I just caught another of Suze’s prompts. She asks:
Should those who live an unhealthy lifestyle have decreased access to healthcare?
It doesn’t seem right that poor lifestyle equates to decreased access, though I can certainly see how some insurance-based systems might say that poor lifestyle means you can still access the same level of healthcare, but you might pay more for it. It’s insurance, after all. They are actuaries who will calculate risk, and presumably if you’re unhealthy, the risk is that much higher.
It’s a bit different here in the UK. We pay a tax called National Insurance. It works like income tax; it’s compulsory and is usually deducted before you even see it. It was introduced exactly as an insurance policy. When something bad happens, we’ve got you covered. By “bad” I mean it is supposed to provide a safety net, and covers things like healthcare and state pension.
It’s a sliding scale, based on someone’s income. So a high earner will pay more. But regardless, once you’ve paid, you’re covered. Basically the theory is that it is universal.
In practise, the level of care we receive varies a lot. In some cases, it can be as dumb as where you live, but there are also circumstances where the NHS says you can receive treatment if you’re X, but not if you’re Y. The result of that is that Y has to pay if they want the treatment, and you can imagine, in some cases that might be prohibitive.
Incidentally, there was a big poll out just yesterday which said that only 24% of people are happy with how our NHS is delivering. That could be for any reason, not just the one I mentioned. A significantly higher number (I think it was high 70s) are on board with the idea that we pay for universal healthcare out of tax, but far fewer are happy with how that is currently delivered. I just mention that in case you have the impression that we Brits love our NHS. We love the idea of it, but we’re extremely dissatisfied with the service as it stands.
Mister Bump 
In the States we are growing dissatisfied with a failing system of private insurance plans, for profit hospitals and such. The problems are more than a bit different than what you describe. But one underlying problem is shared – the inability of large juggernaut systems to rectify problems short of critical failure. We can develop large systems to address major ssocietal issues, but wwe can’t seem to correct them when they start failing, and it’s not only healthcare.
LikeLiked by 2 people
I think that there are many people who have a vested interest in keeping things as they are.
For example, do you knoe the goings-on at our Post Office? Just last night, it was recealed that they knew about problems with their system, but still continued to prosecute people. This was tape recordings of PO bigwigs discussing the actual issues, it felt like real cevidenve-quality stuff I was hearing.
LikeLike
thanks for responding to my prompt. I don’t have an answer to the problems within the healthcare system, either here in the US or in GB…..I just overheard a twit at an outpatient clinic and his words had me thinking about the systems.
LikeLiked by 2 people
all these systems are fine until you actually have to use them.
LikeLiked by 2 people
Interesting. Always fooled myself that the Brit (and Canadian) systems were far advanced over both private healthcare and Medicare/Medicaid in the US. I’m suspecting that even here delivered healthcare would be vastly improved if both government and private “insurers” were taken out of the picture. That doesn’t leave much alternative does it? Ideally (only a start and dream on!) insurers’ money-grubbing hands would be held to the fire (non-profits?) and government oversight (lay twits making medical decisions) put to work at McDonalds. Then there’s the whole device and drug medical machine gleefully feasting on misery.
I do get and allow provision for NOT providing (or wait listing and additional cost for) certain services to people who abuse themselves and expect medical gods to fix’m up on par with people who try to manage the most imporatnt part of healthcare – lifestyle.
It’s a butt-nuster. You figger it out, I reckon you deserve a Nobel prize in medicine, economics, and humanitarianism all at once.
LikeLiked by 2 people
Yep. My first job, we had a big contract, where the client allowed us to cover costs, then to make a few percent profit. If only everything was so controlled, but there are so many people who spot an opportunity to line their pockets.
There were lots of insurance companies up where I used to work. Their offices were gold-plated! That money comes from somewhere…
LikeLiked by 1 person
Also in Italy, regardless of the amount paid, you are covered. Unfortunately, the tax is deducted directly by the State only from employees and pensioners. It is up to the honesty of everyone else to correctly declare how much they earn. but no one does
Therefore, it is the employees and pensioners who bear the medical expenses even of those who cheat and do not pay. This is why our public health is falling into disrepair
LikeLiked by 1 person
I believe persioners are exempt here, but I’m not sure. I think there’s both lower and upper thresholds. That’s why, rather than cutting Income Tax (which benefits everybody) our government has twice tecently cut National Insurance. It’s cheaper for them. The good news, even though our tax burden is the highest it has ever been, it has not done them any favours, because people realise that cuts to NI equals cuts to services.
LikeLiked by 1 person
👍
Thank you very much for your valued reply🙏
LikeLiked by 1 person
What kind of universal care the NHS provides? Normal illness, chronic diseases, and fatal accidents. Things like that or it is all of those things but with a cap on the expenditure that must be incurred in the treatment.
LikeLiked by 1 person
It is variable. Some people affirm that it is good, but I’ve never found it so. For example I once had a broken collarbone and was told to go home and take paracetamol.
We do need to have a sensible discussion about what the NHS will/won’t do, because that’s unclear. An example is social care. The need is becomming greater than ever.
LikeLiked by 1 person
I don’t think you listened to them and went home. Because to turn back a patient with a broken bone seems devilish.
LikeLiked by 1 person
only, really, if your interest is to provide care.
But if your interest is to get rid of people as quickly and as cheaply as possible…
LikeLiked by 1 person
Our health care system in Ireland is much the same, it has gone to the dogs in recent years, basically thehospitals are very overcrowded, leaving people waiting for u to 18 or 20 hours in A and E before they are seen and even longer than that to get a bed if they are being admitted. X
LikeLiked by 1 person
Yeah it sounds similar.
LikeLike
Unfortunately, delivering health care to millions of people is a daunting and very expensive task. While we now have many amazing life-saving procedures, treatments and drugs that can extend peoples’ lives for many years longer than was possible even a generation ago, all that comes at a very steep price. Who decides whether it’s worth the cost, and/or who will qualify for said treatments? I suppose societies the world over will continue to struggle with these perplexing, sometimes polarizing issues, but the one certainty is that delivering quality health care to everyone will continue to be expensive.
LikeLiked by 1 person
Yeah I think it’s fair enough to have a conversation: we will or won’t cover X, but I think the conversation must be transparent, I suspect that there’s more likelihood of that happening in your system than in ours.
LikeLiked by 1 person