Health insurance is all wrong
From my British Husband, Nick:
For anyone that doesn’t know me, I recently moved to the US (from the UK) to live with my now wife, who runs this lovely blog. I was initially going to write a post about a few of the differences between these two great places, but with health insurance being one of the big differences, I decided it needed a post all of its own!
If you don’t know, the UK has a publicly-funded health care system, known as the NHS (National Health Service), which provides free* health care to residents of the United Kingdom. The system is not perfect (my father might still be here today if it were), but it works for the most part, and everybody is entitled to a mostly adequate level of care. If you need to see a doctor, you can. If you have a terminal illness, you can get treatment. If you have an accident, you can think about your recovery, rather than the financial impact that it’s going to have. Health care is available to everybody.
However, thing’s are a bit different in the US, which is a new scenario to me. Health care in the US is run by insurance companies that are trying to make a profit, based on risk — in this case, the risk of an individual becoming ill. Now, I have no problem with companies trying to make money, or the insurance model in general, but applying the insurance model to something as important as someone’s health is just plain wrong.
Here is how I understand it: each individual (unless they have group coverage through their employer) is accessed by the insurance company on the risk of them becoming ill. The calculated risk then becomes a premium, which the individual must pay in order to have the luxury of being able to receive care. Then, depending on the plan, you will usually be required to pay an additional cost if you go to the doctor, are admitted to the emergency room, require medications etc. Additionally, if someone has a history of health problems, they can expect to pay a higher insurance premium, because the risk of them becoming ill is greater than someone who has relatively few health problems. You can literally end up paying tens of thousands of dollars per year, depending on your plan (and the treatment you receive).
Sadly, this often gets to the point where that person can no longer financially afford the premium, or worse still, is refused insurance because they are “uninsurable”. Believe it or not, millions of Americans today are in this very position. People are dying and nobody wants to do anything about it, or at least that’s what it seems to me.
Enter President Obama’s Health Care Reform plan. If you haven’t been spending your spare time chasing hot air balloons around Colorado, you will no doubt be familiar with this term. In short, this public health reform would introduce a public health care option, giving every American access to some level of health care. People that currently have no insurance, would be thrown a life line.
“It will provide more security and stability to those who have health insurance.
It will provide insurance to those who don’t, and it will lower the cost of health care
for our families, our businesses, and our government.”President Barrack Obama
The thing that amazes me, is that there was resistance against this plan. Not just a small pocket of resistance, but massive disapproval. I was astonished. Seriously, does anyone want to stop this madness? People are dying because they can’t see a doctor, and being under treated and over treated left and right. It seems that everyone who was against this plan, didn’t want to see their own coverage affected. They were scared of higher premiums or not getting the same level of coverage they have now. They don’t want change, they don’t like change, and they most likely didn’t vote for Obama. To me, this is extremely foolish (not to mention selfish) and it makes me very sad; these people are worried of being in a position that millions of their fellow Americans are already in.
Anyway, regardless of the resistance, a somewhat mangled version of the health care reform bill recently passed the house of representatives, and is currently in the senate, for more squishing. What comes out the other end is anyone’s guess, but I hope to god it makes even the smallest improvement to this flawed, unfair and unethical health care model.
What do you think of health insurance? Do you think the health care reform plan is a good idea?
* There may be additional costs for eye tests, dental care, prescriptions, and many aspects of personal care. UK residents contribute to the NHS through National Insurance (NI) payments, which is calculated from earnings.
December 4th, 2009 at 1:28 pm
I wholeheartedly agree with you. It is disheartening to me that people disapprove of the idea of some people going uninsured. I only wish Americans would be more open-minded about this, and wish they would understand that if you are already insured, this really doesn’t affect you at all.
December 4th, 2009 at 2:35 pm
I totally agree with you. Being from Europe myself and having lived in the US for 5 years, it is so mind-boggling why soooooo many people are against this. No country has a “perfect healthcare system” but its got to be better than whats going on in the States at the moment!
December 4th, 2009 at 4:49 pm
Hear, hear!
December 6th, 2009 at 9:16 pm
I keep on wondering what is wrong with the suggestion of Obama that all those people are against it. I keep thinking maybe I don’t know enough about it but then I think about the fact that I always think twice about going to the Dr when I’m not feeling good (something I never did in Europe) and then I think they must not be thinking right.
I think Americans are mainly scared to pay more (those paycheck contributions) and not benefit from it. But don’t they realize that if they US government offers an other option that if Insurances want to stay in the game they’ll have to offer something else, something that could be better? Right now they feel safe because people are against it…
November 15th, 2010 at 10:03 pm
I actually stumbled upon this while reading other blog entries of your spouse.
I am reading this a little over a year after it was published, so quite a bit has happened since then.
The biggest problem is most are getting confused with is healthCARE and heath INSURANCE. There is a LARGE difference. EVERYONE has access to healthCARE here in the US. You can go into any clinic and be treated. Same as in the UK. However the difference is who pays for it. What most refer to as health INSURANCE is actually used more like ‘prepaid health CARE’. Think about it. You don’t (and cannot) use your car insurance for basic maintenance and upkeep or breakdowns. It is there in the case of an accident involving circumstances that impair the vehicle. Injuries are usually covered under this as well.
Health insurance in itself is really not as expensive, even for those with ‘pre-existing’ conditions. There are other options for healthy adults such as ‘health savings accounts’, which offer an insurance portion, with the ‘savings’ portion that is able to be used for whatever medical expenses you choose-even elective surgery such as lasik and cosmetic, which normal insurance does not cover. With the Obama-care plan, HSA’s will be outlawed (read the bill, it is in there, I assure you).
People compare this plan like the government mandating auto insurance. However they are not comparing the same things. The government only mandates that if you choose to use the privilege of operating a vehicle on public roads you must have a license to do so, and carry insurance. If you do not drive on public roads, you DO NOT need to carry auto insurance. You can still drive a vehicle on your own land without insurance. Obama’s plan forces EVERYONE to either obtain private insurance (which is restricted to only purchase in your own state) or use the public-funded clinics. This itself forces people to purchase something they might not normally do. Insurance is not required to live a normal life and go about daily activities.
The force to buy is the single biggest problem most of the public has with this ‘plan’. It states right in the bill that this plan mandates several things (read the bill yourself-most of congress has not!). The first one is an insurance mandate requiring all employers to provide health insurance or pay an 8 percent payroll tax penalty. Individuals who do not have insurance will be forced to pay a 2.5 percent “health insurance” tax penalty. (www.scpolicycouncil.com)
If you already cannot afford to pay for healthCARE, or a small premium for health INSURANCE, how are you going to afford to pay a penalty?
I did note that the author stated “..but it works for the most part, and everybody is entitled to a mostly adequate level of care.” If you are satisfied with ‘adequate’ care, then that’s your prerogative. I, however, would like the BEST care available. That is the difference between the US and the UK. We in the US, for the most part, don’t settle with ‘just ok’. We go for the bigger, better, stronger, faster. Is that a bad thing? If it were really that bad, then think about all the technology and advancements in medicine we have now, thanks to the innovations and free-market inventions (that did not require government grants or permits to be done, BTW). The innovations and technology used here far surpasses that used in the UK, and is why many from around the world come to the US to receive treatment for various illnesses.
One main reason of rising health care costs is that very same technological innovation. Innovation is NOT free. It costs money in research and facilities, and necessary supplies. However without such innovation, quality of care will decline. Obama’s proposal to pay doctors and hospitals a flat free to provide medical care will encourage rationing even more than the basic idea of the plan. Already, under the Massachusetts connector plan, there is a 33-55 day waiting period to see a primary care physician. (www.scpolicycouncil.com) Our system here is not perfect either, but by all means, it is FAR BETTER than what you find in the UK AND CANADA combined. If not, then again, why do residents of both UK and Canada routinely travel at their own expense to get treatment here that their own country refuses to pay for or provide at all?
The other issue many have is the severe increase in taxes to pay for all this. The Obama-Care plan will be funded by a cumulative 5.4 percent increase in the top tax brackets (beginning at $280,000). … According to the Cato Institute, 60 percent of those hit with the surtax will be SMALL BUSINESS OWNERS. (www.scpolicycouncil.com) Who then pays for it? The costs will then be passed to the consumers, who are going to be hit with forced insurance premiums or pay a penalty. So costs of goods goes up (making it hard on the family budget)as well as being penalized in one way or another-making it even harder on the budget, if there is any left.
The last thing is this was actually passed illegally. No one in the current congress wants to say it out loud (hopefully the newly elected ones will). This was passed as part of a ‘budget’ bill that was attached to the military spending budget. Therefore it was not actually passed as an official law. The President only signed the bill as a ‘budget’. Obama-care is not officially a law because it neglected to be passed as one is normally passed. This combined with the forced-purchase of a product or be penalized is in itself illegal.
There are other reasons why this “plan” is ‘bad for your health’. However that would mean an additional several paragraphs which would only reiterate most of the points I already made.
December 13th, 2010 at 12:40 pm
Thanks for your comment Lea.
I agree that health care and health insurance are very different, but health care in the US is largely inaccessible without a health insurance policy. This is not the same as the UK at all, because to get this “health care” in the US, you have to pay for it. And we’re not talking a few dollars, we’re talking huge sums of money for just a doctors visit. How many people do you know that use the health care system in this way? Not many I would think, because if you can’t afford health insurance, chances are you can’t afford to pay these non-subsidised health care costs should you get sick. And health insurance is not (in most cases) pre-paid. It makes it affordable, because in most cases you are still required to pay for some of your treatment out of your own pocket.
In the UK, health care is paid for by National Insurance (a portion of your salary), and in cases where you may be unemployed (or unable to work), it is subsidised by the government. To reiterate my point from the original post, health care IS available to everybody, in the US it is not.
You’re right, health insurance isn’t generally expensive (it can be) — but treatment is. Health insurance really only makes health care accessible, and depending on your plan, you can still end up paying a lot of money out of your own pocket if you have a serious accident or illness.
Do you honestly believe this? With the way the system is set up at the moment, not having health insurance is unthinkable. Would you be happy to not have health insurance? Your family not to have health insurance? Knowing that a serious injury, or a downturn in health could leave you bankrupt? Lots of people have no health insurance – and not because they choose not to — because they simply cannot get access to it. And I’m pretty sure they would not agree with your statement, because every day they live in fear of becoming ill, and having absolutely no power to do anything about it.
It’s not a bad thing, but you’re missing the point. Care is available, whether it be adequate or exceptional. It is available, and that’s the point. If you were offered no care, or adequate care, which would you choose? Of course you like the best, and if you can afford the best, good for you. You’ll still be able to get the best, and pay for it, even with the new bill. The issue for me, is that you don’t see the bigger issue, because it sounds like you’ve never been in a position where you can’t afford care, so you don’t see (or care about) the issue. It smacks of ignorance.
How many times have you received treatment in the UK? We have some of the best surgeons in the world, and if you can afford to pay for top level care, you can do so, just like you can in the US. Many of the reasons you get people coming into the US for treatments, is because a lot of the time they are experimental treatments, that may not be proven to work, and are not currently practised in the patients country.
To who though? I think you’re only thinking about yourself in this, which is incredibly shortsighted and selfish.
Again, massively sweeping statement, and I’m now even more curious to know how many treatments you have had in the UK and Canada. See my point above regarding why people come to the US for treatments, but on that note, maybe you can consider why people from the US go to Canada for treatments; I’ll give you a clue, it’s not because they want to go and buy cheap maple syrup.
December 22nd, 2010 at 5:29 pm
Well said Nick, I’m from the U.K as well (Yorkshire) and having lived in both America and England, I’ve experienced both healthcare systems and can honestly say I am so glad for the NHS. I’d much rather have a reliable safety net who’ll always take care of me, then have to rely on greedy capitalists who want to make a profit out of my ill health.
Lea- I think you may want to watch the movie ‘The Rainmaker’ or Michael Moore’s documentary ‘Sicko’…perhaps that’ll change your ignorant views of how ‘better’ American healthcare is than the socialised ones of UK/Canada/France etc.