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Post by lissaharrison on Aug 14, 2011 22:59:05 GMT -6
After a conversation with one of our members I wanted to ask about healthcare where you live. Do you have private insurance, a national service, whats free or not? Do you believe it works? If you live somewhere where you need private insurance are you afraid it would turn to crap if it was nationalised? What are the pros and cons of private and national?
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Post by Jodi A. on Aug 15, 2011 1:46:49 GMT -6
In Australia, we have a universal health care. We pay a % levy on our taxes to go towards this. If you are a high income earner, they charge you a larger % if you don't have private insurance as well. So yes, we can also opt in to private health insurance, and have private hospitals and providers, but in order to get medical care, it isn't absolutely essential. I think only something like 30% of people have private insurance (but don't quote me on that). Our health care system is called Medicare and it is a national system. It doesn't vary from state to state. It doesn't ALWAYS cover 100% of our costs - we often find ourselves out of pocket on things such as visits to our doctors, x-rays, pathology, and various other outpatient services, depending on where we live and who we use. In fact sometimes we can be out of pocket by quite a bit. Low income people and pensioners can get a Health Care Card which will entitle them to discounts on various services. A hospital stay/surgery in a public hospital will generally not cost you a penny. If you go private, whether in a private or public hospital, it gives you more options, but you will end up out of pocket. Just as an example, my husband had major surgery on a tendon in his foot last year. We have private health insurance, and elected to go to a private hospital with a private surgeon because for us, owning a business, we preferred to choose our timing for my husband to be off his feet for 6 weeks (in the public system you have to take whatever they give you). After claiming on Medicare and our health insurance, we ended up with out of pocket expenses of about $2500. We can now claim a PORTION of that on our tax (have I confused you now?). On the other hand, I went private (in a private hospital, with a private room, etc) when I had my youngest, and my only cost was our $50 excess and $700 for my doctor (because I was older, I was considered high risk, so I chose an obstetrician). This included the fact that my daughter was in the SCU for 10 days under the care of the pediatrician that works at the private hospital . I am sure it would have been more expensive if I'd needed a c-section of epidural. Our public system doesn't include dental - we can purchase insurance to cover that, but to be honest, I gave up on it. You hardly get anything back compared to what you pay out. When my son needed a plate for his teeth, they only gave me back $400, and that included for the visits over an 18 month period, it was crazy. We also have a Pharmaceutical Benefits Scheme, which means that many of our approved medicines are capped at about $30 per prescription and the government funds the rest. Low income earners and pensioners pay a maximum of $5 per prescription (so this will generally include the elderly and disabled). Have I confused the shit out of you now?
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nielsy
Junior Member
Posts: 25
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Post by nielsy on Aug 15, 2011 3:49:17 GMT -6
Ditto what Jodi said. We pay for private health care... I feel that it's a scam unless you're using all the extras every month and go to hospital a lot or have conditions. The only thing I actually use is the dental and I used to go to the chiropractor but I can't be bothered lol. The dumb doctor at the hospital prescribed me the most expensive contraceptive pill. It's like $32.25 a month, effing ridiculous. Apparently all the others aren't nearly that expensive but I wouldn't know as I've never been on one before.
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Post by Jodi A. on Aug 15, 2011 5:07:19 GMT -6
Emma, over the years I have been on a number of different pills (yay, not any more - vasectomy ), and MOST of them are 3 months worth for that price. But I couldn't take them, I ended up on the expensive ones too because of my hormonal issues. Marvellon was what I was on. I was told that they'd been trying to get it on the PBS forever.
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Post by sarahm on Aug 15, 2011 8:55:57 GMT -6
Can't believe you guys have to pay for your contraceptive pill. It's free for us in the UK. In fact, most healthcare is free here, except prescriptions, which are £7.20 (I think).
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Post by lissaharrison on Aug 15, 2011 9:21:40 GMT -6
As I live in Scotland prescriptions are free too.
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Post by gbsmith on Aug 15, 2011 9:28:17 GMT -6
Prescriptions are free in Scotland as well as everything else. Although it can be quite hard to find a NHS dentist if you are an adult, kids are easier.
You can get private health insurance in the UK and some places of work provide privatehealth care - sometimes for just the person who works there others for the whole family.
NHS waiting lists can be quite long and consultants are often reluctant to give procedures that THEY don't feel are necesary even if your own doctor has said they are - for example my friend needs an MRI scan on her back as she has been suffering for months but even though her physio said it was urgent the consultant has to be the one to decide and he won't see her until end september. My mum had the same trouble and I was refused a steralisation but they were happy to give my husband a vasectomy as this was a cheeper option.
I think the NHS in the UK has more pros than cons as it entitles everyone to free medical care but it does have it's problems.
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nielsy
Junior Member
Posts: 25
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Post by nielsy on Aug 15, 2011 16:04:35 GMT -6
I'm on that new Yaz pill because I said to the doctor that I wanted the pill that fixes your skin and hormonal weight gain etc. They need to hurry up and cut the price because it's starting to work really well.
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Toni M
Junior Member
Posts: 12
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Post by Toni M on Aug 15, 2011 17:05:40 GMT -6
I'm a big fan of the NHS in the UK I feel for the most part it works really well and ensures that everyone can get medical treatment where needed. We pay a certain amount of our taxes to cover the NHS, so the only our of pocket expenses we have is the prescription charges (£7.20 in England, I believe it is free in scotland and Wales) however some people are exempt from these charges, for example pregnant women (and for a year after baby is born) and children. All contraception is free.
We also have set fees to pay for NHS dental work, they range from £15 for a clean and check-up to over £200 for major work (again people are exempt from charges children, pregnant women and new mummies for example).
The NHS has it's faults such as people in different post code areas can get different treatment (for example a couple in Birmingham could be able to have three rounds of IVF treatment free of charge but a couple in Manchester could only get one attempt) and the waiting lists are longer than if you were to have private treatment. But i feel we would be worse off without it, I love the fact we have universal healthcare so even the poorest of our society can get medical treatment without worrying about having to fund it (people on certain benefits are also exempt from prescription and dental charges).
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Post by ladyheather on Aug 15, 2011 17:21:30 GMT -6
We have public health care where I live, but certain things aren't covered (dental, optical, prescriptions are only subsidized). Many of us have extended coverage through our employers which covers that stuff though. My dental is 80% covered by my extended coverage so I pay $30 for a regular checkup. I am covered for an eye exam and some contacts every couple of years and my prescription costs are reimbursed. It's not too shabby, but I can't even imagine what dental would be like with no coverage. We had to pay hundreds of dollars to have my wisdom teeth out. It was close to $2000 for no coverage!
Public healthcare is not without its problems, but I'd never take private over public. It would probably be good for people in my income bracket, but I don't like to think what would happen to those in lower brackets. Dental and optical issues are bad enough. I honestly don't know how poorer people without extended health care get their teeth and eyes looked after. I can't imagine what it would be like if they had that problem with everything.
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donnab
Junior Member
Posts: 13
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Post by donnab on Aug 15, 2011 20:19:16 GMT -6
I ditto what Jodi said for the most part, except there are doctors, pathology, x-ray and other services that don't cost anything. If you see a doctor who is a "bulk billing" doctor, that means he is willing to accept whatever Medicare pays him so there is no fee to the patient. Those doctors usually send you to extended services (x-ray, pathology, etc) who will also bulk bill.
What many people don't know is that the slip you take to the x-ray/pathology place is the same whether you pay for the service or it's bulk billed. The doctor simply puts a tick in a box on the form and it will be bulk billed. I was told this by my (private) obstetrician when he was sending me for my glucose test with Seth. It was supposed to be a secret, but you guys won't tell anyone. :-)
We haven't paid anything for regular medical services (doctors, hospitals, x-ray, pathology) in a couple years because our GP bulk bills. Also, kids under 16 are always bulk billed regardless of the doctor's practice. However, because of my husband's income, we do have private health insurance to avoid the extra levy and that is what we use for dental, optical and alternative medicine (because I love my massage/acupuncture/chiro). Thankfully, the dental and optical practices we use don't charge any excess to the patient and just takes whatever the insurance and Medicare pay them.
I had both my boys in a private hospital (private room) with obstetrician and stayed for 5 days each time. Seth cost us $48 (vaginal delivery after induction with epidural) and Wyatt was $19 (same delivery/induction/epidural). I have friends who had their kids for free via the public system, but they were also on wards (sharing a room with 3 other women) and didn't necessarily see the same doctor for each of their visits/delivery. (The public system here can be a lot like Kaiser Permanente in method of operation to give a point of reference to Americans)
Like in the UK, our public system has wait lists. I think the US media has tried to use these "dreaded waiting lists" in their scare tactics against universal healthcare. The reality is that if you have something that is urgent, you get taken care of straight away (or close to it). For instance, my MIL was diagnosed with breast cancer about a year ago. From the time it was confirmed to the time she had her surgery was 4 days only because the first doctor she tried to contact was away and his office took a day to get back to her and the doctor she did see had to wait a day to book the operating theatre. She had a double mastectomy, chemotherapy and full reconstructive plastic surgery over the course of several months and is now cancer free. The entire thing cost them NOTHING.
When my mother had leukemia, when I was a teenager in the US, my father had to declare bankruptcy after she died because he was in for around half a MILLION dollars. Of course the state he worked for provided medical benefits, but the insurance company had refused to pay most of that bill.
We in Australia do pay more in tax and it's probably a bit more than US federal and state income taxes combined, but we really do benefit from it in many ways, including free healthcare. I love that we can get medical attention without worrying about having the money to pay for it and I love that I can ring the after hours service and have a doctor come to our house at all hours of the night (also for free!) to treat us if we are sick. I'm also fond of the PBS, because the difference in the price of medicines is incredible! (My Mirena costs $200, but on the PBS I paid $32!)
BTW, Emma, I used to pay $35/month for birth control pills in the US. It's the standard rate I think, because I was on just a common brand. Imagine how much money I dished out being on them from age 16 to 35! If those pills are working for you, then that price is worth it... but it is nice to know there are lots of other people out there paying the same rate for an older product. :-) Also, ask your private healthcover if they'll give you some money back on the prescriptions. Many plans will pay on prescriptions over $23.
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Post by Mary N on Aug 16, 2011 5:52:01 GMT -6
The hardest part, I think, when discussing healthcare issues in the US, is that everyone's experiences vary so widely, depending on the coverage that they have (or don't have). I have had health insurance for every second I have been alive; my parents were always employed by someone that offered benefits, and even before I became ineligible for my parent's policy, I had a job that gave me coverage. Currently, I am a sahm, but have coverage through my husband.
As well, neither I, nor anyone in my immediate family has had any prolonged or catastrophic illness of condition. The closest I have come was about 7 years ago, when I developed an idiopathic kidney failure. I was in the ICU for about 8 days, and a regular medical floor for a little over 2 weeks. I had gone to the ER where I worked, but because of the critical and complicated nature of my illness, I was transferred via helicopter to the U of MD. When all was said and done, I think I might have paid $250.00 out of pocket for the entire thing, including all of the follow-up labs, visits, and sonos I had for about a year afterwards. So yes, for me, private insurance has "worked".
I do fully support having universal coverage in the states, but I would be lying if I said I wasn't a little concerned about how it might impact the quality of care I receive. Thus far in my 40 years, I have never had to wait for any healthcare issues big or small. I have been able to see whichever provider I wanted, and choose whichever facility I preferred. As someone who went through rigorous infertility treatments (which my insurance covered entirely for the 3 IUI's and the first 3 IVF's without any restrictive pre-qualifiers), I have to say that the lottery system that someplace like the UK utilizes is not appealing.
On the other hand, I am not blind to the glaring deficits in our current system, even for those who have coverage. I look at my dad, who, at 69, is relatively healthy. His primary coverage is now medicare because of his age, but also pays out of pocket for supplemental insurance, because there is so much that medicare does not cover adequately, particularly prescription meds. Even with the supplemental insurance, he still forks a pretty hefty sum for the few daily meds he takes (one for his prostrate, a mild anti- hypertensive, and a daily nexium). Luckily, he is a financial position where he can well afford this, but the bulk of seniors are not. The cost of prescription meds for ALL Americans is outrageous, even for those of us with fairly decent insurance.
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Post by lissaharrison on Aug 16, 2011 6:46:18 GMT -6
Well I'll stick my tuppence in now I have some time. As I said I'm in Scotland so here is what I have experienced. My husband is type 1 diabetic, he get's his insulin,needles, a box for the used needles, frequent appointments with the specialist diabetic nurse and roughly four appointments with the consultant every year. He had an accident a few years ago which resulted in an operations and his ankle is held together with pins and plates. So the original hospital trip, then the operation, a few weeks in hospital. At home the GP came to see him every day for a few weeks to check on him as well as seeing the nurse and diabetic nurse who wanted to keep a closer eye on him as the stress of it all, being immobile and foot injuries are especially dangerous when you are diabetic. He is also permanently disabled from that injury so then we have the physiontherapy and ongoing appointments and medication. He is also asthmatic, luckily no symptoms for a few years now so when you add in clinical appointments and medication for that along with the rhino and septoplasty he had because his sleep apneoa was causing extra problems with his asthma. I have had three children, it's simple you get pregnant, go to the doctor, they set you up with the midwife from there you get all your appointments,blood tests scans etc, pick where you are having your baby and that's that. You have the baby come home you get a midwife out every day for 10 days to check on you then you have a health visitor who sorts out health check/progress/immunisations and generally just how you are doing. If you are lucky like me you get the same woman for your births who is late for her birthday dinner so she can stay with you until it's all over. I've had wisdom teeth and my tonsils out in hospital, I was flown to hospital when it was thought I had appendicitis but it was actually a burst cyst. My son regularly sees the pediatrics because he is well below normal/height and weight so they want to monitor him in case of any problems. My Mum had a routine mammogram found she had a lump, was in a few days later getting a lumpectomy and a few days later stared chemo. After the chemo she had radiotherapy and because she lived a distance from the hospital she was put in a lovely hotel for the duration.Along with life long medication, she is also diabetic and has cataracts and glaucoma. As she has glaucoma I was sent of to see the specialist to check me over. So after some of the family history In short we got all that and we got it on the NHS, I am more than happy at what we get for our taxes. Of course nothing is ever perfect, it's not perfect anywhere, whether private or not. Treatment, prescriptions and eye tests are all free (my husband and I get them every 6months and yearly due to the diabetes and glaucoma), you get money towards glasses if you have certain conditions or are below a certain income. Dentistry is without charge to everyone under 16 (or still in full time education), pregnant woman until a year after they give birth and anyone below a certain income. There are set charges for anyone who does pay. I have friends who get "alternative therapies" such as acupuncture through the NHS. As for IVF in Scotland you get three tries on the NHS and couples without children get priority. I personally feel very proud that I live in a society that believes the health of our nation is a priority and in general it delivers well. So as a proud Scot I thought I would stick on some Scottish medical advances and feel bloody grateful for my lot. James Young Simpson introduced chloroform in anaesthesia Sir William MacEwen performed the first bone graft John Macleod won the Nobel Prize in Physiology or Medicine for the discovery of Insulin Sir Alexander Fleming discovered Penicillin Ian Donald pioneered ultrasound scanning in gynaecology Alick Isaacs developed Interferon Sir David P Lane discovered the p53 tumour suppressor gene John Mallard developed the MRI scanner Sir David Jack developed Zantac and Ventolin Sir James Black won the Nobel Prize in Physiology or Medicine for the discovery of ß-blockers Optos plc Scanning Laser Opthalmoscope revolutionized eye disease diagnosis Touch Bionics launched the i-LIMB Hand, the worlds first fully articulating and commercially available bionic hand Irwin McLean's team identified the filaggrin gene as the first definitive predisposing gene for atopic eczema, atopic asthma, hay fever and other allergies
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donnab
Junior Member
Posts: 13
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Post by donnab on Aug 17, 2011 7:46:53 GMT -6
Shoot! Lissa, I'm moving to Scotland! Hmm, too bad the weather isn't better. :-\ You're right nothing is perfect, but at least there's healthcare for everyone.
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Post by elfrieda on Aug 17, 2011 13:13:05 GMT -6
I'm in Canada, we have health care for everybody and pay for it with taxes. I've always been healthy, so haven't used it much. Oh, but I didn't pay anything when I had my baby. Money is never a factor in deciding whether to go to the doctor.
I have to pay for prescriptions, including birth control, glasses, and dentistry. (They do have programs for kids to get teeth cleaning and eye tests, though) Often jobs have work benefits that will cover a certain amount for each year for everyone in the family.
One of the problems is that there are long waiting lists for surgeries, and if you aren't as bad off as a person further down the list, that person gets seen to first. On the plus side, if you're really badly off, you get seen sooner than your place in line deserves.
We need more doctors. They keep getting lured away to the US, where they make way more money. My personal opinion is that we need to let the immigrant doctors start practicing way faster than we have been.
I didn't have a family doctor from the time I was about 9 until I got pregnant at 28. (there were a few months where I snagged a doctor for me and my husband, and a woman, too, yay! But then we moved.)
I occasionally called around to ask if they were taking new patients, but nobody was. Until I said, "I'm about 6 weeks pregnant" and then everyone was all, "Well, why didn't you say so?!? How does an appointment tomorrow suit you?" I was bewildered, but managed to get my husband on the patient list as well.
In between the ages of 9 and 28 I always went to walk-in clinics or the doctors hours at the university health centre.
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