I'm curious about how those who live in countries with nationalized healthcare feel about it. Does it work? Would you know how the experience compares with our (U.S.) system?

We have the much maligned National Health Service in the UK but my parents in their 80's have nothing but praise in times they have used its facilities. I think the quality of the NHS varies according to the area of the country you live in. I assume in the US you pay into some form of insurance scheme ? What happens if you can't afford to pay in?

My brother who regularly visits the US has £10,000,000 medical insurance to cover him. He says this would just about cover a broken arm in the US !!!

In the U.S., if you can't afford to pay for insurance you're basically treated like a criminal. If they find out early enough that you're un-insured (or under-insured), you're either sent home or to an indigent clinic. If they find out too late (ie: after they performed the treatment), they break out the attorneys and collection agents. Many are ruined by catastrophic health bills.

I think I'll stick with our NHS Doug!

Don't forget that if you've ever been sick with more than a bad hangnail, you can't get insurance here in the US. They won't give it to you if you have a pre-existing condition or are not the picture of perfect health.

The best thing to do here in the US is work for a company that provides good health insurance to its employees. But even this is becoming rarer and rarer and with more limitations, stipulations and rules against being sick in the first place.

I just took an outside job. Basically it was so I could get health care insurance.

Fortunately here in the Dallas Texas area we have a fairly good county hospital. Parkland takes EVERYONE- insurance or not. Granted the non-insured people get minimal care but they do get something.

I bicycle with a physician’s assistant that works in the orthopedic department. She says that 70% of their work is on non-paying patients. The hospital gets county tax dollars to help keep it going.

So in effect you can be tied to an employer for fear of losing your healthcare package?

As a matter of interest what would a healthy 40 year old with no previous complex medical history pay per annum to be covered for insurance purposes in the US ?

Well, you can get it, but at an unreasonably high fee. The insurance companies are required by law to offer insurance to everyone, though not necessarily their own. So they have a special 'pool' where they stick everyone with hangnails. Here in Missouri, it's $800/month to be insured out of this pool.

Picks himself up off the floor !!! thats £142 per week in real money.

Be interested to see what the situation is in other countries. I can't give an exact figure per person here because the NHS is funded out of tax and therfore the rich subsidise the poor (in theory).

I spent a year in the US and at one point went down with strep throat.

In the UK I'd have gone to my doctor (free) and got a prescription for antibiotics (which at that stage in my life would have been free because I was under 19 - now would be equivalent of about US $10 for each item prescribed (regardless what it is ... and if you anticipate a particularly bad year you can pay an annual flat rate of about US$50 instead that will cover all your prescriptions for the year ... and if you suffer from certain long-term conditions (e.g. thyroid problems) then you get free prescriptions for life)).

In the US I couldn't afford to go to the doctor (and I *had* medical insurance - but there was a $50 excess on the policy and I didn't have the $50 at the time (cue sound of heart-rending violins)). So I suffered for weeks, probably infecting a whole bunch of people, until my immune system eventually managed to fight it off on its own.

Ever since then I've been a fan of the principle of the NHS, although as with anything else it does have its problems in practice. In the UK medical insurance works out as a perk - you can buy it yourself, or if your employer offers it it's valued at £250 or so per year as a taxable benefit, and it allows you to jump some of the worse queues if necessary. But the NHS is always there as a first port of call, and largely still free at the point of use. I get very uneasy when our governments start suggesting chipping away at the principle of free healthcare.

With the closing of the steel mill I retired from, we lost all health insurance that was provided by my employer. We could have picked up the policy for a little over $1300.00 per month. That was not possible, and we haven't found insurance of lesser coverage that we could afford, and seemed like a reasonable alternative. So now, if my wife or I should *have to be hospitalized*, we are able to get hospitalization (it's law that medical *emergencies* be treated). But we would have to make small monthly payments, which would unlikely ever get the bills paid in full. The high cost of medications my wife takes on a regular basis is not covered, but for the time being, we have been able to pay for it. She is in bad need of having her knees replaced, but that's not an emergency. So she has to live with pain until she reaches the age where she can get Medicare (our government provided health insurance). The insurance provided by employers is beginning to be a thing of the past. So if an employer offers coverage, many people, like Jak, work as much for the benefits as they do for the wages.

Ed

This is one of the few times in my life that I've worked for an employer that provided health benefits. And, the pay I'm working for now is less than half of what I've previously made for other employers (not even what I would consider a "living wage"). I guess they figure health benefits (along with other benefits) are a part of the "wage package". It's a good thing I love my job and the people I work with I guess (and, am expecting a promotion soon).

The other thing about the health coverage I'll get (not eligable for another 3 months yet) is that there are quite a few rules for using it too. For example, if I have a pre-existing condition, I can't have it treated under this medical plan until I've had the insurance for a year. That's 6 months of working before I'm eligable for the medical plan and another year after that until it does me any real good if I have a pre-existing medical problem...

There's also a $350 deductable per year (the "excess" Leah mentioned)...

Since I'm never really sick or go to the doctor on any regular basis, I don't spend $350 on medical in a year. That means that my insurance coverage only helps me if I'm desperately ill and must be hospitilazed or require lots of office visits.

But still, being at the age when something medical is bound to happen, it's the only way to get insurance at all in reality.

Which brings me to another thought (this whole health care thing makes me angry, btw).

As US citizens, aren't we entitled to Life, Liberty and the Pursuit of Happiness? If we are entitled to life, shouldn't it be the US government doing something to insure that that life is preserved by making sure that all of its citizens receive adequate health care???

(Don't get me started on this, it's a sore point... :mad: )

Interesting topic Doug.

Where to start. As a consumer of health care services living in a major city in Saskatchewan, I am well-served by the government run system. Doctor visits are free, hospital care is free. If I'm poor enough drugs are free. If I'm not poor enough for the free drugs, I can get extra insurance for about $500 a year that will pay for drugs (except for pre-existing prescriptions) and other things like ambulance and eyeglasses.

We get very good care from our health system - those who work in the system are among the best in the world.

The problem is that our government now says it can't afford to pay these people what they are worth and they are leaving in droves for greener pastures to the west and south into the states. There is currently a 3 week old strike of hospital workers that threatens to close down the whole system if it continues much longer. Wages for these workers average $10 an hour less than equivilent workers in Alberta to the west. Alberta has a larger much younger population base and if I'm not mistaken, everyone pays a monthly "fee" for the "free" health care they recieve.

Is it working for us? Something will have to change. We have an aging population who require more and more health services and I agree with the government that we can no longer afford it.

Since I'm now on a fixed income which is below the poverty line and am unable to work, any change would be a hardship for me, but I can see that changes have to be made or we will lose it altogether.

I experienced a bit of "US" style health care when I signed up for extended coverage through a private insurer. As I understand it, I have dental coverage unless it can be proven that I had teeth before I went to the dentist and my antibiotic medication is covered unless I was ever prescribed an antibiotic any time in the past. If I take a ambulance to the hospital after an accident, it will be covered, but my insurance premium will double and ambulances will not be covered in the future.

What's the answer? I don't know. If I had known I was going to live this long I would have taken better care of myself....

Margaret

Healthcare here in the US is killing us. What really pisses me off is an illegal alien can get medical treatment for free and we the taxpayers who can't get free medical pay the bills. We have so many crossing the border to give birth thus giving them citizen status and free hospitalization to give birth.
I think our medical costs are out of site due to the outlandish lawsuits brought against the medical profession and drug companies.
Then there's HMO Health Management Org which basically takes all your medical decisions away from the doctor and gives it to some pencil pusher who doesn't know a thing about medicine. There's so much to fix here I don't think they know how to even approach it.
DJ

I'm not going to comment on this yet...too little time and so much to say! I will post a little info I learned last night. My brother's wife is expecting a baby in two weeks and has been reading everything she can get her hands on.

Apparently it costs FAR more to have a baby in the US than anywhere else in the world and yet we are about 20th when it comes to fatalities and/or complications during birth. (20th among technological nations). So, we have an enormously expensive health care system that can't seem to get the job done...

I'm so glad you brought this up, Doug, because I have wondered how the UK and especially the Canadian systems really work -- the Canadian system was discussed as a possible model in the early 90's during our last "national debate" over healthcare reform.

Got to looking via Google for some hopeful news about reform, and came up with some recommendations, and even more frightening data about our current system. :(

The human cost of medical errors is high. Based on the findings of one major study, medical errors kill some 44,000 people in U.S. hospitals each year. Another study puts the number much higher, at 98,000. Even using the lower estimate, more people die from medical mistakes each year than from highway accidents, breast cancer, or AIDS.:shocked:
INSTITUTE OF MEDICINE Division of Health Care Services
The majority of medical errors do not result from individual recklessness, the report says, but from basic flaws in the way the health system is organized. Stocking patient-care units in hospitals, for example, with certain full-strength drugs - even though they are toxic unless diluted - has resulted in deadly mistakes. And illegible writing in medical records has resulted in administration of a drug for which the patient has a known allergy.

Almost 40 million people in this country lack health insurance, more than the populations of Texas, Florida and Connecticut combined. The uninsured are more likely to have poorer health and die prematurely than those with insurance, but they do not suffer alone. Nearly 1 in 5 families have at least one uninsured member. Institute of Medicine report -- Health Insurance is a Family Matter

Well, as a Canadian who has lived in the US, here is my 2 cents.

The Canadian health care system is subject to some underfunding, debates between the federal and provincial governments over jurisdiction, and users can experience very long waits for non-critical surgery, and for routine health problems - i.e. showing up at a hospital with a broken arm.

Other than that it is pretty good. Everybody has care, and very few people die that might have been saved if they had insurance. Our record of false diagnosis - unintentional malpractice is about the same as the US, but we tend not to litigate unless there is obvious negligence.

So the long and short: if you have first class health care insurance through your employer, or you are wealthy, then the US system wins hands down - no contest.

If the above doesn't apply to you - good luck. You are better off in Canada.

Health care here in the US has become a vicious circle.

The insurance companies are "slow paying" the doctors and challenging charges.

The doctors are raising their prices because of the slow cash flow problem. Along with this malpractice insurance for doctors has sky rocketed because of the jillion dollar lawsuits.

I think a big help would be to limit the amount of these lawsuits.

Back in 1987 I had some major surgery. My hospital bill was about $21k. That was a lot of money in 1987. The insurance company decided they needed to audit the bill. Great!!! For the next 6 months the hospital kept sending me reminders that the insurance company hadn't paid yet.

After almost 7 months the insurance company paid all but $5.00 of the bill. Why on earth did this take so long?

My sister who has lived in the states for most of her life, was working in a surgeon's office as an operating room technician. She tells a story about one claim for an x-ray that was challenged by the insurance company. The x-ray was done while the patient was in the hospital and the insurance company claimed that it could have been done as an outpatient.

The insurance company wasn't convinced even when it was explained to them that the patient was under general anaesthetic at the time the x-ray was taken and the surgeon was in the middle of performing knee surgery.

I have to agree with Toad. Our various levels of government always squabble about who should pay, but somehow we all get looked after and despite what seems like long waiting lists for elective surgery, we don't hear much about people not being treated in a timely manner.

Take care,
Margaret

The American Medical system is a round about way that Lawyers get rich while everybody else goes broke!

Margaret,
I suspect that insurance was an HMO. Sounds like something they do.
DJ

As DJ said, many of our doctors are closing up practice because they can't afford the insurance anymore, and the ones that don't, basically throw a prescription at you and walk out of the room within 30 seconds because they overbook themselves.

The pickle I am in is this:

I have a pre-existing condition that started in my teen years. All that time I was covered by my father's plan which was Champus and another governtment benefit. Then, when I turned 23, I was no longer covered by that but I was in college and didn't have a job. I found an obscure insurance that would take me with my pre-existing condition, but they wouldn't cover the condition for another year. By the time the year went by, I finished college and moved out of state. It turned out that when I went to find out about coverage of my condition, they said that they contracted those types of ailments out to another insurance company that didn't operate within the state where I live now. I couldn't change insurance companies, because I had developed a few other problems that then wouldn't be covered under a new plan because they would be pre-existing. So now I live without coverage of the original problem, and I still pay $250 a month for insurance and another $86 a month for the prescription that they don't cover. To be able to go to the doctor for this problem I have to make an appointment and say it is about something else and hope the doctor has mercy on me and bills the insurance under another code, else they won't pay for the visit.


If you can follow that story, congratulations... such is the state of healthcare in this country. Luckily, I have recently found a doctor who is very sympathetic to my problem.

Originally posted by chiquitita
Luckily, I have recently found a doctor who is very sympathetic to my problem.

Good for you! Glad to know a few still exist...

chiquitita, that's a story that tells so much about what is wrong with our system and what needs to be fixed. Have you ever talked with an insurance broker (one who handles many different companies instead of promoting only the one he sells) to see if there is another company that would handle all of your pre-existing ailments in the future, at a rate that would be more affordable? (asking for the moon, I know).

A friend of mine has chronic asthma caused by an on-the-job accident. He has to change insurance companies regularly to keep insured for this problem. He finds coverage, and then when it's time to renew -- they don't want him anymore. Probably because he actually USED the insurance instead of just paying premiums. :(

That is how we found the one I have.. I have also been to ehealthinsurance.com but the problem is that I have had all sorts of problems and tests in the last couple of years so I would have lots of pre-existing conditions, even if the original ONE wasn't applied.

I grew up in Canada and now work in the medical field here in the US for the past 10 years. Both systems have their assets and deficits. The two systems reflect differences in their culture. The distribution of wealth in the US is different than in Canada. The US has an hour-glass shaped distribution of wealth, while the Canadian population has more of a bell curve shape, with a very large middle class.
I wouldn't hesitate to say the Canadian system is superior to the American system, but then there's significant differences in the two cultures and the Canadian system may not work in the US.
As for illegal aliens getting free care, I admit it might put people off, but in the end it actually pays off, because it helps contribute to a healthy population. The child born in the US with illegal parents doesn't have a clue what country (or what world) he or she is being delivered into. It's in our best interest to protect that child. That's one of the reasons why Canada is a healthier society on many levels; Canada puts a premium on the care of the "group" over the "individual". The whole of the population is treated similarly. Mental health is also not as much a stigma in Canada as it is appears to be in the US.
To illustrate the differences in health in the two countries, there are more guns per capita in Canada than there are in the US. I grew up in Montreal, population 1.5 million, which has about 80 murders a year; I now live next door to a city just outside of SF with a population of 150,000 but a murder rate of 100+ per year.
My point is, a healthy population, from birth to adulthood, is in the best interests of everybody. Unfortunately the system in the US doesn't promote this throughout.

Mig

Here in Australia we have a national heath scheme as well as private insurance. The national scheme covers everybody for free hospital care(no choice of doctor) and for some visits to the GP. It's quite complicated and is beginning to fail. Most doctors visits are free if they are part of the government scheme of"bulk billing" but there are those who are not . For those who are not the paitent pays and claims back a set amount from the government there is usually a difference between what these Drs charge and what the govenment refunds. Then on top of that you can have private heath insurance which is not usually tied to employment but rather you pay for it yourself. The benefits of private insurance are a choice of Dr when in hospital, private hospital cover and a heap of other little benefits including a tax rebate for holding private insurance. Our government is trying to encourage everybody to take out private heath insurance and penalize people through taxes if they don't if they are above a certain income level. It's becoming more and more complicated with each new government.