Health care - administrative incompetence

With private insurance the only gain you're getting over the NHS service is better accommodation and so on, but you are paying for the treatment, surgery, whatever. The point is that the treatment won't be any superior to the NHS provision, being as the NHS provision is pretty much state of the art.

If the NHS provision was wanting in any way, then the private sector is right there to sell it to you.

So, not a monopoly. Just an offer you'd be a bloody idiot to refuse.

Rolfe.


And as I think may have been mentioned once or twice before.... the surgeon who will yank your gall bladder next week at the BUPA hospital will be the same one as would have done it 3 weeks later on the NHS!
 
I want to abolish Medicare.
OK, I like seeing specifics, rather than batting the term free market back and forth, which no doubt means different things to different people. So I hope you'll fill in some more detail. What about these core aspects of health care that are government controlled...?

Should government control what drugs are available?

Should government control who is allowed to provide health care?
 
Darat, we should maybe point out that all these "featured consultants" also work for the NHS so you won't be getting any sort of "Top Man" you couldn't get on the NHS. In fact, the way to check that your private surgeon is good is to find out what his NHS appointment is. Since the very best guys have the top consultancy posts at the top NHS teaching hospitals, they can be identified very easily that way.

Rolfe.

If we say it enough times it may get through!
 
I saw that they fund their healthcare very similarly to how we do (~30% public and ~70% private) yet they are able to provide pretty good healthcare to all it's citizens largely using the model that I and many other Americans already use: Savings + Catastrophic insurance.

Ah, now I see why you brought up Singapore. You saw the words "savings" and "catastrophic insurance" and figured it was your idea in practice. Sorry, but it's far from it. You're still yanking on the elephant's tail and insisting it's a rope.
 
Not every purchase. Just the fun ones! I understand how VAT works; pretty much like sales tax in Texas except double (UK) or triple the rate (Sweden). So you have a higher effective tax rate for my income (income +NI) plus the VAT. My insurance is about 2% of income and I voluntarily save about 15% of my income for a variety of purposes including health expenses. So yes, effectively I pay less taxes. Guess what the kicker is, though? I get to choose where and when to spend my money!

Every time I start complaining about my taxes, I think of Europe and cheer up! ;)

I don't think that it is that bad.

My income tax, national insurance and pension work out to around 30% of my total wages.

Yes, there is VAT on some things, but it is pretty understandable, unlike the constant odd taxes here and there when you are in the US, an extra 10% for prepared foods, and extra 30% for this or that.

It is really confusing trying to work out US taxes, this is a round estimate:

Federal tax ~ 20% for the middle class
Social security 6.25%
Medicare 2.9%
State tax ~ 6%

That is 35%, and it doesn't include health care.

http://economix.blogs.nytimes.com/2009/04/08/how-much-americans-actually-pay-in-taxes/

It seems we are arguing about nought, for the vast majority of middle class, in both the UK and US, it is around 30%.
 
No, but if we had a free market, doctors and hospitals would have to compete against each other to provide the service. Prices would have to come down.

They don't have to come down. In fact they might not come down at all.

Let's find a free market solution to the organ donation problem. Why not offer me an incentive to donate my organs? It would vastly increase the number of organs available. Simple, simple solutions to the liver transplant cost problem.

Or you could do what Spain does and make organ donation an opt out programme instead of an opt in one.

Do you guys know what a monopoly even is? The NHS is a monopoly. I have a choice between insurers. If I don't like the coverage or the way they treat me, I can move. Or I can go without. My choice.

Ok, fine the US is an oligopoly, happy?

Nope. The point of that illustration was this: the UKers were trying to say that the NHS takes care of everyone's needs better than the US. Guess what? Most US insurers cover lapatinib! Here's Cigna's policy and they are usually one of the worst ones. Imagine that . . . a greedy US profit monster covers a drug that the altruistic and beneficent NHS does not! :jaw-dropp "Everyone's needs are covered," my hairy toe.

So you've found one instance where the NHS is worse then the US. Clearly this means that the NHS is completely and utterly crap and should be discarded immediately.

It's not like other countries with universal healthcare cover lapatinib, like say Australia where Medicare covers it as part of the PBS.

By eliminating the government as an insurer.

And then? Excluding the government as an employer the government insures those who do not have enough money to afford insurance and also the elderly. Do you really think that insurance companies will drop prices just to attract a group that is more likely to default on payments and a group that, although they might be able to pay, would be considered high risk?

Sure, if you give them to someone with a virus. If you give them to a person with a bacterial infection, they reduce the risks of transmission and
complication.

I suggest that you look up what causes antibiotic resistance, since it's not just giving antibiotics to someone with a viral infection.

They don't, who said that? I said that 1)The UK has said that healthcare is so important that the government must provide it. 2)There are not enough resources to go around so people are denied drugs like lapatinib. 3)Yet there are, somehow, enough resources to go around to pay footballers, pop stars, etc. ridiculous sums of money.

So why make the point then? Since the government is not paying the footballers the footballers are not draining resources for medicine.

Savings for your own needs <> taxation

However the government is still taking money from you against your will.

I can choose my insurance provider within a few months. Government policies take years and $$$ (or £££ in this case) to change.

And if you happen to get sick and your insurance company does not want to pay for your treatment what chance do you have of finding an insurance company that will?
 
For about the twentieth time, when it comes to healthcare,

WE HAVE MORE OF OUR OWN MONEY IN OUR OWN POCKETS THAN YOU DO.

We pay slightly less in tax to fund the NHS than you do to fund the government provided healthcare in the USA.

Then, get this, we don't have to pay any more.

You have to pay all over again to fund your own healthcare because you can't access the healthcare your taxes are paying for.

Maybe our spending on healthcare is high. But in the UK, our take home pay (according to thesalarycalculator.co.uk) would be ~$14,000 less than it is here. Then I would pay 20% (in January) VAT on my purchases of most items, which are already more expensive in the UK then the USA (for example in the UK a MacBook costs $1316 +20%, Texas $999 +8.25%). No matter how you slice it, I have more money in my pocket in the US than I would in the UK AND I have control over my own healthcare costs (which amount to about $5000 per year, all told).

It comes down, as we said in the beginning, to cultural differences. UK=Government take care of us, USA=We'll take care of ourselves for the most part.

If you add the amount you are spending on health insurance (don't forget to include your employer's contribution if there is one, because that's indirectly coming off your wages anyway) to your taxes, you're massively worse off than we are.
Nope, I have about $9000+ more in my pocket per year in the US than I would in the UK. The worst that could happen right now is that my every person in my family has severe medical needs in any given year. In that highly unlikely scenario, then maybe I would have less in my pocket. However, I take that extra $9000 or so (and then some) and sock it away for just such unlikely scenarios. Or to travel the world if I want to. Or spoil my kids. Or renovate my house. My choice.

We have the freedom to make any choice of employment or not to be employed, without having to consider how this might affect our healthcare coverage.
See this is what I have a problem with. You can choose not to work and society is expected to pick up the tab. Preposterous.

I could go on but that will do for now. Wouldn't have xjx388's life on a bet.
Well good because you can't have it! ;)
 
Maybe our spending on healthcare is high. But in the UK, our take home pay (according to thesalarycalculator.co.uk) would be ~$14,000 less than it is here.

But the salary calculator just works out how much tax gets taken off your salary. It doesn't adjust your salary itself. You might get paid more for doing whatever job it is you do if you did it in the UK, which would make up the difference. London is, I know, one of the most expensive cities in the world - as a result salaries are higher here.
 
So the NHSs don't control the medical care market in the UK? I understood from this thread that private insurance was for things like better accommodations, etc. I also understood that doctors were employed by the NHS and that was the free care you were entitled to.

What is the extent of the private system in the UK?

99% of the consultants in the private hospitals also work in NHS hospitals.

I think the 1% would be plastic surgeons, which in all honesty, if they give up their NHS practice, it just sort of looks bad.

All the blood work for private hospitals, done in NHS hospitals.

If there is an issue after surgery and a patient needs an ITU/ICU bed, guess where they do..........................yes, to an NHS hospital.

Can you choose the surgery you want to go to? Yes, you can choose within the area you live in. I have no idea how big it is, but it does make sense to have your surgery close to your home or work.

Can I choose which doctor I see in the surgery? Yes, I can.

Can you choose to go to a different hospital to have a surgery if they have a consultant you like or shorter waiting time? Yes, you can.

Can I choose to pay for drugs that are not covered by the NHS (or by my current condition - see one of my previous posts)? Yes, I can.
 
Ah, now I see why you brought up Singapore. You saw the words "savings" and "catastrophic insurance" and figured it was your idea in practice. Sorry, but it's far from it. You're still yanking on the elephant's tail and insisting it's a rope.

I said that it shows the model can work. It's a model we should learn from and improve to use in the US. Along with many other ideas from other models.
 
I said that it shows the model can work. It's a model we should learn from and improve to use in the US. Along with many other ideas from other models.

Wow - you are willing to learn from a dictatorship but aren't willing to learn from a representative democracy (not only that it's one that you based most of your legal system on)? That just seems very strange to me - so much so that from my perspective you are only willing to "learn" from something if it it matches your preconceived perception as to what the answer should be.
 
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Then I would pay 20% (in January) VAT on my purchases of most items, which are already more expensive in the UK then the USA (for example in the UK a MacBook costs $1316 +20%, Texas $999 +8.25%). No matter how you slice it, I have more money in my pocket in the US than I would in the UK AND I have control over my own healthcare costs (which amount to about $5000 per year, all told).

Where did you grab the UK MacBook price from?
 
Maybe our spending on healthcare is high. But in the UK, our take home pay (according to thesalarycalculator.co.uk) would be ~$14,000 less than it is here. Then I would pay 20% (in January) VAT on my purchases of most items, which are already more expensive in the UK then the USA (for example in the UK a MacBook costs $1316 +20%, Texas $999 +8.25%). No matter how you slice it, I have more money in my pocket in the US than I would in the UK AND I have control over my own healthcare costs (which amount to about $5000 per year, all told).
I don't know which model macbook you are comparing (the top search result on Amazon.co.uk is this one at £789 ($1212) but you may have misunderstood one thing; the price ticket we see in every shop already has VAT included, so you'd be in error if you added a further 20%.
 
This is getting beyond ludicrous - comparing the price of Macs in the USA & UK has nowt to do with either the cost of the NHS or the cost of the USA health system.
 
Maybe our spending on healthcare is high. But in the UK, our take home pay (according to thesalarycalculator.co.uk) would be ~$14,000 less than it is here. Then I would pay 20% (in January) VAT on my purchases of most items, which are already more expensive in the UK then the USA (for example in the UK a MacBook costs $1316 +20%, Texas $999 +8.25%). No matter how you slice it, I have more money in my pocket in the US than I would in the UK AND I have control over my own healthcare costs (which amount to about $5000 per year, all told).

It comes down, as we said in the beginning, to cultural differences. UK=Government take care of us, USA=We'll take care of ourselves for the most part.

Nope, I have about $9000+ more in my pocket per year in the US than I would in the UK. The worst that could happen right now is that my every person in my family has severe medical needs in any given year. In that highly unlikely scenario, then maybe I would have less in my pocket. However, I take that extra $9000 or so (and then some) and sock it away for just such unlikely scenarios. Or to travel the world if I want to. Or spoil my kids. Or renovate my house. My choice.

See this is what I have a problem with. You can choose not to work and society is expected to pick up the tab. Preposterous.


Well good because you can't have it! ;)

Americans don't get enough annual leave to travel the world. ;)

I think you also forget to add in that the minimum (paid) annual leave in most of Europe is 20 days, as well as 9 days of statutory holidays.

I get 33.5 days of annual leave per year.

Based on my salary calculator, that works out to around £ 4000 pounds I am paid to do nothing, which is about $ 6, 000 US.

I think if I added on the statutory holidays, we are quids in equal.

I know which I would choose.

Don't be too jealous that you can't have it. ;)
 
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I suspect that there is often confusion about price when trying to compare uk and us goods: I was astonished to hear that the price shown in the US is not the price you pay.
 
I said that it shows the model can work. It's a model we should learn from and improve to use in the US. Along with many other ideas from other models.

It's not a free market model at all, which is what you proclaim to want. Half the hospitals are run by the government. There are huge subsidies and price controls. There are limits to what you can do with the Medisave money. You can't get private insurance without also participating in Medifund, which is what is used to pay for people who can't afford to pay (welfare).

It's everything you've been arguing against. The system certainly works, but it in no way, shape or form resembles anything you've been advocating. Rememer, you claimed you'd rather let your family die than accept tax dollars to pay for medical care.

It sounds like you understand just as little about Singapore as you do NHS.
 

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