That’s a fine leap of logic. NHS waiting times relate to seeing a consultant, not a GP. Are you suggesting patients are being referred to specialists when the don’t need the care? :dubious:
Go on - admit it. You’re making this up as you go along…
Yes, and badly. We don’t have a single default health plan, unless it’s the Third World theory of just getting sick and waiting for charity.
So, you want a system where the government makes you buy for-profit insurance, but at least it will try to regulate those guys? And this makes sense to you? What do you have against the efficiency of single-payer?
Preferable to triage? No, you’re just wrong here. The beauty of triage is that it’s need-based management and rationing of care. Put money in the system and you suddenly have two rationing systems fighting each other. Does the hospital choose to make more money or provide better care?
I understand the appeal of a nominal co-pay to make patients delay getting care (which doctors just *love *:rolleyes:) or to screen out the time-wasting hypochondriacs (which end up being identified by triage nurses anyway). But it really hurts people without real disposable income. Give us a Basic Income Guarantee before you start with that mandatory co-pay stuff.
“Delays in care.” In the UK? With its incredibly cheap private care for those that want to jump the line? Yeah, maybe, because topping up can be a pain due to regulations; but that’s a matter for internal reform of those regulations, not a credible reason for scrapping NHS.
…32 countries have universal healthcare. When you provide some evidence that the UK is the most centralized, directly government-run health care system in the free world then your assertion would have evidence. However “common knowledge” is not evidence. It is evidence that you continue to just keep making shit up. So yes: your assertion is without evidence until you actually provide some evidence.
There are plenty of other places in the world where doctors are employed by the government. So once again you are talking nonsense.
Show me where people are “wanting to make the US system look bad” and not actually showing that the US system is bad. You are continually trying to show that the NHS is bad over and over again. But you aren’t doing it because you can prove that anything is wrong with the NHS: but because you want the NHS to look bad. What exactly is your motivation?
This, like everything else you have written about healthcare, makes no sense.
It could also be that too little is spent, there aren’t enough doctors, and they are underpaid. Or perhaps Brits live less healthy lifestyles than Swedes and French. I don’t know whether they do or not, but I do know Americans live unhealthy lifestyles and that, more than our health care system, is the primary reason for our poor health compared to other countries.
I honestly see very little difference between the Swedish and British systems. I’ve lived for 25 years in the UK and 12 in Sweden. I’ve been a type 1 diabetic for 19 years, meaning I have seen a fair amount of both systems. I’ve waited for some stuff in both countries, I’ve also been seen immediately in both.
This is, of course, getting away from what the point of my post was. That Sweden’s system is rather centralised with the majority of Doctors employed by the state, something which you seemed to be saying was pretty unique to the UK and was one of the prime reasons why, in your opinion, the British system is poor.
As someone that has extensive experience of the NHS, I’d say the biggest problem it is facing is overhead due to an ever-increasing amount of non-medical personnel as they attempt to run it more like a company than a service.
I’m sorry. I hereby apologize to hibernicus. I thought that Gibraltar was part of “the United Kingdom of Great Britain, Northern Ireland, islands galore and several other places”* and that Spain was not, but apparently Spain is not just part of the aforementioned political superentity, it’s part of Britain!
Man, that sends everything I ever thought I knew about geography down a huge drain. :smack:
/snark off, Spain’s network of public hospitals and healthcare centers is the employer of the immense majority of our doctors, nurses and so forth; the government managing any given one will usually be the regional one, but it’s still the government and people working for it still count as being “in-house” for purposes of, for example, asking for a move to a different location.
(bolding mine)
The mutual insurances aren’t compulsory, nor deducted from your paycheck. Many people go without. Also, complementary insurances aren’t all not for profit mutuals. Private for profit complementary insurances exist and they tend to be cheaper. I still avoid them like the plague because there’s a reason why they’re cheaper despite making a profit (and also because I like the concept of mutual insurance. Even though I never bothered to vote to elect the board or attend a general assembly)
What is compulsory and deducted from your paycheck is the basic public healthcare insurance scheme (technically it isn’t a tax because the system isn’t run by the government but by an entity headed by representants of employers and unions, but this doesn’t makes much of a difference in practice).
(Note that mutual not for profit insurances are also widely used for house insurance, car insurance, etc…That’s a feature of the French insurance landscape)
I’m not convinced. In France, the co-pay is nominal for many generalists (the most common care) and public hospitals (the most costly care). There might be significant co-pays in private clinics (but there’s almost never any reason why you would have to go to a private clinic) and more importantly specialists (that you can’t avoid). Some drugs requires a co-pay, others don’t.
Someone mentioned that it amounts to a 30% co-pay. I’m a bit surprised that it’s so much given the above, but not knowing the detailed structure of the medical expenses in France, I assume it could be true. Plenty of people do go to private clinics for routine procedures for instance because they’re more pampered there and it’s covered by their complementary insurance anyway. And the co-pay for drugs (again often covered by complementary insurances) possibly amounts to a lot of money.
But I’m not sure it prevents people from excessive use of healthcare. Having to pay €2 from your own pocket isn’t going to prevent you from seing a doctor every day if you really want to. I’m pretty convinced that the very wide majority of people won’t overuse healthcare, because most people don’t exactly enjoy seeing a doctor or going to the hospital. Free surgery isn’t in any way similar to, say, free bread or a free car. The interest in abusing the system has to be low.
So, if there are shortages in a given country, I’m pretty convinced the issue is on the offer side, not on the demand side. I can’t prove it, though.
Incidently, the widely published waiting times on the NHS can be highly misleading as well- in february, I needed surgery for a herniated disc- I was referred to a consultant within a week of deciding that yes, I did want the surgery (until then it had been unclear if it would settle by itself, so avoiding the risks of surgery, but it suddenly got worse, risking nerve damage).
The consultant actually told me the official waiting list at the hospital was approx 10-12 weeks at the time, then asked me if I’d rather stay and have the surgery that evening, or come back in the following morning. I was the worst case waiting, so got priority. Treatment on the basis of need.
Incidently, I think it’s nonsense to claim that because the NHS doesn’t always cover all possibe available treatments people here don’t find out about them- we do have this thing called ‘the internet’ here, and it’s a sort of semi-regular thing for local papers to try fundraise for experimental treatments for someone (or woo ones, but I digress). Once a year or so maybe, I come across one of those in the paper, but I’ve never met anyone personally whose treatment wasn’t covered; I’ve been asked much more often for money towards a known treatment for someone in the US, despite not living there.
My mother had surgery this same week. In May, when she was told it seemed the best option, she was asked whether she wanted to have it done in the summer or in the fall. She chose the fall.
The way waiting periods are calculated here (which may not be the same way in other places), she’s waited four months and could have waited seven while still being within the date range she chose. If she’d picked the summer she probably could have selected the date so long as it was between mid-july and mid-august (the heaviest vacational period).
Herpecin is actually a good example of how and why the system outperforms the US. Treatment restriction in the UK is based on cost/efficiency of treartment. In the US, it is based on profit/expense to the insurer. When herpecin was denied, there was a media outcry, and it was reinstated. If that had happened in the US, no insurer would have reinstated it. The Uk system is sensitive to consumer pressure.
Economic orthodoxy is that health care is badly unsuited to market delivery. This was parth of Kenneth Arrows work on uncertainties for which he got the 1972 Nobel Price in economics.
Among the strikes against health care in a market environment is that its rife with externalities -if an insured person is admitted to hospital, neither the hospital nor the insured person bears the cost of treatment. Thus, the fundamental brake against overprovision is removed.
Also, it has no price elasticity. Price elasticity represents the customers ability to not purchase a serivice, if the price is too high. If your kid has cancer, you will pay anything. Hence, a fundamental market mechanism for correcting unreasonable pricing is not present.
In addition, barriers to entry are present. Barriers to entry means that it is very difficult for any small businesses to enter the market and compete with the large established businesses. It is just too expensive to get a toehold in the market. This means that the basic market mechanism where a provider that does not perfom efficiently gets eliminated is severly weakened. And it is far more profitable to form cartels and increase prices than compete for customers.
The US system is far less responsive to consumers.
To be nit-picky, in US terminology the 30% would be coinsurance. Copays are X dollars per visit, payable at the time of service. Coinsurance is X percent of the amount allowed by insurance, to be paid after they process the claim. Maybe France fixes X percent of the cost of a service from some fee schedule as a copay, but that’s not usual in the US. (In the US the other difference is coinsurance always counts towards the out-of-pocket maximum, while copays may or may not).
[QUOTE=Chris Wickham - Reuters]
A British woman paralysed from the chest down by a horse riding accident has become the first person to take home a robotic exoskeleton that enables her to walk.
Although bionic exoskeletons have been used in hospitals and rehabilitation centres, Claire Lomas is the first to take the ReWalk suit home for everyday use.
[/QUOTE]
It’s not clear in the Reuters story whether NHS funded it; but whether they did or not, if Britain is leading us in this kind of application, that’s a strike against our system being better at cutting-edge care.
One thing I noticed in discussions of this issue two years ago is that private care is a lot–maybe an order of magnitude–less expensive for patients in Britain, as a side effect of the effectiveness of NHS.
That may be true. I don’t think the re-walk suit is available on the NHS (yet). Certainly wheelchairs and associated treatments are provided free but I think this lady raised £43,000 to buy the suit privately. It is a good advert for the private and NHS working in conjunction.
It sounds like you know what you are talking about. You best go edit the wiki article on it.
The NHS provides a lot of private health care and also trains the doctors. Also it is used by the private sector as a backstop. If things get tricky with a patient they’ll be whisked off to the nearest NHS hospital (if they are not already on a ward in one) as they are much better equipped.
Private hospitals tend to be pretty small scale affairs in the UK on the whole. My secretary once went and worked for one. She quit after a week as she found that at night she was actually the only member of staff in the building and expected to take on medical stuff if emergencies arose. By dialling 999 and asking for an ambulance.
Also I don’t buy ‘excessive use of health care’ being encouraged in public health systems. And even if it was I’d take it over the ‘excessive under-use’ of the US system but the uninsured and the insured victims of insurance company denial policies.