Healthcare around the world

[LimpingFish]

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, 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!

[Vince Twelve]

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...

[Ultra Magnus]

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 and a bunch of other people.

[Shane 'ProgZmax' Stevens]

Well, 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.

[SSH]

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.

[miguel]

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.

[Vince Twelve]

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.

[Pumaman]

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?

[LUniqueDan]

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.

[Vince Twelve]

Heh, thanks Dan.  Unfortunately it's not quite that easy! 

[SSH]

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.

[SSH]

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.

[miguel]

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.

[Vince Twelve]

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:

Editor'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.

[Matti]

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.

[Matti]

There's an interesting interview with Noam Chomsky 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'."

[miguel]

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

[HillBilly]

[Ali]

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:

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.

[magintz]

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.