Ask a question: 'socialised' medicine

[Bluegoat]

I saw this BBC news in my FB feed.

https://www.facebook.com/bbcnews/videos/10154376768372217/

 

I have just been through 3 surgeries with DH in December here in the USA.  I will say the overcrowding was scary and at a fairly new hospital.  He had to end up having surgery 3x all 10 days apart, and the last one was the scariest.  There were not enough beds.  At one point he was moved out of his pre-op curtain cubicle and another lady from surgery rolled in.  At that point he no longer had a bed or a chair.  DH walked to the bathroom and then walked to the actual OR room, where everyone was scrambling to get things ready. I saw all of this. I heard them calling out for various items and saw people rushing around to get them.  This is after a 5 hour delay for the surgery.  My mom was a career RN  and worked in surgery and ER and I told her about it just to make sure I wasn't being  overly concerned and she said it was ridiculous and dangerous for the hospital as well because that's when things go wrong. I asked one of the nurses and she said they overbooked by 10 patients that day and some of the surgeries went over.  That is the hospital administrations fault.  As a lay person I find that very concerning ethically.  For sure in December everyone wants to have surgery so they don't have to pay the deductible next year, which is also seems unethical.  

 

So, I'm wondering if this whole overcrowding is something going on globally with an aging population?  Will that change some things in socialized medicine?

 I'm in favor of universal health care, but I don't for instance want my parents generation abusing my kids generation. It seems like my childrens generation are going to get stuck with a ton of problems right now.

 

People who work in health administration everywhere are looking for models to provide better outcomes, better services, and so on, for patients.  And also for ways to reduce costs that people will accept and still get good care.

 

It's the reality everywhere that medical costs are likely to be infinite - we could spend as much as we have.  Yet in the end, no one can spend that much - there is going to have to be some kind of decision making in the wider society about what it is we really want and value in our health care.  And how much are we willing to sacrifice, in terms of how much of our personal income, or for things like public education, or parks, or art - all the other things we value.

 

Within a nationwide, socialized system, I think the danger is that some groups could ultimately put their health interests before others.  I live in a province that has a high proportion of elderly people, and they tend to vote for more money on health care.  They aren't so interested I education and IMO we don't allocate enough to education at any level.  But - we have lots of baby boomer voters.  But even that is not a people who are totally self-interested - they have kids and grandkids and friends, and want what is best for others - they just tend to be focused somewhat on their own daily  reality.

 

Personally I think though it is better than the wholly private model of health care, which is ultimately going to be facing the very same problems.  But who makes the decisions there, in what interest?

[lailasmum]

One thing I've noticed in our local hospital is lack of actual space, they lack waiting space and rooms for consultations and it seems to hold things up whilst the person treating you finds somewhere to see you.

[Susan C.]

In US: We just had an urgent matter that required surgery... I had to drive three times long distance in a week (don't want to discuss details, but its fine in the end). The wait where we live was 3-4 weeks to see a GP/Internal Med. doctor... and forget the specialist, and great pain was involved. Sooooo drive (and drive and drive) far away.

My question would be, to Canada and UK: What about specialists? Can you go straight to one? Can you pick one that is well known in their specialty? Or are you "stuck" with whoever you might be sent to by the GP? Let's pretend its cancer... can you pick a medical center well known to treat what you have and with record of good outcomes? So I guess in summary, how much choice does the patient have in socialized medicine?

[goldberry]

NZ has socialised medicine.  You can also buy private insurance and go to private hospitals if you wish.  We have private insurance and it costs us about $2400 for a family of 4 for the year. We have used it twice in 20 years. We have done everything else through the public system.

 

GP visits are same day.  You must be referred to a specialist, and then like the UK you get an appointment card in the mail varying from 2 weeks to 6 months depending on what the GP says is the priority.  I have gotten in to a specialist sports doc and gotten an MRI in 2 weeks; whereas my DS as a toddler got an appointment 6 months delayed when I was concerned with his feet turning inward but the GP was not worried.  I asked him to write the letter anyway knowing there would be a delay.  We could have gone private, but I felt there was no need.

 

My DH had a day of fainting spells last year, and he went to the ER.  He was seen within 20 minutes when he fainted in the waiting room.  When he fainted again in the hall with leads on him, and it looked like his heart stopped for 18 seconds, he was rushed to the Cardiac ward to a private room.  He stayed for a full week, and had every single test under the sun including MRI, blood tests, ekgs, ct scans, etc and finally they implanted a monitor in his chest for 6 months.  Finally, they did a tilt table test and found that he has neurally mediated synchopy, which means he faints sometimes.  So no heart problems at all!!! yea!  All this was 'free'.   We never saw a single bill or any sort of financial statement.  I'm sure it was over 30K. 

 

I think that mental illness is not cared for well here, having experienced it with my downstairs neighbor.

 

Dental is covered for kids under 18 for free.  Adults pay as far as I know.

 

Taxes here are reasonable, If you earn under 70K and have two kids, you pay about 10%, top bracket is 33% but we don't have state, local, or school district tax.  Just one tax.

 

We vote for our health board -- the people who make the decisions how to allocate the money (so do we want to spend more on premie babies or more on knee replacement surgery?) Thus, I feel like I have a say in how the money is spent and where the waiting lists occur.

 

Ruth in NZ 

 

Is it difficult to immigrate to New Zealand???

[goldberry]

NZ has socialised medicine.  You can also buy private insurance and go to private hospitals if you wish.  We have private insurance and it costs us about $2400 for a family of 4 for the year. We have used it twice in 20 years. We have done everything else through the public system.

 

GP visits are same day.  You must be referred to a specialist, and then like the UK you get an appointment card in the mail varying from 2 weeks to 6 months depending on what the GP says is the priority.  I have gotten in to a specialist sports doc and gotten an MRI in 2 weeks; whereas my DS as a toddler got an appointment 6 months delayed when I was concerned with his feet turning inward but the GP was not worried.  I asked him to write the letter anyway knowing there would be a delay.  We could have gone private, but I felt there was no need.

 

My DH had a day of fainting spells last year, and he went to the ER.  He was seen within 20 minutes when he fainted in the waiting room.  When he fainted again in the hall with leads on him, and it looked like his heart stopped for 18 seconds, he was rushed to the Cardiac ward to a private room.  He stayed for a full week, and had every single test under the sun including MRI, blood tests, ekgs, ct scans, etc and finally they implanted a monitor in his chest for 6 months.  Finally, they did a tilt table test and found that he has neurally mediated synchopy, which means he faints sometimes.  So no heart problems at all!!! yea!  All this was 'free'.   We never saw a single bill or any sort of financial statement.  I'm sure it was over 30K. 

 

I think that mental illness is not cared for well here, having experienced it with my downstairs neighbor.

 

Dental is covered for kids under 18 for free.  Adults pay as far as I know.

 

Taxes here are reasonable, If you earn under 70K and have two kids, you pay about 10%, top bracket is 33% but we don't have state, local, or school district tax.  Just one tax.

 

We vote for our health board -- the people who make the decisions how to allocate the money (so do we want to spend more on premie babies or more on knee replacement surgery?) Thus, I feel like I have a say in how the money is spent and where the waiting lists occur.

 

Ruth in NZ 

 

Is it difficult to immigrate to New Zealand???

[Laura Corin]

In US: We just had an urgent matter that required surgery... I had to drive three times long distance in a week (don't want to discuss details, but its fine in the end). The wait where we live was 3-4 weeks to see a GP/Internal Med. doctor... and forget the specialist, and great pain was involved. Sooooo drive (and drive and drive) far away.

 

My question would be, to Canada and UK: What about specialists? Can you go straight to one? Can you pick one that is well known in their specialty? Or are you "stuck" with whoever you might be sent to by the GP? Let's pretend its cancer... can you pick a medical center well known to treat what you have and with record of good outcomes? So I guess in summary, how much choice does the patient have in socialized medicine?

 

UK: in general, for something unusual, you will be referred to the place that specialises in what you have.  So my friend's son with juvenile arthritis went to Scotland's premier children's hospital, because that has the expertise.  For more 'ordinary' things like breast cancer, there will be various local centres.

 

In my area, I can choose to go to one of two major hospitals for treatment, assuming that they have that skill.  One is a big teaching hospital.  I think that out-of-area referrals would probably only happen for more complex cases.

 

No, you can't just go to a specialist - you need a referral from a GP.  That can be a pain, but on the other hand, having one doctor keeping an eye on the whole picture is very worthwhile.  If there is a particular specialist in your area that you want to see (or don't want to see) you can request that.

 

And you can always have insurance in addition to the NHS, or pay cash for private treatment.

[mumto2]

In our area we have a very specialized hospital that specializes in women's cancers. Cutting edge top of the line research facility. Experimental treatments found at very few hospitals around the world. Women in our area generally get sent there and are able to have a bulk of their treatment as an outpatient which is incredible. They do have apartment facilities on site via a charity for people who cannot commute easily. There are ways to move to the hospital with the best outcome via NHS. No idea how but know it is a choice and is apparently possible because I have heard that some people using the apartments are from quite a distance from friends who got to know these people during the course of their radiation and chemotherapy. Some stay at "our" hospital for the duration, others go home weekends. The free apartments have also been offered to friends who had a bit a a problem with the commute.

 

Very ill children frequently are sent to Ormund Street the Peter Pan charity hospital in London. The care from that staff and treatment of the families is incredible. Once again all free. My friend's daughter underwent many surgeries there for a whole combination of issues with a heart defect being primary. They were wonderful coordinating surgeries with many specialists each time. It was impressive.