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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Countries healthcare systems

8 replies

Skatewing · 23/10/2022 08:25

If you are not in the UK or have experience of other countries healthcare systems and how they work, please tell me about them.

I'm not asking about one off experiences, I would like to know how the systems operate from the people that know them.

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Skatewing · 23/10/2022 16:44

Nobody knows?

OP posts:
Minimochi · 23/10/2022 17:13

Why do you need to know?
We are in Germany. Everyone pays into state insurance based on their income. (There's private insurance and various add-on options available.)
We haven't had a problem so far but we aren't really that high maintenance or need a lot of medical help.
DS has been seen due to a bump on the head once and had to stay in hospital for three nights. I got to stay with him, food was provided because he was still a toddler.
DH had to go to out of hours at our local hospital once. He was seen within minutes (no appointment needed) and better in no time.
I've been to hospital for emergency stuff a few times (pregnancy-related) and it's always been comparatively quick and efficient.
I don't have any problems getting same-day appointments with our GP or DS's pediatrician. My gynaecologist tends to be very busy but they try really hard to find an appointment for me whenever I need one. Our dentist is very much on the ball and most basics are covered for all three of us. They are down the road from us.
I've had three rounds of ivf fully funded through our insurance. That depends on the insurance, though. Most pay about 50% of costs.

That said, we never really had issues with the NHS when we still lived in England, either. I had DS there and it was fine. We did leave a few years ago, though.

BritWifeInUSA · 23/10/2022 17:34

How long have you got? I’m in the US and the system here is complex. But personally I feel it’s much better.

In summary, it’s a private system that involves a monthly insurance premium. This is paid whether you go to the doctor or not (like you pay car insurance whether you drive every day or not). There are additional costs associated with receiving healthcare up to a maximum each year. For reference, my maximum is $3000. So no matter what happens to me and what healthcare I need, it’ll never cost me more than $3000 in a calendar year. That might sound like a lot but we pay much lower taxes.

If you are employed by a company with at least 50 FTE employees the company has to, by law, provide a group healthcare plan to the employees. These are cheaper than individual healthcare plans. In many cases, and this is the case for my employer, the company pays the monthly premium. They do this to attract and retain talented employees - it’s a perk of the job. Otherwise you have to buy a private healthcare plan yourself. Even companies with fewer than 50 FTEs may provide a group healthcare plan - again to attract and retain staff. But they don’t have to. You can cover additional family members with your plan. So I work for a large company that provides healthcare. My husband does not. So I cover him under my plan. Our children would be covered too if we had any.

There’s a lot of misinformation in the UK about our healthcare over here. I have lived and worked in both the UK and the US. Adding up my tax deductions and my $3000 maximum each year (which is worst case scenario. Some years I use less than $100) over here is still a lot less than I paid in tax and NI in the UK. I have seen people comment on here when I have posted about healthcare before and the annual maximum “but I don’t have s spare $3000 a year”. Well you would if you were in our wages (which are higher) and at our rate of taxation (which is lower). Even our sales tax/VAT is less than half that of the UK. You are taxed at an insane level there.

Contrary to popular belief in the UK, the ambulance doesn’t pull up and ask how you are going to pay before scraping you up off the road after you’ve been hit by a car. Payment is done much later. My husband had surgery in August and we still have not received the bill yet. Insurance is still doing their thing with it. When the bill does come, we can make monthly payments. It’s not a case of “pay now or we’ll send the bailiffs”.

The benefits here are that we have more choice, more regular and earlier screening, no waiting lists, and higher survival rates for things like cancer. In short, I know where I’d rather be ill. Even if it costs more (which it actually doesn’t, all things considered). For example my husband had a TKN (total knee replacement). From the appointment with the consultant where he the decision was made that nothing else was working and his only option now was TKN, to being in the operating room was less than 3 weeks. And that delay was for measurements and scans.

Delabruche · 23/10/2022 17:40

I'm in Italy and it actually varies according to region. Basically though it is funded by taxes and partly paid for each time you use it. GP visits are free as is maternity care, screening, children's healthcare. You do pay a bit for specialist appointments and xrays, scans etc and this amount depends on your income. It mainly works well but at the moment I am trying to book a dermatologist appointment for dd and there is nothing for a year! I'll probably have to go private which costs from about 60 euros upwards. Some people have additional insurance through their job or bank to cover this.

cato40 · 23/10/2022 18:57

Grew up in Italy an as PP said it varies from region to region. I am from Lombardy and in general the health system is better than the UK. Staff are more caring but also don't hesitate to tell people off if need to (overstaying visitors at the hospital for example). You pay a small amount for specialists but all children have a paediatrician, women have regular women's health appointments and generally there is more focus on prevention and people are more in control.of their health. GP is free, if you ask to be referred to a specialist they don't send you home with paracetamol. Private healthcare is more common and not too expensive. Hospitals are cleaner too.

gogohmm · 23/10/2022 19:51

In the USA our insurance was through exh's work but they only paid the premium up to a set amount per month, we paid a further $250 per month from salary, in addition we paid $15 per drs office, outpatient or in network urgent care visit and $75 for the ER. Out of network we paid 10% of the cost. Prescriptions were $15 each. The copays were for children too! We were lucky, some insurance has higher deductibles. We moved back to the U.K. because our medical costs were over $500 per month due to DD's sn

I know two people who are bankrupt due to their children having cancer

These are early 2000's prices!

lljkk · 23/10/2022 20:38

There are lots of countries with no working affordable health system.
I know some interesting snippets, like ...

20-24 hour waits in A&E in South Korea used to be normal (2014)

In China they don't really have separate primary & secondary care: you go to hospital for everything

In most the world you can get antibiotics just by asking & paying, no one gatekeeps if it will actually help, how many you have or what you do with them afterwards.

Skatewing · 24/10/2022 07:45

Thank you. It is interesting to read how differently it can be managed.

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