Sunday, July 12, 2009

Health Care The Big Issue Facing America Today

As many of you may know I am a Brit who is married to an American Girl, so have a better understanding of what A National Health Service is
and what it does , so for the next three posts I would like to take the opportunity to highlight The good, The Bad and The Ugly" from the health care between the two systems as I perceive them. The three posts are 1. British National Health Service, 2. US Health Care
and 3. Can America Change it's health care and My own ideas for change

The first post is about my perceptions of the strengths and weaknesses of the British Health care System

The British Nation Health Service ( NHS ).

Following the end of World War 11 Under Clement Attlee the dream of From The Cradle To The grave socialism first put forward by
William Henry Beveridge was enacted when the Nationel Health Service Was Created on July 5 1948, which was designed to provide
following three main core principles

1. That it met the needs of everyone
2. That it be free at the point of delivery
3. That it be based on clinical need, not ability to pay

Current Taxation For the Cost Of Health care. It is not easy to define the percentage of tax paid for Heath care in the UK
as the Nation due to it's funding from National Insurance and taxes , But it is estimated at between 8 and 10% of GDP

The British National Health Service

Free at the point of service

No co-pay for
Doctors visits
Hospital Stays
Preventive medicine ( Cancer screening, Heart Disease Screening etc. )

The wages of nurses are comparable to US rates , but Doctors salaries are less than US equivalents


All scripts currently about $10.50 for those liable for payment whatever the cost of the drug

The Good
Health care is free at the point of service for all for Family Doctors, Hospitals etc.

Home visits are an accepted part of health care for the elderly and infirm plus visits to children late at night

Because of the stricter requirements for Drug testing and screening by the Government ( Government pays for drugs so much more resistant
to untried untested ) and drug companies find it more difficult to get unproven drugs to be accepted.

Because the NHS is a government run organisation the litigation mentality against health care professionals has not run riot as in other countries notably the US.

Due to it's large bargaining ability the NHS often pays less for the same drugs in the UK than the Joe Worker pays in his Co-Pay payments
without the additional costs to Insurance companies passed on to Insurance Premiums ( can be as low as 15% for the same drug in the US )

The cost of things like an MRI are standard countrywide and not open to abuse of free market forces

The Health trusts in the UK are mainly run at the top by health care professionals not those more suited to big business with MBA's and degrees in Accountancy and Law

The Bad
Because of the perception of free many health care professionals are complacent and forget that the customer is still paying through taxes

Because the service is free many abuse the system by tying up valuable health care professionals with needless appointments and
using health care as a way to combat loneliness

Because of the constant battle between funding ( taxes ) and needs ( whether genuine or Unnecessary ) the waiting time for those
in genuine need is between 5 and 10 times longer than those who have health care Insurance in the US. This applies to
all sectors from Family Doctors Visits to Hospital Surgery, plus the time allocation for a doctors visit is much much less in the UK.

The Downright UGLY

The place where the NHS falls down more than any other area is because of Underfunding, Overworked Staff and the constant battle between
funding and need, the service is always at breaking point in terms of service, quality.

These are only my own perceptions and many will violently disagree

Sorry about the Non Horsey Post but I thought many might be interested in views by someone who has seen the best and worst of both health care services



Jean said...

Really, really good post!! Thanks so much. I am hoping someone will report on the Canadian system as well since it has a good reputation.

One of my British blogger friends surprised me with a post about how long she had to wait to get new glasses. Here in the US, it's a one hour wait. *S*

I have "good" health insurance through my employer...even in retirement. But their attitude about paying for some treatments is a pain...literally. Chiropractic has a limit and now they have decided the therapy I get for my knees--the only thing keeping me from replacement surgery--is "experimental" and they will no longer pay.

Why does and insurance company get the right to decide what kind of treatment works and what doesn't? Health care should be between my doctor and me.

My lawyer suggested that my doctor and I write to the company explaining the value of the alternative treatment (essentially stem cell injections) as opposed to surgery. I would think the financial difference alone would be convincing if I were and insurance exec having to dole out the money. (We'll see. I am going to my doctor in a week or so--credit card in hand.)

Katharine Swan said...

Great post! I appreciate the non-horsey post because I am type 1 diabetic, and strongly support a national health care system.

I personally support a system where health care is paid for by taxes and provided to everyone, but where people who can afford it may choose to pay for a better plan, or continue with their current plan.

I believe the whole thing about the wait being longer is a bit of a misconception. My dad was diagnosed with colon cancer a year and a half ago, and it took them two months to get him into surgery. He looked up the average wait time for the same surgery in Canada, and it was significantly less than what he had to wait here in the U.S. with private health insurance.

Also, I can tell you from being diabetic that if I were to switch specialists, I would have a wait time of at least three months before I could get in to see my new endocrinologists, because that's how far out they typically schedule appointments, and sooner openings are usually left for their regular patients.

Just some thoughts in response to what you've said. I think your post is a great rundown of the pros and cons of the British system. I just don't think it's fair that someone -- say, a diabetic -- should be allowed to die if they can't afford health care, just because they had the bad luck to be born with something most people weren't.

Le Cheval Endiablé et Phyto said...

Yes, I am interested in.
I do not know the two system. All I know of the British one comes from A.J. Cronin's books. It's not actual.
And we are all interested in Health services.
See you soon

Carroll Farm said...

Thank you for that post. I liked reading about the Good, The Bad and the downright Ugly. You mentioned some good points that I had never considered. I am not a fan of a switching the way the US does health care - but am in agreement that something needs to happen. I pay over $900 a month (and I am a teacher) for insurance on my husband and 2 girls - plus the coverage is crappy. Something should be done, but I think that a big part is to quick 'handing out' to all those who don't pay into the system.

The People History said...

Thanks for the comments on my perceptions on the British National Health Service , it will be interesting to read responces to my critique of the current US system which I am trying to formulate at the moment


White Horse Pilgrim said...

My experience of using the British system is good. It is there when one needs it, and is quick and efficient at times of emergency. My father received good treatment when he was dying of heart failure, and my mother now receives good care for various ailments. The rider at the barm who fell off and broke her back was scraped up and put back together efficiently (and horse riding won't be crossed off what she is covered for.) Perhaps for non-urgent things it is not so quick, and perhaps that is a weak point. But that situation has improved from a low point a decade or two ago.

Another issue is the conflict (whether real or perceived) between "health care delivery" and "bureaucracy". Many believe that there is too much of the latter. Mental health care is not always comprehensive enough, and access to NHS dental care is too limited. However, also remember that complaining and finding fault with institutions are a national tradition in the UK.

On the rare occasions that I visit the doctor, I don't see hordes of "time wasters". The system doesn't look as if it is under undue strain. There is a focus on educating citizens not to waste NHS resources. The impression, as a user, is that it works quite well.

Overall, it is very encouraging to know that, whatever happens to me, whatever misfortune befalls, that satisfactory health care is available. One doesn't want to lose one's job, that carries enough worries without the thought of not being treated when sick.

It is good to know that I am being served by an organisation devoted to "treating the sick" rather than just making money. As an analogy, I know from working in the transport industry how private franchise holders soon turn to milking users out of every last cent and frankly treating them shabbily when, naively, one might have thought that their business was taking people from A to B pleasantly and efficiently.

I have seen the worry abroad in a system where, if one could not pay, one was left to suffer and perhaps die. That was not in the US, nevertheless I remember well how fearful people were.

One might, as an economist, add that it is hardly "efficient" to have an unhealthy workforce. And it is worth adding that the two countries with the highest growth in the 20th century - Australia and Sweden - both have socialised health care.

So I can see that the US might do well to apply a more socialised health care model - my American wife certainly agrees! Americans would do well to understand that the British model is not "socialist" (what fear that word seems to strike into some hearts!) and would, in the US, threaten nothing but the bloated profits of heartless corporations that have benefited mightily from citizens' misfortune. The market does not solve certain problems, there is no "invisible hand", and sometimes a bit of intervention does a world of good.