scrubbedexpat091

Do policies under the new rules still have lifetime maximums?

durham_lad

Good question, I don't know the answer.

My existing retiree group policy with my ex-employer has a $2m lifetime maximum (I just dug it out to check, but it is dated 2011).

However a quick Google says that today, ACAC plans cannot have a lifetime limit.

Beaverstate

While I wish everyone had Cadillac plan health insurance, this as in other threads can turn into....I don't care if it cost 500 Trillion, 4 hundred billion 500 million and $12.50 if it saves just one life...

Pulaski

Why would you wish that, or is that just a pie-in-the sky pipe dream?

ddsrph

What is the underlying principles that makes the British NHS work so well? Is it high taxes, healthier population needing little care, rationed care, low paid healthcare providers? Too many people look at health insurance as a way to purchase healthcare for ten cents on the dollar which can't ever work. When I look around at my fellow Americans I can't help but think no amount of money in the world is going to make them healthy.

petitefrancaise

What on earth makes you think the NHS works so well?

The NHS works on the basis of "most bang for the buck" rather than making sure each individual receives the healthcare they need? Since most UK citizens think of it as "free", it is abused and object to paying even a minimal amount to the cost of their own care. This week there was the case of a guy turning up to St James's teaching hospital in Leeds for his chemo for prostate cancer only to be told that the treatment he needs is no longer available there and he would have to go to Manchester for it. This after his cancer was missed by other doctors......

Give me France any day of the week.

Pulaski

This! .... It's oh so true!

If you get sick you'd better hope there is a program with a budget for the illness you have. Also, if you have something which is not life-threatening be prepared to wait, potentially for a very long time. The classic example would be joint surgery, or a hernia - you aren't going to die from either problem, but you might wait a year or more for surgery to fix the problem.

The ugly truth is that healthcare is rationed, unless you pay extra for private treatment, and is rationed based on the government-set budget and the decisions of the NHS management.

ddsrph

I was basically going by the many rave comments praising it in many previous posts. For our own (American) health care I was very disappointed by the attempt to reform that resulted in "Obama care" The jury is still out on its benefits if any. Most of the negative comments are by people who don't have a clue as to what it's does or does not do. Like all issues we face it's the lobbyists and special interest groups that dictate policy then spend big bucks convincing people that's its really what they wanted/needed. I Don't think this country will ever figure out a rational approach to health care delivery and how to pay for it.
The issue is going to get a lot worse both here and the U.K. as more and more very , very expensive treatment options become available and many have to be told we just can't afford to treat you.

scrubbedexpat091

Pretty much the same in Canada minus the paying private, we don't have that option. Gotta leave the country if you desire faster care and have the means to pay for it.

There is always a new story of someone not getting a treatment or medication because of cost.

Current in this province is about 43% of the budget going to healthcare, and our healthcare providors are fairly well paid, nurses 30 to 40 per hours. Doctors get paid per patient. Amount varies though.

yellowroom

compared to the US system? A philosophy that ensuring the good health of all citizens is beneficial to society and should concern us all. Not being run for profit. An integrated system with considerably less paperwork. The idea that as much as the budget as possible should be spent on healthcare/buildings/equipment and not admin/billing clerks.

Yes you get anecdotes of poor care - but I bet you could find those in every system. I could counter it with the anecdote of the excellent care my 83 year old dad got when he had a stroke recently. Yes you get entitled patients, but again, you get entitled people everywhere including private hospitals. You also get people in my parent's generation who say "I don't want to bother the doctor, I'm sure it's not serious" as they pass out on the floor.

No, the NHS is not perfect. It suffers from successive governments of all parties fiddling with it for their own ideological reasons. It's always going to be underfunded. But in terms of which system I would prefer to have for delivery of healthcare, if the choice was NHS vs US, then the NHS it is all the way.

While this was very true in the past (my dad had to wait 18 months for his hip replacements), one of the things the Blair government did do was bring down waiting lists. The target is for 90% of patients to start non-urgent consultant led treatment within 18 weeks. Unfortunately, that is now slipping and the actual figure is about 85% in some areas. Which is not a surprise - Tory government in, NHS waiting times go up. Plus ca change.

WJS

Also and a big also in my opinion, in the UK you can buy private insurance that is a fraction of the cost in the US and you have no waiting and excellent care. Personally would not live in the UK and depend solely on the NHS and not have private insurance.

ddsrph

I think the UK could have a much better system by simply requiring copays for services and drugs. This would help to fund and reduce overuse by people who haven't figured out that nothing is free.

yellowroom

There already is a co-pay for drugs, it's £8.20 per item at the moment, but a large number of people don't pay that charge (children, elderly, those on benefits etc). I suspect the same people would also be exempt from a co-pay charge to see the doctor.

Pharmacists already have a system for payment etc because they sell other things. For other appointments you'd have to set up a system for payment collection & administer it (eg collect, bank, audit etc). I'm not convinced that once the costs were taken into account, the income would significantly increase the amount of funds available.

While I can see where you are coming from in terms of making people think about whether they truly need the NHS services, I don't think it is a simple solution. How would you differentiate between someone who abuses the system with frivolous trips to their GP, and those with chronic conditions who need to have frequent appointments? Patients with mental health issues? The numerous ante-natal appointments for pregnant women? In circumstances such as those, a co-pay could lead to people skipping their appointments and missing out on needed healthcare.

Pulaski

Private insurance in the UK is relatively cheap because it only needs to provide services when the NHS does not do so, or there is a long wait. For example emergency treatment for catastrophic accidents, heart attacks and strokes, is effectively never paid for by private insurance, nor is chronic treatment for things such as diabetes or kidney disease. I suspect that expensive treatments for cancer are never covered either.
That is likely where the NHS is headed.
Maybe, maybe not, though in an increasingly internet- connected and cashless society the costs of setting up a payment system are not great as you might think. But a lot of the benefit would be in discourging people going to the doctor for a head cold or a bruised knee.

I suspect that any introduction of copays will be tiered, with many people still having zero copays, (children, pregnant women), and then copays dependent on income, with a few pounds payable even for pensioners and those on low income.

WJS

I understand but it is very cheap in comparison to the US and you don't have the waiting periods with the NHS alone and you can access clinics and private doctors and in my opinion excellent medical (if not the BEST) at a fraction of the cost in the US.