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Universal Health Care: from someone who lived under both ...

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Slavister

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... one big reason why Universal Health Care is sane - time and worries saved

A good article here comparing what it's like.

Earlier this year, I shattered my elbow in a freak fall, requiring surgery, plates and screws. While I am a US citizen, several years ago I married an Englishman and became a UK resident, entitled to coverage on the British National Health Service. My NHS surgeon was able to schedule me in for the three-hour surgery less than two weeks after my fall, and my physical therapist saw me weekly after the bone was healed to work on my flexion and extension. Both surgery and rehab were free at the point of use, and the only paperwork I completed was my pre-operative release forms.

Compare that to another freak accident I had while living in Boston in my 20s. I spilled a large cup of hot tea on myself, suffered second degree scald burns, and had to be taken to the hospital in an ambulance. In the pain and chaos of the ER admission, I accidentally put my primary insurance down as my secondary and vice versa. It took me the better part of six months to sort out the ensuing paperwork and billing confusion, and even with two policies, I still paid several hundred dollars in out-of-pocket expenses.
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Slavister said:
... one big reason why Universal Health Care is sane - time and worries saved

A good article here comparing what it's like.
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Did you or your husband have to pay anything at all, other than what is assumed for healthcare in your taxes, in your UK care? Besides the several hundred dollars in out-of-pocket US expenses, what else did you have to pay (insurance premiums, etc.) and what type of coverage did you have (employer?)?
 
As someone who suffers from chronic illness, is incredibly clumsy and accident-prone, and has two young children, I spend an inordinate amount of time in doctors' offices and hospitals. ... I recently opted to switch to a new provider, whose premiums are a more modest but still eye-watering 7% of my salary.
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Is that really an "eye-watering" number for what's presumably the second or third most important expense for her family?

Anyway, seems like she switched to Kaiser Permanente, which is about as close as we get to the U.K. model here (full integration of the payer and the providers).
 
bluesmoke said:
Did you or your husband have to pay anything at all, other than what is assumed for healthcare in your taxes, in your UK care? Besides the several hundred dollars in out-of-pocket US expenses, what else did you have to pay (insurance premiums, etc.) and what type of coverage did you have (employer?)?
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Not me. The linked article's author says it was "free at the point of use" and there was no paperwork (other than pre-op release forms).

Greenbeard said:
seems like she switched to Kaiser Permanente, which is about as close as we get to the U.K. model here (full integration of the payer and the providers).
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So, with Kaiser Permanente, there are no bills to be paid? You waive your Kaiser Permanente card and provider gets paid directly by Kaiser Permanente without anything on your part? (Or say you just pay a copay at the point of service and there is no more paperwork to figure out ... if anything goes wrong?)

chuckiechan said:
It’s a small point, but your care in England was not “free”. Someone paid for it.
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Which noone denies.
 
Slavister said:
Not me. The linked article's author says it was "free at the point of use" and there was no paperwork (other than pre-op release forms).



So, with Kaiser Permanente, there are no bills to be paid? You waive your Kaiser Permanente card and provider gets paid directly by Kaiser Permanente without anything on your part? (Or say you just pay a copay at the point of service and there is no more paperwork to figure out ... if anything goes wrong?)



Which noone denies.
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"Besides the several hundred dollars in out-of-pocket US expenses, what else did you have to pay (insurance premiums, etc.) and what type of coverage did you have (employer?)?"

Please clarify as I did not perceive a complete answer to my second two-part question above.
 
Slavister said:
So, with Kaiser Permanente, there are no bills to be paid? You waive your Kaiser Permanente card and provider gets paid directly by Kaiser Permanente without anything on your part? (Or say you just pay a copay at the point of service and there is no more paperwork to figure out ... if anything goes wrong?)
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I'm sure they track services and spending and transfer funds like any payer-provider relationship. And certainly the patient's share will be based on the benefit design of whatever insurance product they bought.

But out West in particular Kaiser has a closed system--they own the physician groups and the hospitals and you've got to have their insurance product to get in the door. So the premium is more like buying a subscription fee to their system than the way insurance functions when it's distinct from the providers. As far as I know, their providers don't dedicate any effort to contracting with or interacting with any non-Kaiser insurers. It's old now, but this comparison of Kaiser's model and the NHS seems appropriate: Getting more for their dollar: a comparison of the NHS with California's Kaiser Permanente.

Anyway, it's a little different in the mid-Atlantic. Kaiser still owns the physician groups (I think) but they don't have their own hospitals on the East coast. It looks like their mid-Atlantic products use 12 hospitals that of course contract with and take patients from a variety of insurers. But it's worth noting that six of those hospitals are in Maryland, so their prices and budgets are set by the government.
 
chuckiechan said:
It’s a small point, but your care in England was not “free”. Someone paid for it.
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They didn't say it was "free", they said that it was "free at the point of use", which is another way of saying that they did not get billed, but instead helped pay for care for everyone via their taxes, the portion of which goes to healthcare is arguably or even demonstrably less than what we pay for insurance premiums over here.
Yes, taxpayers collectively fund each other's healthcare in the UK, not even remotely a novel concept!
What IS novel is the idea that healthcare is a luxury and a privilege for those wealthy enough to deserve it.

By the way, the UK's National Health Service is a fully socialized government owned and operated system.
Private sector healthcare is available, and insurance policies to pay for it, but the NHS is fully socialist.
It is not "single payer".
The closest thing we have to the NHS in the United States is the VA Healthcare System, also a fully socialized and government owned and operated network.
One big difference is, doctors in the UK "contract" with the Crown to provide services whereas VA doctors are government employees.
 
One more thing, if you don't mind :)
I read with interest this quote:

"That broad public support for reform was crucial. Britain's NHS system was very nearly defeated by opposing interests when it was introduced in the 1940s. It was initially opposed by the municipal and voluntary authorities, who controlled the 3,000 hospitals which Health Secretary Aneurin Bevan sought to bring under national administration, by the various Royal Colleges of surgeons and specialists, and by British Medical Association (BMA), the professional body representing the vast majority of the nation's general practitioners, who stood to lose control of their private practices and become state employees."
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What the author forgot to mention is, in the aftermath of WW2, about 50 percent of those three thousand hospitals were either damaged or in ruins, plagued by equipment shortages and vast nationwide shortages of medicines and even personnel. Britain's economy itself was in ruins, and initially most British subjects even wondered if there would be enough money available through taxes to fund the NHS.

But take a look at what healthcare was like in Britain before the NHS.

 
bluesmoke said:
"Besides the several hundred dollars in out-of-pocket US expenses, what else did you have to pay (insurance premiums, etc.) and what type of coverage did you have (employer?)?"

Please clarify as I did not perceive a complete answer to my second two-part question above.
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I suggest you read the OP article for answers. Best I can tell, she switched employer coverage from something to something cheaper, which costs her 7% of her income in premiums. And there are copays but no deductible.

Greenbeard said:
... out West in particular Kaiser has a closed system--they own the physician groups and the hospitals and you've got to have their insurance product to get in the door. So the premium is more like buying a subscription fee to their system than the way insurance functions when it's distinct from the providers.
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Still unclear though if there are bills involved, etc.

Interestingly, author did not mention in article that her new insurance closely resembles NHS.
 
chuckiechan said:
It’s a small point, but your care in England was not “free”. Someone paid for it.
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Most people understand that. Yes, taxes are part of life. It's how those taxes are spent that is important.

Waste them on perpetual war brought under fraud, or spend on them on healthcare for citizens? Not a difficult decision IMO.
 
Checkerboard Strangler said:
By the way, the UK's National Health Service is a fully socialized government owned and operated system.
Private sector healthcare is available, and insurance policies to pay for it, but the NHS is fully socialist.
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Why does private sector healthcare exist, when the government is providing healthcare for everyone?

The closest thing we have to the NHS in the United States is the VA Healthcare System, also a fully socialized and government owned and operated network.
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Right, which most people would use as evidence against socialized medicine.
 
aociswundumho said:
Why does private sector healthcare exist, when the government is providing healthcare for everyone?



Right, which most people would use as evidence against socialized medicine.
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Are you a veteran? Do you use the VA?
 
aociswundumho said:
If you want anecdotes about the VA, go here and scroll down to the map. I read about 20 of them, I'd say 18 were negative, many were horrifying.
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In some cities the va hospital is the best hospital in that town
 
cabse5 said:
Someone's health care was sacrificed for your care. That's how universal coverage saves money.
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That's precious. Someone's health care is sacrificed here in america every day. For profit health care. Rule number one, make a profit. Rule number two, try to increase that profit. Rule number three take a look at the patient and see what kind of coverage their health insurance will or won't pay for.

Now then, let's get down to the business of trying to not cover pre-existing conditions.
 
aociswundumho said:
If you want anecdotes about the VA, go here and scroll down to the map. I read about 20 of them, I'd say 18 were negative, many were horrifying.
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I asked if you are a veteran and if you use the VA system, and you're pointing me to a website by a group funded by the Koch Brothers?
So okay, you're NOT a veteran and you've NEVER used the system, which treats NINE MILLION disabled vets, by the way.

But YOU HEARD some bad stories on the internet.
 
vegas giants said:
In some cities the va hospital is the best hospital in that town
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I actually CAN think of a couple of very bad VA hospitals.
But that's because my wife and I have personal firsthand experience with them, unlike some people who just "read stuff on the internet." We also have personal firsthand experience with the good ones.

The Memphis VA has always been terrible and for some reason, no matter what anyone tries, they're just incorrigible. One star ratings for the last twenty-five years. And Phoenix is still swamped by four times their previous caseload just as they were when the big scandal first broke out.
Until Phoenix is finally granted the expansion funds they so desperately need they will continue to have and keep their one star rating.

Memphis? I dunno. My wife says it should just be torn down and the vets released to private sector care or allowed to use the closest DoD military hospital instead. Anthony J. Principi's recommendation to merge VA and DoD has a lot of merit.

All that having been said, a lot of recent studies (at least four in recent memory) are saying that for the most part VA care is now equal to and sometimes better than the private sector. (as long as you're not at one of the handful of one star VA facilities, of course)

I know West LA and Long Beach are both good, Long Beach VA is excellent, and so are the Dallas and Minneapolis VA's.
 
aociswundumho said:
My one anecdote would be weak evidence whether it was positive or not.
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There are a ton of veterans here on DP, some able bodied and some disabled, many of whom use or have used the VA in recent times.
Not all of them have positive experiences, but then again, not everyone who has used private sector care has either.
But the point is, you are not a vet and you don't use the system, and when you throw the VA out there as your convenient whipping boy, to make a talking point about the British NHS, you simply have no idea what you're talking about.

In fact, despite the many issues with the British NHS, Brits STILL overwhelmingly demand that the British government continue to maintain it, and not switch it to a private sector system. Their big complaint is that Parliament is starving it of funds.

In answer to your question about why private sector coexists with socialized healthcare in England, most of it is for elective stuff like cosmetic surgery, which is not covered by the British NHS. Also, if you're very wealthy and simply wish to skip to the front of the line, you can pay in cash for your own private doctor and clinic.
But the same thing exists here in the USA. If you have the money, you'll never see the inside of a waiting room either.
Same thing exists in Canada, too.

By the way, the Concerned Veterans for America group exists for one reason only - to PRIVATIZE the VA.
And veterans DO NOT WANT that.
 
Checkerboard Strangler said:
In fact, despite the many issues with the British NHS, Brits STILL overwhelmingly demand that the British government continue to maintain it, and not switch it to a private sector system.
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So what. Many Russians still support Stalin. Do you consider that to be strong evidence that Stalin was, on net, beneficial to the country?

Their big complaint is that Parliament is starving it of funds.
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That's an easy problem to solve - just raise taxes, and tell them the money is for the NHS. They should be happy for the tax increase, because their taxes will be buying what they supposedly want.

Also, if you're very wealthy and simply wish to skip to the front of the line, you can pay in cash for your own private doctor and clinic.
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So it's a two-tier system. Doesn't sound very egalitarian.
 
aociswundumho said:
So what. Many Russians still support Stalin. Do you consider that to be strong evidence that Stalin was, on net, beneficial to the country?
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So you felt compelled to move the goalposts. We were talking about a healthcare system, not a person.
I consider British poll figures about their opinions on their healthcare to be strong evidence that the NHS is beneficial.


aociswundumho said:
That's an easy problem to solve - just raise taxes, and tell them the money is for the NHS. They should be happy for the tax increase, because their taxes will be buying what they supposedly want.
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The funding is there. It is currently being sequestered or held up in numerous council squabbles.
And by the way, be sure and let me know when you find evidence that they would pay LESS in insurance premiums than they do in taxes.
I'll wait right here. :popcorn2:


aociswundumho said:
So it's a two-tier system. Doesn't sound very egalitarian.
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For the wealthiest among us, concerns about egalitarianism have never applied.
Why is that my concern? My concern is whether or not the majority of Americans can afford decent healthcare.

The fact remains that you don't know what you're talking about with regard to the VA.
 
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