Billy_wizz
Established Member
We obviously have very different interpretations of free! In my eyes if you pay for something it's not free even if you collect it at a different time to paying for it
Invasion of US Capitol building
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RobinBHM
Established Member
It is free at the point of delivery, it is not means tested nor determined by pre existing conditions.
USA private system is a terrible system, far more expensive than the UK system and wholly driven by profit.
Imagine having to choose between selling your house or buying drugs for your child......most common cause of bankruptcy in USA; non payment of medical bills
billw
The Tattooed One
Calls from the Republican party in Texas for him to resign.
billw
The Tattooed One
I worked out of an office in North Carolina for one company, and one of the guys there had been involved in an RTA that wasn't his fault - hit by a truck so some pretty major surgery required. He showed me the invoices.....bloody hell. Well into six figures.
It's weird to see so many Americans frothing at the mouth at the thought of "socialist" healthcare but at the same time being happy to pay hundreds of dollars a month to an insurer where the money goes towards healthcare and profit rather than giving hundreds of dollars to the government for just healthcare. Yes there's a choice in the latter situation but would anyone who could afford it risk NOT buying insurance?
If you’re fairly affluent then it’s actually quite sensible to self insure, ie put money aside each month, to cover smaller things. Ie phones loss, jewellery, bikes etc these items add considerable cost to many policies as so many people are bloody hopeless at looking after their property. However to self insure for Heath care you’d need to be Elon Musk.
Fitz.
Fitz.
Ok - sensational. Let's assume that you're in a situation in the US where you have a very sick child and run your assets out. First, the state CHIP program would provide insurance for your child (free) before you got there, but if you were also sick, you'd get disability and medicaid and the disability for your child. You are required to have assets below a certain level if you're getting medicaid, and not have separate income that you're hiding while you collect disability and medicaid, but you are not required to give up your house. If you have no money and a house, you have no money - not "you're not out of money until you sell the house".
There are a lot of people who have the means to buy insurance and think they'll risk it and they *do* get stuck in a medical bakruptcy, but if that occurs, you can discharge the bankruptcy in a filing and start over. If you have the money to pay the bill and you're uninsured, then you're stuck paying.
How far does the disability go? We have some well to do friends with a disabled child (born disabled, but think almost functional - just not quite). They collect disability for their child (which I don't have a problem with, by the way) and their child gets medicaid (which I don't have a problem with). Their means aren't considered with that - the system just provides them additional income and also provides their child with free medical coverage.
I'm sure this kind of truth won't be popular.
One of the biggest groups of risk takers in going uninsured, though, is small business owners. People start a business, they want to plow all of their money into it, so they take a risk. Then, the business becomes more comfortable and they just decide to keep kicking getting insurance down the road further.
There is one big hole in the system here, though, and that is early retirees who *do* have assets. Coverage for someone age 60 or so is about $20k for a very high value policy. If you budget for it, no problem. If you don't, you keep working - you won't be eligible for early medicare unless you qualify for disability for some reason, but if you do, I'm not sure whether or not such people can get medicaid before they run out their assets. It's generally said often here "i have to keep working for the insurance".
Our tax rates are much lower than the UK, though, so it's generally a matter of discretion. Housing is cheaper here, etc. If you wanted to have a couple with two trade jobs with benefits (which is something anyone can do without going to college, etc. Just go to the local and sign up as an apprentice) and you truly wanted to live spartan, you could make $120k as a pair and bank a large amount of it and be very comfortable (a lot of the trades have free or highly subsidized retiree medical, too.
All that said - if you want to be lazy, work only part time jobs that are easy and never really get motivated - this isn't the greatest place to do it.
small business owners do it quite often - but they're usually risk takers just based on the fact that they're starting small businesses. People who are risk seekers sometimes get stuck doing really dumb things, though.
Health care for a person age 40 is probably about 400-500 a month. If you're self employed and making bank at some smart little gig, it's not really that expensive.
I'd prefer to have less generous insurance and less expedient care at half the cost, but I guess most of the country doesn't agree (as in, I'd be fine with NHS type care). You can tell me the care is just as good there, but you're full of it (just that it doesn't matter to me). I've got an english pal who got me into woodworking who is of means and one of his constant rails is the NHS after getting spoiled here. Same with a work transfer couple here who stayed in london 3 years. I asked them about health care and they said "we didn't use it except in emergencies - it's abhorrent". Small community emergency centers that didn't have xrays, and such things. I guess you can save money, but having an emergency care center without the ability to give an xray to a kid who breaks a leg, taking several hours or the better part of a day being sent somewhere else and waiting for care - no thanks.
WE are off in the other direction, though - you can get point of service care anywhere in a suburban area. No restriction and the princely sum of it costing another $10 for me over my regular PCP. Even the PCP takes walk-ins now to try to compete with it (so I would just go to my own doc's office without an appointment - probably be forced to see another doc at the place, but I could just walk in there 6 days a week and the visit is covered no questions asked). That, in my opinion, leads to overutilization. Catering to demanding customers who don't want to be told "you're fine for now, you don't' need a script and you can come back in a month and we'll look again", also not a help.
billw
The Tattooed One
@D_W we do have private healthcare here too where you can basically stay in a posh hospital and probably get treated by the same bloke who'd do the surgery on the NHS except he charges a lot more 
No emergency treatment though, private usually only covers stuff like surgeries, scans, physiotherapy etc.
No emergency treatment though, private usually only covers stuff like surgeries, scans, physiotherapy etc.
our friends had an instance of a child who has attention deficit. He functions well on stimulants. I don't know the full story of what they were telling me (I admit I wasn't fully paying attention), but it was something along the lines of NHS not thinking it was really a "thing", or at least not with the stimulant that he responds to. What is the follow-up for someone like that?
Here, you can run into docs who think the same thing "we're not going to prescribe an advantage for your child", which is pretty narrow minded. The remedy is to switch docs here, or even switch medical systems if the medical system polices are a poor fit.
Here, you can run into docs who think the same thing "we're not going to prescribe an advantage for your child", which is pretty narrow minded. The remedy is to switch docs here, or even switch medical systems if the medical system polices are a poor fit.
billw
The Tattooed One
Droogs
Not the Sharpest Moderator in the box
I do think our system of paying roughly 20 quid a week for a national insurance stamp and getting a health service free at point of need is probably the greatest social achievement in the history of civilization. the fact that everyone gets the help they need is great, yes there are problems in certain areas but i the main they are caused by capitalist greed like the wheelchair situation
Terry - Somerset
Established Member
The US spends 17.6% of GDP on health care, the UK 9.8%.
Double the money should provide a more flexible better service. It also provides the headroom for inefficiencies, poor management, unnecesary treatments etc..
What the extra money demonstrably does not do is provide free at the point of use universal health care - the principal reason the NHS is held in such high regard.
That headline US personal taxes are lower is simplistic - if the cost of health insurance is $5-20k depending on age etc, any tax comparison should take this into account.
This is not intended as a critcism. The US should democratically decide on the balance between public and private provision of services.
But is does illustrate a very fundamental difference in culture and expectation. As always two countries divided by a common language!
Double the money should provide a more flexible better service. It also provides the headroom for inefficiencies, poor management, unnecesary treatments etc..
What the extra money demonstrably does not do is provide free at the point of use universal health care - the principal reason the NHS is held in such high regard.
That headline US personal taxes are lower is simplistic - if the cost of health insurance is $5-20k depending on age etc, any tax comparison should take this into account.
This is not intended as a critcism. The US should democratically decide on the balance between public and private provision of services.
But is does illustrate a very fundamental difference in culture and expectation. As always two countries divided by a common language!
I think you'll find that the average income in the us after taxes and medical insurance is still higher than the uk after tax. Just to start, the GDP per capita is enough larger to cover the health care cost..
Developed into a health care debate though currently there seems to be no need to have insurance if youve caught covid.
Scenes in the capitol building were horrific, and i do stand against such behaviour though at the same time feel terrible about the death of that poor woman. The policeman overstepped his bounds and there was no need to fire. She could have been grabbed and wrestled to the floor.
Donald Trump has blood on his hands from this event, he, more than the rioters should be held to account.
Scenes in the capitol building were horrific, and i do stand against such behaviour though at the same time feel terrible about the death of that poor woman. The policeman overstepped his bounds and there was no need to fire. She could have been grabbed and wrestled to the floor.
Donald Trump has blood on his hands from this event, he, more than the rioters should be held to account.
John Brown
Freeloading Social media influenza
I think the bottom line is this:
In the US, you pay about twice as much for healthcare as in the UK, but the out outcome is worse. However, you can have hotel quality accommodation while receiving your overpriced, inferior healthcare. Also, you have the freedom to badger your doctor into prescribing the drug with the biggest advertising budget. It's unlikely to change, as there's too much money involved, and the "I'm alright, Jack" attitude of many citizens. Medical mistakes are the 3rd largest cause of death in the US, according to some statistics.
The very fact that D_W has written so much on this subject is very telling. Average wages are higher, but minimum wages are, in some places, abysmal. A lot of goods and services are now more expensive than in the UK, whereas a decade or two ago, they were cheaper.
Americans are brainwashed into believing that they are the best country in the world, whereas in reality, they fall short by so many metrics.
In the US, you pay about twice as much for healthcare as in the UK, but the out outcome is worse. However, you can have hotel quality accommodation while receiving your overpriced, inferior healthcare. Also, you have the freedom to badger your doctor into prescribing the drug with the biggest advertising budget. It's unlikely to change, as there's too much money involved, and the "I'm alright, Jack" attitude of many citizens. Medical mistakes are the 3rd largest cause of death in the US, according to some statistics.
The very fact that D_W has written so much on this subject is very telling. Average wages are higher, but minimum wages are, in some places, abysmal. A lot of goods and services are now more expensive than in the UK, whereas a decade or two ago, they were cheaper.
Americans are brainwashed into believing that they are the best country in the world, whereas in reality, they fall short by so many metrics.
Vann
Established Member
Vann
Established Member
Shades of the Hong Kong protests? I'll bet the mainland Chinese government considered the students (and others) to be forcefully gaining entry to a government building in order to change the results of a 'legitimate' law.
Cheers, Vann.
Jacob
What goes around comes around.
You get the full NHS treatment even if you haven't paid the £20 a week for whatever reason, which is what distinguishes it from any private system, along with the fact that state organisation is highly cost effective. We pay much less per capita than Americans and get a much better service. Even Cubans have better healthcare then USA
People keep saying free 'at point of use' as though it's not really free. But anything 'free' is either paid for by somebody else or has some sort of cost somewhere down the line.
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