Can I ask why the U.S. don't want an NHS?

[Fizzielove]

Why don't Americans want an NHS? I just don't get it? Can someone lease explain to this to me?

The United States is a huge, diverse country, and making generalizations about its residents is like me saying "All Europeans think X", which would be absurd. All of our states may share a common language, but Massachusetts is as different from Alabama as Scotland is from Latvia, in terms of politics and social mores.

Anyway, it's your forum, so say what you like, but I do think there are some deep misunderstandings being perpetuated here.

There is also the structural issue of states not wanting federal government involved. Right now here in NJ I think they do an alright job of making sure the poor and sick are taken care of. The early intervention program here is something the UK should copy and implement as its been fantastic for our son. He is a different boy today than a year ago when his paediatrician thought he was seeing autism. It turned out it wasn't but there is a development delay that is being treated as urgent. Cost to us is very very reasonable at $87 per hour. A family with household income of $100k would be paying $17 per hour, again very reasonable.

What I have experienced is that in the UK they preach socialism but end up with a wierd form of capitalism with a bit of communism thrown in while here in the Us they preach capitalism bt really it's much more socialist here compared to the UK. I just look at benefits and I am shocked. Unemployment here in NJ is $500 a week for 26 weeks, cobra allows you to continue on your employers healthcare plan if you want to, if your employer has more than 50 employees it was the case pre Obama that pre existing conditions were covered, financial help to banks in exchange for letting homeowners refinance at no cost so they could avoid losing their home.... There are a bunch of other examples I could give.

The real issue is when you get to states who don't have the income to do anything. States like West Virginia have pockets of poverty that rival any 3rd world slum. The priority in those states is on getting kids fed and trained so they can get jobs. Healthcare is almost seen as a nice to have because when you are struggling to put a roof over your head or keep the roof on your house, healthcare does come second.

The real issue is when you get to states who don't have the income to do anything.
Which is why the NHS works so well
it takes the unused contributions of the rich well and uses them to prevent extreme poverty in other areas

and the US system is dire beyond belief at dealing with Chronic mental illness.

There are more rough sleepers in Seattle than in the whole of England
many of whom have MH issues or chronic health issues groups of tents pitched in the trees of the hospital grounds along the interstate that the system has no way of coping with.

Which is why the NHS works so well it takes the unused contributions of the rich well and uses them to prevent extreme poverty in other areas

Exactly so TalkinPeece. We are net contributors to the NHS, but we truly don't mind. We are no worse off because it is more efficient, and even if we are paying a pinch more, we truly don't mind. These a lot of leverage on that tiny marginal bit extra which is worth it to us, and most high contributors here in the UK.

These = There is

So you have a misunderstanding of Medicare. You need to use your assets first. That means sell you home and use the cash to pay for coverage. Once savings are below a threshold (I think it's $16k but not sure) then coverage is 100%. If you want to keep your home and have coverage that isn't going to happen. It's the same model used in the UK with care homes. Also a lot has changed in the past 12 years! You can't take an event from then and say it's applicable.

Also I don't see what the homeless population in Seattle has to do with socialized medical care. I have family living there. A lot of the people who are homeless have chosen it as a lifestyle. I know because I talked to them. Yes there are a few with mental issues but the police tend to arrest them so they have care through the prison service. They arrest homeless people in Texas. Sounds barbaric at first and then you put the pieces together and it's actually a good way, if managed right, to get these people medical help and out of the extreme heat during the summer months.

Some Americans are fond of tossing around the term "European nightmare" which is a blanket belief that all things that come from beyond the Pond are liberal, socialist and Bad for 'merica. You'll find Americans poor and rich who don't agree with the government rule of anything, particularly when it comes to healthcare unless they're conservative Republican pro-lifers They would rather do without.

" A lot of the people who are homeless have chosen it as a lifestyle."

sorry but that is utter mealy mouthed bollocks

" I know because I talked to them "

of course you did, want2b, of course you did.

Yes actually I did. I noticed the homeless looked a lot different to the homeless here in NYC and northern NJ. I live opposite a shelter and I'm in the process of starting a community group with the goal of moving the homeless shelter to a purpose built center where they can offer the rehab programs needed for this population. The majority of homeless here have heroin and crack addictions with a lower average age than the alcoholics that tend to be older.

The biggest challenge right now is that while the town will give funds to the shelter for running costs they won't give them any funding for them to move locations. Right now, being located between two schools (less than 50 yards to one school and adjoining the other school) and offering drug rehab to all including convicted sex offenders is far from ideal.

It also doesn't help that they don't have enough storage for food, a kitchen that is big enough to offer culinary training to all who want to complete it nor other back to work programs that make a difference.

So yeah I talk to homeless people. Heck I probably have a couple sitting on my stoop right now. As long as they don't deficate on my steps and take their rubbish with them I leave them alone to enjoy a moment of peace and serenity.

A friend of mine in the Us with bipolar was hospitalised last year because she couldn't afford her medication, and her insurance refused to cover it. A charity acted as her advocate and finally got her insurance to agree agree to cover it. But now it is on record that she has been sectioned in a mental hospital, and her behavior at that time caused many problems for her.

Want2be
Medicare Once savings are below a threshold (I think it's $16k but not sure) then coverage is 100%.
Not true.
Medicare covers up to certain budget limits : which in the case I know of does not include working anti rejection drugs for a kidney transplant.

The person lives in a scummy social housing apartment near the hospital with no assets and no hope.

Yes there are a few with mental issues but the police tend to arrest them so they have care through the prison service. They arrest homeless people in Texas.
And then deny ex felons the vote : cool trick in the land of the Free
The country that has 25% of the world's prisoners
Ex cons cannot vote, cannot get housing, cannot get jobs : yeah, great solution

You need an address to vote. As they are homeless they can't vote anyway. It's also not classed as a felony.

It's not ideal but given the resources available I thought it was a better solution to leaving them on the street to burn to a crisp.

Also ex felons in this town do qualify for section 8 housing. If they commit a crime once living there then the housing authority had the right to terminate their lease. It's firm but fair. Follow the laws and lead an honest life you won't have a problem.

Being American and now living in the UK I would like to say the following:

yes, American Medical care is expensive but there are plenty of options of payment. If you need help no one is just going to let you suffer or even just 'die' because you can't pay. My parents are doctors and have always had patients that were on medicare, medicaid and other US backed medical schemes so they could have treatment.

Having had NHS care, although I respect the service and believe that it can't be easy to run such a big operation. I think it's slow, inefficient and can be really basic in terms of care. The NHS staff are overworked and really care is as consistent as employee morale.

I feel, that if there is going to be such a high volume of patients and timed examination of 10 minutes of less per GP visit then the chances of good quality care and treatment will also continue to be low.

On the other hand, if the pressure and demand will be high (which as far as medicine and health is concerned it always will be) then at least money incentivises doctors to do the best they can.

I know this is crass. I don't like it either.

fundraising
If you need help no one is just going to let you suffer or even just 'die' because you can't pay
In theory yes
in reality no
Medicare paid for the transplant, but not the anti rejection drugs
go figure

In the same way the NHS paid for expensive surgery for my back that I broke but put me on a 3 year wait list for physio after. Thanks to the american system I was able to get the care I need to not take pain killers daily. I still have problems when pregnant and all care is covered under our insurance.

I thought I was done with this thread, but I just can't resist jumping in one more time. My husband is a Nephrologist, and he says any person who gets a transplant under Medicare will get his/her transplant drugs covered by Medicare. I obviously know nothing about the person cited earlier, other than what has been posted here, but he/she might have been very poorly advised, or perhaps is not being entirely truthful about the situation (no insult intended, but adherence to some of these complicated post-transplant regimens can be very difficult).

I won't link to the Medicare Bulletin covering this topic because it is horribly complex and unpleasant reading which I would not wish on anyone. However, both hemodialysis, kidney transplants, and meds related to end-stage renal disease and transplants are covered.

That having been said, I think that while the US is too large for an NHS-style system to work, we will likely move to a Canadian-style system (and years ago there was an in-depth study, paid for by the Congressional Budget Office, which recommended exactly that), in which care is provided by "private practitioners" and groups of employed physicians (a mix, like we have now), but the care is paid for by a single governmentally-run system, similar to Medicare, but administered on a state by state basis.

The first step will likely be the opening of governmental insurance to individuals for purchase, which will create pressure and competition on private insurance, which they will be unable to

We will save tons of money on administrative costs, and the for-profit insurance companies will fade away, or take on a much smaller, cheaper, administrative role. It will happen, but it will take time. You have no idea how much support there is for this change, among people who work in healthcare, as well as all of us who utilize it!

*which they will be unable to tolerate.

I actually love the NHS and would like to see it instituted here. It is odd for me to be in the position of defending any element of our system (sorry, Vocational Goat, I am not usually this argumentative). But Medicare is one of the few areas where the US does okay. Medicare for All is a common slogan among healthcare activists in the US.

I work in a system very similar to the NHS, as I have said, the VA, and our per-capita healthcare costs are the lowest in the nation, when compared to general spending on folks who have private health insurance.

The logistics of an NHS system here in our enormous country may be impossible, but a single-payer system is feasible and that is what we will have eventually. Physician salaries will go down (I make twice here what I would make in England) and lots of administrative fat will be cut, but it is long past time for that to happen.

The problem with the US is that there is so much big money involved via big Pharma - hence we have a myriad of 'illnesses' that didn't exist 20 years ago, many of them requiring v expensive care and medication - or requiring thousands of pounds worth of tests, as they don't correspond to known disease.

This book raises this issue.

www.amazon.co.uk/gp/product/B00T5H3Y2K?psc=1&redirect=true&ref_=oh_aui_d_detailpage_o04_

It's impossible to provide for a population riddled with non curable long-term disease (disease which is also not fatal).

pitiless
My husband is a Nephrologist, and he says any person who gets a transplant under Medicare will get his/her transplant drugs covered by Medicare.
You are quite correct.
Medicare has covered an anti rejection drug (Washington State - it varies I know)
but it is one that gives the individual severe nausea and other problems.
Therefore they are never well enough to work
therefore they are in substandard housing and not eating well
therefore the shiny new $75,000 kidney is now dying
along with the body in which it sits

the individual is a family member : my information comes from those who are trying to support them.

I work in ... the VA, and our per-capita healthcare costs are the lowest in the nation, when compared to general spending on folks who have private health insurance.
You have proved utterly the point that profit and competition do not lead to efficient and effective health care.

talkin you have mentioned this relative before. If their diet is bad because they can't afford food they should contact the Sally Ann. We have been involved in helping fundraise the set up a system in each state so those in need can get help claiming for benefits like food stamps and other food programs aimed at the ill or the WIC program. I had no idea there is so much help out there for everything from food to transportation to utility bills, especially if the person is sick. The YMCA also run something similiar but I don't like them as much in this area. Their help us geared towards families but they also cover the sick.

Also the VA is what should have been used as the template for Obamacare. Instead we have a fucked up hybrid system which is extremely expensive for those in the $40-75k household income bracket.

As much as people complain about the VA I think they do a great job given the resources they have. So many soilders return with complex medical needs and when Bush declared war funding should have been increased for the VA that same day. It's horrible planning and now the system is creaking along.

I also agree we will end up with something like what they have in Canada. I'm fine with that. The care there is good and i think the standard in Canada is superior to the NHS.