Does private health care work differently in other countries ?

Here in Australia there is a ‘gap’ payment between what you are billed and what you get back on private insurance. It is quite substantial so you end up paying quite a lot. The main benefit of private health is you can choose your doctor or specialist and you don’t have to wait long. Mostly you are immediately eligible when you join a health fund but sometimes you have to wait a few months. The private health doesn’t cover normal doctor appointments, only hospital and dental and eyes.

In the US, private insurance companies used to be able to deny coverage for pre-existing conditions. That changed with the Affordable Care Act (Obamacare). The law required insurance companies to cover pre-existing conditions, though the law has been challenged and watered down several times.

I would not be surprised if, in the UK, private health insurance companies are trying their best to not cover pre-existing conditions. They are in the business of making money and people with diabetes or cancer will cost them more in the long run.

Message withdrawn at poster's request.

That's right you two Aussie grans! I've just had cataract surgery and total invoice was nearly $4000! $206 back from Bupa, $603 from Medicare the rest from my pocket. But I wouldn't be without my private health insurance.

Private healthcare has always been very expensive here and does not include pre existing conditions. It's best to join the scheme when you are going and but but of course that's when you have children and a big mortgage. We have just an insurance that covers spectacles, neurologist, some dental and thankfully the therapies...I have needed a lot of physio so it takes care of that. We have taken two further dental policies so in all about £200 a month for that but we have been in the scheme for about 30 years. Personally we haven't done too badly out of the NHS. Recently I only waited 4 weeks for an MR I on my back although 4 weeks later I am still waiting to be told what if anything is going to be done about it.

Private healthcare in the UK through monthly insurance payments will not cover many/most chronic conditions, outpatient prescriptions, maternity care. Even if you develop diabetes or rheumatoid arthritis 10 years after you take out the policy it won’t be covered. It’s best for diagnostics, elective surgery, cancer and rehabilitation. It’s a very different model to the countries mentioned here.

I certainly remember my sister in the US having a badly cut finger. She was already paying $$$ for health insurance, so I said, ‘Well, at least you were covered!’

She said, ‘You’re joking - there was a $2500 excess!

Witzend

I certainly remember my sister in the US having a badly cut finger. She was already paying $$$ for health insurance, so I said, ‘Well, at least you were covered!’

She said, ‘You’re joking - there was a $2500 excess!

Omg ! That’s crazy!

I think if you are looking for a different model to the NHS, the best are in Europe.

Better than privste health insurance is a personal health saving account.

When DH left work, his company health schem offered him a low-cost plan, which we took. Then we reached 70 and the monthly cost doubled and we could no longer afford it.

Instead we opened a dedicated savings account into which we paid each month, the sum of money we paid to the health account before we were 70.

10 years late we have a substantial sum of money in it, enough to cover the cost of a hip replacement operation should it be needed. So far we have use the money in the account for filling the gaps in the health system, getting to see consultants so that we at least know what the problem is or getting pain killers prescribed that actual ameliorate pain, rathe an endless succession of painkillers that didn't

And all the time, the money we have paid into the account remains ours, and when we finally no longer need the account the money is there to be spent on other things.

Most "Western" countries have some sort of arrangement between the private and public systems.
In France, the system is effectively private with the state picking up 80% of the cost in most cases (am aware I may be out of date, French grans may correct). Some diseases have costs met in full, and many employers offer the 20% as an employee benefit. I think you get the full cost on retirement?
Anyway, you get the approximate picture.

Some of these 'mixes' are not efficient economically. many provide good care, but spend a lot on admin, and often don't use the workforce efficiently.

When funded properly, our NHS is very efficient, but of course, it now has to fight for funding. I have a feeling that to paraphrase Nye, there are not enough folk left to fight for it.

What is often forgotten as well, is how in some countries (US is the prime example) the insurance companies dictate care. They will, for example say that after 'X' operation, they will pay for Y nights' stay. There is not the flexibility to assess as there is in the NHS.
Having said that, now the NHS is 'outsourcing' care to private providers, this attitude is creeping in. My last joint replacement was outsourced to a private hospital (talk about 'poor doors'!) and it was explained that the NHS had paid for 2 nights' care. Any more, and I would be transferred to the local, overfull hospital. The private hospital could not be inefficient!

I have worked with nurses from all around the world. I have only ever heard one criticism of the NHS "you don't want to pay for it"!

PS: M0nica - my late PiLs had such an account. They dipped into it for convalescent care.