Socailized Medicine?

[ysabella]

Darat, issues specific to socialized medicine would include long wait times, insufficient resources, lack of incentives, slower adoption of technology, less freedom of choice, less physician autonomy, and increased government control over health care.

If people can start choosing where they want their NHS care from within all of the UK, that would improve things as it would create competition for patients. My understanding is that as it is now, your choices have a lot to do with where you live. If you're in East Suffolk and you're obese and you need a new knee, I guess you have to pay cash, or put up with it, or maybe move somewhere else and wait a while.
In the past in Canada, they did not have a choice to pay for something privately if the government provided that same thing, but people have been suing for that right. I'm not sure where it stands at the moment.

Random, I see people quoting that as proof all over when I run searches, but it was one phone survey. No statistics are kept, so far as I can find, on Canadians seeking health care in the States. Note that provinces sometimes look into sending patients across the border to decrease wait times, although I'm not sure that's been done recently. Sometimes there are cooperative projects to serve a given area, which only seems sensible.

One example of a discrepancy between Canadian and American healthcare would be advanced diagnostic scans that use expensive equipment, such as PET, PET/CT, and MRI scans. These are harder to get in Canada, and only sometimes covered, and readily available across the border. Here is a vintage 1997 page on that discrepancy and here is an April 2005 article about it. Here is a page from Manitoba that lists how many PET scan machines there were in Canada around the start of 2005. In the States, there are hundreds.
You can choose to wait for a scan, or choose to skip it, but it will impact your treatment. I think things have improved for MRI. There are more options now to pay to have a PET scan done privately in Canada, so probably more Canadians opt for that.

 

[shecky]

Anyone care to compare NHS to, say, Kaiser medical plans in the US? I know many people with Kaiser and their experiences always sound like the (possibly overstated) horror stories of NHS/ Canada.

 

[Random]

Darat, issues specific to socialized medicine would include long wait times, insufficient resources, lack of incentives, slower adoption of technology, less freedom of choice, less physician autonomy, and increased government control over health care.

I'm not sure how many of these things are not problems with private insurance except for increased government control, which is what I think we should be working for. Private insurance companies are more than happy to deny services, restrict choices, tell physicians which treatments to recommend, etc. Remember that once a private insurance company has your money, they really have no motivation to give it back.

Random, I see people quoting that as proof all over when I run searches, but it was one phone survey. No statistics are kept, so far as I can find, on Canadians seeking health care in the States.

That's kind of the point. A lot of conservatives will throw in the spectre of hordes of Canadians fleeing their system when the issue of universal health care is brought up, but the only study anyone seems to have done in terms of the actual numbers shows that this is silly. In and of itself it's not really evidence of the superiority of one health care system over the other, but it is something to remember when some insurance company PR guy shows up on Faux news and vomits out his talking points.

 

[Ed]

I'm not sure how many of these things are not problems with private insurance except for increased government control, which is what I think we should be working for. Private insurance companies are more than happy to deny services, restrict choices, tell physicians which treatments to recommend, etc. Remember that once a private insurance company has your money, they really have no motivation to give it back.

I don't keep track but there are stories in the british press with some frequency about withholding of service for certain expensive to treat conditions.

I don't understand the delays in treatment with the UK or Canadian systems. I mean, isn't health care supposed to be timely? Perhaps there should be a performance criterion wherein treatment is garenteed within x days and if it cannot be provided the patient gets sent to the US?

 

[Darat]

I don't keep track but there are stories in the british press with some frequency about withholding of service for certain expensive to treat conditions.

Oh it does happen, although most health authorities try to cover it wit ha veneer of "our decision not to use this very, very expensive drug is based on clinical need not based on the fact that the Chief Executive wants his office redecorated and if we pay for this drug he can't get teh hand painted wallpaper flown in from Japan. However they normally get taken to court and in the end have to provide the treatment.

(Also something called "NICE" has radically altered how treatments are "authorised" in the NHS - at long last!)

I don't understand the delays in treatment with the UK or Canadian systems. I mean, isn't health care supposed to be timely?

And in the UK it normally is, however sometimes there are delays and sometimes because of finite resources some people's non-life threatening operations are delayed and in the past the delays have been intolerable.

Perhaps there should be a performance criterion wherein treatment is garenteed within x days and if it cannot be provided the patient gets sent to the US?

Why on earth would we need to do that? We could just do what we already do and use private hospitals etc. that are in the UK.

 

[Beerina]

You seem to be a bit confused about the way NHS works. Everyone has the RIGHT to use the NHS, but nobody is forced to. There are lots of private doctors, clinics, and hospitals, and anyone willing to pay (with or without insurance) can use them. To be clear, the NHS is NOT insurance. I do believe that most private doctors (if not all) put in a certain amount of time providing NHS care as well.

So it's like the public school system in the US -- everybody pays, and can take advanatage of it, but no one is forced to. Private schools still exist. (Indeed, there's now the concept of vouchers, magnet schools, and the like, where the money follows the student, in some cases even to the private school -- the government's service has to compete with private ones for the very same dollars. Well, half of the dollars anyway. The other half stays with the school the kid abandoned. It's good to be the king, I guess )

I'd prefer to not have a big chunk of taxes taken out for that, but at least that's better than a system where it's illegal to go to a private doctor or for those private doctors to have to accept government-approved rates to charge for services.

 

[Ed]

Why on earth would we need to do that? We could just do what we already do and use private hospitals etc. that are in the UK.

I forget the UK system is different from the commie Canadian system.

It does seem, though, that a performance criterion would be nice.

 

[Darat]

I forget the UK system is different from the commie Canadian system.

It does seem, though, that a performance criterion would be nice.

Just come to the UK and say "Targets" to anyone in the NHS and watch their eyes start twitching.

The current government has been introducing targets, league tables etc. into the NHS. Hosptials and Doctors for the first time are under obligations to meet certain targets - for instance my GP must be able to provide me with an appointment within 48 hours and so on.

 

[Freakshow]

Just come to the UK and say "Targets" to anyone in the NHS and watch their eyes start twitching.

The current government has been introducing targets, league tables etc. into the NHS. Hosptials and Doctors for the first time are under obligations to meet certain targets - for instance my GP must be able to provide me with an appointment within 48 hours and so on.

Are you saying that before the "targets", you couldn't always get an appointment with you GP within 48 hours?

 

[Darat]

Are you saying that before the "targets", you couldn't always get an appointment with you GP within 48 hours?

Well it used to be a joke that if you wanted to see your GP you needed about two weeks notice of when you were going to be ill to get an appointment.

By the way that does not mean that you couldn't see your doctor just that it wasn't possible to make an appointment to do so with little notice.

 

[Freakshow]

Well it used to be a joke that if you wanted to see your GP you needed about two weeks notice of when you were going to be ill to get an appointment.

By the way that does not mean that you couldn't see your doctor just that it wasn't possible to make an appointment to do so with little notice.

That's a "win" for the US system, as far as I'm concerned.

I don't think I've ever not been able to see a doctor on the same day when I needed to, and I don't think I've ever not been able to see one in less than 24 hours for any reason. The exception being specialists, but we are talking about GP's here.

 

[Freakshow]

Of course some hospitals and areas will provide better care, facilities and treatments then others - this will happen in any system, so it is not a problem unique to a system like the NHS.

Actually, it is. Because my insurance will pay for me to see a Dr. in another region, if that is what I want/need to do to find a good doctor. Can that be done in your NHS? (Not a rhetorical question. Legitimately wondering if you are allowed to go anywhere you want, and still have it paid for.)

 

[Darat]

That's a "win" for the US system, as far as I'm concerned.

I don't think I've ever not been able to see a doctor on the same day when I needed to, and I don't think I've ever not been able to see one in less than 24 hours for any reason. The exception being specialists, but we are talking about GP's here.

Misunderstanding here let me try and clear it up.

You could and have pretty much always been able to see a GP the same day.

However it used to be well nigh impossible to get an appointment on short notice. So if say on a Monday afternoon I found out I needed an inoculation for say a holiday and needed it the next day and rang the Doctor for an appointment I used to get "Sorry love the next appointment with Dr Geoghan is just after the next blue moon". What I could do however was go to the surgery and be seen in the morning in the open surgery session, which probably meant sitting in the waiting room for an hour or so.

With the changes if I ring in the morning I can probably get an appoint within the next 48 hours which means no waiting in the waiting room and so on. (My local GP practice just published their results and 74% of patients now got an appointment within 48 hours.)

 

[richardm]

Can that be done in your NHS? (Not a rhetorical question. Legitimately wondering if you are allowed to go anywhere you want, and still have it paid for.)

Not at the moment, but there are plans afoot to change that soon.

BTW the target is 48 hours for GPs but in my personal experience I've never had to wait that long.

 

[Freakshow]

However it used to be well nigh impossible to get an appointment on short notice. So if say on a Monday afternoon I found out I needed an inoculation for say a holiday and needed it the next day and rang the Doctor for an appointment I used to get "Sorry love the next appointment with Dr Geoghan is just after the next blue moon". What I could do however was go to the surgery and be seen in the morning in the open surgery session, which probably meant sitting in the waiting room for an hour or so.

I still file that under the "Sucks to be you" column.

 

[richardm]

I still file that under the "Sucks to be you" column.

At least he wouldn't be handed a bill on the way out

 

[Darat]

Actually, it is. Because my insurance will pay for me to see a Dr. in another region, if that is what I want/need to do to find a good doctor. Can that be done in your NHS? (Not a rhetorical question. Legitimately wondering if you are allowed to go anywhere you want, and still have it paid for.)

That is what is being changed it used to be quite difficult to get treatment "out of area" however there are fundamental changes happening now that means this will be much easier in future. However you've always been entitled to seek the best possible care under the NHS, we've many specialist hospitals that routinely take patients from all over the country.

One of the reasons for the changes is meant to be that it will reduce the artificial shortages, for instance in an area with a lot of elderly people you tend to find waiting lists for joint replacements to be higher then in other parts of the country. Stands to reason - more people need them, therefore if the patient is willing they should be able to go somewhere else that doesn't have as long waiting times.

 

[Darat]

I still file that under the "Sucks to be you" column.

In what way?

 

[Freakshow]

In what way?

As I said earlier, I can't recall ever not being able to get an appointment with a dr in less than 36 hours. In the situation you are talking about where they tell you "Sorry, next appt. is in 2008", I am instead able to see a doctor of my choosing and get my innoculation later that same day, or the next day.

 

[Freakshow]

At least he wouldn't be handed a bill on the way out

Neither am I.