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  #907592 4-Oct-2013 07:19
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Reduced per capita costs for healthcare (the US has the highest per capita cost of healthcare in the world by a massive margin). This will be brought about by forcing young people and healthy people to have insurance, which improves the risk pool.

Effectively they end up with a screwed up/complicated version of of universal healthcare (eg. Netherlands), but not single payer healthcare (eg. NZ, Australia, Canada, UK, France etc)

I'd like to share some insight as I can contribute from 2 perspectives (having lived in The Netherlands for 28 years and in the UK for 4 years now).

- healthcare in NL used to be provided by the state, you could purchase additional private insurance that would cover more (lower excess) and use services the government system wouldn't cover
- in 2002 when I was going to Uni I paid 39 euro (NZ$63) in private healthcare per month (voluntarily)
- the government then continued to make healthcare obligatory in 2006 and privatised the entire system
- consequentially the private healthcare cost then rose to around 75 euro per month (NZ$122), nearly double compared to just 4 years before that
- the private healthcare cost has kept on climbing and is on a current level of around €110 (NZ$180) per person per month - triple the cost of 2002, in just over 10 years!
- hold on stop the story here for a sec

This means that in 2013, in The Netherlands, you are paying €110/$180 per person per month, this means for a family of 4 it costs €440/$718 per month! Multiply this by 12 months and your annual private healthcare charge is €5280 or NZ$8620 .. **SLAP** .. yep that hurts

- before it reached these extremes I got a job offer in the UK and moved over here where I pay £0 per month to receive free NHS treatment
- if I want to get better treatment, coverage and lower excess on any charges not covered I can get a private healthcare service here for around £29/NZ$57 per month .. waay more tolerable

- it's not ever yet.. what happens if you can't afford the ridiculous cost that the state forces you to pay in NL?
well after 3 monthly warnings, the tax department will take over and they will levy the healthcare charges as a tax over your income.
this means that it will be taken right off your pay-check without your intervention
if you are not working it will be decreased from your benefits and if you are studying you won't be able to take out a full student loan
the only way to escape the forced healthcare charge is to leave the country and notify your council that you are no longer a citizen, that's the only way to get rid of it..


Yep, the Dutch system is quite interesting, I had someone come and talk to me in the last couple of months about the system there and how they could improve, she was trying to learn from what we are doing as NZ has probably the best value for money health system in the world.

Also you realise you are paying for the NHS as part of the "national insurance" in your paycheck...


Dutchie living in NZ here - don't forget to add on here that you get a monthly supplement if you earn under the nearly 31000 EUR threshold (50,000 nzd).

Nevertheless the system in NL is very complicated as is the tax system and average income figures should be taken into consideration when looking at the healthcare spend.

I think it is also very hard to compare some of the factors of the social system and even for example the housing market. My sister just moved out of home and bought a decent house with no deposit. For me to buy a house in Auckland I need roughly 2 years worth of salary as a deposit...

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  #907696 4-Oct-2013 09:46
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The US based Commonwealth Fund has a lot of cross-country comparison survey data on the efficiency of healthcare systems.
I'm not going to defend that site for being "unbiased", as the clear mission statement for the organisation is to promote ideas for a better performing healthcare system with improved quality, more equitable access, and affordability.
The cross-country survey results are quite consistent - the more privatised (and dependent on  private insurers), the less efficient the system on all measures.  (OTOH if you were to conduct a survey measuring ease of access to $1 million liver transplants for wealthy elderly alcoholic businessmen, the US would probably rate pretty well) The US system is a huge burden to the US economy, with the largest spend per capita in absolute terms and as % of GDP, yet consistently poor measured outcomes. It should be treated no differently from any other sector in the economy where if productivity is measurably very low, then at least accept that there's a problem.  It's hard to believe that the "Tea Party" faction of the Republican Party can simultaneously argue that they're "pro-business" whilst endorsing retention of an extremely poorly performing but large component of the US economy.  But OTOH - perhaps it is easy to believe - as the "Tea Party" doesn't have a cohesive fundamental ideology, they just "cherry-pick" a bit of libertarianism, add in some authoritarian social conservatism, throw a bit of god-bothering in to the mix, stir it up with some xenophobia and conspiracy theory, and throw in on Fox news to the angry crowd looking for "someone else" to blame.

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  #907977 4-Oct-2013 16:10
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ScuL: The biggest bummer is for tourists visiting the US!!

Parks like the Grand Canyon are now officially closed.
I don't have a trip booked over there until March 2014 but I do hope things will be sorted by then!

I'd be willing to bet you could still somehow manage to see the Grand Canyon if you are in the area.   I found it pretty hard to miss!

Son and I are currently doing our long-anticipated roadtrip.  Got to Flagstaff today with the faint hope that a resolution was in site.  On day 1 of the shut-down they barricaded all the viewing points but since this morning they have entirely closed the road (route 64) that accesses the South Rim so can't even get close.  Too many people doing what we had planned, drive by and stop on the highway to catch a glimpse.

So a small part of our holiday ruined but at least we got to Alcatraz last week which was a higher priority.

Still, at least I've still got a regular paypacket coming in, unlike the thousands of government workers here who have been furloughed.

So many people complaining about yogurt these's becoming a culture.



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  #907984 4-Oct-2013 16:24
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P1n3apqlExpr3ss: There were officials putting up fences around war memorials in DC that are normally open to the public 24/7...! Visiting veterans righteously knocked them down and got to pay their respects

Another way of looking at it is that a bunch of Tea-Party activists bussed a bunch of veterans in and then egged them on to break through the barriers while dragging along the Washington Press Corps for the photo op. Word is that the vets ended up unimpressed at being setup for somebody else's game.

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