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Split off discussion of differences in healthcare systems

Discussion in 'Non-Diving Related Stuff' started by RayfromTX, Mar 2, 2019.

  1. RayfromTX

    RayfromTX Student Of Gas Mixology Staff Member ScubaBoard Sponsor

    # of Dives: 200 - 499
    Location: Hill Country of Central TX
    This is a split from a thread entitled,
    Safest locales for diving around the world?

    The sidebar discussion about healthcare systems has been moved here.
    markmud likes this.
  2. Gareth J

    Gareth J Manta Ray

    # of Dives: 1,000 - 2,499
    Location: UK
    Your kidding aren't you?

    Diving in the UK I don't need insurance.
    Despite all the scare stories the NHS is great from that point of view. It operates 365 days of the year 24 hours a day. Free medical care. Fully manned recompression chambers across the UK, operated by the NHS (365 days/24hours). And a free helicopter ride if needed. World class lifeboat/rescue service (which is actually manned by volunteers - RNLI).

    Last year some friends of mine were airlifted off the boat deck from a dive off Malin Head (Irish Republic), after an 80m+ dive, and flown to Portadown Hyperbaric unit in Northern Ireland (UK). This was done as a precaution. The biggest problem they had was someone had to drive the 150 miles each way to pick them up. Zero charge for the service.

    I have DAN dive insurance, worldwide cover EXCEPT the USA. There's an additional surcharge if you want cover for the USA. The USA is considered high risk by DAN.

    To answer the original question, Iceland. Thats pretty safe. Low crime rate, no critters to eat you. LGBT friendly. It's just damned expensive. I do believe that there are low coast flights from the East Coast.
    The UK has world class diving, historic wreck sites and scenic diving. With the exception of the midges (in Scotland) the wild life doesn't eat you!
    We are also a pretty friendly lot as a general rule.
  3. markmud

    markmud Self Reliant Diver--On All Dives. ScubaBoard Supporter

    # of Dives: 200 - 499
    Location: South Lebanon, Ohio
    Hi Gareth,

    You wrote: "Free medical care."

    I was in Costa Rica several years ago. Super country and really nice people. A tour group leader was asked about healthcare. He laughed and said that their healthcare is described as "free". Then he explained that all income is taxed 10% right off the top to cover their "Free" health care (as I recall, it was 10%; maybe it is less).

    He then ended with: It isn't free!

    One way or the other, we all pay for our own health care.

  4. Gareth J

    Gareth J Manta Ray

    # of Dives: 1,000 - 2,499
    Location: UK
    You are correct.

    The NHS provides free health care at the point of use.
    Actual funding is centrally funded via taxation

    As such, rather like Policing, Fire Service, the Military and other essentials provided by Government (or local Government), you are not conscious of actually paying for it. Health care is considered as important as defence in the UK, as such it is seen as a duty of government to ensure that it is available for all citizens.

    There are loads of articles on the internet if you actually want to see how the NHS works its strengths and weaknesses.
  5. TMHeimer

    TMHeimer Divemaster

    # of Dives: 500 - 999
    Location: Dartmouth,NS,Canada(Eastern Passage-Atlantic)
    Gareth J, I know we are straying, but what does the healthcare system NOT cover in the UK? Here in Canada it is technically run by each Province/Territory, though is in effect National because of reciprocal agreements. But, provinces differ on the percentage of prescription drugs that is covered, and I don't think drugs are anywhere near close to free in any province/territory (and of course OTC drugs as well). Also not covered is vision and dental. For those, you either have to be covered by your plan at work, or privately (ie. Blue Cross)--the premiums aren't cheap. As well, we were advised to get Blue Cross for prescription coverage should Cancer occur to the tune of $40K a year. Sound a bit like the USA? I believe everything you get done in a hospital or doctor's office is completely covered by the government (taxes, of course), and that's a lot (like a $100K heart operation). But that is where coverage ends. Are not poor vision or an abssessed tooth serious medical problems? So, what about the UK, Scandinavia, other "socialist medical" countries? What is NOT covered?
    As far as Canadian taxes vs. US taxes, I think the consensus is that we pay a fair bit more in Canada, but there are exceptions depending on each individual's situation.

    Our Blue Cross "out of Canada" coverage is free for 30 days, after which it is very expensive.
    If you are out of Canada for more than 180 days you lose all government coverage for that year -- I believe.
    chillyinCanada likes this.
  6. RayfromTX

    RayfromTX Student Of Gas Mixology Staff Member ScubaBoard Sponsor

    # of Dives: 200 - 499
    Location: Hill Country of Central TX
    This is a split from a thread entitled,
    Safest locales for diving around the world?

    The sidebar discussion about healthcare systems has been moved here.
  7. Storker

    Storker Divemaster

    # of Dives: 100 - 199
    Location: close to a Hell which occasionally freezes over
    Scandinavian checking in.

    If I'm admitted to a hospital - like when I had my appendix taken out - I pay zero. AFAIK I'd pay exactly the same if I needed a helicopter ride and a chamber ride.
    For outpatient treatments, like a fracture, they charge a co-pay of some 2-300kr, or some 25-35 USD per visit.
    Life-critical medications like insulin, BP meds or cancer meds are heavily subsidized; I pay some 200kr for a three months' supply of my BP meds at the pharmacy, and meds issued during hospital visits (say, chemotherapy) are no cost.
    GP visit: co-pay of some 2-300kr.
    There's a cap on total co-pay in one year, I believe it's some 2500kr or around 300 USD. If my co-pays exceed that, I'm getting a refund.
    Dentist: not covered for adults, covered for minors
    Optician: not covered

    And it's financed through my taxes, which, last time I checked were in the low 30s percent of my gross income. That's income tax, property tax etc., but of course not sales tax or special taxes on alcohol, tobacco etc. And I've never taken out a health insurance, only travel insurance. If i travel outside the EEA, l need health coverage in my travel insurance. Inside the EEA I'm covered by mutual agreement, but I should carry a European health coverage card.
    RayfromTX likes this.
  8. chillyinCanada

    chillyinCanada Solo Diver Staff Member

    As far as I know, Alberta healthcare covers one optician appointment every 2 years, but won't buy my glasses. Alberta Blue Cross will cover $200 towards glasses every 2 years (I think). My appointments with Opthamologist are covered by Alberta Healthcare, though some if his tests and treatments are not. Pretty sure the cataract surgery is covered by Alberta Healthcare but only as to a certain replacement lens. My friends have ponied up the difference for better lenses. I will too, though I'm considering going to another country for the whole shooting match because while Alberta Healthcare will cover it, there's apparently a limit on how many get done per year. Mine, apparently, aren't deemed serious enough to get me moved up the list faster.
    I'm a bit bummed about that but one of the side effects of having cataracts in my case, is that I can see the tiniest things whereas prior, had to have reading glasses (now have trouble with distance and low light). Advantage? Seeing the teenie stuff whilst diving is awesome!!
    Dentistry is partially covered by my Blue Cross plan. Again, I'm considering getting certain dentistry items done in Mexico or Thailand.
    lv2dive likes this.
  9. KenGordon

    KenGordon Rebreather Pilot

    Dentistry and opticians are not covered for most working age adults. There is a tax on drugs of about £10 per prescription, but not in Scotland.

    If I were to get properly bent on a boat in the channel I would be picked up by a helicopter (if appropriate), flown to a chamber, treated (and fed) for free. If I needed treatment so as to learn to walk again etc that would happen for free.

    If I suffered from a nasty rash (not DCS) and got doctor prescribed a tube of creme costing £3 in Boots I would still have to pay £10 for it. If they prescribed some super expensive course of drugs at say £100k/year I would pay £10 each time I went to collect them, so maybe £120 or £40 depending.

    People do have health insurance, almost exclusively provided as an employment benefit. The premium is a taxable benefit and seems to be about £1800/year. I guess working people are a good bet.

    There is a parasitic relationship between the private health industry and the NHS. The NHS trains (or imports) doctors, nurses and specialists of all sorts, many end up working for private providers. If you see a consultant paid for by an insurance company it is almost certain he actually works in a local NHS hospital. I was sent by such a consultant to see a physio who then worked for a sports injury specialist but had trained and been employed by the NHS.

    There are private hospitals. There is a smallish one local to me and I took my son there recently when he had possibly broken his wrist. It cost about £250 for a visit and saved a lot of driving about/taking the bus and waiting at the proper hospital. Although apparently a cost, I was ahead on the deal vs losing half a day of work.

    For 40 years though the political direction of the U.K. has been to (pretend to) reduce taxes. The basic rate of income tax was 33% when I started working, higher rate was 60%. Now it 20% and 40%. The 2007/8 financial crash caused a huge drop in tax take in the U.K. and so a big increase in the deficit. The election of a government that is ideologically inclined to low taxes has meant that there is an unprecedented squeeze on government budgets.

    The move to spending money with mega corporations who are not paying any UK tax is also a problem.

    The NHS budget is under serious pressure and the component organisations are are risk of going bust. Thus the NHS is becoming less effective.

    I believe though, that the cost, to the government, per head of population of healthcare in the U.K. is actually lower than that cost in the USA.
  10. Gareth J

    Gareth J Manta Ray

    # of Dives: 1,000 - 2,499
    Location: UK
    TM Heimer

    I am going to get myself in all sorts of trouble here over accuracy. (I am happy to be corrected if I make an error!)

    Medical Care
    This is free at point of use (its paid for through taxation).

    Medical care includes Emergency Care, and access to your GP.
    There is a fixed prescription fee for each drug you have. However, there is a ceiling, if you are using a lot of drugs for a serious illness, of illnesses like diabetes, you pay a fixed fee.
    Dental care is subsidised,
    Optical care, the checkup is free, but glasses (and contact lenses) you pay for.

    Emergency care is excellent, but during busy periods (Pub closing on a Saturday night?), they run a triage / first come system.
    Serious illness. Treatment for cancer and other serious illnesses is free and very good.
    There is a waiting list, especially for less serious issues and cosmetic treatments.

    There is criticism of the NHS, waiting lists, delays in treatment, some treatments not available. Some drugs that are not available from the NHS due to cost. But as systems go its pretty good.

    Currently we have the same EEA arrangement in the EEC that Storker has. However, we are leaving, so that will probably go. The EU appears to want to cut its nose off to spite its face, so although the UK is happy to keep the EEA arrangement, I assume the EU will cancel it.

    I have DAN for diving medical cover out of the UK (even the EU). Its a minimal cost and means I'm covered, for airlift, medical and repatriation. That is with the exception of the USA - DAN want extra for the USA. (Similarly, my company has specialist medical insurance for employees working out of the UK - which we pay a huge addition premium for because we work in the USA ;( ).

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