Comments

Tom;

Thanks for this post, the picture and a moment whilst the village playgroup committee meets downstairs my three girls and I are camped upstairs whilst they battle against sleep and I battle another deadline....a chance to reflect.

In the UK the NHS is pilloried and praised in ofetn unequal measure, its my family experience of the service as someone who has worked for it (and still does) who has sisters who work in it and many customers also, that it is on occasion a place of magnificence and awe. In equal measures I have heard of talent amateurs in the support functions, there is often a certain mentality to work that can frustrate that does exsist at all too many levels. However, given its size and complexity 1.4 million staff dedicated to the care of people, its hard to get an objective view of a health care system until you experience another or at least the prospect!

As I sit here and reflect, I can think of my brothers hole in heart op in 1966 (50/50 back then, keyhole now!), I reflect on the care my fathers mother got after breaking her hip, my mums sister after a life time of personal neglect, of my own limited experiences and of those of my children who have had to be manipulated due dislocted bits or just general childrens bit and sitches. What impressed me then as it does now is that the only thing that mattered then as it does now is that care is free at the point of care, that its available to all no matter what the situation, the age the race the sex or indeed the trivaility or otherwise of the conditions presented.

There are hard times to come for the UK's NHS, it will be at least 6 years of famine if Prof Chris Ham of Birmingham is to be believed. many managers have come and many have left as have the initiatives many bold many unfulfilled too! Many have challenged the boundaries and some make small and significant changes along the way, I wish them well.

I would only ask one thing of any care provision system over and above that of free at the point of care. That they listen as the Dr's and Nurses who treated my father in the last days of his life listened to his son's & daughters request that like him they treated all life with gentle dignity and with warmth. That has no price or any management thinking it is the bare bones of humanity to care for one another best we can.

Thanks

Patrick

Posted by patrick at December 7, 2009 3:44 PM

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/etc/notebook.html

Here's a link to the Frontline Documentary with T.R. Reid from april 2008.
Its good.

Posted by zorro at December 7, 2009 3:51 PM

Tom - What a beautiful picture! It's the perfect backdrop for a winter in wonderland story. In fact, the picture itself evokes a story. Love the sun setting. Or, is it rising? Thanks for the book recommendation. I will purchase it. Maybe it should be required reading for those in Congress too. I've come to appreciate and value Reid's research and reasonable voice.

Zorro – You posted a series of T.R. Reid articles and videos on another blog that I really appreciated reading and listening to. I shall read this interview also.

Thank you both.

Posted by Judith Ellis at December 7, 2009 4:12 PM

Both my parents were medical doctors in the UK. I never heard them complaining about NHS bureaucracy or government interference. They seemed to have absolute flexibility in their patient-relationships and treatment options. They had huge job-satisfaction but not the big bucks of the equivalent US doctors. They carried malpractice insurance (Medical Defence League) and needed it a few times. But they never lost a case (that I heard of) and were not financially impacted. (Loser pays all costs in the UK system.)

Posted by Mike L. at December 7, 2009 5:42 PM

Regulars on this Blog know my views about Universal Health Care. In summary I’m a staunch and passionate advocate of the UK National Health Service. I've worked with hundreds, possibly thousands of UK doctors in my career and my conservative estimate is that about 95% of them are in favour of a universal system over a private system. I know there are problems with our service but I await an evidence based argument of a better universal health care system than the UK system for the entire population. I would also argue that a marker about any alleged civilised society is something around the value we place on the provision of comprehensive free healthcare for the most vulnerable among us regardless of wealth status. For anyone not yet fed up with my arguments about universal healthcare I ask you to listen to this interview with Tony Benn on the US programme “Democracy Now” http://www.democracynow.org/2009/8/18/british_politician_tony_benn_condemns_escalation

Posted by Trevor Gay at December 7, 2009 7:51 PM

Tom,

Another good reference to a guy with good suggestions. However what he is observing as piecemeal improvements is so different than what is being contemplated. Why 2,000 pages? The current proposal is insanity and no one in their fair mind suggest with confidence that the result will be an improvement. It makes you wonder if it is really about healthcare at all.

Why not limit the changes to say 5 suggestions only and try them out for awhile and see if they work. We could even vote them permanent (bear with my fantasy a bit more...). Then maybe we can try 5 more in a few years. Our system would benefit from incremental improvement in order to preserve the many things that the US healthcare system does best (too many for one post).

Suggestions:
1. Take all comers. If you can pay for the plan you get it regardless of pre-existing conditions.
2. Let insurance companies sell across state lines.
3. Cap liability suits to some number, say $100K. (Mike, I like the loser pays format you mention). Tort reform is the best way to reduce the waste of defensive medicine.
4. Design a standard billing form so that every hospital can be served by every insurance company.
5. Impose a deadline for electronic medical records, say Jan 1, 2012. Copy a system that exists and Mr. Reid likes.

Sure I could go on, and so could you, but maybe not for another 1,999 3/4 pages.

Posted by Terry Ransbury at December 7, 2009 10:52 PM

Yes but none of these countries have what America has in health care:

Not a single complaint of not meeting Wall Street profitability expectations of health care related companies.

In America, making money is a human right. Dead or alive is your problem.

Posted by Joe Buck at December 8, 2009 1:29 AM

America should be leading the world in health care for all, not just those who have the right insurance cover or the personal means to pay the bills.

I had a stroke five years ago and the care that I received via the NHS was great. I wasn't treated and streeted, I was cared for, looked after and treated with dignity, as were all of the others in the stroke unit of my then local hosptal, regardless of their age, background, enthnicity or gender.

I know that the NHS isn't perfect (my partner is a nurse who moved away from the NHS to a not-for-profit care organisation)and that there is still a long way to go to get everything right, but it does listen to rational arguments and to complaints when they're made.

I had a problem recently with the anti-coagulant clinic here in Bradford and it was listened to and dealt with in a day and I received answers and apologies within a week. And I didn't even mention that I work as a journalist from time to time.

When it comes to healthcare, there should be no vested interests in treating those who need health problems solving...

Posted by Keith Rickaby at December 8, 2009 4:20 AM

Great comments Keith and thanks for sharing. Sorry to hear of your health problems but I am delighted the NHS has been good for you. I have always said the NHS has many problems but your experience as a patient is overwhelmingly more typical than the doomsayers would have us believe about the NHS in the UK.

There are those who criticise the NHS without knowing a jot about it ... and have certainly never used it as patients. For instance the famous case earlier this year of the US Newspaper 'Investor's Business Daily' which claimed in an editorial; "People such as scientist Stephen Hawking wouldn't have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless."

This caused widespread criticism, as Hawking of course does live in the UK, and has received NHS treatment. Hawking personally replied that, "I wouldn't be here today if it were not for the NHS," he said. "I have received a large amount of high-quality treatment without which I would not have survived."

I'm not qualified to comment on the US healthcare system - I have not used it or worked in it - but when people criticise the UK service from a position of ignorance and complete lack of factual knowledge I think we have to defend our service. I will continue to do so as vociferously as I can until someone convinces me of an evidence based better alternative for universal healthcare coverage.

Posted by Trevor Gay at December 8, 2009 7:48 AM

Thanks Trevor

It was an interesting experience a couple of years ago trying to convince my partner's youngest of the need for ample healthcare cover when he took himself off to the States for two weeks.

He thought that he had enough medical cover from the travel insurance he'd taken out and it wasn't until Caroline had started quoting some figures to him of medical costs in the US that he took out some extra cover, just in case he was injured whilst parachuting, hit by a car or taken ill.

Whilst he was on his travels in 2008 and again last year, what he did find was that many people just didn't have healthcare cover because they quite simply couldn't afford to do so...

I shudder to think how much it would have cost for my treatment if I'd had a stroke in the US, as it came out of the blue just three days after having a medical. The NHS did a very good job and continue to do so, ensuring that I am kept up and running and that any potential problems are dealt with straight away...

Posted by Keith Rickaby at December 8, 2009 8:54 AM

Joe, a cynic after my own heart!

Posted by tom peters at December 8, 2009 9:07 AM

To our NHS friends, thanks for taking the time to post these comments. Exceedingly thoughtful!

Posted by tom peters at December 8, 2009 9:09 AM

I have been dwelling on the notion of socialism and health care?

You seem to be terrified of caring, period?

Is it such a bad system (The US one)?, yes!

Cynicism is fine if you have the insurance, but its the second class citizen you are creating?

The NHS is a start.

have a great day

Patrick

Posted by patrick at December 8, 2009 10:19 AM

The "horror of socialism" is a uniquely (?) American thing. We do allow a socialist military--though with our second ammendment, many of us are mini-militias.

(I personally think that any Congressman who votes against some form or other of universal access ought to be required to vote in parallel to get rid of Social Security. If we wanna dump "socialism," let's not screw around!)

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Posted by tom peters at December 8, 2009 1:31 PM

"(I personally think that any Congressman who votes against some form or other of universal access ought to be required to vote in parallel to get rid of Social Security. If we wanna dump 'socialism,' let's not screw around!)"

Bravissimo, Tom! I have written many posts on being for the public option. But I could care less what it's called so as long as it allows access to health care and does away with precondition clauses. Who needs health care if there is no sickness and why are we punished because of genetics? I would also add that senators who vote against access for others should also be required to pay for their health care out of pocket for themselves and their families. Why should WE pay for their health care? "Physician, heal thyself."

Posted by Judith Ellis at December 8, 2009 1:53 PM

http://www.cato-at-liberty.org/2009/11/27/obamacares-cost-could-top-6-trillion/

If this is half right, the true cost will triple from the promises of our representatives. The unintended consequences of 2,000 pages of legislation increase exponentially with the page numbers, incomprehensible language and the inability of our elected representatives to read and then have a bureaucrat or career service employee administer what is enacted. This monstrosity is the complexity on the other side of complexity.

The Department of Energy was formed in the '70s to reduce our reliance on foreign oil. 116,000 employees and contractors spending over $24 billion annually. How's that working out for us?

Terry Ransbury is on target here. Maybe our Congresspeople could draft a bill of responsibilities for themselves to couple with the Bill of Rights? Perhaps starting with KISS and ending with RTFLegislation.

Posted by David Porter at December 9, 2009 9:14 AM

Getting rid of social security? Tom, a brilliant and succinct-enough-for-twitter reason to vote down the monstrous healthcare bill (thanks David). Who in their right mind would vote for another unsustainable Ponsy scheme like SS? Wish I'd thought of it...

Posted by Terry Ransbury at December 9, 2009 4:49 PM

In light of all the evidence of success in other countries' healthcare systems and the individuals who know how and why it all works, why is it our Congress has decided to reinvent the wheel (as they seem inevitably to do most of the time). To me it all points to one fact: you can't serve two masters, lobbyists/special interests and the American taxpayers. The lobbyists get the benefits, we pay for it - what a great system . . . NOT!

I personally am sick of these incompetent, self-serving numbskulls in Congress and I don't care what party they represent, I don't want them representing me anymore.

The for-profit, private insurance companies are currently going crazy raising healthcare plan rates across the board, has Congress mentioned this at all? We need non-profit insurance and access to the same plan that members of Congress have - DUH!

Let's introduce legislation for two term limits on all Congresspeople - if it's good enough for the President it sure should be good enough for them. I personally don't think Senator Byrd or most other professional politicians are a symbol of anything of value except they have all way overstayed their usefulness. And while we are at it let's make it mandatory that no Congressperson can ever become a lobbyist. I am tired of being dumped on by so-called former political representatives in pursuit of the buck both while they are in office and after they leave.

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Posted by Judith Ellis at December 9, 2009 7:19 PM

While I am largely in agreement with David and Terry points, I find it absolutely extraordinary that such cries were not heard when we were fighting two wars totally multiple trillions where countless thousands of our troops died and an estimated 200,000 of civilians died in Ira. We, of course, did not think of the trillions there, nor did we largely debate their costs the way we are doing now. I am not suggesting that we should not debate health care. I just find it strange that we did not hear how we were going to pay for not one, but two wars. The deficit, as with President Reagan rose the highest before any president heretofore. Was it because the wars in Iraq and Afghanistan were not included in the budget and it was thought that thought that we just had untold trillions hidden in a vaught?

Posted by Judith Ellis at December 9, 2009 8:51 PM

Oops! Accidentally submitted much too soon.

While I am largely in agreement with David and Terry's points, I find it absolutely extraordinary that such cries were not heard when we were fighting two wars totaling multiple trillions where thousands of our troops died and an estimated 200,000 plus civilians died in Iraq alone. We, of course, did not think of the multiple trillions there, nor did we largely debate their costs the way we are doing now. I am not suggesting that we should not debate the cost of health care. I just find it strange that we did not hear how we were going to pay for not one, but two wars. The deficit, as with President Reagan, rose the highest before any president heretofore. Was it because the wars in Iraq and Afghanistan were not included in the budget and it was thought that thought that we just had untold trillions hidden in vaults?

Posted by Judith Ellis at December 9, 2009 9:00 PM

I doubt if any of you that support health care reform have read any of the proposals. It is difficult to read since there are so many referrals to other areas. (Also , the Senate Bill seems to be secret.) However, the most dangerous item that I saw previously was the establishment of a panel that may decide whether your diagnosis will be covered by medicare. The decision may no longer be between patient and doctor.
While everyone has access to emergency room care, not all have access to regular doctor care. There is a difference. This bill may change that. The other matter is the fact that the same law that allows illegal immigrants to attend school (and some to receive free lunch )may also allow illegal immigrants to recieve free health care if this bill passes.

Posted by Mary McCall at December 18, 2009 11:17 PM

buy viagra in toronto Mary - Please cite sections of the bill instead of generalities. This will be appreciated since you have read it. I'm going through it now.

Posted by Judith Ellis at December 20, 2009 10:57 AM