uk_grenada

I used to work on the commissioning side of the nhs. Heres an eye opener. Theres an innoculation for some types of pneumonia. The price of the basic drug is about 150us. The nhs decided a decade or so ago to innoculate everyone over 50, and did it in tranches. The drug co agreed on a price of 20us a dose, because we ordered 20 million doses over a few years, and thats the same nhs price now.

In the us .... Now theres a new better drug, its 450us, the nhs enquired and was offered 190, but the nhs turned it down, not cost efficient, the price drops now every negotiation, the supplier is clearly salavating about the idea of maybe a billion order, buying power works, america for some reason doesnt/cant do it.

NYer

Oh, yeah, like the cooked statistics that infant mortality rates are at 3rd world levels in the US. Not buying.

NYer

Yes, GP has been commonly used in the US although that it seems to be falling out of favor.

uk_grenada

I dont think they are cooked, the us has great healthcare - if you can afford it - problem is all those who cant access this drag the stats down.

Universal fairly divided healthcare funded by central taxation and provided according to medical need is the cure for that, but to be fair it opens up an entirely different can of worms, and americans cant or wont opt for anything less than the jungle of the free market place.

carcajou

If you're poverty-line poor, you get a lot of assistance, but that is the key - you have to actually be poor, not just feel poor, or not be comparatively poor against your neighbours. Many people have enormous trouble understanding the difference.

I have a relative who, I guess the best way to put it is washed out on life and was well below the poverty line on annual income, and went onto Medicaid, and her maximum out-of-pocket for a hospital stay was $75 and maximum co-pay was $4.

Though there is assistance for those a bit above the poverty line, it declines significantly, and the problems come when a person is lower middle-class and not getting insurance through the employer, or increasingly, ordinary middle class in the same situation.

Private insurance will abuse customers and try to gouge/cheat and that has to be watched. The worst of the excess have been curbed - "recission" was a horrible one - but they will try to find every last loophole to deny a claim.

morpeth

Even if one is poor and qualifies for Medicaid, in some areas of the country it is a bit difficult to use- not all Doctors or Dentists will accept Medicaid patients. Where I lived, sometimes people would need to go 40 to 50 miles ( and without any public transport available) to find a Doctor for their condition who accepted Medicaid.

Even those with Medical Insurance can struggle financially dealing with deductibles which can often be several thousand dollars.

One factory I know had a starting wage of 2100 a month- but if worker had a family, cost company well over 1000 a month for insurance premiums, and employee portion 250 + a month depending on plan- so company wherever possible used temporary workers through an agency to avoid paying benefits . Agency by law had to offer health insurance but at $8.50 an hour wages, few could afford the monthly premium- or those that did, in winter would struggle meeting electrical/heating bills. So even for those working the system, system is ridiculous compared to other developed countries.

uk_grenada

In britain, if you are ill your doc may give you a prescription for needed drugs, you just get em and take em. You have no clue what they cost. True it might be pennies, but where i lived in london there was a high polish immigrant community. They brought a lot of untreated TB from poland, some of it drug resistant. Those patients each cost 50-75 thousand in drugs to sort. The ‘smart’ ones took the drugs back to poland and sold them, some died, and the nhs when it found out forced them to visit pharmacies daily to take their pills in front of the pharmacist. Sime more died cause they didnt bother.

Problem is the public health aspects of all this.

Lion in Winter

And you do actually have to make yourself that poor to qualify for that kind of help. The threshold is very low, and you will have to empty your bank account and sell your assets before you qualify, so the "system" (it's more of a business model than a system) actually creates very poor and subsequently dependent people.

civilservant

Here in GA (which did not expand Medicaid under ACA) working age adults can't get Medicaid at all unless you are receiving disability benefits - so that option isn't even available.

celticgrid

If we are clarifying terminology, then I should mention that 'seeing the doctor' is very much a UK term.

I struggle to recall when I last saw a doctor. Assistants and technicians of various sorts, but a doctor? Nope.

NYer

It's cooked only in the sense that foreign newspapers refuse to report that the USA counts stillbirths in their statistics which is not done in Europe and elsewhere. That boosts our figures.

As far as healthcare, what many people don't realize is that prior to the 1970s, at least, healthcare was low cost and there were many insurance companies out there willing to cover people as well as adult children who were on their parents' plan. Blue Cross/Blue Shield allowed that. Then the malpractice lawyers got involved. They sued everything that wasn't nailed down, zooming up health care costs because doctors were afraid if they didn't issue tests, they'd be sued if something was missed. In the 80s, the Republicans tried to issue in tort reform and were fought tooth and nail by the various lawyer associations who aligned themselves with Democrats. Eventually, as always, the Repubs gave up on the issue and I haven't heard a peep out of them on this subject in years. Quite obviously, they were bought off on the subject.

I'm not saying it was nirvana in the past but it was better.

scrubbedexpat099

I have also been told it was not a major problem in the past but the same can be said of the NHS, I do not recollect the issues, there were NHS dentists etc. And the resources were a lot less.

My welcome to America moments were collecting a prescription being told to make sure they knew it was on Insurance and still being charged more than over the counter in the UK, or anywhere else. Somebody who had a nasty cycling accident and was adamant an Ambulance was not called. And going to a Hospital as a visitor and see what seemed like a 6 star Hotel and wondering how this was affordable.

NYer

To be frank, I think the expats are obsessed with American healthcare "deficiencies" to the point where it should be the No. 1 factor in whether to emigrate or not. I've never had a problem with it here but then I don't faint dead away when paying for a prescription.

civilservant

I'm not suggesting that I 'faint when paying for a prescription' either - but then I can afford it.

The fact is that American Healthcare is great, if you have access to it. Those that do not are dying while having their noses pressed up against the glass looking at what they could get if only they 'weren't lazy' or 'pulled themselves up by their bootstraps'

People dying because they can't afford a pill does not reflect well on us as a society.

scrubbedexpat099

Apart from my current cold, I have had hardly any need for anything medical so more what I have seen.

Just as well as my County does not have a Doctor, anything serious and they call a Helicopter, not cheap.

We do not have a Pharmacist either.

Lots of Pot Shops.