Which country has the best Health Care System?

[ATFFL]

The US has the most advanced medical care in the world.

That's nice for the millionaires that can afford it.

You don't need to be a milionaire.  Quit exaggerating.  You're asking for opinions, so don't sh**t on one.

Whoops Richius......I never made that quote......mistaken identity!!!

Both of you have  a green Uk avatar, easy mistake to make in all the crosstalk.

For emergency care, it is the US.  Despite what you may have heard, hospitals do not turn away emergencies if they are uninsured.  They'll work something out in the end.  This lets pretty much anyone get access to top notch medical care in emergencies.

For a long term condition it is the UK.  Getting in the system is a bit hit or miss, but once in you are set.

Not sure about access to perscription drugs.

[Richard]

Nobody can contend that America has the best, because half the people in the United States can't afford healthcare.

I would like you to cite some data on this assumption you're making, because I'm calling bullsh**t now.

You must be logged in to read this quote.

That is why you buy insurance.

[Richard]

As a worker in the UK National Health Service, I was wondering what the views are on which country has the best health care system and which is the best way of funding such a system?

For those who are unaware, the UK NHS is funded through general taxation and national insurance (really further taxation). In 2005 the cost of the NHS is due to be approx $144 Bn. (This is about 7-8% GDP compared with Germany and France who spend in excess of 10% GDP).

The founding principles of the NHS were that healthcare (second to none) would be provided equitably and equally to the whole population of the UK and that it would be free on demand.

The reality of healthcare in the UK has unfortunately not lived up to these principles. Increasing costs has put an increasing strain on budgets and consequently healthcare has become increasingly mediocre in comparison with other European countries and North America.

Although, healthcare is still free on delivery, I feel that the quality of this healthcare is suspect.

In the UK, discussion of the future of the NHS is a very emotive issue. If any political party seriously suggests removing the "free on delivery" ethos...........the party effectively commits politcal suicide.

Perhaps someone could enlighten me on how the US, Canadian and other European systems works and suggest a way forward for healthcare, as I believe the cost and quality of healthcare will become an increasingly important issue!

How does chronic illnesses and prescription drugs work?  Who pays?  And if you're getting a government-paid-for hip replacement, will they use the most advanced alloy available on the market, or do they use the cheapest plastic like Canada does?

[Tory]

Nobody can contend that America has the best, because half the people in the United States can't afford healthcare.

I would like you to cite some data on this assumption you're making, because I'm calling bullsh**t now.

You must be logged in to read this quote.

That is why you buy insurance.

Don't play stupid, it isn't very becoming. And not everyone can afford sky high insurance costs.

[Richard]

Nobody can contend that America has the best, because half the people in the United States can't afford healthcare.

I would like you to cite some data on this assumption you're making, because I'm calling bullsh**t now.

You must be logged in to read this quote.

That is why you buy insurance.

Don't play stupid, it isn't very becoming. And not everyone can afford sky high insurance costs.

I would like to see some sources that state that 150,000,000 Americans can't afford health care.

And you're right: Not everyone can afford sky high insurance costs.  But not all insurance is sky high, and with tort reform coming it will go lower.

[Tory]

I know for a fact that operations in the U.S. usually cost somewhere in the range of 15,000-100,000 USD. That's all I need to say.

I won't be continuting this conversation because it appears that all you want to do is act as a cheerleader for good ole America.

[Filuwaúrdjan]

How does chronic illnesses and prescription drugs work?  Who pays?

As I have a chronic illness and have to use prescription drugs for it...

The NHS is free at the point of use and funded through taxation. There's no insurance, means tests or anything like that. You get a letter telling you that you have an appointment of the Umpteenth of Upmtember or whatever and you turn up at the hospital on that date. You don't pay anything. Simple.
Prescription drugs are more complicated: if you have a chronic illness or whatever, they're free. If it's for something like a cold there's a small fee paid to the chemist.
Pretty much all drugs are generics.

[Richard]

I know for a fact that operations in the U.S. usually cost somewhere in the range of 15,000-100,000 USD. That's all I need to say.

So?  The goal of insurance companies is to spread the risk.  I'm an actuary you know...  Do you know how insurance works?

And if you think it is free in the UK you're deluding yourself.  What would cost $15,000 here would cost the government $150,000 there.

And lastly, do you really think that every person needs a $50,000 operation in his life?  No.  It doesn't work that way.  That is why insurance works.

You must be logged in to read this quote.

Strike 2 for me.  You lost again.

[Richard]

How does chronic illnesses and prescription drugs work?  Who pays?

As I have a chronic illness and have to use prescription drugs for it...

The NHS is free at the point of use and funded through taxation. There's no insurance, means tests or anything like that. You get a letter telling you that you have an appointment of the Umpteenth of Upmtember or whatever and you turn up at the hospital on that date. You don't pay anything. Simple.
Prescription drugs are more complicated: if you have a chronic illness or whatever, they're free. If it's for something like a cold there's a small fee paid to the chemist.
Pretty much all drugs are generics.

Interesting.  So no newer drugs?  And why do you have to pay for something for a cold?  I thought this was a free system for everyone?

What about technology?  My example again: If you get a hip replacement, do you get the latest greatest alloy from the United States or do they use the cheapest possible plastic?

And say you want laser surgery for your eyes?  Is that paid for?

What about dental reconstruction because you were in an accident and shattered your jaw?

Or orthodontists?  Do they pay for alternative forms of therapy?  Reflexology, acupuncture, homeopathy?  Chiropracterers?  Can I go and see one every week for 2 hours because I'm feeling suicidal and the government pays for it?

What about glasses?  Contact lenses?

Sorry about all these questions, but I'm not very familiar with the UK's medical system.

[Bono]

IS health insurance really that expensive there?
Here we have private hospitals and providers aside of the public ones, adn an health insurance for those, for, say a mom-dad-kid family, costs about €1000 a year.

[Filuwaúrdjan]

So no newer drugs?

We get newer drugs. Most prescription drugs are generics which is entirely logical. Why should the NHS have to pay more for a label?

You must be logged in to read this quote.

Because it's not a serious or chronic condition and the NHS is not made of money. If it got serious any treatment would be for free. All prescriptions are free for children or pensioners.

You must be logged in to read this quote.

It is. If you break you're leg and get it fixed you don't have to pay anything... not even insurance beforehand.
Makes sense to me.

You must be logged in to read this quote.

I've no idea about hip operations

You must be logged in to read this quote.

No. An operation has to be proved safe etc. before you can have it on the NHS. N.I.C.E has serious doubts about the safety of laser eye surgery so it isn't going to be on the NHS anytime soon

You must be logged in to read this quote.

Dental stuff is different again. No idea.

You must be logged in to read this quote.

No. Of course not.

You must be logged in to read this quote.

Same rules as drug prescriptions apply (not sure about pensioners).

[Bono]

You must be logged in to read this quote.

It is. If you break you're leg and get it fixed you don't have to pay anything... not even insurance beforehand.
Makes sense to me.

What about taxes?

[Filuwaúrdjan]

You must be logged in to read this quote.

It is. If you break you're leg and get it fixed you don't have to pay anything... not even insurance beforehand.
Makes sense to me.

What about taxes?

Most people get back far more than they put in (the core principle of the NHS is healthcare to everyone, free at the point of use).
There is no seperate health tax; the Chanceller just decideds how much of the total budget the NHS gets.

[scorpiogurl]

If you talk specifically about cancer (a chronic illness), whereas in the past this was managed by complete hospitalisation, today there is much more of a "patient centred" approach where patients are helped to manage their disease. This is done by a combination of hospitalisation (when required), adaptation of home environments e.g. lifts etc to make living easier, home visits by health professionals and social workers, self administration of drugs etc (pain killers particularly). Finally in the UK we have the Hospice System, where the dying are cared for in supportive environment. Hospices are run by the NHS, Marie Curie Cancer Care, other charities and some private companies (I believe). Those run by NHS and charities are free. Many carers in hospices are volunteers.

Prescription drugs. Each item is charged at £6.20. People of pensionable age, people on welfare etc are exempt from these charges. Out patients, who don't have exemption are expected to pay for prescription drugs that are "take home".

With regards to new drugs, these are evaluated by NICE (National Institute for Clinical Excellence). They are evaluated on a cost/benefit basis and then approved for use in the NHS. However, it is possible for doctors to prescribe non NICE approved drugs on private prescriptions. NICE is somewhat slower at approving drugs than the US FDA since it has a cost benefit analysis to do which is not applicable in the USA (I assume). An example of this is the breast cancer drug Arimidex which was approved for use in early stage breast cancer in the USA in 2002 and in the UK in 2004.

[Filuwaúrdjan]

Prescription drugs. Each item is charged at £6.20. People of pensionable age, people on welfare etc are exempt from these charges. Out patients, who don't have exemption are expected to pay for prescription drugs that are "take home".

I'd forgotton what the charges are (I don't have to worry about that now).

[scorpiogurl]

Prescription drugs. Each item is charged at £6.20. People of pensionable age, people on welfare etc are exempt from these charges. Out patients, who don't have exemption are expected to pay for prescription drugs that are "take home".

I'd forgotton what the charges are (I don't have to worry about that now).

No, problem Al :-)

[muon2]

BTW I would agree with Senator States that healthcare here is excellent, but the costs are rising rapidly. Even huge corporations like General Motors are staggering under the weight of medical costs for their employees and retirees. I think something is going to give sooner or later.
Neither Republicans or Democrats seem inclined to consider free market solutions, so my guess is that the country will adopt a more socialist plan.

My observations of socialist systems lead me to believe that they progress something like this;
1) Euphoria- everything is free!
2) Costs rising- This is visible to the politicians but not necessarily to the citizens.
3) Further rising costs prompt politicians to raise taxes.
4) Citizens get angry with high taxes.
5) Politicians realize they must do something to cover costs but are fearful of raising taxes.
6)Politicians enact  wage and price controls to keep costs down. Costs keep rising. Doctors get angry.
7) Politicians create rationing schemes. Shortages occur. Waiting lists occur. Patients get angry. Costs keep rising.
Doctors begin leaving the system because of wage limits. They advise young people to avoid the profession because the compensation does not justify the years of schooling required. Doctor shortage begins to appear.
9) Goes downhill from there.

Just my opinion.

Your points are very good, but fail to note the cause of the problem.

Fundamentally the problems with health care delivery in the US is that it became entrenched as an employer-based program. 50 years ago when the majority of working families could expect a wage earner to stay with a single employers for their career an employer-based system provided a useful connection for the country. 40 years ago patches to the system were added because the retired and poor populations had no connection to the employers. As the 80's showed, the workforce was far more mobile than a half century before, and insurance portability was a problem resulting in higher costs to cover those at risk who changed jobs. The HMO system came into being, but it too has failed to live up its promise to hold down cost increases for employers.

There really is no basis for a connection between the employer and health care, and it hurts business as much as the healthcare consumer. Unfortunately the US population over the last three generations has come to expect a health insurance benefit. In a thread a few months ago I drew the comparison to police services, and I do believe that the  wider public now has an expectation of critical services from the health care system the same way.

I think that some of your fears about the effect of the political system on health care are justified. However, when such a large fraction of society expects the benefit, poiltical forces are going to reflect the desire of the public.

If government must be involved, I think we should utilize smaller jurisdictions. Like the police, critical health care services can be delivered at a scale far below that of the whole nation. Security uses a mix of public and private options - but at a local level. Health care could use some of that same model with critical services provided by localities (eg. county hospitals and clinics), and a wide range of other services left to consumer choice.

[The Man From G.O.P.]

Thg God blessed United States of America has the best health care system.

[scorpiogurl]

You must be logged in to read this quote.

Interesting.  So no newer drugs?  And why do you have to pay for something for a cold?  I thought this was a free system for everyone?

What about technology?  My example again: If you get a hip replacement, do you get the latest greatest alloy from the United States or do they use the cheapest possible plastic?

You must be logged in to read this quote.

All approval of new technology is done by NICE (National Institute for Clinical Excellence) www.nice.org.uk/ Their recomendations are based on cost/benefit analyses. With specific regard to hip replacements, the NHS has 60 types approved in 3 different categories. All have evidence of 10 year survival. A surgeon will make a decision of which type to use based on clinical need.

You must be logged in to read this quote.

And say you want laser surgery for your eyes?  Is that paid for?

You must be logged in to read this quote.

No. Currently that is private. NICE have given an interim report on this matter and although they concede it may be useful in some cases, the general tone of the report is downbeat concerning possible risk of complications.

You must be logged in to read this quote.

What about dental reconstruction because you were in an accident and shattered your jaw?

You must be logged in to read this quote.

This would be treated initially in an acident and emergency department and so would be free........further cosmetic work required at a private dental practice might be a different issue depending on the specific dental practice.

You must be logged in to read this quote.

Or orthodontists?  Do they pay for alternative forms of therapy?  Reflexology, acupuncture, homeopathy?  Chiropracterers?  Can I go and see one every week for 2 hours because I'm feeling suicidal and the government pays for it?

You must be logged in to read this quote.

Dental treatment is a hybrid. If you are registered with an NHS dentist then you receive subsidised treatment. If not then you pay a full private rate.

You must be logged in to read this quote.

What about glasses?  Contact lenses?

You must be logged in to read this quote.

Sorry about all these questions, but I'm not very familiar with the UK's medical system.

You must be logged in to read this quote.

[Richard]

You must be logged in to read this quote.

What good is a health care system that doesn't even take care of people's eye sight?

You must be logged in to read this quote.

So once again, it isn't free?  You may end up unable to eat and in order to get that fixed you have to pay?

You must be logged in to read this quote.

Oh dear.

You must be logged in to read this quote.

More oh dear.


So actually the parts that you're most likely to use, dentists, eye doctors, and some everyday medication is NOT free?  And the part you're least likely to use is free?

Ym....

[The Man From G.O.P.]

Ok UK'ers, please stop pretending your 'socialist' medicine actually works, your not fooling us anymore.

[??????????]

Anyone in this country can recieve medical attention. We have medicaid and medicare. No hospital will turn you away at all.

[ATFFL]

Anyone in this country can recieve medical attention. We have medicaid and medicare. No hospital will turn you away at all.

I said that already, no one seems to want to listen.

An uninsured friend of mine had his appendix out in an emergency operation.  Total cost, 15k.  After going through an arbitration he is going to pay 5k over 5 years.  Reasonable cost for an operation and 2 nights in the hospital.

Thanks to the wonderful way we deal with health insurance all our costs are grossly overinflated, but no one ever pays full price.  Insurance companies have deals with providers to pay roughly 1/3rd of the cost, the real, actual cost before bloating.  Anyone can get the same deal since hospitals would much rather actually get paid than have someone declare bankruptcy and never pay them.

[Tory]

Ok UK'ers, please stop pretending your 'socialist' medicine actually works, your not fooling us anymore.

Hey, guess what, it does work. I know firsthand that it works. Maybe it isn't perfect, but at least I can afford it. I'm glad to know that if I get cancer and need treatment, I can get that. I'm glad to know that a poor single mother can get treatment for one of her kids without having to let the others starve.

You're all cold, heartless bastards.

[Richard]

Ok UK'ers, please stop pretending your 'socialist' medicine actually works, your not fooling us anymore.

Hey, guess what, it does work. I know firsthand that it works. Maybe it isn't perfect, but at least I can afford it. I'm glad to know that if I get cancer and need treatment, I can get that. I'm glad to know that a poor single mother can get treatment for one of her kids without having to let the others starve.

You're all cold, heartless bastards.

You mean to say if you were in the United States you'd be so poor you'd be unable to afford it?  Gee.  Now I see why you're a socialist.