Health Care in Other Countries

[manualman]

I don’t meet the OP’s foreign born criteria, but I do have an illuminating second hand anecdote.

In the mid 1990’s my future father in law was in a bad car wreck in Wales. He received immediate attention, no question asked (like "where’s your insurance card?). They did a great job of stabilizing his condition (stopped blood loss, stitched him up, antibiotics for surficial infections, set broken bones…) and the Welsh staff of the small hospital gave superbly friendly and attentive care.

Unfortunately, he didn’t get better. He had a fracture in his back which was identified on X-rays and addressed (stabilized), but his pain just kept getting worse. His doctor told him that things looked fine and that he “didn’t meet the criteria” for any more advanced testing (such as an MRI). After another MONTH of no improvement (and agony that only drugs temporarily dulled), my future wife and MIL talked American Airlines into allowing him on board (waiving a typical medical stability requirement). Upon return, he was taken to Lutheran General Hospital in Park Ridge, IL where he promptly received an MRI that identified an infection that had been festering in his spine where the injury occurred. Turned out to be a VERY close thing as the infection left unchecked would have soon caused irreparable spinal damage.

I really believe that we should have a national health care system for all medical treatment that existed prior to about 1980. Pay for it with general tax revenue and make it available to all with no private billing. Would probably be cheaper than the current system. For more advanced treatment, make people buy insurance.

This would be the best of BOTH worlds. Get the basics and preventative stuff out there for everyone and keep the profit motive alive to promote advances in medicine. Maybe someday MRIs will be as cheap as X-rays. Then we can add that to the universal care. You get the idea.

I should admit that this isn’t MY idea. I have known a couple dozen Canadians over the years. The ones who have never HAD a major health issue LOVE their system. The ones that have needed advanced care urgently wish they had what I just described above (when it occasionally comes up for discussion it is called “the two tier” approach, and usually gets torpedoed by horrified leftists).

 

[wabrams]

Reality?

Average perinatal mortality:
UK: 4.60 deaths per 1,000 live births
US: 6.75 deaths per 1,000 live births

It conveniently leaves out the fact that we are one of the only countries in the world that count miscarriages and still borns in our infant mortatlity rates. Most countries only count babies who die after birth.

 

[Black_Rose]

I really believe that we should have a national health care system for all medical treatment that existed prior to about 1980. Pay for it with general tax revenue and make it available to all with no private billing. Would probably be cheaper than the current system. For more advanced treatment, make people buy insurance.

Could you demonstrate how would it be even better since many of the drug in the formulary of the Canadian health system are introduced after 1980. It certainly would be cheaper, but it would not be better for everyone.

 

[cynic]

Here in Finland we have a government run health care system as part of the same system that handles pensions. This does not mean that there is not a parallel private system that people can access, but most choose not to.

…

We admitted that in non-life threatening situations there can be some waiting for certain specialists, but medications are subsidized and discomfort is controlled, home care arranged, etc. If it is a genuine emergency it does not matter what one’s financial or employment state is, they get care even specialized surgical care and any charges are minimal for those with means and free for those without.

,

This sounds similiar to the health care system in New Zealand, except that it is funded directly through taxation. There are waiting lists, but they’re usually for non life-threatening conditions, The private sector exists for those who don’t want to wait.

My mother has been receiving chemotherapy for a non-curable form of cancer for the last 3 1/2 years, and has been through just about every drug available. She had breast cancer 12 years ago. Had she lived in US, she may have been booted off whatever the plan was after that, or the cost might have become inhibitory (as it is in NZ). But then I can’t say that for sure. In fact I don’t really know. There are charitably funded hospitals in the US that provide free chemo treatment, so it would be crude to suggest that there aren’t options for the poor, or that Amercans don’t care about their neighbours.

I think ‘socialized’ medicine works best in a small country where hopsitals and practitioners seem to be more accountable to the public. (often through the media) In a country of 300 million people… maybe not.

 

[markbrumbaugh]

In the United States, infants born premature or with major medical problems are given extensive medical attention which comes with both higher survival rates in difficult cases [although may contribute to the calculation of overall life span ] and higher costs. Similarly, elderly patients are given very high quality medical treatment. However, one result is a distortion of the overall statistics on costs and on lifespan. In addition, in the statistics cited above, there were significant omissions, such as much higher survival rates for patients in the United States with such conditions as various types of cancer.

It’s important, however, not to confuse medical care with medical insurance.

Useful insurance programs such as HSA’s with catastrophic coverage are generally denied to individuals for reasons only known to people such as former/ now deceased Senator Ted Kennedy RIP who fought to his death for decades the idea that individuals may purchase their own medical insurance at affordable premiums on the competitive interstate market.

In addition, some state governments not only prohibit individuals from purchasing affordable medical insurance but also restrict certain types of insurance to companies with more than one employee [in other words, sole proprietorships are prohibited from buying “group insurance” which tends to be less expensive]. And some state governments also require mandated coverage for things that purchasers may not want included … which drives up the premiums.

Another issue that the legal system refuses to address is the cost of the lack of tort reform … meaning that there are frivolous lawsuits. In most of the world, the concept of “loser pays” applies to lawsuits, with insurance being available to cover costs of litigation. In the United States, the concept of “deep pockets” pays which drives up the cost of medical malpractice and related insurance, driving up premiums unnecessarily and also results in so-called “defensive medicine” in which doctors order tests that are unnecessary medically but which are necessary in the event of the need to defend against a lawsuit.

There are issues that do need to be addressed, but the political and legal establishments have adamantly refused to address them. Or they HAVE addressed these issues to the detriment of the patient. The state of Texas passed some form of tort reform that resulted in significant reductions in costs.

In the United States, you can shop around for competitive insurance policies, customized insurance policies, and competitive interstate policies and competitive premiums for everything … house, commercial, boat and maritime, motorcycle, aviation, fire, liability, auto, comprehensive, umbrella, … except medical insurance.

The current medical insurance structure in the United States is a residue of World War II, when owing to wage controls, employers lobbied to be able to offer medical insurance as a benefit in order to keep valuable employees. This has resulted in terrible distortion over the years. AND, the Federal tax structure severely penalizes individuals and rewards employers as regarding medical expenses and medical insurance costs. It would only take a minor change to allow individuals to eliminate the tax penalties. In addition, truly tragic cases could be paid for by some form of tax credits administered by hospitals; the individuals, once vetted, would not pay anything and the hospitals would take care of all the paperwork.

[In fact, why is it that HOSPITALS cannot sell medical insurance; should be a piece of cake.] Individuals should be able to buy any kind of medical insurance they want from any insuror including your neighborhood hospital, and have the policy fully transferable in the event you move to some other location.

The insurance industry has complained that they CAN offer low cost, competitive medical insurance [and in many cases they do], but that the policy offerings are unfairly restricted to those people fortunate enough to live only in certain states or work for certain employers.

10 Points!!!

 

[manualman]

Could you demonstrate how would it be even better since many of the drug in the formulary of the Canadian health system are introduced after 1980. It certainly would be cheaper, but it would not be better for everyone.

Details DO tend to foul up simplistic summaries. Yes, drugs would be covered under manualman care, but ONLY those eligible for generic status (IIRC that means expired patent). If you want the latest and greatest, you gotta buy insurance for it. Profit motive remains, so medical technology doesn’t stagnate. Today’s breakthrough drugs become tomorrow’s generics.

 

[Black_Rose]

Details DO tend to foul up simplistic summaries. Yes, drugs would be covered under manualman care, but ONLY those eligible for generic status (IIRC that means expired patent). If you want the latest and greatest, you gotta buy insurance for it. Profit motive remains, so medical technology doesn’t stagnate. Today’s breakthrough drugs become tomorrow’s generics.

The Canadian formulary (although I do acknowledge that the provinces have different formularies) does use some brand-name drugs – your plan would most certainly not be considered an improvement.

 

[Ridgerunner]

Very well done. You did leave out the not inconsequential number of people who get treatment at emergency rooms and in hospitals and pay NOTHING for it. We are generous to a fault in the US but the legislation that a person cannot be turned away from a medical facility without at least being triaged has really hurt hospitals when we have a large population of illegal aliens.

Tort reform would work wonders, as would solving the problem with our porous borders.

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I don’t qualify as one who has experienced healthcar abroad, but since there appears to be a shortage of such people here, I’ll speak even so.

Many other countries do not have to deal with the number of immigrants we do, particularly illegals. In France, for instance, if you can’t prove your legality to the provider, you pay for care in full and in advance. France also has a two-tier system. About 2/3 of it is “public” and about 1/3 of it is private.

Immigration may be good or bad on the whole, but it does burden the healthcare system. Many times I have been made aware of immigrants from south of the border, both legal and illegal, who “self-treat” with powerful drugs purchased over the counter in their own countries. It’s just amazing how much they misuse those drugs, and it’s no wonder that many develop conditions resulting from them. And, if they can’t afford healthcare, they get it for free in the most expensive possible place…the local ER.

 

[manualman]

The Canadian formulary (although I do acknowledge that the provinces have different formularies) does use some brand-name drugs – your plan would most certainly not be considered an improvement.

Oh, I’m not proposing to change Canada’s system. I’m proposing a scaled back version of Canada’s system for the USA. Basic care for all including generic drugs included, but “pay to play” (i.e. insurance) for more advanced care certainly WOULD be an improvement on our current system of public care for the (non-child or eldery) poor, which consists of “stop the bleeding, set the bones and discharge them.”

If Canadians are happy with their system, who am I to argue. But Canada-care has simply never been tried in a world without America’s for-profit health industry. I don’t think it is necessarily a good idea to simply Canada-ize the US system totally when nobody can say for sure what that would do to the rate of medical technology improvement. It may sound arrogant, but the US is THE last major for-profit medical market on earth. Nobody knows what impact the loss of that status will have on the pace of medical advancement.

 

[TheRealJuliane]

Oh, I’m not proposing to change Canada’s system. I’m proposing a scaled back version of Canada’s system for the USA. Basic care for all including generic drugs included, but “pay to play” (i.e. insurance) for more advanced care certainly WOULD be an improvement on our current system of public care for the (non-child or eldery) poor, which consists of "stop the bleeding, set the bones and discharge them."

If Canadians are happy with their system, who am I to argue. But Canada-care has simply never been tried in a world without America’s for-profit health industry. I don’t think it is necessarily a good idea to simply Canada-ize the US system totally when nobody can say for sure what that would do to the rate of medical technology improvement. It may sound arrogant, but the US is THE last major for-profit medical market on earth. Nobody knows what impact the loss of that status will have on the pace of medical advancement.

Not true. People are given the same treatment whether they can pay or not, which is one reason why medical costs have risen as far as they have over the last 20 years. There are a lot more non-payers than there used to be. There are no “poor wards,” or “poor protocols” for hospitals. The doctors don’t know who can pay or who has insurance. Only the business office knows.

 

[wabrams]

Not true. People are given the same treatment whether they can pay or not, which is one reason why medical costs have risen as far as they have over the last 20 years. There are a lot more non-payers than there used to be. There are no “poor wards,” or “poor protocols” for hospitals. The doctors don’t know who can pay or who has insurance. Only the business office knows.

Not true; it’s on the face sheet in the front of every chart. Contains patients med record # w/ in that facility, full name, birthday, address, employer, next of kin, and insurance company (if any).

 

[manualman]

Not true. People are given the same treatment whether they can pay or not, which is one reason why medical costs have risen as far as they have over the last 20 years. There are a lot more non-payers than there used to be. There are no “poor wards,” or “poor protocols” for hospitals. The doctors don’t know who can pay or who has insurance. Only the business office knows.

You have to be joking. My wife works in a hospital as an occupational therapist. Awareness of coverage is front and center and absolutely figures in what care can be given that patient.

 

[vz71]

In the hospitals I have worked at, the business office was far removed from the nurses or the doctors on the floors. And it was considered an ethics violation to discuss economic status.

Unless a patient volunteered the information, no one knew who was or was not insured.

 

[Monte_RCMS]

This sounds similiar to the health care system in New Zealand, except that it is funded directly through taxation. There are waiting lists, but they’re usually for non life-threatening conditions, The private sector exists for those who don’t want to wait.

My mother has been receiving chemotherapy for a non-curable form of cancer for the last 3 1/2 years, and has been through just about every drug available. She had breast cancer 12 years ago. Had she lived in US, she may have been booted off whatever the plan was after that, or the cost might have become inhibitory (as it is in NZ). But then I can’t say that for sure. In fact I don’t really know. There are charitably funded hospitals in the US that provide free chemo treatment, so it would be crude to suggest that there aren’t options for the poor, or that Amercans don’t care about their neighbours.

I think ‘socialized’ medicine works best in a small country where hopsitals and practitioners seem to be more accountable to the public. (often through the media) In a country of 300 million people… maybe not.

There is a thread here on CAF about a very celebrated case in Oregon, which has a state-controlled medical system. They kicked off a cancer victim because they didn’t want to pay for her meds. Created a huge national protest against the State. When the drug company found out about it, they gave / donated the drug to her for free.

 

[RedRoseOfPurity]

Our Finnish system is sometimes called best in the world and I agree. It is not perfect, but we Finnish don´t want to give it away.
We pay our taxes and when we are ill we can buy services with lesser money. Mentally ill and mentally handicapped have homes and pensions and if they don´t know how to make food or handle money, they can have legal guardian.

 

[The_Old_Medic]

I am a dual citizen of Canada and the USA. My paternal grandmother died as a direct result of being denied speedy surgery, in Winnipeg, Manitoba.

She developed an abdominal hernia. Her physician recommended surgery to treat the problem. She was placed on a waiting list, because her surgery was not considered to be “essential”.

Her hernia strangulated, and by the time they got her into surgery, gangrene had set in. She died as a result of that gangrene. This was 100% because of inadequate health care being available, so that she could not get the surgery that she needed.

Great Britain also limits health care, and has eliminated certain medications, procedures, etc. from those that they find undeserving (like advanced cancer treatment, they let you die instead). NHS is going broke, and it is restricting more and more procedures. Having spent a LOT of time (years) in great Britain, I can tell you that anyone there that can afford private medical care gets it. There are a number of private hospitals, insurance is available at a reasonable costs, etc.

I sincerely hope that the US government NEVER controls the kind or amount of medical care that I, or that any person in my family, can receive.

I would like to see a system similar to that in place in Germany. There (since the 1870’s), every employer is required to provide medical insurance (which meets government standards) to all employees and their families. The government will pay the premiums for those that can not work because of disability, etc. BUT, all health care is provided by private entities, people regularly change physicians, hospitals, clinics, etc.

Only a small number of professionals, or the very rich, etc. are exempt from the requirement to have insurance provided (but most of them get it through their professional organizations, or they purchase a policy of their own).

The government only provides health care for soldiers, etc. Other than that, it is 100% private insurance, which covers 100% of all medical costs. Those aged, disabled, etc. and unable to get a policy through employment, retirement, etc. have a private policy paid for by the government. And ALL policies are required to cover virtually anything (including Spa treatments, etc.).

 

[Ridgerunner]

Our Finnish system is sometimes called best in the world and I agree. It is not perfect, but we Finnish don´t want to give it away.
We pay our taxes and when we are ill we can buy services with lesser money. Mentally ill and mentally handicapped have homes and pensions and if they don´t know how to make food or handle money, they can have legal guardian.

Two different things. The mentally handicapped in the U.S. are supported by a combination of state, federal and private funding, usually in group homes, but for the higher-functioning in separate homes or apartments. They have people who look after their needs on a wide range. And they do have guardians. Those who meet the definition of poverty have their medical care paid for them, 100%. It results in a lot of overutilization, but that’s what it is.

The immediate question in the U.S. is whether the government will provide for those in the middle class, most of whom already have health insurance, many of whom can afford it themselves,and some of whom don’t want it. The further question is, if we assume the middle class should be somehow covered by the government, how is it to be managed, and who is to pay for it? Obama favored a full government takeover of healthcare; something like the British system. Democrats in the senate preferred to force insurance companies to provide more accessible insurance and to force those who make more than $88,000/year and employers to pay for subsidies to those who make less than that. That program is already seeming unworkable, since many “waivers” of its requirements have been issued.

Nothing has been done to make health care more affordable. Nor is it clear that health insurance will be any more available under the current plan than it was before.

 

[Cathoversal]

I have an easy solution! Make heath care insurance the same as car insurance. If you are a bad driver… your rates go up. If you are a good drive, your rates are lower!

We, in the US, must start making people accountable for their own actions as well as inactions! A 5’9’ man who weighs 300 lbs because he chooses to eat fast food and other junk should be penalized for their inability to control themselves. It is not right that people who take care of themselves are penalized for those who make bad choices.

If a person is healthy, they get rewarded with insurance that is lower priced than their unhealthy counterpart… Simple!

I know there will backlash because some people are born with conditions they have no conrol over… there should be an automatic exemption for things like that, or a govenment funded subsity.

I lived in Germany and yes… they have a VAT tax that is higher than most of the America’s sales tax! So what? They also have higher income tax… once again so what?

I, as a teacher in Texas, pay nearly 25% of my income (Gross Income) for health insurance! So why not take more for taxes, give me better coverage for cheaper, and allow me one less stress in my life! Oh ya, can’t do that… we (as a nation) need to makes sure everyone lives month to month, dollar to dollar so we can be the most powerful nation in the world (?).

I feel sorry that the rich and elite have no idea how the average man lives! “…Give me your tired, your poor, Your huddled masses yearning to breathe free…” Not this America… we have gone way past the ideal of our forefathers!

Commence with your blasting!!

-Cathoversal

 

[gtrenewed]

Follow the money! If the insurance industry can spend billions lobbying lawmakers, while denying coverage by high price policies or by just saying no, is this a just application of the free market system? Are we so nieve not to notice that the debate rages about medicine instead of insurance?

We use emotional stories of medical failures from other countries; are you really suggesting that our system has less medical malpractice? How about a person with private insurance denied coverage of a heart operation by that same insurance company because they claimed that other medical problems made the success of the operation highly questionable; yet, the attending cardiac surgeon said he would do the operation if we could come up with the money! That person died a month later at 49 years old. In God’s hands now to judge. There are many more stories just like this.

What does it mean to be Christian in a free market system? Scripture talks about the common good of those first Christians. Why do we have food subsidies for the common good using tax payer money to prop up prices which is not a free market system? Yet we must have a healthcare system that is solely free market? Why can we regulate utility companies for the common good forcing these companies to be efficient but healthcare providers and insurance companies can just raise rates without becoming more efficient? How many people’s lives are we willing to trade for corporate profit that buys votes and builds huge edifices in the name of free enterprise?

Stop debating various countries medical systems, a smokescreen concealing the corporate money, and start deciding what kind of people do we want to be. Then start electing people that match that ideal. We can be America with limited government control - free market system and still have healthcare for everyone. For the common good we have police and fire protection, social security, medicare, regulated utilities and food subsidies. Affordable healthcare for the common good is very possible if we decide to stop wasting money in other areas and put it to a proper use for all Americans.