I live in a country where "basic" health insurance is mandatory, and the government sets the minimum deductible too, though you can opt for a higher deductible to pay less on your insurance policy. Plus, we can buy more insurance to get the dentals covered, at least, partly. People under a certain income level get government subsidies.
Well, the subsidies get lower every year, while the insurance prices grow, and deductibles only get higher. Right now it's about 800 euros for a family with two grown-ups. Children under 18 are covered for free, but after 18 they have to pay their own insurance costs. Since health insurance is mandatory, there is no way out of it.
The regional authorities started their own program of partly covering the costs of "low-income" families who they define as those with an income higher (!) than the government determined minimum. While the regional taxes paid by businesses and home owners are rising and those barely making a middle class wage are getting broke on paying their mandatory health costs, the welfare recipients and those working at a low wage get everything nearly for free.
At the same time, in countries like UK people get free medical care since NHS is financed by the taxes so they never have to worry about losing their job and not being able to pay the doctor. The quality is often better than in my own country plus they have a possibility to visit a private clinic, too.
That all made me think. In America, lots of folks are against "socialised health care", but the truth is that healthcare is already more or less socialised in every Western country. The modern insurance system is only good for making insurance companies richer, it has really nothing to do with any "market in health care" or any such thing. I've never though I'd say it, but as of now I'm ready to support our local socialists who advocate for the National Health Fund with low premiums.
It's interesting to me that while conservative Christians in the USA are often the most vocal supporters of stay-at-home mothers, they are also those who object the most against a single payer system, or however it's called. It's hardly a secret, that a lot of American women only keep on working for the health insurance. The system as of now is hardly family-friendly.
We can all wax romantic about the times past when you paid the doctor out of your pocket, but with all the modern high-tech treatments it's utopian to think we can go back to them good old days. And as long as programs like Medicare and similar exist, and emergency rooms treat people for free, the health care is already socialised. Right now, middle class folks are punished the most which strikes me as unfair.
Feel free to share your thoughts and experiences in the comments.
I'll give you my perspective!
ReplyDeleteI am one of the old fashioned Americans who really doesn't want government interfering. For one thing, being forced to volunteer ourselves for something we didn't really want, or pay a fine, put a lot of us in the "no choices" section because the "marketplace" "choices" for insurance were ridiculously expensive. It would have been nearly 1k a month to get insurance for my family through the government marketplace. Just to rent a house in my area is over 1k a month-- how many families can afford both? So it's on socialized healthcare you go.
For another thing, being told that I cannot make any decisions for my 15 year old is really undermining the parent. For example, I could not change from one dentist to the other, without getting my 15 year old to give the healthcare worker to permission to give me permission to speak on his behalf. I have a friend who was told that she could not be in the room during her 15 year old's check-up, and once expelled, her child was queried about their sexual orientation and preferences. The mother was told it was a required rule that she leave (I called the state healthcare system on that one, and asked if it was true. They said no way, that was not a requirement. Either the doctor or the state was lying). With the government involved, and especially in the atheistic state I live in, there is always the potential for undermining families, Christians, and influincing children against the morals they were brought up with. Unfortunate but true.
I can fully understand the need for insurance on large things and even aid on super large (50k) emergencies and surgeries if you are poor, so I'm not saying we don't need those things. We still pay cash to go to preferred doctors (not covered by insurance or socialized healthcare) on certain things. There is a freedom to choose a better doctor or dentist who is not in your county or your coverage area when you pay cash. Back in the day, if I needed to see a dermatologist, I went to a dermatologist, payed them out of pocket and got a discount for cash payment. It was still hard on the budget, true, so of course we only went when we needed something. If you are in the system or on insurance, you have to go to a primary care physician and have them refer you to a dermatologist. That's two appointments and lots of time. If you are on insurance, you have a copay at each place. If you think you need to be tested for something, or referred to another doctor, and the primary physician thinks you are nuts and there's nothing wrong with you, you have to argue to get the tests or doctor referral you want. A lot of people have been dismissed by the physicians and found out later that there really was something wrong with them, that was going undiagnosed. These physicians routinely spend 5-10 minutes with you. Go to a naturopath or find a really good doctor (inevitably not in your coverage area), pay with cash of course, and you get a good hour of listening, examination,problem solving and understanding.
(By the way, if you ever have the experience of going to a rich-person's doctor in a rich part of town, you may be surprised at the better service. Makes me wonder about our lack of choice with doctors in the system. Do they choose drs who are trained for the 5-minute type of "service" for us peons?)
I was glad I found cheaper sort-of-like-insurance with the Christian share type plan, though it also has limitations. I don't want to be shackled to the government healthcare system. I feel that if ordinary people who have had experiences within the system and those who stayed without, were asked to come up with plans, we would probably be a lot further ahead in solving this health care thing than these politicians who have never been in a bind financially for healthcare. And I do believe in the power of the market-- you can see competition working over herein other areas, and you can tell when there is a lack of it.
-Lillibeth
Forgot to say that the system was so inefficient too! It seems also the state computers couldn't tell that we were a family, even though the form to fill out was a family form. So we were given different doctors, different systems, and different dentists. In order to change that, had to call on the first day of the month (the only time you can change doctors) and get everyone on the same system, to the same doctor, same hospital, same dentist. Good luck-- the doctors are allotted so many state patients and you may not be able to fit everyone on their list. Most families prefer one family doctor, of course. I was able to do it but had to be vigilant because for some reason every once in a while things would pop back to random, after I shored everything up.
ReplyDeleteThe state hold music was torture, and the holding times up to 2 hours (I usually hung up after 1-1/2 hrs). I think the hold music was the most frustrating. Whenever I got a person on the line, I would first complain about the hold music. I was so sorrowful to find that my bank bought the same tape to play to its customers. When I die I know that awful set of tunes will be playing in my brain. I was happy when they changed the system to make it easy to call a district care company who was contracting with the state, because then I could get a human voice on one ring.
And it seemed wasteful to me that they did not recognize a family, because every single person got every single letter, announcement, rule change, etc. separately-- even the toddler who couldn't read. I know they have to do that but it would have been simpler if they had identified family units and sent one document. Especially since each and every paper communication (only paper, not electronic) had several sheets in several languages attached. Lots of paper pileup. This probably can not be avoided even with insurance, but it does seem so wasteful. A homemaker would have a neat and tidy filing system if the powers that be would just treat the family as one unit. Just another change I would make to the whole thing if I were all powerful!
They scatter the family by assigning random doctors in different towns, making it difficult for the family. My husband and I have different towns separated by a great distance!
ReplyDeleteThanks, Lillibeth, it was very informative. I've always had this idea that things are better overseas, but apparently not really, it sounds even worse than what we have over here.
ReplyDeleteMy point is that Western governments are already deeply involved in health care, plus we don't really have a health care market, we have insurance market. Health care market would be something like doctors offering you discounts on their services the way a supermarket does, instead we just get an insurance company as a mediator which isn't really the same thing at all. With all the taxes we already pay into the system and all the red tape and government interference we are already experiencing something akin to a NHS would probably be an improvement.
Lydia, here an insurance company usually doesn't assign a doctor, and you have a choice of hospitals. It can happen that a doctor isn't taking new patients, though.
ReplyDeleteSi was wondering with all your knowledge of ancient history and ancient governments, what ancient governments before the 20th century were in the least interested in tapping the medical market! My guess is that modern givernment looked at profit and saw a very successful and lucrative market in the medical business, and also so it as a way of controlling people's personal lives. What governments in the past even tried to meddle in people's choice of health?
ReplyDeleteI doubt there is going back though. Most people in the West see health care as a right, and frankly, most modern treatments are too expensive to be paid out of pocket. In the ancient times there was no chemo, no open heart surgeries and stuff like that. Meanwhile it doesn't seem fair that middle class has to bear the brunt of it. Right now we are required by law to buy health insurance which is only getting more expensive every year, and if we use it, we have to pay deductibles, too. Why the heck do we pay taxes? May be if they stopped sponsoring corrupt Third World regimes under the guise of "help" they could provide the taxpayer with free health care, like in UK>
ReplyDelete"Health care market would be something like doctors offering you discounts on their services the way a supermarket does" Yes, let's get with the supermarket thing! Sounds like a good idea to me.
ReplyDeleteHere in Canada; health care is provided by the government. This of course is paid for by taxpayers. I am grateful that everyone has health coverage. The downside is that it can take too long to see a specialist or wait for surgery. Dental care and optical care is not included. Neither is drug coverage. We certainly don't have a perfect health system but I am thankful that everyone is covered/
ReplyDeleteLadies, we are having a great discussion over here:) Thanks everyone for posting their opinions!
ReplyDeleteBTW, I was re-reading Lillibeth's comment and I'd like to add that it would be great if we at least had an option to pay out of pocket for additional services, which isn't the case. While in UK, if you don't want to wait or desire an additional scan or a check-up, you just go to a private clinic. It's like we are stuck with the worst of two systems over here.
ReplyDeleteI was forwarded this by a friend. I'm American living in Finland so I can see both sides of the coin.
ReplyDeleteYou are right about the middle class, they get the short end of the stick. You make enough to be poor, and that's about it. You don't make enough for really good insurance but you make too much to be covered by Medicaid and Medicare.
The pro-life focuses on the baby in the womb only. Kids and families need financial support, food support, etc. Pro-life goes beyond the womb. If kids can't go to the doctor because their parents can't afford it (happened to me as a kid)...that's just sad.
If Americans took money out of the military programs, raise minimum wage, and better benefits..it'd be thriving. Urban areas need this especially. Poverty is a cycle, you're born into and you need money to get out of it.
There are short comings in socialism, and sadly the Right wingers land on these. It takes a LONG time to get into specialists here in Finland. I need a dental checkup and the first time available was August of this year. I took it, since I can't afford to go to private.
We don't do enough in Finland for those who can't afford food. We live on a very small amount of money but if we had food stamps or some type of food benefit, we'd be MUCH more comfortable.
Medicine issues...sigh. I have lots of expensive meds that the gov't used to co-pay for. The new gov't in 2015 slashed funding to topical skin products for the most part so all the steroid creams and things I need...I have to pay out of pocket. This was the doing of the Center/NCP gov't.
I voted Socialist in our local election since when we had a mainly Socialist gov't the funding was better for everything.
I pay 32 euros for emergency room, my Mom had to pay 500 us dollars. The actual free was above 2000 dollars, thankfully they have pretty decent insurance. :/
America is unequal in all things. I can't bring my foreign husband over since I have no schooling above a high school diploma and I can't land any good jobs. So many Americans living overseas have this exact issue. If these regulations were loosened a bit, lots of people would move home.
Change is coming to America, the young people want a Socialist gov't. This scares all the old folks who were brought up to think COMMUNISTS not actually getting how well they'd benefit from these changes.
It will happen. Everyone is AHHHH about having a right winger in the office again...and I believe in the next 10 years things will change. It scares so many people but American taxes are about the same as Finland...and we have national insurance.
Sorry for being long winded lol. Love your blog!
Chava, thank you for sharing your perspective. I somehow believed that Finland had free medical care. I see that I was mistaken:) Here, the waiting time isn't always bad and thankfully, we don't pay for the ER. However, until you are certain age, the doctor just doesn't take you seriously, as in younger people apparently don't get sick or something.
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