5 ms·

Unfortunately the NHS is, in many ways, pretty bad. They're pretty good at dealing with pregnancies, cancers, and emergencies but try getting seen for a chronic

Unfortunately the NHS is, in many ways, pretty bad. They're pretty good at dealing with pregnancies, cancers, and emergencies but try getting seen for a chronic pain and you'll follow this rough timeline: - Try see your GP. Wait 2 weeks until your appointment. - GP will give a cursory examination and recommend a dietary change, taking ibuprofen/paracetamol, and to come back if problem persists. - Problem persists. Book in with your GP and wait another 2 weeks. - GP will actually examine you this time. They may then refer you to the local hospital, and so you should await a letter. - about 2 weeks later, the a will arrive saying that you should phone up to make an appointment. - within 8 weeks you should get another letter telling you when your appointment is, which will be within 4 weeks. At this point you have spent 20 weeks just to get seen by a specialist. And that's assuming everything goes ok. Admin may not update your details, so the letters go to an old (or wrong) address. They may just entirely forget to make an appointment for you. Probably if you try phone them they just won't pick up the phone. There's a fetishisation of the NHS in this country that protects it from a lot of criticism. Some will say "well you should put up with that because it's free" or some similar rubbish, ignoring that it costs £2200 per person. None of these issues are restricted to the NHS. Any large organisation will have such issues. But it's utterly frustrating stuff like this that makes me consider going private - I shouldn't have to spend hours on the phone figuring out why I haven't been assigned an appointment despite being referred 3 months ago.

com2kid 9y ago
In contrast, to America working for a good employer: 1. Schedule with GP. Say I am in pain. Get in within 2 days. 2. Get a referral to Physical Therapy. Asked if I have any preference where to go. My doctor knows my network and gave me a number of choices that were within network (a number of which were within walking range of where I lived). 3. Call PT office. Schedule an appointment. They apologize that their next opening is a week away. Gladly accept. Physical Therapy is interesting in that it is semi-free market and rather competitive, so it tends to work a bit better than some other scenarios.
- DanBC 9y ago
  To be fair that's usually how it works in England too, with maybe a bit longer to wait for physiotherapy, and the addition of weight loss programmes.
- sevensor 9y ago
  > In contrast, to America working for a good employer: > 1. Schedule with GP. Say I am in pain. Get in within 2 days. > 2. Get a referral to Physical Therapy. Asked if I have any preference where to go. My doctor knows my network and gave me a number > of choices that were within network (a number of which were within walking range of where I lived). > 3. Call PT office. Schedule an appointment. They apologize that their next opening is a week away. Gladly accept. > Physical Therapy is interesting in that it is semi-free market and rather competitive, so it tends to work a bit better than some > other scenarios. Speaking from recent experience, on Obamacare: 1. Live with pain for 6 months because you know you're not getting out of a specialist's office for less than $750. 2. Cave in when the pain becomes unbearable and see a specialist. 3. Make an appointment for PT with a provider who doesn't take insurance at all, because the transparent pricing means no surprises. 4. Pay out of pocket for PT appointments. 5. Spend the next 4 months getting bills for your one specialist visit. Half of these are coded wrong so insurance won't pay. Spend 2h every week on the phone trying to get it sorted out. If you talk to whoever does the specialist's billing at any point, you'll find that they're totally unable to estimate the cost of services. You might as well not even try to figure out how much it costs in advance.
- J_Sherz 9y ago
  Just to add another perspective also working in America for a good employer: 1. Schedule with GP, get appointment very quickly. 2. GP has no idea who is "in network" for you and doesn't seem to care very much. They also don't understand the different insurance plans so have no idea if you're covered for certain types of referral. 3. Schedule appointment with a specialist. Ask for up front cost estimate for consultation/procedure given your insurance plan. Unable to answer. 4. Go to appointment anyway as you don't have many other choices. 5. Receive astronomical bill for some obscure billing code that is not covered by your health plan. 6. Spend time calling doctors office and insurer to figure out the situation and try to avoid or reduce bill. I've experienced the NHS too - for all its flaws, the peace of mind living in the UK from a health standpoint is worth every penny of the associated taxes IMO.
jaymzcampbell 9y ago
This is very true, but, what saddens me the most is that rather than attempt to fix it (for all of society), the failings are used as an excuse to push further privatisation. It feels to me that we in the West are going ever faster backwards over fairness in issues like education, health and housing. I'm lucky to be well off & healthy enough to not (yet) be affected by a poor performing NHS but I wish we, as a country, would pull together on this - from top to bottom. Unfortunately, I just don't see it happening anytime soon, we seem to be increasingly more divided - religiously, economically, politically - than ever before. Society feels increasingly like a "Mad Max" movie in operation. This is only going to end badly for everyone. There is way too much "me me me" from all levels. I find it emotionally exhausting to think about. I don't begrudge anyone who has the means to get private health care from doing so (my girlfriend and many friends do) - so please don't think I am saying nobody should - I just wish there was a more proactive and pragmatic desire to fix the root issues. Of course, I realise I am living in cloud cuckoo land on that. I should add that I can certainly empathise and can agree with your comment about chronic pain. My father is suffering from sciatica and it has been over a year to get an operation scheduled. This will involve him travelling from Northern Ireland to the Midlands because there is an even longer (multi year) wait to be seen in NI.
deleted 9y ago
[deleted]
chimeracoder 9y ago
> They're pretty good at dealing with pregnancies, cancers, and emergencies I agree with everything you say, except the part about cancer. Even by European standards, the NHS is actually quite terrible at dealing with cancers - even "routine" cancers (like breast cancer and prostate cancer), let alone rare cancers. The five-year survival rate for prostate cancer in the UK is 55%, whereas in the US it's upwards of 90%. (Prostate cancer is an incredibly treatable form of cancer; for most people, as long as it's detected early and managed appropriately, they will die with prostate cancer as opposed to from it). Of developed countries, only Japan, Portugal, and Denmark have worse five-year survival rates for prostate cancer.
- jaymzcampbell 9y ago
  I'm unfamiliar with how the US stats get collected - is that 90% of "everyone who had prostate cancer" survives 5+ years; or is that "everyone who had prostate cancer and private medical insurance"? If so then that is rather shocking. Prostate cancer may be something of an outlier given the hesitation people have in discussing it. This is something that has only really recently been attempted to be addressed in the UK. Campaigns fronted by comics like Bill Bailey have tried to make it normal to talk about. The British as a society are still so reserved that I imagine thousands die of preventable cancers and diseases simply out of embarrassment. Edit - I've just had a look at Cancer Research's figures[1], [2] and, using data from 2010/11 - prostate cancer had a UK survival rate of ~84% or so - i.e. nearly the same as the US. [1] http://www.cancerresearchuk.org/health-professional/cancer-statistics/survival/common-cancers-compared#heading-Zero http://www.cancerresearchuk.org/health-professional/cancer-s... [2] http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/prostate-cancer/survival http://www.cancerresearchuk.org/health-professional/cancer-s...
  - chimeracoder 9y ago
    > I'm unfamiliar with how the US stats get collected - is that 90% of "everyone who had prostate cancer" survives 5+ years; or is that "everyone who had prostate cancer and private medical insurance"? If so then that is rather shocking. It's looking at people with prostate cancer, regardless of insurance status. > Prostate cancer may be something of an outlier given the hesitation people have in discussing it. It's not limited to prostate cancer; for survival rates, the NHS does pretty terribly on almost every form of cancer compared to the US. I picked prostate cancer because it's something that's very treatable - the upper limit is close to 100% for five-year survival, which makes the UK's outcomes that much more unacceptable. But the story is the same for all other common cancers (let alone rare cancers, which the NHS is not optimized as a system to treat).
JshWright 9y ago
> ignoring that it costs £2200 per person So... less than 1/3rd of what the US pays on a per capita basis? I'd be cool with that...
Paul-ish 9y ago
It is interesting that people go straight to single payer in their mental model when they think of changing the healthcare system. Germany has a multi payer system (although the government does provide a large % of the total funds) that seems to work for them. Why do so many in the US look to single payer systems as the ideal model?
- rb808 9y ago
  Because all the other English speaking countries have single payer. They dont know what happens in Germany/Holland/Singapore etc.
sitharus 9y ago
Wow, in New Zealand on a similar public system it's quite different. Having had chronic pain myself I've been through this. - Book a GP appointment. Generally get in the same day (costs $20-$80 depending on your GP. I have private insurance that pays up to $38) - GP orders blood tests, these are free. Clinic is on-demand, just show up. Wait times are around 30 minutes. Also prescribes ibuprofen ($5 for 100 tablets) and paracetamol (non-subsidised. $10 for 100 tablets). - GP will assess you and refer to a public or private specialist depending on your preference. In my case a public rheumatologist would have taken around a month to see, so I chose private. This cost $180 for the consultation and $120 for follow-up (insurance paid 80%). - Specialist refers more tests. For me this was an MRI. Public wait times were around 3 months because the machine needed replacement and they'd only pay for serious cases to go to the private clinic. I went private, this cost $1400 (insurance paid 80%). - Specialist orders more blood tests, still free. And they still didn't find anything conclusive. Personally I'd like GP visits to be free. They can be for people under a certain income level with the right GP. The public system also needs more funding, but in NZ we spend less per capita on socialised healthcare than the US, and the US has to add private insurance on top of that.
kennydude 9y ago
Unfortunately the NHS doesn't have the resources it needs right now. Blame the government right now who would rather sell it off to their mates.

com2kid 9y ago

In contrast, to America working for a good employer: 1. Schedule with GP. Say I am in pain. Get in within 2 days. 2. Get a referral to Physical Therapy. Asked if I have any preference where to go. My doctor knows my network and gave me a number of choices that were within network (a number of which were within walking range of where I lived). 3. Call PT office. Schedule an appointment. They apologize that their next opening is a week away. Gladly accept. Physical Therapy is interesting in that it is semi-free market and rather competitive, so it tends to work a bit better than some other scenarios.

DanBC 9y ago
To be fair that's usually how it works in England too, with maybe a bit longer to wait for physiotherapy, and the addition of weight loss programmes.
sevensor 9y ago
> In contrast, to America working for a good employer: > 1. Schedule with GP. Say I am in pain. Get in within 2 days. > 2. Get a referral to Physical Therapy. Asked if I have any preference where to go. My doctor knows my network and gave me a number > of choices that were within network (a number of which were within walking range of where I lived). > 3. Call PT office. Schedule an appointment. They apologize that their next opening is a week away. Gladly accept. > Physical Therapy is interesting in that it is semi-free market and rather competitive, so it tends to work a bit better than some > other scenarios. Speaking from recent experience, on Obamacare: 1. Live with pain for 6 months because you know you're not getting out of a specialist's office for less than $750. 2. Cave in when the pain becomes unbearable and see a specialist. 3. Make an appointment for PT with a provider who doesn't take insurance at all, because the transparent pricing means no surprises. 4. Pay out of pocket for PT appointments. 5. Spend the next 4 months getting bills for your one specialist visit. Half of these are coded wrong so insurance won't pay. Spend 2h every week on the phone trying to get it sorted out. If you talk to whoever does the specialist's billing at any point, you'll find that they're totally unable to estimate the cost of services. You might as well not even try to figure out how much it costs in advance.
J_Sherz 9y ago
Just to add another perspective also working in America for a good employer: 1. Schedule with GP, get appointment very quickly. 2. GP has no idea who is "in network" for you and doesn't seem to care very much. They also don't understand the different insurance plans so have no idea if you're covered for certain types of referral. 3. Schedule appointment with a specialist. Ask for up front cost estimate for consultation/procedure given your insurance plan. Unable to answer. 4. Go to appointment anyway as you don't have many other choices. 5. Receive astronomical bill for some obscure billing code that is not covered by your health plan. 6. Spend time calling doctors office and insurer to figure out the situation and try to avoid or reduce bill. I've experienced the NHS too - for all its flaws, the peace of mind living in the UK from a health standpoint is worth every penny of the associated taxes IMO.

jaymzcampbell 9y ago

This is very true, but, what saddens me the most is that rather than attempt to fix it (for all of society), the failings are used as an excuse to push further privatisation. It feels to me that we in the West are going ever faster backwards over fairness in issues like education, health and housing. I'm lucky to be well off & healthy enough to not (yet) be affected by a poor performing NHS but I wish we, as a country, would pull together on this - from top to bottom. Unfortunately, I just don't see it happening anytime soon, we seem to be increasingly more divided - religiously, economically, politically - than ever before. Society feels increasingly like a "Mad Max" movie in operation. This is only going to end badly for everyone. There is way too much "me me me" from all levels. I find it emotionally exhausting to think about. I don't begrudge anyone who has the means to get private health care from doing so (my girlfriend and many friends do) - so please don't think I am saying nobody should - I just wish there was a more proactive and pragmatic desire to fix the root issues. Of course, I realise I am living in cloud cuckoo land on that. I should add that I can certainly empathise and can agree with your comment about chronic pain. My father is suffering from sciatica and it has been over a year to get an operation scheduled. This will involve him travelling from Northern Ireland to the Midlands because there is an even longer (multi year) wait to be seen in NI.

deleted 9y ago

[deleted]

chimeracoder 9y ago

> They're pretty good at dealing with pregnancies, cancers, and emergencies I agree with everything you say, except the part about cancer. Even by European standards, the NHS is actually quite terrible at dealing with cancers - even "routine" cancers (like breast cancer and prostate cancer), let alone rare cancers. The five-year survival rate for prostate cancer in the UK is 55%, whereas in the US it's upwards of 90%. (Prostate cancer is an incredibly treatable form of cancer; for most people, as long as it's detected early and managed appropriately, they will die with prostate cancer as opposed to from it). Of developed countries, only Japan, Portugal, and Denmark have worse five-year survival rates for prostate cancer.

jaymzcampbell 9y ago
I'm unfamiliar with how the US stats get collected - is that 90% of "everyone who had prostate cancer" survives 5+ years; or is that "everyone who had prostate cancer and private medical insurance"? If so then that is rather shocking. Prostate cancer may be something of an outlier given the hesitation people have in discussing it. This is something that has only really recently been attempted to be addressed in the UK. Campaigns fronted by comics like Bill Bailey have tried to make it normal to talk about. The British as a society are still so reserved that I imagine thousands die of preventable cancers and diseases simply out of embarrassment. Edit - I've just had a look at Cancer Research's figures[1], [2] and, using data from 2010/11 - prostate cancer had a UK survival rate of ~84% or so - i.e. nearly the same as the US. [1] http://www.cancerresearchuk.org/health-professional/cancer-statistics/survival/common-cancers-compared#heading-Zero http://www.cancerresearchuk.org/health-professional/cancer-s... [2] http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/prostate-cancer/survival http://www.cancerresearchuk.org/health-professional/cancer-s...
- chimeracoder 9y ago
  > I'm unfamiliar with how the US stats get collected - is that 90% of "everyone who had prostate cancer" survives 5+ years; or is that "everyone who had prostate cancer and private medical insurance"? If so then that is rather shocking. It's looking at people with prostate cancer, regardless of insurance status. > Prostate cancer may be something of an outlier given the hesitation people have in discussing it. It's not limited to prostate cancer; for survival rates, the NHS does pretty terribly on almost every form of cancer compared to the US. I picked prostate cancer because it's something that's very treatable - the upper limit is close to 100% for five-year survival, which makes the UK's outcomes that much more unacceptable. But the story is the same for all other common cancers (let alone rare cancers, which the NHS is not optimized as a system to treat).

JshWright 9y ago

> ignoring that it costs £2200 per person So... less than 1/3rd of what the US pays on a per capita basis? I'd be cool with that...

Paul-ish 9y ago

It is interesting that people go straight to single payer in their mental model when they think of changing the healthcare system. Germany has a multi payer system (although the government does provide a large % of the total funds) that seems to work for them. Why do so many in the US look to single payer systems as the ideal model?

rb808 9y ago
Because all the other English speaking countries have single payer. They dont know what happens in Germany/Holland/Singapore etc.

sitharus 9y ago

Wow, in New Zealand on a similar public system it's quite different. Having had chronic pain myself I've been through this. - Book a GP appointment. Generally get in the same day (costs $20-$80 depending on your GP. I have private insurance that pays up to $38) - GP orders blood tests, these are free. Clinic is on-demand, just show up. Wait times are around 30 minutes. Also prescribes ibuprofen ($5 for 100 tablets) and paracetamol (non-subsidised. $10 for 100 tablets). - GP will assess you and refer to a public or private specialist depending on your preference. In my case a public rheumatologist would have taken around a month to see, so I chose private. This cost $180 for the consultation and $120 for follow-up (insurance paid 80%). - Specialist refers more tests. For me this was an MRI. Public wait times were around 3 months because the machine needed replacement and they'd only pay for serious cases to go to the private clinic. I went private, this cost $1400 (insurance paid 80%). - Specialist orders more blood tests, still free. And they still didn't find anything conclusive. Personally I'd like GP visits to be free. They can be for people under a certain income level with the right GP. The public system also needs more funding, but in NZ we spend less per capita on socialised healthcare than the US, and the US has to add private insurance on top of that.

kennydude 9y ago

Unfortunately the NHS doesn't have the resources it needs right now. Blame the government right now who would rather sell it off to their mates.