Friday, 14 August 2009

UK v USA Healthcare

I am posting this on A&S because it has the highest hit rate and a lot of American readers, it is a bit of politics and a bit of Health and I feel falls within the A&S remit.

A bit serious for me but needs must.......

All and sundry (forgive the pun) are debating the “Obama” healthcare plan, and are comparing it to our NHS.
There are protests in the USA, there are MPs hammering the NHS over at nourishing obscurity, there are people dying because of poor care in the UK and there are people dying in the USA because they cannot afford Health Insurance.

The NHS is a wonderful Idea, healthcare free at the point of delivery, but of course it isn’t free, we pay for it with National Insurance, which is rising all the time.

So let’s look at the differences: in the USA if you can afford Health insurance you get treatment, sometimes good sometimes bad, and depending if you have an existing illness when treatment may be refused.

In the UK you get treatment without private health insurance, sometimes good sometimes bad, you can have your own health insurance which entitles you to “private” treatment, usually by NHS doctors at private clinics, and can depend if your “illness” is covered by said insurance.

In the USA thousands die because they cannot afford insurance.

In the UK thousands die without needing insurance.

Obama estimates that the cost of his healthcare reform plan will cost between $50 and $65 Billion (around £39 Billion), the NHS costs £100 Billion or so each year.

And of course the USA has a far larger population than the UK.

Can you actually compare the two countries on healthcare?

I don’t really think so, there are basic differences between us, the USA is and has always been fiscally motivated, healthcare is a profit industry, if a hospital doesn’t make money it goes out of business, in the UK healthcare at the moment is motivated by just that, care of the sick, without the profit incentive.

Sadly the NHS is slowly being privatised by the Government, along with Darzi clinics, and “centres of excellence” the demise of continuity of care, and Foundation Trusts, we are seeing the edge of the cliff and like a bunch of hypothetical lemmings we will jump into the quasi American form of healthcare.

Whereas the USA is trying to provide healthcare on a “need” basis not an ability to pay basis, which can only be a good thing for the sick in that country.

Both counties need to stand back and re assess, the UK needs to return to the tenet that was present when the NHS came into being; quality care which is not dependent on your bank balance but on your need.

And the USA needs to drag itself away from the elitist “private” insurance philosophy and embrace health care based on need and not on ability to pay.


Angus Dei politico



yvonnebones said...

Both systems have good and bad. However, you will have noticed that for really difficult to treat conditions UK patients often have to raise funds privately to go to America for the latest groundbreaking treatment: the NHS stifles innovation. Moreover, because the NHS gets paid (via our taxes) no matter what, there is no incentive to greater efficiency. File tracking in many Trusts harks back to the 1950's, computers are used as glorified word processors, procurement is generaly paperbased. No huge corporation would be able to sustain the duplication of work in administration as is done in the NHS. Ultimately, the NHS is extremely costly for the actual services provided, but as individuals do not have to write the cheque, this is forgotten. Then too you have to look at how NICE decides best treatment, which focuses on groups and not individuals. It employs medical staff on the cheap from third world countries. Then there is the inefficiencies in commissioning ..... Well, I could go on and on ......

Anonymous said...

I am sick and tired of the yanks making derisory comments on our online papers regarding topics that do not affect them which concerns another Country where they do not live but seemingly think that they rule (as with all the other Countries of this world) the NHS is not perfect by any means and its funds are limited but at least we do not have to pay colossal monthly premiums that the yanks do. How dare they make arguements concerning another Countries health system when they have sufficient troubles of their own that they should concentrate on? There again, they were always gobby, opinionated, vastly superior and outspoken.

angus said...

I have written many posts about the NHS over on NHS exposed, but the real problem we have at the moment is Labour, who are no different than the Tories when It comes to policy.

They have made too many "Improvements" including NICE, the Healthcare Commission, and the new lot the CQC,and have managed to make healthcare worse, the only people who are better off are the higher management of hospitals and their bosses.

Not enough front line staff, not enough equipment too many managers.

Billions spent on a "super" computer system that doesn't/won't work, staff that are overworked and unsupported, GPs that are thinking of leaving in droves, junior doctors who can't get jobs, Like you yvonnebones I could go on and on.

It isn't the NHS that has lost it's way it is the Government/past Governments, The NHS needs an
MOT, the excess fat needs to be cut away and attitudes changed so that the patient is again King and quality treatment provided.

I have two hospitals within ten miles each way from me, one is a foundation trust and has all the high numbers in it's review, but provides awful treatment, the other is not a foundation trust and provides excellent treatment.

The difference is the attitude of the staff and management.

Bugger me, this is turning into another post so I will stop there:)

CherryPie said...

the UK needs to return to the tenet that was present when the NHS came into being; quality care which is not dependent on your bank balance but on your need.

Well said.

And as you say in your comment there too many managers and not enough front line staff. There is too much emphasis on monitoring and producing targets.

Phidelm said...

I'm with you on this one, AD and Cherie: the whole thing is a bureaucratic nightmare, and has been for decades. I'm from a medical family and have been listening to complaints about NHS management since I was a child - eg no pay rise for nurses while managers got (a) a new office block, (b) wall-to-wall carpets in their offices, and (c) their personal secretaries were provided with electric typewriters while senior medics' secretarial staff were only allowed manual ones ... and I could go on. Nothing changes. The waste is obscene.
Healthcare is a basic right, like housing or like education.
Also,as Angus says, it is an absurdity to compare the NHS with the state of healthcare provision in the USA - whether current or mooted.
I've never in my life encountered anyone in/from the UK who's had to "raise funds privately to go to America for the latest 'groundbreaking treatment'" as 'yvonnebones' alleges. Has anyone else met/heard of such a person?
Funnily enough, the computer system Angus mentions in his comment was designed by an American firm - who went over budget about a year before they delivered (over a year late). Funny, that ...

CherryPie said...

Ah yes Phidelm, those computer systems going over budget and being late. There are so many of those in the public sector, some of which never get delivered and are binned. What a useless waste of money!

His Girl Friday said...

interesting post and comments.
I see a lot of waste here in the US medical system, and high admin costs (two to one, I believe over any other English speaking country).

There's a lot of abuse/fraud in the system as well. Until that, and the bureaucracy is addressed, I'm afraid it's all a moot point; and, people still don't have least the working stiffs caught in the middle. The rich, the poor, and the illegals all get care.

angus said...

I think this topic will be endless, but it is good to see different views on the subject.

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