Compare international Health care

[Ecomike]

Topic is differences in health care, the good, bad and ugly of different health care systems in different countries around the world, and the USA.

I am not convinced that we have the best or the worst system. I believe that parts of our system may be the worst on the planet, and other parts may be the best. I keep hearing debate saying we have the worst, and others saying we have the best, without a real blow by blow comparison of what parts are good, what parts are bad, and what parts we might look look overseas to find better solutions.

I have been out the game for so long, no health insurance at all since 1992, and only seen a doctor twice in 17 years. I do have some second hand info, my brother is a retired doctor, I have friends I grew up with that are MDs. I do not have much faith in our current health insurance industry, or in the current medical practice (doctors, hospitals, etc.), except for our Mash care for emergency accident care.

I have heard a lot recently about Japan, some about Canada, Britian, and Germany, and have even been told that a lot people here Houston) head to Mexico for care they can actually afford, like dentists.

Instead of talking about plans in Congress, lets keep this thread just about pieces of the system and how they differ between the US and other countries, and how they differ from state to state, as I am under the impression what I have heard recently that there are stark differences state to state in the USA.

 

[8Mud]

Basically the German, base system, is half a dozen major insurance companies. The insurance companies actually (in most cases) are job related. Like one company for federal, state local, employees another for the trades etc.. There is some crossover. Payment is a straight percentage of your income, like federal and state taxes.
Not a perfect system, the insurance companies squeeze health care professionals and the patients. The rates are going up, covered services are being reduced. The insurance companies are subsidized and monitored by the government (yes they are in bed together) and when they get too greedy, made to pay out rebates. It seems like the insurance companies move into a new building about every five years, about half of their discards remain vacant.
They manage to get most everybody covered one way or another. It used to get a little ugly, the state would show up and strip your house of everything not considered essential if you were insured on the dole and sell it. You don't hear about that much anymore.
Everybody cheats a little and figures out a way to get some untaxed income, few could survive otherwise. But any major loopholes are covered. If the Germans are nothing else, they are good at organization, oversight and management.
The cost of actual health care is likely 1/3 rd of the costs, the rest is infastructure for the insurance companies (there buildings are newer and in better shape than any hospital I've ever been in) and the multiple bureaucracies that run the whole thing.
They also have a parallel insurance system (with perks), you have to have a minimum income of six figures (in dollars) and/or assets. Its a pre pay system that can actually be cheaper in the long run, depending on how sick you get and how often. The Doctors like it, they get paid quicker.
The Doctors tend to play the system some, they get paid by the visit and have a medicine, test and elective treatment budget. The waiting rooms are generally much fuller the first few days of every quarter.
The insurance companies provide an approved treatment list, for a set of symptoms. It is a primary care Doctor (family Doctor) type thing, your choice. The Doctors often use protocol one (cheap drugs old fashioned stuff), when they should be using protocol three (better drugs), to stretch the whole thing out, the patient may get well on there own while they stall, make them money on additional visits and avoid the more expensive treatments. Few Doctors are greedy enough to jeopardize a patient, but stuff does happen. They will refer you to a specialist pretty quickly if you are really sick, dead people aren't very good money makers for a Doctor.
In the whole, the patient rarely gets his monies worth out of the system, the insurance companies get rich and like the U.S. 10% of the population uses 90% of the budget.
I sure as heck don't know how they make it work, but it does.
I live not far from the German and European banking center, the insurance companies are on the same street. People talk.

 

[DoctorPhate]

There are a lot of misconceptions about the Canadian one so i should explain a bit.

You pay in taxes into the system.

You walk in when you need treatment and you are served.

Emergencies are served first, if you are bleeding from your head you will be served, broken arm.. served, broken leg.. served, the flu... you wait.. I just wanted to clear that one up since everyone seems to think you wait forever while your bleeding out.

You CAN and ALWAYS do choose your own doctor, doesnt matter where you live, what you look like, what kind of dog you have, what your sexual preference is be it man, woman or beast.. you choose your own doctor. If you wish the government to choose one for you they can, but you always have a choice.

Everyone in Canada is covered from multi-billionaires to bums on the street. We call it free health care but clearly it isn't free. Please don't gripe on this, i don't have the exact tax info for every class but obviously we pay for it indirectly through taxes.

Personally I like that I pay alittle more in taxes so if my family or friend or even a stranger gets cancer or something then he will be treated.. NOW.

I must also specify that there are ZERO waits for surgeries.. ELECTIVE surgeries have wait times. I had jaw surgery done when I was a teenager for an over bite and I waited 3 months for my appointment and right before i went in 3 cars decided to try and play bumper cars so they needed my operating room and I had to wait another 3 months. I'm ok with that personally. Its elective.. your boob job can wait just like my jaw surgery did.

 

[AL BUNDY]

Great thread idea.

DrFate, how exactly do you pay taxes into the system? Do they take it out of your checks or sales tax?

 

[Tom R.]

Mike, too often people confuse the quality of health care with the system of health care. IMO, the quality of care in the U.S. is at the top. I know we don't lead in all areas (e.g., infant mortality, longevity, etc.), but overall I think we do quite well. We have much to fix with regard to the "system." I'll still take it over a government run program any day of the week, though.

Some Canadians I know are completely comfortable with their system, while others hate it with a passion. Wait times have and continue to increase, causing more to come to the U.S. for care paid out-of-pocket. I know this also depends on your location. The Canadian system was also criticised for not making available certain life-saving drugs because of the cost.

Someone on another forum mentioned how great the systems in France and Italy are, so I did research and found not all is well in either case. Italy has the lowest "consumer" satisfaction rate in the EU....not by a little, but by a huge margin. France has a few good ideas, such as paying all tuition for doctors. Despite making significantly less than doctors in the U.S., they don't have to worry about paying off a huge tuition bill. The French billing system is supposed to be one of the best due to its efficiency. However, like any government run system, costs are the biggest issue, creating rationing of care and the closing of clinics, wards, and even hospitals. France has resorted to some American style practices to help offset the financial woes, such as implementing co-pays.

Great Britian? No thanks. I lived there and never once heard anything good about it. Even France criticised the GB system as being to socialist for their tastes. Wow.

 

[DoctorPhate]

I pay through sales tax(12% in quebec and 13% in ontario, however is only like 7% in Alberta) and through income tax

 

[DoctorPhate]

http://www.cra-arc.gc.ca/tx/ndvdls/fq/txrts-eng.html

Theres a link to the tax rates in Canada. Keep in mind you have to add the province one to the federal one to get your total tax rate.

I'm currently happily in the roughly 40% tax bracket.

Obviously with the way Canada is setup to help others rather then let them die on the streets it will rub some americans the wrong way so i totally understand when americans get freaked out by our tax rates.

 

[ehall]

Obviously with the way Canada is setup to help others rather then let them die on the streets it will rub some americans the wrong way

What the XXXX kind of comment is that??? We don't let people die on the streets either since emergency rooms are underwritten for uninsured. We also have state-paid insurance for the elderly (medicare) and for poor people (medicaid). One thing we do not do, as per Canada, is send our women in labor to our neighboring countries where there are enough hospital beds and incubators to serve the actual demand. Keep your skanks so we don't have to let them die in the steet please!

 

[DoctorPhate]

probably could have worded that better lol. I can see how you would think i'm implying that americans do allow that.

And since when do we send women to the USA to give birth.. I think thats happened because of one hospital and i believe the doctor who was in charge had his license revoked and was fined significant money.

Thats a generalization just as much as my post would be precieved as one.

I apologize for my wording, I didn't mean to make it seem like no Americans care and that bodies are literally lying in the streets because people can't get health care.

I was trying to say people are dying ON the streets because some of them can't pay their medical bills and end up going into debt and losing their house, car, etc and live on the streets because they have no family left to take care of them. I've seen a few reports of this, obviously its a rare occurrence but it does happen.

The rubbing americans the wrong way part was about the higher taxation, not trying to imply that americans PREFER to see people dying on the streets.

Again, I apologize for my poor writing. I was in the middle of doing something else and I guess I didn't put too much thought into how I was explaining myself.

 

[ehall]

You walk in when you need treatment and you are served. [...]

You CAN and ALWAYS do choose your own doctor, doesnt matter where you live, what you look like, what kind of dog you have, what your sexual preference is be it man, woman or beast.. you choose your own doctor. If you wish the government to choose one for you they can, but you always have a choice.

then there is the reality -- http://abcnews.go.com/2020/Stossel/Story?id=7938095&page=3

A national shortage of general practitioners in Canada means that 1.7 million Canadians don't have access to a regular doctor to go to for routine care.

The town of Norwood, Ontario, has only one family doctor available to serve the entire community. To ration the patient list, the town clerk holds a lottery once a month, drawing a few names out of a box that contains all of the people hoping to get on the doctor's patient list. She calls the lucky winners, but everyone else must continue to wait.

Government controls costs the same way everybody else does, which is to limit access to expensive resources. Claims to the contrary are fairy tales and lies

 

[DoctorPhate]

1.7 million Canadians don't have access to a FAMILY doctor but you can go to a CLINIC which are everywhere for your check ups.

I don't have a personal doctor but I have gone for a check up every 6 months on account of my heart condition. I just go to walk in clinics.

 

[ehall]

here anybody can get a family doctor since it is based on supply and demand instead of govt pencil pushers

 

[DoctorPhate]

Dude, its supply and demand here.. the problem is that THERE you guys pay more so alot of doctors go there.

It isn't government pencil pushers who decide "Hey lets make sure we dont have any doctors" "Oh thats an awesome plan frank.. ok while we are at it lets turn off everyones water supply for 10 hours for kicks"

Thats not how it works.. the government has tons of programs and incentives to try and keep doctors in canada but the problem is they take advantage of our education system, stay for the 5 year incentive program and then dick off to the states.

You must be thinking of Soviet Russia.. I'm talking about Canada

 

[ehall]

Yeah you're talking about Canada where private insurance was illegal until last year

It's not Canada's fault that Canada doesn't have doctors... rofl

Seriously do you understand the concept of supply and demand? If people want doctors they pay for them and poof there are magically doctors to fill the need. If Canada would pay there would be doctors there too. The fact is you don't pay because the govt is the gatekeeper over the expensive resource. That sucks.

 

[urban yan]

I've got a good feeling this thread will end well.

 

[wolfpackjeeper]

I've got a good feeling this thread will end well.

that is really gonna depend on what outcome defines "well" for you. But I have a feeling we are on the same page

Can you pass the butter?

 

[DoctorPhate]

Yeah you're talking about Canada where private insurance was illegal until last year

It's not Canada's fault that Canada doesn't have doctors... rofl

Seriously do you understand the concept of supply and demand? If people want doctors they pay for them and poof there are magically doctors to fill the need. If Canada would pay there would be doctors there too. The fact is you don't pay because the govt is the gatekeeper over the expensive resource. That sucks.

Actually as a financial security advisor I most likely have a better grasp on the concept then you do.

Stop throwing your weight around, you're simply stating things I've already stated that you were previously unaware of.

I don't deny that we don't have enough doctors because we dont pay them 250 000$ a year. They do however make 100-150 000$ with ease. I know that because I have several doctors in my portfolio.

CLEARLY its the Provincial government's fault for not paying enough to the doctors.

However, the reason insurance was not sold was because there was no need for it since everything here is "free". Because we now have a 2 tiered system in a couple provinces, we have the demand for private insurance.

It was never specifically illegal, it was just never given clearance to be sold by CCIR/CISRO.

Again, I sell these products so don't bother arguing with me about something that you know nothing about and I've built my entire career around.

 

[ehall]

CLEARLY its the Provincial government's fault for not paying enough to the doctors.

Now was that so hard

Here is a story about the Calgary quads who had to come to Montana because the province was out of beds -- canada.com

Lange said local physicians had been closely monitoring Jepp's pregnancy and were anticipating her newborns would require care at Foothills' neonatal intensive care unit.

But when Jepp began experiencing labour symptoms last Friday, the unit at Foothills was over capacity with several unexpected pre-term births.

There was no room at any other Canadian neonatal intensive care unit, forcing CHR officials to look south of the border.

perhaps Canada does not pay the beds enough either

 

[SleeperXJ]

then there is the reality -- http://abcnews.go.com/2020/Stossel/Story?id=7938095&page=3



Government controls costs the same way everybody else does, which is to limit access to expensive resources. Claims to the contrary are fairy tales and lies

Ok, are you gona listen to the guy from Canada or the guy from Maryland on Canadian healthcare?

 

[SleeperXJ]

What the XXXX kind of comment is that??? We don't let people die on the streets either since emergency rooms are underwritten for uninsured. We also have state-paid insurance for the elderly (medicare) and for poor people (medicaid). One thing we do not do, as per Canada, is send our women in labor to our neighboring countries where there are enough hospital beds and incubators to serve the actual demand. Keep your skanks so we don't have to let them die in the steet please!

That sounded harsh dude, that's not the America I know and love. :nono: