So, some of you may have heard, some not, but they are talking about reforming the health care system in the united states, with a public option. A lot of people debate about how good or terrible a government ran health care can be, and many references are made to Europe using this kind of system.

So i thought i would ask those that already have this health care system intact,
How do you feel about it in general?
What do you like best?
What do you wish was better about it?
Do you have to wait for standard health procedures/surgeries/other medical stuff? if so, how long?

Just curious, as it would be nice to see another perspective than the political mud slinging going on over here...

Having come from the UK which has free healthcare for all, to Germany where you have to pay insurance, I can see the pros and cons of each system.

Here in Germany I can phone up and make an appointment at any doctor's surgery in the country - and not just GPs (family doctors - not sure what you call them in the states) but any kind of specialist I want. If I have a rash, I go to the dermotologist. If there's something wrong with my ear, I go straight to the ear, nose and throat specialist. In the UK you need to be referred by your GP before you see a specialist and that takes (wastes) time. I guess the idea behind it in the UK is save money by trying to filter out the patients who can be easily treated by general medicine but to me, it's always felt a bit strange that a doctor with no specialty can diagnose almost any problem they think you have, or don't have.

Since coming to Germany I have also realised how much the doctor's in the UK are constrained by NHS guidelines. It's a standardised system as much as it can be so everyone gets roughly the same advice and treatment according to what's wrong with them. In Germany, because each doctor is his own boss, he or she can treat you according to his or her beliefs or customs. So, if you're the type to hate taking pills, you find a doctor who shares those beliefs and you know that he or she will try everything to go down a 'natural medicine' route with you for as long as it's possible. Or if you think that health is intrinsically connected to diet, you go to a doctor who has a special interest in nutrition and take it from there. There is a doctor here to fit everyone's personal preference, which I think it a good thing.

Here in Germany, health care involves the patient much more than it does in the UK. That sounds weird, but basically in the UK you just toodle along to one of the handful of doctors that you're allowed to see (according to where you live - each doc has a catchment area) and you're treated. Here, the patient has to make the decision about which doctor to see, and certainly has more say over their own treatment. I find that doctor's listen to you more here and are happy to take your ideas on board.

The big disadvantage of the German system is, of course, how much it costs. My husband and I are lucky enough to be in a good position financially and I have no idea how we'd cope if we weren't. I think there is an option for people who earn under a certain amount to get free care (or at least heavily subsidised) but I don't know how restricted that care is.

Another thing which annoys me about the health system here is that I pay my health insurance every month, then if I need to see a doctor, I have to pay another 10€ to their practice, and THEN if I need a prescription, I need to pay quite a lot of money again (according to what medicine I need) to pick it up. For example, if I need the contraceptive pill, I have to pay something like 30€ per monthly supply. That particular medication is free in the UK, and for all other medicines, you pay a small, universal amount no matter what you've been prescribed.

My conclusion is that in the UK, patients are treated a bit like cattle, whereas here they are required to think a little for themselves. Patients in the UK can feel very patronised by this. Maybe some people here can feel a little overwhelmed, who knows? On the other hand, patients in the UK can go to their doctor with any little complaint whereas here, you assess how you feel against the financial cost of seeing a doc - obviously not a good thing if you have a potentially serious illness. People here tend to self-treat with herbal remedies etc because of this - whether or not that's a bad thing, I'm still to decide.

Long waiting lists for routine procedures are commonplace in the UK because the government cannot really afford to provide an adequate number of specialists per head of population. Here, being put on a long waiting list would be considered outrageous. But at least in the UK I don't have to pay for each procedure which isn't considered necessary and therefore not covered by my insurance. For example, if I were worried about gestational diabetes (I'm pregnant) I'd have to pay to have the test done. In the UK, this is routine.

The UK is a much better system for those people who simply could not afford adequate medical care. Everyone pays tax, richer people more than poorer people, and everyone gets equal benefits from it. So the less well off in society are supported by people who can afford it. This may sound a little socialist to an American, but to me it sounds fair as we are all lucky enough to live in a country with amazing benefits to our everyday life - and that wouldn't be possible if we didn't help each other as a large community.

Given the choice I'd take the NHS any day, despite it's problems. But for a country like America looking to start such a system from scratch, I'd say there is a lot of opportunity to learn from the mistakes of Britain and other countries with similar systems to make a 'best of both worlds' option. I think America would be insane to reject such an opportunity. Just my opinion!

Sorry for the essay.

If you watch Sicko, (Michael Moore, 2007) the health care is the focus with a biasm towards free national health care.

What i hate about the American Health Care, is it is run by Pharmaceuticals who charge alot of money for medicine. The American Health Care is pretty much run by Corporations who want alot of money at the expense of peoples health. Now while i understand that medicine isn't free, i do know that it doesn't cost as much to produce as sometimes charged. for example a cancer drugs that cost a few dollars to take, are charged in the thousands for each dose.

Nothing should be free, because there are overheads, and of course in the UK the NHS isn't free. However we pay for 'insurance' through our taxes, which allow us to see doctors and get diagnosed. This does mean that everyone is at an equal pacing and queues can be long. Doctors have an alloted time to see each patient, 10 minutes, and it can seem like they don't care. Sometimes a vague illness or problem can be quickly diagnosed and the patient can feel that the doctor didn't care. I don't think this is always the case, afterall doctors are people, it's just how the system is.

I know that 10 minutes seems quick if you have a big problem, but 10 minutes is just a guideline. I've never been so ill that a doctor can't treat me in that time, else i would have gone to the hospital instead.

I guess you have to weigh the pros and cons. I really like the NHS though. It's always there and the job they do is fantastic.

Another thing i like is my EU medical card. It means i can be treated in any country in Europe, just like i can in the UK. I haven't had to use it, but when i was in Italy, my brother-in-laws neice's throat swelled up and she was taken to the hospital and treated and given medicine just like she was in the UK.

Vik has pretty much shared the pros and cons that I would have thought of, to be honest.

But one thing I do wanna stress more on is that the NHS is FANTASTIC ('cause it's free obviously), more so for people who have A LOT of medical issues. There is no way I could imagine having 5 things wrong with me (not that I have, but it's just an example!) and then having to pay for my expenses for those appointments/consultations/medicines :S I'd be skint... or worse, dead by now.

A lot of people speak negatively about the waiting list of the NHS, etc.. but at the end of the day, it's gonna be like that 'cause it's free. And that's the part we have to be grateful about. And saying that, even private healthcare is getting so busy now, that you're having to find yourself wait around for a week to get an appointment. Just a few years ago, you could get one the next day (or even on the same day!). Just also shows how popular private care is getting.

I didn't know much about the medical care in America, until I watched the film 'John Q' (Denzel!). I was disgusted. It was sad. :(

So, some of you may have heard, some not, but they are talking about reforming the health care system in the united states, with a public option.
I've always wondered about the healthcare system in the US. Everything I know about it is just what I heard in John Q (wicked awesome film btw, Denzal Washingon ftw!).

In the simplest way possible, could you or someone else kindly explain how the healthcre plan runs in the US and what they want to do to change it now?

I hope this isn't going off topic because I might have the wrong idea here. In whch case, oops and sorry :$

Edit: Ha, just saw what nerdy said about John Q :$ (I haven't read the replies yet because I don't want my opinion to be influenced by what's already been said before I know how this works in the US)

In the simplest way possible, could you or someone else kindly explain how the healthcre plan runs in the US and what they want to do to change it now?


Ok from what i read by Vik the German system sounds very much like the US health care system. Now i havent seen the two movies referenced, but i wouldnt rely heavily on Sicko for real information as Michael Moore is very well known for his extreme liberal views.

Basically as simply as possible this is it. There are many private insurers, and most americans recieve their health insurance through their company. The insurance company provides you with a list of doctors/specialists that they approve of and you can make an appointment whenever you want to see them. If you go to an unnaproved place you usually have to pay most out of pocket, unless of course its an emergency then you are just taken to the nearest place. Each visit to a normal doctor you pay (generally) $30. to a specialist, $40. Their is quick, fast, good service, and the US has a lower death rate on most diseases than other countries.

The main problem: cost. it is rather expensive, and some families cant afford it. the government has a system (Medicare/Medicaid) for those who cant pay, im not too sure exactly what coverage it provides, i just know its in a financial disaster.

What they are trying to do is lower costs by providing a public health care paid for by (currently proposed, subject to change through debate) taxing the wealthy and taxing the money that companies use to pay for their employees private health insurance. Although the current bills being debated in congress havent been able to sufficiently lower the costs and they are still trying to figure out just what to do. But Obama is really pushing for the change of a public health care system to compete with private health insurance.

Hope that was the "simplest" way to describe the US plan A.J. lol, took a bit longer than i would have liked, ummm if i wasnt clear on anything let me know (or if i forgot something someone from the US can add it, oh and i am presenting this to the best of my ability in a non-partisan way, using non-partisan sources for my information)

I watched that Michael Moore documentary and although I quite like him, I always take what he says with a pinch of salt as he really can manipulate facts and figures like no-one else.

What I was wondering though, is whether or not you can be turned down in America for health insurance? Michael Moore seemed to think that you can, if you are in poor health, and that even when you have the insurance they scrutinize every last penny you get out of them - even refusing to pay for a procedure if they dig up some dirt on you. I was wondering if an American can confirm or deny this? This would never happen here - I think the health insurance companies are obliged by the government to take on anyone and to always pay out for certain things.

Cool, thanks for that Jmac. Just a few questions and comments...

Basically as simply as possible this is it. There are many private insurers, and most americans recieve their health insurance through their company. The insurance company provides you with a list of doctors/specialists that they approve of and you can make an appointment whenever you want to see them.
So its like choose and book which is what we have here. We just go to our normal GPs (its free to see them because its all covered by the NHS) and if we need to be refered to hospital we tell them which hospital we want to go to and which Doctor we'd like to see. I think its fairly newish but I could be wrong. I've only had to do it now so feel free to correct me anyone if its been around for donkey's years. I presume because you go through the insurance company for this its all free... as in you don't pay anymore on top of what you already pay for insurance?

If you go to an unnaproved place you usually have to pay most out of pocket, unless of course its an emergency then you are just taken to the nearest place. Each visit to a normal doctor you pay (generally) $30. to a specialist, $40. Their is quick, fast, good service, and the US has a lower death rate on most diseases than other countries. Forgive me for asking but it was in two separate sentences so I wasn't sure if they were connected; the normal doc and specialist charges - are they only for emergencies? That's actually really cheap! I think the UK equivalent to that wold be BUPA so if the NHS suck and the waiting list is long for something and you go privately through BUPA, you have to pay about £100 per consultation and for check ups (unless they're included in post op check ups which is routine) BUPA isn't unapproved of course, it just means you have to pay for the best healthcare possible and insurance doesn't really cover it.. unless you have health insurace, iirc.

The main problem: cost. it is rather expensive, and some families cant afford it. the government has a system (Medicare/Medicaid) for those who cant pay, im not too sure exactly what coverage it provides, i just know its in a financial disaster. So its the NHS for poorer people but with a few catches?

What they are trying to do is lower costs by providing a public health care paid for by (currently proposed, subject to change through debate) taxing the wealthy and taxing the money that companies use to pay for their employees private health insurance. Although the current bills being debated in congress havent been able to sufficiently lower the costs and they are still trying to figure out just what to do. But Obama is really pushing for the change of a public health care system to compete with private health insurance.
Ok, I don't get this. In the US you pay taxes as do we. Our taxes go towards schools, NHS, emergency services and just about everything the country needs to run. So that's why we don't pay for the NHS, yet in the US you pay taxes and it doesn't any healthcare? Or it does but only for the poorer people and even then its got its catches?

Without giving away too much of the plot for those who haven't seen it, in John Q, the guy played by Denzal needs to pay for his son's treatment because they don't have health insurance. There's all sorts of problems and one thing I remember them constantly saying was "HMO" - what is that and what's it got to do with not having health insurance? I know what it stands for but I don't know how its linked to not having insurance and what the problems are with it.

I've seen random documetaries in the past where people take on minimum age jobs when living in New York for example, and they don't have health insurance. When they fall ill everything falls apart for them and they basically don't have enough to feed themselves and so on. From what I saw then I figured the US healthcare system was pretty crap and wasn't fair to poorer and/or uneducated people. I don't know what the tax money goes towards but I think it should be going towards free healthcare.

The NHS may suck here but at least nobody's denied treatment (unless you're in Holby City and being denied treatment because you're an obese smoker and Dr Rick Griffin suddenly puts a zero tolerance scheme into play - yes I know I need to lay off the really crap British dramas but I really can't help it) and we don't have to prove we can pay for treatment before being treated. That's just ridiculous.

Going privately for an op may as well cost an arm and a leg - or in my mum's case, a womb! In terms of what we recently experienced my mum was told her problem wasn't too important because having a dropped womb as well as other organs was "normal" for women her age and "isn't classed as an emergency" even though she was unable to walk, stand or lift things. The NHS docotors and GPs said she could wait another three months or so before they could consider treating her, purely because they said it was so common. Course we went privately because my mum's health was deteriorating, plus she's borderline diabetic (its diet controlled - for now!) and as soon as she saw a gyno they set an operation date ASAP. It cost just over £5,000 to have the operation within a month's time but if we waited 3-4 months it could have been free. I think its insane that the NHS waiting lists are so long and some people as classed as not being in much need for healthcare compared to others. Not only this but the gyno my mum saw also works as an NHS doctor. As soon as see a doctor privately, everything about them changes and they're overly nice and caring simply because they're being paid thousands more just to see one person for about 30 minutes.

Same thing happened to my dad when he needed a nose op (no, not a nose job!) - the GPs were really naff but when he went privately they were superb and cared so much. In a way I think BUPA is a kinda scam and doctors are really mean for caring more only when they get paid more. It seems like its all becoming about money and not about how people want to get job satisfaction or whatever. Plus they don't really give a monkeys about the patients unless they feel they're worth the effort :/

Sorry, hijacked the thread for a moment there. The point is, I think all healthcare systems seem to fail in some way and there will still be problems in the US no matter what happens.

*AJ* - I can't speak for Jmac, but my impression is that the USA a lot of tax money goes on defense. Here are some figures for the UK (don't know how accurate they are). Not sure why the person who wrote this took 8680 pounds as his basis... maybe it's an average per person per year?

"Of the 8680 pound spend by central government on your behalf this year ...

1120 pounds will go to the NHS
763 pounds will go to local government (to help towards services such as police and education)
520 pounds will go to regional expenditure on Scotland and Wales
440 pounds will go to education
343 pounds will go to defence
135 pounds will be spent on Northern Ireland
75 pounds will go on international development
and 4200 pounds can't be accurately assigned as it goes on demand lead costs such as social security payments (state pensions - roughly 1000 pounds spend for each of us according to the pensions commission - but also unemployment benefit, disability benefit, etc)"

And here's a biased but interesting website to see how much of US tax goes towards the military

http://www.warresisters.org/pages/piechart.htm


God only knows where the extortionate amount of tax we pay in Germany goes.

Ok, I don't get this. In the US you pay taxes as do we. Our taxes go towards schools, NHS, emergency services and just about everything the country needs to run. So that's why we don't pay for the NHS, yet in the US you pay taxes and it doesn't any healthcare? Or it does but only for the poorer people and even then its got its catches?

here is how taxes is spent in the USA (from 2007, in billions of US dollars):
Social Security:......................................... ........... 586
Defense:.......................................... ................... 548.8
Medicare: .................................................. ..........394.5
Unemployment/welfare: ..........................................294
Medicaid/other health related:................................. 276.4
Interest on debt: .................................................. 243.7
education and training: ..........................................89.9
Transportation:................................... ................. 76.9
Veterans benefits:......................................... ....... 72.6
Administration of Justice: .......................................43.5
Natural resources and environment:......................... 33.1
Foreign Affairs:.......................................... ........... 32.5
Agriculture:...................................... ....................27
Community and regional development: ......................26.8
Science and Technology:....................................... 25
Energy:........................................... ................... 20.5
General Government:....................................... ...... 20.1
so vik was right, we do spend a VERY large amount on defense.
however A.J., we do spend money on healthcare for the poor people (see medicare/medicaid) and as i said im not sure about what limitations one has or how much of your health costs medicaid/medicare cover... maybe another U.S. person can help me there....


as in you don't pay anymore on top of what you already pay for insurance?
no, the 30 or 40 dollars per visit is on top of what one pays for health insurance, and is for ANY visit to the doctor.

the normal doc and specialist charges - are they only for emergencies?
see above for the first part, and emergencies depends on your plan. some insurance you pay 50, some 100 dollars for a visit. some its a percentage of the actual bill that you have to pay, some you have a deductible.


"HMO" - what is that and what's it got to do with not having health insurance?
Ok, for those reading who dont know HMO is health maintenance organization. instead of classic insurance (a sum of money paid by insurance company A to person B by way of compensation for a loss suffered by person B), most health insurance is run through HMO's. Basically, the insurance company has a contract with some doctors, hospitals, other providers, that they will treat their patients using certain guidelines in return for a steady stream of patients. kind of like i mentioned before, you get health insurance, they give you a list of approved doctors/hospitals (those in the contract) and you can go to only those doctors (unless its an emergency then the nearest hospital, and they waive the doctor restrictions). as to whats it got to do with not having health insurance, not terribly sure...


I've seen random documetaries in the past where people take on minimum age jobs when living in New York for example, and they don't have health insurance. When they fall ill everything falls apart for them and they basically don't have enough to feed themselves and so on
without health insurance one takes a HUGE risk of that, and health care is very expensive. Currently their are 47 million americans without health insurance (although as some will point out, this includes illegal immigrants, young people who dont want to pay for insurance, feeling as though they dont need it yet, and those transferring between jobs that only dont have health insurance for a few months. also includes some who qualify for Medicare/Medicaid but havent signed up) however, even when taking all those into consideration, there is still a large amount of uninsured americans that risk losing everything if they get sick, hence the effort to reform health care.


What I was wondering though, is whether or not you can be turned down in America for health insurance? Michael Moore seemed to think that you can, if you are in poor health, and that even when you have the insurance they scrutinize every last penny you get out of them - even refusing to pay for a procedure if they dig up some dirt on you. I was wondering if an American can confirm or deny this?

yes you can be turned down for health insurance, mainly based upon preexisting conditions (i.e. heart problems, extreme obesity etc etc). if the insurance company thinks that they wont make money on you they can deny coverage. Although this doesnt happen too often, and most have a policy kinda like 'if you have a preexisting condition you cannot file a claim for anything due to this preexisting condition for 15 years' or something to that effect. Do they scrutinize costs? yes, they are after all trying to make as much money as possible. although most people that are denied payment from the insurance company is if you had a preexisting condition that you did not tell the insurance company about when you applied for insurance.

just a side note, if you dont have coverage and need a medical procedure done (something serious) there are public hospitals that take in everyone, perform the procedure, and then bill you based on your income level. however this provides a large financial strain on the government seeing as they reimburse these hospitals for the costs.

oh and A.J. just a question, is there no way to get a second opinion about the seriousness or urgency of a medical condition in the UK? for example your mom, you had to go do it privately because there was no way for you to get the operation done beforehand publicly?
do many people die while they are on waiting lists because there medical conditions are deemed 'low priority'?

(longest post ever???)

My conclusion is that in the UK, patients are treated a bit like cattle, whereas here they are required to think a little for themselves.
I agree with most of, if not all of what you said but this this statement really sums it up. Which brings me on to what Mal said....
Doctors have an alloted time to see each patient, 10 minutes, and it can seem like they don't care. Sometimes a vague illness or problem can be quickly diagnosed and the patient can feel that the doctor didn't care. I don't think this is always the case, afterall doctors are people, it's just how the system is.
I think this happens more often than we think. My mum was misdiagnosed because the GP menioned the wrong organs which had dropped and then told her to perform certain exercses based on the problem she thought she had. But scrap that, these so called exercses wouldn't have worked in any case so what was the doctor thinking??

I really hate the 10 minutes thing as well. In our surgery there's a digitale sign screen thing which says "Please remember your appointment is for 10 minutes only. Please be considerate to the next patient." I think its kinda mean and yeah, it does make the doctor seem careless. But at the same time, if we know the appointment's only for 10 minutes why do we need to waste at least an hour just waiting?? I turned up 5 minutes late (first time ever) cos there was no parking available and had to wait a further 5 minutes to see the doc.
I know that 10 minutes seems quick if you have a big problem, but 10 minutes is just a guideline. I've never been so ill that a doctor can't treat me in that time, else i would have gone to the hospital instead.
I get where you're coming from and I agree to some extent. Sometimes you just need to talk to a doctor, inform them of what's going on n your life and its not alays good to rush this. I recently had to tell my doctor about an important thing and just about had enough time to say what I wanted! To be fair, this GP is the best in our surgery and he is always booked out for about a month in advance and he is constantly squishing people in cos he genuinely does care :/
[HMO bit goes here]
Actually, that does make a lot more sense now. I think I may need to watch John Q again now that I understand the term and the American system a bit better now :smile:

yes you can be turned down for health insurance, mainly based upon preexisting conditions (i.e. heart problems, extreme obesity etc etc). if the insurance company thinks that they wont make money on you they can deny coverage.
I know obesity can be 'self inflicted' if you like, but heart conditions, genetic disorders, dodgy chromosomes and disabilities; do these uncontrollable things also mean you could be turned down?
oh and A.J. just a question, is there no way to get a second opinion about the seriousness or urgency of a medical condition in the UK? for example your mom, you had to go do it privately because there was no way for you to get the operation done beforehand publicly?
do many people die while they are on waiting lists because there medical conditions are deemed 'low priority'?
I think because my mum was misdiagnosed they underestimated how bad her condition was so they really tried to say it was "normal". To our GPs a second opinion is "oh sure, we'll just get a nurse a GP from the down the hall to pop in and take a look at you" which is pathetic because they're all working on getting everyone back out the door within 10 minutes as Mal said. I doubt my mum could have died if she waited 3-4 months but it would have made her condition a lot worse. The operation itself was life threatening. My mum would have probbaly only jumped the queue and had an op sooner on the NHS if her condition was life threatening. For example, someone with appendicitis is operated on sooner because once the appendix bursts you're pretty much dead. I think its all done by priority and its not right that older people in severe pain are bumped further down the list. I think if anyone saw their mother going through the pain my mum went through they'd opt for private care too. 4 months later and she's fully recovered :)
(longest post ever???)Not quite - should see the debate threads ;)

Now, I know your original post was asking about the health care systems in Europe...but I'll give you what I understand of Canadian healthcare too. Every province has its own individual system, but I think that they are all more or less the same. I'm from BC.

Every person in BC is assigned a CareCard which can be used anywhere in Canada to register someone into a hospital, should they be on holidays or whatever when they need medical attention. This card contains your personal healthcare number, date of birth, full name, family doctor, and all of those essentials. It can also serve as a piece of ID (although not photo).

The system is not entirely free, but based on things like income and number of dependents under the age of 18. Because I am below the poverty line, my little boy and I receive free health care. I think my parents, when all four of us kids were under 18, were paying something like $150 a month or so. This covers absolutely everything except for prescriptions (and you can buy into a program or insurance for that as well), ambulance, seniors homes, dental, and optometry. The latter two may be covered through someone's company insurance though.

So included in your medical would be everything from family doctor's visits, surgery, x-rays, any hospital care, some cosmetic surgeries (tummy tucks and breast reduction are ones I know off hand), mammograms, lab work, public health services/children's immunizations, specialists.....to name things that I can think of at this moment.

What seems to be definitely in common with UK is that you go to your family doctor first, and if needed you will be referred to a specialist. And specialists take FOREVER to get in to see...you'll be waiting for months unless it is an emergency. In most cases, I think, obstetrics and prenatal care are done by your family doctor unless there are complications requiring an ob/gyn. Also, for the most part a doctor visit is only slotted for about 10 minutes...although you can request a longer appointment if you have more questions.

But all in all, I really like the healthcare system we have in BC...I'm about to find out how the Alberta system works because I will be living there by the end of this month!

I like having low taxes. I like having a lot of my tax money go to our national defense. NHC scares the crap out of me. *excuse my language.*

Alright, well after reading many things here is my proposed health care reform:
The goals of the reform are to bring down costs, and insure everyone. This should do it, and i think both political sides will like it:

First, allow insurance companies to compete across state lines. This will increase competition decreasing costs.

Second, Allow people to choose the type of coverage one wants, with some plans being more covering, others less, kind of like car insurance, with corresponding premiums.

Allow the health insurance to be transferrable between jobs, and allow individuals to pay at the same rate that companies pay, not the ridiculous amount they get charged now.

As for pre-existing conditions, make it so health insurance companies can not reject anyone, although the person cannot receive any money on a claim of that pre-existing condition until 10 years of premium paying has passed (this makes it so the insurance companies can balance out the price of your medical bills with the premiums, otherwise the companies will raise premiums for everyone to cover the huge loss from this small group of people).

Pay doctors based upon results and not per procedure as it is currently. This will get rid of some of the unnecessary and highly expensive procedures that doctors perform, lowering cost.

and to make this work a necessary (although unpopular) rule would be to mandate that all individuals have health insurance. Just saying it isnt going to get anyone to do it, so either a benefit or a penalty must be assessed to add incentive. (i.e. a $2000 tax break for those with health insurance, or a $2000 fine for those without insurance. I prefer the incentive option, and think it would be widely accepted). This is necessary to prevent adverse selection. or basically the healthy young people opting out of insurance, meaning the sicker people are the only ones with insurance raising premiums, so more healthy people opt out because of higher premiums, and more sick people means higher premiums... spiraling out of control like it is right now. healthy people having insurance is vital to a health insurance companies ability to keep premiums low.

My reform has no 'government takeover' letting insurance industries continue, so no raised taxes, and it lowers costs while keeping the quality care the same. Also now everyone will be covered. I personally would love to see it happen as stated.

What are everyones (doesnt matter your country of residence/birth) thoughts on this reform? any ways you think i could improve it? anything you dont like?

Very nice discussion here! I really like the explanations of things. Let me just add a bit from my own perspective.

To qualify for Medicaid (free healthcare) you literally must be very, very, very poor. Only certain doctors and dentists take Medicaid because it is frustrating to work with and frustrating to work with many people on it.

Our foster children qualify for Medicaid, and I must say it is great! I only have to pay for over-the-counter medicine for them.

At the end of August, because I switched jobs, my husband will no longer be covered under my health insurance. We were paying about $500 a month for his coverage, plus $65 for each prescription, plus $45 for each doctor's visit (and my visits too). And don't forget the $2000 deductible that you have to pay before coverage kicks in (that is $2000 each, or $4000 together, plus the 500 each month). I could elect to have him covered by my new insurance, but it would cost about $800 per month, which is very prohibitive (that would be about 30% of my income each month).

My daugther is on her own insurance because no one would insure her after she was born. Her insurance costs $155 a month plus $40 co-pays at the doctor's office, and percentage pays for prescriptions (20% I think).

Neither my husband nor daughter have dental or vision coverage. We have to pay that ourselves.

I would love to see a healthcare system with tiers of coverage.

For instance, Very poor would get free like now
Medium poor- would get low cost doctor care and free prescriptions
Working class- would get low cost doctor care and low cost prescriptions
Middle Class- Low doctor co-pays and percentage of prescriptions
Upper Middle Class- Co-pays and percentage of prescriptions
Anyone above that-- buy your own private insurance because you can afford to and will do it anyway!

So included in your medical would be everything from family doctor's visits, surgery, x-rays, any hospital care, some cosmetic surgeries (tummy tucks and breast reduction are ones I know off hand), mammograms, lab work, public health services/children's immunizations, specialists.....to name things that I can think of at this moment.
Just out of interest, is botox covered in the bold bit too? And no, I'm not asking 'cause I'm planning on having it done lol. I ask because someone I know from Canada seems to have her face 'ironed' out when I see her but it often starts sagging (lol) again. Said person imo, is scamming around in the UK in order to get free healthcare *sigh* They often come to the UK and tell the free doctors here about thier problems, claim pension money (they used to work in the UK once upon a time - prolly for all of five minutes :rolleyes:) and thus get prescriptions for free. I'm now thinking this might be a common thing for people in Canada (and/or elsewhere) with links to the UK. If that is the case (which it is for the people I sadly know) then they're just greedy bastards who are stealing the time and effort of doctors who could be seeing much more needy patients with real health problems!

In most cases, I think, obstetrics and prenatal care are done by your family doctor unless there are complications requiring an ob/gyn. Also, for the most part a doctor visit is only slotted for about 10 minutes...although you can request a longer appointment if you have more questions. The other bit I didn't quote is all true but prenatal care is never something you have to wait for. There are some things over here which don't require waiting lists because they're serious matters.

Pay doctors based upon results and not per procedure as it is currently. This will get rid of some of the unnecessary and highly expensive procedures that doctors perform, lowering cost.Problems: Doctor's pay will decrease, patients will complain that tests aren't being done because it's not worth any money to docs, thus claims could be made that docs don't care (and could be sued if a problem is missed). I can't remember ever seeing it in ER or House but in Holby they're constantly going on about tests costing a lot and keeping it to a minimum. There are always cost issues. Maybe that's why the NHS can fail at times and maybe that's why healthcare in the States isn't so bad afterall :/

and to make this work a necessary (although unpopular) rule would be to mandate that all individuals have health insurance. Just saying it isnt going to get anyone to do it, so either a benefit or a penalty must be assessed to add incentive. (i.e. a $2000 tax break for those with health insurance, or a $2000 fine for those without insurance. Dude, poor people :|

To qualify for Medicaid (free healthcare) you literally must be very, very, very poor. Only certain doctors and dentists take Medicaid because it is frustrating to work with and frustrating to work with many people on it. Well that's sad. People can't help it if they're poor.

At the end of August, because I switched jobs, my husband will no longer be covered under my health insurance. We were paying about $500 a month for his coverage, plus $65 for each prescription, plus $45 for each doctor's visit (and my visits too). And don't forget the $2000 deductible that you have to pay before coverage kicks in (that is $2000 each, or $4000 together, plus the 500 each month). I could elect to have him covered by my new insurance, but it would cost about $800 per month, which is very prohibitive (that would be about 30% of my income each month).
I'm pretty sure my jaw just hit the ground! Here's what I would pay to see a doc, go to hospital and have an operation in the local hospital: nothing. Here's what I'd pay for my antibiotics to clear up an infection (if I had one): £7.37 (ish)

I'm so sure you guys are being ripped off and I don't know how you have enough to survive after paying for all that, bills, food and clothes. Kudos to you though 'cause you make it work!

My daugther is on her own insurance because no one would insure her after she was born. Her insurance costs $155 a month plus $40 co-pays at the doctor's office, and percentage pays for prescriptions (20% I think).
Kids under 16 and OAPs, diabetics, pregnant woman and a few other groups get free prescriptions over here.

Neither my husband nor daughter have dental or vision coverage. We have to pay that ourselves.Here dental was NHS and everyone was free but in April 2006 things changed and most dentists went into the private sector because the pay was better. Our dentist started working privately but never charges us unless we let our teeth get into a bad state. He calls this a fine and makes us pay. If our teeth are perfect, he doesn't make us pay. God bless him! Eyecare is free for the people above and is provided by the NHS to some extent. After that you're a poor bugger who has to pay poop loads for eye tests, check ups and frames. Oh how I miss being under 16 lol.

For instance, Very poor would get free like now
Medium poor- would get low cost doctor care and free prescriptions
Working class- would get low cost doctor care and low cost prescriptions
Middle Class- Low doctor co-pays and percentage of prescriptions
Upper Middle Class- Co-pays and percentage of prescriptions
Anyone above that-- buy your own private insurance because you can afford to and will do it anyway!That sounds like a good plan. I still don't understand how you guys pay taxes yet it doesn't cover everyone's healthcare. We all pay taxes and it covers the NHS which is something everyone uses.

LOL AJ, I have no idea if botox is covered! I know that tummy tucks are because a saggy tummy is something that can't be helped when someone has a baby, and is a side effect of pregnancy (still kind of an odd reason to shell out the big bucks!), and breast reduction is because of obvious reasons: back pain, etc.

One thing that I thought was ridiculous....the Alberta health care system (lived there for 8 months last year but didn't switch over my medical plan) was making some cuts in the spring time, and I heard on the radio that two things they were cutting out of their coverage were sex change operations (!) and chiropractics......!!!! There were many an outraged citizen on that one...it would make far more sense to me to keep the chiropractics in there, as that's something that some people can barely move without! Haha just kind of a funny story....silly Alberta.

It sounds like a fairly good set-up in the UK...a little more stuff is covered than in Canada. Well, maybe not too much since the dental stuff has changed. We don't get dental, and optical (just exams) is covered until a patient is 18 years old, after which case they pay $75 for an exam. Come to think of it.....I wonder if I would be able to get laser eye surgery under medical. I seem to remember hearing that one time.
/me ponders the eye surgery for a few minutes........

I find that so many systems are catered to the mid-high income people and not to low income. I'm really happy that I live in Canada because otherwise I don't know how I would make do (having next to nothing as a student). Thankfully I'm also covered under my university for extra stuff, which includes dental and optical I believe. But yeah...most people under the age of 73 (arbitrary number, absolutely no reason for it) aren't going to the doctor to waste time. They have only a set amount of time to waste waiting in the office, and will only go there if the situation is dire. I know I never bug my doctor if it isn't absolutely necessary, but that's just me.

But what I do know, is if I had to pay for my medical coverage at this point, it would completely break me (as with a young child, you're making more frequent doctor visits)...and I would only be contributing to the awful recession by going on assistance, not being able to pay my rent, being evicted, and such. So I'm not sure if I agree with all of Jmac's propositions.

Oh, and AJ, what does NHS stand for (I know what you're referring to but I don't want to use it if I don't know what it means :razz:)?

NHS = National Health Service.

After hearing eye exams cost $75 over there I won't complain (much :smile:) about the £20 I have to fork out every time I go. I would pay less because I'm a student but for some reason with the NHS and the opticians you MUST be at a brick uni. i.e one that you attend on a daily basis whereas I study from home so they don't count it as the same thing!

Even replacing lenses for updated prescrptions costs a fair bit: £39 and it adds up when you have more than one pair and if your eyesight changes a lot more often! Which mine does. And if that's the case, you reach a point where the lens get really thick so they have to talk to you about getting the lens thinned down from £30 - £140. One word: Pfft. I'm proud to be completely short sighted, its proof of all the reading I do lol

As for laser surgery, I considered it until I watched that programme, How it's made. I saw them cut the thin layer of the eye, split it open, do some strange stuff and stick back together again. No thanks :eek: you're welcome casta :p

/me walks around with empty jam jars held up against her face.