British vs. American Health Care

[km gresham]

I thought this was a very interesting and fair comparison of the two health systems by someone who experienced both as a result of his wife's stroke while in England.
It's long, but there is a lot of information on the good, bad and ugly of both systems.

http://www.opinionjournal.com/extra/?id=110006785

[Norman Bernstein]

Very interesting article, Karen... as long as one bears in mind that it's a recounting of just one experience, and an extraordinary one at that, recounted by a person who is NOT a doctor, and by virtue of his own job, might arguably be suspected of a certain bias in philosophy (although, to his credit, his tale did seem to be quite even-handed).

If one steps back and looks at the broader picture of health care, and tries to use whatever metrics are available that can qualify the net efficiency of various medical systems, it still remains a fact that dozens of countries in Europe with nationalized medical systems still spend far lower than the US per capita, and arguably have better results (in terms of longevity, infant mortality, etc) than does the US. The exception: medical care for the wealthy, which is outstanding, in the U.S.... at a high price.

[Scott Rosen]

C'mon. The American system is great, but only if you have good insurance and/or the ability to pay. And as long as you're not dependent on Medicare for your perscriptions.

However, if you are a veteran, and live near a good VA facility, you get outstanding medical care and drugs, at extremely low cost.

For everyone else, it's purely hit or miss.

[km gresham]

From the article:

As for the quality of British health care, advocates of socialized medicine point out that while the British system may not be as rich as U.S. heath care, no patient is turned away. To which I would respond that my wife's one roommate at Cornell University Hospital in New York was an uninsured homeless woman, who shared the same spectacular view of the East River and was receiving about the same quality of health care as my wife. Uninsured Americans are not left on the street to die.

[Crusoe]

Indeed Americans are not "left to die on the street". We are left until we're about to die.
The cost of treatment is then much greater(to the tax payer) than if there had been access to preventive or diagnostic medicine much earlier.

[Dan McCosh]

Re: the homeless. The cost of the truly indigent is mainly absorbed by the hospital in the US, and padded on to other bills where there is insurance. The folks who have something to seize--a home, for example, simply lose it.

[Chris Coose]

Uninsured Americans are not left on the street to die. Uninsured Americans will be buried in closed caskets because they will be picked clean to the bone.

You have not an ounze of empathy for the vast group of middle class Americans who cannot access the system.

[Norman Bernstein]

Uninsured Americans are not left on the street to die. Not of 'emergent' conditions. THOSE get treated for free... then, after release from the hospital, they're left to die because they can't afford follow up care, medication for chronic conditions, periodic testing, etc.

The fact that no hospital can refuse an emergent patient is often used by conservatives to argue for the merits of our health care system... they always fail to mention that emergent care is only ONE component of health care... most people don't die of emergent conditions, they die (and suffer while dying) because of lack of oprdinary health care.

[George Roberts]

Scott Rosen ---

Medicare is great.

My 92 year old mother-in-law is in a nursing home. (Her choice not mine.) The cost is $300/day + medication and hospital visits.

When my mother-in-law's money runs out (late next year), medicare will pay that cost and more for as she is alive.

I hear people complain about their car insurance company, their boat insurance company, the taxing authorities, just about everything.

People want more service than they are willing and able to pay for. (We have a client who pays much more out of his pocket for full time nursing care in his house. He complains from time to time.)

[Joe ( Cold Spring on Hudson )]

As of next month we will be uninsured. My wife's COBRA runs out. She was laid off last year. He company is now going out of business, it was based in lower Manhattan. We pay over $1,000 per month for the COBRA privilege :rolleyes: . We are sorting out individual options. Since we are both essentially freelancers now. Initial investigations of plans are about $1,200 per month for MINIMAL coverage and VERY high deductible and co-pays or $1,200 to $2,500 per month for full coverage and possible dental with lower co-pays.

One of the reason I started my own company years ago was because my wife had health insurance so we could just switch the insurance I was getting from my company to hers. Now we have no such options. It is OUT OF POCKET health and we have a child so it is a must. We went through a rough patch finically and still had to pay $1,000 per month in COBRA Now we are doing better and most likely we will be paying around $1,650 per month thats almost $20,000 per year not including co pays and deductible, for health insurance. WOW :confused: :confused: :confused:

[ 06-08-2005, 11:26 AM: Message edited by: Joe ( Cold Spring on Hudson ) ]

[Don Olney]

Get Sick Go Broke (http://getsickgobroke.org/)

The Study: Illness and Injury as Contributors to Bankruptcy (February 2005)

by David U. Himmelstein, Elizabeth Warren, Deborah Thorne, and Steffie Woolhandler

Abstract
In 2001, 1,458 million American families filed for bankruptcy. To investigate medical contributors to bankruptcy, we surveyed 1,771 personal bankruptcy filers in five federal courts and subsequently completed in-depth interviews with 931 of them. About half cited medical causes, which indicates that 1.9-2.2 million Americans (filers plus dependents) experienced medical bankruptcy. Among those whose illnesses led to bankruptcy, out-of-pocket costs averaged $11,854 since the start of the illness; 75.7 percent had insurance at the onset of illness. Medical debtors were 42 percent more likely than other debtors to experience lapses in coverage. Even middle-class insured families often fall prey to financial catastrophe when sick.

[km gresham]

The bottom line is there is no perfect health care system. And the costs of treating people will be passed on to the citizens one way or another. It won't be "free" to everyone and if it is "free" or low cost the level of treatment available will diminish.

[Alan D. Hyde]

Joe, check Anthem.

Our policy is $2,000 deductible (apiece), maximum $5,000 (family). No dental or eyeglass coverage.

It's under $500/month (self, wife, last child still at home).

An HSA may be worth a look for you, if you wish to cover dental and vision care.

Of course, New York IS more expensive...

Alan

[ 06-08-2005, 11:41 AM: Message edited by: Alan D. Hyde ]

[Norman Bernstein]

The bottom line is there is no perfect health care system. And the costs of treating people will be passed on to the citizens one way or another. It won't be "free" to everyone and if it is "free" or low cost the level of treatment available will diminish. So, are you saying it's better to leave it as is, where the wealthy have no trouble paying for superior health care, while the lower class and poor go bankrupt and die?

[Chris Coose]

Zlong as I'z gots mine.

[km gresham]

In England it's the same - if you want superior health care you go to a private hospital. If you're poor you go where the floors aren't clean and the equipment is old and you get to wait weeks for surgical procedures. I don't see the advantage in that system. Here we don't have poor "public" hospitals and rich private hospitals. Everybody goes to the same hospital. Maybe we should emulate England and y'all would be happier.

[ 06-08-2005, 11:56 AM: Message edited by: km gresham ]

[Chris Coose]

Originally posted by km gresham:
Here we don't have poor "public" hospitals and rich private hospitals. Everybody goes to the same hospital. Beautiful

[km gresham]

Remember, Michael Jackson goes to a regular hospital - but when he goes they clear all the regular people out of the emergency room. That probably should be changed.

[Chris Coose]

Keep on that track about things that should be changed, perhaps you'll get to scratch the tip of the iceberg in health care delivery in America.
Leave the thinking to the Michael Jackson problem and you'll maintain tranquility.

[PatCassidy]

Last year I was working on a boat in the Med. Our engineer had a non-boat accident that resulted in a clean break of the femur. The surgeon in Croatia screwed a titaniom bar to the bone like a splint. Two months later, while were in Malta, the titanium bar broke in half while he was walking, and down he went again with another clean break of the femur. The surgeons in Malta put a bar through the bone marrow. They shook their heads in disbelief about the doctor's decision in Croatia...

A couple months later I had a fluke slip that resulted in an ambulance ride to the hospital on the Dutch side of St. Martin. I shredded the left quad muscles and tendon to the patella. The surgeon was going to put me in a hip to ankle cast for two months. The medical advisory service the boat used instructed me to get back to the states for the surgery. I was put in an immobilized brace and began very limited physical therapy six days after surgery. I was bending my knee after two weeks. The PT continued for three months.

Bottom line: there is a lot more to healthcare systems differences than just the cost.

[Joe ( Cold Spring on Hudson )]

Thanks Alan I will look into it.

[Crusoe]

For anyone that's actually interested, this might be a good place to start.

http://en.wikipedia.org/wiki/Publicly_funded_medicine#Public_systems_around_the _world

Caution: We don't appear to fair too well when compared to other countries. Some people may wish to forego knowledge in favor of dogma and not read it.

[ccmanuals]

Read this to see how the richest nation in the world takes care of it's citizens.

http://www.sourcewatch.org/index.php?title=Defeating_Clinton's_health_care_pr oposal

[LeeG]

Originally posted by Chris Coose:
</font><blockquote>quote:</font><hr />Originally posted by km gresham:
Here we don't have poor "public" hospitals and rich private hospitals. Everybody goes to the same hospital. Beautiful</font>[/QUOTE]sweet ;)

[Chris Coose]

Originally posted by LeeG:
</font><blockquote>quote:</font><hr />Originally posted by Chris Coose:
</font><blockquote>quote:</font><hr />Originally posted by km gresham:
Here we don't have poor "public" hospitals and rich private hospitals. Everybody goes to the same hospital. Beautiful</font>[/QUOTE]sweet ;) </font>[/QUOTE]divine

[Meerkat]

Originally posted by km gresham:
Here we don't have poor "public" hospitals and rich private hospitals. Everybody goes to the same hospital. Nice thought - however, untrue.

[km gresham]

Here - in our city - we have 6 hospitals. Everyone can go to these hospitals. I guess that's not the case in some of the more tony areas of the country. That's a shame.

[Norman Bernstein]

In England it's the same - if you want superior health care you go to a private hospital. If you're poor you go where the floors aren't clean and the equipment is old and you get to wait weeks for surgical procedures. I don't see the advantage in that system. Here we don't have poor "public" hospitals and rich private hospitals. Everybody goes to the same hospital. Maybe we should emulate England and y'all would be happier.
I'd rather emulate Finland, Sweden, Norway, and a host of others where the costs are less than half to the taxpayers, and the care, based at least on statistics like longevity, infant mortality, and cancer survival, is better.

Of course, if you're already rich and buy yourself the best care in the world, here in the U.S., it's almost understandable why you'd oppose such a system. As Galbraith said so wisely (and I'm paraphrasing here), it's not hard to find an ethical or moral justification for greed and selfishness.

[ 06-08-2005, 01:22 PM: Message edited by: Norman Bernstein ]

[Crusoe]

For those wishing to crow about the gross inefficiencies of the british system. This is for you.

www.doctorsforreform.com/ (http://www.doctorsforreform.com/)

[Norman Bernstein]

Before any of you knee-jerk conservatrives get all sweaty over the fact that Crusoe has pointed out a dissent group among British doctors, a quick read of thier website will inform you that their first guiding principle is:


The fundamental NHS principle of care being universally and equitably available must remain. Later in the website, they look to France, Germany, and Switzerland as thier models... and specifically reject the U.S. model.

[Crusoe]

:D

[Norman Bernstein]

Interesting report on MSNBC... illustrating that we're all paying for 'universal health care' already, in a way...



WASHINGTON - Health insurance premiums will cost families and employers an extra $922 on average this year to cover the costs of caring for the uninsured, according to a report released Wednesday.


With the added cost, the yearly premiums for a family with coverage through an employer will average $10,979 in 2005, said the report from consumer group Families USA.

By 2010, the additional costs for the uninsured will be $1,502, and total premiums will hit $17,273. In 11 states, the costs of the uninsured will exceed $2,000 per family.

Problem affects everyone

Families USA says its study shows the problem is not restricted to the tens of millions of uninsured Americans.

Rather, the problem affects everyone, because the insured subsidize the cost of care given the uninsured. Most economists agree that some amount of subsidizing occurs, but the question has been how much.

For individuals, the extra charge this year is estimated to be $341 on average, rising to $532 in 2010. Total premium charges for individuals will be $4,065 in 2005, and $6,115 in 2010.

“The stakes are high both for businesses and for workers who do have health insurance because they bear the brunt of costs for the uninsured,” said Ron Pollack, executive director of Families USA.

Nearly 48 million Americans will lack health insurance for 2005, the report said.

Paul Ginsburg, an economist, said hospitals are having more success negotiating reimbursement rates with private insurers, and they take into account their costs for uncompensated care, he said.

“Ten years ago, I might have been skeptical about a study like this, but in 2005, I’m not,” said Ginsburg, president of the Center for Studying Health System Change, an organization that provides nonpartisan analysis.

'A vicious circle'

Uninsured patients pay about one-third of the costs of their care provided by doctors and hospitals, the report said.

The remaining costs — more then $43 billion in 2005 — are considered “uncompensated care.” The government picks up part of the tab and most of the rest is added to insurance premiums for people with health coverage, the report said.

“Ironically, this increases the cost of health insurance and results in fewer people who can afford insurance — a vicious circle,” the report said.

Families USA supports expanding health insurance coverage to all Americans, or universal coverage.

Uwe Reinhardt, a professor at Princeton University, said universal health coverage would raise costs even more for those currently insured.

Reinhardt said the uninsured would be likely to go to a doctor more frequently if they had coverage. He’s skeptical that taxpayers would be willing to pay the added cost.

From the purely economic perspective, “leaving the uninsured is a bargain” for the insured, he said.

A trade group for insurers declined to comment on the specifics in the report. However, it agreed on the need to reduce the number of uninsured.

“This report shows there are many reasons for us to address the reasons for lack of insurance — one is to improve the health of the population and the other is to get a handle on the cost problem,” said Susan Pisano, spokeswoman for America’s Health Insurance Plans.

The costs for people with insurance vary by state based on a number of variables, including the percentage of uninsured in a state and the amount local, state and federal governments contribute.

The report was based on data from the Census Bureau, the Agency for Healthcare Research and Quality, the National Center for Health Statistics and other sources.

The Associated Press and Reuters contributed to this report

[Meerkat]

Ah well - change will come sooner or later - probably after the epidemic bankrupts most of the hospitals and other care facilities in the US.

[paladin]

I have three insurance policies/programs...one through Allstate, one thru an HMO and a specialized overseas contractor and all total is about 600 per month....and i always have an open ticket from half way around the world to back home. I was hurt in Kazakhstan and flown to Ankara, Turkey for medical help...as it turns out the docor was my U.S. surgeons brother..
another time i was banged up pretty bad and was flown to U.K.....they diverted the plane to a smaller airfield, had an ambulance ready with all the trimmings..got patched up and spent three months rehab/recovery....
from what I have seen, the health care in the U.K was as good as anywhere...even Washington Hospital center...but dunno get hurt in the Soviet Union.....the best hospital that I visited was a military one for bigwigs and I had to call and have drugs flown in, and prepaid for......

[George Roberts]

Joe ( Cold Spring on Hudson ) ---

Fortis Insurance Company seems to give us much better rates than you get.

We pay under $400/month for 2 old people. My kid and my grandkid pay $75/month. Both $10k deductable MSAs (or is it HSAs?).

There must be a lot of lower cost policies.

[Charlie Santi]

I have been under a lot of medical care for the past couple years. I nearly died but pulled thru. I have insurance where I work. It is Blue Cross/Blue Shield I pay $60 a week out of my pay $1000 deductable then 40%. I also pay $280 a month for perscription deductables. I have been into my 401K and sold two of my boats including 'Lucy' my Wright K sailboat. I will be paying on doctor bills for most likely 10 years. I only earn 30k a year before taxes. This country could care less about the working class our only purpose is to keep paying them taxes. I am relived that I am finialy feeling good, I just hope my family can survive the fincial burden we now have. Life but why must it have a price in this country. Charlie Santi