Non-US DU'ers! I have questions about your healthcare systems.

[Viva_La_Revolution]

I have been going round and round with a rabid conservative about the health care system here in the US. He claims "Socialized Medicine" has failed everywhere they have tried it. Claims you all pay more taxes than we do, as a result of the Government running it.

I have tried to explain that what he pays yearly for coverage, prescriptions, office visits, etc (not to mention his wife's recent operation) costs him FAR more than any increase in taxes would.

What have been your experiences with health care in your country (good and bad)?

If this inquiry gets enough replies, I will compile them all in a thread for the Research Forum. We need to crush the RW lies about Single Payer Healthcare.

[ncabot22]

1. Overall, my experience is good

I'm in Canada. My employer pays my MSP premiums and provides extended health benefits. If I were to lose my job, I would have to pay my own premiums, unless I could show some economic hardship. Even if I did, the cost is nowhere near what Americans would pay for health insurance (or so I understand). If my employer didn't pay my premiums, I would be paying $54 a month for full health coverage. I don't think that is too bad.

Some things are irritating. The wait times being one of them. I have two cysts on my left wrist that have been bothering me for a year. It has taken me nearly six months to get an appointment with the appropriate doctor but I see him early January, so no complaints. If it were an emergency, I'm sure I'd get in a lot sooner.

Mostly, I'm happy. I had an accident at work and had to go to the emergency room. I got in almost immediately and a doctor took a look at my hand and ordered x-rays. I was probably there for about an hour and a half. I left and paid nothing. Never received a bill. Didn't worry about whether I could afford treatment at the emergency room. It is nice to have that kind of piece of mind.

Good luck with your argument!

[blondeatlast]

2. Welcome to DU--may I inquire a bit further?

How is "urgency" determined? For instance, I have insulin-dependent diabetes, so any little thing I come down with nearly always requires at least a brief doctor's visit.

Obviously, a little cold isn't a trauma, but say, a very upset stomach can really put me down for a long time and possibly lead to some really serious stuff. Are chronic ailments given some priority even with what would otherwise be a minor problem?

What about suffering from more pain than a Tylenol Extra Strength can manage?

I'm a big advocate of the Canadian system as I understand it, but am just curious how it works for those of us who require a bit more service.

Again, welcome--and for allowing me to use you so early here: :toast: Thanks!

[laundry_queen]

10. It can depend.

If you already have a doctor, normally for me, I can get in to see them in a day or so. If it's really bad, such as a stomach bug where you might become dehydrated and need medical attention sooner because of your diabetes, you will be directed to go to the nearest ER, where you will receive care in a matter of minutes/hours depending how busy they are that day. If you have a regular endocrinologist you see, they can direct you on how to proceed when you call them (for example, they can say, we will see you today, or they can say, go to your ER if it's urgent. If they happen to practice at that hospital, they can visit you there later, as the hospital will have him as your doctor on record.)
Does that answer your question? I don't think in your case, priority will necessarily come into play for everyday stuff, for you will receive your care in a timely fashion. Priority is more for wait lists on non-life-threatening conditions, such as hip and knee replacements. In my post I remarked how my dad will be on the list for 6 months to a year because he is pain free and is completely mobile. My FIL was bedridden and on powerful painkillers and got in within 3 weeks (made a mistake in my other post). My FIL was higher 'priority' than my dad is.

For things that require immediate attention, such as pneumonia or what have you, you will get in right away, no waiting lists for those :)

[blondeatlast]

13. That's pretty much how it works for me here and now.

It's more of my own judgment as to whether I need to go to the ER and I don't recall ever calling it wrong. Generally when I have gone I've been admitted even if it's just for observation.

From what I have heard, it really isn't all that different than what it is for most US citizens as the vast majority of us who are insured are on HMOs and need some degree of pre-qualifying for emergency care anyway.

[newyawker99]

9. Hi ncabot22!!

Welcome to DU!! :toast:

[intaglio]

17. UK here

The service is, to all intents, free. I can see my family doctor, go to accident and emergency, receive specialist advice and specialist treatment without any cost directly. There are two things that have to be paid for; Dental treatment (except emergency), general opthamology and prescriptions. Opticians have to give a free check-up every year and very basic eye glasses can be obtained on prescription; mostly people will pay a bit extra for better frames/lenses. Dental treatment is expensive and only part funded even for the most basic treatments whilst many dentists do not even wish to belong to the NHS system (see note below). Serious optical or dental problems are still covered by the NHS. Prescriptions are part paid for by the patient unless:
a) you are under 16 or over 65;
b) you have a chronic need for medication;
c) you are unemployed and in receipt of state benefits:
in these cases all prescriptions are free. In other cases there is a flat charge of £6.50 (approx $13) per item. Even this flat charge can be avoided if the prescribed item can be purchased "over the counter" more cheaply. An example of this last is that your family doctor advises that you can reduce your risk of heart attack by taking 75mg of enteric coated asprin; he could prescribe it but would likely let you just purchase it.

Funding is from the general taxation pool although our "National Insurance" tax is supposed to provide most of the cash for the pool along with unemployment benefits and state pensions. If you can afford it you can also pay for private health care this gets you more immediate access to some specialists and generally more rapid treatment in more "exclusive" hospitals.



Note: Dentists - or don't get me started

when the Beveridge Report was being converted into legislation there were two significant areas of resistance; Hospital Consultants and Dentists. Hospital Consultants wanted far more than was offered and Dentists wanted pay parity with Consultants. Consultants were essential and so they were sweetened with a bit more pay and the opportunity to do private work on the side.

Dentists were told go stuff it, they would be paid as family doctors. Dentists said we will resign and do only private work. The government said you do that and you will never get all the money from the NHS for basic check-ups for the hoi poloi (it was a Conservative government). Dentists said fine we'll do the check ups but virtually nothing else. At the time (immediately post war) tooth decay was not a problem so this deal with the devil was signed. The result is that newly qualified dentist will work on NHS contracts until they have built up their practise at which point they give up all NHS contracts.

My father, who was a family doctor, was one of the "young turks" who agitated for the NHS. He loathed dentists

[MisterHowdy]

3. Healthcare is fine in Canada

The only thing that costs me is prescriptions, i have no coverage/plan for prescriptions.
The doctors always give me freebies when i go see them anyway.

Our taxes are high, but they also go towards social programs and towards groups with special needs.
I'm sure what the avg. Canadian pays here in excess taxes is nothing compared to what people pay
in the US.

[blondeatlast]

5. Welcome to DU as well. Concerning the tax issue--

Can it be compared to what we US citizens have to contribute for our employer sponsorede plans--which are escalating alarmingly?

For instance, my family is covered thru my husband's employer, who just slightly decreased benefits but also slightly raised our portion? I would guess that we pay about $250 a month now (a bargain for what it would cost if this ID diabetic could even GET coverage, which I can't) but we still pay about $3000 in out-of-pocket costs every year.

So really--considering what you get, are you paying a comparable amount to what we pay for private insurance? Or are you possibly even getting a bit of a bargain?

Just curious--I still very much admire the Canadian system; I've heard wonderful things from fellow diabetics who needed emergency care there.

[Hav]

14. .

I think you raised an important issue with chronic diseases that has to be adressed in discussions like these.
Both my parents have diabetes as well. They need medicine and they need insulin. They need to contribute a part to the cost of their medicine (pretty moderate amount and I think that amount a person has to contribute is limited) but looking at the labels, I know what we would pay if we weren't insured. The prices are crazy and we probably couldn't afford it.

Our family of 5 was covered by our dad's job. I'd say that a bit more than a third of his income is lost for all taxes one has to pay, probably around 15% for healthcare although half of it is payed by the employer.
If you have a chronic disease or something bad happens (cancer, any operation), it's a good deal. If you are a very healthy person with no problems at all, you pay for those who get ill. I'd never protest against such a system even if I'd never been ill because there is always the chance for an expensive disease or accident.
Plus, it's not just medicine that is covered by the taxes. Especially with kids, it's important to regularly check the teeth or eyes for free and so on or going to the Doc whenever something is wrong.

Of course, people moan about the costs and the system is not perfect, but I'm actually ok with it.

[bobbolink]

4. I once had a conversation similar to this with some DUers in other countries

They totaled up their taxes, which *are* great, and more than the total we came up with for US taxes.

However, when education and health care is factored in, their costs were *much* less.

And, of course, the peace of mind should be worth *something*. :hi:

Yanno, this would really be a good question for PNHP... I wonder if they have already done something like this?

One of the problems is, other countries with good health care also cover other things with their taxes, such as education, etc., so it's hard to narrow it only to health care.

I'll be interested to see the conversation this sparks!

Good post! :thumbsup:

[Dr.Phool]

6. Socialized medicine vs Single-payer healthcare.

Under socialized medicine, doctors and healthcare workers are employees of the government. Under a single payer plan, such as John Conyers H.R. 676, healthcare is publicly funded, but privately administered.

The bill, which would expand Medicare to cover all Americans, regardless of age, income or employment status. Co-pays and deductibles would be outlawed. The only things not covered would be electable procedures, such as cosmetic surgery.

The bill would be funded by a 3.5% tax on employers and employees and companies such as Wal-Mart and McDonalds would have to contribute.

For industries such as the Automotive, Airlines, Steel, etc., it would be a god-send, drasticly cutting their employment costs, especially to retirees.

Check out www.healthcare-now.org.

[laundry_queen]

7. My experience has been all good.

I'm in Canada also.
We do pay a monthly premium, but it is peanuts, really compared to the U.S. I believe in my province it is $50-100/month, depending on whether you are single or a family.
I can see any doctor I want, across Canada. I've been on vacation in another province and went to see another doctor there. They simply bill my home province for the visit.
The longest I've had to wait to see a specialist (for a condition that is common, and mild and is easy to live with) is 2.5 months. I had to wait 6 wks for a gastroscopy, just as a precaution before I started on GERD meds, it was just something my dr preferred to do. My FIL needed knee replacement and waited 6 wks for the first one and had the second one done 6 months later (they wouldn't do it until the first one was at 100%). My dad is currently on the wait list for hip replacement, he was told 6 months to a year, BUT he is not in any pain at all, so he's very low priority. FIL had RA so got in quickly.
I've had children and the maternity care has been excellent. No problems getting tests or ultrasounds.
We have extra coverage through dh's work for things our health care won't cover - eyeglasses, dentist, prescriptions, chiropractors.
My only complaint is in the larger cities, an ER visit takes awhile. In our smaller center, it is much quicker. It varies in each area, however.

Our family's experience with the U.S. system was not so good. We had a family member who was misdiagnosed in a U.S. hospital and sent home to die. He was in the U.S. hospital because he lived in a border town and his stay was covered by his provincial health plan. He was then transferred by the family to a Canadian hospital where they diagnosed the problem, cured him, and he's been fine since. My family believes his age (mid 90's) had something to do with the unwillingness to treat him. I'm not sure if there might have been some cost concerns in the U.S. hospital or not, but it has soured my opinion of them, that's for sure.

One common misconception about our health care system is that the government of Canada controls everything about our health care. Not true. The federal government sets some basic guidelines, gives some funding and most of the control of the plan is in the province's hands. The government, provincial and federal, have little to no say in the actual care. Smaller health authorities in each region set guidelines according to each specialty, but they are just that, guidelines. The governments fund it, and that's where most of their involvement ends.

Also, some of the wait times for procedures, or travel times for certain tests have more to do with Canada's sparse population rather than any lack in the system. When you have a community of 500 people in the middle of the arctic, having a fully staffed and equipped hospital is not economically feasible. Those people have access to primary care, of course, but for more specialized stuff, they are either flown out, which is completely covered, or they travel themselves, for which they receive a reimbursement from the govt.

The best part of the whole system is never having to get bills and fight with insurance companies over every little thing. No co-pays or deductibles either. I cringe when any of my American friends talk about having to deal with their insurance company for every stupid doctor's visit. We never have to deal with that. No paperwork or phone calls or letter writing for us.

If you want to guage if the Canadian system is a failure, ask any Canadian if they'd give up our system for a U.S. style system. I doubt you could find one, unless they are exceptionally rich people. Don't forget to remind your friend that per capita, the U.S. spends far more on health care than Canada does.

[applegrove]

8. Normally a vat tax pays for health care. That means a value added tax..

so if you get a haircut..you pay an extra 7% tax. If you send your kid to the mall with $100, they pay $7 into healthcare if they spend it all on fashion. Really not a bad way to pay for something that means so much. People complain about line-ups and such..but that just means you are not in an emergency situation and can wait...like if your thumb is infected by a cat bite. In all the countries where the is universal health care.. people love it and hold it as sacred. So that tells ya how it works. So too health care is never 100% universal. Sometimes the cost of drugs are included sometimes not. It is about 70% universal in Canada and France.

So for all your excessive spending..on fashion, magazines, movies, haircuts, and stuff you don't need..you pay a little tax. Not on food. And nobody goes through a nightmare of paying..or bankruptcy. And preventive health is better so people are healthier and have less disease. Much better all the way around. It ties us together too.

[fairfaxvadem]

11. and forget that whole "myth" about waiting...

Even in an area like DC, where there are literally hundreds of doctors' groups, you just can't stroll in and see a specialist or even my primary care. But particularly the specialists: ob/gyn, gastro doctor, etc. I needed to make my appointment for my new ob/gyn a good 4 months in advance. And when my Primary wanted me to have a colonoscopy, I sure didn't get it the next week. It was at least 6 weeks out.

And I don't have an HMO, I have basically cadillac insurance coverage. I pay nothing, ever.

The only thing I get fairly rapidly scheduled is my mammo, but that's because the radiology center can afford to run efficiently since all they do is take a few pictures and move you out.

When I called my primary doctor due to a sinus infection, they were swamped and I could hear the relief in the receptionist's voice that I was fine having them just call in an antibiotic and I didn't need to see the doc. Else, they really didn't have time to see me for 2 days. I'm sure they would have gotten me in if I had some other ailment, but clearly, they were just busy, busy.

[LeftishBrit]

12. I am very grateful for the British NHS!

I have had a 'pre-existing condition' (Crohns disease) since the age of 5, and would never be able to get affordable private health insurance. Free health care and cheap prescriptions save me a lot more money than I might be paying extra in taxes.

The NHS used to be MARVELLOUS. In fact, anyone with a serious health problem was generally best advised to go to a NHS rather than a private hospital: the latter might have more frills and entertainment and more privacy from other patients, but the former usually had better medical facilities. Things have changed for the worse, since Thatcher got into power and underfunded the NHS, and then Blair got in, and started setting all sorts of ridiculous 'targets' (imagine No Child Left Behind applied not only to education, but to everything else as well) and making major administrative changes for their own sake every five minutes. Even after the ravages of Thatcher and Blair, however, the NHS is still good for most things, and it is great to know that getting ill will not automatically make you bankrupt!

[Violet_Crumble]

15. Healthcare in Australia...

We have universal govt funded healthcare, as well as having the option to take out additional private cover if we want. I'm not sure what the tax rate is in the US, but ours is on a sliding scale and I don't find it too onerous. We also pay 1.5% of our taxable incomes for the Medicare Levy...

I found something online that compares the health systems of various countries that might help you...

http://www.hm-treasury.gov.uk/media/70855/observatory_report.pdf

and here's something that compares the cost of US healthcare to other countries...

http://dll.umaine.edu/ble/U.S.%20HCweb.pdf

[Viva_La_Revolution]

19. lots of good stuff in there...

thanks!

[achtung_circus]

16. Here's a link

http://www.democraticunderground.com/discuss/duboard.php?az=show_topic&forum=190&topic_id=9832

to a previous discussion.

and another:

http://www.democraticunderground.com/discuss/duboard.php?az=show_topic&forum=104&topic_id=3009706

and a study by the University of Maine, repeated many times. Americans pay some of the highrest health care costs in the developed world and have poor outcomes. Canadians pay less and live longer. We may have less plastic surgery and profit margin, so that may skew the figures.

http://dll.umaine.edu/ble/U.S.%20HCweb.pdf

[muriel_volestrangler]

18. Figures for health expenditure from the OECD here

http://www.oecd.org/document/16/0,2340,en_2649_34631_2085200_1_1_1_1,00.html

In 2004, the last full year given, the US spent 15.3% of its GDP on healthcare, the UK 8.1% - or $6102 and $2508 at Purchasing Power Parity exchange rates. The amounts that were public spending were 44.7% and 86.3% respectively - so that's $2728 and $2164. So the US spends more per person on Medicare, Medicaid, Veteran's Administration care and any other government programmes that I don't know about than the UK does for a programme that covers its entire population.

If you have money, and can afford the care, it's probably better in the US. The UK has made some decisions not to provide some expensive drugs via the NHS - and getting them via private insurance might not be easy either (like most people in the UK, I don't have private insurance). It's undoubtedly true that some healthcare is rationed because of budgets in the UK - and while waiting lists have decreased in the past few years, we still have to wait weeks or months for things that many countries would schedule in days.

Here's a long article co-authored by Paul Krugman on healthcare spending.

Over the years since the failure of the Clinton health plan, a great deal of evidence has accumulated on the relative merits of private and public health insurance. As far as we have been able to ascertain, all of that evidence indicates that public insurance of the kind available in several European countries and others such as Taiwan achieves equal or better results at much lower cost. This conclusion applies to comparisons within the United States as well as across countries. For example, a study conducted by researchers at the Urban Institute found that

per capita spending for an adult Medicaid beneficiary in poor health would rise from $9,615 to $14,785 if the person were insured privately and received services consistent with private utilization levels and private provider payment rates.<4>

The cost advantage of public health insurance appears to arise from two main sources. The first is lower administrative costs. Private insurers spend large sums fighting adverse selection, trying to identify and screen out high-cost customers. Systems such as Medicare, which covers every American sixty-five or older, or the Canadian single-payer system, which covers everyone, avoid these costs. In 2003 Medicare spent less than 2 percent of its resources on administration, while private insurance companies spent more than 13 percent.

At the same time, the fragmentation of a system that relies largely on private insurance leads both to administrative complexity because of differences in coverage among individuals and to what is, in effect, a zero-sum struggle between different players in the system, each trying to stick others with the bill. Many estimates suggest that the paperwork imposed on health care providers by the fragmentation of the US system costs several times as much as the direct costs borne by the insurers.

[sg_]

20. I have no complaints atall..

I have attended hospital reguarly since I was 2 years old, had well over 200 xrays, MRI scans, hospital stays, countless appointments and checkups etc... God knows what financial situation my parents would be in if they had to pay for it all throughout the years

Back in 2003 I had an annoying problem with my knee (some bone kept coming out of the side of it, often when I walked or bent it back and I had ligament problems), anyway after an appointment with the doc he said hed open it up to have a look and see what he could do, anyway I got my first date for the operation just over 4 weeks after that appointment but had to refuse it because I was to be away, then got a second date for about 8 weeks after...physiotherapy sessions were arraged until they felt I no longer needed them to check up on it, and im now in fully working condition.

It may not be as "smooth" for everyone but I have no complaints from my experiances atleast.

Im not really sure what way it works but I dont have to pay for my glasses and dental appointments either, I just show them a form and away I go. I know my parents have to pay for their dentist appointments and my ma has to pay for her glasses. I guess its because im still in education.

I am from Northern Ireland by the way.

[2Design]

21. the money usa spends on bombs and bullets and military would

easily pay health care for all - not having to worry about losing your home when seriously sick - so many great things out weigh the rest - the rich can still go to private doctors here or in other countries - it is terrible we have so many uninsured and people living on the streets - other socialized medicine countries seem safer all the way around

[Nutmegger]

22. But socialism is evil therefore socialized medicine is evil too!!!

:puke:

[bonito]

23. Curious, what if one can no longer work

In order to care for a spouse, I know here its your decision and your own your own.