topnswitch
Posts: 3
Joined: 11/24/2005 Status: offline
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I lived in England for the first thirty years and then in the USA for the last ten, so I feel qualified to comment on both systems, having been an in-patient with both... England Advantages Anyone can walk into any hospital in the country (now anywhere in Europe) and get prompt emergency treatment. The Health Service will find you a doctor, it may not be your first choice however. The cost of medicine is much lower, I used to work for a big european drug company - they would write to the government and say "We want to increase our prices by 10% this year" and the government would reply "Well we'll let you have 5% - and since we are your only customer, you don't have much choice". Advertising of drugs used to be banned - no more driving up demand for stuff that wasn't really necessary. Finally, damages for medical negligence were capped, not unreasonably so, but no $20M awards Disadvantages Much higher tax burden - I paid 40% income tax, 9% national insurance (covers lousy pension and the health care) and 17.5% sales tax. Limited choice of doctors and no realistic choice of specialist (though pretty much anyone who made it to surgeon in England seemed very well qualified). Approximately six month's wait for standard procedures that were non-life threatening, could be even longer. No heroic measures, the health service would typically not work to prolong a terminal cancer sufferer's life (like my dad) another six months if they were realistically expected to die within a couple of years. (That said another friend, a chronic diabetic, for twenty years was continually treated and well looked after - so they don't always give up). USA Advantages Money talks - if you have enough of it (or superb insurance) you can see anyone/anywhere for anything, often within a few days. Technical care quality is very good and if it's not you can sue, sue and sue them till it is (though you will probably be dead first). Lower taxes, though as a non-breeder, I've always thought it pretty unfair that I have to pay for my neighbors kids education, maybe that should be paid for by the parents (like South Africa for instance) and healthcare should be universal? Drawbacks What public care exists is really horrible (yes I experienced this with an injured friend in a lousy hospital in Baltimore). Millions of Americans have no coverage. Maybe because they work for an employer that doesn't provide it. There is a HUGE coverage gap, many people hit 50, are laid off, have no realistic chance of getting another job and then have no coverage till medicare kicks in - just when they are most likely to suffer a major illness - this to my mind is the greatest evil in the system. That employers are not required to cover ex-employees (at least on the same terms as current ones) until the employee finds a new job. COBRA should run until medicare - if the person needs it. I've known someone die, because they didn't get themselves to a hospital quickly enough when they had a heart attack - because they didn't have insurance and were worried about the cost. Is this really how a first world country wants to treat it's fellow citizens? Summary Even though I didn't think much of the English system while I was there, I have concluded that I would much rather have it, now that I live here. The right to get instant nationwide help without having to think about whether your insurance will or won't cover it (assuming you are lucky enough to have any), is an incredible freedom (and really should be enshrined in the US constitution). I think all of the other G7 (most developed nations) have socialized medicine and I don't think any of their systems are perfect - but I also think it's something we need to achieve - the second Bush had another crack at Iraq, maybe the second Clinton will have another crack at healthcare :-) Cheers, Dan
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