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You want to see a bigger differential? When I was in the US, I needed an inhaler. It cost $250 to see the doctor and the inhaler was $150. In the UK. It cost
by no1youknowz 8y ago
You want to see a bigger differential?
When I was in the US, I needed an inhaler. It cost $250 to see the doctor and the inhaler was $150.
In the UK. It costs £0 to see the doctor and for the inhaler now is £8.80. Although I remember a time when it was £4.
Americans pay way too much for healthcare.
- polote 8y agoWe pay for healthcare every month, even if we dont go the doctor. Last year I paid 500€ per month for healthcare, and I went one time to the doctor
- CloudNetworking 8y agoI'd say your grasp of how taxes work is not great if you think you paid 500EUR for your use of healthcare that month.
- jlangenauer 8y agoIt’s not tax, we pay to a “Krankenkasse” (roughly a not-for-Profit health insurer), so we see exactly what it costs. The premium is based on your monthly salary.
- rusticpenn 8y agoSo, you pay for others when you are young and healthy and reap the benefits when you are plder and more prone to illnesses.
- Tomte 8y agoYes. That's the "social" in "social market economy".
- barry-cotter 8y agoBy the same logic the zakat in Saudi Arabia is not a tax because it theoretically goes to a non-state entity. If you’re not free not to pay it it’s a tax. It may be a well designed, special purpose tax that stops people doing stupid things but it’s still a tax.
- pintxo 8y agoThere is an important legal distinction between tax and insurance (in Germany). If you pay taxes, the state may do whatever it suits with the money. If they decide once day to no longer maintain the public infrastructure using your taxes but instead increase politicians salaries they are free to do this. If you pay an insurance, on the other hand, you have a legally enforceable right to receive the insurance benefits if you meet the pre-defined criteria for an insurance case.
- barry-cotter 8y agoThat one payment is legally a tax and another is not has no bearing on whether it is economically a tax, any more than the culinary distinction between fruits and vegetables bears on the botanical one. Botanically a tomatoe is a fruit. In the kitchen it’s a vegetable.
- pintxo 8y agoNot sure I can follow you here. What’s your definition of a tax?
- barry-cotter 8y agoI would define it as an involuntary payment, mandated by government. In German law the insurance contribution may not be a tax because payment of it entitles you to certain services. That doesn’t stop it being an involuntary payment, mandated by the government, a tax by common definition. That doesn’t make the legal definition wrong, but it isn’t really relevant outside a legal context just as a chef won't argue with a botanist that actually a tomatoe or a pumpkin is a vegetable not a fruit. Botanically they’re right but who cares? https://en.wikipedia.org/wiki/Tax https://en.wikipedia.org/wiki/Tax A tax (from the Latin taxo) is a mandatory financial charge or some other type of levy imposed upon a taxpayer (an individual or other legal entity) by a governmental organization in order to fund various public expenditures.[1] A failure to pay, along with evasion of or resistance to taxation, is punishable by law. Taxes consist of direct or indirect taxes and may be paid in money or as its labour equivalent.
- quietbritishjim 8y agoThe parent comment said: > I paid 500€ per month for healthcare You misquoted that as: > 500EUR for your use of healthcare that month (Emphasis mine.) Their original statement was correct (assuming that is what they paid!) and didn't sound like a complaint to me, just a factual correction.
- CloudNetworking 8y agoTechnically correct, the best kind of correct :-)
- hh3k0 8y ago500 Euro per month? What is the name of your insurance provider? I have never heard of such outrageously priced healthcare plans (private providers excluded, of course).
- martin_a 8y agoIn Germany, and this might apply to other states of the EU too, you'll pay a fixed percentage of your loan for healthcare services. For Germany it's around 14-15% of your monthly income before taxes. So, if you earn well, you'll also have to pay a bigger sum for healthcare services.
- bkolobara 8y agoIf you earn more than 50k Euro per year you can opt in for private health insurance instead. This greatly reduces the cost of insurance if you have big income. You can get good private insurance for 250-400Euro/month depending on your age.
- watt 8y ago... which will balloon to 600, 800 Euro/month, as you get older. And if don't maintain the same level of income as you retire, you might have another thing coming - the public insurance will not welcome you back.
- Brotkrumen 8y agoAnd once you get older, your private insurance premiums rise, which you may not be able to afford. Public insurers won't let you back in.
- martin_a 8y ago> Public insurers won't let you back in. I find this perfectly valid and think we should get rid of private health insurance at all. It's undermining our system, pretty much like pension for state workers and alike. We really need to unify this system, imho.
- eastendguy 8y agoIn other words: The direct cost of the insulin for the average German is not $55, but $0 - since it is covered by the mandatory health insurance. That said, don't worry that you do not get enough back from your health insurance. This will come soon enough when you get older ;-)
- basch 8y agoAre people not understanding how drug prices work? Intellectual property law is a way for government to grant exclusivity to one firm. This whole "you can get it for x in Canada and y in Germany" is a silly conversation. It's not like it costs 1000x to manufacturer the drug here vs there. The R&D and marketing costs are amortized over the period of exclusivity. Saying "you can just go to Canada to get it" just means "im going to circumvent intellectual property law." It's kind of like, but not quite, piracy. You're choosing where and when which laws apply to you. It also kicks the can down to the rest of the people buying the drug, because we know the pharma actuaries arent going to price their drug at a loss. And then on top of that, like you say, these prices people pay AFTER insurance arent what the cost of the drug is to the population, its an already subsidized price. Germans and Canadians are getting the drug cheaper not only because they have different laws, but because the R&D recovery isnt evenly split between country, they take their money where they can get it. Insulin SHOULD be generic by now (the patent on long-acting synthetic insulin expired in 2014), but the companies continually improve it and always sell the latest variant. And of course Doctors are going to prescribe what works best.
- DanBC 8y ago> but because the R&D recovery isnt evenly split between country, This point, which always comes up in these threads, has already been debunked both in those other threads, but it was even debunked here before you made this comment.
- basch 8y agoYou're saying drug companies make an equal amount of extra money, after manufacturing costs, in every country?
- JauntTrooper 8y agoHere in the US I pay $700 a month for health insurance for my family, with my employer contributing another $1,200. I have a $3,000 deductible, so the first $3,000 of expenses every year are not covered. Above that I pay 20% of costs. I also pay 1.45% of all income for Medicare, which I will not be eligible for until I'm 65, a few decades away. My employer pays an additional 1.45% on my behalf and I pay an additional 0.9% surcharge on all household income over $250k. I'd love to start my own company but health insurance costs are a big impediment. I have young kids, I can't leave my family underinsured. We're healthy now thankfully, but what if one of us gets cancer or is in a car accident and we're hit with $500k+ bills (or worse - if we can't get the right treatment)? I don't know how other people do it.
- djrobstep 8y agoIn Australia you buy em over the counter, no doctor required. So $0 for doctor and they cost $10 (~$7 USD). Prescription requirements for ordinary inhalers is a time-wasting money-making scam run by doctors.
- MRD85 8y agoI pay a couple thousand a year in medicare levy and I rarely see the doctor and don't use regular medication. Someone is fitting the doctors bill.
- xamolxix 8y ago> It costs £0 to see the doctor Kind off, people do pay national insurance, also a part of the overall tax goes into the NHS as well.
- cm2187 8y agoAnd the doctors are paid less than an average accountant in the UK.
- derekp7 8y agoHow much did their education cost? At least in the US, doctors don't make that much after student loan payments, insurance, etc.
- signalsmith 8y agoAre you asking how much it costs to get a medical degree as a UK citizen? In England* there is a cost (£9250/year), but it's slightly misleading to think of it like that because of how Student Loans work here. You pay nothing on your Student Loan up to a certain income (£25k, or $33k), 9% past that point, and then the remainder gets forgiven after 25 years. So in practice, it's an additional marginal tax rate for having gone to university. (* different elsewhere in the UK - e.g. free in Scotland)
- DanBC 8y agoThe NHS is paid mostly by taxes. NI only pays for about 20% of it.
- tsukurimashou 8y ago"It costs £0 to see the doctor" yeah just like in France, but it certainly doesn't cost 0€. You're paying taxes to get "free" services
- YeGoblynQueenne 8y agoAs I understand it, in the US you also have to pay taxes. The difference is that you also have to pay through the nose for healthcare because it's not covered by your taxes.
- hycaria 8y agoA situation that happens in Europe too (though not to the point of bankruptcy). Then there are private insurers, sometimes mandatory. And there are situations where even public + private healthcare do not cover all expenses.
- marvin 8y agoIt’s not a 1:1 comparison at all. E.g. income taxes i Norway and the USA are very similar, but total taxation is much higher than this in Norway due to a huge number of hidden taxes and fees. Lots of proponets of our system avoid mentioning this when comparing, but it is dishonest and gives an incomplete picture. Total taxation in Norway is 50-75% of gross pay, for an average employee (of which only 50% are employed in the private sector).
- NeedMoreTea 8y agoBy the same token, comparing overall taxation isn't a 1:1 match either when comparing against places where some of those are either a tax on employers or a directly purchased service.
- oliwarner 8y agoYou might. You might not. It's easy to look at your own tax receipt and think it's expensive but a) it's a boatload cheaper than it would be (cite: US healthcare atrocities) and b) not everybody earns enough to pay tax in these countries. The people in group b still get treated. Equally. You're not left to suffer and die of readily treatable chronic conditions if you can't afford tax.
- iknownout 8y ago*only in Enlgand.. in Scotland perscriptions are free.. so in what seems like the most obvious thing ever, people are not punished for being ill. I hope you guys get back free prescriptions and higher education soon, but the way things are going... well, good luck.
- skrebbel 8y agoOh come on, this is dishonest. Your doctor doesn't work for free. Someone else is paying them if not you. Possibly the inhaler is also subsidized. When healthcare cost is being discussed, the cost on society should be what's being discussed, not to what extent it's paid for by tax money. Those are two different things and they're only slightly related (in that if healthcare is perceived to be cheaper, people might use it more, which may drive up total cost) (or drive it down through better prevention).
- martin_a 8y ago> Americans pay way too much for healthcare. But they want it that way. They see us over here in Europe as some kind of "socialism" because our taxes will also go into public healthcare, so you don't have to worry about whether you can pay the bill if you have to see a doctor or go to the hospital. Call it "ease of mind" or whatever you want, but I prefer paying monthly, although if not using it, over anything else. edit: As someone pointed out, this might even come out to 0 once you get older and probably get ill more often or need more expensive services. So, it looks unfair when you're young and healthy but it will help you once this changes.
- craigsmansion 8y ago> but I prefer paying monthly very much this. It's like playing in a lottery that you win almost every month, and if at some point you lose, you get a lot of money.
- gtsteve 8y ago> and for the inhaler now is £8.80 Also, if you don't have a job or if you don't earn over a certain amount it won't cost anything at all.
- Symbiote 8y agoThe £8.80 prescription cost is not what the NHS pays the pharmaceutical company — it is probably more, although it's also possible that it's less.
- omgtehlion 8y agoIn Russia this costs 180 RUB ~= 3$, and it is not subsidized, but is sold over the counter, so already includes markup of distributors and pharmacy. I bet manufacturer (pharma company) receives only $2 or less of these money.
- DanBC 8y agohttps://bnf.nice.org.uk/medicinal-forms/salbutamol.html https://bnf.nice.org.uk/medicinal-forms/salbutamol.html £3.60?
- Symbiote 8y agoIn my defence, "The NICE British National Formulary (BNF) and British National Formulary for Children (BNFc) sites are only available to users in the UK". Seems an odd restriction, but it explains why I didn't find it.
- sehugg 8y agoThe pharma industry successfully lobbied for this outcome in 2005: https://www.motherjones.com/kevin-drum/2013/10/heres-why-your-asthma-inhaler-costs-so-damn-much/ https://www.motherjones.com/kevin-drum/2013/10/heres-why-you...
- arethuza 8y agoScotland doesn't even have prescription charges - so nothing to pay here at all.
- eggfriedrice 8y ago>In the UK. It costs £0 to see the doctor and for the inhaler now is £8.80. In Scotland prescriptions are "free", i.e., I don't pay anything for my inhalers, or anything else prescribed by my doctor. This costs the Scottish health service £1.3bn (https://www.scotsman.com/news/bill-for-prescriptions-in-scotland-rises-by-25-in-the-last-decade-to-1-3bn-1-4773180 https://www.scotsman.com/news/bill-for-prescriptions-in-scot...). I don't know how sustainable that cost will be, but I don't hear anyone complaining about the policy, except for opposition parties.
- aliswe 8y agoI gave less than 2USD for a ventolin inhaler while visiting Pakistan. Same exact model costs me about 13USD in Dubai.
- oliwarner 8y agoAnd the pricing for that is open. The NHS pays £3.31 for a Salbutamol inhaler with 200 doses[0]. They are paying private dispensaries (high street chemists, etc) to handle the prescriptions and drugs and whatnot. I still think the prescription price is well worth the cost. They also get Humalog much cheaper[1]. £29.46 vs $240.18 There's no sane way you can see discrepancies like this and not see something untoward happening. [0]: https://bnf.nice.org.uk/medicinal-forms/salbutamol.html https://bnf.nice.org.uk/medicinal-forms/salbutamol.html [1]: https://bnf.nice.org.uk/medicinal-forms/biphasic-insulin-lispro.html https://bnf.nice.org.uk/medicinal-forms/biphasic-insulin-lis...