Some True Stories of Free Government Medical Care in America
70PREFACE
These first hand observations are true and relate to those people who are eligible for free hospitalization and/or care through our government because of being veterans of our military forces...or being indigent.
This is not intended to frighten people.
Some people have no other choice because of finances and they must rely upon that care for their medical needs.
My personal experiences viewed first hand may or may not be representative of what is now occurring in government hospitals throughout the country. This includes VA hospitals and military hospitals as well as county general hospitals.
The only intent in writing this is to inform people that perhaps free government medical care may not always be the panacea that people seem to think it is.
Following are some examples illustrating this point.
Residencies in becoming a doctor
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FIRST CASE IN POINT
I started my career as an operating room nurse at Methodist Hospital in the middle of the Texas Medical Center in Houston, Texas back in 1969. Methodist Hospital was a private entity and was well known for its leadership in having world renowned doctors who were not only excellent but innovative.
Dr. DeBakey was performing not only open heart surgery, but heart transplants as an example when these procedures were relatively new to the medical scene.
It was a thrilling place to work and we were kept on our toes as surgical nurses.
Methodist was also a teaching hospital and most operations always had resident doctors assisting the privately employed surgeons. Naturally as time passed, the nurses and doctors would get to know one another and talk.
We learned from the residents that they appreciated the learning that they acquired by watching these premier teaching surgeons performing their tasks. The residents prime job was to hold retractors keeping the surgically incised wound open so that the operation could be performed more easily. Occasionally the resident surgeons would get to close (sew up) the skin wounds after the underlying tissues had first been sewn back together. This was all under the watchful eyes of the surgeon employed by the patient to have the surgery done.
What we learned from the residents was that they much preferred working at the VA Hospital and at Ben Taub Hospital (the county general hospital) for this reason... They actually got to perform the surgeries themselves on many occasions. They were not merely holding re-tractors and sewing up skin incisions.
Theoretically this was done under the supervision of superiors...and I will share just how helpful it was in my brother's case in a few moments.
For the few people who may not know...a resident doctor is an M.D. They have completed medical school. But to become a specialist they have varying lengths of time (years) in which they need to keep practicing and learning to be certified in their field. So residents are still in the learning stages of their profession. Obviously a third year resident would be more practiced and (hopefully) better than a first year resident.
This is like a mechanic who passes the written part of an exam but who has not yet worked on enough cars to put his book learning into good practice.
The patients in Ben Taub Hospital and at the VA hospital in Houston had these residents doing hands on surgeries. Great practice for the residents! Someone had to be under their scalpels for the first, second and third times...but the surgery patients in those hospitals probably never had an idea that they were their guinea pigs, so-to-speak.
All they knew was that Dr. X was performing their surgery.
After all, this was free medical care provided to them. It is not like they had a choice of doctors from which to choose to have their surgeries done.
We also learned from the residents that the equipment at the VA Hospital was not always what it should have been.
Example...when patients need hip replacements, careful measurements are taken and the correct sized implant is then put into place.
The resident surgeons told us that often they would have to punt and use what was available. If size B was actually needed, sometimes they had to settle for size A or C as an example.
I have no reason to doubt the validity of what they were telling us at the time. We heard this same story from too many of the resident surgeons.
VA hospital care
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SECOND CASE IN POINT
After taking an R.N. Specialist Course in Opthalmology I worked at Baylor College of Medicine in their Opthalmology Clinic for a while also scrubbing for the chief of staff once a week in the O.R. at Methodist Hospital.
They used to have regular times when opthalmologists from around the city would come in to observe and learn from these doctors at Baylor. They would present both common and usual cases (for teaching purposes) as well as the unusual cases.
I will never forget the day when a bunch of pajama clad men showed up from the VA Hospital. They were bussed over to Baylor and most of them were not even told the reason why they were there. They found out the reason on the spot as the morning progressed. Some of them had not even eaten breakfast!
If you know how uncomfortable it is when an eye doctor is shining a light through the dilated pupil of your eye...just imagine having 30 or more doctors taking their turn doing the same.
If they had been volunteers hoping to advance medical science, that would be one thing. But these patients from the VA Hospital were not informed or given a choice.
Enough said.
I was there that day and assisted with some of this. So this is a first hand experience!
Can you imagine multiple patients in private hospitals being rounded up for such a show?
Wouldn't happen!
Or IF it happened, they would have all agreed to it and been informed ahead of time as to what was going to happen and the reason for it.
IF the government takes over the total control of health care are we all going to be subject to things like this?
I really felt sorry for the men from the VA Hospital that day.
Texas Medical Center in Houston, Texas - My brother Jim while in Vietnam
Viet Nam Veterans
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THIRD CASE IN POINT
My brother had served two tours of duty in Viet Nam.
Sadly, after surviving Viet Nam, he was in a helicopter crash at Fort Hood where most of the men in the two helicopters that had collided in mid-air were killed. He was hospitalized for over 9 months before he ever got out of the hospital for a weekend overnight visit.
At first they gave him little chance of surviving, but for many years afterwards he did...although he needed much medical care and many more surgeries throughout the remaining years of his life.
He became a retired disabled veteran and was eligible for "free" government care.
Living in San Antonio at the time, Fort Sam Houston Hospital was where he received the majority of his medical treatment after the initial hospitalization at Fort Hood.
He had been complaining of ulcer symptoms for some time but was dismissed by the doctors who saw him because he was "not walking in to their examining rooms crumpled up clutching his stomach" from what he was told. "If you REALLY had an ulcer you couldn't be walking like you do."
One doctor FINALLY took him seriously enough to do some testing and oh by golly.......he not only had an ulcer but several huge ones that were found to have eaten through the stomach lining and was affecting his pancreas! These were stress ulcers caused by the trauma his body had suffered from the mid-air collision and falling 200 feet to the ground.
Naturally surgery was done.
My parents sat in the waiting room when one doctor after another kept coming out and explaining to other waiting relatives that mistakes had been made.
Then their turn arrived......
They were informed that the doctor performing my brother's surgery had mistakenly cut through the common bile duct and the pancreatic duct severing them!
A resident doctor had done this! Some slip of the scalpel!
At this point my parents were assured that the chief surgeon of the department was going to come in and correct this by doing the necessary surgery.
The repairs were done and it was ordered that my brother was to be NPO (nothing was to pass through his mouth to his stomach...not even a sip of water) for 30 days.
They were hoping that these reattached tubes would stay patent (open) and would be able to function.
At this point, I took leave from my O.R. job in Houston and headed over to San Antonio.
When my brother was back in his room in the ward, what was the very first thing that happened?
A big pitcher of ice water was delivered to his bedside.
Thank heavens we were there to tell them to take it away!
Naturally my brother was thirsty and would have taken some if he had been able, especially as he was still drowsy from the long protracted surgery that had been necessitated.
One of the patients in the same room had a urinary catheter. Urine had been spilled on the floor when the bag was being emptied one day and that same exact spot of dried urine remained intact day after day after day. The floor was not washed...or if it was...they seemed to miss that same obvious spot.
The public restroom on that floor never had soap for washing hands in it. Naturally we used it on occasion...so we know that for a fact.
There were good hearted souls working in that hospital but the stark difference in what I was viewing being used to Methodist Hospital in Houston (private) to seeing the things I was seeing at Fort Sam Houston Hospital (government) in San Antonio was appalling to say the least.
That was so many years ago now that all the tiny details have thankfully been forgotten.
Suffice it to say that when my brother got out of that predicament caused by the care at a government hospital and even though he would have been eligible for more "free" care the rest of his life, my parents told him to seek the private route for further treatments and if necessary, they would help him financially.
They had seen enough of what free government care was like!
Fort Sam in San Antonio, Texas - US health care reform
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CONCLUDING REMARKS
As I said at the start, this is not intended to do anything but share what I had learned and also personally saw with my own eyes when comparing a top notch private hospital with government ones.
It was also many years ago.
Hopefully things have greatly improved?
I would like to think so.
But with regard to the present discussion of improving health care reform, I would personally hate to see freedom of choice eliminated.
I would not want to think that the only choice I had was for so-called "free" government care.
Let me apologize in advance to (hopefully) all the wonderful government hospitals both military and civilian that exist that may not be representative of what my family experienced and what I saw when nursing years ago.
There are good doctors and bad, good nurses and bad, good people and bad. We all know that.
Those in private hospitals can be sued for malpractice but one cannot sue the government when receiving medical care.
Did that account for some of the sloppiness in cleanliness and attention to detail?
I cannot answer that question. I am just reporting what was experienced at the time.
So beware of what you are seeking in the case of medicine totally run by the government.
Me?
I'd like to see health care reform just like most folks.
We NEED it!
I have written some thoughts on the subject in other hubs.
But let's not just totally chuck the system we have.
Let's rather amend and fix what needs fixing so that people have good and affordable health care.
Let's not "throw out the baby with the bathwater".....an old saying that seems appropriate in this case.
On the lighter side...
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CommentsLoading...
Wow... wow... wow.... I have to wonder, since you can't sue a government medical facility if that truly is the reason for the lack of focus in the surroundings and in the care. I mean - I can't completely say they are all like that - some take a lot of pride in their work... but why do they always get a bad rap sheet? A question some will never be able to answer. I had surgery done by a military doctor... she screwed up. I can't necessarily say it was a mistake that could have been prevented because I have seen these mistakes happen in private care as well. The main difference - you can go after someone when you are given the choice but in the government side of things you can not.
This is such an eye opening hub. Thanks for sharing your insights and I hope that this allows others to really see what could happen if Healthcare was totally reformed!
And the debate still rages on with "Obamacare" as of November, 2011.
I agree Micky with your premise. The only thing I fear is that if the system is totally run by government employees and there is no recourse or recompense for egregious errors and malpractice...we might all be treated as in the true examples featured above.
I like the Mayo Clinic model (there are others as well) where the patient comes first and foremost. Doctors all combine their findings...the same test is not done over and over again, and the doctors are on salary. They do not make more money by ordering more tests. Their prime incentive for working there is to heal the sick...not just make money.
If there were more places like that, costs would be lower with the indigent still getting free care subsidized by the government...but hopefully much better care as the rest of the patients served there.
Look how well the government is handling other things...the post office comes to mind. Sometimes private entities can do things better and more efficiently.
If we could combine the best health care models out there and eliminate waste and fraud and still always treat people who cannot afford to pay...then we could have the best of both worlds.
Many things do need fixing but we need not chuck an entire system and hand it over to the government for fixing. I know how highly you esteem our politicians! You really want them overseeing the entire health care system?
There has GOT to be a happy medium somewhere! I pray we find it soon. Thanks for the comment.
It's a long way down here Peggy! Thank you for creating this hub. Health care has to be provided for everyone. That's the way God would have it. Jesus healed the sick, gave sight to the blind, and raised the dead. He didn't charge a cent. It's about the Golden Rule and The Golden Rule trumps all other rules. We can't do shoddy work on a car or a bicycle. We cannot do shoddy work on humans. We are commanded to lift our people up and that's the only bottom line we need to adhere to - in any situation. God bless you Peggy.
Hi Opinion Duck,
Wonder if they are still giving tobacco growers subsidies? Wouldn't be surprised! At least more and more cities and towns are banning smoking inside of buildings making for healthier environments for everyone. 2nd hand smoke is also bad.
I watched a lot of CSPAN early this A.M. and it would seem that because of the new health care bill that passed, many teaching hospitals in major cities (where the majority of doctors are trained) will be running into major funding problems. Who will be there to take care of all the Medicare patients as well as others added to the mix? Doesn't look good from this vantage point...at least not yet! Nothing like passing a bill and then crossing your fingers to hope it works. Ugh!
Peggy W
That would be an exciting concept.
It is interesting that the government is fighting to REMOVE transfats from our restaurants, but after 46 years they just continue to label cigarettes with just a warning.
If they won't take tobacco off the market at least earmark some of its high taxation to a medical fund to treat the medical health effects for those long time smokers. Sort of a medical insurance for smokers to offset their medical costs from those people that don't smoke.
just a thought.
Thanks for the mail..
Hello OpinionDuck,
Hopefully some newly elected Congressional members can perform some much needed CPR!
I think that the baby drowned in the bath water.
Hi Granny's House,
It is so sad that these things are being crammed down our throats by a partisan Congress. Many of "WE THE PEOPLE" are screaming but they shut their ears and ignore us. The checks and balances in our democratic system are currently out of whack. Hopefully the November elections will change that. It is good to have healthy debates and things decided upon on the floor of Congress......not behind closed doors which is currently happening often now.
Those in power keep citing the CBO statistics ( Congressional Budget Office ) as proving that the current health care bill will save money in the long run. But the CBO can only factor in things that they are given to consider. Too much was left out and there are others who claim that this current bill will further bankrupt our system.
Why is it that ALL of our social systems and many government run systems are slated to be or are already running red ink? That includes Social Security, Medicare, Medicaid and even the Post Office. Now we are going to add even more to that burden.
Sorry.....getting away from the point of this hub. They say that people will still have the choice of public or private medical insurance policies. But with many of the rules in place...employers will start dropping insurance for their employees and people will be FORCED into the public system.
Reading this hub, you already know the flaws of the public hospitals ( apologies to any good ones offering excellent care! ).
I had not heard about people moving to France to get better medical care to answer that question.
Sorry about your experience as a child. Thankfully your parents had the where-with-all to move you to a better facility.
Afraid that we are marching down the wrong path although we COULD HAVE achieved medical reforms that made more sense and still offered more options without taking over 1/6th of our total economy in one felt swoop.
Thanks for taking the time to write about your experiences.
Peggy, I think you have done a good job brining these issues to our attention.
I have spent over an hour on this hub.I was almost in tears. I am 52 and it is scary to think that when I am older I may not get the same health care I did when younger.
You need it more when you get older.
What happened to WE THE PEOPLE? Shouldn't we (Americans) decide on the health care plan WE want?
I saw a program on tv. I don't remember which one, but it was about Americans leaving the USA to move to Paris because of the great health care there.They even have doctors that make house calls. Have you heard anything about this?
Also, I have a good friend that is a nurse and the horror stories she has told me about patient care is awful!
I was run over by a car at age 4. My dad was in the military, so I was at a military hospital. I was in a body cast and in traction, my mom said she would come in the mornings and my food would still be sitting on the table next to my bed. How was I suppose to feed myself! She also said I was covered with bed sores. She took me out of there and placed me in another hospital.
Someone needs to be held accountable!
God help us.
Hi Bob,
Glad to hear that your friend made it despite the mistake in surgery.
I truly hope that our healthcare industry is reformed without drastic cuts in service which will probably unfold if present proposals are instituted as law. There would seem to be no other way to fund the present proposals WITHOUT limiting service.
Thanks for your comment.
Hi Peggy, the cutting through the bile duct etc. in example 3, seen it happen also. A good friend of mine put me down as the person who gave the final say if something went wrong in a simple surgery, it did! The idiot slipped with the knife and cut her bile duct and more. It was so bad they came out to tell me they had to do more and she may not make it. Just great, I guess you get what you pay for don't you? She made it but went through several months of coma and hell.
Bob
Hi Hmrjmr1,
Thanks for joining this discussion. Many people want "free" healthcare but there is no such thing. There are costs and either everyone is going to pay more...or we will receive less...pure and simple logic tells us that.
I totally agree with you that we need to put politics aside and tackle this as Americans keeping the best of what we have and improving the rest. We can do this!
Hopefully they will institute no pre-existing conditions; open competition across state lines; institute more tort reform and get all the entities on board like you suggested in figuring out a fair and equitable way to have true reform within our medical delivery system.
Thanks for your comment.
Peggy W - Great Discussion, What is left out of much of the NHS discussion is that the British Government just raised the top tax rate to 51% and 35-40% Tax rates are not unusual. My late wife was English and would never knock the NHS to outsiders, and her experiences with it ended in the early 80's when she met me. Where she wandered into the world of CHAMPUS and then TRICARE. These are the Government funded insurance programs for Active Duty Family Members and Retirees. These are insurance programs from the underworld that were part of my inspiration to call her the Warrior Princess as she had to fight coverage, and claims battles with these guys all the time. There are deductibles and co-pays like any other insurance (so much for Free Health Care for life for Veterans) Veterans only receive health care from the VA if they have a Service Connected Disability. There are many many misconceptions bout the Gov Options that are already on the books. I still think this can be thought out better, explained better, and be done in a uniquely American Way with profitable Insurance Companies,Medical Personnel, hospitals, drug companies, and health care services delivered on time and under budget.
That's American, That's what Republicans, Democrats, and Independents should be standing up for and making sure that's what we get..
Just read this article from the Detroit Free Press regarding Canadians coming to the U.S. for medical treatment. Thought that some of you might want to read it for yourselves.
Hi Misha,
In a few cases some of the hubbers have lived in both places and can offer views from their own lived experiences. As to others.....it does seem that the world is watching what we do with great interest. Thanks for the comment.
What puzzles me enormously in this current healthcare debate on hubpages is why people from countries with government run health care like Britain and Canada are so insistent on USA accepting their model? It obviously goes way beyond simple experience sharing...
Hello Delano9,
I'm not exactly sure what you mean by the following:
"O, most republicans, if not all, dont want a nationalised health care why should they as they get free medical paid for by the american peoples taxes as do the vets, prison inmates and the iraqi people. We pay for their medical treatment and it is in no way sub standard."
There IS NO free government care with the exception of what the government spends on care for our veterans, prisoners, Medicare and Medicaid. They may also be helping people in Iraq who have been injured in the war, but certainly not all the people in Iraq. And those costs are borne by everyone who pays taxes.
As a matter of fact, the government DOES NOT reimburse doctors or hospitals enough to fully pay for those services rendered by Medicare or Medicaid. It is made up by people who pay for private insurance policies.
Medicare and Medicaid are having problems staying fully funded. Private insurance carriers are making money.
So as to Republicans not wanting medical reform because they have "free care" this is simply not true.
Your latter point of people becoming bankrupt due to high medical bills is valid. And this is terrible. This is why we DO NEED MEDICAL REFORM in this country.
Even President Obama is already stating that a public option may not be in this reform package.
A good point was made on one of the morning talk shows.
If insurance policies could be purchased anywhere in America (not just in the state where a person resides) competition would bring costs down for everyone.
The example was given something like this...
Does it make sense that if you live in Illinois you can ONLY buy a car made in Illinois? You can only buy health insurance in Illinois if you live there right now...not across the border in Wisconsin. Why not correct this???
If the numbers of people wanting to buy health insurance is larger, the costs will be able to be less for everyone as the risk pool will be larger. The larger group of healthy people will be helping to pay for those that are sick and needing treatments.
A fellow hubpage blogger just wrote a hub regarding Medicare not wanting to pay for a needed eye operation procedure. That is our government health care provider denying coverage! Private insurance would probably have paid for this procedure ordered by the opthalmologist surgeon who stated that he could lose his vision without the treatment.
Do we really want government employees telling the surgeons that they cannot do a procedure that will save a person's vision?
Thanks for your comment.
O, most republicans, if not all, dont want a nationalised health care why should they as they get free medical paid for by the american peoples taxes as do the vets, prison inmates and the iraqi people. We pay for their medical treatment and it is in no way sub standard. Also the only way you can get a decent national health service in the usa is to abolish all insurence companys but seeing as most republican senators, and some democrats, are in the pockets of these innsurance companies i doubt this will happen. Hopefully no one will have to feel the pain and suffering when a profit organisation dedicated to making money more than the health and well being of their customers deny a claim for a serious health issue over some mediocre technicality,and that persons family have to lose their home, car and life savings because of the great us health care system.......oops it already has happened........alot.
Hello donotfear,
So sorry to hear about your daughter and grandson's treatment with regard to Medicaid. When one has a choice of doctors like most private insured people do, then continuity for both the doctor and patient is more readily achieved. And it makes for better results overall also when they get to know one another.
In the case of residents learning and practicing, that could possibly account for some of the more rapid turnover in being able to see the same practitioner each time with Medicaid. Are you even able to request the same doctor for repeat visits?
Good luck to your daughter completing her schooling soon and on to a better life.
Thanks for your comment. All these comments combined are painting a more complete picture for everyone to understand what we have and where we need to go to achieve the best medical care for everyone involved in this process.
Hi Tom,
Your brother's story is terrible until you guys were there to intervene for him. As I said a long time ago further up in this hub...there are good doctors, nurses and hospital personnel who really care and others who are just there to put in their time and get a paycheck. Sad, but true.
Everyone needs an advocate to be by one's side in order to get the best care whether in a hospital, rehab place or nursing home. Even doctor's offices in the case of getting significant news. Often people only remember a fraction of what they have been told. Good to have another person there to hear all that was said.
People in nursing homes who have regular visitors generally get better care than those who do not. Just a fact of life. The sad thing is that many institutions are understaffed and family members who regularly visit can be the spokesperson for the patient if needed and do the little things to make the patient's life more comfortable.
Some cultures do this automatically...surround the ill person with friends and relatives until they are better.
When my Dad was in the hospital years ago I taught him to question what pills he was being offered...what name of the pill and why it was being given.
I happened to be in the room one day when his roommate was being offered that little cup of pills. My Dad had passed the word on to him to do the same. The roommate asked about the pills and the answer was..."This is for your heart." His response......"I don't have heart problems!" And he didn't!
One has to be an informed patient (if possible) and have advocates by your side (relatives or friends) to make sure one gets the best care possible.
Am sure that this is the best advice no matter where one lives or what type of health care system one has available.
Happy for you that your brother got the good care he needed and all ended well.
Sad thing is that we cannot legislate morality.
Thanks for the comment.
This reminds me of the care my daughter has been given. Being on Texas Medicaid hasn't been easy for her. She never sees the same doctor, never knows who is going to be treating her, and is often brushed off by personnel "oh, here's another white trash addict wanting pain meds..." not so much saying it in words, but in attitude and body language. When my daughter was on Blue Cross Blue Shield, she reports she was NEVER treated this way at the private clinic. She said, "Mom, you wouldn't believe the difference in how I'm treated with this freakin' Medicaid...they acted totally different when I flashed my BC/BS card". It's almost the same for my little 3 year old grandson. As an infant, he NEVER saw the same doctor twice. He had a recurring 'spitting up' problem. So everytime he went to the doctor for this problem, they changed his formula. He had his formula changed about 6 times in 6 months when he was finally diagnosed with silen aspiration and sent to Arkansas Children's Hospital later on.(a wonderful place). Of course, that's AFTER an emergency room doctor found a hernia on him at 2 months! Then it took them 7-10 days to get in to a doctor, then passed on to another. Then finally to Arkansas Children's. But thank God! The people at Arkansas Children's Hospital were wonderful and treated us very decently. I only know that my daughter HATES the Medicaid system but must stay on it for now until she can finish school. That's my story.
My brother was in a life threatening car accident. His leg was broken multiple times, he had broken ribs, internal bleeding and head lacerations. He was in the military. He fought 3 terms in two wars. We rushed to go see him. It took us 12 hours to get there. He was housed in a dirty tin building. Boxes of rat poison were around his bed. He was still covered in blood and gasoline. It was obvious...they were letting him die.
My older sister tracked down a Colonel and chewed his ass from head to toe. My brother was in a real hospital within 30 minutes. They flew him by chopper. They flew in a surgeon from Washington. My brother lived. This happened in the mid 1970s. My sister had threatened to call the President, the National News services and anyone who would listen. My point here is....in any situation...you have to stand up for yourself or have someone who can. I have heard just as many wonderful stories of healing as I have nightmares. I don't really give a damn who or how someone fixes the system....as long as the patient is the priority...then and only then it will be right. How can anyone see someone suffer and think about money? Maybe that is the core of the problem?
Hello Dog Training,
Thank you for your comment.
Mardi,
Thank you so very much for joining in and saying what you have experienced in Canada as well as the United States. We can all continue to learn from one another if we are open to true learning and are not so solidified with our ideas that we will not listen to others.
I truly think that we can get some of the glaring things wrong with our system fixed and keep some of what is good.
Again...thanks for weighing in on this subject.
Really grateful to you for sharing this all. Keep it up the good work as you always do.
Hello Peggy,
I appreciate your hub and your experiences, as well as the various comments posted in response. As someone who did grow up in Canada and now lives in the USA I have a slightly different opinion. I have seen and experienced both systems, although not anything as serious as others and yourself have discussed. Both my parents were treated extensively with cancer issues in Alberta and Manitoba, and I couldn't have asked for a more effective and supportive system.
As a client advocate in Texas I constantly saw women who needed health care that didn't have money and didn't seek treatment as they couldn't afford it. I also personally worked with people that could afford reasonable coverage but were turned down because of a "pre-existing condition". I find this disturbing and horrific as early treatment can often prevent much more significant issues.
Yes, there are issues with all systems, that I think we can all agree. However, the misinformation I hear every day is perhaps the most disturbing of all. In Canada you can select your own doctor, hospital and treatment, elderly patients get the same care as the young, and there are no "death panels" . Typically the wait for most procedures is the same to slightly longer than in the US, however emergencies and life threatening situations are prioritized, not everyone waits in the same line. I never waited more than a day or two to see my physician, which is about the same length of time to get in to see someone here.
I am not a political person, nor am I trying to say what Americans should do. I just think people should do the research and not accept what is being said about the health care in other countries without doing honest research first.
Thanks for your calm and insightful discussion of this very heated subject.
Hello Aya,
Thanks for your comment. Hopefully we will get some good results from all of this discussion on reforming our medical care in the U.S.
Peggy W, thanks for writing this hub and sharing your valuable experiences.
Dear Plants and Oils,
Thank you for all of your input into this discussion. I appreciate it!
I agree, shouting doesn't help anyone. It generates heat, not light. And your fantastic hub has generated a very civilised discussion, it seems to me.
People not wanting the NHS in America - all power to their elbow. Their opinion. But people telling blatant lies about it isn't right.
Hi Plants and Oils,
In reading the article it seems the discussion of U.S. medical care is heated on both sides of the ocean.
I watched Senator Grassley in a town hall meeting today in Iowa and I watched President Obama in a town hall meeting in Wyoming...all on television. Both got very good questions from the audience.
From the UK article it seems most people think it is the Republicans who are all against the health care reform. What you must know is that the Democrats control both houses and many Democrats are also questioning things. By sheer numbers they could over-ride any Republican opposition. There are Republicans and Democrats who are both for and against these health care reforms.
In most cases it is pieces of the proposed legislation that they are opposed to. Unfortunately with a massive bill of over 1,000 pages, it would be very difficult to like everything in a bill. (I actually wrote a hub regarding that...wishing they would simplify the bills. I think that more things could actually be achieved that way.)
The main thing to remember is that all of the proposed bills have to be assembled into one bill before it can hit the President's desk to be signed or vetoed.
I think that progress is being made to eliminate any pre-existing medical conditions that would preclude one from being able to purchase a health insurance policy. Both sides are for this. Senator Grassley explained that on the basis of discrimination they will probably achieve getting that passed. Yea! One down!
This debate is raging in town hall meetings, on television, in the media...as you know...and will continue to do so for awhile.
As things get talked out and more things become clarified, hopefully a reasonable consensus will happen. We do not need all the yelling and shouting that some folks are doing. Just muddies the waters and achieves nothing but ill will.
Thank you for inserting this article into this hub. Feel free to do it anytime. Adds to people being able to weigh the facts or at least differing opinions on how health care should be delivered.
Hi again Plants and Oils,
I appreciate you looking up those statistics. 5 to 10% of people having private insurance is a small number.
Plus...according to Amanda, many people just choose to pay cash for procedures if they want to go the private route without insurance.
Would SURE love to see that Dept. of Health press release regarding the (non) rationing of care in England. If you can find it or find a link to it, feel free to publish it in a comment here.
Thanks again!
Hi Amanda,
Thanks for clarifying this issue. Perhaps your costs for things like surgery, etc. are not as high as they are over here, so people can pay their doctors directly and with payments over time, if needed.
I appreciate your answers!
"But for the rest (probably the majority?) you have a system that handles the rest."
The vast majority. I did a poke around, and it appears about 5 to 10% of people in the UK have private health insurance, including ex pats living here.
"The one thing that is still not clear to me is the effect of any RATIONING OF CARE. We hear it all the time over here that if we were to go to a system like yours, the effect would be that we would no longer be able to receive treatments, surgeries, procedures for some things beyond a certain age."
A lot of that is, frankly, people lying to you. The heart-care-past-60 thing, or brain tumour issue, both aren't true. In fact, the Department of Health was so annoyed about it that it's put out a press release.
Age is taken into account, of course it is. As part of an overall clinical picture. Age can make people too frail to cope with certain operations, for example. But another person of the same age could be much fitter, and able to benefit from surgery.
The only age limits I can think of are free braces (except for accidents etc later in life) which stop at 18, and age limits on IVF (fertility) treatment.
Hi Plants and Oils,
Negligence or malpractice...malpractice sounds worse, but both can harm people. It is good to have some sort of remedy in place to punish those that end up hurting people. We just need to get some caps in place so that outrageous sums of money are not awarded which are helping to cause our increased medical costs over here.
A few states have put some restrictions in place, but the majority have not. I think the cap (I believe it is in Texas) is $250,000 for pain and suffering. Of course that is only one aspect of what people could list in their lawsuits. Still a large amount.
I still remember a lawsuit against McDonalds where a woman spilled hot coffee on herself...sued...and was awarded over a million dollars. Crazy!
We DEFINITELY NEED TORT REFORM...and not ONLY for medical cases. But since that is the subject right now, it would be a good place to start.
It sounds to me like those who can afford it in England can always move to the front of the line IF want to pay for the private care.
But for the rest (probably the majority?) you have a system that handles the rest.
The major exception in the care that you get verses us over here (from what I am learning) is the wait times for things like elective surgeries.
But preventative care would all be covered if I am getting this correct. Any wait times for those appointments?
FREE PREVENTATIVE CARE would be a welcome addition over here and one that makes really good sense. Would catch any problems early and in many cases preclude more expensive treatments later down the road. That is one proposal before Congress right now. It would force insurance policies to include that in what they pay out to providers.
The one thing that is still not clear to me is the effect of any RATIONING OF CARE. We hear it all the time over here that if we were to go to a system like yours, the effect would be that we would no longer be able to receive treatments, surgeries, procedures for some things beyond a certain age.
Understandably that scares many people because right now we have open availability to any kind of care we want or need. Age is not the defining consideration...unless a procedure would be too risky to perform due to other complications in which it might actually harm the patient.
There ARE people falling through the cracks over here due to things like PRE-EXISTING CONDITIONS. That is also being addressed in the bill before Congress and (hopefully) will be outlawed.
Job losses are also creating problems. There is COBRA insurance that people can pay for which keeps insurance coverage intact between jobs for a length of time.....but, if the people are not making enough money and cannot pay for it...what good does that do?
I guess one can always ferret out the problems in one system or another and as one person already commented, there is no "perfect system."
But we will continue to try and effect the best outcome with lowered costs and good medical care as we slosh through this process.
Thanks as always for your comments.
Yes, it is possible to pay for a one off course of treatment privately in the UK. Private health insurance might help to spread the cost if you have it, but it's perfectly okay to use cash or a credit card and book yourself in without paying month in, month out for a service you may never require.
I don't know what the arrangements are between the NHS and doctors about private working hours and schedules, sorry.
As far as costs of private healthcare and insurance are concerned, they are entirely unregulated, as I understand it.
As for what percentage of people have it? I don't know, sorry. Self-employed people may be more likely to take out their own policies, I don't know.
As far as companies go, BUPA is the biggest one, I think, but there are lots of others.
It's possible to sue, yes. For clinical negligence, rather than for malpractice. The test is whether the standard of care fell significantly below that expected of a doctor.
Hi Amanda,
You as well as Plants and Oils are certainly helping to clarify how your system of medical care works in England. Thank you!
Good to know that stents are placed in people over the age of 69. With people living so much longer these days, that is a fairly simple operation that can certainly add to the quality of life ahead and preclude major complications like full blown heart attacks or strokes. Is there any age limit from what you know?
Now I understand about that BUPA insurance. From what you say select key people from large companies get it for free. Others have to purchase it. Is it the only type of health insurance policy available for private purchase or does BUPA have other competitors?
Also, you said that you would rather choose to pay "selectively." Does that mean with cash instead of an insurance policy?
Sounds like your Mom was moved to the front of the line because of her injury. Glad that it worked out well for her and all of you although it must have been scary at the time and painful for her.
We don't have wait lists over here which is one good thing about our system.
The only time elective surgery would be pushed off to a later date would be in the case of true emergencies taking precedence. Generally speaking it would not be so many at one time to push elective surgeries back more than a few hours...or perhaps a day or two if a small hospital was inundated with a major disaster where many people required treatment at the same time.
Thanks for checking back on this discussion and leaving your comment. Everyone can learn from what you say. Looking forward to your answers.
Hi Peggy, I just caught up with the comments thread again, and I can see that you have been having a good dialogue with Plants and Oils. I note that the link you posted earlier, asserted that the NHS does not allow cardiac patients over 59 to have stents. Purely by co-incedence, the father of a friend of mine is in hospital having that operation this week. I don't know his exact age, but he is certainly in his 70s.
Plants and Oils mentioned BUPA earlier, and whilst I personally have no figures for this scheme, the majority of people I know with this kind of cover receive it through their employers as an employee benefit. Only fairly large companies would typically offer this, and then often only to key staff. You can take this cover out privately, but from a personal viewpoint, I would prefer to pay selectively. For instance, some years ago, my Mum needed a hip replacement operation and at the time there was a reasonably long waiting list (I understand it's shorter these days) and we enquired about having the operation done at a private hospital to speed things up. The operation was readily available at a one off fee, and she did not require private health insurance. In the event, Mum had a bad fall around this time and fractured the problem hip. A replacement hip was automatically given, and she ended up skipping the waiting list and not requiring any private care, which certainly made the best of a bad situation!
Hi Plants and Oils,
Thank you very much for your continued responses to this hub in enlightening those of us in America as to your medical system in England.
Apparently the rich people in most countries will always have expanded options over the poor. Nothing new there.
Do most of the people with middle or upper incomes in England carry that extra insurance for medical needs (optional care)? If you had to guess a percentage...what would be your best estimate of people carrying private insurance?
From what you say, all the doctors work most of the time for the general public but then for themselves (for private patients who pay them more) a day a week or so. Is it mandated by the government just how often they can work for themselves? And next question...do most of them take private patients to earn extra money? Are the prices also mandated by the government as to what they can charge private patients or is it what the market will bear?
What about medical lawsuits in your country? Can people sue for malpractice or is it not allowed?
Mind you...I think that it is totally out of control over here with all the frivolous lawsuits and the uncapped...for the most part...awards which are adding to overall medical costs. That needs changing. BUT...there should be some sort of punitive damages for bad doctoring if it is proven to be flagrant malpractice.
How does your country handle that aspect?
Over here there are peer reviews in private hospitals (I do not know about government or military hospitals.) If too much healthy tissue is removed...as an example...when surgeons do their jobs, they could lose the privilege of working at that hospital.
I am going to write to all of my congressmen today about my idea of a catastrophic health insurance policy offered by the government at the federal level to kick in when normal insurance is exhausted because of pre-set caps. Similar to our national policy of flood insurance. Would spread the risk all across America and the relatively few people who would need it...it could keep them from ever having to declare bankruptcy due to medical needs and the bills.
Personally I think that is about the greatest need to help reform medical care in the U.S. It is a disgrace that anyone ever has to declare bankruptcy due to being ill.
Combine that with bringing down the costs which is absolutely attainable if minds are put towards that effort and we will have an improved system for almost everyone.
Our government subsidizes so many things including medical care for those that cannot pay, housing, food, flood insurance...why not catastrophic health coverage?
I realize that most of my responses are geared towards those of us in the U.S., but I continue to thank you for your comments as to your system in England.
You are helping this discussion immensely. Thank you Plants and Oils!
The NHS covers pretty much most things. Plastic and cosmetic surgery is, I reckon, the main area where people go private.
But you can go private for most things - not Casualty Departments or ambulances, there is only one system for that (the NHS system). You can either pay for treatment as you have it, on an appointment-by-treatment basis, or have health insurance. If you have health insurance, they have a booklet telling you what they do and don't cover, and the main insurer certainly (called BUPA) doesn't have the "co-paying" thing that I've seen mentioned in American policies.
Most private doctors you see are also NHS doctors, who have a private practice on the side for a day a week or a day a fortnight.
Salaries vary immensely with experience and grade, for medical staff.
Hello Hxprof,
Obviously I agree with what you said. I think that we could go a long way in cutting costs with tort reform (which is not even currently IN the proposed medical reform bills.....amazing!) and also opening the states to open competition between the insurance companies.
That Maryland Senator in the town hall meeting was asked a direct question (when I was viewing it last night on CSpan) something to this effect:
What SPECIFICALLY has the government EVER taken over where costs have come down? His answer...and I kid you not...was the National Park Service.
He then added that he thought Medicare also fit that description which was not an accurate answer. It was not "taken over" but created and we KNOW the financial mess that is in at the moment.
If there are enough teachers to man the expansion of medical schools that would be a good idea. Of course...if payments to doctors keep getting cut I wonder how many people will still want to enter that field?
Your first sentence said it all...There is no perfect system. Hard to disagree.
Our good friends in Canada, England, Germany and elsewhere have some very good aspects to what they enjoy...but so do we.
My hope is to keep learning (from everyone and everywhere) and take what we have and make it even better.
I would much rather our government spend billions and offer a catastrophic health care policy that people could purchase (to avoid future bankruptcies) instead of paying similar dollars for "cash for clunkers."
That way...just like with FEDERAL FLOOD INSURANCE...if the worst case scenario happens in the case of ill health, people would not have to lose everything.
This would not have to compete with private insurance companies just like the Flood Insurance does not compete with homeowners insurance now.
What do you think?
Thanks for your comment.
Hello again Plants and Oils,
So from what you are saying, in England you generally get your free medical care that is allowed but if you want extras you can purchase it in addition to what is free. Do you have extra insurance for that or do you just pay cash?
How often would you say people pay for the extras not allowed by the government system? And is it only for plastic surgery or do you have the option of getting other things done?
Can the best doctors over there (the most experienced with the best of credentials) ask more for their services? Or are they all paid exactly the same whether they are new and just out of school or practiced and really skilled?
There is no such thing as a perfect healthcare system-universal or private. What needs to be done in the US is anything that will leave the current system in place while reducing costs. Tort reform is an absolute necessity. Getting the 50 states to agree on mandates is another necessity. The mandates make insurance companies work harder, confuse the process of resolving/paying claims and thus make insurance more expensive. The government needs to trim back regulations, not increase them. Many drugs that were prescription only years ago are now available over the counter. Releasing more drugs for over the counter use would cut costs of medications. Medical schools may have to be forced to increase enrollment; currently medical schools help to maintain a small doctor to patient ratio that increases medical costs.
Bottom line-find ways to make the system work better and leave things as they are: Private.
I'm sorry, I mislead you with "IVF". I'm not a doctor / nurse, and I'd not come across the acronym meaning feeding. It means "in-vitro fertilisation" here in the UK.
There is a limit to the number of free NHS cycles, perhaps 3, I think? And they don't go up to any age.
NHS trusts aren't insurance-related, because NHS treatment's free. They are geographical institutions, and run health-care services in a certain area. But that doesn't mean only those trust's hospitals are open to someone - there are hospitals such as Great Ormand Street Hospital for Sick Children which are country-wide centres of excellence.
As for private treatment, there is an unrestricted private medical system here which runs parallel to the NHS. So if I wanted a face-lift or breast enlargment (neither of which I do want!) then I could get it easily by paying for it.
Hi Plants and Oils,
These were your words:
There are age limits for IVF on the NHS too, but they aren't NHS-wide, but set by each trust.
That is why I got the idea that you had age limits for IV feedings. My mistake if I misunderstood.
As to "lots of people have almost no access to proper care at all" in the USA...the statistics do not prove that. Right now (of course due to the economy more people are suffering temporary glitches in their ordinary coverage because of job losses) but that is not the norm.
That "47 million" number they keep talking about without coverage is inflated. A big number of those are people from other countries...here legally on work or study passes...and the illegal immigrants. And some of that number are young people who have ELECTED not to sign up for coverage. This leaves a small fraction of that number who are the true chronically non-insured.
I certainly have no argument about the use of cosmetic surgery being paid for on the basis of what you described. Am sure it would be the same here if we go to a full government system. Those that do it for vanity reasons could probably find doctors somewhere to do it for extra money.
Your NHS Trust sounds a bit like what most of our private insurance companies have already implemented. Unless one pays a much higher premium, one must go to a selected group of doctors or hospitals for the insurance to pay a higher percentage of the cost. If one goes outside the recommended group than the insurance pays less of a percentage of costs. So it is STILL up to the individual to choose. In the case of absolute emergencies...ER care does not apply. Once stabilized, the patient could always be moved to a hospital within the approved list.
This is interesting! I am learning more about your medical system through your responses. Please feel free to correct any misunderstandings I may have from what I say. This is most helpful in learning the truth.
I have read some of LondonGirl's hubs about medical care in England and she is also very satisfied.
The sad fact of the matter is that generally speaking people are healthier when young and need more medical care when older. And our government seems to be cutting the monetary reimbursement (via Medicare cuts) for our older segment of the population. Not a good taste in the mouth as to what may be coming...
"Age limits for Intravenous feedings? Sometimes that could be the difference between life and death."
I'm sure not - it would be on clinical need, not age.
You have rationing in every health care system in the world. In the USA under the current system, though, it's rationed so that lots of people have almost no access to proper care at all.
Cosmetic surgery on the NHS is limited to fairly extreme or repair work, for example. So the NHS does breast reduction surgery if heavy breasts are putting a strain on someone's back, or plastic surgery / braces after fire / accident etc, or breast implants after cancer or other surgery. But you can't just have a face lift or breast enlargement on the NHS because you want to.
An NHS trust runs a hospital or small group of hospitals. But you aren't restricted, I think - I know when I've been pregnant I've always had a choice of whichever hospital I wanted to go to.
Hi Plants and Oils,
Most private insurance companies over here also only pay for braces for children...UNLESS one needs corrective surgery like after an accident where braces would be part of the treatment.
Age limits for Intravenous feedings? Sometimes that could be the difference between life and death.
Is each trust like our different states which regulate insurance practices in each state?
I watched a very volatile town hall meeting last night (it was taped) on CSpan in Maryland where a Maryland Senator was trying to explain the new proposed health care plan (although he admitted that nothing is yet set and finalized.)
When I say volatile I really mean that many folks were ANGRY and vocal about it.
Some very GOOD proposals are in all of the House bills at the moment. For instance...
NO PRE-EXISTING CONDITIONS
PORTABILITY OF INSURANCE FOR PEOPLE CHANGING JOBS
FREE PREVENTATIVE DIAGNOSTIC TESTING...things like colonoscopies and mammograms, etc. which could save costs in the long run by catching and treating things early.
But here is NOT what is yet proposed...
NO TORT REFORM!
NO ALLOWING PEOPLE TO BUY INSURANCE FROM OTHER STATES
(There was a man in the audience that literally had to move from Maryland to an adjoining state just so that he could have health insurance! He is self-employed and his monthly bill would have been something like $2500 in Maryland. Just over the state line he now pays something like $700 a month. That is quite a difference!)
The Senator responded to him and said that it is up to the states to regulate the insurance availability to their people...not the federal government.
This does not make sense! If the federal government is going to set all kind of rules forcing private insurance companies to comply...why not something like this that could drastically bring down costs?
And why no tort reform? If lawyers could not sue and win gigantic awards regarding medical mistakes, this would also bring down costs.
The Senator said last night that Medicare payments to doctors, etc. are being reduced by 30%. ALREADY many doctors are no longer taking new Medicare patients! This (unfortunately) is a government program and is causing some doctors to quit practicing. How many new doctors are going to enter that practice if the government sets the pay scale lower and lower? They will simply decide to do other things.
The link that I inserted above regarding the Atlanta Opthalmologist is (I am afraid) correct in that there will be fewer and fewer specialists. Why should they spend that many more years studying at great cost and effort to become specialists if they will get no more reimbursement for what they do than a M.D. fresh out of medical school with no specialty and little experience?
The Senator also said last night that ILLEGAL IMMIGRANTS WILL NOT RECEIVE FREE MEDICAL CARE. All I know is that if ANYONE shows up at an emergency room today needing help, they get that help. Perhaps for the sniffles ID's would be checked and illegal immigrants might be turned away? But if they are profusely bleeding or not breathing...they will continue to be treated. So I do not think that statement was exactly accurate.
Wish you could have heard this town hall meeting! Lots of good questions and not enough answers yet to please most of the assembled crowd.
PAYING FOR THIS is still a big problem! Apparently the only way to pay for it is to reduce what they are already doing (like the 30% cut in Medicare ALREADY on the books.) THAT IS RATIONING. No other way to look at it.
Maybe (hopefully) they will go back and get some things into this bill that do make sense like tort reform and opening up insurance across state lines. IF there IS a government option...obviously that will be across state lines? Or will that also be more expensive in one state and cheaper in the adjoining state? Makes no sense.
I appreciate your feedback.
For some things. Free braces and so forth for teeth are mostly for under 18s. There are age limits for IVF on the NHS too, but they aren't NHS-wide, but set by each trust.
Hi Plants and Oils,
I did Google this doctor's name and apparently he is legit and has a great reputation. I do not know where he is getting his information.
What is the truth in England? Is anyone past a certain age not given the same treatment as younger folks? In other words is there any kind of rationing over there when it comes to medical care?
I think it's ill-informed. It says, "People in England over 59 cannot receive stents for their coronary arteries. The government wants to mimic the British plan."
That is untrue.
Hi everyone,
Since I had specialized as an RN Specialist in Opthalmology years ago, I thought that this report from an Atlanta Opthalmologist (apparently one of the best in the country) might be of interest to you regarding free government medical care.
http://www.examiner.com/x-6571-Atlanta-Political-B
Let me know what you think.
Hi Mighty Mom,
I agree that we owe a debt of gratitude and the best medical care including other benefits as well to our returning brave soldiers.
The costs of the proposed health care bill currently in Congress is a BIG FACTOR. No argument. Probably also the biggest stumbling block.
Unfortunately health care delivery and health care costs are intertwined and related.
We need to chip away at what can be done to effectively bring down costs so that no one ever again has to declare bankruptcy for sustaining unpayable medical bills. It could happen to any one of us at any time! No one is immune.
Much could be achieved if we could ever get away from the politics involved. This is not the time for a Hatfield's and McCoy ongoing battle of never-ending skirmishes.
Thanks for your comment.
Hi Peggy. I think it downright despicable for our government not to provide the best healthcare avaiable to our returning vets. That is the LEAST of what we owe these brave men and women. VA hospitals should be the standard by which all care is judged!
As to government health care in general. I believe what Obama is trying to accomplish is not related to health care delivery (government run clinics/hospitals) but how health care is paid for. There's a huge difference. And I hope they get something passed soon. As the sad reality is people DO go bankrupt from not having insurance. That's downright criminal. MM
Hi libby,
So happy to hear that you received good care after that drunk driver hit you. That must have been terrible!
Yes, I would also love to learn the reasons most (not all) of the legislators in our Congress voted against having the same benefits that they are proposing for the rest of us. Not fair! Not right! Obviously they know that their plan is better than what we will end up having or there would be no reason for it. That is one of the FIRST things that should be changed.
Yes, we need limits set on malpractice lawsuits. I'm in full agreement.
I believe that if a veteran lives a certain distance from a VA hospital and needs treatment, the VA does pay for it. Your idea of totally eliminating VA hospitals in favor of regular ones is innovative and could probably work.
Insurance reform definitely needs to take place as well so that what everyone has is more affordable. Just being able to shop across state lines would greatly help in reducing costs because of more competition and sharing the risk pool.
Studies could be done as to just how many high tech machines are actually necessary in any one locale to efficiently treat people. We don't necessarily need MRI machines on every corner like a Starbucks.
Medical savings accounts and/or payment plans as you suggested could also be tackled.
Let's all let our congressional representatives know what WE WANT. Let's make sure they understand that WHAT THEY WANT FOR US is the SAME THING that THEY SHOULD HAVE FOR THEMSELVES when all is said and done.
Thanks for joining this discussion.
Hi Peggy, I do think we need cost control within the hospitals and to make healthcare affordable without insurance companies who only add to the debt as well as control what you can get. Not government controlled, but something americans (people) can AFFORD. Workers in healthcare used to be a noble profession. So many go into it now strictly for the money. I know they work hard but so do the rest of us. And limit the frivilous lawsuits. Set rules and penalties on the sue happy laywers on this where the hospitals can sue them for wasting OUR time and money. Like paying a car note, we could start a payment system. I am grateful to be alive and well after going to a state run charity hospital. I was hit by a drunk driver many years ago and they said I would die. I had no insurance yet worked full time. I sued my own insurance company, he had only liablity and I felt honored to pay the hospital even though my laywer said I didnt have to. They shouldnt have VA hospitals. They should give them a card where they can go to any hospital and get the precise treatment they need. I found it interesting reading on this site that Congress veto'ed themselves from Universal Government healthcare. I would love to hear their comments on WHY?
Enjoyed reading your comments on this.
Hi Amanda,
The Hoover Institute is a pretty reliable source. I realize that my point of reference goes waaaaaaaaay back now...but when I was an OR nurse at Methodist Hospital I did become aware of the accurate numbers (at the time) of things like MRI units in Canada verses what we had in the States. If I remember correctly the State of Washington and Oregon had as many units back then as the entire nation of Canada. Don't hold my memory or feet to the fire on that...but it WAS something like that. So as to the figures today...it would not surprise me as to the accuracy given the source.
You have WONDERFUL aspects to your medical care. You certainly don't have to worry about becoming bankrupt if you become ill like many folks over here do. That is awful and needs correcting.
But we do have some good things about our medical care that we would also hate to lose.
Thus the debates and broad issues that are now being discussed by almost everyone in America (and the world, it seems). Thank you for your interest and comments.
We CAN hopefully learn from one another. One great thing about the Internet!
Let's hope our representatives are becoming as well informed and can slice through the mountains of facts and figures and get to the truths and apply them to any new legislation going into effect.
And thank you for your last sentence!
Peggy, I can understand your concerns here. Economies of scale don't always work so well when they're applied to social issues. After all, we're people, not widgets! I looked at you Hoover link earlier, when you posted it on my hub, and I think it's as interesting for what it doesn't say, as for what it does. I'm also very dubious about the validity of the statistics that he quotes. Variations of one or two per cent are to be expected when comparing healthcare outcomes between nations, but variations of hundreds of per cent? Frankly I doubt it! But that aside, it's an interesting conundrum, and one I hope gets resolved with good outcomes for Americans in general. They deserve no less.
I am really happy for you Plants and Oils. Hope that most of us on this side of the Atlantic will be as happy when all this dust settles.
Of course you are right, in that the UK is much smaller than the USA - about 60 million of us here. But the NHS does work pretty well.
Hi Amanda,
http://www.hoover.org/publications/digest/49525427
Please click on the link above and see some of the reasons that I hope we don't totally chuck the system we have.
One thought that just occured to me...
England is about the size of one of our states. Applying the same type of medical care resources that you currently enjoy and spreading it out all across our much larger country may not be quite as easy as in your smaller country. We have vast open spaces in some areas that are more sparsely populated.
One of Obama's proposals is to cut Medicare funding in order to pay for the government plan. According to one of our senators (he is also a doctor) many rural hospitals could not survive and would have to close their doors.
We already have doctors who no longer accept Medicare patients. This is because the government only pays so much (a set price) for reimbursement under the Medicare system. And most of our supplemental policies pay nothing if Medicare does not first pay something.
As more and more of us retire and get on to the Medicare system (which is a government system) that is a scary thought.
So this is not quite as simple as it may seem from your perspective.
Thanks for your thoughts on the subject. I sure hope that we get this right for everyone involved!
Like Plants and Oils, I've found little to complain about within the NHS. Many of the waits and the availabilty of diagnostic equipment are greatly exaggerated in these discussions in my experience. Generally our local GP will see you on the same day for urgent matters and within a day or two for less urgent. We have an allocated waiting time, and unless the practice is exceptionally busy I would anticipate being seen within 30 minutes or less from that allocated time. Three or four years ago I needed non-prority surgery to remove a large cyst and the surgery was completed within 12 weeks of my initial hospital appointment. Yes, this was a wait, but not an overly distressing one. Two friends of mine who have unfortunately been cancer patients both had their surgeries and all necessary appointments extremely quickly, and received a good standard of care. Please be very wary when reading generalisations about socialised healthcare. You can't really compare what we have in the UK with the hospitals that you are discussing in your hub. It's like comparing apples with plums.
Hello again Plants and Oils,
Perhaps Vladimir is referring to the less availability of diagnostic testing machines for the sick or the longer waits except in emergency situations?
I am very happy that you are satisfied with your medical care. Hopefully someday soon everyone over here will be as well.
Thanks again for the comment.
Hello Vladimir Uhri,
Thank you for joining this discussion. As a doctor who has practiced in a socialized setting as well as a free one, your comments carry some added weight.
I am in full agreement that malpractice lawsuits have to be reigned in and awards limited. Most doctors do their best, as you said, but results are not always guaranteed. In the case of gross negligence or misconduct, certainly those doctors need to be penalized...perhaps lose their licenses to practice, etc. But way too many frivilous lawsuits are continually brought and the lawyers encouraging people to sue would not be so eager if the final dollar amounts were limited.
Thank you for your comment.
Hi Plants and Oils,
Most of the people who DO have private insurance are fairly pleased with our medical system as almost all of the polls show.
http://www.hoover.org/publications/digest/49525427
You might be interested in going to the link above to see some of the statistics as to how our system compares to other countries in some aspects. Statistics can prove many things.
What we need to do over here is correct the system so that it is more efficient and cost effective.
Thanks for the comment.
"Sorry medicine in Canada and England is very good, but only for healthy people."
Not at all, acute care is very good here.
The problem I have is that people can sue the doctors who are trying to do best they can, but nobody pay attention to sue the politicians who make worse mess. :-).
Sorry medicine in Canada and England is very good, but only for healthy people.
I practiced in socialistic medicine in Czechoslovakia and here in US. We have here in US best medicine in the world. Believe me. I am in practice for many decades.
We just let socialism infiltrate this country and result is what we see as described by Peggy.
Nothing is free, of course. But in the UK we spend half what the USA does on health care, and live a bit longer to boot!
Hi Plants and Oils,
I agree that we need to do some fine tuning to get it in better shape. This health care discussion of free government medical care is getting much more attention than ever before. (Of course NOTHING is free!)
What I would ideally like would be to learn the best of your system and others and make what we have even better. I just don't want to have less freedom of choice nor less good medical care which could happen if we do not carefully plan for the future.
Thanks for the comment.
I think that not a single person in the UK would swap our NHS for the patchwork insurance scheme you have in the USA. We're proud and possessive about it.
Hello breakfastpop,
I totally agree with you.
Because of government intervention, some things have changed that make absolutely no sense. It used to be that if I went to my GP and was ill, he or his nurse could draw blood and test for what might be wrong. Now (for several years) he can no longer have blood drawn in his office. He has to send me (remember...I am sick...coughing...spewing germs, etc.) to another lab to have it drawn. This exposes more people to whatever I might have plus make it that much harder on me...the ill person... who just wants to feel better and get well.
Make sense? I think not. This happened when I had pneumonia.
Thanks for joining this discussion. Nice to see a new face!
Sadly, I am not at all surprised by the ordeal your brother went through. I hope the day never comes when bureaucrats make medical decisions for me or my family. HMO's are a perfect example of the disaster that occurs when big brother gets between a patient and their doctor of choice. Improve the system we already have, don't destroy it.
Hello MindField,
It is absolutely wonderful to hear about your great medical care at the VA hospital in San Francisco. And I would truly hope that everyone could have the experience you had.
I carefully pointed out in my hub the dates of my experiences and I also apologized to all the good medical care providers out there in government hospitals that might think that my experiences were being generalized.
As a nurse in private hospitals, I would be the very first person to say that things do not always go right. In my hub about the necessity for having living wills, I gave scenerios that I experienced building that case.
And in my hub regarding health care reform I list over and over again the need for limiting the amounts awarded in malpractice lawsuits in order to hold down costs as well as other things.
So it would seem that we are on the same page with respect to most of this. The fact that you list Fort Miley as "one of the top 10 " best hospitals in the country also affected your perspective. The vast majority of hospitals fall somewhere below that.................and waaaaaay below that in the majority of cases, government OR private.
I heard an interesting viewpoint expressed last night on CSpan from a senator (also former governor and a doctor) from Nebraska. He said that if Medicare is cut by the dollar amounts projected by this administration in order to enable everyone to get into a government plan, many small hospitals around the country will have to close their doors. 25 to 50 bed hospitals will no longer be able to be financially viable if rates paid to reimburse them for services provided for Medicare and Medicaid patients are cut. THUS.....the end effect will be that people in more sparsely populated states will no longer have easy access to medical care when needed. Also if those rates are cut to reimburse doctors, many who are financially stable will cease providing care. In many cases ALREADY, doctors are not taking new Medicare patients. Worrisome!
Something to think about!
All the patients that CURRENTLY use a government system for their medical needs which includes military hospitals; VA hospitals as well as Medicare and Medicaid recipients...let's get THAT house in order before we encourage EVERYONE to get onto that system.
He also said that it WAS PROPOSED that Congress and the rest of government employees should be put onto the same system that is being proposed for the rest of us, but that Congress voted it down. Not good enough for them, apparently! Does this worry anyone?
Coming from a nursing background, I am VERY INTERESTED in true health care reform for everybody. If you read my other hubs, I think you will have a truer perspective of where my heart and mind is centered.
Thanks for your comment...and again...very happy you had the experience you did.
Peggy, perhaps you haven't seen my recent hub on my heart attack. I was sent to one of the top ten hospitals in the country, Fort Miley, otherwise known as San Francisco VA Medical Center. I couldn't have asked for better care - at every level.
I had the finest nurses I've been privileged to meet since I was in a UK military hospital 35 years ago; rooms that were thoroughly cleaned every day by highly conscientious housekeepers; delicious food prepared with care; lab assistants who were professional, gentle, and friendly.
My doctors were not only skilled but exceptionally kind. One of them sat with me for thirty minutes describing everything that happened during the procedure. Other MDs came by later not just for medical reasons but to offer a cheery greeting and check that I had all that I needed. Social workers and pharmacist assistants brought me important information that I would require when I returned home.
I, too, am very sorry for your brother's injuries but bringing up decades-old incidents is a bit disingenuous - and so is leaving out hundreds of horrific stories that occur in private hospitals every day.
As to the ability to sue, you need to think more carefully about painting this as a rosy scenario. Isn't malpractice insurance adding hugely to the cost of health care in this country? And isn't it also responsible for doctors leaving particularly vulnerable specialties rather than continuing to practice with the Sword of Damocles hanging over their heads?
Hi Madame X,
I guess because of my personal experiences I am perhaps more leary than most as to what type of care we would ultimately receive.
The other separate issue is the cost. Since Medicare (a government program) is having problems staying aptly funded, how in the WORLD do they think we can add EVERYONE into this...ESPECIALLY with our current economic problems?
I just heard from a friend who returned an email commenting on this hub. He now relies on the VA for his medical needs simply because of the money issue (meaning it is much less expensive for him than going the private route). He admitted that quite often he spends half a day waiting to see a doctor even though he had an appointment and it has then had to be rescheduled. So.........another long wait! That is his main gripe at this point. Hope that is the extent of what he will ever have to suffer at the hands of the VA. That is bad enough... He also admits to hearing LOTS of griping from other VA patients waiting their turns to be seen.
Thanks for your comment.
Peggy - I'm sorry about your brother and what he had to go through. I agree with you and your excellent hub. The government can hardly run a cash-for-clunkers program, I most certainly don't trust them with healthcare. In the end, it comes down to accountability. If you can't sue the government for malpractice, no standard will ever really exist. The private sector has that standard inherently built in. If people don't like one doctor, he doesn't get much business, while a good doctor will. Government-run healthcare is the worst idea ever put on the table. Thanks for a great hub. It's always good to hear from the "inside".
Hi Ethel,
Sorry to hear about your Dad.
It would be wonderful to have the best of healthcare at the lowest possible pricing. That is what we are wrangling about over here in the U.S. and there are so many opinions as to how to accomplish it.
I just wish they would start putting into action the things that both sides already agree upon and not necessarily wait for one giant bill to be passed. Always...too much pork (waste) gets added often at the last minute.
Why is getting ill more scary for you these days?
As I have said before I work for the NHS in the UK. On a personal level my Dad's cancer was misdiagnosed until it was too late. That was back in 1969 and so not part of our current problems. Free healthcare should be available but not if its sub standard. In the UK our National Insurance Contributions taken from our salaries were initially toward the NHS. I must admit being ill is more scary these days
Hi K@ri,
Since you are a nurse you would be more attuned to knowing the difference in levels of care. Sad commentary on that base clinic in your area of the country. At least you had choices!
Thanks for the comment.
You bring up some interesting points. I have had experience with government care while married. Yes, it was cheaper, but I soon found you get what you paid for. I told my husband he could not take our children to the base clinic. I was not happy with the care they received, and so kept my own insurance to allow us to see a real doctor when needed.
Hi again Pete,
With reference to your # 4..."No one said you have to use the government care in fact if you don't really need to you shouldn't."
All I have to say is that most young people injured during their military experience (like my brother) DO RELY upon the government for their care. That is the insurance they have in place at the time. Few are independently wealthy and carry private insurance at the same time that they are serving in the military.
As to older veterans...this is the contract that they had with America when they joined the service. Are we to tell them that they have no right to collect when they need medical care?
This would be like telling wealthier folks that they should not take social security that they have been paying in to for many years because they have a bigger bank account and they really don't need it.
Thanks again for joining this discussion.
Hi Pete,
I agree that this is a small sampling...but true cases. And yes, mistakes are made in private hospitals as well. The BIG difference is that one can sue for negligence in private hospitals which just might keep them responsive to not only their peers but also their patients.
As far as sitting in your house dying because of no medical care...UNLESS that person is in the middle of nowhere with no medical access...that is unnecessary as Medicaid takes care of indigent people.
And for those with no insurance, they can always go to an ER for treatment.
NOW........it should not have to wipe out a person's savings for medical treatment or people should not have to declare bankruptcy as many have.
WE NEED MEDICAL REFORM in this country! You read my other hub...we just need to get it right!
Thanks for your comment.
Number one. This is admittedly a very small sample and it sounds like some of the stories are criminal.
Number Two. I have seen nightmares in the full paid hospitals. I've seen one nurse on a floor supported by a bunch of techs that didn't know one patient from another.
Number three. Those stories pale in comparison to sitting in your house dying because you can't get any medical care at all.
Number four. No one said you have to use the government care in fact if you don't really need to you shouldn't.
Peggy W Hub Author 2 months ago
Hi barbergirl28,
Hope that in your case the medical mistake made by the government employed doctor did not cause lasting harm. As you say, in private practice there is at least some recourse if egregious errors are made. I just wish that we could cherry pick the best of all ideas learning from ALL country's medical systems and institute the best ideas from each one. Why not?
Personally I think that the worst thing we can do is rush into things and make sweeping changes without lots of thought...and at LEAST let our legislators READ and UNDERSTAND what they are voting upon. That did not happen with the rush to pass Obamacare. Now...what next?
Too bad politics has to be involved instead of simply caring about the health and welfare of the U.S. citizens from young to old. Sigh!