Should The State Pay All The Costs Of Delivering A Baby?

[Tonitrus]

I figured it might be all the sex going on in hospitals there.  I've heard there are videos on the internet showing that. 

[garbon]

I figured it might be all the sex going on in hospitals there.  I've heard there are videos on the internet showing that. 

I thought there was that survey that showed the Japanese having a low desire to have sex (particularly women).

[Martinus]

I figured it might be all the sex going on in hospitals there.  I've heard there are videos on the internet showing that. 

I thought there was that survey that showed the Japanese having a low desire to have sex (particularly women).

He is talking about pr0n. 

[crazy canuck]

1) a new level of red tape is created which must assess who is in what categorie and who must pay what - I am not convinced the costs and inefficiencies associated with such a system result in a net benefit.

Most of the information required to run such a scheme is already collected and available - the database for tax credit payments (the unnecessary system Gordon Brown introduced) for example. Additional costs can be minimal with appropriate legislation.

That only accounts for the cost of identifying income levels.  Next all the systems needed to use that information and collect the fees has to be created and staffed.

Drawing it too low could be an issue, but since I was talking about both levying a charge as a proportion of the income and capping the maximum contribution possible, not so much of a one. 

A few decades ago this Province implemented a $5 dollar user fee.  The thought was that the fee was low enough that it would not stop anyone who really needed medical care but it would stop people from abusing the system.  There was no actual evidence of abuse, this was simply based on a belief there was abuse.  The fee was removed after a few years because the cost of health care actually rose as a result of people putting off visits until matters had gotten worse.

I fail to see why that would be so in a system which relies on one universal provider. Or, more precisely, in a system that relies on a universal price setter. Nobody in the actual system itself can directly benefit from providing a better service to a customer paying 5% of his costs compared to one paying 0% of his costs.

To some extent it depends on the kind of method used to implement the collection of fees.  I suppose if a system is created where sometime after the person leaves the clinic/hospital they receive a bill from a central NHS office which collects all fees that will provide some protection but I think you are still discounting the impact that payors will have regarding demanding better services in the facilities near them for the extra amount they are paying.

[Jacob]

Health Care systems in Asia are just never really looked at.  I suppose maybe it makes sense that you compare cultures more similar to yours maybe?  No idea.  I have certainly heard anybody ever say 'Nips just live longer because they are Asiatic savages' or a more PC version of such

Probably because we all talk about the health care systems we know about, so we talk about the systems in the UK, US, and Canada, with a smattering European countries thrown in. Nobody here has serious experience with the Japanese health care system.

[Agelastus]

That only accounts for the cost of identifying income levels.  Next all the systems needed to use that information and collect the fees has to be created and staffed.

But the basic systems are already in place for billing as well (even if we don't seem to use them, see this article http://www.telegraph.co.uk/news/health/news/10022601/NHS-counts-900-million-cost-of-treating-EU-visitors.html) for both EU and non-EU citizens. Pricing is already in place, as is the record of all treatments. Expansion is (or should be) a lot cheaper than starting from scratch.

Collection systems may cost something depending on the method used; but since the majority of the people who would pay a contribution to the cost of their treatment would be either salaried workers or wealthy retirees then the simplest method of collecting would be garnishing wages (with a special "NI" levy, possibly) and state pension payments (which is taxable income.) Leave collection mainly as a function of HMRC's taxation functions. For the high earning self-employed issuing a statement to them and making them include the payment as part of their tax calculation might work as well.

A few decades ago this Province implemented a $5 dollar user fee.  The thought was that the fee was low enough that it would not stop anyone who really needed medical care but it would stop people from abusing the system.  There was no actual evidence of abuse, this was simply based on a belief there was abuse.  The fee was removed after a few years because the cost of health care actually rose as a result of people putting off visits until matters had gotten worse.

I would think that the people most likely to put off visits would be the poorer, less educated members of society - the ones who would not have to make a contribution anyway under the rules I'm suggesting. Universal fees are often self-defeating. Targeted fees are a much better idea.

To some extent it depends on the kind of method used to implement the collection of fees.  I suppose if a system is created where sometime after the person leaves the clinic/hospital they receive a bill from a central NHS office which collects all fees that will provide some protection but I think you are still discounting the impact that payors will have regarding demanding better services in the facilities near them for the extra amount they are paying.

I disagree for the simple reason that if they really, really want a better service (or what they think is a better service) they can use BUPA or an alternative private healthcare provider instead.

[Valmy]

Health Care systems in Asia are just never really looked at.  I suppose maybe it makes sense that you compare cultures more similar to yours maybe?  No idea.  I have certainly heard anybody ever say 'Nips just live longer because they are Asiatic savages' or a more PC version of such

Probably because we all talk about the health care systems we know about, so we talk about the systems in the UK, US, and Canada, with a smattering European countries thrown in. Nobody here has serious experience with the Japanese health care system.

Well this is self-evidently wrong and further is nonsensical.  Why would Canadians and Americans have less experience with Japan or China than they do with Germany?  It is certainly not because we have more German immigrants these days than Chinese ones.  It is certainly not because we have closer economic ties with them. 

[crazy canuck]

Health Care systems in Asia are just never really looked at.  I suppose maybe it makes sense that you compare cultures more similar to yours maybe?  No idea.  I have certainly heard anybody ever say 'Nips just live longer because they are Asiatic savages' or a more PC version of such

Probably because we all talk about the health care systems we know about, so we talk about the systems in the UK, US, and Canada, with a smattering European countries thrown in. Nobody here has serious experience with the Japanese health care system.

Well this is self-evidently wrong and further is nonsensical.  Why would Canadians and Americans have less experience with Japan or China than they do with Germany?  It is certainly not because we have more German immigrants these days than Chinese ones.  It is certainly not because we have closer economic ties with them.

Because we have had the benefit of posters who know something about the German system telling us about it. 

[Valmy]

Because we have had the benefit of posters who know something about the German system telling us about it. 

Ah.  As 'we' I meant the public discussion over here.  I have never heard anybody put up the Japanese system as a model we should follow.  But we have heard Mono discuss the Hong Kong health care system, seems its very similar to the UKs, and we have had posters who have spent time over in Japan who can say something about it.

[crazy canuck]

One more benefit, if the State provided funding then presumably the chances of an undocumented birth would decrease.

[Jacob]

Well this is self-evidently wrong and further is nonsensical.

Easy there big feller

Why would Canadians and Americans have less experience with Japan or China than they do with Germany?  It is certainly not because we have more German immigrants these days than Chinese ones.  It is certainly not because we have closer economic ties with them.

... I don't know about you, but the online places I have hung out on have had more Germans explain how the health system works in their country than Chinese and Japanese. And that's what I was talking about.

As it happens, I do have some experience and knowledge of the Chinese health care system, but it hasn't really seemed worthwhile to bring it up when we've discussed health care. It's not something I'd suggest the US emulate, either.

[Valmy]

One more benefit, if the State provided funding then presumably the chances of an undocumented birth would decrease.

It wouldn't have any impact in the case in consideration though.

[Valmy]

As it happens, I do have some experience and knowledge of the Chinese health care system, but it hasn't really seemed worthwhile to bring it up when we've discussed health care.

Why not?

I don't know about you, but the online places I have hung out on have had more Germans explain how the health system works in their country than Chinese and Japanese. And that's what I was talking about.

Yeah I was thinking you meant something besides online places 

[Jacob]

As it happens, I do have some experience and knowledge of the Chinese health care system, but it hasn't really seemed worthwhile to bring it up when we've discussed health care.

Why not?

It hasn't seemed germane, and while I'm passingly familiar it's not enough to withstand in depth questioning.

But I can give you the brief overview, as I understand it:

Everyone gets an account with a certain amount of money to be spent on medical services, including pharmacy stuff. It's fairly generous for most uses, but if you exceed it you're going to have to pay out of your own pocket. I'm not sure what happens if you exceed the costs due to something terrible happening (cancer, serious accidents, etc) - I suppose there's a provision, but I don't know.

Most people do not use their annual allotment - but fear not, the free market has provided a solution. You can spend your health-care allotment in pharmacies, so now there are many pharmacies whose main trade is all kinds of goods you might find useful but that are otherwise not particularly health related. So you can spend your allotment there.

You can also pay out of your own pocket for fancy places and better care, if you're rich, of course. And I'm sure there are hospitals associated with the PLA and other organizations where you can get taken care of if you have the right connections.

Most doctors, whatever their area of practice, are associated with a hospital. So for most things you'd go to a family doctor or specialist for, you'd go to the hospital to get sorted.

In addition, many if not most people go to Traditional Chinese Medicine doctors and pay cash (much less). Funny thing about those is that there's no privacy... like... you go with your whole family and when it's your turn you go to a table where the doctor sits and he asks you about your bowel movements and pulse and whatever else. Not only is your family there, but so is a random assortment of other patients and their families, all listening to you rattle off your symptoms and answering the doctor's questions.

[Ed Anger]

I discuss my bowel movements...with everybody.