Universal health care - thoughts?

Krista - posted on 09/26/2011 ( 734 moms have responded )

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Not to pick on Sherri (seriously, I'm not), but a comment in the abortion thread made me wonder:

"I agree with everything you say Krista except I am also 100% against Universal Healthcare and I am pro choice. "

I'm curious as to why anybody would be opposed to Universal Healthcare, their rationale, and what they see as a good alternative to it. Are you for or against it, and why?

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Angela - posted on 10/16/2011

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Angela J I apologize I miss your question at the bottom the post you addressed to me.



The system is largely paid for by employers who pay an income-related contribution of 6.5% of their employees' pay and by individual premiums . Of the total funding, 50% comes from the employer benefit, the government contributes about 5% and the rest paid by the individual in premiums. Most citizens pay the equivalent of about 1-2k USD in premiums, and children up to age 18 are covered for free. Those who can not afford it are subsidised by the government.



I am all for helping people become legal citizens or residents. It protects everyone. I am all for helping those who want to fully integrate and do so. I am all for deporting or giving fines for those who refuse to even try to be legal. I am appalled at some people who feel a sense of entitlement despite thumbing their noses to the laws. I am for polices that will help control illegal entry into a country.

I am not for ignoring a growing issue in the USA and also in Western Europe.

I don't want walls with guns but I do want policies that make it hard to hire an illegal for example. I want rules to be enforced that we already have.

I am for the deportation of people who commit serious crimes.

[deleted account]

No, Karla you're right to blame the for profit insurance companies! Think of it this way: they want to make a profit and to ensure that profit keeps happening they need to control supply and demand. So, plan of attack is to get doctors into lucrative arrangements. Remember, they have astronomical student debts to pay when they get out of school. The better educated, the higher the debt! For example, when I was accepted into JHU 20 years ago I was looking at about $30k/yr (plus living expenses and books)! So, a doctor will have those debts PLUS malpractice insurance (which is also stupid expensive, but totally necessary). So the doc will want to make a very good wage, and in steps Deep Pockets (insurance company).

The insurance company now has the doctor on side, which they further keep hemmed in with bonuses. They then jack up their premiums to purge the high risk people (read: poor). Now, to be able to maintain this constant flow of positive returns, they limit what's covered, add new limits to what they'll pay out, basically twist and turn in the wind.

How can they maintain this fourth ring of hell called the health INDUSTRY? By having politicians in their pockets through lobbyist funds and campaign contributions... on both sides.

Doctors are kind of the patsies. They want to help people, but they need to make a living too. Because being a doctor takes a lot of hard work, they want to make a very good living. Heck, we would all like to make a great living, I'm sure.

Okay, I remember this lady I met in NY who is concerned about immigrants of every kind and she's willing to take them in, in the hopes of providing them with a better life. This is what she said to me on the subject, "Bring me your poor, your weak, your huddled masses yearning to be free." Crazy old lady!

Minimum wage should be increased, healthcare should be available to ALL and why not make illegal immigrants already established in the country legal permanent residents (notice I did not say citizens). If those people are residents, they will pay into the system that they are benefitting from in terms of schools and health so it's a wash, rather than them using the public systems and just leaving the bill for taxpayers. As it stands, people who are illegal do not use the healthcare system for preventative medicine. They will only go to the doctor if they are almost on their deathbed because they are afraid of being caught and deported. So when they do present to an ER that will take them (yes, an ER can refuse service), they are incredibly (and expensively) sick. If you keep people fit and healthy, they cost the healthcare system less.

What would be the big deal to include an extra 11 million people to the 50 million uninsured? It's only a small percentage. And as it is, 50 million is a small percentage of the total population, which is why many people (and most politicians) don't seem to want to make a real change. I mean, who cares about "them", right? And people talk about other countries' governments being corrupt!

Karla - posted on 10/15/2011

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The USA has a population of approximately 300 million people; I don’t think the approximated 11 million illegal immigrants would break the bank on UHC. (what is that? 3%?)



Federal US minimum wage went up in 2009



Alabama is learning the truth about whether American citizens want the jobs that are currently occupied by both documented and undocumented immigrants (who are currently fleeing the state out of fear of the new laws concerning illegal immigrants.)

http://www.npr.org/2011/10/14/141343964/...



From what I’ve read most Migrant farm workers are documented and make minimum wage: 12% of all farmworkers earn less than the minimum wage.

http://www.migrant.net/pdf/farmworkerfac...



And according to ABC NEWS:

Illegal immigrants are already eligible for emergency care through the Emergency Medical Treatment and Active Labor Act, signed by President Reagan in 1986. This emergency care is often paid for by Emergency Medicaid, private insurance if the patients have it, out-of-pocket, or it's written off as bad debt or charity care by the hospital.



And this surprised me:

Conducted by two Columbia professors, one of whom is now a high-ranking health official in the Obama administration, concluded that primary care doctors and orthopedic surgeons earned an average of $187,000 and $442,000, respectively, in 2008 -- substantially more than doctors in other countries. That seemed to stem from charging higher fees, not from seeing more patients or using more expensive treatment.

U.S. Private Health Insurance Plans Pay Doctors a High Amount

While there was a smaller discrepancy between the size of payments doctors received from Medicare versus from public insurance plans in other countries, private insurance plans in the U.S. paid doctors the most of any country studied.


Full article:

http://www.ibtimes.com/articles/210673/2...



That says something about the agreement between private insurance companies and doctors. It’s also messing with my head: I was just blaming corporate insurance companies for the inflated insurance premiums and continuing rise in deductibles, but now I see I should be blaming doctors as well.



So, perhaps poor people and unpaid hospital bills are getting a bad rap.



edit to add: I'm more concerned about the current condition of having 50 million uninsured Americans.

http://www.usatoday.com/news/nation/2010...

Angela - posted on 10/15/2011

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I really want to address some post but I have a bday party and anohter engagment Sunday I will try to get on because not only do I find this important but very intresting.
I by no means claim to be a politician, but the immigration issues is one, and needs to be dicussed policy wise. The politicians are going to make poliicies and personaly I hope at least where I can vote I am a part of making those decsions with them not with out them.
I was just talking off the top of my head at the post on immigrations.
I think many deserve for the most part to citizens or leagal residents. Then they are protected and have the same rights as all citizens and legal residents. They can get the tax refunds, UHC etc. Basic ER care is not enough.
I do think we need to address the group not to matter if they are the minority or not who do not want to integrate into society. Those who promote crime and violence. etc.
In addition I think we need to change policy for the future immigrant to make sure they come here and do so legally.

[deleted account]

Actually, I have not noticed any increase in the cost of food above or beyond the increase in cost of other items (but that is mostly because it is not something I pay much attention to-I do not dispute that costs probably have risen).

I do agree that minimum wage should be increased, but increasing minimum wage would not help illegal immigrants because they do not earn minimum wage; they are paid under the table. If employers are found to have illegal immigrants on their payroll, they are heavily fined, so these employers keep the immigrants off the payroll and pay them horrendously low wages. Making them legal, would not help because employers who added them to legal payrolls would have to pay them double what they have been, which would drive prices up even more. But more likely, these crooked employers would simply refuse to acknowledge their legality--immigrants don't have much choice when it comes to work. So I think most employers would simply say "stay on under the table, or look elsewhere" which would get us nowhere.

Because most minimum wage jobs in the US fall into the service and retail industry, a raise in minimum wage would not cause a drastic increase in the cost of NEEDED items for most Americans. It would cause a small increase, but again, you can pay more for the item, or more in taxes to support the government programs people earning minimum wage depend on.

It's a catch 22. I hope all this makes sense--these drugs are making me all groggy and disoriented. Basically, I agree minimum wage should be higher, but I don't think it will help our illegal immigrant population; I think illegal immigrants contribute enough to our society as they are to be entitled to the same health care the rest of us are entitled to, but I would like to make them legal somehow without making their situation worse....

♥♪Megan♫♥ - posted on 10/14/2011

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Kelly, in case you hadn't noticed the cost of goods and services in the US has been going up steadily while minimum wage has stayed the same since the Clinton administration. Politicians keep refusing to do a living wage for people who earn near minimum wage and yet the Tea Party wants to get rid of government assistance programs and everyone in DC keeps giving themselves raises. Where's my raise?

In Canada the cost of living is high since we do pay for health care from our taxes, but our minimum wage is aroun 9.50$ an hour and there's been talk in Ottawa of raising it to 12$ an hour.

[deleted account]

The problem with just making illegal immigrants legal is that we have to pay them more--at least minimum wage--which drives up the cost of the products they help process, such as meat and produce, while making them eligible for all government assistance programs. It is actually CHEAPER for tax payers to allow them to work here illegally.....of course it is inhumane.



I honestly don't have a solution for that. Many people barely make ends meet now and would starve if the cost of produce and meat were driven up any higher, but on the other had--illegal immigrants are people, they contribute heavily to our society, and they deserve the right to proper medical care. Currently, illegal immigrants CAN go to an ER for treatment, but that is the extent of it. If they were in my situation, they would die.



One *could* consider the $$ they save us on the cost of food and other needs a just contribution towards their use of government programs. The money comes from the same place: If they are legal, we pay more for the food, so the farmer can pay the worker more so the worker can pay his share of the taxes OR if they are illegal, we pay less for the food because the farmer can pay the illegal less, but our taxes go up to cover their portion of care--either way, we ALL have to work together to insure everyone gets medical care. It is just a question of whether you'd rather pay higher taxes, or a higher food bill.

Sylvia - posted on 10/14/2011

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Angela, sorry, yes, I see that you went into more detail in further posts. And the link didn't work, it turns out, because CoM auto-added its own URL at the beginning, wtf? :P

I definitely agree that there's a problem. Canada's IMR is a problem, too -- particularly when you drill down and find that IMR is enormously higher among First Nations than in the general population. My objection was to the idea (which your first post on this topic suggested, although later ones don't) that universal health care in the NL is the cause of the problem. Since essentially every country in western Europe has some form of what Americans would call "socialized medicine", that's obviously not so -- the cause must be something else, because UHC is not unique to the NL. (I would also disagree that it's the practice of having midwives as the default prenatal care providers and birth attendants that is the cause of the problem: in many other places around the world, midwifery care has better outcomes overall than OB care. But I'm perfectly willing to accept that there are serious issues with the specific midwifery care that's being offered in the NL.)

Since we're talking about whether or not UHC is a good idea, though, it seems perfectly fair to me to compare health outcomes between the US and other places around the world that have or don't have some form of UHC. And furthermore I think it's fair -- and not just fair but important! -- to compare outcomes between the US and other wealthy developed nations. In that sense it's totally irrelevant, even if true (I don't actually know whether it is true or not), that the USA's higher IMR is boosted by "immigrants and drug addicts", as someone said in a post above. Lack of access to decent prenatal care for an entire segment of the population isn't an excuse, it's part of the problem. It's not, IMO, objectively better for half the population of a country to have state-of-the-art medical care while the other half is SOL, than for (nearly) everyone to have access to reasonably good, but maybe not the very very very best, care.

I toot Canada's horn a lot when talking about health care but we should remember also the piss-poor health outcomes among First Nations communities, which are nothing to be proud of. I don't know what the answer is, but we as a country really need to be looking for one.

ME - posted on 10/14/2011

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Undocumented people are still people...many of them come here because our trade policies and drug policies make life unbearable in their own country. I have no problem with my tax dollars going to pay for health care for everyone. I do have a problem with my tax dollars going toward a failed war on drugs which has led to the murders of hundreds of thousands of people. I also have a problem with trade policies that make a successful life impossible for millions in my own country and around the world. I am sure that the tax dodging corporations are thrilled that ignorant Americans are blaming undocumented immigrants though...

Karla - posted on 10/14/2011

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In the USA

Illegal immigrants generally work, (that’s why the come here to work) and it's estimated that 75% have taxes taken from their wages, and they don't file an income tax return so many are paying more into the system then average low wage citizens. (Most tax breaks are applied when filing a tax return.)

If you read the wikipedia article that I linked earlier you would see that the Affordable Care Act is not UHC and does not cover illegal immigrants.

http://en.wikipedia.org/wiki/Affordable_...



Concerning Illegal Immigrants:

http://roygermano.wordpress.com/2011/02/...



The 1996 Personal Responsibility and Work Opportunity Act barred illegal immigrants from receiving any welfare benefits except in medical emergencies. It also barred legal immigrants from eligibility for welfare benefits during their first 5 years in the country. So, no, illegal immigrants do not exploit welfare services quite simply because they are not eligible to exploit them.



and

In Plyler v. Doe (1982), the Supreme Court ruled it unconstitutional to deny undocumented immigrants K-12 public education. Denying education would not only be crippling to the immigrants themselves, but would have broader social impacts. But regardless, by directly or indirectly paying property taxes, undocumented immigrants pay into public education. In general, immigrants benefit from police service, firefighters, national defense, parks, and other public goods. But again, the taxes they pay contribute to paying for these services.

American-born children of undocumented immigrants are eligible for welfare benefits like Medicaid. But it’s important to remember that the recipients of these benefits are children that the 14th Amendment has deemed full citizens of United States.




If we had UHC I think it would be fairer to the citizens, because then the 75% of illegals’ that pay income tax would be contributing to their emergency care. (That is the only care they are qualified to get according to current law. *edit to add - though I think that's only if they do not have the means to pay their bill.*) Currently any unpaid Hospital bill (by illegal immigrants or anyone who cannot pay their bill) is worked into the budget of the hospital therefore paying patients (whether through insurance or cash) end up with higher bills.



As it is, the US Affordable Care Act will not aid the illegal immigrants any more than they are aided now.

Angela - posted on 10/14/2011

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Angela J I really do not think it is off topic to talk about illegal. Because as you say it is relative to health care. You have to consider their health care and policy concerning them.

The united states and many other Western Europe and countries are struggling with a class of immigrants that they do not know what do with.

This is the immigrant that is not in that class;

Asylum seekers

Students

skilled migrant workers filling jobs that such skill are needed is said host country.

Family reunification

These are all welcomed immigrants in most countries.



Families who have been here for decades and not legal but work and are a part of society.

The immigrant is the ones who have been a host country for decades, performing jobs under the table etc. They have families and are well integrated in the culture and country. Their children are born in the host country, and or brought to the host country.



The unwanted is the illegal immigrant, not seeking employment, not really intergenerating into the host countries society, leaching off the system. They do exist everywhere. They are mostly footing their bills through illegal activity and promote violence and crime as a way of life.

We have to get grips on immigration policies, enforce them and fix a problem that essentially most of western society created.

There was a time we welcomed these people, did not care to make them legal because we did not have to pay for their unemployment, minimum wage, health insurance etc..

At one point in time not anyone one who was legal or a citizen wanted those jobs they were doing.

Again you also had a class of immigrants who were crooks and saw opportunity for organised crime. Look at America's Italian migration to the USA and the connections to organised crime back in the day.

My solution is simple but costly of course but the cost will be offset but a larger population that gives back to society.

grandfather those who want to stay with conditions, learn English, job training etc if you do not have these skills.

If you hold a job make the employer legally hire them they are grandfathered in.

Make sure all children are in school etc and in good health of these families.

Any immigrant that does not go into such a integration program is subject to deportation and fines.

This is what they do here.

Even immigrants such as myself have to follow integration laws, etc or I face fines or deportation. Deportation is a last resort.

If an person is legal they have health care. So to me the answer would be to help those who want to become legal do so in a time frame and at times a case by case look. They do this also here.

For example for my daughter Samantha she was given extra time(as much as she needed) and help because of her learning disabilities. She also had a special test to pass for citizenship. She had a casemanager as do I. Because I want to remain as a resident and she a citizen we had not much problem with what was asked of us.

We did pay a small fee for the test, if you pass the test you pay nothing. 270 euro was the cost, but the courses and programs are worth 7000.00 Euros. We are considered upper middle Class being in the second to highest tax bracket, this really seem like a fair price to pay in my eyes.

Angela - posted on 10/13/2011

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Although it is off the topic in a way I felt the need to comment about the illegal immigrants. I do think they would pose a big problem to a UHC system because they would not be paying into the system but still getting medical treatment. With as many illegals as we have they could run up a huge debt that would have to be covered some how (this is happening now and is a big problem). If they go to the Dr;s and then do not pay the bill the dr/hospital would still need to cover the cost of their treatment. As for letting them become citizens because they have been here and established a life and family I don't agree. I know it is a very messy thing to figure out with kids , family and jobs but didn't that happen before? All illegals were granted citizenship and now we are back in the same boat (thought I was told this was done before but icould be wrong). I think the USA needs to really crack down on the illegals because it is a huge problem in this country and costs this country a ton of money just ignoring the issue. I understand they do jobs that people say Americans wont do and also do it for less pay but they also do jobs Americans would do. I think It has a big impact on our welfare programs as well as our unemployment issue. I don't want to break families up but I also don't think just giving them citizenship is the answer. After all they did break the law before they built the life they have now. I wont say that it is ok to not treat them in an emergency because they are human after all but Americas needs to figure out how to slow down the illegal immigrants coming in and speed up the legal immigrants coming in.

Angela B did you said the employer reimburses the employee for the health insurance cost? Are employers required to provide the insurance? Just trying to understand. Your system does sound different than the rest in a way. Maybe with some changes it could be something America would go for. Who knows?

Angela - posted on 10/13/2011

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LOL I can speak Dutch but I have a heavy accent and I can write it also but my speaking is what needs the practice. After living her I catch myself saying Englsih sentences using Dutch grammar and words.
For example in English you say take your shoes off
In Dutch Schoonen out it translate to take your shoes out
I say that and get really weird looks.It is just unavoidable when living in new country with a new language. I also say my English gets worse as my Dutch gets better. I am always having to switch my brain from English and Dutch.
Sometimes it gets all jumbled.
Oh the Curry is very good I love it too. I send bottles to the USA to friends and family. Did you know it is actually German. But the Dutchies adopted from them.
Do try the stroopwaffels I only found one person who did not like them.
Peprnoten translates to pepper nuts... They taste nothing of pepper but it is because they have a lot of spice. I love them too in fact we just bough a big bag because the stores are starting to stock up on the SinterKlass stuff.

[deleted account]

THAT'S IT! I would never have been able to write that, but I recognise the name. I love them! They should be available all year if you ask me. It's been a while since I've been to the import store, but there are so many nice things. The "curry sauce" (that's how it's pronounced, not how it's spelled - which I can't do), the only form of ketchup I like in the world of ketchups, I can get from my local grocery store at least when I've got the craving. I'll definitely keep an eye out for the waffles. I love to try new, yummy foods!

Also off topic, but noteworthy... while you may not speak Dutch well, you write English like a Dutch person well! :-) Good luck with the lessons!

Angela - posted on 10/13/2011

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@ Donna the cookies at SinterKlaas are called pepernoten! They are yummy so hare stroop waffles ever see those if so buy them they are lekker! (Dutch for good)

Angela - posted on 10/13/2011

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Donna my husband spent 3 months in Perth and before that 6 months traveling all over the country and Bush camping. You are right the Dutch love Australia. It is big tourist destination and many move their if they can.
I think it is the sunshine and the warm people that attracts them. We don't get much sun here!
Like you I am an immigrant and I know how it feels to be treated badly and judge just on where I come from. I know what it is like to get yelled at because I don't speak the language very well yet despite beign her a long time. I have reasons and all are good even the immigration offices excused me from compusalry Dutch lesson for a few years and in fact I am starting again in 6 weeks! Can't wait really.
I would be devestated if for some reason I was forced to leave what is not my home, my family is here, my husband and Clarie and Samantha are Dutch. Sammie has Dutch citizenship, and passport she passed it recently.
So I can't imagin coming from a poor country or worn torn country and leaving everything to only be treated less than human.
At least I came by choice and was not poor. I too had to purchase temp insurance upon entering this country for myself and Samantha.
For me it is about humanity. Defintely grandfather in those who have lived in some place for a long time, have family,jobs etc. Help those who want to become citizens and yes basic health for all humans is to me just humane.

Angela - posted on 10/13/2011

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I want to state this discussion shows their are many flavors of UHC. But what is constant is equal access and no one is denied care for a pre existing condition. That is is affordable for all and over all the care is good as or in some cases better than in the USA.
Americans need to realize when they read about other countries UHC that it does not mean the negatives that effect on country will effect the USA. It will be American UHC.I think most American's can agree that we could come up with a great UHC care for Americans. I thought we were great innovators!

Also I want to state I love The Netherlands their are some cons like bad weather (rains a lot) and room for improvement on tolerance and respect with immigrants and immigration policies. (this seems to be a wester world hot box issue over all) UHC is a new system utilizing private insurance and I am not sure how well the government can keep them in check. But so far it seems to be working. Many of the health care issues in NL have to do with politics and a crappy health minster and a bunch of old fart men on the policy boards. They are back in the stone ages really and just being stubborn. But they do have to think of cost and budgets of course.
There are good midwives, nice home birth practices and after birth care for infant and children is top notch. The well baby clinics are great too.
The quality of life her is exceptional. People are happy, kids are happy, crimes are low and homeless people really don't exist. Education is good and freely available. In fact one great thing about NL is you can choose any school you like anywhere in the Netherlands, we have all types of schools too. Montessori, traditional, creative setting etc. you name we have it. All cost the same except the private international schools which are geared to expats who probably won't be in NL for more than 5 years. They are expensive but you can choose them also.
Gays have equal rights, can get married and we also have living together contracts where you have the same legal rights as married people under law.
So on many issues the Dutch are progressive, tolerant and lovely people. Yes they are very direct and that is the culture they don't care if others think they are rude.
IF you get a new hair cut don't be surprised if a Dutchie will tell you it looks like crap! :)

[deleted account]

Oh no, I agree. Every system has pros and cons. Shoot, LIFE has pros and cons! And the Dutch system is new, so until it's at least 10 years old it can't be judged too harshly for it's delivery of service... which it actually seems to do pretty well at.

Ohh... we love our Dutchies!! (as in the people and not the drug) It's surprising how many Dutch come here. There's a Dutch import store not far from me. Hell, there's a Dutch food section in a major grocery store chain! Of course there's also Aldi's (German, I know), but they often carry Dutch items too... like stuff for Sinterklaas. Those little biscuits that I can never remember the name of, but love. Yum!

I actually find myself agreeing with you on most of your thoughts. Since I'm an immigrant, I can now understand what it's like going through the process and trying desperately to stay in a country you love. You can encourage a person to enter a country the legal way, but it won't always happen. So maybe a 2 tiered plan for non-residents? One for those grandfathered in and emergency care for newer ones? I have no idea how to approach it, but just know that everyone, regardless of who they are or where they're from, should be able to access treatment. I had an insurance before I got residency here. Overseas visitor cover from a private insurance company. I paid a premium and I paid for services, but I could claim those fees and get the bulk (most of the time all) of the money paid back. What's wrong with offering something like that to non-residents? It means the person/family is covered and doesn't become a burden to the system.

Angela - posted on 10/13/2011

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I hope they will provide basic service to illegals too. I know plenty of kids not born in the USA that are now young adults who are ilegals but the USA is all they know and they are educated too. But it is a double edge sword with the issue. I feel people who have been here for years and years shoudl be allowed to stay and get citizenship. But new immigrants must do what is needed to come in the USA legally to protect them and others.

Yes I think the situation in NL is just that the situation here the cons here and I by no means feel anyone should judge UHC as a whole on those cons. They are very fixable. IT is a work in progress. I think it can work and please know their is good doctors.

Yes they hoarded the vaccine, they had it for months before they offered it to the high risk groups but ignored some high risk groups entirely until much later. What is awful is NL was one of the first countries to have 2 vacciens available for all its people while other countries had to ration to high risk first etc due to shortages. We had no such shortage. We just had vaccines worth a lot of money.

What really upset the public is foot ball players got the vaccine before the general public. I think our Health minister is a joke and I hope he leaves soon.

Like I said before my hubby is always looking for an expat post in Oz. His Dad has one and loves it. I would think I would like the health care very much and the country. I love sunshine!!!

Edit to add I am pro home birth by choice too but with good midwives. I am also pro choice for hospital births and if woman want pain relief they should be able to have it. It is our bodies, our birth not anyone should dictated out of politics or money where or how I give birth.

Also all women in the western world should have good prenatal care, safe labor and delivery etc. It is not acceptable to have otherwise.

About the woman who had the baby upstairs she was a first time Mom I don't think she thought of anything like what if something goes wrong in my view the midwife should have made sure 100% that she was in a safe room to give birth. I think it was her responsibility.

[deleted account]

I'm absolutely floored by your post, Angela B. Those stories you relayed don't have as much to do about the UHC system as they do about the quality of care really. Well, except the vaccine thing. I can't imagine why it would be hoarded. The system is supposed to protect it's citizenry. It was the exact opposite here. When they started pushing the H1N1 (and that's exactly what they did... push!) it was free for everyone and I remember getting letters and pamphlets in the post about how it was available at my doctor's surgery, blah blah blah. I didn't want it, but it was impossible to avoid knowing that it was available everywhere for free. Well, at least where I live in SE Queensland.



Funnily enough, the exact opposite is happening here with regard to home births too! They are trying to make it harder and harder for women to have a home birth. The insurance midwives carry has gone up dramatically and I believe that even some companies have made it so that midwives that carry their policy cannot perform home births. I think it's getting to the point of a bit too much intervention is happening. If you get your prenatal check ups and are having a "normal" pregnancy and expected birth, I believe you should have the option of doing it at home if you want.



Why on earth didn't the one woman set herself up on the ground floor?? That's just bad management on the part of the midwife and patient.



As for the illegal population, that's always more of a political football. Personally, I would want at least basic care provided for them. Maybe even charge a small fee when they see a doctor. I have a very dear friend (she's like an older sister to me) who was illegal when I met her. She is the hardest working person I know, even now that she's been a legal US resident for nearly 2 decades she still works 30 days a month. (no that isn't a typo, she works every day of the year with the exception of maybe once every month or two she has a day off to go to church) The illegal population do the jobs that a country's citizens don't want to do and won't do, so why not help them out since they are helping the economy of the land? They are the cleaners, fruit pickers, shit shovellers... the bottom of the barrel... in fact, they could pretty much be classified as the "unclean" caste. It absolutely shits me when I hear people spouting off how the illegals are taking jobs away from a country's citizens. What hogwash! They do the jobs that the citizens think is beneath them, yet they get no appreciation. Sure, the work they do may be tax free because they are illegal, but they also get paid a lot less. There is no set minimum wage for them, and citizens take advantage of that. So, let's give some back and take care of them, since they take care of us. Doesn't mean their status has to change. They can still be classified as "illegal", but at least if they get sick or hurt and it prevents them from working, they can go see a doctor and be treated... like a human and not a working dog. Shit, dogs get treated better.



Sorry... done ranting.



I also agree with you, Angela B, that the quality wouldn't change in the US with the implementation of a UHC. What, like a doctor is just going to suddenly forget all his years of schooling just because of the method of payment? A UHC method would be less bureaucratic and possibly more dependable, in terms of knowing how much you're going to get for services.

Angela - posted on 10/13/2011

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I think the USA system will not be exactly like NL. I know they will not shut down ER's etc. It would be totally unacceptiable for Americans.
What I think they will do is keep private insurace and regulate it also if you read the reforms so far all changes have been nothing but positive.
Americans worry of quality and cost but as one can see in NL we have some of the lowest cost in the world. I think Canada and NL spends about the same.
I also feel the quality will continue in the USA and only improve.
What has not been addressed in the USA is all the illeagal immigrants. The USA has at least 12 million illeags. That will be 12 million people not covered at all. That is a wild guess of a number really it can be much more I read the following, the undocumented population had reached 11 million or more including more than 6.5 million undocumented Mexicans (~60% of all undocumented immigrants). Assuming the same rate of growth as in recent years gives about 12 million undocumented immigrants in the United States as of January 2006, increasing at 700,000–850,000 per year with undocumented Mexicans amounting to about 60%+ (7+ million) of the total by 2006. By September 2006 the illegal population is thought to be about 13 million. About one-sixth of the undocumented population – about 2.0 million people – is under 18 years of age.
So what will be the rules and policy for them? What about the children? This has to be addressed and it has not really been discussed at all. We are talking about a population of people not far off from the entire population of The Netherlands, which currently is 16.5 million people.
If you look at other EU countries they have cracked down hard on immigrants that are illegal and most get litte to none in health care. In The NL they get the basics and some doctors offer equal depending on demographics.

Krista - posted on 10/13/2011

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In case anybody's wondering why I haven't locked the thread yet, it's because there's still some really good, relevant discussion going on. This is obviously a topic that hits close to home for all of us. So as long as the discussion is still going, I'm happy to keep the thread open.

Angela - posted on 10/13/2011

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Donna yes Belgium is only about 30 minutes away and Germany maybe 45 minutes, Paris, France is about 6 hours so all is accessible.

In fact I have a regular Pediatrician in Germany that my daughter Claire sees.

I can go anywhere that is an EU country. The only thing is some things I have to pay for:

When the cost is over the average set cost for a procedure or service in The Netherlands. I will have to pay the overhead. This is rarely much if anything at all.

When a procedure or service is not offered here and not recognized as a medical procedure.

For example I had to go to Germany to get some vaccines not offered here in The Netherlands. I had to pay for the vaccines but not the office visit.

This is where it can get tricky let say a new cancer treatment is being offered in Belgium but The Dutch have to recognized it as a medial procedure, you could be footing the bill yourself.

You can however get around this if a Dutch Doctor states you need the procedure. I guess you can call the double dutch ha ha. I asked about this and my Internal med doc said it is to protect the patient from scam medicine. So basically if a Dutch Doctor approves it, you are fine.

But many Dutch don't know this. They also do not realize their medical system is behind in many ways. They live in a bubble really. The Doctors do find it horrific to close down ERs and not have 24/7 ER services and they even have protested and went on strike for a short time like 2 hours to protest in front of the Hague. So some things will change but the public has to be made aware why we need these changes.

For example many Dutch think the infant mortality rate is high only for certain immigrants IE Turkish and Moroccans. This was spouted out by one politician and they all parrot him. They also feel doctor want to take away from choice of home birth that is not the case, again political propaganda to cover up the real reason for our high infant mortality rates.

Which are Lack of 24/7 ER care and qualified midwives. to name a few. GYN also think all midwife practices should have at least one GYN that they can confer with and that overlooks all the patients. That is not taking over Home Birth practices by any means. But screening for potential problems and high risk is needed before a woman has a home birth!

True story.

Woman had home birth. Dutch homes are notorious for being high and narrow. Meaning several floor up and very narrow stair ways. In fact many homes have a special window that opens all the way so furniture can be moved. Because the stairways are too narrow.

So this woman has a home birth via midwife. The midwife sends a homebirth package to her home. It has special stuff in it for the birth. All sees to be well, she goes into labor and her uterus ruptures she is bleeding to death. The call the ambulance. The ambulance can not fit the gurney up the stair case. So they have to call the fire dept. to get a ladder up to her bedroom window and get her out.

She lost so much blood at this point she goes into shock and her heart stopped. The baby is not delivered and going in distress.

She lived and so did her baby but he has brain damage and is blind in one eye due to loss of oxygen during the delivery. She is a college of my husband. But she really came close to death and so did her baby and she did not have to have any of it happen. She should have had a healthy baby.

But the midwife did not make sure the room was ready for an emergency. She could have had her set up a birth area where ER crew could get to her.

Also the midwife should have known something was not going right before the uterus ruptured. The woman told my husband she kept telling the midwife she was in a lot of pain and wanted to go to the hospital. The midwife told her it was too late for that.

Another story

My friend requested a hospital birth, the midwife still sent the birth package to her home for a home birth. She asked why the package and they told her just in case she had to have it at home. I was like BS in the USA very rare for a person not to have time to get to a hospital unless a rural area for example. I warned my friend I heard the midwives try to force you to do a home birth and to be careful. The fact is the midwives won't get paid for a hospital delivery so I think that is their incentive to discourage hospital births and in some cases delay them.

So her water breaks, she call the midwife. The midwife says all if fine and to wait to go to the hospital. They had her wait for 2 days! She had no contractions! Finally she goes to the hospital and needs a immediate c-section because she has a fever and infection!

These are just a example of the stories I have many more and it is simply inexcusable.

I wanted to have Claire in Germany but due to her going in fetal distress I had not enough time to get to Germany I had to be induced two weeks early right away. Also I had a GYN so thought I was under good care and I was it was the delivery that was crazy due to no ER staff. Lucky for us Claire came out fine but she was in distress and no one was around to do a C section at 4:30am. she did not have 30 minutes to wait. By Grace I did one more big push and came out and come to find out the cord was wrapped around her neck and she also had a neck injury from the birth.

If I got pregnant again I would rent a room in Germany my last month of pregnancy and deliver in a German hospital.

If I were forced to use Dutch midwives I would get all my prenatal care in Germany by a GYN doctor or midwives that had a doctor to look over them and my care.

That is how much I feel women and babies are at risk here.

The H1N1 was also a eye opener. we had enough vaccines to vaccinate everyone twice in The Netherlands but did they offer it to everyone? NOPE. They horded it to sell to other countries! They finally offered it to all the high risk groups but very late and children died here. One little 3 year old girl went to the GP they sent her home and the parents called and came back she was very ill and she had the H1N1. The doc said she had to sick it out.

She went home to bed and died in her sleep! When I heard that it really upset me. See If I were that parent I would say f you to that doctor and went to the ER. But alot of Dutch people trust the system blindly! I would never do that in the USA or here. But in the USA we are taught to stick up for ourselves etc. Here in NL they are not. They are to do normal and not make a scene. IT is considered asocial.

I guess I am one antisocial American with a big mouth but I get want I need :)

Sorry I guess I am ranting a bit! But it really upsets me when I hear of preventable deaths.

But I do realize all preventable deaths happen in all countries and lucky we did not lose too many people to H1N1 but what upset me is the vaccine was available and many of those deaths could have been prevented.

Over all however I do get good care at a resonalbe cost if not better care sometimes than in the USA. We pay the highest cost in premiums but that is because my husband is in the second to highest tax bracket. My neighbors for example get the same care and pay 30 euros that is it.

♥♪Megan♫♥ - posted on 10/12/2011

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Ok Donna, I'm sorry I only read part of the post. That was my fault. I may blame a child for it, but it was still my fault.

Stifler's - posted on 10/12/2011

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I don't have to sign anything here they're just like you're right see ya later if it's just the kids going. They give me my Medicare money straight back with their little machine too.

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@Janice, the problem is that now getting those pills is so much easier! Many GPs hand them out now, whereas when my BIL was a kid (about 16 years ago) they made you climb moutains to get at them. They are the same hardcore drugs (he's on dex) but I have no idea what's changed and I don't think it's for the better.

I actually agree with going through a process like that to eliminate everything else before going to drugs. Shoot, I did it for myself voluntarily! I was going downhill with PND and sent to my GP. Took the evaluation test which said what we already knew, she told me I was crazy (literally told me I was insane, in a joking manner) and asked me what I wanted to do. She was willing to give me anti depressants if I wanted, but knew me well enough to know I don't like taking pills... and I wanted to try counseling first. I did counseling, tried to change aspects of my life, tried to do more exercise, eat better, play with the kids more... I spent about 2-3 months of doing other things before I went back to my GP and she put me on pills. She was ringing me twice a month to check on me and see how I was doing during my experiment (pre-meds) too, which was nice.

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BTW, clinics aren't open 24/7 here either, but public ERs are as far as I know. There is a new kind of clinic starting to come up a bit more frequently these days though. I suppose you could call it an "urgent care" facility. They are open late, usually until 9pm and a couple until midnight. Some are public and some are private (which means you would have to pay).

The clinic where our GP's practice is located is open from 7am until 7pm every day of the week except Thursdays which is until 9pm. They have about six GPs, 1 psychologist, 1 chiro and 1 screening guy (he operates the skin cancer body scanner check thing, can you tell I've not used it?). There are 6 nurses (who double as reception staff) and they have a large 2 bed room to handle all the stuff like dressings and doing any sort of critical or urgent matters (oxygen, vaccinations, etc). It actually looks like a mini ER. There is also a room that is for pathology and the nurses do the collections for that as well. (busy nurses!) What always surprises me is that it's a bulk billing centre, so all services are free and no signing forms is necessary.

Shannen, at my old GP I had to sign the form too for a bulk bill appointment for the kids. The actual fee for a regular appointment is now $70 ($35 of which you get back from Medicare). I stayed with her for 5 years and 4 moves all over the city and only switched after I found this new GP who is only 10 minutes away versus my old GP 30 minutes away. It took a long time to find a doctor who I deemed good enough to take her place though. Also, in that practice if you didn't call by 10am you would probably only be able to get an appointment the next day because it is a busy inner city practice. However, there were a few times when I have rung up at different times of the day (once at 2pm) about a problem, usually having to do with a baby, and they would squeeze me in anyway. So if they thought it was urgent (like bad gastro in a 6 month old), you would get in no matter what.

Janice - posted on 10/12/2011

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Donna, I totally understand the whole ADHD diagnosis being a long process, it can be over diagnosed. I dont know how things are done in other states but getting an ADHD diagnosis is a long process in NY.

Cathy that is a scary scenario, I would be so upset If I was your mom when that happened.

Thank you for answering honestly though. There are 4 hospitals with-in 15-20 minutes of where I live and the quality of care just in my area can vary so greatly.
I just think that as the average American when you come across stories like the ones I have it can make you wonder if all the UHC "slander" is true.

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Meggy, yes I understand that. Canada's UHC is very similar to ours in Aus. It was Angela B's Ductch insurance UHC kind of system I was talking about. She said that the ER closes at night!

Angela B, that's awesome you can go seek the care elsewhere if you choose. It sounds kind of funny to me that you would essentially go overseas for medical care, but I am aware that the distance between countries isn't great. Short-ish train ride really.

I found that totally fascinating to learn about the UHC in the Netherlands. Thanks for sharing all that info, Angela B! For the most part, the system does sound like a decent compromise and could work in the US if a few things were changed. No one says that the US couldn't have that system and continue with the screening schedules they already have (like yearly paps).

Johnny - posted on 10/12/2011

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There are a few smaller ER's that close at night, but they are not "critical care" centres. They are "urgent care" which is sort of a step up from a walk-in clinic. You would never be rushed to one in the middle of the night and find it closed. The one I go to is open from 6 am to 12am. I love it because you never wait. Last time I went for a chest infection. My dad drove me and I took my daughter in with me to sign the paperwork and wait. The nurse came to get me so quickly that I had to ask her to wait so that my Dad could come in from parking to look after my daughter (because she couldn't go in the treatment area). I got my check-up, chest x-ray and prescription and was back out the door in an hour.

♥♪Megan♫♥ - posted on 10/12/2011

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Donna, in Canada the ERs opperate 24/7 and we have UHC. The clinics aren't open around the clock but our hospitals are. From what I understand the pap smears are a once a year thing here as well.

Angela - posted on 10/12/2011

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Well yes I can go out side theNL they do not like it but I can do so. And I have done so

♥♪Megan♫♥ - posted on 10/12/2011

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We don't get dental in Canada and BC health doesn't do eye care. AB covers eye care, but they don't do ambulances however BC does cover ambulance service. UHC varies from province to province.

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That was one of the big questions I had in my mind when I was reading and watching that vid on the NL system. How is the insurance company going to keep turning a profit? Because that's what companies do!

You know, if I were in the US and they were proposing a UHC in that form, I might very well rally against it too... as ludicrous as that sounds. Hospitals need ERs to operate at night and on weekends! Those are busy times! And 2 years wait list for mental health is not healthy either. 5 years for a pap.. yeah, you're right. They aren't really addressing preventative care, which is what helps keep costs down more than cutting services.

Yeah, I don't know about how much they are regulating the insurance companies. They tell them that they must accept everyone who applies. Check. They give a subsidy to the company for the number of high risk customers. Check.They make sure kids are free. Check. They aren't governing doctors fees or monitoring how the insurance company is obtaining their profit margin. At least not from the video anyway. It is a new system and it will take time to work out the kinks. I hope they get it working well! I hope you continue to have good care there. So, if you don't like the wait or service (like for mental health), can you just choose to go out of the country? I know you said that it was only if the service wasn't provided in the NL, but the video sort of implied that you could go any time you wanted, within reason, but what if it's just because you don't want to wait?

Angela - posted on 10/12/2011

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Donna over all I like the system but their is room for improvement. I learned to push the system and I got good care for my Lupus and for Samantha in some areas.
The mental health is the worst, 2 year waiting list
The ER care is bad too. You read that right, they close down after midnight till 7am if their is an ER they go and call on call staff that are suppose to be able to get to the hospital with in 30 minutes. As you know that is not good enough! I think it is stupid. They are also talking of closing more ER rooms so many hospitals wont' have ER's at all!
But they way the keep the inusrance companies in check is to heavly regulate them. At least that is what we are told. However I keep telling Dutchies that they sold us the same BS in the USA and it worries me a lot except at least in the USA we have ER staff 24/7
Same goes for the weekends they have a skeleton crew and have to call ER surgeons and anaesthesiologist on call basis.
So I like many aspects of the health care but many I do not.
After being in a free market and a controlled market that mandates UHC access and the insurance I can say in NL it is better than the USA. But I can't say I am happy with all of it.
I would much rather have UHC like the Aussies. But I think since it is new since 2006 it is a work in progress.
They hope to bring motivation, innovation to a UHC program at a low cost. The cost is still very low and the care retaliative to other countries high.
I have to say I would not have another baby here again. Nor would I trust my cancer care here. I would go to Germany most likely. The mental health has absurd waiting list even for the worst off people who are suicidal. So again if I had serious MH issues I would seek Germany or Belgium unless i could wait 2 years...
Their is some huge issues but they are on it...for the most part. The high infant mortality rate is in the bickering stage.
However much of my care besides the ones I have issues with are very good and cost me nothing. Everyone has equal care and not anyone is going with out chemo or heart surgeries... it is more like some go with out good screening and preventive care. The Dutch are behind with public education and still tend to keep people in the dark about medicine and health they do not use medical terms but layman infantile terms for medicine for example. Treating the public as if they are too stupid to understand.
But again I have chosen this health care over the USA.

Lady - posted on 10/12/2011

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I would imagine they would Angela, they usualy work together an no one would be refused treatment under the NHS. One doctor would respect the diagnosis of an other - plus all te test result!!

Angela - posted on 10/12/2011

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In Netherlands we have full eye exams IE pressure, glacouma screening and cataracts for free. It starts at age 50 and is free.
However if you are like me and had cataracts early you can get a referall from the doctor and go. I had one catract removed and they are waiting on the other because it is not so bad. All exmaines medicaitons exams etc were free.
Prescription lens not or contacts.
Dental is not covered for adults but young adults in school get it for free or very low cost.
IVF and other fertility treatments are covered as well up their are no limits on cycles etc. the only limitations are age, 45 years is the cut off year and men have not any cut off time. Sexist if you ask me but that is how they do it.
Cathy if you get a private doctor and they diagnose cancer lets say will the NHS provide care under not cost even thought it was diagnosed by a private doctor?

Lissa - posted on 10/12/2011

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I just got a letter for my sons appointment which made me think of another point.

My son sees the pediatrician regularly and was referred to the pediatric cardiologist a few months ago, he said everything is fine. Went to pediatrician (new one as we moved) he says although he isn't disagreeing with the cardiologist he wanted to do one more test just to be absolutely sure everything is fine.

So my question would be, would insurance pay for a heart test when your cardiologist said everything was fine because your regular pediatrician wanted to be on the safe side?

I don't have to worry about this, my Doctors don't give a shit who they might offend because they are not affiliated to anyone or a company. My sons Doctor isn't saying well a cardiologist says so therefore it must be OK, he isn't controlled or restricted in this way.

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Oh yeah... and FIVE YEARS for a pap?! That's messed up. It's only every 2 years here, which is reasonable, but for the first 6 years I was here I would get them every 6 months (like I was in the US) and they were still free... without having to fight to have one done.

Plus, I think you said that the hospital isn't opened at night, is that right? What happens to people who have heart attacks and stuff? Nighttime is the busiest times for hospitals, because everything seems to happen at night! Which is why places like Ipswich Base (the one public hospital in this area) starts pumping and they have a sign to let you know that the wait times are longer... but you're still triaged straightaway and if it's serious you get in pretty much straightaway. I can't imagine what would happen if it were shut.

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Lissa, I remember that post! Read it again to stoke the green eyed monster again. :-) You really do have the best system in the world! I also agree with Gillian... that's great compensation for the weather, for the most part. I'd freeze my bum off after 12 years baking in the sunburnt land.



Angela B., so do you like the Dutch system? I read what you wrote and watched the video (because I was only getting about half of what I was reading). Bloody subtitles in white were hard to read, but I think I go the gist of things. It sounded good, until you wrote of your experiences! The lack of modesty thing doesn't worry me one bit nor does the abruptness. I do think that's a big cultural thing. One of my very dear friends is married to a Dutchie and he can be very curt and some have thought he was abrasive... like Germans/Austrians. My best friend in my 20s was Austrian and I can't tell you how many people thought she was just a bitch... when in reality she was the total opposite! It was just how she came across. I love matter-of-fact, straight shooting kind of people.



Your experiences sound awful! I'd hate to have to fight tooth and nail to get basic treatment, and maybe it's that way because the insurance company is forced to keep costs down in order to make bigger profits?



I was going to ask how the insurance companies would be able to continually turn bigger profits. That's exactly what's happening now in the US, when they aren't purging the sick from their books. Mind you, that system COULD appease the corporate gods and get everyone covered. Better than having nothing though!

Lady - posted on 10/12/2011

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Nope we're still waiting, they've gathered references and we should hear what the next stage will be in the next couple of weeeks - we just decided to come to scotland as it was all going to take a while - everything was sorted up here and at last this way if Australia all falls through again we'l be settled somewhere. Hopefully though just after New Year well be heading over - we'll just have to wait and see - can't say I'm looking forward to another big move but it should definitly be our last!!

Sorry to go off topic, I'll shut up now lol!!!

Lissa - posted on 10/12/2011

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So did you let go of the Australia move in the end? Just to get off topic :)

Lady - posted on 10/12/2011

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One of the reasons I'm happy to have moved back to Scotland! There has to be some compensation for the weather lol!!!

Lissa - posted on 10/12/2011

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Yes we do Cathy and it isn't just a can you see the letters eye test either. It is a full eye exam, with pressures and pictures of the eye.

Lissa - posted on 10/12/2011

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OK I have a confession I am too lazy to write out a whole novel so I found something I had written on this subject before.



As I said I'm in Scotland so here is what I have experienced.

My husband is type 1 diabetic, he get's his insulin,needles, a box for the used needles, frequent appointments with the specialist diabetic nurse and roughly four appointments with the consultant every year. He had an accident a few years ago which resulted in an operations and his ankle is held together with pins and plates. So the original hospital trip, then the operation, a few weeks in hospital. At home the GP came to see him every day for a few weeks to check on him as well as seeing the nurse and diabetic nurse who wanted to keep a closer eye on him as the stress of it all, being immobile and foot injuries are especially dangerous when you are diabetic. He is also permanently disabled from that injury so then we have the physiontherapy and ongoing appointments and medication.

He is also asthmatic, luckily no symptoms for a few years now so when you add in clinical appointments and medication for that along with the rhino and septoplasty he had because his sleep apneoa was causing extra problems with his asthma.

I have had three children, it's simple you get pregnant, go to the doctor, they set you up with the midwife from there you get all your appointments,blood tests scans etc, pick where you are having your baby and that's that. You have the baby come home you get a midwife out every day for 10 days to check on you then you have a health visitor who sorts out health check/progress/immunisations and generally just how you are doing. If you are lucky like me you get the same woman for your births who is late for her birthday dinner so she can stay with you until it's all over. I've had wisdom teeth and my tonsils out in hospital, I was flown to hospital when it was thought I had appendicitis but it was actually a burst cyst.

My son regularly sees the pediatrics because he is well below normal/height and weight so they want to monitor him in case of any problems.

My Mum had a routine mammogram found she had a lump, was in a few days later getting a lumpectomy and a few days later started chemo. After the chemo she had radiotherapy and because she lived a distance from the hospital she was put in a lovely hotel for the duration.Along with life long medication, she is also diabetic and has cataracts and glaucoma. As she has glaucoma I was sent off to see the specialist to check me over.

So after some of the family history

In short we got all that and we got it on the NHS, I am more than happy at what we get for our taxes. Of course nothing is ever perfect, it's not perfect anywhere, whether private or not.

Treatment, prescriptions and eye tests are all free (my husband and I get them every 6months and yearly due to the diabetes and glaucoma), you get money towards glasses if you have certain conditions or are below a certain income. Dentistry is without charge to everyone under 16 (or still in full time education), pregnant woman until a year after they give birth and anyone below a certain income. There are set charges for anyone who does pay. I have friends who get "alternative therapies" such as acupuncture through the NHS. As for IVF in Scotland you get three tries on the NHS and couples without children get priority.

I personally feel very proud that I live in a society that believes the health of our nation is a priority and in general it delivers well. So as a proud Scot I thought I would stick on some Scottish medical advances and feel bloody grateful for my lot.



James Young Simpson introduced chloroform in anaesthesia

Sir William MacEwen performed the first bone graft

John Macleod won the Nobel Prize in Physiology or Medicine for the discovery of Insulin

Sir Alexander Fleming discovered Penicillin

Ian Donald pioneered ultrasound scanning in gynaecology

Alick Isaacs developed Interferon

Sir David P Lane discovered the p53 tumour suppressor gene

John Mallard developed the MRI scanner

Sir David Jack developed Zantac and Ventolin

Sir James Black won the Nobel Prize in Physiology or Medicine for the discovery of ß-blockers

Optos plc Scanning Laser Opthalmoscope revolutionized eye disease diagnosis

Touch Bionics launched the i-LIMB Hand, the worlds first fully articulating and commercially available bionic hand

Irwin McLean's team identified the filaggrin gene as the first definitive predisposing gene for atopic eczema, atopic asthma, hay fever and other allergies.

Angela - posted on 10/12/2011

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Angela I sent you a pm because it is too long to post ha ha sorry but I just could not give you all my personal experiences etc without it being long. But on here I will give my short version of the pros and cons I see with UHC in NL (it is long too sorry)



Service, in the USA overall I have had great customer service. I was always treated respectfully and listen to.

In NL their is not much customer service. It is just a matter of fact way of doing things. It is all about practicality and being efficient not you or customer service. So people have cut me off when I speak, and at times been very rude. The Dutch are very direct also so it is part of the culture. For example they will just state you are too fat or you look awful. Americans are not so direct and tend to be more diplomatic of such things.

They do not appreciate modesty. For example you just get undressed in the docs office, no gowns etc. Same as when I got a chest xray, take my shirt off, no gown and had to walk to the machine with my boobies hanging out in front of the xray techs. Same goes with paps, take your pants and panties off walk to the table with your privates showing to only the doctor or maybe a nurse and lay on the table and spread em! This is more a culture thing but one doctor told me they use to have gowns...I guess they find them impractical and expensive. But when I talk to most Europeans they say it is the same for them ...and think I am weird for being modest in front of medical staff.

The Mental health care is good once you get in but the wait times can take up to 2 years! This is only in mental health.

I have never had to wait more than 2 weeks for a non emergency small issue for an appt. Every time I needed to see the GP I got a same day appt unless again it was a small thing like getting a flu shot. Th ER is also very quick in fact faster than any ER room I visted in the USA.

They can be a bit behind on new medications and procedures. Not by much however.

USA has more specialist than they do over here. For example they do not have any OBGYN's just GYN's. The likes of pediatric specialist are limited too. The USA has many but I doubt that will change in the USA even with UHC. They also do not have specialist hospitals, but they are changing that as I write this. The USA does have some of the best specialized medical centers in the world. Look at America's burn units etc for example. Also we do have cutting edge medicine available. Even experimental in the USA .

They tend to be more reactive to medicine than proactive. They do not run test to just see if something may be wrong for example if you complain of headaches the first thing they do will not be a CAT scan. They will wait and rule out other things before they think brain tumor. This however cuts down on cost. In the USA they sometimes run test just to run the bill up to insurance companies.

However they could do more screenings over her for cancers and heart conditions. At the moment they only do a pap every 5 years. However you can go yourself yearly if you want . My insurance actually covers this it is an extra on my package. They have low cancer survival rates and I think it is due to lack of public education and screening. The usa is very good with public education and screenings.

IF you see the GP they most often prescribe you take a Tylenol and tell you to call back if you still have problems. However if you are vocal and say no they will move their butts and do more. The GP's here are not so great and some are down right stupid and I wonder of how their educations compares to Americas GP's or Family docs.

To get to the GP you must call the assistant first (they are like a medical secretary and the gate way to the GP. They can be very nasty at times making you feel like you are bothering them. You must get a referral to see any type of specialist including a paediatrician. I had one doctor who was a real pain about this. He would just tell me to take a Tylenol come back over and over... I changed my doctor and now have no problems at all.

I have head of people having issues with GP and referrals and getting test done but as I said I learned if you are vocal an insistent they will do it. That took me some getting use to but I have no problem now being pushy!

All the specialist are very good however in fact I find them excellent.

In addition I can get second or third etc opinions. I can also go to other countries if I feel they offer a service they do not here, My insurance covers this but with limits as to they have to charge the same prices as they do here in NL if they charge more than I pay what is not covered. Usually it is not much more money. I have went to Germany, France and Belgium. The only thing that is not covered is medical procedures and medications they do not have or offer here in NL. Unless my doctor recommends it and refers it.



Edit to add I do miss just being able to pick up the phone and make an appt. with anyone I want that was nice. But that is not the case for all Americans. I had really good insurance that allowed me to do so at the time I lived in the USA before moving here..

Angela - posted on 10/12/2011

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This is for Angela J

Angela I went extensively with information on the Dutch system because it has been proposed many times over as a model for UHC in The USA



The Dutch system appeals so much to USA policy makers because in contrast to many other European systems, it's actually based entirely on private insurers, rather than a single-payer or entirely national system. Yet the Dutch system is universal, has far superior rates of satisfaction with quality of care and access, and still costs a fraction of what Americans pays for health care per capita in the USA.



Universal health care systems beat the US in almost every measure of patient satisfaction, as well as access, quality, and cost. The Dutch lead all other health care systems in almost every measure. Their citizens are the least likely to think their system needs major reforms, they have one of the best access rates with most patients being able to see a physician within the same day, have short wait times for elective surgery, the shortest ER wait times, they are most likely report they are getting the drugs they need, the best treatment technology, and high-quality safe care. They are the least likely to avoid medical care, or to fail to fill a prescription due to concerns over cost. And more objective measures such as mortality due to health care amenable causes shows the Dutch perform better than most other countries in outcomes (the US performs the worst).



If you have any questions let me know. I am also going to post to you my personal experience with the UHC system in NL. I provided a lot of data so you can compare it and share it with your family when you talk to them about it. I think many Americans feel UHC care is all the same but it is not. The USA can do this with out infringing on your rights or losing quality of care.

**As you read you will discover in The NL we regulate the insurance companies via government but health care is provided by private insurance companies.

I think this system would work well in the USA. Let me know what you think?





Universal Mandatory Health Insurance in The Netherlands

In 2006, the Netherlands launched a national health care initiative to provide universal health care coverage for its population. The Dutch approach combines mandatory universal health insurance with competition among private health insurers.



The Dutch health care system is a work in progress. In 1941, the government introduced a mandatory health insurance plan for low- and middle-income people that provided most of the Dutch population with basic health insurance. Those with higher incomes typically purchased private insurance.

As access to health care increased, so did spending, arousing fears that rising medical costs would jeopardise access to health care, inflate labour costs, and increase unemployment. In 1982, the Health Care Prices Act authorised the Dutch government to control physicians' fees and total revenues. This legislation allowed the government, for example, to replace fee-for-service payments to hospital-based specialists with lump-sum payments to hospitals.



Managing Competition and Access

Growing dissatisfaction with "top-down" health care rationing policies criticised for their inability to promote efficiency and innovation led to broad support for incentive based reform. In 1987, a government-appointed group of advisors proposed a national health care system based on market-driven reform.

Over the next two decades, the Dutch government worked to lay a foundation for merging competition with universal access to health care. For example, the new system required a system of risk equalisation to prevent insurers from seeking only young, healthy customers. Additional reforms included developing a pricing system that would discourage physicians from providing inferior care; determining how to measure quality and outcomes; and arming consumers with more information about the price and quality of insurers and providers.



2006: The Health Insurance Act

The Health Insurance Act of 2006 requires all people who legally live or work in the Netherlands to buy health insurance from a private insurance company. Insurers are required to accept each applicant at a community rated premium regardless of preexisting conditions. In 2006, all but 1.5 percent of the population had purchased health insurance in accordance with the new legislation. It is believed this 1.5% are illegal residents.

The plan is financed with individuals annual income based contributions to the tax collector. Employers are required to compensate their employees for these contributions. In addition, all adults are required to pay premiums directly to the selected insurer, which sets its own community rated premium. Premiums are not required for children under age 18. About two-thirds of Dutch households receive an income related subsidy from the government a maximum of €1,464 (about US$2,200) per household per year.

The income based contributions are transferred to a Risk Equalisation Fund, which compensates insurers for taking on high-risk enrolees. In addition, insurers can use tools to protect their interests. These include managed care techniques, such as disease management. Insurers are also permitted to provide care in their own facilities with their own staff, to control costs better and may sell other products in addition to basic health insurance, like supplemental health insurance or car insurance. Increasingly, insurers will be allowed greater leverage in negotiating prices, service, and quality of care.



Consumer Choice

Insurance companies are required to accept each applicant for basic insurance coverage. Individuals can choose from among 14 private insurance companies and several related subsidiaries. The Dutch government has set up a Web site where consumers can compare all insurers with respect to price, services, consumer satisfaction, and supplemental insurance, and compare hospitals on different sets of performance indicators.

Individuals who belong to a group an employer, patient organisation, labour union, or other legal entity are eligible to receive a premium discount of up to 10 percent. In 2007, more than half of the population received group discounts averaging 7 percent.



As the Netherlands fine tunes its health care system with an eye toward quality and cost, many questions loom. Chief among them are "whether the insurers in the Netherlands are really able to function as good purchasers of care, which forms of 'managed care' will be acceptable to the public, and whether government will be prepared to give up its traditional tools for cost containment by reducing supply-side regulation." On these points the jury is still out.



Helpful links

http://english.minvws.nl/en/#ref-minvws This is a direct link to the website in English to the Ministry of Health Netherlands.

http://youtu.be/YkLxk335cHs Youtube video from the The Netherlands on the new Health Care system explained if you don't feel like reading and you can share it easily with others.





Ref:

W. P. M. M. van de Ven and F. T. Schut, "Universal Mandatory Health Insurance in The Netherlands: A Model for the United States? Health Affairs, May/June 2008 27(3):771–81.

The Commonwealth Fund

Health Affairs, 27, no. 3 2008

Ministry of Health The Netherlands

[deleted account]

Donna at my local Dr I do have to sign a medicare form and if I wasn't low income then I would have to pay some if not all of the appointment cost. I have no idea how much though because I've never been fortunate enough to be rich enough, But most of what is paid is recovered with medicare.

♥♪Megan♫♥ - posted on 10/11/2011

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Don't worry Donna, I'll probably keep doing the same thing. My DH and I had to take our 7 month old to the clinic today (near Gyro Beach) I'm still waiting for someone to go and pay for something

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