Don't panic! UK - style health care will not kill you.

Hi Kate,

This is one of those philosophical debates that really comes to life in terms of how the healthcare systems are actually implemented.  In other words, I am not sure whether either the US or the UK actually have it all figured out right now.  I work in the healthcare industry and therefore I hear about global healthcare reform on a daily basis. 

There are pros and cons to all of these systems.  For example, I have heard that the MHRA in the UK has denied certain drugs in their formulary for late stage cancer patients because they only extend the person's life for 6 months and therefore they did not see the value in paying for it.  I am not sure that access to medicine should be denied for someone who wants it, whether it is to extend life or just make quality of life better.  Likewise, it pains me that in the US, a country of such wealth and industrial development, we cannot find a way to provide some type of health coverage to everyone.

The US is based on capitalism and unfortunately often times that means every man is out for himself.  I make a very decent living and would willingly give a portion of my wages to helping others in need (e.g., I could easily be taxed more in order to give some other family health insurance).  Unfortunately, not everyone feels the same way which is why we are stuck with just talking about reform and not actually doing anything about it.

Heavy topic, Kate!  I wasn't planning on doing any soul searching this early in the morning!!

For example, I have heard that the MHRA in the UK has denied certain drugs in their formulary for late stage cancer patients because they only extend the person's life for 6 months and therefore they did not see the value in paying for i

An unfortunate (to put it mildly!!) side-effect of a system which never has enough money! And it can vary. As the country is divided into different regions for health care, you can get certain treatments in some parts for the country and, for the same condition, not in others! Theoretically the above should not happen if the drug is to relieve suffering, improve the quality of life or prolong life. But that is theory! Not necessarily in practice! Having said that, some of the most dramatic stories reported in the press are not as simple as the patients (quite understandably!) make out.

A quango called NICE (National Institute for Clinical Excellence) has the task of evaluating all medicines and treatments and identifying the one which give the best value for money for the same outcomes. Some of their decisions are controversial!

Swings and roundabouts. Good side, everyone in the country has free access to good medical care which is, in the main, excellent. Downside, there is never enough money for everything!

Kate

Wonderful post Kate,
None of my friends who has needed medical care in the UK has ever had a complaint.  Health care reform is desperately needed here in the US.  We are a country of haves and have nots when it comes to insurance and health care.  Today my son became one of the have nots.  Why?  He recieved his college diploma.  Yes he is employed but his employer does not offer health insurance.  To keep him on our policy it would cost us $340 a month.  I have wonderful health insurance but so many people do not.  When I was much younger I was a single mother with one child.  My son had an infection in his eye and needed a prescription.  I had no money and asked the doctor if my son would be ok if I waited 5 days to get the medicine when I got paid.  I will never forget the doctor looking at me and telling me that if it were his child he would find the money.  Not something a mother ever forgets.  I borrowed the money from my employer and my son was ok.  This is a debate that will go on for a long time I am sure but I feel strongly that every American should have the health care they need.

Teresa

Very true!  Guess we all have to prioritize somehow.

 Working where I work, and talking to people every day who can't get care when they have a cancer diagnosis because they don't have health insurance (which was diagnosed late also because they don't have health insurance), I would be delighted to see ANYTHING happen here that increases the number of people with access to proper medical care. 

Dev, wow, does that really happen? I assumed it was just a sort of scare story perpetrated in non-US countries! I knew that there was a major divide between the lucky ones who can either afford insurance or get it through work, but I thought there was a system of free public hospitals for the others?  Kate

 Yes it really does happen. Some areas have hospitals that will serve anyone, even if they don't qualify for state-based programs like medicaid, but not all areas have facilities like that available. Most major metropolitan centers do, but a lot of rural and even semi-rural areas have nothing helpful. There are a lot of people out there who don't get insurance through an employer and can't afford to buy their own, but don't qualify for other programs because they are employed and do have an income. It's a huge, huge problem here. 

I had assumed it was a myth. I now see why Obama has this as one of his targets. But perhaps this post and my earlier comments about how our taxes aren't as horrendous as perhaps people had thought and about how our national health service is, for the most part, good, may reassure some people.

If you earn more, then you obviously pay more tax! And there areas where hospitals are old and need rebuilidng. And there are staff shrotages in many places. But it is a bit like this board! We read about all the problems; we rarely hear about the routine, daily good service.

A very current example of good practice. My grandson has had diarrhoea for the last four days. My daughter has been coping but got really worried last night at about 8 p.m. because he was crying for his milk and she was trying to give him jus****er. So she phoned the doc. He came out to her house (she could have taken him to the out-of-ours clinic but he might have been infectious), examined Evan, reassured Becky, gave her a sample pot to use. This morning she will take the sample pot down the road to the surgery.

Nothing dramatic. But just the normal, routine of the NHS. And, fo course, no charges. And available to evereyone from the richest to the poorest. Or even the homeless or destitute.

I'll pay my taxes for that! And as a 58 year old, i am likely to start costing the NHS a lot in the years to come and as a retired person, I wouldn't have been able to afford high level insurance.

Kate

 Here it really depends on where you live. Some states have pretty good services that might kick in for the uninsured, but a lot don't. Within states it can also make a difference what city or county you live in as well. There's a lot of variation among insurers as well, you can have insurance but the copays and deductable and lifetime maximums might be such that it is almost useless. I'm lucky, I have pretty good insurance through my employer; but if I were trying to pay for a similar policy on my own I probably couldn't afford it. 
My dad is retired military and he and my mom get medical care through the military, which is in many ways what I imagine a single payer system would look like. Yes, they sometimes do have to wait a while for appointments, but I can say that the care they have has been excellent and there has been a lot that my mom has needed that they probably would have really had to fight a regular insurance company to get. They have had had no premiums to pay, no deductable, no lifetime maximum and very few copays (when you're hospitalised with a military hospital you have to pay for your food during your stay and that's it. When I'm hospitalized with my insurance, I pay $500 a day for the first 3 days). I would be willing to pay more taxes if it meant I didn't have to worry so much about my ability to afford healthcare if I were to lose my job and if I didn't have to see so many people go without.
I do admit that one of the big challenges is that this is a HUGE country, so implementing a single payer system would certainly be an enormous project!

My Son is a RN and worked in the ER and nobody got turned away even with no ins....there are funds at most Hospitals that cover the non insured...Remember it all depends on how the goverment sets this up and we might not be lucky like England with there health care thats sounds decent...How is Spains health care program? We have Family in England and they are happy with there care but need supplemental ins to make sure there covered and they pay for that they said.....i worry because the Goverment did not handle our Social Securiy right and now they want us to trust them with our health...little nervous about that....just me!