Topic: Health Care in England Question

[DRam]

Yesterday one of those 'Obama's Going to Ruin the World' emails hit my computer.  This one compared Obama's health care plan to England's.  There, it was claimed, a person 59 years old or over is not allowed to have a stent put in place as it isn't cost effective to save the life of an old person.

While Obama wasn't my choice for president and I look forward to the day when he's no longer our president, rumor, innuendo and fear mongering irritate me.  I rebut such things whenever possible. 

So how about it, you people from England. Can I truthfully reply to the sender of the above email telling him/her "You're full of it"?  Any truth to the rumour?  If you're having heart problems and you're 59 or older are you just sent home to die? 

[Laminar]

A quick Google search could have cleared that up.

http://www.snopes.com/politics/medical/seniordeath.asp

[SteveD CB500F]

I find such ill-informed comments quite hurtful.

My late father had heart bypass surgery at the world-famous Papworth Heart Hospital in England. He was 69 at the time. The service was completely free (and still is)

He passed away last year with an unrelated illness, aged 78.

[BobbyR]

I am very interested in this topic, personally I think all this hysteria is BS put out by those who are making a fortune from human suffering. My brother is an MD and has run several Hospitals. The current system is forcing Hospitals to close, which will degrade your ability to get timely care. The Doctors make a good living in this Country no doubt, but their costs are so high filling out paperwork and waiting for reimbursement, many are walking away from Medicare and other Insurers.
I have worked with people from Canada and the UK, many of them over 50 and they have had Cancer surgeries and Heart procedures.

I commend you watch a film called Sicko by Michael Moore. I hate the man, but he lays out the facts. He even exposes Hillary Clinton who stopped pushing for health reform after she received big donations. My brother watched it with me and could find no fault in what they were showing. Most MDs I have spoken to are sick and tired of this system.

A lot of MDs are going into procedures like Boob jobs and other electives so they will not have to deal with Insurance or the Government.

I would like to hear what the experience of members here have been with their health care system. 

[SteveD CB500F]

Bobby, the problem with the UK system is that it is unsustainable with an ageing population.

Free healthcare is great but the demand is (almost) infinite and the supply is limited by the ability of the working population to pay for it.

At 51, I do worry about the next 30-odd years. 

[Ecosse]

from what i gather the gorilla in the room regarding the u.s. is the hmo's  corrosive effect. i read doctors were none too happy about it and patients have clearly suffered. sorry but steve is right; single payer sounds great on paper (like communism?) but in practice (sorry) it is not the better way to go...  the baby boomers are coming, the baby boomers are coming!

why is it everyone regardless of political stripe hates and distrusts 'the man' but then wants to hand over yet more of their fate to a huge machine that won't lose sleep if you fall through the cracks? the gov. can't fix a road or balance their budget but, what the heck, i want them controlling so much more of my life? odd. 

[Bob Wessner]

I retired from a large healthcare insurance provider here in Michigan. I wish I had the answers, but I can vouch for the fact that the problems associated with the U.S. healthcare system are legion.

The need to get away from fee for service, soon. Granted some specialties have very high malpractice insurance, but fee for service just invites abuse and overuse often, by some, under the guise of defensive medicine. Profits are made on every test or procedure performed. This is one reason why 70-80% of physicians in the U.S. are specialists.

More emphasis has to be placed on preventive medicine. Approximately 80% of all services are utilized by 20%, or less, of the population, mostly chronic diseases.

They need to level the playing field among insurers. I retired from Blue Cross/Blue Shield of Michigan. It is a non-profit health insurer that operates under strict state regulation. As such, they are the insurer of last resort and must take any and all comers, regardless of their past medical history. There may be a very short time period for certain procedures, but other than that, no one can be turned away. Not so with commercial insurers. The cherry pick leaving the most in need of services for others. They need to ban refusal of coverage by all insurers for "pre-existing conditions."

The stickiest of them all is we (the public) need to re-examine our views on what we are willing to have covered, or as Steve notes, we will go broke as the population ages. Aside from chronic disease, the most expensive years, in terms of medical costs, are the first and last years of our lives. How much money is spent under some pretty extreme circumstances at both ends?

Just some thoughts.

[edbikerii]

Concerns about nationalizing healthcare are not just hysteria or fear-mongering.  Have a look at just a few of the problems with nationalized health care in the UK:

Cancer drugs are not funded adequately by NHS:
http://www.timesonline.co.uk/tol/life_and_style/health/article4597174.ece

We're not just talking about a few isolated cases, here.  We're talking about widespread, systemic, statistically legitimate problems with the NHS.

61% of GPs in London complain of reported rationing and reduction of services due to cost:
http://news.bbc.co.uk/2/hi/health/249938.stm

A simple google search for "rationing NHS" will turn up a whole host of problems with NHS:
http://www.google.com/search?hl=en&num=100&q=rationing+NHS&aq=f&oq=&aqi=

This article points out some interesting things about how nowadays we classify things as medical problems that used to simply be considered "misfortune".  Things like infertility, impotence, poorly behaved children, ugliness, addiction, depression, for examples.  Of course this drives healthcare costs up quite a bit:

http://www.timesonline.co.uk/tol/comment/columnists/libby_purves/article4498748.ece

[BobbyR]

from what i gather the gorilla in the room regarding the u.s. is the hmo's  corrosive effect. i read doctors were none too happy about it and patients have clearly suffered. sorry but steve is right; single payer sounds great on paper (like communism?) but in practice (sorry) it is not the better way to go...  the baby boomers are coming, the baby boomers are coming!

why is it everyone regardless of political stripe hates and distrusts 'the man' but then wants to hand over yet more of their fate to a huge machine that won't lose sleep if you fall through the cracks? the gov. can't fix a road or balance their budget but, what the heck, i want them controlling so much more of my life? odd.  

I see where you and Steve are coming from and at 59 I am sure my need for health care will increase. I see more of a health insurance cooperative with the Gov't (we) paying for those they ( we) are paying for now anyway. I do not have a Doctor that will take Blue Cross anymore, since as Bob points out it is the insurer of last resort.  There are so many uninsured it is scary. I don't know who I fear most the Gov't to the private Insurance Companies.

I gave up taking Ed seriously when he seemed to change location every few weeks. Last report was somewhere in NJ. 

[HavocTurbo]

I have lived most of my life without insurance.

I am self employed. Regularly employed. And employed by the state as a private contractor.

I get calls all the time saying how I can actually SAVE money on health insurance. When I tell them that I don't have health insurance they pause for a moment, then continue to try to sell me something. I ask to be removed from their list and they hang up. Something that I thought was against the law for telemarketers to do. (Used to work for MCI)

I cannot tell you how many times I have been hurt (sometimes severely) and placed in the hospital. But every single time it is either on the jobsite or by the fault of someone else.

Most of my minor injuries (from breaking horses to ride or from being a stupid kid) were taken care of by old methods. Stay in bed and rest until you feel better.

Just my opinion but we all go to the hospital for things that can be taken care of at home. Broken toes, cuts, bruises, dislocated shoulders, etc. Therefore spending all kinds of money on crap we don't need. All in the name of not missing work.

Which is where I think our hysteria comes from. Missing work, paying too much, selfishness priorities, etc. Everyone wants something for nothing.

I find it interesting though that America is one of the richest nations on earth yet we have the #$%*tiest healthcare system in terms of compassion and understanding for the poor and the elderly.

[DRam]

A quick Google search could have cleared that up.

http://www.snopes.com/politics/medical/seniordeath.asp

Yup.  Would have.  But I wanted personal stories and possibly some discussion.  Got it, and thanks to those of you who responded.

[SteveD CB500F]

Ed: anyone can trawl up criticisms of their health service. Depending upon the actual question asked, I can well imagine that 62% of GPs said that they could do more with more money (= rationing?) and that fancy new cancer drugs at £10,000 per treatment are not widely available.

Meanwhile, there are nearly as many uninsured North Americans as there are people in the UK...  

[Ecosse]

bob w, i wonder your opinion about alternatives to hmo's like preferred provider organizations and point of service plans.

yes, every system has it's short comings, pros and cons, and potential for abuse. but i'd rather take the one where the incompetency of a dysfunctional fed is minimized; yes, big @ss corporations have a history of putting it to the people and breaking it off at the end, but at least in a free market the company who hoses the folks least can win out. again, there is no perfect system.  

dram, yours is a legitimate question imo. from all i have ever read or heard you will hear both extremes, of good and bad with personal experiences of medical care, socialized or whatever it is we have in the 'states.

[Bob Wessner]

Ecosse,

Like I said, I wish I had answers. If I did, I could go to Washington and make a bundle.

I can say this though, we were offered various health plans at work. The one's they wanted you to adopt were free, premium-wise, or inexpensive. An example were HMO's. They may be the way to go for a young family with children, but for myself, I rather pay more, which I did to avoid them. Capitation programs (HMO's) rub me the wrong way. The provider group gets so much for the year to cover so many warm bodies. The providers lost money if they performed too many tests, services, etc. They made more money if they rationed things. I didn't like the arrangement, strictly my person take on this issue.

PPO's and POS's are very costly to administer and manage. They were dreamed up designed  as a way to reduce? costs, yet leave the subscriber feeling they had a choice of providers. Performing the claims processes for these, which included provider verification, member verification, and claim edits was done daily and involved millions of claims. They are something of an in between animal between HMO's and just letting folks go to any provider anywhere on a fee for service basis with no controls at all.

We had some v-e-r-y powerful mainframe computers and we barely finished processing by the next morning in order to bring up our networks.. actually, sometimes we didn't make and thousands of folks sat around doing nothing until the work wrapped up.

Of course HMO's were an administrative nightmare as well. Trying to track and receive referrals from the gatekeeper provider was challenging to say the least. We frequently received the claim from the referred to physician before we received the referral, so the claim was either held or rejected.

The emphasis on doing more admin. things electronically is crucial and I think they recognize that in Washington. My department's job was to get providers to submit claims electronically rather than on paper. We provided free, basic software to physicians and really cheap software to small hospitals. I can't tell you how many times I went out to visit particular physicians who had been resistant to visits from our reps only to find a couple of Beemers (four wheels) outside the door, but they felt the cost of a PC and modem was too high.

[DammitDan]

Dad spent the last 15 years working for a private pediatric practice in town that regularly took .40 - .60 cents on the dollar for services rendered from TennCare, Medicare and private insurance companies.  In fact, private insurance companies would regularly hold payment on about 10% of claims for no reason whatsoever, if only because it took too much time and money to haggle with them to actually get the money owed (they usually claimed some sort of "paperwork error" which turned out to be complete BS).  This meant that they had to raise rates on people paying cash (without insurance) to make up for the difference AND hire more staff to double check paperwork and haggle with the insurance companies.  This is where the insurance companies in America are nickle-and-diming the medical providers AND private citizens to death.  They are acting as a middleman, largely passing cash from one hand to the next and taking a cut off the top.

The biggest problem is, say someone comes in to a burger shack and says, "I'm hungry.  I don't have any money, but I want a burger."  The owner is gonna say, "Tough luck," and kick that person out of his shop.  Hospitals and doctors, on the other hand, cannot ethically do this.  If a person is sick or hurt or dying, they are basically required (by their oath, and in some cases legally required) to try and help them.  To make matters worse, because insurance companies have driven up prices for non-insurance carrying individuals, the bill is going to be exorbitantly expensive.  In other words, they are ethically bound to help people whom they know will never be able to pay their bill.  Can you think of any other private business where this would be considered regular practice?

Insurance companies have largely broken the system, especially as they have become less and less regulated.  Dad has been supportive of universal healthcare from day one, simply because of the number of people in America who are going without health insurance (like HT) who are just one debilitating accident away from poverty.

[BobbyR]

Dad spent the last 15 years working for a private pediatric practice in town that regularly took .40 - .60 cents on the dollar for services rendered from TennCare, Medicare and private insurance companies.  In fact, private insurance companies would regularly hold payment on about 10% of claims for no reason whatsoever, if only because it took too much time and money to haggle with them to actually get the money owed (they usually claimed some sort of "paperwork error" which turned out to be complete BS).  This meant that they had to raise rates on people paying cash (without insurance) to make up for the difference AND hire more staff to double check paperwork and haggle with the insurance companies.  This is where the insurance companies in America are nickle-and-diming the medical providers AND private citizens to death.  They are acting as a middleman, largely passing cash from one hand to the next and taking a cut off the top.

The biggest problem is, say someone comes in to a burger shack and says, "I'm hungry.  I don't have any money, but I want a burger."  The owner is gonna say, "Tough luck," and kick that person out of his shop.  Hospitals and doctors, on the other hand, cannot ethically do this.  If a person is sick or hurt or dying, they are basically required (by their oath, and in some cases legally required) to try and help them.  To make matters worse, because insurance companies have driven up prices for non-insurance carrying individuals, the bill is going to be exorbitantly expensive.  In other words, they are ethically bound to help people whom they know will never be able to pay their bill.  Can you think of any other private business where this would be considered regular practice?

Insurance companies have largely broken the system, especially as they have become less and less regulated.  Dad has been supportive of universal healthcare from day one, simply because of the number of people in America who are going without health insurance (like HT) who are just one debilitating accident away from poverty.

+1
Dan, that is why my Brother went out of private practice and into Hospitals. He is now the head of the Hospitalist dept at three Hospitals in the PA and NY. It now takes 3 FTE employees to handle the paperwork for one Doc. I rode with a surgeon who has brought in 3 more surgeons, they have 7 employees, six to handle paperwork and one to schedule appointments, then each Doc has an assistant. He is making money, but he works a crazy schedule. Three days a week he does only hernias at the Hospital. He runs from room to room for 12 hours. I would not wanna be #12.   

[Frankenkit]

My $0.02 as a worker in the medical industry is that I fully hope this health care plan is instituted, for the betterment of humanity and hospitals alike.  Our hospital receives funds from the state and takes in the homeless, etc for all sorts of treatments. 

One trend that has been truly troubling to see is that of disastrous consequences to  what began as relatively minor injuries or conditions, due solely to delayed treatment.  That is to say, people will get a cut or something, or a cough/cold and what stitches and antibiotics would have healed without a problem becomes a gangrenous mess that needs to be amputated, or pneumonia etc involving chest tubes and much more potent and costly antibiotics.   People are not seeking medical services when problems are minor because they are afraid of being turned away, or the expenses, only to give in when the issue is too large to ignore.

Where an ounce of prevention would have been worth a pound of cure, the public (the state and city) is footing the bill.

I would also hope that government funding would encourage hospitals to have better, more humane practices in terms of shift length.  It's not terribly unusual here to see rad. technologists and nurses with 16 hour shifts.  MX may correct me, but I think our angiography techs have 24 hour calls, with the inherent possibility of being there and conscious all 24 hours. 

I think the reality of medicine today is that people are expecting to pay 1960s prices for 2000's medicine.  Unfortunately, in the 60s we didn't have MRI or open heart surgery.  We didn't have interventional radiology or the sheer number of various surgical techniques and treatments we have today, and every single one of those costs money.

That said, I would gladly pay more in taxes if it meant not paying my insurance company to f*ck up my paperwork and overcharge and under pay.    I would also gladly pay more in taxes if it meant poor peoples' kids can be guaranteed to get good health care.  I know I can't keep people from having more kids than they can pay for, but I can at least hope the kids are taken care of.
 
I also would hope that adults could get medical coverage for at least the necessities- annual exams and emergency care at the least.  There is too large of a lower-class workforce that isn't receiving benefits for us to ignore their needs.  They're our part-time janitors, working two or three part time jobs because a lot of employers here are too cheap to hire FTE  employees and give them benefits.

[Ecosse]

kit, i have tons of respect for you and what you do but if you think for a moment the fed won't eff up medical care worse than the imperfect system we have now, i just don't know what to say. seems like a lot of 'hope' being lent out.

if i thought for a second more taxes would improve things i'd be for it too. but that simply is fantasy. never mind how europe works, we're talkin' d.c. here. honestly, they can't manage their way out of a paper bag with a flashlight and a knife.

does anyone, anyone, truly believe the gov can and will handle this matter any better than what we have now?? please.

my major concern is that this is one hell of an experiment because, as history shows, once gov has power they really don't enjoy relinquishment it. and, there never has been a case where, once a tax is imposed, the gov willingly phased it out.

i live at the low end of the economic scale and i've seen people (and myself) get the shaft by powerful entities; but for god sakes the answer isn't to give the biggest power there is more of it over our lives.

all i say is tread carefully with what independence we have left.

[edbikerii]

Steve, I'm sorry to come across as just being critical of the UK.  I am not trying to be.  I'm merely pointing out that the healthcare system in the UK is not the panacea that many politicians here in the US would have us believe.

Considering how the US government has run Medicaid, Medicare, and the VA Hospitals into the ground, I don't see how we can trust them to manage healthcare on a much larger scale.  Is there no accountability to us taxpayers for the corruption and incompetence that our dollars pay for?  Aren't we fools for even considering allowing the government to TRY AGAIN with TRILLIONS of dollars that we SIMPLY DON'T HAVE?

Ed: anyone can trawl up criticisms of their health service. Depending upon the actual question asked, I can well imagine that 62% of GPs said that they could do more with more money (= rationing?) and that fancy new cancer drugs at £10,000 per treatment are not widely available.

Meanwhile, there are nearly as many uninsured North Americans as there are people in the UK...  

[Ecosse]

Steve, I'm sorry to come across as just being critical of the UK.  I am not trying to be.  I'm merely pointing out that the healthcare system in the UK is not the panacea that many politicians here in the US would have us believe.

Considering how the US government has run Medicaid, Medicare, and the VA Hospitals into the ground, I don't see how we can trust them to manage healthcare on a much larger scale.  Is there no accountability to us taxpayers for the corruption and incompetence that our dollars pay for?  Aren't we fools for even considering allowing the government to TRY AGAIN with TRILLIONS of dollars that we SIMPLY DON'T HAVE?

well said.

[DammitDan]

Let's look at it this way, Ecosse.

If I wanted to get a "regular" healthcare plan (major medial, dental, Rx, etc) it would cost me well in excess of $300 a month.  Hell, when I looked into COBRA when I turned 24 and got kicked off my parents' insurance, it would have cost me about $1200 a month for the same services I had been getting before.  $1200 a month for a healthy 24 year old!  This is simply unrealistic.  If anything, insurance should be MORE affordable for young healthy people, but the reality is just the opposite.

As it stands, I am a healthy young 26 year old male with no history of major disease, I am not overweight and have no unhealthy habits (drinking, smoking, etc).  I am currently paying $97 a month for a high deductible health care plan (where I pay any and all expenses up to $2500).  This is basically money in the bank for the insurance companies, as there is very little chance that I will get sick and require expensive treatments.  But it helps me to sleep at night knowing that if I get into a major accident or develop some debilitating disease, at least I will have major medical covered.

Nearly 1 in 3 young people in the United States are currently uninsured.  Imagine if all of those taxpayers started paying a set rate into a collective system?  It would instantly drop premiums by 1/3, and with more people paying into the system (guaranteeing payment to healthcare providers), healthcare costs would go down, lowering the premium even further.  It's a win-win situation.

Things can't really get much worse at this point.  Saying that it wont work simply because it will be run by the government is counter-productive.  There are government programs that worked in the past (just consider the CCC in the '30s, and the government put a man on the moon, after all!)...  There's no reason a well-designed government program couldn't work for us now.

[josixpak]

First of all, it would be impossible to predict how a national health care system in this country would turn out. Canada, Netherlands, and Brazil (for example) all have universal health care. Their systems are nothing alike, so we have no idea how possibly efficient or successful this could be.

I think it is important to realize that health care in this scale could adversely affect SO many aspects of our lives. This include motorcycle riders. I don't mind paying taxes if it helps children or poor people down on their luck. But what about someone who hurts himself because he wasn't wearing a helmet? What if that person is riding around shirtless? That person has a right to do this in most states, but if that person injures themselves because of it, are we paying for it? Can we expect more legislation to protect us from ourselves?

Lung cancer from smoking, health problems from obesity and lack of exercise, abortions etc. Without getting into those specific situations, there is no doubt going to be some problems and opposition to some coverage. And this is only one aspect of how complex this issue truly is/can be. Even with a genius, exceptionally efficient government, this would truly be quite a task!!

[BeSeeingYou]

If you listen to the crap spewing out of conservative right wing cake holes you would have the impression that Canadians, folks from the U.K, and other countries with some type of universal health care are flocking here because the care is so bad in their own countries.  Well, I have friends in Canada, Scotland, and Australia and none of them would trade for what we have here.  I just heard El Rushbo say on his radio program the other day that the reason we have 47 million uninsured is because all those people don't want insurance.  With all the people who take every whacked out opinion of his as fact no wonder there is so much misinformation out there.   Most of the republican talking points are coming from the Lewin Group, a private "nonpartisan study group" funded completely by United Health Care so there you are.  Then we have Congresswomen Michelle Bachmann saying things like one of the reasons she is against it is that universal coverage would be cheaper and it might drive heath insurance companies out of business.  Now we all know how terrible that would be.  Then she spews forth about how offering more people heath care might lengthen waits for doctors and otherwise increase the hassle factor for her.  Another voice of reason in the republican party. The nearest thing to a republican plan I have heard is some mumbo jumbo about "decreasing costs by giving the consumer more control over their health care choices".  What that means I am not sure other than to just preserve the status quo.  Much of the republican opposition seems to be for political reasons.  If Obama is successful it could keep them out of power for a long time.  Given what the republicans have put the country through over the last 8 years would that really be a bad thing?

[Ecosse]

in the end, is not a right versus left issue. yes there are nut jobs on the right (and left), but for the love of god, drop the partisan stuff because the bums we elected are eating it up.

all else being equal (tales of being hosed by the medical system) it baffles me how willing some are to give up even more of what little autonomy from the gov we have left. it is us (people) against them (politicians) and i would hope we all can drop the partisanship long enough to realize this.

i said before the system is flawed in the states and elsewhere, yes, but if those who gleefully give over more of their life to a big lumbering system think this is the better way, god bless ya... i won't try to change your mind. 

[oldbiker]

I had a triple coronary artery by-pass and a valve replacement 8 years ago and it didn't cost me a penny. I was 72 at the time and was in hospital for 8 days. Of course when I was working I paid our National Health Insurance as does everyone here. However if you were visiting the UK and needed Hospital treatment, you would get it without being forced to pay first.