What do Americans really think about Canadian/EU health-care?

[dirtyweasel]

US resident here:

I've heard a lot of good things about Canadian healthcare including low co-pays, health coverage not being affected by employment and no lifetime limits or pre-existing condition exclusions.  I've also heard that if you want a supplemental plan for extra coverage you can get one which I think is really great.

I think that's why I'm excited for the Affordable Health Care Act (aka Obamacare) to go through because I hope it's successful in helping people out.  My mom is a 58 year old unemployed widow who can only get health insurance through the private market because her unemployment benefits ran out.  She pays $750 a month for cruddy health insurance and doesn't qualify for government assistance because she receives "too much" money from my dad's pension (Ha!).  When we were finally able to log onto the new healthcare website it estimated that she would pay something like $175 a month in insurance with the new plan.

[Margo]

I find this really interesting - I am in the UK and I am so grateful for the NHS - I am asthmatic so have regular medication and extra checkups - the only cost to me is the prescription charges which average about £8 month (and when I a child that was free, and would be free if I were unemployed, disable or a pensioner, now) It's possible to buy a pre-pay certificate which covers any prescription charges for a year - I don't have one now, as for me it currently works out at about the same as paying for my regular repeats as I go along, but I used to have one when I was younger and on a  tight budget.

In addition to birth control prescriptions being free, you also don't pay prescription charges if you have certain medical conditions such as diabetes and cancer.

Although the NHS isn't perfect, I do feel that *in general* it is very good. I have always been able to see a doctor at my GP surgery on the same day if I need one, home visits are avaialable when needed. when I was involved in a car crash and ended up with a long term shoulder problem I saw ER doctors, an orthopedic surgeon and a couple of other consultants, and had x-rays,MRIs, physiotherapy and  osteopathy. None of it cost me anything at all.

When my grand-dad was dying, he was able  return home - the NHS provided a hospital bed, the disctrict nurse came daily to help with his personal care and medications and the doctor came every few days. I can't imagine how much that level of care would have cost had we had to pay for it. his consultant at the hospital was incredibly good, listened to what he wanted, made sure he understood the risks, and then made sure everything happened fast, so he got to die at home.

I have quite a lot of friends who live in the US and we have discussed these issues - a lot of them are artists and writers and in many cases either they, or their spouses, have had to take/stay in unsatisfactory jobs to maintain insurance coverage because they can't afford to become self-employed and to have health insurance. A close friend and her partner are unable to marry, because he can't divorce his wife (despite having been separated for years) because if he does, she will no longer be covered on his health insurance, and she has significant mental health issues.

[Diane AKA Traska]

Not all Americans have bad coverage, either.  Let me give you an example (because I love telling this story... warning for factual but not gory descriptions of injury):

Almost a year ago now, I was in a car accident, and the air bag in the car broke my finger.  M was driving, I was a passenger, so M's auto insurance stepped in.  I was taken, by ambulance, to a local hospital where they examined my finger (which, in addition to being broken, was lacerated as well).  I spent, all told, 12 hours in the ER, and left with a plastic splint and a prescription for generic (but strong) painkillers.

About a week later I was in for surgery (which I woke up during!), where two pins were put in my hand to repair the damage, I was given a cast, and was sent home that night with another prescription for roughly the same meds.

Three weeks after that, I went in for evaluation, and three weeks after that the cast and pins were removed.  At that point, I was signed up for physical therapy.  Four weeks of that, and I was back to normal hand operation (my PT was literally left with her jaw hanging when she saw how quickly I was able to master the hand exercises and resume full mobility )

The whole time, M's auto insurer was *freaking out*.  They called numerous times to ask me if I had received any bills from the hospital, and if so, why hadn't I sent them along?  The thing is, I hadn't, ever.  Being on SSI, my insurance covered practically everything.  What did I have to pay?  $3 total for prescription co-pays.  What did M's insurer wind up covering?  The ambulance ride.  Everything else was covered.  I would dearly love if more people had access to *that* level of care!

(For the record, I photo-documented the entire process... even got some shots in the evaluation stage when they removed the first cast, before they put the second one on.  I told the nurse handling it "I want photo evidence to the contrary next time I say nothing interesting ever happens to me!")

With the shape SSI is in as far as lacking funds and me being someone who financially contributes to it that seems like an abuse of the system.  That claim should have been paid by the car insurance and you should have notified the hospital not to use your insurance which is provided with taxpayer money because the car insurance was supposed to pay it.  My understanding from my experience dealing with my husbands multiple hospitilizations and BCBS is that you committed insurance fraud.  He has been contacted almost every time he has been hospitalized to determine if anyone else should be paying and told it would be fraud if it was workman's comp or related to a car accident.  If this happened recently I think the right thing to do would be to let SSI know that it should have been a car insurance claim.

We had something similar happen - I was in an accident and BCBS paid, even though it was an auto accident. When I got the settlement (accident not my fault) I kept the amount of my medical bills in a savings account for three years waiting for subrogation claims from BCBS. Never got them.
Sometimes it seems people at the insurance company don't care if another company should pay the bills. Every time BCBS sent me questions about the accident, I told them it was due to a car wreck, so they knew it was not a standard accident that had no other coverage.

That's the other thing: I didn't sue the insurance company.  No one was "at fault" (and M was the one whose brakes failed anyway), so it didn't seem prudent to try to get money out of what was essentially a true accident.

[English1]

I suppose a perfect system would be one in which everyone got everything they needed and wanted, free of charge.

There's no way to achieve that. So all systems are a compromise. Some people win out, and some people lose out. The difference between the systems seems to be on which people win out, or lose out, and the reason for it, and the scale of it. In a US style system you seem to either win out big, or lose out big, purely down to your financial/employment standing. In the UK system everyone wins out to some extent, and loses out to some extent. We see that as fairer and more equal. Although analysis has shown that you may in practice have different options depending on the area in which you live, which isn't supposed to happen, but it does. So 'fairness' is hard to enforce.

My understanding is that there are a lot of fears in the US over older people not getting prioritised for necessary treatment under a European style system. That's not been our experience with my parents; in fact it's my parents refusing available help sometimes due to wanting to be independent and just general anxiety about health treatments, that has caused us problems. They are in their late 80s and Mum has glaucoma and diabetes. Dad has diabetes, low blood pressure, digestive problems, and Alzheimers. Both have balance problems. Dad fell and cut his head badly last year. Mum fell and broke her wrist recently. They are probably at the hospital roughly twice a month to see their specialists about something or other. Mum's had eye operations and an operation to put pins in her wrist. Dad's head was scanned and stapled up and he has 6-monthly ECGs and other monitoring. He's also just had a new hearing aid. They get diabetes medication, have been sent to fall clinics for physio to help them improve their balance, Dad is on medication patches (a new treatment) for his Alzheimers. They've also had an assessment of their home needs and equipment such as grab rails and a riser chair for Dad provided. Transport is provided for them to and from their appointments. They've not had to pay one single penny for any of this.

[Joeschmo]

Not all Americans have bad coverage, either.  Let me give you an example (because I love telling this story... warning for factual but not gory descriptions of injury):

Almost a year ago now, I was in a car accident, and the air bag in the car broke my finger.  M was driving, I was a passenger, so M's auto insurance stepped in.  I was taken, by ambulance, to a local hospital where they examined my finger (which, in addition to being broken, was lacerated as well).  I spent, all told, 12 hours in the ER, and left with a plastic splint and a prescription for generic (but strong) painkillers.

About a week later I was in for surgery (which I woke up during!), where two pins were put in my hand to repair the damage, I was given a cast, and was sent home that night with another prescription for roughly the same meds.

Three weeks after that, I went in for evaluation, and three weeks after that the cast and pins were removed.  At that point, I was signed up for physical therapy.  Four weeks of that, and I was back to normal hand operation (my PT was literally left with her jaw hanging when she saw how quickly I was able to master the hand exercises and resume full mobility )

The whole time, M's auto insurer was *freaking out*.  They called numerous times to ask me if I had received any bills from the hospital, and if so, why hadn't I sent them along?  The thing is, I hadn't, ever.  Being on SSI, my insurance covered practically everything.  What did I have to pay?  $3 total for prescription co-pays.  What did M's insurer wind up covering?  The ambulance ride.  Everything else was covered.  I would dearly love if more people had access to *that* level of care!

(For the record, I photo-documented the entire process... even got some shots in the evaluation stage when they removed the first cast, before they put the second one on.  I told the nurse handling it "I want photo evidence to the contrary next time I say nothing interesting ever happens to me!")

With the shape SSI is in as far as lacking funds and me being someone who financially contributes to it that seems like an abuse of the system.  That claim should have been paid by the car insurance and you should have notified the hospital not to use your insurance which is provided with taxpayer money because the car insurance was supposed to pay it.  My understanding from my experience dealing with my husbands multiple hospitilizations and BCBS is that you committed insurance fraud.  He has been contacted almost every time he has been hospitalized to determine if anyone else should be paying and told it would be fraud if it was workman's comp or related to a car accident.  If this happened recently I think the right thing to do would be to let SSI know that it should have been a car insurance claim.

We had something similar happen - I was in an accident and BCBS paid, even though it was an auto accident. When I got the settlement (accident not my fault) I kept the amount of my medical bills in a savings account for three years waiting for subrogation claims from BCBS. Never got them.
Sometimes it seems people at the insurance company don't care if another company should pay the bills. Every time BCBS sent me questions about the accident, I told them it was due to a car wreck, so they knew it was not a standard accident that had no other coverage.

I get that mistakes can be made but I think there is a huge difference between a for profit company such as BCBS and extremely limited funds that are provided to people with disabilities to provide for their medical care.  I understand that the insurance companies should be responsible but I have to wonder if a person was sent a bill to pay out of pocket if they would be so cavalier about not ensuring the car insurance took care of it.  Just because one doesn't receive a bill doesn't mean that it's free.  Somebody, or a country of somebodies, has to pay for it.