Thanks for the very good explanation that even makes sense. Did you make your thesis on the subject? :)

That I find very interesting. Do you mean all the same services are available even to tourists and illegal immigrants as to UK citizens (or with a residence permit), or that they are not turned down from hospitals in case of emergency? So, a tourist does not really need a travel insurance (for health), and can go freely go to health checkups or whatever Brits might be entitled to?

In Finland (and actually everywhere in EU Shengen area I think), before you can get a tourist visa (from outside EU), you have to have a travel insurance that covers medical care. I know someone who was skiing here and hurt her shoulder, so she was billed quite a high amount for money for a mere X-ray, and she was supposed to try to recoup the money from her travel insurance later.

So, the hospital will not try to get the money from your insurance company, but first you pay the medical expenses to the hospital, and later in your home country you try to get the money back from your insurance company (good luck with that).

But, if it is a case of emergency (or even minor things that need prompt action) for a person who simply has not money, I don't think any public hospitals will reject you. But you will be rejected if you try to get to dental checkups or something not so important, and of course you don't get compensations for medication you have to buy etc.

As soon as you get a residence permit (not a tourist visa), even temporary, you will get a Finnish health benefit card (KELA-kortti), and you are entitled to all the same services as Finnish citizens.

AFAIK, the main problem with the public US health care is how ineffecient it is. Here in Finland our health care costs a whole lot less (a third, was it?) per person, but we are covered a lot better.

People always complain about the problems in our health care, and admittedly it has worsened over the years, but I think it's mostly because people in here don't get how lucky we are. My husband got a rare bone cancer and he got treated by a team of world-class specialists, and the whole thing cost us 20 euros. Meanwhile I was reading the cancer support group how American patients, who desperately needed treatment fast, were struggling to get their insurance companies to pay up. When you have a life-threatning illness, the last thing you need is to fight against an insurance company only interested in their own profits.

I've had serious medican needs myself, and I've always gotten help, even though the system is slow.

Some stuff I hear about the arguments over the health care system over in USA sounds absolutely redicilous. Like those Sarah palin's "death panels". Oh, the stupidity!

It's difficult to say what is good and bad, especially if you take into account that even a good idea can be carried out really badly.

Some arguments:
- Universal health if done right would undoublty need less bureaucracy (because less middlemen) than privatized health care.
- Also privatized health care also has implicit "death panels". Come on, somebody must decide what treatment is paid how much. So not much difference there.
- Productivity or quality of the health care is a big problem everywhere in every system because costs are always a big problem.
- There are always in every system special interest groups (pharmaceuticals, doctors, clinics, ...) that try to game the system to their advantage.
- If people do not pay a flatrate but do share part of the real costs, they tend to not overuse the facilities. However they might abstain from necessary examinations therefore increasing the costs later down the road.
- Precautionary measures are more effective than later treatment
- Incentives to live a healthier live (less fast food, no smoking, regularly doing sport) can greatly decrease health care costs. It might be good to adapt the premiums accordingly, for example by a kickback when you're doing good.
- In most industrial nations people set great value in health care. They are willing to spend at least 10-15% of gross domestic product on health care alone.
- Incentives for having the most efficient health care system are crucial for the success.
- However for having a doctor for my children on duty in town day and night I would gladly pay my due.
- Universal health care is ultimately about solidarity with the poor. Because they can never pay the money necessary for high quality health care. That's why in germany it's financed like an income tax.
- Universal health care will most likely not take any preconditions into account while private health care most probably will.
- Hybrid systems could easily be implemented. For example a basic universal health care with private personal insurances for premium treatment is easily possible.

So the differences are not that big and are mostly about solidarity with the poor and the ones with losts of preconditions. Those would inevitably be neglected in any private health insurance system. Surely it's not a question of constitutional level.

Efficiency and the need to decide which kind of illness get how much support are inherent problems of all systems. This is the real problem. More and more percentage of people will be retired in the future and they need a lot of expensive treatment. Keeping it payable is the true challenge for the future. Or do you want to tell them - sorry, no money.

In my opinion it's a big pity that the richest country on earth cannot afford proper health care or housing for millions of its people... the priorities must be wrong. But that's just my opinion.

No, not all NHS services are available. Emergency and consultation are available to all and do not require identification. Prescriptions can be filled in some cases but these services are limited. As with everywhere it is advisable that tourists get insurance in case a more serious problem arises. I'm not advocating that you come to the UK without it but if one does forget then there is a safety net and it should be viewed as nothing more. If someone requires more regular care or would like to continue seeing a particular GP then they must have an NHS number which does require residency or proper visas, all EU and EEA citizens meet this requirement.
Medicare/Medicaid is one of those things I've never been able to completely understand and is something I would like to learn more about. It seems that seniors are still complaining about medical bills and prescription charges regardless, but old people complaining seems to be a universal certainty. I do have elder family members in the US but they never mention it except to complain about the home care personnel...again, universal certainty.

Right about now I'm wishing I lived in the American coastal regions, conservatives and all. The worst weather for about a month straight is all there is here. It's hard to believe anyone could beat us on happiness or healthy living with all the comfort food we consume this time of year.

USA spends 16% of their GDP in healthcare (Spain for example spends only 9%), one quarter of the population (ONE QUARTER!!!!!!!!!!!!!!!!) doesn´t have healthcare and they have less life expectancy (and a similar survival rate of people who receive treatment for illness like cancer) . Yes, we have here many other problems, for example, sometimes we have to wait so much time to see some specialists, but the three facts I´ve mentioned are too strong and make almost irrelevant any other one. USA is a great country in many things, but their health system is one of the worst in advanced countries and more likely the one of a third world (maybe second) country.

If you like gambling, you could try to use Polish public health care.

There's a stron chance you will not be alive until your scheduled surgery date will come. Polish health care provides so much excitement.

Doctor says to patient: - You will probably die in next 6 months unless we make a surgery
Patient: - Ok, so when's my surgery?
Doctor: - In next 3 years.

It's complicated, the answer is basically that they're whining about it. Elderly people in the US are extremely spoiled and expect cost of living increases, for example, even when the cost of living doesn't increase. They've had decades to save their money and yet they don't have any more than I do at age 31. There's no reason why most of them couldn't afford a supplemental policy or to save money for it later on.

There's nothing wrong with medicare, but they'll complain about the cost without thinking about who it is that's paying the bills.

Well the Netherlands (until the last reforms they made it was not so good) have a good private healthcare system, the debate is not only about public or private. A privately managed system can be universal if it is also also compulsory like Obama is trying to do (and like they have on the Netherlands), and that means that the government may pay part of the healthcare fees for people with low incomes. I think the "Obamacare" as some people use to call it, can be a good alternative to the actual system, a german-french-spanish like healthcare system would not be viable in that country, but health can be also universal and related with american values.

Okay, the system you mean is universal health care with the government stepping in where private insurances would fail. How much of the total spending is then paid by taxes? How much do private insurance companies earn with these health insurances? Maybe it's better to cut them out and nevertheless have competition. Like privately organized but publicly owned. What about hospitals in the Netherlands? Are they privatized too?

I remember having red that the drug prices are much lower in the Netherlands than here. Wonder why?

Maybe. I've thought that it'll turn into something similar to the 6 o'clock news story about the little old lady that was arrested with 80 cats in her two-bedroom house. 20 of them are rotting corpses and the rest are mostly near death cats that don't know how to take care of themselves . For the people who think that cats need their help, the next logical step to prevent this situation is population control with spay and neutering and getting expensive vet care. The other option is for cats to fend for themselves.

I really do think that legalizing prostitution could help reduce healthcare/population costs quite a bit. It would be foolish to not take Malthus seriously.

Apologies for taking this out of context with the rest of your good points, but would this be considered discrimination? I was under the impression that if I was on the same insurance plan as a professional hockey player I would pay the same premium even though I am very healthy without near as much risk as the hockey player because laws were passed that say an insurance company can't discriminate in this manner.

It rains like crazy in much of my state, too...

This is a good question. Insurace companies kind of can adapt to individual risks, especially upon asking for an insurance they might ask you a lot of health questions. There might be some questions forbidden. Like from next year on here insurance companies must sell only unisex tariffs. On the other hand I know that my health insurance can give me money for taking part in sports programmes. They would pay for part of it.

I don't know the legal situation. Some of it could be discrimination. I would say that smoking or having overweight is nothing that is out of individual control and therefore can be included in calculating the premium but I don't know.

One option is to promote healthier choices through taxes. For example, I'm quite fine with the idea that e.g. tobacco and sweets are now quite heavily taxed, and on the other hand they offer more affordable choices for interesting sports activities etc.

I'm not sure how taking into account the way of life in your insurances or medical payments would work in practise, so rather try to make healthier choices more affordable than the unhealthy ones in every day life.

It is not an easy question because vigorous sports activities may actually increase people's need for medical treatment. A smoker dying of lung cancer in his sixties might end up being cheaper for the society (and maybe even the insurance company) than a former American football player living to 90+ with all kinds of joint problems etc.

Patient: I found this white envelope and I brought it as a present...
Doctor: Oh, in that case we can fit you in tomorrow. 1 PM good for you?