Universal Healthcare: Some Figures

[Prophet 451]

If anyone ever tells you (as someone on HuffPo recently did me) that universal healthcare in the USA would cost too much, here are some figures for you. For the record, I'm a Brit and live under the NHS, I share these figures not to gloat but to piss you off so you guys keep harassing your government into getting your own version.
(All figures from Wikipedia unless otherwise noted)

Amount spent on private health insurance by US citizens: aprox. $2.3 trillion
Medicare/Medicaid budget for this fiscal year: $558.1 billion
Combined total: aprox. $2.86 trillion
Number of uninsured Americans: 46.6 million, 15.9% of population (2005, from cbpp.org)

Aproximate cost to cover all Americans under NHS model (not counting set-up costs): aprox $600 billion
Aprox cost to cover all Americans under French model (generally accepted as world's best, not counting set-up costs): aprox $900 billion
Number of British and French citizens without health cover: 0

Funds spent on administration by private insurers: average 20-30%
Admin costs for NHS (fiscal year 1999/2000): 6.1% (including pensions and benefits)

Things not covered by NHS
Elective abortions (the NHS covers those considered medically or psychologically necessary)
Framces for eyeglasses beyond the purely functional (used to be disgusting but are now quite fetching)
Dentistry (oversight)

Out-of-pocket expenses under NHS
£7 fee for each prescription filled as a contribution to drug cost (the young, old and poor are exempt)
The occasional over-the-counter bottle of asprin, antacids, etc (you could get that from your doctor but why bother?)


In conclusion: A form of universal healthcare in the USA would be vastly cheaper than the current melange, vastly less money would be lost to admin costs and, obviously, everyone would be covered including the unemployed and the long-term sick.

Again, I emphasise that the purpose of this is to make you angry. You live in one of the richest, most advanced nations in the world but you are the only industrialised nation which does not give all of it's citizens healthcare. Now, there's lots of ways to fund healthcare. Britain funds it from general tax revenues. France takes a little from the general tax revenues and the bulk from corporate taxes, Germany does something similar. Coming to this late, the US could easily put together a commission to spend a couple of months studying this and mix-and-match parts until you come up with something special. In the US, losing your job often means losing your healthcare; in France, it means filling in a couple of forms; in Britain, it means ticking an extra two boxes on the back of the prescription.

Stay angry. Stay alert and for the sake of whatever gods you believe in, keep harassing them. My observations of politics leads me to believe that things get done on the Andy Dufresne method (watch Shawshank Redemption) so take that method to heart: Bug the living piss out of your representatives, all day, every day until they finally get fed up enough to do the right thing.

EDIT: In addition, setting up some form of universal healthcare would also provide much needed employment. Why? Because a USHS (for lack of a better term) would require hospitals which require builders, carpenters and electricians. Once they're built, they require staffing, not just with doctors but with nurses, admin staff, handymen and janitors. Make building a health service infrastructure this decade's big public work.

[sui generis]

1. but but are you saying the insurance companies don't have a

right to profit? Think of the economy and all those poor out of work white collar execs! Whatever will they do, wherever shall they go?

[Prophet 451]

2. There's always barber college

I know you meant it as a joke but let me use this to expand on something:
The "free market uber alles" principle cannot work for certain items. The reason is because the customers for those items comprise what is called a "captive market". If the price of, say, a Big Mac gets too high, you just don't have one, no problem there but with essential services (gas, electricity, water, healthcare), you can't do that because you always need them and you always need them reliably. That creates a captive market because although customers can move from company to company, they can't choose to go without your product and that allows said companies to game the system.

We have a few private insurance companies here as well but because everyone is covered by the NHS, they are forced to offer a significantly better product (which generally means luxurious hospitals and brandname drugs rather than the functional hospitals and generic drugs the NHS usually uses). In the US, where you don't have that fallback option, the HMOs can manipulate the system to their heart's content.

Call me old-fashioned but I feel there's something immoral about making a profit off sick people. As for the execs, every hospital always needs janitors.

[sui generis]

7. absolutely agree

and quite frankly the difference in public health when 100% of the population is exercising preventative healthcare is astonishing.

Secondly - America claims to be spurring the economy with "incentive checks", yet the people who would spend on "essential" goods and services for new families are spending their budget on pre-natal clinical and delivery, and lab.

In a much larger sense, if every American who was currently spending $300 - $1000 dollars a month on insurance, healthcare, dental, vision, and accident was spending that money IN the economy we would have a radically different consumer environment.

That's that "trickle up" effect that our beloved idiotic economists completely, and intentionally, overlook.

[Indenturedebtor]

16. It's beyond immoral. They're murderers

Someone is dying with probably every other word in my post because the Ins companies here actively work to deny people proper care. Someone dies with probably every word because there are so many people without health insurance.

Fucking murderers.

[Prophet 451]

18. And there's another reason to have universal healthcare

With private healthcare, some suit decides whether you live or die based on the cost of saving you. In universal healthcare, if the system witholds a particular treatment, the voters (remember, because it's government run, the feelings of voters make a difference) scream to the high heavens and the government gives in (we're currently doing this process with a cancer treatment).

[DesertFlower]

3. thank you for your post.

i'm angry and i've been angry for a long time.

i'm going through a situation right now. my 85 year old mother can no longer live on her own. medicare does not cover nursing homes or assisted living. they run from $2500 a month to $6,000 a month. she has about $30,000 in savings. when that is gone (which will take maybe 6 months) the state will take over paying for her care. of course, i have to put her in a facility that has a contract with the state so when her money is gone she will not have to be moved. i'm going out today to look at facilities.

i've also been told by a hospital administrator that hospital costs for the insured are higher to make up for the people who don't have the money to pay.

does this make sense to anyone?

[Prophet 451]

6. No, and it never did

My grandmother is about the same age. Here, unless you're super-rich (which she isn't), you can get all kinds of help ranging from mobility (essentially, a free taxi service for the elderly and disabled), places in either a nursing home or a "sheltered community" (essentially, a small estate of elederly and disabled with panic buttons in every room and a nurse on-site) and all kids od help adapting your home to your needs. In my grandmother's case, that meant moving her bathroom downstairs, putting in a wheelchair ramp, adapting her dining room into a bedroom and putting grabrails around the bath, toilet and stairs. The local council paid for all of that. Although we chose to do the work ourselves to give it a personal touch, they would also have provided labour (often people convicted of minor, non-violent crimes). All of that is before her assets are even asked about.

[DesertFlower]

9. i was fortunate in finding

a private social worker who has years of experience with cases like my mom's. she's in a psychiatric ward of a hospital right now where she is being treated by gero psychiatrists and a nursing staff that deals with this. she has dementia and extremely bizarre auditory hallucinations. of course, i feel really guilty that i took her out of her home, but i had no choice. she's very confused and doesn't understand how i could do this to her.

[Cleita]

4. That's an old canard that the health insurance companies have spread

far and wide and very successfully. If the insurance companies are allowed to be part of a universal health care system, it WILL cost too much. We need our present Medicare program for seniors, improved, modernized and extended to everyone. This one will work and will down the road cost half of what delivering health care today costs and it will cover everyone not just those who can afford health care and health insurance.

[DesertFlower]

5. exactly. we need HR 676. nt

[Festivito]

8. You're suggesting NHS would cost $2,000/capita, not 3K$?

Canada's costs $3,000/capita(That's apples to your NHS oranges I know). If you were thinking in pounds, however, that would be the same.

The current cost in the US is estimated as $6000/capita yielding 1.8T$. You're suggesting the figure is nearly $10,000/capita. (Either way while not insuring about 16%.)

I wonder where you drew your figures.

[Prophet 451]

10. I noted where I got my figures

That's at the top of the article, all figures from Wikipedia unless otherwise noted. I rounded the $2.26 trillion (working out at $7,439 per person) on Wiki up to $2.3 but otherwise, those are the figures and Wiki themselves drew the figures from the Office of The Actuary in the Centres for Medicare & Medicaid so I figure we can say those are probably accurate.

The running cost figures of the NHS are widely available from HMSO and work out at around £1000 per person, per year. By today's exchange rate, that is indeed around two thousand dollars (to be exact, $1,859.77).

I can't comment on Canada's system since I know nothing about it.

[Venceremos]

11. I used the British NHS

when I was in Scotland in the late 1990's. I went to the NHS doctor because the side of my face near my ear was badly swollen. I'd had recurrent middle ear infections my whole life and I advised the doctor of that fact. But he said the swelling was caused by "the wind" and refused to treat me.

A week later I returned to the same doctor because although the swelling was gone, my hearing was muffled and I had intermittent pain. He again claimed it was from "the wind". I was certain I had an ear infection, as I'd had them repeatedly and knew the symptoms. I therefore asked him for a referral to another doctor for a second opinion.

He refused, saying that patients under the NHS do not have an automatic right to a further opinion. I spent the next week contacting various agencies in an attempt to get proper medical treatment. I was told that in order to get an NHS referral, my first doctor had to agree there was a need for it. Since the first doctor refused to refer me, I was stuck.

I came back to the states a few months later. I visited a US doctor because my hearing was still muffled. The doctor said I had an ear infection that in her estimation, had been untreated for at least several months. She treated it with two rounds of antibiotics and it cleared up. But I permanently lost 30% of my hearing in that ear, from the untreated infection.

I share these facts to encourage you to harass your government into getting better qualified doctors and to get a better system for patients seeking second opinions.

[Prophet 451]

12. We're working on it

I agree, there are some bloody awful doctors in the NHS and that's a scandal. We are working on that and hopefully, things will improve. In Scotland, it's complicated by the bizarre division of laws.

If I gave the impression that the NHS was perfect, I apologise, that wasn't my intention.

[reggie the dog]

13. In France we all have a right to a second opinion

[Prophet 451]

17. Didn't know that

Makes sense though, that's one of the reasons your healthcare is considered the world's best.

[reggie the dog]

20. they changed it recently

until recently you had the right to as many opinions as you wanted and our SECU paid for it, now you can have a second opinion paid for by the SECU. Now your Scottish universities on the other hand, with free tuition for your people, that is something I want here in France and back in the USA, but that is for another thread.

[bobbolink]

14. I certainly hope you don't believe that the US is bereft of medical malpractice?

I'm sorry about what you went through, and the permanent hearing loss.

However, you MUST know that the situation is at least as bad in the US, right? Many tragic mis-diagnoses here, and the resulting deaths.

It's horrible WHEREVER it happens.

[dkofos]

15. Never underestimate the ignorance of the Yanks.

[Prophet 451]

19. I get flamed if I say that n/t