What do Aussies & Brits think of the US health care system?

hollydolly said:
oh how I wish the same thinng happened here..perhaps we wouldn't see so many trying to get in...
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Australia has space enough to accommodate many more people. An orderly program for refugees would go a long way towards eliminating the need to arrive by stealth. That is how post WWII became a time of progress. The assisted refugees had to work where directed for 5 years. Many worked on the Snowy Mountains scheme. Others, like my childhood friend's father, worked for the railways, washing trains. He was an accountant from Ukraine and in that time he was able to acquire English.
 
When it comes to healthcare insurance in the US, has it ever been published how much of the monthly premiums go toward actual healthcare versus administrative and other costs?

I often wonder how much of an American's hard-earned money is spent on an insurance company's operational costs rather than on actual healthcare. These costs would include salaries and benefits for staff, sales and marketing teams, sales agent commissions, TV commercials, claims management, call centers, and legal expenses.

There's also the cost of the insurance company lobbying the government on healthcare policies to benefit the insurance company, as well as financing fraud prevention and investigation departments. Some of these teams may even focus on finding ways or reasons to deny claims, potentially receiving bonuses for saving the company money in this way.

Then there are additional expenses such as renting or buying office space and its associated overheads, paying dividends to shareholders and investors, and covering corporate taxes. All of this, and probably more, is funded by the money the insurance company collects from premiums.

Insurance companies are, at their core, for profit organisations. Imagine a not for profit system where every dollar went directly to healthcare instead of financing a multi-billion-dollar insurance industry. What might that look like?
 

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Warrigal said:
Australia has space enough to accommodate many more people. An orderly program for refugees would go a long way towards eliminating the need to arrive by stealth. That is how post WWII became a time of progress. The assisted refugees had to work where directed for 5 years. Many worked on the Snowy Mountains scheme. Others, like my childhood friend's father, worked for the railways, washing trains. He was an accountant from Ukraine and in that time he was able to acquire English.
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Exactly, we've said this for a long time. No-one in their right mind wants to overwhelm a country...with immigrants, as has happened to us here... but ...Huge countries like Australia should be a little more lenient....
 
CooCooforCoCoPuffs said:
I think it both what you know and who you know.

What the IM was doing, if he did it for getting his OWN au pairs into the country illegally, that is called graft.
If the IM did it for his friends as a favor, that is corruption.

The higher to the top the less "friends" you should keep OR trust.
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The young women were genuine au pairs, not brothel workers, but they came on a visitors visa and that class of visa does not allow them to work. The Minister for Immigration has the power to make exceptions. This was a favour for a friend.
 
Warrigal said:
The young women were genuine au pairs, not brothel workers, but they came on a visitors visa and that class of visa does not allow them to work. The Minister for Immigration has the power to make exceptions. This was a favour for a friend.
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Ah, corruption then. That is a no-no.

How did "brothel workers" get into this mix?
Is there something I don't know about your dear IM? :ROFLMAO: šŸ˜
 
Magna-Carta said:
When it comes to healthcare insurance in the US, has it ever been published how much of the monthly premiums go toward actual healthcare versus administrative and other costs?

I often wonder how much of an American's hard-earned money is spent on an insurance company's operational costs rather than on actual healthcare. These costs would include salaries and benefits for staff, sales and marketing teams, sales agent commissions, TV commercials, claims management, call centers, and legal expenses.

There's also the cost of the insurance company lobbying the government on healthcare policies to benefit the insurance company, as well as financing fraud prevention and investigation departments. Some of these teams may even focus on finding ways or reasons to deny claims, potentially receiving bonuses for saving the company money in this way.

Then there are additional expenses such as renting or buying office space and its associated overheads, paying dividends to shareholders and investors, and covering corporate taxes. All of this, and probably more, is funded by the money the insurance company collects from premiums.

Insurance companies are, at their core, for profit organisations. Imagine a not for profit system where every dollar went directly to healthcare instead of financing a multi-billion-dollar insurance industry. What might that look like?
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Where would the dollars come from to power the non-profit healthcare system?
Higher taxes is the only place it could come from.
 
Warrigal said:
Australia has space enough to accommodate many more people. An orderly program for refugees would go a long way towards eliminating the need to arrive by stealth. That is how post WWII became a time of progress. The assisted refugees had to work where directed for 5 years. Many worked on the Snowy Mountains scheme. Others, like my childhood friend's father, worked for the railways, washing trains. He was an accountant from Ukraine and in that time he was able to acquire English.
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The US once had space enough, too! šŸ˜­

To the best of my knowledge, a legal refugee status program exists in all nations where refugees seek asylum.
Illegal immigration is not the same as refugee status.

Asylum is granted in the US for persons who are persecuted.
Everyone else has to ask permission and stand in line.
To come illegally to the US is to take the place of and use the resources persons of those seeking asylum.
This cruel and unjust to those who are worse off than you.
 
Magna-Carta said:
When it comes to healthcare insurance in the US, has it ever been published how much of the monthly premiums go toward actual healthcare versus administrative and other costs?

I often wonder how much of an American's hard-earned money is spent on an insurance company's operational costs rather than on actual healthcare. These costs would include salaries and benefits for staff, sales and marketing teams, sales agent commissions, TV commercials, claims management, call centers, and legal expenses.

There's also the cost of the insurance company lobbying the government on healthcare policies to benefit the insurance company, as well as financing fraud prevention and investigation departments. Some of these teams may even focus on finding ways or reasons to deny claims, potentially receiving bonuses for saving the company money in this way.

Then there are additional expenses such as renting or buying office space and its associated overheads, paying dividends to shareholders and investors, and covering corporate taxes. All of this, and probably more, is funded by the money the insurance company collects from premiums.

Insurance companies are, at their core, for profit organisations. Imagine a not for profit system where every dollar went directly to healthcare instead of financing a multi-billion-dollar insurance industry. What might that look like?
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CooCooforCoCoPuffs said:
The US once had space enough, too! šŸ˜­

To the best of my knowledge, a legal refugee status program exists in all nations where refugees seek asylum.
Illegal immigration is not the same as refugee status.

Asylum is granted in the US for persons who are persecuted.
Everyone else has to ask permission and stand in line.
To come illegally to the US is to take the place of and use the resources persons of those seeking asylum.
This cruel and unjust to those who are worse off than you.
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Please do some homework on refugee/asylum seekers
 
CooCooforCoCoPuffs said:
the Patient Protection and Affordable Care Act (PPACA). This happened in 2010
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True, but I was talking about before that. Kaiser is the most standout example of an insurance-operated medical consortium. It's standardized care and investment model really started taking off big time in the late 90s. By then, a couple other major insurance companies had already adopted that model and, by 2009, were making money hand-over-fist. Other insurance companies started implementing a lot of the same business policies and called themselves "networks" or "groups"....

Well, in short, I was talking about a totally separate issue. Two issues, actually: the degradation of medical standards of care (in the US), and the loss of revenue from hospitals, surgical centers, and specialized treatment centers that used to fund medical research and innovation. With few exceptions, that revenue goes to the insurance companies now.


Speaking from personal experience, the best place to get better treatment for less, where you can be confident profits are absolutely funding research and innovations, is clinics and hospitals owned by medical universities. And medical universities receive $$millions in donations every year that is used specifically to assist patients who are struggling financially, just as the 2 or 3 remaining mercy hospitals do.
 
CooCooforCoCoPuffs said:
Ah, corruption then. That is a no-no.

How did "brothel workers" get into this mix?
Is there something I don't know about your dear IM? :ROFLMAO: šŸ˜
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Nothing to do with the IM.

Brothels workers often come into the country on student visas.
They often don't know that they will end up in the sex trade.
Their sponsors confiscate their passports and keep them in near slave like conditions.

But, as they say, that is another story altogether.
 
Trade said:
The Medicare part B Premium will be $185 per month per person in 2025. So for my wife and I that's $370 a month. Then there's the $430 a month per person that I pay Blue Cross Blue Shield to cover what Medicare doesn't pay, plus provide us with prescription drig coverage. So that's $860 a month plus $370 = $1230 a month that we pay for our coverage. That's $14,760 a year for the two of us. Then there's the cost of Medicare per person that the government subsidizes. In 2023 that cost worked out to an average of $15,727 per person per year.

That comes to $31,454 for the two of us. So overall the bloated ticks in the Health Care Industrial complex get a grand total of $46,214 to cover both of us. Now for that I gotta say that we get pretty decent coverage although we still have some co-pays and deductables but nothing that I havn't been able to manage so far. But seriously this is a colossal rip off. And the entire Health Care Insdustrial Complex, Doctors, Hospitals, Medical Supply companies, Pharmaceutical Companies, Health Insurance Companies, etc. etc. are all in on this feeding frenzy.
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So in one year, you are paying out an amount of money that could buy you a brand new economy car ? Thats insane. JIM.
 
jimintoronto said:
So in one year, you are paying out an amount of money that could buy you a brand new economy car ? Thats insane. JIM.
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I'm not going back through all these comments to see if someone already explained it, so I'll as you, Jim...how is Canada's healthcare system funded?

To your comment above; When I was a medical reviewer for Blue Shield (major US medical insurance company), I had denied a request to cover a child's upcoming tonsillectomy. Based on how the pediatrician coded the 5yr-old's medical history, the surgery was not medically necessary. A few days later, I got a call from the child's mother. She was livid, and demanded an explanation. I summarized my review but she was not having it.

I'll never forget that call. She was a young, single, hard-working mother of 4 children, and was paying $625/mo for a family policy....over twice what she paid for rent. She was angry, then she was emotional, and then she started crying, and I felt really sad for her. Her oldest child was 6, her youngest was 2, she'd been through a contentious divorce, and she'd taken a second job because the ex wasn't paying his court-ordered child-support. The poor girl was so stressed, and she sounded exhausted.

I actually choked-up when she said that every time she paid Blue Shield, she envisioned $625 worth of groceries her kids wouldn't get to eat. That was tough to listen to. My denial was the correct one, but the cost of her policy was one of the highest I'd ever seen. I suspect our sales rep talked her into some unnecessary add-ons.
 
Murrmurr said:
I'm not going back through all these comments to see if someone already explained it, so I'll as you, Jim...how is Canada's healthcare system funded?

To your comment above; When I was a medical reviewer for Blue Shield (major US medical insurance company), I had denied a request to cover a child's upcoming tonsillectomy. Based on how the pediatrician coded the 5yr-old's medical history, the surgery was not medically necessary. A few days later, I got a call from the child's mother. She was livid, and demanded an explanation. I summarized my review but she was not having it.

I'll never forget that call. She was a young, single, hard-working mother of 4 children, and was paying $625/mo for a family policy....over twice what she paid for rent. She was angry, then she was emotional, and then she started crying, and I felt really sad for her. Her oldest child was 6, her youngest was 2, she'd been through a contentious divorce, and she'd taken a second job because the ex wasn't paying his court-ordered child-support. The poor girl was so stressed, and she sounded exhausted.

I actually choked-up when she said that every time she paid Blue Shield, she envisioned $625 worth of groceries her kids wouldn't get to eat. That was tough to listen to. My denial was the correct one, but the cost of her policy was one of the highest I'd ever seen. I suspect our sales rep talked her into some unnecessary add-ons.
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Instead of turning this case into emotional memories you could have explained to her why you denied her claim.
 
Murrmurr said:
I'm not going back through all these comments to see if someone already explained it, so I'll as you, Jim...how is Canada's healthcare system funded?

To your comment above; When I was a medical reviewer for Blue Shield (major US medical insurance company), I had denied a request to cover a child's upcoming tonsillectomy. Based on how the pediatrician coded the 5yr-old's medical history, the surgery was not medically necessary. A few days later, I got a call from the child's mother. She was livid, and demanded an explanation. I summarized my review but she was not having it.

I'll never forget that call. She was a young, single, hard-working mother of 4 children, and was paying $625/mo for a family policy....over twice what she paid for rent. She was angry, then she was emotional, and then she started crying, and I felt really sad for her. Her oldest child was 6, her youngest was 2, she'd been through a contentious divorce, and she'd taken a second job because the ex wasn't paying his court-ordered child-support. The poor girl was so stressed, and she sounded exhausted.

I actually choked-up when she said that every time she paid Blue Shield, she envisioned $625 worth of groceries her kids wouldn't get to eat. That was tough to listen to. My denial was the correct one, but the cost of her policy was one of the highest I'd ever seen. I suspect our sales rep talked her into some unnecessary add-ons.
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Canada( as a country ) doesn't have a "health care system" because the Provinces and Territories EACH manage their own programs. The Federal Government sets guidelines that the Provinces have to meet. The system is funded through income taxes, and sales taxes on some consumer bought items.

Each Provincial Medical Association has a contract with the Provincial Ministry of Health, that sets out the payment schedule for each type of medical treatment or procedure. Doctors bill the Provincial Ministry of Health monthly by electronic means, for all of the services performed in the month. The Ministry checks the billing, and if found to be correct, the Doctor receives payment by electronic means, in 60 days. Most Canadian Doctors have one secretary who manages their office business because they do not have to deal with any private medical insurance companies.

Yesterday, I went to the Princess Margaret Cancer Center in Toronto to have some blood drawn. I showed the receptionist my Ontario Health Card, she scanned it through her computer, then she gave me a number and said " Have a seat over there " In 12 minutes, my number was called, and I walked into the blood room, where there were 14 technician stations. All 14 were manned and operating. I was in and out in 15 minutes. Simple and straight forward. Princess Margaret is ranked as one of the top five cancer treatment hospitals in the world. JIM.
 
jimintoronto said:
Canada( as a country ) doesn't have a "health care system" because the Provinces and Territories EACH manage their own programs. The Federal Government sets guidelines that the Provinces have to meet. The system is funded through income taxes, and sales taxes on some consumer bought items.

Each Provincial Medical Association has a contract with the Provincial Ministry of Health, that sets out the payment schedule for each type of medical treatment or procedure. Doctors bill the Provincial Ministry of Health monthly by electronic means, for all of the services performed in the month. The Ministry checks the billing, and if found to be correct, the Doctor receives payment by electronic means, in 60 days. Most Canadian Doctors have one secretary who manages their office business because they do not have to deal with any private medical insurance companies.

Yesterday, I went to the Princess Margaret Cancer Center in Toronto to have some blood drawn. I showed the receptionist my Ontario Health Card, she scanned it through her computer, then she gave me a number and said " Have a seat over there " In 12 minutes, my number was called, and I walked into the blood room, where there were 14 technician stations. All 14 were manned and operating. I was in and out in 15 minutes. Simple and straight forward. Princess Margaret is ranked as one of the top five cancer treatment hospitals in the world. JIM.
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Thanks, Jim.

That's similar to how US state & counties work. Every state is divided into multiple counties, and every county has at least one social services office (AKA Human Resources) where people who cannot afford private health insurance can apply for a national healthcare program called Medicaid. It is jointly funded by the federal gov't and the state gov't. Each state combines the federal funds with its own personal and corporate state income taxes, sales taxes, and a special tax paid by healthcare providers, and distributes it to its various counties according to each county's population and demographics.

In Calif, the program is called Medi-Cal. I'm not sure why it has a distinctive name; possibly because some of the funding comes from a distinctive source.
 
jimintoronto said:
Canada( as a country ) doesn't have a "health care system" because the Provinces and Territories EACH manage their own programs. The Federal Government sets guidelines that the Provinces have to meet. The system is funded through income taxes, and sales taxes on some consumer bought items.
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That's interesting.

Here in Australia, Medicare is a federal thing and one has a Medicare card that is the same throughout the country.

Individual states do sometimes have some state specific programs - like additional vaccines on top of the national immunisation program and states health manage some things like notification programs for notifiable diseases - but the overall health care (Medicare) and prescription benifits scheme (PBS) is nation wide.
 
January said:
That's interesting.

Here in Australia, Medicare is a federal thing and one has a Medicare card that is the same throughout the country.

Individual states do sometimes have some state specific programs - like additional vaccines on top of the national immunisation program and states health manage some things like notification programs for notifiable diseases - but the overall health care (Medicare) and prescription benifits scheme (PBS) is nation wide.
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Canada has some very wealthy Provinces like Ontario , Quebec, and Alberta, but we also have some Provinces that have small populations, with a lot fewer natural resources. Prince Edward Island is our smallest Province, both in physical size, but also in population, with only 135,000 people in the whole Province. The far northern Territory of Nunavut only has 35,000 population, as does the Yukon Territory. The Federal Government takes money from the wealthy Provinces, and gives it to the poorer ones, termed as "equalization payments ". JIMB.
 
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