I'm a Brit and America, your health care system is torturing me
1–10 of 75 posts
Re: I'm a Brit and America, your health care system is torturing me
#2The HMO system is misery. PPOs are better but costly :/
Re: I'm a Brit and America, your health care system is torturing me
#3"Rather like when the British rail system ground to a halt because of the wrong type of snow, the American health care system apparently is beset by the wrong type of patients: ill ones."
That is so true. I'm not sure if the betterment of health insurance industry would be the solution, or the health insurance industry itself is actually the problem.
Re: I'm a Brit and America, your health care system is torturing me
#4The HMO system is misery. PPOs are better but costly :/
HMOs are great if you're healthy and plan to remain that way for a while. I have the same deductible and co-pays as a PPO but pay about $200 less per month. The level of care is adequate for my needs, and I actually go to the doctor now because the HMO is integrated with the provider network, so I can book appointments online. Since the HMO also owns the lab and other facilities at the clinic everything that they do to me is covered. They even have an optometrist in case I need an eye exam. Their pharmacy is also really quick compared to most places.
Re: I'm a Brit and America, your health care system is torturing me
#5The HMO system is misery. PPOs are better but costly :/
HMOs are great if you're healthy and plan to remain that way for a while. I have the same deductible and co-pays as a PPO but pay about $200 less per month. The level of care is adequate for my needs, and I actually go to the doctor now because the HMO is integrated with the provider network, so I can book appointments online. Since the HMO also owns the lab and other facilities at the clinic everything that they do…
People don't plan to remain healthy?
Re: I'm a Brit and America, your health care system is torturing me
#6Earlier quoted context omitted.
HMOs are great if you're healthy and plan to remain that way for a while. I have the same deductible and co-pays as a PPO but pay about $200 less per month. The level of care is adequate for my needs, and I actually go to the doctor now because the HMO is integrated with the provider network, so I can book appointments online. Since the HMO also owns the lab and other facilities at the clinic everything that they do…
People don't plan to remain healthy?
Based on most people's actions, it would appear not.
Excessive eating, drinking, smoking, and insufficient exercise and sleep seem to apply to most people.
Re: I'm a Brit and America, your health care system is torturing me
#7Re: I'm a Brit and America, your health care system is torturing me
#8Meanwhile, here in the UK the NHS - weaponised by the left and virtually above criticism/reform as a consequence - tortures people by making them wait months/years for treatment due to rationing of care, this rationing in no small part being due to the fact that care is free at the point of delivery, which leads some people to abuse the service. Even a token £10 charge for GP visits, for example (subsidised for the genuinely incapable of paying) - similar to the Netherlands - would likely deter many of the unnecessary visits, and raise desperately needed revenue. I would gladly pay. But any/all genuine reform is blocked by the left raising the spectre of privatisation. So let's not pretend we have the all the answers here in the UK.
Re: I'm a Brit and America, your health care system is torturing me
#9It is stupid to blame Obama or Trump even for the current state of Obamacare.
The parties involved right now are resulting in a much worse than medicare solution as it is similar to the three wolves one sheep version of democracy (which is the whole premise of libertarian concerns about democratic socialism). It is an attempt to obfuscate the otherwise obvious corruption and theft that is healthcare. Here the wolves are the AMA(doctors), insurers, pharma, and the politicians claiming to want to solve healthcare. The AMA and insurers have insane billing policies based on assuming inept doctors and corrupt patients.
Most insurance today is just passing on the discounted (actual) price on to the insured co-pay or deductible. They cover very little normal costs of medicine nor do they provide any actual services for their premium.
The main reason we don't have universal medicaid/medicare is similar to why the IRS doesn't do electronic filing themselves. Billions of dollars of middleman and tens of thousands of otherwise worthless jobs are on the line.
We need a private/public system. It will initially look costly and it will suck (differently) for doctors and hospitals. However, in five to ten years the costs will stabilize and insurance and other services will be more honest as they will have real competition.
Also, he should try to just fly back to the UK for non-emergency issues. Most foreign friends I have just keep insurance in their home countries as it costs usually 100-200 a year. A $1k flight back to see your family is cheaper than any surgery in the US.
Re: I'm a Brit and America, your health care system is torturing me
#10I favor nationalized health insurance, but I worry American idealism would screw up implementation. The British are aggressive about rationing care. They aim to pay around 20-30,000 pounds per quality adjusted life year: https://www.bbc.com/news/health-28983924
There was an article on HN the other day that talked about how much debt a woman had incurred for her husband’s cancer treatment after she hit her insurer’s lifetime limit. But it turns out that in the UK, the expensive of that course of treatment compared to prospects would have been far above what NHS would have been willing to pay.
If you have socialized care, you need to ration it, ideally focusing on maximizing QALYs for younger individuals with years of productive life left. I fear our political system in the US wouldn’t let us do that.
EDIT: Here is the article: https://www.npr.org/sections/health-shots/2017/08/10/5425892.... The insurance policy's lifetime limit was $500,000, or about 400,000 pounds. Even if we assume British healthcare costs half as much, under NHS's policies, the expected benefit of treatment would have to be 6 QALYs for NHS to have paid even as much as the U.S. insurance company paid. But it was a rare, aggressive cancer and the lady's husband died in less than two.