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?

Surely it should all work off the E111 card?

I have private medical insurance as I live in Switzerland.

I don't have to pay a bill before I go into hospital, or when I come round on a gurney.

I have a chip and pin card. It's swiped in the hospital and the pharmacy and the money is billed to my healthcare provider.

They then remove the franchise amount from my bank (the excess I have agreed to) if I am still under it, or if any costs aren't covered.

On the back of this Health credit card is my E111. So if I am taken I'll in the UK I hand this card over and then they know who to send the bill to.

So the NHS would have to adopt the practice of requiring an E111 card or similar on entry for treatment. You guys would swipe and confirm your UK address and NI number and nothing else would be needed. For me, and the rest if the forrins then either the country would be billed I.e. Canada, or the Healthcare Authority. They'd need an IT system and a central billing office I'd imagine.

It could be a simple thing to check a card on entry to a country. Also it would just require people in the UK to carry an extra credit card in their wallet.

Can someone tell me what happens if you turn up in the US about to give birth. Do they say "well we can't send you home like that here's a free pass for all the care you need"

Presumably we can copy their system.

The US has the highest infant and maternal mortality rates in the western world (and worse than some non western).

That should enlighten you as to what happens.

People die in the US from lack of proper healthcare. Medicine Sans Frontiers have run camps with free medical care that people cue for hours at to get seen to.

lisad, did you miss the bit that visitors are already supposed to pay?

This isn't aimed at visitors, or even health tourists, but at people legally living in the UK who have migrated here. We don't have proper details about who this would actually affect.

So it could be people on employment visas who are paying (often higher rate) tax.

Spouses of UK citizens (who already have to show proof they are earning IIRC £18,000 to even get into the UK).

International students, from whom the UK makes a vast profit in fees and spends, and we often get to keep the brightest too.

It's quite likely to affect people working in the NHS, for heaven's sake.

We'd need to see the details to know. But it would be a huge admin job however it was done, very expensive to police, unlikely to recover full costs due to exemptions around A&E, etc, and to what end? To deprive your next door neighbour of healthcare. Yes, that's an aim I can really get behind.

It's a desperate piece of immigration-bashing politics to try to shore up a Tory party failing to compete with UKIP.

My heart is truly split. Whilst the nurse in me simply won't let anyone suffer, the rational side is saying why are we doing this. Like backonlybriefly says about the US

nicetabard I think those figures can't truly be applied to this situation, here we are saying only immigrants and health tourists will have to pay. In the US those figures will be swayed by residents who are unable to pay.

I had a friend who slipped down some steps in the US and his face was so badly smashed he had to be put into a coma for 3 weeks.

They tested his blood alcohol as part of the insurance regulations and he was over intoxicated and his insurance declared null and void.

The bill would have been way over $100,000 I was told. There was a point where he partner thought they'd have to leave the US and abandon him, it was terrifying. Someone got in touch with their MP for them and it was sorted out via a special UK/US agreement.

It's a harsh world outside the UK, but it's reality for a lot of people - no money, no treatment.

Why do you think it's called a Nanny State?

JollySanta, I imagine that's pretty close to what already happens for visitors.

As far as we've been told, this proposal is to start charging people who have a UK address and NI number.

Sorry, your post about admin, not about abandoning people.

Yes Parsing, and if everyone had to swipe a card per treatment they could charge those not entitled by assigning them a different code I'd imagine, regardless of their tourist or resident status at the time if visiting the hospital.

If someone is here for a short stay or a temp transition they should have a transition insurance cover from their country of origin. If not they'd have a bill sent to their home to pay by a certain date.

If I fall behind on my bills here it can become a police matter. I can be thrown out of the country on my permit for this. I don't see why it should be any different for any other immigrant. I'm a guest in this country - I'm not here to make demands that things are done my way. I respect the rules that are in place until I earn my right to participate and change them.

Oh come on, a swipe card system for all would just be a step towards charging us all directly. There is no way in a million years I would support this.

Why would it be a step to charging everyone directly? If you are exempt, you are exempt.

Or you could stay stalwart to the system of not keeping a plastic card in your wallet and keep moaning about the 80 million mentioned below?

But you have to have the card for the rest of the EU anyway, so why is it restrictive at all. The current walk in system simply doesn't work in today's transient world and something involving administration will have to be done.

When the idea of Identity Cards was put forward, it was roundly hated by loads of people. Have people now come around to this idea?

Baubles if a wealthy state is prepared to let it's own poor citizens die in childbirth / let babies die at birth or when v young, it is hardly going to afford better care to people who can't afford it and aren't even citizens!

It would cost a lot of money to put a system like that in every hospital. The only way the Government would pay for it if it was the first step to charging. It wouldn't make sense financially otherwise.

Of course visitors to a country should have to pay.

For people stressing that this is aimed at uk residents and not visitors - residents of other countries have to pay to use their own health system, if the uk is struggling then I can see why it's being mooted as a possibility.

I would get free emergency care in the uk as part of a reciprocal agreement (and uk citizens get free emergency care here). However I'd have to pay to visit a GP. But I also have to pay to visit a GP here where I am legally resident ($50 a time).

The NHS as a "free at point of care" service for all is already crumbling. We can do too much (which costs too much) for it to continue without huge investment which isn't affordable.

It is perfectly affordable. There just isnt the political will to make it happen.

And the Tories did exactly the same last time they were in Government in terms of attacking the NHS.

They must have part of the system in place anyway, due to the EC agreement. Surely the initial outlay would be offset by the cost savings mentioned below.

I never did understand the anti ID card stance though tbh.

But the NHS costs less per person than the system in the US and gets much better results.

I would have thought that universal healthcare was socially desirable and the hallmark of a civilised nation. The fact that so many people want to deconstruct what we have and replace it with a system like the US where it's terribly expensive and yet loads of people can't even access really basic care is beyond me.

interesting:

[[http://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000#Criticism wiki WHO rankings from 2010) France came out top.

Sooo, you see us paying... how many people a year to administer this system of cards, and address changes, and status changes, and charging, and debt collection, and appeals when they get stuff wrong? And replacements including procedure to prove id when your purse is stolen. Gosh, it could be just like tax credits.

That's before the IT costs, of course, and without counting medical staff's time spent on admin.

For countries which already charge as a norm, you already have and are paying daily for this infrastructure - your whole private insurance structure would fall over without it.

We have a different model: we save huge quantities on the admin and spend it on universal care. There comes a point where it's just cheaper to pay the money on the nurses than on the administration. I don't know where the tipping point is when it's worth having this immense infrastructure to charge some UK residents, but I'm struggling to believe we're at it.

Friend at multinational IT consultancy says his employer is expecting the health division to be their major growth area in the next few years.

They don't do medical equipment. They do admin systems.

In a lot of countries with universal but insurance based systems, a lot of the cost if borne by employers. Implementing that here ie increasing costs for employers of hiring people / keeping them on would potentially have a very detrimental effect on the economy / less well off workers I would have thought. I can't see employers taking to the idea very well.

(Sorry, didn't mean need to prove ID for tax credits, just that system is large, cumbersome, frequently inaccurate, and employs lots of people.)

It's just a step in removing the access to free healthcare at point of need for everyone, isn't it?

Also, it's going to make it harder for a lot of British citizen to access healthcare, especially the poor and vulnerable.