US Adverts on National Healthcare

If a private insurance company offered to indemnify you for something and took premiums for years on that agreement, then refused to pay up when you had a valid claim, you'd be throwing around words like "sue" and "breach of contract," wouldn't you?   

You don't think that insurance change what they cover from one year to the next or judge your claim to be invalid because of some clause they have slipped in without you noticing?  And you think you have redress?  You don't.  You really have little grasp of what private insurance companies are like.

It has nothing to do with choosing to go private.  If you have been paying into a government scheme on the understanding that certain things will be covered, now when you need those things they are not, then you are being forced to pay again.

What are you talking about though? The understanding that WHAT is covered?

It's certainly a complaint you'll hear from many people who have paid into the NHS most or all of their working lives.  My mother fell into this trap 10 to 15 years ago, and I know a lot of people complain about it today.  They were told that by paying N.I. "contributions" they would receive "free" this and "free" that when they needed it, yet now they have to pay again. 

If a private insurance company offered to indemnify you for something and took premiums for years on that agreement, then refused to pay up when you had a valid claim, you'd be throwing around words like "sue" and "breach of contract," wouldn't you?   

Why does the government get to just change the rules part way through the game?

What Mindy said.  Plus I think you'd need a bit more than a 60 year old speech using vague language that was meant to introduce something that had taken years of planning and was meant to be a work in progress. 

I'd be in favor of reform that provides a basic level of care for everyone without government involvement, as long as there's some meaningful mechanism in place to keep hospitals/insurance companies from weaseling out of providing care for people.  As things stand now, though, I don't think the industry is going to reform itself, and since the issues have been evident for some time, I'm ok with the government taking the lead.

I think this is the critical point. I strongly believe governments should only get involved if there has been a market failure. To me, healthcare access in the US is an absolutely classic case of market failure, and one that has been festering a long long time. I have no confidence that the insurance industry will reform itself without regulation and government involvement. I well remember the early '90's when Clinton tried to address the problem. The insurance companies came to Congress and claimed they would reform without government intervention. Of course, once the pressure was off they did no such thing, but merely became even more aggressive in some of their more egregious practices.

You don't think that insurance change what they cover from one year to the next or judge your claim to be invalid because of some clause they have slipped in without you noticing?  And you think you have redress?  You don't.  You really have little grasp of what private insurance companies are like.

Besides, that is exactly what they DO do! Google "recission" for a real horrorshow! They will take your premiums for years and then when you need it, they will yank the coverage! Paul, that is one of the central issues in the whole debate!

Seriously, Mindy's right -- that kind of post makes me wonder if you're up on what the health insurance is like the in the U.S. at all!

I think it also might be difficult to articulate the fear that health care and insurance create in the US.  At one point, I had to carry my own health insurance. First, there were only one or two companies I could choose between, so no real competition at all. I have both allergies and asthma and a long documented history of needing meds for both. Of course, in order to cover that, I would have had to take out a policy that costed over 2,000$...a month.  Instead, I took the reasonable option which excluded my allergies and asthma (my doctor loaded me up with samples to try and last out the year) AND, because I had had an issue with it once, my left ankle (really, once, when I was eleven!).  No matter what, even if it broke because an insurance agent sat on it, my left ankle was in the no-go zone. 

I was terrified of hurting myself the entire time I had that policy--and, even when I had an *amazing* by US standards policy, my prescriptions were still almost 100$ a month and looked likely to rise as the district I worked for scrambled to save money. I had no control over my own health care, and there were no alternatives. 

I understand that the NHS isn't perfect. I understand that it might not do everything it possibly could.  I understand the frustration of paying for something and then not getting what you thought you were paying for.  But I will never, ever feel less than fantastic about living somewhere where I know that I will be able to get treated if I am sick. And where it's "safe" to trip and break an ankle!

And do you want communists like Dr. Ezekiel Emanuel getting his way in any sort of government helathcare program?

http://www.nypost.com/seven/07242009/postopinion/opedcolumnists/deadly_doctors_180941.htm?&page=0

Not like the media to take things out of context to further their point
http://www.time.com/time/nation/article/0,8599,1915835,00.html?xid=rss-fullnation-yahoo

Basic healthcare should be a right, but so should not so basic healthcare that includes care for more expensive or catastrophic things.  When people say basic healthcare, maybe I am wrong in assuming that it means just check-ups and basic injuries.

Oh, I see what you're getting at.  What I mean by basic health care is if you get sick or injured you can go to a doctor and get treatment.  It wouldn't cover stuff like elective plastic surgery.

If a private insurance company offered to indemnify you for something and took premiums for years on that agreement, then refused to pay up when you had a valid claim, you'd be throwing around words like "sue" and "breach of contract," wouldn't you?   

{sarcasm} Haha!  Yeah, you're always seeing stories on the news about insurance companies getting sued for millions and going bankrupt because they denied coverage to a long-time customer. {/sarcasm}

You don't think that insurance change what they cover from one year to the next or judge your claim to be invalid because of some clause they have slipped in without you noticing?  And you think you have redress?  You don't.  You really have little grasp of what private insurance companies are like.

Exactly.

Well, I happened to be reading newspaper archives for other reasons, and remembered Paul claim about broken promises with the NHS.  Apparently, prescription drugs always had what Americans would call a copay in England under the NHS. The rates have varied.  I've found articles in the Observer and Guardian and The Times of London which have shown that the charge for prescriptions:

The Times:
08 November 1949, pg 2 (explains the charge is to prevent abuse, socialists resist the charge)

The Guardian 15 July 1948, pg 4 Letters to the Editor

The second letter describes a transaction on the first morning of the NHS.  He's complaining about proprietary drugs being dispensed at the same cost as other drugs.  He's concerned about the cost of such practices.  

The first letter talks about paying the GP, which apparently was what you had to do in the early days of the GP.  Sounds like that's changed for the better.

There are also references to dental and optical fees.

How can something be taken away (care without out of pocket costs) which people never had?  If there were overt, solid promises that Joe and Jane Bloggs would never have to pay anything for any care other than the frivolous, why isn't there outrage then?  If it is just a case of austerity Britain, why is there no reference to this when the payments increase in the late 1940s and early 1950s?

I found reading articles written about the NHS at the time of its inception really interesting, and I highly recommend anyone with a library card which offers the archive services at these papers take a look when you get the chance.  Much of the debate was very similar (if more civil) about choice and so on.

I hope Paul has a bit of a better understanding of how insurance companies in the States work after trying to compare the two systems at least.

I'm sure I've posted this before   

None of this discussion is helped by the fact that almost the entire population of the UK including virtually everyone on this board is under the misapprehension that National Insurance is 'National Health Insurance'.

It isn't. NI contributions entitle you to a state pension, some sickness & disability benefits, maternity benefit, some unemployment benefit (without means testing) and a few obscure industrial injury payments.  There are plenty of issues surrounding whether we are getting what we thought we we paying for but it's nothing to do with the NHS.

The NHS is funded from general taxation.

There's a really interesting article about health care reform by David Goldhill in the September 2009 issue of The Atlantic.  It goes into great detail about how the current system got to the state it's in, and has some interesting ideas about how reform should take shape.

Without giving the whole thing away, he suggests that while insurance should pay for catastrophic care, we should pay for the rest of our health care ourselves.  Here's a small sample:

Today, insurance covers almost all health-care expenditures. The few consumers who pay from their pockets are simply an afterthought for most providers. Imagine how things might change if more people were buying their health care the way they buy anything else. I’m certain that all the obfuscation over prices would vanish pretty quickly, and that we’d see an end to unreadable bills. And that physicians, who spend an enormous amount of time on insurance-related paperwork, would have more time for patients.

I like the ideas he's come up with, but I don't see how any politician - Republican or Democrat - could ever hope to implement them.

How American Health Care Killed My Father, by David Goldhill

The August 31st issue of The New Yorker has a good explanation of why Americans say they want health care reform, but why half of those polled say they disapprove of the current plan to do so.

There are times when Americans’ attitude toward health-care reform seems a bit like St. Augustine’s take on chastity: Give it to us, Lord, but not yet. In theory, the public overwhelmingly supports reform—earlier this year, polls showed big majorities in favor of fundamental change. But, when it comes to actually making fundamental change, people go all wobbly. Just about half of all Americans now disapprove of the way the Obama Administration is handling health care.

In part, of course, this is because of the non-stop demonization of the Obama plan. But the public’s skittishness about overhauling the system also reflects something else: the deep-seated psychological biases that make people resistant to change.

The article continues here.

Just as an amusing side note...

For those of you who read Dooce (www.dooce.com), you may have seen her link to her husband's blog (Blurbomat).

Apparently he follows the White House Twitter feed and posted a comment to them requesting graphs and charts and he actually got a response from them - complete with graphs and charts!

Here's the link to his post (http://blurbomat.com/archives/2009/08/25/yes-we-can-reform-healthcare/) which has the White House and Twitter links in it as well.

I thought this was an interesting contrast to what Legs posted above regarding archived debate about health care she's been reading.

How far we have come... in some ways... 

The August 31st issue of The New Yorker has a good explanation of why Americans say they want health care reform, but why half of those polled say they disapprove of the current plan to do so.

The article continues here.

Hmmm...this article sounds more accurate to me:

http://www.forbes.com/2009/08/25/health-care-debate-democrats-opinions-columnists-dan-gerstein.html