Tuesday, 15 November 2016

US verses UK health care


You know how it is, you're on facebook and you hook into all sorts of rubbish. You read one thing and then see another on the sidebar and you're away to another clutch of stories about dogs being rescued or cats doing hilarious things.  Today I have been reading "27 grateful people share the most incredible acts of generosity someone has ever done for them" There were lots of stories about good teachers and strangers paying for food etc, but those that stood out for this British girl were those when people in the US were helped out with medical bills. There's this girl who has type 1 diabetes, who currently has little health insurance because she is a student. She is making her medication spin out as far as possible and a lovely nurse gives her some freebie meds. from the pharmacy to help her out. Then there is this woman whose husband has had a heart attack and has recently lost his job, who is helped out by the kindness of strangers. Similarly a guy who has cancer and little health insurance to cover his months of treatment.  I'm sitting here horrified!
Back in the 80's my husband had cancer, it was over 5 years of chemo, surgery and radio therapy before he was clear. At the time he was employed and would have been able to pay into a health insurance scheme (should he have needed to) though the treatment would have come to tens and tens of thousands of pounds. Years pass, with several health issues such as anaphalactic shock from wasp stings, diseased eye and cataract op, all requiring regular medication, and then the firm he works for folds along with the private pension fund that he has been paying into for 23yrs! It is now difficult for him to get a job, but we have the smallholding  so we decide that we can manage as I am still employed. We started to offer Bed and Breakfast, which did pretty well and then seven years ago while he is putting in the mandatory fire escape(!) he becomes ill again and is told that a valve in his heart is no longer working well and will fail at any time (probably damaged by the radio therapy all those years ago) Back into hospitals, open heart surgery and constant, huge amounts of medication for life. And at no time have we worried about the cost.
A few years ago a college friend of mine who married an American was over here for a visit. The year before she had given birth to her third son who was born with a cleft palette and who had many corrective operations. Whilst she was with us her husband, back in the States, was shot outside a cinema and apart from the obvious concern for his health she was also extremely worried that they had used up all their insurance on the son. What a dilemma!
So my British bloggy friends, as if you don't know it already, The National Health Service is THE BEST! I'm sure you all have examples.
All for now
Gillx
PS this is not my planned post, but my little foray into Facebook set me off!

36 comments:

  1. You are absolutely right. I am a Brit but was married to an American and while I never really needed much in terms of NHS treatment as I was young and healthy, my family had their various illnesses (heart surgeries for dad, and major surgeries for my mom and two sisters and one brother) I am so so grateful to have the NHS. When I married I moved to the US and my oldest son was born there. I was young and healthy and had a straightforward pregnancy and birth but also with excellent medical coverage. Not so long after family members of my husband had medical problems and I saw first hand what it was to worry about not being quite so young or quite so healthy, and the fear that they might lose their homes. To do "everything right" and still run the risk of losing everything through ill health is just scandalous. In my opinion, health care - like education - should be free. If only. Don't knock the NHS, your worst nightmares could be just around the corner. Anna (now happily living back in Europe)

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    1. Thanks for your comment. I suppose that which you are saying is the story of our life too. Healthy strong people who gradually grow older (in my husband's case thanks to the NHS!) with less disposable income but higher health needs.

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  2. Yes the NHS is the best, I am so glad we have NI contributions that go towards an excellent service and give piece of mind we are all so lucky in the UK its just a shame we dont show it the appreciation it deserves and there are those who abuse the service and staff.

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    1. I think so too!
      There will always be those who abuse the system I suppose, shame really as such people put a strain on so many services.

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  3. Imagine the cost just of buying medications for Colin's cancer treatment - 10 different tablets a day - that's without the chemotherapy, blood transfusions, endless antibiotics, weeks and weeks in hospital.
    It's frightening to think how anyone could pay for it and what would health insurance costs have been as he'd already had the heart problems?
    Thank heavens for the NHS.

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    1. I think you will find that with each health problem private medical insurance premiums increase. Eventually some schemes will only insure you for certain things, which will Col and David would make them virtually uninsurable even if they could afford the premiums.

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  4. I am an American and yes things are very different here when it comes to health care. My sister had breast cancer and even though she had "good insurance", it cost her $3,000 out of her own pocket for each chemo therapy session. I paid for one session and other family members did as well. It is very true that we are all one health crisis from financial disaster. Many of us, make our prescription medication last longer by taking a lower dose than recommended by our doctor. We may take a half or quarter of the pill instead of the full pill because we can't afford the cost of the medication and we figure some med is better than no med at all. We also have a shortage of doctors which makes for long waits to get the needed services. Even with this, we still feel very fortunate because we still have better health care than lots of third world nations.

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    1. I was particularly concerned about the young woman who was making her meds spins out, I didn't realise it was a common practice!
      You are so right we should be aware that other nations have nothing like our medical care.

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  5. As a Brit living in the US for over 30 years, the hubs and I have excellent health insurance that covers pretty much everything. Whether a heart op or cancer treatment is the situation, we only pay a reasonable deductible and the insurance carrier pays the rest. The choice is ours. Either we purchase a bare bones policy, a policy somewhere between the two extremes, or the 'full octane' more expensive policy, people do the math and figure out what works for them. For years, I purchased the 'bare bones' policies because we were young and healthy but, with age, comes medical complaints and so we will move up a tier for more coverage.

    As a result of the extremely high taxation in the UK, you ARE paying for your health care!!! It ISN'T free and it's a misrepresentation of sorts to claim that it is free. I visit the UK every so often and am amazed at how little I can buy with my british pounds. 500 pounds disappears in no time. So, not only are you being taxed out the wazoo but the cost of living is also much higher than it is here. It's swings and roundabouts. Either one pays for universal health care out of the paycheck as you do there, or one buys a policy and pays a bill every month as we do here. Right now, my bill is $200 a month and includes free tests with no deductible (mammogram, pap, blood work, free physicals) so what would I rather pay? $2400 a year for coverage or one HECK of a lot more out of my british wages in income tax for universal NHS medical care? It's a no brainer.

    The US is a massive country as well so it's a lot like comparing apples to oranges. The UK can fit into a state the size of California with plenty of room left to spare! Never mind about the vast remainder of the rest of the US! Universal health care would be a tremendous challenge here - Obamacare has only been moderately successful.

    My parents live in the UK. My mother has dementia and had to wait so long to see a neurologist that her symptoms were progressively worse by the time she finally saw a doctor. Here, she would've been in within the week. My father has an enlarged prostate and has been wearing a catheter for over a YEAR because of delays in getting him into surgery. He has been trying to get knee replacements for the past 6 years and every time he gets remotely close to getting on 'the list' for surgery, something happens and his surgery never takes place. My sister had to wait months for thyroid treatment - luckily it wasn't cancer.

    Nothing is perfect but please don't denigrate the US when you obviously know nothing of the real procedure here for obtaining health insurance. It is illegal, by the way, to not be insured here. Everyone has insurance, whether it's Obamacare or a policy through the workplace. The only people who are off the radar are those who illegally neglect to file their yearly income tax declarations and those who are living under the underpass, usually as a result of a drug or alcohol addiction. In general, most people have medical insurance here.

    The level of care here is second to none. Even though I am a (disloyal!!) Brit LOL, the Americans get first dibs with the scalpel. Oh, and one member of the family is on medication daily. There is a small co-pay with that med which, even so, doesn't bring our total out of pocket even close to what we would be paying in annual income taxes over there in the UK.

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    2. Hmm, I am also a US citizen and no one I knows has that kind of coverage and pays only $200 a month. Good for you for having that opportunity, but even with what I would say is great health coverage for my family, this year I have three family members each reaching the out of pocket deductible, at an out of pocket, above my insurance premium, of $3,000.

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    3. Hi Anon, thanks for your comprehensive comment. So sorry to hear about the problems your family are having with the NHS. I guess I would be complaining by now if that were my experience!
      Yes I know we pay for the NHS through taxes, I guess I was demonstrating that those who can afford pay towards those who can't and as we get older more people, with less income need more care. I know that my husband would have struggled with even a " reasonable deductable" at the time he needed medical help most.
      I suppose I struggle to see how you can penalise someone who cannot afford compulsory insurance because of their particular circumstances, which was the case with the individuals I was discussing.
      I know that medical care in the US is great!
      Thanks for commenting
      Gill

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    4. To Sam: If the bare bones medical coverage suits your situation, you can find a High Deductible Health Plan at, for example, Anthem Blue Cross. HDHPs can be a good choice if you run the numbers, even if you have a pre existing health condition. Our plan has a $10,000 deductible for surgeries which means a person can have surgery as 'minor' as ingrown toenail removal or as extensive as open heart surgery ..... regardless, we pay that first $10,000 out of pocket towards the final bill. However, like I said originally, that $10,000 is still way less than the income taxes one would pay in the UK for the NHS .... with nowhere near the delays for treatment. Generally, the higher monthly premium paid for health insurance here in the US will equate to a lower deductible too. We just decided that right now a HDHP makes better financial sense for us. We are, however, prepared to pay $10,000 in the event we need to.

      I have known many low income individuals here in California who had their health needs taken care of without having to spend anything. Yes, the waits are longer in the public clinics but nothing like the NHS.

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  6. I found the comments about income tax by anonymous interesting so I thought I would check with mr. google. I'm Canadian so I checked the income tax rates for uk, us and canada and then converted it all to British pounds.
    I'm rounding to the nearest thousand
    U.K.
    11,000-43,000 20%
    43,000-150,000 40%
    150,000 and over 45%

    U.S.A.
    32,500-79,000 25%
    79,000-164,500 28%
    164,500-358,000 33%

    Canada
    27,500-55,000 20.5%
    55,000-85,000 26.0%
    85,000-121,000 29.0%

    So there does seem to be quite a difference in income tax. In Canada and the U.S. we are paying approx 29% up to 130,000 whereas in the U.K. you wold be paying 40%. I'm not even looking above that amount as I don't know anyone with that big an income!!!
    We do have private health insurance, which converts to about 90 british pounds a month, as well as provincial health insurance that is free. We, as seniors, have a maximum ceiling of 15 pounds for any prescription we get, and some are well over a hundred pounds. We don't have to pay for anything else. We do pay a percentage of dental, physio etc. Sorry to have rambled on but I was curious to see how things compare.

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    1. This is from a few years ago.

      http://www.bbc.co.uk/news/uk-england-16744819

      On the average wage 3 years ago, £25,500, £1,094 of it is spent on the NHS. Therefore the amount used for the NHS is about the same as what you state you pay in Canada. Retired people and children do not pay for any prescriptions in England. And in Wale and Scotland there are no charges for prescriptions at all, for any age group. If you need medication for your life time, you pay nothing for this in England either as you are given NHS prescription card that shows you are entitled to these medications.

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    2. So, taxes in Canada and the U.S. are about equal. One would think they could well afford to do the same as we do here in Canada and have a single payer system.

      God bless.

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    3. Hi Anon, Sol and Jackie
      Thanks for those figures, which I have read a few times to get to grips with!
      I think we should also factor in the contributions to adult/elder care that provides support for folk in their old age. While not perfect, it means that older people should not be concerned that they go without.
      Gill

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    4. Figures almost correct but once you hit £43000 it isn't 40% deducted on the whole amount just the amount between £43000 and £150000 etc. So, if you earn say £46000, only £3000 will have the 40% deducted. In the same vein, if you earn £15000, the first £11000 is tax free, then only the other £4000 is taxed at 20%. NI contributions are around 9% or so of your earnings.

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    5. Thanks for that Dc. very clearly put!
      I suppose it could be said that the unemployed, retired and those earning less than £11,000 do have free care!

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  7. Debbie in the U.P.16 November 2016 at 03:01

    I'm in America; i'd rather have Canadian medical care. My husband and i joke about moving there. Some days, it's not really a joke at all!

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    1. I didn't realise there was a difference in how medical was provided. Like Anon says the shear size of your countries is something I struggle to conceptualise!
      Thanks for commenting

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  8. I pay for everything here in France as I've not been able to join the French system. I pay to see the Doc' (€23), I pay for my meds (about €100 each 3 months), and would have to pay a fortune if I needed hospital treatment for anything. I have told my wife to drive hot-foot for England if I look as if I'll need serious treatment. My wife is OK, she managed to join the French system. Thank heaven for the NHS.

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    1. Indeed. As you are a diabetic the meds are a constant outgoing and it is good to know you can "come home" should there be any complications.
      Is there not a seperate insurance system for such as you?

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  9. And I would endorse what you have written. I think we have become so used to it that we feel ready to moan at the slightes thing. We are jolly lucky over here.

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    1. I think so too Weave.
      It is good to know that we do "end of life" stuff well too I think.

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  10. Well I am eternally grateful to the NHS. My son is a type 1 diabetic and needs insulin to stay alive, he is monitored by the hospital and doctor's surgery. I have never taken the NHS for granted but obviously worry about it at the moment with talk of privatisation. Not sure you can measure different countries health and income taxes it is a bit like chalk and cheese, the systems are different.

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    1. We have several family members who are type 1 and I can't imagine them spinning out their meds because they can't afford them can you!? Plus there is all the testing and hospital visits that can be necessary.

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    2. To Thelma: naturally, one must consider the costs of health care. We ALL pay for our health care regardless of the country we live in, the question is HOW do we pay for it and WHAT do we receive in return? I lived in the UK for 24 years and had a child there - it was absolutely the most awful and most dangerous experience I have ever had in a hospital setting, I kid you not. My son was almost born on the floor of the exterior tunnel that connected the wards because the nurses left me alone for hours to my own devices. Never again. I've had 3 more children in the US - vastly different experience. But I digress.

      I sure saw a huge difference in the percentage of my wages I kept in the USA vs. UK too! The point is, compared to the amount of money you have parted with over the years there in the UK for health care, do you think you receive value for that overall expenditure via the NHS? In my parents' cases, they both say no. You may be different.

      It is amazing to me how many people in the UK think that the NHS is 'free'!! and that is always the first thing I think of when I compare the US with the UK so forgive my soapbox approach. I guess my experiences with the NHS have been consistently bad :( so I am not impressed.

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    3. Hello, Brit living in US (over 30 years) worked in NHS whilst in UK. Amazed at wonderful care my parents received via NHS, no expense spared. Healthcare in US is abominable, unless you work for a company with great health benefits, which is becoming rarer.
      My experience is that some people are reluctant to accept that anything can be better outside the US. All has to be taken with a rather large grain of salt!

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    4. The point I was making was about people who were at a place in their lives when they didn't have enough insurance though no fault of their own.
      So pleased that your parent's experience was positive, as have me and mine.

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  11. When I hear about medical bills in the United States I am scared stiff. I live in Canada and while we have provincial/federal coverage, like the other poster we have private insurance as well to cover those things that the government health program doesn't. It gives me peace of mind to know I won't have to pay thousands of dollars when I have an operation or get sick.

    God bless.

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    1. Thanks for commenting Jackie. Seems a sensible thing to do to give you peace of mind.
      What doesn't the government programme cover?
      Gill

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    2. Sorry it took so long to get back. The government program only covers prescriptions after a certain amount is spent. This varies from province to province. With the private insurance we only have very small copays. Same with eye exams and glasses, which the government program only covers exams for those with diabetes and children to age 14 (I believe). With the private insurance we get some coverage for frames and glasses, and pretty much total coverage for our eye exam.

      Dental is another story all together. Our provincial government covers most dental costs for children, but none for adults. The private plan comes in handy as we only pay a small copay for any work or cleaning.

      The government plan does pay for surgery, hospital stays, doctors visits, checkups, mammograms, physio, and a host of other things.

      God bless.

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  12. The biggest cause of bankruptcy on the us is due to ill health. I'm very thankful of the nhs, it's a shame that so many seem to want to make a profit from ir and mps don't seem to value it in the same way.

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  13. I didn't know that, but I suppose that our situation was such when David had cancer we would probably have had to borrow to pay for his treatment.
    Agree re. many mps not valuing the NHS.

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