Does free health care work in those countries that have it

[deb1]

okay, i probably named this thread badly. i was curious how most of the population in those countries that have free health care feel about their care.

I’ve always been afraid that if we adopted free health care in America that the government would somehow mess it up. that might be cynical of me, but part of my thinking comes from being married to a military man and dealing with a free health care system.

for the most part, the military health care system is not bad. i think that the doctors and nurses themselves are very good. but there does seem to be unnecessary red tape and rules.

an example would be several years back, i came down with a sudden infection because my wisdom teeth came in. i was in a lot of pain and was running a fever. the Dr put me on meds and sent me to an off base doctor. the military was willing to pay for my operation to have my wisdom teeth removed but wouldn’t pay for the anesthesia. i had to pay for that myself before the doctor would remove my wisdom teeth. its not like i could shop around for a different Dr. i had to go where the military sent me.

so, i am curious, how does free health care work in countries like England and Canada? are you satisfied with the care you recieve?does the government try to cut cost with your care? do both rich and poor get the same medical care?

 

[Texas_Roofer]

The Canadians I know would say it depends on what service you need, and how often you need it. Minor medical performed by a typical doctor in non rush manner seems to work well. A medical rush for a specialized service is extremely dangerous to the point often people cross the border to buy the service in the US.

In general most government run organizations perform poorly compared to private sector equivalents. This is systematic not coincidental, and thus the problem. There are many reasons which I will avoid for now. Second I do not think the Military doctors are typical of government employees because they are young people fresh out of school working under a military budget. Compare that to say the VA system.

What I would like you to consider is reverting back to the system used through out 90% of human history which was open market systems. Hire a MD if you would like, buy medicine if you would like. In the absence of insurance and heavy regulation the system was very simple and worked well. The system we use today was designed to eliminate drug abuse, not working well is it. The regulation did make rich people out of those inside the regulations, and thus became deeper each year. Did you know the AMA once was active in attempting to limit the growth of medical doctor programs? They wanted a shortage so prices would stay higher. I am sure you know a shortage means some have to go with out medical care because of that shortage. Most current estimates indicate 66% of the money used in the medical profession is wasted, yes wasted. The best looking estimated are 50%, some estimates are much higher. Most every doctor performs 1000’s of tests each year as simple CYA, to reduce lawsuits. In a free market this 50-75% CYA would leave overnight.

Overall I hope we deregulate medicine. Going to a government operated system will not be a good option for the USA.

 

[Kaninchen]

There’s no such thing as “free health care”, it’s “free/cheap at the point of delivery” health care based on one form or another of uniform charge compulsory social health insurance (with no/low cost for the poor/old/young).

My experience of several countries is that everybody moans about their health care system - health care has a kind of “infinite demand” built into it, countries could spend twice their GDP on health care and still people would want more (there’s always some new expensive technology or drug coming on line) - but I’ve never heard of a European politician saying something like “What we need is a health care provision system like that of the US.”

 

[Proletarian]

so, i am curious, how does free health care work in countries like England and Canada? are you satisfied with the care you recieve?does the government try to cut cost with your care? do both rich and poor get the same medical care?

No difference to speak of here in Australia. Most private “hospitals” consist of a separate wing of a public hospital. The doctor and nurse to patient ratio is the same and waiting lists for essential surgeries do not give preference to private patients.

But if your looking for better food (as good as food can be in any hospital) or your own room, then private cover is the way to go.

 

[Smber2c]

I had a roomate for a semester of college from England. He seemed to be a bit intimidated by some of the fees that people bear here (or that their insurance does), but he did say that getting an appointment over there can really be rediculous. He made is sound like by the time he was able to see a docter he’s either already be healthy or wold have to be dug back up.

Though, I’d think the wait isn’t really a joke here either. (I’m not sure what doctor waits are like, my dad is one, so I kinda get same day service from dad or any of his friends whenever I need it )

 

[paradoxy]

Like other state institutions here in Serbia, the health system is corrupt and slow, but still the basic idea is good.

I wouldn’t change it.

 

[melensdad]

i was curious how most of the population in those countries that have free health care feel about their care.

First off if it far from free. It is very expensive, but paid for in higher taxes. Most nations that have “free” health care have tax rates that are much higher than our tax rates here in the US. If your taxes go up from 25% of your income to 35% of your income is your insurance really free?

Secondly, I have a Canadian friend. Both he and I suffer from Kidney Stones. He and I both needed “lithotrypcy” (sp?) to removed large stones. I went into the hospital and within 2 days had the procedure and was back to work the day after my release. My total days off work were 4 days. He went to the hospital 6 weeks later he had the same procedure. He missed several weeks worth of work (and lost wages that “cost” him money). My costs were my monthly insurance premiums + my insurance deductible. His costs were a month and a half of pain, several weeks of lost income, and taxes that are higher than mine.

Sure sounds like a bad trade off to me.

Put it a little differently.

• USA = A dual income family with a $75,000 income will pay roughly 25% in income taxes in the US. That is about $20,000 per year in taxes. They will pay another $8500 for insurance assuming neither of their employers has any insurance support. Total cost = $28,500
• CANADA = A dual income family with an $85,000 income (remember the Canadian dollar is worth less than the US dollar so the Canadian must earn more for parity) may pay closer to a 40% tax rate or about C$34,000 in taxes. The net costs then adjusted are very similar. But the net health care in the US is better.
  Is the choice for “free health care” worth it?

but I’ve never heard of a European politician saying something like “What we need is a health care provision system like that of the US.”

Clearly not, that would mean they would have to LOWER the taxes and give their citizens a choice. Politicians of every country crave power, work to attain more. Turning a publicly funded system back into a private system would be an admission of failure, would require the dismantling of a huge government bureaucracy and the termination of tens of thousands of workers nationally, as well as changing the mind-set of millions of citizens who have become dependent upon the public program. They would have to be “re-educated” to budget for private insurance premiums, and the tax reductions would have to at least equal the insurance premiums and co-payments that the citizens would be paying. Certainly the government would be able to save more than that, but it is unlikely that they would pass on the savings!

 

[Pondero]

I think our Health system works very well, it did for me anyway. I was in need of a triple coronary by-pass operation and from the moment the diagnosis was made it took a week for me to be in the hospital ( Sunnybrook, Toronto) and have the operation. I was out in about a week. Now, I am undergoing rehab therapy which consists mainly of exercises done under supervision for about an hour,twice a week. This cost me nothing at all, all paid for out of tax revenue by the Province of Ontario. I did not need any special private insurance either.

I was given Caduet 5/20mg ( Amiodipine/Avorvastin 5/20mg) recently. It is the one advertised on CNN. As a resident of Ontario, over 65 years old, I paid $4.11 for these prescribed drugs ( 90 of them, on June 11th) The cost was $311.93. The Province must pay the rest of the cost to the pharmaceutical company.

Our Provincial sales tax is 8% and the GST ( Federal) is 6%, making the sales tax 14% on many products you buy. On our it income tax scale means I pay somewhere between 30 and 40% of my total income to the feds. With equalization payments between feds and the provinces and other schemes the fed. tax is given back in part to the Province. A % of the tax is collected by the Province at the time. That is how we finance our health care system.

Having rarely used the health service ( I hardly ever visited a doctor in Canada) over my working lifetime at all, I am now in need of it, and I am grateful to Canada for providing it to me at little or no cost.

 

[Kaninchen]

Clearly not, that would mean they would have to LOWER the taxes and give their citizens a choice . . .

No, it’s that they’d not stand a cat’s chance in hell of being elected.

There’s no point at all in us arguing the merits of the ‘American model’ as against the ‘European model’ - neither product would sell in the other market.

 

[deb1]

No, it’s that they’d not stand a cat’s chance in hell of being elected.

There’s no point at all in us arguing the merits of the ‘American model’ as against the ‘European model’ - neither product would sell in the other market.

i did not start this thread with the intent of bashing other health care systems. i did want to know how goverment provided health care systems work in other countries.

in all honesty, i can see that the american system doesn’t work for the very poor but i really don’t know what a good answer to the problem would be. there seem to be problems with the european model of health care also. but neither system can improve if we don’t ask questions of one another.

that is why i asked.

my questions wer not meant to inflame. there are residents of the uk and canada on this board so i thought that i could get a nonamerican view of their health care system

by the way, everyone, i know that goverment provided health care systems are not actually free and that they are provided for with high taxes. i worded that wrong, because i have heard it called free health care.

 

[Pondero]

I have one correction to make to my previous post. The rates of tax were quoted in that post, but when I looked at my tax return, and I did so a few minutes ago, and divided the tax payable by the taxable income for 2006, the result as a percentage was close to 19%.

 

[Kaninchen]

i did not start this thread with the intent of bashing other health care systems. i did want to know how goverment provided health care systems work in other countries.

I didn’t think you did

in all honesty, i can see that the american system doesn’t work for the very poor but i really don’t know what a good answer to the problem would be. there seem to be problems with the european model of health care also. but neither system can improve if we don’t ask questions of one another.

The thing is that you can’t really divorce the meta-politics from the system. The European models actually originated in Imperial Germany before the First World War, where they were a means of avoiding trouble with the emergent working class and were developed via both Social and Christian Democrat governments in the various Western European countries after the Second World war.

They’ve become part of the ‘paradigm’ and both sides of the political divide pledge at elections that they will make them work better and deal with whatever people are currently moaning about but not even somebody as right wing as Margaret Thatcher considered fundamental change (like abandoning the model itself).

At the core of all health systems is the question of ‘rationing’ (since demand approaches infinity), you either do that by price, excluding various groups (like the uninsured or the obese) from certain treatments, or by things like queues and endless tinkering with management systems.

Europeans can, of course, buy themselves out of queues etc by paying for private insurance to cover such eventualities (while using the system to deal with everyday medical issues).

Personally, I don’t think that there’s any ‘right answer/right system’ for health and there are advantages and disadvantages to both the Private and Public models - both of which are prey to vested interest groups - patients, health workers, drug companies, insurance companies, bureaucracies . . . .

 

[mary_bobo]

okay, i probably named this thread badly. i was curious how most of the population in those countries that have free health care feel about their care.

I’ve always been afraid that if we adopted free health care in America that the government would somehow mess it up. that might be cynical of me, but part of my thinking comes from being married to a military man and dealing with a free health care system.

for the most part, the military health care system is not bad. i think that the doctors and nurses themselves are very good. but there does seem to be unnecessary red tape and rules.

an example would be several years back, i came down with a sudden infection because my wisdom teeth came in. i was in a lot of pain and was running a fever. the Dr put me on meds and sent me to an off base doctor. the military was willing to pay for my operation to have my wisdom teeth removed but wouldn’t pay for the anesthesia. i had to pay for that myself before the doctor would remove my wisdom teeth. its not like i could shop around for a different Dr. i had to go where the military sent me.

so, i am curious, how does free health care work in countries like England and Canada? are you satisfied with the care you recieve?does the government try to cut cost with your care? do both rich and poor get the same medical care?

Deb, I can only tell you of my experience while living in Canada. I developed a very serious infection that was not attended to for far too long and I almost died. The problem started with my first visit to the doctor and went down hill from there. I enjoyed my time in Canada and I made many good friends there. But I cannot recommend their health care system.

As for military hospitals, thinking mostly of VA hospitals, I think changes should be made. I think the VA’s should be closed down and the same services made available on a local level. Most of those hospitals are out-dated and not run as efficiently as others out in the community. And you know what happens when delivery of any service is caught up in government red tape.

It was my observation while in Canada that people get pretty much the same kind of care regardless of their economic status. My husband was transferred there as president of his company’s Canadian operations, thus we were under the Canadian health care system there. We have good insurance and I think it was wrong for the Canadian government to pay for my hospitalization and surgery. I was not a citizen.

One other thing I might mention, no health care is free regardless of what residents of those countries would have you believe. Taxes are higher and such things as primary residence deduction on your income tax form is not there. No deduction for same.

Finally, I think our system here needs reform. With the talent in this country, I am sure we can come up with a better delivery system for those who did it. I think it can best be accomplished outside of the government.

 

[Brendan]

The Canadians I know would say it depends on what service you need, and how often you need it. Minor medical performed by a typical doctor in non rush manner seems to work well. A medical rush for a specialized service is extremely dangerous to the point often people cross the border to buy the service in the US…

I see that here in Detroit (a border town). There are a lot of Canadians who come here to either get treatment that has a long waiting list in Canada, such as MRI scans, or to see specialists.

One interesting thing. My wife is Canadian, from Windsor, right across the border.

The Ontario Health System puts an annual cap on how much a physician can bill the system. If he sees a lot of patients in the first half of the year, and reaches his max, any other patients he sees, he cannot bill for.

So a few of her doctors from Windsor have offices in the the US as well. They see their max patient load in the Windsor office, and see more patients in the US, where they can actually bill for their work.

It’s one of the ways that the Canadian government ‘rations’ healthcare, they limit the number of patients a doctor can see each year.

 

[apricot_yogurt]

Across the UK, the picture varies depending on where you live. Here in Wales I can usually see a doctor the same day, and they are particularly good at fitting children in quickly. Because I am pregnant, I get free dental care, free prescriptions, free eye tests for the duration of my pregnancy, and for 1 year after the baby is born - this is for all pregnant women regardless of income. The Welsh Assembly government has just recently abolished prescription charges for under-30s-children and pensioners are already exempt. I don’t know what the situation is in England, as they run things differently, but overall it is pretty good. There can be a lot of waiting around, but most of the time things are good.
Some companies offer private health insurance so you can either go to a private clinic/hospital or get money back for a hospital stay.
Income tax is 22% at the basic rate, or 40% at the higher rate-if you come into this tax band you should be able to afford it.

 

[jman507]

At the core of all health systems is the question of ‘rationing’ (since demand approaches infinity), you either do that by price, excluding various groups (like the uninsured or the obese) from certain treatments, or by things like queues and endless tinkering with management systems.

You pretty summed up much the whole thing with health care for any system. The system has to decide how best to decide to split access/choice, availibilty, and care with how much the payers are willing to pay. Supply is a scarce resource, and someone is going to have to say no at some point in time, be it patient, medical system, or third party. There are advantages and disadvantages with whichever path.

One thing is if you don’t like the coverage of your current system, it might not be any better in a different set up. If there is more demand than is willing to be supplied, the problem probably isn’t the system, unless it’s set up really really poorly, and the costs are going to the administration. Plus it might end up in a worse situation, because then you also have to sink money into the transistion.

 

[Pondero]

I didn’t know that Ontario doctors are limited in the number of patients they can see. But, if so then it definitely is a great idea. It means that adequate attention will be given to each patient, instead of cramming them all in for the sake of money.

MRI’s are becoming more common nowadays and I would think less people would be shipped by the gov’t across the border for one.
Not having had any health care in the USA I can’t really say how it compares with ours, the only thing I know is that it is expensive. As a ‘snow-bird’ who crosses over to spend a few weeks in Florida I know the cost of private health insurance is prohibitive for Canadians. Relatives who have had health problems in the USA while visiting tell me cost of the service they received is outrageous, fortunately most of it was covered by the insurance they took out.

My guess is that the quality of health service is about the same across the continent.

As I said earlier I am happy with the quality of health service I receive in Canada. I can drop in to see a doctor at any time and get all kinds of tests done should I wish to do so. But, I do try to stay away from doctors

 

[Malcolm_McLean]

so, i am curious, how does free health care work in countries like England and Canada? are you satisfied with the care you recieve?does the government try to cut cost with your care? do both rich and poor get the same medical care?

In Britian the NHS works very well. You don’t have to worry about the financial aspect of healthcare. If something goes wrong, it is their job to patch you up.
Having said that, with an aging population taxes have had to be raised very high to pay for the system. If we ever get into economic trouble then soem hard choices will have to be made. There are also endless complaints about inefficiency. They matter and they don’t matter. The absolute amount of wealth we have in Britain is not a problem. On the other hand, we have an obligation to manage our resources effectively, and when staff are being laid off because hospitals have run out of money towards the end of the year, at a time of increasing budgets, something is obviously very badly wrong.

 

[DiggidyDog]

so, i am curious, how does free health care work in countries like England and Canada? are you satisfied with the care you recieve?does the government try to cut cost with your care? do both rich and poor get the same medical care?

Having been in and out of hospitals here in Canada (with my wife) for the last 13 years, I can comment on our personal experience with the Canadian health care system.

The care itself has been very good, especially for emergency situations. The diagnosis was slow in some cases, but once the course of action was determined, the care was prompt.

I have noticed that over the last 5 years, with health care costs ever increasing, the cost cutting has resulted in higher wait times for tests (for non-emergency tests), longer wait times at emergency (if the triage nurse deems you to not be an emergency), and a degradation in cleanliness.

In summary, the system works but it’s not perfect by any means. My sense is that the degradations will lead to some sort private care being implemented in parallel with the public system in the future.

 

[Brendan]

I didn’t know that Ontario doctors are limited in the number of patients they can see. But, if so then it definitely is a great idea. It means that adequate attention will be given to each patient, instead of cramming them all in for the sake of money.

As I mentioned, quite a few doctors, especially specialists, do half their work in the States.

MRI’s are becoming more common nowadays and I would think less people would be shipped by the gov’t across the border for one.

Actually OHIP isn’t ‘shipping them across the border’, they come over here on their own and pay cash.

In Windsor, the only MRI system is actually in a Vet’s clinic. Needless to say, OHIP prohibits him from using it on humans. So if your dog needs an MRI, no prob. If YOU need an MRI, it’s get in line and then drive to London, or cross over to Detroit and pay cash.

As a ‘snow-bird’ who crosses over to spend a few weeks in Florida I know the cost of private health insurance is prohibitive for Canadians.

I’ve noticed how hypocritcal that seems. Canada says that it is a right of Canadians to have health care, but won’t cover a Canadian if they get sick on vacation. Why can’t they just go to a hosptial where they are at and have the hospital bill OHIP?

My health insurance covers me anywhere in the world.

My guess is that the quality of health service is about the same across the continent.

US Health care tended to be more thourough in it’s in work. More tests, more equiment, more use of specialists.

That means that it’s more expensive, but, on the other hand, the US is also the world’s leader in medical care. The world’s most difficult cases are generally flown to the US for their operations.

As I said earlier I am happy with the quality of health service I receive in Canada. I can drop in to see a doctor at any time and get all kinds of tests done should I wish to do so. But, I do try to stay away from doctors

My Canadian wife would not even consider going back to Canadian Health Care.