About Me

Larbert, Scotland, United Kingdom

Thursday, June 26, 2008

Healthcare systems....

This is David Asman, an anchor on Foxnews in the US. In 2005 his wife had a stroke whilst on a visit to london. I just saw http://www.opinionjournal.com/extra/?id=110006785 over on the BBC website and was interested in some bits.

The Good:
As I was to discover time and again in the British health system, despite the often deplorable conditions of a bankrupt infrastructure, British caregivers--whether nurses, doctors, or ambulance drivers--are extraordinarily kind and hardworking. Since there's no real money to be made in the system, those who get into public medicine do so as a pure vocation. And they show it.

There is also much less of a tendency in British medicine to make decisions on the basis of whether one will be sued for that decision. This can lead to a much healthier period of recuperation.

British doctors, nurses and physical therapists also seem to put much more stock in the spiritual side of healing. Put simply, they invest a lot of effort at keeping one's spirits up. Sometimes it's a bit over the top, such as when the physical or occupational therapists compliment any tiny achievement with a "Brilliant!" or "Fantastic!" But better that than taking a chance of planting a negative suggestion that can grow quickly and dampen spirits for a long time.

The Bad:
As it happened, the best such hospital in England, Queen's Square Hospital for Neurology, was a short distance away, but it had no beds available. That's when I started dialing furiously again, tracking down contacts and calling in chits with any influential contact around the world for whom I'd ever done a favor. I also got my employer, News Corp., involved, and a team of extremely helpful folks I'd never met worked overtime helping me out.

Based on my Latin American scale, Queen's Square would rate somewhere in the middle. It certainly wasn't as bad as public hospitals in El Salvador, where patients often share beds. But it wasn't as nice as some of the hospitals I've seen in Buenos Aires or southern Brazil. And compared with virtually any hospital ward in the U.S., Queen's Square would fall short by a mile.

The equipment wasn't ancient, but it was often quite old. On occasion my wife and I would giggle at heart and blood-pressure monitors that were literally taped together and would come apart as they were being moved into place. The nurses and hospital technicians had become expert at jerry-rigging temporary fixes for a lot of the damaged equipment. I pitched in as best as I could with simple things, like fixing the wiring for the one TV in the ward. And I'd make frequent trips to the local pharmacies to buy extra tissues and cleaning wipes, which were always in short supply.

In fact, cleaning was my main occupation for the month we were at Queen's Square. Infections in hospitals are, of course, a problem everywhere. But in Britain, hospital-borne infections are getting out of control. At least 100,000 British patients a year are hit by hospital-acquired infections, including the penicillin-resistant "superbug" MRSA.

As I mentioned, the cleanliness of U.S. hospitals is immediately apparent to all the senses. But Cornell and New York University hospitals (both of which my wife has been using since we returned) have ready access to technical equipment that is either hard to find or nonexistent in Britain. This includes both diagnostic equipment and state-of-the-art equipment used for physical therapy.

The thoughtprovoking:
But what of the bottom line? When I received the bill for my wife's one-month stay at Queen's Square, I thought there was a mistake. The bill included all doctors' costs, two MRI scans, more than a dozen physical therapy sessions, numerous blood and pathology tests, and of course room and board in the hospital for a month. And perhaps most important, it included the loving care of the finest nurses we'd encountered anywhere. The total cost: $25,752. That ain't chump change. But to put this in context, the cost of just 10 physical therapy sessions at New York's Cornell University Hospital came to $27,000--greater than the entire bill from British Health Service!

"Free health care" is a mantra that one hears all the time from advocates of the British system. But British health care is not "free." I mentioned the cost of living in London, which is twice as high for almost any good or service as prices in Manhattan. Folks like to blame an overvalued pound (or undervalued dollar). But that only explains about 30% of the extra cost. A far larger part of those extra costs come in the hidden value-added taxes--which can add up to 40% when you combine costs to consumers and producers. And with salaries tending to be about 20% lower in England than they are here, the purchasing power of Brits must be close to what we would define as the poverty level. The enormous costs of socialized medicine explain at least some of this disparity in the standard of living.
So a country of hard-working, patient centred staff struggling in an underfunded, unclean hospital with poor equipment. Yeah, I guess that sums up the NHS.....

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