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Originally posted by fbgdavidson I'm a British expat living in the US so have experience of both systems to some extent. My family had private care back in the UK but we had close friends and family that have plenty of dealings with the NHS. The US system absolutely blows and for one real reason. It is run like a business over and above anything else, including care for the patient. If you want to see a specialist you need to get a referral from your PCP who knows jack shit about what the specialist deals with, endless red tape, f'in kills me... My wife was involved in a life threatening car accident a few years back (was in a coma for a week, intensive car for three etc) and whilst the care itself was top notch once the insurance company (and by all accounts she had a pretty decent policy) decided her time was up that was it. She was shipped out of the care ward and back home to me and her mother. Insurance paid for some subsequent physical, occupational therapy and that kind of thing for a month or so but not nearly enough. Once she showed signs of recovery it was up to us to start chipping in. From speaking to other people it seems that's par for the course. My wife was out of work for some time after her accident and it seemed to be a full time job trying to understand all the BS. The UK system (NHS) isn't great but it is a hell of a lot better than the bureaucratic nightmare that the US system seems to be.

Very interesting to hear a point of view of someone that has experience from both sides of the pond. And also its good to hear your wife recovered.

Yes indeed it is a business & its a greedy one. Its basically controlled by big insurance corps & pharmaceutical companies.

I think a lot of the complaints about our health care system center around wait times...but this isn't the fault of the system itself, rather the people who use (read: abuse) it.

Fucking morons go to walk in clinics and the ER for stupid shit like colds and other crap that doesn't really require emergency attention, or even professional treatment. I realize a lot of this has to do with the shortage of doctors, but we're actually working on this by training/licensing/employing other disciplines to diagnose and treat illness; specifically RNs as Nurse Practitioners (which is what I want to do).

Anyhow...the health care system is clogged in such a manner because people generally don't take of themselves, and the focus is not on prevention and health-teaching, but on treatment. People don't want to put in work to be healthy, they tend to wait until minor issues become threatening problems...and that's when you see people going to the clinic for crap that could easily be prevented or, with some knowledge, treated on one's own.

Long story short: our health care system is great. The problem is not the service that's provided...it's that there's too much emphasis on treatment and not enough on prevention.

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Originally posted by jonSun Yes indeed it is a business & its a greedy one. Its basically controlled by big insurance corps & pharmaceutical companies.

Exactlty, which was one of my original points. Some things in life just aren't suited to being provided by the private sector. Insurance is a classic example: who wants to insure sick people when it will cost them money, and who needs insurance more than sick people ffs?

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Originally posted by pkcRAISTLIN the only difference between the two systems is the relative privacy, comfort and waiting lists for elective surgery or the emergency room. the medical care is exactly the same, as most doctors and many nurses work in both private and public hospitals.

There are huge differences between public vs private. I have worked in both systems and i still stand by never getting private health insurance.
The big misconception about private is the waiting times, yea sure waiting for elective surgery isn't too long. What people fail to realise is that often to get an appointment with a specialist, it can take up to 2-3 months. We had an orthopaedic surgeon working at my old work whose waiting list was 6-8 months before he even reviewed your case.

Another misconception i find quite amusing is the level of care is different between public vs private. I know now that people working in the public system are more highly trained/ experienced to deal with different scenarios than in the private sector. Best example of this if shit goes wrong in a private hospital, you automatically get transferred to a public one.

I could go on forever about the health care system having worked in it for over 5 years now and i have been employed at both a private/public hospitals.

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Originally posted by narcism There are huge differences between public vs private. I have worked in both systems and i still stand by never getting private health insurance. The big misconception about private is the waiting times, yea sure waiting for elective surgery isn't too long. What people fail to realise is that often to get an appointment with a specialist, it can take up to 2-3 months. We had an orthopaedic surgeon working at my old work whose waiting list was 6-8 months before he even reviewed your case. Another misconception i find quite amusing is the level of care is different between public vs private. I know now that people working in the public system are more highly trained/ experienced to deal with different scenarios than in the private sector. Best example of this if shit goes wrong in a private hospital, you automatically get transferred to a public one. I could go on forever about the health care system having worked in it for over 5 years now and i have been employed at both a private/public hospitals.

Interesting, coming from a nurse

Ok, forget the public vs private thing. Would you consider our public healthcare to be good, or bad?

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Originally posted by Sushipunk Interesting, coming from a nurse Ok, forget the public vs private thing. Would you consider our public healthcare to be good, or bad?

it has its problems, but so does everything. I think for the attention it gets (thinking ACA/today tonight sooks) it gets an undeserved beating

The problem lies in less gp's are bulk billing, therefore more people think its ok to go to A&E for trivial shit such as a cold, diarrhoea ect. There are a lot of tightarses around and that is putting a huge strain on the system. Jenny summed it up nicely.

Waiting lists on elective surgery may be a little long, but it all goes by classifications/grades..
grade 1= not life threatening can live with it. eg- a hernia
so on and so fourth until you get to life threatening/emergency situations who get priority.

Another thing clogging up the system is the elderly who have no where to go, nursing homes are all full. We are keeping people alive a lot longer and have no facilities for them. The thing which takes the longest time and i have trouble comprehending is the fact that to place someone in a hostel/home they first need to be assessed by a government organisation. At the best you can wait up to 3 weeks for such an assessment then once the person has been assessed they are then placed somewhere (which then takes another few weeks). So thats someone's arse occupying a bed in a hospital that shouldn't be. There are hundreds of people in this current situation right now.

As for care, i know i'd rather be under a team of specialists/doctors as opposed to one person who would prefer to be playing golf than at work

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Originally posted by tubby are you talking in emergency rooms or in months of lead time for non-urgent operations? part of the problems we have is so many idiots turn up to emergency for stupid things (like colds) and complain they have to wait. and now everyone thinks a cold is swine flu it's even worse.

There can be long waits at emerg. in some of the larger city hospitals because there is a scarcity of GPs in some markets and we too have idiots that go to emerg. for a cold; however, this really doesn't have much of an impact on the people that have serious injuries. Where the wait times are bothersome is in regard to surgeries for relatively minor things... like my father had to wait 4 months for a surgery to reshape a bone in his inner ear (he actually died before the surgery date... obviously not related though) or my brother had to wait a couple of months to have his gall bladder removed. I view this as acceptable because there are finite resources and the procedures that tend to have long wait times are generally to correct minor problems. Unfortunately, there are also longer then desirable wait times for some specialized diagnostics, which does pose a real problem in my books.

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Originally posted by RickyM you're just a shit version of Moral Hazard. At least he knows what he's talking about.

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Originally posted by pkcRAISTLIN lol, i love it when moral feels the need to lay the smack down

usually the long waits in the emergency room are due to it not being an emergency. Once you go through triage and they code you as being in no danger of dying you will wait a long time. It should be this way, as those who need the care the most should get it first.

I can remember having a severe allergic reaction once with my throat swelling to the point of almost being closed (my face, hands and cock too lol), and my wait time was approx 1 minute. I went straight from triage to the doctor.

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Originally posted by narcism There are huge differences between public vs private. I have worked in both systems and i still stand by never getting private health insurance. The big misconception about private is the waiting times, yea sure waiting for elective surgery isn't too long. What people fail to realise is that often to get an appointment with a specialist, it can take up to 2-3 months. We had an orthopaedic surgeon working at my old work whose waiting list was 6-8 months before he even reviewed your case. Another misconception i find quite amusing is the level of care is different between public vs private. I know now that people working in the public system are more highly trained/ experienced to deal with different scenarios than in the private sector. Best example of this if shit goes wrong in a private hospital, you automatically get transferred to a public one. I could go on forever about the health care system having worked in it for over 5 years now and i have been employed at both a private/public hospitals.

thanks for that, i was merely parroting my mum, but i think its been a while since she worked in the private system. good to know.

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Originally posted by fbgdavidson The US system absolutely blows and for one real reason. It is run like a business over and above anything else, including care for the patient. If you want to see a specialist you need to get a referral from your PCP who knows jack shit about what the specialist deals with, endless red tape, f'in kills me...

Not to diminish your experience, but this is not telling the whole story of the US health system. This is very dependent on one MAJOR factor. This is OBVIOUSLY an HMO (Health Maintenance Organization) like Kaiser or the likes. I on the other hand, have had a PPO (Preferred Provider Organization) that I can go to a specialist or any doctor within the network I want, whenever I want, as I see fit. No restrictions such as you experienced. Of course, this costs more generally than an HMO to the business, but it is well worth it imho.

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Originally posted by ******** I'm currious of how they came up with a bill of 193K USD for an operation? Even at 1000$/hour that is hopefully less than $10,000 If the operation took 5 hours that would something like $40,000/hour? Where exactly do they come up with figures like that?

not sure how it works in the us, but you actually have to 'hire' the theater room so to speak. There is the surgeon's fees, his assistant's fees, the anesthetist's fees so on and so forth.

My mother was an orthopaedic surgeon and I do remember enough about the whole logistic process being quite involved and the prices for the actual medical equipment is astounding.

Personally, I'm not really interested in being a part of the lowest bidder process... make no mistake, most intensive medical care like that is a premium service + some profit.
Its not like buying a basic necessity like a vehicle, appliance or something where you can haggle for a a couple of bucks here and there, buy a cheaper one with a few less features or something.

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Originally posted by Moral Hazard I handled a claim several years back for a man who rolled his tractor trailer

See that kind of stuff over here doesn't fly, that starts happening and its all over the media for weeks, people get cranky, politicians get sweaty and nervous.