British healthcare system

[mrblanche]

The disturbing thing I've seen in this thread is that people are expecting doctors to get better, and staff to care more under a government run program.

If you think the government is going to be any more generous than your current insurer, you haven't talked to anyone who has dealt with the VA.

[Hot Cruiser]

You say that like its a bad thing. Here's a clue... if a program does not run at a profit, then that means that it is failing. Just like Medicare, Medicaid and Social Security. The government's "cure" for programs that spend more money than they bring in is higher taxes and higher inflation to artificially devalue ongoing debt.

Making a profit is a good thing. It is evidence that a program is sustainable over the long run.

As far as a perceived lack of concern for the welfare of the patient is concerned, maybe your perceptions are a result of your experiences with Medicare, where the government places restrictions on procedures, level of care, and amounts to be re-imbursed. It is no wonder patients paying with Medicare are treated like 2nd class citizens. They are basically stealing from healthcare providers and other patients, who are paying in full for services rendered.

Well, with that sort of logic (profits indicate success) then the private insurers maybe should make even greater profits - why not 100% - 200% - or more? Who is going to pay for that - one or two guesses - the patient, or their employer? How many people would have any sort of insurance with that kind of scenario and applied logic? And for many there is a moral issue about someone profiting from someone else's misery.

As in my previous post Medicare needs some work, especially with reimbursing doctors. The people who are sticking it to others are primarily those with no insurance and who go to ERs for treatment. If one looks at insurance company payment limitations they are there in part to prevent them having to pay otherwise unrecovered provider costs, but also to enhance their own profit picture. My wife worked in hospital medical billing and has lots of experience with that. The ones who really are stuck with paying unrecovered provider costs are patients who are self-insured. Their bill for a given procedure may be many times more than to an insured patient.

Overhead cost for medical care attributable to our insurance setup is around 30%. The Canadian public system's overhead is around 5%. No human system is perfect, but the current U.S. one if not reformed is becoming unaffordable, except for the wealthy. If no one apart from the rich can afford it, what good will it be?

[idmtchris]

If you think the government is going to be any more generous than your current insurer, you haven't talked to anyone who has dealt with the VA.

This is a fact of life that some may find offensive, but having spent 2 decades worrking in Gov't run health care both fed and state and private sector major health care group. I can tell that the most demanding patients are the one getting their care for free. They tend to be unresonable with their requests many times and expect more than the program can provide. Whereas a person who is paying a monthly premium are usually happy if they are just treated nice by the staff, and most of the time accept the decision of the care provider.

U.S. health care needs repaired--that is obvious, but in order to do it I am afraid we will create a system that favors the "haves" over the "have nots". So we will need to be wray of building a class based system, because that will not be tolerated here. Which BTW we already have but it is not that transparent so it does not get a bunch of attention. Example of this is I have the opportunity to get better health care than my neighbor because I can afford better insurance and he is unemployed and cannot qualify for state medical because he earns too much on unemployment. You can argue that the example is not a class system, but it really is.

[Bubba68CS]

Example of this is I have the opportunity to get better health care than my neighbor because I can afford better insurance and he is unemployed and cannot qualify for state medical because he earns too much on unemployment.

So the government screwed up (unemployment and state medical are both government programs, right?). Why not fix that first?

[idmtchris]

So the government screwed up (unemployment and state medical are both government programs, right?). Why not fix that first?

I just think it is absurd that getting unemployment means he cannot qualify for health care assistance. Come on if you dont have a job you really need health care assistance.

[Bubba68CS]

I just think it is absurd that getting unemployment means he cannot qualify for health care assistance. Come on if you dont have a job you really need health care assistance.

I whole heartedly agree. This is why I have an issue with the government trying to run the ENTIRE system. There are all kinds of things like this that come up. As I said in my first post, people who have transplants are kicked off disability immediately after the transplant, despite requiring months of rehab and tests (my parents basically moved down to St Louis for three months after the transplant). The government just doesn't take the time to really think things through (that goes for both parties). If they could show they were capable of fixing what is currently wrong, I may not have quite as much issue with them taking over completely.

[sharky1381]

There are many great examples of areas the government is already involved that need fixing. Medicare, Medicaid, V.A., Social Security, Unemployment, Welfare, Fanny Mae, Freddie Mac, Immigration, AmTrack, Post Office, etc... If Congress would focus on these programs one at a time and fix them the savings would make universal health care possible without tripling the deficit and the size and power of government. It would also result in the citizenry having much more confidence in our elected officials. Fix what is broken before you dismantle a system that works for 80% of the population and replace it with one that will help 20%.

[sdbrit68]

Well, with that sort of logic (profits indicate success) then the private insurers maybe should make even greater profits - why not 100% - 200% - or more? Who is going to pay for that - one or two guesses - the patient, or their employer? How many people would have any sort of insurance with that kind of scenario and applied logic? And for many there is a moral issue about someone profiting from someone else's misery.

As in my previous post Medicare needs some work, especially with reimbursing doctors. The people who are sticking it to others are primarily those with no insurance and who go to ERs for treatment. If one looks at insurance company payment limitations they are there in part to prevent them having to pay otherwise unrecovered provider costs, but also to enhance their own profit picture. My wife worked in hospital medical billing and has lots of experience with that. The ones who really are stuck with paying unrecovered provider costs are patients who are self-insured. Their bill for a given procedure may be many times more than to an insured patient.

Overhead cost for medical care attributable to our insurance setup is around 30%. The Canadian public system's overhead is around 5%. No human system is perfect, but the current U.S. one if not reformed is becoming unaffordable, except for the wealthy. If no one apart from the rich can afford it, what good will it be?

Hotcruiser.............not sure you know me, but I tend to be pretty straightforward.

not in a I want to argue way, but I am definetly more of a pragmatist.

to answer your questions, medicene is a business, if its not profitable, then it wont be there, remember, the U.S. used to be a very capalistic society

as such, when acompany gets prices too out of the ballpark, another will step in and bring the costs down, so yes, if they profit from someones misery, they have a right

same as a funeral home, who has two ways of selling, before the need ( a death), and after the need, time for the sell where they make people feel they have to buy more


The issue was NOT universal health care per se............it was the governments total involvement in it.

we are now used to the government asking for an inch, and taking a mile and a half

1000 pages, was too much, all the " angry mob" protesting wanted was smaller changes


the other part, health care is not a right, nothing in the constitution guarantees health care

morally, do I wish everyone could have it, yeah.............am I willing to pay for it, hell no, I pay enough already

the other reality,

80% of the resources will be used by 20% of the people..........thats just a fact in this country

people like me who have to get hit by a bus to go to an emergency room will be paying for those that go every week for a sniffle


we recently had a worlds largest free clinic...............the line was over a mile long, literally, filled with people who dont speak english and their 16 year old daughters with their own babies ( and this I am serious about)


sorry, but I work hard, and I dont want to pay for anyone else anymore, I got my own worries

[sdbrit68]

This is a fact of life that some may find offensive, but having spent 2 decades worrking in Gov't run health care both fed and state and private sector major health care group. I can tell that the most demanding patients are the one getting their care for free. They tend to be unresonable with their requests many times and expect more than the program can provide. Whereas a person who is paying a monthly premium are usually happy if they are just treated nice by the staff, and most of the time accept the decision of the care provider.

U.S. health care needs repaired--that is obvious, but in order to do it I am afraid we will create a system that favors the "haves" over the "have nots". So we will need to be wray of building a class based system, because that will not be tolerated here. Which BTW we already have but it is not that transparent so it does not get a bunch of attention. Example of this is I have the opportunity to get better health care than my neighbor because I can afford better insurance and he is unemployed and cannot qualify for state medical because he earns too much on unemployment. You can argue that the example is not a class system, but it really is.

this is 100% right on the money

you can see it in other examples.............look at retail, I do 90% of tech support for people who bought the cheapest crap

[MauiAl]

OK this gets silly. First of all those of you who love the UK and Canadian socialized medicine (that's underfunded) just how high would you like our tax rate to be? I know it's well over 60% in the UK. And it's underfunded for crying out loud.

Profits are not evil silly people. If you taxed the top 5% 100 percent of their income it still wouldn't pay for this monster.

We'll all pay and we'll pay a lot for a system that will not encourage anything new.

[darkwalker]

Run by the government or by the insurance companies, healthcare stinks over here now. I have insurance, called up a doctor who was referred to me only to find out that he doesn't take insurance! WTF? $200 a visit out of pocket! His assistant said he got tired of dealing with insurance companies.

[mrblanche]

I see no one has accepted my challenge to name any significant medical advances made under a socialized single-payer system.

[sdbrit68]

I see no one has accepted my challenge to name any significant medical advances made under a socialized single-payer system.

actually, a lot of aids research was done under socialized medicene.............but somehow I think I may be misreading you intent

are we talking research or just good medicene

[idmtchris]

I see no one has accepted my challenge to name any significant medical advances made under a socialized single-payer system.

There are many research activites that come from overseas. Radial Artery cardiac catheritization for a quick simple one. I worked in BioMedical research and our investigators are involved with many investigators that come from socialized medical countries. Your comment has no merit at all. As a matter of fact most of the major research that comes out in the US comes from Fed Govt Grants from the NIA, NIH and VA, not from private research companies or foundations. Private companies use federal research dollars to reduce the cost of their research programs. I could spend hours trying to explain indirect and direct research costs and show how Merek and other companies actually makes millions of of federal research grants and then charges a bundle for the drugs that were discovered as part of a federal funded research program. Sorry but you comment while it sounds good, cannot be backed up. It is our own arrogance that makes us think no other country develops medical advances.

[Kodiak]

Here is my big issue with the current U.S. system. Most of the people in this country are insured through private companies, either privately or thought their employer. Like all companies in a capitalist society they want to make profit. Profit is your total revenue minus your costs. Costs for the insurance companies include the payments they make to service providers such as doctors, surgeons, dentists ect.

Therefore, it is in your insurance company's best interest for you not to receive treatment.

Is it just me or is that a little #$%*'ed up?

In a way, this same issue exists with universal helthcare such as the British NHS system. However, I get the impression that the NHS system is concerned more with ensuring that people get the care they need, than with fitting into a budget. The half dozen or so British people I know support this theory and actually seem sort of proud of their system. Anyone on here that can back this up?

[Bubba68CS]

Here is my big issue with the current U.S. system. Most of the people in this country are insured through private companies, either privately or thought their employer. Like all companies in a capitalist society they want to make profit. Profit is your total revenue minus your costs. Costs for the insurance companies include the payments they make to service providers such as doctors, surgeons, dentists ect.

Therefore, it is in your insurance company's best interest for you not to receive treatment.

Is it just me or is that a little #$%*'ed up?

Thats a half truth. If you are never sick, then yes, that is great for the insurance company (exact same applies to your auto or bike policy...if you never have an accident, the insurance company rakes in the dough). HOWEVER, it is NOT in their best interest for you to constantly be making claims because you are constantly sick due to poor treatment (they cannot refuse payment if you are sick and its covered in the policy). They want you in and out quickly, but most importantly, HEALTHY, so they don't have to pay out any more. It is in the insurance company's best interest for you to be HEALTY...not sick.

[Kodiak]

Thats a half truth. If you are never sick, then yes, that is great for the insurance company (exact same applies to your auto or bike policy...if you never have an accident, the insurance company rakes in the dough). HOWEVER, it is NOT in their best interest for you to constantly be making claims because you are constantly sick due to poor treatment (they cannot refuse payment if you are sick and its covered in the policy). They want you in and out quickly, but most importantly, HEALTHY, so they don't have to pay out any more. It is in the insurance company's best interest for you to be HEALTY...not sick.

I agree that it is NOT in their best interest for you to constantly be making claims. But just like a car insurance company, they will try as hard as they can to find a loophole to get out of paying. Pre existing conditions, classifying a cancer treatment as "experimental" and denying coverage when it is the only chance you have, refusing to pay because you did not "pre authorize" a treatment. That sort of thing.

For instance:

Firefighter Denied Life-Saving Treatment - Local 2 Investigates News Story - KPRC Houston

My insurance company’s medical examination denied me surgery. - Personal Injury Blog: Hamilton Lawyer / Attorney


Although I am sure you could find cases where the NHS has done the same thing.

[CTRider]

I agree that it is NOT in their best interest for you to constantly be making claims. But just like a car insurance company, they will try as hard as they can to find a loophole to get out of paying. Pre existing conditions, classifying a cancer treatment as "experimental" and denying coverage when it is the only chance you have, refusing to pay because you did not "pre authorize" a treatment. That sort of thing.

For instance:

Firefighter Denied Life-Saving Treatment - Local 2 Investigates News Story - KPRC Houston

My insurance company’s medical examination denied me surgery. - Personal Injury Blog: Hamilton Lawyer / Attorney


Although I am sure you could find cases where the NHS has done the same thing.

Sorry, but the things you pointed out are exactly why private insurance doesn't cost more than it does. It's one thing to take a gamble someone won't get sick - it's another to take on the financial responsibility of someone who is very sick, and likely will be until death.

Look at it like a casino:

The house is betting that you'll play more money than they'll pay out. The money you throw down on a game is likely financing those people who hit the giant jackpot on the slots or the large payout on the high rollers table.

They allow you to play based on the idea that you aren't coming to the game with "an edge" that would cause them to pay you more than what would be considered "normal". So, if you show up counting cards or some other "system" considered cheating, you're going to be asked to leave.

Now, you can still go down the street and gamble at another casino, or (if you've been banned), you can play the state lotto or start up a basement Saturday night game with your friends.

The same goes with insurance. If you come in with something that is going to drain thousands from the system (thus potentially raising rates for a large number of customers to compensate), that's bad for the company and potentially results in a more expensive system for the many in order to help the few. There may be some companies that will take you on, but the coverage may not be as good. Likewise, programs like Medicare might qualify you where a private system might not.

While none of us would ever want to be in that situation, it has to be understood that without profit, there is no savings for those that participate.

I'm certainly all for some kind of assistance in making medical care affordable for those that can't afford it, but a "universal plan" isn't the answer. Those than can afford it - and wish to pay for it - should be able to do so without their rates going up to the point where they are forced to go with a public plan due to cost.

We need to figure out how to make private insurance affordable to more people, not put more people on the public dole.

The thing is, we can't accomplish any of this until we fix other things:

- Our immigration problem. We have to get control of our borders so we aren't supporting the cost of those that aren't supposed to be here. Illegal aliens are a drain on our health resources, our job resources and require English as a second language courses. Unacceptable. However, anyone who wishes to serve in our military for at least 4 years will automatically receive citizenship.
- We need to get more people working in jobs where they can afford their own insurance. To do that, we need to make it less desirable for companies to send those jobs to countries where they can use cheap labor. If those companies that claim to be US companies were required to pay their foreign employees US minimum wage or better, they would be less likely to export those jobs.
- Fix Medicare. If the government can't run that properly, they aren't going to do any better with another program.
- Reduce the perks of elected officials. No lifetime health coverage (you pay your own way when you retire or get voted out) and you have to participate in any public health program you come up with or pay out of your own pocket for something else.
- Prohibit only one private carrier having the monopoly on a particular area. Too many cities or even states have only one choice in private carrier. No carrier should be locked out of any area by contract or law.
- The government spends millions each year providing discounted hurricane coverage to large beach front homes - even those owned by the wealthy. If you can't afford to protect your home, don't live on the coast.
- Heavily tax farmers that grow tobacco. Give that money to farmers who wish to grow soybeans, corn or other potential material for alternative fuels in order to help jump start getting off foreign gas.
- Stop spending so much money developing standardized tests and "feel good" programs in schools and, instead, let the teachers actually teach with rough guidelines on what subjects must be covered
- We need to consolidate funding and combine research resources world wide to find cures for those diseases that cause those pre-existing conditions. Right now, there are dozens of separately funded organizations world wide that are working on cancer. We need to pool those resources and compare notes or we'll never get the job done. Plus, duplicate money can potentially be diverted to fund other research for diseases that aren't as "popular" to fund, such as Autism, XP, Polycystic Kidneys that become very expensive to insure.
- We need to devote more research to growing organs outside of the human body using genetic material from the potential recipient. Right now, the donor process is very expensive for a small net gain - maybe 5-10 years extension of life for most people on the list since they never actually get an organ. As a result, they waste away on dialysis or some other treatment for years. Those that get an organ are often equally expensive due to not just the surgery itself, but the lifelong need for often multiple anti-rejection medications. Being able to grow the organ from the patient's own genetic material would speed up the donor process and potentially eliminate most of the need for anti-rejection medicine.
- Sorry for those who smoke, but that's a pre-existing condition. Quit or no insurance for you - or pay a whole lot more to compensate for your future health issues.
- Over 300 pounds? You're at risk for heart disease, diabetes, respiratory problems and even some cancers. Lose weight or pay more.

[sharky1381]

CT, I agree with most but not all of your positions and there are many more. As Bubba said, it is in everyone's best interest for people to be as healthy as possible. That is why group coverage is cheaper than individual plans. They bundle up those who are older and need more care with young people who traditionally use less services. All insurance is based on actuarial tables and is a gamble for all parties. The customers are gambling that they will be covered for whatever injury or illness they contract while the insurance companies gamble that they will take in more money in premiums than they need to pay out in settlements. In the ideal situation they can offer the widest coverage for the lowest price and still make a reasonable profit.

Normally it works fairly well, but once in a while a customer comes up with a disease that requires massive amounts of money to treat if it is covered and that money has to be covered by all of the other customers. If experimental or extremely expensive treatments are excluded then payments are kept lower for all of us and the system works unless we are the unfortunate individual who requires that unusually expensive procedure. In any individual situation we would all like to say it should be covered, but what if it is an illness that can be traced to poor choices by the individual that were 100% avoidable by them. Do we still want to pay more so that individual will be cared for even though he did not care for himself. Just to raise a little controversy here, I'll give an example.

We all have motorcycle insurance I presume. Many have been paying it for many years without making claims. We have been paying for those unfortunate enough to have crashed and made a claim. That is the price we pay for the peace of mind that if we crash we too will be covered. Now take the guy who chose on his own not to wear a helmet and had a relatively low speed crash that would have been minor but for the fact that his skull was fractured causing brain damage. Should we have to subsidize his life time care to the tune of hundreds of thousands of dollars per year even though we have always taken responsibility and worn full protective gear? How many say yes knowing it will raise our rates? Just a thought provoker. Bottom line, government bureaucrats adding another layer to the process will not do anything to improve coverage or efficiency or make health care cheaper. There will always be treatments and procedures that are not covered and I guarantee there will be more under government run insurance. In government run, not for profit enterprises there are little or no incentives to eliminate fraud and misuse as there are in the private sector. It is much easier for government to raise taxes than it is for industry to raise prices.

[vulcancowboy]

We need to remember that profit is not a bad word. If the insurance companies can't make a profit, they will go out of business. If they get greedy and refuse to cover reasonable expenses, customers can go someplace else. That is why competition is so important, it helps to keep greed in check.