Compring Europe/Canada and USA: Personal Liberties and almost essentials?

[joobz]

In a thread regarding the Obama health care plan, BeAChooser made the following claim regarding what Europeans must give up to have UHC.
And fewer personal liberties. Europeans get all those things[health care] by taking money and freedom away from individuals and businesses. And doing without many things that we consider almost essentials in this country. Plus, because US growth rates have on average exceeded those in Europe, the wealth gap is widening. Perhaps one way to look at this, is that we've been doing without now to build wealth down stream. Just like the Chinese are doing. Europeans have been eating the seed corn. But now that Obama is in charge, looks like we're not only going to eat the seed corn but burn the fields they grew in too. :D
Bolding mine.

Now, BAC was asked several times "What are these Personal Liberties and Almost Essentals" that he is referring to. He replied saying that he couldn't answer as it would be "Off Topic" in that thread. Because I think that this is an important discussion, I started a new thread to address this issue:

What are these Personal Liberties and Almost Essentals that Europeans/Canadians sacrifice in order to have UHC?

[Corsair 115]

What are these Personal Liberties and Almost Essentals that Europeans/Canadians sacrifice in order to have UHC?


The only thing that immediately comes to mind for me is the sacrifice of some additional tax dollars. I consider this a more than fair trade for not having to secure private health insurance.

[joobz]

The only thing that immediately comes to mind for me is the sacrifice of some additional tax dollars. I consider this a more than fair trade for not having to secure private health insurance.
Possibly. But one would have to show that the increase of taxes would exceed what would be gained by no longer paying insurance premiums.

[Architect]

BAC has been called on this several times on different threads and IIRC never responds.

[Darat]

It also raises one of my bug-bears (and I try to keep them locked in their cage as much as possible): What the hell does the word "European" mean in a sentence like that?

Everyone living in one of the following nations are Europeans:

Albania
Andorra
Austria
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
Russia
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City

Those are all sperate nations. (And that is not even an exhaustive list - for example there are many regions/countries which are "dependencies" of other countries but are pretty much independent countries in their own right, some of the above nations may also be broken down into separate countries, such as the UK).

To use the word "Europeans" as BeAChooser has done is pretty much meaningless given the vast number of different legal systems, different types of governments, different political parties and so so on that are covered by the word "Europeans".

Even if you want to just use the word "Europeans" to mean citizens of the nations that are members of the EU it doesn't help since again all those nations have their own legal systems and forms of government.

[DC]

by moving to the USA i would become more free in regard of not having to serve in the Army or Zivilschutz (for me because i refused to serve in the army)

in exchange i would loose my freedom to start Peoples Initiatives on a federal level. (very essential for me)

what freedoms / liberties would i gain that i dont have in Switzerland?

[Architect]

You'd be allowed to buy military grade weapons for domestic use. Apparently this is really important to some Americans, as you will have noticed on previous debates.

And youd be entitled to freedom of speech. Ah, no, wait a moment.....ECHR.....we've got that already. Oh well.

[Rolfe]

Some time ago, I tried to call Beerina (or possibly Balrog, maybe both) on this one. And before that, Jerome. They were all categorically insisting that we were "less free" with regard to healthcare issues. I wish I could find the post I made then. (Copied it several times to try to get an answer, as I recall.) I listed a fair-sized string of freedoms that we have with regard to healthcare in Britain that are denied to people in the USA unless they are very rich. I couldn't think of a single freedom that US citizens have that we don't. I challenged them repeatedly to come up with even one, but they all ran away.

Yes, I know US citizens are free to purchase and own military-grade weapons, and lethal non-domestic knives, when we are not. Good luck to them. If these guys are trying to say that owning lethal weapons is so important that it trumps every other advantage, then come out and say it. However, that makes it completely irrelevant to the healthcare issue, which is the area the statement is usually made in connection with.

Unless they're trying to say that if the USA had universal healthcare then the government would ban gun ownership? :confused:

Rolfe.

[Darat]

...snip...

Unless they're trying to say that if the USA had universal healthcare then the government would ban gun ownership? :confused:

Rolfe.

Rolfe.


Well of course they would - given the number of gun injuries in the USA is would be a quick way to cut down on the health-care expenses... :duck:

[joobz]

Unless they're trying to say that if the USA had universal healthcare then the government would ban gun ownership? :confused:

This is what I'm trying to figure out. It can't be the gun thing though. Canada allows guns AND has UHC.;)

[Agatha]

I've been puzzling and puzzling over these "[many] almost-essentials" that we don't have in Europe (anywhere in Europe?) that are available in the US. What could they possibly be?

[Darat]

It's probably this (http://www.roadsideamerica.com/story/2128).

[geni]

Yes, I know US citizens are free to purchase and own military-grade weapons, and lethal non-domestic knives, when we are not.

You are entirely free to purchase any type of knife you like. Carrying it around without good reason may case more problems.

[MG1962]

Yeah I think the whole issue of comparative rights is more a matter of propaganda than actualality. I have had this debate a few times, and the lack of knowledge about rights in other parts of the world does seem lacking

Americans are hammered constantly about being the most free nation in the world. Having more individual rights than any other country in the world. Often without any context being offered to what rights they have

US society is clearly among the most free in the world. But so are a lot of other places. Sometimes those freedoms differ, and it is wrong to claim one out weights another. For example Amercian can carry a gun in the street. And Australian can not. But an American can not meet an Australian in Havana to debate it

[DC]

for me our weappon laws are far to liberal already, we hand out free assault wappons to every citizens at 18.

But somehow this remnds me of Motivational speakers. they tell every idiot that they are good and can do whatever they want to do and so on.
eventually the listeners belive him.

but my TV doesnt tell me day in and out that my country is the most free and most democratic and what not.

(Sometimes my TV claimed "Du bist Deutschland"m but that aint true)

[Dr. Tobias Fünke]

In a thread regarding the Obama health care plan, BeAChooser made the following claim regarding what Europeans must give up to have UHC.

Bolding mine.

Now, BAC was asked several times "What are these Personal Liberties and Almost Essentals" that he is referring to. He replied saying that he couldn't answer as it would be "Off Topic" in that thread. Because I think that this is an important discussion, I started a new thread to address this issue:

What are these Personal Liberties and Almost Essentals that Europeans/Canadians sacrifice in order to have UHC?

It would seem those points are repeatedly made by people who know dick about neither "Europe" nor healthcare. Go figure.

[Rolfe]

Just thinking. Freedoms I have (healthcare related).

Freedom to:

seek medical services without any pre-approval from an insurance company
seek medical services at almost any hospital in the country
change jobs without considering healthcare provision
leave the workforce without considering healthcare provision
play contact sports without worrying about the financial consequences
contract a chronic disease without jeopardising future healthcare entitlement
have over £2 million spent on me in my lifetime by my healthcare provider (if necessary)
access the publicly-funded healthcare I am paying for through my taxes
These are all, I think, freedoms denied to US citizens who do not have very large private means.

I also have the same freedoms US citizens have.

Freedom to:

buy insurance coverage for private medical care
pay for private medical care out of my own pocket
change my general practitioner at will (even within the NHS)
travel abroad to seek medical treatment (again funded by the NHS if judged necessary)
I'm sure I've missed stuff. But I'm still waiting to be told what healthcare-related freedom(s) I'm lacking that are available to ordinary US citizens (excluding the very wealthy).

I'm also waiting to be told what "personal liberties and almost-essentials" I am denied in Britain that citizens of the USA have access to - excluding things relating to purchase and possession of weapons. And as Joobz said, Canadians have similar weapons-related freedoms to US citizens, and yet they have universal healthcare as well. So the two subjects are clearly not related.

Rolfe.

[tyr_13]

You'd be allowed to buy military grade weapons for domestic use. Apparently this is really important to some Americans, as you will have noticed on previous debates.

And youd be entitled to freedom of speech. Ah, no, wait a moment.....ECHR.....we've got that already. Oh well.

So I can buy an AK-47 from Russian! Wait, no, that's illegal. So I can buy a military grade M-16...wait, also illegal. So I can buy a grenade...no...

What military grade weapons are you talking about? Sorry if this is a derail, but I'm kinda confused. Does my brother's Mosin Nagant count because it at one time was a military weapon?

[Comsat Angel]

by moving to the USA i would become more free in regard of not having to serve in the Army or Zivilschutz (for me because i refused to serve in the army)

in exchange i would loose my freedom to start Peoples Initiatives on a federal level. (very essential for me)

what freedoms / liberties would i gain that i dont have in Switzerland?

How many Awesome Rock Bands hail from Switzerland?

Exactly!

Guns clearly equal Rock Fantasticness. Except in the case of the UK, where - er - guns equal - ah - did I ever tell you about my Christmas appendectomy?

As fer Canada, guns and socialised medicine, those Wild Colonial Boys embody the best qualities of the Mother Nation and their Southern Neighbours.

[INRM]

The way I see it, there needs to be a balance between the rights of the individual and the rights of the collective whole (everybody).

Especially when you keep in mind that the society is made of individuals.

[Darth Rotor]

What are these Personal Liberties and Almost Essentals that Europeans/Canadians sacrifice in order to have UHC?
I can have as many guns as I like in my house. I like that. The trick is to keep my wife from rolling here eyes over the size of the arsenal, so I keep the number in single digits. But if I want to, I could have many more.

DR

[tyr_13]

I can have as many guns as I like in my house. I like that. The trick is to keep my wife from rolling here eyes over the size of the arsenal, so I keep the number in single digits. But if I want to, I could have many more.

DR

I'm the same way with swords, staffs, spears, and axes. Of course, I don't think there are anti-sword laws in Britain.

Are there? On second thought, I bet there are.

[mortimer]

But I'm still waiting to be told what healthcare-related freedom(s) I'm lacking that are available to ordinary US citizens (excluding the very wealthy).
What about the option not to pay for health insurance?

[Wildy]

(Sometimes my TV claimed "Du bist Deutschland"m but that aint true)

Just get rid of the French, Italian and Romansh speaking bits and you would be...

[Rolfe]

What about the option not to pay for health insurance?


Sorry, you seem to have this back to front. I'm the one who has the option not to pay for health insurance! If you choose not to pay for health insurance, you don't get treated when you get very sick (unless you're very wealthy).

I have literally no idea where you're coming from on that one, unless you're being sarcastic.

Rolfe.

[Rolfe]

I'm just wondering where all the American believers-in-our-freedoms are? They're vocal enough in hit-and-run posts. I'd have thought that if they meant what they were saying, they'd at least come and explain themselves, even if it turned out they were mistaken.

I still can't think of a single healthcare-related freedom I don't have which citizens of the USA do have. On the contrary, I can think of a fair number I do have that ordinary (i.e. not fabulously wealthy) citizens of the USA do not (see above).

If in fact this perennial statement about "freedom" is simply a restatement of the fact that US citizens have the right to acquire military-grade weapons and carry firearms in public, and that for some Americans this is so important that it doesn't matter what sort of utopia others may be living in, they aren't interested in an unarmed utopia, it would be helpful if they actually said that.

The fact that my purchase and use of firearms is restricted by law doesn't worry me in the slightest. I like it that way, because it also means that my neighbours are similarly restricted. This seems to me to be of zero relevance to healthcare, however. It would be perfectly possible to introduce universal healthcare and leave the US firearms legislation absolutely untouched.

So why does this "we have more freedom" keep getting dragged into healthcare threads?

And we still have no clue what there "personal liberties and almost-essentials" are, that we poor, benighted Europeans must sactifice in order to have universal healthcare.

Help us out here, BeAChooser, Balrog, Beerina and others!

Rolfe.

[Darat]

I can have as many guns as I like in my house. I like that. The trick is to keep my wife from rolling here eyes over the size of the arsenal, so I keep the number in single digits. But if I want to, I could have many more.

DR

As can many Europeans (and many won't even suffer from the restriction you do enshrined in your "Weapons, Ignitors & Firearms Embargo" gun control law).

[Delscottio]

In the US, do employers have to pay you (anything at all) when you're off work sick?

How many days days holiday do US employers legally have to give (paid)?

How many weeks paid maternity pay is given?

What are the rules and regulations re redundancy / job losses in the US (I assume it is State by State??)



These aren't loaded questions btw, I have seen reference to some of the above in other threads without actually getting a full understanding of the above. We have a load of legislation around workers rights etc - I might dig some out later if I have time.

[Rolfe]

I'll be interested in the answers to this. As far as I know, US-types as a general rule get two weeks paid time off, and that counts for holiday and sick leave both. If they want more, they're not paid.

The funny thing is, they all go on about their "wealth" as if money was everything. They deride us for having higher taxes. But really, our taxes aren't a great deal higher, and wealth in dollars or pounds or euros is less important than what you can buy with it.

To have all that extra wealth, and these lower taxes, but only have two weeks off work in a year and no protection from your employer firing you just because he feels like it, and have to pay a lot of money we don't have to pay for healthcare provision, and I think I know who's actually "wealthiest". In fact, I believe if you add healthcare spending (insurance premiums, copays and deductibles) to the taxes the average American pays, they're mostly paying higher "tax" than we are.

Rolfe.

[D'rok]

I can have as many guns as I like in my house. I like that. The trick is to keep my wife from rolling here eyes over the size of the arsenal, so I keep the number in single digits. But if I want to, I could have many more.

DR

AFAIK, so can I. Although there are restrictions on type. Regardless, why is there a choice between guns and UHC? You can have both. The two issues are unconnected. You don't really think you'll have to give up your guns to get UHC do you?

[Delscottio]

I forgot to ask about Welfare Benefits when unemployed / sick. Is there any Government help for the disabled etc?

I'll be interested in the answers to this. As far as I know, US-types as a general rule get two weeks paid time off, and that counts for holiday and sick leave both. If they want more, they're not paid.

The funny thing is, they all go on about their "wealth" as if money was everything. They deride us for having higher taxes. But really, our taxes aren't a great deal higher, and wealth in dollars or pounds or euros is less important than what you can buy with it.

To have all that extra wealth, and these lower taxes, but only have two weeks off work in a year and no protection from your employer firing you just because he feels like it, and have to pay a lot of money we don't have to pay for healthcare provision, and I think I know who's actually "wealthiest". In fact, I believe if you add healthcare spending (insurance premiums, copays and deductibles) to the taxes the average American pays, they're mostly paying higher "tax" than we are.

Rolfe.

[Mass Generalisation alert.]

I always get the impression that the ideology of Capitalism is sold so heavily as the best thing, (a remenant from the cold war I would have thought) Americans actually feel lucky to have the most powerful economy in the world, when the reality seems to be the average person gets a lot of of brown stuff poured on them.

Does the average person benefit from this super economy? - Its debatable from where I sit.

[uk_dave]

Parhaps it's just that under a UHC system it's that much harder to make a massive profit off of the misery of others?

I suppose that's a curtailment of freedom.....sort of.

[Rolfe]

That must be it, I guess.... :nope:

Rolfe.

[Ocelot]

Sorry, you seem to have this back to front. I'm the one who has the option not to pay for health insurance! If you choose not to pay for health insurance, you don't get treated when you get very sick (unless you're very wealthy).

I have literally no idea where you're coming from on that one, unless you're being sarcastic.

Rolfe.

Whislt it may seem that way pretty much all us us do pay into the pot. The NHS is funded from our NI contributions, Income Tax and once we've been taxed on the money we earn, from pretty much all of the money we spend via VAT and duties on fuel, drink, cigarettes and suchlike.

To exercise our right to not pay of your health care we'd have to give up our salary and make a living some other way. Oh there are plenty of unsalaried people in the UK, students, pensioners and the unemployed but asside from the rare crofter eschewing currency in favour of barter we all pay VAT, even if some of us take more then we contribute at certain points in our life.

However having mandated contributions to health is a good thing. It's because of the free rider problem. Everybody benfits from roads, defence, policing and justice and so you don't get given a choice about whether to pay or not. That's the same in the US as here. For some insane reason they treat health differently. They can't stop americans who don't pay from recieving treatment. Those doctors have sworn their oaths and letting people suffer and die by witholding treatment is just a small ethical gap from torture and murder. So thye do get treated and the money does come from the amercan taxpayers and insurance buyers. Sure they punish people after the fact for not having adequate insurance, they ruin them financially but that doesn't pay for all the treatment that ethically doctors and hospitals have to give out. What's more they ruin other people financially too. Just under 200,000 americans every year seek chapter 7 bankruptcy because they got ill without insurance but just under 600,000 more are made medically bankrupt even though they had insurance at the start of their illness. However that's another issue.

So when our american friends say they have the right not to pay for health insurance they're right. If they get ill they'll be ruined paying for a fraction of their treatment and other people will payfor the largest part.

They also have the right to pay insurance which means they're also paying for the free riders who choose not to pay. They can take some comfort from the fact that if any of those free riders do get seriosuly ill they're screwed, but that can't take too much comfort from that, because the same system also screws over three times as many seriously ill people who do have insurace.

The americans are indeed correct that they have the right to pay over the odds their own medical care and that of the free riders whilst they risk bankruptcy anyway should they get ill. What bemuses me is that they are proud of it. I could have more chance of fathoming their pride in the right to nail their penises to a plank of wood which is apparently another right denied to us mollycodled europeans.

http://en.wikipedia.org/wiki/Operation_Spanner

[joobz]

I do not know what the law requires, but I'll take a stab at what is seen in practice.
In the US, do employers have to pay you (anything at all) when you're off work sick?
2 weeks if you are full time(80 hrs/2weeks). If you are part time, nothing.

How many days days holiday do US employers legally have to give (paid)?There are 10 federal holidays. I am not certain that an employer must "pay" you on these days. I do not think so.



How many weeks paid maternity pay is given?
Pregnancy is handled as "a temporary disability". This is due to the law that states a pregnant woman must be treated equally to anyone else and therefore maternity leave gets handled as a disability. Some employers offer real maternatity leave, but this isn't required.
short term disability is 3 months.
http://www.iwpr.org/pdf/parentalleaveA131.pdf




What are the rules and regulations re redundancy / job losses in the US (I assume it is State by State??)
I don't understand the question.

[joobz]

To have all that extra wealth, and these lower taxes, but only have two weeks off work in a year and no protection from your employer firing you just because he feels like it, and have to pay a lot of money we don't have to pay for healthcare provision, and I think I know who's actually "wealthiest".
This isn't exactly true. There are enough work place descimination laws enacted that an employer must have good reason to fire you. This can be performance or business related, but there must be a justifiable reason.


ETA:

Here's some additional questions:
1.) In UHC, are you free to select the drug (generic vs. name brand) if you are willing to pay for it? (I think this was covered a bit before, but I was wondering how far it extended)
2.) At what age is care restricted? Is there an age?
3.) What is the maximum amount that will be covered for a single person in a lifetime. What happens if care exceeds that amount?
4.) Are fertility treatments covered/allowed?
5.) What extra costs (if any) do you must assume if you Some/Drink/do Drugs/....

I'm just trying to get more dialog while I wait to hear from BeAChooser (I wonder where he is?)

[The Painter]

Well of course they would - given the number of gun injuries in the USA is would be a quick way to cut down on the health-care expenses... :duck:

Using your logic, we should get rid of the doctors. They kill more people than guns do.

Doctors kill approximately 225,000/year
Guns kill approximately 31,000/year

[mortimer]

Sorry, you seem to have this back to front. I'm the one who has the option not to pay for health insurance! If you choose not to pay for health insurance, you don't get treated when you get very sick (unless you're very wealthy).

I have literally no idea where you're coming from on that one, unless you're being sarcastic.

Rolfe.
You can opt out of the NHS and not pay taxes into it?

[Darat]

Using your logic, we should get rid of the doctors. They kill more people than guns do.

Doctors kill approximately 225,000/year
Guns kill approximately 31,000/year

So there you go two ways to cut down on the cost of your health-care system, get rid of guns and get rid of doctors.

[Darat]

You can opt out of the NHS and not pay taxes into it?

No - but neither can a USA citizen opt-out of paying, via taxation, for the USA health-care system.

[Guybrush Threepwood]

no protection from your employer firing you just because he feels like it


This isn't exactly true. There are enough work place descimination laws enacted that an employer must have good reason to fire you. This can be performance or business related, but there must be a justifiable reason.


I think there is a gulf between the US and European interpretation of this, assuming this (http://en.wikipedia.org/wiki/At-will_employment) Wikipedia article is correct (possibly an unwise assumption I agree) Then I think that Rolfe's interpretation is accurate, the EU rules are so much more onerous than the US ones that the US rules may as well not exist. Unless a US boss is dumb enough to fire only the black/female/disabled employees (s)he can fire people for very little or no reason.

[Darat]

...snip...

Here's some additional questions:
1.) In UHC, are you free to select the drug (generic vs. name brand) if you are willing to pay for it? (I think this was covered a bit before, but I was wondering how far it extended)

...snip...

Can only answer for NHS in the UK.

Yes, your Doctor can write you a private prescription rather than a NHS prescription or it may be your Doctor will prescribed a named drug rather than a generic. (This happens to me - for some reason the generic version of the pain killer I take plays havoc with my stomach, the branded one doesn't, presumably, since the active ingredients are the same, the formulations are different.)


...snip...
2.) At what age is care restricted? Is there an age?

...snip...

Outside medical reasons - none.

...snip...
3.) What is the maximum amount that will be covered for a single person in a lifetime. What happens if care exceeds that amount?

...snip...

There isn't one.
...snip...
4.) Are fertility treatments covered/allowed?

...snip...

Yes - some may be limited, for example in NHS England you will only be given three cycles of IVF treatment, you can pay for how ever many you want.

...snip...
5.) What extra costs (if any) do you must assume if you Some/Drink/do Drugs/....

...snip...

None.

[mortimer]

No - but neither can a USA citizen opt-out of paying, via taxation, for the USA health-care system.
True. Didn't think of medicare.

[Rolfe]

You can opt out of the NHS and not pay taxes into it?


He said insurance. I can opt out of buying health insurance.

I cannot opt out of paying my taxes that fund the NHS, no.

However, neither can US citizens opt out of paying their taxes that bankroll their publicly-funded healthcare system - Medicare and Medicaid. And as it happens, pro rata, US citizens pay a little more in tax for these facilities than we pay for the NHS.

So, I'm paying x amount of tax to fund a system I can access if I want to.

The US citizen is paying (x + a bit more) tax to fund a system he can't access.

Because I can access the system my taxes pay for, I'm quite at liberty not to purchase insurance if I don't want to. Because the US citizen can't access the system his taxes are paying for, he is de facto forced to purchase insurance.

Who's got the freedom here, again?

When US posters equate our taxes to fund the NHS with their own health insurance premiums, they seem to forget completely that they are paying just as much (and a bit more) tax than we are to fund a healthcare system. Just as we can't opt out of our taxes, neither can they opt out of theirs. So simply saying, "you're forced to pay into your healthcare system and I don't have to unless I want to" is entirely wrong. We're both forced to pay into our publicly-funded systems.

And we're both free to purchase healthcare insurance quite separately from this, that's true. However, I'm a lot freer than the US citizen in that respect, because if I choose to forego healthcare insurance, I'll still be treated. If the US citizen makes that choice, he won't be treated.

Rolfe.

[uk_dave]

There were some interesting programmes about the creation of the NHS shown recently.

A couple of facts which stuck with me was:

1. The opposition of the doctors to the planned NHS

2. The extraordinary conditions the new NHS doctors treating in the population. Apparently, prior to the NHS a lot of complaints went untreated so there was a lot of bits dangling out of people that shouldn't have been!!!

The point being that professional organisations representing the medical practitioners ( or Doctors Unions :D ) opposed any change which might impact on the financial income of their members, and a UHC system is easily overwhelmed in it's initial years having to deal with all of the complaints which have previously gone untreated due to lack of funds on the part of the individual.

[Michael Redman]

You'd be allowed to buy military grade weapons for domestic use.

Not true.

And youd be entitled to freedom of speech. Ah, no, wait a moment.....ECHR.....we've got that already. Oh well.

Sure you do. Ask Simon Singh about that.

For example Amercian can carry a gun in the street. Nearly completely untrue.

And Australian can not. But an American can not meet an Australian in Havana to debate it Sure we can, we just can’t spend any money. ;)

It would seem those points are repeatedly made by people who know dick about neither "Europe" nor healthcare. Go figure.

Irony.

Just thinking. Freedoms I have (healthcare related).

Freedom to:

seek medical services without any pre-approval from an insurance company
seek medical services at almost any hospital in the country
play contact sports without worrying about the financial consequences
have over £2 million spent on me in my lifetime by my healthcare provider (if necessary)
access the publicly-funded healthcare I am paying for through my taxes
These are all, I think, freedoms denied to US citizens who do not have very large private means.

You are incorrect as to these.

If you choose not to pay for health insurance, you don't get treated when you get very sick (unless you're very wealthy).

Rolfe.

Not true.

In the US, do employers have to pay you (anything at all) when you're off work sick?

How many days days holiday do US employers legally have to give (paid)?

How many weeks paid maternity pay is given?

These issues are not government mandated in the US. They are issues of private contract.

What are the rules and regulations re redundancy / job losses in the US (I assume it is State by State??)

We have a state-administered, federally funded/regulated unemployment insurance system that provides partial wage replacement for unemployed workers.

These aren't loaded questions btw, I have seen reference to some of the above in other threads without actually getting a full understanding of the above. We have a load of legislation around workers rights etc - I might dig some out later if I have time.

You also generally have higher unemployment and slower growth because it’s significantly harder to hire and fire workers.

I'll be interested in the answers to this. As far as I know, US-types as a general rule get two weeks paid time off, and that counts for holiday and sick leave both. If they want more, they're not paid.

Rolfe.

It’s pretty common for workers in the US to get two weeks paid vacation at the start of their employment and for that amount to go up the longer they are employed. It is also standard to get a number of paid sick days and holidays in addition.

Of course, these issues are not mandated, and are up to the employer and employee. Some people get little paid time off. I do contract projects and no one pays me when I take time off. My wife has a salary and an annual billing expectation, and can take off as much or as little time as she pleases.

Generally, the trend in the US is for less paid time off. This area is, in my opinion, a clear quality of life advantage for Europeans. It wil be interesting to see how long they can hang onto it.

I forgot to ask about Welfare Benefits when unemployed / sick. Is there any Government help for the disabled etc? We have unemployment insurance for the unemployed, and disability insurance for the disabled.

This isn't exactly true. There are enough work place descimination laws enacted that an employer must have good reason to fire you. This can be performance or business related, but there must be a justifiable reason.

Generally it would be up to the employee to show they were fired for a prohibited discriminatory reason. Most workers in the US are at-will, and can be fired for any reason not specifically prohibited. For union employees and others not employed at-will obviously their contract would determine when they can be fired.


However, I'm a lot freer than the US citizen in that respect, because if I choose to forego healthcare insurance, I'll still be treated. If the US citizen makes that choice, he won't be treated.

Rolfe.

Generally, this is not true. Some Americans may go bankrupt under the weight of medical bills (which I'll admit freely is a ridiculous situation for us to be in), but we can usually get treated. There is care for acute illness in emergency rooms regardless of ability to pay. For minor ailments, doctor visits, drugs, etc. are available on the market for prices most people can afford. It's really only people needing long term treatment they can't afford for chronic conditions that are "not treated" due to lack of insurance, at least untill they get sick enough to need acute care.

[Beerina]

The only thing that immediately comes to mind for me is the sacrifice of some additional tax dollars. I consider this a more than fair trade for not having to secure private health insurance.

Is it so fair you would force it on people who don't want it?

[Darat]

Is it so fair you would force it on people who don't want it?

Well I certainly wouldn't want to do that - if they don't want to live under the rules of my society they are 100% free to live elsewhere. However if they do want to live in my society then there is a charge. And I'm sure you don't support freeloaders.

[Beerina]

Some time ago, I tried to call Beerina (or possibly Balrog, maybe both) on this one.

I doubt it was me. My argument centers around slowing down technological development, which adds up like compound interest, until, a century later, well, which is better: Expensive 2009 medical care, or free 1989 medical care? Or free 1999 medical care, for that matter?


However, having said that:

And before that, Jerome. They were all categorically insisting that we were "less free" with regard to healthcare issues.

If you have to pull out guns to force people to join your awesome system, maybe you should rethink what "free" means.

It never seems like a loss of freedom when you're the one behind the gun. "There ya go! Now just do that. There! See how free you are!"


I couldn't think of a single freedom that US citizens have that we don't. I challenged them repeatedly to come up with even one, but they all ran away.

We can broadcast what the "bad guys" in Northern Ireland are saying without fearing jail. Oh, you probably mean medical care.


Ummm, well, we can go see a doctor in his own clinic without fearing jail, unlike Canadians who go to private, illegal clinics, including one run by the head medical guy in government.


Don't you recall Psych 101 and the experiment where they asked people if they could put up a tiny sign on their lawn, then went back and asked if they could put up a bigger one, then a bigger one?

Eventually they asked if they could put up a gigantic one, and many still said yes.

The control group they just went up and asked if they could just put up a giant sign, and they all said no.


It's called an "emotional investment" in a position.

[lomiller]

What about the option not to pay for health insurance?

Unfortunately that’s fundamentally incompatible with the freedom to go out and find insurance at a later date if you decide you need it. Insurance risk pooling only works if the people who opt out do so irrevocably in perpetuity. Trying to implement both freedoms (opt out, and opt back in at a later date) gives people a license to ride for free, pushing the cost of their own insurance onto others.

[Beerina]

I also have the same freedoms US citizens have.

Freedom to:

buy insurance coverage for private medical care
pay for private medical care out of my own pocket


You are aware that the "single payer" system being pushed at the current time, and in the 1990s by Hillary, do not allow this, right?

Hence one of my previous responses, which might confuse you without that knowledge.

In any case, extra taxes are money I cannot spend on health care directly. It's like forcing people to pay for public schools in addition to the costs they incur sending their kids to private ones.


travel abroad to seek medical treatment (again funded by the NHS if judged necessary)

Ummm, you also use the argument that "if you don't like it, get the hell out of my country!" You can't have it both ways.

And no, we're not talking about just happening to be on vacation when you need it.

[Ocelot]

You are aware that the "single payer" system being pushed at the current time, and in the 1990s by Hillary, do not allow this, right?


No I'm not aware of that because it's simply not true.

[lomiller]

I doubt it was me. My argument centers around slowing down technological development, which adds up like compound interest, until, a century later, well, which is better: Expensive 2009 medical care, or free 1989 medical care? Or free 1999 medical care, for that matter?


You present a false dilemma. Most European countries offer equal or superior medical care for a much lower price.




Ummm, well, we can go see a doctor in his own clinic without fearing jail, unlike Canadians who go to private, illegal clinics, including one run by the head medical guy in government.

What are you talking about? Not only are private clinics not illegal, 90% of Canadian health care is provided by the private sector, either in their own private clinics or non-profit/private hospitals.

[D'rok]

Ummm, well, we can go see a doctor in his own clinic without fearing jail, unlike Canadians who go to private, illegal clinics, including one run by the head medical guy in government.

Can you clarify what you are trying to say here. Who is "the head medical guy in government", what are "illegal clinics", and who goes to jail for seeing a doctor in that doctor's own clinic in Canada?

This has to be the most bizarre statement I have ever seen regarding Canadian health care.

ETA: This is the private clinic that I go too:

http://www.appletreemedicalgroup.com/

Not only is it a private clinic (as nearly all clinics are), it is a franchise of private clinics. Should I be especially fearful of jail? You really need a reality check.

[Architect]

We can broadcast what the "bad guys" in Northern Ireland are saying without fearing jail. Oh, you probably mean medical care.


Far be it from me to question your knowledge of current affairs in the UK, but you'll find that Sinn Fein are, in fact, part of the devolved government in Northern Ireland and hence on the television rather a lot.

[Architect]

Ummm, you also use the argument that "if you don't like it, get the hell out of my country!" You can't have it both ways.

And no, we're not talking about just happening to be on vacation when you need it.

With respect, you have - once again - misread the case put to you.

In the UK we are permitted to seek medical treatment privately at home, or abroad, if we so wish. The point Rolfe is also picking up is that, where waiting lists are excessive or treatment is not available in the UK (for example high specialist items) then the NHS can and does pay for the patient to travel to, say, Sweden for it. At no cost to the patient.

[Architect]

Sure you do. Ask Simon Singh about that.


Sorry, but I'm going to have to call you on that point, Mr. Redman. Are you claiming that the ECHR's binding requirements on member states to ensure freedom of speech is ineffective and how specifically do you believe that Simon Singh vs. Quacks and Charlattans supports your point?

[Darat]

Far be it from me to question your knowledge of current affairs in the UK, but you'll find that Sinn Fein are, in fact, part of the devolved government in Northern Ireland and hence on the television rather a lot.

And even when the broadcast restrictions were in place they would appear on TV and speak, only their voices would be dubbed over by an actor's voice... Ludicrous? Of course, but we still heard what they had to say.

[uk_dave]

And even when the broadcast restrictions were in place they would appear on TV and speak, only their voices would be dubbed over by an actor's voice... Ludicrous? Of course, but we still heard what they had to say.

We won't mention McCarthy era US in any debate on freedom of speech......

...it would be too easy and too cruel.

[Michael Redman]

Sorry, but I'm going to have to call you on that point, Mr. Redman. Are you claiming that the ECHR's binding requirements on member states to ensure freedom of speech is ineffective and how specifically do you believe that Simon Singh vs. Quacks and Charlattans supports your point?

I'm "claiming" that it's all well and good to say "we have that too" when it comes to free speech, but when your legal system allows a journalist to be punished for telling the truth, your claim rings a little hollow.

You also have prior restraint censorship by the government.

And blasphemy laws.

I'm obviously saying nothing about the ECHR. What are you saying about it?

[Eskarina]

ETA:

Here's some additional questions:
1.) In UHC, are you free to select the drug (generic vs. name brand) if you are willing to pay for it? (I think this was covered a bit before, but I was wondering how far it extended)

No, if there is no medical reason not to prescribe the generic, AFAIK, for Germany, the reason being that generics are cheaper than the name brand. But if it turns out that the only drug you respond to or don't have problems with is the name brand, that is what you get, perhaps at a slightly higher co-pay. (Slightly as in a Euro or two.)

2.) At what age is care restricted? Is there an age?

No age limit. To be fair though, a 90-year-old is going to wait much longer for a heart-transplant than an 18-year-old.

3.) What is the maximum amount that will be covered for a single person in a lifetime. What happens if care exceeds that amount?

No limit. Some people go through life with only minor ailments and drop dead at age 90, some need treatment all their lifes, but all of them are covered.

4.) Are fertility treatments covered/allowed?

50% for married couples for the first three tries. After that, they have to pay fully for it, as do unmarried couples from the beginning.

5.) What extra costs (if any) do you must assume if you Some/Drink/do Drugs/....

Not more than anyone else, which is 10 Euros for every day spent in hospital, and the small co-pay for medication. And if they can't afford it, the state, i.e. we, cover for them.

Did I mention that we've got, by law, six weeks of fully covered sick leave (courtesy of our employer) plus a maximum of 78 weeks covered effectively at about 75% of our net income? For the same illness?

I can easily forgo the privilege of being able to deny the holocaust in public and goose-step down the street shouting "Heil Hitler" for the above-mentioned amenities.

[Michael Redman]

We won't mention McCarthy era US in any debate on freedom of speech......

...it would be too easy and too cruel.

I believe this discussion is about today, not 50 years ago.

Today, I can organize a communist party, run for office as a communist, write a communist newspaper, etc. without any fear whatsoever that my government will try to discourage me.

Today, can a European organize a nazi party, run for office as a nazi, write a nazi newspaper, etc. without any fear whatsoever that their government will try to discourage them?

[Darat]

...snip...

Today, can a European organize a nazi party, run for office as a nazi, write a nazi newspaper, etc. without any fear whatsoever that their government will try to discourage them?

Most could.

[Eskarina]

Most could.

Well, I couldn't, but I can live with that, as I don't see why anyone would want to do it.

[D'rok]

Today, I can organize a communist party, run for office as a communist, write a communist newspaper, etc. without any fear whatsoever that my government will try to discourage me.

Are you claiming that this particular freedom is one that you would have to sacrifice in order to have UHC? Or, are you claiming that "Europeans" don't have this freedom because they had to sacrifice it to get UHC? If none of the above, what is your bloody point?

Doesn't anybody read the OP?

[Random]

I doubt it was me. My argument centers around slowing down technological development, which adds up like compound interest, until, a century later, well, which is better: Expensive 2009 medical care, or free 1989 medical care? Or free 1999 medical care, for that matter?

How much money do I have and how expensive will my medical care be? As I’ve said, if medicine produces a magic pill that can cure all of my illnesses but costs more than I will make in my lifetime, that pill is worthless to me. If your goal is optimal health outcomes across the board, access to care has to be an issue you address.

Secondly, is the free market really the best model for medical research? A lot of the latest generation of wonder drugs are coming from private research firms piggybacking on basic research funded by government grants. There may be other research funding models that perform as well or better than the free market (I have a particular affection for government funded prize bills myself). And don’t forget, if it looks like developing a cure for a disease will cost more than can be made by selling the cure, the free market won’t even try.

[Michael Redman]

Hey, I didn't start the tangents!

Yes, I know we're way off the orignial post, but I think the idea that the US doesn't have UHC because it would cost some valuable freedom is silly.

[D'rok]

Hey, I didn't start the tangents!

Yes, I know we're way off the orignial post, but I think the idea that the US doesn't have UHC because it would cost some valuable freedom is silly.

I agree. But that seems to be the primary argument against it from its opponents. That and misinfo about what really happens regarding health care in UHC countries.

[Eskarina]

Hey, I didn't start the tangents!

Yes, I know we're way off the orignial post, but I think the idea that the US doesn't have UHC because it would cost some valuable freedom is silly.

Of course, it is silly. But in his OP joobz was quoting BeAChooser, who was making those exact same claims, and now, I for one, am waiting with bated breath for BAC to provide the meat for his spam claims.

He has been conspicously absent from here.

[Rolfe]

I doubt it was me. My argument centers around slowing down technological development, which adds up like compound interest, until, a century later, well, which is better: Expensive 2009 medical care, or free 1989 medical care? Or free 1999 medical care, for that matter?


You have totally failed to substantiate that claim over months if not years of making it. Technological development is alive and well in Britain and other countries with universal healthcare systems, and in some respects is facilitated by these systems.

If you have to pull out guns to force people to join your awesome system, maybe you should rethink what "free" means.

It never seems like a loss of freedom when you're the one behind the gun. "There ya go! Now just do that. There! See how free you are!"


You do seem to have a serious obsession with guns. Who, exactly, is pulling out a gun to force anyone to do anything? And if you're talking about having to pay your taxes, then there was a whole thread about this just last week.

Using the same rhetoric, your compatriots pull out guns to force you to pay for everything from Star Wars to public libraries.

We can broadcast what the "bad guys" in Northern Ireland are saying without fearing jail.


So can we. For a time, there was a peculiar rule that said you couldn't broadcast what the "bad guys" said in their own voices. However, they were free to speak as they chose, and the broadcast networks were free to have someone else read out those words. Silly, I agree, but not an infringement on freedom of speech.

And that was a decade or more ago. These "bad guys" are now participating in government.

Oh, you probably mean medical care.

Ummm, well, we can go see a doctor in his own clinic without fearing jail, unlike Canadians who go to private, illegal clinics, including one run by the head medical guy in government.


No idea what is and isn't the case in Canada, but I suspect the Canadians are going to come and tell you you're wrong. Like they told you you're wrong before. Like we told you you're wrong about medical research in Britain before, but you just keep on repeating the same nonsense.

I can go and see any doctor in his own private clinic. Done it often. Walked up Harley Street and right in that door. Jail? What are you smoking?

Don't you recall Psych 101 and the experiment where they asked people if they could put up a tiny sign on their lawn, then went back and asked if they could put up a bigger one, then a bigger one?

Eventually they asked if they could put up a gigantic one, and many still said yes.

The control group they just went up and asked if they could just put up a giant sign, and they all said no.

It's called an "emotional investment" in a position.


Wow, you do like setting up straw men. You're a fire hazard. (Would you prefer not to have a publicly-funded fire department by the way?)

As Americans, you participate in a democracy. Deciding to reject a beneficial reform just in case you and your fellow-voters are unaccountably compelled to vote for something else that you actually don't want is a bit silly don't you think?

Signs on lawns is about as relevant as video games, which is to say not really. I don't know about you, but if I need some garden manure, and the farmer offers to deliver it to me for free, I don't usually turn him down for fear that next time, I might tell him it's OK to dump ten tons on my lawn.

Rolfe.

[Architect]

I'm "claiming" that it's all well and good to say "we have that too" when it comes to free speech, but when your legal system allows a journalist to be punished for telling the truth, your claim rings a little hollow.

You also have prior restraint censorship by the government.

And blasphemy laws.

I'm obviously saying nothing about the ECHR. What are you saying about it?

Firstly, the Singh case is based on libel law; you can say what you want but if it turns out to be untrue then you can be sued for damages so arising. This is not in itself a restriction on free speech. Your position might be to question to whether the Quacks are abusing the law, and Singh is free to pursue an appeal - and all the way to Europe if necessary, I would imagine.

Now, is there a specific point you wish to make or are you just going to be vague?

[Corsair 115]

I forgot to ask about Welfare Benefits when unemployed / sick.


In terms of unemployment benefits, the amount of EI (Employment Insurance) is connected to how long you were working and what part of the country you're in. But, generally and if I recall correctly, the maximum is 48 weeks of benefits at a rate of about 55% of your former pay. (Note that when you are working, a small amount of your paycheque is deducted as an EI premium.)

[Corsair 115]

Is it so fair you would force it on people who don't want it?


The nature of an organized society forces certain compromises. Some folks may not get to do exactly everything they might like to do. Some folks may have to pay taxes towards things with which they don't agree. If enough folks don't like a particular situation, it gets changed via their elected representatives.

[Rolfe]

Just thinking. Freedoms I have (healthcare related).

Freedom to:

seek medical services without any pre-approval from an insurance company
seek medical services at almost any hospital in the country
play contact sports without worrying about the financial consequences
have over £2 million spent on me in my lifetime by my healthcare provider (if necessary)
access the publicly-funded healthcare I am paying for through my taxes

These are all, I think, freedoms denied to US citizens who do not have very large private means.
You are incorrect as to these.


Now you see, you have to say what you mean by that. Argument by peremptory denial doesn't usually get very far. (I notice you did delete some of my points, so can I assume these are conceded?)

Are you saying I don't have these freedoms? Because I can assure you, I do.

Are you saying US citizens also have these freedoms? Pardon me if, for reasons of brevity, I didn't enumerate the pathetically restricted ways in which some Americans may get some small semblance of these services.

1. US medical insurance companies demand "pre-approval", right? You can't just proceed with whatever treatment your doctor thinks you need, not if you want your insurance company to pay for it. Oh yes, if you have sufficiently large private means, no doubt you can, but we're talking about ordinary Joes, here. They have to get the insurance company's agreement first.

2. US medical insurance companies have deals with particular hospitals. You can't just decide you want to go to hospital A, even if that's where your doctor wants to send you, if your insurance company has a contract with (or owns) hospital B. If you want them to pay for your treatment, you have to go where they say.

3. You get injured, you need treatment, you have to pay, right? Co-pay, deductions, that sort of thing. Enough to put a bit of a crimp in the family budget, I hear. And if you crock yourself badly enough, so that you might be a long-term drain on your insurance company, there's a 10% chance they're going to find some small irregularity that allows them to cancel the contract retrospectively. You know, all that would worry me if I was into rugby or three day eventing.

4. I understand that $2 million is about the biggest ceiling you'll get on a health insurance policy in the USA. So unless you have more than $2 million in private fortune, no, you're not going to get more than that spent on you in your lifetime.

5. And while you're a taxpaying citizen, you can't access the medical system you're paying for.

Yes, I know, if you're bankrupt then you can access the public system, and then they might even spend a bit more on you after your first $2 million runs out. And if you make it to 65, then you can finally start accessing the public system. And if you show up at a hospital needing emergency treatment then they have to give it to you - but then they'll pursue you for the money, and if you haven't got it, they'll load your bill onto some other schmuck's bill. And the minute your immediate emergency is over, you're out on your ear. Forget continuing care.

While we're at it, do you really approve of a government that compels private businesses to give away their product to people who have no hope of being able to pay, without compensation, forcing them to cover their losses by overcharging paying customers?

So, isn't life great? The only way you can access what we all have as of right is to be very rich (so that you don't need your insurance company to pay out for you), to be bankrupt or almost destitute, or to be over 65. Oh, and you can get just a fraction more if you're prepared to take goods and services you have no intention of paying for, and are happy to let someone else be overcharged to pay for.

I do so envy you! :oldroll:

If you choose not to pay for health insurance, you don't get treated when you get very sick (unless you're very wealthy).
Not true.


See above. You want to be destitute, to have to wait till you're over 65, or you're happy to get only emergency treatment, and that by what some would describe as legitimised stealing? Great system, I'm sure. :nope:

However, I'm a lot freer than the US citizen in that respect, because if I choose to forego healthcare insurance, I'll still be treated. If the US citizen makes that choice, he won't be treated.
Generally, this is not true. Some Americans may go bankrupt under the weight of medical bills (which I'll admit freely is a ridiculous situation for us to be in), but we can usually get treated. There is care for acute illness in emergency rooms regardless of ability to pay. For minor ailments, doctor visits, drugs, etc. are available on the market for prices most people can afford. It's really only people needing long term treatment they can't afford for chronic conditions that are "not treated" due to lack of insurance, at least untill they get sick enough to need acute care.


See above, again. You have to assume that you're lucky enough not to need a big-ticket item (or you can wait till you're over 65 to get that treated), or you're willing to take goods and services you cannot pay for, which the government forces a business to supply to you, to their loss, or that you reach destitution to qualify for Medicaid.

Your special pleading claims that Americans who are destitute, or elderly, or willing to steal with the government's connivance, or just plain lucky, will be OK.

I'm pointing out that everybody legally resident in my country will be OK.

I struggle to see why you're so pleased with yourself.

Rolfe.

[Michael Redman]

Firstly, the Singh case is based on libel law; you can say what you want but if it turns out to be untrue then you can be sued for damages so arising.

You are incorrect. You can be sued either way. And you can lose, even if you are right. In the UK, that is.

This is not in itself a restriction on free speech.

It is.

Your position might be to question to whether the Quacks are abusing the law, and Singh is free to pursue an appeal - and all the way to Europe if necessary, I would imagine.

That is not my point.

Now, is there a specific point you wish to make or are you just going to be vague?

I have made the specific point, twice, that the UK does not enjoy the same level of free speech that the US does. You have responded with two alternate positions it seems you would rather argue against. I'm not interested.

You may have noticed that this conversation has moved on from this tangent.

[Rolfe]

Here's some additional questions:
1.) In UHC, are you free to select the drug (generic vs. name brand) if you are willing to pay for it? (I think this was covered a bit before, but I was wondering how far it extended)
2.) At what age is care restricted? Is there an age?
3.) What is the maximum amount that will be covered for a single person in a lifetime. What happens if care exceeds that amount?
4.) Are fertility treatments covered/allowed?
5.) What extra costs (if any) do you must assume if you Some/Drink/do Drugs/....

I'm just trying to get more dialog while I wait to hear from BeAChooser (I wonder where he is?)


Just thought I'd add to (or confirm) what others have said.

1. If your doctor believes that the branded drug is better for you personally than the generic, he is free to prescribe it. If you wanted it for some personal reason, and you couldn't persuade your doctor to your point of view, you could ask him to write a private prescription for it and pay for it yourself. Though why you would want to do that is beyond me.

2. No age restrictions on care. However, bear in mind that some aggressive interventions might be considered less medically appropriate in the elderly in all systems, particularly if they are otherwise very frail. But for example, my 92-year-old mother lives with me. She gets far more care than I get, due to her age - home visits from the nurse for health checks, house calls from the doctor if she's unwell, and free prescription medicines. They wouldn't give me all that! And they're not going to stop just because she passes a certain birthday.

3. No lifetime maximum. Nobody even keeps a tally of what's been spent on any individual.

4. As someone else said, a certain number of IVF cycles (three? four?) are provided, with trimmings (ICSI and so on). If you want more, then you have to pay privately, but you can certainly go on as long as your finances hold out and your fertility consultant thinks it's ethical.

5. None. Nobody judges your personal life and then decides to charge you money. The only time lifestyle comes into it is when decisions are being made about whether certainn procedures are appropriate. Then, for example, a single available liver may be more likely to go to someone with chronic active hepatitis than someone with alcoholic cirrhosis - but the alcoholic would not be excluded if the transplant was otherwise medically appropriate (i.e. he'd given up booze). Other surgery may be judged too risky to perform on someone who is currently smoking, or grossly obese, and advice given to quit the fags or lose weight first. But people are not barred from treatment for vindictive reasons, and they are certainly not charged more money.

For all the fuss about whether or not some very expensive cancer drugs of questionable benefit should be provided, or people having to wait a few months for an (absolutely free) hip replacement, it's one helluva good deal.

Rolfe.

[Rolfe]

Is it so fair you would force it on people who don't want it?


I'm utterly opposed to armed conflict of all kinds. I wholly oppose paying for a standing army or stockpiles of munitions. You would force this on me?

I can't read. You would force me to pay for public libraries?

And so on.

But unlike the above, hey, nobody's even talking about forcing you to take or pay for something you don't want. Is your position so indefensible that you have to manufacture blatant straw men?

Rolfe.

[Michael Redman]

1. US medical insurance companies demand "pre-approval", right?

Wrong.

2. US medical insurance companies have deals with particular hospitals. You can't just decide you want to go to hospital A, even if that's where your doctor wants to send you, if your insurance company has a contract with (or owns) hospital B. If you want them to pay for your treatment, you have to go where they say.

You may have a larger co-pay and/or need pre-approval to go outside a certain hospital network, but it is not true that you must go where they say or pay yourself.

3. You get injured, you need treatment, you have to pay, right? Co-pay, deductions, that sort of thing. Enough to put a bit of a crimp in the family budget, I hear.

You hear? Great evidence. My co-pay for doctor visits is $10, branded medications are up to $10 a month, and generic medication if free. My wife and I have both had serious injuries (requiring surgery) in the last few years and been out of pocket a few dozen dollars. And not dropped from the insurance, or had premiums go up.

And if you crock yourself badly enough, so that you might be a long-term drain on your insurance company, there's a 10% chance they're going to find some small irregularity that allows them to cancel the contract retrospectively. You know, all that would worry me if I was into rugby or three day eventing.

It doesn’t worry me. As far as I can see, plenty of Americans participate in athletic activity with no worries.

Did you just make up that 10% thing?


4. I understand that $2 million is about the biggest ceiling you'll get on a health insurance policy in the USA. So unless you have more than $2 million in private fortune, no, you're not going to get more than that spent on you in your lifetime.

That may. I’ll concede that one.



5. And while you're a taxpaying citizen, you can't access the medical system you're paying for.

Are you talking about Medicare or the Veteran’s Administration? They don’t require you to be destitute to receive care. They're obviously not universally available, but your statement is false.



I struggle to see why you're so pleased with yourself.

Rolfe.

What on earth are you talking about? I have been quite clear in stating that I do not like the system currently in place in the US.

You seem to be of the opinion that if you have a premise that is basically valid, any nonsense you say in support of it should get a free pass. Don't ascribe your strawmen to me, simply because I'm pointing out some misperceptions.

[Rolfe]

Freedom to:

buy insurance coverage for private medical care
pay for private medical care out of my own pocket



You are aware that the "single payer" system being pushed at the current time, and in the 1990s by Hillary, do not allow this, right?

Hence one of my previous responses, which might confuse you without that knowledge.


Yes, since there's no "single payer" of any sort being pushed at the current time in the USA, and no proposal to outlaw private medical provision, then yes, your responses are pretty confusing.

And right on my TV screen right now, is a US congressman saying exactly that to Kirsty Wark.

In any case, extra taxes are money I cannot spend on health care directly. It's like forcing people to pay for public schools in addition to the costs they incur sending their kids to private ones.


You are aware that right now you're paying more in tax to fund Medicare and Medicaid than I do to fund the NHS, aren't you?




travel abroad to seek medical treatment (again funded by the NHS if judged necessary)






Ummm, you also use the argument that "if you don't like it, get the hell out of my country!" You can't have it both ways.

And no, we're not talking about just happening to be on vacation when you need it.


No, I'm talking about this sort of thing (http://www.theherald.co.uk/search/display.var.2521789.0.swine_flu_scot_is_flown_to_s wedish_hospital.php).

Also talking about being able to choose to travel abroad to access cheap private healthcare in foreign countries. Which is something Americans seem to be doing quite a lot too I gather.

Rolfe.

[Rolfe]

Wrong. You may have a larger co-pay and/or need pre-approval to go outside a certain hospital network, but it is not true that you must go where they say or pay yourself. You hear? Great evidence. My co-pay for doctor visits is $10, branded medications are up to $10 a month, and generic medication if free. My wife and I have both had serious injuries (requiring surgery) in the last few years and been out of pocket a few dozen dollars. And not dropped from the insurance, or had premiums go up. It doesn’t worry me. As far as I can see, plenty of Americans participate in athletic activity with no worries.


Your statements are very much in opposition to what a number of other US posters have reported.

Did you just make up that 10% thing?


No, I didn't. My immediate source is Sicko, but since part of the supporting evidence in the film was a legal interview with a health insurance executive then I think it's well attested.

Are you talking about Medicare or the Veteran’s Administration? They don’t require you to be destitute to receive care. They're obviously not universally available, but your statement is false.


My original post was about freedoms I have as a British citizen, without any other conditions attached such as being very poor, or ex-army, or over 65. Clearly, such restrictions do rather make me "less free" in my ability to access publicly funded care.

What on earth are you talking about? I have been quite clear in stating that I do not like the system currently in place in the US.

You seem to be of the opinion that if you have a premise that is basically valid, any nonsense you say in support of it should get a free pass. Don't ascribe your strawmen to me, simply because I'm pointing out some misperceptions.


Wel, forgive me, but you did come across as defending it. You are reporting a different experience from some of your countrymen, but that doesn't negate the reports of many others on which I was basing my statements.

Rolfe.

[Architect]

You are incorrect. You can be sued either way. And you can lose, even if you are right. In the UK, that is.

I'd love to see a link for this interesting legal interpretation of libel/slander defamation laws. Let's be clear - you can only be successfully sued if you have, in fact, said things you can't back up. If you don't believe me then I suggest you look into the famous McLibel trial.

I have made the specific point, twice, that the UK does not enjoy the same level of free speech that the US does. You have responded with two alternate positions it seems you would rather argue against. I'm not interested.

With respect, all you've done is hand-wave away the quite clear point that you're talking mince. We enjoy freedom of speech in the UK and it's guaranteed by law in the form of ECHR. What we don't have the right to do is tell lies or defame people. Or, to turn it the other way round, I have the freedom to live my life without someone publically telling lies about me.

[Rolfe]

Yeah, I am writing you a detailed email. Right now. I'm just easily distracted....
[/derail]

Rolfe.

[Darth Rotor]

AFAIK, so can I. Although there are restrictions on type. Regardless, why is there a choice between guns and UHC? You can have both. The two issues are unconnected. You don't really think you'll have to give up your guns to get UHC do you?
No, I was responding to the title of the post, and essentials in my view includes being armed. I do not trust my fellow citizens as far as I'd like to be able to, and I sure as hell don't trust our government.

I also like to hunt, and target shoot.

DR

[Rolfe]

Sorry, premature submission.

[Rolfe]

With respect, I think discussion of gun ownership and freedom of speech is completely irrelevant to this thread. We all understand that there are sociological differences between the USA and Europe. However, what was being specifically claimed was that having universal healthcare results in fewer personal liberties, and the loss of "many things that we consider almost essentials in this country".

I simply cannot see how the introduction of universal healthcare to the USA would necessarily impact on your right to go armed to the teeth, or your right to say any damn thing you like.

So could we get back to all these "personal liberties" and "almost essentials" that we poor benighted Europeans have given up in order to get our healthcare systems? Because 83 posts into the thread, I'm still no nearer having a clue.

Rolfe.

[Darth Rotor]

With respect, I think discussion of gun ownership and freedom of speech is completely irrelevant to this thread. what was being specifically claimed was that having universal healthcare results in fewer personal liberties, and the loss of "many things that we consider almost essentials in this country".
As I grok the argument, the idea is that choice is a right, and that the cost of health care raises tax, and thus the choices one has with the smaller pile of dough left over are fewer.

Some people consider that a loss of essential choices, which are similar to freedoms not exercised due to lack of the lubrication of free choice money, a significant issue to bark about.

It's not that batty of a line of thought, though the way it comes off is frequently fear mongering piled upon hyperbole.

Remember, Rolfe, Americans who earn a living often get really up in arms about taxes. So do the wealthier 10-20% who end up paying somewhere between a third and a half of all income tax revenue. (Depends on whose numbers and studies you choose to buy into.)

DR

[joobz]

As I grok the argument, the idea is that choice is a right, and that the cost of health care raises tax, and thus the choices one has with the smaller pile of dough left over are fewer.

Some people consider that a loss of essential choices, which are similar to freedoms not exercised due to lack of the lubrication of free choice money, a significant issue to bark about.

It's not that batty of a line of thought, though the way it comes off is frequently fear mongering piled upon hyperbole.

Remember, Rolfe, Americans who earn a living often get really up in arms about taxes. So do the wealthier 10-20% who end up paying somewhere between a third and a half of all income tax revenue. (Depends on whose numbers and studies you choose to buy into.)

DR
And here is where I think we get to the crux of the buscuit.


The people who "choose" not to get health care do not do so without consequences on them or the rest of society. If and when medical care is needed, and they can not afford to cover the costs (Which is clearly not an imaginary event), it raises the cost of health care for all. This, in turn, raises the costs of insurance. This increased cost of insurance means that more people are likely to participate in "budget" insurances which do not provide the care expected. As such, causing a burden on them and increased likelihood of not making medical payments. This, in turn, raises the costs of health care and the....

Of course the key premise against social goods is that the individual will take the consequences of the actions upon themselves. But when it comes to healthcare, even when they become "bankrupt" as a result, it still causes a ripple effect that effects all. This has the secondary problem of these people who are now bankcrupt not being able to pay their taxes and further increasing the burden upon others.

It is a classic example of freeloading and not even in the most libertarian of arguments, are free loaders considered acceptable. Their "choice" limits the choices of others. By providing a UHC, it is possible to provide a healthcare that doesn't have this negative feedback loop, resulting in uncontrolled cost. This results in higher net wages and more "freedom" for all.

Of course, this is built upon the assumption that the UHC will, indeed, lower the costs in the long run. Based upon the examples we have in other nations, it's not a bad assumption. However, that's no proof. Washington could easily screw it up anyway.

[Morrigan]

How many Awesome Rock Bands hail from Switzerland?


Ahem:
http://userserve-ak.last.fm/serve/_/42207/Celtic+Frost.jpg
http://img8.imageshack.us/img8/4672/bloodritual.jpg (http://img8.imageshack.us/i/bloodritual.jpg/)

And of course the UK owns everyone else at rock, but you already admitted that. :D


Here's some additional questions:
1.) In UHC, are you free to select the drug (generic vs. name brand) if you are willing to pay for it? (I think this was covered a bit before, but I was wondering how far it extended)
2.) At what age is care restricted? Is there an age?
3.) What is the maximum amount that will be covered for a single person in a lifetime. What happens if care exceeds that amount?
4.) Are fertility treatments covered/allowed?
5.) What extra costs (if any) do you must assume if you Some/Drink/do Drugs/....
Canada/Québec:
1) I haven't checked, but I'm fairly certain it's the case, assuming the generic drug is actually different in composition than the name brand.
2) No restriction at all, unless I misunderstand the question.
3) No maximum amount at all as far as I know.
4) As far as I know, it's not covered in Québec and you have to pay it out of pocket (unless you have a private insurance that covers it), but the provincial government tried to pass a bill to change that sometime last year. I don't know what's the status on that.
5) Nothing at all.


I'm just trying to get more dialog while I wait to hear from BeAChooser (I wonder where he is?)
I predict we won't see him in this thread at all, or that if we do, he'll just repeat the same refuted nonsense... just like Beerina did.

[Morrigan]

I feel like reposting this gem (http://www.metal-archives.com/board/viewtopic.php?p=1314379#1314379) I saw on my own forum earlier today, in a similar thread about UHC. It's really quite telling:

Regardless of the benefits or negatives of a universal healthcare system, it goes against the fundamental building blocks of the country.

There you have it folks... ideology trumps reality.

[DC]

Ahem:
http://userserve-ak.last.fm/serve/_/42207/Celtic+Frost.jpg
http://img8.imageshack.us/img8/4672/bloodritual.jpg (http://img8.imageshack.us/i/bloodritual.jpg/)

And of course the UK owns everyone else at rock, but you already admitted that. :D


Canada/Québec:
1) I haven't checked, but I'm fairly certain it's the case, assuming the generic drug is actually different in composition than the name brand.
2) No restriction at all, unless I misunderstand the question.
3) No maximum amount at all as far as I know.
4) As far as I know, it's not covered in Québec and you have to pay it out of pocket (unless you have a private insurance that covers it), but the provincial government tried to pass a bill to change that sometime last year. I don't know what's the status on that.
5) Nothing at all.


I predict we won't see him in this thread at all, or that if we do, he'll just repeat the same refuted nonsense... just like Beerina did.

:boggled: never ever heard of those

[Eskarina]

My co-pay for doctor visits is $10, branded medications are up to $10 a month, and generic medication if free. My wife and I have both had serious injuries (requiring surgery) in the last few years and been out of pocket a few dozen dollars. And not dropped from the insurance, or had premiums go up. It doesn’t worry me.

Good for the both of you. But how many Americans have access to this kind of insurance? Will you still be covered when you lose your job?

[Foolmewunz]

Good for the both of you. But how many Americans have access to this kind of insurance? Will you still be covered when you lose your job?

This has been the most popular form of health insurance in the USA for over a decade. "Popular" insofar as most medium to large employers are buying into it.

As to coverage after job loss, there's a law in the USA, referred to as COBRA which gives most employees the right to continue their coverage after employment ceases, albeit at very likely higher premiums because the insurance carriers are not required to give you, as an individual, the same rates they gave you, as an employee of Great Big Amalgamated Corporation which signed up 40,000 insured.

ETA: Just providing info. I'm a supporter of a National Healthcare policy.

[Rolfe]

As I grok the argument, the idea is that choice is a right, and that the cost of health care raises tax, and thus the choices one has with the smaller pile of dough left over are fewer.

Some people consider that a loss of essential choices, which are similar to freedoms not exercised due to lack of the lubrication of free choice money, a significant issue to bark about.

It's not that batty of a line of thought, though the way it comes off is frequently fear mongering piled upon hyperbole.

Remember, Rolfe, Americans who earn a living often get really up in arms about taxes. So do the wealthier 10-20% who end up paying somewhere between a third and a half of all income tax revenue. (Depends on whose numbers and studies you choose to buy into.)


I realise you're just trying to articulate the argument, but it makes very little sense.

US citizens currently pay a little bit more in tax just to fund Medicare and Medicaid, which only cover a minority of citizens, than we do to fund the entire NHS which covers everyone, and very comprehensively too I might add. I can see why people might be concerned about tax increases, especially in the short term, however experience from other countries indicates that in fact your problem is massive waste in your system, not the need to spend more.

In addition, one has to consider how the costs of "emergency" healthcare for the uninsured are loaded on to the insured and (especially) the self-pay customers in the system.

Every time anyone mentions the plight of the uninsured in America, someone will proudly boast that these people will not be refused treatment. (As an aside, if this is a good thing, which I agree it is, then why is sorting out a sensible system of delivering care to everyone such a bad thing?) However, this is done in a grossly inefficient and frankly oppressive manner.

I find it very strange that in America, of all places, the owners of private businesses are compelled by law to provide their goods and services to people who have no means of paying for them, and without any compensation being made by the state for the resulting losses. These businesses then have no alternative but to recoup their losses by overcharging their paying customers. And while this seems to impact disproportionately on individual paying patients, it also affects the insured.

I haven't seen any estimate of the amount by which insurance premiums are inflated to allow for these overcharges, but I suspect it's quite significant. So the ordinary American loses out two ways. He's paying taxes (just as much as we are) to fund state healthcare he can't access, and then he's paying inflated insurance premiums to offset the losses incurred by the compulsory treatment of the uninsured.

This seems to me to be a fairly significant inroad into anyone's "pile of dough", for which they personally are receiving very little. The existing situation is "restricting choices" of what to do with your money in ways I myself would find pretty annoying.

It seems to me that a great deal of the current bellyaching is a result of people taking a very short term view. If I've taken a wrong turn when hillwalking, and find myself in an isolated highland valley when I want to get back to civilisation, I can't just sit there complaining that I want to go down not up, when it's necessary to climb another ridge in order to get on the road to a bath and a meal. I don't know enough about economy to estimate how much additional spending might be necessary in the short term to get the US healthcare system out of the hole it's in. However, I don't think you have to be a genius to realise that it is in a hole.

Joobz explained the vicious circle that can already be seen in the US. I remember watching the film where Morgan Spurlock and his fiancee tried to live on the minimum wage for 30 days. It was quite clear to me that they would have succeeded if it had not been for the fact that they both developed health issues during that time. Healthcare issues which would be minor for people with access to decent routine healthcare seem to be a significant handicap for many Americans.

Many US businesses are reporting that they are uncompetitive in the global marketplace because of the amount they have to spend on healthcare for their employees. General Motors spends more on employee health insurance than on steel. Employees of many businesses are encouraged to sequester money in healthcare accounts, thus reducing their overall spending power on other items. The US economy is pumping about 7% of its GDP into healthcare-related items, and getting nothing at all in return. This situation is set to get worse, with increasing costs of medical care pushing more and more people into financial difficulties and turning them into a net drain on the system. More and more companies are simply deciding not to offer employee healthcare, throwing more people onto the uncertain mercies of the open market.

I suppose it's not my problem. I pay my taxes, 18.4% of my gross income last month, plus another 9.1% in compulsory contributions to the state retirement pension fund. This doesn't seem onerous to me. And in return, I've been receiving healthcare free at the point of delivery since before I was born, and this will go right on until I finally peg it, even if my income drops below the tax threshold. I have the right to spend more on buying more healthcare if I want to, but I choose not to, as the NHS provision is so comprehensive. Not only have I no personal worries about funding my healthcare, I have no worries about my friends or relatives.

I'm just baffled and concerned by the situation in America. This is the biggest world superpower of all time. We're led to believe that the standard of living is second to none. And yet even among our friends here on the forum (and elsewhere in cyberspace) we encounter distressing examples of people in need simply not getting what every British citizen receives as a right, and suffering significant hardship as a consequence.

I think the American people need to shoulder their rucksacks and climb that ridge, or they're still going to be stuck in the mountain valley when it gets dark and starts to snow.

Rolfe.

[Darth Rotor]

Of course, this is built upon the assumption that the UHC will, indeed, lower the costs in the long run. have in other nations, it's not a bad assumption. However, that's no proof. Washington could easily screw it up anyway.
Not impressed with the assumption.
why?
Washington could easily will screw it up anyway
Fixed it for you. ;)

DR

[Rolfe]

Oh, the good old piss-up in the brewery argument.

You put a man on the moon for God's sake! This is not beyond you, however low your self-esteem is at the moment! :rolleyes:

Rolfe.

[Darth Rotor]

I realise you're just trying to articulate the argument, but it makes very little sense.
--lots of words--
Rolfe.
I appreciate your interest in American affairs.
This is not beyond you, however low your self-esteem is at the moment!
No problem with that here, maybe you don't understand what a clusterf*** is. (But I think you do ;) )

Why not go back to where this all started, when the communists (OK, unions) were able to apply the burden of paying for health care to large corporations for many Americans.

Note, plenty of people did not fall under that umbrella either ... Been years since I read up on this, but I think some Farmer Co-ops had the bargaining power to get group rates on health coverage. The whole point of a group rate, and a big enough group, is risks of catastrophic coverage are spread over a large population, as with other insurance systems.

This set up increased the cost of doing business, certainly, and it laid the foundation for large health care companies who made a profit by servicing various labor/management agreement mandated service provisions. The cost of labor (in my company, for example, the cafeteria plan costs the company about 420 dollars per month in group coverage) is one of a variety of reasons manufacturing jobs have been going overseas for the last two decades.

How about that! Those evil corporations, enemy of the people, the big manufacturing concerns simply are shrinking, and with them the structure that provided a cushion for so many people, and the unions with their power base.

When you get right down to it, you can thank the communists for this whole mess! :D

DR

[Eskarina]

This has been the most popular form of health insurance in the USA for over a decade. "Popular" insofar as most medium to large employers are buying into it.

As to coverage after job loss, there's a law in the USA, referred to as COBRA which gives most employees the right to continue their coverage after employment ceases, albeit at very likely higher premiums because the insurance carriers are not required to give you, as an individual, the same rates they gave you, as an employee of Great Big Amalgamated Corporation which signed up 40,000 insured.

ETA: Just providing info. I'm a supporter of a National Healthcare policy.

Sorry, I asked the wrong questions and seem to have appeared even more clueless than usual. :)

What I really want to know is: how high are the premiums, are there any deductibles, would someone working for the local hairdresser or the carshop have access to the same insurances [sic?] as someone working for Great Big Amalgamated Corporation, would someone with a precondition be allowed into it?

WRT to COBRA, I heard about it. The way I understand it is that the unemployed still has to pay the premiums, whereas in Germany the premium is usually covered by the state.

[Eskarina]

When you get right down to it, you can thank the communists for this whole mess! :D

When you get right down to it, you have the wrong handle on unions. Or maybe just the wrong choice of union leaders.

I'm a card-carrying union member, but I'm certainly neither a socialist nor a communist.

[Ocelot]

You put a man on the moon for God's sake!

Actually it was for Kennedy's sake but I can understand the confusion.

[Praktik]

A little late to the thread, was on vacation out west in British Columbia where my gf's cousin was getting married.

Her sister is engaged now too and she brought her English wanker with her across the pond to the wedding. We found a listing for an alright looking night of music in-town and started drinking before the 30-min walk to the bar and the Englishman was like "Wait a minute, we can't carry these on the way can we?"

And I was like "Helllz no guy, thats the way it is here"

He was mystified. So while the OP lumps Canada in with Europe on the issue of comparative freedom vis à vis health care, when it comes to alcohol consumption and drug matters generally we should be lumped in with the US.

I still don't understand why we have those laws to be honest, what harm are they protecting us from?

I joined in my English friend's bafflement and thought about how in Europe, there are some ways they are more free than I am.

[Delscottio]

A little late to the thread, was on vacation out west in British Columbia where my gf's cousin was getting married.

Her sister is engaged now too and she brought her English wanker with her across the pond to the wedding. We found a listing for an alright looking night of music in-town and started drinking before the 30-min walk to the bar and the Englishman was like "Wait a minute, we can't carry these on the way can we?"

And I was like "Helllz no guy, thats the way it is here"

He was mystified. So while the OP lumps Canada in with Europe on the issue of comparative freedom vis à vis health care, when it comes to alcohol consumption and drug matters generally we should be lumped in with the US.

I still don't understand why we have those laws to be honest, what harm are they protecting us from?

I joined in my English friend's bafflement and thought about how in Europe, there are some ways they are more free than I am.

I assume you mean carrying opened alcohol containers in a public place? If not I haven't a clue what you're getting at!!

p.s Love the description of the bloke! Although went from wanker to friend within a few sentences which isn't bad going.

[Praktik]

Ya thats what I meant.

And don't worry, I meant "wanker" in the nicest possible way..;)

He's an alright chap I guess - just put the pressure on me with an engagement ring into a 2 year relationship w/ my gf's sister. And my gf ain't got no ring yet. And we been together 3.5 years.

There were a few glances my way when the family clustered around the happy couple to coo over the rock.

[ZirconBlue]

1. US medical insurance companies demand "pre-approval", right? You can't just proceed with whatever treatment your doctor thinks you need, not if you want your insurance company to pay for it.

Pre-approvals are often required for some services (such as mental health visits), and are advisable on anything expensive.


2. US medical insurance companies have deals with particular hospitals. You can't just decide you want to go to hospital A, even if that's where your doctor wants to send you, if your insurance company has a contract with (or owns) hospital B. If you want them to pay for your treatment, you have to go where they say.

True HMO plans typically restrict your options of providers to those that are in-network, but a lot of plans have moved into offering PPO-type plans which usually still cover you out-of-network, but with higher co-payments and deductibles.

HMOs will also require you get a referral from your registered primary care physician if you want to see a specialist, while PPOs usually allow you to visit a specialist without a referal.


Wrong. You may have a larger co-pay and/or need pre-approval to go outside a certain hospital network, but it is not true that you must go where they say or pay yourself. You hear? Great evidence. My co-pay for doctor visits is $10, branded medications are up to $10 a month, and generic medication if free. My wife and I have both had serious injuries (requiring surgery) in the last few years and been out of pocket a few dozen dollars. And not dropped from the insurance, or had premiums go up. It doesn’t worry me. As far as I can see, plenty of Americans participate in athletic activity with no worries.

You're speaking of your own plan as if it representative of all plans in the US.

As to coverage after job loss, there's a law in the USA, referred to as COBRA which gives most employees the right to continue their coverage after employment ceases, albeit at very likely higher premiums because the insurance carriers are not required to give you, as an individual, the same rates they gave you, as an employee of Great Big Amalgamated Corporation which signed up 40,000 insured.


When I've lost jobs and been presented the paperwork to continue coverage under COBRA,

A) The premiums were so much higher than what I had paid while employed (even if the rate charged was the same, I now had to make up for the far larger portion of the premium that may employer had been paying as part of my benefits package) that they would have been unaffordable for me even while I was employed, and
2) I was out a job. Where is the money supposed to come from to pay the premiums?

[Fishstick]

Did you just make up that 10% thing?


James Kwak at Baseline described the practice (rescission) as rare, affecting only 0.5% of the population.

It should be fairly clear that the people who do not file insurance claims do not face rescission. The insurance companies will happily deposit their checks. Indeed, even for someone in the 95th percentile, it doesn’t make a lot of sense for the insurance company to take the nuclear option of blowing up the policy. $11,487 in claims is less than two years’ premium; less than one if the individual has family coverage in the $12,000 price range. But that top one percent, the folks responsible for more than $35,000 of costs – sometimes far, far more – well there, ladies and gentlemen, is where the money comes in.
Once an insurance company knows that Sally has breast cancer, it has already seen the goat; it knows it wants nothing to do with Sally.

If the top 5% is the absolute largest population for whom rescission would make sense, the probability of having your policy cancelled given that you have filed a claim is fully 10% (0.5% rescission/5.0% of the population). If you take the LA Times estimate that $300mm was saved by abrogating 20,000 policies in California ($15,000/policy), you are somewhere in the 15% zone, depending on the convexity of the top section of population. If, as I suspect, rescission is targeted toward the truly bankrupting cases – the top 1%, the folks with over $35,000 of annual claims who could never be profitable for the carrier – then the probability of having your policy torn up given a massively expensive condition is pushing 50%. One in two.

Full sourced text here: www.tauntermedia.com/2009/07/28/unconscionable-math/ (http://www.tauntermedia.com/2009/07/28/unconscionable-math/)

Edit: God this URL restriction is annoying.

[Rolfe]

Fishstick, you're quite right. I guess we were just talking among ourselves while we waited for BaC to come and explain what he meant (as if!).

By the way, that link doesn't seem to go anywhere.

You've explained the recission thing very well. I know Moore isn't popular with many people, but the main material he based that 10% claim on wasn't even his own interviewing - it was official footage from some sort of government source, of an interview with an insurance executive refusing to stop the practice.

Of course 10% of Americans are not going to get their insurance cancelled. Unless a customer is turning into a sure-fire loss-maker, the insurance companies have no interest in combing their original application to try to find some sort of error. They only hand the files of the customers who have developed big-ticket healthcare needs to their investigations branch, and it is there that the 10% target is apparently set. The operatives are given that target of loss-making policies to invalidate, and they get bonus payments if they exceed the target. So 10% is actually the minimum, it's probably higher.

I'm not just getting this from Sicko. There was a news item on BBC television a few weeks ago, and more Americans were interviewed about it, not the same people as Moore interviewed.

The one I remember most clearly was a woman who had developed breast (or was it cervical?) cancer. Her file was investigated, and they found an entry in her medical record from several years previously where a dermatologist had pencilled ?pre-cancerous? against a skin complaint which actually turned out to be nothing more than acne. Her insurance company latched on to this and said she had the pre-existing condition of cancer, therefore she was not covered for cancer. She said she had tried to appeal, but the insurance company's decision was binding and that was that. She was in tears during the interview.

There was also a case of a man, which I don't remember so clearly. However, his doctor had run some sort of test on him some years previously without him knowing. It was absolutely agreed that the doctor had never told him about it. I don't remember what the test was for or what the result was. However, when he developed something unrelated at a later date, the medical record entry of the test having been done was used to cancel his policy retrospectively and deny payment.

Nice business these insurance companies are in. Their primary purpose is not to provide healthcare to their clients, it is to pay out as little as possible to their clients. And if you're judge and jury, and you can retrospectively cancel a significant proportion of policies that turn into net loss-makers, so much the better.

The point about universal healthcare systems, and certainly the NHS, is that the purpose of the entire exercise is to deliver care. Another really telling segment in Sicko was the experience of the man who had moved to France from the USA. When he registered with the French health service he didn't tell them about health issues he had - I think he was diabetic. Later, of course, this came out. A baffled doctor or receptionist asked him why he hadn't mentioned it in the first place. He explained that he thought he would be denied treatment for diabetes (or rather, forced to pay for it out of his own pocket) if he admitted he already had it when he showed up. It was of course explained to him that the reason for the questions being asked in the first place was so that his doctors were aware of his needs and could make sure he got the extra care he needed.

I really don't know why so many Americans prefer a system that's motivated to deny them treatment, rather than one designed to give them treatment.

Rolfe.

[Professor Yaffle]

Derail about the IRA split to:
http://forums.randi.org/showthread.php?p=4976229

[Professor Yaffle]

Oops- it was my fault the link didn't work. When I was activating it I lost a letter. Fixed properly now.

:o

[3point14]

I work in insurance in the UK.

There is a body called the FOS (http://www.financial-ombudsman.org.uk/), an independent body that adjudicates on insurance disputes. The decisions they make are binding. Any insured who believes they've been treated unfairly by an insurance company can go to them and have them look at the claim. We then have to do what we're told, pretty much.

Does no equivalent exist in the US for such things?

[Rolfe]

Thanks, got the link now. Fishstick, did I mention welcome? That's a great article.

I'm really quite baffled just how I, as a non-American, seem to know more about US healthcare policy than a lot of American citizens.

The link says that it's only 0.5% of the people covered by that insurance company who are affected. That makes it less than 0.5% of the population as a whole. If we assume that all insurance companies operate a similar policy, and we take a rough figure of about 83% of the population having health insurance cover, then we're down to just over 0.4% of the actual population - roughly. About 1 in 250 people.

However, it's probably less than that. There are probably healthcare plans that don't cut people off in that way. I'm assuming (though the news coverage I saw seemed to imply it was quite widespread). So, less than 1 in 250, maybe 1 in 300?

The chances are that any individual American doesn't know anyone it's happened to. Or they may know one, but assume this is an isolated incident. It's still 10-15% of the people who develop big-ticket healthcare needs while insured. And it's over a million actual people.

No wonder the BBC, and Michael Moore, didn't seem to have much trouble finding people it had happened to.

If the US mainstream media is making a fuss though, I'm unaware of it.

Rolfe.

[uk_dave]

I wonder if the objection some americans have to UHC is really just based upon the notion that because they have paid into an insurance policy all these years, they are now resentful of people who have not been able to (or in their minds couldn't be bothered to/didn't work hard enough to) have medical insurance but are now going to get coverage at no cost to themselves (but at much higher taxation for the good hardworking citizen who wants to keep his/her expensive private medical insurance because it means they are doing better than those who have none) and that, like, isn't fair, coz all that sacrifice will have been for nothing if just anyone can get medical treatment regardless of how hard they work/save!!! And won't anyone think of the children...etc.

[Morrigan]

:boggled: never ever heard of those

Samael I can understand, they aren't that well-known... but you've never heard of Celtic Frost? Damn.

[DC]

Samael I can understand, they aren't that well-known... but you've never heard of Celtic Frost? Damn.

nope, not my kind of music :)

but after your post i saw someone with a Samael t-shirt :D

[stilicho]

What are these Personal Liberties and Almost Essentals that Europeans/Canadians sacrifice in order to have UHC?

I usually hear it's something about guns but, honestly, the gun laws in Canada are really not that much different than in the USA. You can't have one legally if you're mentally ill or you have a felony conviction or you lie on your application.

Maybe the sticking point is tear gas possession. Apparently you Americans can have it but we can't.

If that's all it is, I'll take my UHC and you can have your tear gas canister array.

[Rolfe]

And still BeAChooser, to whom the question was directed, has not replied, in this or any other thread.

Rolfe.

[Geezer]

And still BeAChooser, to whom the question was directed, has not replied, in this or any other thread.

Rolfe.

Well, in fairness making those copy & paste monster posts must take some time, no?
:D

[JoeTheJuggler]

Can't believe BeAChooser is shying away from a debate where he holds a strong position.

I guess we should take it as an admission that he is wrong, and a universal system does not in fact curtail and liberties.

[joobz]

Can't believe BeAChooser is shying away from a debate where he holds a strong position.

I guess we should take it as an admission that he is wrong, and a universal system does not in fact curtail and liberties.

well, the debate is still interesting and it is good that this thread exists to show the lie that the argument is. In future, if anyone tries to make a similar argument, I will simply point to this thread.

[Comsat Angel]

Well, old BeAChooser has been active on the Politics Forum today at 1:39 am - just doesn't want to come here without extensive research, I'm sure!

[Merko]

As someone remarked already, there are a lot of 'free' countries in this world, thankfully. I would never claim that my country (Sweden) is generally more free than every other country. Clearly, there are some things that are better and some that are worse.

With regards to the US though, I would offer the observation that there are a lot of people who go to the US in their 20s to work (after having earned a degree in engineering or economics here in Sweden). For a few years. Then, they come back because they want to start a family, and even though these people are typically (reasonably) high earners, they'll usually feel that Sweden is a more 'free' society for families. Universal health care, parental leave and crime rates are probably the most often cited reasons. Some market economy extremist types probably have issues with understanding how parental leave can be considered a freedom issue, but for most people it's probably much more of a freedom issue than whether or not you need to pay 5% extra in taxes or whatever.

I think that most people value freedom extremely highly. As a consequence of this, I think a rough estimate of freedom for a given country is whether there's a positive or negative migration rate. By this measure, the US would be a very free country (to a large extent because it is freer than the crime-plagued Mexico). But so would most parts of Europe.

[BadBoy]

A little late to the thread, was on vacation out west in British Columbia where my gf's cousin was getting married.

Her sister is engaged now too and she brought her English wanker with her across the pond to the wedding. We found a listing for an alright looking night of music in-town and started drinking before the 30-min walk to the bar and the Englishman was like "Wait a minute, we can't carry these on the way can we?"

And I was like "Helllz no guy, thats the way it is here"

He was mystified. So while the OP lumps Canada in with Europe on the issue of comparative freedom vis à vis health care, when it comes to alcohol consumption and drug matters generally we should be lumped in with the US.

I still don't understand why we have those laws to be honest, what harm are they protecting us from?

I joined in my English friend's bafflement and thought about how in Europe, there are some ways they are more free than I am.
er, do you know what "wanker" means. You may as well have said english c@#t or f@#ker

At least he's no a Canadian twat.

[BadBoy]

Fishstick, you're quite right. I guess we were just talking among ourselves while we waited for BaC to come and explain what he meant (as if!).

By the way, that link doesn't seem to go anywhere.

You've explained the recission thing very well. I know Moore isn't popular with many people, but the main material he based that 10% claim on wasn't even his own interviewing - it was official footage from some sort of government source, of an interview with an insurance executive refusing to stop the practice.

Of course 10% of Americans are not going to get their insurance cancelled. Unless a customer is turning into a sure-fire loss-maker, the insurance companies have no interest in combing their original application to try to find some sort of error. They only hand the files of the customers who have developed big-ticket healthcare needs to their investigations branch, and it is there that the 10% target is apparently set. The operatives are given that target of loss-making policies to invalidate, and they get bonus payments if they exceed the target. So 10% is actually the minimum, it's probably higher.

I'm not just getting this from Sicko. There was a news item on BBC television a few weeks ago, and more Americans were interviewed about it, not the same people as Moore interviewed.

The one I remember most clearly was a woman who had developed breast (or was it cervical?) cancer. Her file was investigated, and they found an entry in her medical record from several years previously where a dermatologist had pencilled ?pre-cancerous? against a skin complaint which actually turned out to be nothing more than acne. Her insurance company latched on to this and said she had the pre-existing condition of cancer, therefore she was not covered for cancer. She said she had tried to appeal, but the insurance company's decision was binding and that was that. She was in tears during the interview.

There was also a case of a man, which I don't remember so clearly. However, his doctor had run some sort of test on him some years previously without him knowing. It was absolutely agreed that the doctor had never told him about it. I don't remember what the test was for or what the result was. However, when he developed something unrelated at a later date, the medical record entry of the test having been done was used to cancel his policy retrospectively and deny payment.

Nice business these insurance companies are in. Their primary purpose is not to provide healthcare to their clients, it is to pay out as little as possible to their clients. And if you're judge and jury, and you can retrospectively cancel a significant proportion of policies that turn into net loss-makers, so much the better.

The point about universal healthcare systems, and certainly the NHS, is that the purpose of the entire exercise is to deliver care. Another really telling segment in Sicko was the experience of the man who had moved to France from the USA. When he registered with the French health service he didn't tell them about health issues he had - I think he was diabetic. Later, of course, this came out. A baffled doctor or receptionist asked him why he hadn't mentioned it in the first place. He explained that he thought he would be denied treatment for diabetes (or rather, forced to pay for it out of his own pocket) if he admitted he already had it when he showed up. It was of course explained to him that the reason for the questions being asked in the first place was so that his doctors were aware of his needs and could make sure he got the extra care he needed.

I really don't know why so many Americans prefer a system that's motivated to deny them treatment, rather than one designed to give them treatment.

Rolfe.
Nice post Ralf.

How about choosing another service that Is currently provided for universaly (as far as I know anyway).

What if the US government privatised all schools? So everyone has to pay for their school place through some employer scheme.

How about privatising the Police, so you have to pay yearly premiums in order to get the Police when you need them. So, you have their specific number, or when you phone 911 you have to povide some policy number before they come.

[DC]

Nice post Ralf.

How about choosing another service that Is currently provided for universaly (as far as I know anyway).

What if the US government privatised all schools? So everyone has to pay for their school place through some employer scheme.
will result in lees qualified workers as alot cannot afford schools anymore. Hurts your economy. or mabye that way you can win back the work that is now don in asian sweetshops.

How about privatising the Police, so you have to pay yearly premiums in order to get the Police when you need them. So, you have their specific number, or when you phone 911 you have to povide some policy number before they come.

Hello, 911? someone just broke into my house, i can hear them downstairs.

Hello Sir, what is you Policy number?

erm i dont know, the policy is downstairs.

Ok sir, pls call back when you have the Policy number. Good luck geting it.

[Architect]

Using your logic, we should get rid of the doctors. They kill more people than guns do.

Doctors kill approximately 225,000/year
Guns kill approximately 31,000/year

Source?

[Gord_in_Toronto]

Source?

Why even ask? How about:

Doctors save the lives of approximately 20,000,000/year
Guns save the lives of approximately 0/year

:boggled:

[DC]

Why even ask? How about:

Doctors save the lives of approximately 20,000,000/year
Guns save the lives of approximately 0/year

:boggled:

Guns do save lives. i think most often that of Soldiers and Police officers.

Sure often it comes with also killing someone, but also saving someone.

[BadBoy]

will result in lees qualified workers as alot cannot afford schools anymore. Hurts your economy. or mabye that way you can win back the work that is now don in asian sweetshops.


Hello, 911? someone just broke into my house, i can hear them downstairs.

Hello Sir, what is you Policy number?

erm i dont know, the policy is downstairs.

Ok sir, pls call back when you have the Policy number. Good luck geting it.
BTW sorry Rolfe (not Ralf)

Ok sir, pls call back when you have the Policy number. Good luck geting it.

Exactly. I posted it as an illustration. But you see, for someone living in the UK, the health service would be considered as given. Same thing as schools, police and fire service etc. To go into hospital for an emergency and then get asked for their cover details would seem as bazaar for people who have the advantages of UHC as someone in the USA would feel about phoning a private security company if their house got broken into. Its just the BASIC needs of a (supposedly) civilized society.

Anyone ever read the Book Snow Crash by Neil Stephenson. He paints a rather worrying picture of the future where Neighborhoods provide their own security/policing and roads are all private tolls with their own security/enforcement organization. etc etc Everything is privatized. Perhaps this is the ultimate capitalist society. If you can pay, you live in a rich neighborhood that has its own security, schools, healthcare and you can travel on the safest roads.

This I know is all a bit extreme, but Im just trying to show how, relatively speaking, UHC is not the devil some US citizens see it as being. In the UK we would no more consider having privatized police as privatized UHC, and that the other end of the spectrum is not worth thinking about.

[Peephole]

I'll try and answer some of joobz question's about universal health care, with regards to the Belgian system (don't shoot me in the face if I'm wrong about something, I'm not a expert):

1.) In UHC, are you free to select the drug (generic vs. name brand) if you are willing to pay for it? (I think this was covered a bit before, but I was wondering how far it extended)
You can ask your doctor to prescribe the cheaper generic brands, name brands get paid back 30% less.
2.) At what age is care restricted? Is there an age?
Insurance is mandatory for everyone with a job, the unemployed and students older than 25. Those still dependant on their parents are enrolled in their parent's insurance.
3.) What is the maximum amount that will be covered for a single person in a lifetime. What happens if care exceeds that amount?
There's a maximum amount no one should ever have to exceed each year, ranging from €450 to €1 800 (based on income). All extra costs should be completely refunded. Children never have to pay more than €650, regardless of their parent's income.
4.) Are fertility treatments covered/allowed?
Up to six treatments up to the age 42 are covered, and costs for these initial attempts should be limited to about €500.
5.) What extra costs (if any) do you must assume if you Some/Drink/do Drugs/....
None as far as I know.

[Ocelot]

Ring! Ring!

Me: Hello Ocelot speaking
Phone: Hello is that Ocelot.
Me: Yes, who's calling please?
Phone: I just need to ask a few questions for security.
Me: Excuse me?
Phone: What is your inside leg measurement.
Me: I'm sorry but who is this?
Phone: It's the Fire Brigade sir. Your inside leg measurement?
Me: £6:50 per lb but what's that got to do with the price of fish?
Fire Brigade: Very good sir you can't be too careful.
Me: Look what's all this about?
Fire Brigade: We're going to need your house.
Me: My house?
Fire Brigade: Yes sir. We're going to need your house.
Me: I'm sorry I don't understand.
Fire Brigade: We need to take possession of your house and sell it to pay our costs.
Me: Your costs? What costs? Is this some sort of joke?
Fire Brigade: We don't joke about such things sir. We need you to vacate the property by the end of the month so we can put it up for auction.
Me: But I don't owe you any money.
Fire Brigade: On the contrary sir you owe us the sum of one hundred and fifty two thousand and seventy two pounds and eighty nine pence. That's with the thirty pound reduction for immediate payment.
Me: That's ridiculous. Why on earth should I owe you that amount of money?
Fire Brigade: Putting out fires doesn’t come cheap you know. Why on our last call to your street, we utilised, let me see now. Seventeen highly trained professional fire fighters, top of the range breathing apparatus, protective clothing and headgear and 830 imperial gallons of 30C arnica. Not to mention malpractice insurance.
Me: I think I remember that, it was last month, my neighbour had a chip pan fire, I was out.
Fire Brigade: Well sir in your absence we put out that fire which, with the prevailing wind conditions, would most definitely, in the expert opinions of our accountants, have spread to your house. Now city statute allows us to recoup a proportion of our costs not to exceed 78.2% of the national debt from neighbouring properties deemed to have benefited from our actions.
Me: Well I'm very grateful of course but isn't that why I pay insurance.
Fire Brigade: Cancelled.
Me: I don't think so, their direct debit went out last week.
Fire Brigade: sorry sir my information is that your policy has been retroactively cancelled due to.. erm let me see here... ah yes "IPM" or as the wags in the station call it "insufficient profit margins."
Me: I thought you didn't joke about such things.
Fire Brigade: I don't sir.
Me: Well what does IPM really stand for?
Fire Brigade: Incorrect Policy Mandate
Me: What?
Fire Brigade: Incorrect Policy Mandate, it means that when you filled in the forms you made some sort of mistake.
Me: What mistake?
Fire Brigade I'm sorry you'll have to take that up with your former insurer.
Me: Well listen I look after my property, change the batteries in my smoke alarm every year and I always keep up to date on my fire insurance so I'm just going to give my insurance company a call and get them to straighten all this out.
Fire Brigade: Very good sir, hope that works out for you. Otherwise our agents will be round at the end of the month.

Ocelot: Dials number
Automated Voice System: Thank you for calling Mutual Exclusions. If you are calling to give us money please dial one to speak to an operator. If you are calling to make a claim, please dial the cube root of 8, if you are calling about an existing claim please dial the square root of 9, if you are calling with a complaint please re-dial our complaints line on *squee* *squee* *squee* 687. If you are dialling to report an emergency please call 999 and make sure you have your policy number handy.

<time passes>

Ocelot: ...and they put me through to you so please please don't transfer me.
Mutual Exclusions: Well sir, I've brought up your details on our database of former customers and I can see the problem.
Ocelot: And can you sort it out.
Mutual Exclusions: It appears that when you filled in your application you said you were living with your mother...
Ocelot: Well yes I was.
Mutual Exclusions: ...and according to our check on the Electoral Register she is no longer living at that address...
Ocelot: Yes sadly she passed away last year, it was very sudden.
Mutual Exclusions: ...and so that means that we can retroactively cancel your policy without paying either of the claims we'd prevaricated over for the past 7 months.
Ocelot: You mean procrastinate.
Mutual Exclusions: I know what I mean sir.
Ocelot: Well how come you’re still taking my money then.
Mutual Exclusions: You haven’t cancelled the Direct Debit
Ocelot: But if you’re taking the subscription surely you’re obligated to provide the service.
Mutual Exclusions: I’m sorry sir but we’re allowed to accept the money on a policy that’s been invalidated by the holder, it can’t be down to us to check each policy is correct every month.
Ocelot: Well why don't I simply update your records, there's no need to cancel the policy.
Mutual Exclusions: I'm sorry sir with two calls in the space of seven months our company has no interest in insuring anybody in your street.
Ocelot: Or paying out on legitimate claims it seems.
Mutual Exclusions: That's a very serious charge sir.
Ocelot: Well it's a very serious business I could lose my house.
Mutual Exclusions. Indeed sir but that's not our problem any more sir.
Ocelot: But I haven't done anything wrong.
Mutual Exclusions: Well sir you should have informed us of you mother's passing. You were paying the rate for somebody who had a relative home all day to raise the alarm.
Ocelot: Well I don't mind making up the back pay.
Mutual Exclusions: I'm sorry sir that won't be possible.
Ocelot: Why not?
Mutual Exclusions: It's not a higher rate. Our assessment is that the elderly and infirm are more likely to start a fire than save the day. Frankly they're a liability.
Ocelot: My mother wasn't infirm
Mutual Exclusions: Well how come she's dead then?
Ocelot: Hey that's my mother you're talking about.
Mutual Exclusions: I'm sorry sir if you can't remain calm I shall have to terminate this call.
Ocelot: What do you mean calm I haven't raised my voice or swore.
Mutual Exclusions: If you carry on in this manner I will terminate this call.
Ocelot: You're being ridiculous, what's your name I'm going to write a complaint.
Mutual Exclusions: There's no need to the get personal. *click*

[Francesca R]

3.) What is the maximum amount that will be covered for a single person in a lifetime. What happens if care exceeds that amount?There's a maximum amount no one should ever have to exceed each year, ranging from €450 to €1 800 (based on income). All extra costs should be completely refunded. Children never have to pay more than €650, regardless of their parent's income.This Q&A is actually quite typical of conversations between those in the US and Europe.

The Q seems to be along the lines of "Surely if the medical costs are high enough then the state-administered cover will run out and the patient will have to pay everything additional personally (or will have to countenance doing without)?"

The A is actually the answer to a different question such as: "What is the max that the patient will have to pay themselves before the state pays everything additional?".

The mismatch between what was asked and what was answered is IMO reflective of the different general mindset.

In a universal health system the role of payer of last resort is the state, in private insurance it is the patient. This contrast applies to insurance-based UHS such as in Belgium every bit as much as single-payer arrangements like the UK. In Belgium citizens have a maximum billing amount, not a maximum level of cover. (There are predefined entitements in the charter of the health system)

I thought that vignette was instructive anyway.

[Ocelot]

Strangely enough this is actually how insurance companies first started up - with fire insurance from fire brigades. The fire truck would only put out a fire if it saw their badge (http://en.wikipedia.org/wiki/Fire_insurance_marks) or fire mark on the wall of the burning building or a nearby property.

[Gord_in_Toronto]

Guns do save lives. i think most often that of Soldiers and Police officers.

Sure often it comes with also killing someone, but also saving someone.

You will note that I said "approximately". :D

[DC]

You will note that I said "approximately". :D

aah now you pointed it out, sure i noted that :D

[Darth Rotor]

When you get right down to it, you have the wrong handle on unions. Or maybe just the wrong choice of union leaders.

I'm a card-carrying union member, but I'm certainly neither a socialist nor a communist.

No, I don't have the wrong handle on unions, at all. I am aware of what their political origins are, in the industrial age, and how that has played out politically in the US. ;)

See, for example, the PATCO strike, and any time in the last twenty years French transport worker strikes. Unions are as at risk for political manipulation and collective stupidity as any other body of persons involved in politics. (They also perform a craft/job/collective bargaining only role, at which they tend to be pretty good.)

That said, I was also having a little fun.

[Dr Adequate]

This is a another thread about UHC?

I can't even be bothered any more. The people who oppose it are so clearly, obviously, blatantly wrong that in order to be that wrong they must also too stupid to be worth my time debating with. It's like trying to talk someone out of sawing their own head off --- if they were dumb enough to think that that was a good idea in the first place, then they're almost certainly not smart enough to understand my arguments as to why this might be a bad move.

[Rolfe]

Well, to be fair, it was actually a thread to allow BeAChooser to substantiate a claim he'd made in a different thread, that citizens of Europe and Canada have to give up significant personal liberties and "almost essentials" to get universal healthcare.

He refused in that thread to say what these liberties and almost-essentials are. Nobody could guess. So this thread was started to see if we could figure out what he was talking about.

Nobody could. That's about it, really.

Rolfe.

[ddt]

As discussion has mainly been focused with the British NHS as example of UHC, it's maybe interesting to describe the Dutch approach (http://en.wikipedia.org/wiki/Health_care_in_the_Netherlands) as an example of a non-single payer system. I'm also reminded of Francesca's remarks on how difficult it is to change an existing system, so I'll also provide a bit of history.

Since 1941, the Netherlands had basically the same system as Germany still has. Low-wage employees (in 2005: under EUR 30,000) were insured by a public system; they had to register with a local/regional non-profit insurer who'd insure them. The conditions of the insurance were set by the government. Premiums were a percentage of your gross income and were deducted by your employer, and your whole family was covered.

People who earned more, or were self-employed, or earned nothing, had to buy private insurance, which was offered by the same insurance companies that sell car insurance, fire insurance etc. Those premiums were per person, and age dependent; and of course, you could choose wider or smaller coverage. Many employers would negotiate a better deal with a private insurer for their (higher-wage) employees.

Some people weren't even insured, e.g., my grandfather, which cost him quite some money when he ended up in hospital with a broken hip.

As long as I know, from the 1970s on, there has been discussion of reform of the health care system. However, all plans that were drawn up somehow failed on political strife. In the 1980s, government instituted a commission headed by a former Philips Electronics CEO, which drew up a plan for a real UHC, which was subsequently shelved by the centre-right coalition. In the 1990s, a Labour Health Minister drew up a UHC plan, and it failed because it was too socialistic in the eyes of their centrist coalition partner.

In the meantime, the public system became harder to finance, so several adjustments were made; e.g., spouses who earned themselves were excluded from coverage; on the other hand, pensioners with modest pension plans were included, but that had to be financed somehow, so privately insured people had to pay a tax on their health insurance to finance the public system. In my own case, that meant that on top of EUR 300/year for my (very cheap) private insurance, I had to pay EUR 500 to fund the public system. :) Finally, the government instituted that publicly insured people should also pay a modest amount (something like EUR 10/month) directly out of their pocket to the insurer. On the other hand, government demanded that all private insurers would at least offer a government-mandated standard policy to their clients, which coincided with the policy of the public insurance. In fact, in the last couple of years of this old system, every year some rules were slightly changed - and in hindsight, in a way to make the transition to the new system as less radical as can be for the people.

In 2006, at last, a truly UHC system was introduced, without difference between a private or a public sector. All insurance companies - for profits and non-profits alike - offer a standard policy. The costs of the insurance are paid roughly half directly by the clients - ballpark cost is EUR 1000/year per adult. The other half is paid through a premium on income (capped at the same EUR 30,000), and divided among the insurance companies through a risk equalization pool, so that insurance companies don't have an incentive to shun high-risk clients. There's a mandatory deductible on the standard policy, between 150 and 650 EUR/year. GP visits don't count for the deductible.

An insurer may offer the policy in two variants: a cost-reimbursement model, where they reimburse all costs; and a service-reimbursement model. With the latter model, the insurer reimburses the costs for doctors/hospitals they have a price agreement with; with another doctor, you then run the risk of paying the difference. However, in practice this doesn't give problems as the costs won't differ by much and most insurers are the former regional public insurers and so they have price agreements with all doctors in their region. Many (smaller) private insurance companies decided with the introduction of the new system to get out of the health insurance business and have sold their portfolio to others.

Above and beyond the standard policy, insurers are free to offer addition insurance. In fact, most offer a bit more in their standard policy, but those items are more marketing gimmicks than real extra benefits. But if you want extra fysiotherapy sessions, homeopathy, a nicer bed in the hospital, etc., you're free to buy extra insurance. Dental care for 18+ is also an extra, and every insurer offers various dental packages.

Every January 1st, a client is free to switch insurer, and the insurer is obliged to accept the client without existing preconditions. And everyone is obliged to take insurance.

As a patient, I never see an invoice; at most an invoice from my insurer to charge for the deductible, but I can walk into a doctor's office without having to worry about money. Likewise, the doctor can simply invoice (electronically) with the insurer and receive his money without much ado.

In fact, the whole system has been set up as a market-driven system - after all, it was designed by a centre-right government. Government sets the parameters - the coverage of the standard policy, complaint commissions and such - and within those parameters, insurance companies and health care providers have to agree on their prices. Doctors - GPs and specialists alike - have always been self-employed, and that is not going to change.

The system has put the insurance companies in the driver's seat. That is a bit of a worry of mine, that in the long run financial considerations from their side will dominate the whole system. That hasn't happened (yet); the system is only a couple of years old, most insurers have a non-profit background, and there are of course various government commissions that oversee the various aspects.

Then there's a list of questions joobz asked earlier in this thread:

Here's some additional questions:
1.) In UHC, are you free to select the drug (generic vs. name brand) if you are willing to pay for it? (I think this was covered a bit before, but I was wondering how far it extended)
I don't know - I guess it's no problem if you pay the difference. Moreover, if a drug costs more than the standard drug for a certain condition, but the manufacturer can show it really works better for a certain subgroup (say, people who also have high blood pressure) the commission that admits drugs for reimbursement will admit it for that subgroup.


2.) At what age is care restricted? Is there an age?
Age limit? What's that?


3.) What is the maximum amount that will be covered for a single person in a lifetime. What happens if care exceeds that amount?
No maximum amounts.


4.) Are fertility treatments covered/allowed?
Yes, max. 6 IVF treatments. There was some discussion last year that people should pay for the first themselves, but that proposal was shelved.


5.) What extra costs (if any) do you must assume if you Some/Drink/do Drugs/....
No.

[Toke]

I'm the same way with swords, staffs, spears, and axes. Of course, I don't think there are anti-sword laws in Britain.

Are there? On second thought, I bet there are.
Not really relevant, but you need a permit to own swords in Denmark.
If you want to carry one to a viking fair you need another permit, one that requires membership of approporiate club/accociation.

It has no relation to UHC.

[Eskarina]

No, I don't have the wrong handle on unions, at all. I am aware of what their political origins are, in the industrial age, and how that has played out politically in the US. ;)

See, for example, the PATCO strike, and any time in the last twenty years French transport worker strikes. Unions are as at risk for political manipulation and collective stupidity as any other body of persons involved in politics. (They also perform a craft/job/collective bargaining only role, at which they tend to be pretty good.)

That said, I was also having a little fun.

Somewhere in my post I forgot the appropriate smilie (which is unusual, as I'm way too fond of them).

I never thought that unions are immune from stupidity, greed or corruption and didn't try to claim that in my post. But they do offer good support in critical situations (and other amenities). And cost a bit.

Hey, it's just like UHC.

And my SO! :aaa!

[Architect]

I'm just throwing this back in to the mix because, as far as I can see, no-one ever came up with a compelling case that those of us with UHC had someone given up some fundamental freedoms.

[Agatha]

Nor any almost-essentials.

[Travis]

You know, I think this whole thing boils down to the fact that many in the US see health care as a privilege that is earned whereas most of the rest of the world looks at it as a right. You can see this in the fact that Americans will brag about how their job provides them with a Health Care Plan, they see that as a sign that they have "made it." So, to them, giving everyone that same standard of health care is like giving all those poor people the same Mercedes Benz Sedan they spent $70,000 on. In other words they worry about what they will use, once everyone has it, to differentiate themselves from the "losers."

[Fiona]

Better smelling soap :)

[Rolfe]

I know this is irrelevant, but it was funny.

Last night, on Top Gear, the presenters had some interaction with the invited audience, with a bit of banter. One of the audience members identified hersalf as an American.

Jeremy Clarkson came right back with, "Welcome to the free world. You'll enjoy it here!"

Rolfe.

[Gord_in_Toronto]

I know this is irrelevant, but it was funny.

Last night, on Top Gear, the presenters had some interaction with the invited audience, with a bit of banter. One of the audience members identified hersalf as an American.

Jeremy Clarkson came right back with, "Welcome to the free world. You'll enjoy it here!"

Rolfe.

Neither irrelevant or off topic.

How about: Democracy by Leonard Cohen?
http://www.metrolyrics.com/democracy-lyrics-leonard-cohen.html
Democracy is coming to the U.S.A. · It's coming through a crack in the wall; ... It's coming to America first, · the cradle of the best and of the worst. ...

[joobz]

Bumped for BAC's Sake. Perhaps he'd like to shed some light as to what liberties I'm taking for granted. Afterall, I'd love to know what I would have to give up to have the superior healthcare system that UK and similar nations have.

[Delscottio]

Can I just say I am allowed to play poker online? Albeit very very poorly ;)

http://forums.randi.org/showthread.php?t=152314 I am surprised this lack of freedom is accepted, strange law.

[Ocelot]

Anu UK 18 year olds want to point out that they can buy a pint in a pub too?

Oooh and of course I could mention that when I travelled to Boston I wasn't legally allowed to sleep with the twenty year old girl I was seeing at the time.

I can smoke cuban cigars and even more potent materials without fear of a brutal US prison system which has incarcerated one in every 142 citizens, over three thousand of which are awaiting the fate of 33 prisoners a year - state sanctioned execution.

[Slayhamlet]

Oooh and of course I could mention that when I travelled to Boston I wasn't legally allowed to sleep with the twenty year old girl I was seeing at the time.

What in the world are you talking about? Were you underage?

Could you please cite the law? Thanks.

[Magyar]

This has been the most popular form of health insurance in the USA for over a decade. "Popular" insofar as most medium to large employers are buying into it.


I BEG to differ! these kinds of policies are only available to large employer/employee pools.
I don't know where you work ], but the only people I know who have similar coverage in my family of 40 +/- people (brothers sisters, and their kids of working age all older than 30, working full time - is 2 people who work for Verizon)



As to coverage after job loss, there's a law in the USA, referred to as COBRA which gives most employees the right to continue their coverage after employment ceases, albeit at very likely higher premiums[ because the insurance carriers are not required to give you, as an individual, the same rates they gave you, as an employee of Great Big Amalgamated Corporation which signed up 40,000 insured.

ETA: Just providing info. I'm a supporter of a National Healthcare policy.


Bolded mine - YEA I'll SAY. we are actually going through this right now. I am self employed. My wife carried insurance with her job for years and we averaged about $350 per month for coverage for family of 4 ( no dental or vision) and $30 per office visit for doctors $40 for specialist and $100 for emergency. She recently lost her job and Cobra
went to $1200 per month for the same policy - we are taking it because it is cheaper than the option insurance we are forced to buy living in MA. NOTE as part of the stimulus package we will get a re reimbursement (maybe in a month or 2 of 50% of that) BUT COBRA is only valid for 1 year and then it can be canceled and you have to go shop on your own if she or I don't find a job that will offer insurance.

[Magyar]

Sorry, I asked the wrong questions and seem to have appeared even more clueless than usual. :)

What I really want to know is: how high are the premiums, are there any deductibles, would someone working for the local hairdresser or the carshop have access to the same insurances [sic?] as someone working for Great Big Amalgamated Corporation, would someone with a precondition be allowed into it?

WRT to COBRA, I heard about it. The way I understand it is that the unemployed still has to pay the premiums, whereas in Germany the premium is usually covered by the state.

Here is a link to MA mandatory health insurance link. This is IF you make less than $66,000
which is the max to qualify
https://www.mahealthconnector.org/portal/site/connector/template.PAGE/menuitem.99762c230fb3e650dbef6f47d7468a0c/?javax.portlet.tpst=1dd8f1b14739404575c4c2100ce080 41&javax.portlet.prp_1dd8f1b14739404575c4c2100ce08041 _viewID=MY_PORTAL_VIEW&javax.portlet.prp_1dd8f1b14739404575c4c2100ce08041 _connector_currentstep=connector-step4&javax.portlet.begCacheTok=com.vignette.cachetoken&javax.portlet.endCacheTok=com.vignette.cachetoken

I don't know if the link will work so I cut and past as well (mods hope this is not a violation)
NOTE - that these are the CHEAPEST plans with the highest deductable and lowest coverage for a family of 4 - which is the average in the US.
.

So to answer your question NO it is not really accessable for the average family of 4 withthe median income in the us of $36,000




Fallon Community Health Plan
FCHP Direct Care
$792.00 $2,000/$4,000 $25 $15 / $50 / $100 $200 $500 per admission after deductible n
Harvard Pilgrim Health Care
Harvard Pilgrim Core Coverage 1750
$802.35 $1,750/$3,500 $25 copay up to 3 medical care office visits per individual (or 6 per family); next visits are subject to the deductible; then 20% co-insurance thereafter $15 / 50% co-insurance after Rx deductible / 50% co-insurance after Rx deductible $250 20% co-insurance after deductible Find Doctor View Plan
Tufts Health Plan
Advantage HMO Select 2000 (Limited choice of doctors & hospitals)
$808.90 $2,000/$4,000 $40 $20 after Rx deductible / $50 after Rx deductible / $75 after Rx deductible $200 $0 after deductible Find Doctor View Plan
Neighborhood Health Plan
NHPThree Select
$883.16 $2,000/$4,000 $25 $15 after Rx deductible / 50% co-insurance after Rx deductible / 50% co-insurance after Rx deductible $100 after deductible 20% co-insurance after deductible Find Doctor View Plan
Fallon Community Health Plan
FCHP Select Care
$908.00 $2,000/$4,000 $25 $15 / $50 / $100 $200 $500 per admission after deductible Find Doctor View Plan
Blue Cross Blue Shield of Massachusetts
HMO Blue Basic Value
$1,131.05 $250 per plan year/$500 per plan year $25 $15 / 50% co-insurance after Rx deductible / 50% co-insurance after Rx deductible $200 35% co-insurance after deductible



As for COBRA - yes you still ahve to pay the premium even if your unemployed AND not only that but you have to pay the employers share as well so your health care cost when you have a job is $350 per month (my family) but when my wife lost her job (we had insurance through her because I am self employed) COBRA went to $1243 per month.

Obama stimulus plan is supposed to to reimburse up to %55 of that at some point or another - still waiting.

[Ocelot]

What in the world are you talking about? Were you underage?

Could you please cite the law? Thanks.

Apparently I was mislead. Appologies for my gulliability.

[Rolfe]

However, I was a bit puzzled while watching the episode of Buffy where she has her 17th birthday, and sleeps with Angel. I didn't see the significance.

The age of consent is 16 here. So the principle is correct, even if the details were wrong.

Rolfe.

[jimbob]

I realise you're just trying to articulate the argument, but it makes very little sense.
--lots of words--
Rolfe.
I appreciate your interest in American affairs.
This is not beyond you, however low your self-esteem is at the moment!
No problem with that here, maybe you don't understand what a clusterf*** is. (But I think you do ;) )


I have seen this argument before:

I don't know if you are aware that the UK governments have been pretty
good at cock-ups:

Ministers didn't realise that they would have to charge VAT (equivalent to GST) on their flagshipolympic stadium project: (http://www.buzzle.com/articles/115223.html)
Olympics 2012: Vat Bill Could Add £250m to Cost
It has emerged that VAT was not included in the budget for the construction and infrastructure needed to deliver London's games.
Fresh controversy erupted over the spiralling budget for the London 2012 Olympics yesterday after it was revealed that the games could face a VAT bill of more than £250m.

Tessa Jowell, the culture secretary, admitted in the Commons that London's initial budget to stage the games did not include the 17.5% cost of VAT on the construction of the venues and infrastructure. The Treasury has indicated that its hands are tied by European law and that the Olympic Delivery Authority (ODA) will have to foot the additional tax bill.

Hugh Robertson, the shadow sports spokesman, said he had been given a personal "cast iron assurance" about six months ago by Ms Jowell in a corridor of the House of Commons that VAT would be waived on building the Olympic facilities. But yesterday she said the VAT issue was one of a number of subjects still to be agreed as part of a new public sector funding package for the games.


The UK Rail system is another example: I can't find the figures *now*, but it was privatised, and the level of governent payments went up.

If it isn't a derail, what other stonking examples of governmental incompetence (of any hue) do the other UK posters particularly like?

despite this, the NHS still works, at a lot lower cost than the US system, I'll quote my sig now for when it changes:

OECD healthcare statistics

http://www.oecd.org/document/16/0,3343,en_2649_34631_2085200_1_1_1_1,00.html
2007 Data (latest available)
UK 8.4% of GDP of which 81.7% is state expenditure = 6.86% of GDP from taxes
US 16% of GDP of which 45.4% is state expenditure = 7.264% of GDP from taxes

[Rolfe]

What about the ridiculous amount of money that was wasted on an IT system for the NHS that didn't work. At all. Ever?

Given that the NHS is a byword for inefficiency and bloated over-management, I'm just astounded that the USA is doing it so much worse. In fact, when you look at what we're getting for our money compared to a lot of other countries, you have to consider that a lot of the criticisms of the inefficiency of the NHS may be over-stated.

Rolfe.

[Toke]

I was told when working in Maersk Line, that we were the most efficient container line in the world. (it might well be true)

We just looked at each other, "The others must be realllly bad."

[jimbob]

Yes Rolfe, the NHS IT fiasco is very pertinent.

There are lots of inefficiencies in any large organisation but these non-systematic inefficiencies do not approach a near-30% overhead that is needed for non-clinical spending in the current US system.

And again, showing that private corporations can also fail the piss-up in a brewery test:


From today's news
http://news.bbc.co.uk/1/hi/england/8240232.stm

Thousands of rail passengers are set to face disruption after a train firm cancelled all but one of its Sunday routes because of a lack of drivers.

London Midland relies on drivers volunteering to staff trains on Sundays but said not enough had offered to work this week so services could not run

The radio said that London Midland drivers were not contracted to work on Sunday, and that the company reduced the overtime payments for working on a Sunday, so it wasn't entirely surprising that once this happened, the drivers stopped applying to work on Sundays...

[Darat]

I was told when working in Maersk Line, that we were the most efficient container line in the world. (it might well be true)

We just looked at each other, "The others must be realllly bad."

That's a common perception - for some reason people always seem to to think that other companies aren't just as bad as their own, or that for some reason other companies don't have their fair share of idiots!

[jimbob]

Indeed Darat, I'd say it is a rule for any large organisation.

[Toke]

That's a common perception - for some reason people always seem to to think that other companies aren't just as bad as their own, or that for some reason other companies don't have their fair share of idiots!

It may be because ones own idiots are visible, and ones general faith in humanity makes one unwilling to belive there are more of them. :D

Cold realities does show that there are other companies a lot less efficient than both Maersk and my current one.