NHS fee to double

  My wife here is currently seeing a physiotherapist, no referral from GP needed, and the sessions are £40 each.

That's paying privately?

Wait until you are in the UK paying a huge tax rate and contributing to the NHS budget the same as all your colleagues (this will easily be more money out of your pocket than your current contributions).  Then pay the NHS surcharge on top - simply because you are a migrant.

Exactly - I’m a U.K. citizen and last year £1,800 of my taxes went towards the NHS.  Over 2.5 years, that’s £4,500.... and I don’t even have to pay the IHS surcharge.

But if you’re an immigrant in the U.K., and you’re on the same salary as me, you’re paying £5,700 towards exactly the same services that I’m paying ‘only’ £4,500 towards, simply because you have a visa and I don’t.... so you’re essentially paying twice.



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That's paying privately?

Absolutely, no NHS subsidy and only a 15 minute walk from the house.

We also signed up to a private dentist recommended by good friends here and after a couple of visits have also been very impressed. For the first visit he did not charge at all for the exam but asked permission to do a full set of x-rays, and like our dentist in Texas immediately brought up the images on his computer monitor and discussed them with me. Cost of the x-rays was £7. A clean and polish with the hygienist cost £53. He said that they accept insurance from Denplan but he thought it would be cheaper to pay privately because he foresaw little need for treatment ongoing.

We have just been back for our second checkup and the hygienist was the same cost and the dentist checkup was £23. He also told me that my teeth are in such good condition that he doesn’t really need to see me more often than once every 12 to 18 months if I continue to have no problems, but recommended the clean and polish every now and again if I wanted. He said the same to my wife. My last appointment with our dentist in Texas, who we love,  was also a clean and polish plus exam by the dentist and that cost $188.

Wow I seemed to have hit a nerve here? Yes, I'm aware that I was comparing two different systems. Apples and oranges if you will? As I stated all countries have their issues with Healthcare. 

As I said, I have been in Healthcare for 38 years. My wife the Brit, has also been in Healthcare most of her life. So I know a little about both systems. And kept up with the changes over the years.

I just had to discharge a patient home this week. Her insurance company only covered 20 days of in house Physical Therapy. She was not ready to go home alone, and care for herself. No extended family, no safety net. A Home health agency will go see her 3 days a weeks for an hour if she is lucky?? Healthcare here is driven by money. In the "old days" It was driven by need.

So really, all I was trying to say. Is that I don't mind paying a little more in taxes or surcharges. If that means someone can go home from a hospital stay, and take care of their needs, and be safe.

I live in East Texas, and have had this very same debate with my colleagues. "Why should I pay for someone else's Healthcare??" This is what, I always hear from them. My retort is "Every human deserves basic Health care." So ya, naeve maybe?? But I'm only human.

My husband lost his job in June 2017 and we also lost our healthcare, eye and dental coverage. He decided to become self-employed and the only insurance we could afford is a s*** policy for healthcare only. We pay $1400 a month to cover four people and our deductible is $7500. In the nearly fourteen years we've been in the US, we have only had three non-check up visits and a few prescriptions.

On Friday, my son was carrying a box into a building in the dark and didn't see the curb. He fell face-forward and knocked out his two front teeth. His girlfriend rushed him to the emergency room. He was there for two hours and he got a CT scan which showed he had no head trauma. The bill? $6500. We went to the oral surgeon today to get him dental implants. That is an eye-watering $8400. Because we don't have dental insurance and our **** plan doesn't cover the oral surgeon, we now have a bill for just under $15,000.

My husband is now looking to abandon his self-employment so he can get a full-time job with "benefits" solely for healthcare. I'm completely devastated that his dream has been shattered like this. But I am grateful the son is fine but it's put a huge cloud over us. To me, £1200 is nothing!!


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Wow I seemed to have hit a nerve here? Yes, I'm aware that I was comparing two different systems. Apples and oranges if you will? As I stated all countries have their issues with Healthcare. 

As I said, I have been in Healthcare for 38 years. My wife the Brit, has also been in Healthcare most of her life. So I know a little about both systems. And kept up with the changes over the years.

I just had to discharge a patient home this week. Her insurance company only covered 20 days of in house Physical Therapy. She was not ready to go home alone, and care for herself. No extended family, no safety net. A Home health agency will go see her 3 days a weeks for an hour if she is lucky?? Healthcare here is driven by money. In the "old days" It was driven by need.

So really, all I was trying to say. Is that I don't mind paying a little more in taxes or surcharges. If that means someone can go home from a hospital stay, and take care of their needs, and be safe.

I live in East Texas, and have had this very same debate with my colleagues. "Why should I pay for someone else's Healthcare??" This is what, I always hear from them. My retort is "Every human deserves basic Health care." So ya, naeve maybe?? But I'm only human.

I completely agree that the USA is completely backwards in thinking that social healthcare is the devil!  And I completely agree that people should get the healthcare they deserve regardless of greedy insurance companies.

My issue is with the UK saying that immigrants are the problem with the NHS and having to pay a staggering amount for coverage.  Most of the things my family needs are NOT covered under the NHS (vasectomy, dermatology, allergist, and most recently to have my ears cleaned).  I've never spent so much out of pocket for healthcare as I have since moving to the UK.  Granted, my circumstances are quite different now. 

My nerve is with the extra money - not with the NHS. 

Wow I seemed to have hit a nerve here? Yes, I'm aware that I was comparing two different systems. Apples and oranges if you will? As I stated all countries have their issues with Healthcare. 

As I said, I have been in Healthcare for 38 years. My wife the Brit, has also been in Healthcare most of her life. So I know a little about both systems. And kept up with the changes over the years.

I just had to discharge a patient home this week. Her insurance company only covered 20 days of in house Physical Therapy. She was not ready to go home alone, and care for herself. No extended family, no safety net. A Home health agency will go see her 3 days a weeks for an hour if she is lucky?? Healthcare here is driven by money. In the "old days" It was driven by need.

So really, all I was trying to say. Is that I don't mind paying a little more in taxes or surcharges. If that means someone can go home from a hospital stay, and take care of their needs, and be safe.

I live in East Texas, and have had this very same debate with my colleagues. "Why should I pay for someone else's Healthcare??" This is what, I always hear from them. My retort is "Every human deserves basic Health care." So ya, naeve maybe?? But I'm only human.

I agree, I used to live in East Texas and had similar conversations. Even trying to explain that the US taxpayer pays more per person in taxes for healthcare without having universal healthcare is pointless. The fact is that it is taxes that pay for Medicare, Medicaid and the VA health system. In 2015 If you exclude military spending that leaves $2.45 trillion in mandatory spending, half of which is SS and other labor costs, and most of the rest is on Medicare, Medicaid and VA benefits.

https://www.nationalpriorities.org/budget-basics/federal-budget-101/spending/

I totally get what kfdancer says about the NHS surcharge, as taxes spent on healthcare for immigrants is tiny compared to the total NHS budget but they are an easy target for the government to say, “see, we are tackling excessive spending in the NHS”.

My husband lost his job in June 2017 and we also lost our healthcare, eye and dental coverage. He decided to become self-employed and the only insurance we could afford is a s*** policy for healthcare only. We pay $1400 a month to cover four people and our deductible is $7500. In the nearly fourteen years we've been in the US, we have only had three non-check up visits and a few prescriptions.

On Friday, my son was carrying a box into a building in the dark and didn't see the curb. He fell face-forward and knocked out his two front teeth. His girlfriend rushed him to the emergency room. He was there for two hours and he got a CT scan which showed he had no head trauma. The bill? $6500. We went to the oral surgeon today to get him dental implants. That is an eye-watering $8400. Because we don't have dental insurance and our **** plan doesn't cover the oral surgeon, we now have a bill for just under $15,000.

My husband is now looking to abandon his self-employment so he can get a full-time job with "benefits" solely for healthcare. I'm completely devastated that his dream has been shattered like this. But I am grateful the son is fine but it's put a huge cloud over us. To me, £1200 is nothing!!


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Man, that sucks.  I can't believe you are paying 1400 a month for insurance and still end up with a bill like that.
That's why I am in no rush to move back home.

I totally get what kfdancer says about the NHS surcharge, as taxes spent on healthcare for immigrants is tiny compared to the total NHS budget but they are an easy target for the government to say, “see, we are tackling excessive spending in the NHS”.

I feel that they are doing it to say "see, we are making immigrants pay their way".

I feel that they are doing it to say "see, we are making immigrants pay their way".

I doubt it. It costs the NHS on average about £1,500  a year for every adult and child.

The call years ago, from the taxpayers on the government site, was to bring in medicals to pass for visas, just as other countries do to protect their health service for their nationals. One consultant stated that it angered him to see people in front of him expecting to have his budget spent on them, when they had been paying lower taxes in another country. Brits doing that and US citizens, were some of the ones he named as being ther worst in his opinion.

There was even a uk-yankee post linked to show the government the abuse and that said something like,
-finally got my British citizenship and now after spending 3 years in the UK I can go home and earn some real money. There had better be an NHS still when I retire to the UK.
Links too to over 40s type threads on ex pat forums, where they talked about how they would retire to to the UK for the NHS, even though they are sad to leave their children and grandchildren behind in (whatever country they were living in where healthcare was expensive). Or how they planned to move their family to  the UK if ever they got cancer or any other expensive illness.

Instead of bringing in the tried and tested sytems that other countries have to stop abuse on their national health systems, the UK government invented the IHS. Which has upset those who had paid 44 plus years of working taxes to the UK for a full state pension and who then retired abroad, as this meant they could no longer use the NHS bill free, while others who hadn't paid in all their taxes to the UK, can. And also upset the healthly, young foreign nationals, who came to the UK to work and will pay their lifetime of taxes to the UK.



 

I doubt it. It costs the NHS on average about £1,500  a year for every adult and child.

I wasn't saying that it covered the cost, just that the government wants to be seen to be doing something about the perceived problem.

I wasn't saying that it covered the cost, just that the government wants to be seen to be doing something about the perceived problem.

But when everyone knows it doesn't stop abuse, they don't buy it. The stopping of the NHS abuse was never about healthy immigrants who come to the UK and work and pay years of taxes to the UK and was everything about stopping those who abuse, including those with a British passport.

I think the NHS abuse from some, has been ignored (for the moment - can't speak for future governments) and the IHS is a fund raising exercise because of the billions it costs the NHS every year to private firms, from when huge areas of the NHS were privatised back in about 2002.

Rather than fund the NHS, the then government privatised huge areas of the NHS, with a scheme called PFI. This then kicked the NHS funding problem down the road for future governments to sort out. PFI = private firms paid for the million pounds schemes and then years later and for years, get billions in interest. Some of these payments to these private firms under PFI, are nearly an NHS trusts entire budget now!

http://www.telegraph.co.uk/comment/9356622/Labours-PFI-landmines-continue-to-explode-in-the-NHS.html

http://www.telegraph.co.uk/news/nhs/11748960/The-PFI-hospitals-costing-NHS-2bn-every-year.html


I have some sympathy for the SNP as they found that PFI had been carried out in some schools in Scotland too, when they took over from Labour. Now years later, it's the SNP who have to fund those school builds of years ago, from the present budget and find the money to pay these private firms (many offshore) their billions in interest.

http://www.heraldscotland.com/news/14432710.__30_billion__The_cost_of_Labour_s_toxic_PFI_legacy_to_Scotland/

http://www.ibtimes.co.uk/many-scottish-pfi-schools-now-owned-by-offshore-funds-1577361

Ouch.

http://www.telegraph.co.uk/news/2018/02/05/charges-migrants-use-nhs-will-double-raise-millions-health-service/

Sucks for a lot of people and I don't want anyone to be in a bad bind, but that noted, it's still cheaper than my personal situation for an insurance policy over here that still wouldn't cover an uncomfortable number of things. Going to keep being optimistic.

I've always had great private health insurance through my former work. But since resigning at the end of last year, and refusing to pay $2k+/month to continue coverage through COBRA, I am now on the other end of the stick trying to navigate getting Medi-cal coverage (public health) for myself and my son here in California. All I can say is I hope we don't get sick while we're waiting for my visa to get approved. I am re-applying for a Spouse visa sometime mid-March because we got a refusal on our first application.

It's been almost 3 months and I am still not approved for Medi-cal coverage even if I'm unemployed. My son was immediately approved. However, due to so many administrative red tape, he is still unassigned to a doctor/healthcare provider. I didn't realize that once the state approved you for Medi-cal, you then had to contact your local county health department and wait until your information got transferred to their system from Medi-cal (takes about a month), then that's the only time you get to choose your doctor/provider, then you again have to wait until you get accepted into their practice. The entire process is so confusing because there is no one point of contact who can help you navigate everything. I have never been this anxious and scared because I know some people get buried in debt when they suddenly had unplanned healthcare-related expenses.

Anyway, I don't know how it is with the NHS, but I'm assuming it's something similar to Denmark's healthcare system, since I lived there for 4 years in my early 20's. I also had to pay a health surcharge for my work visa but I immediately got assigned to a doctor close to my address and I could ask for medication when I absolutely needed it. I remember the entire process was so smooth. At that time, I also heard some debate between my Danish colleagues about why they had to pay for the "freeloaders"?

I guess my main point in my entire rant is that there is no perfect system, but that some "imperfect" systems such as the NHS or Denmark's (because I experienced this firsthand) are better than others (USA). I would gladly pay into a system if it means I have peace of mind for my family. There will always be people who will try to abuse the system, so I guess my say on that is I agree there should be more checks and balances put into place so abusers aka freeloaders will be punished.

Having dealt with Medi-cal for someone else in the recent past, some warnings for you:

You're not going to get to pick your doctor. Theoretically you can, but since so very few actually accept Medi-cal patients, you're hog-tied.  When my daughter had to be on Medi-cal for a while, I phoned literally every doctor's office within 20 miles that was listed in our phone book (and that was a lot of calls) and found none that would take a new Medi-cal patient. Some won't even take you on at all as a self-pay if you don't have private insurance.

You will be sent a list of "providers" once your application is approved. You will then need to contact each of them to see if they are taking new patients. Assuming that your situation is like ours was (in a major metro area) you will then need to contact Medi-cal and tell them you can't find anyone. You will be assigned to a clinic/doctor, which may or may not be anywhere near where you live, but which will be in the same county. Typically, these will be in areas of extreme poverty. The waiting lists are extensive.

If you have a medical emergency you can go to the emergency room, where you will be seen and stabilized. They may ask you for a deposit to cover further care - if you really should be in hospital or need medication - if they know you have applied for Medi-cal and do not have insurance and are in a poverty situation. If you cannot pay it at the time you are in the ER, they may ask you to sign a contract for later payment.

The formulary for Medi-cal is limited - your doctor may think a particular med would be good for you, but it may not be available on the formulary. You  can still get an actual prescription for it, but if it's not on the approved drugs list you will have to cover the cost. Be prepared for sticker shock if you are paying out of pocket for medications in the USA. (A course of an antibiotic for a sinus infection, for example, can go into the three digits if it's not Amoxycillin in the generic form.)

If you have much in the way of resources at all, you will probably not be able to get on the Medi-cal roster. This includes your automobile, if it is newer/worth more than a certain value. Your employment status will be considered, but so will any savings or property you may own. Persons under 18 have a very much less rigorous application process, and your child may also be able to get dental care until they turn 18.

You may want to look at the Covered California website and see if you have any other options at all. I think it is designed for employed people, and I haven't looked at it in a year, but perhaps you might get lucky and find a policy you can purchase out-of-pocket there. Almost anything you do find there will be better than Medi-cal. Kaiser HMO is a decent option. You might also check joining Kaiser outside of Medi-cal, if you can.

My daughter used to occasionally work in various medical offices affiliated with a publicly-funded hospital in California. Several times she worked in the insurance sections. She would come home very sad some days, saying she'd had conversations with patients she knew were going to die because they were in Medi-cal and not a private insurance like Blue Cross, because although treatments/medicine was available, they were not going to get it. If they'd had private insurance, they would have. She had to tell them that their treatment wasn't covered.

My advice for you, in the meantime, is that if you become ill enough to need medication, there are "Minute Clinics" in a lot of pharmacies now, where you can pay between $50 and $100 for an appointment and get a prescription, if needed. You will, of course, then have to pay out of pocket for the prescription as well. But combined they may be well under the cost of an actual doctor's office visit. And, again, if it's an emergency, go to the emergency room. They have to treat you until you are stable - and then they can dump you in skid row in your hospital gown if you can't pay. If you do rack up a big bill with them, if you do finally get Medic-cal, there may be a provision to cover retroactively charges for "catastrophic care".

You'll be happier once you are here and on the NHS. Be happy you have the option to be on the NHS at the minimal charge the government lays on you.

Best of luck with it all.