[pjc50]

The GP system is failing, but the Americans will tell you that a £2k bill for an A&E visit is quite cheap. Mind you, the American system has three sets of numbers which are mostly fictional and completely different: the hospital bill, the amount paid by the insurer, and the out-of-pocket "excess" that you actually have to pay.

Don't forget that in both countries public healthcare has to do a lot for the over-65s who don't have spare money for spiralling costs.

[looseyesterday]

But the choices are not the American system vs NHS. The dutch do a good job of an insurance based system, Singapore is totally different still (though obviously not applicable as its a fairly small country.

A great counter example is Signapore where each individual has a mandatory savings account which can only be used for healthcare. However, catastrophic illnesses and insufficient funds are covered by the gov. Another element of the scheme is that the savings accounts can be used for family members. This incentives people to seek the cheapest care, and keep family members healthy. While the poor, retired etc are still taken care of.

The problem I have with the NHS is that I dont see what my care costs at any point. I dont think that leads to good decision making.

[pjc50]

> I dont see what my care costs at any point. I dont think that leads to good decision making.

How much extra do you want them to spend on computing this? To what extent do you actually want cost factored into your care?

[looseyesterday]

In the context of a Singaporean system what you spend matters, as it reduces your ability to gain benefits in the future. It will discourage people from getting scans and tests that are only of marginal benefit.