National Healthcare services

[Hondo]

Questions to those with National Healthcare.

By using the national services, do you also relieve the taxpayers from liability stemming from malpractice or incompetence?

Is there a set fee schedule that the taxpayers use to reimburse doctors, hospitals, etc.?

Are the healthcare workers the taxpayer's employees or private sector contractors, reimbursed by the taxpayers?

Are the incomes of healthcare workers fixed?

[Camelopard]

Questions to those with National Healthcare.

By using the national services, do you also relieve the taxpayers from liability stemming from malpractice or incompetence?

Is there a set fee schedule that the taxpayers use to reimburse doctors, hospitals, etc.?

Are the healthcare workers the taxpayer's employees or private sector contractors, reimbursed by the taxpayers?

Are the incomes of healthcare workers fixed?

They are very difficult questions to answer as it is very complicated here in Australia.

We have Public and Private health care. Public is paid for by a levy on your taxable income (1.5%), Private if you want it is paid separately and can cover just hospital or extras like dental, physio etc.

It is complicated, most 'elective surgery' comes from Private Insurance, however no matter how sick you are, you will get treated. Non life threatening things will get done by Public, but you will have to wait.

For example, I had an ankle reconstruction at a private hospital, some of it was paid for by my private health insurance, some by Medicare (public) and the difference by me. If I had this operation at a public hospital I would have been put on a waiting list and I would have had no say in who the doctor was, nor more importantly in my opinion who the anesthetist was. It probably would not have cost me anything, though I can't say that for certain.

I can claim 20% back of the 'difference' in my tax return when the total amount reaches $1500 for all out of pocket expenses, prescriptions, dental and so on.

Some rebates aren't covered by medicare if you go private, things like boob jobs, unless it is following a masectomy etc.

Then there are things like Dental, Physio, Chiropractic etc, mostly they are covered by Private health Insurance but only up to a certain limit.

Another example, 12 months ago I cut my finger and when to Emergency, waited 15 minutes (lucky) had 6 stiches put in the end of my finger and it didn't cost me anything.

A couple of weeks ago I cut my thumb (yes I should stay away from sharp things), I went to my local GP, I waited 45 minutes had one stitch inserted and it cost me $175 of which I got a Medicare rebate of about $100.

Poor people, pensioners, single parents for the most part don't pay a fee when they go to the doctor, the doctor charges Medicae directly, ie he 'bulk bills'.

Incomes of healthcare workers fixed? Mostly nurses are employed under an award which can vary from state to state, it seems to me that most public hospital doctors are on contracts which they probably negotiate themselves.

Who employs them? Some are employed by State health departments, some by private for profit companies and some by private not for profit companies.

Aged care is a real mixture here as well and I won't even try to cover that!

Then there are drugs! Some drugs are available a greatly reduced rate on the PBS. However not all drugs are, so if you are unfortunate to need something that is very new and very expensive, you will probably be paying for it up to the $1500 limit when you will get some back as a tax rebate. pensioners and health card holders also get a much reduced rate, they pay about $5 per prescription where as I pay $32 per script, but if I had to pay full price it would be hundreds a month!

Might I ad that overseas trip to places like Thailand are booming for elective type surgery, mostly cosmetic I think, much cheaper, even when you include flights and hotels.

Any others want to correct me or ad more input?

Confused? Good, my work here is done. :)

[Hondo]

I appreciate your answer. Would that system be the same throughout the Commonwealth?

[Camelopard]

I appreciate your answer. Would that system be the same throughout the Commonwealth?

Off the top of my head I would say no. I must admit I don't even know what it is like in New Zealand!

I think Canada varies from provence to provence, but again don't quote me!

[Firstgear]

In Canada, healthcare is funded nationally, but administered provenially, so things do vary from provence to provence.
Where I am, we've had a left leaning provincial government for a number of years, so private clinics are not allowed for things that are covered provinially.
Dental, vision, physio, chiro etc. are not covered, but many places of employment have some type of coverage for these types of things.
Like most government programs here, the healthcare system is expensive and inefficient, although the care is good when/if you can get it.
I've been waiting over a year (almost 2) to have a speciallist look at my back. Some people can't get to see a family practitioner because they're not accepting new patients. When my father (in his 70's) had an emergency operation a couple of years ago, he had to spend a couple of night of recovery in the hallway because there were no rooms available in the hospital.
It's for reasons such as these, that many people here cross the border to the USA for more urgent things. It's become so common that there are clinics springing up in little towns just across the border for things that have a backlog here. One of your polititions even made a joke about it during your recent presidential election, something to the effect of "If we had national health coverage, where would the Canadians go for their health care?."
I don't really know too much about how healthcare workers are paid (eventhough my sister is a nurse). I believe staff working in the hospitals would be provincial employees. Family doctors have their own private practices (just like dental & optics here) and are (I believe) paid a set amount per appointment. It's probably more complex/convaluted than that, but that's how I understand it to be.

[steve_spackman]

Off the top of my head I would say no. I must admit I don't even know what it is like in New Zealand!

I think Canada varies from provence to provence, but again don't quote me!

As with the NHS in the UK.. its a great service, but it has over the years become hard for the NHS to cope with all the immigrants who flock to the UK, which puts a burden on the service and as with any service can and does waste money in certain areas. all in all i have never had any issues with the NHS, no matter it be a doctor or a dentist.

My grandmother has lung cancer..she was seen and treated in no time at all...and it didnt cost her a penny.

atleast on the NHS you cant go bankrupt.

[Hondo]

So far, it seems to be useful for the very minor ailments and walk-in emergencies and the major, life and bankrupt threatening things, with the stuff in between kind of a gray area. I wonder who we will pattern ours after.

Thanks for the link Steve.

[steve_spackman]

So far, it seems to be useful for the very minor ailments and walk-in emergencies and the major, life and bankrupt threatening things, with the stuff in between kind of a gray area. I wonder who we will pattern ours after.

the french

[Hondo]

the french

What do they do, have a glass of wine and die?

[steve_spackman]

What do they do, have a glass of wine and die?

FUNNY

The NHS is the single greatest thing about the United Kingdom.

Yes, it does have examples of poor management, but it has saved my mothers life, cured my father of a debilatating disease and so on....

If it does waste some money, big deal.....it's a price well worth paying.

As with the NHS in the UK.. its a great service, but it has over the years become hard for the NHS to cope with all the immigrants who flock to the UK

Oswald, is that you?

There are many much more valid reasons why the NHS has struggled. The shameful way it was treated by the last Conservative administration being high amongst them.

[Hondo]

I would think immigrants would be a separate problem. I'm guessing that if one immigrated to Britain they would have to prove they had a job or funding until they could get a job and therefore would also be paying taxes for public programs. Now if you had a huge illegal immigrant problem I could see the burden becoming unmanageable. Maybe cut back on the immigration allowed.

[steve_spackman]

There are many much more valid reasons why the NHS has struggled. The shameful way it was treated by the last Conservative administration being high amongst them.

yes i know i was just throwing out a example...

[steve_spackman]

I would think immigrants would be a separate problem. I'm guessing that if one immigrated to Britain they would have to prove they had a job or funding until they could get a job and therefore would also be paying taxes for public programs. Now if you had a huge illegal immigrant problem I could see the burden becoming unmanageable. Maybe cut back on the immigration allowed.

i would agree and this 'problem' is being dealt with...about bloody time

[BDunnell]

What do they do, have a glass of wine and die?

What utter rubbish. You've forgotten that they go on strike in between.

[BDunnell]

Oswald, is that you?

There are many much more valid reasons why the NHS has struggled. The shameful way it was treated by the last Conservative administration being high amongst them.

I couldn't agree more.

[Camelopard]

A few more things, the health system here is state based with funding from the federal government, (states do not levy taxes on individuals since the introduction of the GST (afaik)).

I'm presuming that Doctors, whether in public of private practice would have their own malpractice insurance. Nurses, I don't know, I'll have to ask my wife! Can she be sued if she makes a mistake? I really don't know.

There is a scheduled fee that Doctors use, in reality they can charge what they want, but you still get the same schedule fee back from Medicare.

Nurses tend be employed under the same Award regardless of whether they are employed publicly or privately, however this award and conditions may vary from state to state, for example my wife gets paid less in the ACT than does a nurse working at a hospital in the nearby NSW town of Queanbeyan (only a few kms away) as NSW nurses have better award conditions.

The previous government introduced Australian Workplace Agreements which meant that individuals negotiated their own conditions of employment rather than a fixed payscale. This was one major reason why they lost the last election, but that's a whole new discussion! I should say it was meant to be illegal to force someone onto an AWA, but it did happen.

A good site to go and visit is: http://www.medicareaustralia.gov.au/

There is a lot of info there including stuff about 'The Safety Net'.

I also forgot to mention that we get a tax rebate of 30% on our private health insurance to encourage people to keep their private cover. People were leaving the private funds as rates went up and overloading the public system, allegedly.
http://www.medicareaustralia.gov.au/public/claims/private-health.jsp

See, told you it was confusing!

[Jag_Warrior]

Now if you had a huge illegal immigrant problem I could see the burden becoming unmanageable. Maybe cut back on the immigration allowed.

And then make sure you're prepared to enforce it. Otherwise...

http://county-map.digital-topo-maps.com/california-county-map.gif

[Hondo]

I'm still considering the merits of the whole healthcare thing. Like has been stated in another thread, the cost of health care has been allowed to become ridiculous. I often say if it wasn't for health insurance, you wouldn't need health insurance. Take away insurance and people will quit running to doctors, especially for minor stuff. Like any other business, when the traffic and income goes down, you lower your prices to attract business. I admit thats an oversimplification of the situation, but you get the general drift.

[GridGirl]

But when healthcare is free just as many people run to the doctors with minor ailments I mean why not when its free. My step dad's family seem more than intent on getting their money's worth. There's not a week that goes by when atleast one of them doesnt have a trip to the doctors or hospital. :s

Last time I went to the doctors they were shocked because I had no history despite me being registered with them for over 20 years. They swapped to a computer based system about 10 years ago and peoples medical mistory got up dated when they came in for a visit. As I hadn't been I ended spending most of my visit telling them about my family's medical history. It might come in useful when I visit in another 10 years or so.

[rah]

I'm still considering the merits of the whole healthcare thing. Like has been stated in another thread, the cost of health care has been allowed to become ridiculous. I often say if it wasn't for health insurance, you wouldn't need health insurance. Take away insurance and people will quit running to doctors, especially for minor stuff. Like any other business, when the traffic and income goes down, you lower your prices to attract business. I admit thats an oversimplification of the situation, but you get the general drift.

I think you need to have a balance. You need the option of going private with the backup of a national health service.

But what is minor stuff? Sometimes something minor can turn into something major. Sometimes a GP can see that something is wrong that others can't see.

I have just had a lot of tests done, some at the Govt expense and some at my expense. Most of them showed nothing seriously wrong with me, but they still needed to be done to eliminate what it could be.

[Rollo]

I wonder who we will pattern ours after.


What makes you think that you'll even get an NHS style arrangement?

The total health care expenditures across the world were $4.5 trillion in 2007. Of which, US solely account for $2.2 trillion, $2 trillion in OECD countries and remaining $0.3 trillion in other countries of the world.

$2.2 trillion equals a lot of power for whoever is in control of it. Do you honestly think that Private Institutions are going to hand over any of that power to government? Or worse, lose the right to gain profits and thus massive investment potential? What of the shareholders of these companies?

The Medical Corporations will be in the ears of politicians through the lobby system, to ensure that if anything is proposed it will be eliminated quickly. Or if possible to publicise the costs and privatise the profits through PPP or BOOT schemes.

I think in all honesty, that precisely nothing will done at all.

[ShiftingGears]

Oswald, is that you?

:laugh:

[leopard]

As long as we can make sure that premium paid to the insurance will not burden us, it would be wise to consider about being the insuree, Health insurances offer wide coverage of protection. How do their professionalism handle claim from policy holder is made in immediate effect should be worthily considered for a better tomorrow.

To those neither have health problem nor need insurance for the monthly premium would mean nothing without claim paid for them, advisably to start living healthy, avoid smoking, practicing healthy meal planning, last but not least keep praying to God. :)

[gadjo_dilo]

It's useless to speak about the public healthcare in my country because despite its official organization you can't present yourself to a doctor or nurse ( sometimes even to the hospital doorman ) without an "attention " that may vary (depending on service ) from a package of coffee to a few hundred euros. Some of them are asking directly for the bribe ( "I can do this surgery but you have to pay....."), some don't pretend but expect ( "oh, you shouldn't... " but quickly grab the money ). It's like an unwitten law. You can't risk your skin for some money even if the service is for free. Of course it's the excuse of their very low salaries but at the same time most of us have low incomes. There's nothing wrong to accept "thanks" from someone who was content with your services and give you something with all his heart but it's a mistake to pretend from the poor.

[steve_spackman]

I'm still considering the merits of the whole healthcare thing. Like has been stated in another thread, the cost of health care has been allowed to become ridiculous. I often say if it wasn't for health insurance, you wouldn't need health insurance. Take away insurance and people will quit running to doctors, especially for minor stuff. Like any other business, when the traffic and income goes down, you lower your prices to attract business. I admit thats an oversimplification of the situation, but you get the general drift.

Since they socialised the losses of the financial industry, it doesn't seem as though there should be any problem with socialising health care. Oh wait, someone's making huge profits from denying people health care or payments for health care---that would be HMOs, health insurers & the like. Oh yeah, that's why the US can't have socialised medicine because a small % of the population is making lots of money from it.

[Lousada]

I'm still considering the merits of the whole healthcare thing. Like has been stated in another thread, the cost of health care has been allowed to become ridiculous. I often say if it wasn't for health insurance, you wouldn't need health insurance. Take away insurance and people will quit running to doctors, especially for minor stuff. Like any other business, when the traffic and income goes down, you lower your prices to attract business. I admit thats an oversimplification of the situation, but you get the general drift.

This is a very simplified view. I'm bored so here a little post to show you the different problems that arise with public healthcare.

Healthcare costs rise so hard because the workers (nurses, doctors administration, etc) demand an inflation corrected wage. Of course this is logical and in their full rights. However, productivity has risen only very slightly the last decades. The things a nurse or a doctor does can hardly be made more efficient. So demand goes up and productivity stays the same -> more labour needed -> costs go up further.
Another factor impacting costs is the improving technical advancements. A lot of diseases can now be cured or helped but most diseases are also marginal. It takes a long while before a cure become cost efficient.

This is a slight brush at the cost part or healthcare. Other problems lie in the payment side. Most of these relate to the faults in human behaviour.
If healthcare is absolutely free, people have the tendancy to visit the doctor for everything. This, of course, puts a large strain on the system.
Is healthcare completely at the individuals risk, most people can't afford it anymore. Certainly not the more 'expensive' diseases as cancer or complicated operations. This is something most people don't want.
A third option is forcing individuals to pay the first say 500 euros of healthcare costs in a year before public service kicks in. The downside to this is that a lot of people keep wandering around with beginning illnesses. Most illnesses get exponentially harder and more expensive to treat, the longer you walk around with them.

Then there is the problem with goverment involvement. For a long time the idea over here was that goverment should completely own healthcare. But as studies in all sorts of branches show (telecommunication is a very striking example), completely goverment controlled sectors have no incentive to cost efficiency and are very slow with technical advancements.
So now the idea here has shifted to semi-privatised hospitals that are strongly regulated and receive subsidies. This has improved healthcare services a lot.
Still there are problems with this: how do you assign the correct subsidy? In a hospital, productivity is measured by patients. But if you subsidise based on beds occupied, patients cured or patient turnover or something like that, doctors will start taking excessive care to easy to treat patients and will try to dismiss the more hopeless cases. This is also a topproblem with private practises.

Last and obvious problem is of course the 'sue-culture' that exists not only in the US but also in Europe. It starts already on a small level, people feel a bit ill, look on the internet and then demand that the doctor does something. Two simple examples: too many young, vibrant and healthy people in my neighbourhood get flu shots every year. This is ridiculous as these people will not nearly get mortally ill from the flu and it doesn't protect from killer flu anyway. The other example is something that was in the news some time ago: scientists are alarmed that viruses quickly grow indifferent to anti-biotics because of years of unnecesarry prescriptions. Sometimes it's better to let the disease rage for a while so you yourself become indifferent to them, rather than getting a prescription. People just won't allow that anymore.

Let me not start on insurance companies. They have the power to force improvements in healthcare, but at the same time they have unprecedented power over ill people. They could act as saints or as satan, very dangerous.

Okay this post got a little bigger than anticipated but I'm not going to delete it anymore :crazy: Anyway, the point I was sort of trying to get across is that there are many different problems associated with healthcare. A definite solution can not be achieved. The path that will be taken therefore depends largely on ideological ideas of how you think society should be arranged.
In the US there is more the idea of complete individualism so you have a large private sector. We in Europe are more socialised and therefore think we all should bare something for to help the unlucky few, so we have a large public sector. When people say it's better in the US or better in Europe, for a large part they make an ideological statement and not an economical statement.

I hope I made some sense :crazy:

[Hondo]

You did and as far as baring it for the unlucky few, Americans are good at that. What Americans have problems with is baring it for the irresponsible few, that, as their benefits increase, turn into the irresponsible many, then the irresponsible sh!tload. Unlucky, sure I'll help you. Finance your slovenly and irresponsible lifestyle, nope.

[steve_spackman]

You did and as far as baring it for the unlucky few, Americans are good at that. What Americans have problems with is baring it for the irresponsible few, that, as their benefits increase, turn into the irresponsible many, then the irresponsible sh!tload. Unlucky, sure I'll help you. Finance your slovenly and irresponsible lifestyle, nope.

i thought the US was the land of the free where everyone was considered equal?

[Hondo]

It is. You're free to be worthless and expect a government welfare check and I'm free (or was) to not give it to you.

I'm starting to think you must be about 13 years old.

[steve_spackman]

It is. You're free to be worthless and expect a government welfare check and I'm free (or was) to not give it to you.

I'm starting to think you must be about 13 years old.

;) ...thanks for the compliment

[Easy Drifter]

Just want to correct an assumption that there is such a thing as free healthcare.
There is no such thing. You may not have to pay the doctor or the hospital out of your pocket but the Govt. does.
Where does the Govt. get the money? From the taxpayer. Your money.
The care may be 'free' to those with no income but everybody who does pay taxes pays for them as well as themselves.
Govt. does not make money.
People do.
The Govt. then takes a percentage to manage or mismanage the country.
In Canada, depending on Province, the average person works close to half a year to support various levels of Govt. Tax Free day is late June.

[Mark in Oshawa]

Just want to correct an assumption that there is such a thing as free healthcare.
There is no such thing. You may not have to pay the doctor or the hospital out of your pocket but the Govt. does.
Where does the Govt. get the money? From the taxpayer. Your money.
The care may be 'free' to those with no income but everybody who does pay taxes pays for them as well as themselves.
Govt. does not make money.
People do.
The Govt. then takes a percentage to manage or mismanage the country.
In Canada, depending on Province, the average person works close to half a year to support various levels of Govt. Tax Free day is late June.

The one thing Fiero doesn't want is what Canada has. Private care is pretty much sidelined. If you get sick, you deal with the public system. That is the main drawback we are fighting now. The costs of the public system are a snowball rolling down hill and the public sector unions who live off this system will fight tooth and nail to hang onto it in ways HMO's and private insurers in the US will.

I do believe most US states have some form of public healthcare and it is illegal for a hospital to refuse care in emergencies so at some level, there is a public system. So I guess the question for America is how much do you want the government to pay? Do you want a public alternative of some quality or is it going to be a bare bones operation.

For the reasons Steve stated, there is too much money for the HMO's and Insurance companies to give up without a fight, but I believe a system with private and public options is the best. Beats having no health care....

[leopard]

There is usually different locket usually found in the state owned hospital where government subsidize the expense on. Usually it took long time for the long queue and administrative procedure until we got the service.

Unless the patients came there only to cure their cold, you might need to be aware that your sickness going worse during the time spent for waiting. Perhaps Canada has the same such public healthcare services. ;)