People are apparently clamouring for a health system funded by insurance so...

[Hanschenklein]

Those MNetters in countries outside the UK how much do you pay a month for your health care ? Is your country's system completely financed by this insurance alone or does your government contribute too ?
People call the NHS a financial black hole. They resent the fact that ever increasing amounts of money are apparently being ploughed into the service to see no real improvement. They seem happy to pay via an insurance style system instead.
So how much do you and your family pay ? How do you contribute towards your pension in the absence of national insurance payments ? If you pay a fee to see a GP does that put you off going ? Do you struggle to pay this insurance if not well paid ?
Most importantly is your health service sufficiently staffed, safe and prompt ? Are HCPs in your country valued, well paid and happy in their jobs ?

Yes, people will think this is fine until -

You have a chronic condition
You are old
Your child has disability that needs lifelong treatment
Your child had a life threatening condition like anorexia

Then selling your house to cover the costs or otherwise mortgaging whatever you have because insurance will not cover it or only a fraction will have you change your mind.

The above is quite common in the US.

I am in the UK but have a rare condition so am in an international Facebook group. You do not want the US system if you or your loved one might ever develop a serious chronic condition (which is all of us). Even those with decent insurance in the US seem to be constantly battling with their insurance companies to get the treatment for their condition, or have high co pays they have to fund. There are people on there who were wealthy until they developed this condition and were crushed by the constant costs of treatment and tests.

An insurance based system doesn't mean the completely unequal and socially unjust US system.

There are lots of posts on the thread about various European systems.

Essentially it has to be impossible not to be insured (payments deducted from income at source for employed people and their dependents) and people on a low income have to be covered by the state for the same level of care as everyone else. This IS how it works in most countries.

It's not a matter of choosing between copying the USA or the NHS.

Other countries exist and have better systems.

The NHS is a health system funded by insurance. By national insurance. People pay what they can afford and there is no excess to pay no matter how ‘risky’ (ie chronically unwell) you are.

I really can’t see how changing the NHS to a privately run insurance model would solve the problems we have - not enough staff, an ageing and unwell population.

It's just underfunded and the health aspect isn't ring fenced.

In other countries deductions are MUCH higher with separate, ring fenced, compulsory deductions for health, separate for pension, separate for unemployment insurance, separate for potential care needs insurance - and income tax as well obviously, which is often also higher.

taxsummaries.pwc.com/germany/individual/other-taxes

This is how it works in Germany - I don't know where another poster got 7% of income as the health insurance compulsory deduction - it's 15.5% now (I think the article is a year or more old and says 14.5%).

You can - there is no legal requirement to have health insurance and there is a distinct place where you earn too much for Medicaid and not enough to pay healthcare bills. My stepdaughter fell into that hole a couple of years ago when she had an accident on her own property and broke her arm badly. She had to have an operation and ended up with about $45k of medical bills since she had no health insurance. She is paying the hospital an agreed monthly amount, and sometimes they will simply write off the rest of the bill after a few years if you can only afford a small amount.

Oh, and if your spouse dies, you still owe the hospital for their remaining bills.

Oh sorry I do see where she got it from as she was taking the employer and employee separately! Sorry!

@MooseAndSquirrelLoveFlannel

Mostly I want the NHS to actually claim back the money from people who use it but arent entitled to do so. Tourists and those who dont pay NI for example.

The GHIC/EHIC/CEAM associated schemes should mean the NHS gets paid by overseas governments for providing medical care for their nationals who need treatment whilst travelling in the UK (that certainly should be the case for those tourists from the EU and some other European countries).

I'm no longer entitled to use the NHS and my American husband has never been entitled to use it. When we've been in the UK and needed minor medical attention we've offered to pay and been turned down because nobody seems to be geared up to take your money.

I lived overseas for a while with an entirely private health system. My employer paid compulsory insurance - about £400 a month. But healthcare was excellent and pretty much immediate. Co pay of about £30 to see a GP but if anything I felt more entitled to see them as I was paying so it didn’t put me off.

Why?

This. 👆🏻

@EmmaEmerald although the employee pays, they don’t get any of your medical information. They don’t even know who has cost what. But yes, you can pay and bypass the insurance altogether. There are also no central records. I use the same GP for blood pressure meds, but for anything else (a sick line for flu and an ear infection eg) I just go to the most convenient clinic.

*employER pays.

Here's another. Your family has a history of heart disease/cancer/genetic disability.

Based on your risk, £££££ for your insurance. Totally fair because you are likely to cost them more.

Seriously, socialised medicine is the greatest gift the British ever got. Don't throw it away because you've got a government that hates it with a party that never wanted.

The NHS has, I will warrant, worked very well most posters on MN, from the birth of children through our childhoods.

People have forgotten what it is to poor and survive on the crumbs of medical charity vie base level provision. The generation after the war knew exactly what that was like.

Brit thank ypu.

Agent would your employer know that you'd been to the doc if you were using work linked insurance?

People are apparently clamouring for a health system funded by insurance so..

Where's your source for this? Who the fuck is clamouring to pay private insurance AND their NI?

Lex re family history, do insurers take that into account? I thought they'd be more likely to base it on the client and and do regular physical exams etc.

Oh yes they do... and your current health

"People are apparently clamouring for a health system funded by insurance so."

Where is your evidence to back up your statement? Surely, if people where clamouring, it would be widely reported in the media?

Insurance is about risk. You are assessed on that basis.

Your mother perhaps died of breast cancer a young age (45). That is a material risk.

Sorry if this upsets anyone but insurance is not a flat rate system for medicine in many systems.

If the object is to make money (note that is the purpose of insurance, not to look after you) then it is a crazy person who says I will take that over a socialised risk via the NHS.

I suppose it is now apparent that some posters think insurance is to look after you.

It is not. It gambles that in most circumstances it will not have to pay out.

If it assesses you to be a likely payout and expensive one, then the upfront costs, copay or premium exclusion will be extensive.

Insurance is about money.

I'm in Austria.
It's a contributions based system here which means you have to be paying in to receive health care. I am self-employed and have to pay 27% of all earnings towards health insurance and pension. I don't know what proportion of the 27% is health and what is pension.

There are several different Krankenkassen (the health insurance companies) and you are insured with different ones depending on your job - eg. I'm with SVS, but there are separate ones for railway employees, teachers, doctors, general ones for each Bundesland.

The SVS is a bit shit to be honest as I have to pay 20% excess when I go to the GP or for some outpatient treatment. There is no excess on any hospital stays and the treatment for that. There is a cap per year so if you had a condition which required a lot of GP visits and outpatient treatment you would pay the excess only up to the point of the cap and then no more. Some of Krankenkasse have an excess of 10% and some have none. You can't choose your Krankenkasse!

If you are unemployed your contribution to health insurance is covered as part of unemployment benefit, however you really do have to cooperate with them with regard to looking for work and accepting job offers. If you do not and they stop the unemployment benefit, the health insurance also stops.

Everyone has to be paying in, including pensioners who have to pay 5% of their pension towards health care. They do not have to pay excess however as they are insured in a different Krankenkasse to mine.

It's all very complicated, but the healthcare system is very good and it's easy to be seen and receive treatment. GPs are very thorough and you'll be sent for tests for very minor things - probably wouldn't happen in the UK.

One thing I do like is that you can see a Kassenarzt (has a contract with the Krankenkasse, you don't have to pay anything but in my case I receive a bill later of 20% of the cost due to the excess). You can also see a Wahlarzt (an elective doctor) in which case you pay upfront and then submit the bill to the Krankenkasse to get the money back (the amount they would pay a Kassenarzt - the Wahlarzt might charge more so you'd have to pay that). Or you can see a private doctor and again, submit the bill to the Krankenkasse and get some money back.
My dentist is a private dentist in Hungary. I can receive treatment there, submit the bill to the Krankenkasse and usually within 3 - 4 days I get some money back - not the entire amount because they will only pay the amount they would pay an Austrian Kassenzahnarzt - eg. the equivalent of an NHS dentist.
This sort of thing does relieve pressure on the dentists here as people can choose to go private and still receive a contribution from the Krankenkasse.
There is no problem whatsoever in getting a dentist appointment and treatment here.

Lex I know how insurance works! But that's partly why I'm surprised they want to factor in family history and without the medical records, how would they do that anyway?

my dad had a condition that was only picked up due to a work related medical exam. I thought regular exams would be how insurance raise prices, as well as your age.