[hrothgar]

[quote name='kenber

I don't want to divert the thread to a discussion of American behavior, wise or unwise, proper or improper, but I did want to record the fact that an American going off to London or Paris for the sole purpose of medical treatment is simply outside of my experience.
[/quote]

They (typically) don't go to Paris or London. They go to Ecuador, India, Thailand, Korea...

There's a lot of countries out there with first class medical practices that cost 1/3rd to 1/2 what things cost in the US.

It is worth noting that even in "expensive" countries in Europe, medical procedures are only half as much as in the US

[Cyberyeti]

 hrothgar, on 2015-May-20, 14:03, said:

In the US, the expression is often used to describe situations where US citizens travel to foreign countries for medical treatment.
Typically, the motivation is taking advantage of less expensive medical services.

In general, these cost savings have nothing to do with Health Insurance systems in other country, rather they reflect the deeply dysfunctional nature of the sytsem in the US.

Funnily enough we do have paying health tourism from the UK. People find that things like cosmetic surgery, serious dental treatment etc that are not available or still expensive on the NHS are much cheaper done in for example Poland. The NHS then picks up the tab when the treatment (this is most common in countries where cosmetic surgery is less well regulated than here) turns out to be botched once they return and needs remedial work.

[Vampyr]

 kenberg, on 2015-May-20, 16:25, said:

Every so often I wonder if I am naive or what? I have known people who have, say, broken a leg in Paris and had it treated there. I don't much keep track of these events but my impression is that they have been pleased. To the best of my knowledge, no one I know has ever intentionally gone abroad for medical treatment. I think I would know, and since it would be a surprise I think I would remember.

Apparently it is more common than you think.

Quote

If it is a common practice I would certainly approve of the UK or the EU putting a stop to it. There is no reason people in the EU should be subsidizing our health care.

If by "our" you mean Americans', no, they are not the usual offenders. As to "putting a stop to it", a person arrives in the country at death's door, or as above, about to have a baby, etc, what is the poor NHS to do?

EDIT: Ah, crossed posts above.

[kenberg]

 Vampyr, on 2015-May-20, 17:50, said:

If by "our" you mean Americans', no, they are not the usual offenders. As to "putting a stop to it", a person arrives in the country at death's door, or as above, about to have a baby, etc, what is the poor NHS to do?

EDIT: Ah, crossed posts above.

It's easy for me to get in over my head here. It is always difficult to know what to do when confronted with true desperation. I can't say I know what we do if a person enters the country on Tuesday and on Thuisday announces a severe illness that requires expensive treatment. If the person has resources of his/her own, whether the resources are here or in his her home country, I would hope s/he would be expected to put up some cash. Now suppose they are penniless. I migt begin by asking who paid the plane fare, or who paid the smugglers if that is how they arrived, but probably at some point we or you or someone is stuck with a bill.

As you note, there were simultaneous responses. Richard had in mind trips to India etc (no insult intended with the etc, I realize the places listed are individual places. I was thinking he was speaking of people flying to London for a medical quickie and then flying back. In a case such as that, I would favor giving them a bill, payable i advance.

In short, there are a lot of variations.

[MrAce]

 kenberg, on 2015-May-20, 18:44, said:

It's easy for me to get in over my head here. It is always difficult to know what to do when confronted with true desperation. I can't say I know what we do if a person enters the country on Tuesday and on Thuisday announces a severe illness that requires expensive treatment. If the person has resources of his/her own, whether the resources are here or in his her home country, I would hope s/he would be expected to put up some cash. Now suppose they are penniless. I migt begin by asking who paid the plane fare, or who paid the smugglers if that is how they arrived, but probably at some point we or you or someone is stuck with a bill..

In US they will be treated in emergency room if there is an emergency situation. After they are stabilized and able to be transferred, they will put him in front of the E.R with a white plastic cup of coffee-juice-water in their hand and a wheelchair under their butt that they are not allowed to take out of hospital premises. Unless they show some benjamins. In absence of benjamins, rest depends on the mercy of the gangs or homeless in the hood.

[NickRW]

 cherdano, on 2015-May-20, 12:42, said:

LOL. I made a post making four factual arguments, and one off-hand comment about Farage. I mostly got replies about Farage, most of them misstating what I said (including your own post).
Apparently I have struck a nerve with some posters here.

You call "facts" assertions that you claim you can back up and then don't, while interspersing you comments with language like xenophobe and jerk. Then you want to "LOL" someone who calls you out for it. Hmm...

[helene_t]

I am a health immigrant. I moved to the Netherlands in order to have treatment there at the expense of the Dutch taxpayers. Otoh I paied taxes all the eleven years I lived in the Netherlands while in Denmark I spent more years receiving free education than paying taxes.

If I have gone as a tourist rather than as an immigrant then the Dutch hospital would have sent the bill to Denmark.

There are cases where somebody without an insurance comes and needs urgent treatment and can't pay the bill but they must be rare.

[Cyberyeti]

 helene_t, on 2015-May-21, 07:37, said:

I am a health immigrant. I moved to the Netherlands in order to have treatment there at the expense of the Dutch taxpayers. Otoh I paied taxes all the eleven years I lived in the Netherlands while in Denmark I spent more years receiving free education than paying taxes.

If I have gone as a tourist rather than as an immigrant then the Dutch hospital would have sent the bill to Denmark.

There are cases where somebody without an insurance comes and needs urgent treatment and can't pay the bill but they must be rare.

This is a non-issue for EU tourists in other EU countries due to the reciprocal treatment arrangements for tourists free at point of use if you have the relevant card which is easily obtainable.

There are some anecdotes of British residents with undiagnosed conditions going to their holiday homes in France before going to the doctor as they know they'll be scanned much more quickly over there.

[cherdano]

 NickRW, on 2015-May-21, 02:29, said:

You call "facts" assertions that you claim you can back up and then don't, while interspersing you comments with language like xenophobe and jerk. Then you want to "LOL" someone who calls you out for it. Hmm...

You are right, I made wild claims that apparently needed backing up. Like claiming "increase of property supply will cause a decrease of property prices" or "using the population density of the USA as an argument about reasonable maximum population density is ridiculous". Should I back up this claim by adding a link to a map of Nevada or Wyoming?

So here is what is ridiculous about UK immigration policy: the previous government promised to deliver on a target of "not more than x number of immigrations per year" (I think at some point Cameron made this pledge with x = 100000). That's a ridiculous promise to make, since they had no way of preventing legal EU immigration. So they tried to make up for it by trying to reduce numbers elsewhere at any cost with ridiculous practices. Examples:

• Say a University would be successful in hiring a Nobel prize winner with US nationality. Then that University would be forbidden from giving him/her advice (or, god forbid, help) in his VISA application. Moreover, if he/she made a small mistake in the application - say forgetting one document requested in the application-, then the Home Office would deny the application (rather than delaying the application and requesting the additional document).
  
• Universities have to take attendance of their international students for the specific purpose of reporting those that do not attend frequently enough to the home office. I'll promise you that if someone proposed that US universities have to do that (i.e., essentially becoming an agency of the department of homeland security), there would be an outcry.

The ridiculousness goes on - say, putting a cap on the number of highly skilled immigrants because UKIP voters see to many Polish and Romanian immigrants on the streets (who have nothing to do with the cap).

I hope these examples also illustrate that "Country Y has a ridiculous immigration policy" cannot be refuted by "Country Y had z number of immigrants".

[PassedOut]

 cherdano, on 2015-May-21, 08:39, said:

So here is what is ridiculous about UK immigration policy: the previous government promised to deliver on a target of "not more than x number of immigrations per year" (I think at some point Cameron made this pledge with x = 100000). That's a ridiculous promise to make, since they had no way of preventing legal EU immigration. So they tried to make up for it by trying to reduce numbers elsewhere at any cost with ridiculous practices. Examples:

• Say a University would be successful in hiring a Nobel prize winner with US nationality. Then that University would be forbidden from giving him/her advice (or, god forbid, help) in his VISA application. Moreover, if he/she made a small mistake in the application - say forgetting one document requested in the application-, then the Home Office would deny the application (rather than delaying the application and requesting the additional document).
  
• Universities have to take attendance of their international students for the specific purpose of reporting those that do not attend frequently enough to the home office. I'll promise you that if someone proposed that US universities have to do that (i.e., essentially becoming an agency of the department of homeland security), there would be an outcry.

The ridiculousness goes on - say, putting a cap on the number of highly skilled immigrants because UKIP voters see to many Polish and Romanian immigrants on the streets (who have nothing to do with the cap).

After reading your post, I just read this: David Cameron announces plans to set up Immigration Taskforce to cut migration

Quote

Among the plans, Mr Cameron confirmed he would set up a new Immigration Taskforce to ensure a “significant” reduction in professionals whose skills are deemed by the Migration Advisory Committee to be in short supply – in order to encourage sectors which are "over-reliant" on migrants to train more Britons.

Earlier, the Office for National Statistics announced that net annual migration to Britain has leapt to 318,000, just 2,000 below the highest figure on record. The figures estimated that net migration – the difference between those arriving and those leaving - stood at 318,000 in the calendar year of 2014 – a rise of 109,000 since 2013.

Given the sort of measures you already described, I wonder what new measures they have in mind. And I wonder how the Department for Business will react. This whole approach strikes me as short-sighted, but I grant that I might be missing something.

[kenberg]

 helene_t, on 2015-May-21, 07:37, said:

I am a health immigrant. I moved to the Netherlands in order to have treatment there at the expense of the Dutch taxpayers. Otoh I paied taxes all the eleven years I lived in the Netherlands while in Denmark I spent more years receiving free education than paying taxes.

If I have gone as a tourist rather than as an immigrant then the Dutch hospital would have sent the bill to Denmark.

There are cases where somebody without an insurance comes and needs urgent treatment and can't pay the bill but they must be rare.

I will only comment that life used to be simpler. I like simple.

[blackshoe]

 MrAce, on 2015-May-21, 02:26, said:

In US they will be treated in emergency room if there is an emergency situation. After they are stabilized and able to be transferred, they will put him in front of the E.R with a white plastic cup of coffee-juice-water in their hand and a wheelchair under their butt that they are not allowed to take out of hospital premises. Unless they show some benjamins. In absence of benjamins, rest depends on the mercy of the gangs or homeless in the hood.

There was a case some years ago where somebody was dropped off outside the emergency room at Ravenswood Hospital in Chicago (I was born there) with a gunshot wound. ER personnel knew he was there, but he was not on hospital property, so they left him on the sidewalk. IIRC, he bled to death. So much for "will be treated".

[MrAce]

 blackshoe, on 2015-May-21, 17:21, said:

There was a case some years ago where somebody was dropped off outside the emergency room at Ravenswood Hospital in Chicago (I was born there) with a gunshot wound. ER personnel knew he was there, but he was not on hospital property, so they left him on the sidewalk. IIRC, he bled to death. So much for "will be treated".

I believe you. I meant if he checks in ER or calls 911 ambulance

[kenberg]

I was thinking specifically of immigrants, along the lines of the UK problem. A hundred or so years ago, immigrants were checked for basic health problems and, if they did not pass, they were sent back. When i said I didn't know what we do here, I meant our current policy toward health and immigrants. As always, there are many variations. A person comes in on Tuesday, declares himself seriously ill on Thursday, is examined and it is clear that the problem is of long standing. Now if he was a legal immigrant following a normal path, I would assume the illness would have been discovered when he arrived on Tuesday. And then I assume he would have not been allowed entrance. But I don't know this.

If we did basic checks for health a hundred years ago and don't do them now, I guess I would wonder why that is.

Of course if he entered the country illegally then he would not have been checked. But he also would be here illegally.

Anyway, I took this to be along the lines of some of the discussion about immigration to the UK (I was responding specifically to Vampyr's thoughts), and I mentioned that I am really unsure of what we do here .

[mike777]

 blackshoe, on 2015-May-21, 17:21, said:

There was a case some years ago where somebody was dropped off outside the emergency room at Ravenswood Hospital in Chicago (I was born there) with a gunshot wound. ER personnel knew he was there, but he was not on hospital property, so they left him on the sidewalk. IIRC, he bled to death. So much for "will be treated".

I was born at St. Bernard....there must be a bit more to this story.



"January 1, 2013 at 4:13 pm


Ravenswood Hospital, located at 1931 West Wilson Avenue, has been closed for more than 12 years. Originally built in 1907, Ravenswood Hospital had been a pillar of the north side Chicago community for many years. At the hospital's highest point there were just under one thousand beds. It included ambulatory care, a psychiatric unit, rehabilitation, oncology, coronary care, a trauma ward, a nursing school and student residence on the 7.5 acre site.

Today, Ravenswood Hospital is being demolished floor by floor"

[blackshoe]

I said "some years ago". I said it that way because I don't remember how many. However, I read the story in the news after I moved here to Rochester, so clearly sometime between 1993 and 2000 or so.

I'm sure it was a good hospital back in the day. My father, who was a doctor, and my maternal grandfather, also a doctor, would not have let my mother go there if it wasn't. But this incident really bothered me. Both in that people were dropping off gunshot victims on the sidewalk and then taking off, which says "bad neighborhood" to me, and in that the staff basically just ignored a wounded man because, essentially, they didn't want to get involved. Something about fear of liabilities, iirc.

[kenberg]

A further thought on immigration. It would be useful if advocaes of any particular course of action would include a statement pn the ultimate goal such as "This would be good for the country receiving, or not receiving, the immigrants" or "This will be a burden but I think it is our obligation to those in need".

I suppose Cameron's statement that he wants to reduce the number of skilled workers entering the country so that the UK will see the need to produce more skilled workers on its own sort of falls into this category except that it is so bizarre that it is difficult to take it at face value. It would seem that if you need skilled workers you need them and you might want to sequence the response so first you train more skilled workers of your own and, after that, you might decide to cut back on skilled worker immigration.

But Cameron aside, I think we romanticize the large immigration to the US of days past. A lot of people benefited including my father and thus me, and I am more than willing to acknowledge this. But the US actually wanted immigrants, it wasn't that the US decided to do the world a favor.

And I am not oppesed to doing good in the world, including dealing with the large mass of refugees. I am simply in favor of being clear about our purpose in doing things and being realistic in what can be accomplished, what maybe can be accomplished with great difficulty, and what really is beyond our reach.

[Trinidad]

 kenberg, on 2015-May-22, 05:53, said:

A further thought on immigration. It would be useful if advocaes of any particular course of action would include a statement pn the ultimate goal such as "This would be good for the country receiving, or not receiving, the immigrants" or "This will be a burden but I think it is our obligation to those I need".

I'll give my opinion:
It is a bit of all.

• I think each of us has an obligation to the society we live in. I think it is silly to limit this "society" at any imaginary line that someone drew on a map ages ago.
  
• I think that immigrants have value for a society. That value is, among others, economic and cultural.
  
• Immigration also comes at a cost (or burden) for society. Again, these costs are economic and cultural.

The cost and value of immigration should be shared. This is not the case now.

In addition both sides, immigrants and the local population, have duties.

For the immigrants:
Work on your integration into the new society. Learn the language, learn the culture, get a job, participate in what the locals do in their spare time, get a hobby. This does not mean that you loose your original identity. It means that you gain a second one! You can be a devout Muslim from Pakistan and play bridge on Wednesday evening.

Immigrants who choose voluntarily to come to my country need to realize these duties up front. They will get to play in a bridge club (or play soccer) where people drink beer (with alcohol!) despite the fact that this is forbidden according to the Quran. They will not be forced to drink any beer themselves, but they cannot forbid others from drinking it, no matter how bad it is to drink beer. If they can't live with that, they shouldn't come.

For refugees, the situation is different. They did not make a deliberate choice to come. They just ran. They are traumatized and need all the help we can give them and we should teach them how to live in their new place with this strange culture... and then we can ask them to live up to their new duties.

For the locals:
Welcome and accept the strangers. Help them out when they can't find their way in a very confusing society. Forgive them their cultural errors and realize how your behavior shocks the locals when you are on vacation in Marakech or Phuket. It is not a miracle that the immigrants will make mistakes. Give them a little breathing space. Accept their original identity and don't ask them to denounce it.

This just means that we need to help each other out.

An example of how not to do this:
A few years ago, the Dutch government, strongly influenced by an anti-immigration party, demanded of foreigners that they learn Dutch. I consider that an excellent requirement. Many foreigners thought the same since they already went to "Dutch for foreigners" classes. However, at the very same time that the government required foreigners to learn Dutch, they withdrew their support for these courses. This meant that those good willing foreigners that were actively working on their integration could not afford to go there anymore.

I think that is criminal. It is not working towards a solution. It is an example of knowingly and willingly increasing a social problem for future political gain.

Rik

[blackshoe]

If someone wants to come here, become a useful member of our society, support himself and his family, learn our culture, and think of himself as an American (as opposed to Polish-American or Arab-American or AnythingElse-American) I say more power to him. Or her. I'm not saying immigrants should give up their original culture or forget where they came from. I'm saying they shouldn't expect to come here and stay isolated from the culture of this country. If they want to do that, or come and live off the rest of us, as far as I'm concerned they can stay where they are. If they're refugees fleeing from someplace like Rwanda or Syria or whatever, then I'm happy to give them a place to rest up, consider their options, and decide what they want to do. But not forever. I don't know how long, but not a lifetime. Maybe a year or two. Then they have a decision to make. Stay here and become Americans, or go somewhere else. Yeah, it's not that simple. Not claiming it is, but it's a place to start.

[Vampyr]

 blackshoe, on 2015-May-22, 17:14, said:

If someone wants to come here, become a useful member of our society, support himself and his family, learn our culture, and think of himself as an American (as opposed to Polish-American or Arab-American or AnythingElse-American) I say more power to him. Or her. I'm not saying immigrants should give up their original culture or forget where they came from. I'm saying they shouldn't expect to come here and stay isolated from the culture of this country. If they want to do that, or come and live off the rest of us, as far as I'm concerned they can stay where they are. If they're refugees fleeing from someplace like Rwanda or Syria or whatever, then I'm happy to give them a place to rest up, consider their options, and decide what they want to do. But not forever. I don't know how long, but not a lifetime. Maybe a year or two. Then they have a decision to make. Stay here and become Americans, or go somewhere else. Yeah, it's not that simple. Not claiming it is, but it's a place to start.

I know some British people who feel isolated in their neighbourhoods because everyone else there is Bangladeshi or Pakistani or whatever. Here the byword is "multiculturalism", and although perhaps the streets are not flowing with rivers of blood, it has not worked out too well.