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An American Doctor Experiences the NHS Again

248 points by petepete 10y ago

ZenoArrow 10y ago
Many of the problems with the NHS derive from the UK government's attempts to privatise it. If you're short on time but want to understand more, look at the mess with PFI used to fund the building of new hospitals. EDIT: If you've got more time/interest I'd recommend the documentary Sell-Off: https://m.youtube.com/watch?v=ultKvnw2h3Q https://m.youtube.com/watch?v=ultKvnw2h3Q
- vertex-four 10y ago
  Exactly. The Conservatives literally run on a platform of "Government-run things are shit", so they need to ensure that they don't run anything that works. From the East Coast rail franchise (which went downhill immediately after selling to Stagecoach/Virgin) to the NHS and more.
  - ZenoArrow 10y ago
    Quite right. Whilst there are probably some pragmatic Conservatives, the general ideology of the Conservatives is that publicly-run services are poorly run and should be privatised, even when it's clear that they're effectively run. To give another example, look at what has been happening with the Land Registry recently, there has been talk of privatising the functions that the Land Registry performs, even though the Land Registry is a profitable institution that makes money for the government. http://www.independent.co.uk/news/uk/home-news/land-registry-privatisation-government-brexit-chaos-a7115461.html http://www.independent.co.uk/news/uk/home-news/land-registry... To be fair, New Labour also overused PFI to fund hospitals (PFI expanded under New Labour), so it's not completely one sided.
- TazeTSchnitzel 10y ago
  Yes, the NHS has two problems: 1) Successive governments reorganising it (including privatising services), and 2) Successive governments underfunding it. The rest is pretty fine.
- hansjorg 10y ago
  You seem to be interested in this subject. As an outsider, I've been wondering why there hasn't been more of a ruckus after the Royal Mail privatisation. As I understood it, the shares turned out to be underpriced by about 80% and were primarily sold to a secret list of short time investors that made bank. Have I misunderstood what went down? If not, how is this possible in the UK without any political repercussions?
  - ZenoArrow 10y ago
    I'm not overly familiar with what happened with the Royal Mail privatisation, but thank you for suggesting it as a subject, it sounds like something worth investigating further. I'm also not overly familiar with mainstream news media in other countries, but if you had to point the finger at any one group in terms of why there hasn't been more resistance in the UK to the dismantling of public institutions, a large portion of the blame lies with our crap mainstream news media. The public aren't kept informed about matters of substance, they're distracted by misinformation and personality politics. It may be a problem we share with other countries (from the outside, the US mainstream news media seems similar/worse), but it doesn't have to be this way. We could have mainstream news outlets that gave people a chance to get better informed about the issues being faced in their country/community. It's an essential part of society that is sadly missing, I don't think you can have an effective democracy (effective in the sense of standing up for public interest) without a well-informed public.
  - zigzigzag 10y ago
    If I recall the story correctly, the government sold at a price that had been suggested to them by many highly paid financial services consultants. The fact that the pricing was wrong may or may not have been avoidable, but one of the basic arguments for privatisation is that it's hard to get and keep competent civil servants, so the fact that the final act of privatisation itself is often screwed up is not supposed to be very surprising. Just think how often pricing decisions were screwed up before!
  - laurencerowe 10y ago
    > You seem to be interested in this subject. As an outsider, I've been wondering why there hasn't been more of a ruckus after the Royal Mail privatisation. I think people just care a lot less about the postal service since we stopped writing personal letters with the advent of email and social media. It's just not the lifeline it once was. Postal services are now in the business of delivering junk mail.
Normal_gaussian 10y ago
> Maybe teach kids in school how to use the health care system (hey, why not NHS ed alongside drivers ed or sex ed?). We should probably break the news to her that there is no "drivers ed" in the UK. But she is right. The NHS can be great, but the way the government is fucking with it at the moment will prove disastrous. It is education, not privatisation, those are the answers to the problems of the NHS.
- arethuza 10y ago
  I suspect that some of the meddling with the NHS is intended to be disastrous so that public opinion is more likely to accept profit-generating private schemes. NB Some schools (at least here in Scotland) do offer classes on the theory part of the driving test as "interest" courses. Edit: I eventually found the quote that sums up the approach that is being taken with the NHS: "Only a crisis - actual or perceived - produces real change. When that crisis occurs, the actions that are taken depend on the ideas that are lying around. That, I believe, is our basic function: to develop alternatives to existing policies, to keep them alive and available until the politically impossible becomes the politically inevitable.” Milton Friedman Of course, the crisis that created the NHS was WW2 - I remember my father (who served in the RAF in WW2) being pretty clear that returning to the pre-war status-quo was not an option that anyone was interested in, which is why there was such a resounding defeat of Churchill at the polls when the war ended.
  - dageshi 10y ago
    I think the NHS is a massive government department that uses a huge amount of money (legitimately) and absolutely no government is capable of being in power and not "meddling" with it.
    - arethuza 10y ago
      One thing to note is as this is the UK - we actually have four National Health Services, one for each country: https://en.wikipedia.org/wiki/National_Health_Service https://en.wikipedia.org/wiki/National_Health_Service
madaxe_again 10y ago
The NHS is great at emergency care. I came down with a severe infection a few months ago and landed in Glan Clwyd. I was practically grabbed as I staggered through the door, and spent a few days in a private room (!!!) white they figured out whether what I had was infectious. Then a few days on a general ward, then discharged, well enough to finish sorting myself out at home. The staff were lovely, friendly, genuinely caring people - although I worry for their futures, given that most were EU nationals, and the only UK natives were agency staff. In my less delirious moments we chatted about the impending brexit vote - very worried faces. When it comes to long term or weird and wonderful stuff - not so great. I've been bouncing around referrals for five years, and the lack of digital records means that they have to mail 30lbs of paper to each other before I show up. If the records didn't arrive, I have to dictate my case. Again, and again, and again. Still undiagnosed. One particularly spectacular SNAFU ended up with me having unnecessary surgery, because someone read the wrong notes. Their core infrastructure is in dire need of modernisation. The government seem to think the answer is creeping privatisation. If they hadn't wasted £14bn on lining their chums pockets, the NHS would probably be pretty unassailably brilliant by now. https://en.m.wikipedia.org/wiki/NHS_Connecting_for_Health https://en.m.wikipedia.org/wiki/NHS_Connecting_for_Health
- retbull 10y ago
  It isn't like that doesn't happen here in the US. That sounds like part bureaucratic problem and part difficulty of diagnosis. I know plenty of people who ended up in similar situations or got the wrong diagnosis for years despite having pretty good medical insurance. You'd still have to get your medical records transferred around.
  - deleted 10y ago
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- zigzigzag 10y ago
  You talk about "they" as if government is a single group of people. The fact that the NHS is still fundamentally paper based, in 2016, is exactly the kind of problem that leads politicians to want more use of the private sector. In many private industries, even highly regulated ones like finance, the people who first successfully transitioned the industries to computer based systems are now dying of old age. The NHS hasn't even started. In fact it's fair to say that the NHS has shown no ability to fundamentally improve itself. It deploys new medical techniques and drugs (developed in the private sector) but when it comes to changing the organisation or adapting to new business ideas, like computerisation, it has utterly failed. This is very frustrating for the politicians who are ultimately held accountable for the performance of the NHS. They sit right at the very top and can hardly influence anything - all they can do is set general directions like "use computers for medical records", and then watch helplessly as the incompetent staff below them screw it up, over and over again. Meanwhile they watch as Google or Facebook go on to build self driving cars and global communication networks. Worse, as students of politics, they know full well what the reason is: the NHS is a classic, communist style top down command-and-control system. Deep institutional rot is exactly what to expect from such an arrangement. Yet they can't change it because the British have an irrational knee jerk reaction to anything that implies people in the private sector can be equally or more competent than people in the public sector.
Waterluvian 10y ago
I wish Canada's system was that good. I've been to the ER twice. 6-8 hour wait for things that weren't life threatening but definitely required an ER visit. Ever waited in an ER for 8 hours while sick as a dog? It's awful. But then I think about how often I intend on being at the hospital and will gladly pay 8 hours every time if it means nobody has to find a co-pay to learn if their cancer is back.
- was_boring 10y ago
  Yep, here in America and then paid thousands for the privilege of not dying.
- kelvin0 10y ago
  I can't speak for other provinces, but in Quebec this whole story would have ended very differently. I guess we have a lot to learn from the UK in that department. From what I understand we have a shortage of Doctors AND an ageing population, which makes things even more difficult.
  - raverbashing 10y ago
    Quebec has a shortage of doctors because the College des Medecins is prejudiced against foreigners and makes it harder for immigrant doctors to practice there (compared to other provinces), meanwhile the doctors that do get a degree there are probably not interested in the low salaries and also go elsewhere
    - kelvin0 10y ago
      Thus the shortage, case in point. Thanks for the interesting clarifications.
- andreasklinger 10y ago
  I waited 6 hours in an US emergency room. Compared to EU ER rooms an horrible experience. All kinds of people with unfixed long term problems that apparently only the ER is obliged to handle. Btw the reason was even more frustrating: A us doctor (turned out nurse/practitioner) told my GF that all the obvious reasons are not the cause of her short breathness. So it might be a deadly one - we needed an xray to make sure - we had an xray with us but she wasnt comfortable looking at it because of missing education. She offered us an ambulance to the ER. We had no issues whatsoever - she just tried to cover her ass in case of.
andreasklinger 10y ago
As an european now living in America: The reason the EU model works is that people treat their problems early. You have a concern - you go to the doctor. NHS - with all it's short comes - has the same principle
- chrisseaton 10y ago
  > You have a concern - you go to the doctor. But the NHS keeps telling us to not go to the doctor! "See a nurse rather than a doctor! See a pharmacist rather than a doctor! Phone a helpline rather than see a doctor! Go to your high street chemist rather than see a doctor! Self-treat rather than see a doctor!".
  - andreasklinger 10y ago
    I had subpar experiences in the UK with the NHS but not horrible. Telling people not to go to a doctor is dangerous but i can understand the intend. Eg: (Can only judge with Austria/Germany experience) Pharmacists are extremely highly trained there. They are implicitly used as a simple doctor. We do the same. You feel bit weird you go to the pharmacy just to gauge what it could be and how serious they take it. If serious enough you go to a doctor asap.
    - chrisseaton 10y ago
      > You feel bit weird you go to the pharmacy just to gauge what it could be and how serious they take it. If serious enough you go to a doctor asap. They must be very confident pharmacists. If anyone ever asked me 'do you think I should see a doctor' I would say 'yes' every time. What happens if you get it wrong? Doctors are protected by major institutions, insurance, legal precedents. What about someone working in Boots (UK high street pharmacy chain) who tells you not to bother seeing a doctor and then you die?
      - andreasklinger 10y ago
        1) they are really well trained usually 2) If they are unsure they will tell you. 3) If the judgement is the same as any one else would have done i dont think it could be considered grossly negligent.
maxerickson 10y ago
For lots of Americans, the copay on that CT scan is 100%. I guess if they are getting over cancer they might be lucky enough to have met their out of pocket maximum for the year. edit: Why is this controversial? I literally paid out of pocket for 2 CT scans last year. They both applied against my deductible (so they were 'medically justified' or whatever, not done at my insistence or something). Is being sarcastic about the high cost of healthcare in the US so absurd?
- refurb 10y ago
  That's how high deductible plans are supposed to work! In exchange for much lower premiums, you pay the first few thousands of dollars out of your own pocket. If you have a severe illness, the insurance covers the rest. Usually high deductible plans come with a tax free savings account. You sock a little money away each month so when something happens you have a cushion to fall back on. They certainly aren't for everyone, but if i was young and in good health I'd probably go that route.
  - maxerickson 10y ago
    Sort of. The premiums aren't all that low (they are intentionally high to subsidize care for other patient groups) and the fees have only a vague connection to the costs of providing the services. We have an insane system where mandated government care is underfunded and then the hospital is expected to make up the difference by charging the people that need medical care. People that are having a bad day pay for the people that are having a bad year. Of course I have no way of giving any weight to such a statement, but I'm pretty sure I would have paid 1/3 to 1/5 as much in a reasonably competitive marketplace...
    - refurb 10y ago
      The last time I looked, a low deductible plan might cost $500-700/month for an individual. A high deductible plan can be under $200/month depending on the state. That's a pretty reasonable decrease. Otherwise, yes, I agree that the private system is subsidizing the public system, particularly Medicaid.
jkot 10y ago
My friend had diabetes, her GP could not even diagnose that from basic symptoms, several visits and blood test. I strongly recommend to anyone with 'mysterious' long term illness to visit doctor in other country.
- k-mcgrady 10y ago
  Considering it's a pretty common diagnosis I'm willing to bet your friends experience is anything but usual.
- vertex-four 10y ago
  Some doctors suck, no matter what country you're in. I've heard similar stories from people in the US, India, everywhere. You have a right to a second opinion in the UK - use it if you're unsure.
  - jkot 10y ago
    Yes, but in UK you have to go through GP for everything. It can take months before seeing specialist for trivial stuff.
    - Angostura 10y ago
      What kind of trivial are we talking about? i went with concerns about changes to my bowel habits and the GP had me to a specialist with a camera up my arse within two weeks.
      - DanBC 10y ago
        I guess that's under the "Be Clear on Cancer" stuff? https://www.nhs.uk/be-clear-on-cancer/symptoms/bowel-cancer https://www.nhs.uk/be-clear-on-cancer/symptoms/bowel-cancer > If you've had blood in your poo or looser poo for the last three weeks, tell your doctor. Chances are it's nothing serious, but you're not wasting anyone's time by getting it checked out. Call your GP today. https://www.gov.uk/government/news/government-launches-its-first-ever-national-bowel-cancer-campaign https://www.gov.uk/government/news/government-launches-its-f...
grecy 10y ago
> To receive this care all my cousin had to do was provide her name and birthdate. No copayments, no preauthorizations, no concerns about the radiologist or orthopedic surgeon being out of network For the vast majority of people in the developed world, that's how heath care works.
- Inthenameofmine 10y ago
  Frankly a lot of the developing world too.
- sosborn 10y ago
  I'm an american that lived/worked in Japan for about 10 years. This aspect of healthcare in Japan was hands down my favorite. Just being able to walk into any doctors office and know that my insurance would be accepted. I might be an outlier in that all my of coverage while employed in the U.S. has been fantastic.
lanestp 10y ago
This kind of article is a nonsense puff piece. Giving an example of receiving good or bad care in a health system is of no value. I have had incredibly positive and negative experiences with US hospitals and doctors but my experience is simply a data point. As for the NHS the mother of a friend died due to negligence while being transported home. So it's not all good, which is why the system cannot be judged this way.
- nichochar 10y ago
  You're right. The US system is exactly the same as the British one. Good job on your positive reinforcement, optimism cures.
  - cookiecaper 10y ago
    He's not saying that the systems are the same, just that good and bad experiences are had in both. Thus, a recounting of one smooth experience in the UK cannot be used to say that their system is inherently better than the American system. The post basically says, "Wow, we got medical care and didn't have to pay for it!" Everyone already knows that Britons pay for health care out of their taxes and not at the time of service, so it doesn't really bring anything to the table, and certainly doesn't make a case for or against one system or the other.
- popmystack 10y ago
  You are comparing two completely unrelated things.
- Angostura 10y ago
  luckily, there are statistics on patient satisfaction available for individual hospitals and the NHS as a whole which shows a good degree of satisfaction. Of course no system is perfect and their are a number of hospitals in 'special measures' which means their management is replaced and they are in turnaround. I'm very sorry to hear about your friends mother. I assume it triggered a full investigation?
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neom 10y ago
Grew up in the UK, went to college In Canada, US for the last 6 years. NHS was excellent growing up. OHIP/Ontario Health Care was excellent. The US is contrived and awful.
- falsestprophet 10y ago
  > "NHS was excellent growing up. OHIP/Ontario Health Care was excellent. The US is contrived and awful." contrived. having an unnatural or false appearance or quality What?
  - neom 10y ago
    What do you mean by what? I presume by the italics it means you're unable to comprehend the word contrived? Would you like me to define it for you?
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      [deleted]
DanBC 10y ago
Those hospital wheelchairs are difficult to use, but it's possible to safely push them. > The only real issue was people who show up for care that is clearly not even semi urgent never mind emergent. People do love the NHS. And they trust A&E. Companies would kill to get that kind of brand loyalty. So the answer is to co-locate walk-in doctors and minor injuries with A&E departments, and have fierce triage on entry to divert the people who don't need it away from A&E.
Ericson2314 10y ago
I know rhis isn't the main impediment to policy change, but I kinda want to require that all doctors and nurses study/be a resident abroad, just so most people in any US hospital know what we're missing.
WoodenChair 10y ago
The problem with socialized medicine is not with regards to the routine (broken ankle, high cholesterol) but instead with regards to the even slightly unusual. The economic incentive is not there for highly trained specialists. Nothing about this article is surprising, despite the author's tone. Any modern industrialized country should be able to quickly treat a routine broken ankle. Where that's not possible in the US it's a travesty. Now compare the care of extremely rare diseases in the US and UK and you have something more interesting to talk about.
- aleksei 10y ago
  I have to disagree with this. If there were no private hospitals this might hold true, but as it is the better off will continue to pay for their expensive treatment, keeping the economic incentive for doctors, while the poor will at least have basic treatment available (at no cost, no less). As for comparing rare disease treatment, I can't say but would like to see some more information.
- cjdndjcn 10y ago
  I just about died from scarlet fever a year ago in the US because they wouldn't prescribe me antibiotics since the strep antigen tests kept coming back negative. I didn't get better until two weeks later when they finally gave me the antibiotics anyway. This was despite that fact that I displayed all the classic symptpoms: 107.5F fever, full body rash, chest pain, and blood in my urine. In my experience the only thing exceptionally good about US healthcare is its astoundingly effective PR team.
- NowImUsingNames 10y ago
  I just about died from scarlet fever a year ago in the US because they wouldn't prescribe me antibiotics since the strep antigen tests kept coming back negative. I didn't get better until two weeks later when they finally gave me the antibiotics anyway. This was despite that fact that I displayed all the classic symptpoms: 107.5F fever, full body rash, chest pain, and blood in my urine. In my experience the only thing exceptionally good about US healthcare is its astoundingly effective PR team.
brightshiny 10y ago
I've worked in the NHS, for several different organisations at different levels of the hierarchy (PCTs, SHAs, CCGs etc), as a contractor, over several years. I would privatise it tomorrow. The amount of waste in terms of time and money were eye-watering, every time. The amount of politicking was immense. A project that should take a few weeks could easily expand into a couple of years. I resigned from my last contract because it actually felt immoral to be taking a large amount of cash to either sit around twiddling my thumbs, fight with people, or do work at the slowest possible pace in the most ineffective way. I'd rather do something else. Basically, I've never worked for a private company that was anything like that, even the worst ones, and I find it hard to believe any private company would survive very long working that way. I'll add, my Japanese girlfriend and her friends are utterly unimpressed with the level of service. As was my Spanish girlfriend, who also worked on a hospital's grounds as a medical researcher. I'm not saying we should copy the Americans, no way, but the Japanese system is private, the German system is private, the Dutch and French systems are also private. Going private does not mean chucking the idea of universal healthcare on the fire, it means properly separating the regulator from the provider and removing the kind of conflict of interest that led to the cover up of high mortality rates, among other things. There is more than one way to skin a cat. And no, I'm not a Tory. Try picking up a copy of Private Eye if you want to divest yourself of the notion that the NHS is a saintly institution. Or work there.
- DanBC 10y ago
  > I would privatise it tomorrow There are plenty of examples in this thread of how good the emergency treatment is, and some bad examples of GP treatment. In the UK your "NHS GP" is paid for by the NHS, but is employed by a private company. The private bits of the NHS fucking suck.
- Angostura 10y ago
  How much of that inefficiency was caused by the part-privatisation? Much much paperwork is caused by the inefficient but politically-attractive internal market successive governments have tried to set up.
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privateersman 10y ago
She had two options: go through the GP-based system where treatment can take anything from days to months, or take the initiative by jumping the line and go to A&E. Going to A&E is like having your tech support handled by engineers. Going through the GP system is like calling a support line. She got a positive outcome because she went with the option that costs the most. I'm pointing this out as someone who has gone through both methods. Don't believe the hype that you read about the NHS. It's good to have, but it's not amazing and if everyone went through A&E, the system would probably collapse.
- AYBABTME 10y ago
  Do believe the hype. It might be imperfect, but it's definitely better than what people go thru in the US, and hype is something it could use.
- have_faith 10y ago
  Struggling to understand your point of view. It's not really a case of GP or A&E. They are two different things with different purposes. The A&E is designed for problems that shouldn't wait. Your GP is for ongoing issues that aren't crucial to be sorted right away. It's called Accident and Emergency for a reason. The NHS is far from perfect but I don't know what a better system would be.
  - privateersman 10y ago
    Just pointing out that what people experience from A&E is vastly different from what people experience from the GP system. This article highlights the best part of the NHS, whereas the GP system is like being caught in limbo. If you are rich enough and plan in advance, it can be avoided by going private, otherwise it can mean months, even years of suffering through long waits.
- mcintyre1994 10y ago
  > if everyone went through A&E, the system would probably collapse. I don't understand how this is a bad thing about the system. Yes, if everyone went through the most expensive system designed for urgent things, the system would presumably collapse. But they don't, because the system includes something for less urgent cases, and thus doesn't collapse. Doesn't that just mean that aspect is well designed to avoid collapse that would apparently be inevitable if it were less well designed? Isn't that a good thing?
deleted 10y ago
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UK-AL 10y ago
I find the NHS is good for the little things, gets worse as you go for the more complicated things. My dad had pancreatic cancer and went to the doctors, did every sort of cheap test they could. They didn't believe him, and said it was psychological and sent him to a psychiatric hospital instead. Again nothing worked After constant complaining, eventually they went for the expensive scan, and found that it was pancreatic cancer wasting several months. Awful.
codegeek 10y ago
The article is nice but a specific comment caught my attention which was "I honestly live in fear of having an accident or getting sick here in America." This. No matter what we claim about American healthcare, this points resonates so well with most of us in America. It absolutely is scary to imagine being sick even with insurance. Without insurance, forget about it. Then comes the maze of crazy terms like co-pay, co-insurance, deductible, pre-authorization, in-network, out-network, Specialist referral and god knows what else. Now may I rant about the Insurance companies if I may ? Obamacare was supposed to fix healthcare but it added to the red tape further. No real solutions. Insurance companies still have too much power and they call the shots, not the doctors/hospitals. Good luck fighting a denied claim unless you can shell good amount of lawyer money. I don't know the solution though. America still has one of the best facilities in the world and even though the process is too bureaucratic and downright idiotic in many cases, the care that is actually provided is still pretty good. And I say this as someone who is aware of medical tourism and countries such as India. One solution could be to get rid of insurance scam (yes I call it a scam) and then lets hospitals/doctors compete with transparent pricing in a free market. For catastrophic events, let insurance companies exist. I hate it that to even get an X-Ray, I need insurance and without it, they will look at you as if you came from some strange land. And if you do end up getting a service without insurance, good luck looking at the bill when it finally comes. You can be a crypto expert but won't be able to figure that one out.
- fastball 10y ago
  No ER in the US will turn you away if you have an emergency, regardless of financial status...
  - rdtsc 10y ago
    They will take you but then send you a bill. As a first time visitor to this country many years ago I went an clinic because I had severe strep throat. Waited 1 hour, then some intern saw me for 5 minutes. Gave me a codeine pill and later sent me a bill for $400. That was 1990's $400 dolars, and I had a stipend of only $200 month as a student. That right there is fucked up. Actually, I would rather they just turned me a way -- "Sorry bud, this will be more than you can afford". I know what people will say "Oh you don't have to pay, declare bankruptcy or call and haggle with the hospital". But you know where you haggle with the hospital -- in a 3rd world country when you are bribing the doctors to not kill you. You haggle there as well, and you also have to haggle here to get he "special, I can't pay" rate.
anexprogrammer 10y ago
We get a lot for the money, compared to the cost of other systems. I absolutely don't want to see more privatisation of the system despite most governments nudging towards this. All is not perfect though. Every government wants to be seen to be "doing something", so fiddles. Constantly. Staff is overworked and mostly underpaid. Emergency and cancer care seems to be very good. I'd recommend not needing a non-emergency or mental health treatment in some of the poorer regions of the country though. For instance. If you need Aspergers help for your child, or referral to some CBT for depression in some places you can wait 12 months. Sometimes more. Even so I prefer it to anything like the US system as you can;t fall through the gaps entirely for being broke. I'm glad to pay more tax as a result, rather than an insurance premium or in-work benefit.
dzhiurgis 10y ago
Had 3 visits so far in London hospitals, regarding recurring pain around heart area. Doctor solution was making me keep pain diary as NHS has no money for diagnostics... I did get some basic blood checks though.
- DanBC 10y ago
  Were they emergency visits, or GP arranged visits? What did the GP say when you asked him/her about it?
  - dzhiurgis 10y ago
    GP visits, that's GP. NHS has no money. I think they thought I am eastern european freeloader. The pain is manageable and tends to disappear when I stop drinking, which suggests liver swelling. But then my arms sometimes feel numb. I've moved from UK since. To a place where immigrants pay just as much tax, but do not get free healthcare like citizens do.
greggman 10y ago
Well... Sadly I've had bad experiences I was in London last summer. Got sick. Waited about 9 days for it to get better. No signs of change so went to NHS. Wait one hour. Was led into consultation room and was told I could wait another 90 minutes if I wanted but that I could only see a nurse and regardless of what the nurse found she could not prescribe any medicine. Or, I was told by the same NHS person I could go about a 10 minute walk to a private clinic and see a doctor probably immediately and as a doctor they could prescribe medicine if needed. So ... Yea, wasn't a good first impression of NHS. Not saying USA's system is better. In Japan it's easy to see a doctor but at least in my experience about 30% of them are quacks. Also if you need surgery and you want a good doctor you need to bribe them. This is so common it's a normal part of most medical dramas. I'm scared of getting the giant bill in the USA. But I'm scared of getting hurt by the doctor in Japan if I need any surgery. I don't know the solution.
shanacarp 10y ago
I actually watch this. I'm in a private group for what is collequally called previvors (specifically Young previvors - though some people have had/current do have breast/ovarian cancer, including a few who are dying of it). I need specialized DNA testing for complicated reasons in my family history for risk assessment. It isn't covered. We have UK and European Members. I see who their doctors ares, what research they publish. I know what they pay. ($0) I know that for patients like me, European doctors are way more proactive, even for joining studies, because they can afford to be. I know factually that if I were in europe that test would have been done LAST YEAR. Instead I'm still looking around for one doctor outside of my regular provider to do this one DNA test under research protocols. Doing this one test could potentially save the medical system thousands of dollars. That's what baffles me the most: The insurance companies wants me to use a certain amont of services, but only so much, in the US It is like they actually don't want me to be healthy - and I am not sure why.
cja 10y ago
The NHS is massively overstretched. I'd be terrified of having to go to A&E at Worcester hospital, where I live, but the system we have doesn't allow for me to take my business elsewhere so there's no competition.

248 points by petepete 10y ago

Many of the problems with the NHS derive from the UK government's attempts to privatise it. If you're short on time but want to understand more, look at the mess with PFI used to fund the building of new hospitals. EDIT: If you've got more time/interest I'd recommend the documentary Sell-Off: https://m.youtube.com/watch?v=ultKvnw2h3Q https://m.youtube.com/watch?v=ultKvnw2h3Q

vertex-four 10y ago
Exactly. The Conservatives literally run on a platform of "Government-run things are shit", so they need to ensure that they don't run anything that works. From the East Coast rail franchise (which went downhill immediately after selling to Stagecoach/Virgin) to the NHS and more.
- ZenoArrow 10y ago
  Quite right. Whilst there are probably some pragmatic Conservatives, the general ideology of the Conservatives is that publicly-run services are poorly run and should be privatised, even when it's clear that they're effectively run. To give another example, look at what has been happening with the Land Registry recently, there has been talk of privatising the functions that the Land Registry performs, even though the Land Registry is a profitable institution that makes money for the government. http://www.independent.co.uk/news/uk/home-news/land-registry-privatisation-government-brexit-chaos-a7115461.html http://www.independent.co.uk/news/uk/home-news/land-registry... To be fair, New Labour also overused PFI to fund hospitals (PFI expanded under New Labour), so it's not completely one sided.
TazeTSchnitzel 10y ago
Yes, the NHS has two problems: 1) Successive governments reorganising it (including privatising services), and 2) Successive governments underfunding it. The rest is pretty fine.
hansjorg 10y ago
You seem to be interested in this subject. As an outsider, I've been wondering why there hasn't been more of a ruckus after the Royal Mail privatisation. As I understood it, the shares turned out to be underpriced by about 80% and were primarily sold to a secret list of short time investors that made bank. Have I misunderstood what went down? If not, how is this possible in the UK without any political repercussions?
- ZenoArrow 10y ago
  I'm not overly familiar with what happened with the Royal Mail privatisation, but thank you for suggesting it as a subject, it sounds like something worth investigating further. I'm also not overly familiar with mainstream news media in other countries, but if you had to point the finger at any one group in terms of why there hasn't been more resistance in the UK to the dismantling of public institutions, a large portion of the blame lies with our crap mainstream news media. The public aren't kept informed about matters of substance, they're distracted by misinformation and personality politics. It may be a problem we share with other countries (from the outside, the US mainstream news media seems similar/worse), but it doesn't have to be this way. We could have mainstream news outlets that gave people a chance to get better informed about the issues being faced in their country/community. It's an essential part of society that is sadly missing, I don't think you can have an effective democracy (effective in the sense of standing up for public interest) without a well-informed public.
- zigzigzag 10y ago
  If I recall the story correctly, the government sold at a price that had been suggested to them by many highly paid financial services consultants. The fact that the pricing was wrong may or may not have been avoidable, but one of the basic arguments for privatisation is that it's hard to get and keep competent civil servants, so the fact that the final act of privatisation itself is often screwed up is not supposed to be very surprising. Just think how often pricing decisions were screwed up before!
- laurencerowe 10y ago
  > You seem to be interested in this subject. As an outsider, I've been wondering why there hasn't been more of a ruckus after the Royal Mail privatisation. I think people just care a lot less about the postal service since we stopped writing personal letters with the advent of email and social media. It's just not the lifeline it once was. Postal services are now in the business of delivering junk mail.

Normal_gaussian 10y ago

> Maybe teach kids in school how to use the health care system (hey, why not NHS ed alongside drivers ed or sex ed?). We should probably break the news to her that there is no "drivers ed" in the UK. But she is right. The NHS can be great, but the way the government is fucking with it at the moment will prove disastrous. It is education, not privatisation, those are the answers to the problems of the NHS.

arethuza 10y ago
I suspect that some of the meddling with the NHS is intended to be disastrous so that public opinion is more likely to accept profit-generating private schemes. NB Some schools (at least here in Scotland) do offer classes on the theory part of the driving test as "interest" courses. Edit: I eventually found the quote that sums up the approach that is being taken with the NHS: "Only a crisis - actual or perceived - produces real change. When that crisis occurs, the actions that are taken depend on the ideas that are lying around. That, I believe, is our basic function: to develop alternatives to existing policies, to keep them alive and available until the politically impossible becomes the politically inevitable.” Milton Friedman Of course, the crisis that created the NHS was WW2 - I remember my father (who served in the RAF in WW2) being pretty clear that returning to the pre-war status-quo was not an option that anyone was interested in, which is why there was such a resounding defeat of Churchill at the polls when the war ended.
- dageshi 10y ago
  I think the NHS is a massive government department that uses a huge amount of money (legitimately) and absolutely no government is capable of being in power and not "meddling" with it.
  - arethuza 10y ago
    One thing to note is as this is the UK - we actually have four National Health Services, one for each country: https://en.wikipedia.org/wiki/National_Health_Service https://en.wikipedia.org/wiki/National_Health_Service

madaxe_again 10y ago

The NHS is great at emergency care. I came down with a severe infection a few months ago and landed in Glan Clwyd. I was practically grabbed as I staggered through the door, and spent a few days in a private room (!!!) white they figured out whether what I had was infectious. Then a few days on a general ward, then discharged, well enough to finish sorting myself out at home. The staff were lovely, friendly, genuinely caring people - although I worry for their futures, given that most were EU nationals, and the only UK natives were agency staff. In my less delirious moments we chatted about the impending brexit vote - very worried faces. When it comes to long term or weird and wonderful stuff - not so great. I've been bouncing around referrals for five years, and the lack of digital records means that they have to mail 30lbs of paper to each other before I show up. If the records didn't arrive, I have to dictate my case. Again, and again, and again. Still undiagnosed. One particularly spectacular SNAFU ended up with me having unnecessary surgery, because someone read the wrong notes. Their core infrastructure is in dire need of modernisation. The government seem to think the answer is creeping privatisation. If they hadn't wasted £14bn on lining their chums pockets, the NHS would probably be pretty unassailably brilliant by now. https://en.m.wikipedia.org/wiki/NHS_Connecting_for_Health https://en.m.wikipedia.org/wiki/NHS_Connecting_for_Health

retbull 10y ago
It isn't like that doesn't happen here in the US. That sounds like part bureaucratic problem and part difficulty of diagnosis. I know plenty of people who ended up in similar situations or got the wrong diagnosis for years despite having pretty good medical insurance. You'd still have to get your medical records transferred around.
- deleted 10y ago
  [deleted]
zigzigzag 10y ago
You talk about "they" as if government is a single group of people. The fact that the NHS is still fundamentally paper based, in 2016, is exactly the kind of problem that leads politicians to want more use of the private sector. In many private industries, even highly regulated ones like finance, the people who first successfully transitioned the industries to computer based systems are now dying of old age. The NHS hasn't even started. In fact it's fair to say that the NHS has shown no ability to fundamentally improve itself. It deploys new medical techniques and drugs (developed in the private sector) but when it comes to changing the organisation or adapting to new business ideas, like computerisation, it has utterly failed. This is very frustrating for the politicians who are ultimately held accountable for the performance of the NHS. They sit right at the very top and can hardly influence anything - all they can do is set general directions like "use computers for medical records", and then watch helplessly as the incompetent staff below them screw it up, over and over again. Meanwhile they watch as Google or Facebook go on to build self driving cars and global communication networks. Worse, as students of politics, they know full well what the reason is: the NHS is a classic, communist style top down command-and-control system. Deep institutional rot is exactly what to expect from such an arrangement. Yet they can't change it because the British have an irrational knee jerk reaction to anything that implies people in the private sector can be equally or more competent than people in the public sector.

Waterluvian 10y ago

I wish Canada's system was that good. I've been to the ER twice. 6-8 hour wait for things that weren't life threatening but definitely required an ER visit. Ever waited in an ER for 8 hours while sick as a dog? It's awful. But then I think about how often I intend on being at the hospital and will gladly pay 8 hours every time if it means nobody has to find a co-pay to learn if their cancer is back.

was_boring 10y ago
Yep, here in America and then paid thousands for the privilege of not dying.
kelvin0 10y ago
I can't speak for other provinces, but in Quebec this whole story would have ended very differently. I guess we have a lot to learn from the UK in that department. From what I understand we have a shortage of Doctors AND an ageing population, which makes things even more difficult.
- raverbashing 10y ago
  Quebec has a shortage of doctors because the College des Medecins is prejudiced against foreigners and makes it harder for immigrant doctors to practice there (compared to other provinces), meanwhile the doctors that do get a degree there are probably not interested in the low salaries and also go elsewhere
  - kelvin0 10y ago
    Thus the shortage, case in point. Thanks for the interesting clarifications.
andreasklinger 10y ago
I waited 6 hours in an US emergency room. Compared to EU ER rooms an horrible experience. All kinds of people with unfixed long term problems that apparently only the ER is obliged to handle. Btw the reason was even more frustrating: A us doctor (turned out nurse/practitioner) told my GF that all the obvious reasons are not the cause of her short breathness. So it might be a deadly one - we needed an xray to make sure - we had an xray with us but she wasnt comfortable looking at it because of missing education. She offered us an ambulance to the ER. We had no issues whatsoever - she just tried to cover her ass in case of.

andreasklinger 10y ago

As an european now living in America: The reason the EU model works is that people treat their problems early. You have a concern - you go to the doctor. NHS - with all it's short comes - has the same principle

chrisseaton 10y ago
> You have a concern - you go to the doctor. But the NHS keeps telling us to not go to the doctor! "See a nurse rather than a doctor! See a pharmacist rather than a doctor! Phone a helpline rather than see a doctor! Go to your high street chemist rather than see a doctor! Self-treat rather than see a doctor!".
- andreasklinger 10y ago
  I had subpar experiences in the UK with the NHS but not horrible. Telling people not to go to a doctor is dangerous but i can understand the intend. Eg: (Can only judge with Austria/Germany experience) Pharmacists are extremely highly trained there. They are implicitly used as a simple doctor. We do the same. You feel bit weird you go to the pharmacy just to gauge what it could be and how serious they take it. If serious enough you go to a doctor asap.
  - chrisseaton 10y ago
    > You feel bit weird you go to the pharmacy just to gauge what it could be and how serious they take it. If serious enough you go to a doctor asap. They must be very confident pharmacists. If anyone ever asked me 'do you think I should see a doctor' I would say 'yes' every time. What happens if you get it wrong? Doctors are protected by major institutions, insurance, legal precedents. What about someone working in Boots (UK high street pharmacy chain) who tells you not to bother seeing a doctor and then you die?
    - andreasklinger 10y ago
      1) they are really well trained usually 2) If they are unsure they will tell you. 3) If the judgement is the same as any one else would have done i dont think it could be considered grossly negligent.

maxerickson 10y ago

For lots of Americans, the copay on that CT scan is 100%. I guess if they are getting over cancer they might be lucky enough to have met their out of pocket maximum for the year. edit: Why is this controversial? I literally paid out of pocket for 2 CT scans last year. They both applied against my deductible (so they were 'medically justified' or whatever, not done at my insistence or something). Is being sarcastic about the high cost of healthcare in the US so absurd?

refurb 10y ago
That's how high deductible plans are supposed to work! In exchange for much lower premiums, you pay the first few thousands of dollars out of your own pocket. If you have a severe illness, the insurance covers the rest. Usually high deductible plans come with a tax free savings account. You sock a little money away each month so when something happens you have a cushion to fall back on. They certainly aren't for everyone, but if i was young and in good health I'd probably go that route.
- maxerickson 10y ago
  Sort of. The premiums aren't all that low (they are intentionally high to subsidize care for other patient groups) and the fees have only a vague connection to the costs of providing the services. We have an insane system where mandated government care is underfunded and then the hospital is expected to make up the difference by charging the people that need medical care. People that are having a bad day pay for the people that are having a bad year. Of course I have no way of giving any weight to such a statement, but I'm pretty sure I would have paid 1/3 to 1/5 as much in a reasonably competitive marketplace...
  - refurb 10y ago
    The last time I looked, a low deductible plan might cost $500-700/month for an individual. A high deductible plan can be under $200/month depending on the state. That's a pretty reasonable decrease. Otherwise, yes, I agree that the private system is subsidizing the public system, particularly Medicaid.

jkot 10y ago

My friend had diabetes, her GP could not even diagnose that from basic symptoms, several visits and blood test. I strongly recommend to anyone with 'mysterious' long term illness to visit doctor in other country.

k-mcgrady 10y ago
Considering it's a pretty common diagnosis I'm willing to bet your friends experience is anything but usual.
vertex-four 10y ago
Some doctors suck, no matter what country you're in. I've heard similar stories from people in the US, India, everywhere. You have a right to a second opinion in the UK - use it if you're unsure.
- jkot 10y ago
  Yes, but in UK you have to go through GP for everything. It can take months before seeing specialist for trivial stuff.
  - Angostura 10y ago
    What kind of trivial are we talking about? i went with concerns about changes to my bowel habits and the GP had me to a specialist with a camera up my arse within two weeks.
    - DanBC 10y ago
      I guess that's under the "Be Clear on Cancer" stuff? https://www.nhs.uk/be-clear-on-cancer/symptoms/bowel-cancer https://www.nhs.uk/be-clear-on-cancer/symptoms/bowel-cancer > If you've had blood in your poo or looser poo for the last three weeks, tell your doctor. Chances are it's nothing serious, but you're not wasting anyone's time by getting it checked out. Call your GP today. https://www.gov.uk/government/news/government-launches-its-first-ever-national-bowel-cancer-campaign https://www.gov.uk/government/news/government-launches-its-f...

grecy 10y ago

> To receive this care all my cousin had to do was provide her name and birthdate. No copayments, no preauthorizations, no concerns about the radiologist or orthopedic surgeon being out of network For the vast majority of people in the developed world, that's how heath care works.

Inthenameofmine 10y ago
Frankly a lot of the developing world too.
sosborn 10y ago
I'm an american that lived/worked in Japan for about 10 years. This aspect of healthcare in Japan was hands down my favorite. Just being able to walk into any doctors office and know that my insurance would be accepted. I might be an outlier in that all my of coverage while employed in the U.S. has been fantastic.

lanestp 10y ago

This kind of article is a nonsense puff piece. Giving an example of receiving good or bad care in a health system is of no value. I have had incredibly positive and negative experiences with US hospitals and doctors but my experience is simply a data point. As for the NHS the mother of a friend died due to negligence while being transported home. So it's not all good, which is why the system cannot be judged this way.

nichochar 10y ago
You're right. The US system is exactly the same as the British one. Good job on your positive reinforcement, optimism cures.
- cookiecaper 10y ago
  He's not saying that the systems are the same, just that good and bad experiences are had in both. Thus, a recounting of one smooth experience in the UK cannot be used to say that their system is inherently better than the American system. The post basically says, "Wow, we got medical care and didn't have to pay for it!" Everyone already knows that Britons pay for health care out of their taxes and not at the time of service, so it doesn't really bring anything to the table, and certainly doesn't make a case for or against one system or the other.
popmystack 10y ago
You are comparing two completely unrelated things.
Angostura 10y ago
luckily, there are statistics on patient satisfaction available for individual hospitals and the NHS as a whole which shows a good degree of satisfaction. Of course no system is perfect and their are a number of hospitals in 'special measures' which means their management is replaced and they are in turnaround. I'm very sorry to hear about your friends mother. I assume it triggered a full investigation?
- 10y ago

neom 10y ago

Grew up in the UK, went to college In Canada, US for the last 6 years. NHS was excellent growing up. OHIP/Ontario Health Care was excellent. The US is contrived and awful.

falsestprophet 10y ago
> "NHS was excellent growing up. OHIP/Ontario Health Care was excellent. The US is contrived and awful." contrived. having an unnatural or false appearance or quality What?
- neom 10y ago
  What do you mean by what? I presume by the italics it means you're unable to comprehend the word contrived? Would you like me to define it for you?
  - deleted 10y ago
    [deleted]

DanBC 10y ago

Those hospital wheelchairs are difficult to use, but it's possible to safely push them. > The only real issue was people who show up for care that is clearly not even semi urgent never mind emergent. People do love the NHS. And they trust A&E. Companies would kill to get that kind of brand loyalty. So the answer is to co-locate walk-in doctors and minor injuries with A&E departments, and have fierce triage on entry to divert the people who don't need it away from A&E.

Ericson2314 10y ago

I know rhis isn't the main impediment to policy change, but I kinda want to require that all doctors and nurses study/be a resident abroad, just so most people in any US hospital know what we're missing.

WoodenChair 10y ago

The problem with socialized medicine is not with regards to the routine (broken ankle, high cholesterol) but instead with regards to the even slightly unusual. The economic incentive is not there for highly trained specialists. Nothing about this article is surprising, despite the author's tone. Any modern industrialized country should be able to quickly treat a routine broken ankle. Where that's not possible in the US it's a travesty. Now compare the care of extremely rare diseases in the US and UK and you have something more interesting to talk about.

aleksei 10y ago
I have to disagree with this. If there were no private hospitals this might hold true, but as it is the better off will continue to pay for their expensive treatment, keeping the economic incentive for doctors, while the poor will at least have basic treatment available (at no cost, no less). As for comparing rare disease treatment, I can't say but would like to see some more information.
cjdndjcn 10y ago
I just about died from scarlet fever a year ago in the US because they wouldn't prescribe me antibiotics since the strep antigen tests kept coming back negative. I didn't get better until two weeks later when they finally gave me the antibiotics anyway. This was despite that fact that I displayed all the classic symptpoms: 107.5F fever, full body rash, chest pain, and blood in my urine. In my experience the only thing exceptionally good about US healthcare is its astoundingly effective PR team.
NowImUsingNames 10y ago
I just about died from scarlet fever a year ago in the US because they wouldn't prescribe me antibiotics since the strep antigen tests kept coming back negative. I didn't get better until two weeks later when they finally gave me the antibiotics anyway. This was despite that fact that I displayed all the classic symptpoms: 107.5F fever, full body rash, chest pain, and blood in my urine. In my experience the only thing exceptionally good about US healthcare is its astoundingly effective PR team.

brightshiny 10y ago

I've worked in the NHS, for several different organisations at different levels of the hierarchy (PCTs, SHAs, CCGs etc), as a contractor, over several years. I would privatise it tomorrow. The amount of waste in terms of time and money were eye-watering, every time. The amount of politicking was immense. A project that should take a few weeks could easily expand into a couple of years. I resigned from my last contract because it actually felt immoral to be taking a large amount of cash to either sit around twiddling my thumbs, fight with people, or do work at the slowest possible pace in the most ineffective way. I'd rather do something else. Basically, I've never worked for a private company that was anything like that, even the worst ones, and I find it hard to believe any private company would survive very long working that way. I'll add, my Japanese girlfriend and her friends are utterly unimpressed with the level of service. As was my Spanish girlfriend, who also worked on a hospital's grounds as a medical researcher. I'm not saying we should copy the Americans, no way, but the Japanese system is private, the German system is private, the Dutch and French systems are also private. Going private does not mean chucking the idea of universal healthcare on the fire, it means properly separating the regulator from the provider and removing the kind of conflict of interest that led to the cover up of high mortality rates, among other things. There is more than one way to skin a cat. And no, I'm not a Tory. Try picking up a copy of Private Eye if you want to divest yourself of the notion that the NHS is a saintly institution. Or work there.

DanBC 10y ago
> I would privatise it tomorrow There are plenty of examples in this thread of how good the emergency treatment is, and some bad examples of GP treatment. In the UK your "NHS GP" is paid for by the NHS, but is employed by a private company. The private bits of the NHS fucking suck.
Angostura 10y ago
How much of that inefficiency was caused by the part-privatisation? Much much paperwork is caused by the inefficient but politically-attractive internal market successive governments have tried to set up.
- 10y ago

privateersman 10y ago

She had two options: go through the GP-based system where treatment can take anything from days to months, or take the initiative by jumping the line and go to A&E. Going to A&E is like having your tech support handled by engineers. Going through the GP system is like calling a support line. She got a positive outcome because she went with the option that costs the most. I'm pointing this out as someone who has gone through both methods. Don't believe the hype that you read about the NHS. It's good to have, but it's not amazing and if everyone went through A&E, the system would probably collapse.

AYBABTME 10y ago
Do believe the hype. It might be imperfect, but it's definitely better than what people go thru in the US, and hype is something it could use.
have_faith 10y ago
Struggling to understand your point of view. It's not really a case of GP or A&E. They are two different things with different purposes. The A&E is designed for problems that shouldn't wait. Your GP is for ongoing issues that aren't crucial to be sorted right away. It's called Accident and Emergency for a reason. The NHS is far from perfect but I don't know what a better system would be.
- privateersman 10y ago
  Just pointing out that what people experience from A&E is vastly different from what people experience from the GP system. This article highlights the best part of the NHS, whereas the GP system is like being caught in limbo. If you are rich enough and plan in advance, it can be avoided by going private, otherwise it can mean months, even years of suffering through long waits.
mcintyre1994 10y ago
> if everyone went through A&E, the system would probably collapse. I don't understand how this is a bad thing about the system. Yes, if everyone went through the most expensive system designed for urgent things, the system would presumably collapse. But they don't, because the system includes something for less urgent cases, and thus doesn't collapse. Doesn't that just mean that aspect is well designed to avoid collapse that would apparently be inevitable if it were less well designed? Isn't that a good thing?

deleted 10y ago

[deleted]

UK-AL 10y ago

I find the NHS is good for the little things, gets worse as you go for the more complicated things. My dad had pancreatic cancer and went to the doctors, did every sort of cheap test they could. They didn't believe him, and said it was psychological and sent him to a psychiatric hospital instead. Again nothing worked After constant complaining, eventually they went for the expensive scan, and found that it was pancreatic cancer wasting several months. Awful.

codegeek 10y ago

The article is nice but a specific comment caught my attention which was "I honestly live in fear of having an accident or getting sick here in America." This. No matter what we claim about American healthcare, this points resonates so well with most of us in America. It absolutely is scary to imagine being sick even with insurance. Without insurance, forget about it. Then comes the maze of crazy terms like co-pay, co-insurance, deductible, pre-authorization, in-network, out-network, Specialist referral and god knows what else. Now may I rant about the Insurance companies if I may ? Obamacare was supposed to fix healthcare but it added to the red tape further. No real solutions. Insurance companies still have too much power and they call the shots, not the doctors/hospitals. Good luck fighting a denied claim unless you can shell good amount of lawyer money. I don't know the solution though. America still has one of the best facilities in the world and even though the process is too bureaucratic and downright idiotic in many cases, the care that is actually provided is still pretty good. And I say this as someone who is aware of medical tourism and countries such as India. One solution could be to get rid of insurance scam (yes I call it a scam) and then lets hospitals/doctors compete with transparent pricing in a free market. For catastrophic events, let insurance companies exist. I hate it that to even get an X-Ray, I need insurance and without it, they will look at you as if you came from some strange land. And if you do end up getting a service without insurance, good luck looking at the bill when it finally comes. You can be a crypto expert but won't be able to figure that one out.

fastball 10y ago
No ER in the US will turn you away if you have an emergency, regardless of financial status...
- rdtsc 10y ago
  They will take you but then send you a bill. As a first time visitor to this country many years ago I went an clinic because I had severe strep throat. Waited 1 hour, then some intern saw me for 5 minutes. Gave me a codeine pill and later sent me a bill for $400. That was 1990's $400 dolars, and I had a stipend of only $200 month as a student. That right there is fucked up. Actually, I would rather they just turned me a way -- "Sorry bud, this will be more than you can afford". I know what people will say "Oh you don't have to pay, declare bankruptcy or call and haggle with the hospital". But you know where you haggle with the hospital -- in a 3rd world country when you are bribing the doctors to not kill you. You haggle there as well, and you also have to haggle here to get he "special, I can't pay" rate.

anexprogrammer 10y ago

We get a lot for the money, compared to the cost of other systems. I absolutely don't want to see more privatisation of the system despite most governments nudging towards this. All is not perfect though. Every government wants to be seen to be "doing something", so fiddles. Constantly. Staff is overworked and mostly underpaid. Emergency and cancer care seems to be very good. I'd recommend not needing a non-emergency or mental health treatment in some of the poorer regions of the country though. For instance. If you need Aspergers help for your child, or referral to some CBT for depression in some places you can wait 12 months. Sometimes more. Even so I prefer it to anything like the US system as you can;t fall through the gaps entirely for being broke. I'm glad to pay more tax as a result, rather than an insurance premium or in-work benefit.

dzhiurgis 10y ago

Had 3 visits so far in London hospitals, regarding recurring pain around heart area. Doctor solution was making me keep pain diary as NHS has no money for diagnostics... I did get some basic blood checks though.

DanBC 10y ago
Were they emergency visits, or GP arranged visits? What did the GP say when you asked him/her about it?
- dzhiurgis 10y ago
  GP visits, that's GP. NHS has no money. I think they thought I am eastern european freeloader. The pain is manageable and tends to disappear when I stop drinking, which suggests liver swelling. But then my arms sometimes feel numb. I've moved from UK since. To a place where immigrants pay just as much tax, but do not get free healthcare like citizens do.

greggman 10y ago

Well... Sadly I've had bad experiences I was in London last summer. Got sick. Waited about 9 days for it to get better. No signs of change so went to NHS. Wait one hour. Was led into consultation room and was told I could wait another 90 minutes if I wanted but that I could only see a nurse and regardless of what the nurse found she could not prescribe any medicine. Or, I was told by the same NHS person I could go about a 10 minute walk to a private clinic and see a doctor probably immediately and as a doctor they could prescribe medicine if needed. So ... Yea, wasn't a good first impression of NHS. Not saying USA's system is better. In Japan it's easy to see a doctor but at least in my experience about 30% of them are quacks. Also if you need surgery and you want a good doctor you need to bribe them. This is so common it's a normal part of most medical dramas. I'm scared of getting the giant bill in the USA. But I'm scared of getting hurt by the doctor in Japan if I need any surgery. I don't know the solution.

shanacarp 10y ago

I actually watch this. I'm in a private group for what is collequally called previvors (specifically Young previvors - though some people have had/current do have breast/ovarian cancer, including a few who are dying of it). I need specialized DNA testing for complicated reasons in my family history for risk assessment. It isn't covered. We have UK and European Members. I see who their doctors ares, what research they publish. I know what they pay. ($0) I know that for patients like me, European doctors are way more proactive, even for joining studies, because they can afford to be. I know factually that if I were in europe that test would have been done LAST YEAR. Instead I'm still looking around for one doctor outside of my regular provider to do this one DNA test under research protocols. Doing this one test could potentially save the medical system thousands of dollars. That's what baffles me the most: The insurance companies wants me to use a certain amont of services, but only so much, in the US It is like they actually don't want me to be healthy - and I am not sure why.

cja 10y ago

The NHS is massively overstretched. I'd be terrified of having to go to A&E at Worcester hospital, where I live, but the system we have doesn't allow for me to take my business elsewhere so there's no competition.