Canadian / European / Australian Healthcare Horror Stories

A question: Is it wierd that I’ve never in my whole life thought of health care as an issue related to political ideology?

Where are you? I had to buy some antimalarials last year (and pay full price) and they were quite cheap. I bought them with a bunch of other stuff at the same time, so I can’t remember exactly how much they were, but it wasn’t very much. Probably around US$40 or so for two and a half months worth of antimalarials.

It would be weird if you’d spent the past year in the U.S. and that were still the case :).

I think it depends on how often you think in terms of political ideology. Even here, there are plenty of people who are mainly concerned with taking care of their families and paying their bills and don’t devote much mindshare to politics. They are still thinking of healthcare reform in terms of “Does that mean my premium will go up? I hope it’s not too much.” Then there are others who can’t get a hangnail without blaming it on the Democrats/ Republicans and their flawed cuticle maintenance bureaucracies.

When I was 28, I was treated for cancer under the UK’s NHS system. This experience encapsulates my view of the NHS: it’s generally very good at doing the stuff necessary to save your life, but negotiating the system can be terribly difficult and stressful.

My cancer was detected by an NHS nurse who was examining me for an unrelated problem (which is a long and bizarre story in itself). She booked me a scan for the following morning, which was excellent service. Later that day, I was called at work by the hospital who told me I had to come in RIGHT NOW. There I was told that I probably had cancer and should come back for surgery Monday. So far, so good service. (Except for the cancer outcome, of course, but that was hardly the NHS’s fault.)

It was Friday night by then, so I went out for a drink.

On Monday I was prepped for surgery but waited 6 (count 'em) hours on my lonesome to go into theatre, during time I couldn’t eat or drink. Just before the procedure, my surgeon asked whether I had saved any sperm.

“Umm, what?”, I said.

He explained why.

I said no, over the weekend I didn’t take it upon myself to deposit some sperm for safe-keeping. After receiving a cancer diagnosis, sperm was in fact one of the furthest things from my mind. Perhaps someone could have mentioned this to me, the need to safeguard my sperm someplace secure.

“Oh well, it’s too late now”, Mr Surgeon said.

Just as well I’m not banking on having any kids, I thought.

The surgery went well and I was back in my own bed before long. I wasn’t done with the NHS though - I had to go back for follow-up monitoring every week or so for several months. This follow-up schedule became an absolute nightmare. I waited at least 3 hours each time to be seen by the oncologist. The staff couldn’t manage to effectively book me an appointment without the computer losing the details. All the time I was worried about still having cancer and the stress of dealing with the system became too much. The final straw was when I was scheduled to have a piece of follow-up surgery, which was cancelled two days before the operation. I lost my patience and switched to a private oncologist, which was covered by my work health insurance.

So my experience was GOOD in that the NHS possibly saved my life. My problem was picked early thanks to an excellent NHS nurse, and I did not wait for surgery. It’s simply that the follow-up care was poorly administered and caused an amount of stress that a cancer patient shouldn’t have to go through.

As a footnote, I quit my job to become a full-time student a few months ago, which meant I relinquished my health insurance and I am back on the NHS system. However, I still have the same oncologist I saw under private care, only I see him in a public hospital. It’s a different hospital to the one where I was originally treated, which beings me to jjimm’s point about the standard of care being dependent on your local Primary Care Trust. This hospital seems okay so far at managing appointment waiting times and scheduling.

Oh, I’m nearly 30 now and I’m perfectly fine.

Do other countries have dental and psychiatric care too? In the US you generally have no coverage and have to pay a lot for treatment.

In the UK everyone’s entitled to free psychiatric care, but it’s the worst funded and worst run section of the whole NHS.

Dental care is completely free to under 16s (including braces), under 18s in full-time education, people who are unemployed or on a very low income, people over either 60 or 65 (not sure which), pregnant women (and for a year after the end of the pregnancy, however it ended) and people with certain medical conditions. For everyone else, if they can register with an NHS dentist, they have to pay but it’s nowhere near the cost of private dentists. Emergency dental care is free for everyone.

Prescriptions aren’t free unless you’re in one of the above-mentioned groups. They have a fixed cost - it’s not the cost of the drug. If you get a lot of prescriptions you can get a ‘season ticket’ which costs just over £90 for a year, so that’s the most you’ll ever pay.

Optical care is the least funded of all. Free for kids and pensioners, with free sight tests for the other groups I mentioned and some money towards the glasses themselves, but if you have really bad sight it doesn’t come close to covering the cost of the lenses. There is a scheme where you can apply for more money off if your eyesight is very bad, but damn is it difficult to apply. People who are registered blind (-25 and onwards, I think) don’t have to pay anything.

I know you didn’t ask about the latter two, but they’re also the sort of thing that’s often not covered under private insurance.

In Canada, the dividing line is whether it’s a form of health care provided by a medical doctor. So, psychiatric care is included, dentistry isn’t.

OK, we have had 4 kids born in the public system with no complaints at all. Midwives etc were great and the births were all normal. I have had two operations and spent the right amount of time in hospital and got great care. My father spent his last months in hospital and the care was as good as one could hope for.

My prescription medications are subsidised by the government, if not it would be hard to afford them.

I also have private healthcare on top of my medicare, this is due to a lot of things not being covered by medicare like dentists etc.

So any horror stories? Not really, all the ones you tend to hear are from many years ago or are from incompetence on the aprt of an employee.

Please note our health system is not free, I pay 1.5% of my gross wage and still have to pay for certain things out of my pocket. The doctor our family chooses cost more then the rebate from the government, this means we are out of pocket $20 or so each time we see him: a price I am prepared to pay. Some people will only go to a bulk billing doctor that offers no out of pocket expences and these often have longer waiting times, with mine I can normally see him with a bout 24 hours notice. I was recently at a public hospital and had to wait 3 hours for a doctor although I was triaged within 10minutes of arriving.

But I think I am safe in saying that there would not be many Australians forced to sell their homes because of doctors bills.

Dental care is provided for people with a Health Card [unemployed, pensioners etc] but is pretty bad. Most people would opt for private cover, like I have.

Psychiatric care is covered but the waiting times are pretty long, again private cover is the way to go.

We treat health like we do education, there is a perfectly good education system in Australia but if you want something a bit better then you pay for it. Seems a reasonable way to go IMO.

OH my eldest son has type 1 diabetes and the amount of care he gets is awesome. He has a dedicated unit at the local hospital and at most. He gets subsidised needles, insulin etc and meanwhile the government gives me a tax rebate on donations I make to the JDRF. So another good story!

Oh the bad bit was that his life has changed since Lantus became available but we had to wait 12 months after it’s introduction for it to be placed on the prescribed benefits program. What this meant is that if he wanted to use it before it got listed he [me] paid full price.

Hmmmm… Horror stories…

In Canada… When my wife went into the hospital to have a brain tumour removed, we had to wait about 30 minutes and fill out some forms at the admitting desk. Why didn’t they just whisk her straight in? And she had to share a room with 3 others. I mean, these people could have been just ANYbody. I doubt if they were as important as us.

Also, there was no hospital concierge, and I had to go out to buy my own sushi.

All in all, pretty horrifying.

I know - when my husband had his gall bladder out a week after a serious attack, he had to…share a room!

That whole gall bladder experience cost us (totals up numbers) nothing except the parking charges (he does have Blue Cross through his job that paid for the ambulance ride - I think it was about $200). The fight to get that paid was that he actually had to submit the receipt and wait for the cheque. Bastards.

ETA: Oh, you said that already. Okay, well, they made him…eat hospital food!

Hmmm, the one time I had to go to the emergency ward, I didn’t have my Medicare card on me, and I had to ring my mother to get her to find it and give me the number. That took about five minutes, then I waited another 10 minutes or so before a nice doctor came and stitched my wound closed. Nice of them to treat me even without the actual card, though, wasn’t it?

Sometimes my GP gets more than a half hour behind schedule, and I have to sit in the waiting room reading crap magazines. The specialists I see for a chronic medical condition tend to be pretty good with appointment times, though.

Oh, and my friend Craig had his cancer successfully treated for free, but the radiation therapy made him quite pale and sickly looking for a while. He’s better now, and working again.

Yeah, you’re getting a really great collection of horror stories from the Australian medical system. What was your point again?

In Spain dental is covered but most people prefer to go to a private dentist: there’s less arguing about whether an individual procedure is covered or not, it’s not very expensive and the hours are much more convenient. SS looks suspiciously at anybody “needing” braces and their dentists are only available in the morning, making a regime of frequent dentist visits incompatible with school and with 9-5 jobs.

My private dentist doesn’t charge for one yearly visit, one X-ray and cleaning (he doesn’t run the X-ray on every patient’s yearly visit, only in those where he thinks it’s necessary). As in, nothing, zip, zero cost. Many others have similar customs: the one my youngest brother goes to doesn’t charge for one yearly visit and cleaning but they would charge for any X-rays.

Psychiatry is covered but, since nobody has come up yet with a physical or chemical way to prove that you need therapy, it’s the hardest part to access and stay in. If you need pills for a psychiatric problem, that is easier to stay on than if what you need is therapy.

Oh: apparenly, in my local hospital getting your own room is bad news. If they can, they’ll place you in a double-occupancy room by yourself. If there are too many in-patients for that, you get a roomie. If they place you directly in a single, it means you have it bad. Both my father and my brother’s father-in-law died in room 261, several years apart.

I have a non horror story about irishbaby’s birth.

In the NHS you can have free antenatal care with your GP and midwives or with a hospital OB (the choice is yours unless the pregnancy is complicated). Your delivery is also free, as would any neonatal care your baby should need.

As most private health insurance companies exclude cover for normal pregnancy, if you should choose to go and see an obstetrician privately it comes out of your pocket. If that obstetrician works in the NHS this could mean that you still deliver in an NHS hospital for free, or if not, you may deliver in a private hospital at large expense.

After delivery you’re visited at home by midwives for the first 14-21 days - at least 3 visits, more if they feel you need it. After 21 days you get handed over to the Health Visitor- a specially trained nurse, who is responsible for your child until they are school age. They will call out to the house as often as they feel necessary, and they have a statutory right of entry.

Me- I went to see friend who is an OB in his private office- which, I admit isn’t usual, but is a fairly common favour for doctors to do for other doctors . He delivered my baby by elective c-section in an NHS hospital, and we didn’t pay a penny. I actually CHOSE an open ward- I figured if I was going to stay in hospital for 3 days with a newborn I could use some chat and company, but I could have had a single room if I wanted to pay £100 a night.

I got free antenatal care, including investigation when there was a possibility I was having an ectopic pregnancy, free treatment of Hyperemesis (including medications and a 48 hospital stay), a c-section, free pain meds, and really good support when the baby went home.

The longest I ever had to wait was the hour I spent in A&E before I was admitted with hyper-emesis, and I spent most of that hour vomiting in the ladies’ room.

During my pregnancy I was a member of a pregnancy message board with mainly US members- let’s just say that my experience was better than many of their experiences, especially the ones who were down-sized during their pregnancies and lost their insurance.

What about the DEATH PANELS!!??

The folks on the Death Panels get Life Insurance as well as Health Insurance, it’s a package deal.

Well, this is my best shot.

I had my three babies at a large public hospital nearby. The first one in the ordinary labour wards, the second and third at the midwife-run Birth Centre on the floor down.

The first one was an ok sort of birth experience, except that it was induced which in hindsight I think probably wasn’t necessary, but oh well. But the Birth Centre for the next two was great - the midwives were really professional and supportive, my husband got to stay in overnight with me the first night, the atmosphere was calm and peaceful. It was good.

Last year, when the hospital moved to a new site, the Birth Centre got closed down. Bastards! Just as well I don’t plan on any more babies.

Wait list to see a psychiatrist here is 8 months, unless you’re suicidal or a danger to others. If you’re having crippling panic attacks that prevent you from attending work or functioning as a normal human, they’ll try to fit you in in 2 weeks.

Took the 4 hour trip home where I was already in the system. Went on Sunday night, Monday morning saw my family doctor who got me in to my psychiatrist that afternoon (it would have been morning, but unlike the city above, the emergency room has psychiatrists present and it was his rotation).

I cut my little finger while washing dishes (the glass I was cleaning shattered in my hand), and since the cut was pretty big and bleeding a lot, my husband insisted I should go to the hospital for stitches. Since there is a hospital about 500m from my house, and it was past 10pm on a Friday night, we went there. That did turn out to be a bad idea, though, because while this place does have an emergency room, it really isn’t the main ER in the area, and so was quite understaffed. There weren’t too many people in the waiting room, but any and all ambulances that arrived got seen before anyone in the waiting room, and the ER doctor was also on call to treat any emergency cases in the rest of the hospital overnight (the staff admitted that this was a very unusual circumstances, and it was just bad luck that the second doctor hadn’t been able to come in or be replaced that night).

I was triaged, but that nurse wasn’t allowed to tell me whether she thought my cut needed stitches, since only a doctor can make these sorts of determinations. We settled into the waiting room, but after 4 hours, we gave up and went home, since not a single person had gone through yet (though there were several ambulances). I figured I’d just go to a clinic the next morning, but by then the bleeding had slowed and I was able to bandage my finger up well enough to sleep.

In the end, I never did see a doctor. The cut was a slice, a flap of skin like a partly-cut slice of bread, and so using my first aid kit at home, I just cleaned it twice a day and taped it back into position. It’s healed completely, and you can barely see a scar. My aunt is a psychiatric nurse, and I happened to see her the next day - she said if it hadn’t been stitched up in the first day or so, there really was no point in seeing a doctor any time after that.

So that’s my horror story. A smallish cut on my little finger didn’t get treated.