Does free health care work in those countries that have it

[jmcrae]

One of my many fears about “universal health care” is that it may open the door for euthenasia. Is that an issue in all the countries out there who have universal health care?

No. Because of the fact that we already don’t put a monetary value on life, there is very little chance that anyone would stand for euthanasia as a cost-cutting measure. We value human life enough to pay for the good health of complete strangers through our taxes - if complete strangers are worthy of life, and I’m paying for that, then my elderly parents are, too - most people aren’t thinking about costs at all.

I also don’t think that a universal health care system would change peoples minds on going to the doctor for regular checkups (a great preventative method to catch things early which costs less).

The fact that you can go for a check-up any time you want to helps, though - we are not in the dilemma that Deb’s friend is in, of having to somehow come up with $300.00 every time we go to the doctor.

Not to mention, citizen won’t miraculously wake up and decide that they are going to start taking care of themselves and try to live a healthy life (you think, without insurance they’d do that now).

Perhaps not, although the government does sponsor health and fitness programs, as well, - there are constant public announcements about how much exercise people should be getting, and the Canada Food Guide is published for free, telling people what kinds of foods they need to be eating each day, and what is considered a healthy amount of each thing based on age, sex, and height.

 

[apricot_yogurt]

More praise here for our beleagured NHS. Today I stepped on a rusty nail, which went through my foot. Phoned my GP, they said get to A and E. Went to A and E, checked in, had barely sat down when I was called. Saw a Dr straight away. Nurse comes in gives me tetanus and box of anti biotics to take home. Done. Even got a space in the free car park.

 

[Kaninchen]

I’m sure you might say some places are better than others. Same for the US. If your stuck in a rural area, if you need good care you need to get to a good metro area. I suppose it’s a bit better in the states, just because in general there is more money to put in for every place per same area.

When I lived in the US it used to amaze me just how little people knew of the world outside. When we said that, while we loved living in America, we had every intention of returning to Europe people seemed genuinely shocked, some even seemed to see it as a kind of insult.

One thing I did learn was to be terribly careful about saying anything critical of the US and the ‘American Way’ - just like when we’ve lived in any other country which isn’t our ‘own’. On the whole, people tend to like their country and the way things are done - the familiar - and are suspicious of doing things another way and it should not be forgotten that, in their various ways, all the societies represented on this thread are modern, sophisticated and remarkably successful - including their healthcare. What they are is different.

 

[Texas_Roofer]

Just and FYI the American system is far, far from free market, and thus the concerns here. It started with the private insurance system which worked okay. Then the Government got involved by allow tax write downs for health insurance. Next came “Medicare” which is a form of social or free health care (retirees). Then came SSI which is a form of social or free health care (poor & disabled). First the Doctors fee went wild, then the hospitals, and now the drug companies. Now the government is involved in medical cost cutting and it is a disaster. Thus a big need for a system overhaul.

Here is the current plan: Government requires provides accept 50% as payment in full, the providers triple the prices before billing. How is that for system?

In the MBA classes we had a hospital VP and did case studies on his hospital. Now as a roofer, the roofing contractors being a nearly perfect free market, the hospital accounting was a ridiculous method of accounting. His hospital was not different than other hospitals. We had to provide references and documents concerning regulations, contract restricts, etc. So we had to justify
_______(Bills – 50%) + (30% write off) + (20% outstanding) = profit
It may work in the medical industry but not in free markets. Roofing is more like
_________Bills -5% non collectable – 5% claims against = 2% loss

 

[cynic]

There’s no such thing as free. Someone is paying-- taxpayers.

.

and so they should

And, as the population has begun to age in Europe and elsewhere the weight of the social programs is causing these systems to collapse as there are not enough young workers paying taxes to support them.

.

it isn’t only the old that get sick.

Those countries with socialized medicine have a standard of care that is quite inferior to the US. Their equipment and procedures are decades outdated. The wait for care is lengthy. The care is minimal and rationed.

.

come to the U.K, Australia or New Zealand and you might get a different impression.
Oh and most of us are paying no more tax than you are, with your private system that lets thousands of your citizens die every year because they can’t afford insurance/treatment.

 

[Viki59]

Oh and most of us are paying no more tax than you are, with your private system that lets thousands of your citizens die every year because they can’t afford insurance/treatment.

Correct. Consider this link:
www.dogflu.ca/03032007/07/child_dies_from_dental_infection

The poorest have medical care, but the working poor can’t afford it. Although I would beg or borrow money if my child was ill, it’s not always easy to know when a child absolutely has to see a doctor. Without insurance, you could become destitute taking your child to a doctor every time he complains.
People wait until they are very sick, then flood the emergency rooms for care, which costs much more than it would have to visit a doctor in the beginning.

The US system desperately needs an overhaul. It will be the big issue in the next election.

 

[mary_bobo]

I’m sure that those of us in poor blighted countries outside the US, living as we do, in every way, decades behind the land of the free and the home of the brave, are only too happy to have our American friends explain to us just how hopeless and squalid are our circumstances.

Translation:

“Why is it that description of any kind of way other than the ‘American Way’ brings out the waving of virility symbols?”

No need to resort to insults. I am sure you can add to the conversation without insulting other posters.

 

[mary_bobo]

if you can’t afford insurance in the U.S. and you get seriousely ill, you die. End of story. Occassionaly sub-standard care from a public system is still better than no care. Those who can afford to still have the choice of going private.

That is a gross exaggeration, IMO. Hospitals are not allowed to turn away seriously ill or injured people. They do get care and most never pay for it. The rest of us do. In many places, as is true where I live, there are free clinics that provide for those who cannot pay. But our ER’s are confronted daily with people who are not emergency cases but who do need to see a doctor. I am sure that we can come up with a better way to care for these people without turning one more thing over to the renowned incompetense of the federal government.

 

[Brendan]

If there were no government hospital, then where would she have gone? The private hospital would certainly not have accepted her…

The Catholic Church runs several hospitals in the LA area ( and in most major cities)

Of course, the California government is trying to regulate those out of existance, as the Catholic Hospitals refuse to provide abortion services.

 

[Brendan]

Judith,

One other thing,

Your post was rather intriguing.

You seemed to immediatly discount the role of private charitable groups in providing health care. If the government could not do it, no one else could.

Why? As a Catholic, one would expect to look towards the Church first for such things. The Church has long been the historical provider of health care, and rightly so. When Christ charged a person to “tend my sheep”, that person was Peter, not Cesear.

 

[deb1]

as i said before my health care if via the military so, i don’t yet have to pay the bill for insurance.

for those who do, what percentage of your salary goes to insurance bills? i ask because i was wondering if perhaps that money combined with the regular taxes we pay out, is higher or lower then what our canadian and uk friends pay.

i believe someone on this thread stated that they paid about 40 percent in canada.

i hope that i asked that clearly enough. if not, i can try to reword the question.

i was wondering if the percentage of taxes americans paid combined with the percentage of their medical insurance was added that it might/might not be higher then the overall taxes that people pay for taxes in uk and canada.

i’m really sorry if that doesn make sense.

 

[jmcrae]

Judith,

One other thing,

Your post was rather intriguing.

You seemed to immediatly discount the role of private charitable groups in providing health care. If the government could not do it, no one else could.

You’d still have to be your brother’s keeper, in that scenario. I don’t see any material difference between charity and government - it’s my money supporting others (and our money being pooled together to support us all), in either case.

That’s why they give you a tax discount when you give money to charity.

 

[gmarie21]

as i said before my health care if via the military so, i don’t yet have to pay the bill for insurance.

for those who do, what percentage of your salary goes to insurance bills? i ask because i was wondering if perhaps that money combined with the regular taxes we pay out, is higher or lower then what our canadian and uk friends pay.

i believe someone on this thread stated that they paid about 40 percent in canada.

i hope that i asked that clearly enough. if not, i can try to reword the question.

i was wondering if the percentage of taxes americans paid combined with the percentage of their medical insurance was added that it might/might not be higher then the overall taxes that people pay for taxes in uk and canada.

i’m really sorry if that doesn make sense.

I can tell you what I pay, but I’m not so quick with the percentages right now. My taxable income per year is $18200. Yes, I do live with my mom and work for her, so I do not have to spend money on rent. Of that taxable income (and being at the low end of the tax scale) at the end of the day, I would say that I only end up paying about 10% of my income in income tax (maybe less, I don’t have my return with me but I do receive a good amount back b/c I claim 1 instead of the 2 I should be claiming for my dd and myself on my W4). I also pay for my own insurance (a PPO plan). My dd is covered under her dad’s insurance (except for dental, which I have her covered under mine). I pay exactly $207.30 per month for the combination of my medical insurance, mine and my dd’s dental insurance, and my life insurance. My co-pay for doctor appointments is $30 and I do see the doctor at least twice per year. I do not have a co-pay with my dental, but I usually end up paying at most 20% of the bill (unless I had a procedure that was above what the insurance will cover - like porcelein instead of metal). I am a worse case scenario person so I would rather be safe than sorry and would also prefer to not deal with the waits and inconsistency that comes with government, low-income insurance (which I qualify for) nor with HMO which has been a nightmare for some of my family members.

Also, if ever I do receive a bill that is too high for me to pay in one payment, I immediately call the office or lab or hospital and set up a payment plan arrangement. I have yet to talk to someone who wasn’t willing to set up a payment plan, interest free. It took over a year to pay off my dd’s delivery and our hospital stays (the 20% I had to pay) but I was on a plan of $50 per month ($25 for her bill, $25 for my bill).

Before my dd was under her dad’s insurance she was under mine while I was on Cobra (OUCH) but having known women with children on the KidKare plan that was part of the Illinois system, I didn’t want to have to search for a doctor in my area to take her in as a patient and I didn’t want to have to deal with waits at a doctor’s office nor at a hospital. It was worth the decision because my dd had issues that needed to be addressed and would have not been addressed as needed had I been on the state provided insurance for children.

I also am fortunate to not have to pay rent, so the little that I do have I am able to afford insurance. I figure that it was better for me to purchase my own insurance and to leave room for those who truly need the state-provided insurance. I also make sacrifices in other luxuries to pay for my insurance, but to me, health comes before beauty.

One thing that I think should be stressed or addressed to college students is to seek individual insurance before going off mom and dad’s plan or the college provided plan. If one can get on individual insurance before one gets something that may make them denied by an insurance company in the future, then they can stick with that provider through jobs and illness and not be dismissed. It is much easier to keep insurance when you get sick than it is to get insurance when you’ve been sick. Not everyone would be able to do this, but I think many who go without now, would have not had the insurance problem had they purchased individual insurance when they were healthy. Then again, I may just be naive.

 

[Brendan]

You’d still have to be your brother’s keeper, in that scenario. I don’t see any material difference between charity and government - it’s my money supporting others (and our money being pooled together to support us all), in either case.

That’s why they give you a tax discount when you give money to charity.

It isn’t the difference between the two that intrigued me, but your belief that a private hosptial would not care for such a person if the County hospital did not.

Why did you come to that conclusion?

 

[jmcrae]

It isn’t the difference between the two that intrigued me, but your belief that a private hosptial would not care for such a person if the County hospital did not.

Why did you come to that conclusion?

Because the private hospital is in business to make money by selling health services. They don’t make any money by giving health services away for free - if they give it away for free, they can’t get paid - someone goes without a paycheque (probably the owner). The government isn’t going to step in and help them out if they start giving services away for free. It’s like any business - they can’t have stock walking out the door without being paid for, without going out of business sooner or later, if that’s their only source of income.

The County hospital exists for the purpose of helping sick people get well. If someone can’t pay, they don’t lose anything, because they are supported by the government. The doctors and their staff will still get their wages, and nobody loses anything, because it’s being supported by a broad base of the community - each gives a little, and the whole is paid for.

 

[Jennifer123]

Because the private hospital is in business to make money by selling health services. They don’t make any money by giving health services away for free - if they give it away for free, they can’t get paid - someone goes without a paycheque (probably the owner). The government isn’t going to step in and help them out if they start giving services away for free. It’s like any business - they can’t have stock walking out the door without being paid for, without going out of business sooner or later, if that’s their only source of income.

The County hospital exists for the purpose of helping sick people get well. If someone can’t pay, they don’t lose anything, because they are supported by the government. The doctors and their staff will still get their wages, and nobody loses anything, because it’s being supported by a broad base of the community - each gives a little, and the whole is paid for.

My aunt’s husband had his expensive cancer treatment at a hospital totally paid for by an anonymous private benefactor.
My mom’s husband’s treatment for the stroke that took his life was 95% paid for by the taxpayers.
We are a generous nation.

 

[Texas_Roofer]

Because the private hospital is in business to make money by selling health services. They don’t make any money by giving health services away for free - if they give it away for free, they can’t get paid - someone goes without a paycheque (probably the owner). The government isn’t going to step in and help them out if they start giving services away for free…

The post contains some error though the issue is a bit complex. In the states the private hospital can generate cash from treating poor uninsured patients. The cash is generated by reducing the tax payments, which is legal if the reduction is due to a financial loss. One of hundreds of problems we currently have is with business taxes near 40% and bulk discounting at 55%, that means the non-pay saves the hospital 40% of his bill while the insured often pay 45% of his bill. So it is a nearly a wash, what a mess

 

[stinkcat_14]

The post contains some error though the issue is a bit complex. In the states the private hospital can generate cash from treating poor uninsured patients. The cash is generated by reducing the tax payments, which is legal if the reduction is due to a financial loss. One of hundreds of problems we currently have is with business taxes near 40% and bulk discounting at 55%, that means the non-pay saves the hospital 40% of his bill while the insured often pay 45% of his bill. So it is a nearly a wash, what a mess

I am not sure this is true, because businesses can only deduct their lost expenses, not the lost revenue that they did not get. For example, suppose a doctor bills the person on the street $100 for an office visit. Suppose the cost of the visit to the doctor (salaries, overhead, etc) is $35. If the insurance company pays $45, the doctor makes $10 profit. If a nonpaying customer shows up, the doctor can deduct the $35 in costs, and would save 40% of that in taxes, which would be $14. So for the uninsured care, it would cost the doctor $21 still. It is possible that the rules could be different for health care, so if I am wrong, I will let one of the accountants correct me.

 

[Texas_Roofer]

I am not sure this is true, because businesses can only deduct their lost expenses, not the lost revenue that they did not get. For example, suppose a doctor bills the person on the street $100 for an office visit. Suppose the cost of the visit to the doctor (salaries, overhead, etc) is $35. If the insurance company pays $45, the doctor makes $10 profit. If a nonpaying customer shows up, the doctor can deduct the $35 in costs, and would save 40% of that in taxes, which would be $14. So for the uninsured care, it would cost the doctor $21 still. It is possible that the rules could be different for health care, so if I am wrong, I will let one of the accountants correct me.

I am guessing you missed the earlier post on the subject of medical accounting verses free market accounting? Your comment is not with out an academic point however it has little real affect. For starters the salaries alone run over 60%, add true expenses (short term items) and overhead (building, etc) and you are at minimum over 85% typically over 90%. In theory that difference should be subtracted. Your example would change to $100-$10= $90 meaning a $36 cash savings to the hospital from tax relief. Compared to a $45 collection from the insured patient.

The real world would blow your mind, the hospitals actually mistakenly bills access to everybody. Every item is inflated to the nines and commonly placed on the wrong bill. Several years ago a government official was quizzed ( I think before congress) concerning a man’s (yes, a man; I believe on Medicare) hysterectomy bill ( yes, removal of female parts) The man was furious even claimed he did not have those parts. Want to guess what happened? Yes the government paid the bill. The official said it simply was not practical to check every bill or any real percentage of bills. So your real world example would be like bill inflated to $250 tax relief up to $90. The hospital will not actually get $90 because the tax relieve available will exceed the tax, that is when the Hospital greatly curtails services of this type. BTW there are groups who test the accuracy of hospital bills and their results as far as I know were equally ridiculous.

 

[Brendan]

Because the private hospital is in business to make money by selling health services. They don’t make any money by giving health services away for free - if they give it away for free, they can’t get paid - someone goes without a paycheque (probably the owner).

I think you are operating on some misconceptions about hospitals in the US.

The VAST Majority of private hospitals are non-profit organizations. By law, the cannot make a profit.

Rather, they are charitable organizations that own and operate hospitals.

Most of these are religious affliates, but others are secular institutions (like the Karmonos Cancer Center here in the Detroit area or the Henry Ford Hospital)

And part of their non-profit charters are to provide health care to those who cannot afford it.

Overall, I can’t name a single hospital anywhere near me that is run as a ‘for profit’ institution. Even our largest health insurer (Blue Cross\Blue Shield), is a non-profit institution.

They take in just enough in premiums to cover the expenses of providing the insurance.