Having spent the weekend in the company of a couple of Americans, both seemed to think the NHS=communism. Which was worrying.
And there was me thinking that it was just the reds that did brainwashing!
The idea of taxing internet traffic has got the twitterverse into a tizzy. Apparently socialists monsters want pay for their carriage, and the UN has cooked up a secret plan to get the money. Having failed to find evidence that blue-helmeted geeks are poised to invade cyberspace, the US internet community is now up in arms …
Having spent the weekend in the company of a couple of Americans, both seemed to think the NHS=communism. Which was worrying.
And there was me thinking that it was just the reds that did brainwashing!
That is worrying, I myself up until the other week posted on a Tech site that was mostly US user based and on a Discussion about healthcare costs the NHS got dragged into it... let's just say I asked for ym account to be deleted when this got posted -
"Why should I pay for some fat *****'s heath care when her and her little ********* sit's on her ass eating cake all day", the second word I stared out was rhymes with Piglets only with the P replaced with a N.
While I would normally wave off that one comment as a racist, arrogant and above all idiotic statement from one user but when 20 of them all joined in agreeing with it and one or two disagreeing I left, and fast.
I think we can blame McCarthy for this mess, that man did more ongoing damage to the US than any one else I can think of.
I don't know why the Americans defend their system so much. They pay over the odds for medical insurance (they have the highest medical costs in the world), their treatment is in the hands of insurance companies who will do all they can not to pay out, hospitals will refuse to take you in if you don't have the right cover and will sling you out as soon as the insurance runs out regardless of your physical state.
And where does spending all that money on health care get them? World class services, longer life spans, better quality of care? Not at all. They are rated 37th in the world by the WHO and they are supposed to be one of the most advanced developed nations on the planet. How pathetic
One nation, driven by greed, powered by selfishness with an ego larger than their collective arses and crumbling from within yet they think the world should look to them as a model of how a country should be.
Just a couple of minor suggestions for your comment:
As a percentage of salary I pay no more for the best health insurance here in the states than you do for NI.
No hospital is allowed to discharge patients - no matter their financial condition - if doing so would endanger their life.
No major population area is without a hospital designated as caring for the indigent.
Under the recent health care legislation, no insurance company is allowed to terminate coverage because of previous health history or refuse it because of pre-existing conditions.
Apart from that your comment was................ well, rubbish really.
From what I see you have vastly over-estimated how much NI we pay. The cheapest I can find any cover in the US is in California at $205 per month (subsidised by your employer) and that comes with clauses about you having to pay the 1st x amount of your treatment and doesn't cover dental. Admittedly I haven't done a full search, but looking quickly I can't see anything anything like as low as NI, you are looking at about $1000 per month for a family of 4 and I pay about £100 a month NI and don't need to worry about cover for my family. We have looked at going private and even here with the NHS as competition we are looking at a cost 3 or 4 times higher than that for the whole family for decent cover so it's not going to happen.
No hospital is allowed to discharge patient if (and that's a big IF, there are ways insurance companies and accountants can legally kick people out even if they will die) doing so would endanger their life. But what they can do is diagnose a problem that if left untreated will become life threatening but without insurance off they go. Medicaid will only kick in once the condition does become life threatening costing you as a tax payer far more to deal with it than if the hospital had just treated the original condition.
Ahh yes, the last refuge of the die-hard republican - look we provide mercy hospitals for those without insurance. Again look how much extra it is costing treating people with critical illness than if they had just been treated in the 1st place.
As for the insurance, no they can't terminate coverage based on previous history or refuse it because of a pre-existing condition but what they can do is refuse to cover that condition and you are only covered if something unrelated to your condition happens and if the insurers can find any way to link the new problem to the old then they will and you are no longer covered. They can also base your premium based on those conditions and give you stupidly high quotes for the insurance. They haven't refused to cover you, you just can't afford what they are asking.
Apart from that your comment was................ well, rubbish really. Americans have just been brainwashed into believing they are well cared for.
Let’s go through *your* comments one by one:
“As a percentage of salary I pay no more for the best health insurance here in the states than you do for NI.”
Possibly, but note that if you pay personal Vs. via your company, you will pay a higher rates – madness of tax codes.
Next, you may not, but somebody does – the US spends 16% of its GDP on health care, Vs. 8% by countries with higher life expectancy. And you might get better care, but a large number for a highly developed country don’t.
“No hospital is allowed to discharge patients - no matter their financial condition - if doing so would endanger their life.”
And yet, they do:
Now, *you* may not regard the homeless as “patients” and therefore skate on your statement, but others know better.
“No major population area is without a hospital designated as caring for the indigent.”
And yet the Catholic Church in the US is considering not treating non-Catholics because they have to allow their (non-religious) employees birth control choices. And that is just that issue - don't pretend it doesn't occur for the poor.
“Under the recent health care legislation, no insurance company is allowed to terminate coverage because of previous health history or refuse it because of pre-existing conditions.”
Unless a minor pre-existing condition was not disclosed, in which case insurance coverage is terminated, even if the condition does not relate to the current health issue.
And yes, they cannot refuse to grant you insurance for a pre-existing condition – you just have to be able to afford the cost of such. Good luck with that, because:
“Harvard researchers say 62% of all personal bankruptcies in the U.S. in 2007 were caused by health problems—and 78% of those filers had insurance”
Why folks believe that there is no problem because they themselves don’t have a problem is beyond me. They certainly like it when other folks put their lives on their line when they are in danger.
"Apart from that your comment was................ well, rubbish really."
Yes, yes your comment was.
No hospital is allowed to discharge patients - no matter their financial condition - if doing so would endanger their life...
While that's true for emergency care, it doesn't do much for people with life-threatening chronic conditions. A friend of mine who has insulin-dependent diabetes and some mental health issues is facing losing his medical disability benefits, and I honestly don't know what he's going to do. Even if he somehow scrapes together the money for the insulin, the last time he was off his psych meds he tried to kill himself twice.
Ironically, what disqualified him for disability was finding a full-time job, which he worked for three months before illness forced him to quit again (He has some other long-term medical problems that cause him extreme fatigue due to lack of vitamin absorbtion...which could be helped by injections, which he can't afford.)
Well, it doesn't matter how much we pay or don't pay. I'm an American, and I can say from first hand experience that American doctors are total retards who couldn't find their ass with both hands and a copy of Grey's Anatomy.
Look at the "Empowered Patient" column on CNN for examples of idiocy. I've personally had a doctor tell me I had a knee fracture and ankle fracture, when I really had a collarbone fracture. I've had a doctor refuse to give me a vasectomy based on his religious beliefs. I had a doctor diagnose me with strep throat when I really had scarlet fever. I had a doctor tell a friend "oh that red line up your leg from that cut is nothing to worry about" and the guy was fighting for his life from a blood infection 2 days later.
Clueless doctors are not unique to States, this happens quite often in this side of the pond as well (search UK newspapers for yourself, it makes for sad reading).
My point is that NHS (UK system) and private insurance (American system) are likely to give similar level of care, and the dominating factors may not be directly linked to type of insurance. Instead, this might be linked to incentivization of health care professionals. More specifically, high levels of pay seem to have negative effect on motivation, thus leading to incompetence (just like bankers pay).
You can read more about it and find relevant works here http://whywereason.com/2011/09/01/how-misguided-incentives-negatively-affect-productivity-and-well-being/ or search for Behavioral Economics Incentives
From what I can see, the American system does seem to have some serious flaws, but I'm not all that keen on the NHS here in the UK, either TBH. The idea is basically OK, but yes, there is an element of communism to it and the supposed "costs to the taxpayer" give the state too many excuses to interfere in personal lifestyle choices.
On top of that, standards of service in the NHS are often third-rate, which isn't all that surprising given that anything run by the government has this problem. If you want better care, you have to go 100% private. There's no way of "topping up" the basic NHS provision. The resulting step-change in costs is basically an ideological defence against the NHS being incrementally eroded by private suppliers who could potentially provide a better service.
But there are lots of health services in the world, and some of them look pretty good to me. I just wish we in the UK could eradicate that "not invented here" attitude and look around us a bit. The NHS is past its sell-by date IMHO, but that's not to say it can't be revived if we adopt a more open mind.
Third Rate Care
Pick one and only one. Virtually no one who uses the NHS's services comes away dissatisfied. In 1997, only about 34% of the general public were satisfied with the NHS. Shortly before Lansley started dismantling the service, back in march 2011, that figure was 64%. Amongst actual service users, people who have utilised the NHS in the preceding 12 months, it is unusual for that figure to be below 95%. The NHS is the most efficient and accessible healthcare system in the world.
Leave your weasel words about the NHS "sometimes being crap" at the door, ta.
Its funny, health care does equal socialism to yanks, but police and armies don't. So, it the merkin government want to help you, its evil, it it wants to arrest or kill you, its fine and all American.
"Virtually no one who uses the NHS's services comes away dissatisfied."
Technically correct. But if you die, you don't come away at all.
""As a percentage of salary I pay no more for the best health insurance here in the states than you do for NI.""
Rubbish also, your employer also pays, and often more than the employee.
""No hospital is allowed to discharge patients - no matter their financial condition - if doing so would endanger their life.""
True, but in a narrow sense, indigents get few transplants or new hip/knee joints
""No major population area is without a hospital designated as caring for the indigent."", also true, but if you look at the death rate of these near-bankrupt hospitals you wonder if they are hospitals or hospices.
""Under the recent health care legislation, no insurance company is allowed to terminate coverage because of previous health history or refuse it because of pre-existing conditions.""
AHH, welcome to the death of 1000 cuts, as you try to find a number wherein payment follows in the
huge book of treatment codes.
You speak like a former UK resident??
That said, the USA pays a huge cost for their BAD HEALTH CARE SYSTEM. True, they also have the best of treatments, but only for the rich or covered. Those not covered die 8-10 years earlier than the rich and covered. The rich and covered live as long as Canadians, but not as long as Japanese. Those not covered drag the entire USA age at death stats far down.
As another said, the insurance companies, lawyers, and doctors waste about 40-50% of the US health $$. Eliminate that wasted $$ = a solution.
I am in Canada, and the system works, elective procedures are last in line, critical work is at the front of the line. That said, the Canadian system is riddled with union feather beds - sweepers at $28/hour plus $12 in benefits for example.
US health care costs significantly more than in countries with Beveridge or Bismark models.
US Life expectancy is 50th in the world
US 48th in Infant mortality (174th in reverse order)
The US system wastes money, it doesn't deliver value for money. It fattens wallets. There is little incentive for preventative care. Many people are not covered. Many people cannot afford treatment they need. I wish it were better but frankly it is overpriced and under delivers unless you happen to be making a fortune selling drugs etc.
As regards socialism. What is an army but socialised protection? Which country has the biggest expenditure on armed forces? Doesn't that make the USA the most socialist country? The same could be said for police forces, fire fighters? Perhaps a little less salad and school dodging would improve peoples health and ability to discuss things rationally. Then again, who ever let facts get in the way of politics!
“Rubbish also, your employer also pays, and often more than the employee.”
You are obviously not self-employed, or haven’t had COBRA run out. And check your US tax codes – an old law allows companies to use tax-free dollars to pay for insurance, while if you pay personally it is taxable. One reason it is a mess.
Australian here, living in the US.
As one of my ex-co-workers discovered when his COBRA ran out, then got reinsured, realizing the whole pay-for-services thing skews things:
“I never knew how expensive health care was until I had insurance”
This varies state to state. My healthcare is covered by my employer at just under $500 a month. My wifes by her employer (the same amount, same provider) and my kids out of my sad empty wallet (again the same cost per person, same provider, via work but not subsidised by work). It is probably completely different in other states and other jobs.
Should I lose my job I would pay the full amount via cobra for a few months then be left to find coverage by myself.
The system is insanely complicated, nobody knows how much anything actually costs (with the NHS it is free at the point of use, with Bismark models there tends to be a controlled cost which is easy to find, no mass of different pricing), its a mess. Education and health should be basic things we get right for the benefit of our economy and well being. We fail.
My uncle-in-law in Maryland knows how overpriced the American system is. Mind you, he's Vietnamese born, got automatic refugee status in 1975, and citizenship some time later. He's also a doctor who spent most of his life working in the FDA. In other words, he knows his shit - about the medical system and about the world outside the country. He's not a "USA! USA! Number One!" kind of bloke.
Finally - proper reactions from both sides of the pond.
Speaking as a person living in the US - I'm constantly amazed by the vicious cycle I'm in;
Go to dentist
Dentist maxes out allowance on useful and less useful stuff
At end of year insurance company sees TheRealRoland maxed out allowance
Insurance company increases premium for next year.
And this happens not only with mr. Dentist, but also with ms. Hospital, mr and mrs Glasses...
A long time ago someone on Oprah said on TV: do not buy insurance - it's not worth the money, and in case of a Life Event, you'll go bankrupt anyways...
Everybody mocked him or her (can't remember, the Mrs. keeps telling me about this)
The longer I live here, the more I feel this person was on to something... Keep the money you get, and use it for FunStuff (tm)
I strongly suspect those people who are against health care/health insurance reform have always had health insurance (paid in most part by their employer). Part of the problem is these people don't really understand how much their employer spends on health care coverage. Maybe these costs should be considered part of peoples' income and taxed as income. THEN people will start to see just how much money goes into insurance coverage and might start to think maybe the way we handle this issue isn't working.
When you're comparing Insurance vs national insurance don't forget the employer contributes considerably to both
You didn't look very hard. My coverage (subsidised by my employer) is $150, and I have what is colloquially referred to as a "Gold Plated Cadillac Plan", which means they have to cover me for a whole lot of frivolous stuff, like a sex change operation if I want one.
But on the original topic of taxing internet traffic, the main rational seems to be that some bureaucrats simply don't like the present "winners" and want to skew the playing field.
While I agree the NHS is much better than the American system, baear in mind that not *all* Americans are happy with it, and I wouldn't make any blanket statement insulting Americans.
I've spoken to plenty of online friends who would appreciate our system, and I would say that I have plenty of American friends who are far more friendly/ nice than my British ones...
You don't realise how fantastic the NHS is until you leave the UK. I only moved as far as Ireland and the quality of medical care is light years behind the NHS. It costs €50-60 every time you see your GP (no exceptions for babies and children), it costs €100 if you set foot inside an A&E, and to get maternity care to the same standard as the NHS will cost you about five grand. Yes you can get medical inurance to cover some of these costs, but since the collapse of the Celtic Tiger the quality of cover is increasingly worthless. And the icing on the cake is that my PRSI (NI) payments are pretty similar to the level I paid in the UK. On the other hand, if I'm ever unemployed I'll get a shitload more money than the UK pays. Personally I think that's entirely the wrong way around, but hey, I'm just a guest here.
As for quality of care, yes I've seen some bad examples in the NHS, but I've seen a lot more good ones.
For those arguing how much cheaper NHS is, I would point out that what you pay directly is dwarfed by what you pay in tax dollars.
You need to bear in mind, too, that the US has a substantially larger welfare state. We have generations of people who think the way to get through life is to let the government pay your way.
What works in the UK doesn't necessarily work elsewhere, and if the Americans don't want socialized medicine, that really is THEIR business. Perhaps they can just send all the people who do believe in it over to live in the UK?
Ayn Rand takes her fair share of blame here too.
The system is insanely complicated, nobody knows how much anything actually costs
That's because from the doctor to the insurance salesman they're all gaming the system.
A guy I worked with whilst in the US had to go to hospital for an op. He looked at the final bill and there were items like $60 a pop for a "Mucus Removal Device"... he never saw one, nor could he find one in his room. When he traced down the source of the item this turned out to be a box of tissues that was occasionally replaced.
Another billable item I heard about during that time was "Exercise" for what amounted to the doctor asking them to walk 20 paces.
The reason our health care costs are so high is because we aren't healthy.
I'm glad you brought up that point, some of these comments seemed a bit too insulting for my liking...
I've spoken to Americans who don't like their system, some of whom it made life difficult for, and liked the idea of free healthcare like in the UK.
But in the comments on some American sites I read, there are also a lot of people who don't like the system and support changes to it like Obamacare.
When you pick apart the logic of others, you should pay close attention to your own logic.
"iPlayer provides TV free to anyone in the UK, the cost being covered by the licence fee Brits pay annually for the right to own a TV set."
Its not free just because its included with something you already pay for it.
The people using service like Netflix that use a lot of bandwidth should be the ones paying for the bandwidth they use.
I haven't dug into the details, but the idea of the UN taking the internet sounds bad to me. China has veto powers.
Does the BBC connect to the internet for free? I'd like to hear more about that, if there is a free connection available then where do I sign up?
"The people using service like Netflix that use a lot of bandwidth should be the ones paying for the bandwidth they use."
Sure, and they do. Unless you know of somewhere offering free internet connectivity, see above.
What's the difference between me and Google? So much data to transfer, so fast. The ISPs get in betweeen, and should charge whatever it takes to carry the traffic, with a little left over for network improvements. Why is that so hard?
My eyes have always glazed over whenever someone says "well they (usually content providers) are getting blah blah blah so they should pay". If they aren't paying, then explain how because I would also rather not pay. But nobody ever explains that part, so it's hard to get to the end of a story like this witout falling asleep. But I force myself to, because anyone who thinks I'll suffer anything like global corporation A making some sort of a deal with global corporation B to have my bits turn into second class citizens can fuck right off, so I try to keep my eyes open.
It is to do with network ingress and egress. You have content producers who make traffic, websites etc, you have viewers at the other end who are basically black holes for data, and you have a varying number of links inbetween. The idea is that the producers pay their provider for the data they produce send out into the world. The networks then either peer with each other or purchase transit from other networks to get it to the user. ISP's (which may or may not be involved with the middle of the chain as backbones) then deliver it to the user. They have a lot of power as they can take data off networks and give it to users, everybody wants to love them! They generally do not pay for connectivity to backbones, however, users pay them. Basically money enters the chain from the end user to pay the isp for the 'last mile' network and from the content producers to pay the backbones to link them to the last mile.
Where all this has fallen over is marketing. ISP's have been driven to offer stupidly cheap pricing. Very few folks are willing to pay for quality and many are trapped by a lack of choice. The ISP's, rather than put up pricing, are looking to change the model to drag more money from the other end of the chain. This is bollocks, the content producers have already paid or come to arrangements to get data off their servers onto a network. If the ISP cannot sustain its arrangements, it needs to charge more and invest more.
Yes peering can become one sided (cogent was famed for this) but that is why contracts are written to drop peering should it become unfair to one party. Peering for free as opposed to buying transit is supposed to be mutually beneficial. If it isn't fire the muppet who wrote the agreement.
Rampant Spaniel : "Peering for free as opposed to buying transit is supposed to be mutually beneficial."
Valid point, but I feel you are coming at it slightly off-kilter.
Mutual peering agreements aren't free, the least you pay is to carry the other ISP's traffic, you have to pay for your internal connectivity to handle that traffic.
Just because someone else does the same with your traffic doesn't make it free. Same end point, but we got there via a non-free route.
Because the license fee is an anachronism that needs to be staked, quartered, burned and its ashes flung to the far corners of the Earth.
Though I'm sure some people will tell me "well would you rather have a tax". Myself, I don't see the difference and I'd rather have neither.
And then we can watch all the quality television produced by the commercial providers.... Oh wait
The BBC is respected worldwide for its programming which is only possible thanks to the way it is funded. Yes all the money they get might not always be spent well, but they still produce content that is far better than what most of the world have to put up with,
We should not be watching that 'commie' BBC. Instead we should all be watching 'Big Brother' 24/.7.
Well that's what the advertisers and by inference all 'Capitalists' wants.
I hope you realise that I'm joking but that is the sort of debate I had last month while I was in the US. The NHS, the BBC etc are all regarded as being Commie plots or total fabrications. One of the people taking part in the conversation was a respected politician. You can guess which party he belonged to. (GOP)
This was in a very liberal part of the US namely, San Francisco. I'd really hate to bring the subject up in a more redneck area. I'd be lucky to escape unscathed.
Except that argument isn't valid any more. The BBC produces nothing that isn't either matched or beaten by other broadcasters world-wide. In fact most of the BBC's content is produced by external production companies - it makes very little in-house, most of which is useless tat, and most of what it broadcasts is produced with an eye on foreign markets, which is why the BBC has such long idents. They're filling the time that would be taken with adverts. Even its vaunted nature documentaries and big-name dramas are produced by third-parties and aimed at the international market first and foremost.
The license fee is only used to pay over the odds for slebs and wannabe opinion-makers, and the layers and layers of managers that infest broadcasting house. It is a regressive anachronism that forces people to pay for a service they don't even use.
If Microsoft extracted a tax for every computer that was sold you would be up in arms but when another greedy, overbearing corporation with delusions of superiority does it you're just fine with it.
And why is that? Because people like you have winged for years that the way the BBC is funded is unfair and more should be done to help private companies and why does the BBC have to do everything in-house when it could be so much cheaper to outsource it to private companies.
The BBC might have to outsource a lot of production because of that but they still keep a close eye on those companies and make sure they do the job well. Without that input from the BBC we get the joys of Big Brother and The Only Way Is Essex
"We should not be watching that 'commie' BBC. Instead we should all be watching 'Big Brother' 24/.7."
I didn't know Fox News transmitted in the UK.
Or we get Stargate SG1, The Venture Brothers, Game of Thrones, Futurama, Deadwood, The Wire, Sharpe, The Sopranos, House, Farscape, Firefly... the list goes on and on and on and on. What has the BBC produced in the last decade that could match that? Dr Who. Maybe a couple of documentaries, a "world class" news service that can't even get basic facts about even close European neighbours like Norway and Sweden right and then scads of mindless shite trying to compete with ITV.
Face it, your argument is lame. Other companies produce far better television for far less cost with the added benefit that I don't have to pay for them if I don't want to watch them.
And no, people "like me" haven't been whining about the BBC doing everything in house. My argument has always been that the BBC's funding is simply immoral and has always been used to fund the lavish lifestyles of a self-selected group of wannabe-kingmakers with delusions of grandeur and a belief that they're the only ones who know how the world should be run. In-house or external production doesn't change that; the fact that it's using a government-mandated levy extracted by threat of force to fund private companies is merely the latest layer of icing on the cake.
I don't watch television. To do so would require me to pay the wages of people I am fundamentally in disagreement with and I'm not prepared to do that.
>I don't watch television
That seems rather at odds with your first sentence.
Maybe you've heard of these things called DVDs?
DVDs... or iPlayer. I watch all my tv the next day on iPlayer. So convenient :)
You know what, I live quite a distance away from the UK, and I would very gladly pay the license fee + a bit extra just to have access to BBC programming. As it is, I pay 132 EUR per year for the privilege of watching complete and utter drivel on our national TV, and - get this - I pay this not because I own a telly, but because I'm connected to the national electricity grid. No way out - you have electricity, you pay nice gentleman money for TV, or nice gentleman break knees.
erm... erm.. Sharpe is an ITV1 production.. .. the Only BBC to show it is BBC America as they "co-produced" a few episodes.. which is to say two episodes with ITV1......
Waking the Dead!
Because the ITU is endorsing proposals that would lead to US communication companies making less money from foreign countries' use of the Internet than they do now. Why is that difficult to understand?
Add to big money's control of government the fact that most Merkins feel that they own the Internet and should control it, and you've got an issue everyone can agree on.
Hold on, I *already* pay the carrier, the ISP, via my monthly direct debit. They want even *more* out of me? *And* they want to charge both the produce *and* the consumer? When I watch a film I pay the "carrier" (the local Odeon). They then pay the producer (eg Paramount). The Odean doesn't bill Paramount, Paramount bills the Odeon.