America - its all a bit odd...

Comparing your current premium with one of someone under the ACA is a red herring. With the structure in place in almost any other country the overall cost to each of you would be less and still also cover the unemployed. In most countries the idea of someone's policy being "Cadillac" or in some way better is not an issue, your health care needs are just met as and when you need it.

Under universal systems yes everyone has to be insured (that's kind of the point) and correct people on benefits are covered for free. You are already paying way too much, the US pays 1.5 - 2x more of its very large GDP per capita than other developed countries.

A benefit that conservatives should love but gets missed is that universal healthcare and preventive medicine means a healthier workforce. Fewer sick days, people better able to do their jobs and not worried that getting sick will bankrupt them.
 
A benefit that conservatives should love but gets missed is that universal healthcare and preventive medicine means a healthier workforce. Fewer sick days, people better able to do their jobs and not worried that getting sick will bankrupt them.
And don't forget small/ start-up businesses...they don't have to worry about setting aside crucial funds for new employees to cover health. A big advantage, I am finding out for start-ups here in London.
 
Doc's, hospitals and other healthcare providers need to have an agreement with the insurer. Providers who have an agreement with the insurer are called 'in network'.

If I as a patient use an 'in network' provider the insurer will pay all the agreed costs, usually to the tune of around 80% with me having to meet the other 20%. Many civil service and other govt related health policies pay 100%.

If I as a patient use an 'out of network' provider I have to pay all the costs. There have been cases where people have been in accidents, and taken to an entirely out of network hospital, with out of network Doc's and subsequently received a bill over $1000,000.00. Hard to grasp, consider though I went to an emergency room for 2 hours once and my insurer had to stump up $4000.00. A mate had bad gut's ache and spent a pleasant weekend in hospital till a kidney stone was passed and that cost his insurer over $40,000.00. A GP visit in my neck of the woods is around $130.00.

Around 20% of the population, some 60,000,000, have zero to totally inadequete medical insurance. Why? For a family of 4 our's comes in at around $2500 a month (90%), more than most of the populatione earns.

Unless people have an employer that allows a continuance of policy cover into retirement people are phuqed and have to try and pay for cover themselves. In my experience the only employer who allows a continuance is the civil service.
I see what you are saying about this network but if you could get a proceedure done to a higher quality and cheaper as you have done you would think that they would jump at the chance to pay out less. They must want to keep all the money within this network so they can manage the finances internally.
Thanks for the information though, all my knowledge on the American health system comes from Michael Moores Sicko and in his documentaries although the underlining issue is true they are slanted very much in favour of his position. As you noted above that program did show some 85 yr old boy still working as without his insurance he couldn't afford the meds needed for his wife and himself.
 
You do realize we can always take the Canadian approach right? They have public healthcare plus private. It's kinda best of both worlds.
I'm not sure what you mean by this. Supplementary benefits may get you a private room in a hospital, but it's the same hospital, same nurses, and same doctors in either case. You may end up with a private room anyway without charge if that's what they happen to have available when you show up or if they feel it is medically advisable. Conversely, having supplementary benefits doesn't guaranty that they will have a private room available for you when you show up.

If you go to your family doctor for a routine visit, you show your provincial health card and pay nothing (it's illegal to pay your doctor).

If anything, the UK has more of a "mixed" health care system than Canada does.
 
I see what you are saying about this network but if you could get a proceedure done to a higher quality and cheaper as you have done you would think that they would jump at the chance to pay out less. They must want to keep all the money within this network so they can manage the finances internally.
.....
We have world-wide cover and we can choose any practitioner/GP/specialist we like, except in the US. There, apart from accidents and emergencies, we are obliged to contact AXA and they direct us to a doctor of their choice.
 
I see what you are saying about this network but if you could get a proceedure done to a higher quality and cheaper as you have done you would think that they would jump at the chance to pay out less. They must want to keep all the money within this network so they can manage the finances internally.
Thanks for the information though, all my knowledge on the American health system comes from Michael Moores Sicko and in his documentaries although the underlining issue is true they are slanted very much in favour of his position. As you noted above that program did show some 85 yr old boy still working as without his insurance he couldn't afford the meds needed for his wife and himself.
1. It is not about keeping money in the network.

Dr's and facilities are considered in network if they have signed up with a particular insurance provider. Insurance providers negotiate discounts to minimise their payout to Dr's and facilities. Some Dr's choose not to sign up with particular insurance providers either because they don't think they are being paid enough, or the provider takes too long to pay, or they just don't like them.

If I go to a Dr he doe's not expect me to pay. I hand over my insurance card and he bill's the insurance company.

2. I have seen sicko too. And yes, Michael Moore is pretty much spot on.

The thing is Americans are becoming much better travelled and the internet is informing them of life outside the US too. Nowadays they see how much other people are paying for medical care and they know that they are being ripped off and provided with a second rate service.

My mate is 50, just him and his wife, he pays $1000 a month for his medical insurance out of his own pocket as he is self employed.

Chap I knew in Florida working for Uhaul did not have company provided insurance and could not afford to pay for it himself. He has a history of heart problems, knew he was going to have a heart attack but, could not afford to pay for the preventative care and drugs. He had to have a heart attack before he could receive the care that the hospital is legally required to give to a patient coming into A&E.

Patients are shuffled out of the A&E as quickly as possible so as not to cost the hospital anymore money than it thinks it ought to spend.

Baltimore Sun - We are currently unavailable in your region

99% of medical institutions in the US are privately owned and require payment for service, any service. The Mrs has had people arrested and removed from site for, shall we say, mental issues. The police come along, decalre them nut's and remove them to an appropriate facility. The facility takes them as they are required to do by law. Then the next morning the Dr declares the individual compos mentis and has them discharged so that they are not taking up a valuable $1200.00 a day room.

3. Working post retirement is not a novel act to keep busy by most in the US. It is a necessity. Stop working and you stop getting a subsidised health insurance through an employer. Next time you visit the US ask those nice pensioners who are working in Wally World, Home Depot or other supermarket if they are working to stay busy or to get health insurance.

How many people can afford $1000 to $1500 a month out of their own pocket for health insurance when the State pension only pays out around $1500 a month.

As a family we paid out $48,000 in health and medical costs over the last tax year - that is more than most people earn in a year. Like I said there are around 20% of the population with zero to minimal health insurance.

And the good news for you lot in the UK: The NHS is already talking to US insurance providers so how long before the system in the UK changes to a more US based model? Ageing population. less money in the pot, time to start looking for other ways to make it pay for itself.
 
[snip...

3. Working post retirement is not a novel act to keep busy by most in the US. It is a necessity. Stop working and you stop getting a subsidised health insurance through an employer. Next time you visit the US ask those nice pensioners who are working in Wally World, Home Depot or other supermarket if they are working to stay busy or to get health insurance.

...
That is, frankly, outrageous! We have a deal whereby if you retire after 55 and have worked for the organisation for at least ten years, you can fund private medical insurance for 1.5% of your final salary per month. That is a bargain. At that price, for an old married couple and all that brings with it, I am well happy with that offer.
 
I see what you are saying about this network but if you could get a proceedure done to a higher quality and cheaper as you have done you would think that they would jump at the chance to pay out less. They must want to keep all the money within this network so they can manage the finances internally.
Thanks for the information though, all my knowledge on the American health system comes from Michael Moores Sicko and in his documentaries although the underlining issue is true they are slanted very much in favour of his position. As you noted above that program did show some 85 yr old boy still working as without his insurance he couldn't afford the meds needed for his wife and himself.
It's to do with insurance companies have negotiated deals with health care companies where the former have committed to giving all their business (patients) to the latter in return for a certain price. This lets the health care companies plan and do business based strictly on their deal with the insurance company (taking into account health statistics) without having to worry about competing for the business of individual patients on quality of service or other such patient facing factors.

It also lets insurance companies plan based on a price schedule from the supplier (health care company) and health statistics, to give themselves predictable future costs without having to take the opinions of individual patients into account.

For employers, it lets the HR department negotiate multi-year benefit plans with insurance companies who have a predictable cost base.

You will notice that in the above the patient is either the product or an expense, not an individual whose opinions are considered to matter.

P.S. - I have read that under at least some health benefit plans in the US there is a maximum monetary limit for coverage, after which the insurance company will not pay further as you are considered to be costing them too much money. So if you develop an expensive medical condition you can run through your lifetime financial limit in a few years or less, after which they will not pay anything further and you are simply out of luck.
 
In the UK, weirdly I always had private healthcare from my jobs. Never used them tho.
You should! One of my experiences was a little unsettling (And simultaneously re-assuring). As I hit 55 I was advised to have a colonoscopy. In June, I called the specialist and they said the next free appointment was at the end of August. As I put down the phone, my wife asked me if I had informed the that I am privately insured. Called them again, with this added info, and suddenly they asked if I "Could come in next Tuesday?"

While for me that is good, I can't help feeling that medical appointments should be allocated on need not funding.

It was no fun, by the way. (different story)
 
You should! One of my experiences was a little unsettling (And simultaneously re-assuring). As I hit 55 I was advised to have a colonoscopy. In June, I called the specialist and they said the next free appointment was at the end of August. As I put down the phone, my wife asked me if I had informed the that I am privately insured. Called them again, with this added info, and suddenly they asked if I "Could come in next Tuesday?"

While for me that is good, I can't help feeling that medical appointments should be allocated on need not funding.

It was no fun, by the way. (different story)
NHS appointments are based on need. Hence if your GP has indicated on the referral that there was a suspicion of cancer, you'd be seen with two weeks.
 
How long would I have waited for a routine (Age qualified) colonoscopy with the NHS?
That varies from hospital to hospital but the government target is 18 weeks from referral to treatment or a decision on further management (which could just be "watch and wait").
 
How long would I have waited for a routine (Age qualified) colonoscopy with the NHS?
Further to my post above, a colonoscopy is not considered treatment, but an investigation, so you should have had the colonoscopy, the results reported and a decision on further management within the 18 week timescale.

ETA: There are all sorts of things that "stop the clock" which give hospitals extra time, and they will try and use them!
 
I'm going to risk offending you and disagree, far from thinking Americans are all individualists, I feel that a large majority are herd animals and follow the pack. Some may call that teamwork, others blind faith, and in some cases - stupidity.

This is however not limited to your nationality.
 
Think about it from @LJONESY view point, he is a civil servant so his pay and medical insurance is already funded by the taxes etc that everyone pays. Why would he want to move to a system where he pays a bit more tax to cover those who have no medical cover. No improvement for him.
 
That is, frankly, outrageous! We have a deal whereby if you retire after 55 and have worked for the organisation for at least ten years, you can fund private medical insurance for 1.5% of your final salary per month. That is a bargain. At that price, for an old married couple and all that brings with it, I am well happy with that offer.
All BS and ARRSE posturing aside.

I find it beyond outrageous it is disgusting. The democrats have been trying to bring in some form of european style healthcare for years - that is what Obama care was all about. You may hear all sorts said by the Republicans against the Democrat vision of healthcare but, it is nothing but scare mongering, lies and BS.

It is an often bandied around factoid that there are twice as many healthcare lobbyists in Washington than there are members of the house. The healthcare industry spends a fortune [in backhanders] to ensure that it is not overly controlled and regulated to rein in its huge profits.

I had some medical training years ago and know how to stick a needle in and sew up a hole, try and keep up to date with my emergency medical skills and limited diagnostic ability. There are illnesses and afflictions you can spot with a little training and I see many wandering around that would benefit from a simple procedure or course of pills. I can only assume they have no insurance and cannot afford the treatment. Two thing I have noticed much more in the US are rickets and diabetes - both IMHO a product of diet, but preventable/treatable with better information and education.

For us it depends on how much we have in the piggybank as to whether we come back to europe, or stay here. I have a couple of mates here who have bought a rental property so that the income from that pays for medical insurance. There is still the danger though that the insurance provider will decline payment and the bill comes at you, yes, they can decline payment - we used to have a forum member who had payment declined so he returned to the UK. Like I said, disgusting.
 

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