Socialized Healthcare

[GrayMatterWife]

There are lots of inefficiencies in the UK system, but using one friend of a friend's story to judge socialized healthcare as a whole is not particularily scientific.

We're certainly not perfect. I just challenge the contention that it is the result of massive numbers of people being uninsured. The Dems cry "40 MM Americans uninsured!" Well, not exactly. 9-11 MM are illegal immigrants (why are we, the taxpayers responsible for paying for the healthcare of people here in violation of federal law?). Then there are millions more that are uninsured by choice--young people, primarily, who simply choose to not be insured, although it is available to them (stupid, in my opinion, but hardly giving rise to a suggestion of social injustice).

A big problem we have here is the huge discrepancy in quality of preventative care here between the middle class and the poor--a situation which I don't think will be remedied by making less access for the majority of people the standard through nationalized health care. For example: I live in STL, three blocks from one of the best hospitals in the country. Fantastic cancer center here. Women who live within a seven block radius of the hospital (an upper-middle class - a modestly wealth and well-educated, predominately caucasian population), the 5-year survival rate from first-time diagnosed (that is, not recurring) breast cancer is something around 90%. Very high, because almost all cases are diagnosed very early. By contrast, in the area more than seven blocks (a mere seven blocks) away has a majority African American, less-educated population--working class and below the poverty line. The survival rate is below 50%. Most of the diagnoses are at a much later phase--even end stage, with protuding masses. Why the difference? It's not a health insurance issue, for the most part. It's lack of education and significant lifestyle issues (including transportation to the hospital, job demands, lack of community support for preventative medicine, cultural stigmas, and diet/exercise issues). It is tragic that a seven-block demarcation determines survivability. Here, there has been a massive push through the churches to educate--a popular form of community outreach in the underserved community. And we've now got breach cancer testing vans that go into the community. It remains to be seen how much a difference it makes. We'll see...

No system is perfect. We should just figure out what the problem truly is. If it is a lack of preventative lack, for example, there are other options, rather than taking away the superior care that so many of us receive (and, despite all our problems, we really do have excellent health care here) to help the needy get the care that they need.

[McPants]

Words.

Good post. Agreed, no system is perfect. They all tend to have certain strengths and weaknesses. For that matter, I agree that the U.S. has excellent healthcare. What I don't like is that it is based on ability to pay and that given the amount of money you pay for it, you should probably be getting even better healthcare than you do at the moment. (The U.S. spent the most money on healthcare per capita in the entire world in 2005*).

* = http://www.who.int/entity/whosis/whostat/4.xls

[alison]

I have received excellent health care in Germany. And if you look around a typical American hospital, much of the equipment is top-of-the-line and made in Germany!

[McPants]

I have received excellent health care in Germany. And if you look around a typical American hospital, much of the equipment is top-of-the-line and made in Germany!

German healthcare is great, I'd gladly trade the UK system for theirs any day! Actually, I'd trade living in the UK for living in Germany any day.

[GrayMatterWife]

German healthcare is great, I'd gladly trade the UK system for theirs any day! Actually, I'd trade living in the UK for living in Germany any day.

I've heard primarily about England, Ireland, Sweden, Germany, and Italy. I don't know about the German system. How do they do it?

[McPants]

I've heard primarily about England, Ireland, Sweden, Germany, and Italy. I don't know about the German system. How do they do it?

The Germans are essentially just better people than the rest of us. Smarter, stronger, taller, blonder, more capable, more industrious, more sensibly clad.. I'm sure Alison can chime in with a few more reasons.

Actually, I don't know that much about the reasons why the German system is so good (didn't live there long enough to really get an insight into the whys and the hows of German society), but knowing German culture, I'd expect their healthcare system to be implemented in a ridiculously rational and efficient way.

http://en.wikipedia.org/wiki/Health_care_in_Germany

There was a series of articles re: how European countries approach healthcare. I read a while back and I can't remember where. How helpful! After reading the one about Germany, I didn't think it sounded as good as others (sorry, but at least they've got the blondness). I think the doctors get a set amount of money per...quarter?...no matter their patient load, or with little adjustment for patient load. I'll see if I can find it.

[alison]

There was a series of articles re: how European countries approach healthcare. I read a while back and I can't remember where. How helpful! After reading the one about Germany, I didn't think it sounded as good as others (sorry, but at least they've got the blondness). I think the doctors get a set amount of money per...quarter?...no matter their patient load, or with little adjustment for patient load. I'll see if I can find it.

Exactly. Doctors get a set amount of money that they can "spend" on the procedures that they do, so you'll find that many will cut their hours and the number of procedures they do in order to reach, but not exceed their cap. I honestly don't know all that much about the system, other than what I have experienced as a patient there.

[DCJenn]

It was an NPR Series, Nellie. I'm sure it's on their website somewhere.

If you've not read the article in the New Yorker (I'll post the link), do it. Very interesting and the author is a doc.

Jenn

Yes, NPR! That was it! And what Alison said about it.

Oh my favourite subject!!!

Well as you all know I'm currently living in Ireland, have done all my life apart from the 5 years I lived and worked in London for several NHS hospitals.

I would agree with the residents Abigail is talking off.

Our health public health care system is awful, on a scale with 3rd world is often quoted in the Media. I worked in the ED here and have left. On average there is a 24 hour wait to see a doctor as an emergency, this is providing all ABC's are in tact, if not, you'll be seen sooner. Once admited it would be common to be left on a trolley waiting for a bed on a ward for 3-4 days, infact a lot of people don't even see a hospital ward. (ther is a huge problem with ebd blockers, people in the beds who don't need them but have nowhere else to go ie nursing home etc).
If you need surgery for example orthopaedic, you will be on a list for about 3 years before a first appointment with a surgeon.

We also have a tiered health system, those who can afford it can pay for health insurance but it is expensive. All doctors work for the public health service and cannot ahve a private patients until they are a consultant for 7 years in the public health service (this is after the 10 years they may have taken to become a consultant if not longer). There is one emergency department in the country that accepts private patients, all other departments are in the public system, there are private minor injury units popping up now.

DS had to have grommits, on the public waiting list to see an ENT consultant was 18 months, we brougth him privately and he had them the same week.

Ultrasound/CT/MRI are 9-5 only, if you need these you will have to go to your consultant, they have to call the radiology consultant and they will decide if it can wait until 9am. Traumatic head injury is about the most you will get. the college of radiologist have forbidden all their members for supervising EM doctors in ultrasound as they don't want them preforming emergency ultrasounds. DH has to go for 4 weeks to AMerica to get his supervision and become competent because of this.

There is a shortage of doctors , due to training and finance of employing more, there is a shortage of nurses, everywhere, there is a shortage of beds. Teams of doctors are constantly trying to get patients off their service and onto someone elses load (DH found it wierd the first time he saw 3 teams trying to get a patient onto their service, it is unheard of here). If you come to work in the health service here, you will leave over work, depressed and extremely synical of everything.
I expect doctors leave here and return to America and are thankful that's were they practice and how lucky they are.

My experince of the NHS is very positive, I loved working for it, and couldn't believe the amount of services and speed of access there was for patients, but this varies from NHS trust to trust.

DH has also worked in GErmany and thinks they have a fantastic health service also.


I could rant for pages and pages and pages about all the things wrong witha public underfunded healthservice where any funding goes into more HR staff than doctors but i'll leave it at that.

Don;t I paint a pretty picture

[Michele]

Russ always tells me that of the desirable health care characteristics (good, cheap, and fast), you can only ever choose two. . That's true for our area, though you do get your choice of which two you want.

It seems to my limitedly educated on this subject brain, that de-linking health insurance from your job and making the insurance companies compete for our business would be more in line with capitalism. I don't know that it will change the shortage of GPs/compensation. I guess maybe if the docs themselves could also pick and choose who they work with as well.

[McPants]

I could rant for pages and pages and pages about all the things wrong witha public underfunded healthservice where any funding goes into more HR staff than doctors but i'll leave it at that.

Don;t I paint a pretty picture

Heh, I'm glad I don't live south of the border after reading that description!

Although I of course agree with what you say above, I would like to add that it certainly isn't good when it's the other way around either with regards to administrative staff. A big problem with Swedish healthcare (and one that would appear ridiculously easy to solve) is that they tend to have way, way too few secretaries and admins employed with the result that you have a huge chunk of a physician's time tied up in administrative tasks, leading to unnecessarily poor access to physicians. I believe they're near the bottom of the international table when it comes to the amount of patients per day seen by physicians solely because they have so few secretaries. One would wonder how they can justify spending so much tax money educating doctors (all university education is free of charge in Sweden) just to have them handle paperwork for a living.

[DCJenn]

On the radio this morning they were discussing the idea of healthcare co-ops, much like the electrical and farming co-ops that exist in the midwest.

I'm intrigued and will do some additional research between writing reports and waiting for the electrician. (I'm at home today)

Jenn

[NYCHoosier]

Russ always tells me that of the desirable health care characteristics (good, cheap, and fast), you can only ever choose two. . That's true for our area, though you do get your choice of which two you want.

It seems to my limitedly educated on this subject brain, that de-linking health insurance from your job and making the insurance companies compete for our business would be more in line with capitalism. I don't know that it will change the shortage of GPs/compensation. I guess maybe if the docs themselves could also pick and choose who they work with as well.

Of course! The Project Triangle - can't believe I've never applied it to the healthcare debate before.
http://en.wikipedia.org/wiki/Project_triangle

Of course, now I'm really curious about Germany's system...What are their taxes like? Is there innovation in the medical field there?

Obviously it can't stay exactly how it is right now, but there are soo many factors to consider. The US has a lot going for it's healthcare system, and I don't want us to lose that as we're trying to fix the bad.