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OT- nationalized vs. private healthcare

OT- nationalized vs. private healthcare

After reading the "domestic partner benefits " thread and rather than getting off topic there, I would like to know if someone who lives in a country with socialized or national healthcare could comment on the quality of care that offers. I've lived in the US my whole life and while I see the vicious cycle of rising prices in the healthcare industry (and firsthand as I work in the pharmaceutical industry), I wonder if we switched to nationalized healthcare, would the quality of care plummet? Would the rich would still benefit anyway because they would afford to still get healthcare outside of the system? It seems like it might bring the availibility of healthcare up a notch for low income families, the quality down a few notches for middle income families and the cost up in taxes for everyone. I don't want to make this a political debate, but as I think this will be a debated issue in the next presidential election, I would like to hear what people in countries with nationalized healthcare think of it or if you reccommend it. Thank you for your comments.

Fri. Apr 6, 8:19am

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I've heard that Canadians who live near the US border will stay where they are if they don't mind waiting for care, but that they will cross the border into the US and pay if they want to be treated quickly. It will be interesting to see if any Canadians near the US border will comment on the care they've received in Canada vs. the US.
An interesting thread. Thanks.

Friday, April 06, 2007, 10:02 AM

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the keys to solving the healthcare crisis in America are 1) Jesus and 2) water filtration.

Friday, April 06, 2007, 10:46 AM

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Friday, April 06, 2007, 11:13 AM

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Good question. I have spoken with one Canadian about this and he said he purchases extra health insurance because the helath care given is not satisfactory. I'd like to see others opinions on this in Canada.

Friday, April 06, 2007, 11:36 AM

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Every system has it's pros and cons. I lived in the UK with nationalized health care for too many years, and even worked on the inside (admin capacity) for a couple of years.

The Cons: They are unlikely to run diagnostic tests because they're expensive and "eh, you're too young to have any real problems yet". Yes, I was told this, and it took a trip to the ER in an Italian hospital to sort out the misdiagnosis. If you need to see a specialist, you sit on a waiting list for up to a year just for the initial consult, and then up to another year for the procedure. This applies to anything from a tubal ligation to heart bypass. I am totally speaking from first- and second-hand experience, not urban legend or scary news reports. It's actually reported with pride when waiting times are down to 10.5 months.

The Pros: I really appreciated that health care benefits were not linked to your job. I truly hate that about our system. I also found the general practitioners I went to more responsive than the ones I've had here, and very easy to get appointments with. I was also impressed with their progressive way of dealing with birth control - all other prescriptions have a fixed price no matter what it is, but birth control pills are free (or at least they were when I lived there in the 90s), woohoo! Think how that compares to the way a few plans here still don't cover contraceptives. Also, there is a way around the waiting times through private health care - and insurance to cover that is pretty cheap, like the annual premium is about the same as my monthly premium here in NY. I had this through my then-husband's employer, which got my wisdom teeth surgically removed about 6 months before they otherwise would have been.

The Funny: I could not stop laughing at the wheelchairs at my local hospital (in a major city, not the back of beyond). Perfectly functional, don't get me wrong, but they looked like Victorian museum pieces. Picture your dining room chair with little wheels on each leg. Seriously. They were wooden.

Friday, April 06, 2007, 11:45 AM

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OP here

11:45 poster - thank you for your comments, very insightful. The wait time is what scares me the most. You hear so many cases in the US even now of doctors catching something in the nick of time, what if we had to wait another year for a diagnosis?

10:46 Thanks for the laugh :-)

Any other experiences out there?

Friday, April 06, 2007, 1:05 PM

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OP again

One more thought, there is so much freedom right now to go see a doctor for any little thing (which can be good or bad). Some worriers will obviously take this to the extreme and go to the doctor everytime they have a cough, but if wait times were up and the chances to see a doctor was limited, things that people might otherwise just get up and go to the doctor for (ie. depression, weight issues, UTI [Oh goodness, I would hate to wait for that!], and minor symptoms that could be warnings of a bigger problem) might get put on the back burner to save the hassle and time.

Friday, April 06, 2007, 1:09 PM

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Just to make it clear, the NHS in the UK gives you total freedom to see your general practitioner, who handles most things. I find that that the system here relies unnecessarily on specialists - I see it as "harvesting" as many appointments as possible out of each patient. My regular doc was very good at seeing the bigger picture I went in for insomnia and after a bunch of questions he diagnosed mild depression, which, as much as it killed me to admit it at the time, was correct. My previous doctor was downright nasty about my weight problem though - I went in for a goiter/thyroid check after a doctor in another country noticed it while treating me for tonsilitis. I never even mentioned my extra 30 lbs. Anyway, the system works like a POS here - you see your general practitioner for everything, and they refer you as necessary. It's just that you can't choose your specialist and you have no control over how long it takes to get that appointment.

Friday, April 06, 2007, 1:32 PM

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I live in Israel and health care here is paid for and supplied by the government. Since I work, I pay a monthly sum (not small!) based on my salary. People who don't work (housewives, retired people, etc.) pay a minimal amount. Most care is handled by a GP / family specialist / internist. When s/he think you need to see a specialist, s/he provides you with a referral and usually a recommendation, e.g., Dr. X is really good - try him. You can see some specialists, such as gynecologists + orthopedists, without a referral.
Usually, one gets to see one's family doctor the same day or the next day. If you have to wait 2 days, you start to complain. For specialists, the wait can be from 1 week to much longer - maybe 1-2 months.

I've lived here 19 years and have received treatment in hospitals twice and both times I was very satisfied with my care. In neither case was my wait unreasonable.

Overall, I think I get excellent medical care. I must admit that I also pay for private medical insurance, in case we need something not covered by the government basket of services or an unsubsidized drug. We've had the insurance for about 6 years and never used it in spite of having been sick with various illnesses / situations (pneumonia, broken toe, flu, lupus, arthritis, gout).

I am an American citizen and all I can say is that every time I meet Americans, either visiting here or when I'm visiting America, I listen to an amazing litany of complaints from them about their medical care and I mutter to myself: I'm glad I get my medical care in Israel.


Friday, April 06, 2007, 2:02 PM

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I live in Canada (I was the one to say I'm glad I'm living North). I don't have any additional health care coverage right now. But I'm quite healthy and only 26 years old. I can see my doctor for anything I want- but granted, at the clinic I'm at, it's usually a month of wait time if you don't ask if there's any cancelled appointments to take. But as I've been there for 20 years, I don't want to go to a new doctor who doesn't know my history.

I've been referred to specialists for my feet, to check my moles, and for minor surgery on my toes. I paid $50 total each time I had part of my nail bed removed on my big toes. That's about it.

When my bodyfriend got a NASTY virus he was hospitalized for 3 days. They wouldn't let him out. He was on IV the entire time and had several blood tests and other tests trying to figure out what was wrong with him. He had no coverage, there was no bill.

My mother is diabetic and has congestive heart disease. She has an endocrinologist, a heart specialist, a nurtitionist and her GP she sees, all for free. Tests? Oh yes, she has to do tests. Are there wait times? Yes. Though that *may* be because in my province there is a bit of a shortage of medical professionals... many go south or way north where they can make more $$$. Usually however, it is the first appointment with the specialist you wait for- if they take you as a new patient, then there's not usually lengthy wait times, and they'll see you if an emergency comes up.

I assume there are people who suffer from rarer forms of diseases where either the treatment they seek is not covered, or professionals in this country haven't had much experience with it, or those who have an impatient attitude may not be happy with it. I love it. I do my best to stay healthy, and for the few times that I have needed medical help I have recieved it in a timely and satisfactory manner.

Friday, April 06, 2007, 2:08 PM

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OP thanks for starting this thread. It's very interesting, and I was actualy thinking the same thing when I read the domestic partner benefits thread. Thanks to the people who've responded from countries with nationalized health care also.

There are of course pros and cons to a nationalized system, but I think we in the U.S. are lagging behind in this area.

Friday, April 06, 2007, 3:57 PM

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I'm the one who's been offering the experience of the British National Healthcare System...

Moving back here, the thing that struck me hardest about our system was its unbelievable degree of big business commercialization. Television and magazines are full of ads for prescription drugs, and it really creeps me out. There's a syndrome for everything and a pill to fix it. I go to my doctor here and I feel like they're trying to frighten me into tests and specialist visits, and there's never anything wrong with. But holy cow, they've managed to generate thousands in fees from my insurance company. I feel like my health is coincidental to their business. I swear, I feel like we as a nation are footing the bill for pharmaceutical development for the rest of the world, and the rest of the world just laughs at us for it.

The reason I don't think nationalize health care would work here is that a lot of doctors go into the profession with dollar signs in their eyes. A nationalized system would cap their income prospects, and that really doesn't fit with our capitalistic nature (and I'm not using "capitalistic" in a derogatory way - I definitely consider myself a good little capitalist!).

Friday, April 06, 2007, 4:28 PM

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I read this thread first, then went looking for the domestic partner thread mentioned.

All I can say, is I'm VERY glad I'm in Canada!

The 'mericans are saying in one sentence that they're worried that their taxes would go up for nationalized health care, then in the next sentence they're saying they pay up to $500 per MONTH for insurance. My word!

$500 per month insurance is $6,000 per YEAR. Then you pay all your deductables on top of that. Here in Ontario, you have to earn over $36,000 (assuming no other deductions) before you even pay $6,000 in total taxes.

At my earnings level of about $60,000 per year, my total taxes (before any deductions) is around $13,000. With all the deductions I am entitled to, I pay around $8,500 in tax per year.

As a diabetic, I have 2 endo (diabetic specialist) visits, 4 GP visits and 2 diabetic nurse/dietician visits PER YEAR. And 4 visits to the lab for a full 1/4ly workup on my blood. I'm on Depo Provera birth control, so that adds another 4 visits to the nurse at my doc's office for the shots. How much would all that cost if I had to pay for it???? As it is, all I have to pay for is parking at my doc's office (50 cents for 1/2 hour or less - so about $4 per year)

So, what happens if I actually get SICK? A couple of years ago, I was suffering from some REALLY BAD, frequent headaches. Which meant a visit to my doc, a referral for an XRay & MRI, a referral to a Neurologist and I don't remember what all else. My costs? About $20 for parking at the various locations.

I've lately been suffering sharp pains in or around my "female parts". Again, a visit to the doc, XRay & Ultrasound, and, when nothing was seen there, a referral to a gynecologist. Unfortunately, here is where the "bad" part of our medical system comes in -- my appointment with the gyno is in about 2 weeks. However, all the rest of this stuff was back in November. 4 *MONTHS* wait for the specialist. This may be partly my own fault. I requested a specific gyno, because she is VERY conveniently located for me (in the same plaza where I work), and I've heard good things about her. If I'd let my doc refer me to "just anybody", I could have been in months ago.

Granted, in Ontario, (and, I think all provinces), we aren't covered at all under our health care system for dental, glasses, or prescriptions. In Ontario, though, we can be covered for prescriptions through Trillium (the Ontario government). I pay for my prescriptions quarterly up to .75% of my income ($60,000 * .75% = $450), then they cover the rest. My prescriptions for all my ailments run in total around $5,000 per year. I pay $1,800, the government pays the rest.

Dental, chiropractor & glasses (my daughter & I both have glasses) run maybe another $1,000 per year.

So, call it $3,000 per year out of pocket, and I have ALL the coverage we need. If I or my daughter get sick, or break a leg or something, I do *NOT* have to look at my bank balance first to see if we can afford to go to the doctor.

I think I would be dead if I lived in the US, quite honestly.

Friday, April 06, 2007, 8:31 PM

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Friday, May 09, 2008, 11:11 PM

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I live in Germany and the health care system here is great! In 2004 they had to introduce the co-pay system but we pay 10 Euros once a year - so that's not bad. Since I split my time between the US and Germany, I tend to get all my medical stuff done here. I have a great general doc, a fabulous ob/gyn (who really thinks their ob/gyn is fabulous? I do!), a great dentist, and I know that I can receive the care I need in case of an emergency without wondering how much it is going to cost me.

The downside of this system is that it is expensive. Healthcare takes a big bite out of my paycheck every month - but I figure it is worth it. My brother and his wife just had twins and there were some complications. If they were in the US, they would still be wondering how to pay for the hospital stay and care they received. Since they are here, my sister-in-law got the best care and the twins as well. All are healthy and making great progress.

I've always said that if I when I decide to have children, I am moving back to Europe. Partly because of the health care system and partly because of the work/life balance that comes with mandatory maternal/paternal leave (paid in full for up to 3 months in Germany and then varying up to a 3 years).

Saturday, May 10, 2008, 11:09 AM

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PP here...I forgot to add that in Germany we have a dual system. Some people are covered by the mandatory health system provided by various providers required by the government. But when you reach a certain income level, you can choose a privatized health insurance. I am not at the income level here, so I am not sure what the differences are. I do know that my mother and I have the same health insurance and she has regular visits to the ob/gyn as well as several specialists due to some health complications, and she only pays the 10 Euros/year. Her prescriptions are also covered. I know that if she was in the US, she would be paying almost $200/month just for her medications. Let's not even get into the doc visits and examinations.

I am returning to the US next month and dread having to pay for health insurance. But it's only for 2 years and then I am more than likely coming back here. Like many Americans, I just cross my fingers and hope that nothing serious happens to me.

Saturday, May 10, 2008, 11:15 AM

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I am Canadian and our health care system is excellent, I truly believe in it.

When my sister had cancer she was getting chemo at a cancer centre in Toronto called Princess Margaret. Her husband's family were from the US, and they insisted she get a second opinion from a top Cancer Hospital in New York. They believed that Canadian health care must be inferior because it is socialized.

The physicians in New York examined my sister and told her that not only do the agree with everything the Oncologists at Princess Margaret had diagnosed her with - they also told her Princess Margaret is one the leading and most respected Cancer Hospitals in the world.

And it was 100% covered by our system. Seriously, there are no cons to socialized health care. Only pros.

Saturday, May 10, 2008, 6:18 PM

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A lot of Americans I meet talk about "wait times" A LOT when it comes to socialized health care.

Seriously, this is not a huge issue - an a VERY small price to pay for excellent universal health care.

Saturday, May 10, 2008, 6:26 PM

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Wait times are minimal, and if it is an urgent case you get moved up the ranks.

So let me ask the Americans who think wait times are a problem.
1 - Where do you get this information ?
2 - Do you think that longer wait times are the result of too few doctors in Canada, or that it is open to everyone and therefor people are taking tests / treatment needlessly?
3 - If there are shorter wait times in the U.S. is it because there are more doctors, or because only a small segment of the population can actually afford the test / treatments, and therefor leaves "open" appointments for other?

Monday, May 12, 2008, 9:37 AM

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personally I dont care as much if it works or not (I don't think it would - look at Social Security y'all)

but you don't think $2,568 BILLION in FY2007 is enough for the US governement take from us and throw around??

We should give them MORE?

Monday, May 12, 2008, 10:46 AM

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