I have only just seen this piece, written from the heart, on the differences between, and relative merits of, the UK and US health systems
It really is a fantastic, fair-minded and thought-provoking take - beats Michael Moore.
And it is written by a Fox News anchor, no less!
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Hello, I'm Justin Webb and I'm the BBC's North America editor.
You can stay up to date with Justin Webb's America via these feeds.
Justin Webb's America Feed(RSS)
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This opens up a complex and controversial topic. I have no experience with British health services, but it is certainly the case that the American system is expensive, and because of the cost, inequitably distributed. In the U.S., the doctors and lawyers do very well, and most of the rest of us struggle to get by.
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Why don't us yanks just get together and
rent a few buildings in the UK (or even Cuba),
hire the local talent, and hire a few extra
janitors.
I'll bet that we'd get as good or better care than
we get here, for a fraction of the cost.
Now, if we could just figure out how to
outsource our lawyering...
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Beats Michael Moore indeed! Mr. Asman tell the truth!
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"the purchasing power of Brits must be close to what we would define as the poverty level."
Hmmm. I couldn't really take the article seriously after reading that ludicrous statement, unfortunately, Justin.
It was an interesting take, but clearly one coming from an enormously wealthy perspective, alien to most of us – though not perhaps to you! The point that not all Americans can afford the sort of care he was used to (if any at all), was dismissed in barely a sentence. The perspective of middle-earning Americans might be somewhat different. The perspective of low-earning, or non-earning Americans might be very different indeed. This was the view from the top -- interesting, but hardly objective, or even particularly fair-minded.
It's unfortunate that you yourself relatively frequently fall into the trap of considering only the perspectives of the elite parts of society in which you move, and not the experiences of the public at large. Alas we are not all so fortunate as to be news anchors or foreign news editors!
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This comment was removed because the moderators found it broke the House Rules.
This comment was removed because the moderators found it broke the House Rules.
That's what we call in American (gridiron) football, "offsetting penalties."
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To put it another way: Mr. Asman is comparing the kind of care you can get, not the kind of care you typically do get. Few would argue that American hospitals have great gadgets, the right to sue, a pill for everything, and decent sanitation. The problem is the cost -- including insurance -- for the average American, which puts many of the good treatments out of reach.
While the story is interesting, a comparison with, say, Sweden might give better insight into how we can be more efficient, equitable, and effective in the US.
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Actually, the article does have a point:
we could just let all of our lawyers die, and
then health care would improve for the rest of us.
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My own experience with th American medical system -- personal and that of my parents -- is in keepung with Asman's. I'm sure millions of other Americans have had very similar experiences.
American patients are routinely discharged from hospitals against the wishes of the attending physicians because the HMO or the insurance company -- who have no personal contact with the patient -- decrees it so.
I don't believe American medical professionals are encouraged by the threat of lawsuits to deliver the direst possible diagnosis. (I.e., you'll never walk again, as my mother was told, incorrectly.) People make life-changing decisions based on those diagnoses, and are just as likely to sue when expensive and heart-rendering actions were taken unnecessarily.
From my own experience living and working in the UK, Brits are fully aware of the tax burden imposed on them for public health care, and for other public benefits that aren not provided in the U.S. They don't like the taxes, but they do like those services.
Finally, while it is unlikely that an American emergency room would turn away anyone showing up with a leigitimate emergency, doctors and hospitals obviously do turn away patients with no insurance and no ability to pay. In reality, many Americans who lack health coverage simply do not seek medical care. That is, they become patients who turn themselves away from needed medical care. In many cases, emergency care of catatrophic cost could have been prevented if treatment had been sought earlier.
While "free" UK care is obviously paid for by British taxpayers, care given to uninsured Americans is not free. When an unisured patient is treated in an ER, those costs are reflected in that hospital's billing to every other patient.
It is an invisible tax the rest of us pay via our health insurance premiums.
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Justin,
I have nothing but praise for the British system, which has served my needs perfectly well, and most of the folk I know have had similar experiences. Fortunately, I haven't had too much cause to call upon the system, but it did save my life by early diagnosis and treatment of meningitis almost thirty years ago, so I reckon it doesn't owe me very much.
An interesting essay on heath matters from a Kentucky farmer, which might add to the discussion. It, too, involves experience observing a loved one's treatment.
I hope the Mods (who are as Gods) are happy.
Peace and healing to all,
ed
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Justin.
Nice little piece. I must not say "and from Fox" or would that give the game away.
Unfortunately I have no knowledge of the American health system so I can make no comments as to the clean floors or the level of medicine and surgery practiced there. The London hospital he mentions is University College Hospital where I trained but that is also many many moons ago before plying my trade in Europe, so, again awaiting an incisive comment from me, I must again dissappoint you.
Perhaps the advent of too many chiefs and not enough indians, too many pen pushers and fewer medical staff has had its effect on the NHS hospital system. In my day the matron [now gone] was a feared figure and everything ran like clockwork and was spick and span.Those days have now obviously passed.
If I can at least give some advice on these pages and any are faced with the same dilemma in seeing a loved one with a problem, where any problem for a layman appears severe, and can also be life threatening:- Please , please do not be as dumb as the Fox News anchor and delay the patient reaching the hospital because you have forgotten your mobile telephone. I feel sure that English NHS hospitals do have telephones today or a set of bongo drums to get your messages out to the waiting world if necessary.
Knowing today what I now know about "faux noise" I do have my doubts that he phoned his American medical specialist first. My money is on his skin-care specialist, and then his hairdresser. My, my, he must have looked awful after all that stress running up the stairs to retrieve her cell phone.
wma. MEO.DEO.LLEI
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Ed (#13), I thought that link would be to something having to do with the problems of farming in the Scottish highlands.
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There is exceptional medical talent in both countries, the difference is accessibility. While the USA enjoys the benefits of the latest technology and highly qualified doctors, 47 million of our fellow citizens don't have access to the system. The bottom line when it comes to health care is results, and considering the fact that our longevity and infant morality rates are the worst in the industrialized world, while our health care system is the most expensive, the only conclusion we can reach is that our private insurance system is not working.
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Yes, an intersting article: He as right about lawsuits. Touting for business and 'no win no pay' are not allowed in Britain. But he is wrong about Value Added Tax. It is not cumulative and therefore is different from Sales Tax as levied in the U.S. The company that supplies equipment to the hospital charges 17% on the bill. The hospital charges 17% on the bill to the patient. The hospital then deducts all the 17 percents they have been charged from the total they have charged and pays over the difference. This happens all the way up the chain. The idea is not to encourage virtical inigration in the sales chain.
In all European Community countries the Public Health Service is available to everyone. In Spain, each Region is responsible for providing the Regional Service, base on CAPs (Cetres of Primary Care) and public hospitals. Most are under 20 years old and are well to excellently equipped. It is payed for out of taxation including a small levy on gas (petrol) and oil.
We, and many others, also use the very good private system. To pay for this we belong to a Mutual Society which is non-profit making and of which we are the shareholders. This prevides for private hospital treatment, general practice and treatment, including when travelling.
A couple of years ago I was taken ill with a suspected heart attack on a flight from London to Barcelona. The plane was diverted to Paris. Quie dramatic at the time for my poor wife and daughter when a doctor 2 para-medics and three fire fighters in full gear arrived on board. Anyway I was taken to a Paris Hospital where after suitable teast it was establish that, fortunately no, no heart attack and the next day we were able to carry on home to Barcelona. The point of all this is that all the costs involved were paid for by the Society without question.
From what I have learned, the best Healthcare in the United States is the best in the world but the downside is that 47 million Americans have no effective healthcare.
By the way, if you are wondering what Europeans see in Barack Obama he is young fresh and interesting. If you want to see what I mean, just compare him with the phto on the latest Mark Mardell European blog of the present British and Irish Prime Ministers.
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Having attempted twice to post a comment, none of which has been copied from other sources, I can now sympathise with Ed and others who have had multiple removals. For Moderators to simply say that something "appears" to be an infringement is in my view insufficient - at the very least the supposedly offending passage could be noted. I have written quite extensively about the NHS having been directly involved with landmark decision by the Health Service Commissioner (Ombudsman) and I cannot infringe myself!
Incidentally, #17, Old-Man-Mike, is incorrect about 'no win no pay' in Britain. There are a number of solicitors who provide contingency services and these have been successful, particularly concerning the provision of funding for long-term (continuing) care.
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Ed. #13
Thanks for the great link to Wendell Berry.
" Food, medicine, beauty, and love. When we talk about them in English, they seem so different from each other. But looking at them from another perspective, they are not so different. Good food is a part of good health. Good health leads to good looks. Love surrounds it all.
When we feed or heal, we share love. When we love and are loved, we are beautiful".- Alma Snell.
wma. MEO.DEO.LLEI
With "heath" matters I could not resist it.
{Mares Eat Oats, Does Eat Oats, Little Lambs Eat Ivy.
Sorry, ....but here is a hug [ ].
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What contributes to exhorbitant health care costs in the United States is greed and corruption. Take pharmaceuticals for instance. Since I travel a great deal in the course of my work, I am no longer surprised to find I can buy the same proprietary medicines overseas for one-fifth to one-half of what I would have to pay here. These, by the way, include medicines from American pharmaceutical houses.
Medco Health Care and other agencies affiliated with HMO's routinely lie about their costs. They say they pay $175 for Advair 500/50. I bought the exact same medication in Jordan for $67. I checked with Canada and the price there is also lower than what Medco says it pays. Medicare tells its own fairy tales. They claim the walkers they provide cost them $100 each. They can be found in Wal-Mart for about half that.
When HMO's are involved you can expect fraud. My husband went for a standard eye exam only to find that the doctor charged the HMO for some esoteric treatment (not performed) and billed them $23,000. He couldn't even get the insurer to listen to him when he tried to report it. Insurance companies don't bother policing; they adjust their fees to their payouts.
I am against expanding health insurance. The system we have not only doesn't work, it exploits the insured. Expanding it increases the abuse.
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Justin:
I hope that Mr. Asman's wife is doing OK following her health scare.
Could the BBC team in Washington check that out for us.
Interesting piece of journalism.
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Written by a Fox News anchor -- but also a former Wall Street Journal reporter.
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In an attempt to discover what the Moderators considered to be a copyright infringement, I am posting my comments in three (3) segments. Whichever is removed will be of interest since nothing whatosoever has been copied. So here goes!
PART ONE
#3 noble Floridian "Mr. Asman tell(s) the truth!" But not the "truth, the whole truth and nothing but the truth"!
David Asman writes "Uninsured Americans are not left on the street to die." Really? Mr Asman lives in the rarified atmosphere of the very wealthy who cannot acknowledge that such statements are always entirely accurate. This link to National Public Radio illustrates the point. In any case, it is not really a good assessment of the two systems to compare one emergency admission with the lifetime of care to which every British resident is entitled. The NHS is funded largely by general taxation, not as some people aver, solely by National Insurance contributions. For that they receive basic and often very sophisticated health care over a period of possibly as many as 90+ years. It should be noted that there are actually four independent NHS systems, and the regulations for each vary slightly from country-to country within the Union.
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PART TWO
What the NHS does provide is a safety net for every single person - private medical insurance is available and is more and more purchased. For those who do not wish to do so, a visit to their GP is free, but filling a prescription costs around $15, similar to what a co-payment would be in the American system. In the US, visiting a doctor (GP) could be as much as $50 to $250 (£25 - £125) at 'commercial', walk-in rates - a far cry from the UK. NHS care can continue to death, although the funding of long-term care has become increasingly difficult. Despite a public Consultation and the streamlining of eligibility criteria following on from the Health Service Ombudsman's Special Report to Parliament of February 2003, fewer and fewer patients are paid for. A Royal Commission had studied the matter shortly after Labour was returned to government in 1997 but its proposals were rejected and the Minority Report (whose authors were then elevated to the Peerage) was implemented. This provided that "personal" and "social" care should be paid for by the individual, not by the state. Unhappily for the health service, a landmark judgement in 1999, "Coughlan" decided that where the primary need is a health need, then the NHS must pay. It has become increasingly contentious about where the line between 'health' and 'personal' care is to be drawn. Dementia patients in particular are considered to require "personal" care even though afflictions such as Alzheimer's Disease are terminal. Nevertheless, those with the stamina to pursue a claim for funding may prevail, some taking as long as ten years! The issue was publicised by BBC Panorama in March 2006.
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PART THREE
If Mr Asman had not been a wealthy individual and was a British resident, he and his wife could, as a matter of right, have received a lifetime of care, ante-natal to the grave, at little or no cost to themselves. Such free, continuity of care is not available in America. One must also ask what would happen to a visiting Briton to America should they be in the same situation as Mrs Asman. One of the first things asked is "who's your insurer?" and the ability to pay for treatment may frequently becomes the determinator of what is provided. Taking one medical emergency and attempting to extrapolate a lifetime of care provision can never be an accurate appraisal of the National Health Service.
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I wonder if people in Iraq are getting good healthcare!
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There was a spelling mistake in my last post: I meant to write Eye-rack.
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#23 - The second paragraph omitted the important word 'not' and should have read:
"David Asman writes "Uninsured Americans are not left on the street to die." Really? Mr Asman lives in the rarified atmosphere of the very wealthy who cannot acknowledge that such statements are *NOT* always entirely accurate"
#19 W/A You missed out the last line - A Kid'll Eat Ivy Too, Wouldn't You?
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Speaking as a British-born American citizen, I feel your American bias is showing here Justin.
The piece is a good tale, but lacks proper analysis. The author spent the time to find out about the UK's hospital infection problems but yet didn't mention the US ranking last in the industrialized world by UN rankings? Or the fact Cuba has better infant mortality than the US (and other such faults mentioned by others in comments above)? This piece was entirely too narrowly-focused on just what they saw... for a former Wall Street Journal reporter he should have started with those experiences and fleshed it out more with a lot more analysis and factual information. Then perhaps it will approach thought-provoking levels.
And for a much better piece on healthcare: PBS Sick Around the World
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One of the lies constantly repeated by opponents of universal health care is that its costs outweigh the benefits. Of course, you can directly compare the PPP adjusted per capita costs of US health care vs those of other countries and guess who has the most costly health care system in the world? Why the US, of course, and by a large margin. (Sorry about the link being Canada-centric, but this pdf had the most recent data I could find for free. Brand new data is available at the [Unsuitable/Broken URL removed by Moderator] for a price) People like Asman claim that high health care costs cripple economies and lower the standard of living, yet magically the US can spend a larger part of its GDP on health care without any adverse effect. You can come to the most amazing conclusions when you ignore facts, can't you?
Oh, and hopefully I don't need to mention the obvious to most people on this board: that he's comparing the UK system to coverage that only the richest US citizens can afford. How many Americans do you think can get a diagnosis from "world-renowned cardiologist Dr. Isadore Rosenfeld" with one phone call? 50? 100? 1000? This is the kind of tortured logic you get from the US media: the richest people get the best care, so the US system must be the best in the world. They would learn a lot if they asked someone with a low 5 figure income how good their health care coverage is. But I guess the Wall Street Journal doesn't solicit op-eds on health care from the poor. Or maybe the problem is that these people are too busy waiting in line here to write opinion articles.
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David.
Your insight into American and NHS bureaucracy completed with all the usual surgical skills of the well read, informed blogger. I know that in the UK or Europe today, the health worker in the frontline spends more time completing paperwork to be allowed to treat the patient, than putting on the mask and gloves to carry out the work.Operating with one hand tied behind your back does have its limitations.
Ms Marbles. You are also correct that some use the administration maze to fill their pockets or that of the institutions where they work. In Holland I believe there is now a crackdown on the backhanders being paid for not promoting generic medicines.
Unfortunately, to the bane of colleagues who occasionally strive for the a status of a "god", I have always regarded myself as a simple mechanic, [with a heart] being employed for my manual dexterity and a little brain, not my oratory skills where changing countries and the language, has resulted in my present lack of English communication skills. Ending my # 14 with the MEO.DEO etc qualification letters was not only a friendly pointer at Ed who had mis-spelt a word but also a sarcastic dig at fellow colleagues where there was infighting in the past over whether the title MR Smith the surgeon or DR Smith the surgeon was the most appropriate choice. It was used in memory of a colleague, who should take the credit, having had previous dealings with English medical authority personel.
Eds' link to Wendell Berrys' "Heath is Membership" is a very easy to read article, but although I would agree that there has to be more heart and hugs by the team around the operator for the family of any patient, it is not in the surgeons best interest to overstep the mark. Today,it is only through the head, heart and soul of my wife, a fellow practitioner that I am now retired to live a simple life , [here in a sunny country] and can swing my arms planting trees ,{ not forgetting the vegetable patch}. Giving her whole to every patient, nurse and colleague resulted in a downturn in her own health and she was forced to prematurely retire on a medical pension, to support us both. [But then we had been paying an average 15000 euros per year per practitioner for many years to cover this possibility, together a total of 60+ years].
Medicine in all meanings of the word is dangerous for ones health.
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Hi Justin, I was out last night with a close friend who is an nurse on an intensive care ward in th UK. He was telling me about a patient they have in who is a chronic heroin addict who due to sustained drug abuse has a life threatening heart and lung condition.
He reckoned that the drugs being pumped into this guy alone were costing £20,000 a week yet it was likely that once discharged he would be back using and ultimatly back in hospital. This meant weeks of dedicated care and a huge amount of money were being wasted to no end.
According to my friend there is a hardcore of people who by whatever social misfortune are constantly under medical care draining off ressources meant for the general population. My question is that though we live in a prosperous society and we can care for people who bring these conditions on themselves, should we continue to do this? Is there not a point where we should refuse certain people treatment? I know you can say that in the States it has gone too far the other way where people are refused treatment on spurious grounds. As your piece showed both systems have their faults but I wonder if a middle course between the two might raise our standards here.
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"Checking into the private hospital was like going from a rickety Third World hovel into a five-star hotel. There was clean carpeting, more than enough help, a private room (and a private bath!) in which to recover from the procedure, even a choice of wines offered with a wide variety of entrees. As we were feasting on our fancy new digs, Dr. Cullen came by, took my wife's hand, and quietly told us in detail about the procedure. He actually paused to ask us whether we understood him completely and had any questions. Only one, we both thought to ask: Is this a dream?"
What utter twaddle !! This is simply not a fair comparison Webb, and you know it !!!!!
It is all very well comparing what life is like for very rich Americans - they can pay for the best - what about people at the 'bottom of the pile' experiencing health care in a UK provincial city - which can be very good - with a poor US family living in the middle of nowhere ? They may have NO HEALTH CARE AT ALL !!!!!
RUBBISH !! Do you journalists ever deign to live in the 'real world' ? You certainly have GONE NATIVE.
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Dear Justin
I was surprised and disappointed to hear/see you reference Mr Asman's musings, and then suggest that it is 'fantastic, fair-minded and thought-provoking'.
Now granted, the NHS is struggling, with chronic under-funding, lack of decent management structure, and too many undervalued, unappreciated doctors and nurses. I don't think many would argue with that. Long waiting times, poor conditions (in at least some hospitals), and workloads demands that are far too great for individuals, and it leads to the waiting times and compromised standards with which we are all-too familiar.
However, to paint the US healthcare system as an amazing, wonderful, halcyon-tinted environment, is simply untrue and a grave distortion of the truth. For the upper eschelons of society in the US, their feet probably don't touch the floor, from the moment they sneeze to receiving scans, tests, probes and prognoses. Unfortunately, for the vast majority of 'normal' Americans, the simply is not the case. If you carried out a straw poll in NYC, on probably any street excluding Fifth Avenue, I would be surprised if a majority came back praising the US system. I suggest that they would complain of extortionate insurance premiums, ridiculous deductibles, and would reel off a litany of conditions and clauses that exclude some fairly basic medical procedures.
My wife is American, and since we live in the UK, she has tasted first-hand (for more than one month) the pros and cons of US v UK healthcare. She would tell you that the waiting times and the lack of cleanliness is certainly an issue, which concerns her. She would also tell you that her parents, both recently retired, are as comprehensively insured as mid-level retirees can be, and still pay around $1000 a month in insurance costs. In addition to this, prescriptions in the US can cost hundreds of dollars per month, as against the £7 we pay here.
We have a friend who works in the ER at the world-renowned Cleveland Clinic, and regularly tells us how broken-hearted she is at the sheer number of people she sees every day, who cannot receive anything more than the must cosmetic, perfunctory care, due to a lack of adequate cover. Yes, there are millions of people in the US who are uninsured, but there are scores of millions who are UNDERinsured. As with any insurance claim, this issue only rears its ugly head when a claim is submitted. As with a claim when you car gets stolen, or your house gets broken into, insurance companies can and do try to find clauses and reasons to absolve themselves of responsibility (and therefore payment). Unfortunately, in the US system, it is not your DVD player or your Ford Focus that doesn't get replaced. Perhaps it's the transplant that your child needs, or the physiotherapy that your wife seeks, or the meds that will make the difference to your quality of life.
The NHS, for the main, is a system that is badly in need of overhaul. You would find few (outside of the Labour leadership) who would challenge that. However, the US system needs the same. It is driven by the twin masters of a fear or litgation, and the dangling of the dollar by the big pharmaceuticals - you get our money if you use our products. This is not simply my perspective - look at the campaign positions of Barack Obama, Hillary Clinton, or even John McCain. Do they reflect an attitude that the US healthcare system is working? Clinton unsuccessfully tried to make a difference on her husband's coattails in the 90s, and whether it's Obama or McCain in place come January, I would suggest that the president ignores this issue at his peril. With the world's population, but particularly America's, getting older, the challenges and issues regarding adequate healthcare availability, will come home to roost in the next decade.
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The American medical system remains the finest and most advanced in the world by far. The idea that patients in a hospital could leave and return at will to go to restaurants or whatever out of the watchful eyes and control of medical professionals is ludicrous. They could unwittingly do considerable damage to themselves and reduce their chances for recovery. They would also be away from immediate emergency help if it was needed. A very dangerous idea and not acceptable in the US. I heard a piece on NPR about 15 years ago in which an American emergency patient at night had to find someone with a key to open the door of the emergency room in a hospital in Britain to handle the cae at night. Equipment, training, skill, and every other aspect of medical care in the US is the best even in the lowest rank of our three tier system. Defensive medicine is practiced to be certain that nothing is overlooked. You are either competent and do everything our science deems possible and necessary taking all the steps or risk a lawsuit that will knock your socks off and maybe lose your license. It seems even as an outpatient, there's at least one MRI/CAT Scan clinic in nearly every town in America and they are kept busy in order to pay for them. In rural areas far from major hospitals, helicoptors and private planes are on call to get patients to medical help in the nearest large hospitals in an emergency ASAP. There are no waiting lists, if you have a serious problem, you are in the emergency room in triage and if necessary in the operating room ASAP. Elective surgery in non life threatening conditions could take a little longer but not months, maybe a couple of weeks at worst. Bedside manner while nice and may help patient morale does nothing to get people well no matter how you feel about it.
What is broken in America is not its health care system but the system for paying for it. What we don't want is to follow a European model of socialized medicine which would reduce our medical care system to what they have. Having been a medical student in France many years ago and having seen the inside of French hospitals, American and Canadian medical students there made a pact to get any one of us who was really ill back to North America on the first possible flight out or at worst to the American Medical Mission in Paris ASAP. So much for the much vaunted European system. BTW, as a percentage of GDP America's system is still far cheaper than France's, about a sixth GDP compared to half for them.
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Justin
How can you say this is a 'fair-minded' opinion piece. I agree it's an interesting read. But effectively it, in a rather polite way, slams 'socialised medicine' whilst advocating the wonders of the US healthcare system.
I agree the US system has its advantages - but his comparison was not a fair one. It would have been far more appropriate to assess the relative merits of a county/inner city hospital in America with a public hospital over here.
Also, i'd like to see the relative differences of his experience with that of a person on Medic-Aid or Medic-Care. I feel that an analysis on those differences would provide a much more revealing insight into the merits/disadvantages of both systems.
His conclusion - UK - cheap, germ ladden, everything broken etc etc vs. sleak, shiney USA Nirvarna is really just a centre-right argument.....allbeit put in a very polite way. I wonder what his view would be any different if his wife had been admitted to an inner city American hospital??? But alas....that would never have happened........i'm sure he has exceptional medical insurance
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Great article. Stupid title. "There's No Place Like Home"? Even with Britian's healthcare faults, he seemed to have preferred theirs compared to the States. No public health system is or will be perfect. BUT id much rather have to deal with a dirty hospital than pay thousands of dollars for physical therapy or fight for medicines in the states.
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If you haven't seen it, I would strongly recommend the PBS Frontline progam:
"Sick Around the World"
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
It describes how the national health systems in the UK, Germany, Switzerland, Japan, and Taiwan work.
All of them cost less per capita than the US health system (if you can call it that) and, based on their national health statistics, all provide better value for the money.
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DavidGinsberg #33
You travel a road that as an ex "hacker" I am afraid to enter.:- Draining off resources for self inficted illness and may I add to that the "necessary" treatments for the elderly. Shortly to be approaching my own sell by date, how much of a shelf life should I be expecting. What old fogey like me has a right to "immortality" when one sees the suffering of little children and the afflictions affecting the young? Are we, and the God we believe in closing our eyes?
Eds' link to carrying capacity- http://www.esva.net/~leo/carrycap.html in some respects in giving answers to shunned questions paints a doomsday possibility for this world. Health care costs are a bottomless pit and at one point there must come a halt to various procedures. Who will you put on this World wide team of advisors to play at being God? Clerics, economists and hopefully at the very end of the list, the medical profession?
To promote our own health benifits one must reduce the new patients coming into the system. But what a world it would be without the many voices of little children. Forget our fight for the Panda today. Tomorrow, and for the next 100? years, to reverse the trend in such a world we would need to temporarily cage the few newborn and then seperate them into age groups where we visit them in their protected "zoo nursery" and remember what could have been without our present stupidity.
Everybody from birth to old age should receive full medical cover, so what do you think is a feasable age before our present system calls a halt without extra insurance to "wasteing money"? 60? 65? 75? Do I pull a fast one like Mr Asman because in my immediate family I could call upon all medical services having 2 general pratitioners, 2 pediatricians, 2 dental surgeons, 2 pharmacutical chemists, a general cancer surgeon, a geriatrician, a psychiatrist and a brain surgeon professor at a teaching hospital to extend my lifespan. But [A], am I worth it, [B] do I deserve it and [C] do I want it?
The terminally ill in some countries make the choice of assisted euthenasia and yet still need the consultation of a multitude of knowledgable experts before being allowed the escape from their sufferings . So the few say "Today is a good day to die". But Tomorrow God will be God for all of us.
Good health to all.
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Weather the American or British health care system is better is irrelevant because they are both fundamentally flawed.
When I was younger, my family did not have health insurance so we did not seek medical care unless we absolutely had to.
And I enjoyed good health through out my childhood and young adulthood. I never had the flu until I had a flu vaccine. Last winter I had bronchial pneumonia, which was the sickest I had ever been. This led me to develop an interest in the subject of health and health care. My research has revealed some very disturbing facts about the whole system.
I won’t go too in depth into it because, I would probably be censored for it, but I’ll summarize my thoughts on the health care system like this:
Good health is does not come in a pill from your doctor but a diet with good nutrition and free of harmful toxins.
Just about every commercially available food product is full of harmful chemicals and so chemically simplified as to eliminate vital nutrients. These chemical disturb or completely destroy the natural balance of the human body. I stopped drinking soda last October and generally avoid processed foods preferring to make meals at home from the purest ingredients.
Pharmaceutical companies, for whom good health is not profitable, use their dominance over the medical system to influence medical doctors to prescribe their drugs (which are full of harmful chemicals); the chemicals in the drugs are toxins that build up in the body over time and imbalance the body leading to more sickness.
Natural holistic health alternatives have been routinely and methodically eliminated from markets by government agencies which are unduly influenced by the pharmaceutical and chemical industries whose profit depends on poor health.
One of the benefits of my job is full medical coverage for my wife, my son and me (of course). Knowing that I won't have to pay an arm and a leg to for my family's health care is a compelling reason to stay with my current employer even though I could get a higher paying job somewhere else.
For myself, I still have the habit of avoiding medical attention, but not for the fear of the financial cost, but because I don't trust a medical system whose medical doctors are not physicians in the classical sense (like Hippocrates or Imhotep).
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The problem with the US system is that no one is controlling costs...
Market economics work well for things like consumer electronics or laptop computers. You have an efficient market because you have elasticity of demand (if the Apple laptop is to expensive you don't buy it), complete transparency (I can go on Amazon or New Egg and compare prices and specs), and lots of competition (Dell, Lenovo, Apple, Gateway, etc.).
If you just got hit by a bus, had a heart attack, or a ruptured appendix, you are not going decide not to be treated because it is too expensive. And even with elective treatment you would have great difficulty comparing costs between hospitals, clinics, or doctors. And there is little, if any, real competition between service providers or insurers.
US healthcare costs are climbing far higher than the general rate of inflation because our system is highly inefficient and no one is trying to control those costs.
A US doctor, clinic, or hospital has to have office staff and software to deal with a multitude of insurance company and medicare rules, regulations, and billing procedures. Any sizable US hospital has a billing department with dozens, if not hundreds, of employees that provide no healthcare to patients.
And there are two parallel, multi-billion dollar industries... One to help doctors and hospitals get claims paid... And the other to help insurance companies avoid paying claims. None of those billions are used to provide healthcare... They are just another huge inefficiency in the system.
And for any market to be efficient, the person actually buying and receiving a good or service should be the decision maker.
But that just doesn't hold in the US. I don't decide what health insurance to get... In most cases, my employer does. And is the HR department's department's interested in the same things I am when it comes to my health? Not really.
And once I get my health insurance, do I really know what is covered? Usually after the fact when I get my bill. And if my insurance premium goes up 10%, why was that? What is costing them more? Neither I nor my employer has a clue.
And we have a pharmaceutical industry that is totally out of control. They spend as much on advertising prescription drugs as they do on research and spend about as much again on corrupting doctors... And a similar amount for "influencing" congress and the FDA. And then charge us for all that....
And the pharmaceutical industry is focused on treating symptoms, not on underlying causes. Because they don't want to cure anyone... Where's the money in that? They want to alleviate chronic conditions so you keep buying their overpriced pills forever.
That's why you don't find the big pharma guys developing vaccines. I got a polio vaccination in 1961 and haven't needed one since... They'd far rather sell me the "little purple pill" from now until I drop dead.
And now we have this invidious Republican mechanism of channeling our tax dollars to private companies.... Like Medicare Plan D. You can just see the lobbyists brainingstorming it...
"Many of our patients cannot afford our prices, so... We'll create a program where if they cannot afford it... We'll get the goverment to subsidize it.... Oh, and make sure that the law says that the government cannot negotiate prices with us."
Why were we buying drugs from Canada? And why does the VA pay half for drugs than Medicare plan D? Because, in both cases, the government agencies involved negotiated down the price. And what is wrong with that? If the DOD is buying 10,000 laptops from Dell don't they negotiate on price? I sure hope so.
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It seems to me that the most critical point is being overlooked, both in the original article, and in the subsequent discussions:
***Healthcare is a resource that is oversubscribed, as neither nation can afford consistently first-class care on demand for its entire population, and thus, care is rationed.***
The following are _generalizations_ intended to illustrate the point:
1. In the US, the rationing process is based primarily on the ability of an individual to pay, so the result appears as outstanding care for the wealthy ranging to poor or no care for those without the means to pay for it.
2. In the UK, the rationing process is based on equalizing the limited resource among all, thus resulting in everyone having significantly less than first-class care. (The wealthy can afford outstanding care by going outside the basic system.)
I would expect the following to hold true: the "outstanding" care available to the wealthy both in the US and UK is roughly equivalent; the level of care for the "above average but not wealthy" segment of the US population is probably better than that for the same segment in the UK; the level of care for the "average and below average" segments of the population is significantly better in the UK than in the US. Given the numbers of the various segments of the population, this would result in the mean levels of care to be better in the UK, as borne out by various statistics mentioned previously, e.g., infant mortality, etc.
All of the discussion in the US about "improving" the health care system is essentially about changing only the rationing model, which would result in reducing the quality for the "above average but not wealthy" while raising the quality for the "average and below".
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Expertise and equipment are part of health care. So is the means to pay, augmented by health insurance for most Americans. So is the arena of personal choices (fitness or wellness, smoking drniking exercise diet, etc.).
I'm sure those who don't need to pause to ask "how much will that cost?" receive the very best possible care.
Ten years ago I thought that a relative with cancer received very good care on a retired income, not trips the Mayo Clinic, but access to local experts and a premier University hospital in a fairly large metro area and varied treatments.
Since then, with the same number covered in my family, I have seen the cost for my family health insurance premium increase above COLA rates; seen the deductable amount, co-pay, etc. also increase while some of the local board-certified doctors and dentists leave the plan coverage. I consider myself middle class in economic terms but that has been eroded lately and health insurance costs are one factor.
There are some busy local physicians whose work ethic rivals that of the old tradesmen I recall from summer jobs in college and I'm grateful for them sticking with the insurance plan.
The bottom line for me is that costs have increased (insurance is changed each year with a spin for better value, etc. that means I pay more) and my wife and I spend at least 100 hours a year fighting to get paid for claims (as mundane as eyeglasses for one child or orthodontics for another, an ER visit for smashed fingers, or removal of a bnign superficial tumor) that are initially rejected then re-hashed for months before processing.
So our 'health insurance complex' does not work well for the bottom 75% or more of Americans.
Neither have we benefitted from business-friendly relaxed regulations that inspect clinics far less frequently than fast food restaurants (google Las Vegas and endoscopy to read how 10,000s of people were put at risk for bloodborne pathogens). Nor have the small cost savings from from outsourced medications or food production been free from unregulated abuse (tainted heparin and other medicines kill people, and adulterated dog food killed pets)
This comparison seems like a writer travelling in the first class cabin, then wondering why anyone complains about airline food or jet lag: first class is nice if you can afford it, but it's not what most people experience.
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M Erronious. rambling about how great the states are again.
get off it mate your crazy. one of the most underfunded parts of the NHS is mental health so you would be screwed in England.
life expectancy in the UK is not bad.infant mortality not bad.
access to hospital not bad.
just phone 999 and they come to you,
I got a bad cut from a grinder once phoned up said "should I come down"
they said "your thumb has an artery just apply pressure we will be there. and they were in 10 mins.
Justine Webb you do americans a great disservice when talking glowing of this article.
As an american I have no access to a hospital until I am dying then I get emergency care and the rest of my life I will be paying it off.
The reason Mr. Fox got such a small bill even at a private hospital is because they have to compete with the NHS which is free.(taxes etc).
If there were no other option they would behave like americans and the costs would soar.
My father went through this recently with prostrate cancer.
Living in the states. went to the BEST prostrate doctor in the US(BOHEMIAN CLUB MEMBER).Had all the treatment only to return to the UK to find Guildford hospital , just down the road has a better program with a higher success rate.
Amazed. My English father was.Thought he was doing well there in the states.
My american mum (trained nurse in both UK and US) was not suprised . after all americans always claim greatness ,even when they have no right.
Now they live in the UK because no american insurer will take pre-existing conditions without sucking every penny.
Where as in the UK it's Free.FREE!
As for blunders .an old lady, friend's mom , in the states just had surgery, something to do with bladder,kidneysor guts ,I'm not sure. two weeks after, she is still complaining and they find out the doctor had not stiched her up fully.
No suit
No appology and the HMO was busy kicking her out of hospital.
Never hit news so I assume that is Normal.
Bloody sad is what it is.
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I'll bet one could hire a janitor part-time
for a lot less than $27k, even in the UK.
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then there are always those in the UK that say "why the hell should we pay for some sick yank to get better.they don't pay taxes."
are they right. should american hmo be charged for these services, fairs fair,right?
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Ma give us a resume when did you study medicine in france while you were an engineer or during your time serving in the military or great emperor of errors?
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As for gdp analysis , you have yet to show any real statistics or real analysis of any subject so why should we believe you.
here's one for all to read . hot link it if you want so others can enjoy.
http://economistsview.typepad.com/economistsview/2007/04/health_care_the.html
here's another.
MA you Wrong but like I say the doctors can't fix you.
http://www.nationmaster.com/graph/hea_hea_car_fun_tot_per_cap-care-funding-total-per-capita
I doubt even throwing in gdp to confuse the statistics will work out in your favour.
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I cannot speak for all Americans, just,
perhaps the 98% or so that make less
than $120k/yr, but I would like to resurrect
an old story.
It goes like this:
Once upon a time there was a Chinese
emperor who wanted to shield his young
child from the evils of the world. So, he
built a walled garden in a secret location,
and only let good things happen to that
child.
The location of this garden has been lost
for thousands of years, but, I believe that
Justin has found it and is currently residing
in it.
Now, Mr. Webb, I have a business proposition
for you. If you will reveal to me (and only
me) the location of this wonderful place,
and let me in by the side gate, I promise
to learn to do marginally useful things to
preserve its condition. For example, I
could be trained to spread the journalistic
equivalent of manure on rose beds, and
to perform other periodic maintenance,
such as pruning bushes or sweeping up
clippings.
I promise not to be of the bothersome
sort, just put me up in the garden shed
on the edge of the property.
Just to sweeten the deal, I will allow
you access to my time machine so that
you can go back to the 50's, when America
really was a great place, so that you can
buy all of the Polaroid stock that you want
at $2 a share.
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I tried to post a comment earlier, but it was removed (number 31). I cannot see how it breached any of the house rules. Somewhere it says that I am supposed to receive an email explaining this decision, but I haven't. What gives?
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#46, Jacksforge. I agree with most of what you have said because three of my children lived in England for a time, and one has settled permanently. However, I do take issue with FREE. It ain't. You pay high taxes for health care. Do you happen to know what the tax rate is? I don't.
Justin. Yes, they are kinder in the UK. They are probably kind in small towns in the US. I wouldn't know because I am a city girl, born and bred. But in the large cities you are treated as a nameless piece of meat. And should you have insurance, for which you pay the earth, you are treated as a charity case. I have been in hospital four times for the birth of four children. Three of the births were abroad (not England) and it was a happy experience. The hospital staff cooed over the babies and treated me as if I had done something wonderful (which I had). I had the fourth in Manhattan. When they talk about post-partum depression, they should look to the nasty treatment by nurses. No, I did not suffer depression, at least not once I got the hell out of there.
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Postscript to #53. One exception to bad treatment. My husband was recently rushed to the hospital with a birst appendix. (We are in the New York metropolitan area.) His treatment was wonderful. Everyone was kind and helpful. Why this big city exception? Almost all the staff was Filippino - doctors, nurses and aids. A sad commentary!
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#36: "BTW, as a percentage of GDP America's system is still far cheaper than France's, about a sixth GDP compared to half for them."
That is a lie. As a percentage of GDP, the US spends the most on health care out of all the OECD countries. France spends 11.1% of their GDP on health care, not half.
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As a U.S. citizen living in the U.K. I find it amazing that Brits are so defensive over a health service that they seem spend a great deal of time disparaging.
I am certainly not a "wealthy yank" by any means and in fact I lived in the U.S. for a number of years without health insurance. I have had expereinces of both health systems so here's my take on things.
- Americans naively assume that they can have their nice clean hospitals with all the latest pieces of advanced medical technology under a new U.S. health system that resembles European models... they can't. Like it or not clean floors and advanced treatment options cost money and when governments are reponsible for providing these things they quite reasonably choose to find cheapest available option... even if it's considered only marginally acceptable.
- The British public foolishly believe that most Americans are or would be jealous of their day to day health care provisions. Most Americans who have actually had the unfortunate experience of spending time in a hospital in the U.K., including me, would strongly disagree with this. I have nothing but admiration for the principles behind the NHS, it's the filthy reality of it (literally) that scares me back to the U.S. when I need medical attention. I genuinely believe that if every American, regardless of their health insurance status, could take a tour of an average British hospital, especially the wards/canteens etc, the push for European-style health care in the U.S. would end abruptly.
A few more points:
-It's ridiculous to state that healthcare in the U.K. is free... it's subsidized by a level of taxation that would make Americans seriously consider overthrowing the government.
-The survival rate for a heart attack and virtually every form of cancer is higher in the U.S. than in the U.K.. This includes those Americans without health insurance. Forgetting about cost for a moment, what does it say about the actual qualilty of healthcare in the U.K. when a country with millions of people without health insurance is able to beat country in which every single person has full health care provision? It says two things: First, healthcare in the U.K. may be universal but it is not of a particularly high standard. Second, regardless of you might want to believe about the U.S. healthcare system, it actually does treat those without health insurance.
I will sit back now and await my lashings for daring to criticize the NHS.
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Well I must say, after reading this lively debate on our respective countries's health care systems, that I am very disheartened indeed at all the comments from UK posters on here!!! All the '"Big deal!! Only the wealthyest of the wealthy can afford American health care-no wonder they are so happy with it!!" The whole overall attitude that there is not one thing about our health care system that even slightly does out its equivilant in the UK, is immature and rude to put it mildly!! Yes 47 million people don't have health ensurance, and further more, that millions more are under ensured-hence health care being one of the main issues in this year's presidencial race!! Yes I think this fact an enormous embarisment for our nation-that the richest nation in the world can't even care for its own citizens!!! But that's not to say that we don't do some things better than our UK counterparts, and that's certainly not to say that some UK citizens couldn't be perhaps just a bit positive and grown up enough to admit-hard though it may be-that they could learn some things from us, as I almost always do with respect of what the US can learn from the UK, be it in health care, prison sentencing, gun laws etc!!! Try it Jacksforge, Lord BeddGelert, etc!! You'll be surprised at how much better you feel!! It takes a big person to admit that they're not perfect and that they want to emulate someone else or in this case that they want their nation to emulate another nation's policies!!!
But for the record on health care. I judge it on one condition and one condition alone. Forget all the long drawn out comparisons. Simply ask this question: "Is everyone covered?" Simple as that. If the answer is no, then it is not an effective health care system, and it is unfit for the 21st century. This is what our politicions need to realise!!
Health care is a right, not a privilage!!!
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O, and peterm99 #44: Hands down the best comparison of the US and UK health care systems I have ever read-even better than that article refferenced!! But isn't it sad that unfortionately every country around the world must graple with this unenviable task?
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Basic health care is like a fundamental human right, which is a contributing factor to a certain quality of life that an average citizen of at least the so-called developed countries like U.K, Canada-of which I am now a citizen- and U.S, the people of these countries have a right to expect from the "government of the people, for the people and by the people".
Thanks to the yeomen efforts of a political reformer, years ago, Canada's all embracing national health insurance takes good care of the health needs of the people of this country, although the wait times for certain special procedures need to be improved.
The health care provided by the NHS in U.K
is hardly different.
But if, as mentioned by one of the commentators about 75% of U.S citzens being deprived of proper health care due to
their not being able to afford it, is to be believed, I do hope the Presidential candidates will address it.
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Ed: Please check blog 168 under "Gas Price Election". I long for your reply!
By the way, what happened to blogs 6 and 8? I am proud to say that not one of my blogs has been rejected - maybe this old conservative Brummie-turned-Yank has proved that one can get one's point across without nastiness of some kind! Surely a man of your obviously superior intellect can couch his blogs in terms acceptable to Justin's moderators!
By the way, don't forget tomorrow - it's the noble's 87th!
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Nobody in America goes without health care. Once in awhile you hear horror stories like the one about the woman who died lying on the floor of the emergency room in an L.A. Hospital some time back because she was misdiagnosed the day before and the doctors and nurses wouldn't see her again. That is the rare exception. If it were true that people who could not afford it got no medical care in the US people would be dying like flies. But it isn't true, even illegal aliens get the same medical care even when they don't have a dime. The rest of us pay for it one way or another.
Medical insurance in the US costs about 6000 to 8000 per person per year. That amounts to about two trillion dollars for 300 million people. It may be slightly higher. It's around one sixth of our 14 trillion dollar GDP economy. In france they spend about 1 trillion dollars of their 2 trillion dollar GDP economy for around 50 million people. That's around 2000 dollars a year per person. The UN's assessment notwithstanding, there is no comparison, I'd much rather be sick in the US than in Europe.
Let's not forget that when Yassir Arafat was sick and dying in France, they couldn't even come up with a diagnosis. And it took forever for the UK doctors to diagnose the ex KGB spy's illness.
Between the NIH, CBC, all of the universiy medical departments and their hospitals, the municipal hospital networks, all of the technology, the pharmaceutical companies often working on drugs financed by NIH, there is nothing else like it in the world. Even Canadians come to the US for medical treatment. They don't like waiting around either although I have a hunch their own standards when they do get medical care is similar to America's. And American doctors do collaborate. Not only do they collaborate with their peers in the US, they also perform real time consulting over the internet with other doctors around the world.
The risk of buying drugs in foreign countries either through the mail, over the internet, or visiting is that your chances of getting counterfeit drugs is much greater than if you buy it from a reputable pharmacy in the US. The cost may be higher but someone has to pay for the research. I'm not going to get into the economics of the pharmaceutical industry but for every 100 million dollars to develop a drug which makes it to market, nine fail. Now who do you think pays for that. BTW, the socialist countries like the USSR never developed a single new drug or medical technique worth mentioning. There was no financial incentive to be innovative there just like there was none anywhere else. Socialism just doesn't work.
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Yes health care should be a right like food or water. I don't know why people can't get that. I'm a working class Americian and until recently I had no idea that health care was single payer in Europe. I guess it was'nt something that people talked about much sort of like the dirty family secret that every one knows but no one mentions.
I was so hurt and ashamed of my country which I love it is beyond words. I've worked since I was a child (before I had working papers); and I've had health care 1 year out of the last 12. So in other
words I can't get too sick, break anything or need any sort of surgery or I guess I'll just die with out health care. (The vitamin and herb health store is my hospital) I have friends and relatives who like me work all the time almost never taking any real vacation. The company they work for may provide some sort of HMO but the co-pay ments and deductibles are so exhorbant that they have to choose health premiums or gas and food. Miss one paycheck and you're toast. These are millions of Americans that would poll as having health insurance.
I see this all the time living near Atlanta we have notoriously bad drivers, traffic and accidents. So if their is an accident a person is lying on the ground hurt, bleeding broken bones etc the paramedics are standing over them trying to get them to sign a document saying that they will pay for the ambulance ride ($500-$1000 if you are'nt really hurt). So before you get help you sign. God help you if you are not lucid enough to know what you are signing or don't have insurance once you get to the hospital. Yes homeless people are tossed in the street and
just dumped like garbage from some hospitals through not all.
Also most people get their insurance through their jobs. Can you imagine the power a boss has? I for one am a much more attentive employee than I would like to be with the knowledge that my boss potentially has my life in his hands. In my state at least is 'at will 'meaning that you can be fired at any time with or without a cause and that is that.
You might ask what about the kids? The innocent suffer as well. Children of the working class or working poor are many times ineligible for health care because their parents are a few dollars over the poverty line. So if you are a drain on the system your children are eligible for medicaid if not too bad so sad. This year Republicans voted against a bill that would have given health care to minors no matter what their parents make and our beloved President the compassionate conservative vetoed the bill. Compassion is not for working class Americans but for third world tsunami victims etc overseas. I believe in helping others but lets help our selves first!
The elderly have medicare but it too requires co-pays that some seniors can't afford they need their prescriptions so some are forced to become extemely frugal with their food bills. I have known older people to eat dog or cat food so they could buy medicine. Seriously.
I would be willing to pay more taxes do whatever it takes order to have universal healthcare and fix our health care system. It is unjust and cruel. The punishment for being poor in America is that your life just isn't as valuable and I have a hard time aligning that with my ideals.
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"Nobody in America goes without health care. "
Marcus erronious at it again. living in a dream world.
I live here and have none.
I know plenty of others.
Liar
"If it were true that people who could not afford it got no medical care in the US people would be dying like flies. "
They do thats the flip side of life. apart from that sick joke, many do not see a doctor until the tumor has gone malignent.
cancer survival rates in US are artificially high as many are not diagnosed.
Another thing in this statistical analysis of americas healthcare compared to UK or anywhere , should not be per capita really (unless you want to make america look good by lying) the gdp on health care in the uk covers the whole population.
the healthcare gdp of the US still leaves out 1/6 the population
As to not critisising the UK I will. but not over providing health care for it's people.
In the states you love to say TAX it's a crime. But not funding healthcare-that's a crime.
yea they tax to pay but then here the corperatate hospital system enforces a very heavy tax. with a cosh, it seems.
Health care in europe also entails such measures as work place safety.
The recent analysis of chemicals to prove they are safe.the opposition to GM and cloned products.
the attempt to reduce emmisions and congestion.
All sorts of things effect health. not just the hospitals which are there for when you are sick. or to stop you.
"counterfeit drugs is much greater than if you buy it from a reputable pharmacy in the US."
yea right.
of course the chances of being prescribed a drug you don't need that leads to many complications is higher in the US.
the chances of dying from worry over the bills is higher in the US.
I know 3 people who died in the last 2 years that only found out that they were dying when it was too late.
It happens in the UK too but there at least their famillies were not left with nothing.
In the states death can mean loosing every thing you saved up to pass on to the kids. screw death duty. there's nothing left by the end .the last 2 weeks are when they really try to get every last penny.
I had a granny with MS for 20 years the nurse came twice a day to help.
I've had 3 operations in hospitals in the UK.
Still I think hospitals are not hotels.
If you want health care private in the UK just do it. it is WAY cheaper than private insurance in the US.
http://www.fda.gov/bbs/topics/NEWS/2008/NEW01840.html
http://www.reuters.com/article/topNews/idUSN1450916820080215
PAXIL
CELEBREX
Drugs kill.even US drugs so keep filling your prescription.
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the only drug has not killed is not allowed to be talked about on this site.
There's the reason some posts get kicked.
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As for slamming the russians and the COMMIES cuba has several vaccines invented there.
Russia did open heart surgery with ICE not anaesthetic.
pioneering it is. especially if you are allergic to the anaesthetic.
oh and chrisianleft
You rock.
I'm sorry this country lets you down.and thanks for sharing some reallity with these others.but don't be worried about MA he has a thing about europe,and very rarely makes much sense.
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Vioxx there's a good drug.
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jacks forge
So Russia did open heart surgery with ice instead of anesthesia. I'm sure it's only a matter of time before the UK and the rest of the EU catches up with Russian medicine. Poor America, it never will. And I'm sure Europeans are importing vast quantities of Cuban vaccines too. It's their biggest export after sugar and cigars.
With things so awful here in the US, I must admire you for putting up with it for the sake of your pet. You never did say what your pet is. Is it a trained flea?
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jacksforge
I remind you that thalidomide was approved and legal in Europe but not in the US. Do you know what it is?
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I am a bit of an expert - not having sought this role - with considerable experience with
1) Hip operation (waiting four years and then carried out by same consultant who did Queen Mum)
2) Daughter with colonic cancer
3) Daughter with brain damage
4) Mother in geriatric ward for 2 months
My conclusions.
Diagnosis weak,
waiting for treatment excellent for young, not so good for older
operations performed excellent,
hospitals -with two exceptions- so dirty we too spent our days cleaning
nursing very variable- some excellent - some hopeless or worse
cost - well in US we would have to have sold our house by now- we have received 100,000's of pounds worth of treatment and overall I feel enormously proud of our system.
By the way GP's now earn over 100,000 a year on average, I dont think thats so bad.. VCM
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Fascinating. I have noticed that Fox has excellent coverage of international weather and climate change on its evening news and think it's time for us "liberals" to accept that Sean Hannity et al. are not the whole picture.
Re health coverage, I've recently experienced both UK and US coverage with mixed results as well. I came down with something that looked like MRSA in the UK, and they gave me doxycycline which took care of it and charged me about $100. In a probably unrelated episode a year later, I got CA MRSA here in the US and ended up with 6 days in the hospital, a month of IV, etc. etc. thanks to the doctor *not* giving me doxycycline the week before, I think. But I was surprised that the hospital bill (covered mostly by insurance) was under $25,000. I too had trouble making a "prison break" in the US to go home and get some necessary things taken care of during my stay; the nurses were surprised I was able to bully my way out (and back in)!
I also had trouble in the US because they gave me an unnecessary CAT scan and then it took a day for me to persuade them to pay attention to what they and I could see was the problem instead of their expensive test and get a surgeon in to clean out my suppurating wound. Had I been a little less educated and experienced, I would have been a lot sicker a lot longer because of this, and I shudder to think how close to death I was then.
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Noble Elder,
They were in a bad mood an felt a need to be strict about "intellectual property" - Wendellon same: ;-)But the Mods are as Gods....Congratulations - delayed by the occurrence of a computerless day - You were in my thoughts, and I was slightly ashamed to be missing out on raising a virtual glass to you on the actual day. Many Happy Returns!
Waterman, You may be interested in the scribblings of one Lewis Thomas, a medical man of distinction and an essayist of loving insight. "Lives of a Cell" id the first and best of several collections, from which:The essay relates, of course, to mitochondria, and is entitled "organelles as organisms". Very revealing.
Peter, as usual, incisive and direct. Once again, I am pleased to be a supporter of the NHS and the generally excellent folk who work at its "sharp end".
Salaam, etc. Peace, love and good health to all
ed
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I'm another who thinks that post #44 is very revealing. I'd go a little deeper however in terms of each group and how they benefit. For the very rich, private care in the US will be about a good as for the UK. However the UK will be a lot cheaper. Why? It's the same medicines, same technology, good doctors. Shows how messed up the US system is that value for money is so much worse even at this level.
Take the next step down, the "above average" group. I could well imagine that such people, who aren't poor but still balk at the sight of a $50,000 bill, could be better off in the US. I'd wonder though. If what someone has said is true, that on average Americans pay around $6-8000 per year, then it wouldn't take long before it would still be cheaper to live in the UK and go private, even taking the tax that goes to the NHS into account. And only 17% of US households earn more than $100,000, so a $50,000 bill will be truly crippling for 83% of the population.
Next group, "below average" who may have insurance, or may not, but even if they do it won't be comprehensive. These people really are better off in the UK. Good doctors, everything free at the point of delivery, compared to getting stuffed by an HMO or paying $50,000 which you simlpy can't afford and will be in debt to the day you die. Nice.
And then of course come the bottom of the rung, let's say the 47million uninsured Americans. What can you say? A bit like everything else in America if you're rich, you're sorted, but if you're poor then you're completely stuffed. In this case stuffed means in debt forever and/or dead.
USA! USA!
As for the original article from David Asman, it has been said many times now that he's rich (never once worries if he can afford the $50,000+ bill. Who can afford £25,000 just like that for god's sake!). Therefore his assessment is bogus as it doesn't compare like with like. It compares the best of the US system (nice if you're in the top 5%) with bog standard UK treatment. Rubish.
It reminds me of an article that Justin did a while ago on gun crime. Basically he compared south London with a nice suburban bit of the US. Who would have thought it, but south London was more violent! If you were going to compare like with like you'd compare New York to London, where the knife murder rate is a bit higher in London I think, but the gun murder rate is five times higher in NY. FIVE TIMES!
The article isn't fair minded just because it criticises America (a bit) and praises the UK (a bit), it needs to be properly balanced. If Justin thinks that this is good enough journalism then he's not the journalist I thought he might be.
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One point that I was thinking about is the cost to the US economy of people fearing moving jobs. If you want to move jobs in the US it seems that many fear for their health benefits, and so many will be to scared for them and their families. One of the great things about the US economy is the fluidity of the jobs market. Indeed this is one of the prime goals of the EU and the EURO, to help people move around and get jobs. I'd be interested in an estimate (I doubt one has been made) of the cost to the US economy of this effect. This of course should be added to the cost of US healthcare, as it is the cost to the US of having such a barking method of not treating its ill people.
This comes on top of, of course, the fear of losing your job. In the UK losing your job doesn't mean anything to your health or that of your children. In the US it does. The idea that losing your job would seriously endanger the health of your children is so disgusting that I can't imagine how Americans can live with themselves. Mum/Dad loses job, son/daughter doesn't get treated. Dear god, it's like the 3rd world.
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So Russia did open heart surgery with ice instead of anesthesia. I'm sure it's only a matter of time before the UK and the rest of the EU catches up with Russian medicine. Poor America, it never will. And I'm sure Europeans are importing vast quantities of Cuban vaccines too. It's their biggest export after sugar and cigars.
With things so awful here in the US, I must admire you for putting up with it for the sake of your pet. You never did say what your pet is. Is it a trained flea?
I remind you that thalidomide was approved and legal in Europe but not in the US. Do you know what it is?"
we all know . I know a life long disabled person who got there from Whooping cough vaccine. so yea big mistakes happen,everywhwere., america is not so great. for all your touting.
see it america they just charge you a lot in order to poison you.
question is are you safer here in the states now with your toothless FDA or maybe america has been overtaken.
At least the victims in the UK don't have to rely on a law suit to be able to visit the doctors.
And so russia is pretty innovative.
they are ahead in recovering people from hypothermic conditions. something we here in the states learned from.
give them money they will excede your estimates I am sure.
Cuba already has but you are right they sell little to the UK ,but then we have Wellcome.
And a few others. .Don't need over inflated american drugs.
As for the animal my flea I already told you what animal it is but you were not smart enough to notice.
or rather you are not very good at reading.
another thing you are not good at is listening , which may be why
as an engineer you found all other to be faulty unless they were american (white american)
as a medical student (not doctor?)
I suspect that all your bluff you are neither ,most proffesionals I have met travel the world in search of knowlege from anywhere. you seem to think americans can't learn theny know it all already.
but in a sharing world I suspect you get left out for always demanding more than your fair share.
Oh wait but thats everything.
So apart from trying to insult what have you to say to counter any points I made.
You can laugh but your still so wrong.
Keep taking the Vioxx.
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Noble (60),
(in reply to #168 on the petrol thread) ;-)
You've named two of my favourite British treats - Stilton (with fireside-warmed port, as appropriate) and Pork pies (of which M-M is supreme)! As you noted, nobody appreciates a place and its advantages quite as much as an incomer, though we also have eyes for some of the shortcomings as well.
I wish I could send you a large Stilton (the sort of 'round' you can dig into) and a bottle of fine port in celebration of yet further "injury time".
Slainte!
ed
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One point that I was thinking about is the cost to the US economy of people fearing moving jobs. "shephen h22
73 posting.
The employer will hold it over your head like a guillotine.
Setting up your own business as lets say ,a single mum ,but really for any one, is something not so many think of without the worry of no health care.
Americas new slavery is the health care system.
Employed get cancer, they send you to the doc. you get treated then when recovering the HMO says were not paying, what do you do.
Your not working so you are no longer entitled to access to the hmo anymore.
not enough days at work.
so while recovering you have to go back to work
If your boss gets crappy you put up with it.or loose coverage.
Most americans seem to care more about abortion than keeping kids already born alive.
As a brit I laugh when Americans say they are better off.
not having paid holidays,or paid sick days, or access to a doctor.
How do you prove you are being poisoned at work.
If the boss makes you weld galvanised(very dangerous) do you quit and loose all health care.
Or stay and get poisoned because, well it's not much ,just a little bit,i'll keep the doors open.DEAD
I leave but most places still have people working for them.
Here in the states the people you do not give healthcare to are those you might be poisoning in the job provided.
It is why america is so UN INNOVATIVE.
for every success story there is someone trying to do something but they cannot afford the insurance costs.
America like to squash the dream more than they admit.
the only ones with anything possitive to say are those with big money behind them.not poor people.
I doubt if MA is in a housingblock of million dollar homes he has no coverage,but boy would it be funny if his HMO went enron on him.
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the reason america has no health care is for years the attitude was a selfish I'm alright they should work harder attitude.
the sad thing of the the new drug resistant TB came from the states where patients were not able to afford all the drugs so they quit half way through, and as with many anti biotics and drugs they get stronger if you don't kill them.
The same will be true of most Cures the world dreams up. they will work untill someone cannot afford to pay the price.
Sars was a big worry,imagine how hard that would be to deal with if only 10% were not seeing any doctors.
The germs would spread to million dollar estates .
There's an epidemic coming, one day. and then all you leave behind will start leaving something for you.
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Yes, health system in the US is a disaster. Our doctors make outrageous amounts of money while large chunk of population is stuck without medical coverage because they can’t afford it. Our health system is our embarrassment…
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#73 "The idea that losing your job would seriously endanger the health of your children is so disgusting that I can't imagine how Americans can live with themselves. Mum/Dad loses job, son/daughter doesn't get treated. Dear god, it's like the 3rd world."
I hate to interfere with your enjoyment of your dramatic outrage and smug superiority, but you are incorrect. In the US, poor children are covered under Medicaid and children whose families make too much money to be eligible for Medicaid but whose incomes are under 200% of the poverty level are eligible for SCHIP (State Children's Insurance Program), regardless of parents' employment status.
#77 Vaccinations for dangerous communicative diseases are already available for free through county health clinics. Being able to see a doctor for your symptoms doesn't stop the spread of pandemics; being vaccinated does. Antibiotics for TB stopped working because they were overprescribed, not underprescribed, which blows a hole in your theory.
There are some problems with access and cost control in the US systems, but many commenters seem extremely ignorant of what is actually available. They want to believe that millions are dying on the streets because it suits their ideological agenda.
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occupational safety and health administration.
there to keep americans safe at work.
this is where health care starts for adults. this is where the injuries come from often(of course the rich get injured "playing" with sport injuries,tennis elbow,etc.
funny it would even be called tennis elbow-workers have suffered from the same ailment from before tennis took off so much-but no one cared about them.
offices are safer than most industrial or manufacturing jobs. yet spend more on ergonomic chairs etc while the work force dies.
this show featured on Bill Moyers is very good at explaining how unsafe the poultry industry is.
Does not go in to welding which is just Poisonous.
If you don't stay at work you can't go to the doc.
health slavery.
http://www.pbs.org/moyers/journal/06272008/watch2.html
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Antibiotics for TB stopped working because they were overprescribed, not underprescribed, which blows a hole in your theory.
they were prescribed to people that could not afford to keep up the regime.
hence the resistance.
blows a hole in your bull theory.
People without TB do not take in a vaccine and produce a dangerous drug resistant TB from no where.
They had TB.
you go get better educated.
as for kids not being covered.
are you at the bottom here.
Have you seen what it is like for people with no health care.
SOME states have options that cover Kids oregon for example but not all and many still fall through.
and here's more for you to watch. maybe you could start educating yourself.
http://www.pbs.org/moyers/journal/06272008/watch2.html
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keep at it , by the way are you related to MA2 you only turn up when someone slags off his ideas.or are you one and the same?
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sue last timer we went around all you did was try to get every post taken down. you have ranted at me , and beth ,but have answered at no stage any questions posed to you and offered nothing .
but keep writing,it's almost interesting.
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#81 TB is a bacterial infection not a virus so you can't be vaccinated against it. SARS is a virus. You were arguing that going to the doctor prevents viruses from spreading. It does not. I cannot follow your arguments about public health. Re the insurance for children: I simply pointed out factual inaccuracies in #73's post. I am a mother and a teacher and have spent most of my life caring for and about children. Don't get on your high horse with me.
#83 I have never referred you or anyone else to the moderators. I believe in freedom of expression, no matter how offensive or silly.I rarely comment here because I'm busy and can't spend my time getting involved in elaborate arguments with strangers on the internet. Just because I don't agree with you or someone else doesn't mean that I am "ranting" at you.
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This comment was removed because the moderators found it broke the House Rules.
84 Oh sue who referred this to the moderators. and why there was no offence in there.
Just as when I have slammed your letters before you refer to mods(though you won't admit it)
Short answer .
you can be vaccinated against a bacteria.
doctors are there to help stop infections spreading.(though I doubt they do a good job)
you make up all your stuff.
you lie.
kids do not get free universal health care.
you can't follow arguments on public health because you are of low intelligence.
and you most surely do refer to the mods.
but if the mods want to let you get over whatever offence you took and print the letter before next week all will see what a big deceiver you are.
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This comment was removed because the moderators found it broke the House Rules.
mods you sent back the post 87 but have yet to send why i was removed for post 85.
If you find you cannot print it send the comment back.
as you did with 87.
If I could re read it I might see what it were that caused offence but as it is you are censoring stuff because of a complainent who does not (and in the past has done the same) like to see printed any thing that contradicts their lies.
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Wow!! I'm so depressed I'm kind of wishing we had never declared indipendence from Britain. Well just think about it!! We would've joined the world wars when the rest of Europe did, we would have universal health care by now, most likely no capatal punishment, and the most forgiving judges on the planet!! In short, we'd be what we are today, just fairer, more just, more equal, and more forgiving. And we'd be the same in terms of being dictated to by a foreign power as Canada or Australia-tecnically they are still part of the "common wealth", but obviously everyone knows that the British government has absolutely nothing to do with their affairs (domestic or foreigon) anymore!! I don't know, it just makes one wonder.
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Justin, if this is your idea of a fair piece, your future at the BBC might be in doubt. This piece is laughable, especially the smattering of statistics the author bandies about. And for his information, mortality due to MRSA is more than twice as high in the US as in the UK:
http://www.scienceblog.com/cms/mrsa-potential-public-health-crisis-14604.html
You express surprise that the author works for Fox News. I am not surprised.
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No rash ,
lol this July 4 I will be answering to all yhose that say happy independance day.
say
happy free from healthcare day
happy free from paid holidays day
happy King GW day.
Have fun americans and when your state is burning froom the fireworks happy cleanup and put out the fire day.
Have fun
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and now I will try to re submit the post that Sue had removed though I see no offensive material in it.
not a s offensive as the blatent lies she writes.
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84. At 5:36pm on 28 Jun 2008, sue_catherine wrote:a bunch of bovine stuff.
I'll get on my high horse because you are a person who tells no truth and makes up stuff.
I never said it was a virus. you made that up.
post 74 not 73 and you "pointed out " nothing relevent to that post or any other.
I don't care if your a mother of children or not. Millions of others are too (if you look around).
and I personally believe you are more likely to get a virus if you go to the hospital , and in case you did not notice the connection between doctors and public health.It's there.well in other countries.
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You are false
you falsely accuse people of saying things and put your words as theirs.
And you make up lies and miss information.
You say you cannot be vaccinated against TB.
you can
it's called VAccinaton.
you could call it innoculation ,
Go look it up.
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you say
"You were arguing that going to the doctor prevents viruses from spreading. It does not."
No I say visiting the doctor will empty your bank account.
I May have said it is meant to help.
but then I have been slagging of the american doctors for making things worse through to many drugs with side effects and not providing full drug regimes leading to resistant strains appearing.
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The vacination may do some good, not the visit. going and not getting vacinated will do no good. you may get something at the docs,in the waiting room.
If you want all vaccines to be removed because"they do not prevent viruses spreading "then go ahead
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your blatantly unable to read or keep your thoughts straight .
As for striking comments.
yea I believe you. Not
and you are ranting because you made up all that crap .
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As someone who knows both health care systems very well, I find it interesting that most Americans object to government provided healthcare for one reason. They see it as bureaucratic.
But I find my US healthcare plan the most bureaucratic, cumbersome thing. I have good health insurance coverage here, but every medical or dental visit my family makes involves some co-pay amount (that is the amount I must pay). Thats great if you do not get too ill, but the amounts soon add up if you need tests, surgery etc. You never really know how much an event will cost due to the complexities of your health plan. Some things are covered, others might not and the amounts are very general.
A good example of how the US system is so bureaucratic is my wifes experience just to get a new birth-control perscription. She had to get a new perscription because our insurance changed the list of medications they would pay for. This meant she had to go see a new gynaecologist-her old one was not in the network no more. To find a gynaecologist that was in network meant waiting six months for an appointment! Who said the NHS was terrible? The cost of a five minute consultation was $850-of which she had to pay $45. This is the problem with the US system, you have to find doctors that are in your insurances network and these doctors charge the maximum amount that is allowed by your insurance. How anyone gets by if they do get sick or old because it is very time consuming and assine. The NHS is not perfect but at least you do not have to worry about coverage, co-pay, networks and money.
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Thanks for steering us to this account by Mr. Asman.
As flawed as our system is (and it definitely is flawed!), we still have the best in the world.
Now, how do we put it within reach of everyone, without bankrupting the country, or transforming it into our own shabby NHS?
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re: #98 tigermilkboy
". . . The cost of a five minute consultation was $850-of which she had to pay $45. . ."
This is a perfect illustration of why the US health-care system is so horrendously expensive. Since the cost of health insurance is considered a "fixed cost" (you pay whether you need care or not), the total variable cost to the patient for a 5 minute consultation is $45, which, quite realistically, is not _that_ unreasonable.
However, the other $805 is paid for indirectly by higher premiums for all participants in that particular HMO. To each participant, the extra premium cost is a pittance, but all of the pittances from similar situations will of course add up to make the premiums astronomical.
While this is a great example of the US free market health care system at work, I expect that a more accurate descriptor might be "criminal enterprise".
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tigermilkboy.
good example of the system at work.
oh so someone I know here was getting treatment for cancer but finally their insurance "ran out,)(unlike the cancer).
I say it ran out because having taken too much time off work recovering they lost their job. so now they have nothing. ra ra USA happy independant from health and holiday day.
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Re: my earlier comments.
What I did not say is my wife had seen her old gynaecologist two months earlier and had the full check-up. But to get a 'new' perscription she had to go through the same check-up and lab work again. The new gynaecologist would not write any perscription without the full check-up because the insurance plan dictated the doctor had to do all this. Even the doctor agreed it was ridiculous. The drug change was just a name change ie. brand x to brand y, they are manufactured by the same company and are the same formula. You just can't win unless you are a drug company, doctor or insurance company.
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jacksforge, do you fight with most people around you in the real world or just on the internet?
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I call it as I see it.
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Maybe I'm naive, but it seems that the spouse of tigermilkboy might have avoided some of the expense had she requested her records be transferred from the former physician to the new one..., much as I have to do because my doc is moving to another state!
I work in the employee benefits field. For the edification of some of my British friends, (I'm a British born American) I might add that the cost and specific coverage of insurance plans vary widely among states, even smaller geographic regions, and various employers. Each specific employer group is rated differently on age, demographics, local fees, etc. Therefore, when you look at employment it isn't just the salary one contemplates; the quality and cost of the medical plan is of paramount importance. Of course, there is no guarantee for the future; rates change each year and no employer is OBLIGED to offer medical insurance. Nevertheless, those companies desiring to complete successfully for good employees generally offer something. Regardless, what the employer contributes for that is tax-free income to the employee.
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