Rabbie
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Of course. I enjoy a good friendly argument (as long as I winCool Rab - Truce?
).
What's happened to the NHS???
- Thread starter oumahexi
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KenHigg
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No offence taken
How does US medical insurance work? Let's say you never got sick - hypothetically, you paid for 50 years, then died in a plane crash - would they give you your money back? I'm guessing not, but I'm prepared to learn differently. The money you pay is going to help fund the treatment of people who do get ill, correct? These people have also paid contributions to the insurance company.
The only difference I see is that in a system such as exists in the UK surplus contributions from one person may help people who can't afford to help themselves. In the US, surplus money either goes to help people who don't need help, as they're already looking after themselves, or it gets turned directly into profits for the insurance company.
Would you rather that money you're already spending go to the needy or to a large corporation?
Also, isn't a society judged partly by how well it treats it's weakest members? If the poor are allowed to become sick and die off purely because they are poor (for whatever reason), that doesn't make the parent society look too good. Yes, some people make no effort to help themselves, but I can't believe that's the reason in the majority of cases where people have no medical cover.
What gives the well-off people in a country the right to say that physically or mentally disabled people should be allowed to die because they're indistinguishable from the layabouts?
What if insurance premiums quadrupled or worse? Could you still afford to pay them? You've worked hard (presumably
I counted 9 "?"s so I'm not sure which were real questions you wanted answered
I, as a luckily healthy person, am on board with helping to pay for health care for less fortunate people.
(Now we'll have to find something else to fuss about )But I can't help but seeing myself sitting in line to see the doctor behind the guy that I see standing on the corning every morning begging for money because he's too lazy to work for it...
That's fixable. if you're standing behind him anyway, just give some money there and you won't have to see him on the corner.But I can't help but seeing myself sitting in line to see the doctor behind the guy that I see standing on the corning every morning begging for money because he's too lazy to work for it...
I'm available, if he's hiring.You should be on Obama's cabinet
there are always a few bums who make the system look as if its being abused - but its being abused at both ends ..
a national health system - for us in the UK and Europe is seen as being the smae as private medical insurance , however as we are all paying for it the premium(tax) should be lower as there is no profit .
the abuse comes from individuals and also from the drugs companies whom over charge
a national health system - for us in the UK and Europe is seen as being the smae as private medical insurance , however as we are all paying for it the premium(tax) should be lower as there is no profit .
the abuse comes from individuals and also from the drugs companies whom over charge
KenHigg
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How about this; If you're caught screwing the system you don't get NHS services anymore.
oumahexi
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Cool. The next step is to invite them into your home and provide them with a free shower and free meal every day - What a wonderfull world
You know, they are not all that bad! When I worked in the city I used to buy breakfast for a young man who was homeless, and consequently jobless, just because his mother had thrown him out because he turned 16 and she would now have to pay council tax for him. Not his fault. He was sleeping in a doorway for Christ sake, only a kid! If I could have, I would have taken him home with me. So, like the rest of us, I did the best I could.
Oh Ken, I'm sure you're taking the mickey here, I don't for one minute believe you don't have any compassion for people who have fallen on misfortune, and at this time of the year too, when you are supposed to remember it's all about loving each other.
oumahexi
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No offence taken
What gives the well-off people in a country the right to say that physically or mentally disabled people should be allowed to die because they're indistinguishable from the layabouts?
For that matter, what gives us the right to force them to live if they are terminal? We wouldn't do that to a dog, but we will to a human! I know if I were diagnosed terminal I'd want to go out before I left my family with only a memory of a mindless shell staring through dead eyes at them, but it would have to be my choice, I understand that.
Rich
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Haven't you forgotten that we've cancelled Christmas due to the credit crunch?
oumahexi
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Haven't you forgotten that we've cancelled Christmas due to the credit crunch?
You just don't listen to Radio 2 do you Rich?? They've been running a campaign "don't cancel Christmas"
Rich
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Just in case it has not been previously mentioned. I do not know all the details, but here is some general info for our foreign friends.
The US Govt. does offer to those in need:
1. Medicare for the Disabled and elderly for health care
2. Social Security for Disabled and elderly for income (not much $$ though)
3. Medicaid for the poor for health care. Elderly/disabled people may have this along WITH medicare.
4. Welfare for the poor for income (also not much $$). I think this also infludes food stamps for families who need them.
5. CHIP to cover the children of those who are not poor enough for Medicaid, but are still low income. This is intended to capture those who are working, but don't make much, but make too much to qualify for Medicaid. You buy health insurance through your employer, usually for a VERY low price just for you (b/c the employer subsidizes it), but it can be very expensive to cover your family also, or maybe your job does not offer insurance to you b/c you are part time or comission or something.
6. WIC offers food vouchers for foods deemed healthy to pregnant women (I think) and women (parents?) with small children. Also covers formula. There is a program to get breast pumps too for working mothers, but that may come under the State Department of Health. I am not sure.
7. Free or inexpensive care at the health department.
8. Meals-on-Wheels - 2 prepared meals/daily delivered to the home of the elderly/disabled for VERY low cost. I am not sure if this is a gov't program or not. (I am sure our tax $$ are in there somehow)
I am not familiar with the details of who qualifies for what. The bar is set pretty low for income to be considered "poor" to collect benefits for the poor, and it can be difficult to obtain social security if you are disabled. Some must get lawyers.
I think most of these programs are managed by the individual states, so what you get and how you get it differs nationally, just like insurance differs from job to job. Even insurance from the same insurance company can differ based on who you work for. Speaking generally for a second about employer-sponsored health insurance, some is awful, and hardly covers anything. Some is very good, with low out of pocket costs to the employee. Some (most?) of the services for the poor/disabled/elderly"act" like regular insurance, so the recipients use it the same way. Usually this boils down to selecing your Dr. from a list the insurance company provides, and paying a copayment or %age for the services you get.
Glasses/contacts and dental services are often not covered, or are barely covered for those with regular insurance. This is often covered by a seperate insurance plan your job may (or may not) offer. I do not know about services for the poor/disabled/elderly.
Pharmaceuticals are not covered by Medicare for the elderly, but there is a supplemental plan the elderly can purchase to cover them (or a %age of them). There are other supplemental plans (some cost supplemental $$) for Medicare for other things not covered by the basic plan, but I do not know the details.
There are also conversations about the quality of care. Waits at the Department of Health can be longer than seeing a regular Dr. with regular insurance. I think some regular Drs. take Medicare/Medicaid, but I do not know the details. At the same time, Medicare/Medicaid sometimes pays for services that would leave a person with regular insurance with crushing bills after they come home. (10% or 20% of a hospital stay bill can add up quick!!!) If your aging mother needs a nursing home and is not poor enough, you either come up with $4000/month or she is living with you, whether you can care for her or not. Alternatively, if you that aging mother has no family who will take them in, they stay in the nursing home until they burn thru all their own assets, and then Medicare/Medicaid will kick in. BUT, the nursing home Medicare/Medicaid will pay for may not be nice (some are OK).
The long & the short of it is, the poor are covered healthwise to a certain extent. It is not ideal or the Cadillac of coverage, but it some people do fine with it. My 96-year-old grandmother is covered by Medicare/Medicaid and is fully covered in a very nice nursing home with all of her health needs attended to. Before that, she lived in an "independant living center" (like a low-rent apartment for elderly/disabled who can take care of themselves) that also accepted Medicare/Medicaid. The kicker is that she has my PARENTS there to do all the paperwork & running around to make sure she gets all she has a right to & is covered for. NOTHING is automatic. The must make sure that all "i"s are dotted, all "t"s are crossed, and that paperwork is completed & submitted by the appropriate deadlines. They also made sure she got into the nicer nursing home sponsored by the medicare insurance. The one she was supposed to go to was not so nice.
The poor/elderly/disabled without someone to speak for them and help them with the process do not always get all that they have a right to and often don't even know what they have a right to or how to get it. Again, nothing is automatic. You don't get what you don't ask for. If you end up in the hospital for some reason, you may be assigned a social worker if you need one who can help you to get what you need, but otherwise, it is up to you to take care of your own business, and some just don't know where to begin.
It is also the lower-middle income folks who struggle. Those who are poor (or almost poor) but not poor enough. fall thru the cracks. They may have insurance (or may not be able to afford it, or are not covered by their job), but cannot afford the copayments for services, or pharmaceuticals, or the deductible (which can be VERY high for some companies). For some people, it may be difficult to burn thru a deductible of $500, or $2500, or more before insurance kicks in for the year.
Some employers offer a pre-tax deduction for health care in addition to health insurance. You have so much taken out of your paycheck before taxes for health care (and child care), and set aside. Then you use it as you need it. You still have to pay, but the annual income your tax rate is calculated from is lower. Insurance costs are pre-tax also for employees who sign up for insurance.
Hope this helps some of you. Thankfully, I am fortunate enough to have excellent insurance at my job that covers quite a bit. My out of pocket costs are low. But I have a lot of friends at other employers whose insurance does not cover as much.
The US Govt. does offer to those in need:
1. Medicare for the Disabled and elderly for health care
2. Social Security for Disabled and elderly for income (not much $$ though)
3. Medicaid for the poor for health care. Elderly/disabled people may have this along WITH medicare.
4. Welfare for the poor for income (also not much $$). I think this also infludes food stamps for families who need them.
5. CHIP to cover the children of those who are not poor enough for Medicaid, but are still low income. This is intended to capture those who are working, but don't make much, but make too much to qualify for Medicaid. You buy health insurance through your employer, usually for a VERY low price just for you (b/c the employer subsidizes it), but it can be very expensive to cover your family also, or maybe your job does not offer insurance to you b/c you are part time or comission or something.
6. WIC offers food vouchers for foods deemed healthy to pregnant women (I think) and women (parents?) with small children. Also covers formula. There is a program to get breast pumps too for working mothers, but that may come under the State Department of Health. I am not sure.
7. Free or inexpensive care at the health department.
8. Meals-on-Wheels - 2 prepared meals/daily delivered to the home of the elderly/disabled for VERY low cost. I am not sure if this is a gov't program or not. (I am sure our tax $$ are in there somehow)
I am not familiar with the details of who qualifies for what. The bar is set pretty low for income to be considered "poor" to collect benefits for the poor, and it can be difficult to obtain social security if you are disabled. Some must get lawyers.
I think most of these programs are managed by the individual states, so what you get and how you get it differs nationally, just like insurance differs from job to job. Even insurance from the same insurance company can differ based on who you work for. Speaking generally for a second about employer-sponsored health insurance, some is awful, and hardly covers anything. Some is very good, with low out of pocket costs to the employee. Some (most?) of the services for the poor/disabled/elderly"act" like regular insurance, so the recipients use it the same way. Usually this boils down to selecing your Dr. from a list the insurance company provides, and paying a copayment or %age for the services you get.
Glasses/contacts and dental services are often not covered, or are barely covered for those with regular insurance. This is often covered by a seperate insurance plan your job may (or may not) offer. I do not know about services for the poor/disabled/elderly.
Pharmaceuticals are not covered by Medicare for the elderly, but there is a supplemental plan the elderly can purchase to cover them (or a %age of them). There are other supplemental plans (some cost supplemental $$) for Medicare for other things not covered by the basic plan, but I do not know the details.
There are also conversations about the quality of care. Waits at the Department of Health can be longer than seeing a regular Dr. with regular insurance. I think some regular Drs. take Medicare/Medicaid, but I do not know the details. At the same time, Medicare/Medicaid sometimes pays for services that would leave a person with regular insurance with crushing bills after they come home. (10% or 20% of a hospital stay bill can add up quick!!!) If your aging mother needs a nursing home and is not poor enough, you either come up with $4000/month or she is living with you, whether you can care for her or not. Alternatively, if you that aging mother has no family who will take them in, they stay in the nursing home until they burn thru all their own assets, and then Medicare/Medicaid will kick in. BUT, the nursing home Medicare/Medicaid will pay for may not be nice (some are OK).
The long & the short of it is, the poor are covered healthwise to a certain extent. It is not ideal or the Cadillac of coverage, but it some people do fine with it. My 96-year-old grandmother is covered by Medicare/Medicaid and is fully covered in a very nice nursing home with all of her health needs attended to. Before that, she lived in an "independant living center" (like a low-rent apartment for elderly/disabled who can take care of themselves) that also accepted Medicare/Medicaid. The kicker is that she has my PARENTS there to do all the paperwork & running around to make sure she gets all she has a right to & is covered for. NOTHING is automatic. The must make sure that all "i"s are dotted, all "t"s are crossed, and that paperwork is completed & submitted by the appropriate deadlines. They also made sure she got into the nicer nursing home sponsored by the medicare insurance. The one she was supposed to go to was not so nice.
The poor/elderly/disabled without someone to speak for them and help them with the process do not always get all that they have a right to and often don't even know what they have a right to or how to get it. Again, nothing is automatic. You don't get what you don't ask for. If you end up in the hospital for some reason, you may be assigned a social worker if you need one who can help you to get what you need, but otherwise, it is up to you to take care of your own business, and some just don't know where to begin.
It is also the lower-middle income folks who struggle. Those who are poor (or almost poor) but not poor enough. fall thru the cracks. They may have insurance (or may not be able to afford it, or are not covered by their job), but cannot afford the copayments for services, or pharmaceuticals, or the deductible (which can be VERY high for some companies). For some people, it may be difficult to burn thru a deductible of $500, or $2500, or more before insurance kicks in for the year.
Some employers offer a pre-tax deduction for health care in addition to health insurance. You have so much taken out of your paycheck before taxes for health care (and child care), and set aside. Then you use it as you need it. You still have to pay, but the annual income your tax rate is calculated from is lower. Insurance costs are pre-tax also for employees who sign up for insurance.
Hope this helps some of you. Thankfully, I am fortunate enough to have excellent insurance at my job that covers quite a bit. My out of pocket costs are low. But I have a lot of friends at other employers whose insurance does not cover as much.
I think it differs according to who is asking and what you are applying to get, but I took a quick look. I think some things, like CHIP, are based on people making above the poverty level, like 1.5 times or 2 times the poverty level.
The Federal Poverty Guidelines are as follows:
2008 Health & Human Services Poverty Guidelines
Persons in Family or Household
(higher in Alaska & Hawaii)
1 $10,400
2 14,000
3 17,600
4 21,200
5 24,800
6 28,400
7 32,000
8 35,600
For each additional
person, add 3,600
Found this here: http://aspe.hhs.gov/poverty/08Poverty.shtml
Now, that $10,400 (at about $867/month) will barely cover rent in some places, like San Francisco or New York. That is before you talk about clothes, food, transportation, etc. So you can see here how the near-poor are really in a bind, especially in urban areas. Some places, like the Health Department, offer services on a sliding scale, based on income, but that is still $$ you may not have. Also, the emergency room cannot turn anyone away. They have to stabilize your issue before they are allowed to release you. That sometimes means admission (car accident, woman in labor) for care that you will probably be billed for, but can never afford to pay. Even the ER visit generates a bill even if you do not stay. So obviously, hospitals near poor areas end up providing MORE services marked off as charity, putting THEM (those hospitals) in a bind. Some even close from running in the red so long. Some people with no insurance visit the ER a lot b/c they have to be seen for their health problems. I am not saying that this is or is not common, just that it does occur. Some people are worse off by the time they get to the ER b/c they could not afford to see the primary care Dr. when the problem was small.
The system is not ideal, but I have seen comparisons of the various systems worldwide, each with it's faults & benefits. I don't think anyone has it exactly right.
One thing seems true across the board, if you are rich, you can get just about any procedure/treatment you want, by the best Drs you can find somewhere in the world.
The Federal Poverty Guidelines are as follows:
2008 Health & Human Services Poverty Guidelines
Persons in Family or Household
(higher in Alaska & Hawaii)
1 $10,400
2 14,000
3 17,600
4 21,200
5 24,800
6 28,400
7 32,000
8 35,600
For each additional
person, add 3,600
Found this here: http://aspe.hhs.gov/poverty/08Poverty.shtml
Now, that $10,400 (at about $867/month) will barely cover rent in some places, like San Francisco or New York. That is before you talk about clothes, food, transportation, etc. So you can see here how the near-poor are really in a bind, especially in urban areas. Some places, like the Health Department, offer services on a sliding scale, based on income, but that is still $$ you may not have. Also, the emergency room cannot turn anyone away. They have to stabilize your issue before they are allowed to release you. That sometimes means admission (car accident, woman in labor) for care that you will probably be billed for, but can never afford to pay. Even the ER visit generates a bill even if you do not stay. So obviously, hospitals near poor areas end up providing MORE services marked off as charity, putting THEM (those hospitals) in a bind. Some even close from running in the red so long. Some people with no insurance visit the ER a lot b/c they have to be seen for their health problems. I am not saying that this is or is not common, just that it does occur. Some people are worse off by the time they get to the ER b/c they could not afford to see the primary care Dr. when the problem was small.
The system is not ideal, but I have seen comparisons of the various systems worldwide, each with it's faults & benefits. I don't think anyone has it exactly right.
One thing seems true across the board, if you are rich, you can get just about any procedure/treatment you want, by the best Drs you can find somewhere in the world.
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