Map of life expectancy at birth from Global Education Project.

Friday, September 11, 2009

While we're sitting around waiting . . .

. . . for the U.S. to establish its own communazifascist grandma killing institute to tell us WTF works and what doesn't in medical care, thanks to the miracle of the Internet it is actually possible for Americans to expose themselves to the evil bureaucrats of the United Kingdom. Experience the shock and horror of reading actual, credible information that might even help you make your own choices without the benign, Christian guidance of drug company marketing campaigns, if you dare, by clicking on this link. (Warning: Not safe for the willfully ignorant.)

Yes, that's the National Institute for Health and Clinical Excellence, known to its friends and fellow evildoers as NICE. There's a little search box there about halfway down on the right. Has your doctor told you that you have a particular disease, be it osteoporosis or type 2 diabetes? Have you been told to consider a particular treatment? Type the word in the box and see what happens.

You may want to be careful about who might happen to walk in on you as you do it, and you may want to clear your Internet cache and history once you are done, because you are now an enemy of capitalism and freedom. Don't tell anybody where you got that link. It's just between us.

4 comments:

Bix said...

You give good link.

Anonymous said...

HR 3200 - the public policy part - is very like the Swiss system: Premiums can be adjusted to sex, age, geographical location; insurers are not allowed to make money out of the ‘basic package’ policies (profits are to be returned to insurees or saved). In the Swiss system, there is a co-pay of 10% on all bills till the sum of 700 dollars is reached, whereupon everything is covered. (Pregnancy and child birth are ‘free’.) ‘Basic’ gives unlimited coverage in the public sector (no fancy private clinics, though it is often possible to enter them and have the insurance pay what it would pay normally and add the rest yourself.) Dental is not covered (if a handicapping condition, dental work is paid by Gvmt. disability), elective surgery, and a few other goodies such as spas and psychoanalysis are excluded as well. You can either pay your bills yourself, or the whole thing is handled behind your back, care / medication is free on presentation of a card (and you get a bill for the small sum you owe.)

Coverage is really unlimited. I have never heard of anyone who had a bill refused. I myself was once seriously damaged and paid nothing despite the fact that I had experimental medication, was in a luxury room, stayed 4 days extra because I felt like it, had a speech therapist, etc. (Insurer has a waiver that permits them to do this in cases of ‘exceptional circumstance’..)

Satisfaction with this system is very high, latest consumers’ ass. -anti insurance co in a strident way - poll: little/not satisfied / don’t know (and note the inclusion of ‘little’ - 11%) 17%. Several referenda to instore ‘single payer’ have failed by large, or decent, margins.

Premiums are high. The tax payer actually pays 30% or so of overall cost, invisibly - mostly in the form of subsidies to the poor who can’t pay the premiums. (These are simply given cash in whatever proportion so that they can pay the insurance cos.)

In effect, the insurance cos. are private but they are so closely controlled by the Gvmt. that they aren’t really private. However, they are opaque, which is why many would prefer single payer.

Now, what I wanted to add is that here competition between insurers to keep costs down has not worked. That was part of the original idea. The ‘basic’ package is so constrained that there is little room for competition, and ppl don’t change insurer anyway, it is too much trouble, and if one is satisfied, why on earth bother? Second, insurance cos. regularly go bust (the margins are thus indeed quite slim?) leaving the Gvmt. to bail them out, or forcing the Gvmt. to shift insurees to other companies, etc. This is a costly, bothersome, disturbance to the system. Another pitfall is: recently, the insurers finally finally got legislation changed so that they could refuse to cover those who did not pay / were way behind with their premiums - within the following week a whole slew of chronic patients (Aids etc) found themselves stranded, and had to be taken over by the Gvmt. At least, as readers can note, the underlying legislation ensures that no-one goes without care. Still, the whole thing is a mess, it is all way too expensive, some of the insurance cos. are definetly ‘dodgy’ - and they make good profits from time to time, otherwise they wouldn’t persevere. Needless to say costs rise and rise and no-one addresses that issue. Everyone (political parties) prefers the status quo....

The medical community is on the whole for single payer. They dislike the insurance cos. as they have lost power to them.

Ana

Bix said...

That's interesting, Ana.

I wonder how similar the Swiss system is to our Medicare Part C, the Medicare Advantage Plans. People (and gov.) pay premiums to private insurance companies (in addition to regular premiums people pay for Medicare Part B), but must accept a network of providers and receive varying coverage. Referrals, deductibles, co-pays, co-insurance all apply.

After seeing what Medicare has become, with the Advantage plans, the Gap plans, the prescription drug plans, the denial of service - much of this benefitting insurance companies - I wonder how different "Medicare for all" would be from what we currently have. I guess one big difference would be that everyone would have to buy insurance.

Anonymous said...

"I guess one big difference would be that everyone would have to buy insurance."

Yes, and that is what Obama and the Insurance cos. want.

The tax deductions, exceptions, exemptions, Gvmt. co pays (or whatever form it takes or how it is called) disguises the fact that 'obligatory' insurance will bring in more money to the insurance cos. and the Gvmt, who then hold more power. A kind of corporate - Gvmt. symbiosis.

Good luck to US citizens...

Ana