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Subject: 
Re: Rights to free goods? (was Re: What happened?
Newsgroups: 
lugnet.off-topic.debate
Date: 
Sun, 4 Jul 1999 22:02:25 GMT
Viewed: 
888 times
  
On Sat, 3 Jul 1999 08:42:49 GMT, Mike Stanley uttered the following
profundities...
This is something I'm curious about.

In these European countries that have this utopia of "free" healthcare
I would assume it is paid for with taxes, right?  I've also heard that
in such places those who have the means most definitely do choose
private care.

It certainly isn't a "utopia," at least in the UK. It is bureaucratic,
mismanaged, and all health care is expensive, after all. New
drugs cost a fortune, and is one of the biggest non-labour related
expenses, for one example. (Building maintenance is another).
Nor is it really free! (At least for those who work).

In the UK, it is paid for through National Insurance contributions.
It is a multi-purpose "tax," which not only goes to pay for the
National Health system, but also state pensions, etc. It is a scaled
payment, and the maximum is 180 pounds per month, which is reached
on an income of about 23000 pounds. I am not entirely sure of the
%, or if there is a minimum amount that must be paid, etc. Employers
are also required to make contributions in proportion to what the
employee pays. (I think this is how employer-provided health care
works in the US, to some extent? A tiny bit by the employee, the
biggest proportion by the employer? I think in the UK, it is a 3/1,
Employer/Employee ratio). But as this "tax" also applies
to other things, such as pensions (like Social Security in the US),
it is not entirely for the health service. One thing, though, is
that the NI contributions cannot meet the costs of the welfare
state, and in fact doesn't come anywhere close to meeting its
expenses. The rest is subsidised through other taxes, direct
or otherwise.

I don't know how it works in the rest of Europe, but Germany is
an example of trim and efficient and working state-provided
health care.

With regards to opting for private health care, very much the case.
If people have the means, they use it. If their employer provides
it, they use it. I was flamed a year ago for mentioning the fact
that there is almost a sense of moral duty to do so, if one can!
(It was most likely Larry, but could have been you or Jesse Long).
Because the National Health Service is in many ways strapped for
cash, waiting lists for even some basic treatments can be quite
long, and is the main reason why people who can take advantage
of private health care choose to do so. It also has the benefit
of cutting those waiting lists, though  only slightly.
If so, do those people get to opt out of paying the taxes for the
"free" healthcare they aren't receiving?

No, as most private hospitals and clinics don't have emergency wards.
Technically, you are paying an insurance for the emergency treatment
that wouldn't otherwise be covered by your private health care. And
as the NI contributions cover child benefit, state pensions, etc.,
you don't get away with it.

I'm thinking a system that lets you choose to pay your share of taxes
and receive the care or not pay them and absolutely not be eligible
without providing the cash at the time of service might work, maybe
not.  I assume there are those who might say that even those who
willingly choose to not pay should still be eligible in emergencies or
things that happen "through no fault of their own".


Funding of, eligibility for, etc. etc., this is a continuous
debate in the UK, no doubt on the continent, as well. There
have been a few high-profile cases where doctors have refused
repeat treatment to patients with smoking-related illnesses,
who have not given up smoking after the first treatment.
There has been talk of giving tax breaks to people who pay for their
own, private health care. Another thing suggested would be to
make those who have private insurance, make those insurance
companies liable for NHS-provided care.

Whatever the answer, I can be quite certain in saying that,
if it were to go to a referendum, the majority would never
advocate the abolition of the NHS. It is full of problems,
is in need of a hell of a lot of reform, but no government
would ever try to abolish it. Painfully reform it, but
never get rid of it. (Even mention of reform can be a bit
risky, if not politically suicidal, depending on what you
propose at election time).
--
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Message is in Reply To:
  Re: Rights to free goods? (was Re: What happened?
 
(...) This is something I'm curious about. In these European countries that have this utopia of "free" healthcare I would assume it is paid for with taxes, right? I've also heard that in such places those who have the means most definitely do choose (...) (25 years ago, 3-Jul-99, to lugnet.off-topic.debate)

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