[tranquility]

Hi there,

Not sure if this is the right forum but I think so - if not the mods can move to the correct one

I work for a health insurer in the United States and as most US citizens know, the affordability of health insurance is getting more and more out of everyone's grasp. I hear the politicians go on and on about how the whole country should move to socialized medicine and that SCARES ME.

The only type of socialized medicine now (and I speak about my state only - Rhode Island) is the welfare/medicaid system. When I read the benefits of the health insurance for welfare I am amazed at how much better that insurance is compared to any insurance that you can buy on your own or through an employer. Currently, a person on welfare can get everything for free, this includes prescriptions, over the counter medication like tylenol or excedrine (it just has to be written on a prescription pad by the doc), a paid interpreter to go to a doctors appointment if needed, and in some circumstances taxi service. (many have said RI is the most generous state)

Now, when the politicians tout socialized medicine in this state, I know alot of people think they will get all the benefits that the current welfare system offers. I know that is not true, as alot of money is lost on that plan now and is made up by the taxpayers.

I wonder if my UK friends could share with me the top 5 good things about socialized medicine and the top 5 bad things. I have met a few people from England and Canada who didn't have much good to say.

Thanks!
Tranquility

[January]

Thank you for your interesting post. Benefits change from state to state so I can only speak for mine.

As a disabled person with a very low income, I qualify for Social Security Disability and "welfare". I certainly don't get any over the counter meds for free. Almost every Doctor in my area, (I live in my state's capital city), will not accept my "welfare". I am treated like a second class citizen by most of the medical personnel I see, but also by the other patients who see me pull that horribly embarrassing card out of my purse each and every time I am seen by a Dr.

I get to sit in waiting rooms and listen to the patients with "regular" insurance *****, gripe and complain about the useless trash that won't work so they can have welfare.

If I was healthy enough I would go back to work tomorrow and get off this wonderful "welfare".

I know you meant no harm in your post and I hope you don't take offense at this. I find it's always interesting to know what folks on the "other side of the fence" think.

January

[tranquility]

Hi-

I don't take offense and it's interesting to hear your side of it.

My friend is on SSI for Bi-Polar and she does not qualify for the welfare assistance; rather Medicaid - which in this state is a bit different from welfare. She does get her medications for free but there are alot of doctors that won't take her Medicaid. I think I had heard that if a doctor takes Medicare he has to take Medicaid - but I'm not sure of that.

Also, the program for welfare recipients is Neighborhood Health Plan and they just one some award as being the best in the country as far as patient care.

I think there is a HUGE difference between Welfare and Medicaid. My friend couldn't get any help whatsoever when she was first out of work because she never had kids. That burned my butt because she worked for years and paid her taxes and then the government just turned their back on her. It wasn't until she got SSI that the state finally gave her the Medicaid. Also, because she pays her own utilities in subsidized housing, she can get food stamps.

I do appreciate your comments and certainly didn't mean any disrespect to anyone. I'm just really concerned about socialized medicine when I hear so much bad about it.

Still would love to hear from my UK friends!

Tranquility

[January]

Hi,

Here, Medicaid/Welfare are almost the same thing. I do not have traditional welfare coverage. My pittance of SSI is just enough to not allow me to have all the other benefits.

I have to pay for part of of my medications, which costs me over a hundred dollars a month. I do receive some "food stamps", but you can't buy a whole lot of food with around $50 a month.

I am, however, extremely thankful for what I do receive. It could be so much worse.

January

[kimmydawn]

I have wonderful insurance. I'm blessed and I know it.

However...

My precious little nephew gets state medicaid (one reason I want to adopt) and it's hard to get him treated by a good doctor. He's four years old and deserves ONLY THE BEST this world has to offer, but doesn't get it alot when it comes to his medical treatment.

He has to see one of the very few peds that take medicaid. Recently he needed a procedure done on his toe. We couldn't find anyone to do it and those listed with his medicaid (pardon me) sounded like an advertisement at the local mall. I paid to have him seen at children's hospital, then had to scratch and fight to get approval to have his procedure done there.

A few months ago, he needed dental work. There are two dentists in the area that take his insurance. The first one was so mean and ugly that it took all I had not to cross the room on him. Well, I did, in fact. He needed work so I took him to a ped dentist and because of his insurance they had to do EVERYTHING at once on this little four year old which consisted of shots on both sides of mouth (several) and two big silver caps showing because insurance would approve no more.

Please don't think I'm only griping. I realize that it's a blessing he has this period, but because it's a blessing in one respect, does that make it good or right for our babies?

The surgeon at children's said I did so good because "they" would've hurt him badly. He said, "Why? Children are tough? No, they just have the smallest voices."

I don't know about socialized insurance, but I do know that our children need more than what medicaid offers them in this area.

Also, it's my understanding that medicaid and medicare are vitually the same here as well.

KD

Edited to add...

My boy hasn't even had an antibiotic in his life yet, but two of the very few prescription meds he's needed medicaid wouldn't pay for. He has severe environmental allergies...phlegm so bad that he can't eat and will get sick at times, so meds are necessary at times. We have to pay for that out of our pocket because medicaid won't pay. He's already small. What if he was with mama and daddy and I wasn't around to pay for it for him, ya know?

[January]

Oh my goodness.

((((( The Children )))))))

Jan

[tranquility]

My goodness - he's lucky he has you! You should move to RI I think you would do better.

Tranquility

[kimmydawn]

He might do better, then we'd not survive. Hubby only makes as much as he does because he's been on the job 20+ years.

Thanks, Tranquility.

KD

[Greenleaves]

I live in Ottawa, Ontario and so far I have no complaints other than long wait times and lack of doctors. I have no family doc now b/c mine retired.

I see my pdoc every week for therapy and meds. When I had my breast lump scare I got referred to a surgeon. It took a while, a long time, but I finally got it biopsied, even though they said it was benign. I was worried and they alleviated my worry.

Dental and vision and prescriptions aren't covered though.

Back in California when I was a kid, we didn't have insurance or welfare. My parents worked minimum wage jobs. Some of the docs were nice though, gave us lots of free samples. If I lived in the States I would never be able to see my psychiatrist every week. I'm not sure what would happen to me.

I feel safer knowing if anything bad happened to me I wouldn't be financially ruined. My cousin had to have emergency surgery, it would have cost thousands in the states. Here it is free (thought we have high taxes).

New Zealand...

Not that many people have health insurance. The public system is adequate and while people ***** about wait times on non-emergency services I think it is fair to say that the public system is adequate...

With a community services card (available to people with low incomes and an increasing number of working families) you pay around $15 to see a doctor during normal working hours. ER visits are free but it will cost you more to see a doc after hours at a clinic (maybe $30). Prescriptions are $3 per generic. Some are only partially subsidised (e.g., some varieties of contraceptive pill and some brands of medication) so you might pay a bit more (e.g., $10 per week for Imovane brand but $3 per script for Zotab). Things like anti-histamines and vitamins and anti-inflammatories and pain killers are also available through subsidised prescription and in some intstances it is cheaper to get a script through your doc than to pay OTC prices.

Hospital is free. Wait lists vary... Some people complain about that (hey people will complain when it isn't instant). Sure there are some horror stories but for the most part it seems to work relatively well.

Dental is subsidised through welfare. Ditto for optometry. You can get a certain amount gifted (non-recoverable) towards both.

In Australia things are similar. Medicare or Medicaid (I can't remember which it is)... Medicare I think... That is available to citizens and is similar to what the NZ government provides to low income people. I get limited medicare coverage in virtue of paying a fairly minimal amount to medicare ($350 per year). Only difference seems to be that I don't get optometry, dental, and max something like 29 days inpatient services in hospital. There is a reciprocal agreement between NZ and Australia (and England and the UK and Canada I think) where people from those countries will be treated in emergency, life threatening situations and that no costs will be incurred from that.

Prescriptions run a little differently in Australia. Contraceptive medication is not covered. I think one can make a case if one has especially bad period pain etc but generally speaking one has to fund that oneself. I got a generic and it cost me about $15 per month. With prescriptions I have to pay the first $20 (I think) then medicare will cover from $20-$50 then I have to cover the rest over $50. They won't cover anything available OTC. I haven't bothered submitting a claim for prescription meds.

People are very good here with community mental health services. I've been places and have told them that I'm not a citizen and they have said 'oh, well, we don't need to write you up then' and there hasn't been a problem. They have either written me up as a resident (so no costs are incurred) or haven't written me up at all (e.g., when I saw my p-doc in community mental health).

They are trying to encourage Australian citizens to purchase private health insurance. That being said public services seem fairly adequate to me. It can be expensive to see a doc if you are not low income but high or low income no costs are incurred if you see specialists (or spend days in) public hospitals.

The main difference seems to be on cutting wait times for things like cataract surgery and hip replacements and the like. Private will get that sorted a lot faster than public (though in NZ you have ACC to help you out income wise in the meantime).

There is a push in NZ (as there is in Australia) for hospitals to be run more like businesses than as hospitals. A push for universities to similarly be run more like businesses than as universities. That means that a lot of the funds get diverted to paying exhorbatant salaries to managers. Lots of board meetings and the like. I know that a lot of doctors are fairly disgruntled with the way that the medical system is going in NZ. The hours for registrars (docs in training) are too long and they are given more responsibility than they should have because it is a lot cheaper to put them in charge than to have specialists physically located at the hospital instead of being on call. They do a lot of campaigning / protesting for better working conditions. How much time does one have for studying to pass exams when one is working a 50 hour week at the hospital? How much can one be alert and awake and ready to make important decisions when one has been working for 12 hours in the shift already and there is a car pile-up at 3am?

Everyone's got problems, I guess...

[SeptemberMorn]

I don't know what the answer is, but almost anything has to be better than medical insurance, or any kind of insurance for that matter! That's all I'm going to say on the subject because you won't be able to get me off my

[heyjoe]

I think that it is a disgrace that in a country with so many resources that people are not treated for serious medical conditions and are dying everyday or living in misery because they dont have any money.

[tranquility]

Alot of great, well thought out posts - thank you very much! I do know that in all the hospitals in my state they have signs up that they cannot turn away anybody for lack of insurance, money, ethinicity, sexual preference, etc.....

One of the problems the hospitals are running into is that people aren't paying money owed and the hospitals are getting more and more nervous about it. I know this year they tried to pass a bill where the hospital would try to get copays from the patient and if after several attempts they couldn't, they would bill the health insurer a percentage of the amount. I think this one got vetoed.

It's all a viscious cycle - I've heard arguements from the average joe citizen, the insurers, and the doctors and they all have valid points of where there are issues - but how to solve it? Who knows.

For instance, the docs have to cover verryyy high malpractice costs because everybody sues for everything. Then they see more patients in a day than humanely possible because of low reimbursement rates by the insurer.

The insurer has lower reimbursement rates to try not to drive the premiums up that their customers have to pay. The customers (average joe citizen) get it in the end. I do have to say though, that with technology docs are more apt to schedule all these exensive tests even if they don't really have to (sometimes its because of malpractice).

I know now if a doc wants to send me for a test I want to know why and if anything else can be done instead of incurring that big cost. I also try to go a with a more holistic approach by doing chiro, massage, and hypnosis which comes out of my pocket not my insurers.

The other thing that drives costs up are all the legislative mandates! Holy cow - there is a law, or two or three, for almost everything and it takes employees to make sure you are compliant to the laws. The legislatures see a problem and they just throw another law out and don't stop to think how much that law is going to end up costing the consumers.

It's such a big issue.

I really appreciate all your responses!
Tranquility

Yes it is a very big issue.

I just heard on the news that the US has the highest number of people, in all the developed countries, without insurance. It's very sad, some people don't go to the doctor because they don't want it to break their struggling bank account.

don't know what THE answer is... but.... those struggling here in the US know something has to change.

I tried to get my own health insurance, checked through 10 different companies --9 denied, only ONE would accept me(that's if I pay enormous premiums-- $600 monthly-- which I can't afford) because I have hypothroid and endometriosis. (I'm on the slim side for my height so my weight was not an issue... and the only meds I take is my thyroid meds)

It's sad that a country will let some of their people go without help because they don't fit into any of the "government" catagories.

Just don't know what the answer is....

mandy

what do the other countries have in common?
oh yeah, they aren't as litigeous.
nz has ACC to prevent employees suing employers and to prevent patients suing doctors.
not sure about the UK and australia but i think there is something a bit comperable.

maybe... the freedom to sue results in people not getting so many of their basic health needs met...

something to think about