Universal health care - thoughts?

Cathy - posted on 10/12/2011

Janice -"Basically a parent is very concerned with their child. The GP refuses a referral and only get one after months of fighting and in the end when they get to the specialist they are right and the child needs surgery.
2 questions:
1. Have any of you in the UK run across this issue?
2. Could these parents have chosen to pay out of pocket to go see the specialists with out the referral? "

1. Personally no, but it does happen. As Toni said previously, it varies greatly from one area to another, one doctors surgery to another. BUT you always have the option of getting a second, third or even forth opinion from a different doctor, from a different practice if you really believe there is an issue being ignored. It costs nothing extra than time and effort.
2. An NHS specialist, no chance. You could try going to a private specialist through BUPA, IF they have such a specialist. You would probably have to buy health insurance with them for that service.... but you still need a GP referral. You could try getting a private GP referral but then you have to wait for them to access your medical history ... however once diagnosed you could then return to the NHS if it's for chronic, long term treatment as they don't cover that.

Angela - posted on 10/12/2011

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

Shannen - posted on 10/11/2011

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

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

Georgia - posted on 10/11/2011

Actually, I STILL come out of the doctor's office and ask the ladies at the desk if I need to pay or sign anything. No idea why... maybe I'm thinking it's all going to change one day? Hmm, or maybe I just like hearing "Oh no, there's no fee!" :-)

Georgia - posted on 10/11/2011

O.M.G. WTF, medical expeditions?! I agree with that fella... what country IS that?! Shit, I've seen that in villages in India FFS!

Karla, thanks for sharing that Bill Moyer vid. I watched all 4 parts. Funnily enough, I discovered I'm a cousin to Michael Moore after part 2! For the longest time, I would come out of a doctor appointment or hospital here and ask "Where do I pay?" and people did the "Excuse me?" and gave me that same "Uh, what crazy truck did YOU fall off of?" look! lol I've even had a nurse tell me exactly what that one man did... "Sweetie, this ain't America!" But parts 2,3 and 4 should be very revealing to people.

Incidentally, I believe the guy! For the layperson, all you have to do is watch a show like "Undercover Boss" to see how many CEOs have NO idea what really goes on in their own company to produce their product! As a former Wall Street employee/corporate manager, I know that the guys upstairs have very little grip on reality sitting in that ivory tower. All they care about, like Mr. Potter said, are the numbers. Healthcare is a product to them, not a bunch of people. The only bunch of people they listen to are their shareholders, because those are the people they have to answer to (to keep their jobs/lifestyle).

Janice, you asked about being refused a referral in a UHC system (specifically the NHS). While I can't comment on the NHS specifically, I can see that their system is similar to ours (hell, ours is probably based on theirs, being the Mother country and all). While I have never been refused a referral that I thought was necessary (even though the doctor never suggested it), I have been asked if I wanted a private or public one. When my BIL was a child back in the late 80s-early 90s, my MIL had to see several GPs, a couple pediatricians, a couple therapists, a psychiatrist, dietician and neurologist to finally get a diagnosis of ADHD for her son and for meds to be prescribed. This used to be standard procedure, not to make it difficult to get treatment, but to make bloody sure that it was truly ADHD and not just a kid acting out or have some dietary issues (because diet CAN affect mental state) or some other cause. Also, they didn't like to prescribe hardcore drugs to kids. Their family GP made her jump through all those hoops and it was time consuming. I believe think it took her about 12 months for an official diagnosis and prescription. In the end, they confirmed that she wasn't just a "nervous mum" or batty or just trying to get pills... and she was right that something was very wrong with her son. Now, you can look at it as "OMG, she KNEW something was wrong and no one would help or listen to her until she screamed from the highest hill for the twelfth time!" or you can see it as she does as, "OMG, it was a PITA process and looked like they would never make up their minds, but they were incredibly thorough and I now have a solid diagnosis, so that I can get meds for him for as long as needed." As long as he kept seeing his pediatrician (because at the time a GP couldn't prescribe such hard drugs), he would get a check up and be given a refill. When he changed doctors (at age 25), he had to request a copy of the old ped's records (all of them!) and have an exam done by the new doc before he could get a refill. Now, my husband has a cousin who is 14 and on Ritalin because his mother went into her GP and said "he's out of control! I can't handle him anymore. Can you give me some pills?" and she got them. He doesn't need them, what he needs it parents who give a shit. He just sells the pills anyway.

The quality of care varies from doctor to doctor and clinic to clinic no matter where you are! I've had shit doctors and good doctors in both systems, but the big difference is that it's not a fight to change doctors whenever I want.... I just walk into another clinic. If I want a referral, but my GP isn't willing to give it to me... I just go to another clinic and see another GP who will. I did that for my eldest son not long ago, because I wanted a second opinion because I felt differently from the GP we saw at my clinic (who wasn't our usual GP) and the second GP agreed with me and we got the testing needed (it was just a blood test for Iron and coagulants).

Lissa, I'm still a bit jealous of you in the Scottish system! I think you have the best UHC system of us all!!

♥♪Megan♫♥ - posted on 10/11/2011

Having lived in the US from birth to nearly 30, I can believe it. I married a Canadian back in March and moved up to BC in June. I'm still getting used to some of the health care stuff up here.

Lissa - posted on 10/11/2011

The US hasn't even ratified The UN convention on the rights of the child. I don't know why anyone is even shocked at the lack of health care provision when the US can't even agree that children should not be put to death. I just do not understand those against healthcare for all, it appears to me my healthcare is much less expensive (paid through taxes) and a hell of a lot better.

♥♪Megan♫♥ - posted on 10/11/2011

Lissa, my husband pointed that out. Basically the US is in violation of the Geneva Conventions. But in the Tea Party's opinion Health Care is not an inalienable right because it's not in the constitution. I still say we take away the Tea Party politician's health care and see how inalienable they feel it is. Of course they have money so maybe it won't make as large of an impact.

Lissa - posted on 10/11/2011

Article 25 of The universal declaration of human rights

Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

What more can really be said, medical care is a basic human right.

♥♪Megan♫♥ - posted on 10/11/2011

Oh I keep forgetting to say this. Anyone who works in health care in Canada is considered a government worker (according to my MIL who is a CNA here in British Columbia) they have the same benefits and job stability as other government workers. The pay is pretty good even for low level health care workers like myself

Toni - posted on 10/11/2011

Janice I have never met anyone who has had a doctor refuse to refer them if they have requested, but that's not to say it doesn't happen but when it does it's rare.

I know a couple of people who have been diagnosed with something by the NHS then have chose to pay private to get the op/ treatment quicker, private insurance may not cover it but you can go direct to the private hospitals if you
want. They may well have already had private cover though, I'm not really sure.

Toni - posted on 10/11/2011

In the uk we can choose from a selection of options for care, even if we are potentially dying in 2 months we still get options.

I have had very good experiences with the NHS, and one very bad experience, I don't let this bias my judgement though as it is the exception not the rule.

Let's take my pregnancies as an example:

Positives: I did not pay a penny (excluding car parking at the hospital, which is daylight robbery) for any treatment I required and there was a lot (7 scans, including early internal scans for my first preg and 5 scans for my second, multiple bloodwork (and gd bloods, followed by a gtt in my second preg), a three week hospital stay for preg 1, every other day visits to the hospital for monitoring in preg 2, physiotherapy whenever I needed it (I suffered SPD), weekly hydrotherapy treatment (again for SPD), two early inductions, a two day stay in hospital after preg 1, a 5 day stay after preg 2, use of a heater for my son, a night in nicu for my daughter, use of a bilibed for my daughter, help with bf for both. This is an edited list and doesn't contain everything, but the point all this cost me nothing (I know I've already paid for it with my taxes).

My wait times from referral have always been good too IMO. I have been referred to: a gynaecologist who gave me fertility testing and surgery; a physiotherapist for my knees and during pregnancy; a dermatologist; and a neurologist (as I had recurring headaches). I have never had to wait more than a couple of months for my appointment and if I have been uncomfortable with a doctor I have the choice to see another, without it affecting my waiting time.

Negatives:

The service you receive varies greatly depending not only on your location in the country but the surgery/ gp you use as well. My old gp surgery was appalling, it was near impossible to get an appointment for the same day and was difficult to get it in the same week (I used to joke that I'd be better before I got to see the doctor), my current gps are great 9.9 times out of ten I get to see a doctor on the same day, within a few hours and on the rare occasion I can't an appointment is offered to me the next day, if it is an emergency they always fit you in.

My bad experience happened when I was pregnant with my son, I thought I was miscarrying, the staff in the hospital I went to (not local as I was working an hour away) were lacking care and compassion, they were incompetent and rude (I was yelled at for refusing to let an incompetent dr stick a needle in me for the fourth time to get blood...when he hadn't so much as touched a vein on the first three attempts). They were tardy was admitted at around 11 am at 5.30 pm I was told they wouldn't be able to do anything for me until Monday (this was on a Friday), yes they fully expected me to be ok with waiting three days to find out if I had lost my baby, I kicked off and went mad miraculously they were able to find out I hadn't miscarried, this is the short version there were so many other things they did that made me view this as awful.

Despite that one experience I am whole heartedly thankfulwe have the NHS, the positives outweigh the negatives for me.

We have NHS dentists which we pay small amounts for and certain people are eligible for NHS glasses but tbh I'd rather paybfor my glasses the NHS ones aren't that good :-) our mental health is free as well.

♥♪Megan♫♥ - posted on 10/11/2011

I'm wondering how all the right wing politicians would like it if US citizens declared the health insurance they receive due to being politicians was 'unconstitutional' since it's being paid for by our tax dollars. Then we could start weeding out who gets to stay on the insurance due to pre-existing health concerns (Bye bye Dick Cheney and Bill Clinton) I'm sure after that those 'UHC is unconstitutional, let's overturn Obama care and get rid of grandma's insurance too' would change their tune. If not at least then the American people would know that they're nothing more than hypocrites.

Like a few other ladies on here I'm glad that I'm in Canada now instead of the US. Because back home in New York I do risk being removed or denied insurance because I have a hyper active thyroid. There is also a history of breast cancer and hypertension from my BM's side. I don't know any other family history besides that. True UHC isn't the cure all end all, but it's nice to know that as long as we live in Canada or at least maintain a residence in BC my husband and I won't need to worry about any pre existing conditions or do what Kelly has to do. And Kelly I do feel for you. It's bullshit that people who need health care and life saving treatments should have to worry about losing their homes to save their lives.

Tara - posted on 10/11/2011

See there is a whole other can of worms, people feeling like shit because they need medicaid or medicare or what have you to provide health care for their children.
This puts good health and health maintenance in the light of "haves and have nots".
In Canada, it doesn't matter if you are a single mom with 3 kids on social assistance or whether you are a married mom with 6 kids with one working parent, or whether you make a 6 figure income and have no kids, everyone receives the same level of care. Everyone is entitled to the same specialists, same treatments, same after care, same equipment etc. no one receives sub standard or below standard care, no one has to pick between what ailment is more pressing, no one has to decide whether something is "worth" seeing the doctor about.
We are all entitled to the right to have access to health care, we are all entitled to live as healthy as we can, we are all entitled to help when we need it.
I could not imagine having to figure out how to pay for my cancer treatment, and having to take it from my child's savings for college (sorry to use you as an example Kelly! And so sorry to hear that you are having to go through all of this). but to have that worry on top of having cancer and being a mom to young kids is just too much to fathom.

Karla - posted on 10/11/2011

Here’s a Bill Moyers show you might find interesting as he interviews Wendell Potter the former CEO of CIGNA. (2009) Watch all parts.



And here’s an interesting tidbit from

http://www.aflcio.org/corporatewatch/pay...



David M. Cordani

President and CEO

CIGNA CORP (CI)

Headquarters: PHILADELPHIA, PA

Insurance Carriers

In 2010, David M. Cordani received $15,225,584 in total compensation. By comparison, the median worker made $33,840 in 2010. David M. Cordani made 449 times the median worker's pay.



(you can see why I say "don't get me started" when it comes to Insurance Companies.)

Karla - posted on 10/11/2011

From Angela J.
“Trust me I was not happy with her and I let her know that.”

My 2 cents worth: I believe IF you SIL had scruples she would have created her own profile to make her opinions known. It was downright cowardice for her to hide behind you and spew such extreme opinions and judgments.

“In a way I was hoping to get some answers back that were similar to the ones I was told from family and friends. I say this only because I feel they lied.”

From everything that was said from Angela J- the SIL, I would say your family doesn’t know they are misinformed. The words I saw reflect talking points that come from FoxNews commentators, Glenn Beck, and Rush Limbaugh (to name a few.) Many Americans buy into this yellow journalism because these outlets all claim to be the only ones telling the truth, they claim all other sources are false and slanted, but they are wrong. I know that it is dangerous to trust only one news source, especially if that source is claiming all others are wrong.

Politifact.com and factcheck.org are good sites that check the words of politicians, commentators and sometimes e-mails. Snopes.com also does some fact checking of e-mails. It’s very hard to find reputable sources on-line – too many people are blogging opinions and repeating misinformation (much like your family.)

“I am going to try and find the movie "sicko" (I think that is what it was called) and watch it.”

Just a warning, you family isn’t going to like you watching “Sicko.” The documentary is produced and directed by Michael Moore, and the Right-wing outlets previously mentioned label Moore as evil.

It’s very important to remember with for-profit Corporations that their bottom line is so important that they are willing and able to put pressure on the media and the government to get what they want, and profit is the main goal – not citizens’ health.

Karla - posted on 10/11/2011

@ Janice, please know that many people have been in your shoes. I will never judge people based on whether or not they have Medicaid.

I'll add that the years my kids were on Medicaid were some of the most worry free years of my life in terms of health care. My daughter was referred to physical therapy during this time for a sports injury - she got great care. I'm just sorry there is a stigma tied to it.

Best wishes with your pregnancy! :-) (I miss those years.)

Janice - posted on 10/11/2011

Karla - so true about medicaid making you feel like crap. Shortly (6 mo.) after my daughter was born I applied for the state run insurance for children (CHP). I was surprised that she actually qualified for free medicaid. I couldn't believe it. 18 mo. later I still hate pulling out that card. I want to scream out to the parents around me - "I'm not a loser, health care is the only thing I "get." I was even more shocked when I reapplied a year later and when I marked yes to the "are you pregnant" question and found out I qualify for medicaid for the duration of my pregnancy. As much as I have saved (and will save) in co-pays I still feel like such a loser for using it. 3 months after my due date I lose medicaid and will go back on my husbands insurance (no dental or vision) and although it will cost us a ton in premiums and co-pays part of me is glad because of how badly being on medicaid makes me feel.

Karla - posted on 10/11/2011

I wanted to share my story with those who have the time or interest…



Here’s what wrong with the United States Insurance Industry from my standpoint – compare this to stories from those on this board who have UHC. (It’s a little too much like “Sicko.”)



Mike and I have had to pay 100% of our insurance most of our lives, he was & is self-employed and I was a SAHM. Many times when getting a new insurance plan one of his limbs would not be covered because of an injury he had in the past. That practice became illegal in the late 1990’s.



In 1998 we started a new plan, and a week after it began we found out our five year old daughter had a health issue, the insurance company made aggressive moves to remove her from being covered, I had to send them her whole medical record to prove this was NOT a pre-existing problem. If it had been, they would not have covered her for even a well-child check-up. Since it was illegal for them to write-off a part of the insured’s body, they would just not cover that person at all. (loop-hole.)



Our family medical insurance went from about $350 per month in 1998 to over $700 per month in 2003. In a five year period the Insurance Company had doubled our premium (approximately 15% per year) w/o any major medical problems on our part (our daughter's health issues were managed with diet) I always say, if our income had doubled, that increase would not have been a problem, but it did not. I know of no other industry that can get away with cost increases at this level.



Some states have a healthcare plan for children (for lower middle-class families) if the family doesn’t qualify for Medicaid. The family pays a small premium-fee and the child gets insurance. It’s nice, but it’s a far cry from Universal Health Care.



In 2003 we could not afford $700 per month for Health Insurance so I applied for our children to get the State Health Insurance, we didn’t qualify and I was shocked and humbled by the fact that we qualified for Medicaid. (Another problem with Medicaid for poor families is that one feels deflated to know they are “poor.” UHC would eliminate that label – at least when it comes to healthcare.) The children were then on Medicaid, and I purchased Health Insurance for my husband and I for about $130 per month – it covered almost nothing and had a $5000 deductable. (no dental or vision) In 4 years that premium had doubled to $260 per month. Medicaid sent me a list of 2 providers where I could take my children. I must say the care was excellent, and I never had to worry about money when they were sick or injured – I absolutely loved that part of Medicaid.



Currently I am employed, and my employer offers insurance coverage, which they pay 80% of the premium and I pay 20%. They have worked hard to make my premium as low as possible, and I appreciate that. They have to shop for insurance continually, because otherwise the premiums begin to skyrocket. As it is, we have co-pays and deductibles -- so the insurance is not providing 100% coverage.



Funny thing is, at first I didn't mind the co-pays, because I went for years paying out-of-pocket for so much, but now they have gotten so high that I wonder about the value of insurance. I begin to think the money is primarily going to the Insurance Company and Doctors Office to push papers.



In 2010 I took my daughter to the ER for severe stomach pain. (I had called a health help line first and they advised.) Our out of pocket expense for the visit was $380 which included a deductable, and a co-pay of $50. This is the first insurance I have had that had a deductable payment for an ER visit. I had to go on a payment plan to pay that bill.



For dental coverage I pay 50% of my premiums & my employer pays 50%. The insurance covers 100% of cleanings, and 50% of other care such as fillings and crowns. (So when a crown costs $800, I often wait as long as possible because I don’t have $400 for that crown.) For Vision insurance (glasses, contacts) I pay 100% of the premium. All told my Insurance premiums cost me $3030 per year, and my employer is paying approximately $9550 per year for their percentage. (They probably pay more than that, because they started using a sliding scale.)



Since the economic down turn, my raises do not cover the raises of my portion of the health insurance premium.



Of all my employer’s expenses and all my expenses, this is the one that has by far experienced the most inflation. Anyone who believes there should be little or no regulations on Insurance companies is sorely mistaken. The Insurance industry has played a much bigger part of our economic downturn than has been acknowledged.



I would not be bothered by the dismantling of the Insurance Industry to make way for UHC, but with our current system that won’t happen. Watch “Sicko” and you will learn why. With new regulations things are improving, but I believe that as long as Insurance is “for profit,” US citizens’ health coverage and care will be at a disadvantage.



Again, the Affordable Care Act in the US is not UHC. It is the alternative that people here have suggested. Wikipedia has a good description of it including when certain regulations will take effect.

For Americans this is worth reading:

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

Karla - posted on 10/11/2011

@ Kelly, sorry to hear about your malignancy, but I'm glad it's the best case scenario. I'm glad to hear you have people helping you.

Jen - posted on 10/11/2011

I just want to toss in here that in the US, we're already paying for the sicknesses of our neighbors in premium. while I know there are many factors involved, if you have a population that (ex. my own area) that is high in diabetes and heart disease, you're going to see increases in rates. why not just translate that rate increase to a tax instead since we're paying it anyway.

Angela - posted on 10/11/2011

When I say open I mean government wise not insurance wise. So what ever the Feds are doing it is an open forum, even with discussing health care. In several countries this is not the case.

Janice - posted on 10/11/2011

I'm so sorry Kelly. Best wishes on the road ahead.

Kelly - posted on 10/11/2011

Yes, sort of--it didn't come back like they thought then. The first time, I had cancerous growth in my lymph nodes and several small, benign, but inoperable tumors along my spine. They said if it came back, it would be in the form of multiple tumors.

Last week, they removed a tumor and surrounding tissue, but instead of benign tumor, like the first ones, it was malignant. (This is probably why I was so emotional in this debate--I was waiting on biopsy results). They got all of it, and the lymph nodes came back negative for cancer, but I'm doing a round of chemo preventative. This should not be life threatening, of course they never say that for sure.

It is best I could have hoped for (aside from not having a tumor at all, or having just a single benign tumor). The treatment is "affordable"--I'll use son's college money ad have to cut some BIG corners, but we'll keep our house. I have some wonderful friends who are doctors getting samples of the nausea pill. and friends cooking--it is hard to ask for food from a food bank when your husband makes so much, but when you'r spend $4,000on medical in a month, not much left for food. Won't be like that long though, when I get better will put the money back to Jake..

Janice - posted on 10/11/2011

Ok, I am all for UHC yet I do have some concerns based on issues I noted in my 1st post before things got so heated. I am on a support forum regularly for children with craniosynostosis, a condition my daughter has. Although I hear both wonderful things (especially about Sick Kids in Canada) and not great things from doctors all over, I hear the following issue out of UK quite often (this was posted today)



"So after self diagnosing sagittal synostosis and having to fight for a Referral to Birmingham children's hospital we finally have an official diagnosis! Freddie is sagittal and surgery will be ASAP hopefully before the end of the year. We are awaiting a date for his CT scan now and then we will be given our date."



Basically a parent is very concerned with their child. The GP refuses a referral and only get one after months of fighting and in the end when they get to the specialist they are right and the child needs surgery.

2 questions:

1. Have any of you in the UK run across this issue?

2. Could these parents have chosen to pay out of pocket to go see the specialists with out the referral?



My daughters diagnosis was missed till 14 months old and it was a fluke it was caught - I visited my mom at her new job at Neurosurgeons office and the Ped. NS happened to walk by and notice her head shape issue immediately. We saw the local specialist with out a referral and then when we decided to see a cranial-facial surgeon (my daughters case was borderline for surgery recommendation) we only had to call her ped. for a referral to the insurance to go see the specialists at NYU.



The families who have had to fight their GP for a referral in the UK often have posted pics and the childs condition is quite obvious.

I must note that their are other UK families who had no issues at all.

♥♪Megan♫♥ - posted on 10/11/2011

Angela J, so far what I don't like about the UHC system is you need a referal for everything here in Canada and dental isn't included. Before I moved up to BC from NY I had a wonderful OBGYN and I knew I'd need one up here because I'm a high risk pregnancy. My MIL though didn't even know what I was talking about and I found out from my friend in AB that you need a referal to get one through your GP. And you'll only get one if you're at risk. Finding a specialist in Canada is hard, but your insurance will cover a trip to the US if they can't find one here. But it is a pain in the ass trying to find one. They're short on a few anesthstesiologists here in BC. I also hate being on a wait list to find a GP for my daughters. I had a good pediatric team in Western New York, but I guess they're even short on GPs here in the Okanagan.



As for the quality of health care going down. Doctors are paid to care. For each patient that the dr treats, everyone at the clinic or hospital is needed more. If a dr doesn't do their job they lose their lisence, the patient can sue, the government can sue and they will be prevented from being a doctor at all.



Kelly, I'm sorry to hear that. I'll have my grandma light a candle for you. I don't know why, but they seem to work.

Becky - posted on 10/11/2011

So the cancer has come back, Kelly? I'm so sorry. :(

Angela - posted on 10/11/2011

Thank you Kelly I know some (most) of the comments really hurt you. I know from watching my sister that chemo sucks and I wish you well with all that you and your family have to go thru to help you fight cancer. I wish you the best.

Georgia - posted on 10/11/2011

Angela B, that's a bit inaccurate to say that'll is opened when they make medical decisions. It is opened insofar as the insurance company will let it be opened. In a system like Australia's and from the sound of it Canada's, the doors are thrown wide open.

Politically, I am neither wholly left or right, so I guess that makes me a swing voter. I will look at the issues and decide who best suits MY views. I have voted for both sides.

Angela J, I don't think your family has lied to you at all! I think whomever is giving them their information is the one lying. FOX news comes to mind, because I know that they spout all sorts of propaganda and fear mongering misinformation. What's ironic about that is that the damn company is owned by an AUSTRALIAN! Yup, a UHC eligible Aussie (who has enough money to not care about a UHC).

When you hear information about stuff like UHC is bad/good, you have to question the source and the motivation. Old Rupert (owner of Fox) is a died in the wool Liberal (which means right wing here). He's for having corporate freedom without government controls (or regulation). He has quite a bit of say on what gets broadcast on his networks and it is always extremely rightwing.

I haven't yet seen sicko, but knowing it's a Michael Moore film, it will probably appear very leftist. However, his movies in the past have just shown a real side of the lives people are living. But, the truth lies in between extreme right and extreme left, if politics matter to you. I don't believe a UHC should be a political matter. To find the answer is simple. Should everyone be entitled to decent healthcare, or should it be reserved for only those who can afford it? No system is perfect, nor will it ever be, but in my thinking, as long as you can GUARANTEE that you and your family will have access to any medical care that's needed, then that's all that matters.

In my situation, my husband is the main income earner, I study part time and am a SAHM and we have 2 boys (4.5 & 2.5). If we were under the paying system, it'd be my husband's insurance we'd all be on. He works laying gas mains, so a dangerous job in a way, and if he were hurt and couldn't work he'd lose his job and we wouldn't have insurance. My eldest son tends to suffer febrile seizures with high fever and generally gets very ill. Without insurance or an income, I couldn't take him to a doctor to make sure he's okay. Okay, so it is my family and not yours, so who cares right? Not your problem. But, there is no guarantee in life. My MIL had breast cancer and all the surgeries, doctors and chemo she had wouldn't have been fully covered under any insurance plan. My FIL is 53 and still works, but he wouldn't have been able to afford all that. Who knew my mother would get leukemia 20+ years ago (in the US)? My father had TWO insurance plans to draw from, but still went bankrupt over the bills for treating her for the better part of 18 months. She was 51 when she died, I was 14. Everyone will get sick and need major medical at some point, in some way, because we all age. Wouldn't it be healthier for a country to have a healthy workforce to build the economy than to have one that's just okay? Doesn't everyone deserve to be healthy, for the better of us all since we all benefit with a healthy economy?

The US will never have a full UHC system like other countries, but even if the Medicare system was opened further to into include everyone (and we're only talking legal residents and citizens) and taxes be raised a little for that purpose, wouldn't that benefit everyone, even those who don't use it... but are already paying for it?

Kelly - posted on 10/11/2011

Angela J, I have not read everything that was posted since I was here last, I started chemo yesterday and I can't read long or type fast now, but I saw your more open minded questions, and I wanted to say thanks you for coming back and trying to learn more and shape your own opinions. Don't resent your family for "lying" to you, I doubt they did intentionally, they are just less informed or looking from a different perspective. You have the unique ability to change that because I think you can understand both views in a deeper way.

btw, No one will hold anything that said against you--I know I've said my share of mean things, and they still love me :)

Angela - posted on 10/11/2011

Oh one big plus in the USA is that it is all open when they make decsions on medicine etc. Not all countries have this so you will never be in the dark. Sicko is good but very left, their is also other good sources that are not so left. I will send you those soon busy at the moment... will write you my pros cons and the links soon later or tomm. so check if you like to know. I think I can address your worries and some of the things you hav heard. My family is anti UHC too. So Not my hubby and immediate or inlaws but many others.
I feel for you to have someone like your sis who showed not an ounce of empathy. ttyl

Tara - posted on 10/11/2011

http://documentarystorm.com/sicko/

There you go.
I just wanted to add that in Canada, when there are issues as nothing is perfect, the government will listen to the public, they conduct surveys, they hold public forums to address what needs to change to make the system work better.
Recently in Alberta Canada the provincial government has laid out a 3 year plan to put more emphasis on children and young adult mental health services. This has come about because of studies done that show that there is no health without mental health and the more we can make young people aware of their mental health and how to look after it, the more we can reduce the number of adult sufferers. So the government has seen a need in Alberta to improve their mental health services, so they are. Because they care about their citizens and the future.
Find me a private insurance company that is willing to change the way they administer their services because the people who need them asked them to.

Angela - posted on 10/11/2011

Angela B.
Trust me I was not happy with her and I let her know that.

Thank you everyone for your answers. In a way I was hoping to get some answers back that were similar to the ones I was told from family and friends. I say this only because I feel they lied. Until I married into the family I liked living in my bubble that if it wasn't happening in my home it wasn't my problem. My eyes have been opened to see I need to pay attention to politics and what is happening with my country and the world but I get all my info from them and now wonder how much is true. Don't get me wrong I love them greatly just now wondering if they are believing in all the things they hear or are they to closed minded to see there could be a better way?

As for all the cons you have listed I hear similar stories here. I have waited in the ER for hours and had long wait times to see a Dr. Other than during child birth I have really never had any medical problems so I have no experience in those departments. I know when my family members have had problems they were all well taken care of but then again they have all had insurance so I can imagine it might be different without it.

I have had to go to the ER and dentist with my husband and Dr's appointments for my kids without insurance but I just made payments and didn't have problems but again it wasn't major and ongoing medical problems.

I am going to try and find the movie "sicko" (I think that is what it was called) and watch it. Thank you for all of your help. I know our system needs fixing one way or another. My insurance premiums increased this year by $100/month and last year the only time it was used was for preventative visits.

Lady - posted on 10/11/2011

My mum's parner used to use private health care for his knee operations and hip replacement because the waiting lists were too long and he could afford it - but he was treated for cancer on the NHS - my mum has paid for my sister and herself to see private consultants when NHS have been unable to help - there are options in the UK, But I'm so greatful to have the NHS I would hate to think what life would be like with out it - I fell pregnant just as we were planing on moving to America for a couple of years - in the end we only went for a few months because there was no way we could afford for me to give birth over there - I nver even saw a doctor the whole time we were ot there as we couldn't afford it - luckily I have easy pregnancies. 4 children in the UK never cost me a penny - apart from in my usbands taxes but we pay it willingly for the service we get.

Cathy - posted on 10/11/2011

Yes something for America.

Our system is far from perfect...the budget is in deficit, postcode lotteries for drugs, limited access to NHS dental, limited hospital beds...

Having no middle ground backs up the system.

I wouldn't be without the NHS. I'm in no position to pay for extras. But I know many who could and would if the option for private wasn't all or nothing.

Lady - posted on 10/11/2011

I think she's trying to come up with something for America - and also pointing out that it may be slightly benificial for some of it to be implimented in the UK.
Although some of it is - you can go private in the UK. I know people who have jumped the queue by going private. They needed an other consultation but then would you want to be treated by a doctor that hadn't made a diagnosis?

Georgia - posted on 10/11/2011

I'm confused, Cathy. Is that what the NHS is like, or are you trying to explain a system for the US?

Cathy - posted on 10/11/2011

I think some sort of middle ground needs to be found for the US. In all honesty I can't see full UHC working there. The system struggles without it.

Many are already used to dictating to there doctors what drugs they want. Here the doctors start you on the cheapest drug and if it doesn't work for you they gradually move up the payment scale. For UHC to work in the US, if you want to continue dictating to your doctor what drugs you should be entitled to ... pay a for an extra premium.

If you want dental or opticians (unless it's an underlying medical condition such as glaucoma) appoints and treatment covered .... pay for an extra premium.

If you don't want to wait for non urgent care, surgeries etc ... pay for an extra premium.

America needs a system in place that will cover the absolute basics of health care for all. A doctors appoint, an ER visit, basic prescriptions at subsidized rates, essential urgent care.

I know it's only a TV show and does not fully represent the medical system in the US but I keep thinking of one episode of ER where Kovac get chastised by Romano for not ordering a load of useless tests because they're needed to cover them for insurance purposes even though the family in question had no money or insurance. That moment stuck with me.

If further tests aren't believed necessary by the Doctor then why waste money on them .... if you want to be covered for extra tests other than the basic ones deemed necessary.... pay for an extra premium.

Private care is faster here. Private care you can get all the extra tests. Private you can make demands.... but what you can't do is get diagnosed for a condition on the NHS, decide the wait is too long and try to go private, then it's a pre-existing and they won't take you. I feel if the systems were to merge in some way we would have a much more reliable healthcare system in the UK.

Jodi - posted on 10/11/2011

I AM going to say I did have a bad experience once. When I had my first miscarriage at 13 weeks, I hemorrhaged a couple of days later, quite badly. My husband took me in to the ER where I was triaged, and I waited and waited. I think I should probably have acted like I was worse off, because I think they really believed I was ok. In the end they had to get me a wheelchair because I'd lost that much blood I thought I was going to pass out. Finally......they took me up to the maternity ward where they had an OB check me out.



It was probably a 2 hour wait, and the MINUTE the doctor saw how much blood I was losing, they IV'd me (it was a bitch to find a vein) and sent me off for emergency surgery. After surgery, they kept me in overnight, but you know where they keep you when you lost a baby? In the maternity wing. Listening to babies cry. So, yeah, I was pretty upset by that experience.



Having said that, however, I am sure people in ALL health systems worlds wide have had the occasional individual bad experience. This experience in no way makes me think worse of UHC. Given I am 42 years old, and that is my only bad experience, I think that's a pretty good track record.

Georgia - posted on 10/11/2011

Yup, I've not had many bad experiences here either. Every time I've been in an ER (in Australia) we've been triaged almost immediately, except the one time at the Mater, but that was only because a kid came in by ambulance not breathing and blue. I cut them some slack for that. :-) Still, the triage nurse apologised for our wait. The wait times in ERs are significantly higher in the middle of the night or after things like dust storms. Ipswich Base actually has a sign in the wait room that states between certain hours (about 10pm-6am) wait times can be significantly longer. It's because of the yahoos with flu, it's prime heart attack time I think (it's amasing to see how many heart attacks come in during that time!) as well as the kids (like mine) who like to have fever spikes and convulse in the wee hours.

Even still, wait times are relative. I've had better success here overall since I don't wait days or a week for my GP (which was common with insurance in the US) and if you present in ER, they will actually investigate every possibility. Hence my and Seth's 11hr stint in ER (from 12:30am to 11:45am on a Wed morning). The attending and the resident weren't happy letting him go without figuring out why he had been writhing with back pain and a fever. Turned out to be a chest infection (found by xray), but they did a UA, prepped him for bloods they didn't end up taking and examined every other possibility. So I didn't mind that we'd spent the night there (and were both ratty as from lack of sleep), because I left knowing what was wrong, a script and enough meds to get us through two days so we could go straight home to sleep. What was even nicer was they monitored ME to make sure I wasn't losing the plot, was kept fueled with food and cola and safe to drive home. This is the same hospital that was in the news about a year ago, where the chick supposedly delivered in the supply closet because they were too full. Besides my personal experiences there, I have many friends who had babies there. We all believe it's a BS story. She would have been whisked off to maternity, not stayed in the ER, but even if she had, they would have put her in a bed and the only accessible closet is too small to put a bed into. If she had her baby in this closet, she wandered in there herself. That news story made me really apprehensive about going to Ipswich hospital for the longest time (maybe it was a couple years ago then, I'm bad with dates), but when Seth woke up screaming it was the closest option and I discovered my fears were totally unfounded.

Nikki - posted on 10/11/2011

The QLD Health website is quite interesting Donna, I just had a look at hospital waiting times, in Nambour (where I had Issy) the median wait time in the ER was 34 minutes and the average wait time for elective surgery was 31 days, that's pretty good really. The Nambour hospital always gets a bad rap from the locals, although my experiences have been great.

Shannen - posted on 10/11/2011

Going to the hospitals here in every experience I have had we have been seen ASAP. I have always been triaged as soon as I got there. Last time I went to the ER was for my daughters dogs bites, Not serious at all but they saw her right away. I do know though when the Dr's make their rounds and if I have no other choice I will go to the hospital at that time. I have only had to do this once, well the nurses asked me to come back at that time.

Georgia - posted on 10/11/2011

Angela B has a point. Australian healthcare is regulated by state. Here's mine (queensland): http://www.health.qld.gov.au/

Georgia - posted on 10/11/2011

Oh, I've got to add (someone tell me to shut up)...

With regard to wait times: When living in LA, I had Kaiser Permanente (I'm not even going to give my opinion of them because it's that bad). at one stage. I went into the ER because I couldn't see. The lights just suddenly went out after a blinding headache. Sounds kinda serious, no? Apparently NOT to the ER at Kaiser. I waited, blind, with my step mother in the waiting room (not triaged yet) for EIGHT HOURS before a triage nurse saw me and went "oh shit, you can't see after a massive headache? not good" and took me in. I then waited another FOUR HOURS before a doctor saw me. They did a couple tests and ended up sending me home to make an appointment with my primary care physician! I'm lucky it wasn't anything serious and it got better after a few weeks. Now, that was WITH insurance!! I also very nearly lost my job because I couldn't go to work and I didn't have enough sick leave or vacation days available.

My father died of an aortic aneurysm. He went to the VA (he was a career vet so had medical through them) to get a check up and was told about this aneurysm. The doctor said that if he got a stomach ache to beat feet to the hospital. No exceptions! He was then put on a wait list for surgery because the aneurysm was the size of an orange and ready to blow. The surgery was scheduled for a MONTH later. My father died after 2 weeks, because it burst.

Angela - posted on 10/11/2011

Angela J
I too give you the benefit of the doubt and accept your apology for the family member who you should really kick in the butt for being so rude and heartless to some of the people on her.

I am happy you are asking questions with an open mind . Keep in mind that all UHC is different from country to country with services and pro's and cons. The one thing they all have in common is equal access to medical care to all it's citizens and legal residents.
So when you compare and listen to people with UHC make sure to look at the Reform act and UHC plan in the USA, it very well may be different. It takes a lot of reading and research, I know I did it but it is worth it to be informed and educated with out all the BS the media puts out and all the bickering and bs from politicians.
Don't listen to the parrots who just replay what they here on tv or read in newspapers. The people on this thread are real and have real stories they are not parrots. So I would definitely use this opportunity to get the REAL story of UHC.
It may seem one sided because so many are for it but I am sure others are not and just would not get in the debate. However I am assuming you have heard plenty from the people who are against it. So now you have the opportunity to listen to the other side.
That is the point in a debate in my eyes. To educated others and yourself. To get views that you many have never been able to hear in your own world.
Everyone on here has been respectful to me. Even when I have been the only one who has my views and opinions in a particular debate thread. There has also been times when I was very passionate about a subject and and then I changed my views of the opposing side and thought they had good points. Other times I have been wrong and I have admitted it. So you see in the end it made me a better person to debate topics heavy or light.
Many of us are very passionate and do not mistake that for being rude or picking on you. It is hard not to get emotional at times. I hope you stay and to get as much out of these communities as I have.

My UHC is different than many on here and I will post my pros and cons to you as an American who has used both systems. I think if the USA goes to UHC they will use a system similar to the one I have here in The Netherlands which combines government and private. FYI you can also got to the countries like Oz, Canada, etc Health care websites and get some good facts too. Just goggle it or ask one of use for help with finding the site.
Right now I have to go and get Claire and I ready for an appointment ttyl

Georgia - posted on 10/10/2011

Johnny, maybe it's because you can't die of a bad knee. We have long wait times for knee stuff too... some longer than others.

Georgia - posted on 10/10/2011

OMG That's disgusting! So people have to say "yep, I'll just take death thanks" before they can be put into pallative care?! I can't believe that... well, yes, yes I can. Gotta think like an insurance company.

My ex-bf's mother was on her deathbed from cancer in her brain and all up and down her spine (stemming from a bout of breast cancer, long story). Because she was so bad and they wanted to free up the hospital bed, they moved her to palliative care in a hospice about a block away from the hospital. Her treatment continued until the day she asked to stop treatment, just in a different location... which was much nicer than the hospital anyway. Her room was like a bedroom in a guest house.

Ohh... ER wait times sometimes shit me too. I've been to Ipswich Base with my eldest once and it took us 4 hours to get into the ER (this is after triage and diagnosis) and overall we spent 11 hours in ER. During that time, we were fed and watered regularly (water for the kid, soda for mum) and thankfully they had toys and books to entertain us. When I was pregnant and went to Grafton Base ER, I only waited 20 minutes to get in (only because initially hubby forgot to tell them I was pregnant and not just fat). Mater Children's (which is a private AND public hospital)... I've waited 6 hours there once when my eldest was a baby. We were triaged in a timely manner (20 minute wait) and the rest of the time a nurse would come out regularly to do obs and give baby fluids.

But all these wait times have to be put into perspective. Grafton Base is the ONLY hospital in the Grafton area (population somewhere around 20,000), Ipswich Base is the ONLY public hospital in the Ipswich area (population approximately 155,000) and Mater Children's is only one of TWO children's hospitals servicing an area with a population of over 2 million.

Charlie - posted on 10/10/2011

OMG that would make life so much easier I have doctor files everywhere haha.

Johnny - posted on 10/10/2011

Orthopedic surgery. I will say the wait times for orthopedic surgery are way too long in my province. We are great at cancer treatment, heart disease, etc. But for some reason, knee and hip replacements wait a very long time. One of my girlfriends did get foot surgery within a month. But I had another friend who needed surgery on his knee and waited six. Mind you, he was still walking around fine. He just couldn't go for a run.