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medicare

2K views 8 replies 6 participants last post by  stormie 
In the UK, Health care is free for everyone, but of course we pay more in taxes to fund it all.

There is a prescription charge for medication currently £12 ( $19) for 3 months, although for diabetics and other groups it's free. No charge to see your doctor

Type 2 don't usually dont get test strips on prescription

We also have private healthcare, market leader is BUPA, usually its given as a perk in employement, but for pre existing medical conditions it's unlikely you will get cover.

Unfortunatly the UK is bust at the moment, so there is talk of bringing in US style market reforms :eek:
As an ex-pat Brit now living in France, I got a bit of a shock when last year I got nailed with diabetes. The French service (after you fight your way through the bureaucracy) covers 70% of costs for most things but there are a couple of twists. For the cover you pay a quarterly contribution (rather like the National Insurance contribution in the UK) of 9% of your assessable income above a minimum (about €9000 per year).

First, it's 70% of the charge specified by the government - not of the actual charge. So, to take a simple example, a visit to the doctor is assumed to cost €21. You pay this up front and the service refunds 70% less a €1 admin charge direct to your bank (€14 back). If the doctor charges, say €25 - the extra €4 is your problem.

Second this applies across the board, so last year I had to spend a week in hospital - that cost me €1,400! (Total charge was around €9,000).

The French can buy insurance to cover these extra costs (la mutuelle), but unlike BUPA, cover is available (at a cost ) even to old gits like me with a pre-existing condition. I have decided as an ex-insurance man myself, that the premiums don't represent value for money for me - but that's down to me!

The other twist is that the cover is again based on the figures of what the state has decided is "reasonable". This shows up most clearly when you look at dental care. You need a crown?

  • Dentist charges: €450
  • State refund based on assumed cost of €107.50.
  • Refund (70%) - €75.25
  • "Mutuelle" refund (100%) €107.50
  • So you end up paying €267.25
Prescriptions have a sliding scale of charge based on the State's assessment of the value for money provided. Essential and effective - up to 100%. Largely cosmetic and limited effect? 15%.

Like the UK, chronic conditions (like diabetes), get special treatment but only in respect of the DIRECT treatment of that condition. So, my doctor's visit and blood tests cost me only the admin charge (€1 and €4 respectively) but my dental care? I'm on my own!

And yes, the ADA rules here too. Test strips for a type 2? No more than 200 per year. Target A1c? 7%. Diet recommended - high carb.

The position here is what I expect the UK to move to over the next few years, so start saving your pennies if you need a dentist or a hospital visit :eek:hwell:

John
 
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