New NHS report

[Neil]

Originally Posted by Eric

But it seems to me that your argument is not about the level of medical care .... you so serenely ignore the WHO stats ... but about your paranoid fear of your own govt., or of any govt.

I think you are sort of correct. I was discussing this issue with an American friend and he was explaining how everything the US government touches will end up costing more money with a reduced service in the end.

Maybe barb could explain how medical care works in the US. As far as I understand it people without medical insurance still get treated as they would with an NHS type system.

[bullseyebarb]

Originally Posted by Neil

I think you are sort of correct. I was discussing this issue with an American friend and he was explaining how everything the US government touches will end up costing more money with a reduced service in the end.

Maybe barb could explain how medical care works in the US. As far as I understand it people without medical insurance still get treated as they would with an NHS type system.

Yes, people get taken care of one way or the other. Your American friend is correct in his assessment. Most of the problems we have in healthcare today are the result of previous government intervention in the free market system.

First of all, most us do have insurance of one kind or another. There is group insurance, which is usually offered through one's employer. Individual insurance, which is a single or family policy purchased directly from an insurance company. We also have networks of free and low cost clinics where doctors and dentists volunteer their time. These are well supported with private contributions and have good facilities and equipment. We also have "Minute Clinics" in many stores around the country where you can just stop in without an appointment and receive treatment for minor problems for a very reasonable fee. Then there is the government run Medicaid system for the poor and indigent, which is free to the recipient and covers primary and hospital care. For those 65 and older there is Medicare, a government run program. Seniors pay monthly premiums and there are the customary deductibles and co-pays, as with any insurance. Medicare currently reimburses doctors and hospitals for 80%. Our government is currently proposing to drop the rate of reimbursement to 65%. Seniors pick up the rest of the tab, either out of pocket or by purchasing what is known as Medigap insurance. By the way, Medicare and Medicaid are going bankrupt - which is typical of any government run program. The government sets prices for each service covered under these two programs. Of course, these bear little relationship to what it actually costs for a doctor or hospital to deliver such service.

Private insurers reimburse at rates around 26% higher than government. Hence, hospitals and doctors have relied on the private sector to keep them going. There has also been a fair amount of cost shifting, which has not been helpful to anyone. In addition, there are many unfunded government mandates which push up prices and limit choices in some cases. So, all in all, we really haven't had a true free market in medicine for a very long time.

I am of the opinion that if our current government succeeds in taking over the whole shebang....and believe me they are desperate to do so, the first thing to go will be quality, followed shortly by rationing. Many doctors here are refusing to accept new Medicare patients because they just can't afford to take the hit. Others have already opted out completely and are going all private. There are a lot of very troubling things going on in Washington at the moment and I have no idea where this will end up.

[claytonender]

Originally Posted by bullseyebarb

Yes, people get taken care of one way or the other. Your American friend is correct in his assessment. Most of the problems we have in healthcare today are the result of previous government intervention in the free market system.

First of all, most us do have insurance of one kind or another. There is group insurance, which is usually offered through one's employer. Individual insurance, which is a single or family policy purchased directly from an insurance company. We also have networks of free and low cost clinics where doctors and dentists volunteer their time. These are well supported with private contributions and have good facilities and equipment. We also have "Minute Clinics" in many stores around the country where you can just stop in without an appointment and receive treatment for minor problems for a very reasonable fee. Then there is the government run Medicaid system for the poor and indigent, which is free to the recipient and covers primary and hospital care. For those 65 and older there is Medicare, a government run program. Seniors pay monthly premiums and there are the customary deductibles and co-pays, as with any insurance. Medicare currently reimburses doctors and hospitals for 80%. Our government is currently proposing to drop the rate of reimbursement to 65%. Seniors pick up the rest of the tab, either out of pocket or by purchasing what is known as Medigap insurance. By the way, Medicare and Medicaid are going bankrupt - which is typical of any government run program. The government sets prices for each service covered under these two programs. Of course, these bear little relationship to what it actually costs for a doctor or hospital to deliver such service.

Private insurers reimburse at rates around 26% higher than government. Hence, hospitals and doctors have relied on the private sector to keep them going. There has also been a fair amount of cost shifting, which has not been helpful to anyone. In addition, there are many unfunded government mandates which push up prices and limit choices in some cases. So, all in all, we really haven't had a true free market in medicine for a very long time.

I am of the opinion that if our current government succeeds in taking over the whole shebang....and believe me they are desperate to do so, the first thing to go will be quality, followed shortly by rationing. Many doctors here are refusing to accept new Medicare patients because they just can't afford to take the hit. Others have already opted out completely and are going all private. There are a lot of very troubling things going on in Washington at the moment and I have no idea where this will end up.

Out of interest could you give us some idea what sort of monthly premiums are charged by insurance companies. I also, presume that if you suffer from a medical condition, which is incurable and needs a daily medication (such as diabetes or parkinsons) you would have to pay much higher premiums. Also what about people who might possibly have inherited a medical problem, do they have to pay more, in case they develop the medical condition?

What you seem to forget is that everyone in the UK is already paying for their healthcare through taxes (even if they are not working VAT is paid on many items). However, our healthcare is free to all at the point of use, and no one has to pay any more money even if they have longstanding medical conditions.

[Mancie]

this has turned into a health care in America debate.. the basic principle in Britain is that health care is free and indiscrimanate..wether a person has insurance or not... it may be funded by direct or indirect tax..and that is the big diference between our health care principles and those of the USA.. some Americans seem to have the idea that if you can't afford it you should not get it.

[bullseyebarb]

Originally Posted by Mancie

this has turned into a health care in America debate.. the basic principle in Britain is that health care is free and indiscrimanate..wether a person has insurance or not... it may be funded by direct or indirect tax..and that is the big diference between our health care principles and those of the USA.. some Americans seem to have the idea that if you can't afford it you should not get it.

This is far from the first thread to have taken a detour. That tends to happen during the course of any conversation.

Whilst most Americans still believe in personal responsibility, I think you'd be hard pressed to find any who think that people without resources should be denied medical care. I have repeatedly explained the many ways in which such treatment is delivered. You just don't wish to be persuaded.

[bullseyebarb]

Originally Posted by claytonender

Out of interest could you give us some idea what sort of monthly premiums are charged by insurance companies. I also, presume that if you suffer from a medical condition, which is incurable and needs a daily medication (such as diabetes or parkinsons) you would have to pay much higher premiums. Also what about people who might possibly have inherited a medical problem, do they have to pay more, in case they develop the medical condition?

It depends very much on what sort of coverage you desire. There are 1,700 insurance companies in the U.S. offering a wide variety of plans. Some are quite restrictive, others are not. And some companies are nonprofit, (like Blue Cross Blue Shield.) Higher risk or preexisting conditions can, of course, result in higher premiums - but not always.

I cannot give you a nationwide average monthly premium since these vary state to state. However, I can give you some idea based upon my own community. There are eight different insurance companies operating in the county where I live. Between them, they offer 107 different medical plans. Depending upon individual need, a couple with two children can purchase a family insurance policy with a monthly premium ranging from 145 dollars to 625 dollars, with the average running around $300. For seniors, the Medicare premium is currently $98 per month.

Personally, I have never had a problem with any of the insurance companies I have used over the years. A policy is a contract. You read the fine print. I like high deductible policies with no strings attached.....because I want access to any doctor, specialist or hospital I choose in the U.S. I also maintain a Health Savings Account for out of pocket expenses and carry full coverage and medivac insurance when I travel abroad. So far, so good.