Save your NHS, be kind to your NHS

[MorkandMindy]

I recall back in Britain seeing tabloids proclaiming the salaries of some of the highest-paid doctors, and Nigel Farage saying the NHS should copy some of the things done in America.

Some people in Britain believe the tabloids and getting a short fuse with the NHS and think there is an alternative.

I lived in England for 42 years but now I'm in the US and I can tell you a bit about the alternative - it is very expensive, very complex and the profit incentive means it often does the wrong things.

 

[MorkandMindy]

[This post was expressed by post 4 in far fewer words...]

 

[MorkandMindy]

Financial incentive affects some doctor's judgement:

One example:
A friend's wife had two strokes and he took her to hospital where she got medication to stabilise her condition. She had scans and was helicoptered to a hospital 20 miles away that dealt with cancer which was the underlying problem. My friend was told he could not go in the helicopter but to try to keep up in his car, through downtown traffic...

I now realise that was to prevent him having time to think.

So much of her brain was dead that she was in a persistently vegetative state and would never recover and the cancer was terminal.

When he arrived she was ready in the operating theatre and the surgeon said he was going to perform a life-saving operation.

My friend was not cognizant that 'life-saving' really meant 'death prolonging' so the operation was not just unnecessary but would add a lot more nursing care.

Well the surgeon got 6,000 pounds for the op and the hospital staff, helicopter etc got another 65,000. His various forms of insurance paid most of it so he only lost 20,000 pounds in this scam.

Having doctors on commission can affect their judgement. I've noticed this is more prevalent in male doctors.

 

[MorkandMindy]

Moving the minimum wage up without making corresponding changes to the medical system is not going to benefit anybody because just above the minimum wage you lose your government funded Medicaid.

Our chosen economic system is one where every person and company is expected to have as an objective just one thing - maximise profit - and therefore though not everyone is aware of it, the whole system is designed to take money away from workers and hand it to shareholders, that is it's aim.

It is pointless to criticizing Walmart or Bezos because they are working within the same economic structure we all work in here in the US and they are only doing what they have been told to do, and not maximising shareholder profit would be contrary to corporate requirements.

 

[MorkandMindy]

Yes, Reaganomics is Thatcherism is Thatchernomics is neoliberal economics is the brainchild of Milton Friedman and along with socialism is included in the mix of all the economies in the World I can think of.

And if there isn't enough socialism in the mix the country falls apart.

 

[MorkandMindy]

'With all the people and paperwork involved, the Center for Medicare and Medicaid Services (CMS, which oversees the Medicare program) estimates that it mistakenly denies more than $1 billion in legitimate claims every year. For someone who will have to pay a medical bill out of pocket if Medicare denies a claim, it is important to prevent and watch for errors in the billing process.'



Medicare

 

[MorkandMindy]

View attachment 290459

 

[MorkandMindy]

US healthcare system top level diagram:

 

[MorkandMindy]

Each main part of the NHS links to two or three other parts.

Some parts of the US Healthcare system link with a hundred other parts.

For example a hospital needs to allocate charges, often by proportioning each to a first payer, usually a second payer and a third payer and there can be a fourth payer and even a fifth which might be the payer of last resort allocated after one of the previous payers has refused.

Each of these payers might be one of a multitude of health insurance plans and as I discovered last week, the government subsidy could come from the federal government, the state (US is 50 states plus 3 districts), or in my case it turned out to be - the county.

I had a simple procedure in this county which was covered by my medical plan but one of the staff - the doctor - had an office in another county which I would not have guessed, and was not covered by the same plan and this 'surprise billing' is fairly common it turns out and payment is due today.

 

[MorkandMindy]

The same procedure by the same staff in the same facility may or may not be covered by a particular plan depending on if it is classed as screening which often isn't or diagnostic in aid of treatment which may be partly or fully covered.

The testing lab submits the bill three times and if not paid by then it is the patient's responsibility.


If you give up your World-famous NHS you are in for a world of pain.

 

[MorkandMindy]

COVID in combination with the flu or pneumonia will it is expected to be more serious than COVID on it's own owing to the comorbidity effect.

Last time I looked there were insufficient cases of COVID in combination to be statistically significant but with flu season arriving comes the opportunity to become a statistic and improve the data.

Due to continuing high rates of COVID the United States is encouraging the public to be vaccinated both for their own good and that of anyone they might spread diseases to.

The cost of the vaccinations is included in most healthcare insurance plans of which there are hundreds, but for the uninsured, under insured and those who have not reached the deductible in their plans and are not otherwise covered the prices converted to pounds at 1.30 are:
Flu 30.68 pounds, Flu senior vaccination 56.92, Pneumovax 23 106.92, or Prevnar 13 at 150.00
(Walmart prices)

The highest incidence of these expected comorbid diseases is likely to be in over-crowded and low income areas where the uptake of vaccines is lower and chances of transmission are higher.

The pharmaceutical maker is encouraging patients to take up the vaccines now because the prices will be raised in 2021 to keep up profit margins.

Charging for vaccinations could help keep the US health statistics down toward the bad end of the league table of nations.

 

[MorkandMindy]

Boris says: Pay More Get Less!

Of the 11 OECD countries included for comparison, on cost the US came in as most expensive, and on life expectancy - dead last.



Errata - life expectancy should have read: dead first

 

[HantsUK]

Of the 11 OECD countries included for comparison, on cost the US came in as most expensive, and on life expectancy - dead last.

I think you meant 'dead first'?

 

[MorkandMindy]

It is no surprise the US leads the World on COVID-19 considering the costs that might be incurred in testing.

Although the President has pushed for insurance companies to cover the testing costs there are plenty of exceptions:

1 You have symptoms but the clinic was not convinced you had COVID, did not test and the visit comes up under a different code, and you may be only partly covered. Total charge expect about 1,000 pounds equivalent, actual pay out will depend on how much the insurance covers.

2 The test kit was not FDA approved, no or partial cover. Cost as 1.
3 The clinic charge is covered but the lab work is not.

 

[MorkandMindy]

COVID Testing
The lowest price option is usually a primary care clinic, these are fairly cheap, remember to divide by 1.3 to get the price in pounds sterling.

(update, people are shopping around more now and testing is provided in some places free of charge, but the problems with getting affordable testing earlier may have helped the spread of COVID in the early stages and helped make the US number one in COVID)

 

[Junia]

I don't want US style healthcare here

Scandinavian countries have the best and we in Britain would do well to copy them as regards to welfare and healthcare

 

[MorkandMindy]

One thing I've noticed in profit-driven systems is those in charge make use of any discontent to change the system to make more money for them and provide less value for the customers/patients.

Don't think complaining will make things better, it normally does the opposite.

 

[MorkandMindy]

The health insurance companies in the US make 80 Billion pounds a year in profit.

They have plenty of money to campaign in Britain and buy politicians so - complaints drive change drive destruction of the British health care system.


Some unbiased research might be needed but I suspect the British having a life expectancy only 2.66 years longer than the US is due to low levels of sunlight and some poor quality housing, and without those handicaps the Brits would be doing even better.

 

[MorkandMindy]

The NHS was set up in 1948 to solve the healthcare problems in Britain.

In 1982 it was declared that companies have a sole obligation to provide maximum returns for their owners only. If the NHS was substantially altered in the present era you should expect it to maximise profit by becoming very expensive and doing as little as possible.

And yes my ACA/Obamacare card was declined yesterday by the health insurance company, they do that a lot to save money. Obamacare has a lot of positive publicity because it pays a lot of government bureaucrats and goes through the private healthcare system as well making big money for them as well. Basically the more wasteful a system is the more supporters it gets.

 

[MorkandMindy]

After months of being told different things by different government departments I eventually reached the enrollment period for Obamacare which is a marketplace to buy private health insurance, governed by rules of no exclusion for preexisting conditions and such.

Months late my private healthcare card was finally activated but

I know how the free market works - increase profits by doing as little as possible, cut staff back as close to zero as possible, and charge for everything imaginable.

And that's exactly what's happening right now.