The definition of naive

[scotia]

. And would attract more UK students to study medicine.

I fear you may be mistaken in that hope. There was a substantial increase in the number of UK medical graduates between 2000 and 2008. But there has been little growth since. What is the difference between the two periods? Have we just run out of suitable applicants? Or could it be due to some other reason - like conditions created by government? E.G. did potential medics think the government funding to the NHS in the years of 2000 to 2008 offered good prospects for a rewarding career, but the funding provided by the governments since does not? I suspect there may be a little truth in this - the current funding crisis in the NHS may be putting off potential UK doctors, and this can only get worse if we all feel the need to use private medicine, and the NHS further declines.

[dealtn]

And then, at long last, the results. Oh god, the nail-chewing wait for the results. After three bloody weeks, the private hospital still hadn't sent my NHS surgeon their findings. The reason, apparently, was either that they'd lost my record, or that the person who worked the fax machine was away. (Oh yes, hospitals are the biggest users of fax technology in the UK. May I ask exactly why?)



BJ

You will probably find the reason the fax machine was needed at all was down to the NHS, and I agree it is a total nonsense this technology is still in use and demanded by (NHS) hospitals. Probably doesn't excuse the private hospital if they "forgot" to send the fax, but they may well be used to scan and email, and it slipped the net that way. If the NHS moved into the current century and abandoned fax as a means of communication this type of thing would presumably occur less frequently.

Not sure how you should "score" this one to be honest.

[bungeejumper]

My wife was told by our GP to contact a local private clinic, in order to have a facial mole removed. She booked a consultation and was surprised that removal of the mole was done there and then.

Total cost £250, plus the parking meter outside. They did a biopsy as a matter of course, the result being negative. We were there less than an hour, which included waiting for the local anaesthetic to take effect.

Congratulations, you've seen the private sector working at its best. With smallish day-surgery jobs @ £200-500, the same sort of money you'd pay to your dentist, it's a win-win.

It can be done, and the NHS could work in a similar way.

Well, maybe.

Average cost of a hip replacement to the NHS : £5,000

Average cost of a hip replacement in the United States: $32,000.

No wonder Donald Trump is demanding that the NHS to be opened up to Stateside operators.

BJ

[Watis]

And then, at long last, the results. Oh god, the nail-chewing wait for the results. After three bloody weeks, the private hospital still hadn't sent my NHS surgeon their findings. The reason, apparently, was either that they'd lost my record, or that the person who worked the fax machine was away. (Oh yes, hospitals are the biggest users of fax technology in the UK. May I ask exactly why?)



BJ

You will probably find the reason the fax machine was needed at all was down to the NHS, and I agree it is a total nonsense this technology is still in use and demanded by (NHS) hospitals. Probably doesn't excuse the private hospital if they "forgot" to send the fax, but they may well be used to scan and email, and it slipped the net that way. If the NHS moved into the current century and abandoned fax as a means of communication this type of thing would presumably occur less frequently.

Not sure how you should "score" this one to be honest.

The days of the fax machine are numbered . . .

https://www.gov.uk/government/news/heal ... nes-in-nhs

Watis

[didds]

[
Things must have changed. When I was at university (late 60s/early 70s), the university had its own GPs/opticians/dentists, whose job it was to look after me when I was at college, but not when I was back at home.

sort of ditto,... I was in Aberystwyth 1981 - 1984 and definitely recall having a GP and a dentist in town, and would have still been on the family GP and dentist books back in Kent at the same time.

I know someone in the position I outlined initially and it just seems crazy to me... as it is this person is "only" 100 miles form home GP/services but its a somewhat difficult situation for them. Especially as back in the day (early 80s) my uni year ran early September to late June/early July, so at least "mainly" in Aber and not Kent really [one month xmnas and easter breaks ISTR - but with a GP and dentist in both locations it dint really matter ].

didds

[tjh290633]

Average cost of a hip replacement to the NHS : £5,000

Average cost of a hip replacement in the United States: $32,000.

No wonder Donald Trump is demanding that the NHS to be opened up to Stateside operators.

BJ

As it happens, orthopaedic surgery in our local general NHS hospital is provided by a private subcontractor to the NHS. Those who have used it speak highly of it. There is also a private hospital in the town. People who have used both agree that there is little to choose between them, apart from the cost.

TJH

[scotia]

The days of the fax machine are numbered . . .
https://www.gov.uk/government/news/heal ... nes-in-nhs
Watis

And will they all be replaced by a grand new IT project which will over-run its costs and timescales until it is eventually abandoned (as has happened in the past)? Better keep the fax machines in a safe place just in case they need to be re-issued

[dealtn]

Average cost of a hip replacement to the NHS : £5,000

Average cost of a hip replacement in the United States: $32,000.

No wonder Donald Trump is demanding that the NHS to be opened up to Stateside operators.

BJ

As it happens, orthopaedic surgery in our local general NHS hospital is provided by a private subcontractor to the NHS. Those who have used it speak highly of it. There is also a private hospital in the town. People who have used both agree that there is little to choose between them, apart from the cost.

TJH

Cost to them, that is, presumably?

[Lootman]

Average cost of a hip replacement to the NHS : £5,000

Average cost of a hip replacement in the United States: $32,000.

A number of caveats to that comparison:

1) A large part of the US cost is malpractice insurance, which is astronomical in the US, but more related to the flaws in their tort system than intrinsically about private healthcare. The NHS self-insures so that cost is not included in your £5,000.

2) The way the costs of the operation may be charged out differently. The NHS can amortise the cost of its ancillary support and systems across a much wider base, in a way that a regional private hospital cannot.

3) There are typically three different costs to a procedure in the US even when the care is identical, in order of decreasing amounts:

3a) The cash cost to a walk-in patient with no insurance
3b) The cost above what insurance will pay, which is often written off if you have insurance, but not otherwise
3c) The out-of-pocket cost to a patient with insurance

[servodude]

Average cost of a hip replacement to the NHS : £5,000

Average cost of a hip replacement in the United States: $32,000.

A number of caveats to that comparison:

1) A large part of the US cost is malpractice insurance, which is astronomical in the US, but more related to the flaws in their tort system than intrinsically about private healthcare. The NHS self-insures so that cost is not included in your £5,000.

2) The way the costs of the operation may be charged out differently. The NHS can amortise the cost of its ancillary support and systems across a much wider base, in a way that a regional private hospital cannot.

3) There are typically three different costs to a procedure in the US even when the care is identical, in order of decreasing amounts:

3a) The cash cost to a walk-in patient with no insurance
3b) The cost above what insurance will pay, which is often written off if you have insurance, but not otherwise
3c) The out-of-pocket cost to a patient with insurance

Indeed! as you've pointed out it's a bloody inefficient system they have in the US.

Really handy as a market for the medical equipment I work in but not a place I'd like to rely on for care
Horribly exploitative of their patients/customers/revenue stream.

- sd

[Lanark]

if they wanted to have the grommets fitted under the NHS, they would have to undergo a second consultation on the NHS!

What a waste of resources that duplication would have been!

Thats very common because the NHS and private consultant will often make different recommendations.

I know of cases where the same consultant will give completely contrasting advice to the same person depending if they are NHS or private.

Basically if you are private and ask for some procedure the answer will almost invariably be yes.
If you are an NHS patient the answer will almost invariably be No unless they think they could be sued for malpractice if your condition got worse.

[Lootman]

it's a bloody inefficient system they have in the US.

Really handy as a market for the medical equipment I work in but not a place I'd like to rely on for care
Horribly exploitative of their patients/customers/revenue stream.

If you have insurance the US system works fine. Your out-of-pocket costs are manageable and capped, and the service is generally quicker and more convenient. Standards vary but the very best care is available, which is why it is not unusual for British patients to go to the US for care that isn't available in the UK, either on the NHS or even anywhere.

Also most medical innovation happens in the US, as you surely know given your occupation, and so we all indirectly benefit from the American method of healthcare.

I don't advocate their model for the UK, not least because the average Brit is too accustomed to healthcare being "free". But something between the two would be superior in my view. Even the European models of socialist healthcare involve more in the private sector than the UK, which runs health as a giant government entity.

[scrumpyjack]

Yes the US spend twice (as % of GDP) what other western countries spend, for a worse outcome on average.

https://www.reuters.com/article/us-heal ... SKCN1GP2YN

Certainly not a system one could recommend! The NHS may be inefficient in many ways but at least we don't waste nearly as much on the overhead of insurance companies etc etc that the US do.

[bungeejumper]

Yes the US spend twice (as % of GDP) what other western countries spend, for a worse outcome on average.

https://www.reuters.com/article/us-heal ... SKCN1GP2YN

And two thirds of all US bankruptcies are substantially down to medical bills. https://www.nasdaq.com/articles/medical ... 2019-02-14

The telling issue here seems to be that large swathes of the US population can't get access to insurance. Try getting a quote when you've had a major health issue, even ten years ago, and you're going to get a shedload of refusals unless you've got a fat wallet. So when the worst happens, you go broke.

In fairness, the US situation is compounded by the short duration of unemployment benefits.

The research also noted that 58.5 percent of bankruptcies were caused specifically by medical bills, while 44.3 percent were caused in part by income loss due to illness.

Think I'd rather have the system we've got, thanks.

BJ

[Lootman]

The telling issue here seems to be that large swathes of the US population can't get access to insurance. Try getting a quote when you've had a major health issue, even ten years ago, and you're going to get a shedload of refusals unless you've got a fat wallet. So when the worst happens, you go broke.J

The denial of coverage due to pre-existing conditions was banned as part of ObamaCare. The 65's and over are covered by MediCare which never had such a provision anyway. The poor get MediCaid and veterans get the VA system.

Sure the US system isn't kind to the poor and unemployed, but a fairer comparison for folks here would be what is the average US healthcare experience for someone with a professional job and good insurance, and I'd assess that as equal or better in the US (having had healthcare in both places).

Meanwhile you are probably paying a 28% federal tax rate there rather than 40% or 45% here. There is no free lunch.

[sunnyjoe]

There was a substantial increase in the number of UK medical graduates between 2000 and 2008. But there has been little growth since. What is the difference between the two periods? Have we just run out of suitable applicants? Or could it be due to some other reason - like conditions created by government? E.G. did potential medics think the government funding to the NHS in the years of 2000 to 2008 offered good prospects for a rewarding career, but the funding provided by the governments since does not? I suspect there may be a little truth in this - the current funding crisis in the NHS may be putting off potential UK doctors, and this can only get worse if we all feel the need to use private medicine, and the NHS further declines.

The 2010 increase in university tuition fees to £9k pa has particularly affected medical students who typically study for 5 or 6 years compared to 3 or 4 years for most other degrees. No doubt this will have discouraged some potential applicants. When you add on the cost of maintenance loans (which replaced maintenance grants in 2000) and the fact that these are often insufficient to maintain body and soul in accommodation in many university cities, then it is clear that it is not only the parlous state of the NHS which is affecting the number of UK medical graduates.

[scotia]

The 2010 increase in university tuition fees to £9k pa has particularly affected medical students who typically study for 5 or 6 years compared to 3 or 4 years for most other degrees. No doubt this will have discouraged some potential applicants. When you add on the cost of maintenance loans (which replaced maintenance grants in 2000) and the fact that these are often insufficient to maintain body and soul in accommodation in many university cities, then it is clear that it is not only the parlous state of the NHS which is affecting the number of UK medical graduates.

Agreed - Good Point.

[didds]

The 2010 increase in university tuition fees to £9k pa has particularly affected medical students who typically study for 5 or 6 years compared to 3 or 4 years for most other degrees. No doubt this will have discouraged some potential applicants. When you add on the cost of maintenance loans (which replaced maintenance grants in 2000) and the fact that these are often insufficient to maintain body and soul in accommodation in many university cities, then it is clear that it is not only the parlous state of the NHS which is affecting the number of UK medical graduates.

Yup. My daughter started a degree this September at a uni that also does medical degrees (she isnt!). She was somewhyat shocked to learn that her maintenance loan doesn't even cover her accommodation.

My son has recently completed his degree in deepest, darkest south wales, in allegedly the 2nd cheapest place in the UK to study (after Wrexham). His maintenance loan did cover his rent - but only just. And as his brother opined "well, of course it is cheap - XXX is a sh1t hole!"

didds

[UncleEbenezer]

Yup. My daughter started a degree this September at a uni that also does medical degrees (she isnt!). She was somewhyat shocked to learn that her maintenance loan doesn't even cover her accommodation.
didds

I think the trick is to get yourself a package of scholarships, bursaries, grants, whatever they call them these days.

My nephew has a £16k package of them for this year. That's more living-money than I had even after those fees and a modern rent!

[servodude]

it's a bloody inefficient system they have in the US.

Really handy as a market for the medical equipment I work in but not a place I'd like to rely on for care
Horribly exploitative of their patients/customers/revenue stream.

If you have insurance the US system works fine. Your out-of-pocket costs are manageable and capped, and the service is generally quicker and more convenient.

The point of the insurance system in the US is to make a profit.

The example of CPAPs came up here before.
An equivalent machine in the USA will cost you more upfront than in the UK even with insurance
- insurers would prefer you to hire them though as they will extract far more over the lifetime of treatment
- you will be required to source the consumables (filters, masks) through a nominated supplier at a premium ( and keep to a replacement schedule)

Most current generation CPAPs track and report "compliance"; basically how much the patient is using the device, and how effective it is.
This info is intended for the doctor to adjust treatment.

In the US your "compliance" data goes to your insurer
- they are not required to tell you that this happens
- they use this to adjust your risk profile, increase premiums, ensure you keep to a replacement schedule and to reject subsequent claims

That's not working fine; that's turning a patient's treatment data in to extortion.

It's an ethical pit at the moment.

most medical innovation happens in the US, as you surely know given your occupation

- perhaps in volume given it's size, but the real stars of the field are Switzerland and Sweden; especially if you value innovation or quality
- or If you've got a sleep disorder I can recommend Australia


- sd