Viewing 40 posts - 201 through 240 (of 292 total)
  • the wonderful world of private healthcare US style
  • LHS
    Free Member

    Average life expectancy Utah – 81
    Average life expectancy Mississipi – 76

    Average life expectancy England – 81
    Average life expectancy Scotland – 77

    Conclusion, anyone who thinks the entirity of America can be compared to the UK is stupid

    busydog
    Free Member

    Yeah, people here in the US calling it a “bathroom” is about as dumb as when they refer to it as a “restroom”

    molgrips
    Free Member

    Yeah, people here in the US calling it a “bathroom” is about as dumb as when they refer to it as a “restroom”

    And we call it a toilet. You know what toilet actually means?

    ernie_lynch
    Free Member

    You know what toilet actually means?

    Does it come from the fancy posh french word ‘toilette’ meaning to dress or groom oneself ?

    Junkyard
    Free Member

    Ty Bach ..like that one

    konabunny
    Free Member

    donations to charity are tax-deductible in the UK, too.

    Please explain more.

    ‘Give as you earn’ deducts donations from gross salary

    I’ve never heard of that before, I wonder how many companies sign up to this scheme?

    No, that’s wrong. It’s not just give as you earn (which is a relatively new scheme) that allows tax-free donations, it’s all donations to charity (apart from tiny ones). Charitable donations in the UK have been tax-deductible for donkey’s years. The reason why Americans donate more money (and time) to charity is not because it’s tax deductible there and not here.
    http://www.direct.gov.uk/en/MoneyTaxAndBenefits/ManagingMoney/GivingMoneyToCharity/DG_078329

    Don’t NHS GPs get paid per procedure?

    Couldn’t be further from the truth. The NHS uses gps as gate keepers to control access to expensive and over medicalised hospital based care.

    I do apologise – I’m obviously under the wrong info. As someone else pointed out, I’m also probably misleading people using the word “procedure” which seems to have a proper medical meaning. I think I just meant “interaction” or “appointment” or something.

    In the private US system, the insurance companies use loss adjusters as (usually retroactive) gatekeepers to expensive care. And when it comes to approved/non-approved treatments, the insurance companies are doing the same thing as what NICE does when it decides whether or not to let treatment/drug X to be used in the NHS.

    And actually to go back to Junkyard’s suggestion that he wouldn’t want to be treated by a doctor that had a financial interest in how many treatments he gets – that’s not really how it works in the US anyway. A US GP doesn’t get paid any more for ordering lab work/drugs etc because all of it is outsourced and billed direct to the insurance co or patient/user.

    If you believe that the US has a superior health care system, you’d sort of expect to see a [relatively] high life expectancy rather than one that falls below most of the Western world and at a similar level to Albania

    Life expectancy is determined by far more than the healthcare system. There’s a 1.4 year difference between the US and UK – not really significant (unless of course you’d like to live that extra year longer!).

    ernie_lynch
    Free Member

    Life expectancy is determined by far more than the healthcare system.

    Yep, things such as diet, smoking, alcohol intake, etc, which have nothing to do with healthcare, are extremely important.

    The single best indicator of how effective a country’s healthcare provisions are, is infant mortality.

    In the United States the number of infants dying before reaching one year of age, per 1,000 live births, is 6.06. Which compares with 4.62 in the UK.

    Britain has undoubtedly better and hugely cheaper healthcare than the US.
    It’s also fairer, if that bothers anyone.

    TooTall
    Free Member

    Britain has undoubtedly better and hugely cheaper healthcare than the US.
    It’s also fairer, if that bothers anyone.

    Isn’t the fact that is it so expensive and unfair exactly why Obama is trying to drive the changes through?

    ‘Better’ is very subjective.

    docrobster
    Free Member

    It’s easy to get confused by the various funding streams in the nhs, konabunny, even when you work there.
    Basically gps are paid £x per patient on the list, regardless of how many times the patient is seen. With extra £y per patient for doing things like staying open later of offering extra services like minor surgery, plus a proportion related to performance (quality outcomes framework)
    Hospitals are on a system of payment by results. They get paid a fee for each “interaction”, from a set tarrif. So a first appointment costs more than a follow up, etc.
    Neither the US or UK system is perfect. The uk system is like a big sweet shop with a sign above the door saying “loads of good stuff for free, take as much as you want” then we are surprised when it is abused.
    The US sweet shop has nicer sweets but you have to pay $50 to get in.

    ernie_lynch
    Free Member

    ‘Better’ is very subjective.

    I reckon it is universally accepted that the purpose of a healthcare system is to provide health care. If one healthcare system does this more effectively than another healthcare system, then it can be fairly described as “better”.

    The comment that in the United States the infant mortality is 6.06, which compares with 4.62 in the UK, isn’t my opinion, it’s a fact. So solely on the basis of what is the single best indicator of how effective a country’s healthcare provisions are, Britain’s healthcare provisions are better than the US’s.

    Unless of course you think higher infant mortality is a good thing, in which case the US’s healthcare provisions are better.

    Here’s a nice picture for people who like to pretend that the truth isn’t as it seems :

    Zulu-Eleven
    Free Member

    Ah – Ernie stumbles at the first fence, the OECD’s own cautionary note, which warns against country-to-country infant mortality comparisons, because they are unfair.
    “Some of the international variation in infant and neonatal mortality rates may be due to variations among countries in registering practices of premature infants (whether they are reported as live births or not),”

    The Center for Disease Control says the U.S. ranks 29th in the world for infant mortality rates, behind most other developed nations. But points out that this ranking ignores other statistical nuances that, if adjusted for, would show the U.S. actually has much better care for infants than these rankings allow.
    The U.S. is supposedly worse than Greece, Northern Ireland, Cuba and Hungary in infant mortality rates.

    The U.S. ranks poorly on the infant mortality list largely because they country actually count neonatal deaths, notably premature infant fatalities, unlike other countries who don’t count these infant deaths.

    Again according to the OECD: “In several countries, such as in the United States, Canada and the Nordic countries, very premature babies (with relatively low odds of survival) are registered as live births, which increases mortality rates compared with other countries that do not register them as live births,

    The World Health Organization [WHO] defines a country’s infant mortality rate as the number of infants who die between birth and age one, per 1,000 live births. WHO says a live birth is when a baby shows any sign of life, even if, say, a low birth weight baby takes one single breath, or has one heartbeat.The U.S. uses this definition. But other countries do not — so they don’t count premature or severely ill babies as live births-or deaths. The United States actually counts all births if they show any sign of life, regardless of prematurity, or size, or duration of life, Also, what counts as a birth varies from country to country. In Austria and Germany, foetal weight must be at least 500 grams before they count as live births, In Switzerland, the foetus must be at least 30 centimeters long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless, and not counted as infant mortality.

    Norway, which has one of the lowest infant mortality rates, shows no better infant survival than the United States when you factor in Norway’s underweight infants who are not now counted.

    pretty comprehensive shooting down of Ernie’s argument by Bernardine Healy, former president and chief executive of the American Red Cross 😆

    ernie_lynch
    Free Member

    pretty comprehensive shooting down of Ernie’s argument by Bernardine Healy

    Shot down by a presidential advisor to Ronald Reagan eh ? …..who would have thought it.

    btw, I never bothered watching that Ronald Reagan video you posted on this thread…….what does it say?

    And oh yeah, you never explained what you meant concerning that drivel you posted asking who pays £2000 in total taxes per year. I’ll come back later and see what you’ve posted.

    TooTall
    Free Member

    So, Ernie. This subjective better thing and your basis that infant mortality is the deciding factor…..oh.

    Mrs TT had far better health care in the USA than has been available on the NHS in the UK. She was dealt with promptly in relatively modern facilities and the complete care package exceeded anything either of us has experienced in this country. A trip to somewhere like Peterborough Hospital would be enough to send anyone home claiming a miracle recovery.
    Neither system is good, both have many faults and better is still subjective. Or confusing when you refer non-like statistics as evidence.

    molgrips
    Free Member

    better is still subjective

    I disagree.

    Any system that leaves millions of citizens with no security is not good. No matter how you look at it. End of.

    With regards your hospital experience – it does vary in the US too you know. I’ve heard lots of bad stories about US healthcare too. And it’s not just about machines and nice buildings – Mrs Grips was really worried about giving birth because she thought it was going to be the US style with the whole operating theatre thing and epidurals all round. She was very relieved to find it was just us and a midwife in a room. Sometimes LESS is better.

    Junkyard
    Free Member

    What you going to do next tell me Eton is better than a Peterborough state school? We all know it is….. if you can afford it?
    In respect of healthcare ours is much more likely [ on average] to be better as it treats everyone. I am sur eyou can find examples to support each view but universal health care must , on average, be better than non universal health care.

    tonyg2003
    Full Member

    I work in the healthcare sector and have visited hospitals all over the world.

    The Amercian Healthcare system – if you can afford it – is in many ways superior to the NHS. US citizens paying for healthcare find it completely unacceptible to wait for a hospital appointment or even to wait for a GP (this is one of the reasons why they see the NHS as such a failure). US Healthcare is like going private in the UK (as you might expect). If you have no money in the US – the US medicare system is pretty terrible. No surprises there either. I’ve been in some pretty rough Medicare/Charitable funded US hospitals.

    Actually there are some much better Healthcare systems in Europe. The Dutch system (fabulous hospitals and treatments)is particularly good or even the French system gives better treatment than the NHS. It’s just a question of how much the government can afford.

    The NHS was getting to be so much better over the last few years. Sadly it looks like the piggy bank is now empty and it’s going to be tough times ahead.

    Zulu-Eleven
    Free Member

    Ernie:

    i) I’m fairly confident that Bernadine Healy, who is:

    an American physician, cardiologist and former head of the National Institutes of Health (NIH). She has been a professor of medicine at Johns Hopkins, professor and dean of the College of Medicine and Public Health at the Ohio State University, and served as president of the American Red Cross. Currently she is health editor and columnist for U.S. News & World Report. She has become a well-known commentator in the media on health issues. She is a brain cancer survivor.[1]

    Is eminently more qualified to comment on US infant mortality rates than you are!

    ii) Anyone paying less than approx 2k per year in net taxation is not paying their way… at the moment, thats approx nine million of the UK “working age population” (ie, those officially not economically active, including approx 2 million “housewives”, 2 million students, 2 million long term sick ) on top of this, there’s about 2.5 million unemployed, then there’s children, then there’s those on state pensions, or low pensions.

    Do the sums, and you come out with about half the population paying for the medical bills for the other half the population! see, the NHS really is “free” for half the population after all

    docrobster
    Free Member

    The NHS was getting to be so much better over the last few years. Sadly it looks like the piggy bank is now empty and it’s going to be tough times ahead.

    Very true.

    Lifer
    Free Member

    Do the sums, and you come out with about half the population paying for the medical bills for the other half the population! see, the NHS really is “free” for half the population after all

    Reading that as “I’m alright jack screw the rest of you”

    julianwilson
    Free Member

    Zulu-Eleven:

    2 million students…..there’s about 2.5 million unemployed

    ….as i mentioned earlier, if NarrowMindedTrackWorld is the arbiter of objectivity, it is highly likely these 2 groups contribute a great deal in alcohol and tobacco duty. 😆

    Should you be daft enought to both smoke 20 straights a day and buy it all in the uk, then my back of a fag packet sums (did you see what i did there?) suggest you contribute about £1100 per year to the government. Whether you happen to be on the sick, retired or a higher rate income tax payer. Lord knows how much per year a 30-40 units-per-week alcohol intake contributes, I guess that would vary wildly on how you buy your booze (duty varies on abv and booze type iirc) but this will also be the case regardless of how worthy of free health care some folk on this thread seem to think you are.

    Unhealthy health-service-costing lifestyles are already quite well taxed in some areas, it’s just not been spent (by any government whatever flavour 👿 ) in the right places.

    IanMunro
    Free Member

    pretty comprehensive shooting down of Ernie’s argument by Bernardine Healy, former president and chief executive of the American Red Cross

    Not really.

    The primary reason for the United States’ higher infant mortality rate when compared with Europe is the United States’ much higher percentage of preterm births. In 2004, 1 in 8 infants born in the United States were born preterm, compared with 1 in 18 in Ireland and Finland. Preterm infants have much higher rates of death or disability than infants born at 37 weeks of gestation or more (2-4, 6), so the United States’ higher percentage of preterm births has a large effect on infant mortality rates. If the United States had the same gestational age distribution of births as Sweden, the U.S. infant mortality rate (excluding births at less than 22 weeks of gestation) would go from 5.8 to 3.9 infant deaths per 1,000 live births, a 33% decline. These data suggest that preterm birth prevention is crucial to lowering the U.S. infant mortality rate.

    http://www.cdc.gov/nchs/data/databriefs/db23.htm

    joemarshall
    Free Member

    I hear antecdotal stories about how long it takes to get medical treatment in the UK, especially some of the more specialized and/or sophisticated tests, i.e. MRIs, etc and wondered if that is actually the case there or more myth than fact?

    I’m married to someone who recently needed MRI scans etc., here (Derby) it is a week or so wait in a non-urgent case, same day for an in-patient / high priority one.

    billysugger
    Free Member

    If a child is hit by a car in the US and the car drives off how does this work? Who pays? Is it free at this point?

    busydog
    Free Member

    I’m married to someone who recently needed MRI scans etc., here (Derby) it is a week or so wait in a non-urgent case, same day for an in-patient / high priority one.

    From what you and a couple other posters have described the wait for specialized tests, etc. isn’t nearly the issue that ws portrayed in some of the stories going around from a few years ago.
    I would imagine that in the UK, just like in the US, getting such tests/treatments in a timely fashion varies from area to area.
    One issue we face here in New Mexico is the lack of physicians/dentists, etc in the more rural parts of the state—in some areas there isn’t a doctor within 50-75 miles (of course there isn’t much of anything else either)

    TandemJeremy
    Free Member

    busydog – a lot of what is publicised is when things go wrong.

    Some of the stuff around testing is when people demand these tests but the protocols say not needed at this point – then they get unhappy about it.

    There is rationing and delays for sure in the NHS – and sometimes unacceptable ones. However everyone gets treated and no one pays for the treatment.

    The worst delays are for non urgent treatment – surgery – that can be a long time many weeks – for say a simple hernia repair or for a hip replacement for arthritis.

    ernie_lynch
    Free Member

    Mrs TT had far better health care in the USA than has been available on the NHS in the UK.

    Lucky Mrs TT. However this thread isn’t about healthcare provisions for Mrs TT, its about healthcare provisions for all American people. The purpose of the OP was to highlight just how catastrophically it can fail the needs of people. So it would probably be useful to stick to the issues raised in the OP.

    Junkyard
    Free Member

    One issue we face here in New Mexico is the lack of physicians/dentists, etc in the more rural parts of the state—in some areas there isn’t a doctor within 50-75 miles (of course there isn’t much of anything else either)

    the regan link covered this very issue. If you tell a doctor where to work [ which is what he thinks our system does] you will end up with a state controlled system and socialism ..I am not joking he does argue this very point. In the NHS there would [ probably] be a Dr there. In your system I assume [ to a greater degree] they go where the money is.
    it depends though some rural islands in Scotland have limited provision for example

    molgrips
    Free Member

    isn’t nearly the issue that ws portrayed in some of the stories going around from a few years ago

    When the healthcare debate was going on, people were making up total bullsh*t about the NHS and reporting it. Seriously – total fabrications. The whole debate was an embarassment to be fair. Both sides whipped up into a total frenzy by people spouting made up nonsense. Had many facebook debates with the family. My SIL is for the status quo despite her kids having had injuries and she couldn’t afford the follow-up physio and so on. She values small government more than universal care it seems. But then she was thinking things would be taken away from her, and I couldn’t convince her otherwise.

    However everyone gets treated for as long as they need treatment and no one pays for the treatment

    Important extra feature that is often not mentioned imo.

    busydog
    Free Member

    Some of the stuff around testing is when people demand these tests but the protocols say not needed at this point – then they get unhappy about it.

    We have that issue as well when people hear about a “new, wonderful” procedure and doctor says it isn’t appropriate or needed or the insurance company protocols won’t authorize it—then the patient goes ballistic. If it is the insurance company protocol that blocks it, there is an appeal process that is sometimes successful, sometimes not.
    If it a doctor that says “no”, then some patients go into doctor-shopping mode because, somewhere, there is a doctor who will probably do the procedure.
    Often times, in the case of non-emergency or elective surgery/procedure, the operation/test is pushed out to a second priority status and not done as quickly. If it is truly an emergency or life threatening issue, it gets worked into the schedule one way or another.

    Junkyard
    Free Member

    all Dr love Google doctor patients. i would imagine this is now a universal issue.
    Molgrips is it not free in Germany but you pay to see the Dr [ or get a certain amount of GP visits for free] to discourage this sort of thing?
    Are you in germany or Wales is confused

    ernie_lynch
    Free Member

    Zulu-Eleven – Member

    Ernie:

    I’m fairly confident that Bernadine Healy………Is eminently more qualified to comment on US infant mortality rates than you are!

    As usual you play daft and pretend that the infant mortality figures I gave were my figures. Those figures of 6.06 for the US and 4.62 for the UK are not mine but those of the World Bank (World Development Indicators).

    Furthermore the US Central Intelligence Agency uses the identical infant mortality figures in their CIA Factbook.

    And yet you expect me to believe that those figures are false because of an article you’ve copied and pasted from Fox News, and what a presidential advisor to Ronald Reagan, who was passionately opposed to universal healthcare, has to say on the matter.

    Your claim that the CIA uses unreliable infant mortality rates which makes the US appear less favourably, when compared to other countries, is, in keeping with much of what you spout, utterly absurd.

    The problem for you Zulu-Eleven is that your entire political philosophy is based on a web of lies and misinformation. That is why when your political guru and mentor Dan Hannan, appeared on Fox News to denounce the British NHS to American viewers, he instantly resorted to blatant lies by describing the NHS as a failure which made people, quote : “iller”.

    Of course Dan Hannan, in keeping with other extreme right-wing neo-conservatives both sides of the Atlantic, has a long history of misinformation, telling lies, and talking fantasist bollox. Probably the most stunning example is when Dan Hannan described Iceland as an economic miracle who’s deregulated financial services Britain should emulate. Just a few months later Iceland’s banks collapsed and the country was bankrupt.

    Yep, I said recently Zulu-Eleven, you and other neo-conservatives, see the “truth” as as inconvenient irritant which is best ignored.

    Or at the very most, staunchly denied.

    BTW you still haven’t explained why you asked how many people pay £2000 in total taxes per year. Why the reluctance ?

    busydog
    Free Member

    In your system I assume [ to a greater degree] they go where the money is.

    Our issue here in this state is that not many doctors/dentists want to live in such a rural/out-of-the-way location—-an issue of lifestyle and being so far removed from their peers-in-practice. Going where the money is plays into it for some I’m sure, but even a lot of the altruistic types just don’t want that remote of a location.
    My personal doctor lives in Santa Fe and practices in Albuquerque. Santa Fe is a very high-dollar location, but he prefers the more “pedestrian” practice here in Albuquerque, so he drives 55 miles each way daily.
    Some of the scholrships that are granted to people studying to becme doctors have a stipulation that they serve for a specified period of time in a rural location that doesn’t have good medical service available.

    molgrips
    Free Member

    IME quite a few Doctors want to live in out of the way rural locations, rather than having to live in a big town or city. However our Sticks are not on the same scale as your Sticks 🙂

    billysugger
    Free Member

    I wish they were molgrips.

    We can’t get more than 37ish miles from population on these isles.

    What happens if you get knocked dwn and can’t afford the treatment? Do you just get billed for it to pay down the line? Not trolling, genuinely curious

    docrobster
    Free Member

    One thing I was wondering about, what’s the provision of the less glamorous healthcare services like in the US?
    We all know there a lot of shiny hospitals with hunky docs and whizzo scanners like on the telly, but what about district nurses to go and dress Mrs Miggins chronic leg ulcer? Or CPNs for the elderly to go into nursing homes and advise on the management of grandpa Jo’s terminal dementia. These 2 don’t (currently) pay tax so according to some posts on here they should be left lying in their own faeces.
    District nursing in particular is chronically under resourced in the uk with precious nhs funds being diverted off to more exciting (vote chasing) things like MRIs and angiography suites, but with the population ageing as it is, care of the elderly with long term conditions actually costs more than virtually anything else I can think of (no stats, not googled it, just experience)
    Do our charitable American cousins provide better care out of the goodness of the hearts?
    Genuine question, am interested to know how it works.

    molgrips
    Free Member

    Hmm.. the middle of US nowhere seems romantic, but there are serious issue with it to be honest – afaik anyway.

    molgrips
    Free Member

    Or CPNs for the elderly to go into nursing homes and advise on the management of grandpa Jo’s terminal dementia

    Mrs Grips’ old neighbour has a terminal degenerative condition, I forget what. The husband has had to get rid of as many assets as he can and plough them all into a big fancy house since the state can apparently force him to use his liquid assets to pay for her care, but they can’t take away his house.

    busydog
    Free Member

    The whole debate was an embarassment to be fair. Both sides whipped up into a total frenzy by people spouting made up nonsense

    I agree that the whole healthcare debate got out of control on both sides of the issue and, typical of our delightful 500 members of Congress, they had the smoke and mirrors working overtime on every side of the issue.

    She values small government more than universal care it seems. But then she was thinking things would be taken away from her, and I couldn’t convince her otherwise.

    I think there is a considerable part of the US that just doesn’t want big government so deeply involved in every aspect of their personal business.
    Part of that is because they (myself included) want the ability to choose their doctors and medical care and don’t want that dictated in any form or fashion.

    Another factor that plays into it is that our government spends money like drunken sailors without regard to debt accumulation—-I think healthcare reform (and it is needed here) would have a much better chance of enactment if the government would start acting like financially-responsible representatives and get costs in general under control (i.e. stop the bailouts to industries along with a myriad of other things they throw money at). As long as Congress has the “let’s spend all we have and all we don’t have” mentality, it’s going to be hard to get people to be rational about any new spending, whether on healthcare or anything else.

    molgrips
    Free Member

    Part of that is because they (myself included) want the ability to choose their doctors and medical care and don’t want that dictated in any form or fashion

    Was that really on the cards though? Remember in the UK at least you are still free to buy private healthcare if you can afford it.

    busydog
    Free Member

    IME quite a few Doctors want to live in out of the way rural locations, rather than having to live in a big town or city. However our Sticks are not on the same scale as your Sticks

    Yeah, there are places in New Mexico where gas stations are 100 miles apart. The other issue is housing–in many of the rural areas there isn’t housing available and schools involve 40-50 mile bus rides for kids.

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