Thought I would relay what happened while I worked triage this week-end. Had a 30yo male come in for "toothache", as I am triaging I usually tell people what to expect...labs, xrays or whatever. I am telling this guy he will be able to go to fast track and he would probably be given scripts for pain and an antibiotic but that he will also need to follow up with a dentist to actually solve the problem. He tells me he can't afford a dentist they are too expensive, and I tell him the nurse that DC's him can give him some names of area dental clinics that will work with his financial situation. I stress to him that he will not be rid of his bad teeth unless he sees a dentist. I also tell him it will be cheaper in the long run than paying for continued ER visits as we don't fix teeth. His whole demeanor changes and he says... "What do you mean ER bill?" I explain that ER's do charge for any care and that the hospital also works with people with financial concerns. He stand up and informs me "This is a community hospital!" and I confirm that it is but being a community hospital does not mean free and again that the hospital will work with him on his billing. He goes into a tirade about how rich the US is and it is rediculous that he would get a bill at a "community hospital" and he ripped off his hospital band and LWOT'd.
Anyway just thought I would share, it is amazing to me that so many really think they are owed free care.
As far as paying my wages, no they don't. The Medicare, Medicaid, the State and the Insurance companies pay my wages, pathetic as they are. I know, I saw it all in charity care.
I was actually referring to the Uk where mandatory National Insurance contributions are taking out of our monthly paychecks to pay for our healthcare (hence free care at the point of service but we do actually contribute towards it) and why some members of the public think that they directly pay our wages. From my paycheck to yours, as some like to say. In the US its that big blackhole of taxes that pay for medicaid and medicare, is that correct?
OOPS! Sorry missed the UK reference! But yes, the blackhole of taxes does pay. However, a lot of people work the system but never actually worked a day in their lives. Not talking about people w/legit problems, but we all see people who know how to get stuff and never pay a penny. Lots don't contribute by paying taxes. I pay taxes, social security, medicare, etc, and don't even know if I'll be able to collect SS or Medicare. I can't qualify for any assistence whatsoever. Right now, I changed jobs, have no health ins, am waiting for COBRA (continuation of benefits coverage) paperwork to arrive, which will cost me big bucks out of my pocket. In the meantime I pray and keep my fingers crossed that nobody gets hurt or sick. This is the price I am paying to make us a better life.
the associated press just printed a report that american health care insurance premiums have risen 6.1% this last year alone for a total of 78% since 2001. the average family of four pays $12,106 for health care. i would be interested in these kinds of figures for the british health care because i simply do not know them.
in the mean time the ceo of my health insurance company is making millions of dollars every year. that could pay for more than a few pregnancy tests.
the associated press just printed a report that american health care insurance premiums have risen 6.1% this last year alone for a total of 78% since 2001. the average family of four pays $12,106 for health care. i would be interested in these kinds of figures for the british health care because i simply do not know them..
In answer to your question, I just did a bit of research and there are alot of variables in the individuals National Insurance Contributions in the UK, such as employment status, how much they earn, whether you are a married women, self-employed and so on and so forth. However to simplify things I have picked the general employed population. The Lower Threshold group (eg, those in a lower income bracket) pay 87pds a week(roughly $174)or 4524pds a year(roughly $9048) and those in the highest bracket pay 670pds (roughly $1340) or 35,840pds a year (roughly $71,680.....ouch!). These are figures based on each individual who is emplyed. Those who are unemployed or under 16 do not pay National Insurance. So, according to your figure of insurance in the States, we actually pay more in the UK (if both parents are working) except we all share the burden and our healthcare is free at the point of service(we only pay a flat rate for prescriptions), where as over here it seems there are people (especially the young) who don't bother with insurance. I hope this answers your question!
I suggest you look to the news forum to see how our President stated every American has access to medical care (free) by going to their local ER! Yes, this was a recent statement....good luck to all of us this winter.
Oh, by the way..Pediatric ER get ready for the influx of kids coming your way. This same President has vowed he will not sign off on the childcare bill that has covered children of the working poor for the past 10 years that is due to expire at the end of September.
Specializes in Spinal Cord injuries, Emergency+EMS.
Try working in the Uk where healthcare really is 'free' and then get used to hearing patients demands followed by them saying 'I pay your wages'. I would hear that on a daily basis in the ED. A-holes.
all the more irony when it comes from someone you know isn't a taxpayer becasue they've filled i nthe back of a prescription on a previous visit
the alternative is to try and engage them on discussion about the staged pay award ...
Specializes in Spinal Cord injuries, Emergency+EMS.
In answer to your question, I just did a bit of research and there are alot of variables in the individuals National Insurance Contributions in the UK, such as employment status, how much they earn, whether you are a married women, self-employed and so on and so forth. However to simplify things I have picked the general employed population. The Lower Threshold group (eg, those in a lower income bracket) pay 87pds a week(roughly $174)or 4524pds a year(roughly $9048) and those in the highest bracket pay 670pds (roughly $1340) or 35,840pds a year (roughly $71,680.....ouch!). These are figures based on each individual who is emplyed. Those who are unemployed or under 16 do not pay National Insurance. So, according to your figure of insurance in the States, we actually pay more in the UK (if both parents are working) except we all share the burden and our healthcare is free at the point of service(we only pay a flat rate for prescriptions), where as over here it seems there are people (especially the young) who don't bother with insurance. I hope this answers your question!
the earnings limits are the amount under which you won't pay NI (LEL = 84gbp/ wk, threhold 97gbp /week) and the amount after which NI is only 1% (UEL =645 gbp /week)
you pay 11% on 97- 645 gbp /wk and 1% above that
if you are "contracted out" of S2P (nee SERPS) you are rebated 1.6 % to go into your contracted out pension
from the NI tables
"
The first earnings figure in each table is the Lower Earnings Limit (LEL) (£84 weekly or £364 monthly). This is because NIC liability only arises when the employee's total earnings in the earnings period reach the LEL, even though no NICs are actually payable on those earnings. Both the employee and the employer pay NICs only when the employee's earnings exceed the Earnings Threshold (ET) (£97 weekly or £420 monthly). But, for standard rate NICs, earnings between the LEL and the ET are used to protect the employee's entitlement to benefit.
The employee and the employer pay NICs at the appropriate main percentage rate on earnings between the ET and the Upper Earnings Limit (UEL).
The last earnings figure in each table is the UEL (£645 weekly or £2795 monthly). This is because employee's contributions are due only at a rate of 1% on earnings above the UEL. The employer pays contributions at the rate of 12.8% on earnings above the UEL.
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scattycarrot, BSN, RN
357 Posts
I was actually referring to the Uk where mandatory National Insurance contributions are taking out of our monthly paychecks to pay for our healthcare (hence free care at the point of service but we do actually contribute towards it) and why some members of the public think that they directly pay our wages. From my paycheck to yours, as some like to say. In the US its that big blackhole of taxes that pay for medicaid and medicare, is that correct?