2012.07.07 06:07
A personal experience with British Medical System I like to convey you the first-hand experience of socialized medical practice in Great Britain. There were a surprise and some difference from what I always hear in America. Last week, my family, including my wife and my daughter, Michelle, with her kids went to Great Britain on Michelle's business. My wife woke me up in the middle of the night with severe chills and whole body aching. You know what I mean... the astronomical medical bills afterwards. She was seen in 30 minutes by a nurse clinician followed by a MD about 30 minutes later. Basic lab tests and X-rays were done shortly after. The ER MD came and told her the diagnostic impression of acute urinary tract infection and the plan of action. It took 2 hours since the arrival at ER. IV antibiotic treatment began, and she was wheeled to Clinical Decision Unit (an observation unit) which has 6 beds. There were a battered woman and two drunks. Nurses checked vitals and IV infusion every 30min. The unit was clean but a bit Spartan. The unit MD confirmed her status during night hours. When I saw my wife in the following morning , she looked exhausted but not in acute distress. Although she did not eat much, she was given a dinner, snack, and breakfast. She thought they were similar to the hospital foods in US. The unit MD saw her next morning, and discussed the diagnosis, treatment, and follow-up plan just prior to my arrival to the unit. Short discharge documents including lab findings and X-rays in CD was given. A prescription of 10 days supplies of antibiotic was also given. When I asked the discharge nurse for the billing department for settlement, she smiled and said, "Goodbye and Bon Voyage". We slipped away with a deep sigh of relief and gratitude for the care my wife had received. I learned that British Medical System provides free care for all her citizens and acute care for everyone else including traveling foreigners like us. I felt not only the humane decency and morality in the action of the British socialized medical system but also their efficiency of doing only what were needed. Their medical facilities may be somewhat Spartan compared the deluxe resort-like opulence in American hospitals, but their existence is designed to take care of the sick people as their primary goal. In Great Britain, even though the system is said to be run by a government, but it seemed to work. Shang Rhee |
2012.07.07 06:55
2012.07.07 07:34
We lived in Canada for 10 years
and had the first hand experience of Canada's medical care delivery system.
They deduct x % of money from everyone's paycheck and government is the insurance carrier.
They had to control the cost and they tell how many doctors are needed where etc.
They decide where they can put MRI machine and put an ER servie to aviod the duplication etc.
MRI machine is used with 100% efficiency.
Doctors and nurses are paid by the government who set the fee/hospita rate.
Malpractice insurance was $50 premium a year then in 1977,
just nominal cost for legal expense.
They do not have jury system.
One of my wife's friend was bitten by a dog in her accountant's office.
She lost part of thigh skin which was treated with skin graft, being unable to work.
She sued for pain and suffering, but the judge denied her claim
as the medical "expense was paid by the government,
and she was paid by unemployment insurance, etc. ", the reasoning.
They are too many parasites in US medical delivery system.
2012.07.07 23:08
TLC(tender loving care)?
It's in the museum, if you look for it.
Compassion?
That also is there, if you look for it.
2012.07.08 11:28
I suggest anyone to read the article "Health care in Canada" in Wikipedia for facts and stats.
It gives perspective, points and counter points.
The article mentions that the mortality from waiting for surgery and immediate surgery are similar.
[15 vs 22 in British Columbia statistics in 1990].
My intention was to tell personal experience of socialized medical practice in Great Britiain.
I am saying that it is disgrace for a nation to spend 16 % of GDP
and yet over 16% of population does not have health ins.
Probably everyone agrees that something has to be done.
No industrialized nation has higher cost or uninsured !
It is no shame to learn from others.
2012.07.08 12:17
I know what your intention was, Dr. Rhee.
And I agree with you for the rest of what you said.
I'm glad that we are having this discussion because I'm learning something out of it.
I appreciate your input regarding the health care in Canada as well.
Because I've been practicing such a long time right next to Canada,
I do hear those things I mentioned and certaintly I didn't do my home work to update myself
about the health care in Canada.
I'm not defending the staus quo of health care in USA.
As a matter of fact, the majority of physcians and AMA feel the same way you do, I believe.
If Obamacare addresses the malpractice problem as they do in Great Brittain and Canada,
I believe over 90% of physicians will support it.
One more thing I hear in my specialty, Cardiology, is that
the busiest doctors in the world are doctors in England, particularly those in big cities like London.
This is mentioned publicly in a public forum.
The reason is that in England right now an average Cardiologist or any other specialist has two shifts of work
every day. He spends 8 hours as a government employee, then spends another shift of work in the evening
in his private office for the well off(wealthy) patients who carry a private insurance or pay cash.
So this doctor winds up working 12-16 hours a day.
I believe similar things are happening in Canada, Japan, Korea and others where there is a single payor
socialized medicine.
At least they do not have millions' of uninsured people as we do.
So that is good.
In spite of this, i.e. the rich still get away just as our congrssmen and senators do,
I'm all for the type of health care in England and Canada with no fear of malpractice suits.
2012.07.08 14:28
"If Obamacare addresses the malpractice problem as they do in Great Brittain and Canada..."
Doc, this is a wrong approach. At this point, we don't have to address the malpractice problem.
In a totally free and private society, it is impossible to control the freedom of patients
and lawyers to sue doctors. That freedom is guaranteed by our constitution.
No one can do anything about it.
The right approach is to start the national healthcare "first" and then the lawsuit get controlled by itself.
In the national healthcare, whom are they going to sue? They have to sue the government, not doctors.
With a little technical help from the congress, malpractice problems get solved without violating the constitution.
The best way is to start the thing first no matter how imperfect it may be,
and then look, work, and study for ideal solutions as we go on.
We should not try to find the ideally perfect system first, because such thing does not exist anywhere.
Why are we looking for something that doesn't exist?
Republicans insist on a perfect system first, because they know such thing can not be done.
That is exactly why they insist on it, because they don't want it to actually happen.
For an analogous example, if one want to attempt "a perfectly safe" mountain climbing,
he will never get to leave the front door of his own house.
We can not prepare for and execute such thing, because there's no such thing !!
If one really doesn't want to climb a mountain, he just insist on a perfectly safe climb.
That way, he know that it will never happen. What a good excuse is that?
The same goes with the national healthcare system.
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Thank you for sharing your first hand experience, Dr. Rhee.
I'm happy to hear the good outcome.
It sounds almost too good to be true.
I do hear similar stories from some friends in Canada.
For example, their experiences at doctor's office for the treatments of
minor illnesses is more positive in that it does not cost them anything.
However, from what I know through reading as you do the problem
in England as well as in Canada is when a patient needs to undergo major surgery
or procedure. Some years back it was well known to cardiologists that more people
were dying while waiting for CABG than from complications of the heart surgery.
In Canada, I hear that an average patient may have to wait up to 2 years before
the elective hip replacement surgery.
I do agree wholeheartedly that defensive medicine resulting from liability is the major
contributing factor in our medical cost.
One of the major weaknesses of Obamacare is just that, i.e. not addressing the issue,
as you know.
We know that in both England and Canada the rules and laws made it almost impossible
for an average patient to sue their doctors. When indeed there is a blatant malpractice,
an arbitrary panel, dominated by physicians, decide the award, which is in general much smaller
than what we see in USA.
Good to hear from you in this space, and
would like to hear more from you in the future.