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Nationalized health care around the world
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charlsy



Joined: 08 Aug 2006
Posts: 136
Location: France, Bordeaux

PostPosted: Mon Jun 25, 2007 12:58 pm    Post subject: my mistake... Reply with quote

I'd like to add a correction to my post about french social security. I mentionned a price of 15000€ for a day in hospital. Big, huge oops ! I simply forgot to change the price from francs to euros... So a day in a french hospital, for a room in intensive care, is about 2300€. Still a hefty sum, considering that the average monthly paycheck is 2000€... Two weeks in ICU would amount to a year's salary... So no one except the really, really rich could afford to pay such bills... Thank God for our social security, you can have cancer and treatment ! Not that I wish cancer on anyone...
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Rainey



Joined: 29 Sep 2004
Posts: 2498
Location: Los Angeles, California, USA

PostPosted: Mon Jun 25, 2007 3:10 pm    Post subject: Reply with quote

Yes, charlsy. From someone who does not have national health, I can't imagine what the stress of financial woes would add to the concern for health woes and how it would adversely affect getting about the business of getting well.

My general contractor is a wonderful man. He doesn't have any health insurance even though he's in a profession where he could break a bone or his back at any time because its too expensive for his small company. His long time sig other has insurance (thank god!) and also has a rare cancer with a tough prognosis. They would like to move to the woods in Montana where he's from and spend their remaining time with one another. But she can't stop working or she loses her insurance and her opportunity for care.

How sucky is that! This man is a delight to be around and I've enjoyed all the 4 months we've been in renovation (know too many people who still are happy with their GC who promised them an 8-wk project the 4th month they're still in it?). Lately, there are days when he's just so depressed since his business is fixing things and he can fix anything but the critical life thing he and she are in.

Our priorities are wrong to not focus on preventative care and provide remedial care so people can be productive and have the right resources when they're ill.
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charlsy



Joined: 08 Aug 2006
Posts: 136
Location: France, Bordeaux

PostPosted: Mon Jun 25, 2007 4:07 pm    Post subject: Reply with quote

Health shouldn't be a matter of money.
In the case of France, I would like to add another point. Social security is NOT free : part of our paycheck (about 15%) is taken out every month, and every employer pays a certain amount for each employee (about 25% of the gross paycheck). But we are so used to getting our pay minus that portion that we don't exactly see it ! Although we like to complain that the state takes too much !
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Debbie



Joined: 21 Feb 2005
Posts: 861
Location: Paris

PostPosted: Mon Jun 25, 2007 5:27 pm    Post subject: Reply with quote

Yes, french social security is expensive. We get 20% taken out of my husbands pay check, and then pay mutual (private insurance which is compulsory for us as part of my husbands contract) on top of that.

Have to say though that when you need the french medical system they are great and you have no worries about getting in to see specialists if it is a genuine emergency. I have tested this twice since being here and both times was amazed at how good the service was.

In Australia I still had to wait a few weeks to see the specialist when I had a life threatening illness..... and then pay huge amounts of money out for the privilege.... which was not covered completely by social security or our very expensive (and compulsory in Australia) private health insurance.

I don't think any country has the health system perfectly organised, and really do not think that it can be done. There are too many factors to take into account and too many differences between regions and even cities in the health system to make it possible.
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nima



Joined: 28 Nov 2005
Posts: 93

PostPosted: Mon Jun 25, 2007 5:49 pm    Post subject: Reply with quote

Dear Rainey,

Do send me a pm, if you have the time. I appreciate your generosity, as well as your concern for the maintenance of a lively, but pleasant and topical, discussion in these forums. And I agree that this is such an interesting collection of people (which is probably why I asked a question like this in the first place). So if others want to pm, as well, that might be one option.

I suppose, more than a set of political beliefs, I wanted to elicit something more akin to sociological data. What people, esp. in the US, but other places as well, think about their health system. Because SiCKO paints the American system as being systemically flawed, but there is a growing sense, in other parts of the world, that the safety net of the welfare state is going to have to be rolled back. While there seems to be more pressure globally to turn to the market for meeting social services, SiCKO makes the argument (please go see it when it's released) that for-profit providers cannot be entrusted with the ethical responsibility of health. I was wondering whether people's experiences corroborated that claim.

More importantly, I was wondering if other Americans share this view that privatized health care is untenable.
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tealady



Joined: 20 Jun 2007
Posts: 11

PostPosted: Sat Jul 07, 2007 5:39 pm    Post subject: Reply with quote

I have just a moment to reply now so I'll be brief. Having lived in the UK (with the NHS) and in the US (with private health care system) I MUCH prefer the US way of doing things. In the UK, we all got universally poor care. In the US some got excellent, superb health care, most got very good care, and a few got very poor or no care. Of course, the latter must be avoided but universal health care in a one payer system is NOT the way to do it.
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Rainey



Joined: 29 Sep 2004
Posts: 2498
Location: Los Angeles, California, USA

PostPosted: Sat Jul 07, 2007 9:07 pm    Post subject: Reply with quote

Thanks for being willing to weigh in, tealady. You don't think it's possible to make a commitment to good care within a national system?

I have to say my husband and I got excellent, personal care in Canada. I was MUCH impressed although I know the costs are straining the Canadian economy and, I think, talks still continue in most if not all of the provinces how to cut costs.
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tealady



Joined: 20 Jun 2007
Posts: 11

PostPosted: Sun Jul 08, 2007 8:04 pm    Post subject: Reply with quote

Perhaps it is possible, but I've never seen it. I'll take your word for the situation in Canada, but my own experience in the US, UK, and (very limited) experience when I fell ill in France, and the experience of family members in the UK and Ireland tell me that it is not possible.

I am shocked by friends and family members who have cancer and who have had to wait WEEKS and MONTHS for the necessary diagnostic tests or treatment. Even when they get the test, more weeks pass before they are given to the patient. Unless of course, the person is willing to pay privately. My aunt was able to get an appointment the same day for a test she needed for cancer if she was willing to pay -- otherwise, she would have to wait for weeks. Others are not able to get disease-modifying treatment for Multiple Sclerosis because it is too expensive, whereas in the US, this treatment is routine and easily available with additional funds if necessary to pay for it. This kind of "rationing" is also very short-sighted because it guarantees a higher level of disability. Disastrous!

A National Health Service also goes against what I have observed as part of the American character. The private enterprise system is too deeply engraved. Better would be a severing of health insurance with employment. That seems to have worked well when persons spent decades at the same employment. What I think would work best would be that employers give their employees a set sum (the governement could require a certain amount as minimum) which is not to be taxed and the employee uses this to purchase insurance but the EMPLOYEE chooses the insurance company.

Just as now, the insurance company would be required to accept all gainfully employed persons. In this way, insurance companies would have to focus on the employees for a change rather than on the various employers who only rely on the bottom line. Unemployed persons would receive assistance from the state as part of their unemployment compensation to pay their insurance premiums during their period of unemployment.

This would seem to be more in line with the American character and the need for competition which yields a better health system overall.
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cigalechanta



Joined: 27 Dec 2004
Posts: 200
Location: cambridge, ma.

PostPosted: Thu Jul 19, 2007 1:12 am    Post subject: Reply with quote

I started the Sick-o thread on fodor's. What amazed me was how many of my fellow Americans would not pay more taxes to get health care where other members from other countries said yes. I thing the word socialized scares them?
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David



Joined: 30 Sep 2004
Posts: 1855
Location: Ottawa, Ontario, Canada

PostPosted: Thu Jul 19, 2007 3:22 pm    Post subject: Reply with quote

And yet people are willing to fork out exorbitant insurance premiums for private care while a simple hike in taxes would eliminate the need to pay those premiums! Personally I can't help but think it is the insurance industry which is holding our American cousins to ransom.
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tealady



Joined: 20 Jun 2007
Posts: 11

PostPosted: Thu Aug 02, 2007 10:28 pm    Post subject: Reply with quote

cigalechanta wrote:
I started the Sick-o thread on fodor's. What amazed me was how many of my fellow Americans would not pay more taxes to get health care where other members from other countries said yes. I thing the word socialized scares them?


Speaking for myself, this is what scares me:

Pain relief drug ruled too costly for the NHS
Thousands of arthritis sufferers will be denied treatment with proven benefits by a decision not to pay for a new drug. Guidance issued by the National Institute for Health and Clinical Excellence (NICE), the watchdog that controls access to drugs on the NHS, will recommend today that the drug does not represent value for money, although it has been shown to improve dramatically the severest symptoms of arthritis in almost half of patients.
http://tinyurl.com/3x6vp5

Patients pay the ultimate price for NHS errors, says watchdog
Every year about 13 million people are admitted to acute hospitals in England and Wales. Estimates of the number of deaths due to medical errors vary between 800 and 34,000 a year, but the true scale is unknown because NHS staff are often reluctant to report mistakes and close calls.
http://tinyurl.com/2sg5a9

Main points: London NHS plan
Sir Ara Darzi's healthcare for London plan, published today, argues that despite pockets of excellence the capital's NHS health provision is essentially second-rate. There are stark inequalities in health outcomes across the capital, and the quality and safety of care is "not always as good as it could and should be", the report says. It adds that productivity is low, costs are high, hospital resources are under-utilised and GP services are patchy.
http://tinyurl.com/2dq96e

Lottery winners want car, house – and new knees
Top of the couple’s priorities now is new knees as both have been waiting for operations on the NHS for surgery to repair their painful joints.
http://tinyurl.com/yw36az
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Nicki



Joined: 26 Jul 2006
Posts: 106
Location: England

PostPosted: Fri Aug 03, 2007 1:31 am    Post subject: Reply with quote

Now don't get me wrong, I know perfecty well that treatment for some problems such as breast cancer, joint replacements and IVF are a total postcode lottery in the UK. This is most definately wrong, and needs to be worked out.

However, (and it may just be the socialist utilitarian in me screaming to get out) I can't help but feel that on the whole, it might be better for everybody to get an average level of healthcare than for 50% of the population to get above average healthcare, and the other 50% to get below average healthcare. It seems to me that in the US treatments for those well off are fantastic, and of course I dont begrudge them that - if you can afford to pay for good insurance then good on you. But healthcare for the less-advantaged is poor I believe? And primary healthcare ie on a community level is also not good?

Cigalechanta - I can well believe the socialism is off putting for some Americans! I suppose there is always a fear of the unknown; and in the same way that I worry about a growing disparity between the healthcare opportunities for the rich and the poor in society (because I'm not used to the NEED for health insurance) that Americans would worry about the problems like ineffiency which are associated with government intervention.

Everyone has an idea what they can afford to be taken from their paypacket. This "price" is, according to economics, decided by the market. The French, although they grumble(!) are happy to pay what they do because they receive a high level of care. I wonder whether the increase in taxation that would be required to improve national healthcare in the States would be greater or less than the amount that private healthcare insurance contributions would decrease? The English will have to change what they are willing to pay, if they want a better standard of care. I personally believe that the money allocated to the NHS could go a lot further if we got rid of 50% of the administration rubbish that goes on. But you have to remember that the NHS provides what other people in this world can only dream of; free consultatons with GPs and dentists, hospitals which are open to everyone (with no till in sight) and prescriptions which are heavily subsidised.

You'll have to excuse me, I'm in a good mood with the NHS at the moment as they are doing a fantastic job of treating my grandmother who has leukemia. Keeping a woman with no immune system healthy in hospital which used to have a terrible record for its cases of MRSA is not easy!
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Griffin



Joined: 09 Jun 2006
Posts: 932
Location: England

PostPosted: Fri Aug 03, 2007 4:40 pm    Post subject: Reply with quote

Besides which, many of the problems with the NHS are due to governments wanting to cut corners and invite the free market to have it's wicked way with the NHS. For all its problems, I'd agree with Nicki that the shortage of money is largely due to too many admin staff and chief execs being paid over the odds.

Nonetheless, whenever my family have needed it the NHS has never let us down... yet!!
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Judy



Joined: 29 Sep 2004
Posts: 1196
Location: buried under a pile of books somewhere in Adelaide, South Australia

PostPosted: Mon Aug 06, 2007 3:16 am    Post subject: Reply with quote

I saw 'Sicko' yesterday.

What a tragic health system the US has. Hmm, the word system implies or suggests that something is organised and working. It doesn't seem to be working for most Americans, even the ones with health insurance.
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Donna



Joined: 14 Oct 2005
Posts: 827
Location: Oakland, CA

PostPosted: Mon Aug 06, 2007 6:39 am    Post subject: Reply with quote

Well, we saw "Sicko" last night and it was preaching to the choir for us. It's disturbing and frightening to realize how vulnerable we are, even with health insurance through Sam's employment.

It's also disturbing to realize the number of politicians bought and paid for by the insurance and pharm lobbies. Twisted Evil
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