You're right, it does sound silly. Why would you second guess your doctor about your own clinical needs?
I'm sure they have standing protocols for basics like that. There may be a decision on things like major non-emergent surgeries, but not day to day stuff. In every hospital I've worked with the patient care and billing departments are completely separate. In fact, at the local one, billing is located clear across town. The people providing care have no idea what your insurance status is and, quite frankly, don't care. The priority is patient care, billing is someone else problem. You have it backwards. With private insurance, YOU have to pick up the tab up to your deductible, after that they pay for it. The problem is, if they don't agree with the care you've already received then they will refuse to pay for it and you're stuck with the bill. You probably had no say in whether or not you received that care, but your insurance company can refuse to pay for it after the fact. That's why documentation is so critical in my business. I have to justify every single thing I did for that patient or else we won't get paid for it. Oxygen is easy, but when you get into "why did this patient need to go by ambulance?" that can get into some clever wording. There have also been a few times where the patient didn't need to go by ambulance and that's exactly what I wrote on the report. On those, our billing manager never bothers to even submit the claim. Once again, by the time you get to the hospital you usually get the care whether you can afford it or not. That's why so many hospitals are un-profitable, because they write off millions of dollars every year. The problem is that people can't afford to go to the doctor and so by the time they go to the Emergency Room the problem is well advanced and tends to be expensive. There is a law in the United States called the Emergency Medical Treatment and Active Labor Act (EMTALA) which says that if you go to the hospital you will receive an examination and needed stabilizing treatment, without consideration of insurance coverage or ability to pay, when a patient presents to an emergency room for attention to an emergency medical condition. We won't pay for you to see the doctor when you're a little sick, but we will pay for care when it progresses to the point of being an emergency. This is another reason that a national healthcare system is superior is because it deals with illness while it is still cheap and easy to treat rather than denying care until it becomes an emergency. A doctor's office visit is $65, a trip to the ER is $1500, as a taxpayer, which would you rather pay for? EDIT: To demonstrate how it works, let me share with you a case I played a very small role in. A young girl over on the islands developed progressively worsening difficulty breathing. One of the local doctors on the island actually made a house call (who does THAT these days?) determined that she was very sick, and called 911. Since there is no hospital on the island, she was airlifted to our local hospital on the mainland. There, a team consisting of an ER doc, a pediatrician, 2 or 3 nurses, a respiratory therapist and a radiology tech managed to get her stabilized enough to move, and she was then airlifted a second time to Children's Hospital in Seattle. In the first 6 hours of care she ran up a bill of probably over $150,000, but you know what? Not one single person in her chain of care ever asked what insurance she had or if her family could pay for it. It doesn't matter, the only thing that mattered was getting this child the best care possible. That's why the hospital operates at a loss, Airlift Northwest runs a $2 million a year deficit, the ambulance service can barely remain in business, and no one is getting rich in healthcare, except the insurance companies. I don't know of anyone who would say that she should not have received the best care possible, yet I know plenty of people who say they shouldn't have to pay for it. This is the disconnect in the American system. We demand world class healthcare (though not outcomes) for all, but we refuse to pay for it. Healthcare in the UK is not free, everyone pays for it through their taxes, but everyone also benefits. There is an inbuilt incentive to provide preventative care, and a certain level of accountability that is lacking in the private sector.
Under the NHS you get oxygen when you need it. It us a medical decision, not a commercial one. The patient may want it, but the patient may not realise that too much oxygen can kill him just as easily as too little. The doctor does.
Are you aware of a case where that has ever happened? The theory that it can hurt CHF patients who are running on hypoxic drive has been disproven.
I get really annoyed by this (and the last) government constantly going on about choice. You can choose your hospital. You can choose you children's school. That is great if you live in London or another major city where you have a possibility of choosing but for large parts of the country it's not possible. My nearest large hospital is 30 minutes from where I live. The next after that is 2 hours away. I doubt very much a free market healthcare system is going to change that for the rural areas of the UK. On a slightly OT note how does a private health care system sit with the Hippocratic oath?
There's nothing to worry about moving to a fully free market healthcare system (right now at least) because that isn't going to happen. NHS is staying for good, and in twenty years time it will still be here. People need to get over this fear of the privatisation of healthcare. The one issue in which we're lucky here in the UK is healthcare, because that is the one thing that politicians on both side of the political spectrum are united on and most of them understand that publicly instituted hospitals and clinics is not radical socialism, but an active duty of the government similar to upholding the law, defence, police, and fire brigade.
Problem with our system though isn't it. What we have is not an English, Scottish, Irish, and Welsh parliament, it's a Londonish parliament which doesn't realise that it is so. There are choices of schools in London, so they seem to think there must be everywhere. There are choices of hospital in London, so they think there must be everywhere. They're a bit funny like that - they never seem to realise that they live in the capital and by far the largest city in the UK, and that changing something in London doesn't automatically change the other 55 million people's lives around the UK.
"People need to get over this fear of the privatisation of healthcare" no people need to start valuing the fact that healthcare is free on the point of delivery in the uk Were still trying to claim back cash in the netherlands from the insurance co... and this affects everyone. f*cking forms f*cking joke having said that if I think I need a prescription drug and I'm willing to pay for it then let me .... darwin and that if I fail.
Something needs to change in the NHS, longer waiting times,poorer survival rates and better funded than the French,German system. not to mention NI is now 25% of gross pay (for the majority of people) when you include employers contributions Round here there are no NHS dentist's and trying to get an appointment at the Doctors takes 5 to 10 days all I need is a scrip for antibiotics to deal with a reoccouring ear infection something I now get from the US instead. In the last month alone there have been dozens of examples of people dying due to poor or non existent care available from the NHS
Except that's not going to happen here in the UK. I'm just as sure about that as the fact that the police isn't going to go away either.
You do realise this thread started because the current government wants to get rid of the current system and it is being debated in parliament this week? Unfortunately this largely depends on where you live. When I lived in the city centre I could get a 10 minute doctors appointment within 48 hours if it was an 'emergency'. Otherwise A routine appointment was normally 14 days and I never saw the same doctor more than once. Now I live in the village I grew up in I can normally get an appointment the same day or next day and the doctors actually have the time to talk to you. The level of care i receive there is in a different league to what I received in the city. Dentistry is a good example of how expensive things are when you have to pay market rate for health care. My wife's tooth broke last week due to a filling her previous (NHS) dentist had made a complete arse of. The cost of removal and the fitting of an implant to replace it is over £2000. She had one these implants fitted last year because the same dentist had made a complete mess of a root canal treatment. Guess what our BUPA health and dental cover (provided by her employer) does not cover? Implants.
I'm saying we have nothing to worry about the NHS being marketised, it will still be free at the point of use and always will be. I was specifically replying to the post about it being marketised, not the NHS contracting more private GP practices (that's how discussions work they move forward quite quickly). These are two very different things. I've noticed people using both ideas interchangeably as if they're both the same thing, and I think that's where the confusion lies and that's where the fear of NHS not being free anymore begins to manifest. But like I said before, I can see how this could slowly pave its way to a fully marketised healthcare market and the abolition of the NHS, but again... that is not going to happen. NHS will continue to exist, and however it might be structured the most important thing is it continues to exist and remains free at the point of use. But, I remember hearing from someone once who described the love for the NHS as irrational and that it's the closest thing we have to a national religion. No politician is allowed to touch it, to improve it as they see fit, because it is an instant political disaster for them if they do. The bigger risk being threatened with these reforms is against the Conservative party, politically, not the NHS. Haha that cracks me up every time.
France and Holland have some privatised health care and are doing well. But that is because they are not operating in a free market economy. France and Holland have an obligatory health insurance, a bit like the national insurance here, that offers access to a standard package of health care. People can add to that their own private health insurance to get some added extras. However (and this is the important bit), the government sets the maximum level of insurance fee on the obligatory health insurance, and a maximum level of tariffs that any health care provider can charge for a given service. Health insurance companies cannot refuse to insure people and cannot jack the fees up to an exorbitant level. They don't have to, because a provider cannot milk an insurance company for all its worth. As a result, whatever competition happens between health care providers has to happen on minimising cost (i.e. raising efficiency) and maximising quality within the limits of what they can charge. And they have to compete, because patients can take their business somewhere else knowing that the price will be roughly the same. And although bigger providers could put smaller ones out of business, they cannot jack up the prices afterwards. They could of course cut down on quality instead, but then some new provider could just set up down the road and offer a better quality service for the same price. When you remove cost and price from the equation, all you have left to compete on is efficiency and quality. And that is what the government in countries like Holland, France and Germany have done by putting them under strict regulation. Nope, I'm not the medic. You are. That's my whole point.
I believe it can. It was a little while ago, when I was working as a healthcare assistant, it happened on our ward, although I can't remember exactly the details of that case. Fortunately, the patient was taken off oxygen and recovered. I wish I could be less vague about it. Besides that, in response to the original point, oxygen is a simple example. We have plenty of treatments available that will do you plenty of damage and should not be touched unless you really need them. Anyone fancy a transplant and immunosuppression on a whim? I'd trust my doctor with that one. They do go through 5/6 years of medical school for a reason. Even if at the moment it seems that purpose is just to make us hate the degree.
I don't know if you meant it that way but it sounds like you're under the mistaken impression that our NI contributions go straight towards the NHS. Instead they go into the big melting pot of the Treasury like most, if not all, forms of general taxation and the NHS is paid from that. When I was doing correspondence on NHS waiting times, one of the most common types of letter I got from elderly patients was "I've paid my stamp (National Insurance) for 50+ years and so I'm entitled to treatment, not having to wait a year or more for an outpaitent appointment". Well, it doesn't work that way. Sure they were entitled but in those days, some people had to sit on the waiting list for 2 or more years for elective treatment such as a hip replacement.
Just finished reading this thing from beginning to end and couldn't stop. Very, very interesting. Thanks to everybody for giving me something to think about. I have to say I agreed with the sentiments in the OP and I feel very fortunate to live in a country that offers free healthcare at the point of use. I'm asthmatic and thus far, pretty accident prone and have some titanium additions, so I would think I've had my money's worth! But even if I'd never used it, I would be more than happy to do my part to help others who needed it. Perhaps I could boil the "against" argument down to the age old thing. Anything public sector is generally even less efficient than iTunes for Windows. People think privatisation will fix that. And perhaps it will. I doubt it, but it's certainly possible. But that's not really the point. Free healthcare for all and the egalitarian principles of helping one's fellow man that accompany such a concept, is a fundamental building block for any civilised society IMO and I wouldn't want to participate in any society that didn't agree with that. I also think education comes into the same argument, but that's another thread... Nexxo, I sincerely hope it doesn't come to that, and thanks for making me aware of the situation (I don't watch the news any more as I believe it's bad for my health ) But......... if it does, I shall be leaving.
The national healthcare works for one reason. Preventive treatement is MUCH MUCH MUCH (oh did i say much?) cheaper than emergency treatment ever will be.
