scrubbedexpat099

Submission of the claim requiring fradulent information would be the issue.

And the main purpose of Insurance is to cover you if the worst happens and that would be the very situationyou would not be able to control the information flow.

As far as UK issues are concerned, I had a check up provided by the Company, every 2 years, I think it became annual once you reached a certain age. And I also paid for a subsdised "BUPA' cover, so that struck me as the best of both worlds.

My guess if that there are fewer and fewer 80 year olds who are in Company schemes, so they have to rely on the Government schemes wherever they are. I am reasonably certain my Mother is better of under the NHS than she would be under the US equivalent for her age, they pay out of pocket when needed. Here you pay and pay.

If you can pay in the US or the UK you can get good treatment, if you do not have the resources in the US you are in a much worse postion.

And of course the US system much eventually collapse, or significantly change. But then I guess you can say the same about most other countries arrangements.

ScousePete

What are your deductibles? With some of the lower priced monthly policies the deductible is so high that you might almost be better off keeping that $240 every month in a savings account and tapping into it only if you need to.

jen_andreson

Our deductible is $1000, which we were comfortable with as we wanted the policy mainly for emergencies, etc. The last thing we wanted was to arrive in the US, get hit by a car and stuck with big debt! We pay $20 for a doc and a drug copay depending on generic/brand.

As I said, the way we looked at it is that we pay much less than the NI tax used to cost us, and we put the difference between NI tax and our current US plan in a savings account to cover any emergencies. For us we are better off as our taxes decreased by moving to the US.

I guess I looked at it this way:
UK: average wage is £25000 a year. 9% NI tax (assuming a traditoinal employer/employee split) is £2250, which in dollars would be 4050, or $337 per month.

Or, wage of £60000 a year with 9% is 5400 or $9720, which is $810 a month.

We were somewhere in between, so for us we are saving money. We bank the difference (lower cost of living here helps) and if we need it for health care than so be it...if we don't then we remain ahead of where we would be in the UK.

Bob

The big difference is, your paying social security and medicare taxes, but won't be able to make any claims on them on top of your medical insurance...

jen_andreson

Yes, but I'll be able to do so someday, if SS and medicare are around when I'm 65 (I know that's not looking too promising).

Maybe we are unique in that overall we are better off as the taxes we pay here are much lower that what he paid in the UK. Yes, we've had to put some of that tax savings towards health insurance but overall we are still better off. And, I am much happier seeing that money buy us cover that looks after us, rather than paying it in taxes to run a system that doesn't work.

I realise that many Americans are suffering, but I think people also tend to forget that the NHS isn't free--except to those who do not work or are elderly (and the US offers medicaid and medicare--I know people using both).

Or, am I misunderstanding or missing something that is going to catch up with us in the long run? I'm really trying to get my head round all of this and do what I can to protect my family and our health.

Elvira

(sigh)

Try this for starters:

http://www.consumeraffairs.com/news0...tcy_study.html

" The study estimates that medical bankruptcies affect about 2 million Americans annually -- counting debtors and their dependents, including about 700,000 children.
Surprisingly, most of those bankrupted by illness had health insurance. ...."

Lots more if you google for "medical bills bankruptcy"... And then you might want to google for "Medicare Part D" and/or "Medicare doughnut".

Interesting reading. And pretty scary.

Jerseygirl

We have had this debate many times. I think it boils down to he fact that US Healthcare is good as long as you have reasonably good health and money. My daughter's school friend battled cancer for 3 yrs before she died. Both parents have health insurance through their employer. They are now over $500,000 in debt because of medical bills. After the first year of her treatment the insurance company refused to pay for treatment at Sloane Kettering Hospital in NYC and told them to find somewhere more affordable. The girl was 16 yrs old!! Then the insurance company refused to pay for any more overnight stays in hospital. If you have a major, long term illness here you are probably screwed. On the other hand we have had excellent coverage for health screenings and minor surgery.

The NHS offers 'free' treatment to everyone, no matter what your income is. The downfall is that you may have to wait many years for treatment. I mentioned my mother in a previous post, she's had arthritis of the knees for 20 years. When she was turned down for surgery she had been on the waiting list for almost 5 years. Before that she was given various sorts of medications that usually made her worse. Due to gastric problems she is unable to take the anti arthritic meds, aspirin, ibuprofen etc. If she had been offered the operation 10 or maybe 5 years ago she would now be in excellent health.

For most seniors in this country the cost of their monthly medications costs $100's per month, they are often put in the position of whether to spend the money on meds or food. In the UK it would cost them nothing.

jen_andreson

Thanks Elvira, I'll take a look. I don't doubt that many Americans go bankrupt due to medical bills-it's very scary. However, on the positive, they did receive care (although no doubt the psychological trauma of the debt would cause terrible harm to the health).

Jerseygirl: thanks again for your perspecitve.

My MIL has been on medicaid due to inability to work and support herself: 10+ year battle with cancer and lung disease. I guess she is a lucky one: all her bills and meds are paid for, as is her nursing home. However, I know that she (and we) are lucky for that.

That's where my confusion comes in: she DID/DOES get top rate care and it's all covered-no waiting and no debt. For some reason the system did work for her--a formerly middle class single mum who is now 60, on disability and living out her last days.

Obviously I know that something could happen to us and we wouldn't be so lucky, but I do know that we'd receive quality care with no waiting (and for our situation at least, at a lower price than in the UK).

It's certainly not an easy debate. Would be great to see universal care in the US but I can't see Americans tolerating waiting lists or dirty hospitals!

Jerseygirl

My husband and I often discuss this and usually come to the conclusion that if one of us has a major, long term illness and cannot get insurance coverage we would have to go back to the UK.

I was under the impression that to get the sort of care your MIL has, you have to be more or less pennyless and even then you are one of the lucky ones.

Elvira

You really have to read up on this as it's very complicated, but briefly: those who have problems are people who work but their employer does not offer healthcare - or the premiums, co-pays and deductibles are prohibitively expensive. For instance, Wal-Mart claims to offer healthcare, but very few of their employees can afford it. This affects more and more people every year.

Medicaid and Medicare is only an option for those who qualify. And there is still the infamous Medicare doughnut...

You say that people who go bankrupt did receive care. Yes, they did - for a while, but there comes a point where providers will no longer provide treatment until the bills are paid.

As for Americans not tolerating waiting lists and dirty hospitals: sure, those who can afford it... However, just wait until your doctor wants to prescribe something, or recommends a procedure that is not covered. (We had to switch insurers in order to get surgery for our son because our existing insurers considered it 'cosmetic' - even though there are plenty of studies to show that years down the line it would cause problems that would HAVE to be fixed. As one can only switch provider once a year so, he ended up waiting nearly a year...)

I am not sure why you think that US healthcare is cheaper. The US spends INFINITELY more on healthcare than the UK, and yet 45 million are still without cover:

"Health care expenditures have been growing much more rapidly than income in the U.S. and other developed coun-tries for some time. In the U.S., for example, health care expenditures as a share of GDP have tripled since 1950, from 5% then to 15% today."

http://www.nber.org/aginghealth/winter06/w11833.html

The year before last we (family of 5) spent over ten grand on healthcare (including dental). Last year it was less, but still an awful lot. And we have excellent cover, with low premium (employer pays about 80%), low co-pays and no deductible.

scrubbedexpat099

You might want to do some research on dirty US Hospitals, there have been some interesting posts here from those who have worked both sides of the pond.

jen_andreson

She is pretty much penniless, and lost her home, etc., due to the inability to work, which in turn left her without health insurance. She got disability insurance which gave her the equivilant of being on the dole/benefits, so she had a little to live on. Now she gets free care, and very good care. It's a catch 20/20.

Hubs and I have had the same talk you and yours have had. I was initially dead against returning to the UK after hearing how pensions are £31 a week or such--I though UK life was too hard to face as an OAP.

However, if we faced a catastrophic illness it is good to have the option.

jen_andreson

My statement about US healthcare being cheaper was related to my specific out of pocket expenses, not the system as a whole. As a household our taxes and healthcare expenditure has decreased since we moved, but that could be stickly due to luck. As I said, we save in overall taxes and spend more on insurance, but the net savings is around $6-7000 a year for us, which puts us in a better position (this is in addition to lower cost of living, etc).

When we lived in the UK my husband could not receive the meds he needed as baseline NHS protocal only provided one drug for his illness (intestinal) which didn't help him. We paid $175 a month to get the drug from abroad, and then paid for him to have an operatoin (per my earlier posts) so as to avoid loss of his job/11 months of pain and waiting.

I have read a lot on the US system and I know it has serious problems, starting with the drugs industry, but my point was that for us personally we are spending less and getting better care.

I can now also understand that we are in the minority, which helps me to better understand the situatoin as a whole (my reason for posting).

It's such a confusing and complicated topic.

Elvira

I once did an analysis and found that, when you add up all taxes and deductions (federal tax, state tax, property tax, SS, Medicare and out-of-pocket medical expenses), the two countries came out almost equal in terms of proportion of gross salary - I think there was something like a 1% difference...

I am lucky because I have insurance as a dependant of my husband's. If I were on my own, I probably could not afford it as I am self-employed. I have several friends who work dead-end jobs only to get medical insurance for their families as their husbands run their own businesses and cannot afford it.

scrubbedexpat099

I would just add that NI is not hypothecated, it is a general tax that goes in to the Treasury, so not really a direct comparison.