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OK am familiar with medical care in Canada/UK-strengths and weaknesses. How about other industrialized countries. As we have posters from much of Europe how is it funded, how does it work, and how is it viewed? For example-Italy, Japan, Germany.

EDIT: I'm particularly interested in available of extreme scanning equipment and high end surgery/chemical therapies in regards to the big Killers. If you don't know what I am referring to, be happy.

For all that the English would talk about French Healthcare, it would seem that just stepping off the Ferry would cure your cancer. It's generally regarded (at least where I live) that French Medical care is more intelligently presided over, better funded, with better care and a simply higher standard of medicine and training. Although not having stayed at many different French hospitals (in fact only one), I am not in a position to give a really clear statement on how it works on the ground. I think it's actually quite similiar in organisation to US/UK hospitals.

Personally, apart from my colleagues/friends, I think that it's actually basically flawed, simply as last year my Grandfather sadly died after he was mistakenly given the wrong blood for a transfusion, while in a French Hospital. It's not the actual blood going in, it's the side affects afterwards. So, from now I don't trust French Hospitals if they can't administer a simple blood transfusion.

sA

Australia has a hybrid system. At the basic level there's free medical care for all, which is instant in all emergency cases, but you can expect a waiting period before elective stuff. You're likely to be put in a shared room for after care as well.

If you want you can get your own private medical care. The big difference to US insurers is that Australian medical care is not-for-profit, so while they're still seperate from government their only priority is providing the best coverage for patients given the money raised.

Just recently I tore my ACL playing cricket. I went to emergency ward where it was confirmed it was pretty serious. X-rays were taken and it was confirmed there was no bone damage, so I was referred to a knee specialist for an appointment the next Monday, given a brace and sent on my way. Saw the specialist, he said it probably the ACL, which is serious. I explained I was going to India in April and could surgery wait, and he said probably, we'll see what the MRI scan shows. Had the MRI the next Monday and went to see the specialist again that Friday. MRI showed surgery couldn't wait as the joint damage was pretty bad, and he would schedule surgery with an expected waiting list of four weeks. I explained that was not on, because it would only give a few weeks to recover before my Indian holiday. He said sorry, but that's the waiting list for public health care. I explained I was private, and he said he could book me in for Monday.

I've since had on-going checkups which are covered by my private health care, and physio which is about 70% covered.

It's a pretty decent system. Everyone gets the basic level of care, no-one is bankrupted because they got sick. On the other hand, if you want shorter waiting lists for elective surgery and a nicer hospital room, you pay a little extra.

How about the real stuff-MRI's, ultrasound, and cat scan availability, time between diagnosis and treatment, that sort of thing? I hear real horror stories out of UK and the Candian wait is considerable, vs. even Medicare here.

Frazzled wrote:How about the real stuff-MRI's, ultrasound, and cat scan availability, time between diagnosis and treatment, that sort of thing? I hear real horror stories out of UK and the Candian wait is considerable, vs. even Medicare here.

The only time waiting for the MRI (and remember this is when my specialist thought I was on public health) was until I could find a few spare hours out of my work day. And like I said above, we committed to surgery on Friday, I was cut open on Monday.

When it comes to horror stories, you have to remember there is a very, very large number of people who have it in their best interest to maintain the current US system.

But you only have to look at the numbers comparing US healthcare to the rest of the world. You spend more money on health than anyone else. Yet if you look at any metrics for quality of healthcare, infant mortality, life expectancy, successful births, the US places behind the rest of the developed world. In some metrics you start placing behind developing countries.

Well, I know I was in and out of a German ER in less than an hour, and that was just for a few stitches. I waited 2 hours in triage for a broken arm here in the states before they even came in and set it.

Well I know from first hand, many of our Canadian comrades will come down for treatment in the US due to delays. Not for minor stuff-but the Killers.

So access to MRI et al is quick? Sometimes within 24 hours can mean life/death is required for certain illnesses.

What are the costs like Sebbie?

UK, medical care? is that ment to be a joke?
its gak.
the NHS is bs, i broke my arm a few years back (was helping sort out the arm on a JCB and it got pinched in the arm)

i was left sat in the waiting room for 4 hours with a broken arm and blood pissing out of it because they had to take thier lunch break 1st, then they decided that someone who needed stitches removed took priority, followed by 5 more people who all had checkups there


Edit: if you do live in the UK tell the NHS to piss off and go private for it all.
failing that, military health care here isnt too bad atall.

My Dad would have disagreed with you on the military healthcare. gach I wish I could type.

Frazzled wrote:Well I know from first hand, many of our Canadian comrades will come down for treatment in the US due to delays. Not for minor stuff-but the Killers.

So access to MRI et al is quick? Sometimes within 24 hours can mean life/death is required for certain illnesses.

What are the costs like Sebbie?

While I was on the public system I paid $10 rental and $20 deposit for some crutches. And the public hospital has paid parking, so that costs about $2 a visit (more than that, getting to the machine while on crutches is really annoying).

The surgery was fully covered by my healthcare plan, and all the after care treatment was as well. Apparently if I'd stayed for a full second day after surgery I would have been charged around $100, but no-one told me that at the time. Basically physio once a week has been my only cost, and that's 70% covered by my healthcare, so that's about $20 a visit.

There is strangeness, though, I don't want to give the impression that it's all magical and wonderful. After surgery the nurse came and put a brace on my leg at one point, identical to the one the public system had given me for free. I told them I had one of my own, and rang my girl to bring that one over. Apparently the private system would have charged me a couple of hundred for the brace (that I only would have worn for about a week). I also have a cousin who just got pregnant, and she's giving up her private insurace because pregnancy is cheaper on the public system (though you don't get as nice a room).

I'm confused-there's something new-there's private and public in Aussie? How much was the private payments?

I heard that in Japan where they have a socialized healhcare system, a man died in an ambulance because he was denied treatment in 14 different hospitals. The problem, lack of specialists.

Ireland has a public and private system. If you can afford it, you get to go private, which is generally more pleasant but the same level of care. (You get your own room, less waiting around, etc.) For life threatening stuff it's gonna be the same amount of messing around either way. I have to say we're probably worse than the US for MRIs, various cancer tests, and aftercare to terminally ill patients. Most of this is down to a shoddy infastructure from when the country was dirt poor 30 years ago, and a failure to invest by the governments of the last 15.
If I was dying and had the cash, I would go to the US for treatment if possible. I like the philosophy of our own system, but it needs more public spending.

Frazzled wrote:I'm confused-there's something new-there's private and public in Aussie? How much was the private payments?

I mentioned that in the first post. It's a hybrid system, with a basic level of care guaranteed for everyone. However, if you want a nicer hospital room, a little more choice in which doctor you see, and shorter waiting lists for elective surgery, then you buy your own private insurance.

The payments for private care aren't much because I'm under 30. I don't know the exact amount but it's pretty trivial.

Is the documentary "sicko" accurate when they describe the different medicare of the world?

halonachos wrote:I heard that in Japan where they have a socialized healhcare system, a man died in an ambulance because he was denied treatment in 14 different hospitals. The problem, lack of specialists.

Like I said above, there is a large industry dedicated to telling stories about how social medicine around the world is evil, trying to convince US citizens that their system should be kept. However, the numbers don't lie, the US spends more per capita on healthcare than any other country. In return it gets a healthcare system with poorer metrics than any other developed country, and in some metrics rates worse than developing countries. Single anecdotes don't change that.

LunaHound wrote:

Is the documentary "sicko" accurate when they describe the different medicare of the world?

It's a Michael Moore documentary, so it's never going to be completely accurate. More than anything it was based mostly on anecdote and single instances, so selection bias is easy and inevitable.

However, the basics of it seem to hold up pretty strong. The US spends a bit over $4000 per capita on healthcare, next in line are the Swiss at around $2800, while the average among developed nations is $1800. Despite your wealth, as a percentage of GDP its far and away the highest in the world.

For all that money, you get no great return. You're the worst in the developed world for uncovered citizens, with around 40 million with no medical coverage. You're the worst in the developed world for infant mortality (and by a long way). Second worst for life expectancy.

One thing I actually wonder about... a little history first. I was born with cataracts and had them along with the lenses in my eyes removed at 15 and 18 months old. This was right about 30 years ago. Needless to say my vision is gak. I know it could be corrected a good deal with Lens implants but with my family being dirt poor that wasn't an option. Medicaid (the govt medical program for young or disabled in america) does not cover lens implant because it is too costly and/or elective.

What I am wondeing is if I was in UK/Aus/France would this have been the same situation as described above or would I be seeing alot more close to what regular people see. I also Highly dount that if I has Insurence, which I dont, that they would cover the implants because they would just classify it as a pre existing condition. The reason I dont have insurence is because my job does not offer it for my position. I am quite literally waiting for someone to quit or die so I can get medical insurance. No... I am not making that up either... one person needs to quit or die and I get insurance.

Yes this has been an extreme impact on my life and does create an extreme amount of bitterness that I am defective but was kept alive in some sick sense of "compassion" Even though I can see or something close to it with glasses, it still is no where near as good as someone with normal sight. But you know... I some how deserve this... right?

halonachos wrote:I heard that in Japan where they have a socialized healhcare system, a man died in an ambulance because he was denied treatment in 14 different hospitals. The problem, lack of specialists.

Japanese healthcare isn't socialised.

It's more like the US system. The doctors and hospitals are private, and the patient pays part of the cost of treatment with the balance being made up from private or public health insurance. Much of the insurance is job-related, as in the US.

sebster wrote:

halonachos wrote:I heard that in Japan where they have a socialized healhcare system, a man died in an ambulance because he was denied treatment in 14 different hospitals. The problem, lack of specialists.

Like I said above, there is a large industry dedicated to telling stories about how social medicine around the world is evil, trying to convince US citizens that their system should be kept. However, the numbers don't lie, the US spends more per capita on healthcare than any other country. In return it gets a healthcare system with poorer metrics than any other developed country, and in some metrics rates worse than developing countries. Single anecdotes don't change that.

Like CNN is an evil corporation. Please, they helped Obama get into office. But Obama is a communist, so they could be evil.

Besides, I don't believe in any sort of socialized medicine anyways. Compare medical care to video games. X-Box Live=U.S healthcare, PSN= Socialized healthcare. Sure you pay for X-Box live but its the best quality internet service out there, sure you get PSN for free, but its not as good as X-box Live. Undeveloped countries have healthcare similar to the Wii.

I know that where I live, 90 or so percent of Emergency Medical Technicians(the guys in the ambulance) are volunteers. Also, in our location the EMTs are not allowed to intubate a patient but in some states and counties they are. So, in America each state is different along with each county in the state being different.

Also, I've read reports about the japanese healthcare system. They are socialized, they also have a high inflation rate, and the system doesn't work there. It should work in Japan as they are healthier on the whole than most americans. The doctors spend less time with their patients, they have less specialists(neurosurgeons for example). I've looked into the whole thing as I want to become a surgical specialist and truth be told, if a socialized medical system IS instituted, I won't be able to afford the training and school so I may just as well stay a general surgeon or just screw becoming a surgeon.

Also, One reason America spends more money is because of illegal immigrants. They cost hospitals billions to trillions of dollars each year. Hospitals are businesses and they MUST make up costs in order to a)buy more equipment, b)train more doctors, c)hire more people, d)invest in research.

Since the US system is private, I'm sure the costs are tracked a lot more accurately. In countries where the government is involved in healthcare, are those cost accurately tracked? We just had a state official in Ohio admit that they can't accurately determine how much it costs the State to recruit, hire, and provide benefits for their employees. They know the salary of the individual, but they don't track all the ancillary costs, which private industry does. And the ancillary costs are probably about three times the base salary, so it's not an insignificant amount.

The US system needs improved, I won't argue that. I don't want to see the US government take it over. Michael Moore can rail all he wants aobut how his father gets his Social Security check on the same day each month, but Social Security is quickly going bankrupt and I expect to get nothing out of my payments into that system.

A significant proportion of the cost of US private healthcare is the accountancy overhead.

Similarly, as the NHS in the UK gets more and more 'management', the amount of money spent on 'running things' as opposed to actual patient care is going up.

halonachos wrote:
Like CNN is an evil corporation. Please, they helped Obama get into office. But Obama is a communist, so they could be evil.

CNN might be the only reasonably neutral television news agencies left. Unfortunately, they're still limited to reporting on topics of which they are aware. Special interest stories (like unusual occurrences in other nation's public health care systems) only tend to pop up when facilitated by finance. Now, truly powerful news agencies, like FOX, are not limited by matters of finance. They've become so powerful that they can report on stories they aren't even aware of.

halonachos wrote:
Besides, I don't believe in any sort of socialized medicine anyways. Compare medical care to video games. X-Box Live=U.S healthcare, PSN= Socialized healthcare. Sure you pay for X-Box live but its the best quality internet service out there, sure you get PSN for free, but its not as good as X-box Live. Undeveloped countries have healthcare similar to the Wii.

Generally you don't make your highly subjective opinion (uniformed take on socialized medicine) more objective by comparing it something even more subjective (gaming preference).

halonachos wrote:
I know that where I live, 90 or so percent of Emergency Medical Technicians(the guys in the ambulance) are volunteers. Also, in our location the EMTs are not allowed to intubate a patient but in some states and counties they are. So, in America each state is different along with each county in the state being different.

Ironically, that's one of the main arguments for socialized medicine. Standardization of procedure cuts costs, and improves efficiency.

halonachos wrote:
Also, I've read reports about the japanese healthcare system. They are socialized, they also have a high inflation rate, and the system doesn't work there.

The reports you're read are wrong. They aren't socialized. The government heavily regulates care, but the actual practice is primarily private. As KilKrazy said, its very much like the US. Which would explain why the system doesn't work very well.

halonachos wrote:
It should work in Japan as they are healthier on the whole than most americans. The doctors spend less time with their patients, they have less specialists(neurosurgeons for example). I've looked into the whole thing as I want to become a surgical specialist and truth be told, if a socialized medical system IS instituted, I won't be able to afford the training and school so I may just as well stay a general surgeon or just screw becoming a surgeon.

Which is actually one of the main reasons for socialized medicine. There are far too many specialists in the US, and far too few generalists. One of the main reasons for the ridiculous price of something like an appendectomy? The lack of general surgeons leads to: A) specialists performing the procedure for more money, generals charging more for their now high-demand services.

halonachos wrote:
Also, One reason America spends more money is because of illegal immigrants. They cost hospitals billions to trillions of dollars each year. Hospitals are businesses and they MUST make up costs in order to a)buy more equipment, b)train more doctors, c)hire more people, d)invest in research.

Again, socialize medicine and none of that is a problem. By refocusing the industry on the provision of care it becomes possible for private hospitals to divest themselves from the expense of providing services to non-paying clients. Non-paying clients that aren't generally illegal immigrants, but simply the uninsured.

First of all, schools are socialized in the United states, everyone has access and money/regulation is dependent on the government(federal and state).

School districts without choice often perform less than school districts that allow school choice. This is because of competition over students, the more students that perform well=the more income the school receives.

Why would you want the government involved when they SCREW UP EVERYTHING(emphasis not yelling). Competition is what keeps hospitals hiring specialists and what keeps them paying for training so general meds can specialize. Would you rather have every hospital fit a generic spread of maybe: 30 general physicians, 4 general surgeons, 1 burn specialist, 1 neurologist or would you rather have a hospital with 15 general physicians, 4 general surgeons, 10 burn specialists, and 5 neurologists?

There are hospitals that specialize in certain areas like burns or head injury. So instead of having every hospital be vanilla, you have vanilla, chocolate, mix, neopolitan, strawberry, cherry garcia, etc.

Hospitals compete and that improves care.

If you've ever worked in an E.R you will see why things are so expensive and why it is important to have MORE than just generic doctors and surgeons.

I was doing rounds in an E.R when a guy came in, his heart rate was up, but his blood pressure was down. Testing proved that he had done cocaine, we had to inject him with drugs to slow his heartbeat and then we had to watch him until he became sober. He was an illegal immigrant, luckily another tech and I were fluent enough in spanish to help translate. Later, he decided it would be a great idea to urinate on everything, including me.

Cost for drugs+costs for cleaning equipment+cost for cleaning room+ cost of paperwork=loss
He was an illegal and had no way to pay back the costs, no insurance, nada. The hospital probably lost close to $3,000 on this one guy.

As for specialists: The same night a patient came in and was in an accident. She was bleeding internally and hat not an OB/GYN been in the hospital they may not have determined that she was pregnant and had lost her child. Without surgical specialists who could've helped her, she would've died as well. The hospital was a trauma center and hired people just for these occasions.

If a person with burns would've came in, we could've given basic care before sending him/her 10 minutes down the street to a burn hospital.

The reason why care is dependent on location is this: In metropolitan areas where there are hosptals everywhere, EMTs don't need to intubate patients because they can get to a hospital in a reasonable amount of time, while in rural areas EMTs can intubate because it may take 30minutes to get to a hospital.

The standards are the SAME but the use of certain tools is dependent a)level of skill (3 for EMT: Basic, Intermediate, Paramedic), b)availability of hospitals.

EDIT: Remove loss caused by illegal immigrants and lower cost of care. This lowers cost of insurance and then wham-bam, the uninsured can now afford insurance.

Mod POWERS ACTIVATE!

Guys-am requesting we focus not on the philosophical differences between private/public blah blah. That is for other topics. I am trying to get info/man on the ground viewpoints of other locales. Knowledge is power and I am looking for more knowledge on other systems besides the usual -ALL CAPITALIST DOG/SOCIALIST SCUM debate. I'll reserve that for another post.

As I said, where I live we rely mainly on volunteer EMTs and if hospital pricing is like veterinarian pricing, MRIs are most likely more expensive than x-rays.


Also, chemotherapy is one of the most expensive techniques to remove cancer because they are giving you drugs and drugs are expensive. Radiation treatments could be less expnsive IF you have only 1 or 2 therapy sessions. Back in the day they couldn't use radioactive treatment with pinpoint accuracy so if you had a brain tumor, the whole brain area received a blast of radiation. Now and days, they can blast ONLY the tumor with radiation.

An example of pricing of some more higher up equipment can be compared to a piece of sponge the thickness and size of, lets say, a quarter of the size of a tissue.

This sponge is covered in a chemical that speeds up bone growth and costs about $2,000. This sponge is used by taking removed bone fragments and stuffing them into the sponge burrito style. They then put this roll into the area they want bone to grow in.
So you see that even tiny pieces of sponge can cost a lot of moolah.

Pricing also depends on whether or not they are able to re-use the tools or equipment they use. The use of the sponge is more than an MRI test because the MRI machine can be done multiple times and the sponge can be used only once.

Edited for Fraz's sensibilities.