To ask for info about the world's best health system please?

[haveyourselfamerry]

I am assuming that somewhere in Europe/Canada/Australasia there is a system that works better than ours.

I have spent time in US -we can rule that one out right here....

Free for EU pensioners, or least those arriving before, don't know if it's changed.

I though in Spain relatives had to provide nursing care in hospitals? So bring food, change beds and all that type of care.

The US has a real problem of over treatment amongst the well off. Lots of unnecessary tests, that for some, lead to side effects.

I've lived in several countries and have many close family members in yet others and, believe me, there are no perfect health systems.

Having said that, many of the NHS' problems derive from a population that is exceptionally bad at taking care of itself for reasons that are myriad and transcend the individual. If people were able to take better care of themselves the NHS wouldn't be so strapped for resources.

Brasty - I still remember when an American colleague got excited when she found out I was having a hsg (investigates fallopian tubes) for infertility tests- apparently she had one every time before she tried to conceive as her gaene told her it would make her more fertile!

No, they don't! The food is excellent in Spanish hospitals and although a lot of relatives do sort of descend on the hospital and ignore visiting hours, there is absolutely no need for them to do so, everything is provided and no extra nursing care is needed from families.

I'm from Norway and generally was very happy with the health care system there. You do have to pay for the first £200 (for GP appointments and medication, not for care in hospitals), but after that it's free. You can phone up to get same day appointments if it's urgent with GP, otherwise you might have to wait up to 2 weeks I'd say, so it's not all good. However waiting lists are far shorter, and also you can access proper mental health support (important for me), and there's no limit to how long you can get therapy for example, if you so need it. Medications are free after you've spent the initial sum. Whilst I disagree with having to pay the £200, and also not so keen on the wait to see a gp for a non-urgent appointment, I do feel it works better than NHS in general. After giving birth you stay in hospital for 2 or 3 days, whilst they help 99% of women establish breastfeeding. I believe it has the top % of women bf'ng their babies for at least 6 months, though I couldn't tell you how high it is. The health care system is not pushed to the limit the same way NHS is, and it works like it should. I don't know anybody who attends private clinics regularly, though it is also an option (more affordable than private clinics in England).

Purplebluebird - the UK has far more people than Norway though. Just to give you an idea in 2013 the population of just London was greater than Norway!

Yes, of course. I would still assume UK has a similar % of doctors to population though, since more people would want to be doctors.

My little brother got excellent treatment on the NHS for Leukaemia. My mum had to pay privately to get the diagnosis though - he was fobbed off by GPs and thrown out of A&E departments for wasting their time when the reality was he was desperately ill and had about two weeks to live. Once he got the diagnosis though and got to oncology the NHS were fab and fixed him up good and proper. This was a decade ago now though.

I will back track and say that actually the NHS can be excellent. I received free and successful fertility treatment and my relative received very good palliative care (if only the cancer treatment had been better, I still believe it probably wouldn't have spread to the brain). But! It is cash strapped and care is increasingly inconsistent for it to be a valid service for all society in its current state.

I have lived in two Scandinavian countries, Germany, Ireland and Australia. Germany and Australia are the best out of those, but the most expensive (Germany has compulsory insurance and Aus has a system so complicated that your brain will bleed trying to figure it out - unless you just give them your salary). In none of these countries is health care free for everyone.

Agree - Germany is also excellent, but expensive. My ds was born there and I was in hospital for a week after my emergency section, which was great for establishing breastfeeding. Can't imagine being discharged 48 hours after an operation.

gwenhyfar that hasn't been the case for us. We have a PPO, which is the best policy. We got it through my husband's company, and it's industry standard. I've never waited longer than a week to see a specialist, and I've found that doctors are variable; not all order tests and shove medications into your hands, willy nilly. Should I need them, I have access to the best doctors at the best hospitals in NYC. I delivered my two babies with a midwife at a NYC hospitaldrug-free, vaginal birthsand the care was incredible.

But I still think the NHS is a much fairer system, and it shouldn't only be the well off who enjoy access to stellar healthcare.

In the WHO data in the wikipedia article linked to, if we restrict ourselves to bigger countries then Spain is worth looking at. It is 29th for spending, compared to UK 26th, but is ranked 7, compared to UK 18.

I don't agree only looking at "free at the point of use" systems, that is a bogus approach that tries to build the answer you want into the question. (The UK is not completely free, we pay prescription charges, so called "not free" systems may have perfectly palatable charges.)

Compare that to the NHS where all Europeans currently get free treatment.

Not true. Free treatment for all is for A&E visits only. If you are admitted or referred to be seen as an outpatient, free treatment is only if you live and pay taxes in the UK or have been a resident long enough to have permanent residency. OR if the NHS has a reciprocal agreement with the other European country (which isn't automatic).

Similarly, only pensioners receiving UK state pensions are entitled to free care. If someone has left the UK, pays no taxes here or does not receive a UK state pension they are not entitled to care, even if they have a NHS number and were born/used to live here.

A new system coming into play ties NHS numbers to visas - some visas will still require payment for services, others, such as work visas, once your visa is up your NHS number becomes invalid and you have to pay. Many trusts are tightening up on this, including where I work.

Personally I'd be up shit creek without the NHS, probably dead. So I rate it pretty highly.

I live in NZ, which has a system similar to the UK (and which also seems to be staffed by people from the UK too). It's patchy.

Ambulances cost £60 although the fee is often waived.

A GP appointment can cost up to £30. I've never had to wait long for an appointment.

Doctors don't have a wide range of medicines to prescribe. It's also common for people to fundraise for treatment overseas, particularly cancer, which suggests they can't be treated locally.

Things have got noticeably worse over the last half decade.

Injuries are covered by a compulsory insurance scheme, other hospital visits are free at the point of need, however, there can be long waits for treatment. Private cover is becoming increasingly popular although as one is treated by the same doctors with the same medicine, it's just an expensive queue-jump.

I think the problem is that there is no "National" Health Service and that experience varies massively from location to location. Those living in inner London find it hard to get a GP appointment because too few GPs are attracted to working there given the challenges. But if they are referred to a London Teaching Hospital for something serious, they are likely to get cutting edge treatment. Those living in attractive market towns with good schools will find there are more GPs but the trip to a teaching hospital will be more challenging.

But we all need to recognise that the biggest threat to health care provision is not government cuts or an ageing population. It is the poor life style choices we make in the developed world. The cost of treating the effects of immobility, obesity, heavy drinking, and poor diet are increasing exponentially and will swamp any health care system. We all need to get a grip and get one now!

We have lived in a lot of different countries and the NHS is the worst we have experienced by a long shot. We don't live in the UK but the state of the NHS is making news across the world, people here can't believe it. We have friends and relatives in the UK and some of their experiences are very worrying.
All health systems will behave their faults, no such thing as perfect.

Do you mean works better than the NHS for the same per capita funding?

Or do you mean has more per capita funding and works better than the NHS?

Because the answer to the second is simple:

the NHS (and integrated social care) with more per capita funding works better than the NHS and social care under current funding. Especially since the "austerity" cuts to social care.

The first

The second is hyperthetical I think?

(by the way, I really should know what per capita means. is it per citizen?)

I should also know how to spell hypothetical....

I've found the Dutch system excellent. It runs on a compulsory insurance basis but the very poorest people get a subsidy I believe. You do have to top up some treatments but I've had to use the health care services a lot and the treatment I've received has very significantly improved the quality of my life (with consequent knock-on effects for the children, too).

I live in France and find the healthcare very good. I do have to pay for top-up health insurance, but it's obligatory through my work so i don't notice it going out.

I can get Dr appointments very very easily (usually book them online) and if for some reason my usual Dr doesn't have a free slot, I can ring for an emergency Dr to come to me (obviously if it needs seeing that day).

With DC they are fantastic. My 3 year old was seriously ill and every time I rang for a Dr they were there within the hour. When he didn't get better the Dr sent him off to hospital, then rang my mobile the next day to find out how he was doing! Absolutely lovely.

Yes I pay upfront for the Dr appointment (though poorer people get it waived) but I get 99% of it back.

Yes, "per capita" means per head, so in this case per person in the country entitled to use the system.

Obviously it makes a big difference: many of the systems mentioned on this thread cost a lot more per capita than the NHS (Norway, France, the Netherlands all spend a lot more on their healthcare systems).

If we adopted a new system, but kept the funding the same, it might be no better than the NHS. In fact it could be much worse.

List of countries by total health expenditure per capita

It's one of the big sleights of hand of recent governments, to underfund the NHS and then pretend that it's the type of system that's the problem, not the funding.

Apart from the cost (and yes I realize that's a MAJOR factor in this discussion), my experience of the US healthcare has been really good. Same day appointments, referrals within a week, week in a private room after csection, lactation consultant provided by pediatrician, online home delivery pharmacy for repeat prescription. And with good insurance it doesn't actually cost that much. However, not everyone is lucky enough to have that experience, and that I think is wrong. I know people personally who are struggling to pay medical bills and it depresses me.

I've lived in a few places in the UK and had a few varied experiences of the NHS. It so depends on where you live for GP services. One location could easily get an appointment for a convenient time in the next couple of days, another it was 3 week wait for an 11am appointment which was not convenient at all for work!