[Closed] the wonderful world of private healthcare US style

I agree with you but I am not a US national, I an a UK national and so believe the NHS is great

Mrs Grips is a US national, and she also believes the NHS is great...

CM - I can't get involved in those kind of debates. They boil down to one thing. That is, should the government force society to look after the disadvantaged, or should people take that responsibility themselves.

However, I suspect that some people are adopting that argument to cover up for a) greed in wanting lower taxes and smaller govt and b) mistrust of government.. even if they don't realise it themselves.

To put some perspecive:

Average Single cover isurance policy - $4800 a year
Which in real money is £3000 a year, or £250 a month.

How much do you pay for the NHS a month? I know it differs per person but my National Insurance contributions in the UK far exceed £250 a month.

CM - I can't get involved in those kind of debates. They boil down to one thing. That is, should the government force society to look after the disadvantaged, or should people take that responsibility themselves.

However, I suspect that some people are adopting that argument to cover up for a) greed in wanting lower taxes and smaller govt and b) mistrust of government.. even if they don't realise it themselves

I've been down some of that road with them, you are right, they don't feel govt. should be forcing anyone to do anything, beyond a very few essentials (i forget the details). They deny the greed claim (a), by attesting to the voluntary work and charitable contributions they make and they happily admit to (b) and provide evidence as to why that is entirely justifiable, especially with Obama in place. What is clear is that they don't know much about the UK, but they are quick learners! Honestly, try them!!

Or getting knocked unconscious even whilst having insurance and having the luck to be taken to an emergency room at a hospital that your insurance doesn't cover - when you wake up, they'll check your insurance details and transfer you, but you still owe them for what happened beforehand.

Myth

At least in California, this was true until I think 2009 - if you got taken to an out of network hospital (not contracted with your insurer), or got treated in emergency by a doctor who is not contracted to your provider, you were eligible for much higher fees. In other states you still have to pay - if you get taken to an ER which is out of network your healthcare provider will pay what it thinks are 'reasonable' costs for the service you got, then you get billed for the balance if the hospital thinks it should charge more - and some insurers make up ridiculously low costs for the 'reasonable' cost, so in practice you end up paying a lot. The practice is banned in 10 states, but not everywhere by a long shot.

Read more below if you like:

http://scrubsandsuits.com/news/california-bans-out-of-network-billing-for-er-group

http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/Emergency-Room-Costs.aspx

I know it differs per person

You say that as if it's a small detail!

It's already been established that the US pays in one way or another much more for healthcare than we do as a percentage of GDP.

Your cover is also FAR FAR better than those typical US policies you talk about, even when you don't consider being unemployed, having a temp job, having a rubbish job and so on.

Plus national insurance does not fund the NHS, so it's a pointless comparison.

Average Single cover isurance policy - $4800 a year
Which in real money is £3000 a year, or £250 a month.

How much do you pay for the NHS a month? I know it differs per person but my National Insurance contributions in the UK far exceed £250 a month.

So in the US who would pay that $4800/pa for you're parents/granparents/disabled relatives if they couldn't work or had enough savings?

so why should you be forced to make what is essentially a charitable donation to a cause for which you have no sympathy.

However the problem with the inexorable decline of our society towards an american model is the focus on me, me, me 🙄
I was brought up and indoctrinated in a very Tory family, I started having strong doubts about the wisdom of all this by the mid-80's.
Then I went to the US and came back quite rabidly socialist in disgust at the poverty and lack of health care there.

I do believe it's called civilization, even the Romans gave bread to it's citizens.

That's a really bad example!

It's proven that having a health system that cares for all benefits all - just think pandemics, measles & mumps.

Yes, all true, the herd immunity stuff is all correct, and further The Spirit Level shows that greater equality is better in health and social terms for all starta of society, not just on average.

So in the US who would pay that $4800/pa for you're parents/granparents/disabled relatives if they couldn't work or had enough savings?

Medicare and Medicaid systems provide a level of cover, and the new recovery and reinvestment act has helped this out.

But what does that £250 cover LHS? In my freinds case his insurance didnt cover him for childbirth (didnt cover his wife more to the point). What about long time care?

Does that £250 equate to the level of cover provided by the NHS?

I seem to recall that, somethig like 40,000+ US people die anually due to lack of health insurance. That seems a bit high to me, so there probably a bit of "figure massage" going on. If that is to be believed, that's pretty harsh. Not sure how the NHS would compare to it though.

Medicare and Medicaid systems provide a level of cover, and the new recovery and reinvestment act has helped this out.

Sounds like they have it all sorted
wonder how the poor fella in the OP managed to miss out on all that help?

But what does that £250 cover LHS? In my freinds case his insurance didnt cover him for childbirth (didnt cover his wife more to the point). What about long time care?

With the insurance policies you can tailor it to whatever you feel you will need. If you are a female and have no intention of having kids then you can state this. You can choose to have high or low deductables depending on how many times a year you think you will see your doctor.

Does that £250 equate to the level of cover provided by the NHS?

Hard to do the exact comparison

I seem to recall that, somethig like 40,000+ US people die anually due to lack of health insurance. That seems a bit high to me, so there probably a bit of "figure massage" going on. If that is to be believed, that's pretty harsh. Not sure how the NHS would compare to it though.

Thousands die each year in the UK from contracting MRSA, then take into account the level of service you get from hospitals like that one in Staffordshire.....

Average Single cover isurance policy - $4800 a year
Which in real money is £3000 a year, or £250 a month.

How much do you pay for the NHS a month? I know it differs per person but my National Insurance contributions in the UK far exceed £250 a month.

Median employer + employee NI contributions for employed people are about £490 a month. Although don't forget that NI contributions to cover NHS, unemployment benefit if you lose your job, state pension and a bunch of other things. The NHS also pays for much more stuff - on many US plans we're talking a deductible of $1000 or more, ie. you pay the first up to $1000 of any illness you happen to get. Not to mention having to pay for stuff like GP visits and full costs for prescription drugs (which are also expensive over there for various reasons), oh and some cheaper insurance not paying for the whole amount, just a percentage (I think they call it 'co-pay'), so you can still end up with big bills even with insurance.

Also, for a family the typical cost is somewhat more - $13700, which assuming both adults are working is about $7000 each.

http://www.usatoday.com/money/industries/health/2009-09-15-insurance-costs_N.htm

Every time someone looks at the true costs of the US healthcare system, it is way way more than any other developed countries as a percentage of GDP, or per capita, despite basically not doing preventative healthcare on a surprisingly large proportion of the population, and having completely insane defensive care and/or over-treatment to increase profit on the rest (eg. the extreme medicalisation of birth that was mentioned above, which doesn't lead to better outcomes, but does lead to fatter profits and less chance of lawsuits).

Thousands die each year in the UK from contracting MRSA

and your point is, it's better in the US?

http://www.mrsainfection.org/mrsa-in-the-usa.php

Sounds like they have it all sorted
wonder how the poor fella in the OP managed to miss out on all that help?

Cos medicare doesn't cover preventative or non-urgent care.

eg. If you have chronic pain, mental illness, or any other long term problem that makes it so you can't work or afford insurance, over here, you go to the doctors, get treatment, and you can become a productive member of society again. In the US, if it isn't going to kill you, they don't give a damn, you don't get treatment.

Oh and from figures on here (there is a reference for where they get them from, so I guess they're probably accurate):
http://www.guardian.co.uk/news/datablog/2010/mar/22/us-healthcare-bill-rest-of-world-obama

In the UK, we spend $2815 per person per year, to cover everyone in the country for both emergency and non-emergency treatment. All paid for from tax.

In the US, they spend $6719 per person per year, to cover some people for emergency only treatment, and the lucky ones for all treatment. On average, people spend $3500 themselves on healthcare, and the government spends $3200.

So, their government spends more money per person out of tax, plus they individually spend more additional money each than the cost of UK healthcare, yet they still have a large proportion of people receiving basically third world healthcare, with no non-emergency care.

MRSA and poor service don't exsist in US hospitals?

Cant be that hard to do a comparsion though, the NHS system doesn't seem to exclude anyone or anything for treatment (stand to be corrected on that though). What would a policy cost with a similar level of cover cost?

Hospitals need to make profit, so they tend to do as many treatments as expensively as possible. The insurance companies grumble a bit but then they just pass the cost onto the employers who pay it.

Thousands die each year in the UK from contracting MRSA

Very disingenuous:

[IMG] [/IMG]

On 19 per cent of death certificates which mentioned MRSA in 2009, this infection was recorded as the underlying cause of death. This figure varied between 17 per cent and 36 per cent over the 1993-2009 period.

...

Those who die with MRSA are usually patients who were already very ill and [b]it is their existing illness, rather than MRSA, which is often designated as the underlying cause of death.[/b] There is therefore an interest in the number of deaths where MRSA contributed to the death – only conditions which contribute directly to the death should be recorded on the death certificate.

[url] http://www.statistics.gov.uk/cci/nugget.asp?id=1067 [/url]

I wouldn't trust government statistics if I were you!

http://www.bbc.co.uk/news/uk-england-stoke-staffordshire-13620261

Among the scroungers of this country who will spend a life of taking more from the UK system than they contribute there will be a percentage who do not seek to intentionally abuse the system and have merely had the misfortune to end up needing a service such as the NHS.

I believe to treat these people is what makes us civilised.

Some of us (although on this forum the proportion of Henrys is above the national average) could just end up in such a situation one day.

Genuiinely interesting points re: 'tailoring' your cover depending on what you are or aren't likely to need treatment for, so i guess if you don't have children and live a very healthy 'straight edge' lifestyle you don't need to subsidise fat, boozy or smoky folk.

LHS has managed not to mention the money that US medical 'invests' in loss adjusters, whose work entirely consists of trawling through patients/claimants policies, personal and family histories with the express aim of making claims 'ineligible' and not paying out for their treatment. These people are not employed to make sure the premiums of honest (as in when they apply for insurance with regards to their medical histories) healthy folk are kept low, they are employed to maximise the profits of the insurer.

Don't get cancer, type 2 diabetes, mental health, respiratory, heart, liver or kidney problems as these people will work day and night to find a way of not paying for your care.

It was, by the way, autoworkers' labour unions that were among the people pushing for company-based healthcare instead of state-based healthcare. That was just the beginning of their awful decision making.

They boil down to one thing. That is, should the government force society to look after the disadvantaged, or should people take that responsibility themselves.

LHS - Member
I wouldn't trust government statistics if I were you!

http://www.bbc.co.uk/news/uk-england-stoke-staffordshire-13620261

Where did you get your figure of 'thousands' from?

CM, Molgrips I have the log on of Junkyard for that there forum I will start a thread on Socilaist healthcare to see where i get - feel free to join me and make your presence know via some subtle STW reference to airplanes , bombers or the like.

Don't call it socialist health care, try to be very precise, you might find yourself drawn into an argument about socialism rather than health care. Try some thing like US / UK healthcare provision

I'm there already, in fact that site has a very useful lesson for us. A few years back, maybe 5-8 years ago it was very active in the off-topic section as people from all sorts of political persuasion came together and argued and argued and argued about anything and everything. Eventually, the regulars became familiar with other's standpoint to the extent that there was pretty much no point in trying to discuss anything as the debates eventually reduced to their idealogical standpoints. Slowly the debates died out

Cheers CM will start one tonight and attempt to be precise.
Are they grammar nazis ? do i need to spell stuff proper like?
EDIT:The arguments here wont dry up as we are far too stubborn- not sure that is a good thing. I actually get your point and vow to mix it up a bit. I can see why the roll of gentle troll /debate facilitator is a good one/essential.

no, not grammar nazis and actually very amenable to being proved wrong, if you have reliable evidence. Most are American, so the time lag is a bit frustrating

You might find some contributions from a truculent bastard called deadlydarcy 😀

EDIT: CM, why that forum in particular?

EDIT: CM, why that forum in particular?

Quite an international forum, of some very smart fellas, orignally brought together for puzzles and such, and encompasses views which we don't often see here, including Right libetarians. Also worth exploring Palestinian / Israel questions on there. But they really know their stuff and are strongly driven by evidence

These two, long threads, should give you a sense of audience
http://www.greylabyrinth.com/discussion/viewtopic.php?t=13736

http://www.greylabyrinth.com/discussion/viewtopic.php?t=13578

if you have reliable evidence

Not all arguments can practically be evidence based though unfortunately. Especially not this one, as it's ideological.

the thing is the disadvantaged are not in a position to look after themselves and if they were they would not be disadvataged

True, but not what I meant. I meant should govt force the well off to look after the disadvantaged or should [b]the well off[/b] take the responsibility themselves to help the poor, ie through charities etc.

Most compassionate right-wingers that I've spoken to (there are some) believe that charity should be enough, and that if people don't choose to give enough to charity then that should be worked on through means other than legislation or taxation.

Most compassionate right-wingers that I've spoken to (there are some) believe that charity should be enough, and that if people don't choose to give enough to charity then that should be worked on through means other than legislation or taxation.

what other means are there?

True, but not what I meant.

I meant should govt force the well off to look after the disadvantaged or should the well off take the responsibility themselves to help the poor, ie through charities etc.

Most compassionate right-wingers that I've spoken to (there are some) believe that charity should be enough, and that if people don't choose to give enough to charity then that should be worked on through means other than legislation or taxation.

what other means are there?

Good question. I think they are talking about charity campaigns and appeals and so on. It clearly doesn't work very well!

I suspect that the concept of free will is like a pillar of faith to many there. However I believe we have a moral obligation to help out those less fortunate, which from some points of view contradicts ultimate free will. As above, it's why we came up with the idea of government and taxation.

Ultimate free will is great, but not when it means ignoring your unfortunate fellow man to preserve it.

American culture is heavily permeated with a lot of myths about the power of individual enterprise and self-determination. They can't help it, bless 'em.

There certainly does seem to be a lot of propaganda floating around.

If you've been raised to believe with an almost religious fervour that anyone can achieve anything as long as they work hard (The American Dream), then it's no wonder you see the poor as undeserving.

Of coures this ignores the fact that the American Dream is largely a myth.

America had to be marketed to those living there and those wishing to go there in the 19th and early 20th centuries, for political and economic reasons. This seems to have had knock-on effects.

Fair amount of crap being spouted on this thread by those with no knowledge of what they're talking about, but hey it is STW after all. Plenty of holes I could pick with both sides of the argument, but one point sticks out the most and it's the one surrounding the greedy profits of the insurers.

The average EBIT of the 5 biggest health insurers in the US was 4% last year.

Compare them to Microsoft at 38.46%

Compare them to Shell at 10%

Compare them to Halliburton at 22%

Compare them to Apple at 28%

Compare them to Lockheed Martin at 9%

So remind me again who's making the monster profits?

In my experience the American people donate to charity a lot more freely than in the UK due to mostly (although they would say its from the kindness of their heart) because of a tax right-off. This also means that more diverse and numerous charities receive significant donations rather than the reliance on the big one-off deals like Comic Relief and Children in Need where only a handful of charities benefit.

the greedy profits of the insurers

Well posting a list of profitable companies is hardly useful.

But I didn't accuse insurers of being greedy, I accused them and the hospitals of being profit-making companies. So they have a vested interest in doing MORE to you than might be strictly necessary, or at least making it cost more. This has advantages I imagine, but it also has disadvantages, especially when cover is limited.

Plenty of holes I could pick with both sides of the argument

I'm interested to hear more.

I agree tbh I would not want the doctor to have a financial interest in how much treatment i recieve. It would seem quite likely to make them do things you dont need just for money.
It would also have been useful to see the profits of the hospitals /providers as well as insurers.

LHS: donations to charity are tax-deductible in the UK, too.

Junkyard: Don't NHS GPs get paid per procedure? Isn't that a financial interest in your treatment?

There certainly does seem to be a lot of propaganda floating around.

Yeah, but let's not interrupt the backslapping, eh?

donations to charity are tax-deductible in the UK, too.

Please explain more.

Please explain more.

'Give as you earn' deducts donations from gross salary

I dont think Dr's pay is quite as simple as you suggest. Lets just assume it is do you think it is a good idea or a bad idea.

I've never heard of that before, I wonder how many companies sign up to this scheme?

It would also have been useful to see the profits of the hospitals /providers as well as insurers

The size of their profit is not an issue - the fact that they have to make one by definition is I feel.

Yeah, but let's not interrupt the backslapping, eh?

Look, I'm not anti-US, I've got lots of family there and all. Most countries have problems, and in the US I have come to the conclusion that one of them is the healthcare system. The political situation is simply down to history and ideology, and is highly debatable. The healthcare situation is not. It's a shambles.

Don't NHS GPs get paid per procedure?

That said, GPs and GP practice managers do have the highest GMQ * of any NHS group so everything should be as simple as possible for them

* General Muppetry Quotient

To put some perspecive:

Average Single cover isurance policy - $4800 a year
Which in real money is £3000 a year, or £250 a month.

How much do you pay for the NHS a month? I know it differs per person but my National Insurance contributions in the UK far exceed £250 a month

NI pays for a lot more than just the NHS

It's pretty crude but NHS budget is £110bn / 60 million = £1800 per person per year. That's shitloads cheaper than the US model not to mention the fact that the NHS is so much further reaching, including things like social care, subsidised prescriptions etc

aye, fair point Molgrips.

aye, fair point

Ban him! You can't say stuff like that on here!

Junkyard: Don't NHS GPs get paid per procedure? Isn't that a financial interest in your treatment?

Isn't the paying per procedure only for things that are being targeted as a health measure. Like extra money for hitting vaccination targets etc. Things where whilst it may not be obvious to some individuals that the procedure is in their interest, getting more of them done is certainly in the general interest of society.

Incidentally, as I understood it with over-treating in the US, is that it is very hard to take a legal case for doing too much treatment, unless you really screw something up. Whereas if something bad happens to someone and some test or preventative procedure hasn't been done they might be able to argue that it was some kind of negligence? Or something like that? It was with respect to childbirth that I heard this - that essentially a lot of doctors are unwilling to support home births / non-medicalised forms of birth, because if something goes wrong, they are likely to get sued, whereas even if doing a caesarean makes things more risky (which it supposedly does in many cases), it is less rare to be sued for bad things going wrong in operations assuming they are seen as just accidents / bad stuff happening as opposed to a poorly performed operation.

Litigation and insurance is also a pain. For example, at a US person's house, they were very careful to tell all visitors to be careful of a step at the door. This was because if someone tripped over the step, they might get sued. This isn't because all American citizens are lawyer hungry people who sue their friends. This is because of the health insurance system - in a similar way to car insurance over here, if you have an accident, your insurer tries to work out who is to blame, or if it was just an accident. If they think there is a reasonable chance that someone else was to blame (eg. you trip over someone else's doorstep without them warning you about it), then they sue them to reclaim the money. As the insured person, you have no real choice as to who your insurance company chooses to sue (as you want the money off them for the treatment).

sorry typo it said **** you molgrips

Lol 🙂

It's pretty crude but NHS budget is £110bn / 60 million = £1800 per person per year.

Although there are only 31 million taxpayers, so it's a bit over £3k for each of them 🙂

It's pretty crude but NHS budget is £110bn / 60 million = £1800 per person per year. That's shitloads cheaper than the US model not to mention the fact that the NHS is so much further reaching, including things like social care, subsidised prescriptions etc

Take 30% off the population who are either under 16, over 65 and not paying and the unemployed and you are down to about 40 million = £2750 per person per year or $4500 per person!!

molgrips - Member
Lol

Sycophant

LOL - what Mike D said! ^^^^^

so thats £3,500 per person or $5,670.

As stated, don't think that the healthcare is "free" in the UK.

So lets get the kids down the mines and work till you drop?

LHS - Member
LOL - what Mike D said! ^^^^^

so thats £3,500 per person or $5,670.

As stated, don't think that the healthcare is "free" in the UK.

Free at the point of delivery

And where did you get your MRSA stat from earlier?

Free at the point of delivery? What has that got to do with it?

And where did you get your MRSA stat from earlier?

Google MRSA deaths UK

it's a bit over £3k for each of them

Small price to pay.

But it's bnot a very useful statistic because NHS is funded from general taxation and that is not all personal income tax.

Free at the point of delivery? What has that got to do with it?

Everything in the world! Do you need it spelling out or can you just perhaps read the thread?

It is irrelevant how many taxpayers - the cost per person is what counts - far less than an insurance based system. or do you really want to pay a lot more for your healthcare while others have no cover? Do you really want third world child mortality rates?

The NHS does more healthcare for less money than just about anything else. No one dies in the UK because they are too poor to afford healthcare

29 million people manage to avoid paying tax altogether in the uk? Wow....what about VAT, Fuel tax, council tax, etc?

Can you count the people over 65 that have retired? Surely they have contributed to the NHS at some point have they not? Do you pay tax on your pension? I thought you did, but may be wrong.

Everything in the world! Do you need it spelling out or can you just perhaps read the thread?

Seems you have got the blinkers on a bit there.

No one dies in the UK because they are too poor to afford healthcare

This is what separates us from the beasts

Please explain then.

No one dies in the UK because they are too poor to afford healthcare

No, but an unnecessary amount die due to lack of basic care whilst in hospital - dehydration, nutrition and superbugs. Is this due to the level of funding being too low?

LHS do you have anything material to back that sweeping statement up?

LHS - Member
Google MRSA deaths UK

No, tell me where you got the 'thousands' from and how that contradicts the official stats, instead of posting a completely unrelated story.

http://news.scotsman.com/uk/Dehydration-kills-elderly-hospital-patients.6787851.jp

http://www.bbc.co.uk/news/uk-england-manchester-13786420

http://www.eadt.co.uk/news/ipswich_hospital_apology_after_death_of_mum_following_four_falls_1_929373

http://www.coventrytelegraph.net/news/coventrytimes/2011/06/22/concerns-remain-over-hospital-food-92746-28922202/

http://www.bbc.co.uk/news/uk-england-stoke-staffordshire-13620261

I could go on I'm sure.

LHS - like to back that up with something other than hyperbole? You have already been shown to be talking rowlocks about MRSA. Usually you have decent info. Whats your blind spot here?

I am certain the NHS would be better for more money. Spend the amount even as a % of GDP that the US does and you would nearly double the budget. Thats a politicial decision tho.

We get what we pay for - and even with the large increases in funding since 1997 we still pay less for our healthcare than most comparable nations

EDIT - so hyperbole then not decent data

You make the mistake of believing that Healthcare funding in the UK is covered by tax receipts... in case you hadn't noticed, we're spending more money than we take in, and a big chunk of this is on healthcare - we're paying for the NHS by putting it on the mortgage!

Per-capita health expenditure for the UK, 2010, was (US$) 3129

Now, how many of us pay that a year in [i]total[/i] taxes?

Factor in the young, the old, the unemployed, and the lazy not contributing to the pot - and see where your "free" healthcare is coming from!

LHS do you have anything material to back that sweeping statement up?

Probably read about it in the Daily Mail, so it must be true. 😉

Out sourcing of cleaning was a mistake, bring back the Matrons.

[img] [/img]

LHS, this isn't about picking holes in the NHS. This is about social versus private healthcare. So posting stories about MRSA is not useful, nor is posting about budget deficits.

Why do you think 'free at the point of delivery' is not important?

Probably read about it in the Daily Mail.

Wow, that wasn't predictable at all!! 🙄

Still no source though...

EDIT - sorry molgrips!

Stop bloody bickering! Talk objectively or not at all!

And again LHS, this doesn't happen in the US system then?

I dont think the argument is about whether medical treatment is free under the NHS, we all know its not. Its about whether an induvidual has the right to adequate health care, whether they can afford it or not.

The figure i read is quoted as 44'000 amercain people dying anually beacuse they don't have medical cover. They died because they didnt have the coin. That is shameful for a developed country.

Should add that figure come from wikipedia, so could be way off. Its under teh entry for "health care in the United States" under teh heading "death". 40% chance of dying because you can't afford to recieve timely health care. Nice.