Health Care in Europe

Cover of Sicko (Special Edition)

I've been discussing health care on a couple of people's Facebook pages lately. It is an issue that is near and dear to me, as an independent person having to buy my own healthcare and health insurance in the market. I'm pretty satisfied with my health care insurance, except for the fact that the price is sky-rocketing with no end in sight. And, I have a $2,500 deductible. So, for a simple procedure for my wife I just had to fork over $2,400. For my family of four, my monthly premium is now more than the mortgage on my first house (including taxes, PMI and everything). It's my third largest monthly bill behind only my mortgage and my car payment. Health insurance, which used to be an afterthought (in terms of how much I had to pay) is now a major spot in my budget and is increasing at an amazing rate. This year alone, it jumped over 30%.

I hear from many of my friends that they are scared of a government run health insurance system. They point to examples of government inefficiency, waste and bureaucracy that we all are way too familiar with. However, as Obama pointed out, if someone proposed a plan like what we've got today where it's not portable, you can be denied coverage, the cost is guaranteed to double in the near term and you're not guaranteed to get the care you need whether you're covered or not, no one would vote for it. If you haven't personally felt the sting of rising health care costs, you're probably on an employer paid plan. But, even those buffers are wearing thin. When I first got coverage there were no deductibles or co-pays. No one cared what anything cost. Now co-pays for well-care have increased, people are having to pay deductibles before their coverage kicks in. Employers are asking people to pay some of their own premiums. And jobs are being lost and wages frozen because health insurance premiums are such a significant cost for employers. The system is broken, folks.

I don't think a completely socialized national plan is the answer for America for a number of reasons. But, if you've seen the movie Sicko, you've seen how it has worked for other countries. Recently, people I know were speculating on what health care is like in places like Europe and Canada. I've seen a recent ad on TV where a "Canadian nurse" is warning us to not adopt a system like theirs. I happen to know a guy in Canada who says their health care system is excellent. I know a guy in Ireland who thinks their system is really good. You can still buy private insurance. But, the National Health System is good enough that most people don't. I asked him to share his thoughts with me and he sent the following:

Every health care system in western Europe is different, though all of them are comprehensive in that the whole population is covered, and none of them are financed primarily by private health insurance but rather by tax revenues or by compulsory social health insurance (normally with contributions from employers and employees). They are either run directly by the state or if not are closely regulated by law and by statutory bodies. But obviously I can only speak from experience for the UK national health service (NHS) which also covers us here in Northern Ireland.


I'm not sure what critics of our system mean by "rationed", Brian, so maybe you could clarify that further. Obviously in any health care system, however financed or run, medical resources are finite and that can lead to waiting lists for some kinds of procedures - hip replacements for example. Waiting lists had become quite high for some non-emergency operations in the 1990's, though they have come down considerably in recent years as more resources were pumped into the system, but those who can afford it often take out private health insurance to avoid the waiting lists. We do have private sector clinics, hospitals etc., and some doctors and surgeons combine private practice with working for the NHS.


As part of my terms and conditions of employment in Nortel, I can choose to be covered by a private health insurance scheme for a small premium, but I've never had any occasion to make use of it. The NHS is generally excellent in dealing with the most serious illnesses (and with accident & emergency) such as stroke, heart disease, cancers, MS and so on.


12 years ago, when I had a serious eczema problem - eventually much of my body was covered by seeping sores and rashes - the NHS admitted me to a local hospital where I stayed for about a week. I had regular appointments afterwards at the dermatology dept in the same hospital and received a variety of treatments, including UV radiation treatment when my hands were seriously affected.


Recently, as you know, I found that I had a higher than normal white blood cell count (discovered when I was donating blood which I did several times a year). The blood transfusion service rang me and advised me to make an appointment with my doctor. He saw me quickly and did further tests which confirmed that I had a high wbc count. They referred me to the City Hospital in Belfast, a couple of weeks later, where I was more comprehensively tested and saw a specialist, who told me I had lukemia (CLL to be precise). Currently I go in for testing and a consultation with the specialist 3-4 times a year, and if I eventually show symptoms they will start giving me treatment right away - probably chemotherapy.


Personally, Brian, I would have to say that I've never experienced any serious problems with the NHS - and not only in my own case, but with my family and my wife's family. When my dad had to be taken into care because of dementia, the NHS found a nursing home for him (in a beautiful spot right in the heart of the countryside) and it didn't cost me a penny. I could go on and on...for instance, the old lady who lived next door to me when I moved into this house eventually developed cancer (at 103!) - she had people who called every day to do household chores and make her food, and nurses who were in and out all the time (at the end, they were actually there 24/7, as she didn't want to go into hospital to die).


I'm rambled on and on as usual so just one more comment. The leader of the main opposition party in the UK (the Conservative Party), David Cameron, recently lost his 6 year old son who had suffered from cerebral palsy and epilepsy.
There have always been people on the Conservative Party's right wing who wanted to introduce 'market forces' and increased privatization into the NHS. Cameron has promised the public that he will not go down that route, pointing out that his own son was cared for under the NHS from his birth to his death.
In a speech in 2006, Cameron said :

“I’ve spent the night in A&E departments and slept at my child’s bedside. I’ve got to know the people who dedicate their lives to helping others."


“The fact that we have in this country a health service that takes care of everyone, whatever their needs, whatever their background, is one of the greatest gifts we enjoy as British citizens. We should never forget it, and we should never take it for granted.”

There is a big social consensus in the UK that the NHS has been one of our great achievements in the post-war period. Admittedly it has slipped from its position at the cutting-edge of European health care systems - most experts would say that there are many better national health care systems in other parts of Europe (France and Germany for instance & I would be surprised if the Scandinavian systems aren't top notch but I know nothing about them).


If there's any other info I can give you, Brian, don't hesitate to ask.

Here's my point. Our system is broken. It's unsustainable. If we do nothing, none of us will be able to afford health care in the not too distant future. We already pay way more than many other countries that have much better outcomes than we do. We are scared to trust this to the government yet, the private sector has not only not improved things over the last 15 years since we started discussing this, it's gotten worse. I hear a lot of people saying (now), "Let the private sector handle it". Up until now there's been no motivation to. Health care delivers are happy with the status quo because they can raise prices without any fear of competition. Insurance companies are happy because they just pass that along to you and me in the way of higher premiums and there's not a darn thing we can do about it. No one (until recently) shops for the best price on a surgical procedure. My hope is that, if nothing else, the government's threat to completely overhaul the whole system will motivate some of these corporations to do something before the government has to and maybe, just maybe we'll see real reform in the next couple of years. If that happens withough the government having to insure a single citizen, I'd be fine with that. But, doing nothing is not an option anymore.