the wonderful world of private healthcare US style

Clong – Member

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.

Don’t obsess on fatalities, that’s just the tip of the iceberg, how about all those suffering massively reduced quality of life, or paying through the nose for unavoidable treatments, or having to settle for second-rate treatments…

I could rant on a bit but I’ll try and keep it brief… As an otherwise healthy diabetic on insulin, in the US I’d face an average out-of-pocket spend for a US patient of $11744. Even if I was lucky enough to be insured- and it’s expensive and sometimes impractical to get medical insurance with an existing chronic condition- it wouldn’t cover my costs. 8% of US households with a single diabetic spend 20% or more on medical costs (that’s households not individuals). 1 in 6 US diabetics surveyed reported that they’d delayed or avoided medical treatment on cost grounds. And if you’re lucky enough to be insured when you’re diagnosed, there’s no guarantee that’ll continue- the financial penalty for moving jobs is devastating in that situation.

Not coincidentally, the insurance situation would have almost certainly meant that when I broke my hip, the high-quality keyhole surgery in-situ traction repair I got wouldn’t have been offered, it’d have been the cheap, quick and crap half-hip replacement, with a disasterous long-term prognosis. Instead, I have a leg that works, and that’ll still work when I’m 80.

So when I see comparisons of US and UK healthcare I’m inclined to take it personally.

Was that really on the cards though? Remember in the UK at least you are still free to buy private healthcare if you can afford it.

Not really knowing what was in the cards on the healthcare reform is a lot of why there is so much resistance. Getting a straight answer out of the government is almost impossible. The simplest of any kind of bill/legislation proposed ends up with a myriad of amendments attached that often have nothing to do with the issue and jacks the cost out of sight.
The healthcare reform legislation was, as I recall, over 1000 pages long and they damned well didn’t want the public to be able to see or comment on any part of it before they voted on it. It’s that approach that had people feeling it was getting rammed up you know where.

Northwind – according to Mrs Grips healthcare is the single biggest worry she and her family experienced in daily life. All sorts of issues and worries.

When she was going to university she was working two part time jobs and had no health insurance because she was too old to be on her parents’ policy. So she had to buy her own – she spent $50 a month on care that was limited to a couple of days of emergency treatment. It was all she could afford.

pretty comprehensive shooting down of Ernie’s argument by Bernardine Healy, former president and chief executive of the American Red Cross

No. The argument that the different reporting definitions means the US infant mortality rates are artifically high compared to other countries has no bearing on Ernie’s post. He only compared the US rates against those of England & Wales. We use the same definitions as the americans, so the comparison is valid. The CDC’s own report (i think IanMunro has referenced it above) accepts that reporting diffferences alone do not account for the high US rates and that it is an issue partly due to the high rate of pre-term babies in the US. Even full-term US babies have a higher infant mortality rate than those of most other developed countries.
Possibly a better overall outcome indicator of healthcare related mortality is ‘avoidable mortality’ (also called amenable mortality). These are deaths from selected specific causes and/or age groups which ought not to occur given appropriate and timely medical intervention. An ex-colleague Prof Martin Mckee has done a lot of work on this including international comparisons, mostly in Europe and the ex-eastern block, can’t recall any US comparisons off the top of my head. My own experience is with birth, death and cancer rates within England and Wales.

What happens if you get knocked dwn and can’t afford the treatment? Do you just get billed for it to pay down the line?

Here locally, and I think it’s a legal requirement nationwide, that a hospital emergency room can’t turn down emergency service to anyone, even an indigent person or illegal alien (which is whole other debate around here). Going beyond the emergency room treatment, what happens depends on a myraid of variables: Private insurance, Medicare, Medicaid, self-pay all come into play depending on an individuals circumstances. That is what the entire issue of this thread revolves around. Our system certainly isn’t perfect and has gapsin it that it sounds like the NHS covers to a large degree. One of the sticky issues in this country, right or wrong, is that too many people just don’t want to take any responsibility at all for their healthcare (or work or education or housing or much of anything else) and expect to be taken care of without any effort on their part.

One of the sticky issues in this country, right or wrong, is that too many people just don’t want to take any responsibility at all for their healthcare (or work or education or housing or much of anything else) and expect to be taken care of without any effort on their part

That’s trotted out here too, often.

The way I look at it though is that it’s better to look after a large number of deserving people whilst accidentally giving a few handouts to scroungers than it is to make the deserving suffer to cut off the wasters.

Or in other words, better to give to too many people than to too few.

Thanks busydog

That’s trotted out here too, often.

I am sure it is an issue oft mentioned there as well–and I agree with you that it may be necessary to include the non-deserving in whatever services rendered so as not to exclude the deserving, but it seems like here the number who just want a nanny is growing exponentially—then add to that the est. 12MM illegals in the country since the government has abdicated it’s responsiblity to create any semblance of a secure border.
I really hope we can find a solution, but it will hard to come up with something that will please everyone.

it seems like here the number who just want a nanny is growing exponentially

What do you mean by that?

I hate the concept of “non deserving” especially when it comes to healthcare. High quality healthcare should be available for all no questions asked. Anything else shows the lack of civilisation of a country who will let people die for being poor and / or stupid

What do you mean by that?

Maybe not the right word, but I meant the people who just want everything handed to them and done for them without making any effort to even try to do something to earn it—sort of making welfare a career aspiration.

I am sure you probably have that element as well–it just seems like the number here grows steadily and the growing number continues in good job markets and bad, so can’t lay it all on a poor job market situation.

I have no issue whatsovever with helping people truly in need who are trying their best to pick themselves up, but not inclined to be so helpful with those who just sit idle, making no effort at all and want everything given to them.

busydog – these are people too – and welfare in the US is hardly a comfortable option is it? I thought they relied on charitable food parcels if on welfare and housing will be very poor

sorry – that attitude stinks to high heaven. You need to look into worklessness and why it occurs not blame the workless.

Maybe not the right word, but I meant the people who just want everything handed to them and done for them without making any effort to even try to do something to earn it—sort of making welfare a career aspiration

And they are exponentially on the rise? You sure that’s not just Republican propaganda? Giving people something for nothing is something people are rightly concerned about it, but politicians on the right of both our political spectra play on that to manipulate voters.

You need to look into worklessness and why it occurs not blame the workless

+1, but without the confrontational first part of that paragraph 🙂

I here what your saying northwind, I only really looked at the fatalaties when I quoted that figure. Reading around the subject shows that long term illness raises the cost of health care tremendously. My father has diabetes, among other things, and I get the feeling that he would long been out on the scrap heap had he been in the states. I do get the impression the Americans have an “I’m alright jack” attitude. Present company excluded, busydog. Thanks for contributing to the thread btw, interesting to have your views here.

sorry – that attitude stinks to high heaven. You need to look into worklessness and why it occurs not blame the workless.

No, the attitude of the lazy, career welfare-takers stinks to high heaven.

And there is,of course, no unemployment in the UK???

Worklessness occurs for a myriad of reasons. Two of the factors being: soft economy/job market and another is the above-mentioned lazy, career welfare-takers who have no interest in even trying to work. Those impacted by the job market/economy I have every bit of sympathy for and believe in giving every bit of help we can–the others not so much.
We are obviously on diffent ends of the spectrum on this one and I respect your opinion and your entitlement to it.

And they are exponentially on the rise? You sure that’s not just Republican propaganda? Giving people something for nothing is something people are rightly concerned about it, but politicians on the right of both our political spectra play on that to manipulate voters.

Of course the Republicans feel that is the case and lean to self-determination and initiative as keys to resolution, just as the Democrats take the opposite view and want people see the government as the entity to take care of everything—and both do it to manipulate/drive votes. At the end of the day, IMHO, I think US politicians really have one main agenda—-to continue getting re-elected—which makes me a firm believer in term limits, but that’s another subject.
Neither party is entirely right or wrong. How one views it is driven, in a large part, by their political and social views—-and none of us are likely to sway the other to their point of view. I do, however really enjoy good debate and expressions of opinion—everyone learns a little they didn’t know and enhance their appreciation of other’s views, even if they don’t agree.

Or in other words, better to give to too many people than to too few

would have spent about two pages trying to make that point well said and very succinct.

Worklessness occurs for a myriad of reasons. Two of the factors being: soft economy/job market and another is the above-mentioned lazy, career welfare-takers who have no interest in even trying to work. Those impacted by the job market/economy I have every bit of sympathy for and believe in giving every bit of help we can–the others not so much.

you are correct and yougeta myriad of views
there is no doubt it creates dependency amongst some people or some peoples only aspirations are to get benefits [welfare as you call it]. Here there is no govt commitment to full employment and there are not enough jobs to go around – plenty of wealth mind but not the jobs. Even if every person on welfare did want a job they would not be bale to do this. I have number of views on this Firstly it is better to have happy welfare folk than unhappy. Secondly given all aspects of their lifes , housing etc would you really want to trade places with them. Would the situation be improved by no welfare? given our countried high incarceration rates and costs i cannot see how withdrawing welfare would improve anything tbh.
+ 1 for the debate intersting to see how others view similar issues
I think you would find some sympathy for your view here re welfare [ especially in the press]. However I think almost no one here would wish to change the NHS to your system a few thousand maximum that sort of number I would imagine. Even the most right wing just try to bring in competition to the system but when they try the country screams no and it is electoral suicide here to ruin/mess up the NHS.

busydog – so yo have jobs for all these people to go to? No structural unemployment as a result of government policies?

My father has diabetes, among other things, and I get the feeling that he would long been out on the scrap heap had he been in the states. I do get the impression the Americans have an “I’m alright jack” attitude.

I can see how people get that impression of us, at least some Americans–there are some that impress me that way as well.
I don’t think your father would be relegated to the scrap heap with diabetes at all. A good case in point is my mother in law. She is in ill health (diabetes and congestive heart failure), 84 years old and living in a semi-assisted care facility (she has been offered living with all the kids, but she won’t do it–and to be totally honest would probably drive any one of us crazy).
Her savings/invenstments ran out a while back and the family have, for the most part, contributed all they could, but it still fell short.
With a little digging, we were able to find multiple sources of financial assistance for her that no-one had bothered to explore that now augment her social security income–as a result,her assisted living is completely paid for, allowing her to live in the setting she wants–and the money the family can contribute she can use for things she wants.
There are a lot of vehicles for assistance here, but they aren’t all under one entity and, unfortunately, it does take some digging and creativity to find them. One thing the US needs is a central clearing point for all the programs availble, both government and private–a lot of people, however well intentioned, don’t know how to find all the resources.

cynically one could say they make it complicated so only nice well educated middle class folk have the skills to access it
Our care of the elderly is not covered by the NHS – it is in Scotland so it does raise many issues about fairness etc.
The NHS provides care for illness but not “help” with old age type ailments such as general infirmity/poor health – what’s the word TJ not palliative or medical but ??///cant remember the word.
It is quite complicated here when you go into care as well but that is not usually the NHS

social care?

@junkyard
I agree welfare benefits can’t be stopped, but I would just like to see them focused on the really needy who are honestly trying to make it and giving some level of honest effort rather than the lazy lot who just want a free ride.

busydog – so yo have jobs for all these people to go to? No structural unemployment as a result of government policies?

TJ, of course we have structural unemployment here, some of it actually caused by the governments interference with business (can you say regulating everything to death, a crappy corporate tax structure, etc) and some of it caused by the errors/miscalculations of business itself (over-expanding, miscalculated product lines, underestimating comp;etition, etc). The people whose jobs have been impacted by those and other factors beyond their control I have complete sympathy for and belive the country should give all the support it can (of course if Congress would reign in the debt and stop deficit spending there might be even more help available). It’s just those that want a handout rather than making the slighest effort to do something about their situation that I have an issue with.

Great discussion–I don’t think any country has all the right answers and every time a good answer/solution comes up, a new question or complexity arises.

part of the issue as i see it, half the population will always be below average intellegence, there can only be so many earning alot of money, you will always have people scrapping by. Not so much through their own inability to get a better job by not trying but because there are others who better than they are, so how ever much effort they put in they will not make it.

Add to this a system where there are more people than vacancies and where skills matter, you are always going to have some people out of work. When we had dockyards, steelworks and coalmines, those who were not intellegent academically had an option, but as we move ever more towards a service economy what do you do with those that are not able.

You can say retraining, but that costs money, so if you have none what can you do?

And yes there are some who live on benefits and choose to do so, but in my experience most unemployed want to work. To do something, the question is is there a job they can do and that isn’t always the case.

A system that demands insurance premiums be paid regardless of income will always favour the rich, as per US, To me the UK system while far from perfect does mean that the office cleaner can get the same quality of care as the MD.

The issue of wasters is something that every country has, and it’s extremely difficult to solve. Here at least, they do try, but how can you really separate the two?

You can’t MAKE someone take a job, and you certainly can’t MAKE them do it.

Nice post mrmo

Worklessness occurs for a myriad of reasons. Two of the factors being: soft economy/job market and another is the above-mentioned lazy, career welfare-takers who have no interest in even trying to work.

I can almost hear the sigh of relief from lazy welfare-takers when new government figures show a sharp increase in unemployment.

These lazy good-for-nothing shysters hope and pray for an economic downturn so that they won’t have to work anymore doncha know

Add to this a system where there are more people than vacancies and where skills matter, you are always going to have some people out of work. When we had dockyards, steelworks and coalmines, those who were not intellegent academically had an option, but as we move ever more towards a service economy what do you do with those that are not able.

We in the US are dealing with that transition away from the old-line manufacturing, steelmaking, etc. and more to a service and/or technology based workforce—-and you are right that a certain part of the workforce isn’t going to be able to adapt. Even re-training only goes so far (and not proven to be terribly cost/result effective), especially for the technology related jobs. If I suddently had to learn IT, I would be totally screwed.

it is not just thatthese jobs were typically males exchanging brawn for [ quite good] wages. Now they need to exchange skills – they dont have= for [usually] poor wages.
Miner /steel workers wage v warehouse/call centre for example.
retraining wont help as some of them are not very able – i work with them trust me on that one- and dont really have the skills employers want nor the ability to learn them.

I can almost hear the sigh of relief from lazy welfare-takers when new government figures show a sharp increase in unemployment.

These lazy good-for-nothing shysters hope and pray for an economic downturn so that they won’t have to work anymore doncha know ?

The element I am talking about could care less what the employment level is at as they have, and will continue to have no interest in working as long as someone else is taking care of them.

Those who are unemployed and on welfare who are honestly trying to find work and improve their situation deserve all we can give in the way of help.

it is not just thatthese jobs were typically males exchanging brawn for [ quite good] wages. Now they need to exchange skills – they dont have= for [usually] poor wages.
Miner /steel workers wage v warehouse/call centre for example.
retraining wont help as some of them are not very able – i work with them trust me on that one- and dont really have the skills employers want nor the ability to learn them.

Very true, junkyard. That is another part of the whole issue. It especially hits those workers who are in the last, say, 10-15 years of their career and at a point where making such a drastic career change is even more of a challenge–both interest/capability-wise and salary-wise.

whilst i agree with you busydog on the shirkers in society, i really don’t know if it is actually a big problem. I look around and yes they do exist. But in the grand scheme of things i don’t think there are actually that many.

In the same way there are people who actively avoid tax, at all levels of the job market, either by employing an accountant, being paid cash in hand, or some other method, some legal others not, but non of them are very moral IMO.

Call me cynical but you mention about the illegal aliens and no attempt being made to stop them coming over the border, but in the same way that immigration has been allowed into the UK, you may find it quietly ignored as it keeps the wages low.

as does mass unemployment.

When there is a shortage of labour then you can have a case on “shirkers” but when labour is in surplus someone has to be unemployed

There are stories of countries successfullly cracking down in immigration and then suddenly finding that there wasn’t anyone to do the crappy jobs.

The element I am talking about could care less what the employment level …….

So you think that in the 50s and 60s when we had full employment it was because there were no lazy welfare-takers with no interest in even trying to work at all in the UK ? Human nature was quite different in those days ?

Then suddenly all that change and by the early 80s, ironically under a Tory government, millions suddenly became lazy and were no longer interested in even trying to work ? Human nature in fact changed.

Do you think that because there is 21.3% unemployment in Spain but only 4.3 in the Netherlands it means that the Spanish are four times more lazy and workshy than the Dutch ?

I guess that if you live in a country where you are told everyday how great your economic model is, and how any failings which might exist are purely down to the failings of individuals, then it’s not surprising that you have come to the conclusions which you have. Or at least been told to come.

Yes in every sphere of human activity there will always be the ones who abuse the system and take the piss – in health, finance, policing, education, housing, transport, you name it …… someone is abusing it. But unemployment has nothing to do with that. It is about the systematic failings of society.

whilst i agree with you busydog on the shirkers in society, i really don’t know if it is actually a big problem. I look around and yes they do exist. But in the grand scheme of things i don’t think there are actually that many.

In the same way there are people who actively avoid tax, at all levels of the job market, either by employing an accountant, being paid cash in hand, or some other method, some legal others not, but non of them are very moral IMO.

Agree with that—I read somewhere that the US govt believes there is something like 400BB in uncollected taxes each year–mostly by people skating around the system–indeed not very moral.

Call me cynical but you mention about the illegal aliens and no attempt being made to stop them coming over the border, but in the same way that immigration has been allowed into the UK, you may find it quietly ignored as it keeps the wages low.

Here I think that the illegals have been ignored not just due to the fact that they keep the wages low—it didn’t start that way. It became a reality because employers (mostly agricultural and service industries) couldn’t get Americans to take the jobs, then they found out the illegals would not only take the jobs, but at a lesser salary and in that way the wage-cost did turn into a factor—of course now the employers don’t want that to change.
What is frustrating a lot of people here (especially in the border states) is that the government (feds and state to varying degrees) want to give the illegals the benefits of citizenship without having to go through the process–which has the potential of adding the 12MM or so estimated to be here into the costs of healthcare and other social care programs—-which is exacerbated by the fact that a lot of the illegals are returning the bulk of their earned wages to Mexico–and those being paid cash probably aren’t exactly paying their share of taxes. One of our illustrious congressmen made a statement the other day that “the Republicans are trying to turn the illegal aliens into criminals”—maybe the meaning of the word illegal got changed.

I do believe that illegal and criminal aren’t the same thing.

But a more intelligent solution is required than simply granting citizenship I feel. If they are coming to the US and working, then there’s work for them. So make the effort to tax that work and you should be ahead.

When there is a shortage of labour then you can have a case on “shirkers” but when labour is in surplus someone has to be unemployed

it is true but tlets not pretend everyone on benefits would tke a job if offered or they are all trying to find work. Again trust me I work with them. I gave one guy some advice on how to improve his chances and how to find work but he declined as he thought he was doing ok with what he was currently doing..he last worked 21 years ago.
I often meet people who have never worked.i suspect we are talking about perhaps 5 % of the unemployed i deal with but i have a selective group of those most likely to find work. I am not sure what the true figure is in general and it is only a few geographical places. I assume this gives say 2- 10%??

Both sides here have a point imho but I would never take a big stick to “welfare shirkers” unless we have full employment as it serves no purposes.

When there is a shortage of labour then you can have a case on “shirkers” but when labour is in surplus someone has to be unemployed

True up to a point, however the group I am referring to were sitting on their butts collecting welfare when the job market was booming. Of course the argument can be made they didn’t have the skillset needed,which is true for many—but a lot of them sure as hell weren’t makikng an effort to do anything to change that.

I do believe that illegal and criminal aren’t the same thing.

Have to disagree on that—if you are in violaton of the law in this country, then you are, in fact, a criminal (whether they ever get prosecuted or not, for a lot of reasons is another story)

however the group I am referring to were sitting on their butts collecting welfare when the job market was booming

How big is that group then?

but a lot of them sure as hell weren’t makikng an effort to do anything to change that

Maybe they didn’t know how to change it? Were they getting good help and support?

Have to disagree on that—if you are in violaton of the law in this country, then you are, in fact, a criminal

I thought there were felonies and misdemeanours, one of which attracted a criminal record and one didn’t?

EDIT: seems not, they are both crimes.

However in the UK it’s illegal to break the speed limit, but you don’t get a criminal record for it so you could arguably be described as not a criminal.