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After Brexit UK health insurance won't be valid in the EU countries anymore and it will be more difficult for the brits to travel to any EU country. Will the brits stop travelling to European countries?

Brits will still travel to countries covered by the EHIC scheme, but will no longer be covered. Additionally Europeans will still travel to the UK, but will not be covered.Instead they will have to obtain private health insurance.The UK Government will not be lowing tax as they remove this benefit, but I assume any savings will be reused within the NHS.Differences include:Fee based insurance instead of tax based, so a wealthy individual would probably not notice the difference but a poor individual would - leading to a risk that they might travel uninsured.Age and previous medical conditions likely to be assessed when you apply for insurance. This might make travel impossible for certain groups.People might not get care abroad because of the excess on private insurance and so return ill and require more expensive treatment in the UK.The old might not be able to travel to warm and sunny countries during winter due to health costs despite this being cheaper than treating them in the UK and the general health boost they receive.Private cost might increase as they would need to cover charges that the EHIC scheme covered.Private insurance might not pay at the point of charging, but need you to reclaim later. This means you might need to meet your medical bill immediately and there is the risk of the insurance company later disputing the claim and failing to reimburse you.Possible issues with the health provider recognising your insurance. The EHIC scheme is standard across the participating countries.Additional costs for UK hospitals, etc, charging for treatment and possible involvement with european insurance companies. As UK hospitals won’t refuse emergency treatment, there may be a loss of income.The EHIC system seemed like a good, sensible, low bureaucracy safety net for the benefit of all at a very low cost. I am unclear why the UK decided it was unable to continue to participate.Some comments have pointed out the need for additional travel insurance. This is indeed recommended by the NHS website however the cost of such insurance will depend on your age and existing medical conditions. While, as I understand it, someone who requires regular dialysis can arrange this using the EHIC system, private travel insurance will not cover this.I have also looked at a German Public Health Insurance website (so the equivalent of the NHS) and they also discuss using EHIC for travel. They do also recommend additional travel insurance but only to cover those things not covered by the EHIC scheme, such a medical repatriation and even have a deal with a travel insurance company to provide this additional cover at a special rate. A German suggested this additional insurance costs €10 a year. I cannot confirm as insurance costs are not public but require a quote.In the UK the Government is very keen that you take out full travel insurance so rendering the EHIC unnecessary. I assume the reason is that they can then avoid claims on the the NHS by people who could have used the EHIC. A solution might be to charge a suitable fee for the EHIC and for the NHS to have a set of travel insurance companies offering special deals to those who hold and will claim via EHIC first. If you want to go private, you can always still take out full travel insurance.Edit 25/12/2020: The EHIC system might survive in some form, see Andrew Cox's answer to Will British travellers be able to use European Health insurance Card (EHIC) in Europe after the 1st of January? Has there been an agreement about this on the Brexit deal?Edit 2/1/2021: Added text about also buying Travel InsuranceEdit 22/2/2021: Here is the link to the new Global Health Insurance Card, which currently does not cover EEA and Switzerland, but probably will once negotiations are complete.

Have you ever applauded an act of vigilante justice?

Yes, indeed.In 2009 a team of activists, led by Ric O’ Berry took matters into their own hand despite facing the possibility of arrest or even violence.Every year in Japan, they begin the Taiji dolphin hunt in the small fishing town of Taiji. The hunt begins during the dolphin migration. Fishermen go out into the water in boats and then place long, metal poles into the water which they slam against the side of their boats to create a wall of sound. The dolphins are confused and disoriented by the sound and are no longer able to communicate or navigate using echolocation. They will often swim away from the sound, towards the shore where nets are lowered to prevent them from being able to escape and they become trapped in the shallows and eventually herded into the cove for slaughter.Every year they kill or capture about 16,000 dolphins. The hunt itself has been accused of cruelty and inhumane slaughter numerous times, though they remained rather secretive about the manner in which they carried out the slaughter.Activists like Ric ‘O Berry would often stand near the shore with cameras, attempting to record what they could see but the slaughter was kept out of the view of the public eye as the dolphins were herded into the cove. The fishermen would also tend to become aggressive with the activists and attempt to drive them away.Activists on boats are also barred access by the Japanese boats and Coast Guard, who will block access to anyone trying to get close or interfere with the hunt.Though some can capture aerial views:"Cove" Movie Assails Dolphin Hunt, Gets Oscar BoostOverall, despite claims that the slaughter is perfectly humane, the public was not given much information or transparency into what was actually happening.In addition, this can pose a public health risk. Dolphin meat is often highly contaminated with mercury which makes it dangerous to eat. Despite this, there is a high surplus of dolphin meat made available by the slaughter. At times, it has been found that foods have been mislabeled as ‘tuna’ and other fish products but filled with dolphin meat, in order to trick consumers into eating it despite the risks.Repeated chemical analyses have shown that the level of mercury in dolphin meat is much higher than the maximum allowable level set by the Ministry of Health, Labor and Welfare of Japan and the World Health Organization.The contamination of dolphin meat by mercury in Japan has been documented time and time again, by both nongovernmental organizations and by Japanese scientists."Cove" Movie Assails Dolphin Hunt, Gets Oscar BoostThe activists knew that they needed a way to get into the cove and see what was actually happening. However, the public was not allowed access and there was no way they could legally get inside.They hatched the brilliant plan to place hidden cameras inside of the cove. They disguised the cameras as normal objects like a birds nest, so that the fishermen would not notice them.The night before the slaughter (the dolphins are often left in the cove overnight and slaughtered in the morning) the activists broke into the restricted cove and placed cameras and microphones in order to record the events. They also had to break back in after the slaughter in order to recover the footage, a major risk which would have led to their arrest if found.The results of this were of course, horrifying. The slaughter itself takes hours as the dolphins are slowly killed, one by one, as the water fills with blood and the thrashing, crying and dying of up to a hundred dolphins at once. It’s likely these animals suffer intense fear and anxiety as they are trapped in shallow water surrounded by the dying of others around them. They are stabbed with long spears and left to bleed out.The activists were not caught when they carried out their plot and successfully captured footage of the slaughter. They then left Japan and released their findings in the documentary, ‘The Cove’, revealing the brutality of the dolphin hunt to the world.The fishermen claim that the method of slaughter is perfectly humane and does not cause the dolphins to suffer, though many including other politicians and scientists have disputed this.In a 2013 study which appeared in the Journal of Applied Animal Welfare Science, scientists criticized the methods used by the fishermen, and said:Our veterinary and behavioral analysis of video documentation of this method indicates that it does not immediately lead to death and that the time to death data provided in the description of the method, based on termination of breathing and movement, is not supported by the available video data."Cove" Movie Assails Dolphin Hunt, Gets Oscar BoostDespite the fact that these activists broke Japanese law and clearly recorded without permission, I am glad that this documentary brought increased awareness and scrutiny to the accusations of cruelty and inhumane treatment by the fishermen and aquariums around the world who pay these fishermen to capture prize dolphins.

Would Paul Ryan's budget really end Medicare as we know it?

Take a long look: This graph is the beating heart of Washington's budget debate. It shows the hydra health care monster opening its mouth in mid-century and gobbling up all government revenue within a generation or two.This picture is a partisan Rorschach test. Washington promised to pay for every senior's health care. We can't. Paul Ryan's sees the graph and says, "Let's change our promise." The White House's sees the graph and says, "Let's change health care."-The Atlantic's Derek Thompson end of Medicare "as we know it" is inevitable. In 2011, debates about Medicare primarily focus on how seniors can pay for their healthcare. In 1965 before Medicare was passed as an amendment to the Social Security Act, debates emphasized the financial burdens born by both seniors and younger generations.Rep. Paul Ryan writes in his introduction to the Medicare section of his budget:When President Johnson signed Medicare into law more than 40 years ago, he cited a principal goal of the program that cannot be achieved under its current spending path: “No longer will young families see their own incomes, and their own hopes, eaten away simply because they are carrying out deep moral obligations to their parents, and to their uncles, and their aunts.” Absent reform, the program will end up delivering exactly what it was created to avoid: it will consume the prosperity of today’s younger generation to finance an unsustainable path of spending. Ryan often utilizes the chart below to explain the rapid rise in Medicare's costs.In His Own Words. Rep. Ryan's infographics explains how his budget does not end Medicare:Rep. Ryan's answer in this thread states "simply put, no [the Path to Prosperity does not end Medicare as we know it]." While his answer may lack a level of depth the Quora community has come to expect, his central premise is clear: failure to reform Medicare will end Medicare as we currently know it.Below is a more detailed answer to the question using Rep. Ryan's statements as well as relevant analysis from the healthcare debate.(1) A "grandfather" clause reduces existing uncertainty. Current seniors (those 55 and older) will see no changes. Definitionally, Medicare as we know it will continue for those who planned on receiving Medicare. Uncertainty in the status quo risks ending Medicare's current guarantee to those 55 years and older. Rep. Ryan's plan legislates stability for those who will require Medicare the most.(2) Medicare will still provide a safety net. Yearly payments will be adjusted based off of risk. Those who need additional help will not be put out in the cold by Rep. Ryan's plan. In his own words:When the plan is fully implemented, Medicare beneficiaries will receive on average the standard $11,000, with the flexibility to receive a positive adjustment of that amount based on a risk-assessment from their chosen health plan. ...Under the current system, Medicare frequently overpays for some services and beneficiaries and underpays for others. By risk-adjusting beneficiaries’ payments based on their health condition, this reform targets support to those who truly need additional help. assist low income seniors, Rep. Ryan's plan includes further safeguards determined by income. As of now, Medicare provides the same coverage to Warren Buffet as it does to a senior living below the poverty line. In his own words:Income-Relating. The payment amount is modified based on income, in a manner similar to that for current Medicare Part B premium subsidies. Specifically: beneficiaries with incomes below $80,000 ($160,000 for couples) receive full standard payment amounts; beneficiaries with annual incomes between $80,000 and $200,000 ($160,000 to $400,000 for couples) receive 50 percent of the standard; and beneficiaries with incomes above $200,000 ($400,000 for couples) receive 30 percent.Enhanced Support for Low-Income Beneficiaries. While any Medicare beneficiary, regardless of income level, is able to set up a tax-free MSA if he or she desires, the new Medicare Program establishes and funds an MSA for low-income beneficiaries. Specifically, for those who are fully “dual eligible” (eligible under current policies for both Medicare and Medicaid), and beneficiaries with incomes below 100 percent of the poverty level, the plan provides an MSA payment equal to the amount of the deductible for the average Medicare high-deductible health plan. Those with incomes between 100 percent and 150 percent of poverty receive 75 percent of the full deposit. Choice reduces costs. Premium payment supports offered by Rep. Ryan's budget are grounded in the belief that more active consumers demand and receive better healthcare. Competition over consumers will reduce costs, speed up innovation and offer more tailored and effective care.There is support for this in Medicare's existing Part D. According to the American Enterprise Institute, a think tank that has written to Congress in support of Medicare reform (, Part D empirically reduces costs by providing beneficiaries with options to purchase prescription coverage throughvarying combinations of local pharmacy networks, mail order pharmacy, preferred drug lists, cost-sharing requirements, and premiums. ...Premium support assumes that seniors have varying preferences with regard to the details of their health plans and that enough of them would act on those preferences if given the chance. That would motivate health plans to refine their offerings to increase market share, and would make the plans sensitive to the changing demands of consumers.Since seniors live on limited incomes, plans will be motivated to find more efficient ways to deliver services that cut cost without unduly burdening patients. They cannot simply order more tests or procedures to increase their profits, as is the case in a fee-for-service world, because the total payment for an enrollee is limited. That provides a strong incentive to seek ways to deliver care that are both more efficient and attractive to consumers. Countering cherry-picking by prohibiting experience ratings. Rep. Ryan's plan is written to promote competition while maintaing quality and consistent care. Experience ratings, prohibited by Rep. Ryan's plan, are when healthcare providers differentiatepremiums according to demographics, health status, past health care use, and similar factors. Experience rating in health insurance leads to "cherry picking," in which insurers compete to lower their premiums by excluding all but the healthiest customers. Under such a system, the very elderly and those with chronic illnesses are likely to find that insurance is unaffordable or completely unavailable. What about rising costs and the CBO's analysis? Corey Recvlohe's answer summarizes the researched claims made by the CBO and Think Progress. Their analysis is far from perfect when evaluating Rep. Ryan's budget.James C. Capretta, former Associate Director at the Office of Management and Budget where he was the top-budget official for healthcare, disputes these claims in Kaiser Health News.Ryan's critics have focused particular attention on his plan's indexation of the Medicare "premium support credits" to the CPI in the years after 2022, suggesting that this idea is somehow beyond the pale. But this is sheer hypocrisy on their part because the indexing of government-financed premium credits below cost growth is in the president'' plan too, and yet not a complaint has been heard about that from its advocates. That's right. After 2018, if the aggregate governmental cost of premium credits and cost-sharing subsidies provided in the state-run exchanges exceeds about 0.5 percent of GDP (a condition that the Congressional Budget Office says will be met), the recently-enacted health law requires the government's per capita contribution to health plan premiums in the exchanges to rise more slowly than premiums. The administration actuaries interpret the law to mean that the government's contributions toward coverage will rise with GDP growth after 2018. CBO appears to have a different interpretation. Still, under all interpretations and projections, it's clear that the exchange credits in the new law will not keep pace with expectations of rising health costs. And that's exactly what the president is now saying is so wrong with Ryan's Medicare plan.Critics contend that the Ryan plan would shift huge new costs onto Medicare beneficiaries for reasons beyond the indexing of the credits, and they cite CBO's analysis of the Ryan budget as proof. But this analysis is based on two flawed assumptions. First, it assumes that traditional Medicare can keep cutting what it pays to hospitals and doctors with no consequences whatsoever for the beneficiaries. CBO's assessment is that in 2022 traditional Medicare could provide the insurance benefit for just 66 percent of what a private insurance plan would cost. This is sheer folly based entirely on deep payment reductions for services. If those cuts really were to go into effect as scheduled, Medicare rates would be well below those of Medicaid, and seniors would have very restricted access to care. CBO's analysis also assumes no savings from establishing rigorous competition in the Medicare program. But the cost-cutting in the prescription drug program demonstrates that the potential is there for massive savings from a functioning marketplace.

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