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Ill in England? Your Location Can Determine If You Live or Die
- defqon 3y agohttps://archive.is/bLbiA https://archive.is/bLbiA
- AmericanChopper 3y agoThis website has the least pleasant scrolling experience I've ever seen
- lolinder 3y agoIt gets better after the first three paragraphs, they just decided to do something odd for the introduction.
- AmericanChopper 3y agoIt did get better for a moment, then it started moving sideways…
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- mattbgates 3y agoIt's England... bring out your dead. https://youtu.be/zEmfsmasjVA https://youtu.be/zEmfsmasjVA
- mattbgates 3y ago[flagged]
- Aeolun 3y agoI think it’s amazing that a solid system can be defunded like that until it just sorta crumbles under it’s own weight. There’s no immediate solution either. If you build more hospitals, you need more staff, if you need more staff, you need to make it more attractive, but even if you do you need several years before the first doctors/nurses from the wave with renewed interest in the position finishes university. And that’s only if there is any political will to do so.
- bpodgursky 3y agoHealthcare across the entire west is crumbling, and not through defunding. It's driven by demographic shifts that nobody has a real plan to fix.
- nradov 3y agoUltimately the only viable plan is going to be severe care rationing. In most developed countries we have an aging population with an increasing incidence of chronic diseases and a shortage of physicians. Regardless of whether payments come from governments, employers, or individuals the reality is that we simply won't have the resources to care for everyone.
- HarryHirsch 3y agoIn Britain, citizens have a hard time getting basic dental care that they can afford: https://www.bloomberg.com/news/articles/2023-07-13/uk-dentistry-in-crisis-as-people-pull-out-own-teeth-with-pliers#xj4y7vzkg https://www.bloomberg.com/news/articles/2023-07-13/uk-dentis... The demographic explanation simply does not hold water when routine healthcare is not available.
- themitigating 3y agoBut that's routine healthcare for one particular part of the body. Meaning it could be true for general health. In the US dental is considered a seperate insurance for most. So there's a separation for whatever reason meaning using it to disprove the demographic theory for "regular" healthcare might be valid
- skissane 3y agoIsn't this true just about everywhere? Someone who lives in a major urban area is going to have more prompt access to advanced emergency healthcare than someone who lives in a remote rural area, simply due to factors such as travel time, and the clinical need to physically concentrate specialist medical resources (specialist clinical teams need a certain minimum case volume to properly maintain their skills, and if you try to spread them too thinly, you can actually worsen patient outcomes)–but that inevitably means that some people in remote rural areas will die before they get the treatment they need, whereas they may well have survived if they'd lived in a major urban area instead. Inefficiencies and inequities in healthcare systems can no doubt worsen this phenomena, but even if you could have the most efficient and equitable healthcare system possible, it would still inevitably happen, even if to a somewhat reduced degree. The only countries which can totally avoid this problem, are those that are so small that the whole country is a single major urban area, and "remote rural areas" either don't exist at all, or are such a minuscule percentage of the population as to be a statistical rounding error – so basically city-states such as Singapore, Monaco or Vatican City
- lolinder 3y agoThis addresses the title but not the content. The NHS is failing to meet its own goals in a pretty bad way, pretty much everywhere. Whether this is true in every country I don't know, but it's certainly not an inevitability. > The analysis assessed how quickly patients can access health care in each of England’s 533 constituencies — the British term for electoral districts — and found that nearly every single area is failing to meet even half of eight key indicators tracked by the government, from hospital bed availability to ambulance waiting times. A fifth are meeting none.
- skissane 3y ago> Whether this is true in every country I don't know, but it's certainly not an inevitability. Australia has pretty terrible health care in many of its rural areas, and Australia's governments (both state/territory and federal) are clearly guilty of major policy failures in rural/remote healthcare provision. But even supposing they did a much better job, even supposing they did the best job humanly possible – you are still going to get higher mortality and morbidity somewhere like Ivanhoe [0] – a town of less than 300 people, 800 km by road west of Sydney – than in the Sydney metro area. It is just the inevitable tyranny of distance. Far Western NSW simply doesn't have the necessary population to sustain the most advanced health care facilities (tertiary/quaternary), and the inescapable physical delays in getting to them (even using air evacuation) is going to cause deaths and clinically inferior outcomes. Now of course, England is geographically a much smaller country than Australia – England has over twice Australia's population in less than 2% of the area. However, even in England, I would be surprised if the impact of geography on mortality and morbidity completely disappeared – inevitably, even if the NHS were the best health system humanly possible (and it obviously isn't), someone who lives in central London is going to have faster access to the most advanced healthcare than someone who lives in Penzance, [1] – and there are going to be times when that difference makes a real impact to mortality and morbidity. [0] https://en.wikipedia.org/wiki/Ivanhoe,_New_South_Wales https://en.wikipedia.org/wiki/Ivanhoe,_New_South_Wales [1] https://en.wikipedia.org/wiki/Penzance https://en.wikipedia.org/wiki/Penzance
- rootusrootus 3y agoWhich country has the best health care in Europe? And what makes it the best solution? I ask from the perspective of an American, with access to great health care but it’s expensive. If we were going to reinvent health care here, who should we copy?
- _gllen 3y agohttps://en.m.wikipedia.org/wiki/Euro_Health_Consumer_Index https://en.m.wikipedia.org/wiki/Euro_Health_Consumer_Index
- themitigating 3y ago"American, with access to great health care but it’s expensive" Price counts though right? If you can't afford healthcare in the US then for you it's the worst system
- dkh 3y agoIn my view, a big part of problem the here is how individuals view the costs/quality relative only to themselves and not to those of a different socioeconomic status.
- dkh 3y agoI wish there were a quick/easy answer here (we all prefer would to read those) but the truth is that it's not that simple. Even among the nations with excellent universal healthcare systems, most differ from each other in pretty significant ways. This is in part because no two countries are the same, and every detail can have a big effect on what system would work best for them. There are certainly stats-friendly ones about population, economics, and politics. But there are also equally-important ones that are cultural and harder to quantify--for instance, in some countries the people have a distrust of doctors, or a cultural aversion to visiting the doctor unless absolutely necessary, and that factors into the best design for that country, based on how it would be used. What I can recommend is a great book that compares all the systems, through the lens of an American with the same question you have, called The Healing of America by T.R. Reid. Highly recommended.
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- chaostheory 3y agoNearly every country is now suffering from the age demographic bomb where senior retirees are starting to outnumber working adults. https://www.epbmacroresearch.com/blog/the-global-demographic-vortex https://www.epbmacroresearch.com/blog/the-global-demographic... This has major implications for many social safety net programs and entitlements ie there aren’t enough working adults paying into the system, which is also exacerbated by recent anti immigration movements which was a major cause for the UK leaving the EU. This story is now common in many developed countries that offer socialized healthcare.
- themitigating 3y ago(I'm only pointing this out) There's also the issue where people believe that everyone, regardless of age, should be treated to the maximum level possible (or what they can afford in the case of the US). If you publicity suggested that someone who is 99 years old and in poor health shouldn't receive some treatment that costs a massive amount of money/resources you would be looked at in disgust. No politican would even dare. Combine that with the selfish nature of most people (of course to be fair the instinctual desire to avoid death) and an aging population (as you mentioned) and it seems like a few generations are going to be weighed down to extended the lives of the least productive members of society.
- bruce511 3y agoYep. It's political suicide to bring up fairly obvious age/prognosis limits, but ultimately we all die of something. Assuming most disease based hospital stays (heart attacks strokes, cancers) are biased towards older folk it makes sense that resources to younger folk be prioritised. It makes -sense-, but asking a decent human to turf an "old person" out of bed because a "young person" has arrived (with a survivable, but urgent condition) is tough. In war triage is a thing. Save the ones who can be saved, more-or-less ignore the ones you can't. We cannot, and should not, expect civilian medical staff to triage ambulances, A&E, ward beds. But health services are being drowned in the meantime.
- thri737 3y ago
- Barrin92 3y ago>We have to invest more in identifying and tackling disease earlier if we want to “stop the hospitals from falling over and the GPs from being overwhelmed,” he said. Demographics and shrinking labor forces alone will bring the system to its knees regardless of money. It's absolutely baffling in the face of this trend that preventative, systemic policies are practically never discussed and everything centers around individual care. Countries like Singapore show how you can tackle this, strong interventions to prevent entire populations from being obese, a regulated medical sector to bring costs down and private savings funds to encourage personal responsibilty.
- themitigating 3y agoIt's diffcult to do this in countries where one or more political parties use "personal freedom" as a theme. The UK does have a sugar tax that was implemented 5 years ago that seems to have some good effects https://www.wcrf.org/looking-back-at-5-years-of-the-uk-soft-drinks-industry-levy/ https://www.wcrf.org/looking-back-at-5-years-of-the-uk-soft-... The problem is any regulation is an opportunity for those who don't like the government to attack the other side.
- confidantlake 3y agoIf we invested more money I think the problem would get fixed. You need to be smart but you don't need to be a genius for most specialties. Some of those people that flood into big tech could instead go into becoming a doctor if the money and working conditions were there.
- chaostheory 3y ago> It's absolutely baffling in the face of this trend that preventative, systemic policies are practically never discussed and everything centers around individual care. I’m surprised that countries with socialized health care doesn’t already enforce preventive care. Yes, it’s draconian but otherwise the entire system will fall apart faster. Maybe they will with the advent of CBDCs?
- petermcneeley 3y agoCanada doesnt have these kinds of issues with its universal healthcare. We have pioneered new processes to reduce the burden to our medical system [1]. [1] https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html
- kQq9oHeAz6wLLS 3y ago"We improved our support metrics by simply killing our customers, thus reducing call volume."
- FpUser 3y ago[flagged]
- loosescrews 3y agoI know you are joking, but the problem is potentially worse in Canada. Private healthcare is illegal in Canada [1]. At least in the UK you can get private health care [2]. You could argue that this is only an option for the wealthy, but my point of comparison is the US, which is similar minus the public option. [1] https://www.doctr.ca/private-healthcare-in-canada/ https://www.doctr.ca/private-healthcare-in-canada/ [2] https://en.m.wikipedia.org/wiki/Private_healthcare_in_the_United_Kingdom https://en.m.wikipedia.org/wiki/Private_healthcare_in_the_Un...
- computator 3y agoIt's intriguing that medical care is always the worst kind of service, by far, in every country in the developed world, compared to every other kind of product or service we depend on. Compare it to food, electricity, gasoline, clothing, water, cell service, haircuts, transportation, movies. If you're not in a rural location, you can buy food or a restaurant meal 24-hours a day in less than an hour. There's complex infrastructure and supply chains around food production, but it works, and works fast. But you can't start most medical treatment without waiting days, weeks, or even months. In lots of places you can't even see a family physician or primary care doctor without waiting days. Why is it? It is because medical care is more "personalized" and less of a commodity? Because it's heavily controlled by government? Is it the liability (medical people can get sued for a lot more than a bad haircut)? Due to much higher expectations of what is acceptable medical care compared to, say, food? It doesn't seem obvious to me why the economics of medical care should be so different than everything else we use and depend on.
- chaostheory 3y ago> Compare it to food, electricity, gasoline, clothing, water, cell service, haircuts, transportation, movies Compared to other essential professions, doctors need 8 years of schooling and another 4 years for apprenticeship. As for nurses, they are both abused and underpaid. Maybe AI and subsidizing medical schooling can help? Raising the retirement age should also help. A large portion of the population does not pay into the healthcare system.
- nvm0n1 3y agoDo all doctors need that much or is it just the homogenizing effect of licensing? You could argue that programmers need many years of schooling and apprenticeship to become useful if you set the bar of utility at the same place Google used to, but in reality most people can be useful way before that. Also self-learning makes a big difference but isn't recognized by the medical licensing system.
- candiodari 3y ago
- ghusto 3y agoCounterpoint to all the "it's because it's underfunded" arguments: The money's there, it's just misspent, as with all government lead bureaucracies, resulting in service that could and does kill. There are multiple unnecessary levels of bureaucracy being paid, leaving little room for people who do actual work. This also results in those people being stifled by busy work. Source: Doctors I'm friends with, and personal experience (with family members dying or permanently and seriously damaged).
- moribvndvs 3y agoAm I supposed to feel better or worse, considering private healthcare also has bureaucracies that could and does kill, on top of destroying people financially? Source: work in practice management and billing software, and personal experience
- ghusto 3y agoI was lucky enough to have private healthcare paid for me, and I the only bureaucracy I experienced was having to go to the NHS G.P. first to get a "referral". Basically this is a(n NHS side) tick-boxing exercise where you have to be "referred" to a private doctor before you're allowed to see them, even if you pay. In practice what happens is you go to your G.P. and literally say; "can you write a referral so I can go and see my private doctor", and they do so on the spot without batting an eyelid. > on top of destroying people financially? I'm not sure where that's coming from either? Mine was paid for, but it wasn't exactly extortionate. I could have afforded it myself at the time. I don't understand why it's such an emotionally charged issue for some people. If it's a poor/class thing, does it help that I grew up in a piss poor council estate, and thank god I don't have to rely on the NHS ever again.
- MattPalmer1086 3y agoWell, it is underfunded [1]. The UK spends a lot less per capita than any other developed nation. [1] https://www.bmj.com/content/367/bmj.l6326 https://www.bmj.com/content/367/bmj.l6326
- 3y ago