Canadian and European friends, tell me about your Universal Health Care system
my2hands
Posts: 17,117
Since some folks in my country think you have terrible health care systems, poor care, and bad doctors...
I wanted to ask you for your first hand knowledge and experience with Universal Health care... And also your overall opinion about it and its functioning and success, or failure.
So if you live, or have lived, in a country that provides Univeral Health care then please give us Americans some feedback...
thanks!'
SORRY... I FORGOT OUR AUSTRALIAN FRIENDS AS WELL!!!!!!!!!!
SORRY ABOUT THAT AUSSIES!
I wanted to ask you for your first hand knowledge and experience with Universal Health care... And also your overall opinion about it and its functioning and success, or failure.
So if you live, or have lived, in a country that provides Univeral Health care then please give us Americans some feedback...
thanks!'
SORRY... I FORGOT OUR AUSTRALIAN FRIENDS AS WELL!!!!!!!!!!
SORRY ABOUT THAT AUSSIES!
Post edited by Unknown User on
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Comments
Public hospitals are run by state governments. All are financially accountable to the state health department. A fair few of these have set aside areas on site that are run privately. Emergency departments are overwhelmingly based in public hospitals.
The payment of treatment, however, is run by the federal government, under the universal Medicare scheme. Medicare DOES NOT cover dental, orthodontics, ambulance service, optometry, prosthetics, and some other stuff that I can't recall right now. Medicare patients cannot choose their doctor (but can seek a second opinion if they so choose- just have to wait), cannot choose their room, and get placed on waiting lists for non-essential elective surgery that can be quite long. Unless they can pay out of their pocket, they cannot access private hospitals. Medicare is funded by a 1.5% levy on all taxpayers' taxable income. General practioners have no link to the state health system, and provide services to medicare and private patients.
The federal government provides a 30% rebate on the basic private cover for people who choose to buy into private health insurance. Privately covered patients can access private hospitals, can access public hospitals and choose their doctor, request for single rooms, and get preference on elective procedures.
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I work in a rehab hospital which is run by a not-for-profit board that receives medicare patients but doesn't get state government funding for things like building maintenance and equipment- we get that stuff from the money that comes in for all the workers compensation and car accident insurance schemes, which we get a lot of.
Now, the problems. There is a shortage of nursing staff. Elective surgery waiting lists are long. The ageing population and increasing medicare costs is a problem. The private health insurance rebate has sustainability problems. The lack of a direct link between community GPs and public hospitals leads to communication problems.
Hospitals are increasingly based on financial management principles rather than quality care due to budgetary constraints (both fed and state level governments across the country are obsessed with budget surpluses), which leads to big media stories when things go wrong, which seems to be on the increase.
My understanding of funding is limited to what I come across at my rehab hospital. Funding is based on a person's diagnosis and their age, and an expected length of stay is given as a funding guidance- if they exceed this, we need to justify why they are remaining in hospital in order to keep getting funding from medicare. In private hospitals, the pressure to move patients along is MUCH higher.
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I feel the system has its problems, but on the whole I prefer this a hell of a lot more than the user pays system in the US. Everyone receives medical treatment, and nobody is left out. Except for visitors who are dumb enough to not get travel insurance. There isn't really a challenge from anyone against the medicare system- the big political debates are over hospital financial accountability, the private insurance rebate, and this weird separation over federal and state government responsibilities.
The ageing population, however, is a timebomb that no one really seems to have an answer for. I gotta stop here, cos it then leads to a discussion about tax benefits for families and monetary handouts for making more babies, and just gets wayyyyyyyyyy too complex for one single post.
free eye tests
all ER/hospital/doctor visits are free (whether its a twisted ankle or triple heart bypass surgery)
kids up to age 16 get free dentalcare (NHS dentists then treat everyone and the government subsidies these heavily)
Free cancer treatment
free maternity care including home care visits, etc etc
overall pretty much free for everything so cant really complain (although people do always seem to complain about it)
There was a thread a while back about this. Some horror stories from some US people on how much they have to fork out to be looked after (assuming they haven't got any private insurance). I had a pulmonary embolism a few years ago, from the initial checking in emergency to 5 days in intensive care, scans, etc. all was free. Also had complications at childbirth, again all treatment free (at hospital and home visits after). (well.. not quite free because you pay for it in your taxes, but at no extra cost).
Just wondering how many people in the US don't see a doctor because they can't afford it.
First of all, doctor visits, ER visits and specialist visits have a co-payment of 20-50$, up to a limit of 300$, after which you get a "free card" for the rest of the year, meaning you dont have to pay any more co-payments.
Hospitalization is free of charge.
"Regular" doctors are often private practicing, getting paid by the state after set tariffs negotiated between the state and the doctors' association. Meaning the state pays the remainder of the bill after co-payments are deducted. (or all of it, see above)
That means it is a single payer system, where the state picks up the bill for the most part.
There are waiting lines for some non-life threatening procedures, and in some cases you might have to wait weeks and months. That is true. That doesn't mean you always have to wait, people dying in line or anything like that. But if you have something that scores low on the priority order, there can be some waiting. But it has improved somewhat lately.
We actually spend less than the US pr capita on healthcare, although a bit above other european countries.
(edit) oh yeah, dental is free up to the age of 18.
Bottomline is that everyone gets the treatment they need, regardless of economic status. There are no individual costs aside from co-payments, as long as everything is OKed by your doctor. We have no marketing or advertising associated with health care, and the "billling department" would be the lady in the reception.
My own experience with the system is very good. I once had an eye-infection and walked into the ER late at night. I got a cab for the hospital where they diagnosed me and gave me a prescription that I took to the all-night drug store. Pain went away, and I took drops for a long time, with regular check-ups at an eye-clinic in town. I soon reached free-card limit, and got refunded a lot of that as well through the student organization (which covers co-payments from 40$ and up to limit) as I was a student. Another time, I went to the ER several times with stomach pains, and was eventually sent to the hospital where they put me in and found out I had constipation. I was in there for exactly one day, and paid nothing. (although the ER visits cost a bit, but I was still a student, so no problem) So for me, the system has worked great so far.
Peace
Dan
"Every judgment teeters on the brink of error. To claim absolute knowledge is to become monstrous. Knowledge is an unending adventure at the edge of uncertainty." - Frank Herbert, Dune, 1965
Drugs are not covered unless you receive them in the hospital (or a doctor gives you samples). The only exception is if you are poor or a senior and then I think you pay up to a certain amount then the rest is payed for (and drugs are much cheaper here then in the US).
Things aren't covered are dental, vision and any type of physiotherapy.
I think the system is pretty good. Wait times are a problem, but I think a lot of that has to do with the fact that we are an aging society. Wait times are long at an ER but that is usually because a lot of people seem to go to the ER for non-emergencies for some reason (rather than going to a clinic). There are also wait times for things like MRI's and Catscans but those are typically for people with non-emergency conditions. If you are having a stroke and come to the ER, they will get you a scan ASAP. The number of doctors per person is an issue but governments are making an effort to open new medical schools to help minimize this problem. I also like the fact that even if you are poor, if you show some symptoms that you are not sure about (like a funny looking mole on your arm) you don't have to decide if it is worth the money for a doctor to look at it; which means if it is something bad (like if the mole is skin cancer) you can get treatment early (which gives you a better chance of survival and typically means lower medical costs).
Personally I think it is a pretty good system (yes it could be better but it is improving). Yes it makes taxes higher for me then someone in the US, but I am sure the fact that I am not paying $100's of dollars a month in health insurance kind of equals it out. Plus I like the idea that when I am in an elevator there is less of a chance of the guy coughing next to me of having a serious contagious disease, since he is able to go to the doctor no matter how poor he might be.
Under the MSP (medical services plan) provided by the provincial government, I can see as many doctors as I like until they catch on. Psychiatric services are covered (with a referral), and SOME medications are covered if you fill out the right forms.
ER waits are terribly long (but have been since I was a kid) as are MRI and CT scans. Surgery - some people wait one or two years sometimes for knee and hip replacements. There is a shortage of doctors, nurses, and hospital beds...in some extreme cases, people are sent out of province or even to Seattle.
Most employers offer a taxable Extended Health care package (of which the employee usually pays half). This covers dental care, psychology, naturopath, chiropractor, etc. But in some cases you have to pay a "user fee". In BC, we have NO eye care coverage (for the exam) and most extended health plans don't cover it (but will cover corrective eyewear, but with severe restrictions).
If you have a dental emergency and head to the ER and the on-call dentist treats you, then all subsequent dental visits related to the emergency are covered under the MSP.
If you receive Income Assistance through the gov't all your MSP premiums are paid for and all user fees are waived. Most of your meds are free, too.
There are a ton of problems with our health care system - and we are heading into a public/private health care system (two tiered), which has not been tried before. Things that have been privatized (housekeeping, food services, trades) has resulted in dirty hospitals, crappy food, and things that don't work, or don't get fixed in a timely manner...
I don't know if UNIVERSAL healthcare would be added to plans that already exist, or if employers would use it to scrap their health plans, but it seems like you can still get any operation you want if you can afford it. So that is something that would not change at all.
this would be problem #1 with An American System. Americans don't want to pay taxes for things they do need, much less for things they might need.
47 million.
Not quite sure what you mean but where I work for example, they offer a non-contributory healthcare insurance (for the employee only - dependants can be added on for a fee) but I still get all I need on the NHS if I want. Private healthcare may be that I can get something done quicker, have a private room, etc. Some companies offer medical insurance, but the employee has to pay, some don't offer it at all. Whatever the situation, the NHS is there for everyone at no extra cost so those who work for companies who do not offer insurance, they can still get an operation even if they can't afford it. Furthermore, it's not that much in taxes - well worth it.
i'm not getting in to this damn argument again.
blech.
If I opened it now would you not understand?
i agree, no need for an argument, esp since this thread is simply asking for information from people who ACTUALLY HAVE that information.
the only reason for an argument to develop is if certain people prefer arguing over gaining knowledge.
"Obama's main opponent in this election on November 4th (was) not John McCain, it (was) ignorance."~Michael Moore
"i'm feeling kinda righteous right now. with my badass motherfuckin' ukulele!"
~ed, 8/7
If people don't pat their fee, the government will collect it thru income taxes or taking it out the person's welfare check.
There is complaining in the media about waiting for non-life threatening surgery, but again I, my family and friends have never encountered something of the sort.
1. it has to be properly funded - underfunding the system means that there are breakdowns - it is these breakdowns that allow people who want to privatize health care ammunition - saying it can be done better. Our budget every year has record surpluses but yet our provincial and municipal gov't cannot pay for fixing bridges or pay for health care.
2. there must be investment into preventative care - what good is pouring money into trying to cure people who just by change of environment or diet could have not gotten sick to begin with?
When I go to the dentist, for example, I'm a bit less reimbursed but that's ok. Generally, I'm reimbursed about 75% of what I paid.
the problem I have with the Belgian system is that I don't receive any cent for my glasses ! I have bad eyes but not bad enough for being reimbursed (you almost haveto be blind for that)...
2007: Copenhagen, Werchter
2009: Rotterdam, London
2010: MSG, Arras, Werchter
2012: Amsterdam, Prague, Berlin
2014: Amsterdam, Stockholm
I see there are some problems with universal healthcare but they probably could be worked out on the most part. It seems most people are complaining about the wait for non-life threatening surgeries. How long of a wait are we talking about? The way I see it is, it's better late than never because some Americans wouldn't have the surgery because they couldn't afford it or they will have it and have huge surgery bills they will never be able to pay off that can ruin any credit they may have.
Also how much in taxes do you pay for the coverage? People who go to the doctor more than others probably get the most out of their tax money but the ones who go often are probably the ones who need it the most. Although I am one of the lucky Americans who have good health care, I rather pay some taxes so that all Americans can get good health care as well.
Just curious, are you being reimbursed by the government? If you are why don't they just make you pay 3 euros when you go to the doctor and have that be the end of it (rather than having deal with reimbursements at all)?
2007: Copenhagen, Werchter
2009: Rotterdam, London
2010: MSG, Arras, Werchter
2012: Amsterdam, Prague, Berlin
2014: Amsterdam, Stockholm
Sorry, this doesn't sound like a good deal for me.
for the least they could possibly do
Dude, it's just as bad if you have insurance in the US. If you don't have insurance....I'm pretty sure most of it ends up being written off.... because the price of care is so ridiculous I can't imagine most people who don't have insurance end up paying anything anyway. Half of the charges they make against you end up as an insurance write off because the Hospital or care facility has a deal with the insurance company, then they pay some tiny percentage of whatever the total is IE whatever the insurance company policy writer couldn't find a way to not cover legally. In the end they end up bargaining for you essentially. You pay the insurance company for a reasonable bill. Insurance in this country amounts to a reasonable medical bill. That's it.
People who work in insurance companies should be treated like the mafia. They sell air. Policies are generally good enough in 98% of thier existance to get the money you paid back into them. If you end up really having something bad happen, they cancel your policy anyway.
Lawyers and litigeousness cause all this shit so basically my award for the two lowest scumbucking worthless careers of all time go to Insurance and Legal personel.
I have lived in countries with and without National Healthcare... guess which one I find the best?
i am going to guess that you prefer getting bent over by insurance companies
i am kidding obviously
I would probably be dead now if I had to think twice about going to hospital. When I had the pulmonary embolism, it started with leg pain (which went away), then chest pain which kept on moving. I had discounted heart problems (because I'm so knowledgeable!) and put the pains down to muscle aches (I had been moving stuff about during the day). If I was living in a country without national health and I didn't have private insurance (which I didn't when I first lived in the US as an adult), I would have probably told myself to 'sleep on it and see how I feel in the morning'. But because here I didn't have those worries, my hubby took me to emergency the moment he got home and I told him... good thing too.
http://nl.youtube.com/watch?v=6AMM0CSm_3s
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