to be gobsmacked by the efficiency of private healthcare?

[grovel]

I have never used private healthcare before and we have no insurance. Over New Year my left knee "went". I could not straighten it. Very painful. DH called a GP friend (not in our area) who told him that real diagnosis could be weeks after initial visit to our GP (referral to consultant, probable referral to MRI unit, back to consultant etc). If surgery was required I might have to wait weeks after diagnosis. In the meantime I would be on crutches and painkillers. I was prepared to suck this up.
DH wanted immediate diagnosis. He called the local private Orthopaedic practice. Appointment next day. Scan immediately after consultation. Diagnosis immediately after scan. Offer of surgery within 6 days. Price for all of this - £4,100 (initial consultation, scan, surgery, anaesthetist, 5 physio sessions, follow-up consultation etc). We have decided to go ahead. We are lucky that we can afford to (just about - Butlins, not Greece this year, I suppose, and no car upgrade).
Now I love the principles of the NHS and will defend them until Kingdom comes but this experience has got me thinking about how it is organised. Why do I have to see my GP to get anything started? Why do consultants have to correspond with GPs? Does it really cost the NHS less than £4,000 (fully-loaded) to treat my condition (cartilege-related)? Could Landsley even be right about a physician-led service?
I may be spouting nonsense because I am so relieved to be getting resolution to my discomfort.

A1980 _ I envy your experience of the NHS, you obviously don't live anywhere near me.

I live in London, plenty of hospitals to choose from. All of the hospitals I've been to in London have been great. Polite friendly staff, efficient, good care,.... shoddy admin maybe and too long to write a letter but I can live with it.

I have had scans done at the weekend and late at night as an outpatient on the NHS at my local hospital, it's got a good system and you can book an appt that suits = so it is possible.

The big problem of course is that the Health and Social Care bill is going to turn everything we have been talking about upside down. We wont have a system where we can opt for private it will be the only one available, that's the way the bill is being set up. Steadily and surely the small local providers of care who can't compete with the big ones will fold. Our "Choices" will fold.

Those with complex care needs, the multiple chronic illnesses, those with severe and enduring mental health problems, and anyone who cannot state clearly for themselves what they need will be left, figuratively out in the cold, while the private companies vie to care for the easy cases.

The private companies are looking to make a profit from all this.

We will all need health insurance, all the time.

Healthcare will start to be rationed again as the private providers and NHS PLC or whatever its called will be striving to make the maximum profit.

The concern is that marketisation of the NHS will create far reaching problems that none of us are fully able to get our heads around. I'll stand up and say I am the first.

I like the sound of the system described by the person who lives in Belgium, but I am not clear what happens if you are elederly, unemployed, severely unwell, simply unable to pay? We arebeing lulled into a false sense of security while little by little, bits of the NHS are being destroyed in a way that we will never be able to put it back when the new system fails to work equitably.

You only have to look at the US to see that the sick (and in particular the mentally ill poor) get the short end of the wedge when healthcare goes private when insurance companies are involved. My exFIL, a surgeon in the US, thought the way to improve matters would be to eliminate health insurance. That way, he reasoned, doctors and hospitals could only charge what the market would bear for medical service. I think he may have had a point though he wasn't an economist and neither am I.

I'm now living in the US and can't say enough how much I miss the NHS. A privately run system is horrific. We are lucky enough to have pretty good health insurance over here, paid in part by my husband's job, but we still have to pay high premiums each month and we still have to pay for each doctor's visit etc up to a certain amount (before the insurance kicks in.) But the main problem is, that the insurance companies routinely turn people down even when they have insurance, saying that certain treatments/procedures are not "medically necessary" and therefore not covered. The point is, that private health insurance are answerable to their shareholders and not to patients. If they can turn you down, they will, as the main motive is profit not care. It is a terrifying way to live.

And BUPA are doing the same " we'll decide whether your doctor needs to operate" here in the UK.

As the OP I feel obliged to tell you that the super-efficient private hospital has sent me invoices for £5,700 against a quote of £4,100. An admin error apparently - one that almost caused me a heart attack.

Oops!

Hope your knee is now well and truly sorted, though.

in fairness private healthcare is only effeicient if you can pay for it, if not then it will not treat you at all.

again the us system is good if you can pay for it or pay for insurance. i had a weekend in hospital in america for something fairly minor and it cost $20, 000 fourteen years ago. I had insurance, but even so. Plus you loose your insurance if you loose your job, and if you have something wrong with you the insurance companies did not have to cover you (i.e if a diabetic lost their job, they were screwed when it came to healthcare). I also knew someone who worked for a comapny for years paying into their insurance system, yet when he became ill with HIv he was fired as it was deemed expensive for the insurance to treat him, so he lost his insurance and his income. It went to court and it was ruled acceptable to fire him for his illness. I think Obama has made a lot of good changes to the healthcare system, so that people who work all their lives are not suddenly kicke doff their insurance as soon as they need it.

What do you think happens to people with cancer, or diabetes etc who do not have a large income, and no insurance?

I should also say that when I cam back from america my NHS doctor picked something up on the scans which the american doctors had missed, and I was in hospital within days for further investigations, all free of charge except what i paid in tax.

I've always thought that was one the cruellest aspects of the US system - the way your insurance is tied to your work. So you lose your job because of your illness and, guess what, you've just lost your insurance as well. Talk about kicking a dog when it's down.

Sorry about the bill you got, OP, but that happens in the private sector. I remember when I was pregnant in the US and had to get a simple, straightforward scan at the hospital. The hospital decided, on their own, that they were going to do a full bells and whistle scan and then charged the insurnace $5000 instead of the $500 scan they were asked to do. The insurance paid up, no problem, although since I had to pay 20% of the bill (very common practice in the US), I got a $1000 bill rather than a $100 one. They want to make money out of you, end of.

Why everyone always "looks at the US"?? Why not "look at" the way national health is organized in other developed countries? I don't have any experience of other EU, but the Dutch system is vastly superior to the NHS.

...which is also "free at the point of need"...

Because the US is the best example of a broken system - which also happens to be almost completely private.

The OP wasn't gobsmacked by the efficiency of French or Dutch public care but by the efficiency of private care.

Dutch system is now a mixture of private and public and is not "broken", but combines best of both.

Different systems work in different countries. I have no doubt that the NHS system would never work in the US, for example.

By the way, in what way is the Dutch system superior to the NHS? Cost-savings, efficiency, equity in financing, equity in access, health outcomes, resposiveness, value for money?

No one system scores on all metrics and I think the NHS does very well on quite a few. Is the Dutch system 'vastly superior' on all these metrics?

The Dutch system is good but it is significantly more expensive than the NHS - the Dutch spend nearly 10% (9.8) of GDP on healthcare compared to 8.2% in the UK, but health outcomes are the same (e.g. same life expectancy). So it is a lot less efficient than the NHS.

Dad had a heart valve replacement op a few years back. He had to wait 2.5 weeks in hospital. He could have opted to do it privately but the difference it waiting times was a day. It isn't always amazingly efficient and rapid.

I think it is a bit more complex that just life expectancy vs %of GDP anyone. I hope you agree that quality of life (free from pain for example) is also an important consideration to name just one.
I do not have any data on "metrics", my view is based on personal anecdote (and having half of the family in the Netherlands) of receiving care in both countries. What I can observe (waiting lists do not exist in Holland, it is much cleaner and range/quality of treatments is no less of that in the UK) If I could choose I would always get treated in the Netherlands or in my own home country (but in my home country it would have to be as a private patient).

I think that's my point though bemy. You might get treated quicker in Holland for non-life threatening conditions, for example, but it doesn't necessarily mean as a system it's better because the Dutch spend more money on their healthcare - and (I also now nothing about the Dutch system) maybe the equity of access/financing isn't as good as the UK. The NHS is far from perfect, but I think as a system goes, it's pretty efficient and it's nearly all public.

I just looked at the cost of bupa medical insurance. c.£150 a month for the 4 of us, but the list of things that aren't covered (or may not be covered) is scary. it's not exactly reassuring to know that they'll take £150 a month off you, but won't necessarily cover chronic conditions (and certainly won't cover pre-existing conditions). They also don't cover 'ageing' either, which sounds like nice weasel wording to get them out of covering you for loads.

My OP was only about the (perceived) efficiency of the healthcare provider I went to. This thread has (interestingly and typically) gone off in its own direction(s).

The process was slick. 75 minutes for initial consultation, scan, second consultation and appointment for surgery. One visit. All communication was electronic.

The NHS process (if I understand it right for this kind of condition) would have involved 4 visits to possibly 3 different locations (GP, Consultant, Scan, GP/consultant). There would have been much movement of paper, scan pictures etc around the system.

The questions in my OP were not about NHS vs Private. They were about whether the NHS is well-organised when it comes to routine, non-urgent (but uncomfortable) conditions. I'm talking knees, hips, hernias etc.

I'm not much wiser as a result of this thread about NHS processes but have been reminded again about why we should treasure the NHS's principles.

For such an acute injury it would have more likely been a and e, scan, consultant, treatment needed. Gp wouldn't come into it'

"The questions in my OP were not about NHS vs Private. They were about whether the NHS is well-organised when it comes to routine, non-urgent (but uncomfortable) conditions"

Almost certainly not I would suggest. It's a huge, bureaucratic behemoth that has grown organically and been pruned/reshaped many times by many different governments and had to respond to massive changes in demand and medical advances.

If you will excuse the interestingly mixed metaphors there......

if we were able to start it all again from the bottom up I am guessing it wouldn't be as it is now. Well not for the first few years anyway....

Even insured you don't always get cover for conditions. I had private health insurance. Had it for 5 years, never claimed.

Then I developed growths on my eyes. Insurance company deemed it was cosmetic.

So thats why the good old NHS had me in and the growths removed within 3 days. And I was told if I ever developed the growths again to go to GP immediately.

Needless to say I told my insurance company where to go after that.