A question for Candadians and UK folks and the Universal Healthcare

[PineappleMama]

Well, checking out http://www.acf.hhs.gov/programs/olab/budget/2011/2011_all.pdf

It says that the Administration for Children and Families, ala President's Budget request, is asking for $58.8 BILLION dollars ... that includes things like Head Start, Violent Crime Reduction... lots of things... also $41.3 BILLION to cover things like TANF, child care funding, energy assistance... and so on.

I think if they reasonable expect those kinds of funds to be available for those things that funds for basic health coverage (again, consider insulin and chemo basic) shouldn't be a problem. As Thai says... where there's a will there's a way.

In calculating the costs of a national health care plan that's available to all we'll also need to consider that programs like Medicaid AND Medicare would no longer be needed, since EVERY citizen would be covered no matter their age or income... so the funds currently going to those programs could be used to help pay for the hypothetical new system. Just saying that it would cost X dollars to cover everyone isn't totally accurate... you'd have to say that it'd cost that X - funds already spent to cover SOME, including all those government employees... and then arrive at the amount they'd need to find to pay for the difference.

Does anyone have those kinds of numbers? I found that one site... but that's just a request, not the actuals, and a LOT of other things are included... like Head Start... which to me should fall into education, not health... since it's preschool classes (for low income or non-English speaking parents only)... is there any place that lists the actual costs specifically of Medicaid ONLY, MediCare ONLY so that we can figure out the real world numbers?

 

[newfoundland]

It is a very healthy thing that people are airing such widely different views and opinions. This is exactly was is needed to kick start a revolution and this is in effect what it is! Uk is of course so much smaller than US. It is quite densely populated with a mainly urban population. It also has quite high levels of immigration. One or two points I think are important. Contribution to NHS is not optional and I would imagine if the system, or a similar one is introduced to US it will also be compulsory. The contributions are on a sliding scale, according to earnings with the first $120 dollars a week (or so) not included. The more you earn of course, the more you pay, but there is a cap and I don't think you would feel it was unreasonably high. If you want to join private health schemes in Uk you can of course do so and some people do. This does not absolve you from paying your NHS contributions. Private health care can then be used to 'top up' your NHS care for example, getting a private room, more of a restaurant style menu, and having consultations at times that fit in with your schedule etc. Everyone would agree that there is absolutely no difference in the care you receive whether you are a private of NHS patient.

Each UK hospital is given an annual budget according to the area it serves, amount of treatments it gives, areas of particular expertise etc. The hospital administrators then work out the budget to cover all of their costs, of course wages are a fixed rate, or a national scale. This means that there are no bills flying back and forth, and nowhere is there any information as to who had what treatment costwise, although of course clinical records are kept. It is up to the administrators to get their maths right otherwise they would be sacked. I have certainly never heard of a case of a hospital running out of money.

Regarding fertility treatment, although not life threatening, I'm sure many people would agree it can be a most distressing and challenging condition that no doubt impacts negatively on many people's lives. In UK, all couples are screened before they are offered treatment and families who already have children would not be admitted to the programme anyway. This is a service for primary infertility and it provides for a finite round of treatment, but it does include IVF even using donor eggs etc. These treatments are also available privately at a lower cost than US I believe. Some couples choose to use a mixture of both.

I do think that some people need to get their head around this idea of society. Surely all our nations children are important to every last one of us whether we have any ourselves or not. Never forget that when we get old, and I'm already well on the way to that!, it is those children who will be providing for us! We must regard it as a privilige to educate these youngsters and provide for them when they are small, as all too soon they are grown and we are in need of their care. That is what a society is about, 'from each according to his means, to each according to his needs.' What would be really great is if the polititions set out various plans and then held a referendum so that people could then vote on their favourite plan.

 

[thaiturkey]

Quote:
I think that a revolution in social attitudes is what some of the elite fear!

Although the UK has less sparsely populated land then the US it still had to face this issue in the Highlands and Island of Scotland and, in the winter at east, remote arts of Wales, Devon and Cornwall. Even the Laker District and Yorkshire Dales can be cut off for days at a time by snow. Helicopters and other means are used for emergencies and I haven't heard any complaints made public about poor general service in those area. As you must know, Brits don't keep quiet if they are dissatisfied.

Some Health Trusts have run into budgetary deficits and the government is quite willing to put in its own direct management for as long as it takes to sort out those and any service standards problems. There is no chance of a hospital or financial backer going bust.

I'm not sure whether a referendum with choices would do the job. Those who don't get their choice would for ever complain. The ones most in need of a universal health service would probably be those least able to find or understand the detail of the alternatives proposed. The inevitable smokescreen of disinformation would, possibly, ensure the worst option won. It might take a few years of research, analysis and planning to get the one option that had the best chance of success and then start to implement it. It would almost certainly be a plan that would be introduced in stages over a decade or so.

 

[PineappleMama]

Agree that any national plan would prolly be mandatory, just as SS, Medicaid and taxes to cover the police department are mandatory... whether you actually get to utilize an of those services or not. You can pretty well guarantee that at some point in your life you'd see a doctor, even if only a regular checkup, so you'd get something from the system even if you're totally healthy "never sick a day in your life"... which would be a change from the current system. We all pay for those services whether we can access them or not... and even with Private insurance we are required to pay just to have a card, and then pay again before anything is paid for. At least in a national system you would pay in and be guaranteed coverage... in that hypothetical, like UK, system... not in what we have now, or what was passed... that's a LOT more than ANY insurance company will offer.

I'm sorry if I seemed callous... I didn't mean to be. It's just that I see both sides of the effects. I don't just see good folks like Red finally being able to get the baby they want so much... I also see women like Octomom having another 8 when they can't support the 6 they've already got and that is frightening. If anyone could walk in and get that benefit who can calculate what would happen?

At the same time denying everyone... well then folks like Red would be toast. And that's not cool either.

But if you meet in the middle... SOME folks get it others don't... well I am concerned because we've all seen what happens when our government is given control of something... hello egg recall, peanut butter recall, spinach recall... just to name a few recent ones... and that's FOOD, have to have it to live, even the ones in power are at its mercy... if they can botch THAT... well it's scary to even imagine what they could do if they were put in charge of reproduction... but that's the paranoid in me speaking so I understand totally if others don't agree.

I would LOVE to see a simple, bare bones, cover life and death stuff, plan passed ASAP... all those Medicaid/Medicare workers, they just get converted to claims processors... they keep their jobs... and the system gets retooled... health is improved... I just don't get why that should be so difficult... unless of course those in power are being paid to think otherwise... *growl*

Get something passed, begin saving lives, then they can take a year and hammer out the details of "optional" things. Find the middle ground and such... and then implement that. That stuff, as evidenced by the bruhaha just between this handful of folks here, n'mind an entire country will take more time to sort... but basic stuff like insulin for diabetics... what is the argument there? They need it to stay alive.. They pay taxes into the system. So why shouldn't that be covered? Seems pretty darn easy to me. I don't get what all the hullabaloo over basic health needs is? I get that me, you, everyone else might not agree on the optional stuff... but the basic? I really am completely baffled as to how they spent 30 years arguing over it and then passed what they did.

Seriously, sitting here scratching my forehead trying to wrap my head around that one. Especially when you consider we're already spending all these billions on MediCare and MediCaid and all these other programs, Food Stamps, WIC, etc that are designed to improve the health of citizens. What's the difference between those programs, that are only available to some, and the same funds being spent to cover all irregardless of income, age, sex, race... yada. Anyone know?

 

[thaiturkey]

Quote:
I take your point about possible overbearing government control but even that might be better than for-profit corporate cherry picking.

A step by step approach and plenty of good will is, as you suggest, probably the only way that is likely to succeed, gain general support and avoid catastrophic failure. Perhaps that's what your government has in mind but using the private insurance sector doesn't seem to me to be a potentially good first step. Perhaps they hope that pandering a little to the establishment will gain their support but I think that insurers will screw the new system the way they have screwed the optional one.

 

[birdsNbeesNseeds]

Quote:
Here's just a question I had based on my experience visiting the island of the UK awhile back (ok, it took me 2 years to pay for that trip- but worth it) and my Grandmother's stories of living in and visiting family in Wales:

1- What would be the population difference between a country like the UK and the US?

2- What would be the geographic size difference between the US (including HI and AK) and all of the UK?

3- What would be the actual financial numbers? As in, starting up and annual; to make a comparative program work for a country the geographic size of the US?

4- What would the actual (or realistic) numbers financial numbers be for tax increases? How would this be proposed? All at once? In steps?



I'll probably think of some more later. I know I can probably look up some population stats, but it's bedtime and I'm tired and cranky

The UK currently has a population of around 69m, I think.

I'll get my head around your other questions later but Google will probably come up with the answers.

What's certain is that the US would have a major task on its hands to introduce a full blown care system for all from where you are now. And that even without the self-seeking opposition that you have to face. In many ways it was easy for the UK back in the '40's. The population was much smaller and there was no real opposition. Nevertheless, the project must have been one of the logical and financial planning wonders of its time. From a system where you had to pay cash to a GP and for hospital treatment and following a major economic depression and a devastating war, suddenly doctors were signing up with the new State scheme and hospitals appeared from nowhere. Looking back, it was a rather crude system but it's come a long way since then. Many of the first big hospitals were converted from old Victorian workhouses. One in my home town still has the original Victorian buildings but is surrounded by modern ones. In the same town is a very modern new hospital that is also a centre for research and teaching.

Where there's a will there's a way.

Yes, my grandmother remembered the war rather well considering her age. She even recalled sharing her school with the English children when their school was bombed.

I think starting a system from scratch- or close to scratch was probably much easier than what you may have to do now. My history is a bit fuzzy, but did they just build government hospitals?

What is the pop of the US now, 300 million?

Although we have some gov hospitals here (VA) what would we do with all of the other ones, gov buyouts? Build new ones? Buy all the equipt in the existing ones as well?

As I recall, when I was in the UK, or Europe even- many people didn't like the thought of "identity" papers and even drivers licenses were careful about the information about they held. Here people are VERY cautious about personal information- even to the point of being paranoid sometimes about things like medical information. Just a few years ago the VA lost a number of people's personal info through a lost/stolen computer.

 

[birdsNbeesNseeds]

Quote:
$85 - $100 per 45 minutes

There are many things I like about Canada-

-but I do NOT like this. Mental health services should be a basic right.

 

[BlackBart]

Quote:
$85 - $100 per 45 minutes

There are many things I like about Canada-

-but I do NOT like this. Mental health services should be a basic right.

You must remember like the USA states not all of Canada's provinces follow the same protocol. Dar lives in Ontario, I live in BC.
I know of several people who have been referred to counselors by their GP and it was free. There is also specific society's that offer free consoling.
At $85-100 per 45 minutes that monetary burden alone compounds to the already emotional problems. Mental Health services should be included in basic health-care.
But remember when a Government is cutting costs they usually go for social programs first. Right after the 2010 Olympics was over the Provincial Gov. cut funding to certain programs for children with autism and then revelied the debt the Olympic Games put our Province in.

 

[thaiturkey]

Quote:
Brits are generally against ID cards, despite EU pressure to the contrary. Central databases are being built bit by bit but Brits, for now, can refuse to have their medical records centralised. The benefits of having your medical data available to any doctor have been explained but no-one to my knowledge, suffered from the lack of that. State support for health care and ID cards with personal data are different issues and the British don't like the latter at all.

 

[PineappleMama]

I think Americans are fairly used to that... the ID thing. There are some that choose to fly under the radar. Don't use their social security number (if parents were similar they may have never been assigned a ss# so no card showing it, no pic on SS cards just the number)... and I've always been advised NOT to carry that one around in case I lose my wallet... since they use that number for credit scores, employment, taxes, access to government programs, all sorts of things. Some people also don't get a driver's license (or the Non-DL just an ID card). But getting anything done is tricky without one. Applying for work, they ask for both so they can verify your identity and set up the tax withdrawals from your checks, they may run a background check, some even run a credit check. You won't get ticketed for not having your SS # on you, but if you get caught driving without your license (even if you do have one and it's just in your other pants) you get ticketed. Got to have DL to cash your pay check, open a bank account... quite a lot of things are tied in with it.

Hard to imagine doing all those things without some kind of ID... how does your bank know you are who you say you are over there? I mean, obviously if it's a small bank, everyone knows everyone, that's a given... but a bigger one, or new employees... do you guys carry your passport around for things like that? Curiosity is gonna kill me one of these days.

Actually, that brings up a point... how will someone who's not in the system (the uber off grid 'hippie' to illegal aliens who've snuck into the country) going to access these hypothetical benefits.... what the off grid is doing isn't in any way a crime that I know of, but an illegal showing up and saying "I'm a criminal" right there on the form... couldn't that be used to prosecute them later? Seems like it'd be risky for those folks to try and utilize the system... is it worth it for little things, or only life and death? Do you risk that, or go to a private clinic. Y'all UK folks said that immigrants and visitors and such can access your benefits... but I've also heard you guys have some pretty stringent rules for immigration, visas and such... is it legal immigrants and visitors only, or is anyone who walks in with a broken finger treated and sent off no questions asked no ID needed? Also, do you guys have the same problem with people sneaking into your country as we've got... not pure numbers, but even percentage wise... are y'all going through things like we are, or does the fact that you're an island and you've got good legal immigration routes available combine to prevent that?