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

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

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

    Quote Originally Posted by Slavister View Post
    ... one big reason why Universal Health Care is sane - time and worries saved

    A good article here comparing what it's like.


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

    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.
    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).

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

    Quote Originally Posted by Slavister View Post
    ... one big reason why Universal Health Care is sane - time and worries saved

    A good article here comparing what it's like.
    It’s a small point, but your care in England was not “free”. Someone paid for it.
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    Re: Universal Health Care: from someone who lived under both ...

    Quote Originally Posted by bluesmoke View Post
    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?)?
    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).

    Quote Originally Posted by Greenbeard View Post
    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).
    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?)

    Quote Originally Posted by chuckiechan View Post
    It’s a small point, but your care in England was not “free”. Someone paid for it.
    Which noone denies.

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

    Quote Originally Posted by Slavister View Post
    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.


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

    Quote Originally Posted by Slavister View Post
    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?)
    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.

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

    Quote Originally Posted by chuckiechan View Post
    Itís a small point, but your care in England was not ďfreeĒ. Someone paid for it.
    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.
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    Re: Universal Health Care: from someone who lived under both ...

    Quote Originally Posted by Slavister View Post
    ... one big reason why Universal Health Care is sane - time and worries saved

    A good article here comparing what it's like.
    Someone's health care was sacrificed for your care. That's how universal coverage saves money.
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    Re: Universal Health Care: from someone who lived under both ...

    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."
    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.

    Quote Originally Posted by aociswundumho View Post
    I wouldn't know, I'm not a big Trump fan. I did vote for him, and I'll vote for him again in 2020.

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