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A Question to Our UK Peeps
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Bruce
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Joined: 06 Jun 2005
Posts: 7926
Location: Portland, OR

PostPosted: Sun Oct 25, 2009 3:09 pm    Post subject: Reply with quote

Without getting terribly political, which we strive to do (I've been feeling so striven lately), would our British members who feel like it be kind enough to give us their impressions of the UK's healthcare system: the quality of care, the length of time to see a doctor and to get important procedures done, and the overall costs and the out of pocket costs? I've heard generally decent things from the very few I've been able to ask in the past, but many of our People Who Represent the People say you're all at death's door and being taxed to death at the same time.

Sincerely appreciated y'all.

B
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Philip Banks
Je Ne Sais Quoi


Joined: 20 Jun 2005
Posts: 11048
Location: Portgordon, Scotland

PostPosted: Sun Oct 25, 2009 4:27 pm    Post subject: Reply with quote

As part of our tax system we pay a "National Insurance Contribution" which covers the cost of healthcare, unemployment and old age pension.

The important part here is the healthcare - doctors in general practise, hospital car, dental and opticians. Whilst the National Health service is being over managed it is appears to be be as effective if not more so than the privatley funded system in the USA at a cost of around $2,000 PA for someone on the average income and at no cost to those who are unemployed or on low incomes.

Monday morning you are feeling so unwell that you must see a GP. In the Buckie area you call Ardach Surgery at 0830 and will get to see a Doctor on the same day. Tuesday evening you're worse, much worse so you call G-Doc based in Elgin 15 miles away and depending on your condition they will either ask you to come and see the night doctor or will send to your home a duty doctor or specially trained Clinical Nurse Practioner. It's serious! The person who sees you at home calls an Ambulance and you are taken to the hospital ...... I won't go on but you get the picture. Cost to you NOTHING.

After a number of consultations over a period of several weeks you are diagnosed as having type 2 diabetes and will be on medication for the rest of your life. There is a charge for prescriptions, £5 per item. For the odd prescription this would be ok but as you will require 3 or 4 items per month so you decide on a Pre-payment certificate costing £85 for the year. For this you get all the prescribed medication you need NO exceptions.

A few years ago I went to my GP with a lump on the side of my head just above my ear. He didn't like the look of it and asked me to return the next day and removed it.

The above are just a few things. The system is not perfect mainly because people and politicians are involved but for the majority of patients it appears to work ok.

For a hip operation one could wait on a list for 18 months (worst case). If you wanted to queue jump and had private insurance or could fund it yourself you'd get a referal and have it done within weeks for about $5,000 and there tends to be NO deductibles.

It's possible to find horror stories over here, same as anywhere but on balance people get the care they need when they need it.

What's more important is that Private Healthcare over here is better because no one (for the most part) needs it and so the providers have to make it worth having.

Does that help?
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Jeffrey Kafer
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Joined: 09 Dec 2006
Posts: 4931
Location: Location, Location!

PostPosted: Mon Oct 26, 2009 1:01 pm    Post subject: Reply with quote

fascinating, Philip, thank you. As to that lump on your head excised, I hope it wasn't the lump you think with. Smile
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Simon Fellows
Contributor III


Joined: 15 Jul 2005
Posts: 94
Location: London, UK

PostPosted: Mon Oct 26, 2009 4:46 pm    Post subject: Reply with quote

My experience over the years has been overwhelmingly positive. Philip's covered things pretty well as far a general experience goes. To pick a few examples from the past few years in my life, the NHS has variously: saved my son's life (and I'm not saying that lightly), stitched up my daughter's gashed forehead and cleansed my son's eyes of undiluted washing up liquid. Not to mention the fact that they've delivered all our children. And all under the cover of our National Insurance contributions.

If we're feeling particularly unwell and call in the morning, we can usually get an emergency appointment at our GP's for the end of morning surgery. It generally involves a wait of an hour or so.

The demise of the National Health Service has long been heralded over here but, for some reason, it still seems to be around.

Not unlike ISDN, really.
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Don G.
King's Row


Joined: 11 Nov 2004
Posts: 1071
Location: MA

PostPosted: Mon Oct 26, 2009 4:56 pm    Post subject: Reply with quote

Well, I for one, am happy to hear such positive reports. Unless we happen to know someone who is actually using the system (and I don't), we have no real way of knowing how it is. Sometimes it's hard to separate the truth from the fiction. Thank you for spelling things out at least as they relate to your experience.
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mcm
Smart Kitteh


Joined: 10 Dec 2004
Posts: 2600
Location: w. MA, USA

PostPosted: Mon Oct 26, 2009 5:04 pm    Post subject: Reply with quote

I would be interested in hearing about the Canadian system as well.
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ccpetersen
With a Side of Awesome


Joined: 19 Sep 2007
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Location: In Coherent

PostPosted: Mon Oct 26, 2009 5:43 pm    Post subject: Reply with quote

I am not Canadian but I did have occasion to use the Canadian health care system when I was injured in Vancouver some years ago. The care was fast, the specialists were available nearly immediately, and I came through with a very good impression. And, the total bill for several visits, ER service and drugs was under $500.00.

A friend who was a doc in the Canadian system and now practices in the U.S. said that there are some abuses and shortcomings in the Canadian system, but on the whole it's a very workable, reliable one and the fact the government is involved is not a bad thing.
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Claire Dodin
Club 300


Joined: 15 Feb 2008
Posts: 392
Location: Sunny LA

PostPosted: Mon Oct 26, 2009 6:28 pm    Post subject: Reply with quote

Ok, my experience of the NHS is this:

It's not perfect, it only provides basic care but it's pretty much free for all.
I pay my NHS contribution, £2.40 per week for self employed people (class 2 voluntary contributions), but it is negligeable compared to what I currently pay for less than basic health care in America (pregnancy not covered and high fee to pay per consultation on top of the insurance premium)

On the NHS, I get seen by my GP same day if I call at 9am. If I call after 10am all the slots are usually filled up and I have to wait for the next day. If it is urgent, I can always go to the hospital where there will be on average 3 hours wait to be treated.
If I get medications, I have to pay around £7 per prescription.
I once went to hospital and I was in a dorm of 50 people, couldn't sleep because of the noise but got taken care of entirely for free. It wasn't comfortable, but it was efficient.
Total cost of treatment regardless of how much you use the system: £7 per prescription + NHS contributions (£2.40 per week)

After this experience, I took a private insurance for £50 per month and when I ended up in hospital again it was like staying in a 5 star hotel with my own private room, satellite TV and porter who carried my luggage. The insurance paid for everything without question. Total cost including private room, surgery, consultations and medications : £0 (plus £50 monthly premium)
It's the same insurance that now covers me for the US, at a premium 4 times higher and a much lesser coverage. This is due to the astronomical cost of health care in America, this cost is government controlled in the UK and other European countries. But I do know that this insurance will not deny any claims, which is a huge advantage compared to an American insurance.

As for the French health care, which I think is the best in the world, well, your doctor comes to your house for free, and if you need you also get a health care assistant who comes to your house to give you your medications and do your shopping...... but that's another story.

I hope this helps!
Smile
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Last edited by Claire Dodin on Mon Oct 26, 2009 6:53 pm; edited 2 times in total
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Claire Dodin
Club 300


Joined: 15 Feb 2008
Posts: 392
Location: Sunny LA

PostPosted: Mon Oct 26, 2009 6:41 pm    Post subject: Reply with quote

I forgot to say that I also lived in Spain and that everything was free there too (consultations and medications). But I don't know how much their premium is.

We have a European health care card. If we pay contributions in one country, we get free emergency health care in all the other European countries. It's great! Smile
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brianforrester
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Joined: 30 Jul 2005
Posts: 492
Location: Vancouver, British Columbia, Canada

PostPosted: Mon Oct 26, 2009 10:14 pm    Post subject: Reply with quote

Since Mary asked about the medical system in Canada, I will provide my experiences... short and to the point.

I currently pay $54 per month in medical service plan (MSP) fees, whether I use the system or not. If I had a family I would pay approximately $138.
Approximately 35% of my income each month is paid in taxes.
When I go to the store I pay 12% on pretty much everything.

Those are the number.

In the past 10-years, I've broken both arms once and sprained both ankles 2 times each (call my a clumsy or call me athletic, it's up to you), each instance requiring a visit to the emergency room. Each time, I received prompt attention and was dealt with professionally and in a reasonable amount of time (less than 4-hours each visit). Both broken arms required the oversight of specialist services. The initial consultation and follow-up was adequate... not exceptional, but I still have both arms and they are fully functional.

I have been unable to secure a family doctor as there is a doctor shortage and lengthy wait-lists. I do however visit a walk-in clinic and visit the same doctor when the need arises. Kinda seems like a family doctor to me, whether or not he puts my information in a manila file or a color coded one with the first 3 letters of last name on the spine is somewhat irrelevant to me.

All emergency and doctor visits are covered under msp.

I use an inhaler for mild asthma... they are free to me and covered under msp. I have one other periodic prescription that is not covered and costs me approximately $25 for a 30 day supply. Most traditional and mainstream prescription medications are covered under msp.

I have a fiance with a chronic illness that requires significant specialist care and is not very well understood in traditional western medicine practices. Most mainstream treatments are covered. Anything that is not mainstream is very expensive and not covered. There is minimal collaboration between primary care physicians and specialists; each professional that we visit we must go through a very lengthy history and quite often go through the same test multiple times (most test are covered ... possibly a bit inefficient?)

I have had a number of close friends and family in recent years who have battled cancer; some successfully, some not. The care that they have received has been sufficient and covered under msp. Nothing exceptional, but nothing that stands out as being harmful.

I know that the current wait-list for hip surgery in BC exceeds 6-months and that is after you wait 4-months to see a specialist.

My summary of health care in canada... if you require emergency care, it's free (other than the taxes mentioned at the beginning), it is in most cases adequate and I have not been let down. I have also never been refused service and I have never received a bill from a hospital or ambulance service.

If you require ongoing care outside of mainstream medicine or traditional practices, some aspects are covered and many aspects are not. The collaboration between practices is limited and the time-line for treatment is indefinite.

I am satisfied that the current health care structure in Canada meets my basic needs and I have the same opportunity for treatment as anybody else who lives here.

Do I receive representative value for the amount of money that I pay each year in taxes and other fees... I'm not sure that question can be answered until one has either gone without or has faced a life-threatening situation requiring medical intervention.

Okay, maybe not short but hopefully helpful, matter of fact and unbiased.

Cheers,

Brian
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CarynClark
MMD


Joined: 28 Feb 2007
Posts: 2697
Location: Fort Myers, FL

PostPosted: Tue Oct 27, 2009 6:10 am    Post subject: Reply with quote

Brian, I am glad you were able to hold on to both arms. Smile

Since this is a factual, opinion-free thread, I'd like to ask this question (and refrain from my opinion). Brian offered the percentages paid in income tax and sales tax, which I guess helps to supplement the gov't run healthcare plan. UK/Europe peeps, would you mind sharing what your income tax and sales tax rates are?
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Philip Banks
Je Ne Sais Quoi


Joined: 20 Jun 2005
Posts: 11048
Location: Portgordon, Scotland

PostPosted: Tue Oct 27, 2009 6:20 am    Post subject: Reply with quote

In the UK income tax is banded, the more you earn the more you pay. Rough figure are.

First $10,000 PA tax free
$10,000 - £20,000 10%
$20,000 - $70,000 20%
any income above $70,000 40%

Note that you do not pay the higher rate on everything only the rate within the band. Over and above the income tax we pay National Insurance contributions and the highest earners will pay about $150 per week, the average is around $50. The contributions cover healt, basic old age pension and unemployment benefits.

Sales tax here is called VAT (Value Added Tax) and whilst a lot of essential items are exempt the rate is 15%.

The above will give you a rough idea.
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Deirdre
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Joined: 10 Nov 2004
Posts: 13016
Location: East Jesus, Maine

PostPosted: Tue Oct 27, 2009 7:02 am    Post subject: Reply with quote

What does PA mean?
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CarynClark
MMD


Joined: 28 Feb 2007
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Location: Fort Myers, FL

PostPosted: Tue Oct 27, 2009 7:02 am    Post subject: Reply with quote

Thank you Philip!!! Are the highest earners that pay the $150/week ($600/mo) in Nat'l Insurance contributions those in the $70K+ band? What dollar amount defines the "highest earners"?
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CarynClark
MMD


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PostPosted: Tue Oct 27, 2009 7:03 am    Post subject: Reply with quote

per annum is my guess.
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