F-U-Jimmy

National Insurance is linked to tax but is an additional payment. So if you paid NI you also pay tax at a maximum of 40% plus lets not forget sales tax at 17% ( now its down to around 15% i think). You think its expensive to live in the UK ? Then you would be surprised that in California we pay more tax than the UK

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billyb

This is a tough sitiuation for a lot of people. If people would understand that the hospitals and DR'S are not payed back by Medicare, this is one reasons why things are so expensive. It is like me having to pay for people who have no insurance.

As for pharmacutical companies being the bad guy's, maybe there is a point to that?. I don't have the numbers here, but how many of these big phamra companies, US based are doing the majority of the R&D?.

Therefore we americans are mostyly paying for the rest of the world from our research. I just know that the goverment created medicare and look at what it has become. It is a great big expensive mess!.

Am I for nationalized health care, no way in hell!. I look at the states here that tried that. Massachussets, it is a major failure and the cost are out of control. Hawaii, they stoped their free state run health care after a year. It too was to expensive.

They also tried this in Tennesse and guess what it failed there as well. Imagine this on a national scale, it would be a disator. What can we do to make it better?, we can't continue to have people who are not legal to destroy our hospitals. Just look at what has happened to us here in California.

We need to have the cost come down, but nobody mentions that medical malpratice lawsuits cost 100 billion a year. This would also lower the cost greatly, if DR'S have to carry medical malpractice lawsuit insurance that runs into the hundreds of thousands of dollars per year, guess who is paying their insurance?, you are.

F-U-Jimmy

http://bioethics.net/journal/j_articles.php?aid=61
A few paragraphs

7. Drug company profits, after all R&D costs, have long been more than double the profits of Fortune 500 corporations. In recent years they have jumped to triple and even quadruple the profits of other major companies (National Institute for Health Care Management 2000). The global firms spend two and a half to three times more for marketing and administration than for research (Families USA 2001).

8. Americans pay for more R&D than any other country because the United States accounts for more sales than any other country. But while the U.S. accounts for 51% of world sales, it took 58% of global R&D expenditures invested in the US to discover only 43% of the more important new drugs (NCEs) (European Federation of Pharmaceutical Industries and Associations 2003). This means that other countries are helping to pay for the large, inefficient U.S. R&D enterprise, the opposite of what the editors of Business Week claimed (Business Week editors 2003). William Safire's claim of a "foreign rip-off" as Americans pay for the world's R&D is contradicted by the facts above (Safire 2003).

Research is misdirected by the industry, against patients' interests
9. Most drug innovation provides little or no therapeutic advantage over existing
Independent review panels plus a major industry review conclude that only 10 - 15 % of "new" drugs provide a significant therapeutic breakthrough over existing drugs and involve a new chemical or molecule (Barral 1996; Prescrire International 2003; National Institute for Health Care Management Research and Education Foundation 2002). Other industry-sponsored figures are much higher but not reliable.
10. The FDA approves drugs that are better than nothing (placebo) but does not test them against the best existing drugs for the same problem. Most research is for "new" drugs to treat problems already treated by other drugs.

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tony286

Actually lawsuits are very very small percentage of health care cost.

F-U-Jimmy

U.S. drug prices very high
18. Americans seem unaware how much more they are paying for drugs than other countries, in the name of the "free market" where prices are controlled by corporations. So-called "price controls" abroad are negotiated wholesale prices. Corporate price controls in the U.S. are un-negotiated monopoly prices, which then large buyers negotiate down.

According to a detailed analysis, American employers and health plans pay at wholesale 2.5-3.5 times the prices in Australia and other countries with comparable prices for patented drugs (Productivity Commission of Australia 2001). There is no evidence that these prices do not cover research costs. U.S. generic prices shadow patent drug prices and are also 2.5-3.5 times more.
19. High American prices are essentially monopoly rents charged to employers in every other industry. They shift profits from other industries to the drug industry.

20. If American prices were cut in half, research budgets would not have to suffer unless executives decided to cut them in favor of marketing, luxurious managerial allowances or high profits. They probably would not, because R&D gets such favorable tax treatment compared to other expenses. Lower prices would save other Fortune 500 companies billions in drug benefit costs, and drug company profits could come into line with the profits of the companies who pay for their drugs.

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Elli

Regarding malpractice in Canada:
http://www.cma.ca/index.cfm?ci_id=10035209&la_id=1

"there is little doubt Canadian physicians are in a far more comfortable position than their American colleagues. For instance, insurance fees for Canadian doctors have increased by about 12% in the last three to four years, and most physicians are insulated against them via their collective agreements with provincial and territorial governments. (In Canada, CMPA fees and the size of fee increases vary according to which of three CMPA regions physicians practise in.)

In the US the story is much different, with states such as Florida, Texas and New York witnessing fee increases of 30% to 50% between 2001 and 2002.

"Many high-risk specialists such as obstetricians and neurosurgeons now pay annual fees of more than US$100,000, which is leading some of these doctors to leave practice," the CHSRF concluded."

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Christophe

There is probably no perfect health system but there are certainly some better than others.

In my opinion Health is a too important issue to be left alone to an unregulated private sector which is in our current system exclusively driven by profits with barely no social contribution in mind. This is where the government representing the country citizens and their interest MUST step in. Whether to regulate the private health system or to create a regulated public system.

Strong pharmaceutical, medical, insurance lobbies will fight any such regulation cause it would mean less profits. On the other hand the public who needs health care (and everybody needs it) is divided in three classes of revenues : low-class, middle-class and high-class.

High class probably isn't much interested in public health care as it would mean more financial contribution on their end. However regulation of the private sector (price capping, policy minimum coverage,....) is in their interest since like the whole population they would be covered for a lower price.

For the middle-class the public health care system may be cheaper or more expensive than the current private system depending on the state they live in and the level of income. However there will be a median and I believe the public health care won't globally change much for them im terms of health expenses. The difference lays where the money goes... in a public system most of the money contributes to pay the health expenses of the poorer people rather than paying the dividends of he already wealthy. Regarding a regulated private health sector, they would definately benefit from it. But who will pay for the poor people health expenses then?

The low-class is winning in both cases whether the government regulates the private sector or create a regulated public health care system. The ladder being the best option for them though.

To conclude:

- the STATUS QUO benefits to powerful lobbies only
- a regulated private sector benefits to the whole population except the powerful lobbies
- a public health system benefits essentially the low-class, middle-class in some serious illness, to the community in general at the expenses of the high-class and powerful lobbies.

In any case i believe the STATUS QUO is the worst scenario. Any other two options is a progress.

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Sausage

One thing I need explained to me is the common attitude of "I can afford health cover so why should I have to pay for someone else" ?

It seems kinda foreign to me. Not everyone is wealthy, not everyone has a high paying job, and more often than not our circumstances change and after a good hard working life we can find ourselves struggling. What if you were to fall off your mighty perch and become one of those who needs help?

I just don't understand the 'ME' attitude, and I for one am very happy everyone has the right to treatment in the public system here despite their income, even though I have to fund it through a slight increase in my tax. To me healthcare is a basic human right.. maybe I am barking up the wrong tree here, but still ... explain the mindset to me please.

Relentless

That sounds nice but that isn't even the point. The point is that as premiums go up 25% per year.... soon the 'ME' people will ALSO not be able to afford health care.

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Hunter_ST

I was going to say "unbelievable" -- but it's not, really.

Insurance companies love to take money, but don't want to pay anything out. It should be illegal how those swine ruin people's lives.

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Elli

Bump for a very interesting thread.

Sausage, I totally agree. I don't understand the "me" thing, either. If the guy down the street's kid has an accident and needs medical care, I don't want his house going into foreclosure, bringing my own property value down. I don't want him getting desperate and oging on welfare to feed his family. I don't want him quitting his job because he can't afford in-home care. And I certainly don't want him getting desperate enough to rob from the other folks around him. Just help him out, already!

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Easton

yep, our home insurance and health insurance premiums both jumped about 30% from last year with state farm

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Relentless

They are going to continue to jump 20-30% per year if we do not make systemic changes to the way health care is managed.

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DonovanTrent

Amazing, your post has been up over two hours and nobody's scampered in her to post "THAT'S SOCIALISM!!!!!!!" yet.

I agree with you.

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Elli

Indeed. Is the tide turning?

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aniloscash

you should look at a health care saving account. do you really come close to spending 15k year on medical bills. I would thikn you would be better to get catastrophic insurance and a tax free saving account.

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DWB

Think of the money you could be saving if you were not pissing it away on coverage that will probably drop you when you need them anyway.

rowan

The monthly amounts being thrown around in this thread are insane... for someone outside of the USA anyway... I don't pay directly for my own health care, but I pay indirectly through a Medicare Levy which is 1% of my taxable income. I also pay around $USD100 a year for full ambulance cover for my family. (That's one form of insurance I consider worth it, as a helicopter ride in an extreme emergency could cost several thousand dollars)

rowan

Has anyone considered partial self insuring, eg negotiate a lower premium by paying a higher excess, then depositing the difference into an interest bearing account for when you do (or might) need it?

Sausage

I don't think what they have there is anything like what we have here in Aus.

I have been to the US and unfortunately been on the end of needing treatment there and medicine, and if the sort of shit and prices that are the norm there happened in Aus it would be front page news. Had a mate in the US who lost 2 fingers in an accident and was uninsured and was given the cost of attaching each finger ... $35k total .. he is now without 2 fingers

Relentless

take a close look at what you call 'catastrophic care' and you will find the fine print makes it into swiss cheese. It's a denial waiting to happen. The more expensive plans don't just offer more coverage... they offer coverage with less loopholes for the insurance companies to screw you with. Same thing with going with 'no name' insurance carriers... their business is based almost entirely on denial of coverage when you actually need coverage.

health care savings accounts sound nice... and they work if you have a kidney stone. If something actually bad happens... those accounts get exhausted very quickly and the ancillary catastrophic care rarely kicks in to to help you as much as you might expect.

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NikKay

Quoted for truth. I'm an American who isn't rioting in the streets so I feel as much to blame. But every time I see a poll by Americans that says 60%++ of them are against Universal Health Care I think, "What can I do to fight that??"

Quoted for truth.

Poor people have amazing government-sponsored healthcare that even includes dental. (Although they do fuck older poor people in that regard. If you need a filling, they prefer to just pull your tooth out. Kids however get whatever they need no questions asked.)

My son broke his arm while I was carrying a high-deductible insurance policy and it required a hospital visit because he needed to be sedated while they reset it. The bill came in around $5K. Although my insurance wouldn't PAY anything because I had my deductible to meet, they did apply their negotiated discounts to the bill... I ended up paying around $800 total after the discounts. That's seriously fucked.

On the other hand... I had a lot of dental and jaw surgery that no insurance would cover and I constantly negotiated better rates than I was quoted for paying cash.

Dental discount plans are great if you don't have dental insurance. You get a rate sheet and the participating dentists can't charge you more than what's on the rate sheet.

Medicaid has great dental coverage for kids and pregnant women and I bet the coverage for government employees (including military) is pretty good too. I know a guy in the military that got lasik fully covered!

My father-in-law is going through this right now. He has epilepsy and has been taking the same medication for years. A generic recently came out and his insurance company sent him a letter that they would no longer pay for the name brand option so he would have to switch. Since he switched he is having seizures a couple times a month as opposed to once every few months. They're still telling him he has to stay on the generic.

DWB

It boggles the mind to think that no matter what the people say, they are simply no longer heard. What a shame.