UK's healthcare top of league table out of 11 western countries. US = last

[Parts]

As far as I know, a big flaw with your system is that the care that you receive is frequently decided by the insurance company rather than a medical professional.

Have never known that to be true.

It's apparently quite common with the more expensive treatments, says my research scientist mate at Eli Lilly's.

A state-sponsored healthcare such as Sweden's is plagued by bureaucratic issues instead, if that is of any consolation.

Box checkers and form fillers are the disease that infects the system and the only cure is 

[Semicolon]

Where is Adam?

It would also be interesting to know how mental health care benefits work in countries with nationalized care. What type of frequency is the norm? Are there standards for frequency of appointment that are allowed?

Once you're in the system and past the bureaucracy and queues that are the norm in some parts of the country, you tend to get the frequency of appointment needed, as decided by the medical professionals on a case by case basis. There are no country-wide norms, AFAIK, but I assume that there are budgets to manage that will affect the decisions.

If you have an ASD dx, you're entitled to all kinds of help. I know Lit wouldn't agree with me, but the system actually takes reasonable care of these individuals. The problem is rather to get that dx in the first place, especially if you are an adult, partly because of the bureaucracy involved but mostly because many of the professionals still don't know enough about ASDs to begin with.

Lit lives on government money.

[RageBeoulve]

YEAH BUT THE AFFORDABLE HEALTHCARE ACT WILL FIX EVERYTH- Oh wait its not single payer, and is basically an open door for CERTAIN insurance companies. PPPPHHHHHHBTTBTBTBTBTBTBTB this shit is horseshit.

[Jack]

It's apparently quite common with the more expensive treatments, says my research scientist mate at Eli Lilly's.

That might be true in in situations where a less expensive treatment is an available option. Though it's not really the insurance company deciding what care is received, but rather what they will pay for. Though isn't that also true with nationalized care? If there's more than one treatment and the patient opts for the more expensive one, might they expect some out of pocket expense?

Wishing Bodaccea were here; she said something not long ago about saving money so her child could have surgery to correct his vision. That seemed like an odd thing to say.

[odeon]

It's apparently quite common with the more expensive treatments, says my research scientist mate at Eli Lilly's.

That might be true in in situations where a less expensive treatment is an available option. Though it's not really the insurance company deciding what care is received, but rather what they will pay for. Though isn't that also true with nationalized care? If there's more than one treatment and the patient opts for the more expensive one, might they expect some out of pocket expense?

It is true in quite a few situations where a more expensive treatment also happens to be the better one. Yes, they only decide what they will pay for but in practical terms, what's the difference?

[Jack]

It's apparently quite common with the more expensive treatments, says my research scientist mate at Eli Lilly's.

That might be true in in situations where a less expensive treatment is an available option. Though it's not really the insurance company deciding what care is received, but rather what they will pay for. Though isn't that also true with nationalized care? If there's more than one treatment and the patient opts for the more expensive one, might they expect some out of pocket expense?

It is true in quite a few situations where a more expensive treatment also happens to be the better one. Yes, they only decide what they will pay for but in practical terms, what's the difference?

Not sure what you're asking. You said it's a flaw in the US system, but in practical terms am seeing there's not much difference with nationalized care where the government decides what treatment they will pay for.

[odeon]

It would also be interesting to know how mental health care benefits work in countries with nationalized care. What type of frequency is the norm? Are there standards for frequency of appointment that are allowed?

Once you're in the system and past the bureaucracy and queues that are the norm in some parts of the country, you tend to get the frequency of appointment needed, as decided by the medical professionals on a case by case basis. There are no country-wide norms, AFAIK, but I assume that there are budgets to manage that will affect the decisions.

If you have an ASD dx, you're entitled to all kinds of help. I know Lit wouldn't agree with me, but the system actually takes reasonable care of these individuals. The problem is rather to get that dx in the first place, especially if you are an adult, partly because of the bureaucracy involved but mostly because many of the professionals still don't know enough about ASDs to begin with.

Have read things here before that gave the impression people in nationalized systems aren't choosing their own mental health care professionals. Is that correct? And medical doctors, do people have a choice in that?

In both cases, people have a choice.

[Jack]

In both cases, people have a choice.

Thanks.

[odeon]

It's apparently quite common with the more expensive treatments, says my research scientist mate at Eli Lilly's.

That might be true in in situations where a less expensive treatment is an available option. Though it's not really the insurance company deciding what care is received, but rather what they will pay for. Though isn't that also true with nationalized care? If there's more than one treatment and the patient opts for the more expensive one, might they expect some out of pocket expense?

It is true in quite a few situations where a more expensive treatment also happens to be the better one. Yes, they only decide what they will pay for but in practical terms, what's the difference?

Not sure what you're asking. You said it's a flaw in the US system, but in practical terms am seeing there's not much difference with nationalized care where the government decides what treatment they will pay for.

The government does not decide what treatment we get here.

My point was about the insurance company deciding what they'll pay for. Yes, you can opt for a more expensive treatment but where do you get the money from? We're not necessarily talking about the difference in cost either; I'm told that it's not uncommon for them to simply refuse to cover any part of the cost if they don't approve of the treatment.

From a business point of view it makes a lot of sense as they are a profit-making company.

[Jack]

My point was about the insurance company deciding what they'll pay for. Yes, you can opt for a more expensive treatment but where do you get the money from?

Guessing the same place people with nationalized care get money for treatments the government wont pay for.

We're not necessarily talking about the difference in cost either; I'm told that it's not uncommon for them to simply refuse to cover any part of the cost if they don't approve of the treatment.

Would probably have to have a good example to understand what you're saying. Elle brought up a good point about common insurance limitations for mental health visits, and my own policy also has limitations for chiropractic visits. Though have never heard of anyone's insurance outright denying to pay anything for treatment advised by a physician.

[odeon]

Sorry, I don't have an example immediately available. A quick Google search gave lots of hints, though. For example, why would the following site exist if what I said was false?

http://www.creakyjoints.org/blogs/insurance-matters/truth-about-long-term-disability

My point was about the insurance company deciding what they'll pay for. Yes, you can opt for a more expensive treatment but where do you get the money from?

Guessing the same place people with nationalized care get money for treatments the government wont pay for.

Most likely not, considering that we're talking about different countries. 

[Jack]

Though have never heard of anyone's insurance outright denying to pay anything for treatment advised by a physician.

Was just thinking. Maybe you had read something about some insurance companies who wouldn't pay for pre-existing conditions. Always thought that was a ploy to get people to take their insurance option immediately upon getting a new job. When joining the place I work, pre-existing was fine as long as I signed up right away, but not if I waited and took the insurance later. Though pre-existing condition clauses aren't allowed anymore. That's one thing people in other countries don't seem to understand about health insurance. It was easy to look at the statistics of the percentage of uninsured and say, oh my goodness, but what people don't understand is that a large majority of the uninsured were people who could in fact afford health insurance, but they opted not to have it. The reason many people opted not to pay is because they're generally healthy and only need to see a doctor once or twice a year for physicals and regular bloodwork, which is cheaper than annual premiums. Then they'd want to change their minds and get insurance once they got sick or in an accident. Health insurance used to be a lifestyle choice in the US. It isn't anymore.

[Jack]

Most likely not, considering that we're talking about different countries. 

Out of pocket expense is out of pocket for the patient no matter where they live.

[Jack]

http://www.creakyjoints.org/blogs/insurance-matters/truth-about-long-term-disability[/url]

That's a rant about a few different things, insurance claims, long-term disability claims (which have nothing to do with insurance in the US), the uninsured, all different issues being blamed on the insurance company. Not saying it's wrong, but maybe not specific enough to be fitting to the discussion so will let it go.

[odeon]

Most likely not, considering that we're talking about different countries. 

Out of pocket expense is out of pocket for the patient no matter where they live.

Only, the "government" does not refuse treatment here. It's not how it works at all. There are cases where experimental treatments have been denied, sure, but it would seem that you're equating between insurance companies and governments to compare the different healthcare systems and that just doesn't work.