True stories of socialized medicine

[MoneyJungle]

For those who live in countries with government provided health-care, or those who have been treated by a such a system, I would like to hear your experiences. The perspectives I get as an American are either idealistic or Orwellian depending on the source from which it comes.

I don't want to hear political arguments, but this is probably a fucking ridiculous expectation. I would really appreciate it if people would stay on topic (or at least just STFU about politics, I enjoy more pointless diversions) here because I've heard all the political rhetoric on both sides and I am sick of it. As a man of limited means, INTPc is the only chance I will have to communicate with regular people internationally. I'm just curious about experiences that people in Canada, France, the UK, etc. have had with their health care.

Stories about private medicine would be OK, too. I just want to hear about average experiences with health-care because all I hear is hyperbole on both sides.

I already know that any venereal disease stories about your friends are about yourself. Discuss.

[Jonnyboy]

Just to let you know, there is a difference between government run health care and goverment sponsored health care. The US is attempting to institute the latter I believe. Reasearch the UK and Canadian systems; they are very different.

[mola ram]

A form of social medicine actually exists within the U.S. already.

Military healthcare is very much a socialist way of providing treatment. All treatment is paid for, with no out of pocket expenses for individual service members. Choices are limited to non-existent. It is a very impersonal way of providing healthcare--patients have no say in who the provider will be for a given appointment, one shows up at the appropriate time and gets seen by whoever happens to be on duty that day.

Routine care, non-urgent, non-emergent situations require prior planning--but emergencies and urgent needs are always taken care of in a timely manner.

My own experience with this system has always been positive (well, maybe 90%--nothing is perfect). But I'm also healthy, lead an active lifestyle and don't often require these kinds of services. When I have, though, they have always been there for me.

The case could be made that the quality of the medical professionals providing care are less than what they are in the civilian world. This can be traced to, among other factors, that pay is higher in the civilian world. This parallels an argument against social care currently going on--that there is no incentive to be better because they will get paid the same no matter how good. Military health providers get paid a normal military salary (with some bonuses), but standards of care, treatments, equipment, training and everything else that goes along with it are the same whether it is military or civilian.

There has been a lot made about war veterans not getting the treatment they need/deserve, but these are not the norm. The vast majority of US service members get all the care they need, and at no additional cost. There was a point where family members of service members were even getting plastic surgery (breast augmentation and such) for free through the military medical system. The rationale was that this keeps up the skills of plastic surgeons serving in the military, but that's a different discussion, I think.

Anyway, hope that helps. I'm sure folks overseas and in Canada and such will have other perspectives.

[Technical]

Mola Ram...Prepare to meet Kali! /Indy

[jyng1]

The biggest problem is that healthcare is a hole you just keep pouring money into. With an ageing population and the improvements in medical care and technology high levels of professional care will ultimately become unaffordable.

We have a public system with private backup for those that can afford it. We have a public no fault accident insurance scheme which covers all accidents (including tourists; which also removes the right to sue). As a generally healthy person, I think it works really well. I have broken both ankles and a collar bone in the last few years and got really good care with specialist visits and physio plus 80% of my salary met by ACC.

There are more and more complaints about waiting lists, but the health budgets have been more than doubled in the last 10 years and they haven't reduced, problems with Doctors wages compared to Australia and subsequent retention issues.

I think if everyone was bumped off at around 70 then there wouldn't be any budget problems and the whole system would be sustainable. As it stands the system is altogether too successful and sending itself down the drain.

[jyng1]

Military healthcare is very much a socialist way of providing treatment. All treatment is paid for, with no out of pocket expenses for individual service members.

This is essentially a work place scheme which medically vets the participants prior to enrolling them. It also provides accident cover which results from employment. In the civilian world the firm would be put out of business here with Health and Safety fines (most of the managers would be found criminally liable and put in jail).

But as far as health goes, the participants are screened, young and fit. Apart from workplace injuries it would be one of the cheapest schemes anywhere to run.

[mola ram]

This is essentially a work place scheme which medically vets the participants prior to enrolling them. It also provides accident cover which results from employment. In the civilian world the firm would be put out of business here with Health and Safety fines (most of the managers would be found criminally liable and put in jail).

But as far as health goes, the participants are screened, young and fit. Apart from workplace injuries it would be one of the cheapest schemes anywhere to run.

Fair enough. But I would futher submit the healthcare benefits extended to military retirees. To be sure, they had to go through the military system itself to be eligible, but these folks are also older and more prone to diseases and medical issues that come with age. These folks have some costs, co-pays and such, but it is far cheaper than any civilian healtcare program--without any workplace hazard issues.

But anyway, point well taken.

[MoneyJungle]

I'm a US Navy vet. It was the only time in my adult life I've been insured, so I don't have anything to compare it with. I was often as sick as I've ever been while on deployments, but I would never have gone to medical. My only experience was check ups and getting shots all the fucking time.

[jyng1]

Fair enough. But I would futher submit the healthcare benefits extended to military retirees. To be sure, they had to go through the military system itself to be eligible, but these folks are also older and more prone to diseases and medical issues that come with age. These folks have some costs, co-pays and such, but it is far cheaper than any civilian healtcare program--without any workplace hazard issues.

But anyway, point well taken.

I don't know what the stats are like from the states, and this is only hearsay, but I heard the average time someone lived after retiring from the military here was around 9 years. If that's true, its not much of a liability.

There's no continuing military medical care for retired military personnel here, they i.e. me, go into the public system (and that's OK).

[mola ram]

I don't know what the stats are like from the states, and this is only hearsay, but I heard the average time someone lived after retiring from the military here was around 9 years. If that's true, its not much of a liability.

There's no continuing military medical care for retired military personnel here, they i.e. me, go into the public system (and that's OK).

Generally, eligibility for retirement (pension plan, medical benefits and such)from the US military is 20 years. There are some exceptions, medical retirement, or when we have a RIF situation (not now, for obvious reasons) they'll let folks retire earlier than that. There are others that stay in for 30+ years though, but at least 20 is the norm.

[Usehername]

As a Canadian, I'm a fan.

Yeah, it sucks when you need to wait for hours on a busy Friday night for just two stitches (because there are more important problems to be taken care of). You always wish these things could happen early on a weekday morning, because then you wouldn't have to wait, and have this ER visit interfere with your schedule.

But when you are the more important thing, whether that be due to a long-term illness, or an asthma attack or something that requires considerably more than 2 stitches...

I cannot imagine the weight that must be on some people's shoulders that don't have the ability to buy their own adequate insurance.

And our MDs don't have to be business experts, they just have to be MDs. Because the government pays.

[mola ram]

Yeah, it sucks when you need to wait for hours on a busy Friday night for just two stitches (because there are more important problems to be taken care of).

But it does get taken care of, though, eventually, right?

[Usehername]

But it does get taken care of, though, eventually, right?

Always. :)

[bass_n_treble]

Yeah, it sucks when you need to wait for hours on a busy Friday night for just two stitches (because there are more important problems to be taken care of). You always wish these things could happen early on a weekday morning, because then you wouldn't have to wait, and have this ER visit interfere with your schedule.

And this is different than the United States how?

Oh, right. The lack of sticker shock at the end or that frown you get from the nurses when you say you have no insurance.

The only place I've ever been taken care of in a timely fashion in my 27 years is a fuckin' dentist office.

[cleufir]

I’m from Czech republic.
We have government provided health care system since 1918 or so, but surely not very sophisticated back then. Under the reign of commies (1948-1989) basically any sort of treatment was covered by health insurance, large part of which was paid by employer. But since communist CSSR was quite isolated, standard of treatment one would get wasn’t as advanced as in the west, but mostly still okay to survive. After 1989 goverment provided health care continued, charge for health insurance has risen and the level of treatment matches other EU member states. But then our system made huge losses and had to be frequently subsidised by state, so since last year, every time we visit a doctor or get a prescription we have to pay 1 euro, but never more than 160 euros per year. That pissed of the seniors, who used to socialïze in the surgeries and now it’s too expensive for them. Now is the system profitable, treatment, recovery programs and drugs are still covered. In my opinion it works just fine.

[bluebell]

Our system in Australia is gradually becoming more and more privatised, which sucks IMO. But it's still reasonably good, as far as I can tell. I have basic private hospital cover, but only because the recent conservative government set up the tax system to basically push everyone who earns above a certain amount into private health cover. Very annoying, although luckily not too expensive - the monthly cost is a bit more than I pay per month for my broadband ISP.

If I ever have an accident or need emergency surgery, I have no intention of going in as a private patient as it will leave me out of pocket. In the past (not sure what the situation is as at the moment), going into hospital for emergency surgery or admission as a public patient cost nothing, or very little.

A specific example, using the price of a McDonalds Big Mac as a comparison (the Aussie currency conversion has bounced all over the place in the past few years, so converting into USD is not likely to be particularly helpful, Big Mac price comparisons (http://www.oanda.com/products/bigmac/bigmac.shtml)):

I have a chronic inflammatory disease so I'm permanently on a high dose of anti-inflammatory drugs and need regular blood tests and check ups with my doctor. I also need annual eye tests for various medical reasons. The cost of this is:

- annual eye test at an optometrist = free

- 4 x blood tests per year = free (I think that recently changed though, which is annoying)

- 4 x doctor visits (and I have total choice over which doctor I go to) = $30AUD or 6 Big Macs per doctor visit = it costs me 24 Big Macs per year to see my doctor, who usually talks to me for half an hour each time (my health issues are a tad complicated). The paperwork required for getting a Medicare government rebate for each visit is minimal - I just need to take the receipt to the Medicare office (no forms required!) and get an instant rebate in cash. Some doctors bulk bill, ie it costs zero to see them. If you are on a disability pension or are unemployed, it is usually free to see a doctor. There is also the Medicare Safety Net (http://www.medicareaustralia.gov.au/public/services/msn/index.jsp) available to everyone.

- 2 prescriptions per month for inflammatory disease = $70AUD per month or the cost of 14 Big Macs per month (7 Big Macs per prescription). There is zero paperwork for consumers for this. If you're on a disability pension or are unemployed, I think it costs 1 Big Mac per prescription. Most prescription medications are heavily subsidised here, plus I think (but not 100% sure) that the government negotiates with big pharmaceuticals to get cheaper prices as well. Also there is the pharmaceutical safety net (http://www.medicareaustralia.gov.au/public/services/scripts/pbs.jsp) which is available to everyone.

Also, it is free to visit the emergency ward at public hospitals which most people only use for genuine emergencies, not for general health problems like colds or flu. However, it is done on a triage system, so for non-life-threatening situations the wait to see a doctor (eg for a broken bone or stitches) can be quite long, maybe 5 or 6 hours or longer if it's really busy. You have to pay for ambulance rides but private health insurance for that is quite cheap, I think about $40AUD per year or the cost of 8 Big Macs per year.

I would be interested to see a costed-version and explanations of paperwork and how much choice you get of doctors in the US for a similar example - both if you have insurance and if you don't. I've gleaned from various rants I've read on here that it's a) more expensive and b) the paperwork sucks but I'm not entirely sure.

[jyng1]

I'm not quite sure how the American system currently works or doesn't work, but Obama seems pretty keen to review it with or without the Republicans. I think one thing that hasn't been mentioned yet is that whether the system is publicly funded or private, you still pay. It either comes out of every one's taxes or you pay insurance (if you can). But either way, you pay and those that earn more, pay more tax (unless they avoid it) and subsidize those who pay less. I guess the real issue is what is the most efficient use of your money and how much choice you have in the level of treatment you opt to get. Is it more efficient to run health publicly or privately. If its publicly funded then the system is fairly egalitarian and everyone gets the same level of treatment, no matter how much tax you pay. If its private, then I guess you get what you pay for (or don't pay for).

With a public system, there is still the option of getting an additional level of health care by paying for private treatment which here will give you exactly the same doctor, but you will get your hip replacement straight away instead of in six months.

The other obvious difference is what happens to the people that can't pay for health insurance. A society has to provide the basics for life, which includes medical care. So I'm guessing even in a fully private system like I imagine the US is, the state still has to provide some form of public health service otherwise it would be inhumane. You can't just turn away the dying when they turn up on the doorstep.

[Qfwfq]

My experiences have been good. I've always had a family doctor and visits have always been free. I saw a segment of our system tested a little more when a close relative of mine developped psychological problems and had to be hospitalized. The mental health section of the hospital wasn't very inspiring, but the fact remains it was free. We have a large mental health hospital in my city (I'm in Canada), which is covered and it's the place to be, but the waiting list extends almost 2 years. The medication for my relative is the only thing they pay for, and it's only around 40$-80$ a month. They have recovered well thus far.

[HoneyCyclical]

I would be interested to see a costed-version and explanations of paperwork and how much choice you get of doctors in the US for a similar example - both if you have insurance and if you don't. I've gleaned from various rants I've read on here that it's a) more expensive and b) the paperwork sucks but I'm not entirely sure.

How to answer this?
I live in the U.S. I have a connective tissue disease. I'll start on the non-insured side. I am not insured currently. If I get health insurance it will most likely not cover pre-existing conditions (such as my CTD) because most of the major health insurances in the United States won't cover pre-existing conditions if you haven't had health coverage for over a year. So if I've lost my coverage from a private insurance company over a year ago, then most insurances I get in the future from that year forward won't cover anything connected to my CTD. This is why some people that I know who are/have been uninsured have used alias names and SS #'s when going to the doctor if they suspected they had an illness. Why? Because if they get diagnosed while not insured, then when/if they do eventually get insurance they won't get any coverage for that illness. Say I get diagnosed with cervical cancer right now without insurance. Then I marry someone who can put me on their plan or become employed with a company that provides insurance. At that point nothing that has to do with the cancer will be covered by the majority of private health insurances. I can break my leg and it would be covered but the cancer....nada.

Back to the costs. I take one prescription for CTD currently that happens to be very cheap. It's $25 each month. (I spent a hundred or more dollars each month for years before they figured out what was really going on). Because the medication is toxic to the retina at high levels, I am supposed to get an eye exam at least twice a year. The eye exam for this specific drug is more expensive than a regular ole eye exam. I spent $225 out of pocket the last time I went. I am supposed to get blood tests also twice a year. A standard blood panel including ANA marker and liver enzyme runs about $200-300. The visit to the doctor to have the blood taken and for a regular exam is around $100-120. I am not qualified for any "at need" medicaid because I a.) am not pregnant and b.) do not have HIV/AIDS.
At one point I was told I needed a back brace...but the brace was a whopping $3000. Needless to say, that didn't happen. I was prescribed physical therapy 3 times a week at $75 a pop. That also didn't happen much.
This does not include any accidents or GYN annual visit ($125) or dentist.
I would tally this all up in Big Mac currency if I weren't tired.

[Dark Razor]

I am from Germany, the system here is set up so that private health care and public ("socialized") health care operate side-by-side.

In principal, insurance in the public system is mandatory, however if your income exceeds a certain amount, you can buy private insurance (PI).
If you are self-employed you can voluntarily participate in the public system, or get PI.

Once you switch to PI. it is rather difficult to switch back again (you have to become quite poor before they let you back in) this is to discourage people from joining PI when they are still young and then later when PI becomes really expensive switch back to the cheaper public system.

People who register as unemployed are automatically covered by the public system with full coverage. Pensioners pay the normal fee from their pension.

Should you fall ill and be unable to work, the employer is obliged by law to continue paying your usual wage/salary for a minimum of six weeks (this was first achieved in 1956 through 114 days of uninterrupted strike and campaigning by 35,000 metal workers), after six weeks if you are still sick, health insurance will pay a lower compensation instead. If the employer fires you, he still has to pay for the full six weeks.

If you have family and are the only person working, public insurance will cover your spouse and your children below age 25 without additional costs.
Which is why private insurance is much more expensive except for young singles, since you have to insure every family memeber individually.

Covered are all normal medical treatments /emergencies except glasses, "unnecessary" surgery (like cosmetic surgery), and dental replacements (i.e. fake teeth) most other dental treatment is covered, though. Coverage of physical therapy is also limited.

The only thing you pay for directly is 10 euros when you visit the doctor (but only once per quarter) and part of the costs of prescription drugs (but not more than I think 10 euros per prescription), over-the-counter drugs you have to pay for by yourself completely.

You are free to choose to which doctor you go, you are also free to immediatly book an appointment with a specialist, instead of seeing a general practicioner first, though seeing a general physician first will usually be faster.

I usually have to wait for between one to three weeks for an appointment with a specialist or a dentist, but that's mostly because I have a job and can only go there in the evening or early morning, so I imagine if I had more free time I could get seen more quickly. With a general practicioner you might be able to get an appointment the following day. If you arrive at a doctors office unannounced you will probably have to wait for a few hours but I dont think that's a problem really. ER usually only get visited by people with actual emergencies.

I once required endoscopic heart surgery and had to wait about six weeks for the surgery, though I had put the surgery off for a year or so already because i was scared of it, so the six weeks more or less weren't an issue. It was also not an immediatly life threatening condition, so I assume they put me on the list as low priority.

The cost for this coverage is 15.5 percent of your gross income, where technically slightly less than half is payed by the employer. The amount is capped however, the absolute max amount you pay per month is 8.4 percent of 3.675 euros monthly income (or 15.5% if you are self-employed). So if you earn more than 44100 euros per year the insurance fee no longer increases.

The system is strained, mostly because the pharma mafia are greedy scumbags who use their lobyists to extract as much money as possible from the system, so that it is now "underfinanced". There is also a strong push for further privatisation of the system, which would make the system more expensive and make services worse, but would increase rewards for those who are pushing for privatisation, as always. Doctors are not getting enough money from publicly insured people, that's why they sometimes perform unnecessary stuff on privately insured people to get more money. I guess this could also be alleviated by reducing the amount of money that goes to the pharma industry for overpriced drugs, so that more money is available to pay the doctors with.

[Harion]

the US won the war, but the Germans are living and acting better humanely toward improving the quality of life of others while the U.S. good guys don't want health reform because that's so "socialist" gasp!

better to turn away sick and dying people who have no money than become socialists
what does that mean anyway?

[Unapplied Knowledge]

The cost for this coverage is 15.5 percent of your gross income, where technically slightly less than half is payed by the employer. The amount is capped however, the absolute max amount you pay per month is 8.4 percent of 3.675 euros monthly income (or 15.5% if you are self-employed). So if you earn more than 44100 euros per year the insurance fee no longer increases.


Ow ow ow ow.

Under my company's current private insurance plan, at a salary of around $20,000/yr (14,000 or so euros/yr), the fee is around $140/month (8.4% of gross income) with the employer paying about half (so $70, or roughly 4.2% of gross income). The company's plan doesn't scale as much as the German plan, but still, at a Florida minimum wage full time income (around $14,500), that's still only about 11.6% of gross income at the same rate, 5.8% once you take into account the half paid by the employer.

[Dark Razor]

Ow ow ow ow.

Under my company's current private insurance plan, at a salary of around $20,000/yr (14,000 or so euros/yr), the fee is around $140/month (8.4% of gross income) with the employer paying about half (so $70, or roughly 4.2% of gross income). The company's plan doesn't scale as much as the German plan, but still, at a Florida minimum wage full time income (around $14,500), that's still only about 11.6% of gross income at the same rate, 5.8% once you take into account the half paid by the employer.

Yea but here you will still be insured if you happen to become unemployed, and your entire family is covered as well if they meet the conditions.

[jyng1]

The system is strained, mostly because the pharma mafia are greedy scumbags who use their lobyists to extract as much money as possible from the system, so that it is now "underfinanced". There is also a strong push for further privatisation of the system, which would make the system more expensive and make services worse, but would increase rewards for those who are pushing for privatisation, as always. Doctors are not getting enough money from publicly insured people, that's why they sometimes perform unnecessary stuff on privately insured people to get more money. I guess this could also be alleviated by reducing the amount of money that goes to the pharma industry for overpriced drugs, so that more money is available to pay the doctors with.

The cost of pharmaceuticals is associated with high development costs and litigation. I wonder how cheap they would be if they were exempt from litigation? They could test their new products in Somalia or some other failed state where they couldn't get sued to bring the price down. Payback for piracy?

[Dark Razor]

The cost of pharmaceuticals is associated with high development costs and litigation. I wonder how cheap they would be if they were exempt from litigation? They could test their new products in Somalia or some other failed state where they couldn't get sued to bring the price down. Payback for piracy?

Oh there are quite a number of reasons why "development costs" are so high, also pharma companies often bribe doctors to prescribe the most expensive drug if multiple alternatives are available. However the OP specifically requested that we do not enter in such discussions, so I wont. I stated my opinion and will leave it at that.

[MoneyJungle]

However the OP specifically requested that we do not enter in such discussions, so I wont. I stated my opinion and will leave it at that.:highfive:

[egregious cerebrum]

if health care kicks the bucket, we're back to good ole natural selection

[Oso Mocoso]

Here's my true socialist medicine story -

This old shipwright that I knew used to sail with us on a racing boat. He was from the Isle of Man. He was very proud of his British citizenship. For years he paid British taxes from the U.S. At one point, he needed a kidney. The Brits asked him if had any dependents that would need to go on welfare if he passed away. He said no. They asked if he had a spouse who was financially dependent on him. He said no. They told him the waiting time would be about 12 years, which was more or less a death sentence. He went to an American private hospital and got a kidney.

[80 page GIANT]

Here's my true socialist medicine story -

This old shipwright that I knew used to sail with us on a racing boat. He was from the Isle of Man. He was very proud of his British citizenship. For years he paid British taxes from the U.S. At one point, he needed a kidney. The Brits asked him if had any dependents that would need to go on welfare if he passed away. He said no. They asked if he had a spouse who was financially dependent on him. He said no. They told him the waiting time would be about 12 years, which was more or less a death sentence. He went to an American private hospital and got a kidney.

According to this NYT article from 2006, http://www.nytimes.com/2006/05/15/opinion/15satel.html , 70,000 Ameicans are waitng for kidneys, and, "in big cities... the wait is five to eight years and is expected to double by 2010". So as of next year, that's a 10 to 16 year wait - which is comparable to the 12 year wait in the UK. Also, a US citizen waiting for a kidney dies every 90 minutes.

Another point is that Obama and the democratic congress are not trying to change or diminish health care quality for those happy with their current provider; they are merely trying to make it more affordable and accessible to those who don't already have it, and to offer more options for those who lose their coverage.

[Oso Mocoso]

According to this NYT article from 2006, http://www.nytimes.com/2006/05/15/opinion/15satel.html , 70,000 Ameicans are waitng for kidneys, and "In big cities... the wait is five to eight years and is expected to double by 2010". So that's a 10 - 16 year wait, which is comparable to the 12 year wait in the UK. Also, a US citizen waiting for a kidney dies every 90 minutes.

Probably not extremely rich Americans (or British ex-pats) in expensive private hospitals. Seriously, people in the New England yachting scene don't play by the same rules as most Americans.

[Ferrus]

Here's my true socialist medicine story -

This old shipwright that I knew used to sail with us on a racing boat. He was from the Isle of Man. He was very proud of his British citizenship. For years he paid British taxes from the U.S. At one point, he needed a kidney. The Brits asked him if had any dependents that would need to go on welfare if he passed away. He said no. They asked if he had a spouse who was financially dependent on him. He said no. They told him the waiting time would be about 12 years, which was more or less a death sentence. He went to an American private hospital and got a kidney.
Yeah, I'm sure if you have been educated at the top schools, have an MBA, working in executive management it is no problem getting a kidney, as indeed it wouldn't be in the UK either for that matter. For the rest of us something is better than nothing.

[jyng1]

According to this NYT article from 2006, http://www.nytimes.com/2006/05/15/opinion/15satel.html , 70,000 Ameicans are waitng for kidneys, and "In big cities... the wait is five to eight years and is expected to double by 2010". So that's a 10 - 16 year wait, which is comparable to the 12 year wait in the UK. Also, a US citizen waiting for a kidney dies every 90 minutes.

Probably not related to type of health care; more like dead people don't want to give up their organs. Don't know what they think they're going to do with them. We have donor or non-donor on our drivers licences but apparently even if you decide to be a donor when you're alive, it's still difficult for the ghouls to take your unwanted bits.

Maybe if you really want a kidney, travel to India.

[Dark Razor]

Probably not extremely rich Americans (or British ex-pats) in expensive private hospitals. Seriously, people in the New England yachting scene don't play by the same rules as most Americans.

Time until you get an organ is mostly determined by the amount of donors, which is too low. I guess the expensive private hospital probably has exlusive access to organs farmed from some kids that nobody misses in countries like China or Brazil. So they kind of can order "on demand".

[Oso Mocoso]

Yeah, I'm sure if you have been educated at the top schools, have an MBA, working in executive management it is no problem getting a kidney, as indeed it wouldn't be in the UK either for that matter.

Yeah, but this guy thought because he paid (a lot of) taxes in the UK he could get one through the socialist system. I guess he was naive when you think about it. That was kinda really the point of the story. And while I sorta meet that description, he was more like a wealthy entrepreneur.

[80 page GIANT]

Probably not extremely rich Americans (or British ex-pats) in expensive private hospitals. Seriously, people in the New England yachting scene don't play by the same rules as most Americans.


It is illegal to advance someone on the waiting list due to payment or due to their financial status. However there is a thriving black market for kidneys.

My girlfriend passed away from kidney disease last December. She had insurance for around 10 years through her job with IBM. She eventually became too sick to work, and IBM quit paying her insurance. She continued it through COBRA, but it was extremely expensive, and became her major expense. A payment got lost in the mail. Consequently, she lost her coverage and was not insured for her last few months. The stress of that made her get much more sick.


Our system is completely fucked up.

[Ferrus]

Yeah, but this guy thought because he paid (a lot of) taxes in the UK he could get one through the socialist system. I guess he was naive when you think about it. That was kinda really the point of the story. And while I sorta meet that description, he was more like a wealthy entrepreneur.
I don't have a problem with people being wealthy per se, but I do have an issue with those born with a silver spoon lecturing over the desirability of basic provisions when they themselves have never had to consider it for a moment in their life.

[ciphersort]

If there are any members living in Taiwan I would like to hear your opinions of the health care system there. It looked awesome on television and I believe it was reported that Taiwan has the lowest overhead.

[Oso Mocoso]

I don't have a problem with people being wealthy per se, but I do have an issue with those born with a silver spoon lecturing over the desirability of basic provisions when they themselves have never had to consider it for a moment in their life.

Ferrus, I will concede that that is a valid criticism. I just don't want to have someone force a socialist medical system on all of us. I don't think it's just. Honestly, I wouldn't mind being taxed to pay for one as long as I had the ability to opt out. Kind of like the public school system. I would never dream of sending my kid to one, but I don't object to my tax money supporting them. I mean, I live less than three miles right now from a private school I attended.

http://en.wikipedia.org/wiki/Hopkins_School

I guess what I'm saying is that I think it's fair for people born with a silver spoon in their mouth to devote the same percent of their income as tax to a public system of education or medicine and then opt out of it and pay additionally into a private system like Hopkins. The people in the public system would nothing but benefit from this, and people in the private system would still have that option open to them..

[jyng1]

Ferrus, I will concede that that is a valid criticism. I just don't want to have someone force a socialist medical system on all of us. I don't think it's just. Honestly, I wouldn't mind being taxed to pay for one as long as I had the ability to opt out. Kind of like the public school system. I would never dream of sending my kid to one, but I don't object to my tax money supporting them. I mean, I live less than three miles right now from a private school I attended.

Having taught at private and public schools; the choice you are making is not about the standard of education; more about buying your children their peer group.

A socialist system is all about being just. It's about those that have more than they need ensuring that those that don't have a minimum quality of life.

Even in a communist state such as China, the elite opt out of the same system provided for the masses.

[Unapplied Knowledge]

Yea but here you will still be insured if you happen to become unemployed, and your entire family is covered as well if they meet the conditions.

At the expense of others regardless of whether they agree or not. I would prefer to turn instead to charity rather than resort to theft (though all things considered, if it came down to theft vs life, I would choose the option of legalized theft).

Edit: I don't think many people think like me in that regard.

[meanlittlechimp]

Yeah, I'm sure if you have been educated at the top schools, have an MBA, working in executive management it is no problem getting a kidney, as indeed it wouldn't be in the UK either for that matter. For the rest of us something is better than nothing.

The ironic thing is that the extremely wealthy, and educated support nationalized health care, while many of the rural poor are against it.

The majority of people at Harvard Business School support it; because if something isn't done about health care it's going to sink our economy. GM spends more on health care than steel This gives Toyota and Daimler a significant advantage because it brings down their overhead.

The reason economists say the Iraq war will cost us 3 trillion dollars is mainly due to health care. For instance, as late as 1970 the US government was still paying out benefits to thousands from the civil war. When baby-boomers start drooling on themselves en mass in their old age, we'll be in a world of shit. We have 11 trillion in national debt, which just the interest on is dwarfing all other expenditures (except military spending). When you factor in the unfunded medicare and social security - we'll have 59 trillion in debt.

Every economist and serious policymaker is aware of this. When you factor in rising oil prices because demand side pressure (from the industrialization of billions of people in India and China) - we're in for a shock to the economy that will make our banking collapse seem like a joke.

Health care, Energy and our massive national debt are by far the biggest problems we have to deal with. Ignoring it or keeping our current inefficient system is just going to make things far worse.

[meanlittlechimp]

Here are some informative graphs by the folks at newscientist:
http://www.newscientist.com/article/dn17512-the-scientific-arguments-for-us-healthcare-reform.html

[Oso Mocoso]

Having taught at private and public schools; the choice you are making is not about the standard of education; more about buying your children their peer group.

I would disagree there. Hopkins has a $66 million dollar endowment and has been around since shortly after the founding of the New Haven Colony. They also have a lending library agreement with Yale and several other schools. Hopkins has tons of money to hire the best educators on the market. There's definitely an appeal that you'd go to a school with a wealthy Ivy League bound peer group but I'd argue that a high school with a $30,000 per student price tag has a lot more money to throw at new programs, buying books, and hiring the best teachers and guest lecturers available. I used to work at the Yale Silverstein library when I was an older teen, and honesty Hopkins' library was less awesome but they had some gems. There was a third edition printing of the unabridged Golden Bough which I read in its' entirety while cutting class in the 8th grade. Honestly, I was surprised they would even let me touch it.

They also had the ability to customize curriculum for individual student. I usually got shipped back to Costa Rica for the summers, and one teacher who spoke 27 languages used to work with me 1-on-1 teaching more advanced Spanish than the other kids learned.

[jyng1]

I would disagree there. Hopkins has a $66 million dollar endowment and has been around since shortly after the founding of the New Haven Colony. They also have a lending library agreement with Yale and several other schools. Hopkins has tons of money to hire the best educators on the market. There's definitely an appeal that you'd go to a school with a wealthy Ivy League bound peer group but I'd argue that a high school with a $30,000 per student price tag has a lot more money to throw at new programs, buying books, and hiring the best teachers and guest lecturers available. I used to work at the Yale Silverstein library when I was an older teen, and honesty Hopkins' library was less awesome but they had some gems. There was a third edition printing of the unabridged Golden Bough which I read in its' entirety while cutting class in the 8th grade. Honestly, I was surprised they would even let me touch it.

They also had the ability to customize curriculum for individual student. I usually got shipped back to Costa Rica for the summers, and one teacher who spoke 27 languages used to work with me 1-on-1 teaching more advanced Spanish than the other kids learned.

Yep, had this argument with lots of others. I worked at a public school in a low decile area which at the time had a student who had just won the National Science Award. The type of education is very different from public to private, but it is just one of a variety of variables that determine academic, social or sporting achievement. The private boys school I was at when I was a student teacher was a bit different. The first day I broke up a fight in the first five minutes and in my opinion the school had some serious problems with developing the boys attitudes to society.

I haven't seen any data, but anecdotally private students are not re-known for achieving outside of the rigours of the school environment.

Still say the best thing a student will get out of a private school is their peer group. Kids coming from achievement orientated families all flocking together getting the prerequisites to go out and be successful (whatever that means). But worked with poor kids and rich kids and the biggest difference I would say is the the rich kids parents liked them.

[Oso Mocoso]

I haven't seen any data, but anecdotally private students are not re-known for achieving outside of the rigours of the school environment.

Well ... a bunch of my school buddies have gone on to be idle trust fund kids. I wouldn't call that a stunning achievement.


Still say the best thing a student will get out of a private school is their peer group. Kids coming from achievement orientated families all flocking together getting the prerequisites to go out and be successful (whatever that means). But worked with poor kids and rich kids and the biggest difference I would say is the the rich kids parents liked them.

Personally, for me it was the possibility of having a one on one relationship with individual teachers that I liked learning from. For me, I was particularly interested in reading Latin literature, reading about different religious beliefs that people practiced through time, and improving my Spanish. Oh and there was also a Chemistry teacher I adored.

For me. the place was great because I could read "Commentarii de Bello Gallico" in the Latin and then discuss it with someone else who was older and also passionate about the subject.

For me, that had no relevance to my career or making more money but to read the writings of Julius Caesar in the original language was wonderful and fascinating to me. I really enjoyed Roman books that have survived this long in circulation.

[Huston]

The majority of people at Harvard Business School support it; because if something isn't done about health care it's going to sink our economy.

Really? Gee, to bad that was not passed onto the ones that help destroy the economy. Like Hank Paulson, Robert Rubin, Mark Carney.. or maybe Goldman Sachs just picks the worst ones.. or the republicans, democrats and central banks.

[30footsmurf]

When I was in London my ex girlfriend caught the pink eye at one of the hostels we stayed at. It was awesome though, all we had to do was go to a pharmacy. Some doctor/nurse/pharmacist or whatever the hell she was, was able to prescribe something right away, and I was shooting medication in her eye within an hour of waking up that morning and watching her rub her eyes in misery.
It was pretty cool. I'm curious how it goes for foreigners when they come to the states. I bet we just give them a big fat bill with an extra fee for having to squint our ears to hear their crazy accents.

[30footsmurf]

But worked with poor kids and rich kids and the biggest difference I would say is the the rich kids parents liked them.

Damn thats depressing. I'm looking at teaching in a poor area in the next couple years. Gotta finish my degree first. Any advice for an aspiring teacher to coupe with children who's parents don't like them.
I'm taking off now, but anything you got is appreciated. I'll check back here at some point. I always do.

[bluebell]

Ahem. Can we have more *specific* examples of socialised medicine as requested by the OP? (or American comparisons) I'm asking cos I'm curious about this as well.

[Roger Mexico]

I've heard that many misbehaving nurses in Canada have to wait weeks or months for a hot beef injection.

[depp]

Put it this way- I will go to a state-run hospital here only under particular circumstances, like for example if I was a contestant on 'Fear Factor'.


George Veliotes, M.D., has trained, practiced, taught and managed for 25 years in the world's largest inpatient facility, 3,205-bed Chris Hani Baragwanath Hospital in Johannesburg.

"Those of us who have been here for a long time say you either have to be mad, bad or religious to stay at Baragwanath," says Veliotes, who currently services as one of the public hospital's eight administrators.

[Usehername]

Ahem. Can we have more *specific* examples of socialised medicine as requested by the OP? (or American comparisons) I'm asking cos I'm curious about this as well.

Another thing about Canada is that when we don't have the superclass means to support an ill individual that needs the bestofthebest, they are flown, usually to the States, and the government pays their expenses. My cousin had synovial sarcoma (cancer that attacks the joint tissues) and part of his treatment was done in the USA on Canada's bill. The only downside is that because he was 19 and an adult, my aunt's plane ticket and food wasn't covered for going with him. I suspect that though certainly this has something to do with the structure of the USA's privatized system, it's also partly because Canada's population is so relatively low.

Edit: I guess him dying was an additional downside, but I digress.

[Architectonic]

Considering the USA spends the most government funding on healthcare per capita than any western developed country, I'm surprised it isn't considered to be "socialized".

http://blog.libertarian.org.au/2009/08/12/government-health-care-expenditure-international-comparisons/


He was from the Isle of Man.

He must have lived in Britain in the mean time. The Manx don't have British citizenship because it is not part of the United Kingdom.

The experiences of my family are mixed. Treatment for my condition is more or less unavailable in Australia (it is in the USA, although funding is still weak). My Dad's state of the art cancer treatment (private) is FAR cheaper than in the USA. My sister tried IVF twice in the USA with no success, but she had success the first time in Australia (which was a subsidised procedure with virtually no cost to her).

[Deckard]

Recently had to take the gf to hospital for a kidney infection. Went to the ER at a nearby private hospital first, and the bitch at the desk said it would be a minimum of $400 just to see a doctor, despite the fact that she has health insurance. What's the point of it then? Fuck that. Went to a big public hospital nearby, and they were pretty full. The wait was several hours, apparently. But (luckily?) she soon started puking, and they put her through straight away, though they lacked an immediate place to put her in the main ER ward, so she was just on a gurney in a hall for ~25 mins. I daresay they'd have prioritised her if she'd kept puking or had some other dramatic symptoms.

Anyhow, that first part was the worst aspect of the experience, and it wasn't terrible. They made sure they got a proper diagnosis since it presented unusually, then got her on some good drugs, and kept her there for four nights to make sure she was recovering. The nurses seemed responsive and happy to give pain relief (mostly morphine). The ward she got transferred to out of the ER was nice and new and spacious. Food was good. She said she was seen by a different doc every time, and had to repeat her story to them all, which was frustrating and counterproductive. Don't understand why they would do that - maybe just the way staff rotations work in big hospitals. Would probably be better in most private hospitals.

They just sent her a letter saying they want her back for a checkup, which I was impressed by. Best part of the experience (aside from the fact that the gf is fixed) is that the whole thing was free, minus a trivial cost for the meds she had to buy after being discharged. Gotta love that evil socialism.

edit - forgot to mention, this was in Australia.

[Deckard]

The devil is in the details, as they say (all the more true for us N's, eh?).

As I said, make it worth addressing and I'll be glad to. (To clarify: Quit obfuscating with subjectivisms and simply state what you believe)
I have, fairly explicitly I think. Try harder. I know, that means rereading and that's a lot of effort. Suck it up.

[C.J.Woolf]

Speculation and debate is split into a new thread (http://forums.intpcentral.com/showthread.php?t=37043). Per the OP, please post your experiences here and your theory there.

[msg_v2]

Probably not related to type of health care; more like dead people don't want to give up their organs. Don't know what they think they're going to do with them. We have donor or non-donor on our drivers licences but apparently even if you decide to be a donor when you're alive, it's still difficult for the ghouls to take your unwanted bits.

Maybe if you really want a kidney, travel to India.

The thing that I don't get is that if you want to be an organ donor in Pennsylvania, you have to pay a fee when you get your driver's license. Ok, it's only one dollar, but I really don't understand why there's a fee at all.

[Technical]

The thing that I don't get is that if you want to be an organ donor in Pennsylvania, you have to pay a fee when you get your driver's license. Ok, it's only one dollar, but I really don't understand why there's a fee at all.
I can figure that. It's a tangible indication that you want to donate, which is necessary under the law, and if they put the $1 onto those who didn't donate, it would be considered coercion.

[Unapplied Knowledge]

...Best part of the experience (aside from the fact that the gf is fixed) is that the whole thing was free...

edit - forgot to mention, this was in Australia.

Amazing! You'll have to explain to me how they manage to sustain social programs in Australia without taxes.

[Unapplied Knowledge]

The thing that I don't get is that if you want to be an organ donor in Pennsylvania, you have to pay a fee when you get your driver's license. Ok, it's only one dollar, but I really don't understand why there's a fee at all.

It's a fee (tax) to pay for the unnecessary government regulatory processes involved in such.

[Thirsty]

Three things:

One, a large portion of my "Cousins you've never met" (everybody has these) that aren't living in India are from my mother's side of the family (Irish) and live in Canada. We visited these people once, and whenever politics came up, not a single one did not tell us that our healthcare sucked, and that theirs kicks ass. I initially thought it was family coincidence, however, more or less every Canadian adult that I've spoken with on this topic has bragged about their healthcare being far superior. It seems that, for Canada anyhow, everybody is pleased.

Two, there was a story I heard about on NPR. (Pardon if I don't get the exact details correct, but the important parts remain intact): Apparently an American woman who fell ill went to multiple hospitals in her area. All of these failed to diagnose her. Her family had a connection in Scotland (I believe her father worked there) so, she went there for ~2 months. Within the first week, an Intern at a hospital there instantly recognized her ailment, and promptly prescribed a cure. After the duration of her 2 month stay, she had made a full recovery. After arriving back in the US, she was required to do a follow up exam, which she complied with.

The Scottish medical facility charged her a grand total of nilch. Both the diagnosis of the ailment AND the treatment were free.

It took the woman 6 months of working to pay off the US hospital for the Check Up.


And finally, my issue with the system. This past March, I was an idiot on the ski jumps, used poor technique, and broke my wrist. It wasn't a full fracture, either. The bones in my wrist didn't shatter, they were simply shifted in their position. I received my initial X-Rays at the closest hospital (I was ski jumping in NH, so I wound up at New London hospital) where it was confirmed that I had a "minor" fracture, and that a few bones were shifted around. I then went to the Orthopedist, who was located in Concord. The Orthopedist in Concord refused to accept the X-rays from NL Hospital, and demanded that I get them done at Concord hospital. I was in a terrible mood, and was not taking any of that shit. I told him off, and argued until finally, he gave in. (Problem #1. This was a complete scam, and I encourage anyone put in my prior situation to duke it out.) ~1 month later, my cast was off, and I was required to do physical therapy. I complied.

Currently, the Insurance company, (Blue Cross, Blue Shield) is being a corporation, and is refusing to pay for the following:

-More than 30% of Hospital costs (this includes all X-rays, and a fucking unnecessary CAT scan)
-no more than 20% of 1/3 Physical therapy sessions

These are supposedly "necessary" procedures; the company is SUPPOSED to pay for these. But they're still giving me a hard time.


Worst part is, Blue Cross Blue Shield is considered one of the "better" insurance companies. I can't even begin to imagine what a nightmare the worst ones are.


That's my rant/sob story.



EDIT: Usehername, consider yourself added to my imaginary list of Canadians who think their healthcare is awesome.

[Wheezie]

The UK NHS is certainly not perfect and probably long overdue for review and overhaul to determine the best way to fund the ongoing care of an ageing population. However, in my opinion (possibly because it's the system I live with) it is far preferable to a system that only treats (or gives the better treament to?) those that can pay and also charges them for unnecessary tests, scans etc to get most money from minor procedures - forgive me if this is not the case but I only base my views on that which I see in the news and the fact that I'm not a fan of insurance companies.

Which brings me to another point, the media, we all hear scare stories about the NHS - lack of care, lack of funding etc but ultimately I believe it is 'mostly' just that, scare stories. We read about plane crashes, natural disasters etc every day bacause they are sensational news but we still fly and millions fly every day without mishap.

My own experience of public healthcare is largely good. The fact that if you need help you can get it without worrying about how to pay for it is, or should be, a basic human right in the 21st centuary.

Every single UK employee pays a basic national insurance tax that funds a health service for all, including tourists & visitors, but they also have the option for private medical insurance and can switch between the two without any predjudice. In fact, it's possible to have the private insurance company pay you to be treated by the NHS. Quite often it will be the same specialist regardless.

That's it for now, I've probably got plenty more to say in defence of the UK system but as it's my first post I thought I'd better go & introduce myself in the intro thread now. :ph34r:

[nonperson]

The NHS's major problem is the excessive layers of management added since it services were opened up to an internal market.

I must say that I heartily approve of the suggestion of cutting the NHS payroll by 10%. This would accrue savings in the region of £150 million (conservative estimate) per month.

[Wheezie]

I heartily agree with you regarding the excessive layers of management and administration. Although in an ideal world if there was a 'properly' (as defined by me or other INTP's!) administrated central system a lot of the existing problems could be eliminated as well as lot's of useless managers - what do they manage anyway?

Not so sure about a blanket cutting of payroll of 10% though. Unless handled correctly, I feel fairly sure that the wrong personnel would be affected and that those who add no value but know how to work the political sytem would continue as before.

[nonperson]

Yes there is a danger of the wrong 10% getting cut.

My favourite for the most over administered ministry is the MoD. But that's a different story....