Comment by mmikeff | Hacker News Reader

Comment by mmikeff | Hacker News Reader

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The point I rarely see discussed in these ongoing debates about the best way to pay for healthcare is the benefit of knowing what you have to pay. As I understand it in the US even with health insurance there is likely to be an additional payment required by the patient for treatment, and the cost of that payment is generally unknown upfront.

With the NHS is the UK I can be pretty confident that no matter what medication my doctor prescribes that when I collect it from the pharmacy it will cost me exactly £8.60

I can also be confident that when I go for an appointment to see my GP that it will cost me nothing. This doesn't mean that is is free, as my National Insurance contributions are substantial, but that I know that I don't bear any financial risk from going to see a doctor.

I can't imagine what it would be like to have to worry about whether going to see a doctor about this mole that's changed a bit might land me with an unknown bill. Or to worry that my daughters peanut allergy could see me paying hundreds of dollars when her adrenaline pens expires.

> This doesn't mean that is is free, as my National Insurance contributions are substantial, but that I know that I don't bear any financial risk from going to see a doctor.

In fact, it's more important than that. Because you pay NI upfront, it relieves the feeling of burden that you might otherwise feel towards the NHS, which actually makes you more willing to go to the doctor. This means you're more likely to catch minor things before they become major problems (further reducing NHS costs).

Exactly. It's bad enough to be worried that you might have skin cancer, then to worry so much about the cost that you don't go see the doctor can only compound the issue.

I would guess (and don't know) that if you had super amazing insurance then maybe it covers all these unexpected extras. But for those that do not have that level of cover the decision must go something like:

I'm worried that this mole looks bad,

if I go and see a doctor then I might get a nasty bill,

but if I don't go and see a doctor then it might get worse and when it does I'll have no choice but to go,

oh and the cost of the treatment could bankrupt my family

Yes! I completely agree. Actually in my experience it's even worse - not only do you not know how much the bill will be, you never know when you've received the last bill! First you get a bill from the hospital, but a week later you get a separate bill from the anesthesiologist, then some days later another for the ultrasound technician, then some days later another for the ambulance, etc...

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