Following on from first post about the good the bad and the ugly of the British National Health Service Here are my thoughts of how the current US system works or does not work according to your point of view ( if you did not read the first post please take the time to read it before thinking I am being disengenerous to the US system only ) In a similar way to my first post about the British NHS these are my perceptions not facts about the US Health Care System.
The US Health Care System
The US health care system is made up of two primary parts , Social Health care for those who are entitled to it and Private Health Insurance combined with Private funded and managed Health care Providers.
When reading the following it is important to note the following is an extremely important figure Health Care in the US is 16.8% of GDP ( compared with UK under 10% ) . or more simply for every hundred dollars earned $16,80 is for health careOnly 6 in 10 have private health care coverage, Lowering month by Month of those 1 in 4 work for the federal government or State Government meaning many of those in politics do not understand how the general population who are not government employees are affected with health care costs and lack of coverage.
I must admit I do not have any personal knowledge of how well or how badly the current Medicare / Medicaid System works only what I have learned from reading and talking to those affected .
From my own perceptions the cost for Medicare and Medicaid is a tremendous burden on the US Taxpayer without providing the depth or levels of service provided by the British NHS , we have a friend who is well past retirement age 70 + who is forced to continue work as a Walmart Greeter primarily to pay for her health care costs which implies that even for those who have spent their lives working and paying taxes and Social security are not covered under the current system , we also have a friend whose wife needed a kidney transplant but because her husband still worked ( his employment, health care benefits and salary would not cover the costs and he was forced to stop working so at least his wife could go into the Social Health care system to start the long long wait for the operation. ). A story much closer to home was Zoes own dad who did not have any work and could not afford health care coverage and only went to a free clinic when the pain became unbearable. He was told he had an advanced form of Liver Cancer but due to paperwork and the time to go through the system would have to wait for Medicare approval , for anyone who has understanding of these type of Cancers , the sooner treatment is administered the more likely a positive outcome . Needless to say by the time the paperwork went through the system the advance of Cancer was beyond a clinical solution and he died very shortly afterwards.
I will not attempt to give The Good The Bad and The ugly for the current US social health care system because my lack of working knowledge does not provide me with enough knowledge to do so .
Private Health Care System
Callie covers our health insurance from her job as a nurse ( I did look into obtaining private health care insurance but the cost was prohibitive due to my age and health issues together with Callies MS and Diabetes) so we rely on Callies Health care for which she pays about $600,00 per month towards our cover.
I believe our Co-Pay is in the region of 10% plus for all services so for example our Scripts between us cost in the region of $250.00 per month. Family practitioners visit Co-Pay $25.00. The cost for my broken ankle earlier in the year ended at about $3,000 Co-Pay towards a bill of about $45,000. Because of Callies MS and requirements for a MRI once or twice a year the Co-Pay cost is about $500.00 per year. Co-Pay costs do vary greatly on the insurance provider and coverage purchased so these are just examples.
I have not given these just to tell how much we pay more as an example of Co-Pay costs to those from other countries and to show even with insurance Co-Pay can be a significant chunk of change.
From my own perspective my treatment and Callies treatment are far far superior than we could expect in the UK, our Family practitioner is caring and takes the time to find out medical issues , she is also so nice I have never been great lover of Doctors or Hospitals I expect it's a bloke thing but trust her implicitly . She even took some time to pop into the hospital when I broke my ankle and check I was OK and say hello. Also When I broke my ankle the staff at the A and E were looking at and evaluating damage before we had even provided insurance details , the service from everyone involved Doctors, Nurses, Surgeon, Anesthetist, Aftercare and Heart consultant was professional, Caring , Understanding and I Believe could not have been better anywhere in the world and far far beyond what would happen in the British NHS.
1. You can choose Doctors and nurses that you wish to use ( especially good for us because of Callies knowledge of the Health care providers in the area. )
2. The overall service is caring, efficient and professional .
3. Medical facilities specifically the Hospitals I have seen are better staffed, funded and equipped than the UK.
1. The costs are increasing exponentially for those with private health care as the numbers of uninsured increases and Insurance Companies, Drug Companies and Health Care Providers need to make the same profits
2. The cost of drugs which were first used from 5 years to 18 years ago continue to increase beyond any rational amount ( a good example is the highly prescribed Cholesterol tablet Lipitor where the Co-Pay has increased by nearly 30% in 12 months
3. The costs by differing health care providers differ significantly for the same treatment , just one example is an MRI, an important tool in diagnosis for many illnesses ( generally the same machine is used in most hospitals ) but can range from less than $500.00 to $4,000 depending on the location and provider.
4. Overall health care costs and Insurance has far outstripped any economic logic reasons are multiple
a. Higher Profit Taking By all involved
b. The Medicare decision to only pay pennies on the dollar for health care provision forcing the health care industry to increase prices by higher percentages meaning they would receive more from Medicare when they supply services , I can remember discussing this with a member of staff during my hospital stay and being quite shocked that attempting to save on medicare had forced the burden on those who are willing and able to pay for private health care.
5. Having spoken to a number of doctors and others in the health care profession one of the biggest bones of contention appears to be the high cost of Insurance to cover Lawsuits. ( the litigation mentality in America stuns me sometimes as most class action suits make more for the lawyers involved than those affected at the sharp end ) I am sure this also has some effect on the cost of prescription drugs.
6. I find it fascinating that most health care providers are registered charities often meaning they are not liable to state taxes or property taxes but those running these """" Charities """" are earning in excess of $1,000,000 per year , they are also massive advertisers on TV spending many millions to promote their company / Charity
The Downright Ugly
I am a strong advocate of free health care for all children regardless of race, status or money , how can any civilised society think that not ensuring a child can see the blackboard, Read correctly ( dyslexia ) or hear the teacher depends on parental ability to pay for health care, surely this only deepens the poverty trap by ensuring Public Education only works for those who can afford health care for their children.
I am sorry this post has been so long but many of
The Good The Bad and The Ugly I tried to highlight lead to my own views on what and how I would change the current US health care system and how to fund it.