Just been reading this article over on PinkBike, got me thinking…

1 – How good is the NHS?

2 – How much did it actually cost when I broke my femur a couple of years ago? – 1/2 hour ride in an ambulance, plus treatment at the scene, 3-4 x-rays, CT scan, operation to insert metal plate, drugs – lots of drugs, a week long stay in hospital, follow up x-rays, follow up physio, more physio a couple years later…

years ago a mate crashed and badly injured his elbow in Les Gets bike park. He was picked up by air ambo and was paranoid as he had no insurance 😯 Luckily for him the bike park was sponsored by Kona at the time and they picked up the tab.

I broke the top off my tibia in Morzine. Private ambo to (private) hospital in Thonon, surgery under general, 3 days in hospital, private ambo to airport, entire row of seats to myself and limo taxi home from airport. All ultimately paid for by insurance but just the “upfront” costs put 1000 Euros on my credit card. The total will have been multiples of that.

So

1) excellent and pushed far beyond what it was ever intended to do

2) thousands.

The NHS will be gone within a few years, and we’ll then be left to find out what the US style insurance based model is like to live with.

The NHS will be gone within a few years, and we’ll then be left to find out what the US style insurance based model is like to live with.

Lets really hope not – healthcare should never have a rich/poor divide.

PrinceJohn – Member

2 – How much did it actually cost when I broke my femur a couple of years ago? – 1/2 hour ride in an ambulance, plus treatment at the scene, 3-4 x-rays, CT scan, operation to insert metal plate, drugs – lots of drugs, a week long stay in hospital, follow up x-rays, follow up physio, more physio a couple years later…

Yep, the cost of my leg is pretty much fantastical- and the really not nice bit is, there was a cheap and cheerful option available to them which they chose not to do, and went full genius with the surgery, fixature and physio. They could have turned me around and got me out the door for a fraction of the price, but with a ****ed leg. The physio alone cost a fortune and just wouldn’t have been required if they’d hip-replaced me because there’d be no point.

People say “Why does the NHS cost so much”, well, fixing people well is massively expensive- far more than fixing them badly, and enormously more than not fixing them at all.

I’ve seen medical expense bills from US hospitals in the £100K’s where surgery and a rehab is required plus £30-50K medical flight repatriations are needed.

Don’t ever go to the States uninsured.

Should the state (NHS in our case) have to bear the cost of professional injuries / recklessness?

Would it be unreasonable for someone taking part in, lets say a professional football or rugby match (note I’m discussing professional here, not informal recreation, hobbies etc.) to have insurance to cover an injury received on the field, and to reimburse the NHS for the cost of treatment?

The NHS will be gone within a few years, and we’ll then be left to find out what the US style insurance based model is like to live with.

Much of Europe has an insurance based model where your employer is required to cover you and if you’re unemployed the state provides the cover – unlike the US approach which pretends that the poor people don’t deserve proper healthcare and is an utter travesty for a wealthy modern nation. You don’t have to have a hideously inefficient monolith like the NHS to provide decent free healthcare for all (it isn’t free anyway, it comes out of our taxes!)

Should the state (NHS in our case) have to bear the cost of professional injuries / recklessness?

Car crashes? Lung cancer? Obesity? Arguably mostly caused by recklessness?

Its a fair point jam bo – I fully accept that its a flexible margin between extremes that could be argued either way, however in principle is it an unreasonable suggestion?

Would companies/employers perhaps be more careful of their employees health and safety if they had to foot the bill for staff injuries?

…or, would companies end up trying to avoid employing people with less than perfect medical histories, or intervene more in people’s private lives?

TANSTAFL, if tax isn’t paying for healthcare and employers are, employees or customers will still be paying for it.

No, that wasn’t what I said – we’re talking about industrial injuries, not chronic health problems etc. – so for example someone receives an eye injury at work, falls off a roof etc.

or as I suggested earlier – professional sportsman, eg a boxer, gets injured in the ring – why should the NHS have to pick up the bill?

employees or customers will still be paying for it.

Companies that take care of their staff will have lower costs/insurance premiums, it removes the temptation to cut corners to reduce costs.

But the point is, that’s not a simple line in the sand- industrial injuries can stem from other conditions. A hypoglycaemic diabetic crashes a car into a busfull of nuns, who pays? So it becomes not in a business’s interest to hire anyone not in perfect health. Boxer collapses because of a separate condition.

Yes, it should pick up professional sports injuries, the obese and smokers. The point of paying for the NHS isn’t just to cover yourself in case you fall off your bike, it’s part of what binds us together as a society. We’re already a good way down the road to the sort of selfish, self obsessed society that Americans confuse with freedom. The NHS is one of the few remaining ways that we all help each other, regardless of ability to pay.

The NHS is not inefficient, at least not when you compare it to the US system – a vast amount of medical costs in the US go on non-medical stuff, way more than with the NHS.

Well said rj.

Appendicitis in the US

if you start trying to make decisions on ‘right to treatment’ it gets very messy very quick – the time taken to make that decision isn’t acceptable when you need medical care, and legal challenge to decisions after the event? that would make the NHS ridiculously expensive…

a mate who is a doctor gave the example he was taught at the start of medical school [yes I am invoking Godwin here but it’s a layer of abstraction ok] on hippocratics

‘ok so you make the choice not to treat Hitler cos he’s a genocidal nutter, what about Bomber Harris who also killed a lot of civilians? the point where you draw the line is never clear and you’re a doctor not a politician’

trickydisco thanks for posting, a real eye opener! I lived and worked in US but had health care paid for by employer and never really had recourse to use it.

if you start trying to make decisions on ‘right to treatment’ it gets very messy very quick the time taken to make that decision isn’t acceptable when you need medical care.

But who’s suggesting that?

Its about who picks up the bill afterwards

Nobody delays sending an ambulance to a car crash, but the insurance company gets billed afterwards, have done for years and years.

Dont forget healthcare in the US is business – they will make a profit.

Unsurprisingly its expensive.

Run it eficiently and dont aim for profit and it can be much cheaper.

We need to fight the idea that the NHS is inefficient. We spend less on healthcare than comparable countries (2010 WHO figures are $8223 per person per annum for the USA, $5391 for Norway, $3997 for France and a paltry $3443 for the UK.) A paper in the Journal of the Royal Society of Medicine rated the UK 2nd out of 17 developed nations for efficiency and cost-effectiveness in saving lives. (http://image.guardian.co.uk/sys-files/Guardian/documents/2011/08/07/JRSMpaperPritWall.pdf)
The USA came last.

so they tell us private is best when in reality you pay more and get a s really really shit service]

It is almost as if they are putting profit before healthcare….though that may just be socialist claptrap.

I met a couple in the USA who paid $600 a month for an average healthcare plan and they still had to pay the first $10,000 of any costs incurred.

YOWSERS!

The USA came last.

Because it’s about profit.