A Question for those from "Across the Pond"

The US health care system is one of the best in the world. Governments ruin almost anything they get their hands on. I would much rather have US freedom care than any government run program forced upon me. We are seeing massive Medicaid and Medicare fraud being uncovered across the US and our taxes paid for that mess. We need more privatization, not less.

My husband's blood pressure got dangerously low last year and I had to take him to the ER. My husband was within hours given about every kind of test you can give a human being with low blood pressure. Our insurance paid the vast majority of the cost. We then got follow up appointments with multiple specialists, all within about four weeks. Insurance again paid most of it. I live in a double wide, but I can have access to amazing medical care that is the best that has ever existed in human history. I'll take that over dying while waiting to be seen at a government run clinic any day.

Nassa, you are describing our system with the waits, the seeing RNs and not doctors and so on, but we are paying about 500 to a 1,000 a month for ours along with our taxes. Both systems are failing, but we face systems that may or may not give us care, period!

I'm currently living in Norway, a social democracy with a high standard of living. There is a national health system here (like the UK where I normally reside). It sounds great on paperwork and in many ways it is good as you are entitled to health care (e.g. you don't have to worry about getting sick as there is a safety net irregardless of your income). However the system is under pressure due to an aging population and budget cuts. ER visits take hours, waiting times for "routine" operations can take months, doctor visits are 15 - 20 minutes max. You get assigned a doctor (you can change doctors but max 2 times a year but it's a nightmare trying to find a "good" doctor you gel with because of this limitation). And due to relatively poor pay for nurses, hospitals are short-staffed as are nursing homes, rehabs, etc. The government wants the aging population to live at home as long as possible, but are actively cutting the local council's budgets so less help is available yet more people need help. It's only going to get worse so those who can go private (expensive). Despite Norway still being an oil-rich nation, it's not necessarily better here.

My Mom's 68-yr old caregiver is going back to Africa (Liberia or Nigeria I think) for her knee replacement. I get the whole medical tourism thing but people have to go in with their eyes wide open: there is no legal accountability for failed procedures or post-op problems.

I posted this question on my FACEBOOK as well, and one friend from UK said they paid private (or a friend did) for their spinal surgery. Came to about 9,000 pounds. But wonder then is hospital covered--the surgical suite--by national health. I guess so. Am reading a lot lately about people going to Mexico for treatment. Especially artificial knees, hips, and any tooth work.

There are multiple factors affecting the quality and delivery of healthcare in general (private or universal):

- most industrialized countries now have a preponderance of residents 65+, exacerbated by declining replacement birth rates.

- seniors use/need a LOT of healthcare and related services

A decreasing working-age population means a smaller tax base. Taxes are where govts get their money to pay for the subsidized healthcare. Increasing need plus decreasing tax base = a math problem. The govt cannot just increase taxes on the smaller working population. Yet the money has to come from "somewhere". Countries that have nationalized HC will need to get the funds from other budgets, or allow private pay arrangements, or both.

Again, the population of the US is far larger than any of the existing models currently in existence and I don't think it's a scalable. I think everyone here can find an adecdote about good or bad care in the US or other country. This is a one-dimensional concept of how it works and doesn't prove anything.

In reality it is a matter of "Good. Fast. Cheap. Pick any 2"

It appears our system sooner or later will have to become two tier.
It was announced just yesterday drs can do public and private practice in this province.
Not legislation yet, so feds in theory can oppose.
Drs in one province are leaving as new so called Bill2 wants them to increase volume as in having more patients and if not penalize them for poor performance based on number of patients. Doctors believe that would be detrimental to proper care.
And nurses and others are planning to go on strike, not sure in what province?
In my city, perhaps late 1990, 3 hospitals were closed and only one built. Population doubled since 1990. It does not make sense at all.
Some positive changes I noticed being in hospital with husband this year about 8-9 times.
Lots of nurses and other staff are from many different countries.
It appears process of credential approval is not as difficult as it used to be.
At the same time my husband who is also on the list for private AL and is waiting already months. They have population aged 55 to 100.
That is 3 generations!
Few facts to add to discussion.
At the same time I have to add as very sceptical person I do trust (somewhat) our medical system. Yes, unbelievable speed and seriousness in urgent situations.

Perhaps there aren't, cwillie. My husband's friend in NZ needed an MRI and received a letter saying she'd get one NO LATER than 2030.

From what I've read Judy wait times in Emergency or to see an appropriate specialist or for tests is increasing and in crisis almost everywhere, it's not just the UK. My observation is that the big difference in America is that those with better jobs and insurance (or the means to pay) seem to move seamlessly to the head of the line and many are oblivious to all those who are queuing up for care.

I'd really like to know more about all the other European systems but I keep running into roadblocks accessing information there. The debate here seems to be exclusively driven by comparisons to American health care or the NHS as though there aren't any other successful models out there.

UK here. Our NHS is in crisis due to demand and a horribly bloated beaurocracy. If you get an appointment at our doctor's surgery there is no guarantee any longer you will get to see a doctor, it could be the practice nurse or a physician associate, neither can prescribe drugs. Our accident and emergency is even worse, my husband had a life threatening condition which was discovered through a scan for something else, they told him to go to A&E and he was finally seen 19 hours later. This is not uncommon.
We do not have private medical insurance because there are so many exclusions but we are choosing to pay to go private now, as you can get an appointment pretty quickly. We are fortunate to have the finances, a lot of people don't in the UK.

Since all the high cost medical items are already covered the cost of extra insurance would pretty much always be greater than any benefit paid out Alva, especially since there are undoubtedly going to be deductibles.
I know that people who live in poverty do fall through the cracks when it comes to things like dental, hearing and vision care (although there are often some separate provincial benefits for that), but I grew up with the knowledge that I needed to pay my own way and the need to keep a rainy day fund, and have never had to do without. (Not that paying out of pocket for my dental crown wasn't painful lol)

In Canada, cwillie, were you to want EXTRA coverage is there insurance that you can buy, as there is private insurance for sale in Great Britain. Thank you for participating. Hope Margaret will as well.

Being a news junkie I can tell you that health care is in crisis almost everywhere no matter what the system; shortages of doctors and other health care workers and ballooning costs coupled with decades of under funding.
In Canada access to life saving medical intervention is second to none, but all those with chronic conditions often face longer wait times because every system is running at over capacity - there are not enough doctors to see everyone in a timely manner, not enough long term care homes to get people out of acute care hospital beds, not enough people working in home care to make that an adequate alternative. Universal health care may be a federal mandate but it is administered by the provinces so availability and cost of anything not considered a core service varies across the country.

I wasn't going to get into this but here it is: I'm one of those people who would not have had access to insurance in an American style system, and I've never worked a job here in Canada that offered any benefits package (things like dental, chiropractor, vision care etc). Yet I've never had to choose whether to see a doctor because it was too costly, and my little brush with cancer was fully covered, the only cost was paying for hospital parking.

Evamar, THANK YOU. Cwillie. Where are you. And out to Margaret, my favorite Aussie in all the world. I need more from those actually LIVING this. I hope you find this post.
This is a long standing argument between partner (who after 40 years I start to think of as hubby) and I. It isn't as simple as he things it is. It is a complex issue with many factors. I so appreciate everyone's input in this.

In discussing this topic, please remember that the population of England is approximately 70 million, the population of Canada is 40 million, and the population of the US is 348 million. I'd like to see those national HC systems operate (and tax) for that size population. Not to mention where does the soveignty of each state figure into such a system? Medicaid is federal but still managed by each state.

Regarding prescription meds: in places like Europe the meds are subsidized (and many of the ones developed by American companies). It is ghastly expensive to bring a single medication to market, and then their patents mandatorily expire after 12 years. Pharma has 12 years to recoup/make a profit from a product that can often cost multiple millions to bring to market -- and this doesn't even include the R&D and costs for medications that never make FDA approval.

This is one discussion we often have and it is often topic of national news.
I live in Canada and our medical system is broken.
Many propose two tier system, proponents believe it will help alleviate long waiting for surgeries for example, opponents believe it will increase it.
But as much as there are definitely crisis if emergency arises it is dealt with efficiently, I.e. hospital will take very seriously person with cardiac problems etc. if person needs scans, MRI they are quick in hospitals otherwise people wait for six months. Those are available privately at about $1,000.
We get some dental coverage if making less than $90,000 per annum, but some, for example hubby needing dental surgery will not be covered.
Also, in my case family dr knowing me well if I need to see him he will accommodate me right away knowing I am caregiver and I am not coming with some sniffles or other nonsense. Last time it was suspected infection he saw me immediately and I had ultrasound done right away. No infection! Otherwise waiting is 2 weeks on average.
As for medical like drugs my husband who has Parkinson and takes about 20 levodopa per day but pays I believe max $25 for three month supply. That is about 2,000 pills.
I saw one time the cost of it in USA and it was staggering.
Yes, we pay more taxes overall 5-10% more than in USA. Don’t even get me started on corporate as it is basically double taxation. And we don’t get as many tax credits as you do, for example mortgage interest is not deductible, but we don’t pay capital gains as well when selling properties. And here is a big difference especially with boomers (and do not start with me how boomers are responsible for everything that is bad right now), Most did not inherit and most had their businesses and worked 80+ hrs week. My husband left good job and started his business raising two kids and taking care of his parents. Worked all the time! All in all most seniors are doing well, most bought second, third property. Those with selling business and property are doing well.
Our system as much as there are serious problems and no solutions at least provides very good care for sick people. I cannot say enough good things about our Homecare ( I believe they changed name) govt supported agency which every Canadian is entitled to when sick.
Actually at this point there is not much they can do for my husband and I cannot even describe how much help they provide which is for me. I am entitled to caregiver every day, some evenings so I can go take a class or go for dinner, or dancing, yes I do that.
They even sent person to help with cooking and cleaning. I don’t need that, I am picky about some things.
And as my husband is on the list for placement he will pay $2400 monthly regardless of what he makes or what I make. Actually If needed I will get extra money even if my assets are huge. They aren’t but I will be better than OK, so when I read about some spouses and this added stress I feel for them. I cannot emphasize this enough.
None of that splitting assets, actually during evaluation not one question was asked about our assets.
When I needed help few weeks ago respite care was arranged immediately at $60 per night.
There is of course IMO a little bit of discrepancy with this. I think we need to start paying more for care or drugs, it is not sustainable. But imagine, it was announced few months ago that Covid vaccine was no longer covered. People complained about $100 pay saying they were traveling and needed that, when perhaps paying thousands for trips they cannot afford $100.
We just want too much and somehow expect it.
I don’t mind if we pay more for some services, which would reduce taxes as increases are unavoidable at some point.

Definitely American, recently spent some time in lovely Canada, both coasts, British Columbia and Nova Scotia, as well as New Brunswick. Everyone we met shared freely about their country, good and bad, as did we. Many told us the care is stellar, but the wait is horrific. There is no dental insurance at all, that’s all out of pocket. Many who are close enough and able come to the States for procedures such as knee replacement to drastically reduce the time waiting. The people love the “free” aspect, but also shared their high taxes and rents. One lady in Victoria told us she and her husband rent about 1000sq. ft. for $2300/mo., they are in their 60’s and know they’ll never be in a position to buy a home, but are still grateful to live in such a beautiful place. There’s a kind of frustrated acceptance of the system, much like we have. At least that’s what we heard

The government (no matter what party is in power) has proven to be absolutely incompetent when it comes to managing anything they are in charge of -- with the exception of the IRS, because they are stellar when they are digging through your wallet.

When I was doing mission trips in Hungary, citizens didn't make medical appointments, they just showed up and waited in line (this is in the 3rd largest city in Hungary, so not Budapest). Then if you wanted "good" care or "faster service" or "certain" drugs you had to come with a bribe in your hand. The doctors there are worked hard and paid very little. This is for basic care, not even if you needed diagnosis or treatment for a profound problem.

When my hubs and I were on a 2-week car tour of the SE part of Sweden (2017) which included Stockholm, we barely saw clinics outside of the city. Indeed, at one point it dawned on me that we'd not seen even a hospital in many days of travel. "The Swedes are very healthy." Yes, that is their hedge against their system.

I was on an international flight to Europe when a British woman across the aisle heard our conversation that was about American healthcare. She launched into a scathing review of how she had to wait 3 weeks just to have her broken ankle reset and treated. She had nothing good to say about it.

The royal Saudi family flies to the Mayo Clinic here in Rochester, MN, every year for annual physicals and for any other treatments. The best money can buy, and lots of ethical medical research and med-tech advancements right here in the US.

Yes, the US healthcare system is the worst "...except for all the others." (partial credit to Winston Churchill)

Since Dens Mom was from England I asked the relatives from across the pond how it worked there. From what I understand, is Drs are given a certain number of patients in their area. They are paid for these patients whether they see them or not. There are operations that are considered elective and you go on a list for surgery. It could take months to get a knee replacement. The cost of medical comes out of their salary. I don't think they continue to pay once they are retired.

I have read that the English are very healthy more so than us. Where I live, we have a number of large hospital systems. These systems are buying local doctors businesses and paying the Doctors a salary. IMO, it will be hard to change over to a national healthcare system because we have so many private health insurance companies. If it happens, it won't be in our lifetime, I think.