AIBU to think healthcare system in US is terrible?

[brasty]

"A few months ago I had a well loved coworker pass away unexpectedly. The day before it happened, she didn't look well, and despite recommendations from many of us to go to the hospital (she had known health problems that were serious but not deadly if properly treated) she insisted she was fine and refused, partly because she didn't want to incur the hospital bills. She would likely still be alive today and for many years (she wasn't old) if she had gone to the hospital. It was unexpected and shocking to everyone. She was vibrant and caring and sassy, and everyone loved her. She has a family. This is the problem with health care in this country. No one should die because of fear of hospital bills."

I just read this about someone in the US. And it is shocking that people can die from easily preventable things, in a rich country. I know in a similar situation, my mum would not have called an ambulance for her suspected heart attack. Women having heart attacks often have much more mild symptoms, and she thought I was making a fuss anyway calling an ambulance. If she had had to pay, she would simply have refused to go, and maybe died.

My mom told me that she rejected an epidural in three of her labours because she knew her and my dad couldn't afford the additional cost on their bill. WTF is that bullshit. That's the last thing they should be worrying about while trying to give birth.

The US system is not intended to make it cheap and easy to have 4+ children. There is broad support for this amongst Americans, who are not known for their socialist spirit.

I wouldn't claim to know all there is to know about the US system, and it's probably true that I live in a part of the UK which is served quite well by the NHS, although I accept it has its issues.

My knowledge comes with having two primary breast cancer diagnoses within two years and having had 8 lots of chemo plus radiotherapy for the most recent one. I have to say that I have had fantastic treatment on the NHS. It was prompt, professional and delivered with kindness and sensitivity by the staff.

I am on a few closed on-line groups where there are fellow breast cancer sufferers from all over the world. I am frequently shocked and saddened by women in the USA who are unable to complete treatment because they don't have sufficient insurance cover to pay for it or they have an insurmountable excess to pay. The cost when paying private is extortionate, because private healthcare, like all insurance based services, pushes costs up. Also, many of them have to continue to work throughout the treatment as employment laws seem to be abysmal at protecting them from dismissal during their illness. And if they lose their job, they lose their health insurance.

I also think that they may be overtreated at times. I read of many women, with small slow growing, less dangerous breast cancers in one breast, who have double mastectomies rather than a breast saving lumpectomy. I have a suspicion that what the customer wants, the customer gets, even though the customer has little understanding of risk and may be harmed by what is, in fact, a very brutal treatment. Of course, parent choice may be king - but I do have reservations.

That said, I'm quite upset by the approach of the NHS to surveillance after treatment. In parts of the UK, and I'm in one of them, there is no routine surveillance after formal treatment ends and you are deemed to have no evidence of disease - NED. I have an aggressive cancer and quite a high likelihood of recurrence and spread. I'd quite like to be scanned every six months/annually just in case it raises its head again. Here, they say catching it early won't help your chances of survival. I DON'T believe that and I haven't yet had an answer from a clinician to my question as to what they would recommend if it were their own wife, daughter, mother etc. In USA, they are regularly monitored. Maybe I don't have a proper handle on risk or maybe the NHS simply doesn't have the money to keep me safe. I'll be paying privately for scans.

Sorry that should be patient choice

Olennas
US style preventitive screening is a great cash cow for medical providers
but there is sod all evidence that it improves long term health outcomes

PSA testing has been proven by NICE to be an utter waste of money.
Ditto breast cancer screening below the age of 60
ditto putting people on statins who have no other risk factors

US medicine does not do GPs
so the different specialists fight their own turf
and in the case of a very close relative give mutually exclusive advice
when the person showed them each the other's reports they slagged each other off rather than looking at the patient holistically

i know nothing about US medical care, but of the NHS I know a great deal.
Over the years they have cared for my son when he has had anaphylaxis many times. They have referred him to allergy clinics and at one point we had three london hospitals working together when he needed a new diagnosis and treatment.
My sister's children have severe , life threatening seizures, so we have been a frequent user of NHS.
Recently my little niece fell ill, went to her local hospital , then dashed to a London hospital and on life support. Not expected to live, but somehow has done. She has had constant CT and MRI with that care.
The NHS has paid for my sister, her partner and younger child to stay in a nearby hotel so that they can be near her daughter.
We have had the best care, and we as a family will never get a bill or be in debt because of this. We wont get a bill stating payment for the medical team that saved her life when she had a heart attack for 6 mins, or for her transport by ambulance with highly trained staff on board.
We wont have to fork out any excess for the MRI , CT or any drugs she has been on while in a induced coma etc

We can focus on her and her recovery now, which is the most important thing.

FWIW part of my anger is that the kidney transplant relative could have been cured by the NHS (as they try that one)
but medicaid were not geared up to cure
just to increase fees

Talkinpeece - if there hadn't been NHS screening before 60, I would be dead or soon to expire. Just saying.

TipTop at least your mother had the choice. I didn't have the choice with my 2 kids born with the NHS. There wasn't an anesthetist available to give me an epidural when I wanted one and then when I needed one for the emergency csection, it took 5 hours to find one. My ds almost died.

Amd I do realize that I am not the typical Medicaid recipient, but my comment was directed at trout who said that she was working and so was her dh and so I assumed that they had an income. Medicaid legally must cover birth control and abortion, so not sure where your aunt is getting her information from.

Trout I am sorry that I upset you. I certainly didn't mean to be condescending. I have a very very sick child and have been billed 10's of thousands by doctors and hospitals for many things they had no right to bill me for. I don't know which State you are in, but there is an overseeing body in every State that you can complain to. You should not have to pay for preventative care at all and if you are being billed for it, then you can contest that and win.

I spent most of the last 2 weeks fighting with Anthem to pay for my son's current care needs and even though they were refusing to pay, eventually yesterday they finally conceded that they were legally obligated to pay after I complained to the State Commissioner. A few years ago, I would have just ended up paying for it myself even though they were legally responsible to pay because I didn't know my (and my child's) rights.

TalkinPeace you are saying things that you know nothing about. US medicine has GP's. We see ours all the time. He has general knowledge and refers to specialist when it's out of his scope. I saw my medicaid gp yesterday and had a ekg and general workup, but had to go elsewhere for my specialist blood test (gp does standard ones) and xray. My dd saw her medicaid gp 2 days ago and was given treatment for her acne and period issues. He said that if the suggested treatment doesn't work then he will refer to a specialist. I am really quite curious as to what happened to your relative, because what you are describing doesn't seem to mesh with what I am experiencing. My ds gets all his very very expensive medicines for his various diseases paid for by Medicaid.

Having lived in both countries, with suitable coverage in the us, give me the NHS anyday. Wait times in the US were crap, the hospitals I experienced were no better than ours.
The thing that is the biggest difference for me, was the fact Drs push pharma in the US, it doesn't feel like you're getting offered drugs because they're the best, but who's paid the Dr the most.
Drugs adverts are also everywhere (ask your Dr for this prescription), ridiculous.

Also- water is wet

Jesus araiwa - a lady's died, and you come out with a typical flippant comment. It would be kinder to show some respect.

Yes that is true to an extent, your employer pays 80%ish of your health insurance. If you loose your job you loose it.

However, both DH and I get health insurance through work, both policies cover the whole family so we chose to use DH's as it was better coverage. I then get a pay rise for not using mine.

If DH lost his job I would sign up for my insurance.

As a Brit in the US My view is that the US system is pretty good. I would trust the treatment options over those offered by the NHS.

NHS has the advantage of free A&E care

I've lived in both countries. Id take the NHS any day. With all it's faults.

Dying for a lack of money as I've seen people do in the US is an absolute fucking disgrace and any Americans who advocate this system should hang their heads in shame.

I've lived in both countries too (with good healthcare coverage), and also prefer the NHS for its ethos, but my point is that the OP is far too simplistic. It's just not true that the US system is "terrible" - it has terrible bits to it (including the cost at the point of access, and hitting lifetime limits) but there are also bits that are very good indeed.

In all reality there is no perfect system, both have there faults.

One thing I have noticed is that people in the US are healthier than British people and they have a bunch better knowledge of first aid.

My DH cut the palm of his hand in the kitchen, a 2" cut, pretty deep. If we went to the ER it would have been $1000. However I was able to use butterfly stitches and clean it up for him at home

We can't afford healthcare. Every time I take ds to the doctor I have to weigh up if it's vital enough to pay.

I suffered from a broken tooth which got infected because we just didn't have the money to pay the dentist.

If you have healthcare I think the treatment you get is great.

I've forgone a couple of ultrasounds I really should have had and waited too long for a smear also because of money.

I miss the NHS so much. I am in the lucky position of being able to move back if ds or I get something horrific like cancer which would bankrupt us here.

I recently read Lionel Shriver's book "So much for that"

I was shocked by it and the devastating impact the cost of healthcare has on US people/families. This is pre ObamaCare, but I don't know if it any better now.

A great read anyway.

www.theguardian.com/books/2010/mar/28/lionel-shriver-so-much-for-that

Kursk sorry but I did an lol at that. My first aid knowledge since moving here has improved 1000 times. Dh regularly cuts himself working and we patch it up ourselves. I'd not dreamed of giving someone stitches in the UK.

I live in the US, and I agree that the system here is irretrievably broken. I am also a physician working in the system.

However, I must correct something that TalkInpeace stated. It is absolutely not the case that one is declined care in an ER or denied admission to a hospital if one lacks insurance and cannot pay in cash.

If a person without insurance presents to an emergency room ill, all care is provided. Yes, the person will receive a bill, but if the person is eligible for public health insurance or other coverage, case workers in the hospital will help them apply for it.

There are always threads on Mumsnet shitting on the US healthcare system. We are a huge country with very disparate attitudes across state lines, so it will take us a while to work it out. However, a majority of physicians in the US prefer a single-payer, tax-funded system, covering everyone, similar to Canada's. That is what we will have, in the end but it will take us a while to get there.

I've never heard of anyone being denied care. In fact I have a HUGE outstanding bill with our local hospital from when I was pregnant with ds (parts of it are under dispute as I was incorrectly billed) and they've still treated me and ds since.

Yes but the woman in question did not go to the hospital because she was worried about the bill.

Loppy - you might want to check your entitlement to NHS care on returning to the UK. Most Brit cits who have been living overseas for a while aren't eligible to receive treatment immediately when they move back.

I wish Boots and Superdrug had the type of over the counter drugs and medical supplies that you can find in CVS and Walgreens. And Brits need to make use of their pharmacists in the way that Americans (and the French, and probably loads of other places) do

Loppy

For you to be entitled to NHS care in your position you need to have a U.K. address. So a relative who doesn't mind you pretending to live there.