It would help if you had the first clue about what you are quoting and posting. The marketing was in reference to commercials for drugs. Absolutely nothing to do with how they are paid for.
Healthcare
- Thread starter RDCR07
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In the latest episode of the United Hour Podcast, Nik (@Rood) is joined by CEO Duncan Drasdo and Financial Director Andy Green from the Manchester United Supporters Trust for a special episode on all things behind the scenes at Old Trafford including a brief history of MUST and their aims today, views on INEOS and Sir Jim Ratcliffe so far, and the Old Trafford regeneration.
It would help if you had the first clue about what you are quoting and posting. The marketing was in reference to commercials for drugs. Absolutely nothing to do with how they are paid for.
Ok I am really am going to play devil's advocate here. Sure you would have paid nothing when you had the surgery in the UK. However you would be paying significantly more in tax so its swings and roundabouts. Tax, SS, and healthcare accounted for about 22-23% of our 2017 earnings in the US. I threw our gross wages in to a UK tax calculator and the tax/SS was over 40%. Free healthcare is not free.
I would prefer a single payer system in the US covering all Americans but it doesn't mean the current system is completely broken and the NHS is on some sort of healthcare pedestal.
One of my wifes observation is the doctors and nurses are in the profession for money rather than a strong desire to care for people in the US. That is one of the reasons I said I would give the nod to the NHS staff in a previous post.
This is bullshit. It's not significantly more and you get a lot for that extra tax. Our health insurance premiums alone are a few grand not adding in any scrips, co-pays or treatment costs.
So what exactly would I get for my extra tax in the UK?
*I will happily show Billy my US tax return when i have lunch with him. Then we can throw the gross amount in this calculator. https://www.uktaxcalculators.co.uk/
Our Tax, SS and healthcare was $51,000 in 2017. Using that calculator above we would have paid £87,000 tax and NH in the UK.
It wouldn't have " probably been thrown out", which you would know if you had read the article linked.
We already pay more for healthcare than most countries. The status quo is not free. We can have better care and do it cheaper when we cut out the insurance companies. It's quite simple really
I did read the article. What would happen, if the court is the same as my county, is the judge would have asked them to mediate. That would mean they would go in a room and try and come up with a payment plan or agreement. If he had no income they would have probably accepted a percentage of the debt pay at a low weekly amount. If they couldn't come to a mutual agreement the judge would have heard the case and ordered him to pay a very small amount a week. I have been through the same process myself.
The could have negotiated without the court order if he had not ignored them completely. I do have income and assets and I have negotiated a 10% settlement with collection agencies.
You say that and also say how great the current system is and constantly downplay the problrms with it. Color me skeptical.
You must have reading comprehension difficulties. I have never even said the system is adequate let alone great. I have only pointed out that some aspects of healthcare in the US are in pretty good shape.
The US has a funding collection and distribution problem. The NHS has a funding problem. If you could put the US spend into the NHS it would be an incredible system. Alternatively if the US could figure out a way of funnelling all current healthcare funds (company and private premiums, co-pays etc) into medicaid it would be a great system.
Caveat - if I had to choose between the US system as a working person with insurance and the current NHS system it would be the US hands down for me.
Woah! Why the aggression?
I was talking about people struggling to pay for prescription charges and many go8jg bankrupt/getting in to debt. You countered and said that doesn't happen and then posted the post I quoted.
It had absolutely nothing to do with commercials for drugs at all. I was just asking for something to be clarified seeing as people are saying different things. However, again your hostile tone isn't appreciated. I only quoted something you posted in reply to me in the first place.
Apologies if it came across as aggressive. It was meant to be more flippant and sarcastic, which would still be wrong.
Yes it does. That's exactly what it means.
The NHS is globally acknowledged as the best version of a healthcare system.
Something has to be number one. The NHS is it.
The simple fact that we see it as 'free' when it's actually a paid by all, for all, service... that's not witchcraft. We all know it.
If you really want to make a point, you're going to have to go all in. You quote figures and percentages on a whim.
You've said elsewhere that Americans get paid more, taxed less, that 80% of all US voters are immovable objects. It's all absolute horse shit.
Stop conflating information. If you really want to make a point, take a job. Take that job in the US & UK and apply all logical taxes against both. Take education into the equation for a degree. Then add in two children.
For 90-95% of the population, the U.K. Fares better. For those enjoying a measure of affluence in that top 5-10%, Americans usually 'win'.
Because the US has built a system, not a society. It empties the pockets of a social underclass, exploits them and allows them to rot.
If you'd do better in the States, great. I probably would too. But I still wouldn't choose to hurt others less fortunate than me, just to line my pockets.
I don't understand what your point is. "Yes single payer is better but it cost more in totality for me and I can afford insurance so this way works?"
All this without going near the insanity of people not being covered for treatment because insurance companies say so. The absolute evilness of that system is beyond any comment. Beyond defence.
An article written based on pulling tax rates does not tell the full picture. You can write a hell of a lot off in the US. The numbers for the US in that article are absolutely laughable. Both of our gross incomes were close to one of the bands and we actually paid half the amount of tax they list.
Cut and pasted from simple google search:
A Senior Business Analyst in Manchester, England: Manchester earns an average salary of £44,365 per year.
The average salary for a Senior Business Analyst is $77,810 in Tampa, FL.
Let’s assume a married couple owning a home and both earning the same. Using the calculator above for UK taxes:
Gross = 89,460
Tax/NH = 29,796
UK Take Home = 56,664
The US is a little more difficult because you have deductions to consider. Luckily I know someone that just filed a joint 2017 tax return was pretty much double $77,800.
Gross = $156,000
SS/MC = 9,600
Tax = $20,500
Medical = $4,000 ($2,400 premiums, $1,600 co-pays)
US Take Home = $121,900
It is worth noting a dollar often goes as far as a pound because prices are generally lower in the US. Sales tax is 7% in Florida, so that is significantly lower than VAT. If you buy online there is often no sales tax at all, although that is being faded out. We pay about 60c (85p) for a litre of petrol.
So what extra do you think you would get in the UK? Medical is already factored into the numbers above. If you are working you aren't going to get much more. Only thing I can think of is better public transport.
Let’s do it for someone on lower earnings living alone.
Gross $50,000
Tax $4,000
SS/MC $3,000
Medical $2,400 ($1,200 Premiums, $1,200 copays)
US Take Home Pay $40,600
Gross £35,000
Tax £4,700
NH £3,220
UK Take Home Pay = £27,080
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I have already done that, half my working life on both sides of the pond.
I agree with the sentiment but your numbers are skewed. 30% of the US population are covered by Medicaid and Medicare. Insurance covers a further 55%. Of course insurance costs are a burden on lower paid. Obviously the 15% uninsured would fare better under the NHS. A percentage of the insured would also fair better financially but my guess is most would not want to give up the freedom they have to pick their own doctors.
No at all. I would prefer to pay more tax and have a single payer system. My main point is healthcare in the US is not as bad as many would think.
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And a recap for the folks that spent three pages arguing when I said the majority of Americans are happy with healthcare:
Overall Satisfaction with US Healthcare was 65% in 2016:
http://news.gallup.com/poll/195605/americans-satisfaction-healthcare-system-edges-down.aspx
Overall satisfaction in the NHS was 63% in 2016
https://www.kingsfund.org.uk/publications/public-satisfaction-nhs-2016
Overall Satisfaction with US Healthcare was 65% in 2016:
http://news.gallup.com/poll/195605/americans-satisfaction-healthcare-system-edges-down.aspx
Overall satisfaction in the NHS was 63% in 2016
https://www.kingsfund.org.uk/publications/public-satisfaction-nhs-2016
Certain things like birth control should be covered by Medicaid with everyone having access. Actually why not cover everyone for all Meds using Medicaid. Mandate what prices can be charged at the federal level and big Pharma would be no more.
Leveraging Medicaid is definitely the way to move towards a single payer/UHC system.
I have already done that, half my working life on both sides of the pond.
I agree with the sentiment but your numbers are skewed. 30% of the US population are covered by Medicaid and Medicare. Insurance covers a further 55%. Of course insurance costs are a burden on lower paid. Obviously the 15% uninsured would fare better under the NHS. A percentage of the insured would also fair better financially but my guess is most would not want to give up the freedom they have to pick their own doctors.
Most in America don't have that freedom. Medicare is an HMO system and only about half the employer enrolled programs are PPO which allow picking your own doctors. So only about 27% based on your estimates can pick their own doctors. 57% cannot pick their own doctors.
From an economic perspective: Any for-profit health care system like the US is going to have massively misaligned and fecked up incentives. Proof is here
Personally I have a philosophical problem of sectors like healthcare, prisons being for-profit. Those industries should never be run by private sector actors seeking profit as it creates some truly fecked up misaligned incentives.
I don't think I have had a true PPO since about 2003. I pick my own doctors. There maybe some rules with some insurers like getting the visit approved but there are choices for the most part.
I would tend to agree but the US is probably never moving to a true socialised single payer system.
From what I gather you probably make over $100K a year as a household which puts you in at least the top 19% or above so I don't think your experience is very representative of average Americans. You can't just assume even 50% of US can pick their own doctors because it doesn't look like they can from what I read.
From people I talked to, no one making under $60K had anything like full freedom to pick their own doctors so I would your suggest statement is only true for the richest 20% or so.
Never say never again
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I had to take my wife to the ER the other day. Our bill to be seen was $50. Two people ahead of her had to pay $250 and $450 respectively because they had different coverage.
My earnings are somewhat irrelevant in this discussion. We generally go with the cheapest plan available, usually a high deductible, because I can manage my money and make a HSA work for me. Many employers charge higher premiums as salaries pass certain thresholds. My insurance is no better than 90% of insured Americans.
In this instance never is probably accurate. The hurdles stopping a fully socialized system are immense. There are just too many private hospitals and doctors offices to ever get them under one umbrella. Best we can hope for is a single payer that gives us access to most hospitals.
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Aren't these more or less the same thing ?
Be careful with ER visits. A lot of in network ER department now outsource the doctors. You visit an ER, pay your in network $100, see a doctor and then get an out of network bill from teh doctor's office weeks later. That happened to me at my wifes hospital of all places. Doctor came in for two minutes and we got a bill for $1,500. My HR director called UHC and they waved it though.
Best course of action when you sign the paperwork is write the following near your signature....."I do not approve out of network doctors or services"
No!
Even if there was a huge expansion of Medicaid and a single payer system was available to everyone a lot of doctors and hospitals would stay private. I think something like 15% of Brits have private insurance now, so you can only imagine how many Americans would stick with insurances or at least carry a secondary insurance.
The hospital system is probably always going to be privately owned in the US.
Prisons I agree because it ties into the legal system, which is the original purpose of modern government. Healthcare can't be all state-run... you think maybe the hospitals/clinics, but then you're underestimating the size of equipment and medicine development + manufacturing, the educational side. If its entirely state-run, that's a shitshow I'm not ready to sign-up for.
i love being an american and reading fine print while in the emergency room in order to not get screwed by insurance companies
That's still single payer system since it would be contracting federal money with private organizations - sort of like Canada does it.
Yep. But fully socialized would be federal ownership and control off all hospitals.
We need to figure out a way of retaining the good and eliminating the bad.
I don't think most proponents of single payer in the US are proposing that sort of thing. Something more in line with Canada would be more than enough to move the needle imo.
Oops I think I came in to the broken record thread and not the healhcare one. My apologies.
Single payer is not the same thing as state run though. There is a difference between the government simply providing the insurance coverage. That doesn't mean the entire system is state run though. You'd still have private and public hospitals, doctors, specialists, etc. I suppose in that sense you're right its not like prisons because imo the key is the insurance is covered by government to pay for all citizens health outcomes. Its not that every facility is "state-run".
Even in Goldhill's mostly libertarian solution I posted from the Atlantic article, it still includes universal coverage for catastrophic accidents, terminal illness, etc to ensure no citizen is going broke or bankrupt due to random health outcomes.
That would be a common sense starting point for sure.