Tracking the chaos...
I came to the US from the UK in 1978 at age 21. Since I was relatively healthy growing up, I had only had minor experiences with the NHS, including a couple of visits to the emergency room for injuries.
I did see the mediocre treatment that my father had in an RAF hospital over 18 months of confinement in the 1960s, and remember by contrast the excellent treatment that my mother received when diagnosed with diabetes in the early 1980's.
All in all, it seemed to be a decent system for most people.
That is why I have been surprised to see so many negative comments about the NHS, and praise for private insurance.
All that I can do is to offer a different set of observations from my adoptive country.
Prior to the Affordable Care Act (aka Obamacare), we had the following:
- approximately 10% of the population too poor to afford insurance (and not granted it by their work), and too rich to be on Medicaid
- some insurers kept up to 54% of premiums, with huge incentives to refuse payment
- maximum lifetime benefits, amounting to 10-15 years of treatment for something like hemophilia
- refusal to cover 'pre-existing conditions', which could include anything from pregnancy to cancer risks
The ACA has not been a panacea, but everyone now has access to at least a bad policy. All must cover pre-existing conditions, and do not have a maximum lifetime amount. In addition, children can stay on their parents' policies until age 26.
That said, the costs for some relatively simple events can still be catastrophic even with 'good' insurance, and medical bills still cause up to 60% of bankruptcies.
One remaining problem is that of 'out-of-network' providers. Suppose that you need to go to the Emergency Department, and go to the hospital which your insurance requires. Without your knowledge, any of the doctors who treat you might not be contracted with that insurer, and you could receive a bill, weeks later, for thousands of dollars.
Or, as happened with our first son, your specialist might charge an 'unreasonable' fee, which you would only find out long after the service is performed. Our eventual bill for a normal c-section was $10,000 because my employer had contracted with a mediocre plan.
Scroll forward to 2017, when I had heart surgery. The bill for a 3-day stay in the ICU was $150,000, not counting the surgeon, anesthesiologist etc. Luckily, I had good insurance at that time, and our cost was 'only' a few thousand dollars. A month later, my insurance changed, and the deductibles and co-pays for my rehab therapy alone were almost $10,000 in a few months.
Right now, we have excellent coverage, so covering my medications at $6,000 per month is no issue. A slight change, and the cost to me could be on the order of $1,000 per month, which is coincidentally the cost of those same medications to the NHS.
In short, the US medical system is phenomenal if you have enough money or just have minor health issues.
Sackerson adds: for more examples of the US medical industry's exploitative practices, see here: https://www.instantlymodern.com/trending/overpriced-essentials-horrifying/
3 comments:
No we don't want the US system. Its utter sh&t. Just like the NHS is. It may have escaped your notice that there are other healthcare systems in the world, and in fact the US and the UK are the massive massive outliers. No-one copies them. No-one has State owned State funded State run healthcare (outside of one party states) and no-one has the utter abortion that is the US system either. They all run some version of social insurance models, whereby the State often provides the funding via taxation and National Insurance type charges, and the some combination of private, public and charitable organisations provide the care. Funding follows the patient. There is usually an insurance model at the bottom of it, but the State funding ensures no-one fails to access healthcare. These systems work.
That is what we want in the UK. We are fed up of a 'healthcare' system that works entirely for itself and couldn't give a stuff for the patients. Your laughably aged experience of the UK healthcare system is utterly not relevant, if it ever was. One good thing covid has done is open the eyes of tens of millions of people as to the true nature of the NHS - when we needed it most they literally closed their doors and said 'F&ck off'. Getting healthcare in the UK today is like winning the lottery, and about as likely. Recent surveys have shown that now more people are unhappy with the NHS that are happy with it. We, the UK people who have to live with this monstrosity permanently, are fed up with it and we want better. And we won't be preached to as to its magnificence by people who live in other countries and whose experience of the NHS consists of freebies they had 30 years ago.
The NHS is definitely no longer fit for purpose. It's a massive money drain and the only 'solutions' ever proposed are to throw more taxpayers money at it. The whole thing needs rebuilding from the ground up.
The fact that the American system has it's failings does not detract from the mess the NHS is currently in and the need for reform.
Surely there's a happy medium between the two systems? Or even keep the current NHS system, but strip away the multiple layers of management, bureaucracy and non-jobs and make it fully accountable for the money it spends?
If I was forced to pick one or the other, I'd pick the American system at present, but I believe there are other, better options
@Sobers - I did not 'preach to the magnificence' of the NHS. I pointed out that at least one alternative is not good. Where the bureaucrats appear to be buggering the NHS, in the US most medical systems, hospitals, doctor groups and laboratories are currently being bought up by hedge funds.
They are squeezing all of the system.
One local group is giving a 2-4% raise to their Nurse Practitioners this year, along with raising the patient load by 50%
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