Re: Why move to the US?
 

Healthcare isn't a "market". It should not be governed by the laws of scarcity, because that leaves real people without help - not the mark of an advanced society.

Re: Why move to the US?
 

The provision of it is though - whether you wish it was or not. It cant be provided in entirety by the state as individuals do not place enough value on the health of others, so funding it becomes problematic - no one wants to pay more tax but expects the service to continue as it is (especially given an increasing trend to more net users vs. net contributors)

And leaving decisions regarding provision of services/drugs etcs to a government funded body ends up with NICE and one person being able to claim a certain drug on the NHS, while someone a town over cant. I dont know if similar situtations occurs because different insurance providers in the US assess the value of services/drugs in diff ways- but either way its a problem here and will remain so where there isnt a market involved

I dont think the US is a better model, but the NHS isnt sustainable, and without individuals contributing more to their care it will become less so in the future

Re: Why move to the US?
 

For me it was a combination of 2 and 3 - 2 made getting the visa a formality, but we lived in the UK until I had a good job to come to.
There are probably as many views on the "is it cheaper or not" as there are expats living here but despite taking a substantial pay CUT (that 11 years later has only just about been restored to my 2001 London salary level) what I keep and what I can DO with it is so much more. In London I could barely afford a 700sqft terraced house and I had one 10 year old car - here I have two homes, both 2000sqft or better, 3 vehicles (all bought new), and a rental property business that I could never have afforded in the UK. That said, I don't think that is unique to the US as a school friend has had the same experience moving to Canada. His wife is British, but his lifestyle has changed out of all recognition and neither of us have any intention of ever moving back to the UK.

Re: Why move to the US?
 

But luckily the NHS management is a paragon of efficiency and good organization! :rofl:

Re: Why move to the US?
 

And where the hell have you been???

(not in the context of the NHS, just in general)

Re: Why move to the US?
 

Hmmm - This one's interesting but to my mind they all apply where I used to live in CA. Well maybe not the pilot one.
But if you've moved 30 years ago we're not talking apples and apples.

Re: Why move to the US?
 

Agreed, they both have huge issues, but they both have one common issue - broadly speaking the biggest users of healthcare contribute least, or are least able to afford insurance. In both countries there are large sections of the population with self destructive lifestyles - overeating, smoking, binge drinking who are significantly increasing the amount of the most expensive treatments - for chronic diabetes and heart/ blood pressurw care, all manner of cancer treatments, and orthopedic care. I have not yet seen a plan in either country that provides adequate incentives for those sections of the population to take better care of themselves.

Re: Why move to the US?
 

Nail, head, hit. I wish I could think of one too, as Id set myself up a consultant and make enough money to not care about my own healthcare!

Re: Why move to the US?
 

Would you believe "the Foreign Legion"? :unsure:

Re: Why move to the US?
 

Well I think they have pretty good healthcare. And the nurses are French - always a plus.

Re: Why move to the US?
 

Your suggestion does not alter the fact that the money to pay for this ire balancing ultimately comes from the same place - the tax payer. The difference now being that the less fortunate are shouldered with a bigger burden of point-of-use costs - that's effectively rationing. Not the society for me than you.

You know, there is at least one alternative to just finding different ways to pay for it...

... And that is to reduce the costs. Preventative measures that strongly encourage healthy diets, appropriate exercise, screenings to catch the nasty things earlier, and so on. Also, faster access to diagnostics, better control on the spread of germs etc - at home, at work, in the hospitals for example...

These measures could not simply be restricted to the healthcare sector - education would need to change, school meals, sports facilities in the community, and so on... advertising for certain food stuffs too...

Oh, and allowing people to work longer would help too...

And charging non resident users of the NHS would help... (E111 provisions excepted)

Re: Why move to the US?
 

I understand Taiwan recently changed it's system and seems to be a reasonable, responsible amalgam of the UK/US approaches.

Re: Why move to the US?
 

I agree that my direct experiences with US healthcare have been anything but piss poor.

They have been almost exactly the same as experiences in the UK. Sincere, motivated, caring professionals in both cases.

Admittedly US experience limited to one region and 2 years vs 3 regions and many years in UK. Wife worked in NHS for years before we moved here.

I have no problem. Either with working hard to be a success. It's the working hard at 2-3 jobs just to survive that gets me, and that is true to some extent in the UK - you just don't have the added worry in the UK of not having health care coverage.

In several niche areas the US healthcare is best in class - eg certain kinds of cancer.

But let us not overlook the fact that the US spends almost 18% of its GDP on healthcare and is nowhere close to being in the top 10 in terms of medical outcomes for the general population. On a per capita basis healthcare spend is approx. 2.5x the UK spend. That 18% spend is the largest in the world. The number 2 slot is a shade under 12%. The UK is around 9%. That's a hell of a premium nationally for not being near the top 10 in outcomes, and having between 15 and 60 million uncovered people to boot.

I would add by way of balance that I don't care if the healthcare is #1 or #100 in the world - it just needs to be good enough... I don't apply this perspective to the costs though!

Re: Why move to the US?
 

It must be! We have the same waits in ER as we did in A&E back home ;)

Actually, the costs of admin in the US are staggering and is a significant source of inefficiency at a national level... Every hospital has a large finance department to take care of getting paid. I guess it could be seen as a firm of welfare... In the same way tithing is a form of socialism...

Re: Why move to the US?
 

For us it is my job - the opportunity to re-engineer a global sales force from the ground up and at the same time develop/employ new ways of selling and supporting a global customer base...

We didn't think we'd come here for a long stay... But that's changing -GC applications are in. We do like it here, but there are niggles, as anywhere. Not sure we could afford to retire here though, biggest concern being healthcare provision & costs.