UK NHS versus Swiss health insurance

Finance, Taxes, Banking, Insurance and Retirement
61
One of the advantages of the UK (not the NHS) is that over-the-counter drugs are much cheaper. And you can buy a 100 ibuprofen at once. (There are restrictions on paracetemol, since overdosing on that can kill you a lot more easily than ibuprofen).

Swiss hospitals are cleaner than UK hospitals. UK doctors are more experienced that Swiss ones - they see more. For the same reason NHS trained nurses are in demand worldwide.

Swiss nurses are better on the "care" side, since it is is not a graduate profession, so there's more people in the profession as a vocation. There's more money in the Swiss system, so it works better. There's more expertise in the NHS (if you can get access to it).

As someone on a relatively high income, I pay far less in health insurance costs + tax in Switzerland, as a percentage of income, than I would in the UK.

62

You're exagerating here. If your doctor gives your a perscription for 100 ibuprofen, you can pick them up all at once from the same pharmacy in a box of 100. FACT !

You cannot just walk in to buy 100 ibruprofen over the counter despite it being a non-perscription drug.

63
This happens in private health insurance systems too. It's not a consequence of the funding system per se.

This just isn't true - on an international scale, private medicine is very strictly regulated in the UK. It might not be ideal, but it's generally about as strict as it gets anywhere. There's plenty of countries with poor regulation that don't have a nationalised healthcare service as a scapegoat to blame.

64
Yeah, but they don't do that in the hospital, rather, they didn't do that for me. I was in too much damn pain to pay attention to the boxes they gave me and I got a week's worth. For the last week, I've been dragging my ass to the pharmacy just to buy paracetamol and ibuprofen since I'm taking 4g of paracetamol per day and 1.6g of ibuprofen, i have to buy it for 2-3 days use at a time. I had to go to the doctor today just to get all these two prescriptions renewed and that's basically all it was for. Now if I had to go back to have the narcotic pain killers again, I'd get that, but nobody's going to get addicted to Paracetamol and Ibuprofen; and if suicide is a concern, there are better drugs to kill yourself with.

65
Au contraire. Paracetamol is an effective way of committing suicide. A relatively small dose causes irreversible liver damage. The downside is that if someone overdoses as a "cry for help", they can be ok for a few days before their liver shuts down and they die.

Ibuprofen is not useful for anyone seeking to end their lives.

66
Fine, there are smarter ways to die than Paracetamol. Cheaper too. And besides, suicide is legal here!

Either way, I would think a limited number of paracetamol wouldn't deter someone that wants to commit suicide while in full health, they would simply go to several pharmacies-- while I had to go get my paracetamol and ibuprofen while limping with 1 to 3 broken ribs to the closest one every 2-3 days. I'm really quite bitter about this because it really was a difficult thing to get to the pharmacy when you're in that much pain, only to know you have to do it all over again in two days while still in quite a bit of pain. Especially since I had my emergency discharge papers with the treatment plan and all!

67
Compared with the third world perhaps, but compared with Swiss or elsewhere in Europe I would be very surprised.

Eg private insurance can exclude pre-existing conditions and pregnancy related. The cost is exorbitant too.

In London in particular the private sector is rife with abuse. Harley Street is lined with greedy quacks. Read last Private Eye on HCA's London Bridge Hospital.

68
Swiss supplementary insurance can exclude pre existing conditions and pregnancy cover has a year before becoming active, so similar in these aspects.

69
Swiss basic insurance can also exclude you from treatments on grounds of age. One personal friend in her 70s has been denied physiotherapy following a hip replacement due to age. They will also block fertility treatments for those over 40.

No idea how such situations would pan out with the NHS.

Cheers,

Nick

70
It being legal doesn't mean that the government doesn't want to prevent it. That's a no-brainer. However, the problem the restriction was intended to solve (and apparently did in the UK) was spur of the moment suicide. When I was growing up, it was not unusual to find medicine cabinets with bottles of 200 paracetamol.

The restriction on paracetamol (in the UK) was put in place to reduce unplanned suicides. It worked - at least in the short term.

Why there is a restriction on ibuprofen, I've no idea, since it is almost impossible to take a lethal dose. Why ibuprofen and paracetemol are so expensive here, I've also no idea. In the UK, it's about 1 penny a pill.

71
Not similar ... nothing pregnancy related on UK private health insurance, ever. And pregnancy is where the NHS can really let you down, making life stressful just when you are vulnerable.

You say 'can exclude' ... can you provide more detail? Is that legislated against at all?

72
Fertility treatment is a lottery at any age. You may in certain circumstances get a round of IVF, but maybe not. The vast majority go private, pay very large sums.

Re physio following ops. Generally a long wait and limited service.

That is generally the case with any 'frills' on the NHS. In my experience it offers good but basic care in serious situations, but will make you wait or run around or deny you altogether when it's non-life-threatening.

73

Depending on your insurance here, you might also not get to choose the obstetrician who delivers your child. Or if you get stuck in another kanton, you might not have the cover to be "repatriated" to your home kanton, so there are swings and roundabouts to consider...

Overall, I do prefer the Swiss system to the NHS, primarily because you contribute to it, so tend to think twice before spending and it is less open to abuse, and for the second reason that as a result it seems more efficient - but I've no stats to back this up.

The concept of the NHS, though, is rock-on solid and to be lauded.

Indeed, my primary reason for prefering the Swiss system is more a statement on society and its wastage than about the NHS itself...

Working in the healthcare industry, I also have to point out that the NHS is hampered by NICE - a real double-edged sword, which can result in no choice and in some instances no treatment...

To stop spur of the moment suicides? ( )

I hate the nanny-statishness of having to buy limited packs of paracetamol and ibuprofen. ( Edit : here and in the UK)

There's a fair few quacks in CH private practice, miss-treating, selling pills and potions, so don't think it doesn't happen here.

Similarly, as soon as you leave the GP and head for specialist treatment, it costs an arm and a leg, and without insurance more people wouldn't be able to afford it. Indeed, because insurance covers most things, I do believe that this is just another example of price fixing in CH. So while with the UK the people waste the money, in CH the Drs overcharge.

74
Yes, and vastly, vastly less as a proportion of your income on healthcare.

In UK you would first pay (through tax) for NHS, then pay (as taxable benefit) for private, then pay (in cash) for all the things not covered by either.

This is another reason (of many) why UK tax is much more progressive than it appears. I'm not complaining of tax on the rich, but the 'squeezed middle' in Britain is hurting.

75
When you say nothing on pregnancy cover, how do you mean ? Here in CH your supplementary cover can give you extra scans and a private ward if you want it but the actual birth comes under the basic cover but its irellevant which provider you are with as pregnancy is fully covered with no excess. So the stuff bupa offer in the uk is more or less on a par with here.

In terms of exclusions this is across the board. All providers for supplementary cover can and usually will ask for a history and will offer cover excluding areas they want ie pre existing conditions. Private cover in the uk and supplementary cover here work the same way really.

76
Lot of points covered here already in this thread. Eg re choice, that more basic insurance packages in Switzerland offer less choice than more expensive ones.

I'm not sure NHS is 'rock-on solid'. It has some advantages, but from what I've learned on this thread re Swiss system and my personal experiences with NHS, I'm pretty sure which one I favour.

That's clearly influenced also by the cost that I as a relatively good earner pay for healthcare in the UK. But on a societal basis, is the Swiss system better?

I would suggest yes, but it's a long argument and I've gotta dash. Laters.

77
They don't work at all similarly. Chalk and cheese.

Here's thread on BUPA pregnancy cover.

http://www.mumsnet.com/Talk/pregnanc...e/AllOnOnePage

My personal experience: £12k cash for obstetrician care.

78
I said the concept of the NHS is rock-on solid - free high-quality healthcare for anyone and everyone that needs it.

Whether it delivers it... well, that's not what I was saying.

79
The one thing i don't understand. It's free at the point of delivery, but not really free because you're taxed for it, correct? So the concept of free is a mental accounting thing - you do pay after all, but because it's not at delivery it's perceived as free?

If I, as a tourist, had to go to the doctor, is that also free?

80
OK, you are right, State-sponsored free, just like using the roads is "free". Ultimately we are taxed for everything, so yes we pay.

But if you can't afford the treatment you need or don't have a job, you still get treated - unlike some countries.

For tourists, I don't know. But I don't think that is part of this discussion? Is there any country in the world where as a visitor you can expect free treatment?