Nationalized Health Care

[gunslinger]

I'm a fairly recent addition to the backroom, but I must admit that I'm enjoying the discussions here very much. Recently I read a post in which the author expressed amazement that Americans don't even have free health care. This is a debate which has been going on for some time in America. The liberals often point to Canada and say that they want to create a national health care based on the Canadian system. The conservatives then point to Canada and say that their system is broken and worthless. They say that the wait to see a doctor is so long that for most ailments you will either get better on your own or develop a life-threatening crisis (which moves you up in line) before you see the doc. We are also told that in response to this, illegal storefront clinics have opened up in Canada to handle the overflow, and that the government doesn't force them to close because they realize that their own medical facilities are not sufficient. The upshot is that Canadians pay huge taxes to support National Health care, but then end up paying again at these illegal and unregulated clinics because they can't get access to the National Health Care. I'm not saying any of this is true. I'm only repeating the propaganda we are fed.

I would like to hear from citizens of countries that do have a nationalized health care system. I would like to know how the system works. How do you go about seeing a doctor? Do you have your own doctor who is familiar with your history? Do you have to pay anything for medical care or prescriptions? How long does it take to get in? To see a specialist?

I will add (for those who don't know) that in the U.S. all hospital emergency rooms are required to provide life-saving and child delivery services regardless of the patient's ability to pay. Also, if I owe the hospital $10,000 I can offer to pay them off at the rate of $10 per month without interest, and they must accept it. The shortfalls that the hospital incurs due to this are then, of course, passed on to paying customers. I only mention this so that those of you from countries with free health care will understand that we aren't total barbarians leaving people to die on the front steps of the hospital.

If my fellow Americans don't mind, can we keep to ourselves our own opinions about what America should do until we have some firsthand accounts of the reality of National Healthcare?

[Randarkmaan]

I haven't been to much at hospitals or with doctors, to be honest as I'm remarkably healthy for some reason But I can see the benefits of free healthcare in that you don't have to pay (except the tax ofcourse) in order to receive treatment. The hospitals here in Norway are pretty good on the whole, but they do in fact suffer from the problem that in the recent years more bureaucrats than nurses (especially nurses, who often have to work overtime) and doctors have been employed, and yes lines can get pretty long. I can't give much firsthand accounts, I've only been to a hospital a few times and it went well and my parents didn't have to pay (I was 5 one time and 8 the other time), and I don't talk to people about it that often either. Anyway despite long lines and, in some cases and countries, ridiculous bureacracy I don't feel that abandoning public healthcare in favor of private hospitals where you can get help fast, if you can pay, is a solution the majority can benefit from, rather more money should be used to improve the public hospitals. The taxes needed to support this are ofcourse not low, they support other things as well such as various welfare services, schools, roads and stuff, but still there aint really a whole lot of people who are suffering because of it, most poor people are affected more by a poorly paid job or no job at all than they are by taxes.

Not that much and probably doesen't give that much information, but its my opinion, or at least parts of it.

[Ice]

No. Leave it in the private sector. Make health care more affordable with incentives (Tax breaks, Deductibles.. etc).

[Papewaio]

Australia has national health care.

You can use private health if you want to. And above certain incomes you have to take out private health insurance or pay more in medicare taxes.

Essentially you go to your local Dr and the bulk billing (government subsidies) pays for the cost of it... unless you choose a Dr who charges extra, in which case you have to cover the difference. Specialists are different, and unless you are on a very low income, only a portion will be covered... sometimes it is better to use medicare then private health insurance to pay the difference.

Have the option of using public or private hospitals. Generally however if there is an issue with pregnancy the women will be sent to the public hospitals... as the government ones are run better for emergencies while the private ones are just better at privacy for recovery. Doctors will often work at both public, private and teaching hospitals.

Also we have pseudo-free university education... but thats another topic.

[gunslinger]

Specialists are different, and unless you are on a very low income, only a portion will be covered... sometimes it is better to use medicare then private health insurance to pay the difference.

I'm a bit unclear on your meaning here. Is medicare something you can purchase from the government that goes above and beyond the standard benefits everyone gets? Also, do you know what percentage of salaries goes toward medical taxes?

[Papewaio]

Medicare is a tax. The Medicare levy is 1.5% of your taxable income. If you have a high taxable income but no private health cover then you pay an extra 1% (for freeloading).

If you are on a low income/pension you pay no levy.

[GoreBag]

I've never heard of an illegal clinic. One of the main problems Canada is having with its health care system is that doctors tend to head south where they can be paid exorbitant amounts of money for their practice, and that the government doesn't recognize immigrant doctors from most countries even though a great number of them could easily be doctors in Canada.

[BDC]

Britain's NHS works ok. It is a big shiny example of why you shouldn't just ignore national health systems for a couple of decades and then wonder why they no longer work properly. Also a big, rather dirty example of why contracting out cleaning to the lowest bidder is thoroughly stupid, unless you enjoy watching otherwise healthy people who go into hospital for something minor die of antibiotic-resistant MRSA and C Difficile.

[sapi]

As pape explained, Australia has a public health system, but it's riddled with problems and only really useful for emergency cases.

Most people would go private if they had a choice - but it's invaluable for those who don't.

[English assassin]

I would like to hear from citizens of countries that do have a nationalized health care system. I would like to know how the system works. How do you go about seeing a doctor? Do you have your own doctor who is familiar with your history? Do you have to pay anything for medical care or prescriptions? How long does it take to get in? To see a specialist?

(1) You ring up his surgery for an appointment. Usually you get one fairly quickly. Mine is fiddling the figures at the moment by not allowing you to make an appointment more than 48 hrs in advance, which means a mad scramble on the phones at 9 am every morning, but its still OK. And they aren't really supposed to do this anyway.

(2) Yes. Your GP is your GP and has your records. If you don't like him you can go to another GP. You can't go to a GP in another town (except for an emergency) but you have a choice of your local GPs.

(3) You pay a prescription charge for drugs prescribed by your GP. I don't know how much it is but its probably about £5. If you are chronically ill you get a "season ticket" that lasts for a year and costs £90 or so. You pay nothing for drugs or procedures in secondary care (hospitals). Availability of some modern drugs may be patchy (although you can always self pay). This situation would be a lot better if pharmaceutical companies actually develioped drugs that cured conditions at a reasonable cost, instead of developing drugs that managed chronic conditions at the highest costs they think will be paid. Why are drug companies more interested in managing chronic conditions? You work it out...

(4) how long does it take? Ah, here's the rub. Emergencies are dealt with instantly. Other procedures, including diagnosis, may take some time. Waits are less than they were, but can still be months. In a few cases, they may be a significant number of months. They never admit it but healthcare is to a degree rationed by waiting.

[Hosakawa Tito]

No matter what system one is talking about, health care isn't free. It is either rationed by waiting or cost.

[ShadeHonestus]

*developing a number of nervous tics as a result of restraint from posting on this topic*

[Adrian II]

EA's description sounds very similar to the situation in The Netherlands. Our health care is officialy privatised, but many regulations of state health care do still apply and providers are forced to compete in their core business, which is health care (not financial gadgets, holiday trip dsicounts and such).

Health insurance is obligatory, but you can pick your own arrangement from anything between basic care and highly sophisticated first class treatment, and you can pick your own insurance company to conclude th arrangement with.

If a specific treatment is not available (soon enough) in The Neds, any necessary foreign trips are paid for. So are second opinions from GP's and specialists. Choice of (local) GP is free.

There are some extra charges for treatment and prescriptions, but these are payable only once a year. You can set the limit for these yourself, depending on the 'package' you have picked. You can set it at 0, which means you pay a little more contribution each month than if you set it at, say, 100 euro. Of course students and other young, usually healthy people chose totally different arrangements from old or chronically ill people. All are served though.

[BDC]

(1) You ring up his surgery for an appointment. Usually you get one fairly quickly. Mine is fiddling the figures at the moment by not allowing you to make an appointment more than 48 hrs in advance, which means a mad scramble on the phones at 9 am every morning, but its still OK. And they aren't really supposed to do this anyway.

(2) Yes. Your GP is your GP and has your records. If you don't like him you can go to another GP. You can't go to a GP in another town (except for an emergency) but you have a choice of your local GPs.

(3) You pay a prescription charge for drugs prescribed by your GP. I don't know how much it is but its probably about £5. If you are chronically ill you get a "season ticket" that lasts for a year and costs £90 or so. You pay nothing for drugs or procedures in secondary care (hospitals). Availability of some modern drugs may be patchy (although you can always self pay). This situation would be a lot better if pharmaceutical companies actually develioped drugs that cured conditions at a reasonable cost, instead of developing drugs that managed chronic conditions at the highest costs they think will be paid. Why are drug companies more interested in managing chronic conditions? You work it out...

(4) how long does it take? Ah, here's the rub. Emergencies are dealt with instantly. Other procedures, including diagnosis, may take some time. Waits are less than they were, but can still be months. In a few cases, they may be a significant number of months. They never admit it but healthcare is to a degree rationed by waiting.

You are supposed to be seen and treated within 3 months or something now though. Does mean that your referral might be conveniently 'lost' for a few months, but sooner or later it will all speed up. And once you are seen you tend to get through the system quite quickly.

[InsaneApache]

We have waiting lists for waiting lists, so keeping the waiting list down to the government targets.

[Somebody Else]

You can go with the NHS, and wait. And wait. And wait. And wait. And wait. Then get an MRSA.

Or

Pay and be treated.

Example.

I chipped a tooth, so went to a dentist to have it capped. Was told I would have to wait 3 weeks. So I asked what the wait would be if I paid. I was dealt with 2 hours later. Makes me wonder what they're doing with themselves...

I know which one I opt for, every time - which is not very often, fortunately - benefits of being in rude health, and having a half-decent concept of how to look after myself (not, of course, that I necessarily do... 7 nights of binging without much sleep doesn't strike me as sensible)

[Adrian II]

We have waiting lists for waiting lists, so keeping the waiting list down to the government targets.

Brits travel to The Netherlands or France for all sorts of treatment these days, whereas Dutchmen travel to Belgium and Germany for certain treatments (various kinds of heart surgery and transplants) that have long waiting lists in The Neds. It seems that our European health systems obey the law of comparative advantage...

[Adrian II]

I chipped a tooth, so went to a dentist to have it capped. Was told I would have to wait 3 weeks. So I asked what the wait would be if I paid. I was dealt with 2 hours later. Makes me wonder what they're doing with themselves...

Makes me wonder if anybody ever checks on the British dentists. Our insurance companies would be all over that dentist if he let their paying customers wait for an inordinate length of time. The state in turn checks on the insurance companies, e.g. to make sure they don't plunder their own coffers as well as mine to give their management million euro pay raises. Accountability goes only so far, though...

Sorry, double post.

[Fragony]

If insurance companies covered dentist-costs that is.

[BDC]

You can go with the NHS, and wait. And wait. And wait. And wait. And wait. Then get an MRSA.

Or

Pay and be treated.

Example.

I chipped a tooth, so went to a dentist to have it capped. Was told I would have to wait 3 weeks. So I asked what the wait would be if I paid. I was dealt with 2 hours later. Makes me wonder what they're doing with themselves...

I know which one I opt for, every time - which is not very often, fortunately - benefits of being in rude health, and having a half-decent concept of how to look after myself (not, of course, that I necessarily do... 7 nights of binging without much sleep doesn't strike me as sensible)

Benefits of paying in a hospital are probably less than for a dentists. You'll still probably be in the same hospital after all.

Paying for dentists is definitely the way to go, sad though it may be. Plus the NHS only tends to cover archaic and basic treatments, and even then you need to contribute. Just pay for the quick white filling already.

[Somebody Else]

If I need a doctor, and it'd have to be some serious surgery for me to do that, I'd likely leave the country.

*That, or make a doctor friend come 'round and fix me at home.

Interestingly enough, a family friend, suffering from something akin to MS - I forget the name of it, had to fly to China to be treated for it. Handy not having all those anti stem cell campaigners running about the place...

[BDC]

If I need a doctor, and it'd have to be some serious surgery for me to do that, I'd likely leave the country.

*That, or make a doctor friend come 'round and fix me at home.

Interestingly enough, a family friend, suffering from something akin to MS - I forget the name of it, had to fly to China to be treated for it. Handy not having all those anti stem cell campaigners running about the place...

Why leave the country? Things are no better most other places, and you'll just end up without any family around. Plus then you're in trouble if the money runs out.

[lars573]

I'm a fairly recent addition to the backroom, but I must admit that I'm enjoying the discussions here very much. Recently I read a post in which the author expressed amazement that Americans don't even have free health care. This is a debate which has been going on for some time in America. The liberals often point to Canada and say that they want to create a national health care based on the Canadian system. The conservatives then point to Canada and say that their system is broken and worthless. They say that the wait to see a doctor is so long that for most ailments you will either get better on your own or develop a life-threatening crisis (which moves you up in line) before you see the doc. We are also told that in response to this, illegal storefront clinics have opened up in Canada to handle the overflow, and that the government doesn't force them to close because they realize that their own medical facilities are not sufficient. The upshot is that Canadians pay huge taxes to support National Health care, but then end up paying again at these illegal and unregulated clinics because they can't get access to the National Health Care. I'm not saying any of this is true. I'm only repeating the propaganda we are fed.

Italics: Myth number 1. That rarely (1 or 2 people a year) happens. Now I can imagine that opponents of socialized health schemes in the US would latch on to that. My grandmother needed to have plastic knees installed. Took 2 years for both. She had one done then waited about a year for the next one. She could still walk with a cane. She went and saw her orthopedic specialist every few weeks. My old supervisors wife had a tumour in her limphnodes. As soon as their doctor found it she was in surgery to remove it in the next 2 days. So you see my grandmother waited for a year so that poeple with cancer could get in their first.

Bolds: Illegal clinics? Myth number 2. Quebec has allowed a private surgery clinic in Montreal to open to handle some over flow. Nova Scotia has a private MRI clinic to open in Halifax. All of which opened with the Provincial governments permission.

The problem we have is, like Gorebag said, that doctors leave. So if you don't have a GP most (mistakenly) go to the ER. We have drop in clinics for those without GP's. But many don't know that.

I would like to hear from citizens of countries that do have a nationalized health care system. I would like to know how the system works. How do you go about seeing a doctor? Do you have your own doctor who is familiar with your history? Do you have to pay anything for medical care or prescriptions? How long does it take to get in? To see a specialist?

Canada's syetem is a public insurance scheme. Where each province runs a medical insurance program. That is funded by taxes and free of charge. The public insurance covers, GP visits, nessisary surgery, hospital stays in none private rooms, and covers part of perscription costs. You have to pay out of pocket for eye care, dental care, elective surgery, and the rest of perscription costs. Now if you work for a company that gives you a health plan most of these costs can be covered. My mom works for the school board as an EPA and gets blue cross coverage (reimburment) as part of her salary. For me to see a doctor is relatively easy. I call our GP office. Schedule an appoitment and go. If I didn't have a GP I'd have to find out where the drop in clinic is and go there.

[Somebody Else]

Why leave the country? Things are no better most other places, and you'll just end up without any family around. Plus then you're in trouble if the money runs out.

Don't have much by way of family here either. Country hopping family, mine. I'd probably go to Hong Kong or something for healthcare - that's where my family tends to go for that sort of thing, and they know how to look after people in the East. The money won't run out.

[Fisherking]

Ah yes, Chinese medical care. Isn't that where you can pick out the organs you want ahead of time? With that many prisoners your chance of a match are pretty good…but if it doesn't work…you already paid for it…do you ask for an exchange or does it come whit a warranty?

[Adrian II]

I don't understand the problem with 'seeing your GP'. Dutch GP's are in business at 7.30 or 8.00 sharp. First thing in the morning they have a 'walk-in hour' for all patients who have acute problems or tight schedules. After that they make their rounds of non-mobile patients. 'Seeing your GP' is no issue here.

[lars573]

For us "your GP" is the doctor with whom your medical records are on file. And one GP or GP office (which has several doctors) can only carry so many patients.

[Scurvy]

British GP's are'nt very good, they make you wait for hours, then tell you to go see a real doctor

The NHS is a neccessity, but the idea of it being "free" is slightly misleading...

[Somebody Else]

Ah yes, Chinese medical care. Isn't that where you can pick out the organs you want ahead of time? With that many prisoners your chance of a match are pretty good…but if it doesn't work…you already paid for it…do you ask for an exchange or does it come whit a warranty?

There is indeed a warranty - if you die within three years of the op (through a related cause, obviously), you can claim your money back. You do have to turn up in person though, and they bill you for the paperwork.

[gunslinger]

Thank you all for the information. So many media outlets have their own agendas, both liberal and conservative, that it's difficult to form an intelligent opinion based on the "facts" they give you.

As I probably could have predicted, the realities of NHC fall somewhere between the extremes pointed out by the two sides in America.

My own opinion has been tough to form, but in the end I believe that a National System is not the way to go for the U.S.

The reasons for my opinion:

NHS does not create equality in medical care among income classes; the story posted about having to wait weeks for a filling at the dentist until some cash was produced proved this. That dentist had plenty of time to see a patient, but he was reserving it for a high-paying customer.

The story of doctors fleeing Canada supports capitilist arguments in so many ways, and also illustrates why so many communist and socialist regimes have had to build walls to keep their citizens from escaping the workers' paradise. (Obviously, Canada is far and away a better and more free place to live than those regimes ie: the workers can actually leave without risking their lives if they don't like the way their profession is being run).

It sounds as though most of the NHC systems actually perform well when dealing with emergencies and people who are so poor that they simply could not pay for health care in any other way. The U.S. system also deals well with people in those situations, as I pointed out in my first post. I know that when I (or my insurance company) pay a hospital bill, I am paying not only for my treatment, but also for the shortfalls the hospital incurred when treating other patients who couldn't pay. The hospital administers this smoothly and efficiently. I would much rather leave this task to the hospital than put it in the corrupt and inefficient hands of any government.

I would also rather have my doctor working for me and trying to please me as a customer than working for the government and trying to push me through the system in a way that causes him the least inconvenience.

I believe that I fall squarely into the class that is hit the hardest by health care costs in the U.S. Family of four, family members who are sick a lot, and just slightly too much income to qualify for free or reduced cost state insurance programs and other benefits. So, I know firsthand how difficult it is to pay the extremely high costs of health insurance as well as all of the medical bills that are left over after insurance pays its portion. In many cases, monthly healthcare costs are higher than monthly mortgage payments.

I still think I'm getting a better deal than I would if the government was managing my health care. It seems like when governments get involved in providing any kind of service, taxpayers end up paying premium prices for services that are barely adequate.

Thank you all for your examples.

ShadeHonestus, let 'er rip. . .