What can you tell us Yanks about Healthcare in the UK

hladik are you seriously proposing that we have no armed forces?

Are you also suggesting that we have never had any enemies, have none at the moment and will never have any in the future?

Presumably you could run a system where the private health contractor had to pay the NHS for services provided?

No... I wouldn't actually advocate that position... I speak as a man with a brother currently at Sandhurst... (although I would advocate some pretty hefty budget cuts) but I'm proving that WiganWill's point was totally valid, and that your love of the market is mindbendingly flawed.

By your logic, ANY public or government subsidised service could (and should?) be replaced by market-driven enterprise. Because the market always makes things better no?

Private defense contractors exist.

Why don't we let them 'do' our defense for us in lieu of that giant great Army my taxes pay for?

*Logic fail?

*EDIT: Actually, with a moment's pause for thought, I really cannot envisage a situation where a troops-on-the-ground Army would 'save' me from imminent danger. We live in the future. No one is going to invade the UK with massed ranks of uniformed bodies. So yes, in many ways we don't need the Armed Forces to continue in their current incarnation (assuming we are looking to save money for UK taxpayers and have no far-reaching foreign policy desires that involve 'keeping the peace' in oil rich countries).

The UN? Yes please.
Some missles and a couple of UK Battalions for show purposes? * Probably. *
Trident? Hell no.
Huge, cumbersome, oil burning tanks that we abandon in Iraq because the market dictates that it is cheaper to leave them there and build new ones than bother to fly them home? Er....

We're straying off topic here.

I've made some pretty lengthy posts on page 4 which you should probably read before we continue, but let me pose a scenario and question anyway:

• Two children attend a GP.
  
• GP suspects serious nut allergy in Child 1.
  
• The pushy mother of Child 2 suspects serious allergy to 'something... you know, he always sneezes and stuff'. GP is hugely sceptical.
  
  

Who should get seen first by the allergy specialist at the hospital?

In your wonderful Market Driven World, it is, of course, Child 2, because his dad works for PricewaterhouseCoopers and has a big ole' insurance plan that covers his entire family, whereas Child 1 is merely the son of a cleaner at a private hospital.

In the famous Profitless World of Equal Opportunity, it is, of course, Child 1, who actually has a life threatening condition that needs treatment and support from healthcare professionals.

Which world sounds better to you?

By your logic, ANY public or government subsidised service could (and should?) be replaced by market-driven enterprise. Because the market always makes things better no?

[/I]EDIT: Actually, with a moment's pause for thought, I really cannot envisage a situation where a troops-on-the-ground Army would 'save' me from imminent danger. No one is going to invade the UK with massed ranks of uniformed bodies. So yes, in many ways we don't need the Armed Forces to continue in their current incarnation (assuming we are looking to save money for UK taxpayers and have no far-reaching foreign policy desires that involve 'keeping the peace' in oil rich countries).

The UN? Yes please.

just stopped pissing myself laughing at the thought of the UN saving anyone. Maybe you feel safe because you have a professional army defending you (and the fact that we are ultimately defended by the yanks) and yep sure the world is changing but it would be a foolish man that gave up our army in its current incarnation.

but you are right we are digressing. My love of the market doesn't spread to all areas. every nation decides what system is best for different aspects of its society. As far as i'm concerned it's time for our health system to move away from free health care for all on the point of entry.

As it happens the US system of health is better than ours and not restricted to rationing. The American mission is to maximise life regardless of cost. The NHS is trying to make maximum cost effective use of the resources at it's disposal.
Also absolutely no citizen is denied healthcare in the states (it is illegal to refuse treatment in all 50 states). There is much less queueing. The US have much greater cancer survival rates and there is far more money spent on 'the end of life' care. it could be argued that the American system far from being cruel , is too kind.
Americans seem to me to be deciding whether or not they want to impose rationing. Economically Americans have a problem. Healthcare spending is growing faster than GDP. In anyones book that simply spells trouble.

But as i said earlier, who cares what the Americans do? Culturally they are able to understand that you are born and it is up to you to make what you can of your life. If you want the best healthcare , buy the best insurance and that might involve working hard and achieving rather than relying on richer members of society paying for you. This is a nation of people who historically left tyranny to come to the land of the free in an attempt to live their lives unfettered by govt bureaucracy and meddling (shame about the genocide of the native americans and the influence of religion). I don't hear too many Americans protesting about the state of their healthcare system considering it is supposed to be so appalling according to the left wing in this country.
In the UK we need some new ideas because the NHS can't remain sacrosanct forever. It's expensive and it doesn't deliver the best healthcare. More and more people are getting tired of paying for people who can't be bothered (yep you read that correctly) to work or take responsibility for their health.

Originally i said that it was a mildly interesting thread and this upset some people. Sure it was a bit patronising but to be honest , after reading it all, it is a pretty fair assessment. Hladik wrote a lot of detailed stuff about the ins and outs of the administrative world of the NHS and how cruel it is that people with money should be able to pay for better and quicker care(welcome to the real world) . Then there was a spattering of socialist gumpf as the left wingers talked about how awful private markets are and how life is so much bettter with the NHS (yawn) describing it as a 'free' service while failing to realise that without a market economy producing profits then we would be stuck with truly socialist system of healthcare i.e. none

so the bad thing about the nhs is it's too expensive, and the bad thing about us healthcare is it's too expensive?

costa rica has no army and is not constantly under threat. haven't read the context but just a point.

edit: lots of countries have no army it turns out. http://en.wikipedia.org/wiki/List_of_countries_without_armed_forces#Countries_without_armed_forces

I'm a Yank and I live in London. I've seen both sides. I also work with a lot of pharmaceutical companies so I have more than a passing acquaintance with the different systems.

I freely admit, I bring a lot of personal bias into these type of debates. My mother lives in the States and has leukemia. She couldn't get the treatment that she needs if she didn't have private healthcare. It's massively expensive and is something she feels incredibly guilty about. I'm sure her healthcare insurance would love to drop her as she is massively expensive to them but she has the policy and is guaranteed the treatments.

If her situation in the States was different she might not be so lucky. If she hadn't had the insurance first she might find she was shit out of luck.

However, if she lived in the UK she might be shit out of luck depending on her post code. She is far enough advanced now that she'd be shit out of luck regardless of where she lives because NICE has deemed her current treatment isn't cost effective.

So based on that, my personal biases and everything I have seen; both systems are far from perfect. But I do prefer a system that offers a chance because there are many players to one that has to rule the cost effectiveness of everything for everyone because they are the only player.

This is just my two pence. I'm not interested in debating I'm just a tad bit drunk and rose to the bait when I saw this thread.

so... talk me through the arguements against a us national healthcare system. from what i can gather, it mostly amounts to "i don't want my taxes to pay for their treatment"

They also think it's the first step towards a Communist regime. Tossers.

... as opposed to, say, government-owned banks?

if we're talking market forces, surely it's better to guarantee a healthy blue collar workforce -- especially given that the us is finally realising that it has to have a viable manufacturing sector to remain competitive. and healthy workforce = healthy taxbase.

I am extremely grateful for the NHS. Here's why....

I was born with a severe spinal curvature. I was seen at once by a top consultant in the best orthopaedic hospital in the country, and I remained under his care until he retired when I was 24. In the winter months as a kid I had to go into hospital every two months to have plaster bodycasts applied, and would stay in for 3 days; in the summer months I wore a custom-made metal brace, which was horrible but was a work of engineering art and held my spine in place whilst I grew a bit. When I was 10 I had two operations to fuse the whole of my thoracic spine, 6 weeks in hospital with 2 weeks in halo-tibial traction (pins in skull and ankles, tightened daily with a spanner, ouch). I had more surgery when I was 18 (two more surgeries to fuse my lumbar spine and break my ribcage and reset it into a more normal looking shape), 25 (another ribcage surgery, as they decided they could make it look even better) and finally a surgery in May this year to extend my fusion to L4.

I'm on loads of expensive painkillers but I pay just over a hundred quid a year for a pre-payment card which covers everything. I've had tons of physio, I've had three weeks on a fabulous pain-management holiday, I get free use of my hospital's tropical hydrotherapy pool.

All of my treatment has been free.

I have friends who were also born with spinal curvatures, in countries where the treatment wasn't freely available. They're massively deformed now and have to use oxygen to help them breathe because their lungs are being crushed. It's sobering, they actually started out with curves much smaller than mine.

My spine is fused from T1-L4, I have just one vertebra left to move with. Despite this I am incredibly active, I climb mountains and love to hike for miles. Bluequinn bought me a bike and taught me to cycle last year (it wasn't possible for me to have learned as a kid, due to the braces and plaster casts) and now I absolutely love it - I doubt I'll ever manage a road bike due to not being able to bend forward enough comfortably, so I ride a Dutch bike and a Moulton F Frame instead. My point is that without the NHS I probably wouldn't be anywhere near as fit as I am now, and my quality of life would be in the shitter.

I've had plenty of crap from the NHS and can moan about individual incidents and the odd shite doctor, but on the whole I cannot praise it enough.

Hadn't seen clintsmoker's response until now. A stronger man that I would let sleeping dogs lie, but fuck it:

Maybe you feel safe because you have a professional army defending you.

From whom exactly? Are we talking about the terrorist groups abroad that are killing our soldiers (and their own) with weapons manufactured by BAE? Or the oil rich Middle East states that have fleets of RAF fighter jet?

I wonder how those got there?

Or are you referring to the numerous armies that are constantly trying to invade?

I don't know about you, but I can't recall the last time I saw a uniformed member of the armed forces arresting a domestic terrorist.

but you are right we are digressing.

I concur. Enough with global politics:

As it happens the US system of health is better than ours and not restricted to rationing.

Where has this notion of rationing come from? Are you confusing 'better healthcare' with 'demanding absurd numbers of inconsequential tests and pointless, risky surgery in order to satisfy one's baseless hypochondria, despite the better advice of one's highly trained clinicians'?

I think you might be. As countless people have attested in this thread, when something is seriously amiss, you will, more often than not, get the works.

I see you have ignored my second post above with the peanut allergy anecdote. Which leads me to this:

The American mission is to maximise life regardless of cost.

This is unbelievable bullshit. The American insurance companies' collective mission is to maximise profit, health of their clients be damned.

When has a for-profit company EVER operated without regard to cost?

Have you just ignored the multiple posts from users of the American healthcare system in this thread? Or is this just wilful ignorance?

An American consumer watchdog has highlighted the distasteful depths to which insurance companies plunge in order to keep those shareholders happy.

To pull a few choice conditions and occupations that Blue-Shield California and PacifiCare (a subsidiary of United Health Group, one of the largest health insurance companies in the US) refuse to cover:

• Air Traffic Controllers
  
• Policemen
  
• Firefighters
  
• Construction Workers
  
• Acne
  
• Asthma
  
• Arthritis
  
• Sickle Cell Anaemia
  
  
  

I would now like to point you to your previous statement:

Also absolutely no citizen is denied healthcare in the states (it is illegal to refuse treatment in all 50 states).

Just like here no?

But don't the people who work in the above listed jobs, and the people who suffer from the above listed conditions count as citizens?

I'm fairly sure they do here.

Or are you referring to the fact that, yes, in America, if you are uninsured and you break your arm, you can turn up at A&E, wait half a day, and be treated, but you will then have to fork out $38,000 retrospectively for the privilege?

Someone posted this very story on the ***first page.

---

Does that sound fair to you? Does that sound like a system that is maximising life? Or does that sound like a system where a large portion of the population will probably never set foot in a hospital for fear of being bankrupted? This is a country where at least 30 million people are uninsured, with many tens of millions more underinsured for any number of life threatening conditions. It is a system that kicks people off on technicalities and paperwork irregularities - something that would never happen with the NHS - and that, most of the time, charges extra if you dare fall pregnant.

A country where your healthcare policy can **expire. **That doesn't sound too life-affirming to me.

Culturally they are able to understand that you are born and it is up to you to make what you can of your life.

If you want the best healthcare , buy the best insurance and that might involve working hard and achieving rather than relying on richer members of society paying for you.

Again I am astounded. Never did I realise that Air Traffic Controllers, Policemen and Asthma suffers alike were not upstanding, contributing members of society, but lazy, scrounging underachievers.

Of course, no one can be born with a pre-existing condition and thus be denied treatment by just about every healthcare provider in the country, just like no one can be born into poverty, live in deprivation, drop out of school at 16, not to fuck around doing drugs, but to work a minimum wage job, because their single mother is so crippled by untreated, unmanageable arthritis that she can barely walk, let alone provide for a family. Of course that can't happen with a private healthcare system, because the insurance companies just want to help you get better.

I am glad that you were born priviliged enough that your parents had no use for state funded hospital beds, school desks, midwives and teachers. If only we all could share such a leg-up. Or did richer members of society pay for your schooling?

The NHS is trying to make maximum cost effective use of the resources at it's disposal.

Which sounds like a very responsible government body to me. If people were happy to pay more tax, we'd have even more resources and even better healthcare.

Economically Americans have a problem. Healthcare spending is growing faster than GDP. In anyones book that simply spells trouble.

Yes - stats, shall we have a look? This is a fairly interesting page.

Life Expectancy:

UK 79.1
US 78.1
**
Infant Mortality
**
UK 4.8
US 6.7

** Per Capita Expenditure on Healthcare**

UK 2,992
US 7,290

** % Government revenue spent on Healthcare**

UK 15.8
US 18.5

I'll let you look at the rest yourself. But for** less **money per head, and less money spent by the government, we have **longer **life expectancy, fewer children dying and every citizen in this country is covered.

I don't hear too many Americans protesting about the state of their healthcare system considering it is supposed to be so appalling according to the left wing in this country.

You are obviously not listening then. I'm fairly sure they just elected a famously black* centre-lefter who had repeatedly promised healthcare reform during a very long, very public election campaign.

In the UK we need some new ideas because the NHS can't remain sacrosanct forever. It's expensive and it doesn't deliver the best healthcare.

Wrong. It is much cheaper, per capita, and as a percentage of government spending and it delivers healthcare to anyone who needs it whenever they do.

Yes it needs some reform - I've posted extensively on this issue.

More and more people are getting tired of paying for people who can't be bothered (yep you read that correctly) to work or take responsibility for their health.

Are we including the middle classes here? Or just the poor people? Because I, for one, would be happy if my taxes were not used to fund physiotherapy treatment for some foolish over-40 year old's rugby/tennis/skiing/fixed gear related injury ever again.**

Not to mention all those anti-depressants that bored middle-class housewives disproportionately gobble up between shopping trips and lunches.***

Or anyone involved in a car-to-car crash.

But perhaps I'll endure it and cease to base my political opinions on such absurd generalisations.

I know I will not change your mind, but ultimately, this entire debate comes down to the dilemma I posed in my previous post dated 21st August.

Which world sounds better?

The one where money talks, or the one where life is the priority?

Because for all its flaws - and I myself have listed many - we already have the second world in our country.

Why you'd want to replace that, I will never understand.

• racist.
  
  

** I do not actually hold this opinion.

*** Or this one.

I had to look at this thread while stumbling around for the garage rock one. I haven't even read all of it, and to be honest, don't really feel a desire to do so. Feel free to quit reading here.

We can all provide anecdotal evidence, as I did, and many others. It's anecdotal and while it shapes our opinions is not necessarily a firm foundation for healthcare policy.

Universal healthcare is an admirable goal, but nothing comes free and eventually somebody is paying the piper and somebody is going to come up short. If you are unlucky enough to get cancer you are statistically better off being an American than a Brit as the survival rate is higher. Some Americans, perhaps even many, lack healthcare insurance but every British citizen has it but still might find the care subpar or inadequate and have a reduced survival rate.

In Britain you pay for your healthcare through your taxes. If you choose to supplement that with private insurance, you pay even more. In America there are programs such as Medicaid and Medicare that are government funded for the poor and elderly. Most people need to choose their own healthcare insurance either subsidised through their employer or by doing it themselves.

The problem I have with the "Universal is good and fair and private is bad" argument is that it dismisses a lot of real world issues in healthcare. Somebody has to pay for medicines. Pharmaceutical companies are easy to demonise but it's often done without looking at the facts. The lion's share of pharmaceutical companies exist in only a handful of countries for a reason.

It is incredibly expensive and time consuming to bring a drug to market. It takes decades. And every successful drug must pay for the research into the 999 drugs that somewhere along the line went from promising to failure. If your country has price controls then you benefit, and countries that do not, like the US, pick up the extra price. However if every country decided that nobody should have to pay more than X amount of pounds/dollars/euros then how many drugs will be researched?

It's expensive. And the reason it is so is because it's difficult. But look at the accomplishments that have been made because of it. 25 years ago HIV was a death sentence. It is now largely treated as a life-long disease that can be managed. Look at the leaps and strides healthcare has made and our quality of life and longevity that has benefitted. We can't simply take that for granted and assume somehow, somewhere, someone is going to pay for that, as long as it's not us or anyone we know, and believe that development will continue.

I'm biased. I worked for a pharmaceutical company that brought a treatment for rheumatoid arthritis to millions of sufferers. I showed up in the last 12 months and got to partake in the celebrations, but that journey started in the late 70s. My mom requires a treatment for her leukemia that NICE will not approve as it's too expensive and decided it's not worth whatever extension of her life it grants. That's not being argumentative, it's just a fact that when one payer shoulders the burden, they have to make cost/benefit decisions. I appreciate the fact that she is able to have that treatment because she has private insurance in a competitive market.

I think it's great that I see people putting up honest opinions, beliefs and experiences here. I get frustrated when I see knee-jerk reactions or bumper sticker philosophies. This is a serious issue and it's not just a political divide or difference in cultures that makes people hold different views. If you love or hate the NHS, fine; I'm not going to try to change your opinion because I don't care. I've had good and bad experiences here like I've had in the States, but I too have an opinion based on those personal experiences. I'm simply saying there is much, much more to this debate than a 'healthcare for all or healthcare for the rich' or 'I don't want to pay for someone else' point of view.

Pfizer 2008 Profit: $8.104 billion
Johnson & Johnson 2008 Profit: $12.949 Billion
Hoffman-La Roche 2008 Profit: $10.78 billion
Novartis 2008 Profit: $8.16 billion
GlaxoSmithKline2008 Profit: $6.713 billion
Sanofi-Aventis 2008 Profit: $5.65 billion
AstraZeneca 2008** Profit**: $6.130 billion

Well done America.

(Shame about the abortion stuff, but still, it's a start.)

I believe the health care system of Finland is quite close to the one in UK.

"In a comparison of 16 countries by Swedish Association of Local Authorities and Regions, Finland used the least resources and attained average results, making Finland the most efficient public sector health service producer according to the study's authors."

[ame]http://en.wikipedia.org/wiki/Health_in_Finland[/ame]

And I think it's the same with most Nordic countries. A good system.

Unlucky Finland

I dont really understand this... I've heard the following reported:

USD940 billion plan (presumably that is the cost, which seems a lot)
Healthcare extended to 24 million people who currently have none (how do they do that? Extend what exactly?)
Healthcare extended to 32 million people who currently have none (conflicting number)
Will create a reduction in the budget defecit of USD138 billion (how?)
Health insurers will not ba able to decline cover for pre-existing conditions (i.e if you are sick and need to pay, you just go and grab some insurance first as it cant be declined)

Im not seeing a "reform of the system", just an extension of existing practices, plus that new legal obligation on the part of the insurers.

I cant help but think Sarah Palin would have had the answers.

Hmmmm... it seems that people on low incomes are entitled to a tax credit to help with their premiums. I assume this means unemployed/low income earners are still without cover :/

Well done America, and well done Barack Obama.

What did Bush or Bliar leave their countires? War and pointless death.

Obama will leave his country a system by which MILLIONS will now be insured, and will be able to get the healhcare they didn't have access to previously. It still has to get through the Senate, but I think/hope it will.

I used to live in America, and I know many people that "can't afford to get sick".

On a different note, I had to quote BobbinBird, as what he had to say about his experience with the NHS, encapsulates my adoration of that establishment.

I am extremely grateful for the NHS. Here's why....

I was born with a severe spinal curvature. I was seen at once by a top consultant in the best orthopaedic hospital in the country, and I remained under his care until he retired when I was 24. .....I had more surgery when I was 18 (two more surgeries to fuse my lumbar spine and break my ribcage and reset it into a more normal looking shape), 25 (another ribcage surgery, as they decided they could make it look even better) and finally a surgery in May this year to extend my fusion to L4.

....All of my treatment has been free.

I have friends who were also born with spinal curvatures, in countries where the treatment wasn't freely available. They're massively deformed now and have to use oxygen to help them breathe because their lungs are being crushed. It's sobering, they actually started out with curves much smaller than mine.

...Bluequinn (you deserve to be repped my brother) bought me a bike and taught me to cycle last year (it wasn't possible for me to have learned as a kid, due to the braces and plaster casts) and now I absolutely love it... My point is that without the NHS I probably wouldn't be anywhere near as fit as I am now, and my quality of life would be in the shitter.

What am I missing? They are not implementing an NHS-like system at all, as far as I can gather.

On a different note, I had to quote BobbinBird, as what he had to say about his experience with the NHS, encapsulates my adoration of that establishment.

She. My girlfriend in fact, of whom I speak upthread.

And the last op (to extend her fusion to L4) was done privately, not on the NHS. That's the op that the NHS made us wait 18 months and then cancelled after the pre-op appointment. (can you tell I might have been slightly bitter at the time?) Luckily by the time they did that I had got a job with medical benefits so we had an alternative. AXA PPP didn't see us coming :-)

What am I missing? They are not implementing an NHS-like system at all, as far as I can gather.

You're right. The orgianl bill has changed a lot to appease the right, although it was never that akin to the NHS

Im no expert, but it reads to me as though its still almost totally reliant on individuals paying private insurers. Its not the "Socilaised Medicine" people associate with "Obamas Healthcare Reform".

shhh don't say socialist, there could be yanks about, you'll get bummed!

Hardly... I'd reckon almost everything anyone on this site learnt about the US Healthcare system probably came from Michael Moore.