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British vs. US Medicine

Medicine 2003 Health Care

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#21 Delvo

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Posted 30 September 2003 - 07:38 PM

The USA's costs in terms of GDP are higher not becausewe don't have socialized medicine, but because socialism is trying to wrap its tendrils around the existing system from various different angles in different stages of the process, creating numerous interferences and conflicts that wouldn't be there in a system that were more purely one way or the other. Also, something that has nothing to do with the medical payment system itself, but has to do with American law instead, sucks out a bunch of blood: not to pick on USL here, but it's the lawyers (and the juries who've been taken in by that gimme-gimme culture of lawsuits and produce insane judgements), which have more freedom in the USA to foul things up than in most other countries. The cost of insurance against ridiculous lawsuits is producing MASSIVE pressure on the medical industry, which can be seen not only in the high costs but also in other things like doctors' offices being forced to shut down because they can't afford to operate anymore, or moving from the states that are the worst about this stuff to the states where they can still do their job, or concentrating in major cities because smaller towns don't yield the economy of scale necessary to withstand the pressure that the medical system is under from the trials and socialist intrusions.

It's not that a capitalist system doesn't work as well, or even that "it just hasn't been done 'right' yet"... it's that there is no such system really at work here; the pressures resulting from the trial lawyer situation and government interferences prevent it from being what it's supposed to be.

And, BTW, the costs are somewhat higher, but the result is also more effective... and no, I'm not declaring socialist medicine a failure based on one study of two hospitals. I'm basing it on the fact that that same result pops out no matter how many times these things are evaluated, year after year, as was observed in the first post in this thread...

#22 Jid

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Posted 30 September 2003 - 08:07 PM

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#23 prolog

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Posted 01 October 2003 - 10:53 AM

Delvo, on Oct 1 2003, 12:38 AM, said:

but because socialism is trying to wrap its tendrils
I stopped reading there.  You shouldn't be terribly surprised, given that that sort of rhetoric is neither constructive, appropriate, nor particularly true.

And all I'm going to say in the matter is that when I was younger, I had a huge assortment of health problems (fine motor problems, ruptured lungs, etc.) because I was born prematurely.  I shudder to think what this would have cost my parents had they not lived in a place where I could be taken care of and they wouldn't owe tens or hundreds of thousands of dollars.

Yes, it sucks like hell if you're in pain and it's not life-threatening.  But it's better to guarantee a minimum standard for everyone than create a system in which you get no treatment if you can't afford it, no matter how bad your condition is.

#24 Brit

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Posted 01 October 2003 - 11:27 AM

Una Salus Lillius, on Sep 30 2003, 06:24 AM, said:

But is the problem the *idea* of socialized medicine or the fact that it's piss poorly executed in Great Britain?

I mean yeah, they got it wrong there.


Does this invalidate the idea or should we perhaps be looking for better ways to implement the idea?

Lil
I work for the British NHS and can I tell you that no one is refused treatment here if they don't have insurance or can't afford to pay.  My husband is diabetic and requires almost £200 worth of drugs per month.  He gets these drugs free at point of contact, plus chiropody, blood work every month and regular appointments with the diabetic nurse and our GP.

Two friends of mine were recently diagnosed with breast cancer following routine mammograms, these are given to every woman over the age of 50.  Within one week of receiving the results both were being operated on in a specialist breast unit.  We don't live in a big city but in a very remote rural area.  This sort of experience is quite common over here.

We do pay National Insurance every month for this but there are many people who have never paid any National Insurance and every day such people receive extremely good care.

We even treat visiting Americans in our Accident and Emergency departments totally free.  Try that in the US.

For our recent holiday in Florida we had to take out millions of pounds worth of insurance.

I am not saying that we have it totally right but please look at both sides before making such sweeping statements.  Sadly like everything else you only hear about it when things go wrong.
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#25 Godeskian

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Posted 01 October 2003 - 11:33 AM

Brit,

Can you answer me something. How much of the media hype about patients left on beds for days on end is actually true and how much is hype?

I have never been able to find direct contradictions for the many stories often run in blogs like the daily express,

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#26 usmarox

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Posted 01 October 2003 - 11:41 AM

Put it this way, Gode.  When my eyes were trying to escape from my head, I got yellow-carded through the casualty system, and I was with a doctor inside of 15 minutes.  By the end of the day, I'd seen the regional eye specialist, and on Monday (it was a Friday), I was in for a 9am appointment at Moorfields in London.

That, to me, does not sound much like the NHS I read about in the papers.

When I wanted a verruca removed. on the other hand........
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#27 Godeskian

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Posted 01 October 2003 - 11:47 AM

Indeed Marox, that does not sound like what the tabloids that call themselves newspapers report.

interesting dichotomy

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#28 Brit

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Posted 01 October 2003 - 11:49 AM

Godeskian, on Oct 1 2003, 04:33 PM, said:

Brit,

Can you answer me something. How much of the media hype about patients left on beds for days on end is actually true and how much is hype?

I have never been able to find direct contradictions for the many stories often run in blogs like the daily express,
It happens but the way it is put in the media makes it sound far worse than it is.  You see the truth doesn't make good stories for the press, especially some of our more trashy newspapers.

For every one person left on a trolley there are literally hundreds of thousands who aren't.

Of course it is horrible if the patient is you or a relative or loved one but very often these people are being held in A & E departments while the poor bed manager tries everything short of murder to find them a bed.  In the majority of cases they are still receiving nursing care etc.

I am sure this happens in other countries too, I don't think we are unique in this.  Of course if you are paying a lot of money for your care then you have immense clout.  I wonder what happens to those poor Americans who don't have health insurance and can't pay.  My guess is they don't even get on the trolley in the first place.

By the way I use the term 'trolley' they are more like beds.  I would be the first to admit that we don't always get it right but if you are seriously ill then I do believe we have a pretty good system.
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#29 Brit

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Posted 01 October 2003 - 11:51 AM

Just to add to my previous post, don't forget many of our newspapers are very politically biased.  Therefore any opportunity is taken to 'have a go' at the current Government.
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#30 CJ AEGIS

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Posted 01 October 2003 - 03:49 PM

Jid, somehow I doubt the percent GDP Canada spends on their health care is an accurate assessment of the quality of care given in Canada.  Or will your next trick be to argue the Canadian Military is superior to the US Military because Canada expends less money on theirs?  Iím willing to bet the same applies for the administrative expenses for both respective militaries.  I would instead argue that this is the symptom of the failing socialist model for Health Care in Canada.  The Canadian Health Care system is one that is slowly cutting itself into oblivion.  The only reason that Canada has managed to keep her costs lower is by executing several cuts on your health care system, not buying needed diagnostic equipment, and by limiting the size of their facilities.  I would hardly call this an adequate method for judging the quality of your health care system.  

Canada can no longer even afford to pay for the basic facilities required to care for their own citizens.  From April 1999 to July 2000 there were over 1,400 patients in Ontario who had to be sent to U.S. facilities for treatment. This amounted to a total cost to Canadian taxpayers of $15,000 to $20,000 per patient.  If the Canadian Health Care Model is so efficient then why do you lack the facilities to care for their own citizens?  Iím guessing Canada's National Health Care is severely lacking in several critical areas compared to the US system when you have to start exporting citizens for care.  If the Canadian system is so much more efficient why can't they be treated in Canada?  

Then shall we get into comparing Canadaís Health Care System against those of other countries that have adopted National Health Care?  If you use the GDP figures as an indicator like you seemed to like to one quickly finds that Canada has the highest GDP percentage expenditure of every country but Iceland who it ties with.  Canada of the countries with National Health Care managed to rank 17th in the number of doctors with only 1.8 doctors per 1000 people.  This places Canada in the embarrassing position of lagging behind Poland for he number of doctors and to even reach the same percentage of doctors as France you would have to gain 48,000 more doctors.  This sure isnít going to happen when Canadian doctors are fleeing the Canadian system to practice in the United States.  

Another interesting little tidbit is the access to diagnostics machines in the Canadian system.  While being the number one Health Care spender among NHCN (National Health Care Nations) Canada rates 18th in access to MRIs, eight in radiation machines, 17th in CAT Scanners, and eighteenth in lithotripters (treat kidney stones).  A little bit of irony while on this topic is that in years of lost life due to preventive causes Canada ranks 7th.  Now the funny thing is the six nations that rate higher than Canada all have some sort of private alternatives to the National Health Care System.  Then to top this off Canada rates 6th on the scale for preventing Breast Cancer Deaths and again all the nations above her happen to have privatized competitors to their National Health Care System along with user fees.

I would hardly call Canada a success in National Health Care.  The Canadian system of National Health Care seems to be badly lagging behind even those other industrialized nations that happen to have similar systems just with more privatized service.  So I would hardly tout the Canadian Health Care System as some blinding success when it fails to standup to even the NHC programs of other nations.  

I also have to launch into my own rant in that you seem to think Iím arguing that the US system is some blinding success.  If you think that then you are barking up the wrong tree; frankly I wouldnít rate either Health Care System much above the other in quality.  Both have major issues that are going to bite you in the butt when it comes to your health.  In regards to a look at the US System I have to agree with Delvo in several points he makes.  The Litigation Process and insurance that Hospitals/Doctors have to purchase to cover their hind sides is killing the entire system.  That is where the system needs to be reformed in order to cut costs.  I however still believe that National Health Care in the manner practiced by Canada and many other nations is a major mistake.  I would rather see a system that is driven by competition.

In my ideal system the Private Health Care System (PHCS) would exist just as it is.   Except businesses that provide Private Health Care for their employees would have that expense written off their taxes by the government.  This encourages employers to invest in Private Health Care for their employees to make working for them more attractive rather than spending that money on paying taxes to the government.  Now to expand coverage the government would be in on the process but not as the controlling influence over the system like in Canada.  The first step I would want is to allow for people to write off their medical expenses on their taxes thus avoiding some government bureaucracy in that manner while still providing payment of a sort.  

The next would be a safety net to catch those missed by the other programs. Hospitals and doctors that participate in the government program would receive right offs on their taxes and other expenses that they typically have to dole out to the government.  These facilities would receive points and benefits through that system for treating patients who arenít covered under the PHCS.  Now patients would be allowed to shop around to select hospitals and the doctors that they want.  This encourages competition for providing better care in order to attract patients avoiding the pitfall of lack of market incentive for improvement that runs rampant in Canada.  Personally Iíd prefer to skirt the downfalls of socialized medicine while maintaining a high standard of care.                

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