Ovid_and_Flem said:
In reply to Adrian_Thompson :
Not to get political either, but I'm real curious about Healthcare Systems in other industrialized Nations. Just as an academic discussion not trying to take one position or another
I will dip my toe in then, even though it's dangerously close to politics. ECM, Seth, GRM staff members, please let me know if I've stepped over a line here. Note this is mainly personal opinion.
Background. I lived the first 25 years of my life in the UK using the National health system. Since I moved here coming on 25 years ago I have obviously stayed in touch with friends, family and acquaintances so I basically have 50 years of personal, close family experience, friends, family anecdotes and press coverage of the UK National Health System. I now have close to 25 years of personal, family, friends and news experience of the US pay to play system.
Let's cover the facts first.
The US pays more per capita for health care than any other nation.
Link - US costs per capita $10.3K annually. Next highest Switzerland (with far higher GDP per capita earnings and wages) at $7.9K, average European countries listed was $5.2K
Wiki link US costs per capita $9.9K annually. Next highest Switzerland at $7.9K, average of 2nd through 21st countries listed was $4.7K
PBS link 17.6% of GDP goes to health while the average of the top 35 or so countries is less than 9.5% of GDP.
I could keep linking forever, but I think it's fair to say that in general terms the US spends more than twice (or close to) in either costs or % of GDP of most other developed first world countries on health care.
Great, we pay twice as much, our health care system must berkeleying rock. We must be the healthiest country in the world with the best access to the best medicine. 'Murica F-yeah'.....Opps, hold on. Let's look at quality of health care.
WHO rankings from Wiki US ranks 37th in overall health system performance. We rank 32nd on attainment of health distribution
CIGNA rank of top 10 health systems The US doesn't even get on the list and CIGNA is a freeking health insurance company
US news top 10 AGain the US isn't on the list.
MD Magazine MD, as in Medical Doctor Magazine global rankings the US come 29th
I could go on and on, but I don't think it's unfair to say that the US doesn't even come in the top 20 for health care anywhere.
Now, personal experience.
I will be the first to admit no system is perfect. The British National health system tends to be ranked in the 5th to 15th ish place on these lists while Canada tends to be listed in the upper half of the top ten. Why do I signal those two countries out? Because they are English speaking countries that people who are pro the US system tend to single out as examples of why a single payer/National health system/Socialized medicine can't, doesn't work and will lead to loss of care, death lists, waiting lists etc. Neither of those two systems, nor any other is perfect. Tragically people will not get served, have to wait, mistakes etc.etc. But I honestly believe those cases are so few and far between that they are the exceptions that prove the rule. LEt me list some things that I've never, not have any of my friends, family or extended acquaintances have had to deal with or suffer from in the UK or Canada that I have personally met people that have suffered from here.
- Submitting a claim to a health insurance company who pay, you pay the check in then they change their mines and take the money back leaving you with a $50 overdraft fee (that one was personal)
- A hospital kills them on the operating table having used the wrong anesthetic, they then saved their life and charged them for saving it. The same thing happened to the same person the next time they were in the same hospital for the same reason (Cancer). YEs the hospital and insurance were in the wrong, but a single divorced mother with (what turned out to be) terminal cancer can't afford the money or emotional stress of fighting them.
- Someone was in a car accident while uninsured in their 20's and ended up in bankruptcy
- Someone got an emergency tracheotomy after a snow mobile accident and the insurance company retroactively decided it was needed so called it elective. He list most his retirement savings trying to fight that one.
- This one may not longer apply. I knew a woman in the late 90's early 00's who had a heart condition that was found out while working. They hated their job, it didn't pay well, was massively stressful and a toxic work environment. They tried to change jobs, interviewed and were offered other jobs, but when health care came up they had a pre-existing condition so the new insurance wouldn't cover it so they were stuck in a place that was literally killing them with stress (the ACA fixed this one)
- Getting a new job and the health coverage doesn't kick in for 30 days so I"ve met people who have risked not having coverage. Some got lucky, others had kids who ended up in A&E and they lost thousands. Others (me included) have had to pay for COBRA at eye wateringly high rates.
- Running out of money for elder care.
- Older family members ending up in horrible conditions due to lack of $$"s
Things I've never experienced in the UK
- Out of pocket costs. You need a doctor, you see a doctor. YOu need a hospital you go (or ride in an ambulance) to a hospital. That's it, no insurance, no costs no nothing. Just care.
- Mythical waiting for emergency procedures. Personal example here. Totally my mothers fault, but I'll tell it. About five years ago my mother spent nearly six months here over different trips as my sister, her partner and kids were living with her after a house move fell through. IT was stressful so she extended her stay from the new year to Feb. We had already planned a skiing trip up North the weekend before she left. We went and she stayed at our house with the Instructions 'Don't go outside', 'If you have to go outside don't wear you normal boots, they have no grip', if it's an emergency and icy and you really need to go outside, wear crampons on your boots', 'whatever you do, don't walk the dog, let him out in the back yard, he's fine with that in this weather'. Guess what? She did every single 'Do Not'. slipped, fell and broke both wrists. We got a call from our neighbor who helped her home and in, not knowing she had broken wrists. Because she'd extended her stay her travel insurance had run out and no one had thought about it. Luckily we have friendly doctors and chiropractors, but she couldn't afford tgo go to hospital as Google indicated it would cost anywhere from $7.5-$25K per wrist. Pain killers and splints until she could fly home. Once she gets back (with lots of help from airport porters etc.) my sister drove her straight from the hospital. X-rays and examination all done within a couple of hours. Verdict, two brocken wrists, will need an operation on both to pin them. As it's not fresh it's not an emergency so you'll have to wait. Uh oh, that hideous National Health service waiting lsit we keep hearing about. She had to wait, for days and days. Two days in total then she went in and had them operated on one at a time a couple of days apart. What was her cost for all the visits and follow up? $0 ZERO, zip, nadda nothing. Just fixed for free.
Yes, these horrible waiting lists exist for elective things, but emergencies, critical and urgent care is just that. Seen as soon as possible in 99.9% of situations. No fuss, no hassle.
One more thing. A single payer National health system doesn't' not in any way preclude extra insurance. Many people in good paying jobs have it. I had it for the few years that I worked there before moving here. Not provided by my employer, but through my parents business. Neither I or they ever needed it. It's only needed if you want an elective surgery and don't' want to wait, or if you want a private room. It's available, but it's a luxury, not a necessity.
Oh, and we have the stupid system where one spouse may have great insurance through their employer and the other spouse has E36 M3ty insurance through theirs, but they can't go on the first spouses system without paying a massive penalty
Oh, here's another one more thing. My father eventually passed of Alzheimers, although he had a slew of other issues as well. He spent his last five years in a variety of medical facilities. Do you know what the family out of pocket costs was? Zero, just a reduction in his state Pension, most (not all) was withheld to help cover what I assume was a tiny tiny portion of the cost.
To sum up my vague and roving ramblings my view is this. The pay to play insurance system here costs at least twice what the supposed evil, inefficient single payers systems in other countries costs providing care that doesn't even come in the top 20 in the world. IT's expensive, exclusionary, massively inefficient as well as stressful for all but the top earning people. I am lucky, I have a great paying job with great benefits and even Im normally at least $6-7K out of pocket every year.
This is not to say that the US medical system doesn't have good points. This is still one of the leading countries for research, new technologies, new procedures etc. This country also does a great (although some would say it's just a PR exercise) of helping people from around the world with issues. This country has great health care if you are wealthy. But it cant' be denied that access to affordable health care sucks. Health related issues are the leading cause of bankruptcy, not spending too much, not loosing your job, not buying too much house. Health care costs.
Don't get me started on the number of times I've been double and even triple billed for things. I've also had therapies that were denied coverage by the insurance companies either. Let's also not talk about the number of un-needed tests and procedures that are built into the system. The rate of C sections etc.etc. as all that is getting too much down the opinion and too far away from fact.
OK, that's my opinion in brief.