Migrants To Be Charged For A&E Services

[DoYouLikeMyBaubles]

www.theguardian.com/society/2013/dec/30/tourists-migrants-to-be-charged-emergency-care-nhs

Your thoughts?

This thing:

"The European Health Insurance Card (EHIC) replaced the old E111 in 2006.
Your EHIC lets you get state healthcare at a reduced cost or sometimes for free. It will cover you for treatment that is needed to allow you to continue your stay until your planned return. It also covers you for treatment of pre-existing medical conditions and for routine maternity care, as long as you're not going abroad to give birth.
The EHIC is valid in all European Economic Area (EEA) countries, including Switzerland. For more information about what is covered in each country see our country-by-country guide."

???

What's the card, mousmous? An identity card? Or a credit card? What would happen if someone came in without one?

I was in a London A&E recently with ds (may have shocked them by being the only person all year to turn up knowing my and his NHS number) and one of the receptionists spent at least 30 mins trying to check in a woman from overseas who didn't speak any English. Even with the assistance of the interpreter on the phone (who, it would appear didn't speak English either) it was impossible to discover the circumstances in which she was in the country, what address they should put her down at, etc. Fortunately A&E wasn't busy at this point but it was a huge waste of front line resource.

Hospitals already have billing departments who will try and establish entitlement to care. This can be difficult in some cases and the system - any system - can be gamed relatively easily. It would be a great deal simpler just to charge foreign governments per head of population entering the country - at least where emergency care is concerned.

However, I'm quite sure the government would not announce such a major change to the NHS without having run a successful pilot scheme or two.

And how on earth are people who have gone back to a different country / are here illegally and have vanished, going to be pursued for payment, exactly?

"Perhaps they should contribute and pay something, like taxpayers have to."

Many of them are taxpayers. This isn't targetted at tourists or illegal immigrants.

FWIW, here's the BBC summary of who currently gets what:

• Free NHS care is offered to anyone living in the UK who has temporary or permanent permission to do so
• Asylum seekers, non-European Economic Area nationals who do not have permission to live in the UK, British expats, and visitors usually have to pay for treatment
• The UK has reciprocal agreements with most European nations and 28 other countries, and under these visitors are given free NHS care
• The NHS should claim these costs back from the relevant governments - but research suggests just £73m a year is recouped out of more than £460m at present.

So if they really wanted to save money, they could work harder at recouping the reciprocal costs at national level - without getting into hugely expensive policing and legal costs around individuals.

doris I don't understand that, how does that make you anti-nhs

I'm more concerned with expats who decide to come over when they want to get NHS treatment, sort of having their cake and eating it.

At least ex-pats are more likely to have paid into the system at some point. And why is it "having their cake and eating it?" Not all ex-pats are sunning themselves in a Mediterranean beach club.

the credit card tribpot

mousmous if you mean about having to hand over a credit/debit card at a private clinic, you have to understand that many UK nationals do not have those things.

That £73 million figure is odd. I wonder if that's a misunderstanding and it's actually the net payment? I'm assuming reciprocal healthcare agreements work like roaming charges between phone companies in different countries, and if Vodafone UK owes Vodafone NL 6 quid, and NL owes the UK 4 quid, UK only forks over the difference.

I know many expats who would rather go private than using the nhs.
even in forrin the nhs has a crap reputation.

clam if you chose to go and live abroad, then that's your home and that's were you should have your treatment unless you're willing to pay. You forfeit your rights to our national health service if you chose to be a citizen elsewhere.

It's having your cake and eating it because you want the best of both worlds; living abroad but using free healthcare.

I paid $50 for my Mum to go in an ambulance in NZ when she was having a heart attack.

I paid $50 for DS1 to go in an ambulance in NZ when he was having multiple seizures, I then paid $25 for him to see a dr, then the same to see another dr and then $18 for his medication.

Why should it be any different for this country?

Maybe the point is not that it has to work well, but that it has to sound like it works. If some slip through and get free treatment - especially if in immediate danger - then maybe that's ok.

I don't know how many people actually come here for treatment, but if they are unsure they will get it then perhaps they will go elsewhere.

The genuine migrants may start taking out medical insurance against the chance of getting ill. We should make sure that's easy to to do.

The principle makes sense, but the administration is unlikely to go smoothly!

www.telegraph.co.uk/news/uknews/immigration/10540881/The-300-maternity-tourists.html

This is another issue. It's one that's emotive though. If a woman is willing to travel on a plane, so close to birth it says a lot about how desperate she is for a good maternity care.

I think this should mostly target health tourism:

The Government says health tourism costs the NHS as much as £80 million a year — enough to pay for about 2,000 nurses

That's ridiculous IMO.

Some sources say it's even greater than that.

Well presumably as well as quoting a figure of 550 million quid in lost revenue, the Department of Health has a breakdown of where that money is being lost (accepting that they are trying to count something that isn't there) to explain what the problem in recouping these costs actually is.

Typos and mistakes are always a possibility, tribpot. But I'm pretty sure Vodafone NL would describe your scenario as recouping £6, regardless of the net situation.

Do you know something that suggests the NHS would usually be the recipient of millions of pounds of net payments? Are we not just as likely to owe a net amount under a reciprocal system?

I am in the EU but no longer a UK resident but a citizen. I paid into the UK system for 20 years full whack inc tax ( and have carried on with the penison - often i wonder why).I have had 1 years CB and a couple of checks when I was pg and in the UK - that is it , don't suppose that will even get taken into consideration if we get ill......I also posess a NHS number.

According to same Beeb article, those figures exclude health tourism.

tribpot we could always request to see it on the Freedom On Information website. www.whatdotheyknow.com/ would be a good place to start.

www.whatdotheyknow.com/

Parsing - no, but clearly British people go abroad and access emergency medical treatment, at minimum under the EHIC (however inadvisable it might be not to have insurance to cover repatriation and the like). So the costs go both ways.

Perhaps the way around this is to make visas compulsory for all non EU passport holders.

When I didn't have EU citizenship, I had to prove that I had travel insurance as part of my visa requirement.

May sound a bit unreasonable, but really worrying about the one that may slip through the net might prevent the 50 taking advantage of the system.

In NZ and the USA and the other countries mentioned, there is already a billing system, already card machines and HCPs trained in using them, already a system. They bill each treatment then either the patient or the insurance provider (or the taxation system if you are poor) reimburses. It would NOT be easy to go from a free at the point of delivery system to a paid system. Did you know that 'medical billing and coding' is a career in North America?