I'm an American who recently moved back to America after four plus years of living in Japan. When I left America, I was a young single twenty-something recent-college-grad who was healthy and didn't bother with buying health insurance because I rarely got sick and didn't see the need to spend as much money as it would cost. When I returned to America, I was a married nearly-thirty father (and now father of two). So, clearly, it was time to invest in some healthcare. In Japan, I didn't have to worry about it. In America it became a huge issue.
In America, it is impossible to have civil discourse with people of opposing views on healthcare because it is such a heated issue. Part of the blame lies on the media which fires up controversy for ratings and money, and as a result, fires up tempers and divides the country on issues such as this that are about coming together, not being torn apart. For example, when one politician suggests changing healthcare in our country to be more like another country, another politician will throw about a bunch of loaded terms ("Socialism!") and recite talking points dealing with one or two healthcare horror stories originating in that other country. (Completely ignoring the thousands of horror stories we have here every year.)
Recently, I watched a PBS documentary about health care in a few countries around the world. You can watch the whole thing here:
http://www.pbs.org/wgbh/pages/frontline/video/flv/generic.html?s=frol02p101&continuous=1
I found that it was a particularly even handed examination of what was wrong and right with the health systems in these five countries. And even though each of these systems had some negative points, I couldn't help but feel that they were still doing things way better than America. Particularly telling was the way that the interviewer got laughed at in every country where he asked the question "How many people go bankrupt every year due to medical costs?"
I wanted more, though. I would really love to learn about even more countries' health care and here about the pros and cons.
I won't go deeper into my personal views about the American healthcare system, or how it has caused me great distress in the 11 months that I've been back in the States. But I really want to hear some real, unfiltered descriptions about the pros and cons of the health care systems of different countries around the world. And since this is such an amazing, friendly, international forum, I thought it would be a great place for a nice discussion on the various types of healthcare around the world.
What I'm hoping for is to hear a general idea of how healthcare works in your country, if there are any particularly good/bad points about it, how much you pay for it (whether through taxes or otherwise), how you would rate it against any experience you might have had living in another country, any personal happy/horror stories you might have, or whatever other comments you might have on the subject.
In Spain everybody over certain age has a plastic card which allows you to go the the doctor, and be attended by him (Of course, if you are not that age, your parents take you there and you are identified with their card...). Everybody here who is "legal" has access to it. First aid is also guaranteed... Here we attend, and after that, we ask.
There are some cons: People coming from countries without social care overuse it. And I am not beig a "racist who hates people from poor countries"... Elderly people from rich countries with a non so open social security are always visiting the doctor... It's like a timekiller! :) The ratio of foreign people at the doctor' s office exceeds by far the ratio of foreign people in the streets. Nothing to worry about, since this happens something with consults about non-serious diseases (colds, headaches, flu...). If something is "serious" (Surgery, Chemio, etc...) the ratio of "national/foreign" people is exactly the same as in the streets, of course. A
s said, consulting the doctor for non serious things is something people gets used soon.
There are also some other cons. (Spanish) elderly people has medicines and drugs for free... Result: Everybody asks the doctor to put in the paper that it's grandpa who needs the medicine. And they do. Bad, bad...
Some other cons... In Spain we have 17 "counties". Social care is something that is not statal, the workers of Valencia do not pay the social care of the people from Madrid... BUT... they don't ask your origin when you need to be attended somewhere, so, a hospital from Valencia can be attending someone from Madrid. That is a problem for touristic towns... For example, 80% of the patients in my town are from outside. Doctors have to attend 100 people, but only 20 pay.
And you have to wait... Months... you can advance a lot in the queue if your disease is really dangerous, but sometimes it's too late. If the surgery is not for saving your life, but for improving your life quality (Repairing a wounded knee bone, for example) you are f***. You might have to wait like 3 or 4 years.
Hope it helps.
In Sweden you pay an administration fee of roughly 15 euros for any sort of examination, surgical operation, treatment or consultation. Whatever your issue is, that's the cost.
(There is a high-cost protection with a cap of 800 euros per year. Luckily I have never been close to this).
For operations that are not life-threatening but still complex, like the ones Nacho mentioned (hips, knees, etc) the queues can be very long, several months up to a year or more.
If you have a flu or something similar, there are clinics that can accept you outside of hospitals, they are covered by the same health insurance, with waiting times of a couple of hours.
Dental care is another story; it's not covered by the insurance, but instead there are several high cost protections, as well as a small yearly personal fund. Still, just having a root canal filled will cost you several hundred euros.
Having run from a hospital to another for a while now, I can tell you something abou the Finnish health care system, though it's not really clear to me still.
For an appointment, you call your personal doctor, who'lll see you once he/she has time. This might take a while, depending on how urgent it is. If you're only there to get recepies for allergies, it'll only take like 15minutes, and you'll get in soon. The fee for that is 26,50€ which is the common fee for everytime you visit the doctor.
For a surgery, that's not urgent, the lines can be up to one year, as in Sweden apparently, and some people go to a private hospital, if they have money. Once yuo go see the doctor, you pay the fee mentioned, and he appoints you to a surgery, the surgery will be free. All following measures will also be free, unless you make the appointment yourself.
If you move, change the region you live in, you'll have to check in again and pay the fee the first time.
I was under the impression myself, that it was all free in Finland. But apparently everytime you go there, it costs the fee. If the doctor sends you someplace, be it a surgery, or some medical mumbo jumbo, it'll be free at that point.
Prescribed drugs after a diagnose will be paid up to 40% afaik, by the state health care system. Other than that, you'll be paying yourself. allergy drugs are more expensive without prescription, and you get the -40% only to prescription drugs. Old people and croppled ones get their wheelchairs for free as far as I know.
And us university students: We have an annual 40€ fee that we pay to the student health care service, after which we get free health care, though the lines are WAY long. If you want your eyes checked or moles removed, it'll be a year's wait usually. But it's cheap. Dental care is free the first time. After that 5€ each time. about normal dental care, I have no idea what so ever.
I've got something in my eye. My mum, who's a nurse, thinks it's an infection, so I'm calling in tomorrow, seeing if I can get an apppointment. It'll be 26,50 or 25,60 again. Can't really remember which it was. The health care in my case is great if you have big problems, like a broken leg or epilepsy, but if you have the flu, it could get expensive.
In Ireland, we have the Medical Card scheme. If your means are deemed sufficiently low, you qualify. You also qualify if you are on welfare or disabled.
Most health care services are covered by the card, as well as medication and such.
Everybody else has to fend for themselves. Without a card, a visit to your GP will cost you in the region of â,¬50. A&E will cost you â,¬100.
Not all GPs are part of the scheme though, and we're currently are in the middle of a dispute with participating pharmacies; most of whom have pulled the plug on their support over the lack of sufficient reimbursement from the government.
Hooray!
In the UK we have the infamous National Health Service. Funded through taxes providing you make enough money to be taxed, it provides health care for everybody who needs it. Some things aren't covered by the NHS, like physiotherapy and probably some other things too. I personally use a private dentist and optician, I'm not even sure if the NHS offers these (for "free" anyway).
Although my dental care/glasses HAS always been free (up to the age of 18 anyway) so I'm not sure if it's paid for by the NHS for children at least. Maybe somebody who knows better can tell you.
There aren't any cards or anything.
NHS dental care is free for under 18s (and low incomes, old people, etc) and glasses are subsidised for under 18s, low incomes, etc but if you buy posh frames or reactions lenses etc you have to pay something on top. Dental care is subsidised for NHS dentists for over 18s, but it can be very diffuclt to find an NHS dentist who will accept new patients so many peiople use private dentists and/or dental insurance.
Maternity services in the UK are almost all on the NHS: its nearly impossible to go private for that kind of thing unless you live in London and are very rich: most private hospitals dont have brith facilities.
There is private medical insurance schemes in the UK, most paid for as part of someone's job. Hoeever, most private doctors are actually moonlighting NHS doctors (except in London again) so the level of care is about the same and the only difference is that you get to jump the waiting list queue.
All EU countries have reciprocal agreements that let other EU citizens have a certain level of free medical treatment but you may need to do a lot of paperwork and its worth having travel insurance for things like repatriation costs, etc. bven if travelling within the EU.
One little known fact* I found out recently. In the UK, if you take a taxi to the hospital you can claim the cost of the journey back on the NHS.
*[citation needed] [could be a load of bollocks]
Which five countries would those be? Canada? Their healthcare system is so burdened with inefficiency, wait times, and outdated equipment that their own Supreme Court labelled it as dangerous. Germany? Recent predictions are that their single payer system is literally going to bankrupt their country, and as a result they've begun to experiment with markets (private practices, self-insurance methods similar to Health Savings Accounts in the US) to try and save money. France? They are also experimenting with markets to ease the burden and raise care standards. UK? In spite of the Blair administration's narrow view of NHS being the only plausible solution, markets for private practices and private insurance are starting to flourish. I could give you a long list of references, but I'll stick with two really, really great books on the issue:
I highly recommend you read The Cure by Dr. David Gratzer before putting much stock in anything PBS has to say on the matter. Seriously -- as in order the book right away. Another great book on this subject: How to Cure Health Care by Milton Friedman.
I want a book report on my desk in a week, Vince. And don't forget I know where you live!
:)
ProgZ posted before I finished typing. I'll respond to you soon ProgZ, but I need to do something first. Love ya! :-*
Original post:
This is interesting, guys, thanks.
In America, you only hear about other countries' healthcare via people like Michael Moore ("All other countries except for America are perfect! It's all free and everybody holds hands and sings!") or people like every Republican politician or any talking head on Fox News ("All other countries except for America have terrible healthcare! They kill babies!")
A lot of Americans can't accept that there are some things that other countries do better than us. Yes, those countries' systems have some problems, but I would weigh "I had to wait four months to fix my knee" against "My whole family went bankrupt and we lost our house after I got cancer and the insurance company cancelled my coverage because they found out I visited a dermatologist once as a teenager" any day.
There may not be a perfect formula for healthcare, but if Americans would quit covering their ears and going "lalalalalala" whenever it's suggested that another country might do something better than us, we might be able to improve by adopting some ideas from other countries.
I'll post my story about Japanese healthcare when I get some time. But I'd love to hear more from other countries, too. What do you think your country could do better?
QuoteA lot of Americans can't accept that there are some things that other countries do better than us.
That's very interesting, I must say that I have never understood America's reluctance concerning public healthcare and it is fascinating to see other countries mind sets.
In the UK pretty much everybody will complain about the NHS, long wait times etc. but realistically no-one wants to completely do away with it.
Quote... but I would weigh "I had to wait four months to fix my knee" against "My whole family went bankrupt and we lost our house after I got cancer and the insurance company cancelled my coverage because they found out I visited a dermatologist once as a teenager" any day.
Completely agree.
Quote from: ProgZmax on Tue 04/08/2009 15:28:58
I highly recommend you read The Cure by Dr. David Gratzer before putting much stock in anything PBS has to say on the matter. Seriously -- as in order the book right away. Another great book on this subject: How to Cure Health Care by Milton Friedman.
I'll take a look at those. Do they have cliff notes? I'm kind of busy working to pay off all my medical bills. :=
Seriously, though, the PBS show linked above is, I think, very even handed, though it was probably a little left leaning in that it pretty much started with the thesis that things in America could be done better. If you think that things are just fine as they are, you'll probably find it biased.
The countries that you talk about have almost entirely government-run health systems. We're starting on the other end of the spectrum with an almost entirely capitalist system (For most of people, that is, who don't qualify for Medicare, or the Veterans health coverage). Both approaches seem to have problems.
The countries with government-run systems seem to be solving (?) their problems by mixing some capitalism into their single-payer systems. Mixing the two together.
Now in America, the option of completely wiping out the private companies in favor of a government-run-only system (jumping to the complete opposite of the spectrum to be like the UK or France) isn't even being considered by politicians, so would you agree that adding a government option, and moving in a tiny baby step towards the systems of those other countries, would be a positive one?
I really am trying to be even handed about the whole thing, I just can't look at our current system and think, "Now that's a system that every country should model themselves after." Which seems to be what America wants to be in the world. A shining beacon of democracy and capitalism, yeah?
Quote
I want a book report on my desk in a week, Vince. And don't forget I know where you live!
:)
Well, I also know that you won't take an airplane, so I'm betting I can get away before you get here!
There are plenty if things I dislike with Sweden (actually I was going to start an entire thread about it, but I think it will have to wait now) but one thing I can't really complain about is our health care.
I have been operated on once as an adult; I was..."fixed"..."downstairs" if you get me (nothing serious, it was just getting a bit troublesome and I preferred to get rid of the extra part.) I went to a doctor, got examined and referred for surgery. Some 3-4 months later they called from the hospital. I underwent the surgery - with the special robe, the anaesthetics and the whole shebang, and spent an evening on observation ward with tea and sandwiches. Everything cost me 15 euros.
To me it's very distressing that everything I just wrote would be described as socialism-communism-bureaucratic-this-and-that in USA, and Americans would knee-jerkingly dismiss it.
Come on, man... explain your "downstairs" problem... don' t make me to get on my knees.
You know that extra part of...that thing down there...
oh heck, I was circumcised because my foreskin was acting up on me
Andail, I've had the exact same thing. But I was a little child and don't remember anything except that this happend.
As for the topic: I don't have the time right now, but I'll post something about the german healthcare system soon.
I've experienced two healthcare systems, Irish and UK.
Ireland I don't remember a lot about other than having to pay £50 for a visit to the GP just so she could prescribe me the pill. Then I'm pretty sure I also had to pay for the pill on top of that. Fastest £50 I've ever spent, literally... I spent maybe two minutes in there talking to her.
I also remember my parents getting lots of hospital bills for things like childbirth etc... and they were quite short on money so I'm not sure how they afforded it. It was only after they separated that my mother and sisters became entitled to medical cards. Before that I had to once put off going to the GP for a week with a UTI because I couldn't afford to pay. My brother also started to experience scary blackouts and seizures that the hospital/GP could not identify the cause for, and now he's on a 9 month waiting list to see one of the only two experts in the country. Meanwhile his fits are getting worse and worse...
However, despite this I am glad that there is a cheaper public service available to people with little money, as being on a 9 month waiting list is better than being on no waiting list at all. If my mother could afford, she could go private but it just isn't an option in her case.
Irish system, not so great in my experience, but maybe it's better now.
The UK system has always been good to me. I have had two operations and both were non-urgent and the waiting lists were only about two/three months. Anything serious is treated faster of course... my boyfriend had his appendix out pretty snappy. Now that I'm unemployed I get any medication for free, which is something I'm so so grateful for as otherwise I could not have afforded any pain relief after my tonsilectomy. The Pill is also free over here (so you'd think we'd have a lower teenage pregnancy rate..)
Nobody I know has any complaints about the NHS except for maybe having spoken to a rude receptionist or or something, but otherwise the service is great and I am happy to pay my national insurance contributions. Maybe the sussex area runs things better than other areas of the country.
I had private medical insurance with a company I worked for a while back but I never availed of it and decided not to continue it after leaving the company. I could get private if I wanted but I'm very poor at the moment, and the NHS is fine for me anyway. One thing I do want is private dental though, as soon as I can afford it. The first time I visited an NHS dentist in the UK he gave me a filling I didn't need. Bad experience! The difference between private and NHS dentists seems quite significant...
I'm very grateful to the NHS over here. I wonder what the arguments against a national healthcare system in the US are? People can still get private medical insurance if they wish, it's not like everyone will be forced to use the national healthcare system. It's about pooling in and helping your fellow countrymen... I don't see a problem with that.
Quote from: Meowster on Tue 04/08/2009 20:28:49
Irish system, not so great in my experience, but maybe it's better now.
Oh, don't get me wrong, the concept of the Medical Card scheme and free health-care is terrific. In practice, it's less than stellar.
Lack of hospital beds, lack of specialists, mass mis-diagnosis, and the infamous HSE (http://en.wikipedia.org/wiki/Health_Service_Executive#Criticism), scupper most of it.
Anyone who can afford to go private does, and those who don't qualify for the scheme, yet can't afford to go private, suffer the biggest screw-job of all.
Alright, time for me to contribute my story of different countries' health care.
I lived in Japan for four-plus years and got a bit spoiled by the cost of health care there. It's very cheap.
In Japan, the government has decided on a very low price for every imaginable procedure. If you have a cut that needs stitches, there's a formula based on the length of the cut, location of the cut, and number of stitches that you needed that translates into a price. The hospitals have to follow that book exactly. Prices are very low. Regular trips to the doctor will cost somewhere in the neighborhood of 3 to 10 US dollars. Medicine is similarly low priced.
The problem with this, of course, is that a lot of Hospitals find themselves under funded and doctors underpaid and they cannot raise the prices to compensate without waiting until the next time the government revises the price book and even then, prices may go down further depending on what the government decides. The government, as I understand it, then supplements these hospitals to keep them afloat.
I may not be 100% accurate on that, but that's how I understand it.
But from a patient's perspective things are great. Waits are pretty low. I usually experienced a 45 minute wait on a walk-in with no appointment to see a doctor, which isn't that bad. Obviously emergencies get you seen much faster. The longest wait I ever had was 90 minutes to see my daughter who had the chicken pox and needed some ointment. This fairly low wait time is more impressive considering almost every medicine is prescription-only over there, so if you need something for whatever reason, you've got to swing by a hospital or clinic, and doctors are extremely stingy with medicines. They prefer to give you a small amount of antibiotic or whatever and then have a follow up appointment and prescribe more if necessary. Contrast that with America where they prescribe you more than should be necessary and call it good (which can be a bad thing and a good thing).
So, doctor visits are much more frequent in Japan, and in order to keep the waiting times down, visits with doctors are very brief. When you check in, you're usually given a thermometer and pointed at a blood-pressure machine in the waiting room so that you can get all that out of the way yourself. Then, when it's your turn, you walk into the room with the doctor, who already knows what you're there for since you already told a nurse and doesn't ask you to repeat yourself. He checks out what needs checking, tells you what's up, asks you if you have any questions, and sends you back to the waiting room. A nurse in the room takes down his instructions, turns it into a prescription or whatever and hands that to you a few minutes later. In total, you get about 5 minutes face time with the doctor, and you're out the door. I never felt rushed or mistreated though. The nurses also make sure you understand everything (usually takes more time with me and my Japanese ability). The system works really well.
When it comes to surgeries, there isn't much wait at all. I went in with an ingrown toenail, suggested surgery to prevent it from happening again, the doctor agreed and two hours later, I was tied to a table in a surgery bay, surrounded by two surgeons and several nurses, hooked up to a heart monitor, and getting nervous about whether or not the doctor misunderstood my Japanese and was about to take the whole foot. Full story here. (http://xiigames.com/2007/07/09/doctor-sugiyama-or-how-i-learned-to-stop-worrying-and-love-the-japanese-system/) It was extremely cheap considering all the things that went in to it.
I also had a septoplasty to repair my deviated septum. I'm not sure if there was a waiting line or not because I scheduled it several months in advance and didn't have any trouble reserving the days that I wanted (which fit into my work schedule best). I spent five days in the hospital afterwards. In America, I would have been kicked out to watch after myself after a day. Hospital food in Japan is awesome.
And as for child birth. Wow, it's like night and day when compared to America. First of all, the wife and baby stay in the hospital after birth for a week standard. You can request to leave earlier if the baby is healthy, but they recommend and welcome you to stay the whole time. My daughter had to stay an extra week because of some mild jaundice and some eye infection she developed. 100% of the cost was covered by the government. Also every time she visited a doctor in her first three years, we could keep records and get the money refunded by the government.
Total cost from conception to three years of age: $0.
In America, just recently I had a son. He stayed a day in the hospital and then came home the next. He had much worse jaundice than my daughter had and had to be hooked up to this cool UV glowing vest.
(http://farm4.static.flickr.com/3662/3556783249_a8b7b9d956.jpg)
Even after my insurance, I was paying $150 per day for two days for the rental of the vest plus $150 per day for the nurse to come and check him. Cheaper than staying in the hospital, to be sure, but still...
Total cost from conception to three months of age: $4000 (or thereabouts)
I feel fairly confident that if we have another kid, it's going to be in Japan.
Quote from: LimpingFish on Tue 04/08/2009 21:08:11
Quote from: Meowster on Tue 04/08/2009 20:28:49
Irish system, not so great in my experience, but maybe it's better now.
Oh, don't get me wrong, the concept of the Medical Card scheme and free health-care is terrific. In practice, it's less than stellar.
Lack of hospital beds, lack of specialists, mass mis-diagnosis, and the infamous HSE (http://en.wikipedia.org/wiki/Health_Service_Executive#Criticism), scupper most of it.
Anyone who can afford to go private does, and those who don't qualify for the scheme, yet can't afford to go private, suffer the biggest screw-job of all.
Like my parents :-/
What are they doing with it now that the entire country has collapsed in on itself? I remember just before I left, my mum was saying something about how only a certain amount of medical cards were allowed to be issued that year or something... which I thought was ridiculous, to only allow a certain amount whether or not more people qualified... but I am not sure if that is true, my memory might be skewed, do you remember anything like that?
I also read somewhere that they might bring back university fees in Ireland now that everything there has blown up in the recession.
Vince, that story about Japan's system sounds amazing. Completely different from over here, and seems to work which is cool.
Quote from: Meowster on Wed 05/08/2009 00:30:18
What are they doing with it now that the entire country has collapsed in on itself?
They started by trying to do away with card coverage for anybody over seventy, regardless of their means. These people would instead have been treated the same as non-qualifying over-seventy's currently are, receiving an annual grant of â,¬400 (which, hilariously,
is means tested). The whole idea imploded when the streets around government buildings were flooded with pensioners stamping their Zimmer frames in protest.
Now, largely based on the recommendations of An Bord Snip Nua (http://en.wikipedia.org/wiki/An_Bord_Snip), they plan on introducing a
partial allowance to cover the cost of medicines (rather than getting them for free), along with cuts to hospital funding (by forcing doctors and consultants to work for less).
Not to mention the fact that people on welfare will find a couple of euros disappearing from their weekly benefits.
And university fees are likely to make a comeback, yeah.
We really are in a bit of jam at the moment. :(
Hear that Celtic Tiger wheeze!
Quote from: Vince Twelve on Tue 04/08/2009 21:30:05
Total cost from conception to three months of age: $4000 (or thereabouts)
Seriously, just after writing this I arrived home to find a $300 hospital bill for something related to Zen's birth that I don't understand and didn't expect. So... bump that number up to $4300... frak me... I'm broke again...
The NHS works well enough for physical ailments, but it's terrible for mental health.
Because it's obviously tough to know what's going on inside someone else's head, the current guidelines for doctors say that everyone should basically be assumed to be faking, and if they can manage to sit through a 40-minute psych evaluation, well, that's basically the same thing as taking on a full-time job, right?
Further reading: opinions from an ex-NHS psychologist (http://ihouldbeworking.blogspot.com/search/label/Mental%20Health) and a bunch of other people (http://www.mentalhealthforum.net/forum/showthread.php?t=2822).
QuoteWell, I also know that you won't take an airplane, so I'm betting I can get away before you get here!
I'll get you yet :(.
Also, about the merging of methods suggestion:
What a lot of people don't seem to realize is that American health care has not been operating on a market system since 1948 -- 8 years after the employer tax credit was offered for health insurance, creating an imbalance in private and employer (now government backed) insurance. Before 1940 nearly everyone had some form of private insurance in the US, and health care experts (like Dr. Gratzer, Dr. Brian Day (both of these men Canadians)), Milton Friedman and many others) are suggesting we gradually move
back to a market system that works something like the FEHBP we have today (Federal Employee Health Benefits Program). The FEHBP works completely different from all our other health care schemes in this country, and it's not surprising that it's also the best system we have. The FEHBP encourages competition from more than 24 insurance companies by allowing members to choose the plan that most suits their wants and needs and at a price they can afford. As a result, each insurance company tries to offer the best range of coverage at the best price to beat out the others -- but the proof is in the numbers. Adjusted for inflation, the FEHBP costs raise at something like 2.7% of the GDP per year vs Medicare at 6.7% and Medicaid (which is set to start doubling in 2020) at around 5%. I read some of these reports awhile ago so I apologize if some of these numbers are not exact, but I can tell you that the FEHBP spends consistently less money per year and offers better service and options than public employer insurance -- and it has been proven sustainable time and again, unlike our public system (or NHS).
Health care in the United States is the
only public system in the country that does not operate through markets and competition, and it shows: it shows in the maximum claims by doctors on insurance, in the premiums, and in it's general inefficiency to offer something for everyone. In contrast, having the medical and pharmaceutical industries compete for your dollar cuts them down to size and gives you more options, and that's what people really want: options, choices. Health Savings Accounts are a great step towards this and one of the few things the Bush Administration did right; unfortunately, they still regulate the hell out of private insurance making it more costly than it should be (and when I say regulate I mean regulate vs. employer-sponsored insurance). If HSA's and other private insurance offered the same deductibles and tax credits and enjoyed less regulation (for instance, if you could invest more than $9000 USD into an HSA per year) there would be many more people switching to these and many more plans available. Consider than an HSA with a monthly payment of around 40 dollars could completely cover a family on welfare for catastrophic events (broken bones, pregnancy, etc) while requiring them to make a reasonable co-pay for generic doctor visits and medications. The great thing about HSA's are that anyone can apply for one, and depending on where you live you have a range of choices for plans, can pick your doctors and specialists based on cost, personal research, and need, and so on.
Definitely read
The Cure. You can get it for 7 bucks off Amazon, last I looked.
One problem with free-at-the point-of-use systems like the NHS is that it encourages Munchausens and lonely people can use doctors and nurses as a social crutch. It also means that people tend to exercise less common sense and call out doctors for colds, etc. which can also lead to overuse of antibiotics, etc. Of course, people wanting their money's worth if they have to pay to see a doctor also leads to over-use of antibiotics, too.
Portugal has a Healthcare system that I consider pretty fair when relating to what I've been reading.
You do have a card with a number that stays with you all your life. You're given a Family Doctor who is basically someone that will always be your doctor and the system tries to provide the same one to your keen.
Public Hospitals have a minimum fee (5euros) I think, and if you can't pay for serious operations the state will.
Of course the downside is the long waiting lists.
Basically if you have money you rather go to a private Hospital, but if not, the cases of people suffering badly without treatment are dropping every year.
I must say that if it isn't perfect it is pretty decent.
Of course Portugal is on the verge of bankruptcy because of the heavy healthcare system.
I'll look into the book, ProgZ. As long as he isn't suggesting sticking with what we've got, I'll hear anybody out! Because what we've got clearly isn't working right.
Quote from: ProgZmax on Wed 05/08/2009 04:49:35
Health care in the United States is the only public system in the country that does not operate through markets and competition, and it shows
But healthcare surely is the one thing that should not be left to the markets.
Consider car insurance, for example. If I've been a crap driver and crashed my car once a week, no insurance company is going to offer me cover and I'll have to stop driving. Fine, that's the way the market works.
But with healthcare, if I have a long-term medical condition that needs some sort of regular expensive drugs or treatment, surely no health insurance company will offer me cover either... so what happens then? Do I just die from my condition because no company will cover me? Is that fair?
Vince, just get out of there and move North. You'll have 100% public system, a better life span for you and your family, and way cheaper (if not 100% free) medication precisely because the governement makes more regulations.
But I warn you : it's fucking freezing during the winter.
Heh, thanks Dan. Unfortunately it's not quite that easy! :)
Quote from: Pumaman on Wed 05/08/2009 18:39:53
Consider car insurance, for example. If I've been a crap driver and crashed my car once a week, no insurance company is going to offer me cover and I'll have to stop driving. Fine, that's the way the market works.
Actually, the way it works is that lots of people drive uninsured and sucks to have an accident with them. Some suggest that 3rd-party insurance should be compulsorarily included with gasoline to avoid this problem. Not sure how that fits in with the healthcare analogy.
Actually, a funny story: http://www.theregister.co.uk/2009/08/12/hawking_british_and_alive/
Some US rag claimed "If Stephen Hawking were British he'd be dead already because of the NHS". Well, actually, he is British and he's alive and he's been treated by the NHS.
I am proud to say that the waiting lists average time for surgeries has dropped to 3 months in Portugal. It came on today's newspapers.
SSH that is just one example of the ridiculous bullshit being thrown out across all types of media here to the brainless mobs who just eat it up and repeat it at the top of their lungs to anyone who will listen. I shudder to think how many people heard that guy's claim, nodded, agreed, pumped their fists in the air, and then never even noticed the misleading retraction:
QuoteEditor's Note: This version corrects the original editorial which implied that physicist Stephen Hawking, a professor at the University of Cambridge, did not live in the UK.
The retraction should say "This version corrects the original editorial which
implied clearly stated that physicist Stephen Hawking would be euthanized by a system such as the British NHS, when in fact, he lived under it for most of his life and credits it for saving his life."
With all this intentional spread of misinformation and fear, I have no idea how America managed to make it to it's current position in the world, and certainly can't see it maintaining that position.
Quote from: Vince Twelve on Thu 13/08/2009 14:33:23
With all this intentional spread of misinformation and fear, I have no idea how America managed to make it to it's current position in the world, and certainly can't see it maintaining that position.
I think the spreading of fear and misinformation is one of the reasons for the USA's position in the world. If the government wouldn't create fear of Saddam, communists etc. the people wouldn't be dumb enough to sign in and fight stupid wars in countries they couldn't find on the map. And they wouldn't support such a large military etat either. If the conservatives wouldn't give out misinformation about other countries policies (regarding healthcare, social services or surveillance [the patriot act still is on, right?]), the people wouldn't condemn and label good things as "socialism".
The more the population is being kept ignorant, unaware and frightened, the more freedom the government has to do for whatever it wants to do. But I certainly agree that the USA can't hold its current position much longer... we'll see.
There's an interesting interview with Noam Chomsky (http://www.youtube.com/watch?v=nvo9O4A18d0) about healthcare and a functional democratic society.
"The privatized healthcare system is complaining bitterly right now because if there's an option of a public system [...] they won't be able to compete. That's a way of saying 'we're so inefficient and costly, we can't compete with a national health care system, so it's unfair'."
I guess that for a country as big as the USA, to provide a efficient health care plan could mean that other areas like the military forces could suffer enormously in terms of state funds. So in the meantime I don't think that big changes will occur. At least until US keep a war(s) going
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It's a while since I've dared entery a thorny political debate on the forums, but I had to take one remark to account:
Quote from: ProgZmax on Tue 04/08/2009 15:28:58
UK? In spite of the Blair administration's narrow view of NHS being the only plausible solution, markets for private practices and private insurance are starting to flourish.
I'm not sure if this was your intention, but it suggests both that the Blair administration has a strictly socialist agenda regarding the NHS and that private healthcare is a new thing in the UK. Private healthcare is well established and new Labour has pursued a firmly free-market oriented agenda with regard to public services. They introduced foundation hospitals, which (similar to academy schools) are state run but independently operated in a manner designed to allow private sector like competition within the public sector.
It's also worth noting that the concept of the self regulating free market inspired their policy of light-touch regulation for the financial sector.
Now, I haven't read the news in a while, but I think it's going really well.
I agree that despite a lot of bad press the NHS has always been good to me as well. Usually you can see a doctor within 48 hours and you know the only thing you'll usually have to pay for is prescription medication; unless you're low income or Welsh.
I know I have the peace of mind if I needed a quadruple bypass it would cost me the same as getting diagnosed with a cold but on the other hand there are lots of people who abuse the system or misuse the good nature of everything.
A lot of people go see a doctor every few weeks for a sniffle when really any person with common sense would know just to get an early night and they'd be fine the next day and if not then think about going to see a doctor. This drains the doctors time making them a lot busier and perhaps a visitation cost; even if it's only £5 might help stop a lot of unnecessary visits (and could be made free for pregnant women, children, under 18's, unemployed etc...) I know it's a further cost but I know I wouldn't mind paying that the once or twice I go to visit a doctor. These extra funds could go towards improving services and funding the nurses and people that deserve the money and something as small as £5 isn't a kick in the teeth like the Irish â,¬50.
NHS is great for people with chronic illnesses that aren't their fault (which seems to be the opposite of what the US people think). e.g. my wife has Type 1 diabetes and so gets all her treatment for that completely free and all other prescriptions, too. Pregnant women get free prescriptions too, and free dental (since babies can drain the calcium from a mother) and that lasts until 1 year after the birth of the child whether the child survives or not. Now, I'd like to know how someone with Type 1 diabetes would get by in the US witout spending a fortune.
Frankly, after recently having a baby in America *while covered by a good insurance plan* and still having to shell out thousands of dollars of hospital costs, I don't understand how poor people have babies... And I have no idea how people of any financial situation manage to survive with serious diseases. Especially if you didn't have coverage when you were first diagnosed with the disease. It would then become completely impossible to get insurance. So you have to choose between getting treatment or going bankrupt. And people in this country are worried about the government rationing care... as if that isn't what the insurance companies are doing now...
Interestingly there's just been a thread about this on another forum i frequent (asrai.org if you care)
It seems that people who have socialised medicine wouldn't give it up for the world and people that dont have it (americans mainly) rabidly oppose it.. I'm not sure what that tells us.