4 ms·

Waiting lists in my area for 'non-urgent' cases of mental health are over 1 year.

colechristensen 5y ago
When people promote universal single payer healthcare in the US, this is the kind of thing I want them to know about. There are downsides.
- enneff 5y ago
  Well the alternative you’re working with there is only the wealthy are able to afford that healthcare. Poor people just can’t. How is that better?
- ggm 5y ago
  Nothing is perfect. That said, overall the cost to the system in healthcare provision in the US is approximately DOUBLE that of the NHS per capita. If you took half of that difference and applied it judicously, waiting lists would drop quite a bit.
  - colechristensen 5y ago
    Do the people on waiting lists care what it costs the government or what could be but isn’t?
    - ggm 5y ago
      Do they stay on waiting lists if they can afford to go private? No. They certainly care that their likely path to a fix is not going to bancrupt their family, if they elect to stay on the waiting list and when they get to the top, the surgeon who sees them is the same as the private one, and the anaesthatist, and the nurses, most times.
- pmoriarty 5y ago
  These kinds of wait times are not an inevitability for single-payer. I have Medicaid in the US and I get seen within a week to a month (sometimes even same-day) in non-emergency situations, and 100% of my medical bills are covered by the government. The worst part of it is that for certain specialties there just aren't many doctors who accept Medicaid, so I pretty much have to take what I can get... but this shouldn't be a problem if every doctor accepted a single-payer plan. On the other hand, for things like mental health care there's a large amount of choice in my area. So overall I'm pretty pleased.
  - colechristensen 5y ago
    Sure, but this is partially enabled by the fact that often doctors lose money on Medicaid patients which is why they often don’t accept them. The situation would not be the same if everyone was on the same payment plan.
- somewhereoutth 5y ago
  Actually no. Care is rationed according to need, not ability to pay. Unfortunately the UK has a government that wants a US style system, so they reduce funding as much as they think they can get away with. The US system is worse on every single metric (unless you're rich of course - which is the point of it).
  - colechristensen 5y ago
    Rationing according to needs apparently scaled so that people with real but not severe beds needs get delayed for a long time.
- FDSGSG 5y ago
  What are the downsides? People in the UK can still have private insurance if they want, which actually tends to be much cheaper than in the US.
- Delphiza 5y ago
  Lack of mental health and illness services is due to a lack of supply i.e. not enough clinicians. How it is delivered (or not) is orthoganal. The lack of clinicians may be related to pay, working conditions, brexit. I mostly believe that in the UK, the idea of 'getting therapy' is not as culturally universally accepted as the US, so has largely not been considered neccesary by society (see 'keep a stiff upper lip'). That is changing, especially amongst the young, but it will take a while for people to want and move into those jobs. Source: someone who is willing and able to pay for services, but cannot find them
k0k0r0 5y ago
I had some strange change of mind about this. Previously, I was shocked about long waiting times as well. I must note that in my area the waiting time is rather a low 1 digit number of months, so the situation here is much less severe. But my opinion on this changed over the years. As in any peer group, I guess, there is some broken people in mine, too. I draw all my experience from that. Sometimes I feel there is way to many in my peer group. But aparently this is normal among young european people with higher aducation, I don't know. Maybe simple people talk about his more... Anyways. Waiting at least three months for somebody with a median-type depression seems hard even without suicidal thoughts. I guess, that waiting time is even harder for the people who suddenly notice how they live their life is fucked up, and they need help. E.g. due to sudden realization of their own toxic behaviour, sudden realization of their terrific past and its effect on them, burnout (surprisingly, I have not expierienced that within my peer group, yet, apart from once rather tangientally) or even simple realization of a highly unhealthy relationship to work or significant other. However. Aparently, finding a therapist with whome effective treatment is possible, is extremely hard. In particular, those with - let's call it - interesting past, seemed to switch therapists once or twice before finding someone with whome to work yielded noticable changes in their life. Also a good fraction of those in my peer group had questionable therapists. I can not jugde this, but I believe that achieving the art of being a good therapists (at least for some people) is among the most difficult skills one might aim for. After finding a therapist that treatment often lasted for years. And with that as a support, they changed their life. Sometimes, entirely. Of course, this is not true for all of them, unfortunately. And maybe even only for less then half of them. Nevertheless, for some relevant fraction of them it lead to invaluable gains in their life. It lead to something, that is definitely worth to wait for a couple of months. I noticed a problem is missing opportunities for non-pharmaceutic intermediate help for "non-urgent" cases waiting for "real" therapy. E.g. group-therapy with the clear intent of being for people that wait for something else. While this doesn't solve the problem of too little "supply" when compared to the "demand", it may help those people a lot. Even if only to show them, we care, even though resources are scarse (or terribly organized, whatever of these two). Also I wrote "demand" with some kind of thruth behind this. At least for some in my peer group zi feel like their desire to be "sick" and their demands for help is a (possibly pathological - I cannot jugde this) problem in itself.

When people promote universal single payer healthcare in the US, this is the kind of thing I want them to know about. There are downsides.

enneff 5y ago
Well the alternative you’re working with there is only the wealthy are able to afford that healthcare. Poor people just can’t. How is that better?
ggm 5y ago
Nothing is perfect. That said, overall the cost to the system in healthcare provision in the US is approximately DOUBLE that of the NHS per capita. If you took half of that difference and applied it judicously, waiting lists would drop quite a bit.
- colechristensen 5y ago
  Do the people on waiting lists care what it costs the government or what could be but isn’t?
  - ggm 5y ago
    Do they stay on waiting lists if they can afford to go private? No. They certainly care that their likely path to a fix is not going to bancrupt their family, if they elect to stay on the waiting list and when they get to the top, the surgeon who sees them is the same as the private one, and the anaesthatist, and the nurses, most times.
pmoriarty 5y ago
These kinds of wait times are not an inevitability for single-payer. I have Medicaid in the US and I get seen within a week to a month (sometimes even same-day) in non-emergency situations, and 100% of my medical bills are covered by the government. The worst part of it is that for certain specialties there just aren't many doctors who accept Medicaid, so I pretty much have to take what I can get... but this shouldn't be a problem if every doctor accepted a single-payer plan. On the other hand, for things like mental health care there's a large amount of choice in my area. So overall I'm pretty pleased.
- colechristensen 5y ago
  Sure, but this is partially enabled by the fact that often doctors lose money on Medicaid patients which is why they often don’t accept them. The situation would not be the same if everyone was on the same payment plan.
somewhereoutth 5y ago
Actually no. Care is rationed according to need, not ability to pay. Unfortunately the UK has a government that wants a US style system, so they reduce funding as much as they think they can get away with. The US system is worse on every single metric (unless you're rich of course - which is the point of it).
- colechristensen 5y ago
  Rationing according to needs apparently scaled so that people with real but not severe beds needs get delayed for a long time.
FDSGSG 5y ago
What are the downsides? People in the UK can still have private insurance if they want, which actually tends to be much cheaper than in the US.
Delphiza 5y ago
Lack of mental health and illness services is due to a lack of supply i.e. not enough clinicians. How it is delivered (or not) is orthoganal. The lack of clinicians may be related to pay, working conditions, brexit. I mostly believe that in the UK, the idea of 'getting therapy' is not as culturally universally accepted as the US, so has largely not been considered neccesary by society (see 'keep a stiff upper lip'). That is changing, especially amongst the young, but it will take a while for people to want and move into those jobs. Source: someone who is willing and able to pay for services, but cannot find them

k0k0r0 5y ago

I had some strange change of mind about this. Previously, I was shocked about long waiting times as well. I must note that in my area the waiting time is rather a low 1 digit number of months, so the situation here is much less severe. But my opinion on this changed over the years. As in any peer group, I guess, there is some broken people in mine, too. I draw all my experience from that. Sometimes I feel there is way to many in my peer group. But aparently this is normal among young european people with higher aducation, I don't know. Maybe simple people talk about his more... Anyways. Waiting at least three months for somebody with a median-type depression seems hard even without suicidal thoughts. I guess, that waiting time is even harder for the people who suddenly notice how they live their life is fucked up, and they need help. E.g. due to sudden realization of their own toxic behaviour, sudden realization of their terrific past and its effect on them, burnout (surprisingly, I have not expierienced that within my peer group, yet, apart from once rather tangientally) or even simple realization of a highly unhealthy relationship to work or significant other. However. Aparently, finding a therapist with whome effective treatment is possible, is extremely hard. In particular, those with - let's call it - interesting past, seemed to switch therapists once or twice before finding someone with whome to work yielded noticable changes in their life. Also a good fraction of those in my peer group had questionable therapists. I can not jugde this, but I believe that achieving the art of being a good therapists (at least for some people) is among the most difficult skills one might aim for. After finding a therapist that treatment often lasted for years. And with that as a support, they changed their life. Sometimes, entirely. Of course, this is not true for all of them, unfortunately. And maybe even only for less then half of them. Nevertheless, for some relevant fraction of them it lead to invaluable gains in their life. It lead to something, that is definitely worth to wait for a couple of months. I noticed a problem is missing opportunities for non-pharmaceutic intermediate help for "non-urgent" cases waiting for "real" therapy. E.g. group-therapy with the clear intent of being for people that wait for something else. While this doesn't solve the problem of too little "supply" when compared to the "demand", it may help those people a lot. Even if only to show them, we care, even though resources are scarse (or terribly organized, whatever of these two). Also I wrote "demand" with some kind of thruth behind this. At least for some in my peer group zi feel like their desire to be "sick" and their demands for help is a (possibly pathological - I cannot jugde this) problem in itself.