TWIT 885: St Jeff's Memorial Hospital

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What are your thoughts about today’s show? We’d love to hear from you!

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I have never understood the US medical situation. I grew up with the NHS in the UK, and a similar system, here in Germany.

If you are sick or injured, you just go to the doctor’s or the hospital and get it treated, you don’t even think about it, for most illnesses.

If you are in a car accident, you have to pay a handling fee, but you generally get that back from the insurance of the liable party. But that is usually a small amount.

You can get private medical insurance here, but that just generally means a single room, instead of a room with 4 beds.

I had a pain in my foot, went to the doctor, he prescribed orthopaedic inner soles for my shoes and sent me to the specialist. Calcium build-up on the heel, was in hospital and had it chipped away within a week, I was back at work again, before the 6 weeks of statutory sick pay was over.

To actually have to worry about whether a job has health insurance or whether I have enough savings to get treatment is totally insane, to me, if you are living in a civilised country.

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Some Americans talk about Canada’s socialized medicine, or whatever… and we have something somewhat similar to what you mentioned. There is one huge downside though. (Well two actually, more on the second one in a bit.) The most major downside is that you can go see your family doctor, or another doctor in an emergency (like at a walk-in clinic or a hospital emergency room,) and they will treat you, but if you need medication, you better have health insurance. So say I have diabetes, I can be seen by a doctor, who will recommend treatment and it will most likely include a medicine (insulin injection, metformin pills, or something else) but these treatments are not covered my the government. If you’re unemployed, or otherwise working a job that doesn’t include health coverage, then what point is there being prescribed a solution you cannot apply???

The second downside is the lack of medical professionals. Many people, for the last two decades at least, are unable to get a family doctor because their numbers are too few for all the citizenry. And these days, with covid infections reducing available staff there is also the fact of covid having caused burnout such that many that were in the system have decide to leave it. We’ve been having smaller emergency rooms having to close for some hours or days at a time. I suspect recruiting new staff is not easy when you have a huge market in a nearby country (the USA) that pays better because their system is not socialized.


Every employer has to insure their employees and the government covers the unemployed, students, pensioners etc. for health cover, including medication. (The employee pays a contribution based on salary and the employer pays the rest.)

If you are working and don’t receive any supplementary benefits, you have to pay 5€ per prescribed medicine. There are some special treatments that aren’t covered or “lifestyle”! Illnesses, such as gout, that aren’t covered.

I suffer from gout, but managed to prove it wasn’t a lifestyle illness- I avoid the foods that can cause it and I drink less than 1 unit of alcohol per month on average, so the health insurance covers my medication.

I’ve paid all my life through contributions deducted from my salary. For years, I never saw a doctor and never used any medication, but at other times. I was sick and the insurance covered operations, medication, treatment, osteopath etc. Also, the employer covers the first 6 weeks of sick pay, at full pay, after that, the medical insurance covers pay at 2/3 normal pay. If you are long term sick and unable to work (years), you get a sort of disability pension.

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UK prescription costs are currently £9.35 per item, or £108.10 a year for unlimited prescriptions if you prepay, which is a no-brainer if, like me, you have more than one monthly prescription. There are various long-term conditions (like diabetes) that are exempt from prescription charges.

Thinking about BMW, Tesla etc. tying features to your account/ID, I assume when you return or sell the car you’ll logout and all those features disappear. The next owner would have to purchase them again.

There are benefits to this approach. The manufacturer doesn’t have to build cars to order. Also, the customer can customise the car as they want. I don’t do much driving on motorways, so could just enable adaptive cruise for our annual drive to France. No need for heated seats or steering wheel in the summer. Fancy adaptive headlights, just enable those in the winter when I drive in the dark and so on.

But it will become like cable cutting, it won’t save you any money.


To understand our system is to first understand the NRA then understand the AMA.


Was great to see Megan again.


The European way of handling this sounds fascinating. So many employers here don’t offer medical coverage because even THEY can’t afford it. And those that are lucky enough to get subsidized coverage still suffer with red tape bureaucracy while they’re trying to get treated


In the UK, the employer’s contribution and the employee’s contribution are paid into a central fund, the NHS, and this is used to fund doctors, hospitals, therapy and medicine (plus a yearly budget from the government). In Germany, the contributions are paid into non-profits, which are tasked with paying for everything, plus a budget from the government (through other taxes). A few years back, they made a surplus and had to pay back to their members (individuals, not the employers.)

One of the good things about the system is, the contributions are based on how much you earn, not how healthy or sick you are today. That means, you contribute now, and it covers those less lucky than yourself, later, if you are ill and unable to work, others pay for your care.


I second that. I was actually coming in to comment that very thing. She was a favorite personality of mine on TWIT and I was sad when she moved along, though fully support her in doing what’s best for her and her family. Would love as her time allows for her to come back and make appearances again.


that really stinks…my wife and i have medicare because we are retired now! Medicare is the US’s version of socialized medicine for retirees! We also have an addition to Medicare called Senior Plus which bumps up Medicare on steroids. I just went in hospital for bilateral cataract surgery (aka both eyes simultaneously) on July 11th, and the entire thing was covered, surgery, meds et al and my out of pocket co pay was $10…all my diabetes meds are also covered each month! We also have socialized medicine here, for seniors