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  #441  
Old 18.08.2009, 04:47
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Re: Americans put the boot into the NHS

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I knew that American medical costs were a lot higher than the Swiss but this difference is huge. At todays exchange rate $9,800 = CHF 10,509. I had a colonoscopy six month ago and the total cost was CHF 866.85 (standard TarMed tariff). Thatís CHF 9642.5 cheaper and more than enough to pay a return air flight !
It is the malpractice insurance. Those friendly attorneys that advertise on TV late at night are killing the system.
My daughter had a MRI scan that cost $25,000. Based on the results she had surgery and the bill was $178,000. For all of us the prospect of having to deal with one of those bills is a reality if things go wrong. Loosing your job and then loosing your insurance or working for an employer that does not provide benefits. The prospect of retiring happily may turn into a nightmare no matter how conservative you are with your finances.
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  #442  
Old 18.08.2009, 05:16
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Re: Americans put the boot into the NHS

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It is the malpractice insurance. Those friendly attorneys that advertise on TV late at night are killing the system.
My daughter had a MRI scan that cost $25,000. Based on the results she had surgery and the bill was $178,000. For all of us the prospect of having to deal with one of those bills is a reality if things go wrong. Loosing your job and then loosing your insurance or working for an employer that does not provide benefits. The prospect of retiring happily may turn into a nightmare no matter how conservative you are with your finances.
Yep, malpractice insurance is absolutely astronomical - look at Florida, yearly premiums are over $150,000 in some parts of the state for certain specialties:

http://www.hcla.org/pdf/HCLAReportFINAL.pdf

Pennsylvania physicians have recently seen small
declines in their liability premiums, but doctors there
aren't out of the woods yet. OB/GYNs saw their premiums
skyrocket from an average of $37,556 in 2000
8
to $167,000 in in 2008 ó an increase of $130,000 in just

eight years.

Your daughter's MRI cost $25,000?!?!?! That's horrible, and a lot higher than the average MRI costs currently - my wife, who is a radiologist, says that the highest cost MRIs she performs is around $3,000. Now if you're talking multiple studies, yeah it can rack up, but for a single MRI that's crazy.
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  #443  
Old 18.08.2009, 05:23
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Re: Americans put the boot into the NHS

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Your daughter's MRI cost $25,000?!?!?! That's horrible, and a lot higher than the average MRI costs currently - my wife, who is a radiologist, says that the highest cost MRIs she performs is around $3,000. Now if you're talking multiple studies, yeah it can rack up, but for a single MRI that's crazy.
Crazy isn't it. It was because she was too "wiggly" so they had to bring the anesthesiologist to sedate her.
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  #444  
Old 18.08.2009, 06:07
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Re: Americans put the boot into the NHS

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It is the malpractice insurance. Those friendly attorneys that advertise on TV late at night are killing the system.
My daughter had a MRI scan that cost $25,000. Based on the results she had surgery and the bill was $178,000. For all of us the prospect of having to deal with one of those bills is a reality if things go wrong. Loosing your job and then loosing your insurance or working for an employer that does not provide benefits. The prospect of retiring happily may turn into a nightmare no matter how conservative you are with your finances.
I always assumed that, everyone says that malpractice is driving costs up, then I thought of all the people I know, who have had strong cases and been unable to sue.
The assumption is actually not true ( see article below)- at least not in NY.

Also in states like Arizona bills are being passed that will reduce the number of lawsuits. So why are health costs rising?

Because of insurance and fraud in the system, as the article that I posted from the Atlantic explains, Obama is doing something to tackle this, but the problem has been around for a long time and is deeply entrenched.

There is no transparency, so that the customer (patient) can not compare rates for a cheaper deal. It actually talks about the issue of MRI/catscans in the article.

Most people don't bother to go through the breakdown of their medical bills when they arrive. I do, and was amazed at the cost. I started to phone the insurance provider to ask what all these services were, most of it made no sense. It put me off going back to the doctor for unnecessary repeat tests. The problem is that if you refuse tests and fall ill some insurance will refuse coverage, so you have to follow doctor's orders no matter what or find another doctor.

I have condensed the article, but here are the key points

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The aggregate amount paid to injured patients in New York for malpractice judgments and settlements has dropped dramatically since 2006. When viewed over a longer period of time, malpractice payments in New York have risen at roughly the same rate as inflation from 1993 through 2008. The frequency of malpractice payments has remained flat, even though there has been a dramatic increase in the number of doctors practicing in New York. A small minority of doctors are responsible for the lionís share of malpractice payments. Malpractice payment amounts appear related to serious injuries or deaths. Despite claims that doctors are fleeing the state, New York State has the third highest per capita number of doctors in the nation. In addition the number of doctors working in New York is growing at a significantly higher rate than the stateís overall population. Medical malpractice claims have remained stagnant over the past dozen years.
http://www.nypirg.org/health/Contraindication.pdf


Incidentally, I do know someone whose obesity had caused her to have knee surgery she was unable to return to work in the allotted time and was fired. She sued successfully- spent some of the money on 3 'hummers'.
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  #445  
Old 18.08.2009, 06:21
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Re: Americans put the boot into the NHS

Health lawsuits are not always directed at doctors, some of the biggest are directed at products such as drugs, implants etc. Anyone remember Sulzer Medica hip replacements?
2001

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WINTERTHUR, Switzerland — Sulzer Medica, Europe's biggest maker of orthopedic products, now faces about 1,000 lawsuits over a recalled hip implant, up from 800 previously reported. The Swiss company said insurance probably won't cover all the related costs.
http://articles.latimes.com/2001/jul...iness/fi-20532
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  #446  
Old 18.08.2009, 17:17
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Re: Americans put the boot into the NHS

This thread has been very interesting in that it has shown aspects of the American health system that I was not previously aware of. In particular I find the cost of some procedures that have been quoted quite extraordinary.

Iím not a great supporter of the NHS as I think it need many improvements. However, that said, I would rather have the NHS than the American system any day.

Fortunately, living in Switzerland, I think Iíve got something far better than either of the above and, not having enjoyed good health in the last two years and needing a large amounts of medical attention, Iím very glad I live here and not in the USA or UK !
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  #447  
Old 18.08.2009, 18:29
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Re: Americans put the boot into the NHS

Strange really , reading about the fear of losing your job because you'd lose your insurance. It was like that in the mills in England lose your job....lose your home. Which when you think about it, an American who loses his job and got ill could say bye bye home in a very short time. I don't think that's very progressive at all.
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  #448  
Old 18.08.2009, 18:41
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Re: Americans put the boot into the NHS

Here's a good article from Today's FT comparing the UK and US health systems.

In reply to one of the arguments going on previously in this thread, private health cover is definitely seen as a status symbol in the UK and such cover is dangled as a benefit by many top tier employers.
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  #449  
Old 18.08.2009, 20:53
ch-expat
 
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Re: Americans put the boot into the NHS

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Strange really , reading about the fear of losing your job because you'd lose your insurance. It was like that in the mills in England lose your job....lose your home. Which when you think about it, an American who loses his job and got ill could say bye bye home in a very short time. I don't think that's very progressive at all.
What I also find astonishing is those uninformed idiots yelling at obama for trying to promote some (very mild) reforms.
I am self employed now after having worked for corporations all my adult life.
I pay currently $1,100/month for my family and I have a $5,000 deductible meaning the first $5,000 are out of my pocket. The bottomline is that I pay around $16,000-$18,000/year for healthcare depending on how much service I use. It also means that in all likelihood, my insurer will just cash my entire premium without spending a penny on me as am I liable for the first $5,000.
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  #450  
Old 18.08.2009, 20:59
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Re: Americans put the boot into the NHS

Here's an interesting story from CNN

http://edition.cnn.com/2009/HEALTH/0...ef=igoogle_cnn


Good for these docs. Nevada is one of the places really hit hard by the recession. The woman receiving chemotherapy in this story made just under $9.00 an hour. She makes too much money for medicaid, but really not enough for any sort of decent health insurance and obviously her employer does not provide coverage.

Please correct me if I'm wrong, but if this woman lived in the UK, her cancer treatments would be covered. And yes, she is getting her treatment, but there should be a better way.


This, I think is why the US needs health care reform.
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  #451  
Old 18.08.2009, 21:04
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Re: Americans put the boot into the NHS

This is exactly the problem a doctor friend has told me. He says people have to quit their job so their income is low enough so they are eligible for Medicaid and can thus get treatment for a serious condition. Alot of low skilled jobs do not provide healthcare....or if so not much of the premium is subsidized....it takes alot of hours at 9 dollars an hour to pay an insurance premium of say 3 to 5k.
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  #452  
Old 18.08.2009, 21:05
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Re: Americans put the boot into the NHS

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This thread has been very interesting in that it has shown aspects of the American health system that I was not previously aware of. In particular I find the cost of some procedures that have been quoted quite extraordinary.

Iím not a great supporter of the NHS as I think it need many improvements. However, that said, I would rather have the NHS than the American system any day.

Fortunately, living in Switzerland, I think Iíve got something far better than either of the above and, not having enjoyed good health in the last two years and needing a large amounts of medical attention, Iím very glad I live here and not in the USA or UK !
The US system is quite good if you are fortunate enough to have your
employer paying/sponsoring your healthcare policy.

The problem is if you want to be self-employed or you get laid off.
That is the problem. There are not enough low-cost alternatives.

The problem with Obama's plan is that his plan is about 300 billion
short per year depending on whose estimate you read. He has
to come up with a plan that is financially sound.
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  #453  
Old 18.08.2009, 21:23
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Re: Americans put the boot into the NHS

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Irrelevant - the poster was arguing health insurance is some sort of status symbol, and it's not, at least in my experience of associating with status-conscious populations.

I've been thinking about why this doesn't sit well with me, and I realized that I disagree with your choice of demographic. Anyone can be status-conscious, regardless of income, employment or education.

I used to work in telecommunications research. When caller-id was first introduced in the mid-80's, people were surprised that it wasn't the affluent demographic picking up the service. Proportionally, more people in less affluent neighborhoods bought lots of telephone services (multiple lines, caller id, three way calling). Turns out that there is a concept of affordable luxury. So ok, you can't buy that porsche or summer in the Hamptons, but you can have the best phone service, indistinguishable from the rich. There are a lot of instances of affordable luxury in consumer goods. I think it's also a matter of pride for families to try to provide the best health care for their families, and as we've said before, the absence or presence of coverage does matter in job choice for some - both in choosing a job and electing to stay in a job that you'd otherwise leave. So yeah, maybe it is a status symbol.
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  #454  
Old 18.08.2009, 21:29
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Re: Americans put the boot into the NHS

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The problem with Obama's plan is that his plan is about 300 billion short per year depending on whose estimate you read. He has to come up with a plan that is financially sound.
That's interesting as I didn't realise that any plan has actually been announced. I was watching the CNN reports on the 'debate' on Sunday and I understood that, at the moment, 5 committies are preparing recommendations and when these are ready a plan will be formulated.

Are details of Obama's plan published anywhere ?
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  #455  
Old 18.08.2009, 21:30
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Re: Americans put the boot into the NHS

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The US system is quite good if you are fortunate enough to have your
employer paying/sponsoring your healthcare policy.
But even corporations have a tough time keeping up with the explosion of the cost to them so they start to seriously cut back on benefits. it has been out of control in the last 3 years. Between 2000-2008 the cost to the company I was with had tripled.
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Old 18.08.2009, 21:34
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Re: Americans put the boot into the NHS

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But even corporations have a tough time keeping up with the explosion of the cost to them so they start to seriously cut back on benefits. it has been out of control in the last 3 years. Between 2000-2008 the cost to the company I was with had tripled.

it is 16% of GDP going up to 20% soon.....totally unsustainable with or without the Obama plan.
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Old 18.08.2009, 21:45
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Re: Americans put the boot into the NHS

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I've been thinking about why this doesn't sit well with me, and I realized that I disagree with your choice of demographic. Anyone can be status-conscious, regardless of income, employment or education.

I used to work in telecommunications research. When caller-id was first introduced in the mid-80's, people were surprised that it wasn't the affluent demographic picking up the service. Proportionally, more people in less affluent neighborhoods bought lots of telephone services (multiple lines, caller id, three way calling). Turns out that there is a concept of affordable luxury. So ok, you can't buy that porsche or summer in the Hamptons, but you can have the best phone service, indistinguishable from the rich. There are a lot of instances of affordable luxury in consumer goods. I think it's also a matter of pride for families to try to provide the best health care for their families, and as we've said before, the absence or presence of coverage does matter in job choice for some - both in choosing a job and electing to stay in a job that you'd otherwise leave. So yeah, maybe it is a status symbol.
I know that, in my daughter's school, the children who don't have health insurance feel humiliated, even if other kids know not to discuss it. of course though people discuss their health coverage and provider, it is the same as which phone plan you have, more money=more options, but not necessarily better outcomes.
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Old 18.08.2009, 21:50
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Re: Americans put the boot into the NHS

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The US system is quite good if you are fortunate enough to have your
employer paying/sponsoring your healthcare policy.
HollidayG,
It is also killing the entrepreneurial spirit. The silicon valley for example is completely relying on that spirit to prosper and it is not working.
I see more and more talented people staying at Cisco or Oracle when a few years ago they would have jumped to a startup with lousy benefits.
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  #459  
Old 18.08.2009, 21:58
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Re: Americans put the boot into the NHS

I wonder if any of our American members can clarify a couple of points Ė

If you have a very good insurance, provided by your employer, are you guaranteed to be fully insured even if you develop something like cancer ?

What happens when you retire ?
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  #460  
Old 18.08.2009, 22:03
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Re: Americans put the boot into the NHS

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I wonder if any of our American members can clarify a couple of points Ė


What happens when you retire ?

Once you are 65 ( I believe) you under a government plan.
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