A question for Candadians and UK folks and the Universal Healthcare

[PineappleMama]

http://www.hmrc.gov.uk/rates/nic.htm

That link you posted shows how much is taken out weekly... but it only divides it into Levels... doesn't say what amount those levels are.

It says Lower Earnings Limit, Primary Class 1 pays £97/wk...

...but what, in Pounds, IS the Lower Earnings Limit, Primary Class 1... I see Upper, is it just Upper and Lower or are there more shadings than that... and they just didn't include all the possibles on this particular list?

I have this sneaking suspicion that I am (yet again) making things more complicated than they have to be... but given how convoluted OUR tax laws are I don't think it's too much of a surprise.

 

[thaiturkey]

Quote:
Complicated isn't it! I admire you for taking the trouble to figure it out. I never did - just paid.

If you are a Class 1 payer, you pay 11% of income above earnings of £97 pw and up to earnings of £844 pw. Above earnings of £844 pw you pay 1%. Note that your employer pays more than you do. In this context, £ = equals earnings and % equals the rate of NI contributions on those earnings. I haven't figured out what the third, fourth and fifth fields in that chart mean yet. I'll have a crack at that after lunch.

 

[newfoundland]

Regarding the UK health care system, or as we call it the National Health Service, I would like to stress the quality of care available. Don't suppose that because it is a service owned by the state and paid for by taxes that is a second rate service. I have no personal experience of hospitals in the US, only what I see on television, and it must be remembered that some hospitals in UK are hundred of years old, but I think any US patient would instantly recognise the similarities in the two systems. Expertise and equipment is generally state of the art. Many doctors come from all over the world to train in the National Health Service. Whatever your ailment you will be referred to a specialist department in your area, but in fact you have the right to choose to be treated in any hospital you choose in the UK. Waiting times for appointments are strictly controlled so urgent cases are seen swiftly and only those who can wait longer, without jeopardising their health, will wait a little longer. Most doctors particularly specialists also see private patients but there is absolutely no difference in the care one receives whether private or National Health Service. Where there is a difference is this. Most patients are accommodated in rooms of 4 to 6 patients, few private rooms exist. In some older hospitals, patients are still nursed on wards of 8 to 10. Visiting times are strictly controlled and only allowed at certain times of the day/evening. Food is nourishing but basic and there is only a small choice. Most people in the UK do not have private health insurance and lets face it we would all rather that money was spent on staffing, latest equipment and screening services than on giving people individual rooms and offering a choice of 8 meals three times a day. UK hospitals are not hotels they are clean comfortable centres of health care and the National Health Service is held in the highest esteem by the population, so much so that every government has had to ring fence it's budget so that no cuts can be made or risk losing the election.

 

[thaiturkey]

Quote:
Complicated isn't it! I admire you for taking the trouble to figure it out. I never did - just paid.

If you are a Class 1 payer, you pay 11% of income above earnings of £97 pw and up to earnings of £844 pw. Above earnings of £844 pw you pay 1%. Note that your employer pays more than you do. In this context, £ = equals earnings and % equals the rate of NI contributions on those earnings. I haven't figured out what the third, fourth and fifth fields in that chart mean yet. I'll have a crack at that after lunch.

I can't figure the other fields. However, we have the main rate which is, given the tax free lower band, less than 11% of gross pay for employees.

 

[joebryant]

Quote:
Are some people excluded from Medicare or is it voluntary?

Medicare is nowhere as good as England's plan for all citizens, but it's basic level is free. It pays for most hospital costs, and it sets limits on the charges that hospitals and doctors can make.
Everyone who's 65 and over can apply for the free part. It pretty much covers everything that could go wrong with you; however, you still have to buy supplementary insurance from private insurance companies to cover any costs that the limited uses Medicare doesn't cover, e.g., two of the same test in six months time. You also have to buy your own prescription coverage if you're on a lot of expensive medicines. It does not cover preventive glasses and dental care expenses.
The supplementary medical, prescription, dental, and visual expenses and/or insurances costs take a HUGE chunk out of retired citizens' fixed incomes, but it's a thousand times better and more secure than what they could get from private insurance companies alone. Still there are many old people who are driven into bankruptcy by supplementary insurance costs and prescription prices, but even with that it's a great safety net for most elderly citizens, and it could have been for all citizens if "single payer" insurance had not been defeated by the private health insurance and pharmaceutical companies' bribe money to "our representatives" in Congress.
.
The problem here is that if you are poor and can't get Medicaid or you are employed but don't have or are not provided medical insurance, and you go into the emergency room of a hospital with something like an evident cancer, the emergency physicians are basically only required by law to treat you enough each time to get you out the door so you can go home to suffer and die.

 

[Dar]

I have not read every post in the thread BUT heres my take on things

My mom has breast cancer, she was diagnosed and operated on and started chemo within 6 months... thats from "Oh I have a lump, go to doc, and start the whole testing phase
I consider that very short for a wait

I had to go to a dermatologist, 6 month wait just to get in... BUT I had a choice of going to another city (20 min away) and get in, in 3 weeks

my dad cut off 3 fingers on his left hand... went to the hospital and was sewn back together WITH his fingers... no choice of paying the rent/mortgage as you hear some stories from the US.. the choice of a finger being re attached or eating and paying bills that month


yes its true we are not covered for dental and optical through our health care system unless you are under a certain income level (I think its about $20,000 a year total household income) BUT children are covered under the local board of health and the government does cover eye exams for children

prosthetic devices are not covered but they do have assistance programs to help cover the cost... on a sliding scale (If anyone in Canada needs information on this please email me.. I am the coordinator for a not for profit agency that helps people find the resources/agency's to assist in the cost of devices, supplies)


so yes we have a good system... its not great.... but its better then nothing... no medical exam to be insured... no denial of coverage cause you are over weight.... or have a pre-existing condition.. is there waste and abuse of the system ABSOLUTELY

I can choose my own doctor... not my insurance provider
I choose what hospital I go to.. not my insurance provider (**if 911 is called they ambulance will take you to the closest hospital.. you dont get a choice.. if you transport yourself you choose)

yes there is a shortage of doctors and funds.. but i would rather have a broken system that works most of the time then no system at all

 

[xke4]

Canadian here. I agree that there are many things about our healthcare system that need improvement but it is a relief to know that anyone.......me, my neighbour, someone from out of town...anyone...can walk into an emergency room when needed and get the same care as the next guy. Everyone is the same. Sure we carry a health card, but if you don't have it with you, you aren't turned away. I have the freedom to choose any doctor I wish ( as long as they are accepting new patients.....some areas are in dire need of family dr's), can request and get a second opinion by whomever I wish and do not pay out of pocket for any of it. Things like cosmetic surgery and some operative procedures are delisted but for the most part, everything is covered. I have paid for crutches, splints and physio in the past. But never a dr's office visit or surgery. Of course, it isn't really free....our taxes cover it.....but it is there for everyone. We never delay going to the dr because we don't have coverage. Our wait times are longer in many instances but true emergencies are usually moved to the front of the line. One can always drum up a story about someone who slipped thru the cracks but I bet if you polled a large group of Canadians on the street, most of them would be satisfied with our system.
As for dental, smaller companies may not be able to offer it but most large groups do. I know of no one without coverage. But before anyone disputes this...I am just saying none of the people I know are lacking coverage. Dependent children, as long as they are full time students are usually covered by dental and extended health care plans ( many people have this too thru their work to cover private rooms and prescriptions etc) until they are 25.
My Dad has had an Abdominal Aortic Aneurysm repair, a quadruple coronary artery bypass graft done and a re-do of his aneurysm all in the past 2 years and paid zero. For anything.

 

[Dunkopf]

Kind of sounds like what you really need is covered no waiting. getting your zits taken care of requires a longer wait.

I just made an appointment for my yearly physical. First appointment to see my doctor is 2 months from now. I have the same thing for other non emergency issues.

My insurance policy is 1200 dollars a month (14,400 per year) with a 500.00 deductible per person maximum of 3 deductibles per family (1500.00 per year). Then there is copays of 1000 per person maximum of 3000.00 as long as the provider are in the preferred provider list. If they are not preferred you have to pay 30% copay. The average family income in the USA is around 45,000. So if nobody goes to the doctor and just premiums are paid that is around 33% of gross income. If we all get in a major car accident and the person that caused it doesn't have insurance then we will pay full deductibles and copays an extra 4500 and will probably have to pay the 30% to a few people. Ambulances are rarely covered under preferred provider, plus there are additional charges for emergency rooms and anyone coming to your home to take care of you will not be covered under preferred.

So if I make an average family income and I don't have any need of a doctor. My medical coverage will be about 33% of my gross income. Add that to what I pay in income tax and SS and Medicare and my taxes are around 50%. If I need my medical care or if I have prescriptions then the amount is higher.

Fortunately I make a lot more than 45k a year and my company pays 70% of my medical premium. If I was an average American I would be SOL.

 

[fiddler]

Quote:
I couldn't understand it either. I think many in this country describe heartlessness as "freedom" and "personal responsibility".

I wanted a single payer system, which would not be like the UK. The government would not directly run the health system, but would pay all insurance claims. It would be like Medicare (which everyone who has it really likes) for everyone.

You are correct that having insurance is now compulsory.

As it is now, people will still have to find their own insurance. Employers will provide some. Medicare will serve those over 65. Medicaid will serve those whose incomes fall under a certain level (higher now than before). Everyone else will have to figure out where to buy a policy. Hopefully the "exchanges" will make insurance more affordable. There is supposed to be help for those who cannot afford a policy.

Major changes will help: insurers are not allowed to deny coverage for pre-existing conditions, insurers are not allowed to cap benefits, children may stay on parents' policies longer.

In the end, it will still be a very complex system, hard to navigate (as it is now), too expensive for some, money wasted (in my opinion) on profit for the insurance companies.

The new law will help contain the rising costs of health care, but not enough. We still have to find ways to do this. There are many good ideas out there, and groups working on it. We will have to wait and see.

 

[fiddler]

Quote:
Here is a key to cutting costs. Can Americans accept "plain but excellent"? I really don't know.