British expats rate US healthcare: "a pain in the arse"
Feb 18th 2015 | 3:55 am
#61
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Re: British expats rate US healthcare: "a pain in the arse"
Finally, as a lawyer, I can tell you that the greatest single cost savings that could be enacted with US healthcare would be limitation of recoveries in malpractice cases. That didn't happen with the enactment of the ACA because the plaintiff's lawyers were the greatest single contributors to the folks who legislated the ACA and The One who signed it into law.
New study shows that the savings from 'tort reform' are mythical - LA Times
Feb 18th 2015 | 4:39 am
#62
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From: Mallorca
Re: British expats rate US healthcare: "a pain in the arse"
I lived in Germany at the time, and had same happened in Germany I can assure you it would have been at least 4 hours before anybody would have even looked at, an additional 2-3 hours before completing the xrays and all the rest, and perhaps another hour for an intern to plaster a cast up to my knee (because that would be the cheapest and least risky way). But I would have paid perhaps only €50(?) in total from my deductible.
Feb 18th 2015 | 4:51 am
#63
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Re: British expats rate US healthcare: "a pain in the arse"
Only once - While hiking in Virginia, I twisted my ankle and cracked a bone. I remember being rather impressed with the speed in which my case was attended to, the quality of the facilities, the personal attention and professionalism of the nurses and doctors... IIRC, I was out of the "ER" in under 2 hours, x-rays, a removable splint, everything. Wasn't cheap - over $1000 if I remember correctly. I eventually was able to claim quite a bit of of it back from my insurance though.
I lived in Germany at the time, and had same happened in Germany I can assure you it would have been at least 4 hours before anybody would have even looked at, an additional 2-3 hours before completing the xrays and all the rest, and perhaps another hour for an intern to plaster a cast up to my knee (because that would be the cheapest and least risky way). But I would have paid perhaps only €50(?) in total from my deductible.
I lived in Germany at the time, and had same happened in Germany I can assure you it would have been at least 4 hours before anybody would have even looked at, an additional 2-3 hours before completing the xrays and all the rest, and perhaps another hour for an intern to plaster a cast up to my knee (because that would be the cheapest and least risky way). But I would have paid perhaps only €50(?) in total from my deductible.
But really, you made some definitive statements about US healthcare based on your exposure to it being one ER visit?
Last edited by Giantaxe; Feb 18th 2015 at 4:54 am.
Feb 18th 2015 | 5:12 am
#64
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From: Mallorca
Re: British expats rate US healthcare: "a pain in the arse"
My one US emergency room visit (fell over in the street and sprained my ankle) clocked in a little over four hours. They wasted an hour of my time by failing to xray both my ankle and foot as the doctor had requested. Oh, and 15 mins because they didn't want me to walk the 2 blocks home on the crutches they had supplied me. And this was on a midweek afternoon, hardly "peak time" for an ER. Cost? Just under $4k.
But really, you made some definitive statements about US healthcare based on your exposure to it being one ER visit?
But really, you made some definitive statements about US healthcare based on your exposure to it being one ER visit?
Still, the point is the same: The NHS is an institution that matured over the course of generations - mostly at a time when there were far fewer political barriers. Nobody should expect that the US healthcare system will somehow become anything like it anytime soon - probably not in your lifetime.
And it's worth mentioning that "free" always comes with compromises. The NHS is far from perfect, but then, it's "free" innit?
Feb 18th 2015 | 5:17 am
#65
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Re: British expats rate US healthcare: "a pain in the arse"
Still, the point is the same: The NHS is an institution that matured over the course of generations - mostly at a time when there were far fewer political barriers. Nobody should expect that the US healthcare system will somehow become anything like it anytime soon - probably not in your lifetime.
I don't know a healthcare system that doesn't come with compromises.
Feb 18th 2015 | 5:42 am
#66
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Re: British expats rate US healthcare: "a pain in the arse"
Part of the reason that so many people in the UK have private healthcare is that it is provided by their multinational employer as part of their benefits package. It is rarely a priority when considering a job offer, but it is still provided by many companies, perhaps because getting their staff past waiting lists and back to work quicker is in the employer's own interest.
Feb 18th 2015 | 5:44 am
#67
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From: Lehigh Valley, PA USA
Re: British expats rate US healthcare: "a pain in the arse"
Apparently BUPA has almost 4 million customers in the UK (of the 63.8 million pop). I understand that the attraction is that if the GP clears his patient for a procedure, the privately insured patient can be set up almost immediately for the procedure, rather than waiting 3 -4 months as with NHS. Usually the treatment takes place in a private hospital, and where it is to be done in an NHS facility, the private patient can frequently "jump the line." BUPA and the others are usually an employer benefit, but private plans average about £45 a month. My 80 year-old aunt had a BUPA plan.
My take is that the NHS provides the world’s finest health care system, (by comparison to which the US health care system, we have to say, is a house of cards that has come tumbling down, despite the best efforts to salvage it with the ACA - and is a pain in the arse) and that 90% are personally satisfied with it (the NHS), but approval in polling runs 50 - 65%.
My earlier questions regarding funding have the following answers: £97 billion to NHS England, representing about £1,900 ($2,900) per person vs. $8,900 in the US. it is a line item in the budget, and not the biggest. England spends about 8.2% of GDP on health care vs. almost 18% in US. 21% of the NHS England budget goes for mental health care (is that, perhaps reflected on this site?
)
Conclusion: UK gets bigger bang for the buck than the US with its system. US healthcare is overburdened with treatment of obesity-related health issues and provides far less than a Third World level of care, not to mention it is a pain in the arse, burdened as it is with administrators whose twin goals in their careers are to maximize profits and deny coverage.
Finally, as a lawyer, I can tell you that the greatest single cost savings that could be enacted with US healthcare would be limitation of recoveries in malpractice cases. That didn't happen with the enactment of the ACA because the plaintiff's lawyers were the greatest single contributors to the folks who legislated the ACA and The One who signed it into law.
My take is that the NHS provides the world’s finest health care system, (by comparison to which the US health care system, we have to say, is a house of cards that has come tumbling down, despite the best efforts to salvage it with the ACA - and is a pain in the arse) and that 90% are personally satisfied with it (the NHS), but approval in polling runs 50 - 65%.
My earlier questions regarding funding have the following answers: £97 billion to NHS England, representing about £1,900 ($2,900) per person vs. $8,900 in the US. it is a line item in the budget, and not the biggest. England spends about 8.2% of GDP on health care vs. almost 18% in US. 21% of the NHS England budget goes for mental health care (is that, perhaps reflected on this site?
) Conclusion: UK gets bigger bang for the buck than the US with its system. US healthcare is overburdened with treatment of obesity-related health issues and provides far less than a Third World level of care, not to mention it is a pain in the arse, burdened as it is with administrators whose twin goals in their careers are to maximize profits and deny coverage.
Finally, as a lawyer, I can tell you that the greatest single cost savings that could be enacted with US healthcare would be limitation of recoveries in malpractice cases. That didn't happen with the enactment of the ACA because the plaintiff's lawyers were the greatest single contributors to the folks who legislated the ACA and The One who signed it into law.
There, Sally, FIFY. Sheesh!
Last edited by FlaviusAetius; Feb 18th 2015 at 5:57 am.
Feb 18th 2015 | 5:49 am
#68
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Re: British expats rate US healthcare: "a pain in the arse"
Only once - While hiking in Virginia, I twisted my ankle and cracked a bone. I remember being rather impressed with the speed in which my case was attended to, the quality of the facilities, the personal attention and professionalism of the nurses and doctors... IIRC, I was out of the "ER" in under 2 hours, x-rays, a removable splint, everything. Wasn't cheap - over $1000 if I remember correctly. I eventually was able to claim quite a bit of of it back from my insurance though.
I lived in Germany at the time, and had same happened in Germany I can assure you it would have been at least 4 hours before anybody would have even looked at, an additional 2-3 hours before completing the xrays and all the rest, and perhaps another hour for an intern to plaster a cast up to my knee (because that would be the cheapest and least risky way). But I would have paid perhaps only €50(?) in total from my deductible.
I lived in Germany at the time, and had same happened in Germany I can assure you it would have been at least 4 hours before anybody would have even looked at, an additional 2-3 hours before completing the xrays and all the rest, and perhaps another hour for an intern to plaster a cast up to my knee (because that would be the cheapest and least risky way). But I would have paid perhaps only €50(?) in total from my deductible.
Yes, facilities are well equipped - they should be - this is a health INDUSTRY and a lot of MONEY is in play - you'd expect to see this, and frankly, I'd be happier if there was a little more of that in the NHS, of course. But I've seen little in the US system personally that says it is better in medical terms/outcomes.
A year ago I was in ER, 3 x-rays and a CT scan, plus neck brace, was $16,500. It was a car accident - the other party got stuck with the bill -rather, their insurer did. The hospital was OK accepting $4K initially, but slapped me with a lien so that if I got any payout from the other party, the hospital could come after that payout and use it to make up any shortfall from the original $16,500 bill.
A total effing scam ,which is one reason why auto insurance here is criminally high.
Negligence and other claims referred to earlier have at best a 2-3% hit on total costs - I know several GPs, nurses and surgeons, and asked them about their insurance costs as %age of their revenue - it's around the 2-3% mark, except for certain types of surgery (thoracic) and the anesthetist (highest costs).
Feb 18th 2015 | 5:54 am
#69
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Re: British expats rate US healthcare: "a pain in the arse"
There is scant evidence that that is true. For example, this recent study in JAMA pegs the likely savings at "at best, 2 or 3%" of US healthcare costs:
New study shows that the savings from 'tort reform' are mythical - LA Times
New study shows that the savings from 'tort reform' are mythical - LA Times
Since the study’s publication, the results have often been applied to current healthcare expenditures to approximate the cost of defensive medicine across the nation. If these statistics are applied to the nation’s $1.4 trillion annual health care expenditure, healthcare costs could have been reduced by $124 billion overall, and government healthcare expenses by $50 billion per year. This would be a savings of $174 billion per year. Adding the cost of defending malpractice cases, paying compensation, and covering additional administrative costs (a total of $29.4 billion), means the average American family pays an additional $1,700 to $2,000 per year for health care just to cover the costs of defensive medicine. With the nation’s healthcare costs expected to reach $4.3 trillion by 2017, the cost of defensive medicine to the average American could triple in the next 10 years.
More recent studies, including one conducted in 2006 by Price Waterhouse Coopers for America’s Health Insurance Plans, believe the costs associated with defensive medicine are much higher than estimated. For example, costs associated with medical liability are estimated to account for between 7 percent and 11 percent of health insurance premium dollars. Since the 1996 Stanford study, one of the fastest rising costs in medicine has been medical imaging. Approximately $100 billion dollars per year is spent on imaging, and radiologists estimate that $30 billion per year is unnecessary imaging. In the absence of tort reform, however, a doctor serving in the emergency department may order a computed tomography scan of the head for patient with a headache, “just in case.â€
The need for tort reform in the current healthcare debate
Whose study do you want to trust?
Feb 18th 2015 | 5:55 am
#70
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Posts: 6
From: Springfield Missouri
Re: British expats rate US healthcare: "a pain in the arse"
Just for laughs I went to the healthcare.gov site and filled out the information. They offered me a 900.00 dollar a month healthcare package that had a 5,000 dollar deductible. WOW! That is insane.
My husband has insurance through his employer and we pay 300 for a month for the entire family including my 21 year old son, with 40 dollar co pays to the doctor, 7 dollar medications, and a 1,500 dollar deductible.
I thought Obama came to save us?
My husband has insurance through his employer and we pay 300 for a month for the entire family including my 21 year old son, with 40 dollar co pays to the doctor, 7 dollar medications, and a 1,500 dollar deductible.
I thought Obama came to save us?
Last edited by saraanderson; Feb 18th 2015 at 5:57 am.
Feb 18th 2015 | 6:08 am
#71
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From: San Francisco
Re: British expats rate US healthcare: "a pain in the arse"
A study by Stanford economists Daniel P. Kessler and Mark B. McClellan compared healthcare costs in 28 states with tort reform to healthcare costs in states without tort reform. The effects of medical liability reforms were analyzed using data on Medicare beneficiaries who were treated for serious heart disease in 1984, 1987, and 1990. They found that liability reforms reduced defensive medicine practices, leading to a 5.3 percent reduction in medical expenditures for acute myocardial infarction patients, and a 9.0 percent reduction in costs for treating for ischemia patients. Significantly, they found no effect on quality: Mortality and complication rates were the same. The difference was in costs; states without tort reform paid an additional $500,000 per elderly patient each year.
Since the study’s publication, the results have often been applied to current healthcare expenditures to approximate the cost of defensive medicine across the nation. If these statistics are applied to the nation’s $1.4 trillion annual health care expenditure, healthcare costs could have been reduced by $124 billion overall, and government healthcare expenses by $50 billion per year. This would be a savings of $174 billion per year. Adding the cost of defending malpractice cases, paying compensation, and covering additional administrative costs (a total of $29.4 billion), means the average American family pays an additional $1,700 to $2,000 per year for health care just to cover the costs of defensive medicine. With the nation’s healthcare costs expected to reach $4.3 trillion by 2017, the cost of defensive medicine to the average American could triple in the next 10 years.
More recent studies, including one conducted in 2006 by Price Waterhouse Coopers for America’s Health Insurance Plans, believe the costs associated with defensive medicine are much higher than estimated. For example, costs associated with medical liability are estimated to account for between 7 percent and 11 percent of health insurance premium dollars. Since the 1996 Stanford study, one of the fastest rising costs in medicine has been medical imaging. Approximately $100 billion dollars per year is spent on imaging, and radiologists estimate that $30 billion per year is unnecessary imaging. In the absence of tort reform, however, a doctor serving in the emergency department may order a computed tomography scan of the head for patient with a headache, “just in case.â€
The need for tort reform in the current healthcare debate
Whose study do you want to trust?
Since the study’s publication, the results have often been applied to current healthcare expenditures to approximate the cost of defensive medicine across the nation. If these statistics are applied to the nation’s $1.4 trillion annual health care expenditure, healthcare costs could have been reduced by $124 billion overall, and government healthcare expenses by $50 billion per year. This would be a savings of $174 billion per year. Adding the cost of defending malpractice cases, paying compensation, and covering additional administrative costs (a total of $29.4 billion), means the average American family pays an additional $1,700 to $2,000 per year for health care just to cover the costs of defensive medicine. With the nation’s healthcare costs expected to reach $4.3 trillion by 2017, the cost of defensive medicine to the average American could triple in the next 10 years.
More recent studies, including one conducted in 2006 by Price Waterhouse Coopers for America’s Health Insurance Plans, believe the costs associated with defensive medicine are much higher than estimated. For example, costs associated with medical liability are estimated to account for between 7 percent and 11 percent of health insurance premium dollars. Since the 1996 Stanford study, one of the fastest rising costs in medicine has been medical imaging. Approximately $100 billion dollars per year is spent on imaging, and radiologists estimate that $30 billion per year is unnecessary imaging. In the absence of tort reform, however, a doctor serving in the emergency department may order a computed tomography scan of the head for patient with a headache, “just in case.â€
The need for tort reform in the current healthcare debate
Whose study do you want to trust?
The referred-to Stanford study picks on just two types of patient:- myocardial infarction patients, and ischemia patients, which are likely pretty high risk situations.
Last edited by Giantaxe; Feb 18th 2015 at 6:12 am.
Feb 18th 2015 | 6:11 am
#72
Lost in BE Cyberspace
Joined: Jan 2006
Posts: 13,212
From: San Francisco
Re: British expats rate US healthcare: "a pain in the arse"
Just for laughs I went to the healthcare.gov site and filled out the information. They offered me a 900.00 dollar a month healthcare package that had a 5,000 dollar deductible. WOW! That is insane.
My husband has insurance through his employer and we pay 300 for a month for the entire family including my 21 year old son, with 40 dollar co pays to the doctor, 7 dollar medications, and a 1,500 dollar deductible.
I thought Obama came to save us?
My husband has insurance through his employer and we pay 300 for a month for the entire family including my 21 year old son, with 40 dollar co pays to the doctor, 7 dollar medications, and a 1,500 dollar deductible.
I thought Obama came to save us?
Feb 18th 2015 | 6:25 am
#73
Just Joined
Joined: Feb 2015
Posts: 6
From: Springfield Missouri
Re: British expats rate US healthcare: "a pain in the arse"
Yes, his employer covers part, and we have deductibles. It was shocking to see self pay was more than double what we pay now after our premium went up.
I really feel for those who are not covered by their employers, and I understand why some are not getting health coverage even now.
I am not sure why whenever talk of universal healthcare starts in this country people get paranoid. Fear mongering starts, then the politicians back off.
I really feel for those who are not covered by their employers, and I understand why some are not getting health coverage even now.
I am not sure why whenever talk of universal healthcare starts in this country people get paranoid. Fear mongering starts, then the politicians back off.
Feb 18th 2015 | 6:26 am
#74
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Joined: Feb 2010
Posts: 4,759
From: Temecula, CA
Re: British expats rate US healthcare: "a pain in the arse"
Only once - While hiking in Virginia, I twisted my ankle and cracked a bone. I remember being rather impressed with the speed in which my case was attended to, the quality of the facilities, the personal attention and professionalism of the nurses and doctors... IIRC, I was out of the "ER" in under 2 hours, x-rays, a removable splint, everything. Wasn't cheap - over $1000 if I remember correctly. I eventually was able to claim quite a bit of of it back from my insurance though.
I lived in Germany at the time, and had same happened in Germany I can assure you it would have been at least 4 hours before anybody would have even looked at, an additional 2-3 hours before completing the xrays and all the rest, and perhaps another hour for an intern to plaster a cast up to my knee (because that would be the cheapest and least risky way). But I would have paid perhaps only €50(?) in total from my deductible.
I lived in Germany at the time, and had same happened in Germany I can assure you it would have been at least 4 hours before anybody would have even looked at, an additional 2-3 hours before completing the xrays and all the rest, and perhaps another hour for an intern to plaster a cast up to my knee (because that would be the cheapest and least risky way). But I would have paid perhaps only €50(?) in total from my deductible.
More recently, in the US, I was in ER for vomiting with extreme headaches, got admitted to ER fairly quickly... and then waited for two hours. Apparently I was categorized as "fairly urgent" but the doctor I was assigned to went home and they failed to transfer patients over properly to another doctor.
But I wouldn't base my opinion on a healthcare system by 1 visit to ER/A&E in each alone.
Feb 18th 2015 | 6:33 am
#75
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Joined: Jan 2006
Posts: 13,212
From: San Francisco
Re: British expats rate US healthcare: "a pain in the arse"
Yes, his employer covers part, and we have deductibles. It was shocking to see self pay was more than double what we pay now after our premium went up.
I really feel for those who are not covered by their employers, and I understand why some are not getting health coverage even now.
I am not sure why whenever talk of universal healthcare starts in this country people get paranoid. Fear mongering starts, then the politicians back off.
I really feel for those who are not covered by their employers, and I understand why some are not getting health coverage even now.
I am not sure why whenever talk of universal healthcare starts in this country people get paranoid. Fear mongering starts, then the politicians back off.
I think what I find shocking is that many with employer-provided insurance don't realize the true cost of their insurance. And this, I suspect, feeds into your point about "fear mongering" as they don't perceive any cost issue with the current system.
Last edited by Giantaxe; Feb 18th 2015 at 6:38 am.
