Wednesday, 9 August 2017

Tech: 5 people from around the world share what it's like to have single-payer healthcare

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There's a lot of talk surrounding single-payer healthcare. Here's what people who actually get it have to say.

The United States is one of four countries (and the only industrialized country) that lacks universal healthcare.

Some proponents of the US model say this increases people's level of choice, allowing citizens to pick the plan that is right for them.

Advocates for a single-payer model argue government-funded care significantly reduces cost and provides a stronger social safety net.

Business Insider spoke with a handful of people around the world to find out how single-payer actually shakes out.

Canada

What's it like living in a country with single-payer healthcare?

In Canada, doctors have waiting lists and the process is more like getting into a country club where you have to be recommended by other members. Once I finally got "inside" the system, I was pleasantly surprised.

The wait to see my doctor is never more than a few days, but referrals to specialists can take a bit longer. Special equipment, like MRI machines, always have a waiting list and work around the clock, so it is not unusual to get an appointment a month or two out, with a middle of the night time slot. It is a little strange to drive an hour to a hospital, which seems deserted at 2 a.m. and find the radiology waiting room packed.

What do you really like about it? What do you think people might overestimate?

Aside from some system glitches, I would say that Canadian healthcare, like an American HMO, works pretty well most of the time, especially if you don't get sick!

I have had my Canadian medical coverage since 2012, and the biggest challenge has been getting the US to acknowledge it is real.

Can you share how much you pay in a typical month for your healthcare?

In Ontario, there is no monthly out of pocket cost, though each province is different. We do carry an additional plan, which covers prescriptions, massage etc.

Heidi Lamar, business owner, dual citizenship in the US and Canada



United Kingdom

What's it like living in a country with single-payer healthcare?

Basically, it's a lot easier. You don't worry about healthcare, ever, for any reason. It's just there. Like the police or the fire department. There are no bills, no paperwork, no deductibles, no insurance companies to deal with, no "patient statements," no risk of going bankrupt if you get the "wrong" disease.

What do you really like about it? What do you think people might overestimate?

Brits over-estimate how good the care is going to be for non-serious conditions. The NHS is geared toward preventative care and emergency care, so if you have a non-serious condition, like tinnitus for example, you are going to wait many weeks to see a specialist. Your treatment will be free, but the wait might be a couple of months.

Can you share how much you pay in a typical month for your healthcare?

Zero. My only costs are: over the counter medicines like aspirin and allergy meds, which cost the same in the UK as they do in the US. If you go to the doctor (free) and need a prescription there is a token prescription charge, which is £8.60 ($11.17) per drug.

Jim Edwards, Editor-in-Chief, Business Insider UK



Finland

What's it like living in a country with single-payer healthcare?

Life is much easier when your healthcare is covered without thinking about it. I have lived many years in a country where people have to choose whether they have or don't have coverage for their health. Single-payer healthcare is easy and fair, providing basic security for all people regarding their health.

More specifically, what do you really like about it? What do you think people might overestimate?

I think healthcare is one of the basic public services together with education, dental care, and childcare that belongs [to] all citizens. I think there is enough evidence to show that when people have access, or sometimes responsibility to take care of their health, it will be cheaper for the society and those who pay taxes for in the long run.

I also like a public healthcare system that provides all mothers with free pre- and post-natal healthcare and parental leave for both parents — that is one way to reduce problems with newborns' health.

Can you share how much you pay in a typical month for your healthcare?

In total, for most people who are employed, the healthcare is about 2.5% of taxable income. That is shared between employer and employee in a rate of 1% to 1.5%, respectively. Unless a person has an optional private healthcare plan, no other payments are necessary.

Pasi Sahlberg, Director General, Centre for International Mobility



Australia

What's it like living in a country with single-payer healthcare?

In [Australia], you know, if you get sick you can be treated. We have a system called Medicare. Basically you get your Medicare card and you can go and see a doctor. Some doctors charge premiums on top of Medicare. It basically means that if you are sick in any way the public system will find a way to treat you.

The doctors won't always be the best in their field and there will also at times be waiting lists, but overall it's pretty good.

What do you really like about it? What do you think people might overestimate?

One observation is that [in the US] when you visit a doctor you have a nurse and a doctor in the room. We don't have that. One doctor, in and out much faster and more efficient. We also don't have teams of admin people working behind the counter. I would think this drives [US] costs up and is why everything costs so much.

Can you share how much you pay in a typical month for your healthcare?

It's possible to pay zero for healthcare in Australia. It's a little extreme, but it is possible.

David Boldeman, Account Director, Business Insider



Iceland

What's it like living in a country with single-payer healthcare?

I love living in a country with publicly-funded, universal healthcare, paid for by government taxes. I especially like the fact that every Icelandic citizen, irrespective of his or her economic status, has the same healthcare coverage.

What do you really like about it? What do you think people might overestimate?

What I like about universal healthcare is that it gives you peace of mind.

The shortcomings we have do not stem from the single-payer model, but from the fact that the government needs to spend more on healthcare — that is, build additional hospitals and nursing homes, improve and subsidize mental healthcare, and reduce out-of-pocket expenditures, particularly for marginalized populations.

Can you share how much you pay in a typical month for your healthcare?

I do not know how much my family and I pay per month for healthcare. That in itself says a lot; the typical Icelander does not have to fret over healthcare costs as a critical part of the family budget.

In the Icelandic system, the government pays 80 to 85% of all healthcare expenditures, funded by taxes. The rest is mostly paid for through service fees.

Gummi Oddsson, Sociology Professor, Northern Michigan University





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