Health care reform, anyone?

[TracyTN 237]

My (UKC) husband hates the healthcare system here. He doesn't even want to talk about it because it pisses him off so much. His position is that people opposed to a basic universal system that covers all are simply selfish bastards who don't care if their access to care hampers someone else's.

That isn't why hubby hated the NHS. He just objected to paying 11% of his salary for the standard of 'care' he and his family received. Meaning waiting over a year for elective surgeries, calling the doc when you're sick only to be told the first opening was a week later, struggling to find an NHS dentist and when you did, the guy was one step above a quack, etc (I won't bore you with his continuous examples - nor the one I witnessed where I threw a wobbly in the middle of the ward). I know not all NHS trusts are the same as the one he unfortunately lived near, but to me, if it's national health - it's national health. At the bare minimum, keep the same standards from trust to trust. That suggests to me that the system isn't as wonderful as I'm always told it is.

We both agree that the large population of the uninsured is one of the biggest problems with the US system, and in theory, don't object to paying a little more so everyone has a chance to have coverage.

[Gemmie 142]

I would rather pay 11% of our salary than 25% in insurance (which is what we're looking at now).

Plus, as much as it sucks, I would rather have to wait a little longer when I need care than having to pay so much money in 'case' I need it.

[Empress of Groovy 373]

That isn't why hubby hated the NHS. He just objected to paying 11% of his salary for the standard of 'care' he and his family received. Meaning waiting over a year for elective surgeries, calling the doc when you're sick only to be told the first opening was a week later, struggling to find an NHS dentist and when you did, the guy was one step above a quack, etc (I won't bore you with his continuous examples - nor the one I witnessed where I threw a wobbly in the middle of the ward). I know not all NHS trusts are the same as the one he unfortunately lived near, but to me, if it's national health - it's national health. At the bare minimum, keep the same standards from trust to trust. That suggests to me that the system isn't as wonderful as I'm always told it is.

We both agree that the large population of the uninsured is one of the biggest problems with the US system, and in theory, don't object to paying a little more so everyone has a chance to have coverage.

I can understand that. I know the NHS isn't perfect, and Jon would concede this too. And I agree that the disparities among trusts really shouldn't be. But the way some people talk here (who likely haven't set foot in an NHS hospital), you'd think that British hospitals are basically military tents full of groaning, overlooked patients who will likely expire before anyone gets to them.

One thing I will say Jon's been very impressed by here (not to stereotype) is dental care. He's had to have a ton of work done that he'd put off for years, and although it's costing an arm and a leg, he's very happy with it. Especially two nearly pain-free (!!) extractions. A little off the subject, but...

[TracyTN 237]

I would rather pay 11% of our salary than 25% in insurance (which is what we're looking at now).

Plus, as much as it sucks, I would rather have to wait a little longer when I need care than having to pay so much money in 'case' I need it.

I'm not sure I'm following. The 11% of salary I mentioned was what was taken out for NHS (insurance) contributions. I don't pay nearly that much of my salary towards my employer's insurance plan. If you're talking about going on your own for it, then yeah I agree. One of the other parts of our system that is jacked up.

I don't think anyone minds waiting a little for elective surgeries - but a year for hubby to get his shoulder fixed (when it was CONSTANTLY dislocating) seemed a bit excessive. Not to mention being ill and being unable to get care. Personally when I'm sick, I want to see the doc and get meds to feel better - not wait until a week later when I've suffered through the illness to heal myself. Seeing as we pay less than hubby did for that privilege, I don't really see it as a benefit of the NHS (though granted that is NOT the case across the board here).

I can understand that. I know the NHS isn't perfect, and Jon would concede this too. And I agree that the disparities among trusts really shouldn't be. But the way some people talk here (who likely haven't set foot in an NHS hospital), you'd think that British hospitals are basically military tents full of groaning, overlooked patients who will likely expire before anyone gets to them.

One thing I will say Jon's been very impressed by here (not to stereotype) is dental care. He's had to have a ton of work done that he'd put off for years, and although it's costing an arm and a leg, he's very happy with it. Especially two nearly pain-free (!!) extractions. A little off the subject, but...

I don't think even hubby would paint it as THAT dire though I did sit with him in hospital for 3 solid days just trying to get a consultant to look at his fingers that he nearly cut off with hedge trimmers. Once they did look at them, after having dug around in there, they gave him no pain meds to go home with. LOL.

My hubby is amazed at the state of his teeth since he got here. After his first cleaning, he marveled at the fact that he could feel individual teeth with his tongue for once. HA. Our dental insurance is pretty reasonable, but yeah, on the whole it costs more than what he paid out to his NHS dentist (though not every procedure is more expensive here with our insurance!). When comparing quality to cost, it seems like the correct balance to him.

[Justine+David 218]

The whole system abuse thing is sort of inevitable, I'll grant Nich. Heck, when I was a college student, my neighbor was a single mom who worked part-time and was offered a full-time job but declined it because she told me that her government assistance would go away. Our folks on welfare should be fed and clean and have a place to live...but not necessarily luxurious so that there's no incentive to go off of the system. In the UK one of my friends' brothers has 2 kids with a girl he's not married to and they have a car and a place to live and they don't work...and they're quite content not to.

That sort of stuff is frustrating beyond belief and I understand that. Programs like WIC are necessary though, because the health of a population is measured by the health of its infants-right at the beginning of life, not to mention being a good thing to feed kids and babies. But trust me, I get the abuse thing. At another hospital I worked at a few years ago there was a mom with a large history of drug abuse with a brain-dead baby who kept him alive pretty much purely because she wanted to qualify for housing...

But for every family that's abusing the system, there are genuine families who are at their wits end and have the choice where they make enough money not to qualify for medicaid but taking their kid to the hospital will bankrupt them. Honestly, it's the families that are dirt poor that get seem to be relieved of the hospital bill, but lower-middle class to middle class are screwed depending on their insurance company, or if they even have one.

[Trompe le Monde 1,107]

Bear in mind that National Insurance covers other things besides the NHS - state pension, unemployment, etc.

If HCR had featured a single payer system the NHS comparison would be apt, as it is what is proposed (a mix of public and private fixes) is closer to Switzerland and Japan.

[TracyTN 237]

Bear in mind that National Insurance covers other things besides the NHS - state pension, unemployment, etc.

Yes, but I still don't see why that should matter in getting all the trusts at least slightly closer together on standards of care.

I still think the best solution for us would have been some kind of hybrid between our system and the UKs. What I've read is making me a tad more concerned about how much its going to cost us, too.

[Trompe le Monde 1,107]

I think we are right to be concerned about what this all means, but I have to be honest I have a hard time hearing words like "anti-christ" and all the other overwrought verbiage being used about this when some of the reforms - eliminating the ability to deny children with pre-existing conditions by insurance companies and lifetime caps on coverage - seem like stuff most sensible people should be getting behind.

One thing that worries me is the whole issue of cost control....something Republicans had an opportunity to influence in the bill (which was actually pretty similar to Mitt Romney's plan in MA and proposals laid out by the heritage foundation many years ago) but chose not to in favor of just saying no. Even if people don't agree with the bill, can anyone honestly say that a child born with asthma "deserves" to be denied coverage?

[TracyTN 237]

I think we are right to be concerned about what this all means, but I have to be honest I have a hard time hearing words like "anti-christ" and all the other overwrought verbiage being used about this when some of the reforms - eliminating the ability to deny children with pre-existing conditions by insurance companies and lifetime caps on coverage - seem like stuff most sensible people should be getting behind.

One thing that worries me is the whole issue of cost control....something Republicans had an opportunity to influence in the bill (which was actually pretty similar to Mitt Romney's plan in MA and proposals laid out by the heritage foundation many years ago) but chose not to in favor of just saying no. Even if people don't agree with the bill, can anyone honestly say that a child born with asthma "deserves" to be denied coverage?

I agree. I'm not an Obama fan by any means, and I am quite skeptical about this bill - but to go to those lengths is ridiculous. As is opposing common sense things like denying coverage for pre-existings (or the child you mention).

I just read today on the WSJ's site that the MA plan is way out of control cost wise (according to that state's treasurer), but that is supposedly what this bill is modeled after. That scares me.

[Justine+David 218]

For those concerned about cost control, what do you think about the single-payer system? So everyone would be equally taxed based on their income...

[Trompe le Monde 1,107]

well, a single payer system is one way to control costs. Though in this country the first step would be tort reform, which the current bill doesn't even touch.

[Justine+David 218]

Le sigh. Yes. You wouldn't believe how much money we spend on tests that the patient doesn't need...

[thesnowman 1]

In the UK if myself or my family were sick I could call up before 9am and I would be seen that day at my local doctors surgery. In the USA it took me over two months to get an initial doctors appointment and then when I was sick the soonest they could get me in was 6 days later. In the UK when my son was born I paid nothing, I had a midwife come round to the house for two weeks after the birth and then a health visitor came around at regular intervals to give us help. IN the USA my wife had her birth plan ripped up by a doctor who gave her a forceps delivery because, and in his own words, "he didnt have the time to wait as he had to get home". This invasion cost us over 4k. I pay over $800 in premiums for my family and an extra $200 in FSA payments, I got offered a good job while my USC wife was pregnant (and at college), but the new jobs health benefits didnt kick in for 6 months which meant I had to decline as I couldn't afford the cobra payments to leave.

The NHS isn't perfect, I ended up using free works private medical care for surgery as I didnt want to wait, but I would rather have the NHS than the US system. My wife got a prescription for some severe migraines, we took it to Walgreens and they said that the insurance wouldn't pay for it all, and told us to take half a pill a day rather than the whole one, we said fine we will pay for the rest and we were told that we couldn't as the insurance wouldn't pay for it we weren't allowed to either.

So I would rather the government be in charge of health care than an insurance company who we have spent hours on the phone arguing with over costs. Luckily my wife spend a few years working in a doctors surgery and done insurance billing so she knows their tricks.

[TracyTN 237]

In the UK if myself or my family were sick I could call up before 9am and I would be seen that day at my local doctors surgery. You lucky devil! Though I know some trusts were like that - just not the one hubby was in...! In the USA it took me over two months to get an initial doctors appointment and then when I was sick the soonest they could get me in was 6 days later. That's odd - were you a new patient of that doctor or? That's the only time I've ever experienced a delay in getting an appt. I can normally get in on the same day with my doc if I call in the morning - worst case, the next day. In the UK when my son was born I paid nothing, I had a midwife come round to the house for two weeks after the birth and then a health visitor came around at regular intervals to give us help. IN the USA my wife had her birth plan ripped up by a doctor who gave her a forceps delivery because, and in his own words, "he didnt have the time to wait as he had to get home". I've only paid $40 so far during my pregnancy (a copay for an extra ultrasound). And I would have gotten a new doctor if one had ripped up my birth plan. Screw that! This invasion cost us over 4k. I pay over $800 in premiums for my family and an extra $200 in FSA payments, I got offered a good job while my USC wife was pregnant (and at college), but the new jobs health benefits didnt kick in for 6 months which meant I had to decline as I couldn't afford the cobra payments to leave.

The NHS isn't perfect, I ended up using free works private medical care for surgery as I didnt want to wait, but I would rather have the NHS than the US system. My wife got a prescription for some severe migraines, we took it to Walgreens and they said that the insurance wouldn't pay for it all, and told us to take half a pill a day rather than the whole one, we said fine we will pay for the rest and we were told that we couldn't as the insurance wouldn't pay for it we weren't allowed to either.

So I would rather the government be in charge of health care than an insurance company who we have spent hours on the phone arguing with over costs. Luckily my wife spend a few years working in a doctors surgery and done insurance billing so she knows their tricks. Not all insurance providers here have good prescription coverage - mine does. But it does seem inconsistent, that's for sure. I have never had to fight on the phone with my insurance company. In fact, I can't think of a time where we had a major disagreement. It was normally me not understanding what was/wasn't covered. Didn't mean I was always happy to pay that out of pocket cost, but normally it wasn't anything more than, say, $40. And sometimes even the specific plan that you're on from that insurer. Not perfect, but it also doesn't mean EVERYone has horrid experiences w/ their insurance companies.

I just think of all the things our government is fabulous about botching up, and the idea of them handling our health care, too, scares the ####### out of me. Esp. seeing how the NHS in the UK doesn't really seem to have it all figured out either.

[Nich-Nick 3,354]

I just think of all the things our government is fabulous about botching up, and the idea of them handling our health care, too, scares the ####### out of me. Esp. seeing how the NHS in the UK doesn't really seem to have it all figured out either.

That's the main thing that worries me. Can the government adequately oversee it? We all probably have so many different experiences with health care and insurance that flavor our opinions. I dealt with slightly over 3/4 of a million dollars in medical billing for 26 months of cancer treatment for my husband who succumbed to the disease. I found software to help me keep track of it. There's three hospitals and over a hundred providers submitting bills. Yet I never had an argument with my insurance to pay anything. I had to make many phone calls to understand something or straighten out a bill with a provider. I've found that I call up the provider, like a hospital, and tell them my insurance doesn't cover whatever they billed and they take it off the bill in a heartbeat.

Example to provider: You charged for a private room. I didn't ask for one and my insurance will not pay that. Ok, I'm taking that charge off your bill.

Example to insurance: You didn't pay $1000 of an ambulance service bill that was out-of-network. We didn't order the ambulance transfer or get the opportunity to choose an ambulance. Ok, we will pay it.

I'm sure I've gotten well over $10,000 taken off just by making phone calls. I hope the government has people to answer questions and deal with issues better than the USCIS info line, the Social Security office, and the state run DMVs.