OK so ethically where do you lie with regards to private health insurance?

[Curmudgeonlett]

is it a good thing to use it because you're covered and it takes the financial burden off your GP and into the private sector?

or

is it ethically wrong because you get seen sooner than NHS patients?

My OH is still paying for the NHS through tax/NI so I don't see anything wrong in us paying to go private for stuff

Each to his own although personally I doubt most people take it beacuse they wish to unburdon the poor old NHS (and I doubt a few people going private makes a bit of difference) personally I wouldn't go private for anything 'important'

Although I am not taling about private dental treatment that is a completely different kettle of fish.
US system bad news imho (we don't know how lucky we are sometimes)
Can't imagine a 12 month wait for terminal patients!

I have cover through work, but this doesn't cover everything.

Don't think it's ethically wrong to have it. Would consider buying cover for myself & DD if I didn't get it through work. I was surprised at how inexpensive some of the cover actually was if I'm totally honest.

Right, well, my old view was:

If people don't care about and use the NHS and vote on the basis of it and fight for resources for it then it will crumble and health care will become something only available to anyone with the money to buy it. And that is wrong and erosion of the welfare state, going the way of the states etc. I turned down PPP as part of my salary package 10 years ago on principle.

Now: I've become selfish. I have BUPA for me and my family and wouldn't move to a job that didn't provide it.

Deep down I think it's ethically wrong, yes. I do. But hey ho.

i'm afraid ethics doesn't come into it for me. we had PHI with my hubby's old job and he used it for some physio. now he's self employed we havn't bothered to take out our own policy. if i thought my son would benefit from being seen privately i would find the money - at least to get a diagnosis. at the moment, thankfully, we havn't been in that situation and i do (naively?) think that the nhs would not let my son down if he needed help. to add a little fuel to the fire i do think the NHS would be a lot less overburdened if people were prepared to take their gp's advice and not instantly demand to be referred to a "specialist" for every little thing. because we live in such a "sue you" society (thanks USA) our gps are then afraid not to refer and the hospitals are clogged up with loads of needless appointments. also (starting to rant now) you would not believe the amount of appointments that are made with gps and hospitals each year where people don't bother to turn up - surely more ethically dodgy to be a time/moneywaster?
ps not actually a gp myself!

i am fundamentally opposed to it. and in any kind of emergency situation i really don't think you can beat the nhs.

We have PMI because I don't want to use the local NHS hospital which is filthy. Frankly that means I'm not on the waiting list and I'm not taking money from the NHS.

BUT my PMI uses NHS services for some things which funnels money back into the hospitals.

In answer to the OP (and apologies in advance as I have not read the full thread!)...

I don't think there is anything unethical in choosing to go private, consultants normally have a percentage of their time devoted to see NHS patients and another to see private patients, the fact that you are going private doesn't mean you are taking the place in the queu of another person but choosing to be seen in the "portion" of time the dr devotes to non-nhs patients. And... less private patients do not necessarily mean more nhs patients being seen by the same consultant because, after all, the consultant still will have to keep to the budget assigned to him/her by the NHS?

By opting to be seen as NHS patient you are not in a more ethical position either... after all, a good part of the taxes of those persons opting to go private is still paid to the NHS even if they are not using the service.

Having experienced both the US system and the UK system, I'll take the US system any day. I have been self-employed a good chunk of my adult working life and therefore have had to pay for my own health insurance here in the USA. It can be expensive if you choose a plan that gives you complete choice and low deductibles (excess), but you can also get perfectly adequate health care (better than anythign I got in the UK) for very reasonable prices that are far less than what I paid in taxes in the UK. There is free coverage for the poor which is certainly as good as anything I experienced in the UK.
Blu, I would take what people are saying on your US website with a grain of salt. There are great cultural differences between what Americans and the British consider deprivation. And there is also a vast difference in what is considered a minimum level of care. When I had a foot operation in the UK and complained because I was given a pair of mismatched crutches (different heights), I was told that I should be thankful that I got a pair at all. In the USA many would have been complaining if they had been used or the wrong color, forget about anything else. When my husband chopped his arm with a chopsaw and had 50 stitches on a Friday afternoon, no one thought it odd that the hospital was out of pain killers and he was told to go to his GP on Monday morning for some. An American would have expected to be on a morphine drip overnight at a minimum.

Sofia... I think I'm 100% with you in this. Different expectations, that's the thing!

I'm with you Sofia... but then I always think you speak wisely.

Its not ethically wrong at all. I only have it through work, I wouldn't pay for it myself currently but would otherwise if I could easily afford to. Its been great having quick treatment for me and one of my daughters in a better quality and cleaner hospital.

Its the government (not just the current one)thats to blame for the decreasing NHS service over decades.

Many people won't use it out of principle -why should they when they have paid their taxes etc.

Agree with deb34 100%

Regarding Deb34's post... the fact that you demand being seen at the hospital doesn't mean your GP will be able to get you an appointment. There are a set of NHS guidelines which specifies which conditions can be treated at hospital and which should be treated by the GP. And, even if your condition is listed as "to be refered" that doesn't mean you will get the appointment, particularly if that department doesn't have enough budget for it. And in the current NHS budget cuts climate, this is hapenning very often.

Let me guess this straight: the argument that it might be ethically wrong is because having a private health care system takes doctors out of the NHS meaning the have nots get longer waiting lists and the have do's get fast-track treament?

But then...the NHS draws so many doctors and nurses from places like Africa, the Phillipines, India, China and now Eastern Europe which has a knock on effect of prohibiting treatment in their home countries to increase our quality of healthcare. It's all swings and roundabouts really. In that sense the NHS is a form of private health care because it uses finance to offer a level of healthcare that is only available to a select group of people.

When the Daily Mail start up about 'NHS tourists' I do have mixed feelings because I think a system that operates by limiting access to treatment for people from less wealthy nations around the world should at least offer some token access to our facilities.

if we live in a capitalist society it is not wrong - you can choose how to spend your money and for me health is the single most important thing you can havein life... so go for it...

But the US system can still mean huge biils even when you're covered by insurance. A good friend of ours had prostate cancer and is still paying off the bill for what wasn't covered by his healthcare, about $21,000.

My ds also has a friend in LA who, in the excitment of passing her exams to become a vet, forgot to renew her insurance. She developed cancer, losing an arm and her parents have had to find over half a million dollars for her treatment. They're on the verge of bankruptcy.

we used to have private health insurance but dont any longer because of the cost although ethically i do agree with it. I had my ds privately simply so i could have my own room but the arselicking from docs etc was quite nice. the midwives were another kettle of fish completely though

We have had private health care from my dhs employers. But it meant him paying an extra 900 a year in tax.
We have used it once to get dd1s cyst removed. I went to the NHS an they referred us and they consultant really looked down his nose at us. I had to go and sit in the corridor to cry. It was horrid. As soon as we got our BUPA referral, the doictor said I've got children the same age, I will treat your child like one of my own. That made me feel better, and then when she had her op we had a room on our own which was really nice.
Some of the bills got (wrongly) routed through us and I was very surprised by how cheap it was.
Now dh is changing jobs I think we will not pay for private health care insurance, but just pay as and when required.
The NHS is underrated btw, if you had a heart attack its the place to go. Still fab and grateful that we live in a country that provides free healthcare.
Lucky enough to be able to chooose.

Suedonim, something not quite right with your friend's story. If she was passing her exams to become a vet then she would be an adult and financially responsible for herself as far as social assitance is concerned. She would be entitled to medicare (unrelated to her parents' income/assets) which is coverage for poor people and her parents would not have to come up with money for her treatment. Also, pretty hard to "forget" to renew your insurance, they send you reminders and give you a fairly long grace period if you don't make a payment. It's like homeowners insurance....you need to have it and you are taking a risk that you shouldn't take if you can't afford the consequences. The whole process involves a different approach and attitude than in the UK. There is a responsibility placed on the individuals to make decisions about their own ability to handle deductibles (excesses) and the individual has to make decisions on their own without it being mandated by the state. There are plenty of affordable choices of insurance for all types of people of all income levels. I, for example, have an insurance that has a total deductible for my whole family of around $12,000. I know that I can afford to cover this. If I couldn't then I would choose a policy that offered less choice of doctors, but lower costs and deductibles.

I don't know the ins and outs of the situation, SofiaAmes, as I say, it's a friend of ds and his dw. I have a feeling the insurance was missed because she moved at the end of uni. Thinking more on the matter now, istr that medicare paid out for basic treatment, ie amputation, but her parents have paid out for other treatment and a prosthesis. I'll try to remember to ask ds about it sometime.

He also knows people who have had to mortgage their homes to treat their dd for long term depression and anorexia.

What's the situation in the US on getting health insurance if you've already had an illness? Ds's mil has had breast cancer - will she still be covered by her insurance should it (god forbid) recur or will that now be excluded?

SofiaAmes can I hijack this a bit and ask if you know the answer to this? If you have medicare you get free treatment on the NHS yet we need insurance to go to the US? Would obv. NEVER go to the US without insurance but is it that what you get is so little that you need insurance or is it so bad or is it the deductible thing so you need to cover that?
Also does the deductible thing mean that you would have to cover the first 12,000 of any claim? So something like a broken arm or appendicitis would be seriously expensive?

Sorry, I always get them mixed up, it's actually Medi-cal for poor people and Medicare for elderly. To qualify for Medi-cal you need to be not only low income (which isn't so difficult to qualify for) but also have less than $3000 in savings and I think it's possible that you also have to be a legal immigrant, though I'm not totally sure on that one. So an English person on vacation here would be expected to pay their own bills. I didn't know that people who qualify for Medi-cal in the states get special treatment on the NHS. I thought everyone got free treatment...isn't that part of the problem with the NHS...too many patients and not enough money. The reason for the insurance is not to get you better care (like in the uk), but to help pay for the cost of the regular medical care which isn't subsidized by the government the way it is in the UK. Care and free options vary from State to State. For example in California there is very cheap health insurance for the children of poor to middle income people regardless of their immigration status.

If you show up at an emergency room needing care, they must accept you and give you care. However, if you don't have insurance or provable means of paying your bill, then the private hospitals are allowed to transfer you once you are stable to a county (government) hospital. You will be presented with a bill at the end of the end of your stay in either the private or county hospital.

Regarding my insurance... I have 3 individual policies for me and my two children. Each policy has approximately a $3500 deductible, so worst case scenario if all three of us got appendicitis and a broken arm in one year I'd have to fork out $12,000. In fact, last year both my son and I ended up with treatments that used up most of the deductible, so my medical costs last year were about $4,000 for doctors and then another $4000 in insurance premiums. BUT, I could have chosen an insurance that had much much cheaper premiums and no deductible, but far less choice of doctors. In theory, my medical care would have been equally as good, but maybe not as luxurious or pleasant and probably more like what you get in the UK. But the difference is that I get to make that choice.... the government doesn't make it for me.
I think the point of the deductibles is that it forces you to take an interest in the cost of your medical care. This is a big problem in the UK and in my opinion a large part of what is drowning the NHS. I was always amazed how people in my office in the UK would go to the doctor when they caught a cold or got a tummy ache. In the US it costs you money to go to the doctor, so you don't go unless you need it. Here, people generally don't use ambulances to go to hospital because they can't afford a taxi, because you pay for the ambulance. Maybe if fewer people went to the doctor every time they sneezed, there woudl be more money in the system to pay for cataract surgery for the elderly. There also seems to be precious little preventative care in the UK vs what you get in the USA which sort of seems make fairly poor financial sense when you are offering a socialized medical system .

I'm sure Sofia will be around to answer, but perhaps I can help a bit too 1dilemma.

You need to get some quotes from insurance companies for different types of coverage. As a general rule, the higher the deductible (excess), the lower the annual fee.

I have health insurance in the US, and think I have generally the same philosophy as Sofia. I will/can pay out of pocket for 'regular run-of-the-mill' healthcare issues. My healthcare coverage kicks in if/when there is a major health problem that would be very expensive to treat. By having what I call 'catastrophic coverage', I pay out of pocket for visits related to 'little stuff' (flu, regular gynae visits, ear infections, etc), but have a significantly lower annual premium. My health care only would be used if there was a serious health crisis in the family.

Healthcare is very expensive in the US, and many families who pay on their own (meaning it's not provided by employer) are choosing this sort of catastrophic coverage.