The NHS & the United States of America

Rather than hijacking another thread, thought we could move the debate here.

What I find very odd from most of the complaints in the US, is that they'll somehow have no choice where they go for medial treatment anymore and that there'll just be the one 'monopoly'. I'm not sure if you guys know this, but in Britain we also have plenty of private hospitals.

I had an operation 6 weeks ago to correct my jaw (I had a 1cm gap between my jaws). I wanted nice food, a television, my own room, an en-suite bathroom and a date that I choose. Those are all luxuries, and I paid for them (well, my insurance did).

Just for reference, my operation is considered vital to my health, due to the only contact on my teeth being my rear teeth before the operation, it was not cosmetic.

However, if I was from a less-fortunate family and I couldn't afford that kind of treatment, at least I could have the same operation, by the same surgeon, in an NHS hospital and it wouldn't cost me a penny. I could enjoy the benefits of having teeth that line up, allowing me to eat - I would just have to "suffer" sharing a room and not having a TV for a day.

Having the option is priceless. If you want to be a snob, you're still welcome.

On a side note Americans, how are people that you know responding to it: is it generally regarded as silly?

Your operation does not sound like it would have been fun but I hope it went well for you.

That pretty much describes the situation here in Aus too. Waiting lists for procedures is longer in the public system, which is paid for by a 'medicare' tax levy, to which everybody contributes to in some degree.

People are encouraged to have private health insurance (in fact, if you do not, and earn over a certain amount, there is a tax penalty that makes it worth one's while to go private - the penalty is about 9/10 of the cost of insurance), but the public system, as overloaded as it can get for certain procedures, is working fine.

I really don't understand (and haven't been interested enough to read up) what all the hoohah is about with medicare reforms in the US. I don't understand a culture that seems to worship individuality over and above community to the point where there might be debate about looking after the health interests of the poorest and most disavantaged members of that community.

david

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Originally Posted by asheep_uk

Having the option is priceless. If you want to be a snob, you're still welcome.

On a side note Americans, how are people that you know responding to it: is it generally regarded as silly?

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I have coverage that I pay for. And from my perspective, I've been screaming for a change for a long time.

The people that you lot see on television, yelling at senators and other people... they also have coverage. So they don't care about the others. That's their problem...

And that's more honest than they will ever be.

Glad you got the operation. Glad it worked out well for you. No more jawbreakers!

A great deal of it is hate centered and has nothing to do with health care. Health Care is the scapegoat for the entire political shift.
Lobbyists are creating an astroturf movement. If you've watched Countdown or the Rachel Maddow show they go into great detail about who's paying what to whom and where that money is being put to use.
http://www.youtube.com/watch?v=0W8BbJXjda8
About that alleged Death Panels

could it be because they are afraid ppl will take advantage of the system? would it be like you paying for someone else court fee or disability because that person was stupid to get into that situation, or someone stays unemployed to receive govt. handouts..etc?.

There could be some ppl that stuff themselves or smoke themselves to death, and end up the community have to pay for their health care. How could they prevent this type of system abuse?

not that matters to me personally, but im just very curious

Frets, the Democrats can keep buying the astroturf tinfoil stuff (while bussing in Acorn members to townhall events) and continue ignoring the polls. Sure way for them to continue losing support.

asheep, I think the issue is that, for many people, the "extra" stuff you are talking about is not seen as a luxury and is rather standard expectations for health care by many Americans. All of the hospitals I've been to here (including a wide variety from "nice" to "bad (state run)" to "teaching") have good food (the cafeteria rather than the delivered stuff at least), a tv, in-room bathrooms and importantly a date of your choosing. Most of them were equipped to hold more than one person in a room, but the other beds were empty.

They don't want to see the standard they are used to watered down and then have to pay more than they already do to have what they used to have.

It's the opposite of focusing on the individual instead of the community. The current system serves the community better than the proposed one would. It's out of the frying pan and into the fire to turn a high quality system for almost everyone into a mediocre system for everyone. There are ways to cover the uninsured (most of whom can afford it but choose not to buy it anyway) without creating DMV-care.

FL, everything you just posted is either a republican talking point that has no basis in fact, or an outright lie.
Watered down standards? Hello? The uninsured don't get to see the inside of a hospital room, hospital food, tv, or surgery at all here.
Most of whom can afford it but choose not to? That is a ridiculous soundbite that was pulled out of thin air.
Astroturf, tinfoil? LOL. Do you really believe that the same industries that spent hundreds of millions to defeat Clinton's healthcare plan aren't going to spend as much or more to oppose this one by any means necessary?

Your arguments and statements make Michael Moore look like Walter Cronkite by comparision... speaking of MM and comparisions, asheep, if you want to see a look into the differences of our healthcare system compared to healthcare in the UK, Canada, France, and Cuba, go have a watch at freedocumentaries.org of the documentary, "Sicko".

http://freedocumentaries.org/film.php?id=133

While there is some cherry-picking of interviews (most notably showing some Canadian hospital ER patients who only waited 30-45mins for treatment as opposed to not showing others who may have waited 4-6hrs for treatment), overall it gives a very spot-on look at the way treatment is handled between the USA and NHS and what those who have experienced both have to say.

On a side note, my mother has experienced healthcare in the US throughout her life both uninsured and with company provided insurance, and she has spent the last 16yrs over in the UK under NHS.
She visits me here at least 2-3 times a year and she follows our news/politics very closely.
She makes no bones about it, according to her experiences the healthcare system in the UK is miles above and beyond the system in the US, and everything we are being told by the insurance industry, the drug industry, and the opposition party that they own is nothing but distortion and lies to keep the status quo and not cut into corporate profits, period.
She has had multiple surgeries and treatments under the NHS and the longest she had to wait for a non-life threatening surgery (cornea transplant) was a month because there were others ahead of her who were more in need or going blind.

Can you name a US insurance company I can get a quote on?

Avmed, Cigna, Aetna, Blue Cross

Guardian, Kaiser-Permanente, Ceridian...

So from Aetna I got a quote of $160 (£100) for one of the packages. For a similar package from Aviva, a British company, I'm quoted $400 (£250). But the difference is in Britain, if I don't pay that, I can just walk into an NHS hospital and get the same treatment, but for free, whereas in the US, I just don't get anything?

I think I'm missing something here, because $160 a month doesn't sound that unreasonable, or was the list I got a list of all the packages and I'm suppose to add them all up rather than just take the best deal?

Oh I don't know any US addresses, so I put mine as 1600 Pennsylvania Ave, Washington, DC 20500-0004 – not sure if that makes any difference.

haha... pick a better address.

As a non-smoker, my fees per month is about that ($~160) with dental, mental, regular health, and subsidized medicine (co-pay). With a family, it can hit much higher, about 500-1000 for one household.

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Originally Posted by Loyal Rogue

Watered down standards? Hello? The uninsured don't get to see the inside of a hospital room, hospital food, tv, or surgery at all here.

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Hello. The uninsured is a small percentage of people (15% at most) and many of them are young people who choose not to pay for coverage (about half of the 15% can afford it or qualify for public coverage already). Because many of them are young and healthy, they don't need to see the inside of a hospital anyway.

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Originally Posted by Loyal Rogue

Most of whom can afford it but choose not to? That is a ridiculous soundbite that was pulled out of thin air.

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Maybe "most of" isn't quite right. "About half" is right: http://www.patientpowernow.org/2008/...ord-insurance/

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Originally Posted by Loyal Rogue

Your arguments and statements make Michael Moore look like Walter Cronkite by comparision... speaking of MM and comparisions, asheep, if you want to see a look into the differences of our healthcare system compared to healthcare in the UK, Canada, France, and Cuba, go have a watch at freedocumentaries.org of the documentary, "Sicko".

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Once you are finished wasting your time with that film, you can find many well-referenced articles on Google debunking nearly every claim Michael Moore makes.

LR, still waiting for you to stop describing your bias and start backing up your claims.

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Originally Posted by Loyal Rogue

On a side note, my mother has experienced healthcare in the US throughout her life both uninsured and with company provided insurance, and she has spent the last 16yrs over in the UK under NHS.
She visits me here at least 2-3 times a year and she follows our news/politics very closely.
She makes no bones about it, according to her experiences the healthcare system in the UK is miles above and beyond the system in the US, and everything we are being told by the insurance industry, the drug industry, and the opposition party that they own is nothing but distortion and lies to keep the status quo and not cut into corporate profits, period.
She has had multiple surgeries and treatments under the NHS and the longest she had to wait for a non-life threatening surgery (cornea transplant) was a month because there were others ahead of her who were more in need or going blind.

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I'm glad that your moms anecdotal perspective is presented as "a side note." Had you not mentioned that, for lack of other substantiation, one might conclude that this is your sole basis for your beliefs.

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Originally Posted by asheep_uk

I think I'm missing something here, because $160 a month doesn't sound that unreasonable, or was the list I got a list of all the packages and I'm suppose to add them all up rather than just take the best deal?

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You're not missing anything. In fact, I paid less than half of that ($75 per month) for a Blue Shield PPO in college. PPO meaning that I could go to any hospital I wanted.

The family plans are more. Obviously to cover more people. But, it's tough to compare that way because buying a plan for an individual family is at a different price than if you get the plan through your employer (as most people do here). They charge a lot more if you aren't in a group policy.

I get my healthcare through a family policy, so it's less, but I can see why people in Britain complain about how expensive private health insurance is. But we also complain about the NHS – but seriously, it costs nothing, if you want more, pay for it. But I guess people aren't happy with that, they want US-style healthcare but they don't want to pay for it.

Stupid world.

The only thing that slightly upsets me about the US is that if I call an ambulance right now because my arm fell off, I never have to worry about how much it costs.

Is there any bargaining to be done to have state-funded Accident & Emergency, but leave everything else to insurance?

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Originally Posted by asheep_uk

So from Aetna I got a quote of $160 (£100)

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Originally Posted by asheep_uk

I wanted nice food, a television, my own room, an en-suite bathroom and a date that I choose. Those are all luxuries, and I paid for them (well, my insurance did).

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$160/month is not getting you this.

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Originally Posted by gerbick

haha... pick a better address.

As a non-smoker, my fees per month is about that ($~160) with dental, mental, regular health, and subsidized medicine (co-pay). With a family, it can hit much higher, about 500-1000 for one household.

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160 is about what I would pay for myself. However if you, I, or asheep had a uterus it would be over 300(i think).

I think if I was to get state funded you're poor insurance through the state it would cost me around $60 a month. But if I wanted to keep what I was on when I was in school with my mothers insurance through Cigna it was quite a bit higher...

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Originally Posted by hanratty21

$160/month is not getting you this.

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I paid less than that for a PPO. If I had a condition that required hospital stay, I could choose a place that offers those things.

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Originally Posted by asheep_uk

The only thing that slightly upsets me about the US is that if I call an ambulance right now because my arm fell off, I never have to worry about how much it costs.

Is there any bargaining to be done to have state-funded Accident & Emergency, but leave everything else to insurance?

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You already get emergency help. If your arm falls off and you call for an ambulance, they will get and treat you regardless of having insurance or not. Then they settle the bill later. If you're not insured, you'd probably end up rehabbing in a state hospital which tend not to be as nice as some of the private ones.

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Originally Posted by WannaBe_80z

I think if I was to get state funded you're poor insurance through the state it would cost me around $60 a month. But if I wanted to keep what I was on when I was in school with my mothers insurance through Cigna it was quite a bit higher...

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That probably has most to do with your choice of places you can go and the deductable you have to clear (if you have one at all).

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Originally Posted by FlashLackey

I paid less than that for a PPO. If I had a condition that required hospital stay, I could choose a place that offers those things.

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With what kind of deductible? If you tell me none, then you have my vote for the new Health Care Czar. You've solved the problem. :rolleyes:

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Originally Posted by FlashLackey

Hello. The uninsured is a small percentage of people (15% at most) and many of them are young people who choose not to pay for coverage (about half of the 15% can afford it or qualify for public coverage already). Because many of them are young and healthy, they don't need to see the inside of a hospital anyway.

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...and if you look at the figures by race
uninsured black people - 18.5 - 19%
uninsured hispanics - 32 - 35%

(http://www.census.gov/hhes/www/hlthi...ric/index.html)

...so somebody is getting the rough end of the pineapple.

david

<edit> and if you live in Florida, or New Mexico one in 5 is not insured.

I had medical insurance with Cigna paid for by my company.
I had dental treatment and also an Arthroscopy on my knee.

Some of the dental treatment had a limit on the claim.

Then I was made redundant and my free insurance ceased...

However insurance or not, there are limits when certain medical treatment
and medication is required.

What really P's me off is that certain drugs, ie for cancer treatment
are considered too expensive to give out on the NHS.

Considering much of the funding for research is donated by the public
who relentlessly raise money by running marathons and the like.

In my cynical mind, it would seem illogical to ever find an absolute cure for such disease as there would be no need for anymore funding.

Cancer Research is one of the most popular 'charities' people raise money for.
Many of these people have had friends or relatives who have been affected
by this disease.

None of these people are likely to benefit if long term medical treatment is
rerquired.

I believe that the drug companies are artificially inflating the price of such drugs.

They quote they have made staggering progress and cured cancers in animals.
This encourages people to send more money.

These animals are healthy when they are given cancer so they respond to drugs.

Most people who develop cancers are in poor health and they do not respond in the same way to drugs..

However drugs that have been found to help some patients continue to be unavailable to the majority of us.



"We are almost there. Keep sending you money."

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Originally Posted by asheep_uk

I think I'm missing something here, because $160 a month doesn't sound that unreasonable, or was the list I got a list of all the packages and I'm suppose to add them all up rather than just take the best deal?

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I took a look at the Cigna quotes for myself if I was single and I'm guessing that $160 is the monthly quote for the lowest Cigna plan with a deductible of $5000 for you.
That means if you had an emergency and had to go to the hospital the first $5000 of the bill would come out of your pocket. After that your insurance would pay either 80% or 60% of the rest of the bill depending on if you were at a Cigna network hospital or not.

When I was 22 I had a motorcycle accident.
Snapped my femur in half, got pretty banged up overall and woke-up with my foot next to my face.
I didn't have insurance so the ambulance drove over 45mins past 6 hospitals that wouldn't accept me until we got to a county hospital that had to take me because they receive tax funding.

Luckily it wasn't anything life-threatening or else I could have died during the ride. (I know in your system that sounds impossible, but over here we've had horror stories in the news of people who have died because they were turned away from the "wrong" hospital for lack of insurance or because their insurance company refused to pay unless they went to a different hospital in their network.)

Anyway, it took a couple of days in the hospital to have surgery to put a metal rod and some screws in my thighbone, then 2 days of physical therapy which I barely remember because I kept passing out from the pain of the nerve damage in my groin, then was sent home with a $26,000 bill.

If I had the Cigna insurance plan you were looking at, I would have gone home with a $9,200 bill for an in-network hospital or a $13,400 bill for an out-of-network hospital instead... oh yeah, plus the cost of the ambulance ride which was $480.
That is what $160/mo buys you.
Doesn't sound too bad until you actually need to use it. ;)

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Originally Posted by Loyal Rogue

I took a look at the Cigna quotes for myself if I was single and I'm guessing that $160 is the monthly quote for the lowest Cigna plan with a deductible of $5000 for you.

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Probably not. asheep is young and vibrant. you are old and dying. Hence the difference in quotes.



being 35 i just got quoted 142 a month, 500 deductible with a max 2500 out of pocket. co pays 20 bucks.

Ouch.
Why I oughta... *shakes fist*

I didn't see a $500 deductible plan. The lowest I saw was the Open Access 1000 which has a $1000 deductible.
I did make one mistake earlier though. I didn't see the max out of pocket.
That means my earlier figures would drop to a $5,000 bill for in-network and a $10,000 bill for out-of-network hospitals.

I just had my 3rd child a few weeks ago and I have really good insurance through my employer and I still have to pay out my ass. I dont care what anybody says, our healthcare system sucks.

Every year it seems like my rates go up, and my coverage drops. Of course, when having a wife and 3 kids, you have to bite the bullet and make sure you can get the best available insurance. It's just sickening to find out every year how much you actually spend on healthcare.

Asheep can confirm, but I believe if you were in the UK and your wife worked, she would've had paid time off for pre-natal treatments, free prescriptions, free dental, no bill for the hospital stay or delivery, and then 6mos paid maternity leave, and an additional 3mos paid plus 3mos unpaid maternity if she chose to take it.

I think if I ever decide to have a kid the wife will be taking a very "extended vacation". ;)

Yeah.

It obviously is paid for somewhere along the line. It comes out of something we have called "National Insurance", or NI - essentially a tax.

If you earn £30,000 ($50,000) a year, you'll pay £220 ($360) a month to NI.

Your employer also contributes, paying directing to the government – about £250 a month ($410). You never see that money, it doesn't appear on your payslip, it's just something employers have to do. (In return, if you're sick, the employer gets money back from the government to help with your sick pay.)

NI helps to pay for your pension, but I suspect the majority of it goes to the NHS.

However, if I go to the hospital every single day and have every tooth replaced, every bone reinforced with steel and my wife has 10 babies, I still only pay £220 a month. And nobody checks that you do, soon as you're ready to leave the hospital, you just walk out. You don't even have to give your address. (But they like to take it, so they can update your patient records.)

Here's when it really works: say I'm 18 years old and I earn £4.77 (the minimum wage for under-22s) and I work 20 hours a week, because I'm on an apprenticeship, or I'm too ill to work anymore than that, my NI is £0.00, but I can still have as many babies or break as many limbs as I want.

The Prime Minister probably pays about £450 a month in NI. If you earn £1,000,000 a year, you pay £1,146 a month.

Oh don't forget the dad gets paid time off too!

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The Prime Minister probably pays about £450 a month in NI. If you earn £1,000,000 a year, you pay £1,146 a month.

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And that's going to be the problem in the US. "It's unfair that the rich pay for everybody's healthcare...", thus the whole "socialism" slant that was made popular by a person who obtained medicine under assumed names in different countries... like Haiti.

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Originally Posted by Loyal Rogue

If I had the Cigna insurance plan you were looking at, I would have gone home with a $9,200 bill for an in-network hospital or a $13,400 bill for an out-of-network hospital instead... oh yeah, plus the cost of the ambulance ride which was $480.
That is what $160/mo buys you.

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:)

My $360 a month pays for that, but I don't have to drive around south London trying to find a hospital and I don't get landed with a $15,000 bill. And if I loose my job tomorrow, I don't actually have to pay at all.

I normally see the US as being ahead in the game, but that's pretty shocking.

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Originally Posted by gerbick

And that's going to be the problem in the US. "It's unfair that the rich pay for everybody's healthcare...", thus the whole "socialism" slant that was made popular by a person who obtained medicine under assumed names in different countries... like Haiti.

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But that's how the rest of your taxes work? The rich pay for the schools, the fire engines, the policemen, your postal service (?), your wars – everything?

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Originally Posted by asheep_uk

But that's how the rest of your taxes work? The rich pay for the schools, the fire engines, the policemen, your postal service (?), your wars – everything?

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You'd think that common sense would prevail, but it does not. They - I am a few levels removed from ever considering myself "rich" - feel as if they are carrying the burden of a bigger government due to the new administration without looking at the trend that the government was already getting bigger in the last decade.

Thus, the rich feel as if they are funding something they fundamentally do not believe in, nor wish to support.

Same for healthcare. They feel as if things are fine. They're covered. So everything with everybody is ok. Only a small percentage of people are uncovered according to misinformed people.

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Originally Posted by gerbick

They - I am a few levels removed from ever considering myself "rich" - feel as if they are carrying the burden of a bigger government due to the new administration without looking at the trend that the government was already getting bigger in the last decade.

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They have been complaining about their burden for decades. I really remember it ramping up during the clinton admin, with the top 10% paying 80% of the taxees (or some such)

I was just looking up tax rates for comparison and I'm a little surprised.

For childless single taxpayer making a decent middle class wage of $50,000/yr the basic income tax rate in the US is 25%.
In the UK it's 14.9%. Is that right? I thought you guys paid much more taxes than we do?
For Social Security we pay 6% and for NI you pay 11%.
So our total on the above is 31% and your total is 26%?

I'm sure there's a bunch of small variables like sales tax (VAT), state income tax, fuel taxes, tobacco taxes, etc., but for the majority of the tax burden it looks like you guys are paying less and can still afford better social programs.
So what am I missing?

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Originally Posted by asheep_uk

your postal service (?),

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I don't think the postal service receives any public funding.

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Originally Posted by TallGuyLittleCar

They have been complaining about their burden for decades. I really remember it ramping up during the clinton admin, with the top 10% paying 80% of the taxees (or some such)

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Quite funny how you went to yet another democratic president. Dare I say... I see a trend?

Time to be honest. You don't like Obama in office, do you?

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Originally Posted by gerbick

Quite funny how you went to yet another democratic president. Dare I say... I see a trend?

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they complain more when a democrat is in office. And I don't really remember them complaining when Sr. Bush was in office, but then agian I wasn't even driving yet. They complained through Dubya's years as well, but less vocally for obvious reasons.

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Time to be honest. You don't like Obama in office, do you?

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I like him more than Nancy Pelosi, but less than Ron Paul.

I think he is doing a better job than McCain would have done, and try to be careful to keep in mind that he has to work with congress just as all previous presidents have done. Do i think he is a socialist, no. Do i think the joker socialist posters are funny.. a little.

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Originally Posted by Loyal Rogue

I was just looking up tax rates for comparison and I'm a little surprised.

For childless single taxpayer making a decent middle class wage of $50,000/yr the basic income tax rate in the US is 25%.
In the UK it's 14.9%. Is that right? I thought you guys paid much more taxes than we do?
For Social Security we pay 6% and for NI you pay 11%.
So our total on the above is 31% and your total is 26%?

I'm sure there's a bunch of small variables like sales tax (VAT), state income tax, fuel taxes, tobacco taxes, etc., but for the majority of the tax burden it looks like you guys are paying less and can still afford better social programs.
So what am I missing?

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Our top-tax rate, if you earn over £37,500 ($62,000) is 40%. Our NI is 23.8%. Our VAT is 15%, but will go back up to 17.5% in January 2010. You pay council tax for the house you live in, which is based on where your house is and how big it is. We pay road tax for our cars, which for a 1.2 litre petrol car is about £115 a year. We pay VAT and fuel tax on petrol and diesel. So yeah, we're drowning in it. But for some reason that doesn't stop us buying new cars and making our average house price £150,000 ($250,000) compared to the US $215,000. (And most of our houses are rabbit hutches compared to what the US has.)