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[Hallcat]

We don't have a choice here.  There isn't a national health system.  As bad as it sounds from some of the stories I've heard navigating the system and working out a way to get the care you need seems better that getting the bill in the mail.  We pay a hefty percentage of our gross pay to cover health care insurance.  And another hefty percentage paying what insurance doesn't cover, deductibles and coinsurance.

@Vasco, GO! Scientology, they never get health care and only pray for a cure...that is a possibility?? 

But what do you do for a slash that need stitches?  Pray for closure?   

[Wooster]

 

I saw last week that one of the UK private medical insurance companies are copying some of the worst practices from some of the US firms already, a bloke was told that his insurance wouldn't pay out because he hadn't suffered the right kind of heart attack..

[Thermalsig]

I saw last week that one of the UK private medical insurance companies are copying some of the worst practices from some of the US firms already, a bloke was told that his insurance wouldn't pay out because he hadn't suffered the right kind of heart attack..

Don't go blaming that shite on us. If they had figured out how to do that long ago, they would have.

[Norv]

One of the main problems I see is that the cost of health care is hidden in so many systems.  In the capitalistic system it is hidden in insurance premiums a - in the socialist systems (national health care) it is in taxes.  When you insulate people's decisions from the costs of those decisions, they make choices that aren't optimal. 

Example:

It sounds to me like Nivlac's doctor went nuts on the tests and meds because it makes him money to do so and Nivlac won't complain becasue someone else is footing the bill.  Hellcat reccomended that you tell him you are footing the bill because she know's that will change what the doctor prescribes.

IMHO there are 3 situations concerning health care:

Totally capitalistic - Imean that we remove the insurance companies and people use the money that they would use for insurance and pay their medical bills.  Most people would be better off by a huge margin if this happened.  Yes there would be a small number of people who would not be better off (the ones who have catastrophic illnesses), but the situation isn't that much worse than if they had insurance....  the copays and deductables for such an illness are a huge amount of money - at that point I would care less if my bill was 500k or 150k.  Plus overall there wouldn't be the HUGE overhead of maintaining an insurance beauracracy.  I work in this field and let me assure you that the cost of administering insurance plans, and coding for insurance, and negotiating contracts, etc, are HUGE.

Totally Socialistic - We give a huge portion of our salary to the government and they provide us with healthcare.  Eventually this will turn into the same kind of mediocracy that you see and the department of motor vehicles - but at least you don't have all of the overhead associated with having multiple payors.

Combination - I think this is what the US has right now.  Worst of both worlds - you have the overhead of insurance companies with a lot of the mediocracy of the socialist system.  If you don't believe this is what we have - ask anyone who is very familiar with medical billing who their biggest payor is...  pretty sure it will be medicare.

Anyway - good discussion!

[Wooster]

The combination here is PFI's

Private firms pay for the new facilities (and sometimes the management) for 30 years, during which time the Government lease the property and pay the bills.
Some work, some don't and if the management don't perform or standards fail to meet the targets, then they get kicked out and replaced.

It leads to some funny working practices though..

This costs us on average £100 a week (if you are working), the unemployed, kids and pensioners get it free though.
One thing to come out of it though is that their isn't any runaway profiteering on the NHS and everyone can reasonably expect to receive roughly the same treatment (it varies a bit depending on the region though..for instance, some authorities approve funding for different (usually new and expensive) drugs than others)
Personally I don't think there should be any at all, but them's the breaks.

Btw..even Thatcher didn't dare touch the NHS when she was in power.

[Thermalsig]

If you don't believe this is what we have - ask anyone who is very familiar with medical billing who their biggest payor is...  pretty sure it will be medicare.

Ask Hallcat, she manages an insurance company. You'd think that working for an insurance company would insure you decent insurance. Wrong, the insurance at her work is one of the worst plans I've ever seen. I pay for the kids on my insurance plan and she stays on hers because it's provided for free. We hope like hell she never gets sick.

[Hallcat]

Just an example of what I deal with everyday:

I received an appeal from a person who had had her claim denied.  It was an ER visit.  The diagnosis that was provided on the bill was obesity.  The plan that she has does not cover obesity.  She sent me a letter explaining that she was at work when she felt light headed and dizzy.  The nurse at her work took her blood pressure and it was 180/110.  Her fellow employees took her to the nearest emergency room.  She sent me a letter explaining what happened and even took the initiative of getting her medical records to send as an attachment.  The medical records confirmed that the bill was submitted with the wrong diagnosis.  I agreed with her that it was a medical emergency and that while she was obese, that was not the reason for her visit.  I had one of my employees pay the bill today.  She went from owing out of her pocket $13,000+ for that visit to only owing $220.  But that is what you have to do with the system we have here.  You have to prove that it is a payable claim.  Its unfortunate. So many people don't speak up and just get put into collections, their credit gets ruined and that messes up the rest of their lives.  I'm not completely in favor of a NHS because that would put me out of a job.  But something does need to be done so that people will continue to seek the healthcare that they need.  It just seems to be a basic human right to me.

My plan at work is horrible.  We have people not going to the doctor when they should, not getting the meds they should, and even worse, self diagnosing themselves and sharing meds.  Most of which are from Mexico.  I don't think the executives of our company realize what the little people are doing to get by.

[Vasco]

We have a mixed system here in NZ.  NHS means really long waiting lists.  People with cancer can wait months to years for an operation and some die whilst still on the waiting list.  Heart conditions etc are the same.  If you have something that causes pain and is not life threatening you can wait decades as the life threatening issues have precedence.

If you want to avoid the waiting lists then you have to have medical insurance and even with insurance it can cost you as the excess on claims and the things not covered are huge.

The bottom line is that medical treatment today is very expensive and governments can't afford to fund it on the existing tax intake and insurance companies get too many claims to make it profitable unless they have huge excess etc.

 

[Wooster]

I made a mistake earlier with the cost to the average punter for the NHS.
For most working blokes, it's 11% of your earnings p/w, so for me that's about £45 a week. Married women get a reduced rate I think, of about 5%.

[Norv]

I also believe that humans deserve a certain level of healthcare and I think that it is easily within our grasp.  Honestly, it doesn't matter to me how it gets paid for - but I hate to see healthcare dollars paying for overhead that is not neccessary. 

I think most decent people would agree with me so far.  Now we get to a sticky point, what is that guaranteed level of healthcare?  Is it immunizations?  Is it anything modern science can do?  The first is inadequate and the second is not sustainable because society simply does not have enough resources to do that for everyone.

I've neglected talking about the profits that many make on the current system  - that money could be used to increase the minimum level of healthcare offered to everyone...  such a better use than to line the pockets of people who are already wealthy.  I don't mind people making decent money - but I couldn't live with myself if I were getting rich by shorting people on healthcare.  In my mind it is different than taking profits for selling Pepsi.

[Thermalsig]

Norv, what I think you're saying, and something to which I agree, is that health care should should not be part of the capitalist equation. I agree, health care should not be a profitable proffession. Unfortunately, that will never happen in America with out a very serious thought pattern change. Why should any one profit from saving or prolonging a life?

More to say, but no need as we have all heard it before.

[Wooster]

It took a national disaster (WW2) and a loan from the USA for us to get the NHS.