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Fact vs. Fiction : How Bad Would a British Health System Be In America

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posted on May, 11 2009 @ 11:23 AM
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This post is meant to put some info out there for Americans on the British Healthcare System that may be adopted here (Ex-Sen Daschle was on board with this until his "tax issues" surfaced). Here is some data - Good and Bad.
Here is the Good -
About Healthcare Costs

Since its launch 60 years ago, the NHS has grown to become the world’s largest publicly funded health service. It is also one of the most efficient, most egalitarian and most comprehensive.

The system was born out of a long-held ideal that good healthcare should be available to all, regardless of wealth – and that principle remains at its core. With the exception of charges for some prescriptions and optical and dental services, the NHS remains free at the point of use for anyone who is resident in the UK – more than 60m people. It covers everything from antenatal screening and routine treatments for coughs and colds to open heart surgery, accident and emergency treatment and end-of-life care.

Although funded centrally from national taxation, NHS services in England, Northern Ireland, Scotland and Wales are managed separately. While some differences have emerged between these systems in recent years, they remain similar in most respects and continue to be talked about as belonging to a single, unified system.

Measuring the efficiency of healthcare systems is notoriously difficult. The NHS – in common with other healthcare systems – has never consistently and systematically measured changes in its patients’ health. As a result, it’s impossible to say exactly how much extra “health” is created for each pound spent.

Nevertheless, in the UK life expectancy has been rising and infant mortality has been falling since the NHS was established. Both figures compare favourably with other nations. Surveys also show that patients are generally satisfied with the care they receive from the NHS. Importantly, people who have had recent direct experience of the NHS tend to report being more satisfied than people who have not.

Please visit the link provided for the complete story.


Breakdown of NHS Structure

* Secondary care is known as acute health care and can be either elective care or emergency care. Elective care means planned specialist medical care or surgery, usually following referral from a primary or community health professional such as a GP.

* Primary Care Trusts (PCTs) are in charge of primary care and have a major role around commissioning secondary care, providing community care services. They are now at the centre of the NHS and control 80% of the NHS budget. As they are local organisations, they are best positioned to understand the needs of their community, so they can make sure that the organisations providing health and social care services are working effectively. The PCTs oversee 29,000 GPs and 18,000 NHS dentists.

* There are 175 acute NHS trusts and 60 mental health NHS trusts which oversee 1,600 NHS hospitals and specialist care centres. Foundation trusts are a new type of NHS hospital of which are currently 115 available across England.

* Emergency vehicles are provided by the NHS ambulance services trusts. There are 11 ambulance trusts in England. The Scottish, Welsh and Northern Ireland ambulance services provide cover for those countries.

* NHS care trusts provide care in both health and social fields. There are few care trusts and they are based mainly in England. There are none in Scotland and the Scottish NHS has no plans to introduce them.

* NHS mental health services trusts provide mental health care in England and are overseen by the PCT.

Please visit the link provided for the complete story.


So right of the bat - Increase in Age, Decrease in Infant Mortality, People happy with their Medical Plan...BUT...Taxes are higher since it costs 90 Billion Pounds per year to run (average increase of 3% per year on spending since it started. So Its "free" (let's not debate this right now), no one is turned away and is based on clinical need instead of ability to pay.



posted on May, 11 2009 @ 11:23 AM
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Here is the Bad -
Brown apologizes for unacceptable failings at Stafford 'Third World' hospital

The commission launched its investigation in March last year after receiving 11 alerts about high mortality rates through an early warning system.

Sir Ian Kennedy, chairman of the Healthcare Commission, said the true scale of the hospital's failures was not known.

But he said patients had died because of deficiencies at 'virtually every stage' of treatment.

Among the findings of the report were:

* Receptionists carrying out initial checks on patients;
* Two clinical decision units - one unstaffed - used as 'dumping grounds' for A&E patients to avoid missing waiting targets;
* Nurses who turned off heart monitors because they didn't understand how to use them;
* Delayed operations, with some patients having surgery cancelled four days in a row and left without food, drink or medication;
* Vital equipment such as heart defibrilators was not working;
* A savings target of £10million met at the expense of 150 posts, including nurses

Please visit the link provided for the complete story.

Long Wait for Neurology Care

The report concluded that “long waiting lists for access to neurological services are common”. Access to occupational therapists and psychologists is essential for people with conditions such as multiple sclerosis, Parkinson’s disease and dementia. Yet hospital inpatients with these conditions had to wait up to two weeks to see a therapist, thereby prolonging their length of hospital stay. There is even less access for outpatients, with six months waiting for some and a complete absence of rehabilitation services in other areas.

Please visit the link provided for the complete story.

Kidney Patients Denied Life-Extending Drugs

Patient groups said the decision, announced today by the National Institute for Health and Clinical Excellence (Nice), would condemn many sufferers of kidney cancer to an "early death".

The four prohibited medicines include Sutent, which can prolong life in kidney cancer patients by up to two years. The draft guidance also rejects Avastin, Nexavar and Torisel. Nice said the drugs were too expensive, at about £24,000 a year per patient, for the benefits they offered and would mean the health service was less able to afford more cost-effective drugs for other illnesses. However, the decision reignites the debate around how the NHS prioritises which drugs are approved for use.

It comes just a week after Andrew Dillon, the chief executive of Nice, said smokers and the obese should not be denied NHS medication because of their lifestyle.

Following Nice's latest decision, one surgeon said there would be no point in accepting kidney cancer patients if he was not able to prescribe Sutent because so few respond to other treatments.

Please visit the link provided for the complete story.


And Finally this Chart is Excellent at this page :
UK Cancer Survival Rate Lowest in Europe


England is on a par with Poland despite the NHS spending three times more on health care.

Survival rates are based on the number of patients who are alive five years after diagnosis and researchers found that, for women, England was the fifth worst in a league of 22 countries. Scotland came bottom. Cancer experts blamed late diagnosis and long waiting lists.

In total, 52.7pc of women survived for five years after being diagnosed between 2000 and 2002. Only Ireland, Northern Ireland, Scotland, the Czech Republic and Poland did worse. Just 44.8pc of men survived, putting England in the bottom seven countries.

Please visit the link provided for the complete story.




So even though it is "free", there are clinical limitations (Cost-Benefit Analysis on whether treatment is used or not used) and not all is happy.
So you can pick your MD (Primary Care Provider), much like now if you have Medicare, Medicaid or Insurance provided at work (Blue Cross, Blue Shield, Etc).

My Take : Probably Good....until I need something expensive done (like a knee replacement or CABG). What do y'all think?



posted on May, 11 2009 @ 01:05 PM
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I don't buy the Michael Moore style 'Utopia' claims of the UK healhcare system, but I do think it's pretty good, especially for the poor. When I was younger I had an illness that required very expensive medication, and at that time I was young and in a low paying job, I could barely afford my food, let alone health insurance. Even if they had given me back my 5% national insurance tax, I still wouldn't have had enough money, as 5% of a very small wage, is a very small number.

So in that regard I do think the NHS system is not bad, at least it means everyone gets some pretty good cover, and the wealthy can pay for private treatment/insurance if they wish, although they will basically get the same doctor, in the same office in the same hospital in most cases, just perhaps a little faster for non-life threatening illnesses.

An argument I agree with in favour of the national health system, is the money lost to the inevitable government bureaucracy, can never compare to the money lost to profit in a private system.



posted on May, 11 2009 @ 01:16 PM
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If the NHS is so awesome then how come there are countless companies in the UK offereing private insurance.

Fact-The NHS is underfunded. This can sometimes result in extremely long waiting times for the most basic of care. I had a neighbor who waited almost eighteen months for physical therapy to help with a shoulder injury. Meanwhile she was in some quite intense pain while waiting. Look on line and see what the average waiting times for some types of care are. Not to mention the PAP screen debacle they had several years ago. It seems many of the tests were not even being screened.



posted on May, 11 2009 @ 01:53 PM
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RB - Thanks for sharing that. I do have a couple of questions for you. What is your country of origin? I think that is important in this discussion. I am here in the US. The Michael Moore version of healthcare is alot to swallow (ie. crazy - I will not go to Cuba for treatment - only for Cigars and Scotch). There are alot of scare tactics in the media when this issue is talked about. I felt the need to throw in a few negative cases from England to be fair.
Government overspending is totally a worry here. But how bad is it? Now it's $5 per Tylenol here....could it be more? Less?
The image link I included was a list of the cancer survival stats - The US is #1. Do you think it would stay in the Mid-60% range or decrease?



posted on May, 11 2009 @ 01:57 PM
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reply to post by ratcals
 


This is EXACTLY what I wanted to hear. People living in the UK with any experiences they can share (positive and negative). I am not familiar with the PAP debacle. I am familiar with what are claims of 6+ month referral wait times. Any and all info from our British friends are welcomed.



posted on May, 11 2009 @ 02:00 PM
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Who says we have to base our system on the U.K. model? If we are to move to universal health care it should be based on the best in the world and built up from that.

The best health care in the world is in France not the U.K.



posted on May, 11 2009 @ 02:03 PM
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reply to post by ratcals
 


The NHS is underfunded?
the NHS gets PLENTY of money,far too much actually.The real reason for all the waste and disorganization in some hospitals is because of politicians sticking their noses in and not leaving it to the directors and managers to run the god damn things..red tape everywhere,goals to reach blah blah woof woof Anyway despite all its flaws the NHS is one thing i can point to in the uk and say all in all im proud of.I have never ever seen an argument from say americans to make me change my mind,i think its appaling for a *civilized* country not to have fair and just healthcare service thats not determined by how big your wages are.

[edit on 11-5-2009 by Solomons]



posted on May, 11 2009 @ 02:08 PM
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reply to post by harddrive21
 


I'm in the UK. I'm not trying to say that the UK system is great, just that it does work acceptably for the poorest members of our society, and in that respect I think it's better than the USA system.

Here's a program that ran recently, about the poor in the USA, and asking questions of what Obama would do.

www.youtube.com...

In that program, they show the tent cities, they show charities who have stopped work in third world nations because the poor in the USA need more help, it shows that there is a level of poverty in the USA that should be unacceptable in a first world nation.

Here in the UK, we really don't have that kind of poverty, everyone can get a roof, food, and medical attention at least.

So my main argument is that the system does work better for the very poor in the UK, than the system in the USA does for its poor.

So, that is what I think you would see if you went to that kind of healthcare system in the USA, the poor would get much better treatment than they can get now. Other areas it is a little more difficult. You cite some issues of NHS not allowing certain drugs, but the same is true when you look at USA health insurance, they work their hardest to stop people getting expensive treatments, and I think they will work harder in the USA to deny people as it means more dollars in their pockets, whereas in the UK, there is not so much of this profit pressure to deny.

Statistics on this can be difficult to work with, for every number that you can find where the UK is behind the USA, I'm certain I can find one where the UK is ahead.

Although there will be many arguments about technicalities of the systems and their various strengths and weaknesses, I think most will be able to agree that helping the poor, and trying to remove the profit motive from healthcare are good aims that are addressed much better in a public system than a private one.

[edit on 11/5/2009 by RubberBaron]



posted on May, 11 2009 @ 02:11 PM
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Some quick data on the French


The World Health Organization has named the French health care system the best in the world. (The U.S. ranked 37th). It's physician-rich, boasting one doctor for approximately every 430 people, compared with a doctor for every1,230 residents in the U.S. (and French docs tend to charge significantly less). The average life expectancy is two years longer than the U.S. And while the system is one of the most expensive in the world, costing $3,500 per person, it's far less than the $6,100 spend per capita in the U.S.

The French are responsible for co-pays, but some 80% of them have supplemental private insurance to cover the co-pay. People least able to pay and those with chronic or serious illnesses often have the best coverage. Because I'm being treated for cancer, I'm cent pour cent —100%—covered.

Please visit the link provided for the complete story.


The Healthcare System I Want is in France



posted on May, 11 2009 @ 02:15 PM
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Harddrive, have you had a chance yet to look at the fact check pages for the movie Sicko on Michael Moore's website? Lots of statistics, links, etc., that make interesting reading. Here is that link:


www.michaelmoore.com...


I agree that the Sicko scenes on the Cuban health care system raise as many questions as they try to answer.

Still, the movie was much more of a shocker than I expected. Bottom line is, if you hear a lot of attacks on government-run healthcare, you will have to "follow the money" to decode why those sources are complaining about "socialized medicine."



posted on May, 11 2009 @ 02:24 PM
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reply to post by RubberBaron
 


RB - Definitely wasn't saying that "We're #1!"...hell or 2 or 3. With the poor we truely stink out loud. But there are safety nets in place for most. The biggest uninsured group in America are the people that work full or part time that are not offered insurance through work.


The face of the uninsured may not be what you think. Though many without health insurance do live significantly below the poverty level, nearly seventy- percent live in homes with at least one full-time worker. Health insurance is either not offered by the employer or the percentage that the worker is asked to pay towards insurance premiums is too expensive. Medicaid and the State Children’s Health Insurance Program have reduced the number of uninsured children under the age of nineteen. Nevertheless, more than eight million children, three-quarters of whom qualify for these programs are still not insured. Young adults between the ages of nineteen and twenty-nine with low income and unstable jobs are the fastest growing population of the uninsured in America.

Please visit the link provided for the complete story.


Who Are The Underinsured In America?

And I will watch the YouTube Link when I get home later - sounds interesting.



posted on May, 12 2009 @ 01:46 AM
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My God will you not be satisfied until we have 1776 again? Maybe we should have let the germans have their way with the UK? These questions about impossibilities seem absurd. If it were in the US it wouldn't be the UK system then, mmmmmmmmk! Otherwise why call it the US and why not just call it the King's Colonies again, I mean how bad would that be, right?



posted on May, 12 2009 @ 02:01 AM
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I think what it comes down to is the ignorant with the selfish mindset of "i dont know them, i dont want to help them."

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Whats funny is...if that same person was put into critical condition that came with a 80,000$ hospital bill, they wouldnt second guess other people paying the bill for them.

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I love knowing that if i break a limb; i can go to the hospital and get it corrected without having to worry about affording food for the next 2 months.

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but again......comes down to that mentality "i dont know you, i dont want to help you." your poor I dont need to help you, you cant help me.

its disgusting really. thats the number 1 argument i hear, that or its socialism....

OR its not socialism and your just ignorant and stuck in the 1950's. hurry up and age so your family can go into debt due to hospital bills. gotta love irony.

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Im canadian, just so you know.

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i havent read all the posts, just the one above this...are you people really argueing about what it should be called?

the UK system, the US system...... that #s just trivial. well ima proud amurcan and i dun wanna have it basedon... no shut up and stop bickering about trivial #.

[edit on 12-5-2009 by epitaph.one]



posted on May, 12 2009 @ 02:15 PM
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reply to post by epitaph.one
 

Well Hello my brother from the North (or East if you live near Windsor). There are some differences in each of the national systems that are used in the world (looking at outcomes, funding, etc). The French, British and Canadian systems, which cover pretty much everyone, does have some slight differences. The system that we here in the US eventually decide on will be our own, but it will have some basis on the other programs.
I hope that you can share some of your experiences with the medical system from Canada (copays, wait times, etc). The more information that can be put out there by average people instead of lobbyists or focus groups, the better.



posted on May, 13 2009 @ 10:57 AM
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I have friends in Canada (and friends who WANT to move to Canada), and the health system seems to have both good and bad points... I see they've been mentioned.

Personally, I'd like it. Here in the US, one of the big problems is that when you're elderly or poor, the cost of seeing a doctor keeps you out of their offices until your condition's reached the point where there's a medical emergency. And then it's ambulance rides and critical care units and in the end, cost for these patients is dozens of times higher than the cost of regular health care at a clinic.

Prevention is the key -- not emergency response. We've been trying to teach that since the 1980's (when I was in grad school and taking courses in the Department of Preventive Medicine).



posted on May, 13 2009 @ 01:44 PM
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reply to post by Byrd
 


Byrd - Thanks for the comments. I agree that prevention is the key to a longer life. But there is one thing that I get to experience daily at my job, and it's Non-Compliance.
Most of my Diabetic patients do not eat right, do not exercise, do not take their medications and say the lab results are wrong (elevated A1C, Blood Glucose, Cholesterol, etc).
It feels like most of my patients, when given a pill to help their disease state, will not make any lifestyle changes that are needed as well.
For the elderly, yes, with some minor interventions, can avoid most of the lengthy hospital visits/stays. Blood Pressure control will prevent most issues with Stroke or Heart Attack or Renal Disease.
As for the poor, same as above.
BUT access to medical care, medication and testing will do wonders. It would be great to not have the ER's being used as a Primary Physician. Overall, it probably would help most of the people out there.
How do you feel about raising the Sin Taxes though to pay for Healthcare (increase of 2 bucks on cigarretes, 3 cents per 12 oz of regular soda/energy drinks, 10 cents on potato chips)? Would you have incentive programs for people to lose wait or stop smoking?



posted on May, 18 2009 @ 10:00 AM
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I've watched sicko and was shocked, I then stopped and thought about my own situation for a minute. I currently do not have health insurance. My husband has his insurance paid by his company and has our three children added to his plan for $360/ month it would be another $360/mo to have me added and since I'm in good health and haven't seen a doctor since being pregnant I decided that $360 would help buy food.


So, after seeing patients in the US thrown out on the streets like garbage and a friend of my husbands getting diagnosed with cancer and not having insurance or able to even receive the treatment he needs without paying up front. Fundraiser in the process to help pay his medical bills. Many people give money to help uninsured when they become ill. Why not free healthcare? Why not pay with taxes? If eventually these people are going to get your money for healthcare then why not now? Why not? What is everyone so scared of???

It really is sad that people in Cuba and Gitmo can get better healthcare than many Americans. If you have insurance and can afford it great. So, why do many people think it is ok to just throw out the hundred of thousands who don't? Are we all really that selfish? Not me or mine so I don't care?

I will eventually be put on my husbands policy either at next pay raise or when children grow up and move out...
Depends on finances and the economy...I just can't afford to get sick.



posted on May, 18 2009 @ 10:50 AM
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I will start off by saying, I am an American who, up until about 3 months ago had been living , studying and working in the UK, for 2.5 years. I’m back Stateside.I was fortunate enough to be relatively healthy for the entirety of my time in the UK only going to see a local GP once or twice for various minor issues. I can say that the service that I received, on the NHS, was prompt and efficient, aside for having to sit around for a little while waiting for my appointment, like everyone else. Medication that I needed was cheap. All in all, my assessment of the NHS is a positive one, even in living in Staffordshire, which is where the Daily Mail(which is referenced in a link in the second post and is a completely worthless newspaper) noted problems of a “Third World” Hospital.

My wife, who is British, has been in hospitals in the UK many times and is an avid supporter of the NHS, having also worked for the NHS on several occasions from an administrative perspective, she still maintains that they do an excellent job.

Now, as I said, I am back stateside, and I work for the health care service…it’s a Temp to Perm position…and I do not have Health Insurance…well, I sorta do, but only because I’m in Massachusetts…the thing is, I have never really “had” health insurance since I was covered under my parents insurance plan. I’ve consistently worked, full time…but unfortunately, mostly through employment agencies which, until lately were not require to provide for such insurance…etc…and obviously, though I earn well over minimum wage, with bills to pay and loans to pay off…I simply cannot afford health insurance, or really to go to the doctor’s for a checkup…or to go to the dentist…which is care I could have received, and did receive while in the UK under the NHS, even not being British…

I have to say, it isn’t fair. It isn’t fair that I, and tens of millions of Americans like me, cannot afford medical insurance and subsequently medical care. When we talk about health care reform and the institution of nationalized health care, the conversation eventually goes onto the topic of “I don’t want the government making decisions about my health care.” Well…we allow the Health Insurance companies to make those decisions, and their motivation is to make money…we know that they do whatever they can to cut costs and make profits…we know that they deny people coverage for pre-existing conditions… Then the conversation goes onto “well, those companies have a right to make those profits, they are not socially liable to all of the public, it’s a business…” and that’s exactly the problem…

We live in a society where life is business…we are nothing more than fleshy sacks of cash for these industries…and that is not ethically right…

Its my opinion that health insurance is little more than a scam…they are a scam that inhibits the pursuit of life, liberty and happiness for far too many people in this nation…and it is for this reason that we need to get away from this “profit driven health care model” that we exist in….

And in any case…we, America, are not the standard….we are the exception. If our system was so good, everyone else around the world would be adopting it…but it’s the other way around, most of the liberal democratic countries have nationalized healthcare systems…



posted on May, 18 2009 @ 03:32 PM
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reply to post by madhatr137
 


First of all, thank you for the insightful post - Star for you!
I do have some further questions about your British experiences and the Massachusetts Insurance.
First - outside of wait time, which you mentioned, where there any other negatives from the NHS that you may have seen or heard? You mentioned your wife is British and Pro-NHS - any experiences you can share? As for medications in England - are there copay levels - like Brand is 30 bucks, generic is 15 for a month supply?
Second - the Massachusetts system - how much are you responsible for paying? Is your employer (temp agency or other) supposed to pick up the premium? Is the premium based on salary/yearly wages/w-2? Does it cover medical, dental and medication or some of it?



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