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American using Britain’s NHS (2015)

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Re: American using Britain’s NHS (2015)

#21

Post by washadjeffmad »

new299 wrote: post #15

"In the UK, I showed up at 9am and was seen instantly" I don't think that's ever happened to me. Most likely this person was the first patient of the day, so appointment times haven't slipped yet. 30 minutes in the minimum I've had to wait in general. I've also had to wait weeks to see a GP (in the countryside). I find anecdotal articles like this pretty unhelpful in general. We all have our own anecdotes, it's more…

I'm not really familiar with NHS processes, so when it took you weeks to be seen, did someone just take your info when you walked in and say they'd get back to you when they could, or was your condition evaluated first (diagnostics run, etc) and an appointment scheduled for you for a particular date a few weeks in the future?

Re: American using Britain’s NHS (2015)

#22

Post by majormajor »

tomalpha wrote: post #2

So how does the US improve its healthcare system? More interestingly, can the US political system ever enable an evidence-based debate around it? From the other side of the pond, it feels like debates end up being emotional rather than scientific. (I’m a Brit and love the NHS with a passion but would not claim that it’s without flaw. Neither would I claim that we necessarily have more reasoned debates about issues he…

The US's problem is that things are massively inequal with income and wealth. And political power tends to follow the income and wealth. So for a significant (and over-represented politically) fraction of the US, we have better health coverage than what I can see about the NHS (I read Terry Pratchett's descriptions with despair and disbelief). Similarly, the problems the writer describes in the US system - those haven't happened with my health plans, despite costing them very large chunks of money at times. General doctor scheduling seems good in the article, but that's a pretty minor aspect of the complete care picture.

A more fair system could be quite a bit worse for people currently in positions of influence, and that's what's going to make it hard. That's how we got Obamacare in the first place - incremental improvement for some, trying not to screw it up for the most consistent voters - and even it's coming close to voter revolt-driven rollback.

If you want meaningful change I'm convinced it's going to have to come from the Sanders-style wing. The mainstream Democratic and Republican parties are too aware of how good they've got it, and at whose expense that comes, currently.

Re: American using Britain’s NHS (2015)

#23

Post by thefounder »

calpaterson wrote: post #6
tomalpha wrote: post #2

So how does the US improve its healthcare system? More interestingly, can the US political system ever enable an evidence-based debate around it? From the other side of the pond, it feels like debates end up being emotional rather than scientific. (I’m a Brit and love the NHS with a passion but would not claim that it’s without flaw. Neither would I claim that we necessarily have more reasoned debates about issues he…

I personally get the sense that it's quite easy for the NHS to look good when you compare it to America. When you compare to other western countries the results don't always seem so great and there are definately situations where as an outsider I think things are clearly pretty bad (like NHS IT system procurement). I don't hold out much hope for reasoned debate to help things though - who can form a reasonable opinio…

What other western countries? I believe NHS got the first place this year(again)...I don't have time to search for the link but you can google it!

Re: American using Britain’s NHS (2015)

#24

Post by sambe »

I have never seen such a bureaucratic/inefficiently operated institution - and there are plenty to choose from in the UK. My electricity company replaced all Vs with Ks in letters to us for 7 months. The NHS is much worse (try even getting a letter to arrive within a month - to the right address - let alone receive any medical treatment).

I have not dealt with US healthcare but having experienced other countries' I'd strongly suggest not following the UK system - other European countries certainly come to mind as working substantially better. Of course, there's a huge "Save Our NHS" push due to the number of people it employs, unions, misplaced national pride etc.

Re: American using Britain’s NHS (2015)

#25

Post by arseraptor »

sambe wrote: post #24

I have never seen such a bureaucratic/inefficiently operated institution - and there are plenty to choose from in the UK. My electricity company replaced all Vs with Ks in letters to us for 7 months. The NHS is much worse (try even getting a letter to arrive within a month - to the right address - let alone receive any medical treatment). I have not dealt with US healthcare but having experienced other countries' I'd…

Funny how your anecdotal point is just that, anecdotal. Here's another anecdotal point for you -- Pancreatic cancer (stage 2). Diagnosed on the first visit even though a private doctor had missed it previously. Surgery in less than 5 days, excellent follow-up and post-surgery care including the surgeon having a set of non-mandatory procedures approved in record time (10mins) as a preventative step towards recurrence. Two years later, cancer free with excellent reminders and follow-ups on periodic checkups.

Your experience does not dictate the system, as doesn't mine.

Re: American using Britain’s NHS (2015)

#26

Post by vixen99 »

arseraptor wrote: post #25
sambe wrote: post #24

I have never seen such a bureaucratic/inefficiently operated institution - and there are plenty to choose from in the UK. My electricity company replaced all Vs with Ks in letters to us for 7 months. The NHS is much worse (try even getting a letter to arrive within a month - to the right address - let alone receive any medical treatment). I have not dealt with US healthcare but having experienced other countries' I'd…

Funny how your anecdotal point is just that, anecdotal. Here's another anecdotal point for you -- Pancreatic cancer (stage 2). Diagnosed on the first visit even though a private doctor had missed it previously. Surgery in less than 5 days, excellent follow-up and post-surgery care including the surgeon having a set of non-mandatory procedures approved in record time (10mins) as a preventative step towards recurrence.…

So instead look at the statistics. In many sectors they are dire.

Re: American using Britain’s NHS (2015)

#27

Post by justinmk »

pbhjpbhj wrote: post #20
gaius wrote: post #13

Earlier quoted context omitted.

Aneurin Bevan believed that the cost of the NHS would reduce over time as the population got healthier. The current NHS budget is £125Bn/year. Many people think it is underfunded, but noone is willing to name a figure for fully funded. Is it £150Bn, 200, 500? No progress will be made, by either party, until someone stands up and does this.

You can't put a figure on it. The system interfaces with every area of life, and with capitalism. Western Capitalism says the amount spent on healthcare should grow until all available money becomes profit for the Capitalists. Meanwhile there's always some new area of life that impacts health - spend on sport, then on encouraging sport by paying for teachers, then on improving colleges where the teachers train, ... b…

> Meanwhile there's always some new area of life that impacts health - spend on sport, then on encouraging sport by paying for teachers, then on improving colleges where the teachers train, ... before you know it the NHS is funding a deep mine in Siberia

In other words, central planning doesn't work[1]. NHS was a "special case" that tends towards the general case, as is the tendency of all untouchable mandates.

[1] https://en.wikipedia.org/wiki/Economic_calculation_problem

Re: American using Britain’s NHS (2015)

#28

Post by jdietrich »

washadjeffmad wrote: post #21
new299 wrote: post #15

"In the UK, I showed up at 9am and was seen instantly" I don't think that's ever happened to me. Most likely this person was the first patient of the day, so appointment times haven't slipped yet. 30 minutes in the minimum I've had to wait in general. I've also had to wait weeks to see a GP (in the countryside). I find anecdotal articles like this pretty unhelpful in general. We all have our own anecdotes, it's more…

I'm not really familiar with NHS processes, so when it took you weeks to be seen, did someone just take your info when you walked in and say they'd get back to you when they could, or was your condition evaluated first (diagnostics run, etc) and an appointment scheduled for you for a particular date a few weeks in the future?

The former. Access to the majority of non-emergency care is gatewayed via your GP (primary care physician/family doctor) - if you need to see a specialist, you can only do so by asking your GP for a referral. You'll then wait weeks or months to see a specialist, although you may be sent for tests before then. We have a chronic shortage of GPs and the system as a whole is severely underfunded, meaning that many people have to wait weeks just to be seen by a doctor. The average wait to see a GP is 13 days, but can be much worse in some areas, especially in winter.

Some GP practices have reduced the strain by offering appointments with Nurse Practitioners, who can treat common and uncomplicated conditions. This solution is far from perfect, because there's a lot that Nurse Practitioners can't treat.

Some patients are just going to a hospital emergency department because they can't get a GP appointment in a reasonable time frame. This just increases the strain on the system, because care delivered in an ED is considerably more expensive. The four hour target is actively counterproductive; When ED managers are faced with a waiting room full of people with coughs, rashes and sprained ankles, they are forced to choose between prioritising clinical need or hitting their targets.

http://www.pulsetoday.co.uk/your-practice/practice-topics/ac...

Re: American using Britain’s NHS (2015)

#29

Post by lucideer »

sambe wrote: post #24

I have never seen such a bureaucratic/inefficiently operated institution - and there are plenty to choose from in the UK. My electricity company replaced all Vs with Ks in letters to us for 7 months. The NHS is much worse (try even getting a letter to arrive within a month - to the right address - let alone receive any medical treatment). I have not dealt with US healthcare but having experienced other countries' I'd…

> I have not dealt with US healthcare

Since we're detailing anecdata, I went on a working holiday to the US and had an accident in work. I was fully covered under my travel insurance, and doubly covered under my employer's insurance. I broke several bones in my hand and needed a costly operation to insert pins. The payment approval time from insurers took longer than the minimum wait for the operation before bones fused. I did not have the operation and have had problems in my right hand since.

I take your point about other European countries doing it better, I'm sure that's true. But the article is using the US system as a metric. I'm living in Ireland and would love to have a system as good as the NHS over here. Everything's relative but when you're comparing the NHS to clearly inferior systems there's not much point playing devil's advocate. There are enough individuals with a vested interest in the disassembly of the NHS as it is.

Re: American using Britain’s NHS (2015)

#30

Post by strawcomb »

sambe wrote: post #24

I have never seen such a bureaucratic/inefficiently operated institution - and there are plenty to choose from in the UK. My electricity company replaced all Vs with Ks in letters to us for 7 months. The NHS is much worse (try even getting a letter to arrive within a month - to the right address - let alone receive any medical treatment). I have not dealt with US healthcare but having experienced other countries' I'd…

It's actually one of the best value health care systems.. Sadly it is being made inefficient by the current government.

If we are going by anecdotal evidence, the NHS has been absolutely brilliant for me.

https://www.theguardian.com/society/2017/jul/14/nhs-holds-on...

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