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Why would some people want American style healthcare?

211 replies

FishCanFly · 01/11/2019 12:31

I mean, to abolish the NHS for extortionate private insurance?

OP posts:
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Graphista · 04/11/2019 21:26

@Oliversmumsarmy I am not surprised at your story at all.

I think you may have been one of those who posted on my medical misogyny (which is a worldwide issue not just a British one) thread last year on which there were a ridiculous number of examples where not examining/referring patients properly, treating symptoms rather than making a genuine effort to identify the cause of symptoms and dismissing patients as "neurotic" and "hysterical" even to the point of passing them to already overstretched mh services was seemingly standard practice across the country.

Such practices not only leave patients suffering (in some examples described on the thread the lack of care was even fatal!) but also long term cost FAR more than if a little extra cost had been approved in the first place.

It's short sighted, inefficient and dangerous!

It's at least partly/sometimes due to policies which discourage appropriate referrals or investigations being made, policies which financially incentivise/disincentivise primary hcps from acting in the best interests of the patient rather than in what is cheapest in the short term.

The pushing of LARC is one very clear example of this. So many women are being pushed into having mirena coil or implant NOT because it's what's best for them but because there is a financial incentive for hcps to do so and a financial disincentive to remove them if the patient experiences difficulties with them especially soon after their put in.

There's been some truly shocking stories about this on mn and in the media generally (but unfortunately not as yet making real headlines cos it only of course happens to women and women don't matter!)

And making complaints is as you say incredibly difficult.

Patients are stonewalled, prevented from accessing notes, persuaded to accept pointless non apologies and placatory acts that don't really remedy the problem.

In addition in some areas (inc the one I currently live in) if you complain about a gp or gp surgery good luck getting another gp until you reach the point where the relevant authority steps in and assigns you one against their wishes. Patients who complain are effectively "black balled" albeit unofficially "current list full" "you're not strictly within our catchment area" etc or setting impossible hoops for patients to jump through to be accepted as a patient.

IMO gps should never have been allowed to effectively remain outside the nhs legally/financially. They are to all intents and purposes private contractors to the nhs. So the nhs struggles to police/manage them.

But of course it's not just gps, I've had numerous hospital Drs dismiss my endo symptoms even in a&e and basically treat me as someone making a fuss about nothing - almost all of them men.

Posters may be interested in as well as googling "medical misogyny" also googling "the gender pain gap"

Several posters on my thread noted that they had male relatives present with exactly the same pain symptoms sometimes even to the same dr even within days of their visit and the male patients received far more sympathetic responses and were prescribed strong painkillers etc

Women are expected to tolerate more frequent and greater levels of pain than men are.

Absolutely no good reason for this.

Oliversmumsarmy · 05/11/2019 11:41

This is not a new thing caused by lack of funds.

My ulcer issues were from the early 70s
My gf died early 80s from a heart attack hours after being examined by a doctor and being told he wasn’t having a heart attack.

Friend moved to a European Country a few years ago. After being there for a few months she became very ill.

She went to the drs. They did a blood test which gave 25 pages of results

They tested for everything and got a diagnosis from those tests.

In the UK you would be sent for a blood test to test for 1 thing at a time and maybe in a couple of years (If you are lucky) they would come to a conclusion.

ScreamingLadySutch · 05/11/2019 11:45

What is this binary (its this, or that) thinking? There are other ways!

The European model works perfectly well. Some input from the patient, some state funding.

Why not that?

Interested in this thread?

Then you might like threads about this subject:

ChardonnaysDistantCousin · 05/11/2019 11:47

Because that’s not scary enough for some. Especially pre election.

JenniR29 · 05/11/2019 11:49

Because they are rich, they stand to to profit from it and don’t give a shit about anyone else.

Can’t think of any other reason why you’d want an insurance based system.

ChardonnaysDistantCousin · 05/11/2019 11:54

Because they are rich, they stand to to profit from it and don’t give a shit about anyone else.

Most of Europe have a insurance contribution system which work better than the NHS, are they all rich there?

Kaddm · 05/11/2019 11:54

Insurers are bastards generally so I would be afraid of having to rely on them for healthcare. They do anything to avoid paying out.

That said, the NHS often spectacularly fails people. And that's why people are talking about having an American system. Of course, it could be out of the frying pan and into the fire. The NHS is a wonderful institution but something is badly wrong with it. Management, money, both, other stuff...who knows. But as evidenced on this thread, there are serious fuck ups. Mine are minor in comparison- I had to go to the GP NINE times over 3 or 4 months to try to get a painful problem fixed. Every time, they prescribed needless, useless medicine or gave crap advice. Eventually I paid to go private and the consultant fixed the problem in under 15 mins and said everything done for me by GP surgery over the past 4 months was not only useless, but counterproductive.

Oliversmumsarmy · 05/11/2019 11:58

Or JenniR29 it might save your life one day or at the very least not leave you in so much agony for years you cannot sleep because of the pain.

Atm the NHS isn’t accountable for its errors. If you do try to find out why something went wrong and request your notes they they invariably disappear.

Atm the NHS is wasteful and irresponsible and has no real thought for the people passing through its doors

All very well having nice nurses and doctors but if they are treating you for something you don’t have and not doing anything about the combination of symptoms you do have then they are wasting everyone’s time and money.

Over the past few years I have been in and out of hospital with Dp and the irrelevant stuff that is done which doesn’t need doing and probably costs so much money is breath taking.

Anerak · 05/11/2019 12:02

It's not a case of American style or nothing. There are other healthcare systems in the world, systems that work very well. The Dutch healthcare system would be ideal to replicate as it's affordable for everyone and the level and speed of care is excellent

WburgWanderer · 05/11/2019 12:33

@IheartNiles

Do you know how difficult it is to get a work visa? It's extremely unlikely that an American can strategically decide to get a work visa and move to the UK to live and work in order to get cheaper health care.

Quite apart from that, if she was living here and working and presumably paying taxes, why shouldn't she get care? Those in the UK on a visa from a non-EEA country also pay an annual NHS surcharge, in addition to taxes.

It is probably completely true that this woman's care in the US system was very expensive and was cheaper here. However, please don't spout this sort of health tourism rubbish. If she was here on a visa, she went through proper channels and was perfectly entitled to her care.

Oliversmumsarmy · 05/11/2019 12:46

However, please don't spout this sort of health tourism rubbish

Dp has been in a lot of different hospitals

There has always been at least one person on each ward where there has been a conversation with a manager (and in some cases interpreter) about their country of origin and the manager explaining about how they intend to pay for the treatment.

Usually the manager ends up shrugging their shoulders and walking off when it becomes clear the NHS are not going to be paid

LucheroTena · 05/11/2019 13:27

wburg with respect, you don’t know much about this case.

This woman was a health tourist. She came over with a known cancer in a state of frank relapse as she’d stopped treatment when her insurance lapsed (tablets alone for this cost £36,000 per annum in UK, probably much more expensive in US as the NHS as monopoly provider is able to negotiate discounts). She was educated and able to get a work visa. She then needed a bone marrow transplant. Her cancer then came back and she went back on the tablets which she will probably need to continue lifelong. She will need to remain in the UK in order to continue this medication.

She had been working for only a couple of weeks when she presented so had paid in very little to the NHS.

Whether she had not disclosed her illness on her visa etc I don’t know.

She was able to access treatment here. The rights and wrongs of that are up for debate.

We have also had plenty of people on student visas with obviously known illnesses come here to obtain medical treatment. In addition we have UK nationals who have flown over their relatives from other non EU countries for a ‘holiday’ who suddenly need treatment for what is obviously a long standing illness. By the time their cases are investigated and they are given a bill they have had treatment and disappear.

It goes on and it’s not infrequent.

JenniR29 · 05/11/2019 14:38

@ChardonnaysDistantCousin The European model could work well (depending on which country we model it after) but I thought the OP was talking specifically about the US system which is nothing short of extreme capitalism, people are dying because they can’t afford insulin.

@Oliversmumsarmy The NHS has already saved my life thanks! It’s not perfect but I’ll take a free at the point of access system over a US one any day.

WburgWanderer · 05/11/2019 16:30

@IheartNiles

You are right - I don't know the details of the case you were talking about. I'm not disputing the existence of health tourism either, no doubt it happens. My point was only that it's not a simple matter to obtain a work visa, that's all. Her work visa would be dependent on her actually working, i.e., continuing to pay into the system. If she needs continuing treatment, she must maintain her visa (or overstay, which is a different conversation).

As you say, the rights and wrongs of all of this are up from debate. It seems fairly clear from your comments and others that health tourism is not being dealt with properly, neither by the NHS nor the Home Office.

Oliversmumsarmy · 05/11/2019 17:12

The NHS has already saved my life thanks! It’s not perfect but I’ll take a free at the point of access system over a US one any day

Well you aren’t you one of the lucky ones.

Dgf lost his life to a NHS misdiagnosis.

Dp has a terminal illness thanks to the NHS

I have endured 11 years in agony.

Friend had 13 miscarriages because of being stitched up wrong after the birth of her 1st child.

We had to sort out the mess that the NHS made of Dp costing us for one operation alone £79,000

As far as we are concerned going to the NHS just prolongs the agony before you go private and get actually diagnosed and treated

1moreRep · 05/11/2019 17:44

it's a very low percentage of the population that cost the system the most and contribute the least. This is a significant problem not only on cost of healthcare but also safety of staff- i'm talking substance misuse etc. I think this is a huge motivator for people who want to change the system.

however, i would want to know about disabled people/ children who can not work, what would be put in place for them.

Jux · 05/11/2019 19:30

Why are peoplesuggesting that the NHS is free? It's not, it's free at the point of use.

If people stopped paying for private healthcare and put that amount into the NHS, it would be better. If you paid a tiny bit more tax, you'd get a better NHS and no needfor rivate healthcare. Same with schools - if more wealthy families paid the equivalent amount of school fees in tax, then schools would be better and they wouldn't need to go private.

Of course, this also depends on which colur of government you vote for.

JenniR29 · 05/11/2019 19:37

Oliversmumsarmy

How exactly do you think an insurance based system would help you? We have comparable healthcare outcomes with the other European countries. Under any system people will have good and bad experiences.

hettie · 05/11/2019 21:51

The problem with an insurance based model is that if your unlucky enough to have a prior condition your premiums are extortionate. Ds was born with a congenital problem. It's manifestation is serious but random, may never happen again or could happen twice in the next 18 months. We can't afford to travel to the US (not that I'm desperate too tbh) because the insurance is eye watering. It's also a problem because it disensentivises preventive healthcare. All the risk is outsourced to the consumer and the state has less control.

MissConductUS · 06/11/2019 00:33

The problem with an insurance based model is that if your unlucky enough to have a prior condition your premiums are extortionate.

As I explained up thread, under current law in the US you cannot be charged more or denied coverage based on your medical history.

en.wikipedia.org/wiki/Community_rating

en.wikipedia.org/wiki/Guaranteed_issue

The unfortunate side effect of this is that coverage costs for young, healthy people is much higher than what it actually costs to insure them as they are effectively subsidizing older, less healthy insureds.

Oliversmumsarmy · 06/11/2019 02:10

How exactly do you think an insurance based system would help you

Given I have had to pay to go private to actually get a correct diagnosis then I would have not had to spend the money on private healthcare all in one hit.

Try finding £79000 to pay for an operation to maybe extend the life of your partner.

For me paying into an insurance scheme and getting private healthcare would have saved me personally thousands and given private healthcare has always come up with a correct diagnosis in minutes and not left me in agony for at least 11 years of my life an insurance based system would have been so much better for me.

JenniR29 · 06/11/2019 03:12

My worry would be that your care is in the hands of your insurance provider and what they deem necessary. I had to jump through a million hoops (and pay excess) with my home insurance just to get a broken laptop replaced recently, I can’t imagine the stress of dealing with ‘computer says no’ when ill.

Also what about those who cannot afford insurance or the excess? Will they receive substandard care? I assume we’d still have to use the existing NHS infrastructure to provide the necessary levels of care anyway so I’m not sure how insurance would drastically change health outcomes.

I get that it’s not US system or nothing but does anyone really trust the current government to not enter into a system that benefits the rich? They have already been in secret talks with the USA.

WhizzingFizzbee · 06/11/2019 04:06

I don’t believe the NHS is viable in its current form long-term, especially with an increasing, aging population. We already get rubbish care and no staff as it is.

Also, I’m not a socialist, so me being able to pick and choose who I see for my problems and what treatment I can have is good. I don’t want to wait six months for operations or be denied medication or treatment because of a postcode lottery, when someone who hasn’t worked a day in their life gets it all for free. How is that fair?

Oliversmumsarmy · 06/11/2019 06:50

JenniR29 we have dealt with healthcare in the US on a number of occasions.

To some extent health tourism in reverse.

Health insurance in the US has saved dps life (literally) on more than one occasion where the NHS hasn’t treated Dp for an illness and dismissed his symptoms. Then because of his job he has then got on a plane to the US and 24 hours later he has ended up unconscious and fighting for his life in intensive care.

Yes he might have still made it to the hospital if he had been in this country but the wait in A&E might have made the outcome completely different.

We have always had excellent care and a speedy diagnosis when in the US.

I don’t think we have ever been to a dr or seen any HCP in this country who when you go in and list your symptoms they have made the correct diagnosis from the start.
It usually takes at least several appointments and multiple tests and treatments over at least 6-8 months before they can decide what you have and get you treated for it.

Usually it is the very same thing you said you had in the first place

JenniR29 · 06/11/2019 06:59

I think people are being a little delusional about the quality of service that would be offered to them if everyone had to be insured.

The reason private healthcare is so lovely and efficient now is because the companies are in a competitive market selling a luxury product. If the market were to be flooded with consumers overnight then they wouldn’t need to offer anything.

We would still need to use existing NHS hospitals and staff in order to meet demand too, you can’t just change the entire medical infrastructure of the country overnight. We are already short of thousands of doctors and nurses.

You only need to look at the privatisation of the rail service to see that the money you spend as a consumer is not reflected in the quality of service you receive.

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