The NHS & the United States of America

[FlashLackey]

here is an interesting way to compare Health care systems of 8 countries with similar economies and governments (USA, Japan, France, germany, Great Britain, Switzerland, Netherlands) - http://www.npr.org/templates/story/s...ryId=110997469

...seems USA spends more per person but with fewer people covered by the health care umbrella.

So, good if you are one of the covered group, but really tough if you are not.
(By FL figures, that is 3 out of 20 - 15%), and if you are hispanic, 6 out of 20 are not covered, and if black, 4 in every 20 are not covered).

davidp

<edit> I'll just wait for this link to be labelled socialist propaganda as well, shall I?

NPR is certainly on board with many socialist solutions to issues.

I've already agreed that we spend too much on health care. My contention is with people claiming that we have poor quality health care. We don't. In fact, I think we lead the world in health care quality and innovation, largely due to the amount we spend on it.

The 15% figure isn't right. Half of those people can afford health care but choose not to pay for it. So, it's more like 1.5 out of 20 that needs help (and that figure is debatable as well given what health care costs and what salaries they are counting as needing assistance).

I'm not sure why you keep bringing up race. Do you think the purpose of our health care system is to hurt people of certain races? It's not breaking news that the demographics include more minorities in lower income brackets. Is that supposed to make people feel different if people of specific races are without health care over others? Are uncovered white people less of a problem?

A lot of other things come out of National Insurance, such as your pension. You also receive money (and so does your employer) for unlimited sick days, which are unlimited – those are things your HMO does not cover. And do bare in mind that £200-odd that your employer pays you don't "get" otherwise, it's just a part of employing people in this country.

We have a similar system here in social security for retirement.

It's not a tax on your salary, so it's of no personal effect.

That, my friend, is an illusion.

If companies didn't have to pay it, they sure as hell wouldn't give it to you.

Why wouldn't they?

If their competitor does, they lose market share and make less profit. There's a reason there are employees in the first place. A company doesn't magically have products and decides to share income due to government mandate. A company needs to have workers and to pay them competitively in order to be successful. If there is a tax companies didn't have to pay, that typically manifests itself in more jobs and/or higher pay.

But the fact remains you have to pay for it soon as you're well enough, and if you didn't have insurance, you're ****ed.

Yes. For the small percentage of people who can't afford $160 a month for health insurance, they could end up in a situation where they had to file bankruptcy. That is a problem that both sides of the debate have offered solutions for.

Rather than paying $700 for a healthcare plan that sorts you out, why not pay $700 to sort the whole country out - and an 'insurance' policy that pays for your hospital, your sick pay, makes sure the company you work for isn't out of pocket and funds your pension when you retire? And you never, under any circumstances, have to get out your cheque book.

Because it doesn't perform as well. That and it costs more for people who want the "luxury" of choosing when they see a doctor and get treated, having a bathroom, etc.

United Kingdom, average annual per-person spending
$2,723

United States of America, average annual per-person spending:
$6,402

It's black and white, why has it taken so long for it to even be talked about again?

Yes. We spend too much. But, our quality of care is higher. The trick is to reduce spending as much as possible, without reducing the quality.

The subject has been debated consistently for as long as I can remember.

If we judged all private companies 1 year at a time and condemned them for having a red year.. we wouldn't have very many private companies.

I wasn't judging them based on one year. Are you not familiar with the other bad years and problems with the USPS?

FlashLackey, let's say the ‘United Health Service’ sprung up overnight. The government started taking $250 more tax off your paycheque, but you no longer need to pay anything for medical insurance. You could choose whichever UHS hospital you wanted and whenever you walked out, you would never have to take care of any bills or insurance, ever. Hypothetically, the UHS provides the same level of care that private hospitals do, using the same doctors, but you have to share a room with 3 other people.

Would you run straight out and buy private medical insurance?

No. But, the problem is that your hypothetical same level of care is not a reality. You can't even choose when you get treatment. If I have lung cancer, I don't want to wait on a list in order to receive radiotherapy to save my life. I would rather be able to control my health care decisions as a direct consumer. Government involvement into that equation is not necessary.

[gerbick]

I know in my very early twenties in the choice between 100 bucks a month insurance and 25 bucks a week booze money the insurance lost.

The fact you quoted what you had quoted and responded in kind, pray tell what the **** do you mean by that? That only hispanics and blacks are buying alcohol instead of insurance?

[asheep_uk]

No. But, the problem is that your hypothetical same level of care is not a reality. You can't even choose when you get treatment. If I have lung cancer, I don't want to wait on a list in order to receive radiotherapy to save my life. I would rather be able to control my health care decisions as a direct consumer. Government involvement into that equation is not necessary.

But here, if I can't afford health insurance, I'm too ill to work, or whatever, I can still get the treatment. If I want to be chucked through a CAT scan first thing tomorrow morning, I can pay for it. I have both options. But the difference is, that if I don't have the luxury of affording health insurance, I can still get help – even if it is a little longer coming – but at least I don't have to re-mortgage my house.

[FlashLackey]

and I like the final paragraph here - http://www.whatswrongwiththeworld.ne...#comment-69247

Yeah. A lot of people are flocking TO the US for medical care. I have seen no statistics showing that people are leaving the US in substantial numbers for health care reasons. While there are entire businesses profiting from organizing trips to the US for medical treatments they can't get quickly enough or well enough in Canada, the UK, etc.

....you tell me

...if you are trying to tell me that 1 in 5 blacks and 2 in 5 hispanics who live in the United States choose to have no health umbrella, I think you are being disengenious again (or totally naive).

It may have been in the other related thread about this. But, I did tell you. I'm not just speculating how many people choose not to buy health care. It has been studied and documented. Look for the link (possibly in the other thread).

Again, race has nothing to do with this. Anyone who is potentially disadvantaged should have our equal concern, regardless of race.

[FlashLackey]

But here, if I can't afford health insurance, I'm too ill to work, or whatever, I can still get the treatment. If I want to be chucked through a CAT scan first thing tomorrow morning, I can pay for it. I have both options. But the difference is, that if I don't have the luxury of affording health insurance, I can still get help – even if it is a little longer coming – but at least I don't have to re-mortgage my house.

But, you can afford health insurance here. You said yourself that the cost seemed reasonable. So, why not have the luxury option as the permanent standard? Why not pay for it that way instead of having the government take it before it gets to you?

And if you can afford the mortgage on a house but don't have health insurance, you would be in the category of people who can afford insurance but choose not to pay for it.

[asheep_uk]

But, you can afford health insurance here. You said yourself that the cost seemed reasonable. So, why not have the luxury option as the permanent standard? Why not pay for it that way instead of having the government take it before it gets to you?

And if you can afford the mortgage on a house but don't have health insurance, you would be in the category of people who can afford insurance but choose not to pay for it.

Well, not reasonable, I don't like the idea that my coverage could be dropped and they may or may not decide to cover certain things.

This malarkey about certain things being covered, like pre-existing conditions. What are you suppose to do then? If nobody will cover you and you need the treatment, you have to pay. So then even if you do have a mortgage, if no insurance company will cover your illness because it's "pre-existing", how do I avoid the $20,000 bill then?

I'm paying for people who aren't as fortunate as me to have the same basic human rights, to be able to have medical care when they need it. The mortgage was a bad example – but say then, I wouldn't be able to afford the rent on my flat, what do I do then, live on the street?

Can you at least agree that it would be fairer to every person in the country – not the individual – if you had a national health service?

On a completely different note, I always fancied living in New York at some point, but this really puts me right off. What about if I get hit by car? Like that lady in Sicko, when do I pre-approve the ambulance ride to the hospital and how do I afford the $5,000 excess?

[david petley]

My contention is with people claiming that we have poor quality health care

it seems to depend on one's criteria for quality.

If you think very good services, that only the wealthy can afford, is quality, then it is just an elitist viewpoint in my books and you need to get out and walk a mile in someone elses' shoes.

david

[Loyal Rogue]

Again, the main difference (problem) is that the primary goal of the NHS is to provide treatment whereas the goal of the US private insurance industry is to maximize profits for their shareholders by NOT providing treatment.
If you make a claim, it will be fought.
If you are a small business and you have an employee that makes a large claim, your policy will be dropped or your premiums raised to the point where you can't afford it anymore.
The goal is to keep collecting premiums from those who don't use the service and deny or eliminate those policyholders who do use the service.
Bonuses and promotions are handed out to those review doctors that deny the most claims and withhold the most treatments saving the insurance company from so-called "medical losses".

Can you imagine if the police or fire department operated the same way?

The funny thing is that in every country that has adopted Universal Healthcare, "conservatives" fought it tooth and nail all the way up until it became a reality. Afterwards those same "conservatives" changed their tune and would now fight tooth and nail to keep it. LOL

[FlashLackey]

Well, not reasonable, I don't like the idea that my coverage could be dropped and they may or may not decide to cover certain things.

How do you think that might work? Your coverage being dropped?

This malarkey about certain things being covered, like pre-existing conditions. What are you suppose to do then? If nobody will cover you and you need the treatment, you have to pay. So then even if you do have a mortgage, if no insurance company will cover your illness because it's "pre-existing", how do I avoid the $20,000 bill then?

You pay for health insurance before you have a problem. What do you expect? That you should be able to pay nothing into the system your entire life and then sign up for $160 a month after you get sick and get $100k of treatment?

If you get sick while having a policy like 85% of our population, the insurance company is on the hook to pay for the treatment.

I'm paying for people who aren't as fortunate as me to have the same basic human rights, to be able to have medical care when they need it. The mortgage was a bad example – but say then, I wouldn't be able to afford the rent on my flat, what do I do then, live on the street?

You would file bankruptcy and wouldn't have to pay a dime. The consequence would be damage to your credit that would take time to correct. To avoid that, insurance companies will negotiate with people in those situations to settle the claim for what they can afford (some payment is better than nothing).

Can you at least agree that it would be fairer to every person in the country – not the individual – if you had a national health service?

No. I don't agree with that. It would be a disservice and would result in more people dying before they would otherwise. There is nothing fair about that. And there is no reason why healthcare needs to be nationalized in order to cover everyone. I have proposed a solution that covers everyone without putting government in control of administration. Then we could enjoy the same high quality and everyone could have it.

On a completely different note, I always fancied living in New York at some point, but this really puts me right off. What about if I get hit by car? Like that lady in Sicko, when do I pre-approve the ambulance ride to the hospital and how do I afford the $5,000 excess?

I truly think that it would be unfortunate if you have bought into Michael Moore's nonsense to the point that you would make any life decisions based on his film. There are cases of weird things happening between people and insurance companies. We're talking about a multi-billion dollar industry covering millions of people who each have hundreds of transactions between them over years. Legitimate grievances are bound to be had by consumers.

You should know that you can get an insurance policy and live in New York. The chances of anything like what happened to that lady happening to you are lower than you being attacked by a great white shark in the Hudson river.

If you think very good services, that only the wealthy can afford, is quality, then it is just an elitist viewpoint in my books and you need to get out and walk a mile in someone elses' shoes.

I've walked hundreds of miles with no shoes. I don't need anyone trying to patronize me about what I need to do or suggesting that I don't sympathize with people or haven't been there. In this case, it's exactly the opposite. I care about this issue because it is the poor that will get the crap end of the stick under socialized care. Just like they do under socialized education. Only the wealthy can afford high quality private school while the poor are stuck in our crap public system.

Asheep has confirmed that point exactly. The poor are stuck not able to choose when to a see a doctor or get treatment, not having a bathroom in their room, tv, quality food or a private room. If you want those "luxuries" you have to have the cash to pay for them. And so it would be here too. The crap hospitals for the poor and the better ones that the wealthy can afford.

Currently, it's not as you say "only the wealthy can afford." 85% of our entire population is covered. 85% of our country is not wealthy. And half of the remaining 15% could afford it if they chose to.

Again, the main difference (problem) is that the primary goal of the NHS is to provide treatment whereas the goal of the US private insurance industry is to maximize profits for their shareholders by NOT providing treatment.

Except that the people working in a for-profit system have motivation to innovate and improve their service to be competitive. In a public system, the motivation to remain efficient and effective is greatly diminished. So, the public ends up with a poorer product. How many examples of this happening does a person need in order to recognize that pattern?

If you make a claim, it will be fought.

I've had hundreds of claims between my family and I and not one of them has ever been fought. We've not been dropped and our rates have never been raised on account of our health expenses (and there have been very very high ones with us due to pregnancy complications my wife has had. We're talking six figure bills.).

If you are a small business and you have an employee that makes a large claim, your policy will be dropped or your premiums raised to the point where you can't afford it anymore.

Thank you. One other example of why businesses should not have anything to do with providing insurance. That certainly wasn't a conservative invention.

The funny thing is that in every country that has adopted Universal Healthcare, "conservatives" fought it tooth and nail all the way up until it became a reality. Afterwards those same "conservatives" changed their tune and would now fight tooth and nail to keep it. LOL

Nonsense.

http://www.youtube.com/watch?v=FiSPRkq28iU

[asheep_uk]

Dan Hannan is a ****ing nobody moron who was paid a **** load of money by your insurance companies to slag off a system that, yes, has its faults, but provides for every man, women and child in Britain.

He's not even a real MP, he's an MEP – Member of European Parliament. He has no power, say or vote on any NHS matters.

FlashLackey, consider this: I'm a single father with three kids. Their mother died of cancer. She was the income earner for the household and had insurance for us. Now I've got a part-time job, as well as looking after the kids, but it doesn't come with insurance, so I'm having to pay for it myself, which I can barely afford for the whole family. I can't afford broadband or to take the kids on holiday. I can only just put food on the table after the I pay the insurance. I have a liver disease, which my insurance company doesn't cover because it's "pre-existing".

In a year's time I will need an operation to remove my liver.

In this circumstance, what would happen to me in the US today? What would you propose?

I don't think, if I were in that position, I would give a crap about TVs or my own room –*but rather than paying thousands of dollars for insurance, I would be able to pay my rent without worry and make sure my kids had want they needed.

In Britain, with the NHS, I would get the care I needed, and so would my kids if they needed it to, but as I only work part-time, I pay £17.71 ($30) a year for that right.

Can you not agree that, in that circumstance, a national health service is better for his family?

[TallGuyLittleCar]

The fact you quoted what you had quoted and responded in kind, pray tell what the **** do you mean by that? That only hispanics and blacks are buying alcohol instead of insurance?

//edit. eww that does look kind of bad

DP asked why somebody would choose not to have healthcare. I gave an example of why I didn't. A good portion of the 1 in 5 to 2 in 5 of those blacks and Hispanics without healthcare might be within the early 20s age bracket.

In a follow up post I stated the reason why Hispanics and blacks would/cold be higher in that specific example is that due to lower college enrollment and well off parents more of them will have to make that choice than white kids.

Although pretty much everybody I can remember knowing at that (up to around 24 or 25) could have afforded healthcare but chose vice's and entertainment.

[hanratty21]

The fact you quoted what you had quoted and responded in kind, pray tell what the **** do you mean by that? That only hispanics and blacks are buying alcohol instead of insurance?

*Let's not forget about the Irish, too*

everyone's a little bit racist...

[Frets]

Everyone thinks this is just about the uninsured. It's also about regulating an unregulated industry. The health insurance industry.

If one thinks that "Competition fixes all" in regards to health insurance they are sadly mistaken. When Obama during the election spoke of the turmoils his mother went thru with her health care provider trying to get them to own up to their responsibilities it struck a nerve with me. My father had insurance that didn't even begin to cover the costs of my mothers treatment when she was dying of cancer. My mother passed away, my father lost his life savings and his house as

Insurance companies already deny needed treatment. Depending on coverage you won't get the doctor or hospital you want, you get the one in you coverage group. Your insurace company can deny or delay your treatment if they either deem it unnecessary or simply want to hold on to the money longer.
I'm sure I've posted this link before but for those who may have missed it check out
http://www.youtube.com/watch?v=vKI9be55N00

[gerbick]

Meh. The disappointment of having to lose my father to something that was incorrectly diagnosed and pushed aside as a "pre-existing condition" and ultimately it was found in the very last diagnosis as something totally different and that led to his death bothers the living hell out of me.

And suing won't help a damn thing either. But instead, the people will argue mother****ing tooth and nail, call people nazis for supporting such a thing and yet I wonder if they will think that when they've been somehow put in an unforeseen predicament or situation that their paid for healthcare should have provided a solution for and not sheer apathy.

The changes proposed by Obama, et al, would not have been affected my father's outcome - I'm not that stupid either. However, it pains me that people have the audacity to think that people actually want to be uncovered - when a lot have no choice to do so. It's either pay for a light bill, or pay the health bill... or pay for groceries... or pay for health coverage. I've seen that.

Had zero to do with choices. Just circumstances. And it's easy to ignore or think otherwise if you've not been in that situation for quite a while.

Anyway, argue on. I'm amazed at the argument against a change than the reasons why a change might be needed.

[asheep_uk]

Just watched
http://www.guardian.co.uk/commentisf...care-obama-usa and
http://www.youtube.com/watch?v=nYlZiWK2Iy8

What I can't get my head around is why are so many people so passionate about lining the pockets of the insurance companies?

[asheep_uk]

http://www.youtube.com/watch?v=vKI9be55N00

Wow.

"One out of every $700 spent on healthcare in the US goes to Stephen Hemsley, CEO UnitedHealthcare."

[TallGuyLittleCar]

What I can't get my head around is why are so many people so passionate about lining the pockets of the insurance companies?

3 possibilities.
1. they are stupid.
2. they are shareholders of insurance companies
3. it isn't quite that simple as big evil mean insurance companies taking advantage of people.

[david petley]

I have seen no statistics showing that people are leaving the US in substantial numbers for health care reasons.

http://www.time.com/time/health/arti...861919,00.html
<THIS LINK DOES NOT WORK - but is the heading of the first paragraph in the second link...

http://www.health-tourism.com/medica.../usa-research/


...Not statistics per se, but reporting based on statistics.

david

[Loyal Rogue]

Wow DP, I didn't realize the number of people leaving the US for medical tourism was THAT high... growing exponentially from 150k in 2006 to 750k in 2007 to an est. 6 million in 2010?!?
(btw, your link didn't work: http://www.time.com/time/health/arti...861919,00.html )

FL tried to make it seem that the article he quoted earlier was saying that people are flocking TO the US when it actually said the opposite.
I knew it was bad but not as bad as TIME is reporting.
I know it has gotten so prevalent that surgery centers here in South Florida are running radio adverts trying to scare people into not going out of the country for surgery because they are losing business... but 6 million?

[david petley]

Wow DP, I didn't realize the number of people leaving the US for medical tourism was THAT high... growing exponentially from 150k in 2006 to 750k in 2007 to an est. 6 million in 2010?!?
(btw, your link didn't work: http://www.time.com/time/health/arti...861919,00.html )

....I know it has gotten so prevalent that surgery centers here in South Florida are running radio adverts trying to scare people into not going out of the country for surgery because they are losing business... but 6 million?

sorry about the link to time.com ...seems to only work from within the other link I offered. It is the first paragraph heading 'Researchers have confirmed that'.

And from what I read, it is not 6 million, but over one million, by 2010.

david