To those in countries that have universal healthcare

[glocke12]

Can someone from a country that HAS nationalized healthcare please post here and tell what things are like in terms of:

Copays. Do they exist? If so how much are they?

waiting for appt. procedures etc..(how much time elapses from time you call for an appt. and the time you are seen ? for me it is within 24 hours.

availability of prescriptions: Any problems getting anything filled?

Can you see the doctor you WANT to see, or do you see the doctor they TELL you to see?

Is the same level of coverage available to everyone? Or can those with the means to do so purchase a package that offers a better level of service?


People from the U.S., please dont respond, we dont have universal healthcare, and I am looking for answers to those questions from people in countries that have it. Everyone else, please answer the questions with minimal rhetoric and commentary, and above all LETS BE NICE>>>:D

[ergdegdeg]

Copays: EDIT (after reading glocke's definition of it and not the translation I found ;) ): Insurance usually covers 100%. If not, you have to pay for it yourself.

waiting for appt. procedures: Strongly depends on the doctor. From right away in a case of emergency to 2 or 3 weeks if it's just a routine check.

availability of prescriptions: If you need some kind of medication - you get it. Unless it's not paid for by the insurance (only things you don't *really* need - like the Pill).

Can you see the doctor you WANT to see, or do you see the doctor they TELL you to see: You can pick the doctor you want. There are also some doctors who don't contract with the social insurances and you have to pay for those yourself (usually, those are more experienced) and can afford not having so many patients.

Is the same level of coverage available to everyone? Or can those with the means to do so purchase a package that offers a better level of service: Yes, if you have enough money, you can get a private insurance and go see "better" doctors and get appointments faster.

[djellison]

Copays. Do they exist? If so how much are they?

not sure what you mean there



waiting for appt. procedures etc..(how much time elapses from time you call for an appt. and the time you are seen ? for me it is within 24 hours.

If I need to see my GP, I can phone at 8am and be seen that morning.


availability of prescriptions: Any problems getting anything filled?


Never actually had to have one written out - but my other half has never had any trouble with them.


Can you see the doctor you WANT to see, or do you see the doctor they TELL you to see?

Usually the one I want to if he's in that day.


Is the same level of coverage available to everyone? Or can those with the means to do so purchase a package that offers a better level of service?

One could pay and go private. I've found the NHS to be superb, however. My job means I work with doctors quite regularly - and spending time 'behind the scenes' just makes me more proud of it.

[JG271]

Sorry, what is a copay?

Quite often you can see a doctor that you want - for an appointment, but not if you are on a ward.

Waiting times vary wildly with where you live and what treatment you need. For a simple consult it is usually the next day or two where i am. Other than that, i've had relatives who have had quite rapid treatment, although again the local hospital is very good.

No problems with prescriptions where i am, although i haven't had much experience myself.

The NHS seems to vary depending on where you live - in terms of general care and specialized care - some places are better than others, simply. You can go private completely, but not a cross between the two (yet, its bound to come soon.) If you choose to pay for a part of the service privately, then it has to be in its entirety, you can't have some treatment done private and some not for example.

The whole system seems to be slipping towards a privatized system, something which i personally am against. Doctors are starting to get performance related pay, and businesses can now take over GPs surgeries (i think the american equivalent is a clinic?) and run it for the government.

If you have any more questions, i'd be glad to answer them.

[glocke12]

A copay is a small fee that is paid to the doctors that covers what the insurance does not cover.

For example: If insurance covers 80% of a doctors vist, and the doctors vist is $100.00, the insurance company pays $80.00, and I pay $20.00.

That probably is not the techncial definition of a copay, but that is how it works in the real world.

Other question I have:

Does your form of healthcare cover dentists, orthrodontists, etc?


Any doctors on this board from countries that have universal healthcare? What are your thoughts on it?

[ergdegdeg]

Does your form of healthcare cover dentists, orthrodontists, etc?

Dentists are fully covered (except you want more expensive fillings and anesthetization). Orthodontist you have to pay for yourself (I'm not sure if it's paid for if it's really severe but probably yes).

[JG271]

Here dentists are mostly paid for, except for specialist appointments i think?
Orthodontists are on the NHS if the treatment starts before you are 17. Things like breakages or replacements cost money however.

[djellison]

A copay is a small fee that is paid to the doctors that covers what the insurance does not cover.


Ahhh - well - no. It's free to everyone.

[Queso]

Copays. Do they exist? If so how much are they?
Only on dentistry, since Mr. Brown decided to change the contracts of NHS dentists in such a way most of them went private.
waiting for appt. procedures etc..(how much time elapses from time you call for an appt. and the time you are seen ? for me it is within 24 hours.
Our local health trust has drop-in centres. You turn up and will normally see a doctor within an hour. If you want to go to your own GP it's more difficult to get an appointment, but still you ought to be seen within three days.
availability of prescriptions: Any problems getting anything filled?
No. The doctors and senior nurses at the drop in centres are both able to write prescriptions.
Can you see the doctor you WANT to see, or do you see the doctor they TELL you to see?
See above.
Is the same level of coverage available to everyone? Or can those with the means to do so purchase a package that offers a better level of service?
Same level to everyone except when it comes to seeing consultants. You can jump the appointment queue for specialists by paying. Some people also go completely private.

[.Andy]

Australia.

Copays. Do they exist? If so how much are they?
Nothing.

waiting for appt. procedures etc..(how much time elapses from time you call for an appt. and the time you are seen ? for me it is within 24 hours.
I book an appt with my GP the same day that I want to see him. Alternatively I can rock up to a medical centre and been seen within an hour.

availability of prescriptions: Any problems getting anything filled?
Never. You just take it to a chemist and it's filled.

Can you see the doctor you WANT to see, or do you see the doctor they TELL you to see?
Yes you can see the doctor you want. I have a great GP that I've been going to for years.

Is the same level of coverage available to everyone?
This is the idea of the system.

Or can those with the means to do so purchase a package that offers a better level of service?
Yes you can purchase a better package if you want (i.e. go private). If you're in need of elective surgery you get in more more quickly in the private. It's not really required but there are private hospitals with more attractive surroundings. They usually employ the same doctors and just use the public surgeons/operating theatres. At a certain level of income there is a tax benefit for taking out private cover.

[Ntombi]

The most telling thing from this thread so far? None of them had a clue what a copay is.

I wish I could insert a jocular smiley there, but it's not in me right now... :(


BTW, I saw a fantastic documentary on PBS several months ago that compared the universal healthcare systems of the world. It looked at the pros and cons of each system, talked about how each came into being, and how it would or would not work in the US. I was infinitely more informed and depressed at the end of those two hours.

[JG271]

BTW, I saw a fantastic documentary on PBS several months ago that compared the universal healthcare systems of the world. It looked at the pros and cons of each system, talked about how each came into being, and how it would or would not work in the US. I was infinitely more informed and depressed at the end of those two hours.

Similarly, i saw a short program about a charity that flew out to remote areas to give people healthcare and dentistry that they couldn't afford. I was so amazed when they talked about health insurance, and how people spend $1000 a month on it, and how easily people are left behind by the entire system.

It made me appreciate universal healthcare a lot more... and realize I'm lucky to have it.

[scotthayes]

I can only echo what those from the UK have said.

Last time I was ill (ear infection) I saw my doctor the same day I called. I had to pay for my prescription (around £7 no matter how may tablets were on the prescription). Thank fully I've never had to have surgery. However I can tell the story of a friend who needed major heart surgery. It didn't cost him a penny. We pay for our health care through taxes and national insurance payment. Our NHS may not be perfect but I never have to worry if I can afford to see the doctor or if I need an operation. and of course I don't have to worry if I'm covered for a pre-existing condition if I change job.

When my dad had throat cancer and needed major surgery and a huge amount of medication it cost him around £120 for a year for all the drugs needed and again the surgery did not cost him anything.

As I said it's not perfect here but on the whole it is pretty outstanding.

Oh and as for the same level for everyone. I have a friend who was a visitor to the uk on a temporary working visa. he came down with septicemia, he was worried about getting treatment as he thought he would have to pay for it, but as he had paid tax and NI he was FULLY covered. so yes it is pretty much the same for everyone.

[Lyle]

The most telling thing from this thread so far? None of them had a clue what a copay is.It's interesting to me is that some people (those who can afford it?) choose to pay for private insurance so that they can get better care. Also JG271's observation that the system seems to be becoming more privatized in various ways.

[nick9191]

UK, all free, same care for everyone, see doctor of your choice same day or more likely a couple of days if not very important.

People can go private and pay insurance, however you still have to pay the same tax.

My dad had a big knee operation. He did have to wait a couple of months however it got progressively worse so the doctor managed to push him forward. They did a good job, he didn't catch MRSA, and he's fine.

[geese]

+1 with the other UKers here.

I've moved quite a bit in the UK- never had a problem getting a doctor within 20 min walking distance, never had any complaints with doctors, and I've used NHS drop-in centres twice in a semi-emergency.

Once was on St Patrick's night in a hospital near Crouch End, London. Lots of cheery drunk people, including one family who'd looked had a punch-up but had all made up and were having a giggle about it. I had to wait a couple of hours to get a small injury treated, but you cant complain, really.

NHS Direct is a great service- a lo-call number you can call to get medical advice if you're unsure if you need medical attention. NHS dentistry is a bit of an arse though.

I dont know why anyone would want to be forced to pay medical insurance though- I dont know how a large nation such as the USA can be hoodwinked into believing that their current system is better then some form of Universal Healthcare. Private Healthcare is great if you can afford it, but why should you be forced into it? If I had to do that, I couldn't fund my compulsive bike-buying/music habit.

[.Andy]

It's interesting to me is that some people (those who can afford it?) choose to pay for private insurance so that they can get better care.
In Australia you don't really get better care with private health insurance. It usually gives you the same level of care - you're largely treated by the same surgeons in the same operating theatres but have nicer wards (i.e. private rooms). Medically this really doesn't add up to better care.

What it allows however, is for more timely care. For example getting your gall-bladder out (non-emergency) is something you can jump on a list to do in the public system for free. It may take six months (usually less) and in that time you have to refrain from eating overly fatty foods (no cheesecake). However you could do it under the private system in a month or so and be back on the fatty food wagon immediately. Private insurance also covers things that the public system doesn't like cosmetic orthodontic treatment, gym memberships, sport shoes, etc etc. It's an adjunct to the public system here, and having private care by no means excludes you from using the public system if you desire. For some things the public system is far better (i.e. emergency and intensive care) and for some things the private is better (i.e. elective surgery).

[skunk]

NHS dentistry is a bit of an arse though.A curious choice of metaphor, to be sure.

[Lyle]

In Australia you don't really get better care with private health insurance. It usually gives you the same level of care - you're largely treated by the same surgeons in the same operating theatres but have nicer wards (i.e. private rooms). Medically this really doesn't add up to better care.

What it allows however, is for more timely care... Private insurance also covers things that the public system doesn't like cosmetic orthodontic treatment, gym memberships, sport shoes, etc etc.Thanks for this information, that makes it a bit more clear. I was having trouble making the leap from "Universal health care is great and everyone receives exactly the same level of care!" to "... but some people choose to pay for private insurance." (i.e. why would you pay extra if there wasn't in fact some difference?)

A related question: In the U.S., for a number of professions, it's expected that your employment benefits will include partial or complete payment of (private) health insurance costs. If I were a senior-level software developer (or some other professional) looking for a job in a country like Australia or the U.K., would employers typically offer private insurance as part of their benefits package or is that not even considered since you have universal coverage?

[Queso]

A related question: In the U.S., for a number of professions, it's expected that your employment benefits will include partial or complete payment of (private) health insurance costs. If I were a senior-level software developer (or some other professional) looking for a job in a country like Australia or the U.K., would employers typically offer private insurance as part of their benefits package or is that not even considered since you have universal coverage?
Most "professional" firms in the UK offer flexible benefits packages. You can choose private health insurance if you want it, have larger pension contributions, or just trade it in for more days holiday. It's up to you.

[Iscariot]

Copays. Do they exist? If so how much are they?

Nope. But if you don't have your provincial health card, a visit will cost you $20 (you can return with your health card within 21ish days for a refund).

waiting for appt. procedures etc..(how much time elapses from time you call for an appt. and the time you are seen ? for me it is within 24 hours.

I have two family doctors, when I visit them my appointment is usually within 30 minutes of the scheduled time. Most of the time I go to a walk in clinic though, where I wait, well, 30 minutes.

Two years ago I went to the doctor complaining about a heart palpitation. I got an EKG one hour later. I've also gotten chest x-rays, arm x-rays, and ultrasounds within 24 hours (usually at my convenience) for non-serious concerns within the past two years.

I have simply never had to wait an unreasonable amount of time for any procedure, and I was in and out of the hospital many times as a youth.

availability of prescriptions: Any problems getting anything filled?

I have only ever had one prescription I couldn't fill at the local pharmacy. I had to go about three subway stops to get that one filled.

Can you see the doctor you WANT to see, or do you see the doctor they TELL you to see?

If I go to see my family doctor(s), then I get to see my family doctor(s). If I go to the clinic, I just go for when my preferred doctor is working (I have his schedule), and I get to see him. I've never had a problem with seeing someone I didn't want to see, or being told I couldn't see who I wanted to see. The only time I've had a different doctor fill in for the one I went to see I was notified via telephone 24 hours beforehand, but I can't tell you if that's standard procedure or just the way my family doctor runs his practice.

Is the same level of coverage available to everyone? Or can those with the means to do so purchase a package that offers a better level of service?

Single tier system, everyone gets the same level of care (without branching into homeopathy, dentistry or cosmetic).

[Abstract]

I'm from the Province of Ontario (Canada), and I've never paid for anything, nor have I ever seen a bill. :) I just show them my Health Card (looks like a driver's licence), and I sit down and wait for the doctor to call me to his office. That's it.


I've never had surgery, but the wait times are long. I don't know how long they are for each treatment (obviously), but it'll depend on what you need. You need to wait a bit for MRIs and such, but the wait times depend on where you live, and the hospitals near your home. I think CT scans can be done rather quickly, but MRIs take a while. Necessary surgery also has a long waiting list, but I guess if the procedure is life-saving, it gets rushed, while procedures that aren't as urgent are at the back of the line (maybe a 6 month wait?)

[iBlue]

I'm in England, we've got the "NHS". It's not bad but it's not great. I still largely prefer it over the way the healthcare system in the US is operated. (I am an american, for the record. I've been in the UK for just over 2 years.)


Copays. Do they exist? If so how much are they?
No co-pays for anything medical but there is in Dentistry, which is mostly private now. (thanks Brown, you numpty!)

waiting for appt. procedures etc..(how much time elapses from time you call for an appt. and the time you are seen ? for me it is within 24 hours.
If it's an outright emergency my GP will fit me in the same day but usually I have to wait a couple days for an appointment.

If you need referrals to specialists or diagnostic tests within the NHS there can sometimes be a considerable wait if it is not deemed life-threatening.

availability of prescriptions: Any problems getting anything filled
No problems or restrictions that I know of. They all cost £6.85 (IIRC) and birth control is free for us girlies.

Can you see the doctor you WANT to see, or do you see the doctor they TELL you to see?
You need to find a local GP according to where you live so your options are often limited. Referrals to whom you see within the NHS are also limited to the GP's prescribing area. Personally I have private insurance through my husband's work so I can see any specialist I please without hassle or waiting, but even with private you do need to stick with your own GP for those referrals..

Is the same level of coverage available to everyone? Or can those with the means to do so purchase a package that offers a better level of service?
The NHS is the NHS and if you want more you can supplement that with private insurance.

[Mord]

I've a fair amount of experience with the NHS and I'm very glad that it's there. It's not perfect but when it comes down to it I don't worry about my health as I know that I'll be taken care of.

That said I was referred for surgery last december and it was all held up due to incompetence at various levels, though it's not time critical surgery so it doesn't matter so much. It's all resolved now mind, but I still have to wait a few months more.

[Abstract]

Interesting read. (http://www.canada.com/calgaryherald/news/story.html?id=8cbaa963-4f63-4a66-b5b8-f704dee13986)

Alberta spends more than any other province on health care, but has a mediocre medical system burdened by long wait times for treatment and a shortage of physicians, according to a new study.

The Frontier Centre for Public Policy, a Winnipeg-based think-tank, released a report Tuesday that ranks Alberta's health system fifth among provinces, citing problems such as poor access to new medications and high infant mortality rates.

Ontario's health system received the best ranking in the study, followed by British Columbia and Nova Scotia. The study authors concluded the best health systems aren't necessarily the most expensive, noting the top three performers were below-average spenders.

[robbieduncan]

Most "professional" firms in the UK offer flexible benefits packages. You can choose private health insurance if you want it, have larger pension contributions, or just trade it in for more days holiday. It's up to you.

I wish. I'd trade the medical coverage for more holidays in a flash but that's not an option (and we do have a so-called flexible benefits package).

[Dagless]

Copays. Do they exist? If so how much are they?
What's a copay yada yada...

waiting for appt. procedures etc..(how much time elapses from time you call for an appt. and the time you are seen ? for me it is within 24 hours.
Less than 24 hours. I live in a busy countryish place but I can ring up the GP's at 8:30am and get an appointment for dinnertime. Last time I needed to go there I rang at 11am, GP at 2pm and at hospital for an xray by 3pm.

availability of prescriptions: Any problems getting anything filled?
Never a problem. If the GP's next door pharmacy doesn't have a certain medication in stock then it's delivered at your door by the hospital.

Can you see the doctor you WANT to see, or do you see the doctor they TELL you to see?
Yup, you can make requests if you want. Just incase you need to see a same sex doc or just fancy one of the others (or the same) :D

Is the same level of coverage available to everyone? Or can those with the means to do so purchase a package that offers a better level of service?
Appears so. I've only been members of 2 different GPs but they were both the same in terms of speed and quality of service.

However if anything serious was up then my family would foot the bill if I needed urgent private care. Had no cause for it yet since the NHS (at least inth' ills) has been very quick for me. I've never waited more than 3 hours in the emergency room (normal time is 25-30 minutes, or instant for a real emergency).

[Unspeaked]

The trouble with this thread is that it's asking very basic questions about universal healthcare.

All the respondents thus far have been relatively healthy and only use their doctors for routine things.

Where these systems break down - and I know this first hand from several family members overseas - is when someone starts to have serious health issues (surgeries and such).

That's when the private insurance that many are referring to comes into play, and that's when you find many folks from abroad coming to the US to have procedures performed.

[scotthayes]

The trouble with this thread is that it's asking very basic questions about universal healthcare.

All the respondents thus far have been relatively healthy and only use their doctors for routine things.

Where these systems break down - and I know this first hand from several family members overseas - is when someone starts to have serious health issues (surgeries and such).

That's when the private insurance that many are referring to comes into play, and that's when you find many folks from abroad coming to the US to have procedures performed.

I disagree. In the UK private medical insurance is nice to 'jump the queue' and get a nice private room. As I said the NHS isn't perfect but it does mean that people do not have to worry if they need surgery, they don't have to worry about paying for it. If I needed surgery, they wouldn't be asking for my insurance details, they would just do it and I wouldn't have to worry about having to pay for any costs afterwards.

People knock our health care system over here but it is there when you need it.

[Queso]

All the respondents thus far have been relatively healthy and only use their doctors for routine things.
In 1994 I had a serious motorcycle accident. In the subsequent three days I had two operations totalling nine hours at the nearest hospital, where I was also kept in for a total for 12 days for after-op observation. Over the next six weeks I attended a different hospital (one of my choosing) for follow-up care before having two courses of physiotherapy weekly over the next sixteen months to get my leg and wrist working again.

Total bill = £0.00

My father also only has two-thirds of a working heart following a series of heart attacks in the mid-90s. He's currently on his second state-provided pacemaker, regularly sees specialists for monitoring and on rare occasions is rushed to hospital when it goes off.

Total bill = £0.00

[GorillaPaws]

Another point to make is that the US or any other country considering universal healthcare can choose to be as similar or as different as other "model" nations as it wants. So if the country thinks that having a small co-pay will discourage unnecessarily frequent visits by hypochondriacs, then it could implement such a system. Also, if the waiting times for elective procedures is too long, then they can invest more money to the causes of these issues (not enough MD's, facilities, etc.).

[Dagless]

In 1994 I had a serious motorcycle accident. In the subsequent three days I had two operations totalling nine hours at the nearest hospital, where I was also kept in for a total for 12 days for after-op observation. Over the next six weeks I attended a different hospital (one of my choosing) for follow-up care before having two courses of physiotherapy weekly over the next sixteen months to get my leg and wrist working again.

Total bill = £0.00

My father also only has two-thirds of a working heart following a series of heart attacks in the mid-90s. He's currently on his second state-provided pacemaker, regularly sees specialists for monitoring and on rare occasions is rushed to hospital when it goes off.

Total bill = £0.00

I had no idea about any of that :o

I've bashed my head open 3 times, my bro has broken his arm twice, sister bashed her head open once. Mother and grandmother needed some eye surgery, other grandparent needed a hip replacement. Throw in some stomach cancer, glaucoma [sp?] and an impalement. All for a sum total of... £0!
But that's a lie since I had to pay for a bus home once, so lets say £1.20.

Pops had a knee op recently but it was private, private healthcare plan from his employer. Probably cost a good few thousand!

[Iscariot]

The trouble with this thread is that it's asking very basic questions about universal healthcare.

All the respondents thus far have been relatively healthy and only use their doctors for routine things.

Where these systems break down - and I know this first hand from several family members overseas - is when someone starts to have serious health issues (surgeries and such).

That's when the private insurance that many are referring to comes into play, and that's when you find many folks from abroad coming to the US to have procedures performed.

I had pyloric stenosis. I was treated immediately. This required fairly major surgery to correct.

My dad fractured his skull. He was treated immediately for that. He's also had both of his knees replaced with minimal wait time.

My grandfather had a heart attack and required a triple bypass — which he got immediately. Also had the same knee replacement surgeries as my dad.

My grandmother had lung cancer and required chemo, which she got immediately.

My (other) grandfather had skin cancer and liver cancer, which has required chemo and surgeries, all of which he got immediately.

[skunk]

<endless list of major ailments>You're a pretty high-maintenance lot, aren't you? :)

[Iscariot]

You're a pretty high-maintenance lot, aren't you? :)

Yeah, there's a long family history of medical problems. IIRC, only one family member has made it to life expectancy in the past 30 years. It's lifestyle related.

They've all bequeathed their extra years to me, though, which is why I'll live forever.

[iJohnHenry]

Oh, and now for the pièce de résistance, the Ontario Drug Benefit (ODB, but not Old Dirty Bastard).

Pay your $20 deductible once a year, and get 80% of your Rx covered.

Over 65 years of age only, please. :D

[miloblithe]

That's when the private insurance that many are referring to comes into play, and that's when you find many folks from abroad coming to the US to have procedures performed.

On the other hand, many Americans seek healthcare abroad. It's apparently difficult to find good statistics.

This source estimates that the number of U.S. citizens seeking healthcare abroad was 150,000 in 2006 and rapidly growing.

http://www.patientsbeyondborders.com/media-room/faq.php

This source says 500,000 in 2005.

http://news.globehealthtours.com/category/medical-tourism-statistics/

Here's an article in Forbes about it:

http://news.globehealthtours.com/category/medical-tourism-statistics/

Some U.S. employers, concerned about rising health care costs, are using financial incentives to encourage employees to experiment with medical tourism. This is an especially common practice at large firms that self-insure and pay directly for their employees' medical expenses.

On the other hand, wealthy foreigners do seek care in the U.S.

http://www.forbes.com/2008/05/25/health-hospitals-care-forbeslife-cx_avd_outsourcing08_0529healthoutsourcing.html

This article states that more foreigners seek care in the U.S. than do U.S. citizens seek care abroad, but that seems to be achieved by cooking the numbers a little:

...It narrowly defined medical travelers as only those whose primary and explicit purpose in traveling was to obtain in-patient medical treatment in a foreign country, putting the total number of travelers at 60,000 to 85,000 per year.

60-85,000 seems to be a lot less than the numbers above.

[Abstract]

This article states that more foreigners seek care in the U.S. than do U.S. citizens seek care abroad, but that seems to be achieved by cooking the numbers a little:


How can they leave if most of them don't have a passport? ;)


Lots of people are flying to Asia for cheaper surgery, both necessary and cosmetic, so I'm not sure if what you said is accurate.

[Topher15]

I've read that if you decide to go private the the NHS will actually give you in cash the cost of the treatment it would have cost them. Not sure if that has been implemented however they were talking about it.

Does your form of healthcare cover dentists, orthrodontists, etc?
Yes. I had three years orthodontic treatment plus surgery without any cost.



It's clear from this thread that people in countries with universal healthcare prefer it, despite the problems it can have, such as queues, bureaucracy, etc. The fact is all health care is rationed, either by clinical need (emergencies get imitate attention whereas you must wait for elective procedures) or by cost (either whether you can afford it, or whether the insurance company are willing to pay for it.) Both have their pros and cons.

To be honest I'd rather die in a queue waiting for surgery than die because I would not afford it. And I like the fact that my tax contribution for the NHS actually goes to help others through the service rather than some suites in a HMO.

It's interesting to me is that some people (those who can afford it?) choose to pay for private insurance so that they can get better care.
Well there is no doubt private healthcare is better. In my view the best healthcare systems are those which include both options: a certain standard of universal healthcare (which I regard as a right) and a private system which people can choose to use if they can afford it or it their employer covers it, rather than being forced into an expensive insurance system which does not have clinical need as a fundamental principle.

If I needed surgery, they wouldn't be asking for my insurance details, they would just do it and I wouldn't have to worry about having to pay for any costs afterwards.
Ditto. Who the heck wants their doctor calling someone in a cubical asking for permission to perform a procedure!

The trouble with this thread is that it's asking very basic questions about universal healthcare.

All the respondents thus far have been relatively healthy and only use their doctors for routine things.

Where these systems break down - and I know this first hand from several family members overseas - is when someone starts to have serious health issues (surgeries and such).

That's when the private insurance that many are referring to comes into play, and that's when you find many folks from abroad coming to the US to have procedures performed.
I'm sure you'll hear the occasional disaster story--they do happen--but overall the system is good. I'm sure someone will naturally be critical of the NHS if things did not go well for them but from an objective assessment that is not the rule.

[hulugu]

I had no idea about any of that :o

I've bashed my head open 3 times, my bro has broken his arm twice, sister bashed her head open once. Mother and grandmother needed some eye surgery, other grandparent needed a hip replacement.....and an impalement.

Apparently family dinners are a full-contact sport around the 'jimmi household.
;)

[cleanup]

I'm covered by the provincial government of Ontario and my university. I'm living on my own and don't have a GP, but visiting a walk-in clinic and getting treatment takes a couple to a few hours, max. Any medication or drugs I am prescribed in the process is immediately filled, either at the walk-in clinic's pharmacy or elsewhere. I can go to one of the many walk-in clinics scattered downtown, or visit the university health clinic on campus, which is essentially the same thing. There's maybe 6+ hospitals within a 20 minute walk, for my particular location. And any and all of them would treat me if I needed it.

Years ago I was in a biking accident and broke my jaw and shattered four teeth. I was operated on that night. I stayed in the hospital for a week, got plenty of pain medication, and went home. Obviously from this point, any surgery I require is cosmetic, and as such my previous orthodontist is well paid, but that night I crashed my bike, and that week I was in the hospital, was completely paid for.

You really can't ask for much else. They give you exactly what you need as soon as you need it. That's much more than the US healthcare system can say.

[GorillaPaws]

They give you exactly what you need as soon as you need it. That's much more than the US healthcare system can say.

Actually, that's not completely true. My father's a general and vascular surgeon and I can't tell you how many times he's been on call and had to go in to the ER at 3AM to operate on someone with no insurance and never see a dime from it.

[jplan2008]

Actually, that's not completely true. My father's a general and vascular surgeon and I can't tell you how many times he's been on call and had to go in to the ER at 3AM to operate on someone with no insurance and never see a dime from it.

Yes, we have universal healthcare in the U.S. for emergency rooms. The usual shortsightedness. Usually it would cost less to treat people before they end up in the ER. And then the hospital discharges them the second it's not life-threatening, but maybe sooner than someone with insurance, and they're back in the ER for more costly treatment. We can't quite bring ourselves to openly deny someone emergency treatment at an ER (although that also happens), but don't acknowledge it's no better to let people get that sick to begin with. And the people who have some funds, but for some reason can't get health insurance, lose everything. And of course, if someone needs a procedure like a transplant, they usually won't get that without insurance.

[Scarlet Fever]

I had a car crash last december, in which I fractured my kneecap. Because my injuries were sustained in a motor accident, the TAC (Transport Accident Commission) paid for everything. They organised for me to have surgery that night, they paid for the X-rays and MRI scans I had, they paid for the crutches and brace, and they've paid for me to have physio and gym sessions once a week for the last 9 month. On top of all that, they paid me 80% of my wages when I was out of work due to my injuries, which was around $3,000.

I reckon our system works :D

[iBlue]

The trouble with this thread is that it's asking very basic questions about universal healthcare.

All the respondents thus far have been relatively healthy and only use their doctors for routine things.

Where these systems break down - and I know this first hand from several family members overseas - is when someone starts to have serious health issues (surgeries and such).

That's when the private insurance that many are referring to comes into play, and that's when you find many folks from abroad coming to the US to have procedures performed.
Really? Are you sure about that? Because I see I am not the only respondent to have had serious medical complaints. I did not go back to the US to sort it out either. When I was unwilling to wait for tests I went with my private insurance though, which suited me fine. I might not have been completely thrilled with the way the NHS handled my case but I understood why it was handled as such.

Regardless of healthcare being universal or private there are always hoops to jump through; the medical field is one of bureaucracy. There are also always going to be people who have been failed or disappointed. I was one of those but I know plenty who have had no problems whatsoever. I just had a particularly complicated and mysterious problem and I didn't voice my concerns loud enough.

Like I said, I've had it both ways. I am an american living in the UK and I actually prefer the system here over what you have to deal with in the US… just for the record.

[skunk]

Like I said, I've had it both ways. I am an american living in the UK and I actually prefer the system here over what you have to deal with in the US… just for the record.You can come again. :) "Having it both ways", you probably will...

__________


For myself, my son was taken ill at three years old, was seen immediately, medicated, followed up, spent six months in Great Ormond Street Children's Hospital under one of the foremost experts in hydrocephalus, was fitted with a ventricular-peritoneal shunt, was looked after on many occasions at our local hospital, had CT scans, MRI, a lifetime supply of anti-convulsive drugs, had all his equipment (oxygen, special bed, suction machine, splints, catheters, and finally a specially-adapted wheelchair) supplied, visits from the district nurse and overnight respite care at the local hospital once a week, besides additional care during severe epileptic episodes, three bouts of pneumonia, four strokes and a major spiral leg fracture. His care lasted for nine years. Total cost? ZERO.

Is that major enough for you, unspeaked?

[djellison]

Where these systems break down - and I know this first hand from several family members overseas - is when someone starts to have serious health issues (surgeries and such)..

Well - I had surgery twice when I was a kid. I don't remember the first - and I have only excellent memories of the second. (they mainly involved getting lots of Lego, and attention from lovely nurses)

My mother, however, has been in and out of hospital dozens of times, often for major abdom. surgery. I think 14 weeks was her record stay. Cheltenham, Bath, Birmingham, the Middlesex in London, lots of different hospitals - and I've been impressed with them all.

Now I work in a company attached to the NHS indirectly ( medical education ) I spend a lot of time in wards, clinics and theatres doing filming. And I still remain impressed by what we're able to offer every single person in the UK. Nurses are just brilliant. A plaster technician who can do a back-slab on an arm faster than you can say back-slab. The busiest A&E in the entire country ( Leicester ) with doctors who can, in a second, identify who needs help and who doesn't. The talent, the resilience, it's astonishing.

I think everyone should get an invite into an operating theatre and a ward once or twice, just to see the work that happens, and the money involved. You know those drug pumps that go 'BING BING BONG' that lots of people have on wards? Theyre >£3k a piece. Instruments for laproscopic surgery -, 2, 3, £400 each. New Laproscopic optics trolley - £20k. A new suite of 4 ENT consulting rooms - about £250k.

That I can have access to any of that, as and when I need it, for what it costs me out of my wages - it's remarkable.

One thing that really REALLY pisses me off - is crappy patients. I was on a post-op Knee replacement ward. Everyone was happy, everyone was enjoying their new knees, everyone was laughing at the guy with the camera and joking about their scars getting an oscar. Apart from one grumpy demanding cow up in the corner. Moaning she was in pain despite having the full whack of medication. Moaning she wasn't getting the attention she needed despite the consultant leaving his pre-op assesment clinic to go and check on her. Moaning about the noise ( there wasn't any ). I felt like screaming at her.

Then there's the case of a close family friend who is a GP up north. He tells of the day he was doing his rounds one afternoon, including a call to a young boy who's mum had phoned in desperate for the doctor to come that afternoon. He arrived, went in - and what did the parent say
"See - I told you I'd call the doctor if you didn't start behaving"
There was nothing wrong with the kid...apart from a moronic mother.

Or the women who wasted the emergency services time, phoning 999 (UK equiv to 911 ) to complain that the rabbit she had bought from a small-ads advert didn't have floppy ears.

The NHS get's abused by patients, it gets abuse from the media. But frankly - what it provides is astonishing. Between patients on the list in a theatre one morning, the surgeon and I were chatting away in the corner while I changed tapes on my camera. He had a mac (good man) and we were looking at his holiday photos. I saw his car...lovely thing...very expensive..I could only dream of it. But you know what? 7 years of med school, 20 years of 50-60 hour weeks. He deserves it.

[smwatson]

Big long really good thing.

Top post.

My dad's a GP, and he spent years training and even more years working to get to where he is. He also moved from Edinburgh to crappy Cheshire for work, sacrificing the potential to repeat the finest moment in his entire life (police escort across Forth Bridge on emergency call-out :p).

Despite the newest round of GP contracts not being particularly kind to him, and new infrastructures messing up how he used to treat patients (complicated, I don't get him, you'd have to ask someone who wasn't stupid ;)) he's still working for the NHS. The NHS is GOOD. Very good. People take it for granted, when the fact is you get world-class healthcare for very little expenditure.

And you never have to find out what a copay is. Bonus.

[Dagless]

Apparently family dinners are a full-contact sport around the 'jimmi household.
;)
:D
But thankfully there's nothing serious in the family. All my grandparents are banging on into their mid-80's and still very active. Just gotta be careful about crossing roads is all :D
The impalement was nasty. My bro was playing cricket on a public field and the ball had gone into the nursery school grounds. Rather than walking around and using the gate he climbed over the claw tipped fence and dropped. Was walking the dog at the time, on the way back spotted a trail of blood leading back to the house and there was an ambulance.
Unlucky sod. Got one hell of an awesome scar though.

I've read that if you decide to go private the the NHS will actually give you in cash the cost of the treatment it would have cost them. Not sure if that has been implemented however they were talking about it.

I'm not sure on this, but I caught the tail end of a Lib Dem party advert last night that said it's something they want to bring in. That if you needed to go private the NHS would foot the bill.

[.Andy]

The trouble with this thread is that it's asking very basic questions about universal healthcare.

All the respondents thus far have been relatively healthy and only use their doctors for routine things.

Where these systems break down - and I know this first hand from several family members overseas - is when someone starts to have serious health issues (surgeries and such).

That's when the private insurance that many are referring to comes into play, and that's when you find many folks from abroad coming to the US to have procedures performed.
You've got it wrong. Universal health care works very well for people with serious and urgent health problems. Where private insurance arguably works more effectively is for non-serious and non-urgent health problems. Under universal health care you have to wait in line for elective surgeries and non-urgent treatments, often for months. The urgent/non-elective cases get seen first, as it should be.

[leekohler]

Is that major enough for you, unspeaked?

I wouldn't expect him to answer any time soon. ;).

[Unspeaked]

I wouldn't expect him to answer any time soon. ;).

And why not?

:)

I see the last page of this thread basically became one huge reply to my statement. Though it's nice to see so many stories about cases where universal healthcare (though primarily NHS, since nearly everyone who replied was in the UK) worked great for serious issues, it would be nice to see some hard data on this. Granted, I will readily admit I provided no such data myself, but I'm not convinced I was right, either.

Maybe I'm in the minority, but I have seen both European universal healthcare and privatized US healthcare in action - and have both options readily available to me - and can think of no case I would not choose the former.

Again, though - I would sincerely love to see more data comparing the two. The links posted earlier regarding US citizens seeking treatment abroad and non-US citizens getting treatment here were particularly interesting.

[jplan2008]

Here's one overview of some studies of wait times in Canada. http://www.amsa.org/studytours/WaitingTimes_primer.pdf Wait times are generally longer in Canada than in the U.S., but generally people tend to over-report the wait time.

One study looked at idea of Canadians coming to the U.S. for healthcare.

From 1994 to 1998, 2,031 Canadians were admitted to hospitals in Michigan, 1,689 to
hospitals in New York, and 825 to hospitals in Washington. During this period, these
hospitalizations represented only 0.23% of all the hospitalizations that occurred in the
three provinces bordering these states.

In sum, the number of Canadians receiving care in the U.S. appears to be
extremely low compared to the amount of care that Canadians receive in Canada. There does exist a group of Canadians who come to America 1) To receive therapies not approved in Canada;
2) To avoid long waiting lines; and 3) Because of limited capacity in Canada in certain technologies. However, these Canadians are by far the exception, not the rule. The idea that Canadians flock to the U.S. specifically for healthcare loses even further legitimacy when one considers that the number of Canadians treated in the U.S. does not just include people who specifically go to the U.S. for healthcare; it also includes care given to
Canadians traveling in the U.S., Canadians working in the U.S. on business travel, and Canadians who move to the U.S. during the winter to avoid the cold ("snowbirds"). Finally, in some rural areas of Canada, it is more convenient to go to the U.S. than to travel long distances to healthcare
facilities due to simple proximity [14].


But, these seem like made-up issues. Shouldn't we be more concerned with the outcomes of the systems? Who is healthier and lives longer? I haven't seen any study that shows that the U.S. system is actually better at producing a healthier population, and actually is not even at the median for industrialized countries.

Here is one of numerous studies. http://www.oecd.org/dataoecd/29/52/36960035.pdf

Compared healthcare in OECD countries (generally Europe, Japan, Korea, U.S., Mexico, see list here http://www.oecd.org/countrieslist/0,3351,en_33873108_33844430_1_1_1_1_1,00.html).

1. The U.S. spends most per capita of any of the countries, no surprise there.
2. The U.s. has less than average (for these countries) number of hospital beds, doctors, nurses.
3. The U.S. has had a lower gain in life expectancy and smaller decline in infant mortality than many of the other countries.

Also, the U.S. has the third lowest level of smoking (after Canada and Sweden) -- the only positive -- and the highest obesity rate -- no surprise there, either, but obesity is increasing everywhere.

Total health spending accounted for 15.3% of GDP in the United States in 2004, the highest share in the OECD and more than six percentage points higher than the average of 8.9% in OECD countries. By comparison, Switzerland and Germany allocated 11.6% and 10.9% of their GDP to health, respectively, and France 10.5%.

Despite the relatively high level of health expenditure in the United States, there are fewer physicians per capita than in most other OECD countries. In 2004, the United States had 2.4 practising physicians per 1 000 population, below the OECD average of 3.0.

There were 7.9 nurses per 1 000 population in the United States in 2002, which is slightly lower than the average of 8.3 across OECD countries.

The number of acute care hospital beds in the United States in 2004 was 2.8 per 1 000 population, also lower than the OECD average of 4.1 beds per 1 000 population. As in most OECD countries, the number of hospital beds per capita has fallen over the past twenty-five years, from 4.4 beds per 1 000 population in 1980 to 2.8 in 2004. This decline has coincided with a reduction in average length of stays in hospitals and an increase in day-surgery patients.

Most OECD countries have enjoyed large gains in life expectancy over the past 40 years. In the United States, life expectancy at birth increased by 7.6 years between 1960 and 2003, which is less than the increase of over 14 years in Japan, or 8.6 years in Canada. In 2003/4, life expectancy in the United States stood at 77.5 years, below the OECD average of 78.3 years. Japan, Iceland, Switzerland, Sweden and Australia were the 5 countries registering the highest life expectancy.

Infant mortality rates in the United States have fallen greatly over the past few decades, but not as much as in most other OECD countries. It stood at 6.9 deaths per 1 000 live births in 2003, above the OECD average of 5.7.1 Among OECD countries, infant mortality is the lowest in Japan and in the Nordic countries (Iceland, Sweden, Norway and Finland), with rates all below 3.5 deaths per 1 000 live births.

[scotthayes]

And why not?

:)

I see the last page of this thread basically became one huge reply to my statement. Though it's nice to see so many stories about cases where universal healthcare (though primarily NHS, since nearly everyone who replied was in the UK) worked great for serious issues, it would be nice to see some hard data on this. Granted, I will readily admit I provided no such data myself, but I'm not convinced I was right, either.

Maybe I'm in the minority, but I have seen both European universal healthcare and privatized US healthcare in action - and have both options readily available to me - and can think of no case I would not choose the former.

Again, though - I would sincerely love to see more data comparing the two. The links posted earlier regarding US citizens seeking treatment abroad and non-US citizens getting treatment here were particularly interesting.


The data means nothing when you are in the A&E or facing major surgery. As many have said, the NHS isn't perfect but I'd never want to live in a country where there isn't universal health care.

[Ntombi]

And why not?

:)

I see the last page of this thread basically became one huge reply to my statement. Though it's nice to see so many stories about cases where universal healthcare (though primarily NHS, since nearly everyone who replied was in the UK) worked great for serious issues, it would be nice to see some hard data on this. Granted, I will readily admit I provided no such data myself, but I'm not convinced I was right, either.

Maybe I'm in the minority, but I have seen both European universal healthcare and privatized US healthcare in action - and have both options readily available to me - and can think of no case I would not choose the former.*snip*
And therein lies the rub: everyone in the U.S. is not as lucky as you. Some have a choice between the emergency room and nothing. I have been a proponent of universal health care, but I didn't have a clue it would become so personal an issue for me.

I was one of the lucky ones. Worked from the age of 9, had great insurance through my parents and then myself, and even though I had numerous health issues (car accidents, minor surgeries, sports injuries, asthma, allergies, etc.), it wasn't a big deal.

Until I got sick, couldn't work, and lost my savings and my health insurance.

After two years of being too sick to work (and no coverage for all the tests I needed), I still didn't have a proper diagnosis until I was admitted to the hospital on an emergency basis. Suddenly, after not being able to get those tests, I'm getting them all over the course of a week (plus staying in the hospital and racking up the bill by the hour). Now that I have a diagnosis (MS and some other things), I'm still dealing with the financial fallout of that time. Not to mention the fact that there are some health issues that became more serious because I couldn't get seen.

There does exist a safety net in this country for emergencies, but for chronic or non-emergent cases (that often turn into a more expensive emergency sooner or later), there are few, if any, options.

Unspeaked, I'd like to hear your solution. Or do you not believe there's a problem?

[skunk]

Maybe I'm in the minority, but I have seen both European universal healthcare and privatized US healthcare in action - and have both options readily available to me - and can think of no case I would not choose the former.Is this what you meant to say? :confused:

[Peterkro]

Unspeaked if you were visiting the UK and experienced a life threatening and complicated problem all the insurance in the world won't help you only the NHS has the skills and expertise to deal with such a situation. It is a fairly regular event for patients to be quickly transferred from a private hospital to a NHS one when some medic or other goofs and serious facilities and staff are required.

[Unspeaked]

Unspeaked, I'd like to hear your solution. Or do you not believe there's a problem?

There's obviously a problem with health care in the US, I'm not denying that.

All I can do is offer my own experience - as several have done in regard to NHS - and say that the system has worked well for me.

I've even welcomes more info so I can learn more about the subject.


Is this what you meant to say? :confused:

Woops, I didn't mean that. One too many words, I think.


Unspeaked if you were visiting the UK and experienced a life threatening and complicated problem all the insurance in the world won't help you only the NHS has the skills and expertise to deal with such a situation. It is a fairly regular event for patients to be quickly transferred from a private hospital to a NHS one when some medic or other goofs and serious facilities and staff are required.

Of course, but that's like saying if you were in the US and experienced a life threatening and complicated problem, the NHS won't be able to help you. I don't see your point?

[Peterkro]

Of course, but that's like saying if you were in the US and experienced a life threatening and complicated problem, the NHS won't be able to help you. I don't see your point?

The point I was trying to make and none too clearly :), is that there exists a private medical industry in the UK that makes a lot of money selling itself as better than the NHS whereas the reality is for anything complicated it doesn't have the resources to deal with it and promptly dumps the problem on the NHS,it also cherry picks wealthy clients for it's insurance schemes, if the working class tried to take out private health insurance in any numbers they would go bust pronto,not of course they would let that happen.

[Unspeaked]

The point I was trying to make and none too clearly :), is that there exists a private medical industry in the UK that makes a lot of money selling itself as better than the NHS whereas the reality is for anything complicated it doesn't have the resources to deal with it and promptly dumps the problem on the NHS,it also cherry picks wealthy clients for it's insurance schemes, if the working class tried to take out private health insurance in any numbers they would go bust pronto,not of course they would let that happen.

Ah, ok, now that makes sense.

And that's something I did not know about private health insurance overseas.

So what exactly does this "extra" insurance buy the wealthy, then?

[BoyBach]

So what exactly does this "extra" insurance buy the wealthy, then?


Something to talk about at their dinner parties.

[Cromulent]

So what exactly does this "extra" insurance buy the wealthy, then?

Fewer patients on a ward or maybe even a personal room. More pampering but bugger all else when it comes to health care, except maybe quicker surgery wait times for non serious operations (such as hernias etc).

[.Andy]

So what exactly does this "extra" insurance buy the wealthy, then?
Read the thread. This was asked and answered at length on page 1.

[Unspeaked]

Read the thread. This was asked and answered at length on page 1.

The only person who described it as anymore than simply speeding things up and avoiding lines on Page 1 was you, and since my question was a direct reply to Peterko about the NHS, I didn't think your observation on Australian health care was closely tied.

[.Andy]

The only person who described it as anymore than simply speeding things up and avoiding lines on Page 1 was you, and since my question was a direct reply to Peterko about the NHS, I didn't think your observation on Australian health care was closely tied.
Fair enough. Let's clear up the ambiguity in this post of yours to clarify things;

The trouble with this thread is that it's asking very basic questions about universal healthcare.

All the respondents thus far have been relatively healthy and only use their doctors for routine things.

Where these systems break down - and I know this first hand from several family members overseas - is when someone starts to have serious health issues (surgeries and such).

That's when the private insurance that many are referring to comes into play, and that's when you find many folks from abroad coming to the US to have procedures performed.
Which countries were you referring to exactly and what serious conditions 'surgeries and such' did they have to travel to be treated for?

[Iscariot]

it would be nice to see some hard data on this.

"The World Health Organization (WHO) in 2000 ranked the U.S. health care system first in both responsiveness and expenditure, but 37th in overall performance and 72nd by overall level of health (among 191 member nations included in the study)."

Comparing the US to the UK or Canada in a number of statistics from cancer deaths (per capita) to available hospital beds to life expectancy reveals results in favour of the UK or Canada, and usually both.

[SMM]

I know you said 'no Americans', but I am posting anyway. I have some personal experience with the UK NHS.

In 1993, my wife and I were on a ~6 week holiday to the UK. We took the non-stop, polar route from Seattle to Heathrow. British Airways has very nice seats and service, so the flight was long, but comfortable. I had been in an auto accident a couple years earlier and suffered a neck injury in the C3 area. It took 18 months to finally calm the symptoms down so that I felt reasonable comfortable again. At the time we left for the UK, I was only having infrequent flare-ups, lasting 2-3 days. I had a large horde of Percocet for those times, but seldom needed them. I did take a few on the trip 'in case'. To cut to the end, my neck was not ready for a 12 hour flight (or whatever it was). It quickly seized up after we landed.

Our first week we were in a B&B near Bath. By the time we headed out for the Wye River Valley, I had used all the medicine I had brought. I cursed, knowing I had nearly 100 sitting at home. I asked the landlord's wife (nurse) where a doctor's office was. She gave me directions to the 'surgery' at Ross, the nearest city, which was fairly close. She told me I did not need an appointment. So, the next morning I made the trip there. Everyone was incredibly kind and helpful. They got me in to see the doctor in very short order, less that half-an-hour I seem to recall.

While I was waiting to be called, I had a look around. I was immediately struck by, and totally impressed by how much emphasis they paid to preventative care and citizen health education. Every wall seemed to have a large display of information, ranging from non-smoking, substance abuse, issues related to exercise, pre-natal care, etc. There were numerous large calendars also. They had classes for most of these, which were listed on the calendars. While I was waiting, someone came in announced a class was ready to begin. To my surprise, a large number of people got up and began heading in that direction. The people were actually participating in good health education/preventative care. How unlike the US I know.

When I saw the doctor, he very friendly. I explained the situation and showed him by prescription bottle (now empty). Many medicines have different names in the UK and he did not recognize mine. He looked in a cross-reference manual without any success. Then he called someone and said he needed info on an American medicine. While we waited, he told me that he had spent some time in Seattle a few years earlier. He really loved it there, and we remained engrossed in good conversation until he received a reply. I heard the doctor's part of the conversation, which was a series of 'right''s and finally thanks.

They did not have the exact formula for Percocet, but did have a generic equivalent. He said it looked like I was taking 2, every 4-6 hours, so about 8 per day. I confirmed and he wrote me a an order for 8 a day for 40 days. He said, he thought I would benefit from a deep-tissue massage and if I would be interested? He could get me in the next AM. That was done and I filled the prescription at a nearby chemist.

The entire cost to me was zero, 0, nadda, zilch. They explained, there is a small fee built into the VAT, B&B rates, and one more thing (do not recall). So, foreign travelers were covered the same as regular citizens. The doctor told me, even if I had an emergency need for heart surgery, it would be covered 100%.

I was totally impressed by the entire experience and thought back to my experiences in the US. What a difference. The UK system is clearly superior to ours, in my opinion. I would vote to change it in a heartbeat. Right now, I have end stage-liver failure (Hep C). I will not bore you with the details, but it has exposed the very worse in our health care system.

[és:]

Thanks for posting that, SMM. I'm glad you've had a good experience.

Our healthcare isn't even the best example of socialised medicine. France, Sweden and places like that are rated as the best healthcare in the world and go even further to make everything perfect.

Not every country runs the system perfectly, but the system itself is very good. I would never live in a country like the USA where they make such a massive profit out of the patient and the drugs sold to the patients. There would be a riot if they tried to take the NHS away from us.

[iBlue]

Excellent and interesting post, SMM. Thanks for posting it.

The point I was trying to make and none too clearly :), is that there exists a private medical industry in the UK that makes a lot of money selling itself as better than the NHS whereas the reality is for anything complicated it doesn't have the resources to deal with it and promptly dumps the problem on the NHS,it also cherry picks wealthy clients for it's insurance schemes, if the working class tried to take out private health insurance in any numbers they would go bust pronto,not of course they would let that happen.

:confused: My "working class" husband and I have private insurance through his work, and while I know it's an exceptionally good policy, I am honestly not sure what you are on about here. They've been nothing but helpful and have, without hesitation or quibbling, covered extensive and expensive tests to figure out WTF was/is going on with me. Things including a few different specialists, exploratory surgery, numerous blood tests and scans, including ultrasounds and putting cameras in uncomfortable places, and MRIs and other ungodly expensive medical things. I was not passed back to the NHS even when things were uncertain and complicated. They just kept on.

Maybe I'm just a part of the purported low numbers of working class people with private coverage and maybe if there were more of us things would be crappier, but as it stands right now, I have no complaints whatosever about any of it. Between the NHS and private coverage, I feel totally at ease about my medical care. That's something I never felt in the US, with constant fear of losing medical insurance and being completely screwed over by that. (something I've also had experience with).

I'm not trying to be argumentative, but I am trying to understand what you are getting at.

[és:]

being completely screwed over by that. (something I've also had experience with).


After watching Sicko, I thought that the number of people with insurance that are turned away might have been exaggerated. However, I hear it more and more.

It's a real shame that insurance companies in the US actually employ people to try and get out of paying insurance.

[robbieduncan]

:confused: My "working class" husband and I have private insurance through his work,

With the best will in the world, and not wanting to start an argument, e may have once been working class, but I don't think his current role would allow him to stay there. The pair of you are now firmly in the middle classes...

[Queso]

With the best will in the world, and not wanting to start an argument, e may have once been working class, but I don't think his current role would allow him to stay there. The pair of you are now firmly in the middle classes...
There's virtually no line between the working and middle class these days. It's the benefit class that have become the bottom rung of our particular caste system. Everyone else has the ability to own their home, run their own business, get their children to university etc.

I suggest a new definition. Wordle class has a nice ring to it :)

[iBlue]

After watching Sicko, I thought that the number of people with insurance that are turned away might have been exaggerated. However, I hear it more and more.

It's a real shame that insurance companies in the US actually employ people to try and get out of paying insurance.
I had never been turned away in the US when I was uninsured but I have had to pay MASSIVE hospital bills when I had no choice but to seek medical care. There were plenty of times where I just had to deal with health concerns alone because there was the constant "god, can I afford to get help?" worry. It's ridiculous that a nation that boasts itself as being so civilised has such an uncivilised way of treating its people.

With the best will in the world, and not wanting to start an argument, e may have once been working class, but I don't think his current role would allow him to stay there. The pair of you are now firmly in the middle classes...

Is there a difference these days? Seems the line between the rich and the rest grows larger by the millisecond.

edit: haha, yeah, what Queso said.

[Peterkro]

Excellent and interesting post, SMM. Thanks for posting it.



:confused: My "working class" husband and I have private insurance through his work, and while I know it's an exceptionally good policy, I am honestly not sure what you are on about here. They've been nothing but helpful and have, without hesitation or quibbling, covered extensive and expensive tests to figure out WTF was/is going on with me. Things including a few different specialists, exploratory surgery, numerous blood tests and scans, including ultrasounds and putting cameras in uncomfortable places, and MRIs and other ungodly expensive medical things. I was not passed back to the NHS even when things were uncertain and complicated. They just kept on.

Maybe I'm just a part of the purported low numbers of working class people with private coverage and maybe if there were more of us things would be crappier, but as it stands right now, I have no complaints whatosever about any of it. Between the NHS and private coverage, I feel totally at ease about my medical care. That's something I never felt in the US, with constant fear of losing medical insurance and being completely screwed over by that. (something I've also had experience with).

I'm not trying to be argumentative, but I am trying to understand what you are getting at.

I was kind of expecting that :). I'm not having a go at ordinary people who have health insurance and who it works well for,but pointing out that given the relationship between poverty and health problems BUPA et al definitely don't want the great unwashed joining up in large numbers. As you no doubt know the restriction on getting insurance with pre-existing conditions are draconian at best,for instance there is no way in the world they would accept me (Hep C even though I'm cured ). The dumping of cases on the NHS I was referring to involves emergency procedures that private hospitals don't have the facilities for. The truth is that most of the specialists operating in private medicine in the UK are the same people who operate in the NHS and quite a lot of equipment used is either hired from the NHS or shared with them. I fully understand that some people may want to take advantage of the speed of treatment offered by private medicine which is fine but to think they could offer a alternative to the NHS for large numbers of people is a non-starter. I have quite close connections with people who work both for the NHS and private medicine and am fairly aware of the problems both face (neither is by any means perfect), which means I'm fully aware of the amount of cherry picking that goes on.

[annk]

Copays. Do they exist? If so how much are they?

There's a very small fee per visit. About the equivalent of 30 USD, and it's important to remember that in Norwegian terms, that's a smaller amount of money than it would be in the US.

waiting for appt. procedures etc..(how much time elapses from time you call for an appt. and the time you are seen ? for me it is within 24 hours.Varies.To see a doctor for a regular office call CAN happen the same day, but it can also be a couple weeks' wait. For a procedure at a hospital you can easily wait several months, or even a couple years.

availability of prescriptions: Any problems getting anything filled?Prescriptions aren't covered until you spend about 380 USD. Then they're free for the rest of the year. The next year, you start over again. Medicine for chronic conditions is given on a special kind of system, and while you still have to pay for it until you reach the 380 - limit, it's subsidised to a certain extent.

Can you see the doctor you WANT to see, or do you see the doctor they TELL you to see?We all have to choose a primary physician, who is required to have a sub if s/he isn't in. It's possible to change your primary physician up to once a year, I think. When you're referred to a specialist, you can sometimes choose, or at least you're given a list of options. For hospital procedures, you generally are referred to the hospital your doctor suggests (based on which hospital has the central expertise in that area of medicine in the country), but technically you are allowed to choose.

Is the same level of coverage available to everyone? Or can those with the means to do so purchase a package that offers a better level of service?The same coverage is available to everyone, but those who want faster service and who can afford it, can go to a private doctor or hospital.

Some examples from my own life: I was for example told that my son would have to wait two years to have his tonsils removed, despite the fact that the doctor felt they were giving him health problems. A colleague of mine waited two years for a hernia operation. My son recently needed a fairly routine procedure done (outpatient), and because it would have taken 11 months in the official queue, we chose to go to a private clinic.

[iBlue]

I was kind of expecting that :). I'm not having a go at ordinary people who have health insurance and who it works well for,but pointing out that given the relationship between poverty and health problems BUPA et al definitely don't want the great unwashed joining up in large numbers. As you no doubt know the restriction on getting insurance with pre-existing conditions are draconian at best,for instance there is no way in the world they would accept me (Hep C even though I'm cured ). The dumping of cases on the NHS I was referring to involves emergency procedures that private hospitals don't have the facilities for. The truth is that most of the specialists operating in private medicine in the UK are the same people who operate in the NHS and quite a lot of equipment used is either hired from the NHS or shared with them. I fully understand that some people may want to take advantage of the speed of treatment offered by private medicine which is fine but to think they could offer a alternative to the NHS for large numbers of people is a non-starter. I have quite close connections with people who work both for the NHS and private medicine and am fairly aware of the problems both face (neither is by any means perfect), which means I'm fully aware of the amount of cherry picking that goes on.
I can see how that may happen, emergency cases being put on the NHS but I don't think that's necessarily a bad or unreasonable thing. Private takes care of the other more tedious and perhaps complicated problems where it may not be an emergency but deals with the impatient patient. There's plenty of cost associated with that. I get what you're saying though.

As for the pre-existing conditions thing, I know that is more often the way with insurance. It sucks but you can understand why they do it. The policy I have however says (and I quote) "Medical history disregarded." They waived pre-existing and cover you anyway. So they're not all totally rotten. :o :)

[Peterkro]

There's virtually no line between the working and middle class these days. It's the benefit class that have become the bottom rung of our particular caste system. Everyone else has the ability to own their home, run their own business, get their children to university etc.

I suggest a new definition. Wordle class has a nice ring to it :)

Excuse me but that's complete bollocks.

[BoyBach]

Excuse me but that's complete bollocks.


I have to agree with this statement. Social mobility has practically ended under the New Labour project.

[és:]

There's a very small fee per visit. About the equivalent of 30 USD, and it's important to remember that in Norwegian terms, that's a smaller amount of money than it would be in the US.

Varies.To see a doctor for a regular office call CAN happen the same day, but it can also be a couple weeks' wait. For a procedure at a hospital you can easily wait several months, or even a couple years.

Prescriptions aren't covered until you spend about 380 USD. Then they're free for the rest of the year. The next year, you start over again. Medicine for chronic conditions is given on a special kind of system, and while you still have to pay for it until you reach the 380 - limit, it's subsidised to a certain extent.

We all have to choose a primary physician, who is required to have a sub if s/he isn't in. It's possible to change your primary physician up to once a year, I think. When you're referred to a specialist, you can sometimes choose, or at least you're given a list of options. For hospital procedures, you generally are referred to the hospital your doctor suggests (based on which hospital has the central expertise in that area of medicine in the country), but technically you are allowed to choose.

The same coverage is available to everyone, but those who want faster service and who can afford it, can go to a private doctor or hospital.

Some examples from my own life: I was for example told that my son would have to wait two years to have his tonsils removed, despite the fact that the doctor felt they were giving him health problems. A colleague of mine waited two years for a hernia operation. My son recently needed a fairly routine procedure done (outpatient), and because it would have taken 11 months in the official queue, we chose to go to a private clinic.

That's horrid.

[annk]

That's horrid.

There are definitely some bad sides to it, but at the same time, no one is out-right denied medical care (though of course that's of little comfort to those who die waiting for help, as was the case for some cancer patients a few years ago). To be fair I ought to have mentioned that when my son was born, I was in the hospital for 6 days, and didn't pay a penny. So there are good sides to it, to.

[és:]

There are definitely some bad sides to it, but at the same time, no one is out-right denied medical care (though of course that's of little comfort to those who die waiting for help, as was the case for some cancer patients a few years ago). To be fair I ought to have mentioned that when my son was born, I was in the hospital for 6 days, and didn't pay a penny. So there are good sides to it, to.

I didn't mean the system is horrible, I'm a massive fan of socialised healthcare.

I'm just horrified at the experiences you've had, probably through bad implementation. Two years for tonsils? I went in to hospital in the afternoon and had the operation to remove them the next morning.

That's how it should be. There is no reason, in a well run system, for there to be longer queueing or wait times or any worse treatment. As I said earlier, I doubt that I'd live in a country without socialised medicine.

[yrsonicdeath]

There was something on NPR about this a few weeks ago where they went to several countries with such systems and sort of followed workers in the system around for a day. I'll see if it is still available to listen to and if I can find it.

EDIT: I guess what I caught was part of a larger series. http://www.npr.org/templates/story/story.php?storyId=91972152

[skunk]

Excuse me but that's complete bollocks.Indeed it is. The gulf is wider than ever.

[Queso]

Indeed it is. The gulf is wider than ever.
It all depends on how you define "middle" and "working" class. I take it your (and Peterkro's) definitions are different to mine.

I think anyone who has to work in order to live (rather than having independent means) counts as working class, however much money they actually earn. As such the old definitions of education and/or property ownership being middle class no longer apply. Of course there is still an underclass in the UK, but it is mostly made up of those who are state-dependent rather than self-dependent. If anything, we've moved from a three tier working/middle/upper class society to a two-tier have/have not.

[skunk]

I think anyone who has to work in order to live (rather than having independent means) counts as working class, however much money they actually earn.An awful lot of middle-class people too have to work in order to live, in my classification system, but there's a huge gap both above and below them.