Guardian journalist gets shock

Having premature twins in Manhattan can cost in the hundreds of thousands – and in my case did – and my UK insurer never passed on a bill.

The only mystifying thing was how it made any money. Well. A few days ago a nervous-sounding agent rang me from Britain and, in what sounded like a script dictated by lawyers, said that he regretted to tell me the company, a huge European conglomerate, was getting out of the US market and my policy would not be renewed in January.

Things which are not profitable to supply stop being supplied. Shocker, eh?

or apply yourself to the free market and buy insurance from, for example, a provider part-owned by Jared Kushner’s brother that dwindling numbers of New York doctors accept and has a $14,000 (£10,000) excess on a family policy that costs more than $800 a month. (This isn’t an anomaly, it’s the industry standard.)

Things cost to supply what they cost to supply. NHS costs £2,000 per capita per annum. £8,000 for a family of four (I assume there’s a Mr. Viner around somewhere). That NY policy doesn’t look out of the correct price range, does it?

19 comments on “Guardian journalist gets shock

  1. And when you realise that you can’t afford either the higher insurance premiums or the huge excess that comes with a lower premium, what do you do? Personally I quite like a at least partially tax-based insurance system.

    Answers welcomed from all those who think they know how the Singapore model works.

  2. Singapore, in one view, gets this right. The insurance part, that horrendous costly thing which bankrupts people, is tax paid. Routine medical care is forced savings paid (ie, it’s an assurance system, mandatory part of wages go into health account, you don’t spend it then it gets added to your pension pot).

    In economic terms this is a damn good idea. Equity, socially, perhaps not so much but there we are.

  3. “Things cost to supply what they cost to supply. NHS costs £2,000 per capita per annum. £8,000 for a family of four”

    Fair enough, though most of those NHS costs are not for people of the age range considered here. So whether the average family has to pay £8000 or not into a hypothetical NHS insurance scheme depends on the extent of cross-subsidisation such a scheme would incorporate. Though as you say, it does at least reveal that the US figures are in a comparable ball park.

  4. Subsidy – well, it should be, if such there is going to be, the relatively healthy newspaper executive who is paying more in than the minimum wage worker who makes her coffee, no?

  5. A letter each year to the tax payers on how much the NHS costs them would be an eye opener for many.

    Probably best to describe it in terms of how many months PCP payment on their 318 BMW or mortgage payments on their executive slave box.

  6. Singapore is a weird system: it shouldn’t work, but it does. Most hospitals belong to the state and most doctors are employed by the state; but you pay from your own compulsory insurance. On paper it sounds like the worst part of the U.S. system (insurance), fused with the worst part of the UK system (state-run provision).

  7. Singapore is a weird system: it shouldn’t work, but it does.

    It works because it’s a small number of ethnic Chinese self-selected to cooperate with one another and generally make themselves useful. Good luck applying that elsewhere!

  8. When I read of US medical costs I think How the hell can it cost XXX thousand dollars to GIVE BIRTH???? That’s not an illness or accident. This example, yes, is an unexpected medical event – premature birth – but normal birth is as normal a bodily event as having a shit.

  9. jgh – but we generally don’t expect the government to cover having-a-shit expenses?
    I suspect that for most people, their lifetime cost of having a bathroom exceeds their childbirth costs??!

  10. Tim N

    The descendants of imported coolie labour, Malay, Chinese, Tamil etc + younger sons of white colonialists are a self selecting monoculture? Whatever you’ve been smoking, I want some.

    It’s a while since I was there but I’d put Singapore as multi culri as London or NY.

  11. Singapore has huge numbers of non-residents and permanent residents. By far most of the citizens are ethnic chinese.

  12. ‘NHS costs £2,000 per capita per annum. £8,000 for a family of four…’

    Wrong!

    The NHS is free… that money tree pays.

  13. Bit of a rambling comment but strangely enough I have experienced Singapore healthcare up close this week a couple of times.

    Accident and emergency. Dropped a very sharp knife off the kitchen counter whilst making lunch this week. It landed blade down on my right big toe just next to the nail and nearly cut all the way through slicing off flesh. Oh. After the shock and elevation and compression my wife came home and drive me to A&E. triage inside two minutes. Five minutes to fill out the form to identify me. Nurse takes me to minor opertations room tells me there is a 45 min wait for a doctor. Twenty mins later a doctor comes in and starts treatment (stitches). Out in 45 mins. 666SGD (£370) bill. Insurer will pick it up but I had to pay on the spot. By comparison by last NHS A&E trip took almost as long to get to triage as it did to get treated here. When I take the kids it’s fast in the UK but as an adult you would prefer not to go unless serious as the wait time is huge.
    I would have preferred not to go here but I needed someone else to see me back together.

    2 – I have had shoulder pain for three months. NHS GP tries two simple tests (and doesn’t get any pain in response) prescribes NSAID and says come back if it doesn’t go away. (Cost £8.60 prescription charge) Singapore GP carefully checks me over, tries different movements until she identifies what is hurting – prescribes NSAID and something else to help me sleep. Her staff sort me out with a consultant appointment two day later after approval by insurer. Cost SGD4.10 for the drugs or about £2.50. Consultant sees me this morning and hones in on the issue but says might be bad, only way to tell is MRI and x-ray. Gives me a chit and his staff book me an appointment for noon, SGD1100 for the 30 minute MRI and SGD80 for the X-ray. I have to pay and claim back. My follow up is Sat morning at 11am.

    Now the insurance comes with my wife’s work and is top notch and not cheap but the private health I have in U.K. For our family is through work and I still have to pay £1100 out of my wages per year for family cover which is only really there for diagnosis. I pay tens of thousands in tax so consider I have paid for my NHS insurance as well.

    Which system is better? Singapore. The staff treat me like a paying customer, not a problem. I don’t get patronised by our GP but get a detailed explanation from all healthcare professionals when I ask for one rather than them assuming I am not well educated enough to understand.

    Almost everyone who is here is Chinese. The vast majority are are ethnic Chinese but there are only 3.5m in total. It makes Singapore more mono cultural/ less diverse ethnically than London. There is no comparison. The other notable thing is that people are socially conscious so don’t throw rubbish on the ground or act like complete arses like most poor people in London, and some of the more wealthy ones as well. Maybe the caning for offenses is a good deterrent?

  14. This example, yes, is an unexpected medical event – premature birth – but normal birth is as normal a bodily event as having a shit.

    Not sure it is quite that routine.

    Historically, about 1 in 100 births resulted in maternal death.
    (source: https://en.wikipedia.org/wiki/Maternal_death
    Wikipedia – but the sources on that page look pretty reliable)

    I’m pretty sure that taking a dump doesn’t have a 1% fatality rate.

    But I agree in the majority of cases, it should just be a case of putting on a baseball glove and being ready. Easier if you can convince her to shout ‘catch!‘ just before…

  15. I hope Mr Newman realises that if he were to write as badly as this girl does he would be unlikely to prove a successful author.

  16. A bit OT – I see from Guido that the Guardian’s going tabloid.

    How will progressives sneer at the working class if they can’t sneer at “the tabloids” as a proxy?

  17. Who could have ever guessed that, if the per capita cost to provide healthcare is ~$10,000, insurance should cost ~$10,000?

    /s if it wasn’t obvious.

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