"Free" health care!
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"Free" health care!
| Thu, 07-22-2004 - 7:15pm |
I wonder how many of you have had to live without health insurance? You say that health care is not a right? NO WONDER! You have always had a place for the bills to go other then your mailbox! How many of you have ever asked what the actual cost of your prescriptions are? Do the math! Do you have any idea what it is like to call around from doctor to doctor trying to find one who would see you WITHOUT insurance? Have you ever stood at your doctor office and humbly asked for samples instead of a prescription because u know that your $360 check wont stretch enough to cover your $280 med bill AND the doctor appt. Don't even mention medicaid! If you make enough money to buy food and scrape by...you do not qualify.
Go ahead and be technical but if you ever run into some bad luck you will see things in an entirely different light!
Go ahead and be technical but if you ever run into some bad luck you will see things in an entirely different light!

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It's a pretty complex system and not easy to explain but in a nut shell it pretty much works like this:
Every person in the country is covered by Medicare, our universal health care system. It covers 75% of the 'scheduled' cost of all out-of-hospital doctors visits and 85% of the 'scheduled' cost of all in-hospital doctors services in private hospitals. Public hospitals are totally free of charge - but like most public systems there can be a waiting list for required surgeries and you don't get your choice of doctor as a public patient in a public hospital. Medicare also covers 75% of the 'scheduled' cost of diagnostic testing.
The 'scheduled' cost is determined by the government and if the doctor/testing labs charge over and above this (as they often do) that additional out-of-pocket cost is born by the individual. However, there are 'safety nets' in place such that once out-of-pocket expenses reach a certain limit 100% coverage kicks in - but it's structured such that very few people ever reach the safety net limit.
In addition, people can take out private health insurance which covers the cost of addmitance to a private hospital (thereby allowing people to have their choice of doctor and have procedures done immediately) and also covers the 15% of doctors services charged upto the 'scheduled' fee for in-hospital service. Again, if the doctor charges more than the scheduled fee it's an out-of-pocket expence.
Some doctors and testing labs will 'bulk bill' especially for low/no income individuals which means they send their bill directly to Medicare and accept the 75% of the schedule as full and finaly payment. However 'bulk billing' rates have dropped considerably in the last few years and this is a hot issue here politically at the moment.
And of course, individuals who don't have private health insurance and need an operation and aren't prepared to wait on a public hospital waiting list always have the option of going to a private hospital and paying their fees - 75% of the doctors fees for the surgery will still by reimbursed by Medicare.
We also have the Pharmaceutical Benefits Scheme (PBS) which covers the cost of most prescription drugs such that when we have a prescription filled we pay a 'prescription fee' which is currently about $27 regardless of the actual cost of the drug. Low/no income individuals pay something like $4 instead of the $27 fee. If the drug you require is not on the PBS list you have to pay the full cost of it but if you have private health insurance some of this cost will be reimbursed by your insurance depending upon your policy. Drug companies are paid the full cost of the drugs by the PBS.
There is currently great concern here that the about to be passed through parliament FTA between the US and Australia will drive up the costs of drugs because of elements of the FTA.
This is all funded by a 1.5% levy on taxable income (over and above normal income tax). If individuals earn above about $50K there is an additional levy if they don't have private health insurance. This is to encourage higher income earners to take out private health insurance in order to lessen the burden on the public system.
In any case, I do take issue about those 'standards' you refer to. According to the WHO and other organizations, the health of americans is 'way down there'. 37th if my memory serves me right. After all, that IS the bottomline. And americans are the MOST unhappy with their healthcare SYSTEM (not the services themselves - big difference).
And I won't go back to the issue of 'financing' drug development, because I've already pointed out that this is incorrect. On an absolute number basis, yes, american companies develop a lot of drugs and treatments, but you can't compare a country with 300 million people with one with 30 million people! Various organizations have demonstrated that the bigger profits drug companies make in the US DO NOT foster more research. But you are free to continue believe this.
I don't think our system is perfect, BTW. From what I gather, the system in Japan and France are better than ours. There's always room for improvement.
Edited 8/3/2004 11:29 am ET ET by nicecanadianlady
Just to add my 2 eurocents.....LOL
If one means to say "how about you?" In French that would be "et toi?"
So in this case I'd agree with you that "tu" as in "et tu" would be Latin, or maybe it's Canadian French?
Thanks for the clarification.
(feel free to make fun of my syntax, spelling, etc) But speaking for myself…
No bone chance parlevouis France’.
I also read your post in #246, but will have to respond later (hopefully tomorrow).
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