UK's healthcare top of league table out of 11 western countries. US = last

[bodie]

When i was a little girl i used to think the hospitals were gifts from the Queen.  I don't think i understood the meaning of the word 'national' and i knew the national anthem was a song  for the Queen and so when i used to hear adults moaning about our national health service' i used to think to myself "our Queen is a meanie"

[bodie]

Wow, really thought the hospitals were completely divided between public and private. Didn't realize the NHS is so underfunded it also services private insurance, giving first priority to patients who can pay. Doesn't that piss people off? Hasn't everyone already paid?

http://www.mirror.co.uk/news/uk-news/nhs-hospitals-performing-private-operations-2286913

The Mirror is a tabloid newspaper that supports Labour.  The Sun is another tabloid but shows favouritism to The Conservatives.

None of the tabloids are credible.  The Mirror has an agenda to persuade the public to vote Labour at the next election.  It is trying to anger the British public.  There may be a tiny element of truth in the story but most of the story is not official.  The only official quote they have is kind of contradictory to their story

But a Department of Health spokeswoman said: “These figures need to be put in context. The private income quoted is less than 0.5% of the NHS budget for 2013/14.

“This income must be reinvested back into NHS services and patients will benefit from increased investment in facilities and new technology.

"The Health and Social Care Act ensures that services for NHS patients will always come first and that the responsibility of any NHS organisation is to provide NHS services and any private work is supplementary.

“Any patient should be seen in order of clinical priority. Average waiting times are low and stable, and the number of patients waiting longer than 18 weeks is nearly 55,000 lower than in May 2010.”

If you look at one of their shocking statements  "Under the controversial NHS shake-up, hospitals can now earn up to 50% of income from private work."  Note how they say  'can'.

and
"He said there was growing evidence that patients are being forced to go private because they are being turned away from the NHS or spending so long on waiting lists." 

It is a cleverly worded article but the 'growing evidence' is not included.

"Dr Clive Peedell, co-leader of the National Health Action Party, said lifting the cap on private treatments would see a rise in waiting NHS lists."  even this man who is a co-leader of the National Health Action Party only states the the would be consequences.  BTW the National Health Action Party is just a micky mouse group of people with no official status.

In a nutshell,  the tabloid press are notorious for political bias, gossip, hearsay tittle-tattle.  I include the Daily Mail in that list although it believes it is above the tabloids.  It's not. 

There are a few credible papers,  and the aptly named 'Independent' would be my paper of choice if i wanted truth.

[bodie]

I would not tell ANY country to copy our universal health care.   I would say that any country considering this should really look closer at all the other places in the world that do it so much better than us.

Italy, Greece, Spain etc.  I think Iceland has no private healthcare, certainly no private hospitals. 

I think introducing this system in the US would also be a logistical nightmare.  Like it has been pointed out,  the power shifts between political parties quite often (like here) and it might suffer the same fate  -  it gets funded correctly for a few years and then it gets stripped of cash.  The US is HUGE compared to the UK and i can't think of many other places of such a size that could be comparable.  Maybe Russia.  I know they have inherited the old Soviet system ( communism!)  but now has a private sector too.  I don't think it ranks highly at the moment but Putin is improving this area.

I also doubt the political climate in USA is the right time to implement a universal health system.   If you look at the birth of the NHS it was a different time altogether.  1948 / 49  -  a massive rebuilding and restructuring was implemented at the end of the war.  You know that saying "if you want something doing then ask a busy person".... there had been talk of a national health service before the war.  About twenty years previously the UK bought in the National Health Contributions system which gave every working man/woman an allocated GP.  There was an awful lot going on and i honestly believe if we hadn't done it when we did it would probably never have happened.   There was still much squalor here left over from the Victorians and the bombings.  The public politely 'demanded' it and mostly the whole of the Medical Profession backed it.   It was a huge undertaking.   The climate in the US is not the same.

[bodie]

This map shows life expectancy rates by country.  The UK is only slightly higher than the US.

I was shocked to read that a man born in Japan can expect to live to about 82 compared to parts of Africa which is only 47 years old. 

That just sucks.   

[Jack]

The Mirror is a tabloid newspaper that supports Labour.

Thanks for making that point. Never really know what sites are considered reliable sources in the UK. There's actually a large number of articles on the web claiming basically the same thing, the NHS has been legally allowed by current legislation to subsidize its income by catering to the private sector for up to 50% of its income, when before it was very restricted to 2%. How can the NHS serve the private sector when there's a waiting list for people who can't pay? Can't understand how something like the NHS gets away with charging patients at all, much being allowed to accommodate half of their beds to people with private insurance.

[Jack]

I would say that any country considering this should really look closer at all the other places in the world that do it so much better than us.

Think it's better when countries look at their own issues. What works in one place doesn't work it others. Wouldn't suggest the UK should get rid of the NHS any more than would suggest the US needs one. Just don't think either one is necessarily better than the other.

[bodie]

The Mirror is a tabloid newspaper that supports Labour.

Thanks for making that point. Never really know what sites are considered reliable sources in the UK. There's actually a large number of articles on the web claiming basically the same thing, the NHS has been legally allowed by current legislation to subsidize its income by catering to the private sector for up to 50% of its income, when before it was very restricted to 2%. How can the NHS serve the private sector when there's a waiting list for people who can't pay? Can't understand how something like the NHS gets away with charging patients at all, much being allowed to accommodate half of their beds to people with private insurance.

If it has been going, and nothing would surprise me, it is because it is not in safe hands at the moment.  It is governed by people who favour a private system.


It is unlikely to catch on as  you would feel short changed if you paid privately and ended up in an nhs hospital.
It is really the hospital that people pay for.  Private hospitals are generally known to be much better.

Can't understand how something like the NHS gets away with charging patients at all, much being allowed to accommodate half of their beds to people with private insurance.

All people with private policies have paid their way to nhs services as well through their taxes.  People with private insurance pay twice.

[bodie]

I would say that any country considering this should really look closer at all the other places in the world that do it so much better than us.

Think it's better when countries look at their own issues. What works in one place doesn't work it others. Wouldn't suggest the UK should get rid of the NHS any more than would suggest the US needs one. Just don't think either one is necessarily better than the other.

The nhs has been a good way to bridge the gap between rich and poor.  It is supposed to produce equality in health care.  It has done this in some areas.   This is vital for poor people in the UK.  You are all born equal in the US.  In the UK it is much harder to break out of the class system and the old boys network. 

[Parts]

This map shows life expectancy rates by country.  The UK is only slightly higher than the US.

I was shocked to read that a man born in Japan can expect to live to about 82 compared to parts of Africa which is only 47 years old. 

That just sucks.

The luck of the draw starts with where your born then moves onto how much money your parents have it seems

[El]

The NHS is being destroyed by pliticians, as Adam and others have pointed out. Rather than interpreting that as a cue to allowing private health insurances to replace national healthcare, it should be a wake-up call to fix the problems. Your system only works for those who can afford it.

That study was a ten year study. 60% more likely to die in 2004, currently only 45% more likely to die than hospitals the US. The NHS has never been run or funded properly because it's run by the government. The private sector is the only thing about the UK system that works well, and that's for people who can afford it. nationalized health is a crap system only the wealthy can afford to get away from. That's the point have been trying to make; the government shouldn't be trusted with public health. You're making that point for me, by agreeing the government is destroying it's own system. The private sector does everything better than the government. The US system works for everyone and poor people with public coverage have access to the same health system as people with private coverage. The system just has some financial problems to be addressed, and they are being addressed, without dividing the medical industry by class.

oh jeebus.  There's so many things wrong with that comment I don't know where to start.

[Jack]

:shrug: It could have been worded better.

[bodie]

I found this.  It is a long read.  If anyone can be bothered.  Maybe just try reading the bold bits.

It is written by an American woman who lived and worked here for fifteen years but now resides back in America.  So her perspective is unlike others here -  she has had real experience of both systems.   She points out things i had not considered. 

http://potentialandexpectations.wordpress.com/2009/08/13/this-americans-experience-of-britains-healthcare-system/

As the healthcare debate picks up pace, I find myself being asked with increasing regularity what I think of Britain’s healthcare system.  Six months ago, I’d have jumped into the answer with gusto, but these days…  I don’t know, I am just so fatigued by all the fear-mongering and hysteria, the ignorance and the downright idiocy of the current debate that I can hardly summon the energy to add my voice to the cacophony.

But the other night when a friend of my mother’s emailed me and asked that now-familiar question — what was my experience and what did I think of British health care? — and I was surprised to discover that, once the initial weariness had worn off, I found myself turning her question over and over in my mind, composing my answer.  When I sat down last night and started my reply, the words fell out me, my fingers tapping rapidly at the keyboard and my mind so engrossed in the assignment that I was stunned when I finally looked at the clock: it was 2.30 in the morning.  I had been so consumed because what I had to say had been bursting to come out, an outraged truth that was tired of being bottled-up and was begging to be told.

When I lived in the UK, I railed against the NHS (the National Health Service).  I cursed every delay, every perceived inconvenience, every way it differed from the care I had received in the US.  But I moved to the UK only a few months after graduating from university and, until then, I had been covered on my parents’ very generous insurance so I had experienced American healthcare only as a dependent.  I was judging my British experience from a lofty and privileged position of someone who’d always had gold-plated insurance.  And I was naive, because I’d never had to pay for it, never had to worry it wouldn’t be there, never really had to deal with the paperwork.  I never really understood what I was comparing the NHS to at all.

I also realise with hindsight that a lot of what I held against the NHS had nothing to do with the system itself and actually were issues that could happen in any system.  I blamed the whole system when the loo in my local doctor’s office or hospital wasn’t clean enough.  I blamed the whole system when the only space I could find at the hospital carpark was miles away in the very furthest corner.  I blamed the whole system when the doctors’ receptionist was grumpy or I didn’t much like my doctor’s manner (or his diagnosis).  But the truth was that I believed in the healthcare system I had grown up in and I didn’t like the idea of socialised medicine — I didn’t like socialised anything — so I saw problems with it where-ever I chose to look.  And I held onto that belief right up until I arrived back in the United States, and discovered that grumpy receptionists and dirty hospital bathrooms and annoying carparks can happen in any system — because they have nothing to do with the system itself.  They’re management issues, human nature issues, and they happen everywhere.  And a lot of the fear that Americans have about change in their healthcare actually center around these kind of issues that have nothing to do with the system itself, be it socialised or for-profit.

So my return to the US and my sudden immersion in the American healthcare system was a rude awakening for me and it made me look at both systems a little more realistically.  There are great things about healthcare in the US — great things — and I truly do believe that the quality of the care here is second to none.  But there are great things to be said about Britain’s system as well and the trouble is that, at present, far too few people are saying those great things and far too many here in the US are beginning to believe utterly ridiculous things about the NHS.  Let me play a small part in putting that right by outlining my experience of the British healthcare system.

    First, I’ll start by pointing out that the NHS is truly one of the most socialist — almost Soviet — healthcare models that a country could possible choose. Unlike the health systems in France, Germany, and most of the rest of the developed world, it is totally government-run, almost totally centrally-controlled, and supported entirely through taxation.  It is mammoth — the single largest employer in Europe, which is incredible when you realise it serves a small country with only 60million people.  And with that kind of size come huge problems — consultation times are too short and it takes too long to get test results, amongst other things.  It is not a perfect system by any stretch of the imagination.  But it’s important to realise that when I talk about my experience, I am talking about the kind of system that truly is the very far extreme of what the nay-sayers are claiming will be the end result of public health provision in the US.  The British system is the very stuff of their nightmares and yet, the truth is, it’s nothing like what they imagine.
    My healthcare in the UK was never dictated by a bureaucrat.  Decisions were made by me and my doctor alone, and whatever we decided was the right course of action was the course that was taken.  The scope of care available to me was far, far wider than what is covered even by the ‘very good’ insurance policies I’ve had here in the US.  There were no limits on the number of times I could see my doctor, or the number of tests/procedures/consultations/etc that I could have in a year (or month or lifetime…) Whatever was deemed medically necessary by my doctor was covered — period.  In fact, I’ve experienced a lot more limitations on my care since I’ve moved back to the US — the most memorable of which was when I had to beg the insurance company to cover a single visit to a nutritionist when E2 was diagnosed with 12 food allergies and was severely underweight.  That simply never would have happened in the UK — if she needed it (and she did), she’d have got it (as her sister did after being diagnosed with a single allergy). To illustrate the point further, when I gave birth to E1, I stayed in hospital for five days because she had problems with breastfeeding — and that was entirely my decision.  I was free to leave hospital whenever I wanted, be that after one day or after a week, and I had the full support of the midwives to stay until they were sure we were breastfeeding properly and ready to leave — no administrator/bureaucrat/insurance company made that decision for me!
    There are delays — there are delays — but to be honest I have experienced delays just as bad here in the US. In the UK, I might have to wait weeks or months to see a specialist if my case was not urgent, and that was frustrating.  Here in the US, when I was in excruciating pain last year (so bad that I lost control of my bodily functions when the pain hit), I was referred to a breast surgeon by the ER doctor (7 hour wait in ER) — but the trouble is that we had to call five medical centers before we could find a surgeon who could see me any sooner six weeks, and even then it was only because they had a surprise cancellation.  And the last time I needed to take E2 to the allergist here in the US, the earliest they could fit me in was two months later.  There are delays in both systems.  And by contrast, you can get very speedy service in the US… and you can get it in the UK too.  When I needed to see my GP in the UK, I rarely had to wait until even the next day.  When I thought I’d found a lump in my breast, I saw the doctor the next day and was sent to a specialist within the week.
    I had my choice of doctors.  My small rural town had two GP offices (a GP is a General Practitioner, a family doctor) with about 5 GPs in each office — I could choose either office and any GP in that office I chose.  I could choose to go to the GPs office in a neighbouring town if I prefered (though some offices limit the regional area they’ll cover).  I could change GPs at anytime for any reason, no questions asked.  When I had my babies, I had my choice of any of the hospitals in the region, or a homebirth (the midwives in my area loved doing homebirths!).  When my GP referred me to a specialist, he’d send me to whomever he thought best, but if I wanted someone or somewhere else, I could request that, no problem.  And I always had the option of a second opinion, either through another NHS doctor or a private doctor.
    I never once received a bill in the UK.  There are no copays, there are no deductibles, there is no such thing as max-out-of-pocket. I have an NHS card which I showed at my GP’s office when I registered, and from that point on, I never had to fill out any forms or show any ID ever again. In fact, I think I lost my NHS card years ago — I have no idea where it is. It doesn’t matter — I don’t need because I am covered for everything once I am registered with my GP.  When I stepped on a piece of glass and sliced up my foot, I went up to the local hospital, was seen immediately (rural hospital on a Tuesday afternoon), they took note of my name and address, patched me up, and I went home — simple as that.  No bills, no paperwork, no hassle.  Yes, Brits pay to cover it in their taxes, but the cost spread across the entire country and so it isn’t nearly the burden that insurance is for Americans.  In fact, Brits spend only 8.4% of GDP on healthcare, compared to the 16% of GDP spent by Americans and what they get back is a system beats the US on so many basic measures of healthcare results.  This is good quality care.
    Brits believe that healthcare is a human right and are happy to have a system that covers everyone, all the time. They are HORRIFIED when they hear stories of Americans who have to hold fundraisers to pay for desperately-needed operations.  It blows their minds that anyone goes bankrupt or loses their home because of medical bills.  The idea that someone would lose their coverage because of a pre-existing condition or because they are so sick they can’t work is totally alien to them.  These things simply do not happen in Britain.
    Even with a comprehensive healthcare system that is available to all and completely free (at the point of delivery) the UK still has a healthy private system running alongside the state system.  There are numerous large private insurance companies providing private health insurance to those who’d like to have it (or whose companies want to offer it).  There are private hospitals up and down the country.  Most specialists practice both within the NHS and also privately (they split their weeks).  You can pretty much get your healthcare however you’d like — on the NHS, through private insurance, or paid out of your own pocket.  I hear people in the US saying that with in the British system, you can’t see anyone but your government-assigned doctor, but that is totally untrue.  And you can chop and change your care as it fits your life — I’ve had my care for an medical issue start on the NHS, and then switched my care to my private insurance if it suited my needs better.  I’ve had other medical issues that I stayed with the NHS for the whole way.  And when my husband had an elective medical procedure done that was covered by neither the NHS nor insurance, we simply paid for it out of pocket.  It’s a flexible system and the private sector has not been quashed by the fact that there is a comprehensive, free public system running alongside it.
    Because healthcare is not tied to employment, companies are free to focus on their core business and people are free to make career decisions (and life decisions) based on what is best for them instead of what preserves their healthcare.  Brits never worry about keeping their healthcover — they never worry about pre-existing conditions; they never worry about continuity of care if they change jobs; they never get trapped into a bad-fit job because they have to keep their healthcover. They are much freer to be entreprenuers than Americans, because their only worry is whether their business will succeed, not how they’re going to provide healthcover for their families when they’re self-employed.  Companies, particularly small companies, are free to focus on their core-business because they not burdened by the administration of healthcare for their employees — they never have to pay someone in HR to manage health benefits; they don’t have to juggle insurance companies and negotiate lower premiums; they don’t lose employees because their healthplan isn’t as good as some other company; they don’t see their bottom line rocked by a sudden rise in premiums.  Decoupling healthcare from employment is hugely freeing to both individuals and employers, and can actually a very good thing for the economy at large.
    When things go wrong, the government answers to the people in a way that insurance companies never do.  For example, there was a cancer drug called Herceptin which was not covered on the NHS because of the cost.  A group (led by Ann Marie Rogers) began a campaign to change this, suing their local health trust, and gained huge public support.  They ultimately won their case and got their local trust to offer the drug — but because of the political pressure this campaign had created, the government extended the drug to the entire country.  Imagine trying to convince an American insurance company to cover some expensive drug that they don’t want to cover, and then having that decision convince every other insurance company to do the same.  And again, when I moved to the UK fifteen years ago, wait times in the NHS were much worse than they are now — but the public got fed up with it, made their voices heard in the General Election, and the new administration made cleaning up the NHS one of their highest priorities.
    There is an emphasis on preventative care and the simplest way this happens is that people actually go to see their doctor when they are sick.  Because there’s no cap on visits and no copay and everyone is covered, hardly anyone hesitates to go to the doctor when they need to, which gives them a chance to catch little issues before they become big issues and spot contagious diseases before they spread to the rest of the population.  And here’s another way the focus is on prevention: when I had my babies, the midwives came to my house to check on us every day for the first 10 days after the baby was born, and then the Health Visitor (a community nurse) came to the house once a week for six weeks, and then I could go to her clinic (held once a week in town) for as long as I wanted after that with any concerns I might have (as well as being able to see a doctor — my choice).  It’s all done to ensure the mother and baby are healthy and well, to support breastfeeding, and to catch problems as early as possible.  I was utterly shocked when I found out that most new mums in the US are simply sent home with their babies, with no follow up in the first six weeks, and left to muddle through as best they can!
    None of this actually tells you anything.  Isolated anecdotal stories (like these) don’t actually give anyone the information they need to decide the merits of one system over another.  All it does is tell you whether my particular doctor was good or bad, whether the nurse I encountered was having a good day or a bad day, whether the receptionist liked her job or hated it.  There are good stories and bad in both systems, and it just depends on who you talk to.  It’s much like public schools. You could ask parents across the US to tell you what they think of their kid’s school and you’d get a whole spectrum of answers: some schools are good, some are bad, some districts are rich, some are poor, some teachers are passionate, some have lost the will to live. But none of these things tells you whether the overall concept of publicly-funded schools is a good or bad one. If you drew your conclusions based on a bunch of stories from a handful of people about their personal experiences, you’d only be getting part of the story. And it’s no different with the concept of public healthcare.

I can sum up my experience of the British and American healthcare systems in one simple sentence:  given a choice between the two systems, I’d choose the NHS in a heartbeat.  And though this is the experience of only one single person out of millions, unlike so much of the propaganda and hysteria surrounding the current healthcare debate, it is the absolute Gospel truth.

———————-

Addendum:  This is an incredibly important issue with a lot of misinformation flying about.  If you have experience of both the US and UK healthcare systems, I invite you to please leave a comment here and let us all know what you think of both systems.  This debate needs more voices of experience and a lot less uninformed fear.

The nhs runs much better under a Labour government.  So, yeah, the government, and the changing of it every few years is its main problem.  I think things would be much worse if our healthcare here was totally private.  Fat cats making huge profits while people become bankrupt in order to stay alive.   

Also,  the assumption that the Private clinics in the UK get better results is far from accurate.   There are some fields Private Clinics boast better results.  Fertility, or IVF is one.  They are also credited with being the best in hip replacement, knee replacements etc.  Cosmetic surgery, dentistry and laser eye surgery too.    When you come to look at the major life threatening illnesses like cancers and heart disease then outcomes are either similar or better with nhs.  Cancer Research UK say to patients on their website that there is very little difference in outcomes.   Private hospitals however do provide a better standard of accommodation,  that is fact.   Also,  a posh little doily thing under your cup of tea.   

[Jack]

The results of ten year independent study for quality of care by an organization which works directly with the NHS as an analysis consultant probably says more about the reality of the matter than one person's anecdotal perspective. Though at least she's aware of that too.

None of this actually tells you anything.  Isolated anecdotal stories (like these) don’t actually give anyone the information they need to decide the merits of one system over another.

Going to stick with the stance that both are problematic, one isn't any better than the other, and the UK isn't the answer to problems in the US.

[odeon]

The NHS is being destroyed by pliticians, as Adam and others have pointed out. Rather than interpreting that as a cue to allowing private health insurances to replace national healthcare, it should be a wake-up call to fix the problems. Your system only works for those who can afford it.

That study was a ten year study. 60% more likely to die in 2004, currently only 45% more likely to die than hospitals the US. The NHS has never been run or funded properly because it's run by the government. The private sector is the only thing about the UK system that works well, and that's for people who can afford it. nationalized health is a crap system only the wealthy can afford to get away from. That's the point have been trying to make; the government shouldn't be trusted with public health. You're making that point for me, by agreeing the government is destroying it's own system. The private sector does everything better than the government. The US system works for everyone and poor people with public coverage have access to the same health system as people with private coverage. The system just has some financial problems to be addressed, and they are being addressed, without dividing the medical industry by class.

Sorry but this is just not correct. The US spends more money on healthcare per capita than any other nation on earth, yet 16% of the population does not have a health insurance and as a result have a significantly higher mortality rate than the rest. Your system does not work for everyone.

Private health providers should not be trusted with national health care. It is never in their interest to give expensive treatments to people who can't pay for them.

In your country, universal healthcare is not a right, it's simply something enough money may be able to buy.

[odeon]

Yes it is never in safe hands long enough. 

That's probably the best argument against nationalized health in the entirety of this thread, for the US anyway, where the government is constantly changing. Maybe a system of royalty in rule would be in order here first.

Actually, one only has to look at your recent history to see that your alternative does not work.