Real Changes in US Healthcare (Euro members please share your opinions)

[JohnRoberts]

On paper it sounds logical and looks fine. Pool everybody together into one system so the healthy subsidize the sick and injured. T

And isn't this exactly the idea of private insurance, only writ smaller? 

I like to refer to insurance as privatized socialism.  So do you you want huge CEO salaries & stock dividends with your socialism, or would you rather cut out the middlemen & have your socialism run by the government?

While this has been well discussed, I will repeat. true insurance after the original Lloyds of London pooling risk model, to share losses of oceangoing cargo, is a percentages game to average out "extraordinary" losses between many shippers.  Socialized healthcare is a soup-to-nuts coverage of all healthcare, not remotely the same. For example automobile insurance, protects against the "extraordinary" vehicle accident. Automobile insurance does not pay for oil changes or replacing worn tires. If it did we would probably see similar distortions in that industry.

I would love to purchase "extraordinary" healthcare insurance but never found a practical policy for individuals. I recall as an executive at a decent sized company, we self-insured our workers and bought our own ballon insurance policy to protect against outlier high claims years.

In my mind a good way to get healthcare back under the influence of free market forces, is to get individuals back paying for their actual healthcare and perhaps sell them "extraordinary health event" insurance, to cover isolated events. Of course this hinges also on who do you think should pay for your (our) healthcare. I think I should pay for my health care, not a bunch of young pukes.  Note: the government doesn't have it's own money, so if we don't pay for our healthcare, somebody else is. This whole business became confused back in the '30s when health care was made a tax deduction. Again OK if talking about extraordinary health care, but IMO not OK for routine matters.

The crux of this disagreement is very basic... does individual decision making represent the individuals self interests, better than government bureaucrats. This question has been well argued for decades by famous economists, and opinions still vary. I side with individual decision making, with the government having a role only as a safety net.  Imagine the health resources we could free up, by making that entire industry truly competitive. While this example is a little shop worn from being repeated. LASIK eye surgery dropped in price so dramatically due to free market forces and competition, not some insurance company or government intervention.

JR

 

[hodad]

Automobile insurance does not pay for oil changes or replacing worn tires. If it did we would probably see similar distortions in that industry.

I would love to purchase "extraordinary" healthcare insurance but never found a practical policy for individuals.
JR

Auto insurance doesn't cover thrown rods either, which would roughly be equivalent to a heart attack, let's say.  And stuff like that--the human stuff that doesn't relate to collision or theft in car insurance--is the stuff that the preventative maintenance does so much to safeguard against.  My latest insurance (through my wife's work--it changes every year) offers a discount if you get checked out & are good on cholesterol, BP, etc., and if you're not will give you the discount anyway if you work to deal with your issues.  It makes sense, and probably saves money over the long haul.

Further, the greatest expenses in healthcare are end-of-life expenses--the last 2 or 3 months,  IIRC--and not in the maintenance type stuff.  And just like changing your oil and belts can help your car last longer and run better, routine checkups and maintenance of your body do the same for you.

 

[JohnRoberts]

Auto insurance doesn't cover thrown rods either, which would roughly be equivalent to a heart attack, let's say.

A broken or clogged fuel pump might be the better analogy for automotive heart attack, but I suspect you are going for severity of the failure not its nature. 

And stuff like that--the human stuff that doesn't relate to collision or theft in car insurance--is the stuff that the preventative maintenance does so much to safeguard against.

I live in one of the fattest states in the country and I am constantly amazed by how much of the health care costs incurred by young people and young adults is self inflicted. It doesn't seem logical that such self inflicted injury should be a cost shared by us all. Unfortunately humans are not completely rational regarding personal behavior. I'm not so old that I don't remember how I thought about such things when I was young (and didn't think). I only got serious about my own health after I turned 40 and realized I was still here.

My latest insurance (through my wife's work--it changes every year) offers a discount if you get checked out & are good on cholesterol, BP, etc., and if you're not will give you the discount anyway if you work to deal with your issues.  It makes sense, and probably saves money over the long haul.

That is not a new trend, but common sense for all involved. Even the evil single payer private insurance tries to reduce costs with programs targeted to get the insured to have some skin in the game financially, not that they don't already have skin in the game literally. If they share some of the cost for using premium brand name drugs via co-pays, they will use them more selectively. Of course the brand name drug pushers understand economics and respond by subsidizing prescription costs to neutralize the co-pays and reduce the free market forces on the patient. This is perfectly legal, and good business, but bad for overall health care costs. 

Further, the greatest expenses in healthcare are end-of-life expenses--the last 2 or 3 months,  IIRC--and not in the maintenance type stuff.  And just like changing your oil and belts can help your car last longer and run better, routine checkups and maintenance of your body do the same for you.

I am not convinced that living well means we will die well (quickly and cheaply). I had always planned to die young and pretty in a fiery car crash, but that ship has already sailed (at least the young and pretty part).
 
JR

PS: I realize the cognitive dissonance between my competing arguments that individuals are better served by making all their own decisions, and the apparent poor choices of so many (smoking, over eating, etc). A cost of liberty is that some will not prosper, but the majority would be harmed by a nanny state that tries to manage all of our personal  decisions. No system is perfect, but IMO free choice is less bad.   

 

[living sounds]

A cost of liberty is that some will not prosper, but the majority would be harmed by a nanny state that tries to manage all of our personal  decisions. No system is perfect, but IMO free choice is less bad. 

But the majority is harmed by a "everyone for themselves" system. Societey bears the shared cost of raising and educating a person one way or another. And if that person then dies prematurely or is rendered incabable of working properly and contributing to society the loss of someone not repaying what was invested into him (however cynical this sounds, that is how it is) is again everyones loss. This cost is always socialized, but there is a choice to socialize the costs to prevent it from happening. Ultimately everyone wins.

Things like end-of-life care or unhealthy lifestyle can be dealt with accordingly. The 100.000 bucks a month cancer treatment that doesn't prolong life could only be covered for those who choose to pay a premium when they are younger. Premiums can be higher for smokers or fat people or those who like to indulge in risky sports. And society as a whole can be influenced to live healthier by better education, taxing unhealthy food or benefits like free sports opportunities.

Science has shown again and again that humans are ill equipped to make intelligent choices on their own in many situations, our decisions are instead guided by intuitive but misleading cognitive biases. The actual homo economicus exists, but is a very rare species usually suffering from personality disorders in the autistic spectrum. So in order to get the best outcome for everyone there is no other way but to gently tweak the rules so people make the right decisions.

 

[JohnRoberts]

A cost of liberty is that some will not prosper, but the majority would be harmed by a nanny state that tries to manage all of our personal  decisions. No system is perfect, but IMO free choice is less bad. 

But the majority is harmed by a "everyone for themselves" system.

While that doesn't sound literally correct no one is suggesting we abandon a safety net for the helpless, and I will counter argue that as many abuses have been performed in the name of the common good, as for religion. 

Societey bears the shared cost of raising and educating a person one way or another.

I though this was a "natural" responsibility of parenting, while as a single person I don't mind my tax dollars supporting education, as long as they don't waste my money, and actually teach the kids something useful.
---
I read a complaint from a college professor about how the education level of the students they were getting was so bad, it limited how much they could teach them. This is a failure on way too many levels. How did these students get promoted out of high school? How did they get accepted into college, if they lack the basic tools to learn? I bet the college and HS teachers got paid the full amount, for these substandard outcomes. This doesn't bode well for us. Where will the smart government handers to tell us what do, come from? Not these college pukes. 

And if that person then dies prematurely or is rendered incabable of working properly and contributing to society the loss of someone not repaying what was invested into him (however cynical this sounds, that is how it is) is again everyones loss. This cost is always socialized, but there is a choice to socialize the costs to prevent it from happening. Ultimately everyone wins.

People are not the property of the state, to be managed by the state for profitable return... The state is our creation and our property. The state answers to us. We are the owners, not them.

Things like end-of-life care or unhealthy lifestyle can be dealt with accordingly. The 100.000 bucks a month cancer treatment that doesn't prolong life could only be covered for those who choose to pay a premium when they are younger. Premiums can be higher for smokers or fat people or those who like to indulge in risky sports. And society as a whole can be influenced to live healthier by better education, taxing unhealthy food or benefits like free sports opportunities.

OTOH letting the dumb asses die young works for me, unfortunately it isn't that simple. We now have young kids with "adult onset" diabetes usually caused by decades of bad diet and lack of exercise. If we socialize their healthcare cost, it's a small logical leap to also manage their self destructive behavior, to reduce that cost. This seems unavoidable in a limited resources world. These kids are supposed to be healthy to pay for me in my old age.  . This sounds more like bad science fiction than my idea of a functioning free society. Type II diabetes is relatively quick to express, the years of over eating can also increase the incidence of cancers, a growth related malady, so this bad behavior raises health care costs all around.

Science has shown again and again that humans are ill equipped to make intelligent choices on their own in many situations, our decisions are instead guided by intuitive but misleading cognitive biases. The actual homo economicus exists, but is a very rare species usually suffering from personality disorders in the autistic spectrum. So in order to get the best outcome for everyone there is no other way but to gently tweak the rules so people make the right decisions.

natural selection baby...

I know I'm not smart enough to make your life choices for you...  While this is an old debate. I advise any new to this dance to read Hayek's "The road to Serfdom" not as a call to authority, but as a primer to explain my POV.

JR

 

[DaveP]

I shall stick in my 3 pennuth and probably lose most of the US friends I've made on the Forum!  But Lassoharp did invite us!

As the UK national health service started a year before I was born I have never known anything else, but my parents told me of what it was like in the pre-war years.  There was only minor health insurance then and you basically died if you got something serious.  I had an operation for appendicitis when I was 8 and a fractured femur and pelvis following a car smash at 18, God alone knows what that would have cost me under your system.

For the life of me I can't understand how Americans confuse a health system with socialism or worse communism.  It has absolutely nothing to do with the political system we live under, its just a way of looking after the population in an equal way.  For such an overtly "Christian Country" you have a way of "walking by on the other side" as far as healthcare is concerned.

Its a bit of a joke over here that Americans don't have passports or know where places around the world are, that disgraced republican candidate who had problems with Libya recently was a case in point.  How he thought a fastfood chain qualified him to run for President I don't know.  If Americans saw how we lived in Europe perhaps they would not be so paranoid.

By the way, I am not anti-American, far from it.  In fact I owe my very existence to an American serviceman.  If he had not screwed my Dad's first wife while he was away fighting in Italy in WW2, he would never have got divorced and married my Mum!

best
DaveP

 

[living sounds]

If only people behaved rationally some of the Austrian school economics might actually work, but again, they rarely do. Even intelligent, well-educated, successfull people I know aren't capable of taking proper care of their health, they need to be prodded in the right direction. Our brains are hard-wired for unhealthy nutrition and food companies employ advanced psychological tactics to insure people make poor choices and rationalize them. Modern life is extremely stressfull and the pressure in the workplace in recent decades has increased to a point where it makes many people sick. Pay for many people is so low they often can't afford healthy food, real wages have declined... And in the US they often can't even get healthcare...

Natural selection isn't working much anymore for humans, and it only plays itself out over longer timespans. We'll soon be able to succeed it with targeted genetic manipulation anyway.

As for the supposed drying up research - there is so much BS in pharmacological "research", so many pseudo innovations, botched studies etc., it would be better to give the money to independent universities and just let scientists do real science without the malplaced incentives.
From what I've read the burocratic overhead with insurances in the US is also quite amazing. Socialising this system might be a blessing.

 

[ricardo]

Most of us Euros & loyal ex-colonials probably find some of the stuff here quite incredible.

I don't think there is any doubt that a healthy National Health Service promotes a healthy and efficient private health industry.  The Private Health Industry must offer something which the NHS can't provide if they are to compete.  Indeed, more than half Private Health hospital beds are in NHS hospitals as some of these, eg the London Teaching hospitals are the best in the world.

One small but significant example is the govt. owned British Pharmaceuticals.  They make the most common prescription and over the counter drugs and these are sold at all supermarkets & chemists at half to 1/3 the price of branded stuff.  But the sales of Panadol etc (ie branded over the counter drugs) are little different from the rest of the EU.  (Hmmm.  Must mean all POMs are hypochondriacs.)

The situation in the former rebel colonies shows what happens when $$$ (aka free market) reigns.  And Cuba illustrates what a totally Socialist system can achieve in health care.  Hence the Medical Vacation destinations for Americans.

The question here is whether the present Obama government can provide an efficient National Health Service.  I can't answer that question.  But I'm certain that politicians who believe the poor should pay more tax than the rich, can't.  Baroness Thatcher was the most obvious example of this with her, "Of course the NHS is safe in our hands!"

 

[JohnRoberts]

I shall stick in my 3 pennuth and probably lose most of the US friends I've made on the Forum!  But Lassoharp did invite us!

welcome to the pool,,, just don't pee in it...while you're still in it.

As the UK national health service started a year before I was born I have never known anything else, but my parents told me of what it was like in the pre-war years.  There was only minor health insurance then and you basically died if you got something serious.  I had an operation for appendicitis when I was 8 and a fractured femur and pelvis following a car smash at 18, God alone knows what that would have cost me under your system.

I have several decades of experience with the system here, and have studied a great deal about most other major systems. They all have their strengths and weaknesses.

I am far from advocating the status quo, I just want more competition not less.

For the life of me I can't understand how Americans confuse a health system with socialism or worse communism.  It has absolutely nothing to do with the political system we live under, its just a way of looking after the population in an equal way.  For such an overtly "Christian Country" you have a way of "walking by on the other side" as far as healthcare is concerned.

I don't feel compelled to respond to this.. there must be some american you are talking about somewhere.

Its a bit of a joke over here that Americans don't have passports or know where places around the world are, that disgraced republican candidate who had problems with Libya recently was a case in point.  How he thought a fastfood chain qualified him to run for President I don't know.  If Americans saw how we lived in Europe perhaps they would not be so paranoid.

We have jokes about the Brits too, but I see no useful befit from repeating them here, such exchanges are generally offensive, and I don't want to offend. My several visits to GB were pleasant and the vast majority of my friends there managed to escape the stereotypes. 

Regarding Cain's presidential run, I think even he was surprised by his early success, and surely he wouldn't have pressed that far, knowing what must have about what was lurking in his closet. But that's the purpose of the primary process to vet out the weak sisters, and drag the dirty laundry into view. Sometimes I think our process is too long and drawn out, surely too expensive. Advertising spending  alone for 2012 will be a couple $B. We could do some good stuff with a few $B, We have aids infected individuals who aren't on medication for example. I guess if our politics wasn't important, you guys wouldn't be paying so much attention to it. Enjoy the cheap laughs. 

I have travelled around GB some and seen how you live. I am not very paranoid about it, while I do not wish to become a colony again, or rejoin the empire.  FWIW I do prefer the beer in GB over the beer in Germany, despite the Germans making such a big deal about their purity laws et al... more self serving BS IMO, and before you tell me about how bad the American beer is, I brew beer, and my American beer can kick any countries beer's ass (while Belgium has a good fighting chance in that competiton). 

By the way, I am not anti-American, far from it.  In fact I owe my very existence to an American serviceman.  If he had not screwed my Dad's first wife while he was away fighting in Italy in WW2, he would never have got divorced and married my Mum!

best
DaveP

I was a serviceman who spent a little time in Europe, but not in GB, and not during WW2 (early '70s), so it wasn't me babe, but You're welcome from all of us, we try hard. 

I am rather content to be a joke and underestimated by the rest of the world, it makes everything so much easier.

JR 

 

[JohnRoberts]

If only people behaved rationally some of the Austrian school economics might actually work, but again, they rarely do. Even intelligent, well-educated, successfull people I know aren't capable of taking proper care of their health, they need to be prodded in the right direction. Our brains are hard-wired for unhealthy nutrition and food companies employ advanced psychological tactics to insure people make poor choices and rationalize them. Modern life is extremely stressfull and the pressure in the workplace in recent decades has increased to a point where it makes many people sick. Pay for many people is so low they often can't afford healthy food, real wages have declined... And in the US they often can't even get healthcare...

I repeat my mention of Hayek was not a call to authority or for your benefit, just some (possibly) instructive reading to help explain my personal perspective to others.

The US system is so screwed up between legal liability, and the establishment controlling access, that way too much medical attention ends up performed in emergency rooms for 10x or more the fair cost. 

I wish I had your faith in government as a benign master, but I worry that they are just grabbing power to control another 15-20% of the formerly private economy. 

Natural selection isn't working much anymore for humans, and it only plays itself out over longer timespans. We'll soon be able to succeed it with targeted genetic manipulation anyway.

I am also not smarter than natural selection, but it is complex. On simple examination it is powered by reproductive drive so only a relatively early life phenomenon. Extending lifespans seems to be over the horizon for this. 

As for the supposed drying up research - there is so much BS in pharmacological "research", so many pseudo innovations, botched studies etc., it would be better to give the money to independent universities and just let scientists do real science without the malplaced incentives.
From what I've read the burocratic overhead with insurances in the US is also quite amazing. Socialising this system might be a blessing.

ding ding ding,, yup the current system is broken, I am just arguing about the fix... we'll see, I can't predict the future either.

JR

 

[lassoharp]

I had an operation for appendicitis when I was 8 and a fractured femur and pelvis following a car smash at 18, God alone knows what that would have cost me under your system.

This along with comments from Peter Purpose and Kingston was what I was interested in hearing as far as wanting to confirm what I have heard for years from various people who either live or travel abroad - the confirmation of the absurdly high medical costs in the US, and the high quality of other health care systems.

For the life of me I can't understand how Americans confuse a health system with socialism or worse communism.  It has absolutely nothing to do with the political system we live under, its just a way of looking after the population in an equal way.  For such an overtly "Christian Country" you have a way of "walking by on the other side" as far as healthcare is concerned.

For those with an interest in promoting the socialist angle as a political strategy, I think they could care less as long as it serves to preserve the status quo.  But I will never underestimate fanatics.  Common sense says that all political doctrines - capitalism, communism, socialism etc are conceptual and none ever adhere to the ideal in practice and all can suffer equally from the darker half of human nature.  Too many atrocities have been committed in the name of Christianity for me to comment on the latter statement.  My father and grandparents were full Native American and though they fully adopted a Christian faith they were both extremely politically active in local Native American affairs regarding tribe recognition and land rights.  Hypocrisy duly noted and agreed with.

If Americans saw how we lived in Europe perhaps they would not be so paranoid.

In regards to seeing a workable low cost healthcare system I have faith that the majority will see it as a godsend.  I recently met a military contractor who spent a lot of his free time in Thailand. He was having problems with his gall bladder and learned that emergency surgery was required.  Since he had grown up in the US he had a good idea of what the cost might be so he brought about 3 thousand in cash with him to the hospital, mainly to cover an expected deductible to his insurance plan.  Including pre surgery testing and after care he wound up spending several days in the (according to him, very clean modern, competent) hospital.  When it came time to pay he pulled out his insurance card and the American doctor just kind of laughed and told him it probably wasn't necessary and handed him the bill - $125 USD.  Guy couldn't believe it.  He's a believer now.  I believe we are in the midst of an ongoing war over the territory of belief systems and perceptions in the US.  You seldom see any national media coverage on the subject of how little people outside the US pay in health care costs despite story after story of people going bankrupt over medical bills.  What you often hear from people's mouths are things like "Well, sure if you want some 3rd world quack to operate on you in a rat an roach infested hospital, then go ahead".  I hear nice looking people with college degrees saying things like that.  When you confront them further with facts to the contrary you often hear - "Well, now you're describing socialism!!" .  Now, where do they get such ideas?, and who has a vested interest in promoting and maintaining those public perceptions? My impression of those who start screaming "Socialism" is that they somehow believe they are defending something sacred, political or religious and common sense gets circumvented.  For those who have a special vested interest in the high profitability of the current US health care system, including insurance and pharmaceuticals, the loss of paranoia by the majority you speak of will likely be the start of big paranoia for the former.  If the current US way were the only feasible way to handle national healthcare then I would have no criticisms, high cost or not.  But it isn't and the current system isn't about to give up their cash cow without a fight.  They're not going to take it upon themselves to change their direction, so who's left to create change?  I see only two: The government or the people.  But, the government has a business stake in the health care industry - partnering up with large pharmaceutical companies in a for profit manner is not exactly being a good servant to the people is it? (drug costs still heading for the moon as we speak).  Obama seems to have honest intent to make some serious change.  If his plan doesn't work it certainly won't be all his fault.  That leaves us with the people and the truer, (IMHO) American way - Occupy. 

 

[living sounds]

What you often hear from people's mouths are things like "Well, sure if you want some 3rd world quack to operate on you in a rat an roach infested hospital, then go ahead".  I hear nice looking people with college degrees saying things like that.  When you confront them further with facts to the contrary you often hear - "Well, now you're describing socialism!!" .  Now, where do they get such ideas?, and who has a vested interest in promoting and maintaining those public perceptions? My impression of those who start screaming "Socialism" is that they somehow believe they are defending something sacred, political or religious and common sense gets circumvented.  For those who have a special vested interest in the high profitability of the current US health care system, including insurance and pharmaceuticals, the loss of paranoia by the majority you speak of will likely be the start of big paranoia for the former.  If the current US way were the only feasible way to handle national healthcare then I would have no criticisms, high cost or not.  But it isn't and the current system isn't about to give up their cash cow without a fight.  They're not going to take it upon themselves to change their direction, so who's left to create change?  I see only two: The government or the people.  But, the government has a business stake in the health care industry - partnering up with large pharmaceutical companies in a for profit manner is not exactly being a good servant to the people is it? (drug costs still heading for the moon as we speak).  Obama seems to have honest intent to make some serious change.  If his plan doesn't work it certainly won't be all his fault.  That leaves us with the people and the truer, (IMHO) American way - Occupy.

In a America the corporatist right wing was incredibly effective spinning their agenda and transporting it into peoples minds. Way more than anywhere else in the developed world. Now it has finally started to crash down once more, affecting a bigger swath of society than just the permanent underclass already created by these policies. Change is long underway in the younger demographic, although the way the current political system is set up prevent many actual policies from being implimented. Majority rule doesn't work thanks to the filibuster, and the corporatist judges in the highest court sit there until they die.

I wish I had your faith in government as a benign master, but I worry that they are just grabbing power to control another 15-20% of the formerly private economy. 

My faith lies in well-written laws and regulations. Government is the representation of the population, not some seperate entity. This is a nice spin the US right wing has invented. I've never heard it said here. People may complain about politicians, but government is just the organisation working for everyone. Our government did a remarkable job keeping unemployment low despite the economic crisis, by quickly implimenting lot's of small, smart tweaks.

I think the real fear of the American conservative in regards to single payer health care is that it might actually work. The one thing conservatives can't live with is having their world view shattered...

 

[JohnRoberts]

I'm about ready to channel my inner taxi driver and ask... "You talking to me? "

I have tried to be clear and concise about my concerns.

good night for now... I grow weary of the dance.

JR

 

[ricardo]

I have tried to be clear and concise about my concerns.

John, you have been very clear about these.  You don't think Obama's government can run an efficient expanded Public Health Service, reduce total costs to the nation and ensure a fair deal for everyone.

But what alternatives are your proposing?

Are you saying the Republicans have an agenda which will reduce the cost of public health to that of the UK, Scandinavia, Thailand or Cuba?

Because as sure as death & taxes, "business as usual" won't do it.

 

[Kingston]

I wish I had your faith in government as a benign master, but I worry that they are just grabbing power to control another 15-20% of the formerly private economy.

I actually went to high school in California - including taking economics and history classes - so I know where this thinking comes from. I'm not saying doctrine, but it's not far from brainwashing when you only show how one system works and leave it at that. At the same age curriculum we were already comparing systems, writing essays about their respective strengths and weaknesses in Finland. The curriculum doesn't assume "goverments are bad, private economy good".

Americans seem to have little faith in the Governments ability to run anything - and with the far too low tax rates you're not really giving the government the tools either - and then you're happy to hand control to private industry. Their only purpose is to make money to the owners. That's the major difference why health care over there sucks. Customer is only there as a source of money. There's no moral obligation to keep people healthy. All choices are made to make the owners more money. Customer health is secondary, if even that. It can only go horribly wrong when the private industry makes so much money they also control the regulation.

You actually do want an "all powerful entity" controlling health care that has a moral obligation to keep people healthy. A government could do that and they cannot have a financial stake. These things need to be decoupled at legislation level. Ref. Europe.

I haven't really seen compelling arguments for an all capitalist fully free market controlled system, other than that it allows some people to get really really rich. It clearly does not work with health care. The customer is not served. The provider is out of control.

 

[emrr]

The american system implements an interesting form of slavery too; slavery to one's place in economic life in permanent form, once one becomes ill and needs public assistance beyond what one can afford.  Once one needs public assistance for that which insurance will not cover, or cannot be afforded, one is locked into an economic status quo.  If you are sick, and your wife gets a $0.25/hr raise, you can be guaranteed that social services will negatively adjust your assistance by the same amount.  If you inherit a small amount of money, they will balance that against your assistance.  The 'American Dream' is effectively sidelined. 

I have a brother in law who cannot afford insurance due to pre-existing conditions; diagnosed as epileptic at age 14.  He was born in Canada, and I believe has dual citizenship.  He just took a trip to the emergency room, followed by a week in hospital, that will possibly bankrupt he and his wife.  Turns out he has a non-cancerous brain tumor 1/4 the size of his brain, so at age 30 his American option is to apply for permanent disability, and the corresponding treatment that might come with.  I don't know if returning to Canada is really an option, or how long it would take to qualify.  In hospital here, he was advised not to check out as it would be hard to readmit him without insurance if he left, never mind his inability to pay for services rendered.  He's been forced to take temporary disability leave from work, since his drivers license is revoked and he's considered a safety hazard.  It's hard to see a good end. 

 

[DaveP]

Hey JR,

You are the type of American we need....have passport, will travel!

You are right about us watching the goings on in the US because it does affect the rest of us.  You had a President who was challenged by the English language and replaced him with an articulate man, and an inspirational speaker, but to our dismay you seem to have trashed him after such a short time in office.  The mess you were in was never going to be sorted in such a short time by anyone.

My band played a few gigs in American airforce bases during the 60's and the beer was like fizzy water (Bud?) so I'm glad you are doing something to rectify the situation!  Why do US servicemen rough house each other all the time?

The National Health System is about the only thing I'm proud of about the UK at the moment.  My Dad died of Alzheimers 20 years ago and it was like seeing someone you loved fade away little by little every day.  I now feel exactly the same way about my own country, it is almost unrecognisable to me now.  I retire in 3 years time and we are going to live in France, that way I won't have the  decline of my country thrust in my face everyday.  The cult of celebrity, reality TV argh! SUV's to do the shopping, mass obesity, litter everywhere, loss of national identity, obsession with mobile phones, rant, rant!  Living in rural France is very much like the UK was 50 years ago, I can't wait!

best
DaveP

 

[living sounds]

  I retire in 3 years time and we are going to live in France, that way I won't have the  decline of my country thrust in my face everyday.  The cult of celebrity, reality TV argh! SUV's to do the shopping, mass obesity, litter everywhere, loss of national identity, obsession with mobile phones, rant, rant!  Living in rural France is very much like the UK was 50 years ago, I can't wait!

Rural UK isn't? I've been to south-west England and Cornwall often, and in the countryside, in small towns and villages things seemed to be very old fashioned still. Love those old shop fronts and fields with stone hedges and thatch roof houses. And British beer has always been great.
But it is kinda strange though to come - from these places of  rural serenity - to a bigger town to witness brawling drunk overweight underage girls wearing belly tops. When and how did this happen?

 

[DaveP]

Living sounds,

Yes parts of rural England are great but so are the prices; £500k plus for what you describe.

If your private pension is going to pay out 16% of what you signed up for, then you have to downsize and live off the equity in your house!  I bought an old farmhouse in an acre of rural heaven in France for £68k, do the math!

Regarding the "binge drinker generation" we are still working that one out.  There is no doubt that alcohol is very much cheaper now than when I was their age, I just could not afford it back then.
We have imported an American lifestyle to a larger extent than Europe and manufacturing and manual work is much less than it used to be so maybe that's partly to blame.

There is also a culture in the young of "live now for tomorrow we die", they don't seem to have any other ambition than to get more plastered at the weekend than they did the week before.  They seem to be growing up much slower too.  I bought my first house at 22 and did it up myself and I was was not alone in this, no young person would do such a thing nowadays, they'd sooner stay at home or rent a flat.  Money that I spent on my house, they spend on mobile phone contracts and going out.  Like I said, I don't understand my own country anymore.

best
Davep

 

[emrr]

I did see something in the news about action to place minimum pricing standards on alcohol in England, due to bottom brands pricing less expensively than water...didn't I?