Medical insurance and health care in your country

Just to be clear, health care is never "free." You either pay for it with premiums to private insurance companies, who are obligated to shareholders to make a profit, or you pay for it with taxes to a government.

In the US, we have two systems. One for people under 65, and one for people over 65. The over 65 people get medicare, which is health insurance run by the government. It works well. If you have a lot of money, you can buy supplemental private insurance, which is pure profit for the companies selling it, because the big portion is already covered by medicare.

The other is for people under 65. It is provided by totally private companies, and exists to earn significant profits.

You pay for Medicare in advance through the "Payroll Tax," which is 7.5% for employees, or 15% for self employed people like me.

You pay for private insurance by paying a monthly premium. Your employer may subsidize that with a group plan, so you pay a few hundred bucks out of your paycheck for it, or if you are self employed, you can pay 1,000 bucks a month for it -- sometimes more -- plus the 15% tax you pay to have medicare, when (or if) you make it to 65.

In many other countries, you pay for healthcare through taxes. That is generally lower in cost than our private, for-profit insurance.

CD
 
caseydog said:
Just to be clear, health care is never "free."
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Actually mate, in the UK the deduction is called National Insurance or NI. From the moment my wife arrived in the country she was covered by my NI. I did not pay anymore. UK citizens, for whatever reason who have never worked get the same treatment as me. The % of NI deduction is based on your salary. I did not care a hoot that a person earning and paying a lot less than me got the same care. Social justice for me is the strong support the weak.
 
CraigC said:
I understand that health care is free in Italy, but the family is responsible for bedding, personal hygiene and meals. Only the actual treatment is free. Is this true?
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Nope, it's not proper free since we pay health care with taxes.
And absolutely not, family doesn't have to manage bedding, personal hygiene and not even meals, the hospitals do this.
 
caseydog said:
In many other countries, you pay for healthcare through taxes. That is generally lower in cost than our private, for-profit insurance.

CD
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We are obligated to do both. We are obligated by law to have private insurance which we pay a monthly fee of about 100 per person a month for, and pay a yearly 'own risk' fee of 385 euros a year annually, plus in certain cases 'personal costs' when you reach a certain limit of medicine or medical aid costs.

The rest of our healthcare costs are covered by taxes. It's a complicated and very expensive money mill, though not as expensive as US healthcare.
 
caseydog said:
Another thing about US healthcare. If you have insurance, the insurance company has contracts with the hospitals, and they tell the hospitals how much they are going to get paid. If you don't have insurance, the hospital charges "full-retail." So, when the hospital sends a bill for $10,000 to your insurance company, the insurance company tells them, we are going to pay you $2,000, and the insured person owes you $500. No negotiations. This is what you get.

The insurance company sends the insured person a statement that says, this is what you owe the hospital. The hospital sends the insured person a bill for $500.

If you don't have insurance, the hospital sends you a bill for $10,000, and tell you where to mail the check.

CD
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We are so lucky in the UK, I can't imagine having to make cost based choices about the health of loved ones. I have noticed though that as soon as insurance companies get involved in the provision of anything technical, the costs go through the roof. We have that here now with dentistry and animal healthcare. Both used to be quite cheap, now most people have insurance and the costs are obscene.
 
Morning Glory said:
Too Much Information - what does PMI mean?
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The point of maximal impulse (PMI) is simply that... the point where there is a maximal impulse against the chest that can be felt. Most often, this is from the apex or tip of the heart: also referred to as the apical impulse. However, in certain conditions, the apex of the heart does not cause the PMI.
I would have thought it was obvious as Tasty Reuben and I were discussing medical procedures.
 
Ok, here's my coverage in a nutshell:

I pay $175/month through my employer. That includes a $2650 deductible that I have to cover before they'll cover anything, but I do get to take advantage of the negotiated rates that my plan provides, so an office visit is more like $70 than $300.

Once the deductible is met, insurance kicks in, and except for some random things here and there, everything is covered 80/20 by insurance, as long as I stay in-network, and it's usually 50/50 if I go out of network. My carrier is Blue Cross/Blue Shield, so their network is huge. Actually, I've had about every major carrier there is here, and I've never had a network issue.

The next threshold is my maximum cost, which is $5500. Once I've paid $5500 within a calendar year, then everything is covered 100%.

Additionally, I have an HSA (Health Spending Account). For every pre-tax dollar I contribute, my employer contributes a certain, much smaller amount, something like a 90/10 match. It's basically a bank account that I have a debit card for, but it can be used only for legitimate healthcare expenses.

This is for two adults, no kids, and is separate from dental insurance and vision insurance. We have to re-enroll every year, and there are usually adjustments to coverage each year.

Even though we have a fairly comfortable income, there's no way we could afford that same policy if we had to pay for it ourselves. Hence, why I still work.
 
epicuric said:
We are so lucky in the UK, I can't imagine having to make cost based choices about the health of loved ones. I have noticed though that as soon as insurance companies get involved in the provision of anything technical, the costs go through the roof. We have that here now with dentistry and animal healthcare. Both used to be quite cheap, now most people have insurance and the costs are obscene.
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Another thing to keep in mind with for-profit healthcare - your MRI at one hospital can be much more/much less than a hospital 30 minutes down the road.

I have the usual mid-50's health concerns, while MrsTasty is a healthcare bonanza. We learned pretty quickly, once we started paying for this test and that test, that all hospitals are not created equal.

Back in 2015, they found a growth on my wife's pituitary gland, so her endocrinologist wanted a test done to get a baseline on size. Of course, she wanted the test done at her facility. Since her clinic was an hour away, we asked about having it done locally and just having the results sent to her.

"Yes...you could do that, but I don't recommend it. My techs know what I look for and what I need to see, and it's in-house, and there is no monkey business in getting me the results. I have them immediately."

$4200, and I paid $2500 of it (my deductible at the time).

The following year, she wanted the same test, to measure any growth. The only reason we pushed back the second time was because the tech who administered the test the first time really messed up my wife's arm trying to find a vein, so this time, we didn't ask, we said, "We're doing this at our local hospital."

$1300. A year later, same exact test. Difference: big city hospital versus little country hospital. Exact same test.
 
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