Health care?

[james7]

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Originally Posted by marko I want to live in Greece: free health care, 30 hour work week, retire at 55 (I'll take a half pension!!), lounge around eating good food and drinking ouzo...live long and live well! Let the grand kids pay for it!!

At least the last part of your dream will come true without you moving anywhere. Your grandkids will be paying for our national debt.

[Chuckanut]

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Originally Posted by marko I want to live in Greece: free health care, 30 hour work week, retire at 55 (I'll take a half pension!!), lounge around eating good food and drinking ouzo...live long and live well! Let the grand kids pay for it!!

I would hope we can find some compromise between the two extremes. One mentioned above, and the other, our current system, which makes health care very iffy for many people. My 2 cents.

[ERD50]

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Originally Posted by obgyn65 I am not sure what's the interest in asking such a divisive question. It is unlikely we find a consensus on this website.

In this country, not so very long ago, slavery, and then Civil Rights was a very divisive question, w/o consensus.

I guess those people like Abraham Lincoln and other abolitionists and those that followed should have just kept quiet. Don't want to ruffle any feathers, no, just keep that head deep in the sand. Everything will be better that way.

Now, I agree that the OP question was far too open-ended. But that's another matter.

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Originally Posted by Buckeye They consider our lack of available healthcare for those who can least afford it barbaric.

Actually, healthcare is available for those who can least afford it.

I'm not defending our system, I think it is really screwed up and needs change. But distortions don't help. Now, if you can afford it, it can put you in the poor house. That's a problem, but it's not what you stated, but I suspect those Euro-friends of yours believe it to be true. Have they seen sick people on the sidewalk that would not be treated by us barbarians?

-ERD50

[Alan]

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Originally Posted by l2ridehd And as to the premise that we have the best health care, a lot of people travel to the US for specialist care. Very few if any travel to the UK or Canada or Norway or anyplace else for specialist care.

There are plenty of folks who travel to specialists in countries with Universal Health care. Many sports pros go to specialists in different European countries depending on their problem. (They also go to specialists in the USA).

We have some good friends who traveled to Nantes, France for surgery. She had a condition called Pudenal Nerve Entrapment for which surgery was available in Houston but was not covered by their HI company at the time as it was still classed as experimental. (They live in Louisiana). After trips to Houston for tests to confirm the diagnosis they faced a $25k bill for surgery or they could could go to Nantes where they could have it done privately by the surgeon who pioneered this particular surgery. The total cost of the surgery and hospital stay was <$5k so they both went to Nantes and spent about 10 days there. It still took awhile for recovery but she is doing great and they came to stay with us in England for 2 weeks last year and they did lots of driving on their own, plus some walking trips with us.

The UK, in particular London, is a popular destination for patients seeking treatment. In the past I've read of a US HI company on the East Coast offering to send heart patients to London for bypass surgery, paying for a 2nd person to travel with them including the cost of several nights stay. I think it was Guy's Hospital, that has a world re-nowned Heart center, that was the destination.


Medical Tourism

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The United Kingdom is one of the most active of medical tourism destinations, especially London.

[youbet]

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Originally Posted by Midpack Still worth comparing "facts" if nothing else?

I'd like to see that happen........ Just once........

[Midpack]

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Originally Posted by youbet I'd like to see that happen........ Just once........

I see it here often enough, but not always...

[james7]

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Originally Posted by Alan There are plenty of folks who travel to specialists in countries with Universal Health care. Many sports pros go to specialists in different European countries depending on their problem. (They also go to specialists in the USA). We have some good friends who traveled to Nantes, France for surgery. She had a condition called Pudenal Nerve Entrapment for which surgery was available in Houston but was not covered by their HI company at the time as it was still classed as experimental. (They live in Louisiana). After trips to Houston for tests to confirm the diagnosis they faced a $25k bill for surgery or they could could go to Nantes where they could have it done privately by the surgeon who pioneered this particular surgery. The total cost of the surgery and hospital stay was <$5k so they both went to Nantes and spent about 10 days there. It still took awhile for recovery but she is doing great and they came to stay with us in England for 2 weeks last year and they did lots of driving on their own, plus some walking trips with us. The UK, in particular London, is a popular destination for patients seeking treatment. In the past I've read of a US HI company on the East Coast offering to send heart patients to London for bypass surgery, paying for a 2nd person to travel with them including the cost of several nights stay. I think it was Guy's Hospital, that has a world re-nowned Heart center, that was the destination. Medical Tourism

You are absolutely right. An American man just came back from Sweden for lifesaving surgery that is performed nowhere else in the world. The cost was $450,000 and he is still trying to pay it off. Sweden has a socialised health system with long waiting times for surgery, and sometimes even emergency treatment, but they also have world renouned research institutions providing groundbreaking treatments for various illnesses.

[youbet]

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Originally Posted by james7 You are absolutely right. An American man just came back from Sweden for lifesaving surgery that is performed nowhere else in the world. The cost was $450,000 and he is still trying to pay it off. Sweden has a socialised health system with long waiting times for surgery, and sometimes even emergency treatment, but they also have world renouned research institutions providing groundbreaking treatments for various illnesses.

I tried to find more info about this but couldn't. The WIKI article Alan listed didn't mention Sweden. It raises interesting questions. Did this private pay American cause any Swedes to wait longer for their similar surgeries? Did the Swedes charge a "mark-up" over what the cost to their socialized system actually was? How does the average Swede on the street feel about Americans, or others, receiving services from their socialized system while they have long waiting times?

I can understand how "outsiders" fit into the health care systems of capitalistic, private-pay systems like ours. It's harder to imagine how one would fit into a socialized system as a private pay "outsider."

I'd appreciate comments from folks who know.

[Animorph]

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Originally Posted by youbet I tried to find more info about this but couldn't. The WIKI article Alan listed didn't mention Sweden. It raises interesting questions. Did this private pay American cause any Swedes to wait longer for their similar surgeries? Did the Swedes charge a "mark-up" over what the cost to their socialized system actually was? How does the average Swede on the street feel about Americans, or others, receiving services from their socialized system while they have long waiting times? I can understand how "outsiders" fit into the health care systems of capitalistic, private-pay systems like ours. It's harder to imagine how one would fit into a socialized system as a private pay "outsider." I'd appreciate comments from folks who know.

Sounds like he contributed $450k to their socialized system. And would Swedes even be eligible for this procedure under their program, or would they have to pay for it outside of the system?

[nun]

The American system delivers excellent care and outcomes at a vey high cost. However, many cannot afford insurance or are refused access to good coverage because of pre-existing conditions This becomes a big issue for ER'ers who have to find insurance on their own before Medicare starts.

I live in MA where we have Romneycare and I'm glad that I can retire early and be guaranteed that I will be able to buy good coverage for $340 a month no matter what pre-existing I have. Of course as a UK citizen I also have the option to move to the UK and use the NHS at no cost and that's the option I'll probably choose.

As I have experience of both systems I can talk about the benefits and failing of both. The UK system delivers excellent care at half the cost of the US. There are waiting lists and some procedures won't be done that would be done in the US because their efficacy isn't proven in the opinion of the NHS. But US insurance companies also deny procedures too and I'd argue that they are a lot more arbitrary.

I grew up in the UK and much prefer the UK system. Most foreigners who come from countries with Universal Care are sorry for Americans, and are amazed that they fight so hard to keep a system the performs so poorly.

It's easy to quote examples of poor outcomes from all systems. For the US it would be the millions with no insurance and who don't go to the doctor because they are afraid of the cost or the family that has a massive bill for their daughters cancer treatment. I'm the UK it would be someone waiting for a year for a hip replacement or not getting a new breast cancer drug. But to believe that a system is the "best in the world' in the face of evidence to the contrary and the opinions of those that have other systems sounds as if hubris might just reduce you lifespan. It's certainly costing America a lot of money.

[youbet]

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Originally Posted by Animorph Sounds like he contributed $450k to their socialized system.

But I'm wondering if their price to him, the $450k, was marked up over their cost. Is Sweden, despite their socialized system, getting into the medical tourism game? Or was this just a one time humanitarian type thing where they just charged the recipient their cost and garnered some international goodwill and prestige?

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And would Swedes even be eligible for this procedure under their program, or would they have to pay for it outside of the system?

I dunno.... If I was a member of a socialized medical system and outsiders with cash were jumping in line in front of me, I'm not sure I'd like that.

My curiosity about this is driven by wanting to understand how we would handle, under a single payer or other gov't health care system, the millions of non-citizens we provide care for today. Currently these costs are absorbed by the provider and then reflected in the bills of those who can/will pay. With a gov't based system things might work differently but it's hard to imagine what it would be like.

[youbet]

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Originally Posted by nun I live in MA where we have Romneycare and I'm glad that I can retire early and be guaranteed that I will be able to buy good coverage for $340 a month no matter what pre-existing I have.

Do you know how "Romneycare" is working out financially for MA? It seems like if MA is able to do it as a pay-as-you-go system for those very reasonable premiums, they have a winner. Are the premiums collected today covering all costs so that MA residents won't be looking at some sort of debt mountain or higher taxes in the future? If so, it's a great system.

My Medicare Part B + Part D + supplement will cost more than $340/mo and we know that Medicare isn't making it financially. I wonder how MA is doing it? Maybe just more efficient than the feds?

[george76]

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Originally Posted by nun I live in MA where we have Romneycare and I'm glad that I can retire early and be guaranteed that I will be able to buy good coverage for $340 a month no matter what pre-existing I have.

Would you mind sharing where one can find this quote of $340?

I have checked the massresources.org. It seems most quotes are much higher than that, like around a $1,000 for an individual.

Thanks for your help.

[Midpack]

An interesting article that touches on several of the medical tourism issues raised. Globalisation and health care: Operating profit | The Economist

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A bit of rivalry from top foreign facilities may introduce transparency and price competition into an inefficient system riddled with oligopolies and perverse incentives. For example, American and European hospitals may cut prices once they realise how much potential business they stand to lose. By Deloitte’s reckoning, medical travel will represent $162 billion in lost spending on health care in America by 2012. There are signs that American health-care administrators are starting to feel the heat. European hospitals may not be immune from such pressure, either. On one estimate, some 50,000 British medical tourists headed overseas in 2006, spending millions of pounds for care in such places as Turkey, India and Hungary.

[Sirka]

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Originally Posted by PaddyMac Try being self-employed, working part-time or unemployed and see how you like it. ... But the idea that insurance needs to be tied to employment is just plain nuts.

+1
Sometimes you can't get the insurance - this is what is wrong with our Healthcare.

[scrabbler1]

I approach this issue from an actuarial perspective, given my professional background of 23 years n the actuarial field.

Whether it is a single payer or individual mandate, we need to have everyone paying into the system so we don't have those "free riders" who pay nothing into the system yet collect benefits. I prefer single payer. Pass a "Medicare for All" bill and raise the Medicare and/or income tax to pay for it. Businesses would no longer need to provide health insurance for their employees, Medicaid would disappear, unemployed people get coverage, pre-existing conditions become irrelevant, and an illness would not bankrupt anyone any more.

[farmerEd]

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Originally Posted by george76 Would you mind sharing where one can find this quote of $340? I have checked the massresources.org. It seems most quotes are much higher than that, like around a $1,000 for an individual. Thanks for your help.

I shop my policy every year, I just got a quote from BCBS in Mass with an effective date of March 2012; The cheapest policy from BC/BS for an individual was $289.61/month or $763 for a family policy. A better policy (HMO Blue with $1000 deductible) also from BC/BS was $484 or $1276 for a family policy.

The best thing about Mass health insurance, to me anyway, is the 'guarantee issue'. If you want a policy, and can pay for it, you can get one. If you need health insurance and you can't afford it, you can still get it.

There is a certain piece of mind in knowing that you can't simply be denied coverage when you get sick - I would think everyone could be on-board with at least that aspect of 'Universal' care. Whether it be Romneycare or Obamacare.

[Sirka]

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Originally Posted by scrabbler1 ... Pass a "Medicare for All" bill and raise the Medicare and/or income tax to pay for it. Businesses would no longer need to provide health insurance for their employees, Medicaid would disappear, unemployed people get coverage, pre-existing conditions become irrelevant, and an illness would not bankrupt anyone any more.

+1
This would be great, but I can't imagine Congress passing it. They would have to give up their PLAN.

[nun]

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Originally Posted by george76 Would you mind sharing where one can find this quote of $340? I have checked the massresources.org. It seems most quotes are much higher than that, like around a $1,000 for an individual. Thanks for your help.

Go to

https://www.mahealthconnector.org

The rates will vary according to age zip code etc. Mine is for a bronze plan for a 51 year old single male in Boston.

[Alan]

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Originally Posted by youbet But I'm wondering if their price to him, the $450k, was marked up over their cost. Is Sweden, despite their socialized system, getting into the medical tourism game? Or was this just a one time humanitarian type thing where they just charged the recipient their cost and garnered some international goodwill and prestige? I dunno.... If I was a member of a socialized medical system and outsiders with cash were jumping in line in front of me, I'm not sure I'd like that. My curiosity about this is driven by wanting to understand how we would handle, under a single payer or other gov't health care system, the millions of non-citizens we provide care for today. Currently these costs are absorbed by the provider and then reflected in the bills of those who can/will pay. With a gov't based system things might work differently but it's hard to imagine what it would be like.

Are you sure they would be jumping the queue? Does Sweden not have private health clinics outside the socialized medicine system like the UK has?

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Stockholm Care represents six County Council hospitals and several private care providers.

In the 1980's Prime Minister Margaret Thatcher was once asked in parliament why she went to a private clinic for a surgical procedure. "Do you not have faith in the NHS?", she was asked. Her reply was that by using a private practice she was not increasing the burden on the NHS.

When in the UK last year if DW or I had needed to go to an ER or have some other specialist care we already knew the nearest private hospital that was in the BCBS plan.

Socialized medicine does not necessarily mean there are no private clinics and hospitals providing services for those that can afford it.