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Thread: Europe's free, state-run health care has drawbacks

  1. #16
    Elite Member witchcurlgirl's Avatar
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    Our system absolutely needs reform, but in reporting on it I wish journalists would stop referring to the EU style of health care as 'free'.

    It's not free, it's paid for by taxes. Nothing in life is free.



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    Elite Member crumpet's Avatar
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    Quote Originally Posted by A*O View Post
    I don't think there's an ideal system. In Canada there is no private health system at all, everyone uses the public one which is great until you need something non-urgent but important done and then you just have to wait your turn - sometimes for a very long time. My sister should have had a precautionary colonoscopy 4 years ago when my dad died from colon cancer which could be genetic. I had one almost the next day, she is still waiting. Having said that she isn't exactly thumping the doc's desk demanding one and she'd never hop over the border to the US and, shock, pay for one so let's hope she's OK.
    See, that is also my concern. The waiting times. I am just not okay with that. Also, there are not enough physicians here to really serve everyone under a national healthcare system. How will that affect wait times for care? That, and what happens to older citizens when money is tight in the system? I mean, is a 70 yr old going to get the expensive treatment they need in a timely manner or is the government going to write them off as not a good investment, instead funding the care of younger people?


    Our system absolutely needs reform, but in reporting on it I wish journalists would stop referring to the EU style of health care as 'free'.

    It's not free, it's paid for by taxes. Nothing in life is free.


    That is a pet peeve of mine,too.
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    Elite Member sluce's Avatar
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    Crumpet reaises a good point that I don't really understand. Under UHC are the doctors independent folks who pay for med school and open a practice and then bill UHC like our Drs bill the insurance companies? Or are the put through med school by the government and then work for the government?
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    Super Moderator Tati's Avatar
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    ^ It's the latter here in Canada. They pay for med school and can do whatever they like when they graduate.
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    Elite Member katerpillar's Avatar
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    Quote Originally Posted by crumpet View Post
    See, that is also my concern. The waiting times. I am just not okay with that. Also, there are not enough physicians here to really serve everyone under a national healthcare system. How will that affect wait times for care? That, and what happens to older citizens when money is tight in the system? I mean, is a 70 yr old going to get the expensive treatment they need in a timely manner or is the government going to write them off as not a good investment, instead funding the care of younger people?

    In Australia, we have a two-tier system. There's public healthcare and also the option of private healthcare, which about 40% of the population have insurance for. For emergency stuff there's no waiting list - they're hardly going to keep you waiting in a queue if you come into an ER with appendicitis, spinal injuries or such. If you need urgent treatment, eg for cancer, you get it within days. It's just the "elective" stuff that has waiting lists, depending on the procedure and how quickly it's required for the patient involved, according to the system of classification that they use based on discomfort, chance it of deteriorating into an emergency etc. You might have to wait a few weeks or months for a non-urgent specialist appointment, too. That's in the public system, though. If you want to skip the waiting lists and all that, you can buy private health insurance. You also get to select all your specialists and stuff when you're treated as a private patient.

    Also, although you're sometimes required to pay upfront that's not the case in public hospitals, only when seeing GPs and for specialist treatment as a patient not admitted to a hospital. However, many will bulk-bill (charge the government, via your Medicare number, only what they will directly pay to the doctor), especially if you're a pensioner, earn below a certain amount or a student. If you can't pay upfront, most (except GPs) will allow you to pay your account later and Medicare will send you a cheque made out to the doctor.

    It'd be nice if everyone could just get the surgery or treatment they needed right away. However, even having to wait 6 months is better than never being able to get it at all because the patient couldn't afford it.

    Quote Originally Posted by sluce View Post
    Crumpet reaises a good point that I don't really understand. Under UHC are the doctors independent folks who pay for med school and open a practice and then bill UHC like our Drs bill the insurance companies? Or are the put through med school by the government and then work for the government?
    I covered most of the billing stuff above. Med students may pay for their whole degree themselves if they go to one of the 2 private unis in the country, but most pay in the same way everyone else pays for a uni degree in Australia. The government pays about half, the rest you pay for. However, if you can't pay as you study, the government will give you an interest-free loan to cover it until you can start repaying it when you're in full time work. Doctors can work in the public system, private or both.
    Last edited by katerpillar; July 7th, 2009 at 01:08 PM.

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    Quote Originally Posted by sluce View Post
    Crumpet reaises a good point that I don't really understand. Under UHC are the doctors independent folks who pay for med school and open a practice and then bill UHC like our Drs bill the insurance companies? Or are the put through med school by the government and then work for the government?

    Usually in countries with UHC tuition costs are much lower than in the USA. There aren't such things as student loans in Europe, because going to college goes between 0 and $1,000 a year (and there are scholarships available for those from low-income families).

    If going to college in the USA is very expensive, Med Schools usually charge outrageous prices. Plus, the AMA (American Medical Association) lobbies against giving more students the possibility of attending Med School because they want a limited (and low) number of doctors out of University each year.

    A UHC system is not possible with the lack of doctors the USA currently suffers. The AMA must get over it and allow more students into Med School.

    In countries with UHC you can go to private or public Medical Schools, and then work either in the private or the public sector or both.

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    Quote Originally Posted by A*O View Post
    I don't think there's an ideal system. In Canada there is no private health system at all, everyone uses the public one which is great until you need something non-urgent but important done and then you just have to wait your turn - sometimes for a very long time. My sister should have had a precautionary colonoscopy 4 years ago when my dad died from colon cancer which could be genetic. I had one almost the next day, she is still waiting. Having said that she isn't exactly thumping the doc's desk demanding one and she'd never hop over the border to the US and, shock, pay for one so let's hope she's OK.
    I think a lot of non urgent care depends on how squeaky the wheel is. Some things like back pain, you're just screwed waiting forever. But my MIL's mother died of colon cancer, so she gets a screening done every year. It also depends on where you live, near a city, more services and likely your doctor has more connections. Nevertheless she should be putting the gears to her doctor about getting one. There is a huge drive to get one performed yearly so she shouldn't have to be waiting for 4 years.

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    Elite Member katerpillar's Avatar
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    Also, unlike the US, in Australia you can study medicine either as a postgraduate degree (which is a bit shorter) - or as an undergrad immediately after high school.

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    Quote Originally Posted by sluce View Post
    I am mixed on this. I have only experienced private care here in the US and have been blessed to always have really good insurance. I know that part of the reason why my rates are so high is because I am paying for the care that is given to those who have no insurance too. I like the idea of Universal Health Care but wonder how much my taxes will go up and would it be greater than what I pay in premiums for my insurance now. I have also heard horror stories of people who cannot get the care they need through UHC. I am afraid you would end up feeling like a number in the system instead of a patient with a team of medical professionals you have selected.
    And increased taxes are almost certainly what you will need to pay for a "free" health system and that is the deal breaker for a lot of people even if that tax is lower than any private health premiums. And it's true that you can't always pick and choose your doctor - in the UK at least many top specialists opt out of the public system altogether and take private patients only. On the other hand there are excellent specialists who stay in the public system because that system paid for their training and they have sufficient moral integrity to pay that system back with their expertise and skills. It really boils down to what your medical problem is, where you live, how urgent it is, how many other people are on the waiting list, etc.

    Having said that if you require immediate emergency treatment you won't be turned away and I have to say the maternity care I received for free on the NHS was excellent. But I had straightforward pregnancies so I don't know what would have happened if I needed ongoing prenatal care. I'd probably have gone private to be honest.

    The main reason people have private health insurance in the UK is to avoid long waits for treatment and perhaps in order to see the doctor of their choice. The private clinics and hospitals tend to be a little more comfortable with private rooms, etc. I don't think the standard of care is necessarily better but staff are paid more so there's bound to be a knock-on effect.
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    Elite Member CornFlakegrl's Avatar
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    Quote Originally Posted by witchcurlgirl View Post
    Our system absolutely needs reform, but in reporting on it I wish journalists would stop referring to the EU style of health care as 'free'.

    It's not free, it's paid for by taxes. Nothing in life is free.
    I hate that too. Everyone running around demanding free healthcare. It's never free.

    And frankly, here in the ol' USA everything our government runs tends to turn into a very expensive clusterfuck.

    Mostly, I disagree that a universal / public healthcare system solves the problem.

    The problem is the high costs. Governement funded insurance doesn't reduce the costs...it just pays for them in a different way (i.e. through higher taxes). It's a bandaid that doesn't treat the infection.

    I suppose to lower costs our government would cap / limit payments. That's either going to mean less available covered treatments or healthcare providers will get paid less. Meaning more of them will close up shop, reduce beds, etc.

    So if we already don't have enuf docs to cover a universal system, what will happen with less?

    I'm not sold on this.

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    Elite Member Honey's Avatar
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    Quote Originally Posted by buttmunch View Post
    I think it depends on where you live in the UK. Where I lived I had fantastic care from the NHS. We all did. Very professional, quick treatment, etc.
    Same Butt, I think the NHS do the best they can, but will always get slated for it

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    Friend of Gossip Rocks! buttmunch's Avatar
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    I had both my heathens in Sweden and had absolutely amazing care, despite both being complicated pregnancies. The pediatrician even came to my house one week after we came home from the hospital to not just check out the baby but also to see our home. It's a weird thing they do in Sweden and it was pretty cool to know they were making sure the kid was in a good place. Lovely care both before and after the birth.
    As far as UHC not really being free, well, neither is state school, road works, garbage pick up or loads of other things. I just consider it another service the government should provide and have no problem paying for it.
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    Elite Member Fluffy's Avatar
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    Quote Originally Posted by sluce View Post
    I am mixed on this. I have only experienced private care here in the US and have been blessed to always have really good insurance. I know that part of the reason why my rates are so high is because I am paying for the care that is given to those who have no insurance too. I like the idea of Universal Health Care but wonder how much my taxes will go up and would it be greater than what I pay in premiums for my insurance now. I have also heard horror stories of people who cannot get the care they need through UHC. I am afraid you would end up feeling like a number in the system instead of a patient with a team of medical professionals you have selected.
    Health care corporations in the US are also for-profit corporations. They need to make a profit to make their shareholders happy. That's the main reason why health care is so expensive in the US. Also, their administrative costs are at least, if not more, 15% of all health care costs. Government-run Medicare is only 3% of costs. Many health care execs have gotten huge retirement and bonus packages too. United Healthcare gave one of its execs more than $1 billion in stock options when he retired. There's the increase in health care costs right there.

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    Friend of Gossip Rocks! buttmunch's Avatar
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    Excellent, fluffy.
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    Silver Member albatross's Avatar
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    Quote Originally Posted by Fluffy View Post
    Health care corporations in the US are also for-profit corporations. They need to make a profit to make their shareholders happy. That's the main reason why health care is so expensive in the US. Also, their administrative costs are at least, if not more, 15% of all health care costs. Government-run Medicare is only 3% of costs. Many health care execs have gotten huge retirement and bonus packages too. United Healthcare gave one of its execs more than $1 billion in stock options when he retired. There's the increase in health care costs right there.
    One reason admin costs are so high is because insurance policies in the US are complicated. Coverage varies from individual to individual. So, even when dealing with honest insurers, there is a lot of confusion regarding what is/isn't covered. The way a treatment is worded on an insurance form can make a difference in whether it is covered or not, which leads to resubmission of claims with new wording to describe the same procedure.

    IMO, part of the problem with this constant debate is that the focus always seems to be on the government-funded single-payer systems.

    There are other systems, such as the ones in the Netherlands and Switzerland. Those systems provide coverage for everyone while using private insurers. The government sets compulsory requirements and insurers have to offer that compulsory coverage to everyone. The insurers can also offer additional coverage above the compulsory level (they can also deny individuals for this extra coverage). Those systems also require individuals take more responsibility, and in the US, a lot of people seem to want freedom without responsibility (not just as related to health care).

    There are pluses and minuses to all of the plans, but there are ways to provide UHC without handing everything over to the government.

    See Health Care Reform Plans - Countries for a simplified comparison of UHC plans in other countries. That site also has information about other proposed plans, some provide universal coverage, others don't.
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