<p>Nobody said they were poor but the pay is barely what a starting lawyer or MBA might make here. In Germany it’s about $65,000. France around $100,000. Britain is highest at around $240,000 which is a HUGE jump from 2004 and reflects a new structure. I seriously wonder how that would work here in the long run. I don’t have figures for nurses, etc but they are probably low too.</p>
<p>What I would love to know is how we pay for a system of national health care. Do our taxes rise? Do we require physicians and hospitals to accept lower payments? Do we reduce services available to individuals? Where does the money come from?</p>
<p>Though I like the idea of a national health care program in theory, I have never been able to get my arms around how it would work on a practical level.</p>
<p>Well, in my single-payor (though not universal) health insurance in my state, a portion of my government salary is deducted and paid to an autonomous entity, governed by a board of consumers and health care providers. They determine what is a covered benefit. (There is a board of appeal made up of consumers and providers). They in turn contract with all providers (individuals and groups). There is no “underwriting”, as the funds are in a self-insurance pool. There is very, very little overhead, and no profit, and no insurance company, which means that the cost of providing the “insurance” and the “care” is roughly 30% lower than for the same coverage from the for-profit insurers. Paperwork still exists, but in nowhere near the quantity it does among the other insurers. Meanwhile my health care premium for next year has gone down - again!</p>
<p>Congresspeople have this option now. It’s also called “Cheney Care”. ;)</p>
<p>For most people with insurance, their taxes would increase, but would be more than offset by lower premiums. Hospitals would no longer be saddled with paying for the care they provide the uninsured. Less primary care would be provided in emergency rooms.</p>
<p>Insurers wouldn’t like it. I say give them half a trillion dollars, and tell them to go away. (Obama’s plan, in contrast, is a giant boondoggle for the private health care companies.)</p>
<p>Sallyawp–Well, for one, we and our employers would not be paying health insurance premiums. I pay about 3000/yr, and my employer pays three times that. My employer is a college, which means a portion of every tuition bill goes to pay the insurance premiums of all the employers. And you are paying insurance premiums for everyone who works at your kid’s college. Similarly, everything you buy, from cars to groceries, includes the amount necessary to pay toward insurance premiums in every industry.</p>
<p>So, yeah, there’d be taxes, but all the above would disappear.</p>
<p>Additionally, I know that every hospital and doctor’s office spends inordinate amounts of money and time dealing with each individual insurance plan. This includes all the workers employed in the actual insurance overseeing, but also the time each doctor spends on the phone negotiating with a myriad of different plans as to what treatment will be covered for each patient.</p>
<p>With a single payer plan, all that third party headache would disappear; uniform insurance means doctors spending their time treating, not negotiating.</p>
<p>In the UK you pay a % of your income for National Insurance Contributions. There is a salary cap above which the % drops.</p>
<p>Retirees are covered and do not have to make contributions. Prescriptions are free for retirees and children. My husband is retired and we pay much higher premiums now than when he was employed. 
We dread each year when we await news on how the company he retired from is going to change the retiree program - sadly always for the worse.</p>
<p>Barrons, the average income of a doctor in Germany are lower than in the US but not that low. The average income for a physician in private practice are 84,976 Euro a year, or $128,000. The average clinical physician earns $98,000 or 66,000 Euro.</p>
<p>You also have to keep in mind that the income distribution in Europe is different and so the same income means a higher social standing. In Germany only 5% of the working population earn more than 52.000 Euro ($77,000) a year. In the US the top 5% earn more than $153,542, twice as much.</p>
<p>Mercymom…and how would you deal with folks (like my DS) who have a chronic illness and need both doctor’s visits and medication to prevent further issues? These are the types of patients that are “expensive” to the health care system but they NEED care also. I wish he didn’t have to go to the doctor for this issue twice annually, and use two medications daily. BUT the reality is that is the case. I don’t want to deal with a different set of doctors with different protocols just because it costs less.</p>
<p>Our state doesn’t require auto insurance which is why I have uninsured drivers coverage. It doesn’t sound fair that those that get injured by others have to pay the cost but that’s the way it is.</p>
<p>Seems to me that we need safer roads for cyclists. I don’t cycle to work because it is too dangerous. I tried when we moved here and quickly gave up on the idea.</p>
<p>So what happens to someone with who is relatively healthy, who is currently employed and who has employer sponsored healthcare? Assume, too, that this person covers all of his or her out-of-pocket health care expenses on a pre-tax basis by using a health care flexible spending account. If that person’s taxes go up by even 1-2%, it may dwarf the amount that person is otherwise spending on healthcare on an annual basis.</p>
<p>I am concerned that any national health care plan that results in increased taxes would put a significant number of working Americans who already have health insurance in a far worse situation financially than they are in now. </p>
<p>Every paycheck, Americans see a huge percentage of their salaries go to federal, state and local income taxes, FICA (for a social security system that will likely not exist in its current form, if at all, by the time retirement rolls around) and Medicare taxes. On a daily basis, Americans pay sales taxes on everything and property taxes that in many areas of the country are through the roof. Where does it end? When do we get to say that enough is enough?</p>
<p>I’m not suggesting that our health care system is working for many people, because it is clearly not. However, if raising taxes to fund a national health care system is the only answer, then I am always going to have a tough time getting behind it.</p>
<p>Yay Socialism.</p>
<p>But again, Sally, those insurance premiums the employer and everyone else’s employer are paying are coming out of someone’s pocket. Every dollar that relatively healthy employee spends goes to help cover someone else’s insurance premiums under the present system… However, the system that collects them now is rife with redundancies, inadequacies, and inequities.</p>
<p>“I am concerned that any national health care plan that results in increased taxes would put a significant number of working Americans who already have health insurance in a far worse situation financially than they are in now.”</p>
<p>Ah, but there’s the rub. At any one time, there are 45 million or so folks without insurance. But if you added up the number of people who were without insurance at some time within the past year, the number rises well above 80 million. And the vast majority of them are working folks who thought they were secure. But since what happens to them is portrayed as an “individual” as opposed to “societal” problem, they think they are better off with lower taxes. The reality is far from (especially in that, when they have insurance, a good part of their premium is going indirectly to fund those without any.)</p>
<p>Everyone in America could be covered (and relatively easily, actually) at the same aggregate amount that is expended today. But not with private insurance, and not with individuals paying premiums rather than taxes.</p>
<p>
I would definitely.</p>
<p>I’m a bankruptcy lawyer. In well over half of the consumer cases that I file, medical bills are a significant factor in precipating the bankruptcy filing and in many of these cases the individuals ARE insured and still end up with bills they can’t pay because of high deductible plans, non-participating providers, etc., etc., etc. How anybody can say that we don’t need a national healthcare plan when more than 50 MILLION Americans – many of them children – lack healthcare coverage, in one of the richest countries in the world, is beyond me. I lived in Europe for several years and the fears of “socialized medicine” are wildly overblown. The fact of the matter is that most of the industrialized nations with national healthcare have lower rates of chronic disease, longer life expectancies, and better health outcomes for their populations than WE do. There’s no question that if you’re wealthy or if you have good private insurance, you have access in the U.S. to some of the best healthcare in the world. But that’s no excuse for not providing universal and affordable access to a high standard of medical care for ALL U.S. citizens. The idea that we can’t or shouldn’t do it at this point is simply ridiculous, and reform is long overdue. The fact that companies like Wal-Mart and GM are pushing for national healthcare ought to tell you something – they know that if something isn’t done, it’s going to put American business out of business and bankrupt the country.</p>
<p>Well I can’t say I disagree with the idea; I just worry about the transition. Not only as a provider, but as I consumer. I admit I am a LITTLE entitiled. In a “managed heath model”, I am impressed with the level of maintenance care, and in the outcomes for chronic conditions, but for the average consumer with the average complaint ( say “my throat hurts and I went antibiotics”), I wonder how it will shake out.Does anyone know if there is direct to consumer (drug) advertising in these countries where “it works”?</p>
<p>Mr. Payne, does that mean you are willing to go to a non-us medical school?</p>
<p>^probably. My dad was state physician, working at various institutions and government departments. He made more $ than the private physicians without the insurance coding and billing headaches. </p>
<p>Oregon State U, had its own student health clinic, with 5 physicans. I avoided the clinic when I was sick but visited him when I wanted a free meal.</p>
<p>^ I am encouraging DS to try to get a consultancy position. And sincerely hope that he does not get “hired” by MS and has to participate in their group health insurance that statistically accounts for the women of child bearing years and men in their 50’s. That’s capitalism and choice.</p>
<p>I’ll never support nationalized healthcare until we have control of our immigration problem!</p>
<p>I’ll never support nationalized healthcare until we have control of our weight problem!</p>
<p>Thumper1, I completely agree with your post 27, what makes you think that I don’t?</p>