This is called bed-blocking or ‘delayed discharges’, and is a particular issue here at the moment, having risen 42%. Apparently there are a significant number of patients stuck in hospital who could go home if there were someone to care for them. Unfortunately because of the cutbacks in Social Services and the increase in the number of households where both adults work, these patients can’t be transferred from the hospitals.
I’ve been thinking about traveling, and just remembered that China was an interesting case.
In the late 1940’s China started a system of co-operative health care funding,: individuals paid most of the cost, and the commune contributed a smaller fraction. By the end of the 70’s, most (90% ?) of rural China had this kind of cover. (Arguably, it replicated and extended the role of private co-operative benefit schemes, for which the Chinese were well known)
In the 80’s, huge numbers of people left the country and moved to the city, leading to the collapse of the health scheme (and the end of the Iron Rice Bowl, the universal social security guarantee).
China started trying to rebuild their health cover scheme in the 90’s, but AFAIK, it’s still less universal now (in 2017) than it was in the 70’s.
This was alluded to in an earlier post. Patients are kept in a £400 a day hospital bed because there is no bed in a care home at £100 a day.
Hospital beds are funded by the NHS, while care home beds are funded either privately, or by the local authority. LAs have a vast number of services to provide from their limited resources, ranging from Police through refuse collection to fixing the roads and the reduction of funding for care of the elderly has often been a ‘soft’ target for cuts.
Many people, myself included, would like to see what is essentially an extension of medical care, transferred from LAs to the NHS.
@GMAN… Yeah, right. I’m sorry to hear that you had a bad experience in Ontario, but your assessment of our system is way off. I also have a personal story. I’m from Toronto. I had a routine ultrasound in 2015 to monitor my fatty liver. It was a Saturday. The tech noticed what appeared to be a tumor on my kidney and called my family doctor to let her know. She called me that same day and told me it sounded potentially serious and wanted to schedule a better scan. She had already called a nearby hospital and they made an appointment for a CT scan about 2 weeks later as well as an appointment to a local kidney cancer specialist just after that. My doctor thought the CT appointment was not fast enough though, and called a couple of more places after talking to me.
She got me an appointment at another hospital at the end of the following week (5 days?). I went to see the specialist 2 weeks later, and at the first appointment, based on the CT results, he scheduled surgery surgery 6 weeks later. He also scheduled a biopsy and said if the biopsy results came back as non cancerous, then he would cancel the surgery. I got the results back less than a week before the scheduled surgery. It was aggressive cancer, as the doctors had suspected. A few days later, I was under the knife, and he ended up removing the entire kidney once he got a good look at the tumor. In my opinion, the system worked as it was supposed to. It would have been difficult to get faster service. In the best of all possible worlds, I may have got the scan within a day or two, and then met with the specialist within a day or two, and then the biopsy done within a day or two, then the results of that within a week (I was told my particular biopsy needed longer in the lab for some reason… can’t remember how many days they said were needed after the biopsy to get results). Once biopsy results are in, if surgery required, then surgery within 2 weeks would be very fast. If that all happened that way, it would have taken maybe 4 weeks from discovery to surgery? In my case it was 8 weeks from discovery to surgery. I would love to know how long it would have taken in the US… I’m certainly not sure it would have been less than 8 weeks from discovery to surgery. Moreover, if I was American without insurance, forget about 8 weeks… how about no doctors visits and death from kidney cancer within a year or two… and for all of that, I was billed zero dollars by the health system.
The main difference between my story and that of GMANCANADA is the role of his family doctor. First off, the doctor may not have been that worried about the cyst for some reason. CT’s are more common, faster, and cheaper, and hence have shorter wait times than MRI, so why did the doc not order a CT? Should be able to determine the nature of the cyst using CT. Also, as you mentioned, when you complained and she “made a call” and then you had an MRI within 2 days… so that tells me that the doctor did not do that in the first place because she was not worried that it needed to be looked at immediately. If she did think that, then the simple answer is that she was too lazy to make the call to request an emergency appointment, which she obviously did later on… if that’s the case, then it’s not the system that’s broken, but just a crappy doctor. Our entire system is based on triage… when a doctor believes something needs to be looked at quickly, they can “make the call” to request you “cut the line”. The system is prioritized based on need rather than first come first served. The doctors do it every single day. If you think the doctor has not made the right call, and has not escalated it sufficiently, then it’s your responsibility to insist with your doctor that the wait time is too long and ask them to intervene… which is what you did, and it worked. If they refuse, then ditch them and go see another doctor.
I personally know a few similar success stories in Toronto. (i.e. super fast triage of a patient from first doctor contact to surgery)… so why is your story more important than mine?
Rather than suggest we dump our system, you should instead suggest that people in places like me should make sure they advocate for themselves and hold their doctor accountable if they feel the doctor is not serving them well. It’s all you had to do. It’s not a lot to ask compared to what some Americans are asked to do… i.e. asking someone to mortgage their house if they do not have sufficient insurance to cover a serious illness. That’s just shameful.
In my opinion, rather than introduce a private system, we need to increase funding to the existing health care system to include prescription drugs and dental care as well as to help reduce wait times for things like MRI, etc… a couple of extra thousand per person per year should accomplish that.
Also, there has been no serious attempt to repeal Canada’s health care system, which has been in effect for decades. If any party were to campaign on the issue, they would lose the election by at least 80% to 20%… there’s a reason why no politicians in Canada are crazy enough to suggest repeal of universal health care. It’s an extremely popular program with the vast majority of Canadians. It’s popular for a reason… it’s because most Canadians disagree with GMAN. I guess GMAN is in the 20%… I’m guessing that many in that segment would actually be worse off if they did go to a private system, but hey, the grass is always greener on the other side right?