Hi, I am from India and been a Type2 for almost 6yrs now. Here, the medical insurance is from private firms and covered by your employer. Also, if you are taking insurance after getting D, then it is not covered, so on and so forth. I hear that there are 10 doctors for every 50,000 people in India(?)
By 2020, India the second largest populous country in the world (or may be 1st already) will be the Diabetes Capital Of the World. I feel like running away with my family to a place where there is free medical care, like in Britain or Canada or some other countries I don't know about? How good is the "free" medical care given in these and other countries. I am very curious to learn how other countries treat their citizens.
Sai.
I think there's pros and cons? In some of the "National Health" countries, CGMs are hard to come by. There's been a few posts from Canada (if you search for a poster named "DiabeticWarrior" I think there's an account of a strange encounter with a doctor and her staffer, basically telling him he couldn't ask the doc questions when he ran into her in the lobby or something like that?
I know that in the USA there are emigrants who end up receiving aid from the state but I have no idea what all might be involved in that? That coverage also tends to be very limited.
Private insurance in the USA is sort of hit or miss, a lot of it depends on what your employer chooses for you to have?
I'm very cautious to use the word "free". Even "free" medical care in other countries comes at a cost. The money does have to come from somewhere. While the US for example doesn't have a "free" medical care system (although there is assistance available) the tax rates on both income and VAT taxes are generally lower than the countries with "free" medical care.
As acidrock says, private health insurance is hit or miss on both cost and benefits . . . a lot having to with what an employeer is offering.
I have a cousin that lives in England and while I don't have any anecdotal stories I can relate, I know she does keep a conventional health insurance policy to bypass the English system which she has told me can be quite frustrating at times.
Yes, we pay for Medical Care by being taxed ...No-Thing is for free in this world http://www.drugcoverage.ca/p_diabetescover_table.asp?language=1
Maybe this link will help you .
Hubby( almost 82 ) and I( almost 72 )have no complaints about our system ..everyone is different ...we do have an Extended Health Benifit Plan to which we contribute monthly .
I have heard some tales of people when I was on a visit to Canada (Vancouver, BC). My colleague's relative had some kind of cancer and was on a "waiting list" of some sort - which mean he/she had to wait for 2-5yrs to get operated upon. The person took a "medical tour" to an Asian country for the operation. So, I do know its not all well in Canada. Or USA for that matter - where uninsured people need to be on state's cover(?) or have harrowing tales to tell. I have friends, relatives in USA who have all kinds of stories - both good and bad.
One thing is for sure - Insurance, by definition itself is a for-profit organization, which pools money from all the stakeholders and mitigates the collective risk of the members !!!
Now, how can we change the same, in terms of :D especially? Can't we have a separate pool of our own like TuD insurance company - which pools all members money and also asks for donations, grants from organizations, governments, to cater to the need of :D's all around???
Not sure how this could be envisioned on a large scale, but - all big things start small. This is my "two cents" to the cause, what say???
well, I didn't dare open the "provincial health system" can of worms!
If everyone in the pool is sick (TuD insurance company)...the pool would need to have close to a 100% copay or premiums higher than we could ever afford to pay. Even if the plain was non profit we still could not afford it.
I seems like you do not understand the fundamental issue, someone has to pay for it!!
I'm a worst case...I have spent many years as a type 1, my insurance company's has never made a dime profit off of my premiums and now I have cancer and waiting for a organ transplant..the cost if I survive and receive the organ will be 1,000,000.00 without complications and the maintenance will be 50,000 per year until I die.
I have a family member with MS and her medication cost is 9,000 US per month..shes 19...30 years on this medication will cost 3,240,000 US...she is also a insurance company's worst nightmare.
There is no such thing as free or equitable medical care anywhere in the world. It's a misnomer. There are aspects of socialized medicine that are good (I think). To some degree, you have a guarantee that your basic medical care will be covered. At a minimum, diabetics can get access to insulin in places like Canada and the UK, which is the very basic thing that keeps us alive for the short-term. BUT, those places have limits on things like test strips and if you want a pump or CGM, you have to jump through many hoops and can be waiting for a LONG time. In addition, I know in the UK the care you are able to receive varies depending on which county you live in. I think the same thing goes for Canada (i.e., different provinces/jurisdictions have different procedures and limits).
In the U.S., if you're really poor, you qualify for Medicaid, and you can actually get decent care through Medicaid, depending on what state you live in. All diabetic supplies are covered through Medicaid. If you're old and/or disabled, you may also qualify for Medicare. Medicare also has its limitations (I know pumps aren't covered for many and CGMs are definitely not covered), but again, you'll have basic access to insulin and some testing supplies.
Now, if you're lucky enough to have a job that offers decent health insurance in the U.S., you definitely have access to some of the best medical care around. I am fortunate enough to fall into that category and I have never had an issue getting what I need (pump, CGM, insulin, supplies, etc). Yes, I do spend about $200-$300 per month out-of-pocket on co-pays and miscellaneous stuff related to diabetes, but I am VERY lucky that I can afford this.
So, I don't think there is a "best" country for medical care and diabetes. It sort of depends on what your needs are. If you're a T1, best (to me) means having guaranteed access to insulin and the latest technology that one requires to manage their BGs and stay alive and complication free. And that doesn't really exist as far as I know.
It's true, healthcare is never free. I have experience in living in Germany and Belgium and you pay a considerable amount of taxes for your health insurance. It is also true, that things like a pump or a CGM are hard to come by if your diabetes is "controlled" and you are not a child.
I, however, like that I don't depend on my employer and on being employed to receive decent care. I think care for PWD is better in Germany than it is in Belgium with basically unlimited amounts of strips provided for free and only very low costs for insulin. In Belgium the amount of free strips is limited to 5 a day but you get all the insulin for free. But in both countries you can live with T1D without it being a huge financial burden.
I don't think that having an insurance just for Ds would be a good idea, as it somehow would contradict the idea of an insurance where everybody pays in but not everybody needs to use it to the same extend. That doesn't work if everybody has diabetes.
In Canada we actually have health benefits (insurance) through employers, too. So the basics are covered by the province (you're right, depending somewhat on which province you're in, though insulin and test strips and doctors and hospitals are virtually always covered), and then you can get things like pumps and even CGMs covered through employer heath benefits (same as insurance in the U.S.).
I think there are pros and cons to each system, but I am also *very* glad to live somewhere where I am not going to ever have to worry about having access to basic medical supplies and care, and still have access to "advanced" stuff like pumps through employer health benefits.
May I add re the $ 7,400 per annum DTC is the disability amount ( for self ) ...Federal non-refundable tax credit rate is 15 percent .
Guess what went through my head ,when I read MountainCat's comment too quickly about the $ 7,400 approx .." party time :) "
To add as well : wise to take out medical/travel insurance when going abroad .
Hi John, sorry to hear about your situation. I was assuming that not everyone is sick, right now...which delays the risk of some patients. Those who require USD 100k right now, say, can take from the pool - and repay in installments(?)
One thing is for sure, we need to pool enough money, for ourselves, and for family. I wouldn't want my family to end up bankrupt after me!
Since we have made a start to the discussion, I welcome ideas of how we can mitigate the risk, costs, etc.
For organ transplant, you can actually try to go to some other country where the cost of medication would be cheaper, better facilities available and you will have a good feeling all around - that's what medical tourism is all about.
But I guess you must have given it a thought already.
Hi MoutainCat, I appreciate your courage to be self-employed. But the question here is do you have enough money stashed up somewhere so that you wont end up at the mercy of others, government, insurance agencies?
In India, millions of people die just because they don't have access to primary medical care. Leave alone highly sophisticated diseases with tongue-twisting names.
Netherland's Health Minister's recommendation : this is what is planned (in the Netherlands ) : if you miss your appointment in a Hospital setting , you will get fined .The article states as well : patients , who are no-shows cost the system yearly 300 million euro's .
Hi Emmy: My experience has been exactly the same as your experience. Mountaincat is correct...there is no Canadian Health Care System. Here in Ontario there is a shortage of doctors. (My current GP only works a couple of days per week). The emergency rooms are filled with folk who would be better served if they had a GP. Both my brother and mother spent a night in Emergency and were sent home with all the others. My brother died immediately and my mother fought and fought for months. My mother's condition could have been treated if they had taken her concerns seriously that first night. No idea what happened to my brother. It really bugs me that we paid such high taxes all our life just to be discounted when we finally need it.
If you have a file at a government hospital here in Saudi Arabia, you have access to free healthcare. When it comes to diabetes healthcare in particular, it is no secret that a large percentage of the overall population is diabetic. So it makes sense that a great deal of the yearly health sector budget is allocated to diabetes care centers. I get lancets, blood glucose meter, strips and the whole lot. I got my pump too. And free supplies. They wouldn’t supply me with sensors but every once in a while they give you one to see you’re getting by. Although I know other hospitals who do give sensors to their patients. Lab work too The doctors are well qualified- from what I’ve sen so far. They’re very tricky with pumps though, but I managed to get one. I know that there’s about 100 pumpers in my clinic. All for free since its a nonprofit teaching hospital. I have an insurance too if I needed to see the doctor for pressing matters. There are no tricks or downfalls or hidden costs. The health sector in our country is indeed very generous.
Takes some reading: a Canadian travelling for dental care to Poland ... " It used to be that tourism was driven by aspirations of seeing pyramids or drinking tequila at the swim-up bar.
But as the population in Western countries is aging, accessing health care is driving many people abroad to get what they need when they need it.
Medical tourism is a $100-billion industry this year, according to the U.S. research firm Frost & Sullivan. It estimates business will increase a further 20 per cent next year....con't :
http://www.canada.com/vancouversun/news/westcoastnews/story.html?id=e5484a32-f3a8-439b-a9f0-f485e1c3f382
Truly : our " bible " on the coffee table : BC Health Guide ...Healthwise handbook !!... ONtario family has difficulty too : Doc is retiring in June and neither have found a replacement .
That is why so many Canadians come across the border to the US, things as simple as an MRI that u might have to wait a few days for here in the US can take weeks and even months from my understanding.
Standarized health care does come at a cost, from my understanding of countries that do offer standardized health care, the taxes they pay are much higher. I don't think any one health care plan is ideal, they all have their pro's and con's and as AR said, in the US its all dependent on what your employer chooses to offer their employees. My husband and I are both fortunate to work for large employers, and fortunate enough to have coverage from both of our jobs, so my health care costs are slim to none. Unfortunatly not everyone is that fortunate and for many they are just lucky to have very basic health care.
Also government health care like Medicaid can be very difficult to qualify for as it is income based. They dont care if u have a pre existing condition and your employer doesn't offer good insurance...if u make a decent income...your on your own. So I do not think there is any one right or wrong answer to this question, I think both systems private and standardized health care has its pros and cons, what works and what doesnt.