[zippyRN]

(Original post by muddywaters51)
The NHS is actually a joke

Also please stop calling it "free". Its free at the point of entry but it defnitely isnt free. It costs 120+ billion pounds every year.

services are free at the point of delivery, there is no 'co-pay' for many services ( dentistry being one of the few services where some form of 'co-pay' is in place

Inefficient with money and do not deliver a good quality service especially for how much some people pay into it.

really ? can to evidence that brave assertion especially given the 'unlimited' cover that the NHS provides

Pretty much every single time I have used the NHS the service has been terrible.

'service' , 'treatment' or 'customer service did not provide the full concierge service of a five star hotel ' ?

There has been one exception. Im not exaggerating either and Ive heard plenty of similar stories. What is my alternative? Pay even more for private healthcare which right now I would strongly consider doing next time I have a health related problem. So I have to pay twice to recieve decent healthcare, while other people are freeriding it.

and private healthcare i nthe uK rides the coat tails of the NHS ... FACT

The waiting times are beyond terrible in more ways than one. When you get to the GP,

really ? most of the problems with access are down to people out right lying about access difficulties or being unwilling to accept appointments with Nurse practitioner,s GP registrars or even sometimes with a GP other than their list one - i suppose i'm lucky that i have confidence in all the partners and most of the salaried GPs at the practice i'm registered with .

delays in the course of a clinic are unavoidable, unless you make all GP surgeries like an evil master criminals lair and have a trap door in the floor that opens and ejects the patient at the end of their allocated time ...

oddly enough i've never had a problem getting an appointment within a day or two and if some thing has been genuinely urgent i've been seen the same day - including home visits ( how many US primary care physicians do home visits for no extra charge? )

ER,

even with the abolition of the 4 hour target as a central measure of ED performance ( instead replacing it with a slew of clinically based measured) most people get seen , treated and discharged / admitted within a reasonable time frame, it is impossible to provide sufficient staff to mean that no-one would ever wait to be assessed or to be seen and treated ...

the last time i went to the ED i was triaged within 10 minutes of my walk-in arrival and out of the department in 2 and a bit hours including waiting half an hour for the ENP service to start at 8am

waiting time in X-ray was less than 10 minutes ( and that was because there was another ED patient in the room being x-rayed)

the physio, the fracture clinic, the waiting times are ridiculous.

access to physio is a combination of lack of funding and lack of suitably senior staff

fracture clinic waiting times - we usually get people into clinic within a day or two and delays during a clinic as i said above with reference to GPs are somewhat unpredicatable

The time it takes to get an appointment for a scan or the physio is ridiculous as well.

god forbid we actually reserve time and space for urgent cases ...

The attitude of a vast majority of the staff is terrible. Unhelpful and unfriendly. This includes receptionists, doctors and nurses.

have you considered that you may be failing the attitude test if your IRL attitude and demeanour is the same as your posting style ?

Countless doctors who don't speak English that well and have extremely thick accents. It takes some effort to understand them. It is usually south asians but Ive had some east europeans.

resists the temptation to suggest that you are racist ...

What makes it worse is that you have to pay for other peoples personal choices. Why should I have to pay towards an obese persons health problems brought about through their own personal choices. Why should I pay towards their diabetes meds or their blood pressure meds. Why should I pay towards a smokers cancer treatment or their emphysema treatment. Why should I pay towards treatment for STDs. Why should I pay for the treatment of health problems brought about through drug use. This includes alcohol.

This is one of the reasons why I dont like fat people.

i'm all right jack libertarian mantra that, which is all well and good until you go and crash your motorcycle exercising your libertarian right not to wear proper PPE and are left a drooling vegetable reliant of state funded care ...

[zippyRN]

(Original post by thisisnew)
Pretty much what I was going to post. Maybe awareness and early detection is a lot better and more widespread in the US than in the UK. Catching a cancer early is the best 'cure' afterall...

assuming it;s actually a cancer that's going to kill you ...

the overdiagnosis and over treatment of prostate problems in the USA is well documented hence their 'miraculous' cure and survival rate , it also forgets the common side effects of Prostate Cancer treatment ...

[muddywaters51]

(Original post by zippyRN)
.......

- It is not racist in any way. Only someone who is hyper politically correct would read into what I said as racist. I have no idea why you would even bring it up. Doctors speaking with thick accents and broken English making it very difficult to understand is not something which I think is acceptable. In my experience they have pretty much all been South Asians mainly from India. Ive also had some East Europeans. Please go on and tell me how its racist to want to understand your doctor. As I have said before it doesnt matter where the doctor is from if he is yellow, brown, black, white as long as I can understand them.

- Im not trying to argue UK vs US healthcare. Im not suggesting US healthcare is perfect. They have problems of their own which they need to fix

- It great hearing all of your stories about your good experiences with the NHS and Im glad it seems to be working nicely for some people. It doesnt change the fact I pay a lot of money for the service and I get back bad service. Your nice stories dont make my bad experience any better.

- My attitude is pretty good I would say

I really dont understand what youre saying at the end about motorcycles.

[Chiko 1001]

(Original post by Sdiff)

http://riffenberg.wordpress.com/2009...urvival-rates/

The only private healthcare system in the developed world is also best at saving lives

So what is this, if not a vindication of the free marketeers? "Curing cancer" is often seen as one of "society"'s fundamental goals today. Yet it seems as if private companies in the USA are making quite good progress on that without the need for government interference. As you can see, Britain's healthcare is performing terribly. Similar poor performance is noted in other countries with socialised healthcare.

This is not a matter of greedy capitalists and money: millions of people die, who would otherwise survive if they were in a privatised healthcare system.

Many people say "America is great, but it won't be so pretty when you find yourself in need in healthcare"

Really? Looking at this chart, America looks like a nice place to get sick. I do value my life after all!

And before you talk about the cost: Americans spend a lot on healthcare because I) They are not particularly healthy and ii) they spend a lot on cosmetics. two factors completely unrelated to private vs socialised. Regardless, I don't think you will be too concerned about cost if it's your life that's going to be saved.

So what do you say. Is it time to question the NHS, the holy grail which was rushed in at a time of national turbulence?

Absolute *******s and therefore can't take you seriously as you have no understanding of the costs involved in healthcare. America isn't expensive because everyone's unhealthy and vain- Scotland has some of the worst public health statistics around. Our coronary disease rates are devastating. America is expensive because it is a private system. If a doctor does a test he gets paid. The people who pay aren't medically trained, the doctor is. Therefore whatever the doctor says is necessary, people will believe is necessary. So doctors have a huge incentive to practice very wasteful medicine. The patient doesn't suffer a huge amount, save for unnecessary radiation, but it costs hugely more to treat a patient because of the use of resources and the markup for private profit.

Here in the UK, with nationalised pooled resources, doctors are not paid on a case by case basis and are it's not in their interests to put patients through tests they don't need. So they don't. So it's cheaper. In the UK a lot of acute injuries are diagnosed by a thorough examination and history. In the US they'd have done an X-ray and CT before you could finish introducing yourself.

Also, I'm very concerned with cost if it's my life to be saved. There is no infinite pool of money anywhere that will pay for everything. If we don't ration our resources effectively they will run out and people will start dying, fast. I'd rather have 20% mortality rates that could be sustained and improve gradually than move to a new system with 5% mortality for a decade, only for the money to run out and rates to suddenly hit 80% because resources were no longer available.

It's very well saying that the cost doesn't matter if it's your life at stake- and I'm sure everyone will agree- but if you physically do not have the money in your bank account then no amount of good prioritising and well wishing will do you any good. The only way to be fair and equal across the board is to be free at the point of delivery.

[InvertedLayman]

NHS is better than nothing, the cancer survival rate for England probably wouldn't even be on that list if it weren't for the NHS.. didn't think about that, did you?

Also if you want private healthcare you CAN get it over here, did you ever consider that? Or are you just a poor person wanting private healthcare that you wont pay for anyway? In both cases.. fail.

[DynamicSyngery]

(Original post by Chiko 1001)
America is expensive because it is a private system. If a doctor does a test he gets paid. The people who pay aren't medically trained, the doctor is. Therefore whatever the doctor says is necessary, people will believe is necessary. So doctors have a huge incentive to practice very wasteful medicine.

That's not actually true. The 'person' paying is usually an insurance company or the government, that employs its own doctors as advisers.

It's more legal problems - if you don't run a lot of expensive tests of negligible value, you stand to lose even more money by being sued for malpractice, and there are extensive regulations regarding minimum content of insurance schemes to "protect" people from the greedy corporations. So the US has dug itself into a hole where everyone's incentives are to over-provide medicine, but that is not really the fault of the market.

For comparison, France and a lot of other EU countries have a very similar system. Healthcare is private at the point of delivery, and then the government and insurers reimburse the cost of approved procedures. The only difference is that those systems are more frugal, and that's because of legal incentives. It's not like insurance companies in a free market cet. par. would want to spend more.

[Chiko 1001]

(Original post by DynamicSyngery)
That's not actually true. The 'person' paying is usually an insurance company or the government, that employs its own doctors as advisers.

It's more legal problems - if you don't run a lot of expensive tests of negligible value, you stand to lose even more money by being sued for malpractice, and there are extensive regulations regarding minimum content of insurance schemes to "protect" people from the greedy corporations. So the US has dug itself into a hole where everyone's incentives are to over-provide medicine, but that is not really the fault of the market.

For comparison, France and a lot of other EU countries have a very similar system. Healthcare is private at the point of delivery, and then the government and insurers reimburse the cost of approved procedures. The only difference is that those systems are more frugal, and that's because of legal incentives. It's not like insurance companies in a free market cet. par. would want to spend more.

And where does all that insurance money come from? Premiums. Yes, the corporation swallows the cost at invoice but it's not as though that doesn't come back round to the individual.

[DynamicSyngery]

(Original post by Chiko 1001)
And where does all that insurance money come from? Premiums. Yes, the corporation swallows the cost at invoice but it's not as though that doesn't come back round to the individual.

Insurance policies don't require specific medical knowledge to purchase, any more than the public need to all be qualified car mechanics for the market in car insurance to be efficient. The whole point is they are general insurance against any medical problems (or none!) that I may encounter in the future, and don't require me to make specific purchasing decisions for individual procedures.

[Chiko 1001]

(Original post by DynamicSyngery)
Insurance policies don't require specific medical knowledge to purchase, any more than the public need to all be qualified car mechanics for the market in car insurance to be efficient. The whole point is they are general insurance against any medical problems (or none!) that I may encounter in the future, and don't require me to make specific purchasing decisions for individual procedures.

...that's not the point I was making. I was pointing out that the cost is borne by the individual as a result of increased costs to the insurer, who then passes those costs on to their customer in the form of higher premiums. The incentive to provide unnecessary tests is unrelated to who actually pays the bills.

[DynamicSyngery]

(Original post by Chiko 1001)
...that's not the point I was making. I was pointing out that the cost is borne by the individual as a result of increased costs to the insurer, who then passes those costs on to their customer in the form of higher premiums. The incentive to provide unnecessary tests is unrelated to who actually pays the bills.

Costs are borne by the individual in the NHS, via taxation. What's your point?

The people proximally paying the bills - insurance companies and the government - know at least as much as the hospitals and have an incentive to reduce costs irrespective of how much they charge the customer (or taxpayer). The reason for over-provision is regulation and extremely loose definitions of malpractice.

[Chiko 1001]

(Original post by DynamicSyngery)
Costs are borne by the individual in the NHS, via taxation. What's your point?

The people proximally paying the bills - insurance companies and the government - know at least as much as the hospitals and have an incentive to reduce costs irrespective of how much they charge the customer (or taxpayer). The reason for over-provision is regulation and extremely loose definitions of malpractice.

It's a very, very long stretch to suggest that poor use of resources in the NHS isn't swallowed up more than in the private sector! If you make a claim against health insurance your premium will go up. If more people are ill, taxes are hardly going to rise, and if they do then it's all one pool of people- say a company has 50,000 people on its books it insures, it'll have to put up premiums a lot more per person to recoup its costs than the government, which is taking in healthcare money from 70million...

[SaySaam]

(Original post by muddywaters51)
If Im showing symptoms of cancer then 8 weeks doesnt sound like a healthy waiting period to find out if I do actually have cancer. Paying thousands into the NHS and then having to wait for 2 hours in a waiting room to see a doctor is not ok with me.

8 weeks? Count yourself lucky, I had to wait 10 months for a diagnosis.

But I still realise how amazing the NHS are - if it wasn't free, I wouldn't have gone to get anything checked out.

According to the internet my cancer was so unimportant, there was only one decent website about it - and it wasn't even cancer research. Without a nationalised NHS nobody would bother to provide treatment for it, as it just isn't sensational enough.

That's why the proposed moves towards regional privatisations are worrying - the less sensational types of cancer are not going to be thought about, especially when the treatments are specialist and expensive to run. It could get to the extent where there are only single digit RIAT centres in the UK.

The NHS needs to be there to stop that from happening - instead of developing the areas where there is profit and/or public support, the NHS focuses on all areas of healthcare.

(But yes, I am bitter about it)

[ncsoftlover]

(Original post by Sdiff)

http://riffenberg.wordpress.com/2009...urvival-rates/

The only private healthcare system in the developed world is also best at saving lives

So what is this, if not a vindication of the free marketeers? "Curing cancer" is often seen as one of "society"'s fundamental goals today. Yet it seems as if private companies in the USA are making quite good progress on that without the need for government interference. As you can see, Britain's healthcare is performing terribly. Similar poor performance is noted in other countries with socialised healthcare.

This is not a matter of greedy capitalists and money: millions of people die, who would otherwise survive if they were in a privatised healthcare system.

Many people say "America is great, but it won't be so pretty when you find yourself in need in healthcare"

Really? Looking at this chart, America looks like a nice place to get sick. I do value my life after all!

And before you talk about the cost: Americans spend a lot on healthcare because I) They are not particularly healthy and ii) they spend a lot on cosmetics. two factors completely unrelated to private vs socialised. Regardless, I don't think you will be too concerned about cost if it's your life that's going to be saved.

So what do you say. Is it time to question the NHS, the holy grail which was rushed in at a time of national turbulence?

The only positive things about the American health care, is that they generally have the access for the most advanced technology and medicine.
With that said, the lowest life expectancy in all developed nations, highest infant mortality rate in all developed nations, 40 million uninsured is nothing to be proud of. You can't just look at cancer survival rate and decide how well a health care system functions, second only to US, Canada does have high cancer survival rate and a complete public funded system.

[zippyRN]

and of course the US 'survival' rates for men with cancer is due to them treating and 'curing' indolent asyptomatic slow growing Prostate might-be-cancer...

[Sdiff]

(Original post by ncsoftlover)
The only positive things about the American health care, is that they generally have the access for the most advanced technology and medicine.
With that said, the lowest life expectancy in all developed nations, highest infant mortality rate in all developed nations, 40 million uninsured is nothing to be proud of. You can't just look at cancer survival rate and decide how well a health care system functions, second only to US, Canada does have high cancer survival rate and a complete public funded system.

The poor life expectancy is due to poor health, not poor healthcare.

[ncsoftlover]

(Original post by Sdiff)
The poor life expectancy is due to poor health, not poor healthcare.

no evidence of that
Most fast food loving nation now belongs to Canada, obesity is as much of a problem in Canada as it is in the US, and interestingly, Canadian now spend the longest average time (in the world) sitting on a chair surfing the internet.
Knowing Canada is just as racially diverse as Americans, and we have pretty much identical lifestyles. How do you explain the fact that Canada has one of the world longest life expectancy, at more than 81 years. Each Canadian is expected to live 3 years longer than Americans.
Aside from what I just said, surely the highest infant mortality rate among all developed nations is not due to poor health?
And to think that a country that spends by far the highest proportion of national GDP on health care, and the nationals can still be described as having "short life expectancy due to poor health", then surely, something must be wrong to cause such inefficiency? Maybe the health care system should focus a bit on healthy lifestyle education?

[zippyRN]

(Original post by Sdiff)
The poor life expectancy is due to poor health, not poor healthcare.

and the poor health is exacerbated by a shortage of primary care providers and a lack of access to the primary care that is there ...

[Barden]

(Original post by Sdiff)

http://riffenberg.wordpress.com/2009...urvival-rates/

The only private healthcare system in the developed world is also best at saving lives

I should think that one has to actually be a patient to be included in such statistics. I.e. People who died because they had no treatment at all (due to not being able to afford it) probably aren't included in the USA's stats.

[DynamicSyngery]

(Original post by ncsoftlover)
no evidence of that
Most fast food loving nation now belongs to Canada, obesity is as much of a problem in Canada as it is in the US, and interestingly, Canadian now spend the longest average time (in the world) sitting on a chair surfing the internet.
Knowing Canada is just as racially diverse as Americans, and we have pretty much identical lifestyles. How do you explain the fact that Canada has one of the world longest life expectancy, at more than 81 years. Each Canadian is expected to live 3 years longer than Americans.

Canada doesn't have equivalent obesity - http://4.bp.blogspot.com/_IzGDYJE7jO...FATTBURGER.PNG - look particularly at the right hand column: while countries like Canada and the UK have similar (though still lower) proportions of people who are just about considered overweight, the US has nearly 50% more seriously obese people than Canada as a proportion of population.

For racial diversity, idk why it matters to this, but US is only 63.7% non-hispanic white; Canada does not seem to record race for whites, but 'visible minorities' add up to only 16.7% of the population. And if we're taking health in country of origin as a proxy for health in US/Canada, that would rather give Canada an advantage because most of its immigrants are from East Asia which has high life expectancies. I'm not sure if that's a genetic rather than lifestyle issue though, so maybe doesn't matter at all.

The fact is that the effect of healthcare on life expectancy in developed nations is barely measureable. The (small!) differences in life expectancy are determined mostly by lifestyle and genetic factors. Healthcare is mostly a quality of life service at this point, and one that is probably overvalued.

[ncsoftlover]

(Original post by DynamicSyngery)
Canada doesn't have equivalent obesity - http://4.bp.blogspot.com/_IzGDYJE7jO...FATTBURGER.PNG - look particularly at the right hand column: while countries like Canada and the UK have similar (though still lower) proportions of people who are just about considered overweight, the US has nearly 50% more seriously obese people than Canada as a proportion of population.

For racial diversity, idk why it matters to this, but US is only 63.7% non-hispanic white; Canada does not seem to record race for whites, but 'visible minorities' add up to only 16.7% of the population. And if we're taking health in country of origin as a proxy for health in US/Canada, that would rather give Canada an advantage because most of its immigrants are from East Asia which has high life expectancies. I'm not sure if that's a genetic rather than lifestyle issue though, so maybe doesn't matter at all.

The fact is that the effect of healthcare on life expectancy in developed nations is barely measureable. The (small!) differences in life expectancy are determined mostly by lifestyle and genetic factors. Healthcare is mostly a quality of life service at this point, and one that is probably overvalued.

* If you take the average life expectancy of 300 million citizen and the result is that each person is expected to live 3 years shorter than Canadians, I'm afraid that's not a small difference, it's a significant difference, the difference between one of longest lived country in the world, and a country and ranked number 36, below US, you'd find no developed country, and that's pretty telling.

*People certainly like to write off health care saying it has nothing to do with life expectancy, well life expectancy is indeed determined by a lot of factors, but having a good health care system is highly +vely correlated with long life expectancy, do you seriously think that the only developed nation without a universal health care system happen to be the shortest lived developed nation, and that's purely a coincidence? How about the fact that if you run down the list of countries with highest life expectancy, most if not all of them have at least some form of universal health care access?
And you can find the list on Wikipedia, or elsewhere if you're bothered by wikipedia's credibility.

* The Canadian/US comparisons still stand. It's still true that Canadians love fast food as much if not more than Americans, (there was a report claiming that we eat at fast food restaurants more often than Americans. It's still true that us Canadians spend the longest average time (in the world) surfing internet instead of doing outdoor activities. It it still true that even though our obesity problem may not be as bad as the US, it is still pretty bad. It is still true that Canadians and Americans have nearly identical lifestyles.
So what really is the reason behind the (huge!) distinction between our life expectancies? hmm what can it be?

Oh and don't forget the US holds the honorable designation of the highest infant mortality rate in the developed world, that may not have much to do with universal health care, but it reflects the inefficiency of their system, this is something that you cannot just explain away using lifestyle differences arguments.