Desert Dubliner

Swiss have an even better system and it is completely private. It is miles ahead of NHS and anything the socialist Europe produced at great cost to their taxpayers and with muddled 'entitlements'.

The Swiss system is what the US could have if the federal and state governments took their fingers out of this mess, stop mandating botox and sex change operations as part of basic insurance packages and allowed for cross-border competition of insurance companies.

Still I have never heard of an American who had to spend 8 hours on a trolley in the 'Emergency' 'Service' while this is a common occurrence in Ireland and apparently the UK. Could be that I did not hang out with enough Americans but it could also be that they don't spend days on trolleys in the emergency service.

Another particularly annoying thing in general discussions about the socialised medicine is when people start pulling some Cuban statistics to support their view on superiority of Cuban over American healthcare. It's not happening here thankfully but it is common. My favourite statistic is deaths at birth. In USA they try to save 20 weeks old babies and most of these die in the process and end up under death at birth column while in Cuba these go directly to the bin and end up under miscarriage column.

Anyway.......

Miss Anne Thrope

Switzerland is as much of a red herring as Cuba. The US system is not bloated because of any government mandates; those have hardly had any impact yet and will ultimately help manage costs down.

Remove your ideological blinkers. Simple fact: the UK achieves much better health outcomes for its population across the board at every stage of life (except in a few specialist care cases which are only available to very rich patients anyway) for an expenditure of approximately half the proportion of GDP (that's without even adjusting for the fact that US GDP per capita is also higher than the UK). Significantly better results for half the cost.

Having lived and been ill (minor fortunately) in both countries, under both systems, I know where I would rather be ill.

britexpat76

I flew home from Abu Dhabi for surgery 2 years ago. My Bupa had expired but they still sent me private and were excellent. I would still fly home for treatment than have work done here.

Meow

But you have heard of Americans who never go to a doctor, hospital or dentist as they either cannot get insurance or cannot afford the premiums? People have to choose which treatment to have based on what they can afford or what their insurer agrees to pay, not based on what is best for them. (It's worth noting that to get private medical insurance that includes elective treatment in the US, premiums more than double compared to excluding that and being covered for the rest of the world.)

In what is supposed to be one the the greatest and richest countries in the world there are people who are suffering or dying prematurely due to the lack of a national system that helps those in need. In my view that is a national shame.

scrubbedexpat141

The NHS is something to be extremely proud of.

My Grandmother was a Head Radiographer and was sent abroad by the NHS to aid developing / new hospitals in their practices...Kuwait had her for a year for example.

As with all things that employ 000's of people and operate across a country in 000's of premises, there will be faults and examples of issues or unscrupulous individuals slipping the net. This is a fact of life.

The majority of people in the service do a bloody good job for not a lot of money and I have been lucky to have survived at 3yrs old thanks to good surgeons. If I hadn't survived, the world would be a far, far, far worse place.

Desert Dubliner

Well it's nice to see someone free of ideological bias like you. How else, other than it being a result of a thorough unbiased consideration, can one explain the position that the mandated absence of cross-state competition of health insurers would have no effect on cost! Pure fiction on my behalf. The necessity to have a legal entity operational in each state and the associated administration, HO etc is free of charge. Also the fact that the insurers need to factor in the various unnecessary treatments mandated in the basic package also does not have a cost implication. No, there are no other reasons behind the expensive 3rd world care other than them (Americans) being fat and stupid.

Desert Dubliner

Of course they can't afford the premiums. Their dear government made health insurance tax deductible for companies only and not the individuals, mandated a long menu of liberal preferences in basic packages, and prevents the insurers from competing across borders.

If the government ordered Apple to have a factory in each state and mandated that an iPhone must have each and every application included in with it, and have a different design for each state, they would not be able to afford an iPhone either.

claimsboys

Loving the righteousness of this thread.

The NHS is a wonder, but its on its knees, quite literally, and anyone that thinks for a second they don't pay for it, albeit inadvertently is quite mistaken.

For residents only, no not quite, I know a shed load of expats who pop home every 12 months to keep there doctor and dentist registrations alive. Some of them have been out of the country for over 10 years and don't do anything but bloody moan about England, but all that changes when they need health care of a kind.

And as was rightly pointed out, the good is never reported, but an article on Sharon and Dave from Cardiff having their first child, whilst wonderful, is not very newsy, or headline grabbing.

Regardless of how good the NHS has been, or indeed is, these tales that are reported, and rightfully so, should not happen, it's carelessness and simply wrong doing, nobody accidentally tapes a dummy to a baby's mouth.

Miss Anne Thrope

This is utter nonsense. Of course health insurance providers have to be organised around the primary administrative units of the United STATES of America which is a federal union after all. That's a necessary cost of doing business just like it would be, for example, in education or policing were they privatised (or is in the case of private security businesses including those who run "correctional facilities"). Are you seriously trying to argue that this need to be organised on a state level accounts for 4 or 5 or, god forbid, 8% of total GDP which is the type of cost premium the US endures over other developed nations, even those with substantially private healthcare?

And equally mandated provisions are insignificant in contributing to cost. Blue Cross/Blue Shield, for example, mention neither factor in the whole section of their website devoted to the subject of healthcare cost drivers. CIGNA, another massive multistate multinational insurer, don't even broach the subject on their site.

Now if you want to make a real argument about what differentiates the US, then you could bring up the issue of legal costs which do have a meaningful impact on the total cost. However, the fundamental issue is that "the market" in this instance does not function so there is a profoundly inefficient allocation of resources with a huge amount of redundancy in facilities and provisions which the system allows investors to fully recover in charges. There are profits that must be extracted at every transaction which in turn adds hugely to the already inflated total cost, like it or not. Finally, because the burden of costs is felt directly by employers rather than employees, there is little incentive to change. The insurance companies like it. The political parties like it and the uninsured and under-insured hardly vote anyway.

Consider if road provision was truly private and serviced by a number of competing companies who each built a road connecting, say New York to Boston. Each company could then charge users similar amounts to use their parallel roads and thus ensure their profitability. The cost of getting from NY to Boston would be far higher than in the current government managed system. There would be much more choice, but the choices would be fairly meaningless and meanwhile far more land would be covered with tarmac. Of course we don't organise road-building that way and, for the same reasons, it makes little sense to do the same for health-care (at least from an efficiency perspective).

scot47

I have no quibbles with using residence as the test. I worked abroad for years (paying NI) and then came back to be resident.

Meow

The voluntary NI payments that non-residents may make are purely to build up entitlement to State Pension and are not related to healthcare.

claimsboys

Sorry, did my thread implicate a suggestion that I have the answers to the NHS's woes. No. And what may you suggest?

Waiting impatiently.........................

Theseus

No-one does think they don't pay for it. It is free at the point of use. It does not discriminate, it offers healthcare to all. There is no refusal of treatment because you are poor, or have the wrong insurance. The NHS is an amazing thing, its not on its knees. Can it do better? yes of course but with those cnuts in power cutting funding thats not going to happen.

My amazing grandad died a week ago in an NHS hospital after receiving fantastic care in difficult circumstances where different consultants couldn't agree on treatment. The fact that they were even bothering to argue about it shows the amount of care the NHS gives to patients, no matter their age or anything else. He was 93 and 6 months ago could still play a round of golf with a handicap of 15. The docs didnt just look at his notes see his age and give up, they tried to fix him.

Tell me you get that in the US or anywhere else without a nationalised health service.

unfortunately these sensationalised horror stories just allow a biased media to sway public opinion towards more privatised health services.

claimsboys

Sorry to hear the death of your grandfather. Almost similar to my grandfather.

As per usual, and I'm learning fast, the thread posted generates a life of its own, and people start banging on about other countries, personal arguments etc.

I would beg to differ, the NHS, as a result of the most appalling management through successive Governments, not just this one, is at the point of melt down.

The bureaucratic, multi layered management system which is needed, only in a much more refined state, is eating the finances of the NHS, as a result..... Front line jobs are being cut.

I never did start this thread as a compared with the US, and quite frankly, I care not for the US's medical state.

Quite how you can claim such stories to be sensationalist is beyond me?

And I will state once again, for all the good the NHS does, it does not overlook the fact that there is more and more incidents happening in recent years, no doubt as a result of cost cutting measures.

Staffordshire Hospital is currently under review for the deaths of 1200 people whilst in its care over a period of time, the time scale eludes me as present.

Such stories are indeed worthy of report, they may just actually make this, or the next Government sit up and listen.

Meow