Not on a theoretical level, but how would you practically have to pay costs, access specialist doctors?
I guess I’ll give a non-horror story account from the US. My wife and I are fortunate to be on a good insurance plan though my work, we pay about $200/month total for the both of us out of pocket, and my work covers the rest.
Were on an HMO plan, so basically we have a fair bit of restrictions on which doctors we can see, and finding a new primary is always a pain.
On the brightside, medical care for us genuinely is cheap as hell (besides the insurance cost, ofc). My wife recently cut her hand in the kitchen and we had to rush her to urgent care to get stitches. We didn’t pay anything at the time, and got a bill in the mail for $20 the next month, and that was pretty much it.
We’ve never (thankfully) had any major medical issues that need treating though, so hard to say how something like that would play out in reality.
All that being said, if I lost my job, or if my job decided they wanted to cheap out I health insurance and I was - for some reason or another - unable to get a better job, then I’d be fucked. So don’t misconstrue any of this as an argument against universal Healthcare, just because it works well for me personally
It’s so interesting that the main point against universal healthcare is that it’s cheaper because you don’t pay in your taxes. Yet the US have taxes and you still have to pay 200$/month, and your employee is paying even more money that would go in your check.
Also, you lose your job and you are fucked, that seems like a horror story to me, how do you not live in axiety?
Sounds pretty terrible though. Paying $200 monthly to pay $20 for a simple visit is insane to me. I’m an expat living in Europe (so I don’t have the full privileges of locals), yet I pay about $200 per year for private medical insurance which makes doctor visits pretty much free for me. There is also an extended health insurance from the company (costs me about $20 monthly), which covers drugs, dental health an profilactical visits for free
In Poland, it doesn’t. They just steal our money without anything in return you have to wait for years to get into surgery what you pay taxes for.
That is not true. Not fully true, and the true part is blown out of proportion by various populists (especially right-wing, who would like to replace what we have with USA model or worse).
Most basic health care is organized by the government and paid through taxes and social insurance (which is obligatory). Unfortunately it is not financed enough and it shows, more in some areas and less in others. GP access is quite good, especially in larger cities, unless someone didn’t care to choose his ‘first contact clinic’ right. Those clinics are mostly private, but working on government contract. One can usually get a GP appointment within a week, often same day. Urgent GP appointments are available 24/7 through special ‘holiday and night health care points’.
Things became worse when popular specialist help is needed. One needs a referral from his GP and may need to wait months for appointment. There is the point were people who can afford that, would often go private. That and dentists / orthodontist.
Big problems are in children psychiatry, mostly due to lack of funding.
Medicines are much cheaper that in USA. When prescribed by a doctor they are usually partially or even, in some specific cases, fully paid by government. That is not make it affordable for everyone that needs it, but it is not very bad.
When something very bad happens – serious accident, cancer, etc. then the public health care gives the most. Public hospitals will do what they can (with limited funding and overworked personnel) for free. People are not sent away because they are poor and won’t have huge debt to pay just because they got sick.
There are private insurances, or rather subscriptions services. They used to give better access to basic health care that the public services, but recently they don’t offer much more. And you must pay for the public service anyway. They usually totally fail in more serious case (chronic illness, cancer, serious accident) – one would get to and be treated by a public hospital too.
In short:
Pros:
- health care is basically free for everybody by principle
- GP access is good, and serious cases are handled quite well
- medicines are available and prices are not horrendous
Cons:
- not all the free health care is practically available, sometimes available appointments are months or years in the future
- dentists, orthodontists – not really available via public health care and private options are expensive
- doctors, nurses are other personnel are underpaid and overworked
- there is a lot of bad PR around health car here – this doesn’t help improving things
Not well.
America. Ideally you have insurance through work. Going to your PCP may be ~$50, same for specialists. Urgent care and ER will be higher, then there will be additional bills depending on what needs to be done and your insurance. Then there’s “in-network” and “out-of-network”. In-network will be covered more by insurance than out-of-network. It’s tricky for hospital stays. In my area there are doctors who are out-of-network working at in-network hospitals. So you will get 2 separate bills - one from the hospital and one from the doctor.
Honestly it’s terrifying having an emergency because you really don’t know how much it could cost. Most insurance plans have a max out of pocket. One number for the individual, one for the family. The lowest I’ve seen is $2k/$6k while the highest was ~$16k/30k. I’m in a LCOL city though. Max or of pocket is the maximum you should ever have to pay for a single year. You will almost definitely hit this if you have a baby or need more than a couple days in a hospital.
For people with low income there are sometimes assistance programs at hospitals. One common outcome is you go into a payment plan and maybe years later your remaining debt is forgiven. The payment plans can be very cheap. I’ve heard of $25/mo. Still it’s probably for a bill that’s in the thousands if not 5 or 6 digits.
If you don’t have insurance through work you can buy your own insurance but many people just wing it. Most hospitals will charge less when there is no insurance to bill. Maybe 1/3 what they would charge insurance. This will still be in the 4-6 digit range. So you go into a payment plan, or maybe there’s additional financial assistance from the hospital, or you just ignore the bill and take the credit hit when it goes to collections.
There are programs through the government, Medicare and Medicaid. They cover quite a lot but if you’re under 65 then I believe you have to be disabled to qualify.
The quality of care is generally high though, so that’s cool.
In the UK the cost of healthcare is included in a tax called National Insurance, it’s about 10% of wages. It can be thought of mostly as emergency use only. Mental health and minor ailments are not treated. If you want that kind of service you need to go private and most people cannot afford that so they go untreated. I know a newly qualified doctor who cannot find a job despite there being a shortage of doctors.
On the plus side, we do have a brand new aircraft carrier and a royal family.
It doesn’t really matter, but worth knowing, only a small amount of your national insurance goes toward NHS costs. The NHS is primarily funded by general taxation. Your National Insurance contributions largely go to paying for state pensions.
As an American, that’s a way higher tax than I expected. Does everyone pay it, even people earning under a certain threshold? In the US we have social security and Medicare that everyone has to pay.
