In PM tonight, how the NHS has become part of the health reform debate in America.
The ad comes from the Club for Growth.
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It's fine if you've got health cover in the States, but not joke if you haven't. And so many people are tied to a job just for the health insurance it provides rather than taking a chance with a new job elsewhere.
Personally, I'm happier in a country with a health service available to all, albeit an imperfect one.
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Is that true? Is there a "price" set for treatment?
It seems unlikely that this wouldn't have been revealed somewhere in the UK.
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Anyone who believes US Repulican propaganda needs their heads examined.
However, the Tories here will love to use Rebulican style electioneering to win the next election and so I say "be prepared and keep ypur eyes open and remember past performance. The Health service is far better now than it ever was.
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...anda very interest review from a Canadian specialist of the US system vs the UK and Canada. Well, worth a read:
http://www.latimes.com/news/opinion/la-oe-rachlis3-2009aug03,0,538126.story
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Charlie @ 4 - interesting, thanks.
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Stephen (2):
I'm sure there are limits to what each Health Trust can afford, but after that the patient (or relatives) surely have the option to go private if they can afford it, rather than the implication in that advert that whatever the NHS decides is your lot.
I remember the days when American Individualism was tempered by a sense of Responsiblity. Perhaps you can't care about your community because that's too close to Communism, which is what a lot of Americans seem to want to say when they say (or spit) the word Socialism.
Incidentally, isn't the symbolism of the Statue of Liberty and the Stars and Stripes sickening to the British way of thinking? How uncomfortable would we be at a political advert finishing with a split-screen of the Union Flag and Nelson on his column?
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I saw an interesting programme on BBC4 the other week about Bevin and the introduction of the NHS, I think first broadcast for the anniversary. Hang on, I'll try iPlayer for a link.....
.....nahh, couldn't find it. Maybe on youtube or somthing.
Anyway, the opposition to the NHS was principally from the existing private health sector, just as with the USA today. Bevin either placated, bribed, steam-rollered or charmed the various groups to force home the scheme.
And it worked.
Despite the initial rush of demand for teeth and spectacles, the trade off of having a healthier nation contributing to the economy versus the cost of the NHS actually worked. To say nothing of the huge social improvements.
It strikes me that this is the most damning response to the American resistance to public health care. Learn from history. The health sector shoudl be about making people well first, not about profit first.
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(7) Yes, and the biggest compromise Bevan had to make was with the GPs and consultants, which has been the biggest headache for the NHS ever since. However, if he hadn't effectively bought them off we probably would have never got an NHS. The terms meant that GPs could remain as private businesses, and consultants could undertake private work. In other words, they work within, but not for, the NHS.
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Read this..
http://www.guardian.co.uk/world/2009/aug/11/nhs-united-states-republican-health
We have NICE to make decisions on what medication can and can't be afforded so as to prioritise money most effectively - the yanks just leave 50 million without ANY healthcare.
Which would you choose ? Our system ain't perfect, and theirs does well on cancer treatment, but come on - which would you choose ?
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And there is no level to low to stoop in the propaganda war against public healthcare...
http://blogs.ajc.com/jay-bookman-blog/2009/08/10/it-doesnt-take-stephen-hawking-to-figure-this-one-out/?cxntfid=blogs_jay_bookman_blog
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Re: #4. Charlie and #9 lordBeddGelert
Thanks, read both articles. the sort of health service the American Conservatives are frightened of, was the NHS that we had under the last UK Conservative government. Don't expect the NHS to survive Tory spending cuts if they win the next election.
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Stephen (2). Nhs had what is called a national tarif. So yes, there is a set price for each new and follow up outpx appointment and also for each surgical procedure.
I can understand the resentment that the American middle class have about paying for health care for the "poor". In these times! When social care was set up in uk there was no private insurance.
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An interesting thing to note from the Grauniad piece as the following data from the World Health Organisation:
"(the )UK spends less per head on healthcare but has a higher life expectancy than the US. The World Health Organisation ranks Britain's healthcare as 18th in the world, while the US is in 37th place."
So, our system of "socialised" medicine is cheaper per head to run, results in a longer life expectancy, and ranks better than the system that the US currently has, and still certain right-wing groups/organisations over there refuse to even consider reforming their system because of the "demon" implication of any sort of Social Responsibility.
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It would be interesting to know how many people on the blog ever lived in the US or had to use the medical services there. It isn't all free in the UK. Depending on age or where you live, prescriptions aren't free and keep going up. As I am over 60 they are free. My eye test is free, but glasses certainly aren't, "Thank you, Mr McNickle, that's nothing for the examination, but the glasses are £200." And so-called NHS dental care isn't exactly cheap. The health service I got in the US, like here, cost unless you were covered by insurance, either private or at work. And any hospital or doctor's office I used were much more up-to-date and a lot cleaner.
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I know of plenty of American experiences of people who had been paying for health insurance for years and years. Then when they discover they have a long-term illness, they discover that their insurance companies refuse to pay the cost of care (a bit like our care-home situation and the debate about what is nursing care). Anyway people with long-term or terminal - nursing intensive care find they often have to fight their insurance companies who would like to treat their clients like a road accident and deny all responsibility to be able to force the claimant into taking LESS cover than what they first thought they had! Whats good about that?
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David (14)
I have found some quite acceptable reading specs at my local pound shop!
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I'll agree, David, that things generally (though always) can appear much more up to date in the States, it is only a generalisation. The standard in many GP surgeries and hospitals here is now much higher than a few years ago.
The health service over here doesn't cost people who aren't covered by insurance, which is possibly the greatest difference. It is true that there are some services that people generally (though not in every case) have to pay for, such as dental treatment and glasses. I'm not a great fan of our dental services, btw, and having had treatment in other countries, e.g. Spain, where perhaps people might have expected standards to be lower, I can only say that our dentists could learn a lot from other countries. But, I feel safer in general living in a country where I know that I won't be worrying about whether or not I can afford to pay for a lifesaving treatment.
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fJd 15, Ah yes, nannygoatal stories. We all know some of them.
fJd 16, Bifocals? I already buy clothes at charity shops.
fJd (anywhere), Quick, see the new box, before it gets deleted.
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fJd 18, I know pipple here who aged so much waiting in a doctor's office that their prescription was free.
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fJd 18, Aaaaand, they make you use hand gel when leaving a hospital here to prevent taking away dirt.
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David, sounds like you need to move health authorities ;o)
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Actually the NHS is never used as an example of good health care. It's more likely to be Canada or Germany or indeed France. We need to get over ourselves here.
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22: Has anybody here suggested that the NHS is superior to the healthcare in the countries you mention? The point is that some in the US have chosen to contrast OUR system with that in America.
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I moved to California from the UK 2 years ago, and have, in that time, got a very good idea of what a shambles the American health 'system' is.
To start with, my wife has very good coverage from her employer, but still has to pay $500 a month to cover me (I'm unemployed).
Another example how ludicrous the system here is was when I had an operation last year. The hospital is contracted to provide this particular procedure for a certain fee, but charged the insurance company $35 more than the contract price. Therefore, a few months later we had a bill for $35 to cover the difference.
I honestly think the NHS is very good. Yes, it's a bit creaky and not perfect, but at least you simply get treatment and don't have to worry about HMO's, insurance companies, hospitals, private ambulance companies, copayments, whether your GP is in the right medical group, etc!
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I lived in the States for many years and had my 2 children there. My son's birth in 1984 cost in excess of $8000, every Paracetamol billed at $1 each. My husband's hip replacement cost more than $30,000 in 1990. Luckily I had fantastic insurance with an international organisation, which was the envy of every American, but even then we had to pay 20% of every doctor visit, 20% of the FULL cost of any drugs, and 20% of surgeon and anaesthetist fees - surgeon's fee for the hip op was $4000. The idea that health care is rationed here and not in the US is utterly risible, it's just that it's totally based on money in the US.
Now most insured people in the US have HMOs which decide on how much your health "fund" is, and once it's gone, that's it. The NHS has its problems, but if you're being pushed into A&E with a heart attack, do you want the first question you're asked to be "Where's your Blue Cross (insurance) card?". Who's opposing "socialised health care" in the US? Surprise surprise, insurance companies and doctors. And Sarah Palin. I rest my case.
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lordBeddGelert @ 9
Heard about this on the Today programme this morning. Looks like a classic example of 'three lies in one'!
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If you were listening to PM around 2 years ago, you may remember hearing Eddie interviewing me and my kidney donor, Maff, about my kidney transplant (doing very well, thanks very much). As it happens, I'm a dual UK-US citizen. I've never lived in the US, so I don't have direct experience of the US system. Even now that I've had a kidney transplant, the cost of anti-rejection drugs is such that I could never afford to go and live in the USA. I could never imagine having the resources to pay the astronomical 'insurance' cost. Can you even buy insurance that will pay for something that's guaranteed to happen?
The advertising against Obama's health care plans that's happening in the US would surely be illegal in the UK. It is absolutely all funded by and in the interests of the enormous health 'industry' in the US.
Americans who believe that state-sponsored healthcare is a step down the dirty road to communism have been indoctrinated for decades.
When you really need it, my experience is that the NHS is amazing - and while never omnipotent, delivers an extraordinarily good service. I would bet that for the amount that is currently being spent on healthcare in the US - much of which is lining the pockets of the various people who sell the drugs, equipment and services over there - you could probably pay for an equivalent of the NHS that could deliver great care to the whole population.
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The 'Club for Growth' states that healthcare decisions should not be made by "politicians or bureaucrats". I'm sure there are plenty of bureaucrats in the insurance companies who will be making funding decisions about people's care.
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Father of friends, when over 90, let his American Health insurance policy lapse. While staying with his carer he had hospital tests which cost $20,000 without any overnight stay. This was not covered by the replacement insurance policy. He did live to be over 100, despite their health system, rather than because of it.
I visited a friend of my mother's in a "home" in San Francisco. She was terrified she would be kicked out when they realised she needed medical care. I was shocked by the sight of gun magazines in the visitors' toilets.
When our daughter joined an ante-natal class she met a woman in her forties who was expecting twins,perhaps having had fertility treatment. This mother had to go back to work immediately after the birth, as her job carried health insurance for the whole family, while her husband, who was self employed, could not afford it. The twins went to a child carer who overfed them to keep them quiet.
To understand the USA, you must understand the effect their Heath Care System has on the whole society.
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I was astonished when you ask if there was anyone listening who had experience with both the US & UK medical systems, that's me! I lived most of my life in the US, before meeting my husband, who is English. I worked as a temp in the US, and while permenent employees in the US enjoy health insurance, temps most certainly do not. Nor are they paid for sick time, you get paid to work. So, if I fell sick enough to stay home from work, it would automatically cost $50 (a day's wage), if I was sick enough to need the doctor, it would cost $50 to see the doctor, and if he prescribed medication, the average price was...$50. So, for a day off work, I'd be $150 out of pocket and my weekly wage was about $210. That's about $7 an hour, fairly good wages where I lived, particularly since I didn't have a degree. I got very good at herbal medicine.
Contrast it to my life now, last year I had a case of bronchitis that lasted for several weeks and I at last went to my GP, whose office is literally two streets from our flat. It cost...nothing. The prescription for antibiotic cost...£5. While the NHS is far from perfect (as well I know, I work for the NHS in admin), I would far rather live in a country that has enough respect for its citisens to at least attempt to care for their medical needs, free of charge.
I dare say, if you look into those in the US who are protesting you'll find they have connections to the AMA. (American Medical Association).
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Where money follows the patient there is the possibility that a hospital that is in financial straits may suggest an operation unneccessarily, as it brings them much needed money.
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I don't understand why there is such hostility in the US to state supplied health care. I've never heard anyone proposing that _all_ US doctors & nurses will be compelled to work for the state - presumably a fair number would choose to remain in private practice, not least as they would probably earn more than the state employed physicians.
It's also misleading to compare the 'cost benefit analysis' of NHS treatment versus the "decisions made by patients and their doctors" in the video. For US patients lucky enough to have health insurance the medical funding decisions are made by their insurance companies - and the narrow and legalistic way that the rules are applied means that many procedures are wholly or partially excluded (such as only saving one eye or ear of a pair because the health insurance policy only "preserves sight" or "hearing") and treatments can be ceased if they are classified (by an insurance company official) as long term.
Finally, for US patients without any health insurance the options are bleak - emergency conditions stabilised, and then discharged from hospital.
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I recently returned to the UK after 10 years in the US. I was employed by a large corporation in the US and so had full health insurance. From my perspective neither system is perfect but I have to say I am happy to have the NHS and not to have to worry that if I lose my job here it won't affect my ability to obtain healthcare. Talking to people in the US with the recession on us you realise that losing your job in the States comes with the added penalty that your health insurance will end so the stakes are much higher.
With all the references to the NHS N.I.C.E and the propoganda in that Republican ad, does anyone realise that in the US it's often the insurance companies that determine which treatment you have? Often they will only pay for certain treatments for a particular condition. A colleague of mine had recently had a baby and spent weeks on the phone battling with his insurance company over different bills and payments. Most policies have a $1 million lifetime limit. Sounds like a lot but it won't get you that far if you need major long term treatment. After that you are on your own.
I also noted that when you go to the doctor, a simple treatment or procedure will often take several appointments since they can bill the insurance each time. In addition you will undergo test after test in the event that you decide to sue the doctor for misdiagnosis at a later date. All this adds to the cost of healthcare as well as the huge premiums the doctors have to pay for mal-practice insurance.
The statistics on life expectancy in the US are dragged down, I suspect, by the people who don't benefit from full insurance. If you have full insurance you can get the best care anywhere and won't have to wait on a long waiting list.
Clearly the US needs healthcare reform since the costs are out of control but there is a common mistrust of anything that appears to be government run and can instantly be labelled as 'socialist'. TV propoganda ad campaigns as shown above are an effective tool in the US for reinforcing these concepts.
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A friend of mine lived in the US for 25 years and had to return to the UK as her insurance wouldn't pay for her care any more, and she had run out of savings.
The NHS is quite a good service, and not as bad as some suggest. I have lived in Canada and it amazes me how people assume they must have a better system. They also have waiting lists and you pay for everything other than that provided by your doctor or hospital. Hence the need for insurance for dental, optical etc. You also have to pay towards the cost of drugs which can be very pricey for conditions such as cancer.
My experiences of NHS hospitals has been good, and surprising for some out there, the service has been good and the environment clean.
Of course there are some problems but it is better to have a service to moan about than none.
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27 - Hi BB, good to see you here again. Hope all is going well with you and Maff. :o)
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I am an American living in London for the last two years. I paid a lot of money in the US for a very good policy, of which my employer paid half. There are countless types of plans with varying costs. I use NHS but my company bought me private insurance here, so I feel as if I'm being treated similarly to my US plan. I find the NHS is fine for most of the people, most of the time. The 45 million uninsured Americans will benefit from a national programme. And there are millions under-insured who will also benefit. Some Americans seem fearful of change but fail to recognize the US government is already providing healthcare through medicare and medicaid which is primarily for the elderly. I see a US national healthcare plan as a necessity. Anyone wanting more than the minimum level can buy additional options. Kids need jabs. We need to reduce emergency room visits and offer preventive care. I see this as the leveling of the income brackets and Americans hate to admit it. A rising tide lifts all boats.
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It would be interesting to hear more about what conservatives had to say during the debate in this country before the creation of the NHS if the BBC has the cojones to do so. It would be understandable if you don't want to upset Cameron and co though, given their possible plans for a national treasure almost equally as valuable as the NHS.
I lived in the US from 1984 until 2001 and experienced excellent health care initially from Yale University's health plan and subsequently from a variety of private health care insurers. My ex-wife was a lawyer with a national reputation and so the care we both received was slightly superior to that I've had in the UK which was nice. But not so nice for the 44 million Americans who got no care as they have no coverage. I'm very confident that you'll find that American HMO's (Healthcare Maintenance Organisations) routinely limit care on an affordability basis for those who have cheap coverage to a far greater extent than the NHS do.
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I have been both insured and uninsured in the US, and lived in England, The Netherlands and France. When I was in the US, my (now ex-)husband ran himself over with his car (I did say 'ex-') and the first hospital the Fire Dept ambulance took him to wouldn't accept him in emergency because he wasn't insured. The next hospital was 40 miles away. They realized his auto insurance would cover it. At another time in the US, I belonged to an HMO. That meant leaving my regular doctor (who was great) and using the facilities of the HMO. I wasn't impressed, and the total cost (in 1984) was greater than the total cost of my Dutch insurance (in 2009)... that's total contribution: employer and myself combined, in amounts in those years. Allow for inflation, and I have to wonder what on earth the HMO was doing with all that money.
I've had friends in the US, professional people like lawyers, who could not afford insurance *and* pay for 'pre-existing conditions', and also friends who couldn't change jobs because conditions that arose during their present coverage became 'pre-existing' if they changed insurers (which are usually tied to particular jobs).
As far as I can see, the current plan for the US is that if you are covered and like your insurance, you can stay, and it's the 50 million uninsured who will benefit. The insurance companies are going to be reined in to some extent, and because they have been basically milking people, they are spreading around a lot of misinformation to see if any will stick. It apparently has, because (1) few Americans travel at all, (2) when they do, they are generally cut off from whatever local systemss there are because they are in the military or on an extended trip, (3) they've been primed to be reactive and unthinking by the mass media and other special interests, and (4) they have a knee-jerk reaction against anything branded 'socialist' by anyone.
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I am in favour of MORE socialised medicine; I recall my spell at Stanford University Medical Center, California when my colleagues regularly spoke in horror of this appalling concept. They now don't appear so horrified by socialised banks, insurance companies and car companies.
Socialised medicine with central planning AND denial of many treatments is the only way to keep the NHS on the rails, providing a universal service, in the face of the astronomical costs to come at the same time as the inevitable Big Squeeze. You can't have everything 'On the Rates' but you can keep us out of the Third World situation of ultra plush clinics for the wealthy, along with collapse of the public system. You can do that, but you'll have to be watchful and make some REAL hard choices- as opposed to the pretend ones the politicians are talking about.
The NHS is good, and has enjoyed some triumphs. There will be more to come: The National Bowel Cancer Screening Programme may be one of them. Socialised Central Planning did that.
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This piece terrified and angered me when I heard it earlier. We are told that 40 million people are without access to healthcare in the US, but the Republicans disagree with free healthcare for all on the basis that first it will socialise the state (at which point terrified scaremongers start shouting that the US will soon turn into Russia if they don't do something about it) and secondly that giving politicians power to legislate on healthcare provision will put a price on life that ultimately will lead to someone other than nature (or God, or whatever you want to call it) deciding when someone must stop living because the state can't afford to sustain care.
I think these reasons are wrong, but moreover I'm interested to know what's the Republican answer? Do they want to work toward solving this gigantic problem? Or do they think that if you're not successful enough to have insurance you don't deserve it? Survival of the fittest in action in the first world. Is this what Roosevelt meant when he used the phrase "rugged individualism"? Let the poor go to the wall because the free market weeds out good from bad? I do hope not.
I'm no socialist, and very rarely an angry listener, but I really can't abide this stance!
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SteveB66 makes a good point about the number of unneccessary tests US doctors do. But in addition to that, I found that they refer you to a specialist at the drop of a hat. My internist - the closest thing to a GP that they have - was more like a referral service for other doctors. In addition to him, I had an allergist, an osteopath and a gynaecologist. My husband had his internist, an orthopaedic surgeon, and a circulation specialist. My son had a paediatrician. So, 8 doctors for 3 people. Most of the things I was referred for, my GP would have dealt with equally well in the UK. Eventually I found a doctor who would treat both me and my son, who was great, but he was close to retirement and one of the last of a dying breed.
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Re; #37 proudhon
"It would be interesting to hear more about what conservatives had to say during the debate in this country before the creation of the NHS"
My mother(85) will tell you that the tories fought the creation of the NHS "tooth and nail" they tried every trick to scupper the NHS and vowed to dismantle it. However, when they got to power they found that a) it was extremly popular and b) it was nowhere near as bad as they predicted. Mind you during the 80's the Tories certainly tried their hardest to destroy the NHS with constant cuts.
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I think the American advert has a point. While I’m sure the American system isn’t perfect, the UK system is a long way of ideal. The NHS is hardly a model of efficiency, riddled as it is with bureaucratic inertia, institutional thinking and poor customer service. None of that is to comment on the commitment of many of the staff who work in the health service. As for the observation that I could always go private, I can’t. With my income I’m trapped within the state system and unable to afford health insurance. If I wasn’t forced to pay the taxes required to pay for the state health system, then I might well be able to pay for private insurance.
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Some interesting comments, particualrly from those who've lived in both countries. I've had the 'healthcare discussion' with people in America more times than I care to remember. Generally, its only those who have travelled outside USA, and those who have no healthcare provision, who are the ones seeking reform. The majority fear change. Ultimately, its up to them to decide for themselves, though I appreciate this is difficult, when they view alternatives from a conditioned 'user-choser' perspective. The 'constant drip' from the networks and press reinforcing opinion in favour of the private healthcare sector kills off any desire for change. Obama has a tough job; dealing with Israel and Iran will be easier.
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I lived in the US for 12 years and I have a chronic disease that requires surgical intervention at regular intervals. The only time this has brought me near death was when I was living in California, and had no health insurance. Even once I had health insurance (which I could only obtain through my work - I would not have been able to get coverage for my disease through personal insurance) the treatment I received depended on the particular insurer - some were great (Kaiser Permanente for example) and some were fairly awful. For a while, I lived within 20 miles of one of the best research hospitals in the world, but was unable to access it because my health insurer did not cover treatment there. I was routinely tested unnecessarily, which is one of the major padded costs of the US healthcare system - the profit motive is one of the most corrosive aspects of the US system and loads it up with all manner of unnecessary costs.
In the UK I've always been able to get the help I need even if it sometimes takes a little longer to access - although NEVER when I'm in an emergency situation. The journalist you interviewed last night, who complained about her London hospital being "scary" seemed to exemplify a sick US society where the wealthy and privileged classes choose to lock themselves away from the less-privileged. This, of course, is how their healthcare system is modeled.
If the US system is so wonderful, why does the US spend a greater percentage of GDP on healthcare than any other nation - by a significant margin - and yet have poorer health outcomes and lower lifespans than many other nations?
The NHS is not perfect, and it sometimes struggles, but it's one of the most precious jewels in the UK social net (rather like the BBC actually). It was hard-won, and we destroy it at our peril.
PS It is not the first time that the NHS has been used perjoratively in the US healthcare debate. In the 1980s when Hillary Clinton was leading on healthcare reform, the same tired arguments about "socialised medicine" were trotted out. The irony of all this is that the vast majority of insured US citizens also have no right to choose their own doctor or when/where they will be treated. Instead of being controlled by a clinician, as it is here, these decisions are made by someone working in a back office, for the insurance company, no different from choosing whether to pay out on a claim on your car insurance or home insurance. These are business decisions, not people-centred ones.
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rpovall: I'm glad you raised that point about the interviewee describing her stay in the hospital as 'scary', since it was used in a sentence which also include 'old women'. At the time I heard her comment, I was unsure whether to laugh (thinking of a horde of zombie women advancing on her bed) or to throw the radio out of the window at her apparent ageism.
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Because I'm American, my English wife gets Medicare and a US pension based on mine. Try reversing the situation.
As my wife was an NHS nurse for over 30 years, I can have nothing but praise for the service. She would shoot me if I didn't. Once a nurse, always a nurse.
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Here's an interesting indicator...
The number 1 trending topic on the social networking micro-blogging platform, Twitter, is #welovethenhs (we love the NHS) - the un-hashtagged topic NHS comes in at a credible fourth (mainly by responses to that stupid, unresearched US article claiming Stephen Hawking would be dead by now if he lived in the UK, and the NHS operates "death panels")
And on a similar but different theme, Swine Flu also features in the currently trending topics - together with #iranelection (a permanent fixture over the past few weeks), "Goodnight" (must be bedtime somewhere in the US...), "Tweets are pointless" (err...probably some daft quiz), "District 9" (a recently released film, apparently), "Hour Passion" (dunno) and "Criss Angel" (a controversial US street magician)
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While discussing my previous blog entry with my husband, I remembered a few other choice things about US health care (strangely enough, I worked for a temp for the Medicare/Medicaid department there...). Temps were always offered health insurance....at a price out of our own pockets. I was disinclined to accept that.
If your job offered health insurance, you would be provided with a list of GP's you could attend, use any other, and you either would have to pay, or the company would only pay a percentage of the bill. This would result in many individuals needing to go to a new GP after many years with a GP, in smaller towns, that GP might have delivered that patient as well as treated them throughout their life. A new GP would know nothing of the patient's history.
US Health Care is big business, and powerful big businesses have a crucial impact on politics in the USA.
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I'm incensed at the mis-information and downright lies that have come from some on the right in the US regarding the NHS. I've had some experience as a patient and relative of patient over the last ten years that show up for complete fabrications the statements that are being bandied around. A few examples:
1. At my previous job, I had Health insurance as part of my pay and benefits package. While there, I developed large scale psoriasis that eventually needed treatment as an outpatient over an eight week course. I went through the insurer, saw the specialist, had the treatment, then sorted out all the paperwork. Time taken from the initial GP decision to refer me to the start of the treatment was approximately 4 weeks. A few years later, the company was taken over, so the Health insurance changed to a different insurer. As Psoriasis is a chronic condition, I needed another round of treatments. As it was a pre-existing condition, it wasn't covered by the new insurer, so I went via the NHS system. The upshot was, my GP referred me to the same hospital, same department, same specialist, and I had the same treatment. Time taken from referral to the start of treatment was about 5 weeks. Upshot: I got the same level of care irrespective of which route I took, it took approximately the same length of time, and with the same outcome.
2. My father (79) has developed heart problems recently, so severe that it looks like he will soon be going in for surgery for a heart valve replacement. All this is being done on the NHS. He has the option of going private, as he's got the insurance as a legacy of his work. However, as with my treatment, he'd be seeing the same doctors in the same hospital regardless. Naturally, he's worried about this, but a quick survey of the village he lives in has revealed 9 or 10 people who are older than him who have been through the same procedure at around the same age. So much for the claim that people over a certain age are refused treatment for heart problems!
3. My sister developed Breast Cancer about 8 or 9 years ago. She was treated through the NHS. Now, she's been given the all clear. Cost of treatment to her? Nothing.
The NHS is not perfect. There are issues of too many middle managers, treatment for elective procedures can vary in lead-time from NHS trust to NHS trust. But compared to the alternative, I'm damned glad we have it.
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It's tops on twitter right now!
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The NHS saved my life more than twenty years ago.
Am I grateful? You bet!
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How did that happen? What's wrong with my first post?
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A hiccup in moderation perhaps, HintheH? Usually, somebody is usually allowed to post unmoderated after a certain number of posts have already been made. But, as you've illustrated, it can go bizarrely wrong.
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Thanks, Big Sister, It is a bit weird.
I'll just have to be a patient patient.
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Better than being an impatient inpatient, HintheH ;o)
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I am listening to an article on BBC World Service about the right-wing opposition to US healthcare reform. It has become a hot Twitter topic with a huge number of UK individuals countering Republican talking-points which argue that the NHS is letting us down and letting us die.
Stephen Fry has added his voice in support of NHS and has said that even right-wing UK politicians support the NHS.
However, I have watched dozens of recent USA talk-show clips on Youtube featuring our MEP Daniel Hannan who clearly hates everything the NHS stands for. Hannan delights in spinning half-truths and extreme examples to criticise the NHS. He has lectured in the USA (July 2009) on the subject warning the USA against healthcare reform and stating that the NHS Buerocrats are wielding an "aweful power to decide who lives and who dies".
Hannan even suggests that the shorter average life expectancy in USA is not related to their selective healthcare but probably attributable to "a bunch of reasons including street crime and so on".
The man is dangerous because of the harm is is doing in the USA made even worse because he is doing it in our name and at the expense of the EU taxpayers - us.
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I am an american citizen living in the UK. I have had the same exact surgery through both the American medical system and the NHS for frozen shoulder. Both systems were very comparable; both had a wait for surgery and both were same day. The NHS were more thorough in that they required a post surgery visit and took every precaution against MRS. I had insurance coverage in the US and I was fortunate that the bill was paid, however the costs of coverage was taken out of my wages. There is no free system and it is time for a change in America. Imagine not facing bancruptcy or foreclosure when faced with a life changing illness.
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I think that the Americans need to look at the French system which is probably the best in the world. In fact if I was young Obama I would call the French Minister of Health and ask to borrow a few of his bureaucrats to build the new US health care service. Why reinvent the wheel?
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This comment was removed because the moderators found it broke the House Rules.
The NHS works, not everyone who goes there dies and some people have nice stories to tell. So it's a question of degree. Look at Staffordshire and you have actually only read about a small percentage of the problems and just in the last few years. Look at the budget, the Labour party keep telling us how much they have spent but the service is not really that good. If I was in Parliament and said sorry guys you only have 30% of last years budget there would be an outcry. Well if you see the escalation in spend 300%+ under Labour it doesn't seem to have made much difference. If a 300% increase makes barely any difference then slashing the budget would make no difference. I would not and do not suggest that. The money poured in is not being spent well. Tony Blair specifically promised reform before more money. Everyone in the Labour party recognised that the NHS was terribly inefficient. In these tough economic times we can't afford to have a management consultant, manager and bureacrat filled NHS. That is all the Labour party has done, unintelligently throw money at the problem.
If the NHS is so damn good why is nobody else copying it?
The most ridiculous arguments are used against criticism of the NHS. You want the poor to die, you only want rich people to etc etc. The NHS is badly run. Pleas accept the criticism. It has had an enormous budget increase and very little has been achieved or if a lot has been achieved a lot more could have been achieved with the same money. The NHS is full of bureaucracy and buck passers and it seems almost impoossible to pin responsibility on anyone. Why are our great allies and friends the Americans so frightened of having their health system turn into the NHS?
Just because there are some nice stories and some good people in the NHS and my mother worked for the NHS and I know people who work there now, does not mean that it is a good health organisation.
The percentage of bad stories is too high. If there was US style litigation the NHS would be bankrupt. But Brits take it on the chin and some, particularly the elderly are too scared to talk.
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GeoffreyFirth wrote: "If I wasn’t forced to pay the taxes required to pay for the state health system, then I might well be able to pay for private insurance". In 1990 my husband's boss was paying $800 a month for insurance for himself and his family - wife and 3 kids. Well Geoffrey, why don't you find out how much you're paying for the NHS, refuse ANY NHS treatment, and see what you can buy privately. Lots of luck!
Nice to know that we're all subsidising private care, because private hospitals don't have A&E provision. Actually private hospitals "aren't legally registered and regulated as hospitals at all. They are registered as nursing homes".
THis link reports the death of Emma Nicholson's husband at the "prestigious King Edward VII hospital used by the Queen Mother":
http://news.bbc.co.uk/1/hi/programmes/panorama/archive/450689.stmDr
"Carl Waldmann of the Royal Berkshire hospital, and a member of the Intensive Care Society, has found that it is costing the taxpayer millions of pounds, and causing disruption to NHS patient's operations, to treat emergency patients who have had to transfer from private hospitals. Some of the major private insurers, including BUPA refuse to reimburse the NHS". Now that's the kind of socialism a Republican can do business with! Yeehaa!
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I've never been to America but I bet its a load of rubbish!
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I know one thing I would rather have the NHS than the US system any day. The NHS has it's faults mainly too many managers who haven't a clue how to manage and not enough medical staff. Durham is a good example a new hospital built with far to few beds, some land that belonged to the hospital being sold for private development, ie upmarket houses. I have always found our NHS staff excellent.
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Looternite what a load of piffle. My local NHS hospital has far less beds than the old hospital and we have labour council and a labour govt.
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My uncle paid for full healcare in the states all his working life. When he was diagnosed with throat cancer a the age of 61 he thought he was fully covered. However the insurance company sent him bills whislt he was dying to the tune of $300,000. when he queried this he was told that the hospital he was with were overcharging by 20%. He ask them to recommend a hospital which was suitable for him to have treatment and was told they all overcharge by that amount. This was in Florida and basically he was left with a bill for $300,000 out of his estate. As he had 2 children, one of 3 years and anoither of 6, he was worried sick about their future. Needless to say, he died without all this being resolved and his estate had to pay the balance. It was absolutely disgraceful and caused terrible heartache to a man who was in the last months of his life and who believed and was always reassured that he was fully covered by his insurers. So much for the American way. There are many things wrong with the NHS but having had experience of living overseas, I have to say it takes some beating. I was dangerously ill in Panama and had to be rushed into hospital. My uncle had to leave a cridit card number before they would treat me. Anyone complaining about the Health Service here should try living abroad and then compare. The American Service is only okay if are wealthy enough to ba able to afford it.
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They have a point we value the lives of child killers more than NHS patients.
How much will it cost keeping the killers of Baby Peter alive?
Couldn't that money be better spent on the NHS?
We aren't prepared to discuss the death penalty but we let NHS bean counters decide on who lives and who dies.
You pay your money and take your choice?
I am not sure about the Brown's getting involved in a Twitter battle defending the NHS. It's just a fad that relies on existing technologies.
Playing around on Twitter only makes you a twit:
[Unsuitable/Broken URL removed by Moderator]
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Should I be cross about the bizarre misinformation our American cousins are promulgating? Or should I just be baffled? Probably better for my health just to be baffled ... hang on, someone at the door - that'll be the death panel, I expect.
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The soundbites from the Americans who are opposed to a universal healthcare system only confirms my opinion of 'average' (WASP) Americans.
It is clear that the entire American society and its mores are entirely based on the cult of the individual and personal greed.
All their opinions are driven and indoctrinated from a small age via the poisonous US press and entire media machine, which exaggerates the negatives in all policies promoting any form of common social conscience and shared ownership and responsibility, even to the point of blatant lies. Added to this is US xenophobia if anything 'un-American' (I.e anything without a profit margin that's not owned and exploited by the US).
On the few previous leisure trips I have made to the US I have seen the shanty towns with crude wood and corrugated huts, with open sewage, that exist on the outskirts of prosperous US towns and cities, further indicators that unless you are in a well paid job and have private income and insurance then you are excluded from good free healthcare and many of the social benefits that we have in the UK and across most of Europe.
Whilst I do not believe that our NHS is in any way perfect, and there are many significant improvements that could and should be made, at least we can get medical treatment without worrying about being presented with a huge bill or having to carry an insurance certificate or credit card to receive excellent emergency care.
I speak with something of an understanding of these issues as members of my immediate family worked for decades in a large inner London NHS trust.
The irony is that current issues plaguing the NHS are precisely those policies copied from the US and implemented by the Tory government under Thatcher; who dissolved the NHS into thousands of trusts, creating innumerable tiers of management jobs and the associated chaos, insufficiencies and duplication of all aspects of resourcing, finance, purchasing and crucially hundreds or thousands of incompatible, independent and dissimilar IT systems across trusts and even individual departments within trusts or hospitals. This replaced the NHS as a provider of medical treatment, training and research and turned it into a 'profit-centred' organisation, mimicking the American private care system.
These problems were further exacerbated by the outsourcing of contracted services such as cleaning, which immediately emasculated the authority and responsibility of the medical staff (Sisters and Matrons) and passed this to the non-medical accountants, it's no wonder that MRSA & C-Diff is a unresolved issue!
Whilst the old NHS was far from perfect, as it was primarily ruled by consultants who ran it as a means to treat their private patients using NHS resources and wrote their own rules, it was still a far better platform to build a single healthcare organisation than the current chaos we are currently left with.
Its a tribute to each and every NHS trust that they can operate under this ludicrous system and continue to provide the quality of care we still enjoy
It would take a brave and wise leadership to implement a truly strategic position on this matter rather than the current (and previous) weak-willed pseudo-tory 'New Labour' (or New-Tory as I prefer to call them) government who are just trying to make this current system work, which is obviously impossible, and instead make the change required to create a single truly National Health Service; removing the postcode lottery treatment, passing medical matters back to the clinical staff, not accountants or business managers.
I therefore heartily applaud Mr Obama in trying to implement any policy with a social conscience, but I fear that he will be facing an uphill battle to proceed against the reactionary and selfish Republicans, and an even greater battle to obtain sufficient funding, as most of the money has been spent on either propping up the already rich banking industry, which is akin to handing over the transfusion service to a team of leeches and vampires, or on US instigated overseas wars (and please don't get me started on that issue!).
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In all the coverage I've seen from the 'town hall meetings'. It is very noticabe that all the people complaining of the horrors of universal health care are white. Whereas the people seen queuing for the few free clinics are mostly black with a few hispanics.....
Land of the free home of the brave ???????
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There are thousands of spurious statistics being bandied about during this debate but the only one that matters is the WHO figures for infant mortality. Infant deaths per 1000 live births, UK 4.9, USA 6.3 (the worst of the industrial nations). Translated that means that the NHS works a whole lot better than the US system and other European countries with "socialised" health care do better still.
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http://www.telegraph.co.uk/technology/twitter/6021362/Gordon-and-Sarah-Brown-join-US-pro-NHS-Twitter-campaign.html
Rather like Hillary Clinton losing her temper when being asked what her hubby thinks, do I really care what the wives of Blair and Brown think? Did I elect them?
It's like somebody becoming famous because somebody that may be famous in their own right once had sex with them.
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I am an American who now lives in the UK. My parents had insurance when I was growing up and it wasn't until I left home that I learned what it was like not to be insured. I worked for a number of years at part-time jobs or as a temp and I just couldn't afford it. I got hold of a fake student ID in order to use the inexpensive university health service long after I was no longer a student. Then I started using a local health clinic which charged on a sliding scale based on income. It was great to have, though it only provided a basic level of care, and not something I'd have had access to if I lived in a small town. Then I finally got a permanent job and had health insurance provided by my employer. Fantastic -- but the copayments increased every year. My sister and her two young kids had no insurance for a few years after her divorce. She was finally able to get some because the state she lived in provided inexpensive private health care plans for people on low incomes.
I've had two operations on the NHS and although the system isn't perfect (no system is), it's far far better than that in the US. I know that if I change jobs or become unemployed I won't lose my health care. I don't have to worry about a devastating illness becoming an excuse for my insurance company to stop covering me. And when I do get care I don't have to spend hours battling with my insurance company and filling in endless forms to get the coverage I thought I was paying for.
It's appalling that so many Americans living a country that they believe is the best in the world, the best country in history, think it's OK for their fellow citizens to be denied health care because they can't afford to buy it. That's not a civilised society. A civilised society in the 21st century would provide health care for everyone.
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72 - gosh, you are boiled, aren't you?
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It would be interesting to see what would happen if Republicans Abroad tried to arrange a "Town Hall" meeting somewhere in the UK to persuade us to scrap the NHS and adopt the American system. I think I can guess!
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I am a Canadian, who has lived for a while in the US and now lives in the UK. As you may be aware, Canada has a healthcare system similar to the UK's. When I was in the US, I came across someone who had no healthcover, and had broken her finger. She was in a lot of pain, but could not afford to go to a doctor.
If that were in Canada or here in the UK, at the bare minimum, one would have consulted a doctor. It is unthinkable that this is the plight of so many in the richest country in the world.
I am very glad that we have the NHS here and a the OHIP in Ontario, Canada, whatever their flaws. In fact, I have a T-shirt I very proudly wear, which says:
'What's the definition of a Canadian? An unarmed American with Healthcare! Heh Heh Heh!'
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I'm a retired American living in the UK for about 25 years. I use the NHS now and have had private (employer paid) health insurance here in the past. I've also had the experience of living in the US both with and without insurance. All of these experiences provided perfectly good care. I was lucky, however, that during my uninsured period in the States, nothing serious happened.
The current debate in the US over the provision of universal, affordable health care is being hijacked by the Republican Party and their sponsors to undermine the Obama presidency. The use of attacks on the NHS in this campaign has nothing to do with the real NHS and everything to do with spreading confusion and fear among an uninformed section of the American public.
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How would the Americans like it if I were to base my opinions on say, the film...'One flew over the Cuckoo's nest'?...oh you mean its really like that!?
See how pathetic it all sounds.
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It seems to me that the Republicans are deliberately missing the point of Obama's plans in order to scare a significant proportion of the US population into opposing them. There's no suggestion of nationalising the health service in the US - just making it more accessible for all. Surely this has got to be a worthwhile goal?
I had my first child in the UK and my second in the US. The US experience was better in many ways - private room, 48 hour stay, nursery facilities - and was mostly covered by health insurance, although there's always a co-pay element. However, and this is the really important thing - there were people in the same town as me who weren't attending vital pre-natal checks because they couldn't afford them and who would have been charged several thousand pounds immediately after the birth with no means of paying.
What's more, there were no home visits once you left the hospital - just a phone call for a couple of days to check you were OK. I might have had my own bathroom and a meal menu, but I'd far rather be in a ward in a UK hospital where everyone had the right to the same care. There's no way the NHS is a perfect system, and we all moan when it doesn't work for us, but it's better than a system that actively makes healthcare unreachable for the poorest people. It's as simple as that.
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The situation as it stands in the USA is that obviously, health care is far, far more complicated than it is here in the UK. The patients need certain health care and the doctors try to provide it, but the insurance companies- the ones most concerned with profit margins- are the ones who ultimately control a person's health care. Health care is expensive because technology requires a certain standard of care and staffing, malpractive insurance, but also because of of administration costs, of which a large part is made of of insurance paperwork, phone calls, billing, etc. Additionally, the suing culture in America has driven up costs of malpractice insurance very dramatically for the doctors. This cost, of course, is ultimately passed back to the patient, as doctors must be very meticulous and regimented in their care to cover themselves legally; however, again we are back to insurance companies who quite often do all they can to deny procedures which the doctor orders. Truly for anyone who has a health care plan, their well-being is in the hands of the insurance company to which they pay premiums.
It should be recognized that the sickest patients are subjected to the most difficulty, as they have the most claims and highest premiums. Lifetime maximum costs paid out mean eventually one will be cut off from coverage completely. Once this happens it is extremely difficult to obtain coverage again, as many insurance companies won't cover, and if they do pre-existing conditions are excluded. If coverage is offered, premiums are so high that one cannot hope to afford them.
The real tragedy of health care in the USA, however, is the individuals who do not have health care plans and are not eligible for state assistance. They are the ones who need a voice in this matter. They often cannot get care at all. If they do, payment is usually expected immediately. A single office visit can easily be $50-100 and a trip to the emergency department begins at roughly £500 the moment you walk in the door. Medications are extremely expensive, something which we in the UK have no sense of as we either pay nothing or a set fee per item, ie £7.20 in England. (We do not realize that one medication can actually cost hundreds of dollars per month!) Many doctors and hospitals can and do decline to care for anyone without insurance because obviously the cost is a genuine burden to the patient. However it should also be pointed out exclusions are also common for those with state Medicaid/Medicare, as the reimbursement for care back to the doctors and hospitals is so low it is not seen as profitable. Most practices, IF they accept Medicaid/Medicare patients, only take a limited few.
Given the huge monster that US health care has become, I feel some form of socialized health care in the USA would benefit all but the insurance companies. This hopefully would streamline the beast and offer medical coverage to all, improving the overwhelming burdens of system as it currently stands, and hopefully removing ethical conflicts of interest in having insurance companies sitting at the driver's seat of healthcare.
My background: Professionally, I have worked as a nurse for a large HMO company in the USA and also in private practice in a GP group. I have seen and been involved with the difficulties patients experience, both in having insurance and not. I have spent countless hours on the phone with insurance claims for patients. On a personal level, I have seen all aspects as well, having been subjected to personal insurance plans, state Medicaid/Medicare health coverage, but also experiencing the loss of coverage completely while faced with serious medical problems amounting to hundreds of thousands of dollars in health care costs.
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I'm not sure if she'll be able to log onto this Blog, but a very close friend of mine works as a legal assistant in a large US legal practice dealing exclusively with health issues. Her input to the debate would be very interesting. I'll email her a link and see what she has to say.
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"The current debate in the US over the provision of universal, affordable health care is being hijacked by the Republican Party and their sponsors to undermine the Obama presidency. The use of attacks on the NHS in this campaign has nothing to do with the real NHS and everything to do with spreading confusion and fear among an uninformed section of the American public."
Precisely. How fortunate we are that such behaviour never happens here.
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"Given the huge monster that US health care has become, I feel some form of socialized health care in the USA would benefit all but the insurance companies."
And their bedfellows, the drug companies.
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Not to forget the litigators, who benefit from all conflict.
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bbr 76, You must be joking. I dislocated my elbow playing softball in the US and paid all the bills myself and it didn't bankrupt me. A broken finger? Tape an ice cream bar stick to it and get on with life. That will be £50.
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BS 81, I send links of my Glass Boxes to a friend in the US and he can look at them.
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David (86): Does he like them?
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85 DMcN.
Why didn't you reset the elbow yourself? If my 78 year old mother can do it I'm sure that you could. The arm only stays blue-black for 2-3weeks and housework is still possible during this. NHS - who needs the NHS?
NB. no lolly sticks were used at all and so £50 was saved
"Right then! Call that tuff? We used to get up 3 hours before we went to bed. Our father would come home drunk and beat us with metal whips for 5 hours. If we were lucky we fed on scraps that the cat brought in....."
(whose copyright?)
Regards
from London deep in NHS country
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BS 87, As he doesn't know the concept, he thinks I'm nuts. As we hung around together for years in the 1970s-80s he should know that I'm nuts. He is.
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P_T 88, If you'd seen the odd angle it was at, you'd know why. I did, however, reset a slightly dislocated shoulder after going over the handlebars of my bicycle near St Albans. Got back on the bike and rode home. Unfortunately, the broken glasses didn't heal.
The £50 was for my advice.
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I apologize for the time lag of this comment. I just found this piece.
I'm American, living in California and have a website for political independents called "The Political Stray". For some time I've been searching for commentary from our Canadian and Brit friends. Americans are puzzled by the silence in the face of the nasty onslaught about their health care systems from our political right. I only know better because my fiancee'is British.
Perhaps linking people to British and Canadian sites is the trick I've missed. I only hesitate to do this because of "the ugly American" types that always jump on intelligent commentary. I apologize for them in advance. We despise them as much as you do.
I did want to correct one thought, that is that American doctors are against reform. Our doctors hate the system as much as we do and have been fighting it for years.
I would encourage our allies in both countries to speak on the American blogs, speak loudly and ignore the idiots. Do it for the one American you may have met that you knew was normal and a fairly decent person. Contrary to the middle-aged, white power-monger image - contrary to the sex, violence and auto obsessed image portrayed by our advertisers, most of us are decent people trying to swim upstream against corporate giants that have quietly built a empire that threatens us all.
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