American politics

[Kompakted]

Good to hear you're on the mend.

I'm surprised you didn't go straight to your private medical insurance in the first instance?

I guess the difference between the NHS and others (eg US) is the service is 'free' at point of access, so workload/patient numbers will reflect that. Of course, everyone should have best of care but Id imagine (behind the scenes) budgets and resources are limited.

I had a similar issue to you, and after bloods poop and urine tests I then had a CT scan within 12 weeks which was pretty good going imv. (All was well btw)

However, I fully agree with the overall 'brush off ' view. Try and pin it on mental health (not that it's a bad thing they're asking, I'm just suspicious of why they're asking) , dish out antibiotics, dish out painkillers....all essentially attacking many problems from the wrong end.

In the way minor injury units are springing up, I think diagnostic centres should be as well. From my pov I just want to know what's wrong with me, diagnosis is everything, not just so I can get my head round it and make a plan to recover, but so the disease/problem has less time to advance/develop and potentially put me in a worse place than was necessary.
I don't have access to pmi any longer but twice have paid for my own scans to short circuit the route to diagnosis (they're not even that expensive, relatively speaking).

The way they deal with Musculoskeletal problems for example is so backwards. Rest it and take pain killers, not worked- book you 3 sessions with a physio, not getting better, send you for an x-ray, still bad? you might get a scan out of them if you've not lost the will to live by then. Any doctor and especially the physiotherapist needs diagnostic tools to know what they are dealing with FFS.

I have never even looked into our private medical cover before it was just something I vaguely knew I had and something that appears on my wage slip every month. I kind of had the view that I imagine some of these Americans do "bet it's a right faff to use/get a claim approved". Turns out I put myself through unnecessary misery for nothing. The funny thing was both the consultant urologist, consultant anesthetist and surgeon I saw are also smployef by the NHS and all of their bread and butter work is working at the local hospital they just top up their income via the private work.

I did note that individually the fees are not that much for the basic consultations, blood tests and ultrasound scan. The CT scan and surgery were the most expensive items billed to my insurer. The insurance company were charged £150 per outpatient consultation, the ultrasound scan was i think another similar fee. Blood tests were £85. The CT scan was £400, the surgery was £1,400. I had the surgery the week after the hernia diagnosis was confirmed which was pretty nuts and does show the benefit of having the private cover. Unsure what the current NHS waiting list for my area would be for that kind of non-urgent procedure but I suggest I'd be waiting into the new year at least.

 

[thfcsteff]

It is virtually impossible to compare the US system denials with UK. In guarantee that if you researched it even a tiny bit beyond the current United Healthcare-driven headline, you'd see a world of difference. Like Ricky said, glad you're on the mend.

 

[Mikey10]

Interesting regarding the "he got it coming" side of the debate on the murder of Brian Thompson and the concept of "denial of medical claims".

The NHS deny medical treatment all the time. In fact ironically there's an almost constant stream of patients going from the UK to the US to access things like cancer treatment that is available over there that isn't over here on the NHS.

Another ironic example for me recently:
- I developed bladder and bowel problems and went to see my GP. They formed the opinion that I was dehydrated and stressed and said there were no need for any further tests and sent me away with a referral to talking therapy and an instruction to drink more water.
- symptoms didnt improve and got worse and so they put me on antibiotics but still stated there was no need to be referred for tests, scans or specialists.
- antibiotics helped a bit but not much so I then turned to my private medical insurance through my work.
- They pre-authorised a referral to a consultant urologist, blood tests, ultrasound, CT scan and follow up consultation.
- Fast forward a few weeks I'd been diagnosed with an inguinal hernia of my bowel through my muscle wall which had caused inflammation of and then infection of my prostate and bladder. I had a CT scan and ultrasound scan of my bladder, kidneys and prostate to rule out any other factors and was referred for surgery which I had 4 weeks ago and I'm almost fully recovered.

In my case the private insurance company immediately authorised the medical treatment denied to me by the NHS back in July and meant that I lived for months in pain and discomfort as a result.

So denial of medical claims or requests for treatment is not something exclusive to any health care system and ultimately it always boils down to the assessment of whoever is deciding on treatment versus what the patient feels they want and need.

Glad to hear you’re recovering well.

 

[Bullet]

The funny thing was both the consultant urologist, consultant anesthetist and surgeon I saw are also smployef by the NHS and all of their bread and butter work is working at the local hospital they just top up their income via the private work.

Yes, I had the same experience. I find it jarring that it is the same humans that treat you.
It makes sense, but I just found it surprising somehow, like you are literally paying to jump the queue, but still get pretty much the same treatment by the same people.

I did note that individually the fees are not that much for the basic consultations, blood tests and ultrasound scan. The CT scan and surgery were the most expensive items billed to my insurer. The insurance company were charged £150 per outpatient consultation, the ultrasound scan was i think another similar fee. Blood tests were £85. The CT scan was £400, the surgery was £1,400.

These costs are tiny aren't they, for your peace of mind and for the savings at the back end.
I.e. if they gave you a CT scan to start with and found out what treatment you needed early on, it would save so much faff and paperwork and misdiagnosed drugs/treatments.
Cheaper to diagnose well rather than fob off. Especially for cancer.
Imagine if someone "saved" a couple of grand and waited 6 months and then found out they had Stage III cancer!




In terms of costs, it reminds me of a drug I worked on tangentially; I think it was the most expensive drug in the world, Soliris. It is for the treatment of rare diseases, PNH and aHUS. It costs roughly $500k per year, or £333 per year.

I believe some patients took the drug for 2 years, racked up a bill of a million dollars and then died, leaving their family bereft and destitute, utterly bankrupt with debts they can never pay; and therefore other patients decided not to take the drug, it is just too costly.

Likewise for the NHS, that cost of Soliris is really too much to prolong the life of one person; if you have a choice of e.g. doing 5 heart transplants that would save the lives of 5 people, or extending one person's life for a year, personally I would choose the former. Purely hypothetical, I have no clue of the cost of a heart transplant.

 

[scaramanga]

It is virtually impossible to compare the US system denials with UK. In guarantee that if you researched it even a tiny bit beyond the current United Healthcare-driven headline, you'd see a world of difference. Like Ricky said, glad you're on the mend.

The best healthcare I've ever seen was given to my wife in the US. Far better than any public health system I've seen.

Germany's system has worked well whenever I've needed it - that's also insurance based.

 

[thfcsteff]

The best healthcare I've ever seen was given to my wife in the US. Far better than any public health system I've seen.

Germany's system has worked well whenever I've needed it - that's also insurance based.

I think Germany's system is very good, yes, but critically there is public provision.

I don't disagree, the actual SERVICE in the US can be exceptional. I have decent care, but it costs. A lot. That'd not including co-pays. One of my contracts covers my healthcare and allows me to purchase healthcare for my wife and daughter (who is a student - my son has his own and moved away a long time ago). Every two weeks, I pay $940 for a plan which covers the pair of them. So approx $1880 a month. Or approx $22560 a year. Then depending on the service, there are co-pays (doctor visits, for example, are billed at approx $570 a turn and my co-pay is $30. Any medications have a copay. If I have an MRI, that is billed at around 5-6k and I pay $250-300 cop-pay. My vision plan allows me basically $180 a year and then the rest is on me. Dental is similar to health.
I am grateful I can afford it, and relieved that at least my plan is paid for. Kaiser is cheaper but sits in the middle with regards to care. If you don't have insurance/cannot afford it, things get problematic very quickly.
I'm interested in how your wife's care was covered? Did your Bupa/whatever have a provision, or did you have special travel coverage???

 

[Rorschach]

I think Germany's system is very good, yes, but critically there is public provision.

I don't disagree, the actual SERVICE in the US can be exceptional. I have decent care, but it costs. A lot. That'd not including co-pays. One of my contracts covers my healthcare and allows me to purchase healthcare for my wife and daughter (who is a student - my son has his own and moved away a long time ago). Every two weeks, I pay $940 for a plan which covers the pair of them. So approx $1880 a month. Or approx $22560 a year. Then depending on the service, there are co-pays (doctor visits, for example, are billed at approx $570 a turn and my co-pay is $30. Any medications have a copay. If I have an MRI, that is billed at around 5-6k and I pay $250-300 cop-pay. My vision plan allows me basically $180 a year and then the rest is on me. Dental is similar to health.
I am grateful I can afford it, and relieved that at least my plan is paid for. Kaiser is cheaper but sits in the middle with regards to care. If you don't have insurance/cannot afford it, things get problematic very quickly.
I'm interested in how your wife's care was covered? Did your Bupa/whatever have a provision, or did you have special travel coverage???

Wow. That is expensive. It is no wonder that so many go bankrupt in the US over their healthcare.

 

[scaramanga]

I think Germany's system is very good, yes, but critically there is public provision.

I don't disagree, the actual SERVICE in the US can be exceptional. I have decent care, but it costs. A lot. That'd not including co-pays. One of my contracts covers my healthcare and allows me to purchase healthcare for my wife and daughter (who is a student - my son has his own and moved away a long time ago). Every two weeks, I pay $940 for a plan which covers the pair of them. So approx $1880 a month. Or approx $22560 a year. Then depending on the service, there are co-pays (doctor visits, for example, are billed at approx $570 a turn and my co-pay is $30. Any medications have a copay. If I have an MRI, that is billed at around 5-6k and I pay $250-300 cop-pay. My vision plan allows me basically $180 a year and then the rest is on me. Dental is similar to health.
I am grateful I can afford it, and relieved that at least my plan is paid for. Kaiser is cheaper but sits in the middle with regards to care. If you don't have insurance/cannot afford it, things get problematic very quickly.
I'm interested in how your wife's care was covered? Did your Bupa/whatever have a provision, or did you have special travel coverage???

I have a private bank account (up yours Farage) and one of the benefits is worldwide health insurance. Didn't pay a penny for it - they just took me off to a room to confirm the insurance was in place and then I never heard about it again.

Germany's healthcare isn't publicly provided, but there's an element that enforced pay in by employers/ees and a govt scheme that provides it for those who can't afford it.

So it's universal, but it's insurance based like the US. Like a working version of Medicare.

 

[thfcsteff]

I have a private bank account (up yours Farage) and one of the benefits is worldwide health insurance. Didn't pay a penny for it - they just took me off to a room to confirm the insurance was in place and then I never heard about it again.

Germany's healthcare isn't publicly provided, but there's an element that enforced pay in by employers/ees and a govt scheme that provides it for those who can't afford it.

So it's universal, but it's insurance based like the US. Like a working version of Medicare.

Indeed, I know their system and the provision you outlined is critical. I am interested to know your thoughts on the figures I quoted for healthcare in the US via insurance. Real numbers. Experienced by me every year. Imagine being one of the millions who cannot afford it. And imagine if the incoming circus decides to dispense with the Affordable Healthcare Act and see individuals trying to access private plans have to once again get accepted/denied based on pre-existing conditions.

 

[scaramanga]

Indeed, I know their system and the provision you outlined is critical. I am interested to know your thoughts on the figures I quoted for healthcare in the US via insurance. Real numbers. Experienced by me every year. Imagine being one of the millions who cannot afford it. And imagine if the incoming circus decides to dispense with the Affordable Healthcare Act and see individuals trying to access private plans have to once again get accepted/denied based on pre-existing conditions.

I'd happily pay what you pay for the quality provided in the US. I do think the German system is better but the private provision is the important part.

The UK desperately has to rid itself of the NHS though. It's a millstone around our necks and we'll never be able to improve our service without a grown up conversation about how we can still have universal healthcare without a monolithic money pit.

 

[Kompakted]

I'd happily pay what you pay for the quality provided in the US. I do think the German system is better but the private provision is the important part.

The UK desperately has to rid itself of the NHS though. It's a millstone around our necks and we'll never be able to improve our service without a grown up conversation about how we can still have universal healthcare without a monolithic money pit.

So age 65 is generally considered a good dividing line between when people are generally healthy and where chronic illness is fairly common.

Guess what the average life expectancy was of a man.in the UK when the NHS model was devised in the post war period?

 

[Cundies undies]

I'd happily pay what you pay for the quality provided in the US. I do think the German system is better but the private provision is the important part.

The UK desperately has to rid itself of the NHS though. It's a millstone around our necks and we'll never be able to improve our service without a grown up conversation about how we can still have universal healthcare without a monolithic money pit.

Oh ffs, when the UK eventually spends what is needed for the NHS, then long term illness/diasbility becomes a shorterm inconvenience. With a good outcome for those that are long term unemployed, add in some sort of disability manufaturing line, whether its for Raytheon or lockheed, manufacturing a panel that has 50 holes in it.

 

[SkipRat]

Oh ffs, when the UK eventually spends what is needed for the NHS, then long term illness/diasbility becomes a shorterm inconvenience. With a good outcome for those that are long term unemployed, add in some sort of disability manufaturing line, whether its for Raytheon or lockheed, manufacturing a panel that has 50 holes in it.

adding 10 million to population, 80% of which are migrants and there children, in just over 20 years...

Teh NHS has literally been swamp.

Couple that with rise cost ofof new treatments... Retention problems... etc etc

The NHS need a complete overhaul, along with teh rest of the frigging system...

We are litterally throwing good money after bad.

Not to mention it has been a political football for the last 40 years.

 

[Kompakted]

Oh ffs, when the UK eventually spends what is needed for the NHS, then long term illness/diasbility becomes a shorterm inconvenience. With a good outcome for those that are long term unemployed, add in some sort of disability manufaturing line, whether its for Raytheon or lockheed, manufacturing a panel that has 50 holes in it.

This is the fundamental resourcing issue with all healthcare systems: and it means that the NHS will never be adequately resourced over winter, because for the vast majority of the year, it doesn't need that resource, and staff engagement and job satisfaction would die if you move that red line higher. You can't just bring in agency doctors and nurses over the winter either - it's not like there's a qualified medical professional that will sit there doing something else for months then pull on their gloves in November ready to help out

What the NHS needs is reformation, deunionisation and honest conversations.

The unions will just endlessly tell the public how overworked and stressed their members are. Which is true, but making healthcare an easy stress-free job is impossible.

The unions fight reform, such as cross training to allow doctors and nurses to move from say, one department to A&E during the winter. Or use of private resource to assist in peak periods. And they fight evening, night and weekends being classed as standard contracted shift patterns, as their members want the overtime uplift payments for volunteering for extra shifts (but will still happily complain to everyone theyre overworked). The press and public lap it up and therefore the NHS winter crisis is just an annual event.

 

[Gilzeantoscore]

The best healthcare I've ever seen was given to my wife in the US. Far better than any public health system I've seen.

Germany's system has worked well whenever I've needed it - that's also insurance based.

Err, yeah because you could afford to pay for it. What about the millions of Americans with no health insurance?

 

[Kompakted]

Err, yeah because you could afford to pay for it. What about the millions of Americans with no health insurance?

I think the German system is a good hybrid. It isn't "every man for themselves" like the US system, but the mandatory provision by employers of health insurance and a national health insurance payment deducted effectively from taxation means that not only is there a safety net for those that need the state to pay for their treatment, it is extremely well funded and went into the Covid 19 pandemic with billions of euros in excess contingency funds.

 

[scaramanga]

Err, yeah because you could afford to pay for it. What about the millions of Americans with no health insurance?

I'm good with universal.healthcare as long as it's based on an insurance model.

It's the NHS that's a problem.