public health care - what should it cost? (Full Version)

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LadyEllen -> public health care - what should it cost? (3/20/2010 9:54:55 AM)

This is based on UK NHS spending (it does not include private health insurance spending) that provides cover to everyone of us 60 million in our socialist utopia, our working population and our working population engaged in private industry, whose payroll taxes go to paying for the substantial number of public sector employees of course.

At an annual spend of £110 billion (£110,000,000,000-00), this provides cover at a cost of £1840-00 per person per year.

Discounting the unemployed and those otherwise not working but of working age, the cover represents an annual cost per worker of £4900-00. This is recovered by way of a 14% employer payroll contribution plus a 9% employee payroll deduction at source.

Discounting those engaged in public sector jobs and counting only those in the private sector, the cost per worker is £6700-00 per year. Again recovered at source by contribution/deduction.

How does this compare to typical US private health insurance cover in terms of the monetary sum I wonder? How does it then compare when the UK system covers whatever, with only script charges, glasses and dental falling outside the sytem (subsidised for the low paid and unwaged).

Reckoning on a US population of 400 million, the same service as provided by the NHS scaled up should cost out at $1,136,666,000,000-00. How does that compare to annual revenues for private health insurance companies in the US?

E



Moonhead -> RE: public health care - what should it cost? (3/20/2010 10:12:50 AM)

Prescription charges are also covered for those with certain medical conditions, as well as the unemployed, Lady E.

Aren't the Americans fishing for something more like the French and German systems where there are public subsidies for a variety of private medical providers, though? As you say, the whole UK welfare state is far too Marxist to suit most Americans. It's the sort of system they have in Cuba, after all.



LadyEllen -> RE: public health care - what should it cost? (3/20/2010 10:29:44 AM)

If you ask the Americans, it depends on which American you ask as to what they want it seems.

I'm more interested in a cost/benefit analysis of the current "system", the proposed system in the disaster formerly known as a bill and a system like ours.

E



Moonhead -> RE: public health care - what should it cost? (3/20/2010 10:37:02 AM)

One problem they have that doesn't seem to be getting mentioned amongst all of the pissing and whining is work based medical insurance. That's a big part of the reason that manufacturing industry has been fleeing their country for the last thirty years, and it certainly pushes up the price of what little they still manufacture domestically instead of in a third world sweatshop. Mind you, that's an issue that'd be quite hard to quantify in real terms, I suppose.



TreasureKY -> RE: public health care - what should it cost? (3/20/2010 1:14:33 PM)

Lady E... I'm not sure I understand precisely what you are asking, but from my experience (as a Human Resources Manager by profession) I can tell you that the typical health insurance coverage provided by the employers I have worked for cost roughly $900 (£547) per month for an employee with a spouse and dependents (not including life, vision and dental coverage).  Of course, the employer would pay a good percentage of the premium for the employee, and less of a percentage of the spouse and dependents.  The employee's contribution would usually run between $250 to $400 (£152 - £243) per month, depending upon the employer.

Do those figures help you in any way?



willbeurdaddy -> RE: public health care - what should it cost? (3/20/2010 1:33:07 PM)


quote:

ORIGINAL: LadyEllen

How does that compare to annual revenues for private health insurance companies in the US?

E


Revenues to private health insurance companies is irrelevant. They are just pass throughs with admin costs tacked on. Total medical expenditures are 16% of GDP, so about $1.9 trillion, and that includes everything...medical, dental, vision, cosmetic etc. You have to be careful in making gross comparisons though. For example, higher costs should be offset by the economic value of shorter wait and recovery times and they are never factored in. UK has much tighter controls on tort claims as well. Im not sure how the terminally ill are handled in the UK, but in the US a large percentage of that 16% of GDP is spent in the last 6 months of life.



pahunkboy -> RE: public health care - what should it cost? (3/20/2010 1:37:14 PM)

lady E.,

when congress passed medicare D, the RX plan- those prices are a no bid contract.
tho PA does negotiate its own prices.



subfever -> RE: public health care - what should it cost? (3/20/2010 2:03:11 PM)

I want to see a system where no one gains from the ill health of others.

And when that day comes, we will see far less ill health.



Thadius -> RE: public health care - what should it cost? (3/20/2010 2:38:40 PM)

Afternoon Ellen,

Is the £110 billion just the government expense, or does that include the difference that is made up by individual spends (script charges, etc..)?

I wish you well,
Thadius



rulemylife -> RE: public health care - what should it cost? (3/20/2010 3:10:28 PM)

quote:

ORIGINAL: willbeurdaddy


quote:

ORIGINAL: LadyEllen

How does that compare to annual revenues for private health insurance companies in the US?

E


Revenues to private health insurance companies is irrelevant. They are just pass throughs with admin costs tacked on. Total medical expenditures are 16% of GDP, so about $1.9 trillion, and that includes everything...medical, dental, vision, cosmetic etc. You have to be careful in making gross comparisons though. For example, higher costs should be offset by the economic value of shorter wait and recovery times and they are never factored in. UK has much tighter controls on tort claims as well. Im not sure how the terminally ill are handled in the UK, but in the US a large percentage of that 16% of GDP is spent in the last 6 months of life.


More random numbers and unsupported conclusions.

If you ever find time in your busy schedule of being a worldwide financial expert to decide to post some citations I may actually start to take you seriously.






willbeurdaddy -> RE: public health care - what should it cost? (3/20/2010 3:30:40 PM)


quote:

ORIGINAL: rulemylife

quote:

ORIGINAL: willbeurdaddy


quote:

ORIGINAL: LadyEllen

How does that compare to annual revenues for private health insurance companies in the US?

E


Revenues to private health insurance companies is irrelevant. They are just pass throughs with admin costs tacked on. Total medical expenditures are 16% of GDP, so about $1.9 trillion, and that includes everything...medical, dental, vision, cosmetic etc. You have to be careful in making gross comparisons though. For example, higher costs should be offset by the economic value of shorter wait and recovery times and they are never factored in. UK has much tighter controls on tort claims as well. Im not sure how the terminally ill are handled in the UK, but in the US a large percentage of that 16% of GDP is spent in the last 6 months of life.


More random numbers and unsupported conclusions.

If you ever find time in your busy schedule of being a worldwide financial expert to decide to post some citations I may actually start to take you seriously.






Well that puts me miles ahead of you, because there isnt a chance in hell I would ever take you seriously.



ShaharThorne -> RE: public health care - what should it cost? (3/20/2010 8:07:43 PM)

quote:

ORIGINAL: pahunkboy

lady E.,

when congress passed medicare D, the RX plan- those prices are a no bid contract.
tho PA does negotiate its own prices.



I pay $5.80 a month for my Part D.  Usually it was 33.30.  I am qualified in a few programs that helps pay for my Medicare A & B.  If I want, I can get food stamps.

Tomorrow, I have to go to the bank and withdraw some funds (I use a 24/7 bank) so I can give some of the money for Lizard's NYC trip.



LadyEllen -> RE: public health care - what should it cost? (3/21/2010 7:28:01 AM)

Thanks Treasure - looks to be about the same overall cost per employee then, with roughly the same sort of split between employer and employee, with our system covering everyone, including non workers, equally rather than what appear to be variations according to particular insurer/employer/patient and variations in treatments available. I accept there is still something of a postcode lottery over here as to what is available when it comes to more expensive treatments, (some regions provide and some dont - something that is being sorted out apparently), but it seems overall we're ahead on this one in terms of covering everyone for a like cost per worker rather than those benefitting from private cover. Many large employers here by the way also offer private cover as an employment benefit (or you can buy it yourself) - the advantage is quicker treatment (access to specialists) than through the NHS though NHS waiting lists are way down on what they were only a few years ago now so the advantage is less than it once was.

Willbeur - administrative costs are very much relevant and are included in the NHS budget as it is part of the overall cost here as it is there. I'm not sure which billion you mean in your post (UK or US), but 16% of GDP is 4% higher than here. This should mean, exchange rates, demographics and cost of living differences notwithstanding, you ought to be able to cover everyone in the US to NHS standards and save half a billion a year.

Thadius - the £110 billion would include cost of drugs; even the script charges we pay are a fraction of the cost of most drugs if we bought them privately with a script from a private physician. I'm not sure whether the script charges offset the total cost, but all in all it should be a marginal effect. The script charge I believe is around £8-00 per item (not sure as I have a "season ticket" that covers all scripts for 12 months at a substantial discount), but there are around 10 options on the script form whereby one pays nothing if one is (for example) pregnant, unemployed, long term sick, retired and so on.

E




SL4V3M4YB3 -> RE: public health care - what should it cost? (3/21/2010 7:41:12 AM)

Yep there are problems with both systems but if your insurer is going to drop you because you have long term healthcare needs or a family history of a certain condition then what kind of coverage is that? It's basically insurance companies stacking the cards in their favour.

When talking about car insurance you can probably accept that it's right for higher risk drivers to pay more but when dealing with issues beyond the control of human beings such as their health needs I think the whole insurance game is immoral.

Someone else mentioned waiting lists, my view is that if you want to pay more to go private and jump the queue then that is a personally decision. As a patient however they should be aware that in the UK when things go wrong with the procedure private institutions are often not resourced well enough to cope. i.e. they cope with the routine but don't allow in their budget for the unexpected. Personally I'd be really nervous about going private unless it was abroad.



cadenas -> RE: public health care - what should it cost? (3/21/2010 8:02:58 AM)

quote:

ORIGINAL: LadyEllen
This is based on UK NHS spending (it does not include private health insurance spending) that provides cover to everyone of us 60 million in our socialist utopia, our working population and our working population engaged in private industry, whose payroll taxes go to paying for the substantial number of public sector employees of course.

At an annual spend of £110 billion (£110,000,000,000-00), this provides cover at a cost of £1840-00 per person per year.


Really, this is the only meaningful number: the average cost per person per year. Sure, you can subtract those in the public sector, but then you'd also have to subtract their expenditure. Else you are comparing apples and oranges.

Also, the numbers between UK and the US aren't really comparable because in the UK, pretty much nobody is uninsured or underinsured. In the USA, we really have four separate groups: we have people in government programs, we have people adequately insured by private companies, we have underinsured people (with private insurance that doesn't cover enough to make a difference), and we have uninsured people (without any insurance).

Surprisingly, the largest group is actually people insured by government programs; about a third of the population is either in Medicare, Medicaid, Tricare or similar programs

Another third is either uninsured or underinsured.

The US population has just recently reached 300 million, the 400 million is not expected until a couple decades from now. Health care spending is about $2.26 trillion, or approx. $7500 per American (including uninsured). I believe it works out to about $12,000/year/insured person. For comparison: the taxes on a median income family are only around $$2000-$4000/year.




Mercnbeth -> RE: public health care - what should it cost? (3/21/2010 9:40:28 AM)

You mean it won't be FREE? !



slvemike4u -> RE: public health care - what should it cost? (3/21/2010 11:24:29 AM)

quote:

ORIGINAL: Mercnbeth

You mean it won't be FREE? !
Entertaining Merc....complete bullshit,but entertaining all the same.....psst,have you completed your move yet?(not meant as snark,actually asking)



Mercnbeth -> RE: public health care - what should it cost? (3/21/2010 11:38:21 AM)

quote:

ORIGINAL: slvemike4u
quote:

ORIGINAL: Mercnbeth

You mean it won't be FREE? !
Entertaining Merc....complete bullshit,but entertaining all the same.....psst,have you completed your move yet?(not meant as snark,actually asking)

Mike,
Glad you took it in the spirit it was offered.

Won't be "complete" for at least another year, but in the submission stage. Heading back at the end of May. I'll keep you posted.



slvemike4u -> RE: public health care - what should it cost? (3/21/2010 11:50:05 AM)

Thanks....and of course good luck with it all.



cadenas -> RE: public health care - what should it cost? (3/22/2010 1:13:10 AM)

LOL! It will be more free than what we have now :-)

quote:

ORIGINAL: Mercnbeth
You mean it won't be FREE? !





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