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UK has best health system in developed world, US analysis concludes

bmj.com

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Re: UK has best health system in developed world, US analysis concludes

#61

Post by Boothroid »

DanBC wrote: post #53
mikeash wrote: post #39

Earlier quoted context omitted.

Is it really a big deal to wait 6-8 weeks to get an x-ray for a minor issue? Obviously this is not ideal, but it seems pretty minor compared to the ridiculous stuff we deal with in the US system, especially if you compare to the pre-ACA US system.

Some people in UK have very long waits (over 6 months) for treatment that should be relatively easy to provide and for things that are not minor. One example would be 'community based psychological therapies' - long form talking therapies. these are an alternative to far more expensive inpatient hospital stays. Without it people are subjected to increased detentions under S136 of the MHA; they use A&E more often; the…

I don't think the gatekeeper GP system helps. What are GPs for? Hugely overpaid generalists supported by a powerful lobby (BMA) that cares little about patients and overwhelmingly about increasing doctors' pay and conditions. I'm hoping technology undermines their position over time.

Re: UK has best health system in developed world, US analysis concludes

#62

Post by arethuza »

jseliger wrote: post #37
comstock wrote: post #10

This analysis of a report seems pretty bad, even with only the title and abstract available. Firstly, the report doesn't even cover the entire developed world, just 11 countries. Notably, Japan doesn't appear to be included. To be honest, I found that slightly offensive. Secondly the U.K. isn't the overall clear "best" of those 11. It's not bad, and does better on some things, worse on others. In my subjective experi…

In my subjective experience (as a Brit) British people often think the NHS is the best health service in the world Having experienced it, I'm surprised that Brits feel that way. When I was studying abroad a while ago (which was not a great experience for other reasons... https://jakeseliger.com/2012/11/18/about-the-university-of-e... ), I needed an x-ray and then a CT scan for what appeared to be a minor issue. So I…

I was in an NHS hospital last week for an infected bite on my arm.

Time waiting for X-ray - maybe 30 seconds, mostly taken by the time for me to get to the X-ray room.

Doctor in A&E said I needed an X-ray, I walk next door to X-ray department where they X-ray me immediately and I walk back to the A&E department where the doctor has already looked at the X-rays by the time I got back there (i.e. within a couple of minutes of them being taken).

Re: UK has best health system in developed world, US analysis concludes

#63

Post by ramchip »

deepsun wrote: post #46
ramchip wrote: post #24

Earlier quoted context omitted.

I'm also really puzzled by the omission of Japan. It has the highest life expectancy in the world, I would expect a comparison of health systems in the developed world to include it.

From my friends' stories, Japan healthcare experiences were pretty bad: 1. Extremely long lines in small rooms, so people cram together to get a better chance of coughing on each other. 2. For any illness doctors listen to you and prescribe exactly three drugs: antibiotic, pain reducer, and "something for stomach". For any symptoms. 3. There is no "sick leave" thing, so if you're sick -- you are absent. 4. Because of…

I work in Japan, actually. I have sick days, never waited more than about 15 min at the hospital (without an appointment!), and the care was excellent. YMMV - I recon sick days are indeed unusual.

Re: UK has best health system in developed world, US analysis concludes

#64

Post by kalleboo »

IsaacL wrote: post #14

This really is a matter of what variables you choose to measure. For example, the US is by far the world leader in medical research spending - 44% of global medical research is spent in the US. (Until recently it was even higher). [1] On the same note, many nations regulate the price of prescription drugs - drugs where the initial R&D was done in the states. (Yes, drugs are sold at a huge markup, but that's to recoup…

> As with the US education system, the availability of government funds has massively pushed up prices

Although people on here keep saying one reason insured people are overpaying for treatment is because Medicare/Medicaid generally underpay for services rendered and hospitals have to make up the difference on other paying patients?

Re: UK has best health system in developed world, US analysis concludes

#65

Post by DanBC »

2skep wrote: post #57
mikeash wrote: post #39

Earlier quoted context omitted.

Is it really a big deal to wait 6-8 weeks to get an x-ray for a minor issue? Obviously this is not ideal, but it seems pretty minor compared to the ridiculous stuff we deal with in the US system, especially if you compare to the pre-ACA US system.

Actually, I never understood this. Is demand and supply matched and this is just the lag in the system (ie 6-8 weeks remains 6-8 weeks forever) or demand is greater than supply and this number will grow. If it is the former then there doesn't seem to be a cost advantage for the wait. A temporary increase in supply could bring this waiting time to zero with just the cost of 6-8 weeks worth of x-rays outsourced. And th…

Demand is increasing. Supply is falling.

Re: UK has best health system in developed world, US analysis concludes

#66

Post by jlarsson89 »

As a swede living in London, I was shocked to find the NHS still uses paper prescriptions that are consumed upon use, at least in my limited experience. In Sweden, every prescription I have is digital and tied to my ID, accessible from any pharmacy or hospital in the country and is not necessarily consumed upon use, I can easily reuse it and renew it.

Re: UK has best health system in developed world, US analysis concludes

#67

Post by arethuza »

_dps wrote: post #45
mikeash wrote: post #44

Earlier quoted context omitted.

As I said, it's not ideal, but it doesn't seem nearly on the same level as the US system. I'd rather spend 2-3 months functionally blind than be bankrupted because of a pre-existing condition. Socialized medicine horror stories all seem to be along the lines of, "I had to wait months, it was very inconvenient," possibly with the addition of "I decided to pay extra to get it taken care of sooner." US medical horror st…

To be clear: I'm not suggesting the US system is good or that the NHS-style system is bad. But I do think there is a systematic diminuation of the badness of wait times among advocates of NHS-style systems. I, personally, find descriptions like "it's not ideal" to substantially underplay the human suffering involved. And "it's very inconvenient" is, again in my opinion, a gross understatement of the suffering of losi…

A couple of years back my son developed an eye infection that didn't respond to the antibiotic drops our GP prescribed. I took him back a couple of days later and we were referred first to a private ophthalmologist (who we didn't have to pay for) and then to the specialist eye department of the local hospital that same day (associated with the medical school of a world top 20 university) where he was regularly seen twice a week until the condition cleared up.

I know the NHS isn't perfect, and I don't really care whether it is #1 or #10 in some ranking. But what I do know that over the last 20+ years of having a family with multiple serious accidents (rugby, climbing etc.), childbirths etc. they've provided excellent and timely care.

Did I have to wait three weeks to get an MRI scan for a sinus infection that was recurring? Yes I did. Did I care if it was being used for properly ill people in the meantime? No I didn't.

It's not perfect, put it is pretty bloody good.

Re: UK has best health system in developed world, US analysis concludes

#68

Post by tonyedgecombe »

Boothroid wrote: post #61
DanBC wrote: post #53

Earlier quoted context omitted.

Some people in UK have very long waits (over 6 months) for treatment that should be relatively easy to provide and for things that are not minor. One example would be 'community based psychological therapies' - long form talking therapies. these are an alternative to far more expensive inpatient hospital stays. Without it people are subjected to increased detentions under S136 of the MHA; they use A&E more often; the…

I don't think the gatekeeper GP system helps. What are GPs for? Hugely overpaid generalists supported by a powerful lobby (BMA) that cares little about patients and overwhelmingly about increasing doctors' pay and conditions. I'm hoping technology undermines their position over time.

The trend seems to be towards giving GPs more responsibility. My surgery seems to do a lot more than they did twenty years ago. You are right about the BMA though.

Re: UK has best health system in developed world, US analysis concludes

#70

Post by bboreham »

ggambetta wrote: post #15

As a resident of the UK and a former resident of Switzerland, I can't understand how they came to this conclusion. Don't get me wrong, the NHS is great and the system works much better than in the US, but health care in Switzerland is just on another level. Before you say "but in the UK it's free" - considering what I paid for (private, mandatory) insurance in Switzerland, and the National Insurance contribution that…

> the National Insurance contribution that gets deducted from my paycheck in the UK

National Insurance nominally covers state pension and unemployment benefits, not the health service.

Of course, it all goes into one pot of money, but your entitlement to the above goes up the more years of NI you have paid in, whereas your entitlement to NHS does not change.

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