Sunday, August 06, 2006

Wave of the Future

The year is 2040.

You're in need of an elective hip/knee/whatever replacement..

So your employer gives you a six week leave, (insurance) pays your plane ticket + incurred medical costs when you're in the great country of...


Because its now cheaper to PAY ALL THAT rather then have it done at the private facility next door.
National Health Care is now in place, + you've got the option of waiting a year on this procedure, or going someplace else. Malpractice premiums keep going up- so does the cost of health care.

I was listening to the radio the other day when this topic came up. Scared me so bad I just about dropped my Norand(electronic scanning device-pretty much the cost of a pump and 6x the size of one) on the concrete floor.( Yes, I've done this before) I do NOT want to go to India for any medical procedure, that would be a disaster. Quite aside from the question of followup, (they just release you + you go back to the US-no way to really get back in contact with them for emergency situations) medical care over there is not predictable. (no way to track reputation of doc/hospital?) Some folks might like it though. (hey, its a vacation!) Surgery is most definatly expensive, and if I had no other options I'd be forced to do that- not willingly,though!

I don't understand it all(I don't think anybody does). I've got mixed feelings on the subject of
national health care(with no offense to my UK readers), yes, we'd get the medications we'd need free-but everything is at a price. More taxes- less incentive from the healthcare people to work hard. Back in Feb, before I had my AVM surgery my neuro-opth was casually commenting on this topic. It doesn't matter how many hours he worked, he does it because he's a slave to his job(awesome doctor) he doesn't care about the money-but geez, one would think MORE time should equate to a greater salary. Maybe that wasn't right- maybe people in the NHS don't get payed a flat rate salary but the thought is kind of disturbing. When I work overtime, I want that overtime pay-+ doubly so, when I get to be a nurse and start making even bigger bucks!
Not to mention waiting x number of months for non-emergent things that National Health Care deems not necessary/can wait.

But its coming, so we'd better get used to the idea.

And stock up on diabetes supplies. (that's if your insurance company is generous on rx's. Mine isn't, but they do shell out on expensive surgeries!)


othur-me said...

If you want to reach your follow up team in India by phone, all you will need to do is call Microsoft help desk. The same person might even do both jobs!

type1emt said...


Caro said...

This going abroad thing is happening frequently here in the UK. In fact there was a recent ruling that said the NHS had to pay for people to go abroad if they had to wait an "unreasonable" length of time in the UK. No one really knows what constitutes unreasonable though!

It disturbs me though that there are some really high class medical facilities in places like India, who cater to this "health tourism", yet many natives still can't get access to even the most basic care.

It is true that everything in the NHS is at the expense of higher taxes and National Insurance contributions (which also cover the cost of a true welfare state). Not everything is free either. Unless you have a chronic condition - including diabetes - all prescriptions carry a charge, as does dentistry(for those who can access NHS dentistry at all - an exception to 'care for all' despite multiple promises from Tony Blair, they are actually making it even harder for us dentists to work in the system) and optometry. There is also the issue of supply and demand. People often take the NHS for granted and will see the GP (PCP) at the drop of the hat because they don't have to think about the cost and whether their problem really warrants the attention of a doctor, or could be dealt with by a pharmacist or nurse practitioner.

However most people who work in the NHS are truly committed. They have to be, because the pay and conditions really aren't that great, especially at junior levels, and for nurses in particular. Also remember that most consultants also carry out private work.

(As an aside, I also get bugged when people have a bad experience, say on holiday, with a particular doctor, and are quick to blame it on "socialised medicine", when in reality poor doctors occur everywhere, as do great doctors regardless of what system they work in.)

And many of the stories about NHS waiting lists are overblown. Non-emergent things do get pushed further down the list, but only so really urgent stuff gets taken care of right away. I guess I see it as priority setting.

I guess at least with nationalised care everyone gets looked after and no matter what their condition or ability to pay. No one has to stay in a job they hate because it has great insurance, and there is no variance between what is covered for everyone, as there is with different insurance policies. There are problems at times with the coverage of specific items until they have been evaluated for clinical effective vs cost. Until Insulin Pumps had been evaluted in this way, getting one was extremely hard work (I know from bitter personal experience) and there has been an ongoing media furore about Herceptin. But the care is there for all. Which I guess is something.

There are downsides, but there are upsides too.

type1emt said...

Thanks for that Caro, it cleared a few things up.
BTW, what happened to your blog???did you get rid of it, switch to another one, what? its not coming up for me..((

Caro said...

Hmmm... my blog is right where it's always been. Someone else mentioned having trouble too. I don't actually know if there was any Typepad maintenance scheduled that may explain a problem. Try again, and let me know if it still isn't working!

type1emt said...

still isn't working..