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Do you people get all your diabetes stuff for nothing?

Well I'm not sure it's really "zero cost" there. My taxes would be $45,000/yr more there and I think they're pretty high here ($75k). Plus your VAT. Unfortunately I don't think we'll ever rebuild it from the ground up. I favor expanding Medicare by adding 64 year olds, then 63 and on down. Over time. They are who needs decent healthcare most. Just sneak in a little more Medicare tax gradually. We all pay it and employers match it. Nobody's gonna miss it. The Obamacare thing was a pretty bad idea and it worked out pretty badly for the most part.
 
I'm a Brit, living in America. Today, I was just beginning to gather the documents for my 2017 tax return (I file my return very early in the following New Year, for various reasons). The medical expenses for my wife and I so far this year amount to at least $24,000. About two-thirds of that is the monthly premium for insurance, the remaining third is "copays" and "deductibles" not covered by insurance. We buy our own insurance because we are self-employed.

We are both about 60 years old. We are not particularly sick, and my diabetes was a minimal part of the cost, given that I am T2D, do not take drugs or insulin, and do not self-test. We simply had a few random "medical episodes" such as me having kidney stones, and various aches and pains that needed X-rays, physical therapy or other treatment. We also both had full annual medicals, routine colonoscopies and other preventive care. Not to mention eye care. Also dental care, for which we do not have insurance (dental insurance makes little sense for individuals in the U.S.; those who have it are either on government programs or get it through their employer).

Our general health insurance, by American standards, is excellent and we can afford the high premiums (we make too much money to get any subsidy from Obamacare). The actual cost of our treatment this year was a fairly large multiple of what we were actually charged, after the insurance payments kicked in (we actually get to see the "before" and "after" billing statements and they are fairly mind-blowing).

The U.S. system is deeply broken. In practice everyone does get treated -- you will hear very few stories of people who won't get accepted for treatment at one emergency room or another. The costs of treating all those un-insured people is borne by (1) those who do have insurance, and (2) the taxpayer. Millions of un-insured or under-insured people skip their preventive care. Obamacare was a brave attempt to fix the problems and in fact made a big difference, but the real problem is a lack of recognition here that medical care is a fundamental human right. Also, a fairly widespread attitude that people are somehow to blame for their own bad health.
 
What you pay for insurance is probably at least 50% more than you would have paid before Obamacare for the same insurance. I agree with the no preexisting conditions provision of Obamacare. Of course I'm a diabetic and was without any health insurance for 25 years due to diabetes. And the fact that I didn't need much medical care saved me over $100,000 during that time too. But because Obamacare tried to "make the market" what it in fact isn't it makes insurance very expensive for people like you who don't get a subsidy. It was made for people who get subsidies, sort of Welfare Health Insurance. As for the "before" and "after" billing statements those are a joke. Unless you don't have insurance. Then you could go bankrupt. I've seen statements for pacemakers I put in that say the pacer is $60,000 when I know the hospital paid about $6,000 for it. Know how much they get from Medicare? About $6,000. Medicare is the best insurance there is here I think. More people should be able to get it.
 
TheBigNewt said:
What you pay for insurance is probably at least 50% more than you would have paid before Obamacare for the same insurance.
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Our premiums went *down* modestly after the introduction of Obamacare. Mind you, we always insisted on buying full (and therefore expensive) insurance even before Obamacare because we knew that otherwise, we were only one major illness away from bankruptcy. Also, we live in Massachusetts, which basically already had Obamacare (in the form of Romneycare) so almost nothing changed for us, except that the coverage improved somewhat and the monthly premiums fell by a few percentage points.

TheBigNewt said:
Medicare is the best insurance there is here I think. More people should be able to get it.
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I totally agree.
 

It's zero (in my case and those of others I know) and we do not have VAT and GST does not apply. Even some prescription drugs are handed out for nothing. An annual subscription to ambulance services costs $100 (AUD) even with flights to hospital but private room / private hospital are something else again. Wish we didn't need it at all, but if you get sick and need attention, this country is better than most. Medicare is VERY good (and just 2% of your taxable income) and private insurance as a top up (dental for example) is inexpensive. We do have high income taxes so that accounts for much of the costs. I know of people who've undergone stents ... cost zero again
 
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We have a saying here for that "damned if you do and damned if you don't."
There was also a joke about tea and that trump is the punishment you get for the Boston tea party... or a very salty cup of tea!
Unfortunately we are all stuck with what we have and no amount of discussing is going to change anything... I again reference animal farm which seems so befitting to all governments around the world. The more you believe their bs the more they get away with.
Like I said before there are good and bad points in every country... no country will be 100%.
 
What country are you in? (helps to put in your sig if you want). Australia?
 
Commonwealth Fund: 2015 International Profiles of Health Care Systems
http://www.commonwealthfund.org/~/m.../jan/1857_mossialos_intl_profiles_2015_v7.pdf

New York Times: The Best Healthcare System in the World: Which One Would You Pick?
https://www.nytimes.com/interactive/2017/09/18/upshot/best-health-care-system-country-bracket.html
@TheBigNewt Having worked in the NHS, and being very familiar with the VA, I would agree 100% with the following quote from the NYT article:
“U.S. analogues are Medicare (more like Canada) and the Veterans Health Administration (more like Britain).”

How does the quality of the U.S. healthcare system compare to other countries?
https://www.healthsystemtracker.org...rtain-cancers-higher-u-s-comparable-countries

Commonwealth Fund: International Health System Profiles:
http://international.commonwealthfu...33.391030521.1513119175-1945893016.1513119175
 
Interesting links. Funny, Switzerland has what they termed a health insurance system similar to Obamacare, except only 30% get a gubment subsidy. Here 80% get one. I wonder what % of Swiss get their health insurance via their employer. It's quite a bit here I think. The Obamacare exchange is mainly used by people who qualify for a subsidy, so if you don't get one it's pretty pricey. That one guy from the UK who's here said he and his wife pay $16k/year for their insurance they picked the high end plan. Me and my wife pay $2400/year. The high end plan is $5,000/year, but my employer picks up 75% of the tab so it's still way cheaper than his Obamacare plan. I wonder how much it costs for insurance in Switzerland. Bet it's less than here.
 
TheBigNewt said:
Yeah one major difference is that US healthcare is largely a for profit industry, which I think drives up costs.
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I don’t think that “for profit” is the big issue, as the insurance companies are only making a profit of about 1% of turnover. I expect the issue is a lot more due to duplication of services, and unneeded tests etc done due to the risk of being sued. Also, the "best" drugs being used, without any proof that the improvement in outcomes, is worth the costs. And a system that stops cheap drugs being approved, and allows doctors to take payments from drug companies.

Until the legal system in the USA changes so doctors can take the risk of not doing anything unless it is clear that action is of benefit, rather than the current system that requires the doctors to prove they have taken all actions possible, not much will change. For example, disabled children are a fact of life, not a reason to cut most mothers open to protect the "no claims" discount on the doctor's insurance.

Doctors are also paid a lot more in the USA then the UK, in France they are paid even less, but seem to have a happy life unlike doctors in the UK.
 
TheBigNewt said:
What country are you in? (helps to put in your sig if you want). Australia?
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The mention of AUD means it was from Australia, however unless unemployed or on a pension health care is very expensive in Oz. Long story, but I had to get an emergency supply of Insulin interstate
GP Dr visit $85 ($15.70 I can get back, but only after finding one of very few offices and queuing for an hour and they are only open restricted business hours.
We used to get 25 pens of insulin for approx $34, yesterday I got 5 Lantus pens for $76
I pay 2%of my income for medical. I'm forced to have private health insurance $2800 that partially covers private hospital and nothing else.
 
No, the threat of being sued for malpractice leading to more expensive "defensive medicine" is mostly fake news. States who have passed laws that limit patients' awards for pain and suffering haven't done much to lower medical costs unfortunately. Doctors cannot get perks from drug companies anymore. Back in the day one company sent me to the NCAA Final Four basketball tournament. They can't even host a local dinner and make a presentation about their new drug anymore, all that stuff came under heavy gubment scrutiny a long time ago. What drives medical costs up is "fee for service". The more tests you order the more charges you generate. Almost all physicians now are employed by hospital corporations or huge medical operations like the Mayo Clinic. Those outfits perform all the tests their doctors order, see the emergency room patients, admit to their hospitals, own the drug benefits companies, etc. Only the Veterans Admit medical care isn't fee for service. That's one reason I like it, no pressure to order a CT scan on everybody with a headache.
 
Chowie said:
We used to get 25 pens of insulin for approx $34, yesterday I got 5 Lantus pens for $76
I pay 2%of my income for medical. I'm forced to have private health insurance $2800 that partially covers private hospital and nothing else.
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That's about what I pay for Lantus pens. I pay quite a bit more for Novorapid ($250/box of 5). That's my copay with insurance too.
 
I am originally from Australia but I live in London now. Because I basically never needed much healthcare in Australia I am not really sure what the situation is with going back there. Certainly I could not afford to pay US prices for things. I have been back to visit but only for long enough that I could just take supplies with me. It's not that I ever had much desire to go back there permanently, things were going okay here, but it would be nice to know I at least had the option.
 
I won't go on at length about the joys of the British NHS, I'm sure Americans will regard it all as dangerous 'socialism'. Being over 60 I get all my prescriptions free and before that I paid a standard yearly rate equivalent to 1-2 items per month. I had a shock recently seeing some supplies in a pharmacy at non-prescription rates. The 200 test strips I get at a time would cost me £120 if I had to buy them off prescription. Ouch.
 
snowleopard said:
The 200 test strips I get at a time would cost me £120 if I had to buy them off prescription. Ouch.
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I don't get my strips using my insurance like I do insulin. I buy 600 strips (12 bottles of 50) for $120, or 20 cents apiece. I can buy different ones at Walmart right off the shelf for the same price. Accucheck strips cost way more though.
 
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