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RE: Health Care Reform - 3/6/2010 7:38:55 PM
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iluvatar
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quote:
ORIGINAL: davelinde
What I don't know is just how much that good care costs - something tells me it doesn't come cheap.
No, it probably doesn't come cheap, but neither does our current system. We currently spend WAY more per capita on health care than any other country. According to Reuters, the US spent $7681 per person (or 16.2% of GDP) on health care in 2008. I've only been able to find information on spending by other countries from 2004-2005, but at that time, our per capita spending on health care was 53% higher than that of the #2 (Norway). As a percentage of GDP, it was 45% higher than the #2, France.
-Dan.
_____________________________
Well, I've been to one world fair, a picnic, and a rodeo, and that's the stupidest thing I ever heard come over a set of earphones.
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RE: Health Care Reform - 3/6/2010 7:48:34 PM
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bolt.
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quote:
What I don't know is just how much that good care costs - something tells me it doesn't come cheap.
Our medical care is included in our taxes, which have different rates for your 'first so-many thousand' then more for income more than that but less than so-much, etc. If you follow >> this link <<, you can select any province, put in an income, and it will tell you the answer in flat percent-of-total terms. It assumes you are single. Then try >>this link<< with the same amount and see what the difference is.
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RE: Health Care Reform - 3/6/2010 7:58:59 PM
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bolt.
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I did the comparison for $80,000 taxable income.
The American would pay $16,188 federal taxes including no healthcare coverage.
The Canadian would pay $13,677 federal taxes including basic healthcare coverage.
Though, I'm not sure if the provinces cover some health costs from provincial taxes. I do know it's considered a federal responsibility. It would be a better comparison if I could have found an American calculator that included some states to use as examples of total tax burden.
Yes, we have some wait time challenges for non-emergency procedures, but our system is more than sufficient as basic coverage including critical needs. We have no death panels.
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RE: Health Care Reform - 3/6/2010 8:00:06 PM
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iluvatar
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quote:
ORIGINAL: bolt.
quote:
What I don't know is just how much that good care costs - something tells me it doesn't come cheap.
Our medical care is included in our taxes, which have different rates for your 'first so-many thousand' then more for income more than that but less than so-much, etc. If you follow >> this link <<, you can select any province, put in an income, and it will tell you the answer in flat percent-of-total terms. It assumes you are single. Then try >>this link<< with the same amount and see what the difference is.
Wait a minute.... those calculators say that your taxes in Canada are equal to or less than our taxes here in the US??? AND you have a national health care plan??? How can that be?
-Dan.
_____________________________
Well, I've been to one world fair, a picnic, and a rodeo, and that's the stupidest thing I ever heard come over a set of earphones.
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RE: Health Care Reform - 3/6/2010 8:06:02 PM
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iluvatar
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quote:
ORIGINAL: bolt.
I did the comparison for $80,000 taxable income.
The American would pay $16,188 federal taxes including no healthcare coverage.
The Canadian would pay $13,677 federal taxes including basic healthcare coverage.
Those were the numbers I plugged in, too. Though, to be fair - with the exchange rate, you'd plug in $80K for the US and $82,444 for Canada. But the point still stands: your taxes are no higher than ours. (our state taxes
quote:
Though, I'm not sure if the provinces cover some health costs from provincial taxes. I do know it's considered a federal responsibility. It would be a better comparison if I could have found an American calculator that included some states to use as examples of total tax burden.
Yes, we have some wait time challenges for non-emergency procedures, but our system is more than sufficient as basic coverage including critical needs. We have no death panels.
State taxes in Massachusetts are 5.3%, so @ $80,000 my combined state and federal taxes are almost exactly what they'd be if I lived in Ontario. However, if I didn't have that average $4700 in employer-sponsored health insurance premiums eating into my paycheck, I could probably get a raise.
-Dan.
_____________________________
Well, I've been to one world fair, a picnic, and a rodeo, and that's the stupidest thing I ever heard come over a set of earphones.
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RE: Health Care Reform - 3/6/2010 8:44:06 PM
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jaymai
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Laura Ingraham (sp?) was on O'Reilly the other night and she opined that the democrats were not willing to reach out to republicans on healthcare reform. O'Reilly pointed out that the GOP has shown little indication of reaching out to the democrats either. Ms. Ingraham said bluntly, "They don't have to." She claimed that because they're on the side of the "American people" (at least THEIR "American people"), they don't have to compromise.
She's right. This "Let's start over with a blank sheet of paper and write this bill" is just a smokescreen and an attempt to stall for time. Whenever a basketball team is overmatched, their best strategy is to try to get a lead and run out the clock. The longer nothing is done, the worse it looks for Obama. Even with a majority in both houses he has been rendered ineffective. He realizes that if this bill doesn't pass, no matter what happens going forward, he will be considered by his own constituents, the most ineffective and incompetent President in modern history. The right will continue to paint him as the most dangerous man who ever held the office - a socialist, marxist, muslim extremist sympathizer bent on destroying the country who must be opposed at every turn by patriotic Americans. True, nothing will get done for four years, but some people who are suffering now believe it's worth the sacrifice to save our country from certain disaster at the hands of this evil tyrant.
A brilliant strategy which I hope fails
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RE: Health Care Reform - 3/6/2010 9:16:31 PM
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davelinde
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quote:
ORIGINAL: iluvatar
quote:
ORIGINAL: davelinde
What I don't know is just how much that good care costs - something tells me it doesn't come cheap.
No, it probably doesn't come cheap, but neither does our current system. We currently spend WAY more per capita ... a percentage of GDP, it was 45% higher than the #2, France..
I've seen this before - at first blush appalling -we pay more and get less... how can that be? Do you know if the per capita spending is per insured person or per all people? It seems quite odd.
For sure part of the higher spending is higher costs. Doctors make more, malpractice is more, admin is more so the US spends more to start.
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RE: Health Care Reform - 3/6/2010 9:46:27 PM
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iluvatar
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quote:
ORIGINAL: davelinde
quote:
ORIGINAL: iluvatar
quote:
ORIGINAL: davelinde
What I don't know is just how much that good care costs - something tells me it doesn't come cheap.
No, it probably doesn't come cheap, but neither does our current system. We currently spend WAY more per capita ... a percentage of GDP, it was 45% higher than the #2, France..
I've seen this before - at first blush appalling -we pay more and get less... how can that be? Do you know if the per capita spending is per insured person or per all people? It seems quite odd.
I believe it's all, not all insured.
quote:
For sure part of the higher spending is higher costs. Doctors make more, malpractice is more, admin is more so the US spends more to start.
Sure, doctors make more, but overall, doctors' wages are only a fraction of health care costs. Even in something relatively cheap and easy like dentistry, there are at least 2 support personnel for every doctor, plus various equipment and facility overhead. In a hospital, I'd imagine doctor salaries are even a smaller percentage.
-Dan.
_____________________________
Well, I've been to one world fair, a picnic, and a rodeo, and that's the stupidest thing I ever heard come over a set of earphones.
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RE: Health Care Reform - 3/6/2010 10:15:07 PM
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tacitus
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Malpractice law suits only make up 0.5% of the cost of health care in the US, so it's not the huge factor that many Republicans claim it is -- tort reform wouldn't make much of a dent in the overall costs.
Here is an interesting chart:
http://yglesias.thinkprogress.org/archives/2009/10/excess-spending-in-us-health-care.php
And it really does look like the cumulative cost of the private system -- paying doctors more who order a larger number of, more expensive tests, than in other countries has the cumulative effect necessary to make up the difference. I wish I could find another chart on the same blog from last year that showed how much more expensive routing scans and other outpatient procedures are in the USA compared to elsewhere - it was not just 50% more, it was more like 4 or 5 times more.
The difference, of course, is that a national health care program has the ultimate economy of scale -- they can spread the costs across the whole population, and they have much more power to control pricing (as does the VA and Medicare).
There is also the issue of end of life care. It's a very delicate one, and risks bringing up the specter of the so-called "death panels" that everyone was wailing about (but it is in reality a completely different issue), but the fact is that the costs of treating people in the last month of their lives have skyrocketed. I believe a recent 60 Minutes said it was going around double the annual cost of the whole of the Dept of Homeland Security budget, and still rising.
The problem is understandable -- nobody wants to die before their time -- but these often heroic measures (like giving a transplant to a chronically ill 80-year-old with little chance of success) are becoming more commonplace to the point where more and more people are clinging on to life for a couple of weeks longer in a stressful and very expensive intensive care units as opposed to ending their days in peace at home surrounded by their families.
Medicare is footing about 95% of that end of life care bill since very few people can afford such high cost care, and it is a major difference between the US and most other countries. As with other aspects of healthcare, though, now it's happening, it will be very difficult to change what people want.
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RE: Health Care Reform - 3/6/2010 10:28:42 PM
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iluvatar
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quote:
ORIGINAL: tacitus
There is also the issue of end of life care. It's a very delicate one, and risks bringing up the specter of the so-called "death panels" that everyone was wailing about (but it is in reality a completely different issue), but the fact is that the costs of treating people in the last month of their lives have skyrocketed. I believe a recent 60 Minutes said it was going around double the annual cost of the whole of the Dept of Homeland Security budget, and still rising.
The problem is understandable -- nobody wants to die before their time -- but these often heroic measures (like giving a transplant to a chronically ill 80-year-old with little chance of success) are becoming more commonplace to the point where more and more people are clinging on to life for a couple of weeks longer in a stressful and very expensive intensive care units as opposed to ending their days in peace at home surrounded by their families.
Medicare is footing about 95% of that end of life care bill since very few people can afford such high cost care, and it is a major difference between the US and most other countries. As with other aspects of healthcare, though, now it's happening, it will be very difficult to change what people want.
Maybe Dinosaurs had it right with "Hurling Day"
Part 1
Part 2
Part 3
-Dan.
_____________________________
Well, I've been to one world fair, a picnic, and a rodeo, and that's the stupidest thing I ever heard come over a set of earphones.
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RE: Health Care Reform - 3/6/2010 10:31:24 PM
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relady
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quote:
Businesses must make profit or they can not remain in business PERIOD. You seem to think making money = efficient and well run. That is simply not the case. I'll repeat it one more time, slowly. COMPANIES CAN BE VERY VERY BADLY MANAGED AND STILL MAKE MONEY. LOTS OF IT. PROFIT DOES NOT = EFFICIENCY. Nice try, though.
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RE: Health Care Reform - 3/7/2010 4:50:30 AM
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_jjp_
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quote:
ORIGINAL: relady
quote:
Businesses must make profit or they can not remain in business PERIOD. You seem to think making money = efficient and well run. That is simply not the case. I'll repeat it one more time, slowly. COMPANIES CAN BE VERY VERY BADLY MANAGED AND STILL MAKE MONEY. LOTS OF IT. PROFIT DOES NOT = EFFICIENCY. Nice try, though.
i will say it for you one more time very slowly MAKING PROFIT NECESSARILY MAKES A COMPANY MORE EFFICIENT THAN THE FEDERAL GOVERNMENT WHICH IS $12TRILLION IN DEBT.
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RE: Health Care Reform - 3/7/2010 4:51:41 AM
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_jjp_
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quote:
ORIGINAL: iluvatar
A couple times, people have pointed out that Medicare has less operating overhead (and is thus MORE efficient) than private insurers. You, OTOH, have never given us any numbers on how inefficient the government really is. Your only "evidence" is their debt load.
-Dan.
Actually go back and look at the links I posted regarding waste and inefficiency in medicare and that is just one single government program.
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RE: Health Care Reform - 3/7/2010 7:03:50 AM
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jaymai
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quote:
ORIGINAL: _jjp_
quote:
ORIGINAL: relady
quote:
Businesses must make profit or they can not remain in business PERIOD. You seem to think making money = efficient and well run. That is simply not the case. I'll repeat it one more time, slowly. COMPANIES CAN BE VERY VERY BADLY MANAGED AND STILL MAKE MONEY. LOTS OF IT. PROFIT DOES NOT = EFFICIENCY. Nice try, though.
i will say it for you one more time very slowly MAKING PROFIT NECESSARILY MAKES A COMPANY MORE EFFICIENT THAN THE FEDERAL GOVERNMENT WHICH IS $12TRILLION IN DEBT.
Since saying stuff slowly makes no sense in a forum, I'll type real slow, and not in all caps cause that means I'm yelling:
The primary purpose of the public sector, federal government, is not to make a profit. It includes, but not limited to:
1.Ensure the essential goods and services are available for everyone;
2.Provide the goods and services that are too important for the security of the country;
3.Provide goods and services that cannot be provided by the private sector.
These things don't always turn a profit, and I think I can make a case for all those things being in the constitution. Take prisons and the military, two things conservatives love so much and never minded spending money on. I doubt if you look at our miltary's "balance sheet" you'll see much "efficiency" there as well as prisons, police, watchdog agencies, public works, etc. Those who use the argument that the private schools are "better" and we should scrap the public schools, well, if the public schools could "cherry pick" their students, they'd be "better" too. But they don't have that option.
Right now, health insurance companies that are "efficient/profitable" as you call it, are so because they can "cherry pick" their customers. Those with pre-existing conditions can be denied coverage, for example. Some people would say, too bad, they have a right to make a profit. What if your police department charged for protection? They charge people who live in nice, safe neighborhoods more, but since you may live in a high crime area, they decide it's not worth it so you have to fend for yourself?
The federal government is in debt primarily from trying to provide for the national security by fighting two wars on different fronts. How much ROI (return on investment) have we gotten from that project? They've also had to deal with a few natural disasters at home (how profitable was that Katrina business venture?). And I'm not even going to get into the benefit packages congressmen and presidents (for example) get for the rest of their lives. So it's not surprising that the federal government is looked upon as being more "inefficient" than the private sector. Some churches are more profitable than others too. Are the profitable ones considered the most efficient? So it seems that to determine whether something is efficient vs. inefficient, one must first determine what the primary purpose of that enterprise is, wouldn't you agree?
Of course you wouldn't. 
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RE: Health Care Reform - 3/7/2010 7:19:30 AM
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iluvatar
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quote:
ORIGINAL: _jjp_
quote:
ORIGINAL: iluvatar
A couple times, people have pointed out that Medicare has less operating overhead (and is thus MORE efficient) than private insurers. You, OTOH, have never given us any numbers on how inefficient the government really is. Your only "evidence" is their debt load.
-Dan.
Actually go back and look at the links I posted regarding waste and inefficiency in medicare and that is just one single government program.
I never said it was perfect. But if you're going to show that it's worse than the private sector, you have to also examine how wasteful the private insurance companies are. The articles you posted were mainly about how the private companies with which Medicare contracts are ineffective and abusive of conflicts of interest.
-Dan.
_____________________________
Well, I've been to one world fair, a picnic, and a rodeo, and that's the stupidest thing I ever heard come over a set of earphones.
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RE: Health Care Reform - 3/7/2010 9:38:28 AM
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_jjp_
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quote:
ORIGINAL: iluvatarI never said it was perfect. But if you're going to show that it's worse than the private sector, you have to also examine how wasteful the private insurance companies are. The articles you posted were mainly about how the private companies with which Medicare contracts are ineffective and abusive of conflicts of interest.
-Dan.
Those private contractors ARE a part of medicare which is a government program that i have shown proof of inefficiencies contrary to the claim that i provided nothing.
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RE: Health Care Reform - 3/7/2010 9:12:39 PM
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davelinde
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quote:
ORIGINAL: tacitus
Malpractice law suits only make up 0.5% of the cost of health care in the US, so it's not the huge factor
...a larger number of, more expensive tests, than in other countries
I misunderstood that stat too... the 0.5% is the amount that could be SAVED by the tort reform proposals - NOT the cost.
BTW - from what I read the COST of malpractice insurance is somewhere beteween 10x and 50X the cost in other countries. To doctors it's a big deal -- and to a doctor who gets sued (and wins) who would not have been sued elsewhere I assume it's a HUGE deal.
There are also countries who use a LOT more care and testing than in the US... I think the country testing itself the most is Japan. The source I read said that the high utilization of health testing was because it's all free to the person being tested....
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RE: Health Care Reform - 3/8/2010 1:57:07 AM
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tacitus
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Thanks for clearing that up, David. Japan is probably not the model I would want for the USA. They do a lot of testing, but their government stipulated reimbursement is extremely low compared to many other countries. They also have trouble finding beds for emergency cases. (At least they were a couple of years ago. Not sure if that's still true today).
But the great thing is (or should be) that, should the will be there, we have over a dozens good systems to examine to choose from and select the best aspects of. Taiwan did this before setting up their own healthcare system.
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RE: Health Care Reform - 3/8/2010 12:02:14 PM
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davelinde
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quote:
ORIGINAL: tacitus
Japan is probably not the model I would want for the USA. They do a lot of testing, but their government stipulated reimbursement is extremely low compared to many other countries. They also have trouble finding beds for emergency cases. (At least they were a couple of years ago. Not sure if that's still true today).
But the great thing is (or should be) that, should the will be there, we have over a dozens good systems to examine to choose from and select the best aspects of. Taiwan did this before setting up their own healthcare system.
I've only heard of three systems (and the US uses all of them):
Privately managed risk pool (in US for profit insurers)
Government managed risk pool (Medicare)
No risk pool (pay cash for services)
Is there another structure in use? Most countries have a hybrid structure of one or more and the actual experience with the system will depend on what (if any) regulations are in place.
Of course - those models are just for the payer side, on the provider side you can also have private providers both for profit and non-profit and government owned providers. The actual quality of the care you get will depend on the provider -- of course the fear in the US is that something that ends up in the new regulations will force changes on the provider side that will limit access or reduce quality.
btw - I understand that Japan uses private non-profit insurance for everyone. It is mandatory so there is no pre-existing condition issue (but it's mandatory). And, as noted, pricing of services is regulated, sometimes severely. The example I read about was MRI's which are, by statute, much cheaper than the US. However, the Japanese designed a cheaper MRI machine to hit the cost target (this is the only "success" story I read about... but it does illustrate how it might work well).
Currently the three US systems work against eachother with price controls. There are a lot of people in Medicare (government pool) which dictates provider costs (at something like 85% of actual I think?). To make it up private insurance is charged more by providers (but they have negotiating clout so they can get a deal). Anyone paying cash for services will pay the most. Ironic.
I had not read about waiting times in Japan (like the anecdotes from Canada and the UK)... but they may have them.
What system do you think is best and why?
Personally I like the goal of a unified billing and record keeping system and I think it should be mandated by statute. It would reduce admin costs, improve quality of care, and improve the patient experience. Then again I just hate paperwork.
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RE: Health Care Reform - 3/8/2010 12:45:53 PM
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tacitus
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I was talking about the differing hybrids of those basic systems. As far as Japan and waiting times, the reports I was reading from a couple of years ago was more to do with a chronic shortage of beds for emergency cases which resulted in a number of accident victims being refused admission several times before finding somewhere where they could be accommodated. Obviously that sort of thing is unacceptable as the norm, but I have no more recent news at hand to know whether they have fixed those problems since.
As for the best system? Well, I admit that I haven't done an in depth study of all the various national health care systems. I am only very familiar with the British (private and public) and American ones, and on balance, having experienced the American system both from a high salaried position and a low one, I would pick the British one in a heartbeat. I am aware that the French system is often upheld as the being the best in the world objectively and subjectively, but I am not overly familiar with how it works from day to day, but am aware of the fact that it can incur some at-point-of-contact costs, though they are usually heavily reimbursed.
More generally I think a national health service should:
1. Cover everyone, regardless of income, though I have no problem with requiring those who can afford it to pay something towards the cost of the treatment, as in the French system, but in no cases should the extra cost put an undue burden on the patient.
2. Free at the point of delivery (with the caveat of (1)). Recovering from a serious illness or undergoing major surgery is stressful enough without having to worry losing everything you have earned over the last so many years. Medical related bankruptcy is rife in the States, but is almost unheard of in most other countries. It's tough to put a price on how valuable that is -- being able to pick up the pieces and carry on without racking up a mountain of debt and financial worry. Especially great for small business owners and potential entrepreneurs, particularly if someone in their family already has medical issues.
3. Have a healthy private health sector too. One of the most ridiculous claims make by those against a public option of any sort is that it would completely destroy private medicine. In France, the private sector is a full 35% of the system, and more than half the doctors work in it, fully of part-time. My mother opted for private surgery to repair torn ligaments in her shoulder. My parents are retired and not particularly wealthy (both were teachers), but they decided to pay rather than wait another six weeks for the surgery. What helped them decide was that she could have the rehab under the NHS (i.e. free) even though she went private with the surgery. This type of synergy between the systems (rather than all or nothing) strikes me as very sensible and pragmatic.
4. Top-up insurance (only recently allowed in the UK) is an excellent idea. It's much cheaper than full private insurance but adds peace of mind for those who believe they might not get everything they need from the public system. There will always be some rationing under any system, but this seems to be an excellent way to hedge your bets, if you can afford it.
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RE: Health Care Reform - 3/8/2010 5:21:01 PM
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davelinde
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From: New Jersey
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quote:
ORIGINAL: tacitus
...I think a national health service should:
1. Cover everyone
2. Free at the point of delivery (with the caveat of (1))
3. Have a healthy private health sector too. One of the most ridiculous claims make by those against a public option of any sort is that it would completely destroy private medicine. In France, the private sector is a full 35% of the system, and more than half the doctors work in it, fully of part-time. ...
4. Top-up insurance (only recently allowed in the UK) is an excellent idea. ...There will always be some rationing under any system,
One observation I read about health care is that NO system is without complaints. ALL of them have issues with access and costs. The difference being in the US the access debate is about disparity between have/have-not while elsewhere access is about waiting lists.
I've also read that the French system is currently best-in-class all considered.
For point 1... initially I was opposed to this - but as I looked into what others have done I've dropped my initial objection. Now my question is how do we get there and at what cost? If the answer is we get there at any cost and as fast as possible I have concerns.
For point 2 - I understand that "free at the point of delivery" is a cornerstone of the UK system. As you noted, the French must pay up front then get something back. Personally I think that is FAR superior. People getting services for free do not value them or use any restraint - it's one of the problems I see with the US system. No one knows what anything costs and make treatment choices without concern for costs, only what will my insurance pay for. For a public system to work well people need to feel it's their money they are spending and NOT just something they are entitled to. I believe that the French up front payments get rebated on a sliding scale and it's done within 30 days. I also think there is an annual cap at which point you get 100% back (or maybe stop paying?).
Points 3 and 4 go together... I tend to agree here - not really sure actually how best to have public and private plans co-exist but allowing that seems to give good flexibility. Some national systems I'd read about explicitly prevent private services, I don't favor that.
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RE: Health Care Reform - 3/8/2010 9:26:21 PM
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bolt.
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I think making treatment decisions without regard for cost makes for far better medical decisions.
_____________________________
Are you having trouble getting your daily dose of the life changing Word of God?
Let my friend Brian at Daily Audio Bible help you too.
>>audio link<<
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RE: Health Care Reform - 3/8/2010 10:51:28 PM
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tacitus
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The issue of up-front costs is a tricky one, and I don't pretend to know the best answer. There will always be some tension between ensuring people are not afraid to get to the doctor's in a timely fashion, and having too many hypochondriacs cluttering up the services.
However, even when health care is free at the point of delivery, it can be surprisingly difficult for many people to make the decision to go to the doctor's -- particularly for men, as studies have shown in the past. I am a prime example of that. Many moons ago, when I was still in England, I discovered a rice grain-sized lump on a part of my, er, internal plumbing (to keep it modest!). I remember wondering what it was and having some worry about it, but I soon put it out of my mind. Well, this went on at intervals until that same lump was the size of a baked bean and then I finally panicked and made an appointment to see the doctor. I was fortunate -- it turned out to be a benign cyst, thank goodness -- but several months went by before I went to the doctor, and there was no thought of the possible cost involved, which I knew would be zero, even in the worst case scenario. A cousin of my father died from the very same cancer my mother recovered from quite easily. The difference? She got on to the problem much quicker (thanks in part to her doctor, it has to be said.)
Now there are cultural difference that might make a difference should America take that route -- I know Americans are far more comfortable talking about mental health issues than us Brits are, for example, so that would have to be taken into account.
There is also the issue of preventative health care. You really do want to make it as easy as possible for people to decide that they should go for regular scheduled screenings since early detection (in most cases anyway -- prostate cancer is still controversial) is far cheaper than dealing with advanced disease. And I suspect that the majority of those who are likely to visit more often are going to be in the low income group since health tends to track fairly closely to income level.
There have been suggestions in the UK that there should be a flat fee for a doctor's visit ($30) but the panel of doctorsrepresenting the interests of the NHS doctors does not like that idea at all. (They believe the free-at delivery concept is a cornerstone of the NHS)
Interestingly, people making too many appointments doesn't seem to be the biggest worry in the UK -- it's missed appointments, since they clog up the schedule and prevents those who really want to come in from making an appointment.
All that said, I am not averse to some form of charging up front, as long as it doesn't deter the people who really need to see the doctor. I think in any American system it's going to be very likely anyway, just because of where we are now. It's all a question of balance, I no doubt it would all be terribly complicated to get right should we ever get there!
Finally, I think most British specialist and surgeons take private patients (not 100% sure about that, but I believe it's true). If you continue to have a healthy private system alongside the public one, then doctors have more options when it comes to boosting their income beyond what the public system pays. Hospitals can also have private wards or wings for that extra bit of care and attention for the paying customer.
< Message edited by tacitus -- 3/9/2010 12:58:33 AM >
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