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Old 03-06-2009, 06:13 AM
Kandigol Kandigol is offline
Join Date: Sep 2008
Posts: 18
Default Re: The Joys of Rationed Healthcare

Originally Posted by Rich View Post
So, Bob admits - rightly - that excellent, expensive, high-tech healthcare is going to have to either be rationed or otherwise severely limited. Why oh why would anyone or any company make some high-tech super-duper cure-all machine when it knows from the outset that it will never recoup its costs? This is the flaw of universal coverage. I applaud Bob's admission of that fact, but it doesn't precisely fill me with confidence in the forthcoming control over my health by HHS.
Rich, I experience European healthcare. Have experienced it all my life, except for the year I lived in South-Asia and Afghanistan and the six months I spent in Ann Arbor, Michigan teaching. So I can consider myself a bit of an expert. I also have three years experience with the Israeli system, which is probably the most comprehensive public health care system around.
Well, right now here in the Old Country were have a mixed system. You choose a one-payer private insurance company, pay the basic premium or around 100 euro's a month and opt in for extra insurance, like extra dental.
Children up to the age of 18 are freely insured. Their parents dont have to pay for all anything that is considered part of the basic package, except for high end orthodontics and stuff like that.
This basic package for adults and children alike is very very broad. It covers all serious stuff, medicine, therapy and what not. The insurance companies have to accept all customers for the basic package, for the extra policies they can opt to lay a higher premium on someone who is at risk.

How does this pan out in practice?
It works and it does not. Suppose you need cancer treatment. Your doctor will send you to a cancer clinic. The medical staff has trained all over the world, and are as good as anybody in the western world. You will get the treatment a person anywhere in the US would receive. You are not able to receive the cutting edge cutting edge Mayo Clinic, Sloan Kettering stuff, but as soon as a therapy or treatment is more commonplace, it will get to Amsterdam soon enough. No worries here. The same goes for state of the art fertility treatment, things like that.

But how about say you need run off the mill hypertension medicine? The every morning pills? This is where the problem starts. There are about fifty different kinds of treatment for hypertension, and some medicine is more expensive than others. So your GP is only allowed to prescribe the cheapest, most common ones. Even though the slightly more expensive ones have less side effects, or whatever. The government will try to keep a grip on costs by being cheap with medicine, the amount of times you can visit a specific therapist per year, household help after surgery, the things more people actually have to deal with.

The monitary blessed can always opt to pay everything from their own pocket. You can opt to pay privately for whatever they may need.

This works more or less the same in other European countries, too. In England, you can get really good treatment, but because of the cheapness of the NHS, the hospital will look like it just suffered an earthquake.
In Israel, the health system works more or less the same as in Europe.

As Europeans, we know we are paying for all this ourselves by paying our monthly premiums and our general taxes. No one is under the illusion we get it for free. Esp as you get older, it gets to be more expensive cause you need more, and you have to fork over quite a bit in extra premiums for extra insurance policies.
But at least we have a system that provides care for everybody, including the chronically ill, the mentally ill, etc. Even foreigners who are legal residents have to join in.
A lot of money is provided by the government for general preventative health care. Vaccinations are free, breast cancer exams, pap smears etc, anti-smoking counseling etc. This begins to touch upon the subject of the nanny state, and indeed there has been a debate going on whether the state should decide if we are allowed to smoke, drink, get high and get fat. Those discussions are cultural markers, someone in Sweden will give you a different answer than someone in Ireland or Portugal. But in the US, you have your own version of the nanny state when it comes to smoking tobacco or dope, or eating trans fats. I'm not saying that is wrong, but there may be a nanny state enthousiast hidden away in all of us.
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