Health care reform, anyone?

[Gemmie 142]

Has anyone seen Saw 6? John's entire point in the movie is that private insurance companies are playing God and deciding who gets to live or die based on health and wealth (he has cancer and is denied coverage for treatment based on this... basically being told he's going to die because he's costing them). That's exactly how I feel. I feel incredibly sorry for those parents who have kids born with disabilities and have to go through more life changes just to pay for it. At least in the UK, everyone is covered no matter what, and you don't worry for your entire life when you lose a job, get pregnant, get sick, etc.

Edited March 30, 2010 by Gemmie

[SMB x2 0]

I didn't quite appreciate how good the NHS was until I picked up my first prescription of 30mg lansoprazole (for cronic indigestion) from Walmart. I blinked at the cashier in utter incredulity when she asked for $150 for a month's supply, I was used to paying £4 with the NHS (and, of course, paying nothing when the Welsh Assembly decided to pay for all prescriptions).

Before I started a decent job here with good insurance, I was rushed to the ER with chest pains. It's pretty sobering, staring up at the ceiling whilst they wire an EKG to you, not something you expect in your early 30s. Anyway, mercifully, it turned out just to be muscular pain and nothing to worry about; until, of course, the bill arrived and I had to pony up $600.

So yeah, hospitals here are amazing. It was like staying at the Hilton when we stayed in our suite for a couple of days, after having our baby last year. Compare and contrast my sister who was in and out of hospital in 4 hours after her baby was born in the UK. You don't half pay for it though, and even having insurance doesn't necessarily make it much better. I mean, there's insurance and then there's insurance. And even if you're lucky enough to have insurance, through a decent job or something, there's still the endless battles with medical coding drones. Shan's trippled insured and our bills are still occasionally an endless parade of "why the hell are they billing us for this?"

Anyway, step in the right direction, although I appreciate why any degree of socialised healthcare is going to get up the nose of some locals. It's as alien to them as the notion of not having socialised aspects to society to me. I think there's probably a lot of good things in this bill which have overshadowed by the general debate. I like how large food chains (20+ locations) will need to provide nutritional information on meals. I think that's something we should do in the UK, with those big coloured salt/sugar/calories/etc labels on the front of food packaging.

As an aside (if you're still reading this long post ), hi everyone! Been a while since I posted, I can't believe I'm 3 months shy of having been here 2 years. In fact, I've been working for a whole year, and it's absolutely flown by. I think now is as good a time as any to share my insights into moving to the US, so hope to post that soon.

Stu

[Usui Takumi 1,562]

Coming the other way at it, when I first started using the NHS I thought I had entered candy land. It was amazing. In the US my father was laid off while I was in University so I went on a catastrophic plan and was paying 100+ for prescriptions.

When I moved to the UK and got my first prescription, my jaw about dropped at the 6 pounds I was being charged. I could get into a surgery within 24 hours which was nice too. Coming back to the US my wife typically waits a week just to get in.

In the US we pay about 380 for insurance. In the UK, combined we paid about 600 dollars to NI a month...but when you add social security and medicare payments to insurance then the US is actually pretty comparable in terms of "premiums" obviously we have a 1500 deductable so we pay more for less in comparison to the NHS.

[weescotlassie 2]

My view on the matter is between the insurance companies & the pharmacuticals are only interested in making money to gain profits.. How can they justify the cost of the drugs in america? When in the UK don't matter what prescription you are seeking from pharmacies it will only cost you £5 & thats it.... They don't care about the wellbeing of the people never have done & never will... They are the ones who play god with peoples lives & that has to change.. So i think they are heading in the right direction of change to a better system to what they have now... I'm planning to move over to the states this year & so not looking forward on how i will deal with the health insurance... So i can't fault much on the NHS if the system works then it works...

[celticstar 2]

It's now £7.20p for a single prescription here in the UK.

I have to admit that health care is one of my concerns about moving to the US, over here I can get in and see my doctor on the same day for emergencies or within a week for non urgent appts.

I was diagnosed with ME over five years ago and that process involved a lot of blood tests, x-rays, MRI scans and hospital appts, all of which cost me nothing because of the NHS.

After being diagnosed I had my own ME counseller who taught me coping methods and gave me an idea of what to expect with my long term health, without her I would have seriously struggled to get to grips with my condition.

As it was, I was able to concentrate on getting all the care that I could for my - at times - extremely debilitating illness, there are still days when I cannot even walk to the bathroom and am pretty much bedbound, thankfully these days are few and far between and only occur when I've pushed myself too hard and too far, I know the warning signs thanks to the brilliant care I received at the hands of the NHS so can listen to my body when it starts to tell me that enough is enough.

Would it have been the same if I had to go through the American health care system?

I think not, I would have been stumped at the initial blood tests and further tests purely because of the money involved.

Therefore I wouldn't have gotten a definite diagnoses and wouldn't have been able to subsequently get the after care that I needed.

There's also the time I had a big motorcycle accident, I had various internal bleeds, lots of broken bones including my spine and a lengthy hospital stay, after I was discharged I also had a long time in Physiotherapy and lots of follow up hospital appts.

Of course, I'm not American and didn't go through the American health care system, I might be wrong. My point is that ok, there are flaws to the NHS, of course there are, there's still bureaucrats running it, but in essence it works and it works well.

Having a health system run this way is not the end of the world as some people seem to think (not on this thread I hasten to add) it's worked more than once for me and plenty of other people that I know.

It's not the system that makes the people work, it's the people that make the system work.

[Justine+David 218]

My view on the matter is between the insurance companies & the pharmacuticals are only interested in making money to gain profits.. How can they justify the cost of the drugs in america?

This doesn't answer all of the questions, but I do know that it's about $300 million from start to finish to create a new drug with laboratory testing and all of that. And that doesn't include drugs that don't make it out of the trials that the pharmaceutical companies just lose all the money on. I'm not defending them by no means, just something to know.

[Rebecca Jo 1,962]

This doesn't answer all of the questions, but I do know that it's about $300 million from start to finish to create a new drug with laboratory testing and all of that. And that doesn't include drugs that don't make it out of the trials that the pharmaceutical companies just lose all the money on. I'm not defending them by no means, just something to know.

Well, I wonder how long it takes to make back that $300 million?

Let's take the example of the drug Advair. It is manufactured by Smith Glaxo, which is actually a UK company. There is a patent for the drug in the US, which of course is good for twenty years. The drug sells in the US for roughly $180 per month depending on the strength. In the UK the drug of course costs 6 pound sterling. Literally millions of people take this drug worldwide. There is presently no licensed generic for it (there is a counterpart being produced in India).

So could the argument be made that US citizens are paying the cost of development of drugs worldwide? It's either that or, (if the drug can be sold in the UK for 6 pounds) then US consumers are the ones providing profits. Something to think about.

When the patent runs out on Advair (2012 I believe) I am sure Smith Glaxo has made their money over several thousand fold.

[Boiler 45,403]

How do you know the cost of the drug in the UK?

[Rebecca Jo 1,962]

How do you know the cost of the drug in the UK?

Well how do you not know?

May be 7.50 these days in some trusts. Nothing in others.

If you mean cost of development, I have not a clue. I was merely going with Justine's example of $300 million US. Advair was developed a long time ago and I've not got a clue how much (in sterling) the development costs were.

(edited for clarity)

Edited April 7, 2010 by JohnnyQuest

[Justine+David 218]

I mean...it's obvious that they make lots of money because they used to be able to send doctors who promised to prescribe their drugs all kinds of perks like "toys," vacations, etc etc. Now it's against the law to do that (and rightfully so) in order that doctors aren't biased for or against a drug.

[Boiler 45,403]

Well how do you not know?

May be 7.50 these days in some trusts. Nothing in others.

If you mean cost of development, I have not a clue. I was merely going with Justine's example of $300 million US. Advair was developed a long time ago and I've not got a clue how much (in sterling) the development costs were.

(edited for clarity)

I do not think the Pharmaceutical Companies give it away.

Edited April 7, 2010 by Boiler

[Rebecca Jo 1,962]

I do not think the Pharmaceutical Companies give it away.

In some parts of the UK, people do not pay for prescriptions.

I have no idea what the NHS pays the pharma companies for these drugs. It's the same concept though as pharmaceutical insurance. Some people pay a lot and some a little. Except in the UK, "a lot" will be no more than 7.50. In the US, "a lot" means full retail price if you are uninsured. Or the humiliating experience of begging samples from your primary care physician or from the drug companies themselves through their "indigent" programs.

If the NHS can offer low cost prescriptions, it certainly can be done in the US. Five times the population equals five times the customers.

[Gemmie 142]

I remember my family complaining that they had to pay 6.50 for prescriptions at the time (because when you're on low income or over a certain age they're free) and having a good old moan about the NHS. But now I see that this is NOTHING.

[Usui Takumi 1,562]

I may be totally off base here, but I always thought that drugs are cheaper in the UK because of the NHS' buying power. IE Since they purchase the majority of all drugs they have a lot more bargaining power to get the best price.

Again I may be way off.....

[DukeOfYork 28]

It all comes down to subsidies. I'm willing to bet that NHS pays subsidies to offset the cost of prescription drugs. They do the same in Spain, Canada, etc. That and they have contracts with big Pharma for their drugs. Since Big Pharma can't make much money off the UK, Spain, Canada, etc, they make up the difference by charging full price here in the US. So yes, we subsidize the cost of drugs for the rest of the world, along with doing the research and producing them.

I'm not saying it's right, but that seems to be how it is.