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The United States healthcare system for years has been built around hospitals. It is only recently that there has been any sort of movement to reduce inpatient admissions and length of stay. If you bring/send medical/nursing care to patients in their community they are likely to have an easier time accessing and not put off required treatment. This in turn often leads to not only better outcomes but can cost less as well.
This is very interesting.
Free medical education is a whole other thing that would have to be supported by taxes, though. University education in general. The US has been going in the opposite direction, slashing support for higher ed. There's no way taxpayers would pony up to make university education free. They might agree to higher taxes to cover health care (though I don't see anyone here raising their hand, yet), but they'll scream bloody murder if the gov't extends the "socialism" to include education.
What percentage of income to the French pay in taxes?
Free medical education is a whole other thing that would have to be supported by taxes, though. University education in general. The US has been going in the opposite direction, slashing support for higher ed. There's no way taxpayers would pony up to make university education free. They might agree to higher taxes to cover health care (though I don't see anyone here raising their hand, yet), but they'll scream bloody murder if the gov't extends the "socialism" to include education.
What percentage of income to the French pay in taxes?
Long story short the French government has other ways of revenue besides direct income taxation. Value Added Tax (VAT) is one way France and many other EU nations raise vast sums of revenue aside from an income tax.
Free medical education is a whole other thing that would have to be supported by taxes, though. University education in general. The US has been going in the opposite direction, slashing support for higher ed. There's no way taxpayers would pony up to make university education free. They might agree to higher taxes to cover health care (though I don't see anyone here raising their hand, yet), but they'll scream bloody murder if the gov't extends the "socialism" to include education.
What percentage of income to the French pay in taxes?
In most EU countries you also do not find something so common in the United States; hospitals literally almost on every corner in competition for the same set of patients.
Here in the USA there are for profit, not for profit, charity/last resort, among a bewildering array of hospitals often in many urban areas within a ten mile radius of each other. This leads to duplication of services, equipment and often a surplus of inpatient hospital beds.
Now in Europe/UK there are private hospitals outside of state healthcare systems, but by and large most facilities are state owned/run either directly or indirectly. Thus you don't have expensive over lapping of services and so froth.
In the example one mentioned up-thread about a high risk mother to be transported from her village to the next area equipped to handle her delivery; the solution in the USA would probably be for that small hospital to "tech up" with equipment and staff to meet a situation that rarely occurs. In the meantime all that staff and such have to be paid for regardless.
In most EU countries you also do not find something so common in the United States; hospitals literally almost on every corner in competition for the same set of patients.
Here in the USA there are for profit, not for profit, charity/last resort, among a bewildering array of hospitals often in many urban areas within a ten mile radius of each other. This leads to duplication of services, equipment and often a surplus of inpatient hospital beds.
I wish! Where I live now, there's only one hospital, a Catholic one (abortion patients have to drive an hour away to the next city). They've been cutting costs and getting rid of the more qualified nurses, and have been hiring nurses with minimum qualifications. They've also bee cutting back on the number of staff in general, so there aren't enough nurses for the number of patients they have. Doctors have been complaining that the patients haven't been getting their meds, haven't been getting the prescribed exercise, etc. And there's no alternative available to this neglectful care.
In my home town (Berkeley, CA), there's also only one hospital. The emergency room is so crowded, even high-priority emergency cases have to wait all night, about 12 hours before they get help. I'd like to move back "home", but I'm terrified of the lack of hospitals and the congestion!
The way hospitals in the US used to work is that each one had their own speciality with all the relevant equipment, so one would have all the cardio stuff, another would have kidney and maybe lung equipment, another would have something else. Patients and emergency cases would go to the hospital that had the specialists they needed. Then in the 70's/80's, when hospitals were reorganized, they all began to compete with each other. So each hospital had to buy all the latest equipment for all specialties. Naturally, this was very expensive. Hospitals began itemizing their billing and charging for every tongue depressor, every aspirin. And hospitals then were forced to become charities in order to survive. They developed fund-raising projects; some ran used clothing stores, others opened art galleries, others hosted fund-raiser dinners, etc. Formerly non-profit hospitals became for-profit but with a charity fund-raising arm.
Yes, I know. But ask them to fork over that money to Uncle Sam, and suddenly people get skittish. So I'd like to know how many are willing to pay an additional major chunk of money on their annual income tax (in lieu of monthly insurance payments) to fund a French-style system.
Figure approx. $600/month (give or take a couple hundred $$) x 12 = $7200 due on April 15, in addition to whatever tax they currently pay. Roughly $7200 (probably more for higher earners, significantly less for low earners) for the privilege of being able to get the kind of services and medicines that have been discussed in the two threads on this forum relating to healthcare in France. And bear in mind that some people in France still buy insurance, in addition to paying taxes to support the public system. Doctors also earn a bit less than in the US, I think. Depending on the specialty.
Belgium has a system of health care very similar to France's, alltough our system is less generous.
In Belgium every employee pays 13.07% of his bruto income @ 108% in social security, divided as follows:
Employers pay 24.77% of their employees bruto income @ 108% in social security. Amounts for above mentioned categories are slightly higher for employers and they have to pay for a few more categories such as insurance against work-related diseases, insurance against work-related accidents, child support for their employees.
These rates may seem very high to some, but you should also keep in mind that these payments into the social security system are fully tax deductable.
So if you take a blue colar worker here, earning € 2 000/month (which is slightly above average), he/she wil pay:
€ 2 000/month * 108% * 13.07% = € 261.40/month in social security, including € 76.68 in healthcare.
Given an average tax rate of some 25%, his/her monthly payments in social security will be some € 196.05, including € 57.51 for health care, which covers "every family member, living under the same roof".
Now compare that with the monthly cost of your private health plan!
Paying into the system is mandatory: between 99.6% and 99.8% of the population is covered.
Employers have to collect the social security payments of their employees directly. When a company goes broke, the social security system is the first privilleged creditor.
A visit to a GP here costs € 5 (€ 25, of which € 20 is refunded). Essential medication is subsidized, thus inexpensive for the patient. On average some 85% - 90% of medical bills is paid for by the social security system.
Another thing that may sound strange to Americans (?): paid sick leave. When an employee becomes sick, he will receive the first weeks of his sickness his usual income, paid for by his employer. After those first weeks (depending on sector, usualy 4), he will recieve a sickness allowance covering 55% - 60% of his usual income from social security. During sickness (or pregnancy), employees are protected by law against lay-offs, something our labour courts take very seriously.
We have legislation to protect people against high medical bills. When the co-payments go above a certain amount, they will be paid for directly by the social security system.
For lower income families the treshold is set at € 350/year. We don't have people who went broke due to medical bills.
A blue colar worker here can send his kids to college/med school. It's not easy, but it's doable and tuition fees here are now way near what we hear from American or British colleges.
Ghent University estimated the total cost for a college student, studying, still living at home, not entitled to a grant or whatever at € 2 639.60/year (http://www.ugent.be/student/nl/stude...ren/totaal.pdf).
The Belgian (unofficial but nevertheless mandatory) absolute minimum wage is set at € 1 472.40/month for 2014.
Another thing that may sound strange to Americans (?): paid sick leave. When an employee becomes sick, he will receive the first weeks of his sickness his usual income, paid for by his employer. After those first weeks (depending on sector, usualy 4), he will recieve a sickness allowance covering 55% - 60% of his usual income from social security. During sickness (or pregnancy), employees are protected by law against lay-offs, something our labour courts take very seriously.
Most Americans (who aren't independent contractors) have paid sick leave. They're paid full salary for the days they're at home sick. If they become disabled, large employers (not small businesses) will hold their job for them, and hire someone temporarily to take their job, while the regular employee applies for social security disability payments.
Most Americans (who aren't independent contractors) have paid sick leave. They're paid full salary for the days they're at home sick. If they become disabled, large employers (not small businesses) will hold their job for them, and hire someone temporarily to take their job, [...]
I'm glad to hear that.
Strange though, but that's not what I read in the American news outlets.
[...]while the regular employee applies for social security disability payments.
Well, I suppose anyone can apply for anything... I looked it up in a leaflet for the general public (http://www.socialsecurity.gov/pubs/EN-05-10029.pdf) and I found, amongst lots of other interesting information, this:
"Social Security pays benefits to people who cannot work because they have a medical condition that is expected to last at least one year or result in death. Federal law requires this very strict definition of disability. While some programs give money to people with partial disability or short-term disability, Social Security does not.".
Perhaps there are similar programs on the state level over there, with less stringent criteria, to support sick employees and their families. If so, I would be interested to hear about those.
I'm not saying that there aren't American employers, granting their workforce some kind of paid sick leave arrangement, as a voluntary hiring and retention tool, but I haven't found much of what is so common in Western European countries: paid sick leave and a decent, gouvernement guaranteed health care system, intended to reach as much needy people as possible.
As a real right, meaning: firmly embedded in law.
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