Costs of Universal/Socialized Healthcare

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I know this isn't about politics, but at least here in the U.S. it is a very politically charged issue, so I felt this forum was most appropriate.

I'm hoping that this thread doesn't degenerate into a is it a good/bad idea, nor do I want to critique Sicko in this thread. What I'm more curious about is how much of your total tax bill goes to healthcare if you live in a nation with universal healthcare (and that should include just about everyone on these boards except people from the U.S.). I assume that it's a percentage of your income so that someone making 30,000 Euros per year doesn't pay as much into the system as someone making 50,000 Euros each year. (I'm just using Euros as an example - your thoughts and contributions are still welcome if you live in a nation like the UK, Canada, etc., that has universal healthcare but doesn't use the Euro.)

Of course, I do not intend for this to exclude my fellow Americans either. For Americans, I'd like to see how much you pay out of pocket for healthcare insurance, and then compare that to what people pay in healthcare taxes in other nations.

One thing that is strange about the U.S. (other than that now we are kind of an oddity of NOT having a universal healthcare program) is that most people who have insurance through their employment pay the same amount of money for heathcare reagardless of how much your salary is - in other words, it's a flat fee, and not a percentage of your income. I'll use my company as an example. I pay about $185 out of every paycheck to secure health insurance for myself, my wife, and my child. I'm on the "family health plan". The thing is, everyone who is on the family health plan pays $185 every two weeks irrespective of salary. It doesn't matter if you are a janitor or the company president - it's $185 every two weeks. Also, it doesn't matter how many kids you have. It's $185 every two weeks regardless of whether or not I have a single child or 10 children.

What I'd like the result of all this to be is to see whether or not it would be more or less expensive for most people who pay for their insurance to switch to a universal system. Granted, part of that is going to be based on your salary. Someone who makes only $20,000 per year would likely be better off paying a percentage of his income into taxes than buying the company health plan, whereas someone who makes $200,000 per year would almost certainly be better paying the flat rate as opposed to a percentage of income, but maybe we can look for a general trend.

Anyway - for me it is this:

No universal healthcare in my country - and I pay $185 every two weeks for health insurance.

 

I'm guessing you meant this the other way around?

(By the way, NHS = National Health Service, the government organisation in the UK that provides healthcare.)

I dunno, I pay for NHS but havent really used it. That being said, if I developed an illness I know that the NHS would provide, but then again, apparently its quality is low.

I dont know if I prefer the way it works in the US - it sounds like if you cant afford health insurance you are really screwed, and those with more money can afford better insurance and thus better healthcare. But then again, I dont know how that works in practice - maybe health care is affordable in the states?

Personally I think I would prefer health insurance, so that I can decide how much cover I need and change providers to suit my needs.

 

No - I meant what I said - that the guy making 30,000 should not have to pay as much as the guy making 50,000.

That's exactly what I'm asking - how much do you pay for it? If you are talking about the NHS, I'm assuming you're in a nation where paying into it is obligatory.

That's a pretty accurate statement.

Well, that really depends. If you get your coverage through your employer, in which the employer picks up part of the bill, it's not too bad. As I said in my first post I pay about $400 per month to cover my family. However, even if you have health insurance, you still have to pay to see a doctor - you just don't have to pay as much. For example, with health insurance, if you go to a doctor that charges $100, you'll probably only have to pay about $20 with the insurance picking up the rest. Whereas if you don't have insurance, you'd have to pay the whole thing.

If, however, you are unemployed, or do not use the coverage your employer provides, then health insurance can be prohibitively expensive. You could easily spend $500 per month for decent single person coverage. In other words, if I was not taking advantage of my employer's insurance plan, I would probably need to spend more to cover just me as I spend to cover my entire family.

 

Health care is one of the biggest if not the biggest post in the expenditures of any state with universal health care. Do not know the exact figures though. What I would guess is that for most healthy people with average or above average income you lose out on universal healthcare while if you get really sick or heck, even in your old age you cash in a lot of the money you have paid into the system.

 

Do you mean in GDP (what the whole nation pays) or in percentage of the state taxes (what the taxpayers/state pay)?

 

Actually, that's a myth. I've used the NHS a fair few times and don't have a bad word to say about them.

NHS payment is obligitory for everyone. It's not a great deal to the individual, and it's based on ratio, so people on high incomes pay more for the health service, but the ratio is the same.

The idea of the health service not being state provided is alien to me. I couldn't imagine not having it. If I was to break my leg, I'd need to go to the docs to get it fixed, but if I couldn't afford the cost... man. Imagine that "Yeah, I'll fix that, cast it up, no worries at all.. just sign this bill for £5,000 and give me your credit card and I'll get right on it". No thanks!!

I bet a lot of people end up putting up with stuff, or getting it done on the cheap by some Dodgy Dave.

The NHS makes sure that anyone, even people on horrible incomes, or the unemployed, can get good health care when they need it and know they'll be taken care of. It's not just something people with money can get. I'm proud of it.

 

Here health expenditure accounts for ~8.8% of our GDP, which is really quite a large proportion. A quick glance at the latest government budget shows that health spending is costs about 20 cents for ever dollar of tax we pay. To give you a comparison or two, the ministry of education takes about 15% of our taxes and ministry of social development about 29% (heh, and the military only 3% ).

Private health care will always comes up better value for the dollar, although there's a huge catch - you have to be able to afford it.

 

Per capita, the nations with universal healthcare pay less for healthcare than we do. Healthcare expenditures likewise makeup less of their GDP.

 

That in America the healthcare discussion is so rotten is largely to the fact that the right has managed to brand 'univeral healthcare' as a term, invoking scary mental images of huge socialised administrative apparatus, an anonymous state health machine, maybe a health care number (of the beast?), an abomination to every small budget loving conservative. And how large is the step from socialised healthcare to socialism? Yes, I was being sarcastic. Needless to say I find the GOP stance on universal healthcare silly, bordering to irresponsible. Such labeling is the largest single obstacle to having a sensible and constructive dialogue (as opposed to 'debate' or 'dispute') in the US about healthcare (and about any other political issue).

I still do have my family doctor (for about 25 years now) under Germany's socialised health care system, by choice.

It is a comfort to know that in case I get seriously ill, the costs of my treatment will not ruin me or my family's retirement planning, or leave, say my spouse, or me, with depleted retirements funds at a time when I can't possibly ever refill them.

 

I think that the percentage directed to healthcare from taxes is around 7% here in Finland. Correct me if I'm wrong.

We're supposed to have this "universal" healthcare, but there's major problems in our healthcare system. For some reason it doesn't work that wonderfully, sure it might be better than in some other countries, but there's major inefficiencies. For one, the queues are fairly long in public healthcare, not long ago it was possible that you'd have to wait for six months or even over a year for some operations. And not just some fancy ones either, but just for your regular dentist appointments as well.

It's so much easier to go to a private clinic when you've got something that needs to be fixed than wait for who knows how long to get a doctor's appointment.

So the money we pour into the system doesn't automatically make it better. The hospitals in here have a very strict hierarchy, up to a fault. For an example there's been a few cases in which an older person has fallen out of bed, but couldn't be helped back into bed since the people around didn't have the proper authority and/or education. So the elderly person has been left to lie in the ground or the people who've actually helped have been berated for acting without proper authority. There's a major shortage in hospital staff, since the wages and especially the terms of employment aren't as good as in the private sector or in other countries. Quite a few nurses seek employment from other Nordic countries since they're more appreciated in there. In Finland healthcare and hospitals would definitely need people with better management skills...

One major problem that's coming up is the aging of the baby-boomers. This'll mean serious diffculties with our healthcare system and I just can't see how privatizing would help the situation at all.

 

Well they just managed to blackmail the government into giving them higher wages by keeping the entire system as hostage so they should be happy. True enough they aren't competetive with Norway but unless our forests magically turn into oil they are never going to be either. Another factor which contributes a lot to the problems in our healthcare system is the fact that many of the municipalities are horribly indebted and can't afford to hire as many nurses or doctors as required leading to the stafflevels being lower than required.

Still it's not all bad, if you really need urgent care it comes swiftly enough but if you're there because of some minor medical issues you better cancel all other programme for the day because you're probably in for a long wait. That can be coped with though and I'm a lot more worried about the care for the elderly which is rapidly falling apart. The horror stories that emerge from retirement homes from time to time because nurses lack the time are utterly repulsive. Not that I blame the nurses, they must prioritize and when there is not enough workforce there is only so much a limited personel can do.

 

In Australia the cost is split over state and national governments, so I'm struggling to come up with an exact value (it's late atm ).
We do have a universal health care system called medicare, but health care services are becoming increasingly privatized. There has been a big push to get people onto private health schemes in order to curb government expenditure on an aging population (the baby boomers are growing up). People below a certain income threshold have access to most services free of charge, or for a minimal fee. People earning over a certain amount do not have access to some public services such as dental, and (i think) have to pay a larger "gap" (the difference between what the government pays and what the health care provider charges). Most well off people have at least some form of health insurance (often for things like ambulance cover and the promise of cheaper insurance later on for early adopters). More expensive health care plans often include things like dental, optical and chiro. I'm not sure that all of these cover the entire cost of treatment, but they get you most of the way. I'll let you know in a day or two on the price of these health insurance plans (they tend to be advertised on the tv a lot).

The whole system gets bagged a lot, mainly because of 6-12month delays on elective surgery and the odd case of people being stored in one of those portable beds in a hospital corridor because of lack of space. Overall it probably isn't too bad; everyone who needs emergency treatment gets it, people don't accumulate huge debts because of hospital fees, and the poor all have access to basic services.

 

Heh, mate, here most dentists have gone off the public health system and we still have a good half a year wait to get an appointment You can't blame the public health for that - that's more a shortage in labour.

 

I've heard that in Canada, the government limits what doctors can get paid for in a year, thus creating longer wait times for surgery. It's what happens when governments don't want to pay for propper healthcare.

That said, I'm glad that we have it here, and emergencies are always taken (even though some emergency rooms are understaffed or even closed for periods of time).

 

We're having a bit of a health crisis in Queensland at the moment (don't know about the rest of Australia - under the impression it's no good all over though), though I wouldn't blame government provided healthcare for that. Apparently (according to my mother, who's a nurse), the private hospitals are significantly worse than public hospitals anyway. The problem is more one of a lack of doctors than the fundamental system.

As for what it costs - I don't think that really matters. Too many horror stories from America where the poor can't afford proper healthcare for me to even worry about that sort of thing. If it can't be accomodated, the government should be rearranging the budget, not trying to farm it out to corporations. Unless we're attaching dollar values to how much a human life is worth, I don't think a system where the poor die because they can't afford what they need to survive is defensible when it's well within the means of the community/country to keep them alive. Government provided healthcare is the best way of ensuring that with how things are presently arranged.

 

Found it!...kind of.
In 2004 Australian health expenditure was 9.3% of GDP, or AU$66.6billion. This aparently worked out to be around $3300AUD (US$2913) per person per year (or about $126 (US$112) per fortnight). Of course, because it comes from tax, high income earners and businesses would foot most of this bill. If the averages are taken though, this probably wouldn't compare well to the US$183/fortnight you spend on you and your family...which seems kind of odd to me considering most health care insurers would have to make a profit, yet the Australian government does not. Perhaps insurers generally look after healthier people than the Australian government does.

I spotted this map earlier and just about the only developed nation not to have a universal health care system is the US, it is really somewhat of an anomaly.

This is a very interesting topic Aldeth! I can't say I've ever really considered it before.

 

Rags, can you tell me just how state-owned the welfare system in Germany is? When I was a student there, we had some options... I used TK, but there were others who did not have it. I thought there were several different funds, which strikes me as odd for a state healthcare program. Maybe it was just different provincial funds, though. At any rate, we had to have an insurance, but it was OK if it was not the default one (TK).

To be honest, while the money seemed like a fair bit (for a student from an Eastern European country, that is) I'd say the system worked quite well in return - if there were big waiting lists for anything important, I didn't see them. The system worked relatively quickly imo... the only thing I had to wait a little for was the dentist. I wish I could say anything nearly half as good for the system here, really.

 

Shaman,
ok, state owned is unprecise, state supported and mandatory for a large part of the population, with a variety of choices, is better. And it works reasonably well.

 

Universal, government-provided health care works wonderfully if it is designed by intelligent, rational, thoughtful people who genuinely care for the good of those who will use it. The problem with such a system here in the US is that it would be designed by Congress.

I have yet to hear one proposal for universal health care here in the US that isn't filled with horrible problems. The big one I've heard about what Clinton is proposing is that doctor and patient have no choice of each other. This means that the doctor can't legally refuse a patient and if a patient refuses the doctor then they have refused treatment. This may not be a big problem in some fields, but in others, like psychology, this is terrible. The psychologist-patient relationship is central to the entire process of therapy. If a psychologist can't develop a good relationship with a client, he or she should (and usually does) refer them to another psychologist who may get along with them better. Under Clinton's plan, this would amount to refusing to treat the patient.

Of course, the other big problem is that medical school costs money, lots of money, and doctors don't make lots of money in return, then it deters people from getting into the business in the first place, and then you run into the kinds of shortages many of you are seeing.

 

There's been quite a bit said about the pay of doctors. In Australia at the moment, many doctors are tied pretty closely to the public health system, and this by and large tends to keep pay down. Right now the mean wage of a general practitioner is below that of a general Dentist in South Australia; this is pretty inequitable imho given the disparity in the amount and intensity of the training. Dental school ain't easy (5years, $8.5k/year, 30+hrs a week, barely any free time), but it doesn't really compare to the input required to get through med school, which is a year longer, more hours/week and requires internship in some form or another. Add that to the stress/liability of dealing with peoples lives and I'd say that in general most doctors don't earn enough.

I think I've hit a brick wall with the cost aspect of public private health systems.

public: would have to cost less if everyone in a country were trying to get health cover (as no profits are being made), though perhaps it is in reality more expensive because thousands of people have access to surgery/care when they may not have been able to afford it a private system. Majority of it is funded by the rich, as well as profitable businesses.

Private: cheaper for the rich than a public system, insurance companies make a profit because they're able to turn away the sickest members of the community (this may help to boost the economy)