fall apart from neglect (The UK NHC seems to be heading this way).
To ensure this will not happen to Canadian Medicare, the governments here have various rules -
if a doctor/clinic does not charge the medicare fee schedule then neither he nor the patient gets reimbursed by medicare; no “extra billing”. You cannot be “half in, half out”. The fee schedule is the payment rate.
most provinces do not want “for profit” clinics or hospitals. Many hospitals are run by local health authorities.
-getting reimbursed for work done outside the province will typically only be up to the provincial fee schedule for the same service. However, some people find it quick to get a scan or test doen across the border for the extra cost, to help speed the process.
As a result there are very few doctors outside the system. Most are specialized - athletics, service for the super rich, etc. This means there are no opportunities for special health insurance to do what Medicare already does, and no companies would agree to offer such a benefit. The system may not be perfect, but it beats the mess in the USA.
The Blue Cross my company offers me was things like private room premium in hospitals, TV rental in hospital room (!!); prscription and dental benefits, eyeglasses and some additional items not covered. Other than the dental/prescription, which can break the bank, the rest would be cheap.
Well, it’s universal in that access is guaranteed for everyone (“access” doesn’t necessarily mean that everyone participates – that’s still a problem). And despite being in the current constitution, even “access” wasn’t there until the single ruling party was finally kicked out at the national level.
Or rather, you’d have to mean that it beats the mess in the USA for people that don’t currently have insurance. I have zero complaints, and it’s not a mess from my perspective. I think I’d prefer the Mexican system in the USA than the Ontario system (the only Canadian system one I’m personally familiar with).
No. The big deal with UHC of any stripe is that eliminates 90% of the BS. There is one schedule of covered procedurs, there is one schedule of prices/billing rates, there is one payer to bill. There are no pre-existing conditions, no loss of medical care when you change jobs or get laid off, so no “golden handcuffs” on job converage, nobody starts to wonder when they get pregnant “How will I pay for delivery?”, and the only question is “are you a resident?” and prove it with your health-card.
Yeah, it’s a government bureaucracy and like all such, is run to meet inappropriate and shifting goals. I have a thousand ideas how the system could be improved, and service streamlined, but it still beats the US system where my dad had t argue with Blue Cross over whether his gallstones were a pre-existing condition “because they grow for years and years and so must have started before he was covered.”
The entire approval/refusal bureacracy and the mess of different paperwork at all points of the system cannot possibly be efficient.
To reiterate the OP’s question - the governments in Canada deliberately make it impossible for a parallel private system to emerge precisely to avoid the same mess as in the USA. The typical accusaton thrown around in an election to scare voters is “my opponent wants to change our system so it’s the same as the USA.”
The only medical insurance typically offered in Canada privately or from employers is just for supplementary coverage.
Yes and no. If they all cover the same procedures, and all have no pre-existing conditions, and pay the same doctors the same rates -why bother having multiple parallel systems with all the bureaucracy and extra work? Why tie it to an employer? Why not just charge everyone a higher income tax and be done with it After all, the poor are going to pay less or nothing anyway and still get coverage, so why not wrap it into the income taxes?
The American system was great when a hospital stay might be the equivalent today of a few hundred or a couple of thousand for a really major procedure, and a treatment at the Emergency room might be about a hundred dollars. Now that everything medical risks running up bills the equivalent of a small mortgage, universal compulsory insurance is the only way to go.
The Mexican government systems do pay the same rates for all procedures. Heck, they’re government hospitals and government employees. The “seguro popular” (the one not linked to workers or government employees) does have a more limited scope of what they cover, but it’s really quite broad and encompassing. Private insurance (or cash out of pocket), though, will cover you for private hospitals that aren’t government owned, and which don’t have government employees. Government-owned systems (or systems like you describe where all providers are only paid the same amount and provide only the same services) have virtually no economic incentives to do better. While I realize we’re talking about health care, we’re still talking about an exchange of something for a service, and so incentives absolutely do factor into the mix. Discounting outliers, invariably private systems are better than public systems. Where do you go in Canada when you need a treatment the government won’t sponsor? A private provider.
As for pre-existing conditions in the USA, remember that that only applies for discontinuities in coverage. So if you change jobs and have to switch insurance companies, there are no limitations for pre-existing conditions.
I know what you mean. And that’s the most basic reason that anyone – where UHC is available – is willing to carry private insurance. Except in Canada, where you can’t (pracitcally speaking, that is, and as a replacement for public insurance).
I know you said ‘excluding outliers,’ but I visited a private maternity hospital and found it to be much worse than any of the three maternity wards I’ve been around (I moved areas, so was shown the facilities of multiple hospitals). Sure, there were more private rooms, but they had flimsy walls which weren’t much better than drawing the curtains around your cubicle. The private hospital made a big deal out of offering different choices for every meal, including vegetarian, Kosher and Halal, apparently not realising that NHS hospitals do this too. They guaranteed a doctor at your bedside instead of a midwife, but I didn’t see that as an advantage.
The big issue for me was, if there were serious problems and the baby or mother had to go to intensive care, then you’d have to be transferred to an NHS hospital anyway; I’d rather not have to take that extra time. Lack of intensive care or very specialised facilities seems to me to be common in private hospitals in the UK.
Maternity care is a big part of healthcare, so I was shocked at how much better the NHS was on this.
It’s like the local council gyms often being much larger and better equipped than the private ones, despite also being a lot cheaper for the direct consumer.
The example often quoted in Canada (and like all urban legends, probably generally NOT true) is the USA public schools. Where a neighbourhood becomes “in transition” or whatever the polite term is, anyone who can afford it, sends their children to a private or parochial school. Soon, all that’s left at the public school is the poor, the problem kids and druggies the private schools rejected, and the difficult cases that require extra attention but slow down the whole class. Funding suffers because the people affected and their parents are not the vocal majority and the others don’t care to pay the taxes to keep it up. The middle class - don’t care the school is falling apart because their little Johnny or Suzie is in a good environment in the private school away from the rifraff.
This is the situation we often hear is happening to in the UK NHS public facilities. Canadians want to make sure everyone has astake in the health of health, so it does not become another massive tax drain like US Medicare serving only a small proportion of the (poor) public. Right wing and corporate types want to avoid the pressure to be adding another layer of very expensive benefits to corporate payroll.
So far, I would guess 90% of people in Canada like our system. The rest will complain because they are at the time having problems getting service and think being able to walk in and pay is great. They just don’t realize it means “sell the house so you can pay”. You can wait 8 months for a “free” hip replacement, or pay $50,000 to have it done in the USA. that’s great if you have $50,000 to spend. If your choice was “$50,000 or live in pain because you can’t afford it” they would have a different attitude.
You’d only hear that from people who are lying. Given that only 9% of the populace has any private healthcare at all (and that includes specific plans like insurance against cancer, so that you’d get a cash payout to live off; for those people, all other healthcare is still NHS), the NHS really, really is not just the preserve of the poor.
So you’ve managed so far to avoid the trap Canadians are worried about… If only 9% have private health care, I assume that such insurance coverage is not a common work or union benefit. I suspect like most media coverage, we hear teh worst about NHS just as the Americans hear the worst lies about our system.
(For example, during the last election there was an political ad where some woman claimed “The Canadian system refused to operate on my brain cancer!” In fact she had a begnin tumour so she was told she would wait for the removal operation. She went to the USA instead. No word on what that cost her…I bet the political party picked up the tab.)
What proportion of that 9% are just rich enough, and what proportion buy private individual vs. work or group insurance for private coverage; and how comprehensive is it? DO “privates” never go to NHS or is private a supplement for some treatments? Is private insurance something most people would like to get or is it seen as a waste of money?
the other main feature of Canadian health care is the doctor charges ONLY the prescribed amount. Thus there is no “extra billing” and it will not end up in a situation where the doctor gets a token amount from Medicare and the majority of his service fee from the patient - an alternative “pay twice” system we want to prevent.
Treatment you had to pay for that was worse than what you could get for free[sup]1[/sup] wouldn’t make much of a business model!