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 ?

I work for the NHS too but I’m not sure ppl feel “lucky” when they can’t see a GP and have to wait years for basic surgical procedures. The GP thing is a serious problem. We are storing up a lot of problems down the line. By the time many conditions become serious enough to warrant waiting 7 hours in A&E, and repeated visits, it’s already very difficult to treat effectively. I personally feel we need to adopt a more European system, irrespective. We need to put the political totem poles away and focus on providing effective and efficient healthcare. And the NHS is just not doing that. That’s the reality of it. You can shout in ppls faces all you want but NHS has to change. Any government or any colour will have to face up to that.

The US isn’t a perfect example of that as the elderly get Medicare and the poor get Medicaid which is really treated just like any other insurance programme.

Tbh it’s those who work that get kinda screwed under the US system since they have little choice in what scheme their employers enroll them in.

Mandatory insurance of around 100 euro a month. You can choose to add extra insurance for dentistry and extra physiotherapy and stuff. If I want to see a GP I can come the same or next day. An ambulance arrives within 10 minutes. When I broke my wrist it was set about 3 hours later in A&E. It was a bit busy so I had to wait because I wasn't urgent. I once rocked up to A&E with some chest pain and never even sat down, was taken for examination immediately (was all fine).

I recommend paying for better sevices.

I agree with what @MintyFreshOne just said in commenting on @BritWifeInUSA's post upthread. The working poor who earn just too much for Medicaid are screwed, as are those who struggle to organise their lives.

@BritWifeInUSA lives in a state with no income tax, so she lives in one of nine states out of fifty - Alaska, Florida, Nevada, South Dakota, Texas, Washington, Wyoming, Tennessee. New Hampshire doesn’t tax wages, though it does tax investment earnings and dividends. She talks about low energy use so possibly one of the southern states. I live in Maine where we pay 6% state income tax on top of what we pay the federal government. Sales tax in my state is also 6%, so I agree, smaller than VAT though applied to more things I think (again, varies by state).

Posted too soon... When it works for you it works really well, but there's a big onus on you to be proactive in checking up on your doctor, choosing your surgeon etc. And the amount of paperwork is a killer, as is dealing with insurance companies. So many people employed whose main business is to deny paying for your care, and your insurance payments pay their wages!

Netherlands here - Eur 120 per month, kids free.

Service is fantastic - you call the hospital's emergency number, tell them what's wrong, they ask you to drive in or send an ambulance then when you arrive someone meets you at the entrance with a clipboard with your full medical history and you're seen pretty much straight away.

Giving birth is in a private room where you stay after baby is born until you go home, no shared maternity wards etc.

GP appointments I've only ever been offered same day, unless it's a nurse appointment for a smear test for example, then it's within 48 hours.

Dental is quite an expensive add-on and orthodontistry for kids is not free, but other than that, I wouldn't change, it's sublime.

The above is all just my experience, but I'd never accept the NHS standards our families deal with back in the UK.

I'm in Germany and I pay close to €800 a month for the family. I am expecting it to increase again this year.

The self-employed are also fairly screwed under the US system unless they are making a lot of money, except that they can claim hefty medical expenses against tax.

In my country the doctors get paid by the insurance company. there is some kind of coded system where different procedures/appointments have a code and a certain price. I believe that the doctors then pay the nurses (who are always doctors assistants/admins) and also things like rent or cleaners I believe. If its a bigger place like a clinic or a hospital then it get done centrally. Things like blood checks are done by lab places who also get pays by the insurance companies per certain "item".

I think one issue much of the world is going to have to face is vastly increased costs for health care, regardless of how we choose to fund it. Rapidly ageing populations, long, long lives thanks to advancing medical treatments and top heavy society. Medical costs my cripple us but what's the alternative?

The nhs could be a great system if we could get doctors away from putting off investigations into illnesses that if found early would be a very minor issue.

The NHS saved £300 by not giving me an mri scan. But then spent £250,000 + my disability benefit over 7 years “guessing” at what could be wrong with me.

A 15 minute appointment with an osteopath who I was able to discuss all my symptoms with at one appointment and she diagnosed me with what she thought and then I went for a mri to confirm it.

If I was able to discuss more than just one symptom at a time and I was sent to have an mri so much money wouldn’t have been wasted.
That is where the NHS’s money is going.

Dh spent 4 months in hospital and nearly died because of there put off spending any money approach
Caught early it would have been 1 over night stay. Not bed blocking for months

We ended up paying for dh’s cancer treatment

I actually liked the shared maternity wards.
We all had a good giggle at stuff that was going on.

I didn’t feel particularly lucky when I found out I had been left in constant agony walking (shuffling)around with a slipped disc for7 years and having to go private to fix it.

I didn’t feel particularly lucky having to pay for dhs spleen to be removed and all his cancer surgery and hospital stay for something that would have been a 1 night stay in hospital if his gp hadn’t told him constantly that he was worrying himself by going on to dr Google .

He hadn’t his dad had died of the same cancer.

I pay 100 euro insurance a month and only pay the first 400 euro per year of expenses, anything after that is paid by the insurance company no matter how costly it is. There is no private health care, only NHS. I can see my GP the same or at most the next day.

I also pay 52% income tax. I believe that that in part also funds health care.

People are clamouring for nothing of the sort. What utter bull.

In the UK, the GP is the gatekeeper.

What you have is an extremely poor system of managed care.

The lack of investigation of symptoms is down to a calculation that maybe nine times out of ten the GP will be right and no more money will have to be spent. The calculation isn't always right.

www.ft.com/content/e5999ea6-fa60-4b0c-993b-4e88033ba6ea
You get issues with diseases like cancer.
Investment in the health service is vital.

One major problem for the NHS is bed blocking - how do other countries avoid this? Who pays for elderly care homes?

Great thread OP, surprising how much people pay in other countries - there'd be riots if people were asked to pay sums like that here.

@MrsMullerBecameABaby 15% half is payed by your employer.
These 7,3% cover me and my DC in full time education

I am currently having treatment for cancer (12 rounds of chemo)
I pay 10€ per day in hospital, I am not exempt

And 5€ per prescription, again not exempt at the moment

If the costs reach a certain percentage of my income I can get an exemption
Everything else is covered by my contribution to the social coffer

(Germany)

Not in the UK, I have private health insurance as well as paying into the madatory government scheme because tbh you wouldn't want to go near a government hospital here unless you really really had no choice. Even with the government scheme if you haven't paid enough in you won't be treated for everything and often the bills end up bankrupting people despite the shoddy care.
My private health insurance is 700$ a year paid in a lump sum, if it was paid monthly it would be around 1100$ over the year. This covers me for inpatient only, any GP visits, A&E visits not resulting in admission etc. are paid for out of pocket. I am lucky we can afford this, I have friends who aren't so lucky and are left with the choice of risking the government hospitals which are bordering on dangerous or ignoring illness until they can afford the 50$ GP fee + whatever tests, medicines etc. cost

British expat in Australia.

You don't have to have private health cover. You can use the public system if you like.

There are free GPs, but they are generally not as good as the charging GPs. You can book an appointment with any GP you like. I can usually get a same day appointment for my paid-for GP, and she is excellent and very thorough. Receptionists are very polite. You are treated as a customer. My GP costs about GBP40 for a normal visit. Blood tests and standard vaccinations etc are free.

You can get treatment in public hospitals if you want, or you can pay for private cover. We have top hospital private cover, costing about GBP 88 per fortnight for a family of 4. It is cheaper if you want more basic cover , or if you earn less money. My fund is a not for profit. There are various out of pocket payments when you use it, but nothing too huge. I can still choose to use the public system if I want. Public hospitals are high quality but longer waiting lists etc.

The health funds cannot refuse to cover you and, after a 1 year waiting period, they have to cover all pre-existing conditions.

Dental is all private. You can pay as you go or get private insurance that covers "extras" like that as well.

Eye tests are free. Glasses you have to pay for.

I'm very happy with the health system here and I don't mind paying as we can afford it and health is a priority. I never had private health cover in the UK so can't really compare the two.

In the US, perhaps, but that's not how it works in Australia.

Insurance premiums are based on your age, what level of cover you want and how much you earn. Many health funds are not for profit.

The health funds cannot deny you cover, no matter what your history, and they must cover pre-existing conditions after a year.

The US system is completely bonkers. But it's not the only other option.

Oh and you can choose your health fund and change your health fund. They all have slightly different offerings and prices.

I'm sorry to hear that, Prokupatus. I hope your treatment is successful and not too hard on you.

To correct a post upthread about Germany - self-employed people can opt into statutory insurance (I am one and I have), but they (obviously) cover both the employer's and employee's contribution. So for an employee half the 16ish % of gross income mentioned upthread comes directly out of gross income (passed on by the employer, who pays the other half). I pay the lot directly to my insurer. (They base it on the previous year's tax assessment. When you submit a new one they pay you some back if you've earned less and you pay the difference if you've earned more than previously. You can offset it against your tax liability). This is obviously hundreds a month and I do swallow hard sometimes when I see it go out of my account but never have I felt it's not 'worth it'. You pretty much pick your own specialist - sometimes there is a bit of a wait for an appointment but you would not be left suffering for months on waiting lists.

Fairly trivial example - last summer I found a hernia, went to my GP (on-the-day access with a bit of a wait in the waiting room), she confirmed it and advised me not to get it fixed in the local hospital (another story), I found a practice in a nearby town that does nothing but hernia ops as day cases, got an appointment a couple of weeks later, had to cancel as had Covid but got another two weeks or so after that, was offered the op, had it - less than two months after finding the hernia. And it was a small painless one so not 'urgent' in any way,. and I don't live in a very affluent region.

MH treatment is another thing which is worlds apart from the UK. You may have to wait a few months for psychotherapy (and waits of 6 months are considered scandalous and there is a push to change it), but then you get at least 25 sessions of CBT or 100 sessions of more analytical therapy (your choice or depending on therapist availability), paid for by statutory insurance. You by no means have to be suicidal to be admitted to a psychiatric ward.

There is no assessment of risk, previous conditions etc in the German statutory system. It is a legal requirement to have insurance, so statutory insurers have to take you (unless you've previously chosen to be in the private system). The premium is based on your income alone. Same for pension insurance. It does mean middle earners in particular pay a lot in social insurance (and taxes, which are similarly progressive), but overall Germans are fundamentally happy with this because they agree with the principle of a society that looks after everyone.