Health Care: The Ticking Time Bomb

When I was in nursing school I worked a min wage job that didn't provide health insurance. My wife, son and myself could have milked the government and used the .gov medicine, but we didn't want to add to the problem. We went without health coverage for three years and paid as we went, some of which I am still paying. Not a lot though. It can be done WITHOUT the government.

I pay for my own health care. Because, I don't have insurance, I get to pay full price. I cannot negotiate for a lower fee. If I don't pay, well I get sent to collections, I can get a judgement against me and I'm considered a poor credit risk. I don't qualify for any government programs because I'm single, have no dependents, and I work at a $12/hour job for a living. I have dial up Internet, no cable/ satellite TV, no cell phone. I walk to work instead of drive. Wash my dishes by hand as well as line dry the laundry. I live quite frugually.

Many times I decide if the doctor ordered blood work is really necessary in order to remain on medication. Sometimes I take one pill once daily instead of two twice daily as prescribed just to make the prescription last longer. In the hard months, I take my chances and go without the medication. Sure the pills are expensive but not near as expensive as the required bloodwork and doctor's visit every six months in order to keep the prescription current. I haven't ended up in the ER yet. If I did, I don't know how I would pay for it. So yes some affordable insurance would be a Godsend for me. It could even have a $5000 deductible. I just need a policy to take care of the major stuff.

Meanwhile, I know people who go to the doctor everytime the kid gets a snotty nose because their insurance will pick it up.

Fuzzy

Regarding the mammogram, in Europe the guidelines for routine mammography do not recommend routine screening for women under 50. There is no evidence to suggest that routine screening at an earlier age is beneficial, and is more likely to be harmful.In the UK every woman between the age of 50 and 70 is invited for mammography every 3 years.
Because it is often perfomed in mobile units (ie trucks that go from hospital to hospital) it is done an a geographical area basis, so some women do not get one until they are 53. There are plans here to change that so that in 2012 all women over 50 will have had one by the time they are 51.

Regarding "other screening" we do not routinely check BP,cholesterol,serum glucose,urinalysis until age 55.

PAP smears are performed on all females aged 16 and over every 3 years.

There are now private firms offering (randomly writing to people at home) screening tests for aortic aneurysms,peripheral vascular disease and carotid artery disease at a cost of $240.

Despite the fact that we pay 6.5% of our pre-tax earnings towards the NHS and employer pays additional similar percentage (for me that's $5,500 per year or $460 per month) our system is rationed according to government guidelines. If the guidelines don't say it, then you don't get it unless you are prepared / can afford to pay for it privately The guidelines are often out of date as far as evidence from clinical trials go, and some GPs are either reluctant to follow them due to increased costs from their "budgets" or lack knowledge.

We also pay on top of this for dental care, prescriptions and eyewear.

Thinking about stroke- GPs are reluctant to start patients who have AF and who meet the guidelines on warfarin (coumadin equiv) because they think it is a dangerous drug or they have to pay specialist teams to monitor it.They wil put the patient on Aspirin depspite the well known and accepted evidence that warfarin is 3 times more effective then aspirin for stroke prevention in these patients.

The evidence for thrombolysis in acute stroke has been around for over 10 years, and whilst some (a few) hospitals in the UK have been doing it since the late 90s- the government has taken till last year to implement a national stroke strategy that says all hospitals that admit acute stroke patients have to have a thrombolysis service in place, however they don't say it has to be available 24/7 so many hospitals only provide the service Mon-Fri 9-5! which to me is unnaceptable. It is only since the advent of the national strategy and targets for stroke that the managers in many of our hospitals are listening to the Stroke Physicians and putting some extra resources into stroke care.I think you will find that is very different in the US.

Our system is very target and budget driven which is not always best for patients, but in addition guidelines are not always adhered to,especially by those in primary care. Money will be pumped into whatever is "en vogue"often by taking away money from a service that was "en vogue" the year before. For example, our Cardiology specailist nurse were given higher pay bands than a lot of other clinical nurse specailists because the government threw millions into cardiology. However that pot has now dried up so the cardiology nurse specailists have all been downgraded under the auspice of a "service reorganisation". Conveniently they waited until they had all done nurse prescribing courses before downgrading them.

I agree that for many in the US that have chronic diseases our system would be a better system. But you need to bear in mind that here many of those people have paid considerable amounts into the pot for many many years and taken little out, and have little control over what they can and can't have regarding investigations and treatment.

I wonder how much people pay for health insurance and how much a PAP smear or mammogram would cost over in the US?

I can understand that-but would you sacrifice quality for cost?

What good is quality when you can't afford it? No system will be perfect but the system we have now does not work. Some type of reform is needed. Quality for cost? "I would much prefer a bologna sandwich than to starve.". I don't think that the quality of health care will be compromised. Yes we have the best health care in the world but when one catastrophic illness can bankrupt a family. "What good is it?" When people die because of the cost. "What good is it?". We tout ourselves as a moral Christian nation, it is time we walked the walk instead of talking the talk.

Hey Ron, the system we have now does work for 95% of us.

Clearly it doesn't. Maybe it is great that I have fantastic health insurance, but I know a lot of people who don't. I would say right now it is more like 50/50. God forbid you ever find yourself in a situation where you can't afford or don't have insurance. Maybe then you can take off your rose colored glasses.

How does a system work when health care premiums have risen 4 times faster than wages. How does a system work? When health care cost are a factor in half of the personal bankruptcies since 2000. When lack of insurance leads to an estimated 18,000 unnecessary deaths per year. When the insurance industry is not regulated and plays with peoples lives by denying necessary treatments. Tell that to the people that can't afford needed medications because they can't obtain insurance because of pre-existing conditions. Tell it to someone that has lost a loved one because they could not obtain the medical care they needed. Our health care in this country for many is "Don't get sick.". What does your 95% comprise? Does it comprise those fortunate enough to health care excluding those that do not in the totality.

So what would you say was an affordable amount to pay, considering you don't care what the quality of the care is like?
I think you are wrong to think that you will get the same level of care,investigations,staffing and technology from a government run system.

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