Universal Health Care-British Style

Parent Cafe
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I wasn’t directing my comments to the Canadian system - they were general. I mean that I want to be free to seek services as I choose. If I’m not happy with a particular hospital system I want to be able to switch to another. Ditto with doctors, diagnostics, specialists, etc. I don’t want to be constrained. If I’m not happy with the constraints of my particular health insurance provider or program within that provider, I want to be able to choose another that I find more amenable even if I want to pay more money for the privilege.</p>

<p>For example, some HMOs and health plans (like Kaiser) are restrictive in who one can see and where one may receive services. I choose to pay extra to not have those constraints although I have co-workers using those plans who like them (so far). </p>

<p>I also like a free-market based system since generally if there’s a niche someone will fill it. This means that if someone recognizes a lack of diagnostic equipment, a lack of reasonable services for joint replacements, etc., it’ll generally mean someone will provide services to improve that area. </p>

<p>I understand that in some ‘universal healthcare’ systems the country ‘allows’ some private healthcare in addition to the social one. IMO this alone points out that something’s missing in the social healthcare but I do think there’s an issue when these private healthcare services aren’t allowed by the country. I think this has been an issue in Canada. Even if private healthcare is allowed, I’m concerned about the cost since I’d essentially have my money going to the social healthcare and then I’d have to dip further for the private healthcare I wanted. Wealthier people will be able to do this but those with less means would have a harder time essentially paying for both.</p>

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<p>NY times has an article on the intensionally uninsured.</p>

<p><a href=“http://www.nytimes.com/2008/02/23/us/politics/23health.html?ref=politics[/url]”>http://www.nytimes.com/2008/02/23/us/politics/23health.html?ref=politics&lt;/a&gt;&lt;/p&gt;

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<p>ucsd<em>ucla</em>dad said:</p>

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<p>(I know, I know; I said I was leaving this post.)</p>

<p>Again, compare health care to education. For some, public education isn’t “good enough,” so they pay extra for private school. For some (including all of us on CC), the free public education through 12th grade isn’t enough, so we pay for college. Not at all dissimilar from a “public” healthcare system, with “private” additional coverage available. Just like what we have now for Medicare – everyone over 65 is eligible for Medicare, and some choose to purchase Medicare Supplement policies. Sounds like free choice to me.</p>

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<p>VeryHappy:</p>

<p>Comparing to education - I’m not happy with our current ‘universal’ system. I did send my kids to private school for K-6 and essentially was double dipped - paying for public I wasn’t using as well as private I used. I shouldn’t have had this level of expense or, ideally, felt the need to do it. Fortunately, I could afford it. There are plenty of others who’d like to do the same thing but can’t because they can’t afford it, in part because they’re already paying for a system they feel doesn’t meet their needs. An ‘opt-out’ or voucher system would go a long way to resolving this but a lot of people don’t want that because it’d jeopardize the social system. This is similar to some arguments made by some countries regarding their limitations placed on private healthcare that might jeopardize their social system as well as exposing the failures of that social system.</p>

<p>I don’t want to take this thread to the topic of education - I was only responding to the comparisons to healthcare. </p>

<p>And, I never view any of these systems as ‘free’ because I know that in reality I’m paying for it whether I use it or not - more than a lot of people.</p>

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<p>dntw8up: I’m not sure why but there seems to be a presumption that health care is an entitlement.</p>

<p>kbaloney: It has to be since all prisoners get free, good health and dental care.</p>

<p>dntw8up: It’s an entitlement for prisoners because when we confine them we prevent them from being able to use private insurance.</p>

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It’s not free choice when you have no option as to whether to pay into the system or not.</p>

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<p>ucsd<em>ucla</em>dad: That is not really a very good argument. Taxpayers pay for all kinds of things they do not receive direct benefits from. It’s part of being a member of a democratic society - the social contract and all.</p>

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<p>1of42:</p>

<p>I don’t know which of my responses you referred to.</p>

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<p>Opie, I’ve known of people that live/lived extremely healthy life style and STILL had major health problems like cancer (just on CC, LTS and mini come to mind). I’ve known kids who got cancer when they were young, longer before you (the generic you) could blame it on lifestyle. No one is immune for the possibility to chromic/terminal illness, NO ONE. It’s not quite the same, but my own mother was a model of good prenatal care (didn’t smoke, drink, drink caffeine, do drugs, eat unhealthy, etc.) and still had a baby at 26 weeks.</p>

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<p>ucsd<em>ucla</em>dad: The latest one, the “it’s not choice if I have to pay for it whether I use it or not”. It’s still choice as to what service you use, you just don’t get to opt out of paying for the one you’re not using. I actually really like that kind of system; the rich who really want better care can get it, but they also subsidize the care for the people who aren’t able to. And eventually, as each person leaving the system effectively gives it more per capita funding, the system reaches an dynamic equilibrium of those in and out of the single payer system.</p>

<p>The thing is, you’ve still got all the free choice in the world under the single payer/private competitors model - it’s just the choice that you prefer costs you more in that paradigm, which is why you don’t like it. ;)</p>

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<p>“Opie, I’ve known of people that live/lived extremely healthy life style and STILL had major health problems like cancer (just on CC, LTS and mini come to mind). I’ve known kids who got cancer when they were young, longer before you (the generic you) could blame it on lifestyle. No one is immune for the possibility to chromic/terminal illness, NO ONE. It’s not quite the same, but my own mother was a model of good prenatal care (didn’t smoke, drink, drink caffeine, do drugs, eat unhealthy, etc.) and still had a baby at 26 weeks.”</p>

<p>WHOAAA TOBIA BACK UP AND THINK ABOUT MY POST…</p>

<p>I am not discounting the FACT that people get sick for absolutely no reason what so ever. You’ve missed the point entirely cause your all worked up…</p>

<p>MY point plain and simple is if we as a culture work towards a better lifestyle with exercise and proper food consumption choices encouraged we WILL reduce the cost of care because then we WILL be treating those who GOT sick, not those who MADE themselves sick. Do you not understand the point? </p>

<p>Your undies are all in a bunch for absolutely no reason towards me. I don’t disagree with you some people get sick, but wouldn’t you agree some people MAKE themselves sick? </p>

<p>I know, I’m one of them. I’m not speaking from some ivory tower. I know some of my lifestyle choices have caused me to become dependent on several medications to function and I know I have robbed my wife and kids of years of my life… The problem is, I don’t get a do over… </p>

<p>To the other poster who made a remark about atheletes having to go in for medical treatment for injuries… I long for the days when all a doc had to do was set a bone, slap some plaster around it and send me on my way… </p>

<p>Compare that cost to everyday taking 10 pills a day for hypertension and type II, plus now I shoot up twice a day with lizard spit… (which actually is helping a great deal). Mainly because I became too busy, too tired, too preoccupied, too stressed to exercise. I did this to myself, and what’s worse I did this to my family.</p>

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<p>Yeah - I really don’t like having to pay more. Do you?</p>

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<p>No, but that’s not having less choice, that’s not liking the choice you have. There’s a pretty large difference. ;)</p>

<p>And for the reasons I posted before, I think the public/private hybrid is the best system (and so, apparently, do the top 30 or so health care systems in the world).</p>

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<p>I guess either I didn’t make my point well or you just disagree - If one is forced to pay for social healthcare regardless of whether they use it or not and would like to use private, they may not be able to afford it since their bucks already went for the social that they didn’t use. This is essentially giving some people, those who can’t afford to pay for both, less of a choice. </p>

<p>Maybe the social healthcare countries should provide a voucher system for healthcare to enable those who choose a private option the ability to use it. That way they’d have a true choice.</p>

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<p>That’s only not choice in the same sense as the fact that a poor person cannot afford private health care. Obviously it is effectively less choice, but it is not in the sense that we normally talk about - which would be the government legislating against allowing private care. You would still have the choice in that case, but one would be more economically feasible than the other. That’s all I’m saying.</p>

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<p>What is important to consider is how much it costs the public. Americans are very aware of the costs because they come out directly from their pockets. I know exactly how much it costs me to get the health coverage I receive for myself and my family. If I were to pay through taxes, I would not know as clearly.</p>

<p>When I was living in the UK, we paid taxes under the PAYE (Pay As You Earn) system. Many bureaucrats were employed to figure out how much tax was needed to be deducted from individuals’ salaries and wages every month. And every month, our paychecks were slightly different, as those bureaucrats adjusted their calculations. When members of the public complained about the size of the bureaucracy needed, a study was conducted to compare the UK and the US systems. The study argued that proportionally, the costs to US taxpayers of paying accountants to do their taxes were equivalent to what the UK taxpayers paid to the small army of bureaucrats. Of course, with turbotax, the US system of self-reporting may not cost as much as it did 30 years ago.</p>

<p>So, one issue to consider: how much do we want to pay for health care, whether through private insurance or through taxes? How much choice do we think we should have and how much is it worth to us? How much power would a single payor have to impose some lines of treatment or certain drugs instead of others? Even in the private sector, I have found that my new drug provider will pay for some and not others. If I and my fellow employees find this policy too restrictive, we can hope that our company will look for other alternative providers. How likely would that be under a single payor?
Just an anecdote. I had been complaining of symptoms for months. My GP ordered a battery of tests, but they were inconclusive and was therefore reluctant to recomment radical surgery. Then I went traveling and got to talk to someone who absolutely insisted that I have surgery. So when I got back from my travel, I told my GP and she agreed to it. I had the surgery. Good thing I did because I had a tumor that could not be detected through the several tests I had undergone. Would I be able to insist on a surgery that a GP was not convinced was absolutely necessary under universal health care? Would I have to pay out of pocket for what seemed at first glance an unnecessarily radical procedure not warranted by the known information? </p>

<p>This is not an attempt to denigrate single payor universal health care, but to raise the sort of questions that need to be addressed while considering the pros and cons of various systems and associated costs.</p>

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<p>marite, it sounds as though the system in the UK is very different than the one in Canada. Here, yes, you would be able to insist on the surgery, and no, there would be no out of pocket expense. That doesn’t happen here. For procedures, treatments, care that is covered by the provincial health insurance program, you would always be covered. I suppose if your primary care physician still refused, you would have to seek a second opinion from another doctor. For prescribed medications, I have not seen a drug plan which will limit the types of medications covered. The pharmacist may inquire as to whether you’d prefer the generic equivalent but it is always up to the patient what drug they wish to take. The Ontario Health Insurance Plan does not have control over this issue. Employers are the ones who provide drug plans in their benefit packages, along with dental plans, coverage for eyeglasses, etc. </p>

<p>I think you’ve made an important point with the cost issue. As I said, probably in my initial post in this discussion, I don’t think that most Americans would be willing to pay the amount of increased taxes that Canadians do in order for everyone to be covered. That PAYE system in the UK is interesting. I hadn’t heard about that, and it seems strange!</p>

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<p>"How many prisoners would carry health insurance or see a dentist if they were not in prison?</p>

<p>Most people are in prison because they are poor.
They couldn’t afford health insurance."</p>

<p>True, but that is not why taxpayers provide prisoners with health services. We prevent prisoners from having the option to procure and use private insurance, so we accept responsibility for the health of the prison population. It’s important to all of us to keep prisoners relatively healthy because doing so protects the health of the free.</p>

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<p>And what is the feeling on here regarding the bill Bush has just put forward to tie Medicare premiums to income? In other words, higher income seniors would pay more than lower income seniors for Medicare.</p>

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<p>[Cut-off</a> cancer patient to get $9M - Yahoo! News](<a href=“http://news.yahoo.com/s/ap/20080223/ap_on_he_me/health_net_damages]Cut-off”>http://news.yahoo.com/s/ap/20080223/ap_on_he_me/health_net_damages)</p>

<p>“The award came a day after the Los Angeles city attorney sued Health Net, claiming it illegally canceled the coverage of about 1,600 patients. City Attorney Rocky Delgadillo also said the company illegally ran an incentive program in which it paid bonuses to an administrator for meeting targets of policy cancelations.”</p>