American using Britain’s NHS (2015) • Hacker News Board

Re: American using Britain’s NHS (2015)

#101

Post by DanBC » Sat, Mar 03, 2018, 8:52 PM UTC

Havoc wrote: post #49

>In the US, having sat in many an ER waiting room for hours at a stretch, the idea of a hospital seeing nearly 9 out of 10 patients in four hours would be regarded as a miracle. That is so bizarre. I'd be concerned if it takes and hour. Seriously it's called emergency room because it's an emergency, not a "it can totally wait" room.

They have vigorous triage. If you're about to die they have fully stocked ambos with paramedics providing treatment to you on the scene and then transporting you, with blue lights, to an A&E and direct into majors.

If you turn up with a broken finger you're going to have to wait for most of those 4 hours.

(I'm not defending the 4 hour limit. I think it's weird and needs to go)

Re: American using Britain’s NHS (2015)

#102

Post by DanBC » Sat, Mar 03, 2018, 8:54 PM UTC

moduspol wrote: post #39

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…

What evidence do we want to compare? That's kind of where it loses me. We already have a system very similar to single-payer for our veterans and it is notoriously inefficient, bloated, and unpopular. What many are clamoring for in the US is already being tried in the US and failing exactly the way opponents claim it will. Evidence that it works well in other countries is worth considering, but it in no way proves su…

> that are similarly culturally homogenous

London is culturally diverse. Moreso than any US city. And its NHS seems to be working ok.

Re: American using Britain’s NHS (2015)

#103

Post by DanBC » Sat, Mar 03, 2018, 9:06 PM UTC

CasaDeTony wrote: post #73

As I'm also an American using Britain's NHS, I was pleasantly surprised to see the article mostly matches up with my experiences using local services (though as others have called out, NHS GPs and Specialists still have regular 15-30 minute delays for pre-scheduled appointments, IME) The only downside I would call out is that I pay slightly higher taxes in the UK than I would in the US, and I imagine that part of it…

I'm not sure how it factors into taxes, but the US government spends more per capita on healthcare than the UK government does.

https://visual.ons.gov.uk/how-does-uk-healthcare-spending-co...

Re: American using Britain’s NHS (2015)

#104

Post by moduspol » Sat, Mar 03, 2018, 9:09 PM UTC

DanBC wrote: post #102

moduspol wrote: post #39

Earlier quoted context omitted.

What evidence do we want to compare? That's kind of where it loses me. We already have a system very similar to single-payer for our veterans and it is notoriously inefficient, bloated, and unpopular. What many are clamoring for in the US is already being tried in the US and failing exactly the way opponents claim it will. Evidence that it works well in other countries is worth considering, but it in no way proves su…

> that are similarly culturally homogenous London is culturally diverse. Moreso than any US city. And its NHS seems to be working ok.

The NHS doesn't exist only in London. It covers the UK, which is 87% white (followed by Asians at 7%).

A nationwide system in the US would be covering far larger and more diverse areas.

Re: American using Britain’s NHS (2015)

#105

Post by projectileboy » Sat, Mar 03, 2018, 10:06 PM UTC

alyandon wrote: post #78

Here in the US I had to take my son (he was 5 years old at the time) to the emergency room when he had slipped in the bathtub and hit his head which caused a huge gash right above his eye. We sat in the emergency room for 5 hours before any of the staff bothered to look at his open wound and then another 4 hours after that before they actually treated him. The most infuriating part of the experience was the not-so-su…

100% f'ing right. People who think the US health care system is fantastic either (a) haven't used it much, or (b) are rich enough not to care - and in this category I'll include those with good employer-provided health care (although this number is dwindling rapidly)

Re: American using Britain’s NHS (2015)

#106

Post by oligopoly » Sat, Mar 03, 2018, 10:25 PM UTC

gaius wrote: post #37

nugget wrote: post #32

Earlier quoted context omitted.

I don't see how public health can dramatically improve until we start to have radically different conversations about diet across all levels of society. If you follow the money spent in health care it leads directly to obesity and related lifestyle diseases.

The NHS spends £11Bn/year on type-2 diabetes, 80% of which according to Diabetes UK is caused by or could be addressed by lifestyle choices. Not just diabetes of course, I don't mean to pick on one subset, I mean the NHS has to spend an awful lot of money on things that really shouldn't be things in the first place. People who really love "our NHS" eat right, exercise, and get enough sleep... The rest are just trying…

There's actually quite a few illness that can and often does have origins as 'secondary gain'[0].

It's quite insane that there isn't more done to address root cause. With diabetes-2 I think NHS fails at the point when they don't address people who are at risk. Help people to change their habits by attaching pain and pleasure to their choices and making it personal. This would save NHS lot of money and most importantly help the individual.

https://www.goodreads.com/book/show/144873.Healing_Back_Pain...

Re: American using Britain’s NHS (2015)

#107

Post by lttlrck » Sun, Mar 04, 2018, 1:50 AM UTC

Scoundreller wrote: post #41

vixen99 wrote: post #26

Earlier quoted context omitted.

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

UK residents have the 20th highest life expectancy in the world. 21st for health-adjusted life expectancy. The Japanese take the top spot and live +2 years. The average American lives -2 years. There's a lot more to health than the health care system, and this doesn't say much about how painful the process can be, but the stats look pretty good for the UK. https://en.wikipedia.org/wiki/List_of_countries_by_life_expe.…

But how much of life expectancy can be attributed to the healthcare system? Maybe Brits spend more time outside, and are less stressed, etc etc. how have the rankings changed over time and what changes in the healthcare systems correlate to those trends?

Re: American using Britain’s NHS (2015)

#108

Post by js2 » Sun, Mar 04, 2018, 1:57 AM UTC

jdietrich wrote: post #42

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…

>So how does the US improve its healthcare system? On both sides of the pond, we need to break the false dichotomy of UK vs US. Our systems are almost diametrically opposed, but they get vastly disproportionate mindshare and airtime. In any debate about NHS reforms, people will inevitably hold up the US as a cautionary tale and vice-versa, but hardly anyone raises Germany or Australia as a workable middle ground. Thi…

Similarly, a PBS episode comparing different healthcare systems:

https://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

Re: American using Britain’s NHS (2015)

#109

Post by tim333 » Sun, Mar 04, 2018, 3:10 AM UTC

cstross wrote: post #76

oldcynic wrote: post #5

As a Brit using the NHS I can only add that I trust, and expect, every government to make the NHS worse whilst they talk of how marvellous it is. I would really like it given to an independent cross-party body, or the civil service, to try distance it from politics and The Treasury. I'd like to see legislation to heavily penalise drug companies seeking 20,000% price increases and the like. Both sides fiddle with it,…

I'd like to see a long-term outcomes-based comparison between NHS England and the Scottish NHS, frankly. The Scottish NHS is a fully devolved issue and has been diverging from the English system for most of a decade now, with a greater emphasis on preventative healthcare and screening programs (not to mention free prescriptions for all). In another couple of years we may even have some hard statistical data on what p…

I believe they did a study and outcomes were better in England. I'll try google it.

Re: American using Britain’s NHS (2015)

#110

Post by dbbk » Sun, Mar 04, 2018, 5:05 AM UTC

Havoc wrote: post #49

>In the US, having sat in many an ER waiting room for hours at a stretch, the idea of a hospital seeing nearly 9 out of 10 patients in four hours would be regarded as a miracle. That is so bizarre. I'd be concerned if it takes and hour. Seriously it's called emergency room because it's an emergency, not a "it can totally wait" room.

Although it is an emergency room, a lot of people still turn up when it's not an emergency. It's heavily triaged. If you seriously need attention RIGHT NOW, you will get it. It's not like people are sitting in waiting rooms and dying in the meantime.