Imagine life without the NHS?

On the inherited medical debt issue: as far as I understand it, it's not (as with all healthcare things in the States) there isn't a single or straightforward answer. It depends on who the debt is to, and who the next of kin is, and which state you live in. But, generally, if you have healthcare debt, it's taken from your estate. If you were on Medicaid (so state funded) insurance, they can reclaim every penny from when you were 55. If it's a private insurer, they can claim the debt.

If you don't have enough in the estate, and leave a spouse, s/he can be sued for the money, and sometime are, but it is probably less likely with Medicaid (mainly because you'd have to be poor to have been on Medicaid). If you only have adult children, in theory they could be held liable, but it's rare in practice.

If you have children under 21, and certain other extenuating factors, they can't even take the debt from your estate.

fleurpepper said: Unfortunately, as said above, the UK Conservatives are looking to a system akin to the one in the USA - and that will leave many out, either due to low salaries, unemployment, invalidity, chronic disease, and because those systems (are currently BUPA/Spire, Nuffield- exclude pre-existing conditions, and go up with age, and exclude some conditions, including those they treated in the past. Many European systems are based on the premise that there is a safety net for all.

How do (presumably non–Tory) people know about what the UK Conservatives are trying to establish? I'd love some links if anyone has any.

The safety net premise should certainly be kept. I don't think any UK government would get away with not including that – not for long anyhow.

As I do not know any Americans, I have watched videos on You Tube about American healthcare and other aspects of their way of life. The cost of health insurance is awful and then there is the co-pay aspect plus you may not be covered at your nearest hospital because a particular insurance is used there as opposed to the one you are insured with!

Many Americans who have left the USA are so grateful that the country they have chosen to live in provides better services for less outlay than they have been used to.

Unfortunately, many Conservatives and especially the current far-right batch of incompetents seem to think the USA way of doing a lot of things is the way to go. It is not.

The Tories have a different way of looking at the world and, try as I might, I cannot understand their way of thinking.

ExDancer

I can't help asking Glorianny what happens if you can't, or don't, pay?

Do you know I have no idea. The fact that someone could die and their next of kin could be saddled with a huge debt just shocked me so much. I assume it's the same process as any other debt in the US

Baggs

MayBee70

Baggs

Several geographically European (so not just EU) countries have systems that seem to work pretty well so I imagine that if we didn't have the NHS we'd have sorted out something similar. My optimistic side thinks we could still do this.

So what happens to those of us that have paid into the NHS throughout our working lives? Will that money be transferred to the new system. Also, most of the talks regarding NHS privatisation seem to have been with US companies so I would assume that any new system will be based on theirs. We seem to follow them in most things. Someone’s husband was in talks with the US regarding NHS privatisation recently but I can’t remember who it was? Was it Dido Hardings? It was someone like that.

My post was in the past tense, MayBee, and then the hypothetical. I've no more idea about possible future details than anyone else – probably less idea than most people.

My point was that there are lots of health care systems in other similar countries that seem to work well. I can imagine that gradual changes could give the NHS some similarities to them.

The thread did appear to be asking for what people imagined. Sorry if my inadequate imaginings weren't doom-laden enough or political enough for you!

Unfortunately, as said above, the UK Conservatives are looking to a system akin to the one in the USA - and that will leave many out, either due to low salaries, unemployment, invalidity, chronic disease, and because those systems (are currently BUPA/Spire, Nuffield- exclude pre-existing conditions, and go up with age, and exclude some conditions, including those they treated in the past.

Many European systems are based on the premise that there is a safety net for all.

I warn you not to be ordinary, I warn you not to be young, I warn you not to fall ill, and I warn you not to grow old.

Neil Kinnock, in this instance, was right.

MayBee70

Baggs

Several geographically European (so not just EU) countries have systems that seem to work pretty well so I imagine that if we didn't have the NHS we'd have sorted out something similar. My optimistic side thinks we could still do this.

So what happens to those of us that have paid into the NHS throughout our working lives? Will that money be transferred to the new system. Also, most of the talks regarding NHS privatisation seem to have been with US companies so I would assume that any new system will be based on theirs. We seem to follow them in most things. Someone’s husband was in talks with the US regarding NHS privatisation recently but I can’t remember who it was? Was it Dido Hardings? It was someone like that.

My post was in the past tense, MayBee, and then the hypothetical. I've no more idea about possible future details than anyone else – probably less idea than most people.

My point was that there are lots of health care systems in other similar countries that seem to work well. I can imagine that gradual changes could give the NHS some similarities to them.

The thread did appear to be asking for what people imagined. Sorry if my inadequate imaginings weren't doom-laden enough or political enough for you!

HousePlantQueen

*Beautiful*, the NHS is free at the point of use. I am saddened by comments such as those made by Elizabeth27, private medical insurance is all well and good if (a) you can afford it and (b) you are basically using it to queue jump/get your hip replaced/varicose veins stripped, but private medical companies only provide services which can be costed; they do not have A&E, do not have ICU, and heaven help anyone who develops a life changing condition such as MS.

Even the best private medical insurance will not necessarily prevent you from eventually becoming bankrupt if you are unfortunate enough to have more than one family member with a life-changing disease. It happened to a friend of mine. He ultimately lost his home because of the bills racked up through co-pays, excess premiums, etc, which became overwhelming.

I think we are eventually heading down he USA route to healthcare, certainly with this government... they are not going to touch the 'European' model.

The drawback with private healthcare is that basically everyone needs the most comprehensive cover - because no one knows what's round the corner. If you only purchase the plan you can afford, then you will be in trouble if it doesn't cover your needs - which you obviously can't anticipate.

There will of course be a 'safety net' for the impoverished and the elderly with multiple health problems - one that will prevent you from dying on the street, so to speak. But I know for a fact that my somewhat risky NHS surgery at age 79 which gave me a new lease on life and possibly many more good years of it, will be a thing of the past. And I know because my surgeon told me that I'd be unlikely to undergo such a procedure privately because I would not be able to afford it and private surgeons build up a register-of-reputation, mostly be performing surgery that is fairly uncomplicated with low risk. You'll find many desperate patients in the US looking for surgeons to perform similar kinds of surgery that are more risky, but are turned down, frequently. My consultant / surgeon has 20 years experience in the field and has honed his skills in the same discipline, thanks to the NHS.

How the impoverished here in the UK are ever going to afford healthcare, goodness only knows. Even without the energy hikes, they're struggling.

My sister in the US (widowed, self employed) was paying over $800 a month for health insurance for herself and her young dd years ago - I don’t know about now - niece is grown up and independent.

But Dsis still had to pay a $2500 excess for treatment of a badly cut finger. I was ? when she told me that.

I’m reminded of a very disturbing book I read many years ago.
It centred on a hospital. The private medical company were killing people who were costing them too much.
Pure fiction, of course.

Baggs

Several geographically European (so not just EU) countries have systems that seem to work pretty well so I imagine that if we didn't have the NHS we'd have sorted out something similar. My optimistic side thinks we could still do this.

So what happens to those of us that have paid into the NHS throughout our working lives? Will that money be transferred to the new system. Also, most of the talks regarding NHS privatisation seem to have been with US companies so I would assume that any new system will be based on theirs. We seem to follow them in most things. Someone’s husband was in talks with the US regarding NHS privatisation recently but I can’t remember who it was? Was it Dido Hardings? It was someone like that.

Fleurpepper

No, I can't imagine, as it is (well, was) the best system in the world.

What happens under the French system about pre-exisiting conditions? If we have to move to a Health Insurance system, it has to ensure 2 things a) that those who can't afford it are covered by a safety net. Having 10% of the population not covered as in the USA is just NOT acceptable. And b) that Insurers cannot refuse or exclude pre-exisiting conditions or some conditions.

A person I know, returned from another country with pre-existing conditions is treated free of charge, even operations because she doesn’t have an income over 9, 654 euros.

I have suggested that she could work to improve her life but she has refused because she would lose this, free transport and cheaper housing

Sorry got preoccupied with my own circumstances. We need to fund the nhs, train recruit and retain medical staff. I expect improvements can be made but we need to keep our nhs.
It isn’t free because we pay into it but it’s free at the point of use which it should be
Id happily pay £25 for a doctor appointment but I’m lucky not to be surviving only on a state pension, or caring for a young family on minimum wage.

Several geographically European (so not just EU) countries have systems that seem to work pretty well so I imagine that if we didn't have the NHS we'd have sorted out something similar. My optimistic side thinks we could still do this.

No, I can't imagine, as it is (well, was) the best system in the world.

What happens under the French system about pre-exisiting conditions? If we have to move to a Health Insurance system, it has to ensure 2 things a) that those who can't afford it are covered by a safety net. Having 10% of the population not covered as in the USA is just NOT acceptable. And b) that Insurers cannot refuse or exclude pre-exisiting conditions or some conditions.

I can't help asking Glorianny what happens if you can't, or don't, pay?

I tried to buy private health cover aged 43 after changing jobs which meant I lost my previous good terms and conditions. My RA diagnosis meant I was refused cover. The expensive treatment I’ve had the past 15 years means I’m mobile and healthy.
The nhs is a lifeline for many. One of my loved ones is having £1500 of treatment weekly currently. In the USA it would be sell the house

Elizabeth27

Over 90% of American citizens have health insurance, either employer or state paid. There will be some that fall through the net but it is available to all.

There are many countries without the NHS that cope very well.

In "Unsheltered" the middle class couple lose their health insurance when he loses his job. They then don't qualify for anything until they lose any assets and are eligible for medicare.
90% means that 1 in every 10 people has no healthcare.

The other thing I didn't realise about the US system is that any healthcare debt is inherited after someone dies. So if your loved one has cancer and your health insurance doesn't cover their treatment you have to pay all the rest even after they die.

At the moment I prefer the French health system over the NHS.
The waiting lists seem so long in the UK and I do like the idea seeing a doctor within a week or earlier, face to face.

I do pay 25€ to see a doctor but 70% is refunded under the normal system but as I pay for extra cover all paid except 2€.
I don’t pay for prescriptions.

I don’t know how much each person in the UK has to pay each year out of their income for the NHS but for those under 9, 654 euros will receive free health care, including optician and dental care.

However, opticians as well as dentists, gynecologists etc. have a month or so waiting period.

I think there are other European countries that are better than France though.

I think all of us who have lived, or who have family, in the US know that the system there is very broken indeed.

My brother-in-law, who is in his mid-70s, and healthy, and living in the US, spends 50% of his social security (a great deal higher than a UK pension) on healthcare costs, because, despite what you may believe, Medicare is not free (Part A which covers mainly hospital care, is, but has some co-pays) and Part B, which covers things like GP visits, is not. I can't list all the premiums, but essentially if a single person earns up to $88,000 (£75k) or a couple £175,00 (£149k) per year their premium is $148 per calendar month.

And even then, it still does not cover all one needs.

Here is a list of exemptions even if you have Part A and B:

www.medicare.gov/what-medicare-covers/whats-not-covered-by-part-a-part-b

My DIL is American. She has a friend who had a Heart Transplant. Iwas interested to see how they got on. It was successful, eventually he got the bill over $500.000 luckily most covered by insurance but not all of it.

Stats to back up my claim about the NHS cost, from The Health Foundation, using ONS and OECD figures

Under the French system, we paid 25.00 Euros for each GP visit. This was then reimbursed from the State after ca. 6 weeks. For specialist care, a referral is needed. This sometimes costs 50.00, a portion of which is reimbursed but not a great deal. However, it does tend to stop malingerers who have to pay up-front. System by and large works well. If you are indigenous, then the State picks up the tab. Same applied to Belgium, but definitely not to Switzerland, where the cost of health insurance is horrendous!

Elizabeth27

Over 90% of American citizens have health insurance, either employer or state paid. There will be some that fall through the net but it is available to all.

There are many countries without the NHS that cope very well.

But having insurance doesn't mean that it is free - many have to pay towards their premiums and you still have to "co-pay" when you use services.

Now this is going back over 25 years but an American friend with insurance had to pay $2,000 in co-payments when she had her baby and then $500 when the baby was a few month old and had a chest infection.