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jfirneno

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Re: Brexit
« Reply #960 on: November 10, 2016, 06:11:06 pm »

Says immediate past history.

According to you.  Time will tell.
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Alan Klein

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Re: Brexit
« Reply #961 on: November 11, 2016, 12:40:50 am »

I've read a great deal about comparing Europe to the USA.  I find that a completely incorrect comparison.  The USA is one Country.  Europe (actually a continent) is probably denoted to mean the European Union.  While there are EU regulations, each member country is still indepentent and has their own laws and regulations.  While this may not be the ideal solution under for such a Union, it is so.

Alan, in Germany I pay roughly 570 Euros per month for my medical plan, my employer contributes 230 Euros.  I pay the first 2,100 Euros of annual bills I may submit to my medical insurance.  I hope you aren't really of the impression that all medicine in Europe (which country?  there is no European medical system or insurance)  is free.  It ain't.  It's f'n expensive!!  And when I retire in less than four years, I'll have to pay my monthly contributions without any employer's contributions.

I read a great deal of crap being written about the EU and the USA.  It's being stated as fact.  I wish there were some great, wise book in which all Facts were written.  There isn't.  Wikipedia isn't always completely right either.  Subjects aren't just black or White, right or wrong, left or right.

You and your employer are paying that much, especially you?  Well, how is that different than the USA?  I thought socialized medicine was free.  What have I missed?  What about other countries over there? 

Currently, my wife and I are retired here in America.  I'm on Medicare and have two secondary insurance plans that pay for most of anything Medicare doesn't pick up.  I'm basically getting them for free as I worked for NYC government in my last job.  My wife isn't on Medicare but she pays practically nothing as she retired as a teacher.  So we're very fortunate.  Of course these "free" benefits were paid for over the years with lower salaries as we could have worked in private business where the pay is substantially better.  So there's a tradeoff. 

To repeat my questions though, how is it that you're paying that much in Germany and what's going on in other European countries?  Your post is astounding to me and totally opposite everything I every heard about medical care over there.
« Last Edit: November 11, 2016, 12:47:27 am by Alan Klein »
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myotis

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Re: Brexit
« Reply #962 on: November 11, 2016, 02:47:07 am »

You and your employer are paying that much, especially you?  Well, how is that different than the USA?  I thought socialized medicine was free.  What have I missed?  What about other countries over there? 

Every EU country is different, as it seems to be  only "cross boundary" issues that the EU focusses on. As an example I cited the 2500 pieces of legislation passed by the EU in its lifetime, but that's probably less that the average number of pieces of legislation passed in the UK every year. The bulk of it which doesn't even go through parliament for a vote. In 2010 the UK Government passed about 3500 new laws with only 5% going through Parliament

So knowing how day to day things are done in Germany, or the UK,or Spain tells you very little about how they are done in the other EU member states.

The UK National Health Service, is probably what you are thinking of however. This has the idea of medical care being available free to everyone at point of delivery. 

There are some every day costs.

Medicines prescribed by Doctors are subsidised by the state, so you pay for them "per item", Its just over £8 per item. However, that is England only, in Scotland and Wales prescribed drugs are free, and if you are over 60 in England it is also free.   If you have a chronic illness, which means you take more than two medicines a month you can pay an annual fixed fee for your medicine rather than the per item fee.

Eye checkups and Dental checkups, which used to free are now charged for, as a are glasses and any dental care, but as with medicines, dental care is subsidised so you cannot be charged more than £234 per treatment, but that quickly mount up. This applies across the UK.


None the less, it is essentially free at the point of delivery, as we pay for it through our taxes.  Spain seems to be similar, and Germany has a compulsory medical insurance approach. No idea about the other countries.

Cheers,

Graham

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mbaginy

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Re: Brexit
« Reply #963 on: November 11, 2016, 03:27:30 am »

You and your employer are paying that much, especially you?  Well, how is that different than the USA?  I thought socialized medicine was free.

Alan, I no longer have a clue about health insurance in the US.  I've lived in Germany so long and will end my days either here, in Poland or Italy.  Ain't nothin' free in Germany; those days have long passed.  Living is becoming extremely expensive, with cost of living ever increasing (regardless of what statistics may show).

When I retire, I'll be expected to continue my health insurance because it is mandatory to have such.  A great idea, but not necessarily possible.  There are two general health insurances: "private" health insurances and those operating according to government guidlines (but not federally managed).

Years ago I was suckered into a less expensive "private" insurance.  No Major difference but they contributed more towards new glasses every year, should these be necessary.  Then (damned) politicians from the FDP Party created a law that if you were over age 55, you were stuck in the "private" insurance market and there was no way of returning to the (subsequently less expensive) government style insurances.  Even when retired.  So I dread retirement and having to pay those monthly rates.  Maybe going to jail for not being insured is cheaper in the long run.

No Alan, no free stuff here.  And the citizens are becoming ever more frustrated.  I just hope they won't be goose-stepping again in the future.  Jumping from extreme to another.
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Rob C

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Re: Brexit
« Reply #964 on: November 11, 2016, 04:06:23 am »

I, as with all the legally self-employed in the UK, paid a weekly national insurance stamp, plus an annual 8% or earnings towards health, if I remember correctly - it was all quite a while ago! When I left the country, I continued to pay a voluntary contribution that entitled me to a state pension. I paid a Spanish self-employed contributiom too, for a while, and realised that I was thus paying the equivalent of three UK ones, the Spanish payment being twice the cost of the UK one, and as I say, I was paying in both countries.

So I stopped working here and paid into a private health insurance scheme which, in the end, was over € 3600 p.a. eight years ago. God knows the cost today. Anyway, the meds are all on a sliding scale according, as I understand it, to circumstance groupings, and whatever my circumstance is deemed to be, I pay 10% towards the cost of prescription meds. Hospital is free.

The system is also struggling to make ends meet, and I imagine it's not going to get any easier. It seems that the cost of meds is very high, so maybe the attractions of state control over the pharma industry might appear on the horizon one day. I don't see that as a bad thing. There's something distasteful about the correlation of money, health or death. Much the same lives in my mind regarding the medical profession. I would rather they get paid less at the top, there be more of them, and that they work normal hours where there's a chance they don't make mistakes due to exhaustion. For this to work, it would have to be an international agreement, so that they don't spend state money learning, and then fuck off to become rich elsewhere. Yes, students also pay towards study in some areas, but the real cost... In short, too many vital services have become embroiled in the pursuit of personal wealth. If you want that, become a starving artists who gets lucky; go build condos; but don't milk the desperate.

I feel better now; might even get up off my ass and pour another mug of tea. Seems the best idea of the day, so far.

;-)

Rob
« Last Edit: November 11, 2016, 06:13:05 am by Rob C »
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Alan Klein

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Re: Brexit
« Reply #965 on: November 11, 2016, 04:26:46 am »

Glad you got that off your chest.  Hope you feel better.  I'm going to sleep.

Rob C

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Re: Brexit
« Reply #966 on: November 11, 2016, 06:04:35 am »

Glad you got that off your chest.  Hope you feel better. I'm going to sleep.

That's the time differential; screws the entire world!

Thank goodness there's but one Sun to influence our daylight. Imagine if the Equator also had a say beyond the seasonal by virtue of its own, independent Sun 2!

Sweet dreams.  Had a strange one: I was trying to make a cellphone call to my wife, who had abandoned her car, leaving her bag on top of the hood. I took the bag away and went to a bar with the Rolling Stones and it was there I tried to make the call, realising that without the keys to the car, she couldn't get home. First problem was that the 'phone resembled a paperback and I couldn't get to how to dial a number. Anyway, I managed to connect despite not knowing how, and my equally late father-in-law answered, saying "Hello?" Nothing further continued in that episode. Strange, these connections. And some think there is no God. We haven't even touched the surface.

Rob

Paulo Bizarro

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Re: Brexit
« Reply #967 on: November 11, 2016, 06:46:34 am »

  Of course your import duties are what pays for socialize medicine.    It is free after all, isn't it? 

A few facts to enlighten you:

1. The European Union is more than one country.

2. In Portugal, my country, healthcare works in several ways:
- if you are a public servant, every month you contribute with 3.5% of your salary to a healthcare fund (it's called ADSE). Then, when you go to a doctor, ADSE contributes up to a certain amount of the expense, depending on the type of treatment. Say your eye doctor prescribes new glasses that cost 500 EUR (frames plus lenses). ADSE will contribute around 180 EUR total. Not very different from a private health insurance really.
- if you work for the private sector, many companies will offer you a health insurance policy. That is my case. I do not have to contribute with any part of my salary for that.
- however, in Portugal, every worker, irrespective of public or private sector, will contribute every month 11% of his salary to the National Health Care Service (NHCS). So, for example, in my case, I can choose to use the company's health insurance option, or the NHCS. According to our Constitution, Health should be free for every citizen, and the NHCS caters for that to a certain extent. Of course the NHCS works poorly for the most part, since it is underfunded, and many people use it preferentially, due to not having access to ADSE, the company they work for not providing health insurance, or not having money to pay for their own private health insurance.

So overall it does not work bad, I have no regrets in paying 11% of my salary to help the less fortunate to have access to a minimum of health care. But free it is not.

Slobodan Blagojevic

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Re: Brexit
« Reply #968 on: November 11, 2016, 07:53:10 am »

... dental care is subsidised...

Ah, that explains!



P.S. And Manoli, stand down! I know you are going to post how the image is photoshopped and then link to a BBC article about how bad British teeth is a myth. I know, but a joke is a joke  :)

myotis

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Re: Brexit
« Reply #969 on: November 11, 2016, 10:09:23 am »

Ah, that explains!



P.S. And Manoli, stand down! I know you are going to post how the image is photoshopped and then link to a BBC article about how bad British teeth is a myth. I know, but a joke is a joke  :)

:-)

Cheers,
Graham
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pegelli

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Re: Brexit
« Reply #970 on: November 11, 2016, 03:00:45 pm »

I think "free" medical care doesn't exist. It's either paid by personal contributions (from your own pockets), by insurance (where the premium comes from your pockets) or by a government medical plan (funded by the tax from your pockets). Obviously combinations of these three possibilities exist, but they all cost you money. Only your personal risk is spread over a larger group with insurance or a government medical plan.
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pieter, aka pegelli

donbga

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Re: Brexit
« Reply #971 on: November 11, 2016, 03:37:47 pm »

Well almost a fifty page thread and now this:

http://tinyurl.com/zpw22tf

Pardon if this has already been cited. The views posted at this link do not necessarily reflect my own, I simply found it amusing.
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Alan Klein

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Re: Brexit
« Reply #972 on: November 12, 2016, 11:23:12 pm »

Farage met with Trump today. http://www.cnn.com/2016/11/12/politics/nigel-farage-donald-trump-meeting/index.html

What effect do you think that will have on Brexit and the EU?

Farmer

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Re: Brexit
« Reply #973 on: November 13, 2016, 01:00:12 am »

Zero.

Trump's the moron who congratulated Scotland on voting for Brexit, failing to realise they did nothing of the sort.  Farage is now pointless, having pushed for something and then walked away when it happened, leaving no actual plan as to how to manage it or what to achieve from it.

It's a bit like it's a bit like two actors meeting up after the release of the movie.  One of them was an extra and now has a major role in a new movie, and the other was a major supporting role but is now floundering after a poor performance and wondering if he can find a new career.
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Phil Brown

omegadeep

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Re: Brexit
« Reply #974 on: November 13, 2016, 07:55:08 pm »

I've read a great deal about comparing Europe to the USA.  I find that a completely incorrect comparison.  The USA is one Country.  Europe (actually a continent) is probably denoted to mean the European Union.  While there are EU regulations, each member country is still indepentent and has their own laws and regulations.  While this may not be the ideal solution under for such a Union, it is so.

Alan, in Germany I pay roughly 570 Euros per month for my medical plan, my employer contributes 230 Euros.  I pay the first 2,100 Euros of annual bills I may submit to my medical insurance.  I hope you aren't really of the impression that all medicine in Europe (which country?  there is no European medical system or insurance)  is free.  It ain't.  It's f'n expensive!!  And when I retire in less than four years, I'll have to pay my monthly contributions without any employer's contributions.

I read a great deal of crap being written about the EU and the USA.  It's being stated as fact.  I wish there were some great, wise book in which all Facts were written.  There isn't.  Wikipedia isn't always completely right either.  Subjects aren't just black or White, right or wrong, left or right.

Most German residents (approx. 70 million people) are members of the government health system. If your gross salary is less than 56,250 Euros per year, or 4,688 Euros per month in 2016 then membership in the GKV is mandatory. The government health insurance scheme is administered by approximately 120 Krankenkassen and they charge the same basic rate of 14.6% plus a possible median supplemental rate of 1.1% of your eligible gross salary to a maximum monthly income of 4,238 Euros (2016 figures). If you earn more than this, you do not pay a higher insurance premium. Assuming a maximum monthly premium of 775 Euros as an employee earning at or above the threshold and are therefore as a voluntary member, your contribution is approximately 425 Euros and your employer will pay approximately 350 Euros. The general minimum period of membership with a particular Krankenkasse is 18 months. You can switch government health fund providers by giving two months notice after 18 months membership or if a supplemental premium is demanded or increased.

The medical benefits provided include in-patient (hospital) care as a ward patient with the doctor on duty at your nearest hospital, out-patient care with registered doctors (Kassenärzte) and basic dental care. Please note that there is no coverage for private doctors or surgeons, a private room in hospital, alternative/homeopathic medical care, dental implants, and vision products for adults or any medical benefits outside of Europe. Your non-working dependents living at your address in Germany are presently insured at no additional cost and simply need to be registered with the same Krankenkasse as the paying member.

If you choose to join the German government system, you can register with any of the available Krankenkassen which are non-profit associations administrating the government health scheme. Some (for instance AOK, TK, BEK, DAK) are very large and have millions of members while others (often called BKKs) might have just a few thousand members. This does not mean that the benefits are very different, as all health insurance funds must stick to the government regulations on the minimum they offer. The premiums may also vary somewhat due to the new regulations and it would also be optimal to research which voluntary supplemental programs the Krankenkasse offers in order to be able to participate in for instance a no-claims bonus, free checkups or discounts on health travel plans. Tip: Make sure you ask about the possibility of communicating in the English language to make your life easier, though only a limited number of Kassen actually offer this service and have English speaking staff.

You and your dependents must also become members of the government long-term nursing care scheme (Pflegepflichtversicherung). This covers some of the cost of meeting personal nursing needs, such as the feeding and bathing of those who become substantially disabled. A new reform of the nursing care has been instituted and this has caused an increase of the cost. The cost is either 2.35% or 2.6% of your gross salary (maximum approximately 110 Euros per month if you have no children) of which your employer pays only up to 49.79 Euros.

If you would like insurance coverage to supplement the government system benefits, you can purchase a policy from any private health insurance company, German or international; for instance if you would like access to and reimbursement of costs for a private doctor and a private room in hospital, homeopathy and other alternative treatment or higher dental reimbursements. Emergency evacuation from places outside Germany included with a private travel insurance policy should also be considered as these are not paid for by the state health insurance plan and it would be very costly to have to pay for such benefits out of pocket.

Public health insurance funds sometimes offer supplemental insurance plans from a particular provider, offering a group rebate. Such tied plans are not always ideal as you have a wider choice of benefits on the private health insurance market.

In the UK the Health Service is paid for through general taxation at 20% base above UKL 11,000 p.a. 40% above UKL 43,000 p.a and 45% above UKL 150,000 p.a. and National Insurance paid as either a percentage of gross pay or rates as low as UKL 2.60 a week for self employed.  Free at point of delivery, no forms, no signatures just an NHS number given at birth.

Nothing is for free, but everyone in Europe is covered for life,young, old, sick,poor, unemployed et al.
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omegadeep

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Re: Brexit
« Reply #975 on: November 13, 2016, 08:13:03 pm »

Farage met with Trump today. http://www.cnn.com/2016/11/12/politics/nigel-farage-donald-trump-meeting/index.html

What effect do you think that will have on Brexit and the EU?

None at all . Farage and UKIP only ever got one seat in an election of 650 MP's in the UK Parliament (Commons) and three in the Upper House (Lords) out of around 850 and is regarded as a bit of a laughing stock by many, except the far right leaning press. Apart from UKIP supporters he is generally regarded with disdain by most people. He may have been the inststigator of the leave vote, but many more people had a hand in the campaign.
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Alan Klein

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Re: Brexit
« Reply #976 on: November 14, 2016, 12:45:14 am »

Omegadeep:  Frankly I am quite surprised that Germans are paying so much money. Some how I thought you had socialized medicine and everything was paid by the government.  Also some questions:

1.  What do you mean ward patient? In the USA, we don't have wards (unless its a special section like a recovery area after an operation.  Insurance usually pays for semi private room - two patients are the max.  Private rooms have to be paid extra.

2.  What happens with pre-existing conditions?  Do insurance companies insure these people if they come to them as new insureds?  How does the insurance company offset the loss with these patients because the insurance premium payments won't be enough to pay for the services?

3.  How much more is the private add ons?  What I see here in the USA is that the better doctors are dropping out of government programs.  So while you have insurance, you wind up with less skilled doctors, surgeons, etc.

4.  What will the long-term effect of two tiers of doctors have on the health of the people and the state of medicine in Germany?  Will smarter youngster forgo medicine for other careers since the monetary rewards are less then they have been?

5. How are medical costs controlled when you have maximum demand (everyone is insured)?  Are tests and other procedures limited? 


Frankly, it seems Germans are paying a lot of money for less than optimum services unless they can afford private insurance.

mbaginy

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Re: Brexit
« Reply #977 on: November 14, 2016, 12:58:28 am »

... Nothing is for free, but everyone in Europe is covered for life,young, old, sick,poor, unemployed et al.
I know all that, which you hade written.  My point was to explain to Alan that there was no free medical insurance as he has mentioned.

You failed to mention that once over age 55, one cannot return to a Gesetzliche Krankenversicherung, you're stuck with the private insurance.  The government health plans have a certain price cap.  The private insurances don't, and they keep increasing their monthly premiums each year - often dramatically.  I recall an increase of 163 Euros monthly some six years ago.  That's boardering on criminal in my view.  And there is no legal way out of that scheme (thanks to that creep Philipp Rösler).

There are hundreds of thousands (in Germany) without any health insurance.  These are usually self employed who simply cannot afford the insurance.  That's illegal but what are they to do?  Living in general is becoming too damned expensive!
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omegadeep

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Re: Brexit
« Reply #978 on: November 14, 2016, 07:11:30 am »

Omegadeep:  Frankly I am quite surprised that Germans are paying so much money. Some how I thought you had socialized medicine and everything was paid by the government.  Also some questions:

1.  What do you mean ward patient? In the USA, we don't have wards (unless its a special section like a recovery area after an operation.  Insurance usually pays for semi private room - two patients are the max.  Private rooms have to be paid extra.

2.  What happens with pre-existing conditions?  Do insurance companies insure these people if they come to them as new insureds?  How does the insurance company offset the loss with these patients because the insurance premium payments won't be enough to pay for the services?

3.  How much more is the private add ons?  What I see here in the USA is that the better doctors are dropping out of government programs.  So while you have insurance, you wind up with less skilled doctors, surgeons, etc.

4.  What will the long-term effect of two tiers of doctors have on the health of the people and the state of medicine in Germany?  Will smarter youngster forgo medicine for other careers since the monetary rewards are less then they have been?

5. How are medical costs controlled when you have maximum demand (everyone is insured)?  Are tests and other procedures limited? 


Frankly, it seems Germans are paying a lot of money for less than optimum services unless they can afford private insurance.

1 . Wards means rooms or small wards.  I've just been in an NHS UK Hospital and had my own room ...this hospital was 68 % single rooms remainder four bed rooms.

2. Covered by law... you can't not insure someone who has a health problem.... that would be illegal.

3. No private add ons that I'm aware of ... you can always opt to go totally private in any country, but it's not always the best care, sometimes far worse.

4.Money isn't such as issue... you work in medicine generally because you want to help people and it's rewarding, not for the money.

5. If you need a test then it's done... the system can cope.... if there is an overspend then the Government will spend more on health.

I have an ongoing cancer problem with Multiple Myeloma and here in the UK I've had Radiotherapy, CDT Therapy and a Stem Cell transplant and various follow on treatment since 2003, including diagnostic MRI imaging  Last year I caught viral pneumonia and was rushed to my local hospital. Within 6 hours I'd been rushed to a specialist hospital by an ECMO 12 man recovery team, because I was about to die, and placed on an ECMO machine where I  received 1 to 1 nursing for three weeks while unconscious. Sadly the ECMO treatment caused a stroke and when I came around couldn't read, write or tell the time, nor walk. I then received 1 to 1 rehab assistance and then specialist rehab stroke nurses visited me at home for treatment. Due to the rapid intervention I've made an almost total recovery from the stroke, save minor cognitive problems. 

After eight years I now need another Stem cell transplant, and they already have my stem cells in cryogenic storage,  they have done a bone marrow aspiration, scans and I'm waiting for the right moment in a clinical sense to enter therapy. This time around it will be Valcade, Dexamethasone and chemo  for about six months followed by the transplant. During that time I will have not only the Consultant but also what we call a Clinical Nurse Specialist to assist. For the Stem Cell Transplant I will have my own isolated room with filtered air conditioning  and personal assistants to provide safe food and clean conditions, due to the high risks of catching bug when undergoing such treatment.
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omegadeep

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Re: Brexit
« Reply #979 on: November 14, 2016, 07:16:39 am »

I know all that, which you hade written.  My point was to explain to Alan that there was no free medical insurance as he has mentioned.

You failed to mention that once over age 55, one cannot return to a Gesetzliche Krankenversicherung, you're stuck with the private insurance.  The government health plans have a certain price cap.  The private insurances don't, and they keep increasing their monthly premiums each year - often dramatically.  I recall an increase of 163 Euros monthly some six years ago.  That's boardering on criminal in my view.  And there is no legal way out of that scheme (thanks to that creep Philipp Rösler).

There are hundreds of thousands (in Germany) without any health insurance.  These are usually self employed who simply cannot afford the insurance.  That's illegal but what are they to do?  Living in general is becoming too damned expensive!

I've never come across anyone without heath cover in Germany and I do have a lot of close German friends.  If you are too poor then the state provides. Official stats suggest that 0.2%, all self employed may not have health cover. My suggest is if you are earning too little shut the business down and claim unemployment benefit. Voluntary Krankenkasse contributions
If you’re self-employed or just not working, you can get private insurance or pay voluntary contributions to a statutory Krankenkasse. This is calculated as 14.9 percent of your income, but for some reason they base this calculation on a minimum income of €1916.25 a month, resulting in a monthly charge of €274.02 – obviously a high sum for the low-income self-employed. People who aren’t working or have any other kind of income can pay the seemingly arbitrary amount of €121.79 per month.

Those who can prove they earn a living through artistic activity or writing of some kind are eligible to join the Künstlersozialkasse, an organization which will pay half of your social security contributions (as a percentage of your income), including pension contributions and your Krankenkasse (you have to belong to one in addition to the KSK) – a great deal compared to the other options. What constitutes ‘artistic activity’ is debatable. Getting into the KSK can be tricky. Most people hire a consultant to help with the paperwork, but it’s worth the effort. www.kuenstlersozialkasse.de

It's a matter of fact that Health Insurance for non Germans is expensive, which is why there is an EU healthcard, which I always carry, giving me free treatment anywhere in the EU and EEA.
« Last Edit: November 14, 2016, 07:24:48 am by omegadeep »
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