To ask about the American healthcare system?

[ZortNarf]

There's a lot of talk about the NHS being sold off to the Americans. From what I can see it's just about American companies getting higher prices from the NHS - so not 'selling it off'.

But if they were allowing American companies in to run the NHS would that be a bad thing? I've no real idea what healthcare's like in America except from TV. Is it bad? Don't we keep raising money to send sick kids there when we can't treat them here?

Genuine question. Surely doctors are doctors and hospitals are hospitals? Should I care who runs them, owns them, or whatever?

You should absolutely care. I get to see inside a lot of different health systems round the world, and the current US system where it is every doctor for themselves, and they are totally incentivised to not refer you on to others but to do everything they wish because they are paid by the item is so broken that the people who pay for it are pushing reforms starting soon.

Oh, I was thinking more of the way the hospitals are run than the way it was charged. Presumably it would still just be 'NHS' to us and the charging is done in the back office? We wouldn't need to worry about costs would we?

In the nicest way possible the fact that you are asking this questions shows how little you understand about how healthcare systems works. That's not necessarily a bad thing, but if you are genuinely keen to learn more about it I would advise that you do some reading into it, rather than starting a thread in AIBU.

The NHS is not being sold.

Why would US firms want to be involved if they didn’t see big profits in it? Where do you think those profits are going to come from?

Yes of course it's bad. Have you seen the charges for giving birth for someone who has medical insurance (hint it's thousands of pounds) let alone someone who doesn't. What about someone with a chronic condition or a cancer surviver who won't be insured at all? The American system is massively more expensive than our system and has worse health outcomes. The only advantage to it is that a small number of people on the board of insurance companies make huge amounts of money.

No you pay for everything.
My favourite part of the bill my aunt got for a stay in a us hospital was $103.45 for mucus recovery system (1 box of tissues (already part used) to you or i). If you are lucky enough to be able to have good insurance you still have to pay a portion of your bills and you can only go to specific hospitals depending upon your insurance these are just some of the problems with the American health care system so I'm sure you can see why this is problematic

If any political party sold off the NHS, no-one would ever vote for them again and they'd be utterly finished. This is why I find it really hard to believe any rumours of the NHS being sold off.
Doesn't add anything to OP's question! US healthcare can be pretty good, but is also a complete rip off.

Here's a couple of Medicare bills to ponder on.

Obviously only a worry if you are rich. If you're poor ... well ask some Americans who don't have healthcare what their experiences are.

The NHS isn't being sold off.

But putting aside costs, ask yourself the question, if you had a life threatening condition, would you prefer to be in the average US hospital or the average NHS hospital?

My sister is now a US citizen, married with 3 kids.

They pay $1500 a month in health insurance. This is a rate subsidised by their employers.

So if you have tens of thousands a year despite that you would like to spend on health care, yeah, it would be great.

Going without health insurance is a very bad idea. Dsis's anaesthesia alone during one of her births cost the insurance company $6000.

I was listening to a podcast the other day about cystic fibrosis and there was a young American guy being interviewed who had CF. He was saying that he was alive and relatively well with a good quality of life because he was able to take a certain drug, he could only take that drug because he was lucky enough (and well enough) to find a job which would offer him a particular level of insurance to get that drug. He couldn't afford to pay for it himself so if he wasn't well enough to work or lost his job for any reason, he couldn't take it and his health would go seriously downhill and he could possibly die. It really brought home to me how much we take the NHS for granted here.

Why would US firms want to be involved if they didn’t see big profits in it? Where do you think those profits are going to come from?

You do know the NHS already does business with the US right?

It's run a very different way to here. Here medical staff have a say in treatment and flexibility. There it's down to accountant/insurance who give go ahead. Waiting times if you don't have great (expensive) insurance can be worse. Treatment options can vary state to state. They wouldn't want to run it for the patient benefit, but for the stakeholders. So costs will rise to make a profit, leading to cuts being made elsewhere to afford to pay the company. If it's like other private takeovers of UK health services, they may cut options/treatment/services/staff levels to trim every penny.

As for the staff working in the US health system, a great many hospitals are not unionised so doctors nurses etc have no protection no representation. Wages can be shocking, job security, safety, benefits like maternity leave etc often non-existent, and this obviously leads to staffing shortages on top of poor quality equipment and supplies.

I lived there.
Dh had a very well-paid job with top insurance.
The healthcare system was APPALLING.

Imagine not being sure if you should take threadworm tablets (cheap here) because it'll cost you hundreds of dollars per pill?
Not being sure if you should call an ambulance because it will cost you $500 to go a few blocks?
Are the hospital suggesting you get this x-ray/treatment because it's strictly necessary or because they want to sell you something?

There's a lot of having to self-diagnose and make important health decisions when you also bring finances into it.

I had the bad luck to have to take an ambulance to hospital there. The hospital and staff and treatment were in no way any better than NHS ones here. In my case the staff were either overworked or didn't care about basics like bringing me a drink of water etc.
I got a $10k bill for a night's stay in intensive care when I hadn't been there at all, I'd been on a normal ward. When I went to the hospital to query it a guy in the finance (or whatever) section said he'd look into it and gave me his card to contact him. When I got home I realised the card had no name or contact details on at all, just the department name! Unless you're fully versed in navigating the insurance system, the whole thing is a Kafka-esque nightmare.

Apparently they pay less tax due to this but where I was, the roads and schools were still awful.

The NHS is an absolute lifeline, we cannot risk it turning into the absolute mess that is the US system.

It's nothing like what we see on TV. The NHS is a godsend!!

I gave birth in a hospital where they charge you extra if your baby needs to be resuscitated as they're born. 😱

Oh and lots of plans don't cover mental health care, you'll have the privilege of paying extra for that luxury.

Contraceptive pill - you only get the exact number you're allowed under the plan. If you're going away and need to get an extra pack you have to go through a few hoops.

Gosh, that was your experience with top insurance exsfer? That’s literally unbelievable!

I once attended a medical center in Florida for an infected blister on holiday. It cost me $275 for a 5 minute appointment with a nurse, two plasters and some cream to reduce inflammation.

Not literally unbelievable if you know your insurance plans. OK maybe not the plan that a millionaire would have but a very highly respected company that looks after their staff.

If I'd been fully informed I could've paid less (insisted on going to 'urgent care' rather than another department) or got a cab to the hospital. I can happily scan in the paperwork if no-one believes me.

The NHS IS being sold off, that is the tories plan and they are perfectly open about that.

Right, this is my two pennies' worth: If you look at the stats, you have to ask yourself why outcomes for patients are so much worse in the US, in a country that spends double per person what the UK does on healthcare. Some of this can be explained away by the issues surrounding insurance and access to healthcare, but not all of it. My thoughts are that it's to do with the culture around medicine and healthcare. Doctors are humans, they are people who are susceptible to bias and the influence of the culture they work in like anyone else. If they are working in a system that rewards them financially for doing more investigations and procedures, and where there is an ever-present risk of litigation if they miss something, they are going to carry out more investigations and more procedures, whether or not that's in the patient's best interest. As well as eroding the trust that should be the basis of the doctor-patient relationship, this leads to over-medicalisation and over-treatment, both of which are rife in the US. It's obviously a very complex issue, but I think that is a massive part of the problem. Whether or not it's morally/ethically/medically the right thing to do, if you (as a patient) want a certain procedure done, and you are able to pay for it, there will be a doctor who is willing to do it. Plus they advertise medications on the TV FFS! What is that all about??

If we had to have another country run our NHS, I'd much rather it went to one that was well run or at least in the top 13. The USA spends more then us and is ranked 37th (we're 18)

Your room charge came to $7k Serendipity did it come with a fucking butler?