What can you tell us Yanks about Healthcare in the UK

Ha - repped!

I resent that. I've watched episodes of House, Scrubs and ER, so there's not much I don't know about US Healthcare.

Never watched Grey's Anatomy though. It looks shit.

Even shitter than Scrubs, that is.

Okay, I'm not expert, but I think I can get you started on some of these:

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)

I'm not sure what the exact reason is but essentially there are two kinds of people that are getting a big advance in Healthcare. The first being those in the bottom percentile of salaries (very poor). The second being those self employed or small business owners that could never afford to pay the high premiums of private insurance companies as it would cripple their business. The small business one is a big one as the rules are currently very unfair.

Will create a reduction in the budget defecit of USD138 billion (how?)

This is a tricky one. Essentially, it requires all the States to adopt a big increase in taxes and reform their systems. The numbers will be debated forever.

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)

Currently they can decline over pre-existing conditions. So if you've just been granted healthcare by the government it wouldn't do most diabetics any good as they're already diabetic. So they added this in.

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.

Exactly (not the Palin point). It is essentially requiring Americans to pay for insurance by using subsidized money from the State/going for the "Public Option". There will be no NHS and the government won't be running the health care industry. The big news stories now are States (like Texas) that are suing the government on State's Rights (see the American Civil War). They reckon that the government can't tell them what to do. It won't amount to anything, but makes the Red States feel better about themselves for a bit.

If you're really interested a great radio program on NPR has been covering it for the past few weeks. Check out a few of the shows (going back as far as you can so you're not lost) and you'll get a feel for what the right and left are arguing about.

http://www.kcrw.com/news/programs/lr

Again, I'm not the right person to be covering this stuff, but I hope that gets you started!

I resent that. I've watched episodes of House, Scrubs and ER, so there's not much I don't know about US Healthcare.

Fair shout... I didnt think about those shows.

To be fair, I dont know anything myself. I had a bit of a read of this thing (http://www.whitehouse.gov/health-care-meeting/reform-means-you), which is extremely light on in data. I believe it links to the full proposal which I planned on reading until I realised that I dont actually care quite that much.

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".

You're right, I think. AFAICT, it extends their own version of the evil socialist NHS (Medicare) while making everyone else get insurance or be fined. At the same time, people will be given money by the government to help pay for insurance (obviously much more efficient than a single-payer system...) and there's some legislation that tries to stop insurance companies fucking all their new and existing customers quite so hard.

They'll still be 23 million uninsured (!!) in America, mostly illegal immigrants, and people that don't have to buy insurance but can't or won't enrol with Medicare. But that's OK, they can still wait until their condition becomes life threatening and then turn up at an emergency ward for treatment (again, obviously the most inexpensive and efficient system for all involved).

Anyway, that's what I can glean from reading news reports. If anyone - a Yank, for instance - has a better idea of what's going on then please correct me. I sort of stopped following the news about this after it became clear that the right of Obama's own party was going to fuck this up as much as possible.

I read somewhere, and a quick Google has failed to throw the article up, that the US Government spends more per head of population on healthcare than the UK government.

The US health insurance industry is probably the largest cartel in the world and a byword for private sector inefficiency.

So.. .why cant everyone get Medicare?

So.. .why cant everyone get Medicare?

Well, that would be socialism, wouldn't it?

And socialism for nations is national socialism, which is Nazis. Or something like that.

Bang - Godwin!

I had to have a good, hollow laugh at this post (even though it is very old).

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.

Yes... Let's come back to that point in a moment.

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?

You're quite right - pharmaceutical companies are driven by profit, and if there aren't any patients paying for drugs then the drugs won't be developed. For instance, the company I used to work for developed one of the most widely-used HIV treatments (often used in HAART) and was then forced to give it away for free in developing countries, leaving the company to pick up all of the initial R&D costs and the ongoing production costs. They now claim this as a huge act of altruism, but I will let you guess how much research they currently do into antiretrovirals. [None.]

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.

Well, there is an obvious alternative to private R&D. Public R&D? There's no compelling reason why better research would be done in a private lab. I've worked in organic chemistry both publically (universities) and privately (pharmaceuticals) and I saw more and better work being done by PhD candidates (salary approx. £12,000) than by long-term employees in pharmaceutical labs (salary approx. £60,000). The difference is that at the moment, drugs are developed in the private sector and the system isn't broken enough (at least for first world consumers) to generate the policital will for something better.

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.

Athritis is a good example of a "lifestyle" disease, along with impotence, depression, insomnia, chronic pain, schitzophrenia or migraines. While these conditions are miserable if you are a sufferer, if you're being given drugs for them then you are probably someone who lives in a first world country and doesn't have to worry about malaria, etc, etc as a priority. That's why pharmaceutical companies develop them. There is money in them, because these are important problems for Americans and Europeans. There isn't money in saving lives per se. That's why some people think that a system which didn't depend solely on market forces to work would be a better idea. For instance, you could develop drugs for the most important and serious conditions, with the most sufferers. You wouldn't have to patent them. You wouldn't have to spend more money on marketing than on basic R&D, so as to wring maximum value out of your patents. You wouldn't have to distort your evidence base to show efficacy. You wouldn't have other government labs scrambling to waste huge amounts of resources (and animal lives in clinical testing) for "me too" drugs that are just different enough to patent, without providing any appreciable benefit over existing therapies...

And you don't have to be biased just because you work for a pharmaceutical company. For me, my time working for and with pharma companies was an interesting eye-opener. Lots of nice people in a ruthlessly unpleasant system.

If you're still reading, I'd be interested in knowing which area of your company you work in. Are you doing lead development, biology, process chemistry, repping, or what?

i have been looked after by the nhs for the last year and a half. they have been fantastic. i've had more than £200,000 worth of treatment 'for free'.

i did see some bad nursing during my stay in hospital, and did have a bad physio for a short while, but that was completely outshone by the incredible treatment and care i have had, and still have, from all the consultants, registrars, SHOs, nurses, receptionists etc involved in my treatment.

it's not perfect, but i owe a huge amount to the NHS and am forever grateful.

I can't believe anyone would think they can pull out of paying for the NHS because they don't use it.

It's like an insurance company. You don't take out exactly what you put in, you rely on other people's contributions. One person might use 10 times more than they put in, another might use a 10th of what they put in. But hey, that's the system, and in leu of serving your country, pay yer fuckin' taxes.

Not worth a new thread but:

I'm not registered with a GP. I have been to see one only once in the past 10 years - (about 6 months ago when I had a bacterial throat infection that resulted in my tonsils swelling so severely that I had difficulty breathing. I couldn't eat for a fortnight and had difficulty drinking - lost a lot of weight).

I have occasional heart murmur/palpitation things which seemingly come out of nowhere - very fast and erratic heartbeat sometimes for as long as five minutes -then it disappears.

I'm planning to cycle to Spain in August and want to have a full medical check up before I go. What's the best way to do this?

The doctor I met in January RE. my throat seemed under so much pressure from huge queues that I just don't think that I'd get a full and thorough check-up I want - specifically my heart.

What's this private healthcare lark all about? I genuinely have no idea about such things.

Is it possibly to pay a one off fee for a full medical at a private healthcare centre or do you need to "be a member" or equivalent.

I live in deepest darkest Hackney where (from ringing around a few practises) they seem hugely under staffed and under pressure which I don't want to A. add to and B. from a more selfish perspective I don't want that to affect the quality and thoroughness of my examination. I've never had a medical in my life from memory so don't really know the extent of it apart from the dramatic interpretations of latex gloves and being asked to cough.

Thoughts/tips/htfu's all welcome.

Full check up... you'll be lucky! From my experience GP's are don't really give a shit about preventing future problems or general fitness, they just meet the targets they need for funding.

My call would be go private, but it will cost a fair buck!

Lay off the coffee.

you could register to take part in a clinical trial. They do a very thorough medical. blood, urine ECG the whole thing basically. If they give you the all clear to take part you know you are OK.

Don't take part though... http://news.bbc.co.uk/1/hi/england/london/4808836.stm

I can check your prostate for free

you could register to take part in a clinical trial. They do a very thorough medical. blood, urine ECG the whole thing basically. If they give you the all clear to take part you know you are OK.

Heh, I remember volunteering for a girl I was quite into at the time who studied tropical medicine to do that. I wasn't allowed to eat for 24 hours beforehand and then woke up late so bombed it across town (about 12 miles) in hardly any time at all and as soon as they had taken the blood sample I passed out.

Quite embarrassing.

I can check your prostate for free

Can Tynan film it?

He has to pay

I respect that.