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> The NHS provides universal care but not universal treatment. You go to the doctor, they go shrug can't help you. That isn't actually the case. There are cer

by louthy 7y ago

> The NHS provides universal care but not universal treatment. You go to the doctor, they go shrug can't help you. That isn't actually the case. There are certain treatments and drugs that NICE (National Institute for Clinical Excellence) [1] won't sanction due to them either being ineffective or too expensive for the returns, but mostly you will get coverage for pretty much everything. The main issue with the NHS is waiting times, but that can easily be avoided by topping up with private healthcare for about £80pm. So, because of the NHS private healthcare is also cheap. [1] https://www.nice.org.uk/about/what-we-do https://www.nice.org.uk/about/what-we-do

hogFeast 7y ago
It is the case. You have just explained part of how that operates (you appear to be incredibly casual about a bureaucrat deciding whether your life will generate a sufficient "return"...is that because you think it can never happen to you?). But, in addition, the NHS has a fixed policy on whether they will treat certain conditions or not (I know this because I look after a relative with one of these conditions). In the US, you can seek a second opinion (from someone who is very specialist). That doesn't and cannot occur in the UK. You can seek a private opinion but you will be seeing the same doctor (who will likely not know anything beyond NHS policy). The only solution in these cases is (usually) to go to a system that has an active private healthcare market (Germany, the US, Netherlands, etc.).
- louthy 7y ago
  > (you appear to be incredibly casual about a bureaucrat deciding whether your life will generate a sufficient "return"...is that because you think it can never happen to you?). Not at all. I understand that there's a pot of cash and unless we have a government that is going to expand that pot of cash by either raising taxes (which I would be all for) or increasing borrowing that then we need NICE to make some decisions. Their mandate is to consider what's best for the population as a whole, not what's best for the government. It may have let you down, and I really do feel for you and your situation, but the extreme negativity with which you portray the NHS is unwarranted in my opinion. I don't know what condition you're referring to, but if it's chronic then I assume it would likely bankrupt you if you tried treating it in the US. Other aspects of our system that work very well is that NICE can negotiate with the pharmacutical companies for lower rates, because we have the buying power of 65 million people. US hospitals are often negotiating individually and so their costs sprial. > You can seek a private opinion but you will be seeing the same doctor (who will likely not know anything beyond NHS policy) That is far too sweeping a statement, this is the truth map: * There are private only specialists * There are NHS only specialists * There are private only specialists who may do NHS overspil work that a private hospital has tendered for * There are NHS hospitals with 'private wings' where you'll be treated by an NHS specialist Depending on the specialism a specialist may be 'attached' to a private hospital group (like HCA) and you can call up HCA [1] and get a quote for anything you like (that they provide). If you have private insurance then you can get that private work covered if the insurance company is willing to pay for it - just like all insurance healthcare models around the world, or you can pay for it yourself. I have spent the past 15 years building a healthcare software company and work with the biggest private healthcare companies in the UK (and recently with the NHS). [1] https://www.hcahealthcare.co.uk https://www.hcahealthcare.co.uk
- mnm1 7y ago
  With either public or private healthcare a 'bureaucrat deciding whether your life will generate a sufficient "return"' will be the case. At least in the case of public government run insurance, they have an incentive to keep you alive and healthy. In the US private system, their incentive is only to profit. In other words, their incentive is that you die and save them having to pay for care.

by louthy 7y ago

hogFeast 7y ago

It is the case. You have just explained part of how that operates (you appear to be incredibly casual about a bureaucrat deciding whether your life will generate a sufficient "return"...is that because you think it can never happen to you?). But, in addition, the NHS has a fixed policy on whether they will treat certain conditions or not (I know this because I look after a relative with one of these conditions). In the US, you can seek a second opinion (from someone who is very specialist). That doesn't and cannot occur in the UK. You can seek a private opinion but you will be seeing the same doctor (who will likely not know anything beyond NHS policy). The only solution in these cases is (usually) to go to a system that has an active private healthcare market (Germany, the US, Netherlands, etc.).

louthy 7y ago
> (you appear to be incredibly casual about a bureaucrat deciding whether your life will generate a sufficient "return"...is that because you think it can never happen to you?). Not at all. I understand that there's a pot of cash and unless we have a government that is going to expand that pot of cash by either raising taxes (which I would be all for) or increasing borrowing that then we need NICE to make some decisions. Their mandate is to consider what's best for the population as a whole, not what's best for the government. It may have let you down, and I really do feel for you and your situation, but the extreme negativity with which you portray the NHS is unwarranted in my opinion. I don't know what condition you're referring to, but if it's chronic then I assume it would likely bankrupt you if you tried treating it in the US. Other aspects of our system that work very well is that NICE can negotiate with the pharmacutical companies for lower rates, because we have the buying power of 65 million people. US hospitals are often negotiating individually and so their costs sprial. > You can seek a private opinion but you will be seeing the same doctor (who will likely not know anything beyond NHS policy) That is far too sweeping a statement, this is the truth map: * There are private only specialists * There are NHS only specialists * There are private only specialists who may do NHS overspil work that a private hospital has tendered for * There are NHS hospitals with 'private wings' where you'll be treated by an NHS specialist Depending on the specialism a specialist may be 'attached' to a private hospital group (like HCA) and you can call up HCA [1] and get a quote for anything you like (that they provide). If you have private insurance then you can get that private work covered if the insurance company is willing to pay for it - just like all insurance healthcare models around the world, or you can pay for it yourself. I have spent the past 15 years building a healthcare software company and work with the biggest private healthcare companies in the UK (and recently with the NHS). [1] https://www.hcahealthcare.co.uk https://www.hcahealthcare.co.uk
mnm1 7y ago
With either public or private healthcare a 'bureaucrat deciding whether your life will generate a sufficient "return"' will be the case. At least in the case of public government run insurance, they have an incentive to keep you alive and healthy. In the US private system, their incentive is only to profit. In other words, their incentive is that you die and save them having to pay for care.