Near-universal Mexican Healthcare Coverage Results From Science-informed Changes 732
ananyo writes about improvement to Mexico's healthcare system. From the article: "A revamp of Mexico's beleaguered health-care system is proving to be a runaway success and offers a model for other nations seeking to reform their own systems, according to a review published this week in The Lancet (abstract). The key to the scheme's success is the way in which it has modified its reforms in response to scientific assessments of their effectiveness, the authors say. Launched in a law in 2003, the Mexican scheme was designed to sort out widespread inefficiencies and inconsistencies in the country's health-care system. Some 50 million Mexicans — nearly half the country's population — who previously were not covered by health insurance are now enrolled, leading the scheme's architects to claim that the country has near-universal health-care coverage. As well as the increased coverage, the scheme has seen the number of conditions treated under Mexican public health insurance nearly quintuple. Admittedly, the former health minister Julio Frenk, now dean of the Harvard School of Public Health, is a co-author on the paper."
Here I come. (Score:5, Insightful)
Re:Here I come. (Score:4, Insightful)
So will I have to go to Mexico for my low price drugs now? Sorry Canada
No. This mean that the United States are the new Mexico. Enjoy your third-world country while it last, each year there are less and less of them.
Re:Here I come. (Score:4, Interesting)
It's a supply-and-demand problem.
Canada and Mexico healthcare is basically "free" so demand is high, while supply is limited. Naturally standard of care goes down in order to increase supply. It's also why you get waiting lists and all that.
US healthcare is expensive, and supply is high, but demand is low (as fewer can afford it, though I thought Obamacare was supposed to fix that). Hence lots of money to spend on shiny new toys to fix people, and no waiting lists. (Of course, there are other costs as well - like people delaying trips to the doctor so they can get more ailments before seeking treatment...).
Unfortunately, I don't think anyone's figured out where the curves meet, probably because it's considered a basic necessity for a functioning society
Re:Here I come. (Score:5, Insightful)
No ObamaCare won't do any such thing in actuality; though it may pretend to do so it will actually make all the costs go up as it lacks any actual cost control mechanism. Their ideas was "make everyone get it and the insurers will lower their prices" but it doesn't work that way - especially when the insurers are the number one or two problem (the other being malpractice lawsuits, which again ObamaCare does nothing to cure).
If you want real health reform in the US, then you have to address malpractice lawsuits in some meaningful manner, and also address the fact that insurance companies do everything they can to keep from paying anything - which results in 3, 4, or more appeals before a doctor gets paid - each appeal making costs higher as it requires money to file, and personnel to file and track - people that could otherwise be helping service patients. Solve those to things and health care costs will drop dramatically.
Re:Here I come. (Score:5, Insightful)
Good god, doesn't anyone know how to do a little reading on subjects before giving their lectures? As much as everyone hates insurance companies, they actually contribute very little overall to the cost of health care (less than 10%), and malpractice lawsuits contribute far less than even that. The BIGGEST contributor to the outrageous health care costs in the US is, by far, a lack of pricing regulations over pharmaceutical companies and manufacturers (which every other developed country in the world has) and a willingness by politicians (and insurance companies) to sign contracts with pharmaceutical businesses to meet their ridiculous prices. Why do you think people can go to Mexico to buy the same medicine for less than 1/10th of what they pay for it in the US? It's not like Mexico can afford to subsidize a wide variety of medicine; most of that stuff is completely unsubsidized. It's because pharmaceutical companies know they can charge outrageous prices for cheap medicine knowing that we'll buy it if we have to.
And "Obamacare" does indeed address this issue, although nowhere near as much as it should, and that was even before it got neutered by the corporate henchmen we know as (mostly Republican) Congressmen. If you seriously think "real" health care reform is just making it impossible for people to sue for botched operations (which can already take years in many states, if it's even permitted), you need to stop watching Fox Noise.
Re:Here I come. (Score:4, Insightful)
US healthcare is expensive, and supply is high, but demand is low ... and no waiting lists.
After a recent move, my wife was told by our "Gold-Plated, Big Expensive Best-of-Breed" insurance company that it was a 6-month wait to find a gynecologist in our new Major US City. We have friends in other places who have been told that there would be a one-year wait for an obstetrician. :-) Pediatricians are better, seeing as how they only asked for a three-month wait. I, being a middle-aged father, am of course invincible and have no need of medical care.
We've seen this trend replicated in three different cities across the US. Our family and friends are seeing the same trends. We are both fortunate and blessed and are what passes for "well-off" in the current economy, meaning we can afford to buy new clothes and school supplies at the end of August. If WE are having issues, I cringe to imagine what it's like for people in the same situation I grew up in.
My wife, who grew up in one of those Socialist Hellscapes Fox keeps warning us about, does not understand why any of this should be a problem. She likens living in the US to seeing a movie star in person. You're in love with the glamour until you meet the real person who dropped out of high school to indulge a drug addiction and eating disorder for a couple of decades.
Unfortunately, I don't think anyone's figured out where the curves meet, probably because it's considered a basic necessity for a functioning society
Healthcare, like the military, fire department, and the mail, is a classic market failure. Patients put their lives in the hands of their doctor. There is no time to haggle over price in an ambulance. Despite all the hoopla about "informed consent" and "patient responsibility," even doctors are discouraged from trying to treat their own illnesses, because people who are sick are by definition unable to make detached, clear-headed choices. Furthermore, patients haven't gone to medical school, didn't pass board specializations and haven't spent twenty years of their lives in a hospital. At some point, you have to trust your doctor, because Google and WebMD just doesn't cut it.
That dependence and need for trust totally guts any power the patient might have in a business negotiation.
I don't think anyone's figured out where the curves meet
Sure they have. Given time, Demand will pay any price Supply asks. I'm a middle-aged father. Statistically speaking, I'll die from a preventable but untreated medical condition because I want to spare my family the worry and expense of my healthcare. But my kids? I'll go all unhinged John Winchester over that. My kid gets sick with anything worse than the sniffles, and I'll hand over my wallet, bank accounts, 401k, mortgage, whatever. You want it, it's yours.
It gets worse. Even if YOU are able to negotiate in the marketplace for optimum services, what about those less fortunate than you? No, I'm not making a moral argument for charity. I've learned better than to try to argue for ethics or morality. I'm making an argument for YOUR health. We need a national healthcare system, and yes, you want to keep that alcoholic bum in the best health we possibly can -- and yeah, I'm including dental here -- because communicable diseases spread. Some random bum has a dental abscess that gives some bug a place to camp out, and suddenly he's literally spraying viruses every time he opens his mouth. Some poor busboy passes him on the way to work, and before you know it, your silverware's getting wiped down with that virus.
Now, I know that some people don't wanna pay for that bum's healthcare, but you have to ask yourself. Do you wanna pay some tiny fraction of a percent for a national healthcare system, or do you want to pay for your personal lengthy hospitalization?
Re:I'm confused... (Score:5, Insightful)
I thought the Mexican healthcare system, was to come to the US illegally across the border, and get onto our welfare system...help drain Medicare, and clog up our Hospitals' Emergency Rooms....?
No, that's just a side result of the Mexican Jobs Program. The health care in Mexico is all covered, but they'd have to go home to use it.
Re:Here I come. (Score:5, Informative)
Uh, by just about every objective standard the US is one of the lowest developed nation when it comes to healthcare outcomes is and absolutely the worst when it comes to outcome per dollar spent. How anyone who has ever been involved with the US system of healthcare providers and insurance companies could want to keep it is beyond me.
Re:Here I come. (Score:5, Insightful)
The US fails, because it has a HUGE middle man bureaucracy that skims 20% off the top called Insurance. IF I got my "benefits" as salary, I could be much more efficient in my health care dollars than Insurance.
Case in point, I can get my meds via Insurance for $25 (co-pay) or I can go to Walmart and get them for $12 (which I do). I have insurance, but it is more expensive to use than paying cash. That is not efficient.
My daughter just spent 4 hours in Emergency, the Insurance paid (after discounts) 16,000. Four grand per hour?
Re:Here I come. (Score:5, Funny)
I don't know about you, but that's already where *I* go. Avoid that nasty border tariff. Plus, they aren't that funky blue color down there, like they are around Albuquerque.
Re:Here I come. (Score:4, Insightful)
You get used to facebook having a "Like" button. Slashdot needs one, for people who don't currently have mod points to go "+1 Funny"
Just got back from Mexico dentist... to Canada! (Score:3, Interesting)
Well, I'm here in Edmonton, Canada and I just recently got back from visiting a dentist in Puerto Vallarta, Mexico. Sure glad I went! Gotta do your research though!
Alberta dentist's have raised their prices in many cases to more than triple what they were 6 years ago. I even would've saved money by going to the States!
I feel bad for families who can't fly to Mexico on short notice... or me if I get stuck timewise next incident.
Re:Just got back from Mexico dentist... to Canada! (Score:5, Funny)
Word of mouth?
According to the Chart... (Score:5, Informative)
From National Geographic Magazine:
http://blogs.ngm.com/.a/6a00e0098226918833012876a6070f970c-800wi
Guess who gets the least bang for their buck in Healthcare?
Re:Here I come. (Score:5, Funny)
Re: (Score:3, Insightful)
And they would.
Mexico has, ironically a very strict immigration policy.
While they demand every right in the book for their people coming here. They give no rights or services at all to illegal immigrants there.
Kevorkian Panels. (Score:3, Funny)
Admittedly, the former health minister Julio Frenk, now dean of the Harvard School of Public Health, is a co-author on the paper."
Will there be any death panels?
Re:Kevorkian Panels. (Score:5, Funny)
They prefer to call it Carousel.
Re:Kevorkian Panels. (Score:5, Funny)
Re: (Score:3)
The Mexican drug cartel wipes out the poorer villages. Does that count?
Re:Kevorkian Panels. (Score:5, Insightful)
There are death panels in both socialized medicine and private medicine with health insurance, the question is whether they're manned by government-employed medical professionals on a salary, or corporate-employed statisticians with a vested interest in your death.
Scientific assessment of effectiveness? (Score:5, Insightful)
Translation: "We did some things we thought would work, and then later we stopped doing the things that weren't working and did more of the things that were."
In an ideal world, governments behaving sensibly wouldn't make headlines.
Re:Scientific assessment of effectiveness? (Score:5, Interesting)
Translation: "We did some things we thought would work, and then later we stopped doing the things that weren't working and did more of the things that were." In an ideal world, governments behaving sensibly wouldn't make headlines.
You'd be surprised to know how much of the real world operates on things they believe to work rather than having any proof that it's effective. For example I remember one person telling me about this new program they created to work with young criminals. He had suggested they give it to 50% of them, using the other as a control group. That was shot down in flames, of course this worked and no juvenile should go without such a program from now on. Did it work? Is this well spent money or a waste of resources? Who the fuck knows, since society changes so you can't say shit comparing old statistics to new statistics. The irony was they said this was "too important" to not provide help, while health care that deal with real life and death situations would never use medication they had no clue if worked or not.
It's a little better on the private side but there's a helluva lot of things that are done on pure belief, you may have had some very persuasive business cases and PowerPoint presentations at the start of the project but very rarely is it properly followed up at the end of the project if the goals were actually achieved - if they were even properly defined, quantifiable and measurable to begin with. Of course sometimes projects go wrong for reasons that were impossible to predict when the project was started, but most often not. Most companies just want to bury the failed project and not try deconstructing why they started a project with such flawed plans, requirements and goals. Usually because it'll reflect poorly on some executive who authorized it.
Re:who cares about free healthcare in a civil war? (Score:4, Interesting)
All financed by American prohibition. When you see all the cash they find in a drug lord's mansion, do you see pesos, or dollars?
NYT had an interesting write-up. . . (Score:5, Insightful)
. . . about a year and a half ago, and while it's not all bad [nytimes.com], it's not quite as glowing as TFA.
“You have people signed up on paper, but there are no doctors, no medicine, no hospital beds,” said Miguel Pulido, the executive director of Fundar, a Mexican watchdog group that has studied the poor southern states of Guerrero and Chiapas.
The result is that how Mexicans are treated is very much a function of where they live. Lucila Rivera Díaz, 36, comes from one of the poorest regions in Guerrero. She said doctors there told her to take her mother, who they suspected had liver cancer, for tests in the neighboring state of Morelos.
Sounds like the problems the opponents to universal health care in the States are always worried about.
Re:NYT had an interesting write-up. . . (Score:5, Insightful)
Sounds like the problems the opponents to universal health care in the States are always worried about.
The problem of making health care cheaper so there isn't so much profit in it?
told her to take her mother, who they suspected had liver cancer, for tests in the neighboring state of Morelos.
Given the choice of travelling for a few hours to have (free) tests, or the American alternative of selling your house to pay for them, I wonder which is the worst?
Hey, you forgot to call; it "Obamacare". Don't worry, I'm sure that will be in half the posts anyway.
Re:NYT had an interesting write-up. . . (Score:4, Informative)
No one in the US has had to sell their house to get medical tests or treatment unless they were purposely trying to manipulate their income and assets to sneak into a government program and have the state pay for their health care.
Medical expenses are the majority cause of bankruptcy. And while you do not have to 'sell your [primary] house' to declare bankruptcy, the idea that _no one_ has sold their house for medical treatment is insane.
As is the idea that 'selling your house' is the problem. The problem is _losing_ it, and plenty of people do not own their home and miss mortgage payments or rent due to medical expenses. But I will take the premise at face value.
So, taking it at face value, let's google 'sell house for medical treatment'. And let's see what do we find...a bunch of home medical stuff...hey, look, the second damn page: http://www.prlog.org/11847260-selling-house-to-pay-for-medical-bills-leads-to-pillow-talk.html [prlog.org]
Please note this story is from 2001, when medical expenses were much lower. Also note that reason that story was reported was a weird human interest fact it turned out for the best...presumably, the ones that do not are not reported.
Re:NYT had an interesting write-up. . . (Score:5, Insightful)
Personal sneers I Fuck off with that .
The Mexican system is imperfect. It's still a lot better than the US system, which is a disgrace and serves the medical business sector ahead of the people.
Sorry, that's bullshit. In most regions of Mexico you'll be lucky to find a doctor, let alone a hospital. You're going to have to travel a good distance for any kind of serious treatment or care. When you arrive you're going to quickly learn that although you're supposed to be treated free of charge, the person actually giving treatment will require payment "under the table". In other words, a bribe.
Sure, things are pretty good within the major cities and population centers, at least relatively speaking, but even so the quality of care is vastly inferior to the US system. And much of the training, supplies, equipment, and a lot of funding for things like advanced cancer treatment centers is only in place because of US-based donations and aid programs. It also doesn't hurt that most of their prescription drugs are produced by sub-standard facilities which don't actually have a license to make them, which lets them sell expensive drugs for pennies on the dollar.
Yeah, you do realize that even with all this, you're defending the healthcare system of the wealthiest country on the planet by contrasting it to one of the poorest (that's also wracked by drug wars largely due to the policies of the wealthiest)?
Re: (Score:3)
Check out how much the Mexicans spend on healthcare at the moment, compare it to the US, compensate for numbers. Then despair American slashdotters.
Of-course there's still problems - but as the NYT piece says: "A decade ago, half of all Mexicans had no health insurance at all." ie in many cases, they were not able to afford treatment.
Critics sometimes seem to overlook that a public healthcare system does not mean that people who wish to get treatment privately cannot do so...
Re: (Score:3)
Of-course there's still problems - but as the NYT piece says: "A decade ago, half of all Mexicans had no health insurance at all." ie in many cases, they were not able to afford treatment.
Right, and now they can afford it, but there's no treatment to get, which is what is fast-approaching here in the states. Last time I had health insurance there was literally no one in my county on that insurer (first blue cross, then blue shield) accepting new patients. Why will this be any different?
Re:NYT had an interesting write-up. . . (Score:5, Funny)
But no, all these socialist systems that have come before Obama were just not tried *properly* now were they? They didn't have a leader as *smart* as Obama to implement them, *this* time they will get it right I'm sure.
It is better to not post and be thought a troll than to post and prove it.
Re: (Score:3)
Notable too that you ignore the experience of the entirety of the rest of the first-world. And had to invoke the Soviet Union to try and find someone who's doing it worse.
Re: (Score:3)
So these opponents of universal health care have an alternate system where people from the poorest area
Re:NYT had an interesting write-up. . . (Score:5, Informative)
Re:NYT had an interesting write-up. . . (Score:4, Insightful)
Sounds like the problems the opponents to universal health care in the States are always worried about.
No, the only problem that the opponents of universal health care in the USA are always worried about is that it wouldn't let the rich get richer by letting you die.
Shocking (Score:5, Informative)
You mean, using someone who actually understands the field he's working in instead of a politician with little or no qualifications, actually gives better results? OMFG this is revolutionary!
Seguro Popular -- it's not universal (Score:5, Informative)
Yes, the claim that Mexico has near universal coverage is accurate, but Mexico's health care is not a US or Canadian (-provincial) style. This Wikipedia article is pretty accurate: http://en.wikipedia.org/wiki/Health_care_in_Mexico [wikipedia.org] about how it works.
Ex-President Fox's Seguro Popular is mostly what the article talks about, and that's what (properly) gives Mexico the right to say that it has nearly 100% coverage. And it's a good program -- my mother-in-law's maid's kid received a kidney transplant under the program.
It's important to distinguish, though, that you're not forced into this system. You can still buy private insurance, or pay cash. (Last time I had to go to a hospital in Mexico, they simply wanted my credit card).
tl;dr: the Mexican government hasn't taken away choice.
Re:Seguro Popular -- it's not universal (Score:5, Insightful)
Re:Seguro Popular -- it's not universal (Score:5, Insightful)
Does someone feel "forced" to pay for police and other services with taxes?
Yes, many libertarians.
Would anyone rather have a private company to call in case of fire, than pay tax money for that service?
Yes, many libertarians.
Am I making a weird extrapolation between police and healthcare?
Yes, many people don't see the connection between public safety and public health. And most of them are libertarians.
Re: (Score:3)
Define "many". I'm not an American, but the only place I ever come across libertarians is Slashdot.
Over here in Europe, the Libertarian movement is so small it goes completely unnoticed.
Re:Seguro Popular -- it's not universal (Score:5, Interesting)
>of course employers would NOT pay for healthcare
Just a minor correction, although I agree with your post. I live in a country where there is such a system, and employers DO pay for healthcare if there are on-the-job injuries, indeed it's illegal to claim those from private insurance - it MUST be paid by the employer (who is free to take out insurance against such events but not forced to - they can cover accidents out of pocket if they prefer - at least for smaller companies this is often viable).
The reason has nothing to do with healthcare cost however, it's one of the more efficient and effective ways to regulate work-place safety. If the employer is automatically liable for the cost of on-the-job injuries (however minor or major) without litigation or such ever entering into it - a guilty-by-default status, then they have every possible incentive to make the workplace as safe as possible.
Frankly if you pay for every skull fracture caused by slippery floors, it's no longer economic to save money on slip-proof mats now is it ? Ultimately this may increase the cost of doing business but I would argue it only increases it to what it OUGHT to be in the first place. Skimping on worker-safety is not a saving, it's basically murder-for-money.
Re: (Score:3)
I went on COBRA a year or two ago when I switched jobs. I was pretty shocked at how much my insurance cost ($1,440 a month for a family of 3). I was used to paying about $600/month for it. Until I had to pay my employers share, I had no idea how much the insurance actually cost, and I can now see where raises went the few years before.
I know firmly think all employers should have to show the employer paid part of insurance coming into your check, and then going out, pre-tax dollars, just like 401k and stu
Re:Seguro Popular -- it's not universal (Score:5, Informative)
And that point is insignificant with universal coverage because the option to get luxury health care wouldn't exist either.
The far right keeps saying this, but it's simply not true. In England, everyone is covered by universal coverage. But many people buy supplemental health insurance because they want more of a premium plan with extra coverage/benefits. You can still have all the luxury health care you want. You are just going to have to pay extra for the luxury bits. Which all sounds quite reasonable. Stop spreading FUD.
Re: (Score:3)
Health savings account? Most young people (the ones in the best health) can't afford to save money, they're living paycheck to paycheck, and they deserve a little leisure too so they don't go insane. Also, many health problems are caught with routine physicals and treated, or they become more expensive and/or impossible to treat satisfactorily. You're advocating for a system with more illness, not less.
1. Nothing's free. What you're saying is, young people should have free health coverage. That means *I* have to pay for it. I already work two weeks out of every month to pay for government programs.
2. Routine care is cheap to pay out of pocket. It's about $125 for a family doctor visit, or less if you shop around (go capitalism!). So it's always a better deal to buy catastrophic illness insurance and then pay out-of-pocket for regular care - unless you go to the doctor more than twice a month.
Re: (Score:3)
Back to the fire and police analogy, would you want your State Police dissolved and your neighborhood patrolled by the FBI? Your local Fire Department replaced by FEMA? You probably don't.
Oregon has a fine public healthcare system. Romneycare is supposedly pretty good. I wouldn't mind if my state enacted some kind of public health sy
Re: (Score:3, Insightful)
It's the same in any country with socialised healthcare though - if there are private facilities available, there's nothing to stop you paying to use them.
Here in the UK, you can use the NHS, or if you'd prefer to have dirty hospitals, bad food, the bare minimum of treatment and staff who cannot speak English and a view over the executive staff car park full of new Jaguars and Mercs, you could go private.
Making a profit is fundamentally incompatible with good healthcare. Something has to give.
Supply and demand doesn't apply here (Score:5, Insightful)
I don't know why people don't get it. The "free market" people out there love to say "government shouldn't mess with it" and usually, I agree except when government has no choice.
Any time there is an unlimited supply, the government needs to help. Such cases include matters like "copyright" and "patent protection." The supply is unlimited and therefore must be enforced by government to use other means to get people to pay for something with an unlimited supply.
Any time there is an unlimited demandm the government needs to help. Such cases include matters like healthcare, water and electrical service. People need what they need and it has little to do with market conditions. Often is is "use or die." Government needs to ensure that needs of the people are met before suppliers are allowed to exploit the need to gain unlimited profits.
It's interesting and amusing to me that many such free market proponents are great with government enforced or assisted items like copyright but not with health and power regulation. "Only when it serves their interests." So it's selfish humanity as usual... and in the end, that's why we have law in the first place -- to help us to act against our own nature.
And the US has ... (Score:5, Insightful)
And now to further accentuate how ridiculous that is, the Mexican government just beat us to health care reform as well. A significant portion of their country is embattled in violent conflict in the drug war, yet they can pass health care reform. Up here, we can't pass it because of a collection of idiots who are afraid of (their own lack of understanding of) "socialism".
Yeah, go ahead. Mod me down. I can take it. At least I said my piece.
So will all the Mexicans go back home now? (Score:3)
Sounds like a better deal for them there than here.
So Mexico gets their act together on health care (Score:5, Interesting)
Leaving the United States as the largest third world country without universal health care.
We're getting beat by Mexico while Congress is fighting over funding for Planned Parenthood by people who want to turn Medicare into a discount coupon program.
Not really (Score:3)
These neoliberal politicians seem to live in an entirely different country, and Frenk is no exception; no wonder he's now run as far away from Mexico as possible and is now teaching elsewhere, standing, no doubt, on his alleged achievements while being the secretary of public health in Mexico.
As any mexican will tell you, his boasting is far from the truth; while he may have instituted a program that supposedly provides coverage for people not otherwise under any sort of health care plan (i.e. those who are not, as workers, covered by the mexican institute of social security (IMSS), or as government workers, covered by ISSSTE), he did so without increasing health spending significantly (from 2003 to 2005 it only increased 0.2 percent and it has remained constant ever since: http://corta.me/7mz [corta.me]). So how can you cover 50 million more people without increasing spending? very poorly, that's how. Understaffed and underequipped hospitals, lack of medication, soul-sucking bureaucracy and hoops to jump through, I don't think that's anything to boast about; as befits his neoliberal lineage, Frenk instituted these policies for the macroeconomic "bottom line".
IMSS is supposed to provide coverage for workers and their families. However this entails people working on a stable, formally constituted company which has the obligation to cover fees for employee coverage. It's not a privilege, it's a right that companies must provide to their employees. However, since Mexico has had near zero growth in the past two decades or so (and more so since 2000, when the disastrous, conservative PAN party arrived in power), job creation has stagnated, and even receded in some cases. Millions of people have to resort to the "informal economy", since there's no company through which they can have access to IMSS, this popular insurance thing was created to give some semblance of health care coverage to the 50 million poor and underemployed in Mexico. But make no mistake; this is not the glowing achievement that Frenk would have the world believe. It's really the government hastily trying to fulfill, in a half-assed way, their constitutionally mandated obligation for health care (Mexican Constitution, 4th Article). This has been there since 1983, so actually Frenk's implementation means a 20-year lag for the government to fulfill its obligations.
Re:Like everywhere else it's been tried... (Score:4, Insightful)
Re:Like everywhere else it's been tried... (Score:5, Informative)
Re:Like everywhere else it's been tried... (Score:5, Informative)
In AU everybody is covered by public health care, if you earn more than $72K Aus (current ~$75k US) you pay an extra 1% tax.
This equates to about $700 a year which (I am sure not by coincidence) is about the starting point for a single non-smoker private health cover. If you do take out private cover and earn > $72k you don't pay the extra tax.
All up I feel its a fair system
Re:Like everywhere else it's been tried... (Score:4, Informative)
lol.. isn't Australia a duel health care country consisting of private and public system like England? I'm pretty sure I was going to have to buy insurance when I was thinking of moving there.
Is the NHS in the UK inadequate these days? I don't live there but I'm quite sure I'd be happy with "just" the NHS if I lived there. Having other insurances to cover e.g. loss of income from illness is one thing. I wouldn't have to have private insurance to cover transplants or cancer treatment, nor would be in a better situation to get such treatment than my poorer neighbor, and thats the important bit.
Re:Like everywhere else it's been tried... (Score:5, Informative)
Re:Like everywhere else it's been tried... (Score:5, Insightful)
I suppose you consider fertility treatments to be frivolous.
I hate to say this, but they ARE frivolous, at least when compared to other things such as cancer treatment.
Not to mention, you COULD just adopt... or do as you did, and pay for private care.
Re:Like everywhere else it's been tried... (Score:5, Informative)
I posted this elsewhere, but its entirely relevant to most discussions on here -
In 2010 (year picked because figures are unlikely to be revised), the UK spent £118.2Billion on the NHS, for a population of about 63Million persons.
Thats a per population head equivalent of £1906 or $2954.
In that same year, the US spent about $381Billion on Medicaid and about $509Billion on Medicare - both of which highly intersect with what the NHS provides, for a population of about 311.5Million persons.
Thats a per population head equivalent of $2858.
Except the US Medicare and Medicaid programmes don't cover 311.5Million persons - Medicaid covers roughly 50Million persons, and Medicare covers roughly the same number - theres about a 6Million person intersection between the two (persons that are enrolled in both), so, again roughly, the total number of beneficiaries for these federal and state programmes is around 94Million.
That makes it a per eligible head equivilent of $9469.
And you know which system I would rather have? The one I currently use - the NHS at $2954.
The US system is just very very badly run.
Sources:
http://www.gao.gov/highrisk/risks/insurance/medicaid_program.php [gao.gov]
http://www.gao.gov/highrisk/agency/hhs/reforming-medicare-payments.php [gao.gov]
http://www.kff.org/medicare/upload/7305-05.pdf [kff.org]
http://en.wikipedia.org/wiki/Medicaid [wikipedia.org]
http://en.wikipedia.org/wiki/Medicare_(United_States) [wikipedia.org]
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There are other reasons that health care is so much more expensive in the US, though... because they never instituted proper tort laws (in part because of the privatized medical system), doctors' malpractice and other insurance is a lot higher. This, in turn, gets passed on to the users of the system, and it becomes a vicious circle... people sue for larger and larger amounts of money because they won't be able to get insurance in the private system, and need to be able to pay the increased medical fees, bu
Re:Like everywhere else it's been tried... (Score:5, Interesting)
The evidence is that the amount of money that can be saved by various tort reform laws is approximately 2%:
http://www.nber.org/bah/2009no3/w15371.html [nber.org]
Now, that's not nothing, but it's not even close to explaining why US health care costs 3.5 times that of the UK. Some things that are more likely to make a difference:
1. Most health care in the US is fee-for-service, so doctors get paid more if they do more procedures, no matter how useful those procedures are. Solution: put doctors on salary.
2. The US spends a lot of money keeping people alive as basically a vegetable in a hospital during the last year of their life. Solution: end-of-life counseling and legalizing euthanasia.
3. A significant portion of health care costs are insurance companies, hospitals, individuals, and government each haggling to try to make the other parties pay for the cost of care. Solution: Single payer and single provider, so there's nobody else to haggle with.
4. Another significant problem is that people without insurance and money to pay for care tend to seek care at emergency rooms, which both makes it harder for ERs to handle real emergencies and means we spend easily 5 times what we would have spent to treat the same condition in a doctor's office. Solution: Cover everybody.
In other words, you get pretty close to what every other country in the world is doing, and it gets a lot cheaper to provide health care.
Re:Like everywhere else it's been tried... (Score:4, Informative)
Even that article doesn't quantify the costs caused by what it calls "defensive medicine". These are tests and procedures done a doctor covering his ass rather than trying to diagnose and treat evident conditions.
Re:Like everywhere else it's been tried... (Score:4, Informative)
I thought that there were states in which various flavors of tort reform were instituted, and the reform was NOT followed by interesting savings. I think Texas is one example. (I'm doing this all from memory; yeah, Wikipedia says insurance companies saved money, not sure any else did, or that it was big money. Shaving 2% off costs and dumping it entirely into the lap of the insurance companies would be a big win for them, that's for sure. http://en.wikipedia.org/wiki/Tort_reform [wikipedia.org] )
Re:Like everywhere else it's been tried... (Score:5, Insightful)
Medicare and SS spend more money than they take in, so to finance these pyramid schemes the gov't sells bonds.
SS takes in more than they make, you fucking moron. Which is where as these IOUs come from...the rest of the government borrows from them.
Jesus Christ on pogo stick, it's completely astonishing how many people are complete and total idiots.
Here, let me explain to you: You know how you don't have a job because you're too goddamn stupid to work a cash register? (And I also think it's unfair they fired you! Does it really matter if customers pay you or you pay them? Isn't it enough that money moves?) You know how you have to keep borrowing from your parents to pay off your credit cards? You know how they don't charge you interest?
They are, this analogy, social security, and you are the rest of the budget. And you are standing there arguing that they are borrowing too much and spending too much and will collapse, because look at all those IOUs they have from you! (IOUs are bad, right? So having IOUs must be bad, right?)
Hey, dumbass, it's you who have the problem, they're the people fucking bailing you out. The government has borrowed 2.7 trillion dollars from social security.
You get rid of social security, (even if we _don't_ pay it back, aka, we steal the 2.7 trillion dollars we've already borrowed, aka we default on US government securities), and in the future the rest of the budget is in a lot more trouble and has to borrow more, resulting in more interest. We borrowed $805 billion in 2011, so basically you're saying 'I wish we had to pay interest on an extra $805 billion each year!'.
And having stole 2.7 trillion dollars from our security holders (Even if said holders were ourselves), I can only imagine at what interest rate we'd have to offer on those added bonds. And our existing ones.
TL;DR: Conservatives think a place the government can, and has, borrowed money without interest (Instead of issuing bonds which do cost interest), is somehow causing the budget issues, and the fact that it has so much money is obvious proof that it is bankrupt.
(Medicare, OTOH, hovers on the line of taking in too much and too little, but is not separated out like social security and doesn't have a trust fund, so extra money just disappears into the general budget, and comes out another year, so it's harder to see that it's revenue neutral in general. People gasp and point out that it costs X billion dollars one year, and don't notice it made X billion dollars another. Right now, in a recession, yes, it's costing us.)
Re:Like everywhere else it's been tried... (Score:4, Interesting)
Re:Like everywhere else it's been tried... (Score:4, Informative)
Lawsuits only make up about 1-2% of the health care costs.
It's not the lawsuits. It's the insurance doctors (and now some nurses and PAs) are required to get to insure you against those lawsuits. This can be north of $100k/yr and in some cases (depending on the state) close to a quarter million a year for a surgeon.
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But they dont have any doctors there. they all left because of the low wages.
What, you mean the Tea Party people are lying about that?
Re:Like everywhere else it's been tried... (Score:5, Interesting)
We were only discussing whether a public universal healthcare system automatically tanks the economy. Whether this system provides better or worse care, or does it for ore tax money than would otherwise be spent in private insurance is a completely separate discussion.
(but as a clue, I have seen lots of studies saying that for example the US healthcare system provides about half as much "care per dollar" than most single payer systems. A lot of this is of course due to legal and bureaucratic overhead).
Re:Like everywhere else it's been tried... (Score:5, Interesting)
Let me put it this way, 10 years ago a little over half of the costs in my dad's practice were billing insurance. Its now over 75%. That right there should tell you a lot about how a single payer system could save money.
The next largest cost is malpractice insurance; when about half the doctor's lost their malpractice insurance so they closed up shop, the state stepped in, but its still a big problem.
Finally a single payer system consolidates information about what a doctor does. In other systems, like the VA, they're using that to shape doctor's practices. Basically they get the leaders in the field together to try and figure out an ideal process (e.g. weighing the risks and costs of a test to see when you should jump to the most accurate test vs using less accurate but less costly or more safe screening). Any doctor can go outside the reccomendation; all they need to do is basically check a box. If more than a certain percent of a doctors patients go outside the expected range, they then review the cases. There may be other mitigating circumstances, so they are reviewed by doctors and that feedback is used to refine the reccomendations or to consult with the doctor about how to be more cost-effective. This system shapes doctors behaviors toward providing proper medical care at a minimal cost, without ever preventing a patient from receiving the care their doctors feels is appropriate.
Keep in mind, for many people the government already provides care. If you don't have insurance and its life-threatening, the poor, veterans, etc. Before we were married, my wife worked as a pharmacy teach and she would see all these people getting pills on the government's dime and then selling them in the parking lot, yet the government wouldn't cover her and private insurance was more than she made, so she couldn't afford her bi-polar medicine. If she quit, the government would cover her, but she's the type of person who likes to pull her own weight so she went without. How much sense does that make?
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You fail to explain how this will reduce the cost of insurance.
If 75% of your costs are dicking around with the insurance company arguing about whether illness X or medication Y are covered on a particular plan, for a particular patient, during a particular phase of the moon, etc., then you could spend 3 times more on everything else, and still come out of it spending less, if you had a single payer system where you just send them the bill (the charges being determined by the payer), and they pay it.
Re:Like everywhere else it's been tried... (Score:5, Insightful)
A healthcare system coudln't tank an economy unless people were forced to pay into it.
Single payer universal health care means healthcare is a figure in the budget, just like infrastructure, defense etc. If there is a budget deficit you have to cut down on something (infrastructure, defence, healthcare, whatever). People are "forced to pay into it" no more or less they are forced to pay into defense or infrastructure. Having too large expenses for healthcare is entirely possible, reasons can be for example if you have a shift in demographics where fewer young people pays for the healthcare of a large aging population (Japan has this problem whereas the US does not). This can cause economic issues, but the same can be true if you have an aging airforce.
Re:Like everywhere else it's been tried... (Score:5, Insightful)
If the government promised to people they better pay it. That will come out of someones paycheck.
Still the same as defense. Also comes out of someones paycheck. And what the government promises, they better deliver if they want to be reelected. You are still not making a point I feel.
Re:Like everywhere else it's been tried... (Score:5, Insightful)
Seriously? You're seriously asking that question?
In the civilised world, we view people who refuse to help the sick and injured as evil scum. In your country you may be happy with people dying, untreated, on the streets. YMMV.
Re:Like everywhere else it's been tried... (Score:5, Funny)
Because Reagan signed that law into being in the 80's.
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For the same reason the police investigate crimes for people who cannot pay private investigators.
Re:Like everywhere else it's been tried... (Score:5, Insightful)
I think we do have a right to healthcare, as well as food and housing, at least as long as the country can afford it. The wealthy already get to have luxuries because they're rich, why do they also get to have the necessities, like shelter, healthcare and food as well?
I also think we should cut our military budget by at least 90% before we start saying we can't afford to provide everyone with healthcare.
Re:Like everywhere else it's been tried... (Score:4, Insightful)
Homework: Discuss how this contradicts your belief that the free market is always the best solution.
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If we're talking about health care, the longevity and infant mortalty are good metrics. They're not that bad as part of an overall metric for scoring a nature, either.
Socialism has been tried in many places, failed in some where it was tried to excess, but works fine in others where it has been used appropriately. The dose makes the poison. Socialized health care works well everywhere it has been tried. Most countries, including the US, have socialized transport systems (in our case, highways -- arguabl
Re:Like everywhere else it's been tried... (Score:4, Informative)
The hospital I work at would probably not charge for the Q-tip itself, but add the fully burdened cost to the service provided.
Follow through, though. I'll try to make it easy for you.
The Q-tip was purchased and probably has an acquisition cost of $.01.
It was stocked by a nurse who needed to track inventory to maintain a non-profit status ($35/hr). 30 seconds to place it in the correct position and check off that it is now in inventory. ($0.50)
It was housed in a rolling cabinet that cost $2K. (assume cost is amortized over several years) The cart is cleaned once a week. The Q-tip bucket's share of this cleaning is 30 seconds @ $20/hr. let's say it's $0.01
It was requested by a care provider and took 60 seconds to log the care request into the government mandated electronic medical records used for tracking and assuring proper follow up to care. Cost of 60 seconds of care from a family practice physician (assuming $120K/year) is $1.
The request was printed out at a nurse station and picked up by charge nurse. Evaluation: 15 seconds. Delegation of the service 10 second. For a nurse making $70K/year, that is approximately $0.24.
The CNA ($25/hr) will open up the cabinet, get the Q-tip, walk the Q-tip to the patient. (2 minutes) Cost: Approximately $0.25
CNA logs the patient ID band and confirms the service will be performed: 30 seconds. (approximately $.10)
Actual use of Q-tip by CNA: 1 minute, including disposal in approved container. (approximately $0.20)
Disposal of Q-tip by janatorial staff: $0.01.
If procedure is properly performed and there are no adverse issue, you have an OCOGS of over $2. And you think it should be free?
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Which means nothing on its own. How should we account for the quality of care, taxes paid by each person recieving care, etc?
That's a different argument/question from the one you originally posted. As Voltaire used to say, define your terms in the discussion. Other countries whose economies are not tanking due to their health care systems: Singapore, Israel, Switzerland, Japan, Brazil, Rwanda, Chile to name a few.
These countries are either doing well as developed nations or on the verge of becoming ones. As for Japan's economic woes, they have everything to do with an aging population, lack of women's participation in the work
Re:Like everywhere else it's been tried... (Score:5, Informative)
Australia (where I am)
Canada
The United Kingdom
Most of Europe, for that matter
South Africa
New Zealand
Singapore
Japan
And that's just off the top of my head, with a bit of googling to back it up. You know, basically every single first world country except the United States, who recently were in a massive recession and are looking to head that way again.
Re:Like everywhere else it's been tried... (Score:5, Interesting)
Yes they say the words that make you happy... do they actually deliver?
Still trolling? Let me repeat his statements for you, in a new wording
- All of the "first world" economies, except the US, pretty much have universal socialized health care.
- The systems are popular in these countries (they are all democracies, so they would have to be quite popular to remain).
- All of these economies are of course facing more or less rough times at the moment, but their economies would still be regarded as "healthy" on a global scale or seen over a few decades.
Re:Like everywhere else it's been tried... (Score:5, Informative)
Popular? In Canada any hint of weakening the public health care system is met with outrage. It's one of the few things you can guarantee will upset Canadians, and get your government booted. I suspect the same is probably true in other countries that have them.
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By looking at basic economic figures, such as Gross National Product, National debt, poverty percentages, unemployment rates, education levels etc. And yes, get over it: almost all of the countries in question are doing much better in those areas than the USA.
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Since you're the one making the argument publicly funded healthcare and a healthy economy are impossible, why don't you define "healthy" for us.
Re:Like everywhere else it's been tried... (Score:5, Informative)
Investors. The country with the highest tax burden in the world right now, Denmark, is at the moment loaning money at an interest of -0.25%..
YES, that means rich people, very rich people, and investors in general, believe the Danish economy is so healthy they are willing to loan them money at negative interest, just so that Denmark can protect they money for them.
Re:Like everywhere else it's been tried... (Score:5, Informative)
Who's giving anything out for free? Public health care systems simply involve one not for profit entity, the government, paying.
Speaking as someone who actually does medical research, in Canada, drug companies do and fund plenty of research here. We have excellent, unified records for epidemiological studies and a comparatively simple, consistent system with little risk of frivolous lawsuits.
Re:Like everywhere else it's been tried... (Score:5, Informative)
The Nordic states are doing pretty well, and they all have universal socialised healthcare. The Netherlands claims it has privatised healthcare, and the best service in the world, but in fact 75%+ of the cost is transparently covered by the taxpayer, and poor people do get free healthcare.
Singapore (Score:5, Interesting)
The United States relies upon private health insurance to provide much of the financing for medical costs. This is unusual: in Britain, Canada, and Spain, for example, health-care costs are largely paid for by the government. In Austria, Belgium, France, Germany, and the Netherlands, medical costs are paid for by a system of "social insurance": it is compulsory for most people to buy insurance, but insurance premiums are tied by law to income rather than to the risk of a claim.
The United States system makes it voluntary to buy insurance, and premiums are linked to risk, not to income. But these market-based premiums, beloved of many Americans, do not seem to be delivering health care that makes them happy. A recent survey revealed that only 17 percent of respondents in the United States were content with the health-care system and thought no substantial reforms were necessary. Why the discontent?
The superficial reasons are simple enough to describe: the system is hugely expensive, very bureaucratic, and extremely patchy. The expense first: US health cares costs a third more, per person, than that of the closest rival, super-rich Switzerland, and twice what many European countries spend. The United States government alone spends more per person than the combination of public and private expenditure in Britain, despite the fact that the British government provides free health care for all residents, while the American government spending program covers only the elderly (Medicare) and some of the marginalized (Medicaid). Most Americans worry about health-care costs and would be stunned to discovered that the British government spends less per person than the American government but still manages to provide free health care for everyone. In fact, if you figure in the costs of providing health insurance to government employees and providing tax breaks to encourage private health care, the US government spending on health care, per person, is the highest in the world.
Bureaucracy next. Researchers at the Harvard Medical School found that the administrative costs of the US system, public and private, exceed $1,000 per persons. In other words, when you count all the taxes, premiums, and out-of-pocket expenses, the typical American spends as much on doctor's receptionists and the like as citizens of Singapore and the Czech Republic spend on their entire medical care. Both places are countries with health outcomes very similar to those in the United States: life expectancy and “healthy life” expectancy (a statistic that distinguishes a long healthy life and a long life plagued by years of severe disability) are a shade lower in the Czech Republic than in the United States; and in Singapore they are a little higher than in the United States. The costs of US bureaucracy is also more than three times the $307 cost per person for the administration of the Canadian health system, whic
Re:Like everywhere else it's been tried... (Score:4, Interesting)
Germany.
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For further shaming of the US system (and to the benefit of other systems) you can compare with the WHO ranking of health systems [wikipedia.org] though that might be a less objective metric.
Re:Like everywhere else it's been tried... (Score:5, Informative)
When I select HEALTH index (only) the United States ranks #38. The United States is trailing the industrial powerhouses of Cuba and Costa Rica.
Build your own index using UN data:
http://hdr.undp.org/en/data/build/ [undp.org]
Re:Like everywhere else it's been tried... (Score:5, Informative)
I don't know where I said that paying for public healthcare leads to a collapse.
I was thinking of this: "Like everywhere else it's been tried...let's watch the mexican economy tank in 3...2...1..."
The current method of providing healthcare is basically stealing from future generations (which will eventually lead to collapse), if you think about how it works (at least in the US) it is a big ponzi scheme. Every generation needs to convince the ones after them to buy in to the insurance/Social Security scam. Please explain how else it could work.
I don't know what you mean by "stealing from future generations". If you have a budget neutral (i.e. not deficit spending) based, tax financed, public healthcare system, how will that be problematic? Look at Sweden for example. There is a single payer universal healthcare system paid for by taxes, at the same time there is a budget surplus and the national debt has been quite rapidly reduced in the last decade. Are the current generation of swedes "stealing" from the next generation of swedes?
Re:Like everywhere else it's been tried... (Score:5, Informative)
Every generation needs to convince the ones after them to buy in to the insurance/Social Security scam. Please explain how else it could work.
Simple: the population of people requiring healthcare treatment at any given moment, even at 0 population growth, is always going to be much smaller then the population who are able-bodied and working. Across the volume of that total population, if everyone kicks in a small amount of money, then we can ensure that there's cash available for all of them when they themselves need medical treatment.
Also, since insurance gets more efficient as you dilute the risk pool, expanding it up to the size of the entire country's population has enormous benefits - as well we follow on ones such as providing for government collective bargaining on the cost and purchase volumes of pharmaceuticals (the government is the largest possible purchaser, ordering the largest possible volumes, which means it'll always be able to negotiate a good deal).
Social Security (in the US) is not a scam, incidentally. It only becomes a scam if the American populace let that happen, which will be if they allow the government (screw it - allow the current batch of GOP politicians) to reduce SS benefits to future generations. The scheme has been enormously well-funded, and is owed billions by the US government, which has avoided raising taxes by "borrowing" against SS savings. It's alleged bankruptcy is due to the fact that that money was never paid back, because it was never used for anything profit earning in the long-run: it was wasted away as tax cuts to the rich, and still is.
Re:Like everywhere else it's been tried... (Score:5, Informative)
You seem to be confusing taxes to fund universal health care with social security, which is a large confusion. Health care insurance is pretty much pay as you go, and though there is a skew in costs to the elderly, young people are somewhat aware of reasons they might need it (pregnancy and delivery, usually routine, sometimes not; random medical horribleness, that sort of thing).
Social security is mostly a young-to-old transfer, but it is hardly a Ponzi scheme; there are projections for costs and projections for benefits, and it does not have Ponzi characteristics; people get their money out regularly (unlike a Ponzi scheme). If we accept the usually conservative projections of future SS budgets, then the money set aside in the SSTF will not be adequate starting sometime around 2035 -- but that is not an inherent Ponzi problem, that is something instituted in the 80s to help manage the retirement of the baby boom. Benefits won't stop; they'll just be smaller. We can fix that with relatively minor tweaks to funding or retirement age, and these fixes do not have the "then-another-fix, and another, and another" nature, at least not according to the usually conservative projections; you have to bring the system into demographic balance, and then you're done. The baby boom is one heck of a pig in the snake, and that's what causes a lot of the "problems" of SS.
A second important part of SS that you are ignoring is Survivor's Disability Insurance. When we went out to buy healthy insurance on our own (one of the joys of working for a startup), the initial estimates of the policy size were enormous. The sales-ish person we talked to helpfully pointing out that SDI takes care of a huge chunk of that. If it were not for the SDI part of SS, I would have been sending larger checks to the life insurance company for the last 15 years.
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You display the ignorance that indicates that you are a drone repeating the mantra instilled in you by propaganda. There are plenty of countries doing very well with universal healthcare. The majority of them also offer private health care for the rich who think they can buy their way to better health with additional insurance.
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Re:Ironically... (Score:5, Insightful)
Only an American could ask that with a straight face.
"It's just that today... where do you honestly want to be treated?"
Any country that won't bankrupt me to do so. Because there's no point in being treated if you then have nowhere to live, recuperate, no life to enjoy after and have to work (while in ill health) for the next 20 years to pay it off. I would love to be treated in a perfect hospital with every medicine and treatment available and have it all done while people bring me cocktails and rub my feet. Of course. But the truth is that it's a choice being PAYING LOTS OF MONEY and being treated okay, or PAYING NOTHING and being treated when necessary.
If I cut my finger, I'll do it myself.
If I sprain my leg, I'll do it myself or walk into a hospital if it really develops complications.
If I break my leg, I have to go to hospital.
If I break my spine, I have to go to hospital.
If I get cancer, I have to go to hospital.
At no point would I ever *PAY* for those services. Think about that. I get cancer, I probably have 10-20 years at most if it's serious and will never truly rid myself of it, and I get ALL my treatment paid for me. How much would that cost on insurance, and how much would that cost if you had no insurance and had to pay cash? Now what if I'm diagnosed with, say, cerebral palsy at birth? How much is my insurance going to be then? Have you even SEEN the cost of quite basic medical treatment?
My country, the UK, is shit and wonderful at the same time but wouldn't expect a dying man to pay for his own care (maybe his car parking at the hospital, but that's a minor issue in comparison). The hospital might be crap. It might have worse care rates than private wards. The staff might be belligerent. But I'm not running up debts that I will never be able to pay while I'm laying there unconscious and can't do anything about it.
In the UK, the healthy pay for the sick.
In the US, the healthy pay (next to) nothing and the sick are left to fend for themselves.
Nice attitude to humanity, there.
I never to sit there, adding to the stress of my illness, with what might happen to my insurance payments, or my house, or my family, or anything else.
Sorry, given the choice, I'd go to a hospital where the treatment is "free" and the only cost is the queue and the waiting time. Because the simple, economic fact is that *I* cannot afford to pay for anything serious (and wouldn't go to hospital for anything that wasn't) and I already pay as-much, if-not-more tax than the US and we do just fine on "free" healthcare.
Literally - if I went on holiday to the US I have to buy a travel medical insurance that I *NEVER* have to purchase in the EU. Because if I break my leg in Spain, the treatment will be paid for by the UK. If I break my leg in the US, they won't pay (because of your ridiculous healthcare arrangements) and I have to BUDGET THAT INTO MY HOLIDAY. If I fall into a coma in the US, whether my fault or not, that's me bankrupt back in my own country trying to pay off the US medical bills. Or I can pay a fortune for insurance that NOBODY in the EU requires me to have. (And, yes, US residents are charged for the cost of their healthcare in the EU but they are used to it!). I actually have to take it into account just holidaying in the US.
Either pay for everyone's healthcare out of my taxes, or ask me to pay towards everyone's healthcare as a separate payment. Don't pay for some of it out of my taxes, then make me pay for anything above a slight cold, and then make insurances compulsory, and then let insurers set the prices how they like (the point of insurance should be to cover EVERYONE for an equal price - i.e. if you all pay $100 a month, then the guy who needs a $10 operation gets it as does the guy who needs 100 $10,000 operations - otherwise you are just paying for your own healthcare).
And, in the UK, I have the option. I have complete, free, blanket NHS protection on anything I ever do. I can also pay fo
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millions of Americans are not flocking to mexico for free medical care... rather millions of mexicans come north.
But many Americans do flock south to Mexico for reduced-cost medical care. For example, my dental work will be about 10% down there what it would be up here... or 20% of what it would be if I still had dental coverage.