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Britain apologizes for third-world-like hospital

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Atheus

Diamond Member
Jun 7, 2005
7,313
2
0
Originally posted by: Ocguy31
Originally posted by: CanOWorms
Stuff like this is routine in Europe, especially when it comes to the medical care of minorities. It's part of the silent genocide.
Genocide has been thrown around so much it doesnt mean anything anymore. Now when those minorites have a real genocide on their hands (darfur), the African Union wont do anything to stop it.
Replying only encourages him.
 

JohnnyGage

Senior member
Feb 18, 2008
699
0
71
Originally posted by: eskimospy
Originally posted by: JohnnyGage
Originally posted by: eskimospy
Originally posted by: Ocguy31

I would be willing to gamble that most legal and productive people here in the US can find a way to get a job that helps with insurance, or pay for it on their own.

It seems to me that Americans prioritize a HD DVR cable box, cell phones for all 4.5 people in the family, eating at Chilis twice a month, and driving that brand new SUV. Then, when they get a $100-$400 medical bill, they freak out.

Or, they just go without insurance and play the "get hurt, get medical care in ER, file bankruptsy" game.
And you are basing this on what? Average medical costs for a family of 4 were $15,609 last year. I find it strange that I hear on here about how the tax increases people will face to pay for UHC are backbreaking, but you seem to be arguing that an average family has $15,000+ sitting around that they just blow each year instead of getting health insurance.

You realize $9442 of that is payed by the employer right? And the total out of pocket avg. is $2675--so your point is moot. Something tells me that if you have to pay for 300 mil Americans it's going to cost trillions so taxes will be significantly higher. And do you think most people would put up with higher taxes and sub standard care? I don't think so.
Right, and my point is nowhere near moot. Did you not understand what I wrote? We were talking about the uninsured, and so obviously part of their coverage is NOT being taken up by their employer. The number was simply to illustrate that Ocguy's idea that instead of people paying for a cell phone that they could pay for health care was silly.

Furthermore, as has been mentioned over, and over, and over again on here, UHC care is not sub-standard, nations with it have better health statistics than the US does overall and for a fraction of the cost.

Period.
I guess if a country that spends only a certain % of their GDP on healthcare and then ration it--then sure it's cheaper.
 

fskimospy

Elite Member
Mar 10, 2006
72,161
22,766
136
Originally posted by: Ocguy31
Originally posted by: eskimospy
The number was simply to illustrate that Ocguy's idea that instead of people paying for a cell phone that they could pay for health care was silly.
You've responded fairly to that point, now how about his aspect:

Originally posted by: Ocguy31


UHC would crumble just like Hawaii's did recently. We do not have the facilites, staff, or the infrastructure to accomodate everyone in the US going to the doctor with a fever. Just look at your average ER room, where hospitals will treat you regardless of immigration status or insurance coverage. I was in one with a buddy 2 weeks ago in Brawley, CA. It was a nightmare.

Add in a time where we have NO MONEY for the programs that are already in place, this is like someone who is about to lose their home wanting to put a Yacht on a credit card.

Hillary Clinton was the one who wanted single-payer healthcare, and she failed at getting elected. Obama is not pushing for UHC, thankfully.
We most certainly do have the facilities/staff/infrastructure to treat these people. You would save huge amounts of cash by treating people with a fever instead of hospitalizing them when it turns into pneumonia, this can be translated into all sorts of other services.

Furthermore, most indications seem to be that UHC would SAVE us money. Billions and billions and billions of dollars. Honestly, I believe opposition to UHC is simply ideological in nature. I'm not pushing it because it expands the welfare state, I'm pushing it because it's proven to work. I think that if you were shown a private sector method that could save us 20-50% of the money we spend on health care annually, and that it could do so while providing similar or superior health outcomes, you would be all over it.

But yes, sadly Obama is not pushing for UHC. That's the only reason I wanted McCain to win actually, I figured that under him the system would get so bad that people would simply demand UHC. Now we'll likely get another band-aid instead of solving the problem.
 

ebaycj

Diamond Member
Mar 9, 2002
5,418
0
0
Originally posted by: eskimospy
Originally posted by: Ocguy31
Originally posted by: eskimospy
The number was simply to illustrate that Ocguy's idea that instead of people paying for a cell phone that they could pay for health care was silly.
You've responded fairly to that point, now how about his aspect:

Originally posted by: Ocguy31


UHC would crumble just like Hawaii's did recently. We do not have the facilites, staff, or the infrastructure to accomodate everyone in the US going to the doctor with a fever. Just look at your average ER room, where hospitals will treat you regardless of immigration status or insurance coverage. I was in one with a buddy 2 weeks ago in Brawley, CA. It was a nightmare.

Add in a time where we have NO MONEY for the programs that are already in place, this is like someone who is about to lose their home wanting to put a Yacht on a credit card.

Hillary Clinton was the one who wanted single-payer healthcare, and she failed at getting elected. Obama is not pushing for UHC, thankfully.
We most certainly do have the facilities/staff/infrastructure to treat these people. You would save huge amounts of cash by treating people with a fever instead of hospitalizing them when it turns into pneumonia, this can be translated into all sorts of other services.

Furthermore, most indications seem to be that UHC would SAVE us money. Billions and billions and billions of dollars. Honestly, I believe opposition to UHC is simply ideological in nature. I'm not pushing it because it expands the welfare state, I'm pushing it because it's proven to work. I think that if you were shown a private sector method that could save us 20-50% of the money we spend on health care annually, and that it could do so while providing similar or superior health outcomes, you would be all over it.

But yes, sadly Obama is not pushing for UHC. That's the only reason I wanted McCain to win actually, I figured that under him the system would get so bad that people would simply demand UHC. Now we'll likely get another band-aid instead of solving the problem.

I fail to see a significant difference between UHC and a massive employer's group health plan. You have lots and lots of healthy people paying into the system, who get coverage when they need it (get sick), and who subsidize the people who are regularly ill (long-term diseases/disorders, cancer, etc..) The only real difference is the size, in which case, a larger group gets you better negotiating power.

Righties don't complain about huge group health plans. Why do they complain about UHC?
 

Mursilis

Diamond Member
Mar 11, 2001
7,756
11
81
Originally posted by: eskimospy
We most certainly do have the facilities/staff/infrastructure to treat these people. You would save huge amounts of cash by treating people with a fever instead of hospitalizing them when it turns into pneumonia, this can be translated into all sorts of other services.

Furthermore, most indications seem to be that UHC would SAVE us money. Billions and billions and billions of dollars. Honestly, I believe opposition to UHC is simply ideological in nature. I'm not pushing it because it expands the welfare state, I'm pushing it because it's proven to work. I think that if you were shown a private sector method that could save us 20-50% of the money we spend on health care annually, and that it could do so while providing similar or superior health outcomes, you would be all over it.

But yes, sadly Obama is not pushing for UHC. That's the only reason I wanted McCain to win actually, I figured that under him the system would get so bad that people would simply demand UHC. Now we'll likely get another band-aid instead of solving the problem.
If I actually believed UHC would save us money, I'd be fine with it - I have almost no idealogical objection to it, so your assumption is wrong on that count. However, I simply distrust the theoretical cost savings, simply on the basis that gov't programs have a tendency to spiral out of control, cost-wise. Medicaid, Medicare, and SS are all costing FAR more than they were projected to cost 10-20 years ago. Why won't UHC be the same story?
 

Genx87

Lifer
Apr 8, 2002
41,061
494
126
Originally posted by: DukeN
Originally posted by: JohnnyGage
Originally posted by: eskimospy
Originally posted by: Ocguy31

I would be willing to gamble that most legal and productive people here in the US can find a way to get a job that helps with insurance, or pay for it on their own.

It seems to me that Americans prioritize a HD DVR cable box, cell phones for all 4.5 people in the family, eating at Chilis twice a month, and driving that brand new SUV. Then, when they get a $100-$400 medical bill, they freak out.

Or, they just go without insurance and play the "get hurt, get medical care in ER, file bankruptsy" game.
And you are basing this on what? Average medical costs for a family of 4 were $15,609 last year. I find it strange that I hear on here about how the tax increases people will face to pay for UHC are backbreaking, but you seem to be arguing that an average family has $15,000+ sitting around that they just blow each year instead of getting health insurance.

You realize $9442 of that is payed by the employer right? And the total out of pocket avg. is $2675--so your point is moot. Something tells me that if you have to pay for 300 mil Americans it's going to cost trillions so taxes will be significantly higher. And do you think most people would put up with higher taxes and sub standard care? I don't think so.
And what about the large number of people who don't have employers that pay $10K in medical costs? The remaining $6K a year isn't a number to sneeze at either.

Not everyone makes 30K+ each year with generous employment benefits like healthcare benefits exceeding $9-$10k in value.

As for the sub-standard care, do you actually have any qualitative data about this or are you basing your opinion on a story you read about a small number of incidents?
These kinds of studies are hard to gauge how they apply to people who have to foot more of the bill. In eskimopy's study a large portion of the cost was picked up by the employer. I am going to assume those are insurance costs. Then the employee who is paying 3900 in what looks like more insurance costs. The actual out of pocket cost was 2675.

If you dont have medical insurance it is very possible you arent spending 15K\year. It sounds like you should save 3900\year from deducted insurance costs. The employer is non-existent so there goes 9400 of it. We are left squabbling over 2700 bucks in our of pocket cost if this is correct. Though I will admit a lot of those costs may be co-pays and pharmacy costs that may be picked up by insurance so jump it 50% and it is in the 4K range.

It is also hard to judge from the study what kind of insurance people have. Higher deductibles cost less than full coverage.

Either way the question becomes for most people like myself who pay 720\year for insurance via my employer and had a total medical bill of 1800 bucks last year. Will UHC benefit me?!??? Will paying more in taxes give me better care?

I dont know many who wont admit our system is borked. The problem I have is people claiming UHC is the answer when we clearly already have a disconnect between the person consuming and the costs of the procedures. Adding 40 million into the demand side is only going to make it worse without increasing supply and letting the people know how much these things cost.
 

chess9

Elite member
Apr 15, 2000
7,748
0
0
Originally posted by: Phokus
That's 1 hospital... America has yet to apologize to the 50+ million uninsured in our own country.
Well, I've seen two of your healthcare Trusts in person, and I'd say they are pretty awful by American standards.

And, just today, one of my English friends, who is 69, and has not been sick recently went to his PCP and asked if he could have a full CBC just to see how he was doing. He's never had blood work done once in England. Hard to believe.....The VA does it twice a year for me. Anyway, the doctor refused.

I would support nationalized healthcare, but, please don't copy the English system. LOL! They will kill you.

-Robert
 

chess9

Elite member
Apr 15, 2000
7,748
0
0
Originally posted by: Mursilis
Originally posted by: eskimospy
We most certainly do have the facilities/staff/infrastructure to treat these people. You would save huge amounts of cash by treating people with a fever instead of hospitalizing them when it turns into pneumonia, this can be translated into all sorts of other services.

Furthermore, most indications seem to be that UHC would SAVE us money. Billions and billions and billions of dollars. Honestly, I believe opposition to UHC is simply ideological in nature. I'm not pushing it because it expands the welfare state, I'm pushing it because it's proven to work. I think that if you were shown a private sector method that could save us 20-50% of the money we spend on health care annually, and that it could do so while providing similar or superior health outcomes, you would be all over it.

But yes, sadly Obama is not pushing for UHC. That's the only reason I wanted McCain to win actually, I figured that under him the system would get so bad that people would simply demand UHC. Now we'll likely get another band-aid instead of solving the problem.
If I actually believed UHC would save us money, I'd be fine with it - I have almost no idealogical objection to it, so your assumption is wrong on that count. However, I simply distrust the theoretical cost savings, simply on the basis that gov't programs have a tendency to spiral out of control, cost-wise. Medicaid, Medicare, and SS are all costing FAR more than they were projected to cost 10-20 years ago. Why won't UHC be the same story?

Government control is an oxymoron, that's the problem. We'd have to hire the Japanese to run UHC if we are going to have it. :)

-Robert
 

alchemize

Lifer
Mar 24, 2000
11,489
0
0
Originally posted by: ebaycj
Originally posted by: eskimospy
Originally posted by: Ocguy31
Originally posted by: eskimospy
The number was simply to illustrate that Ocguy's idea that instead of people paying for a cell phone that they could pay for health care was silly.
You've responded fairly to that point, now how about his aspect:

Originally posted by: Ocguy31


UHC would crumble just like Hawaii's did recently. We do not have the facilites, staff, or the infrastructure to accomodate everyone in the US going to the doctor with a fever. Just look at your average ER room, where hospitals will treat you regardless of immigration status or insurance coverage. I was in one with a buddy 2 weeks ago in Brawley, CA. It was a nightmare.

Add in a time where we have NO MONEY for the programs that are already in place, this is like someone who is about to lose their home wanting to put a Yacht on a credit card.

Hillary Clinton was the one who wanted single-payer healthcare, and she failed at getting elected. Obama is not pushing for UHC, thankfully.
We most certainly do have the facilities/staff/infrastructure to treat these people. You would save huge amounts of cash by treating people with a fever instead of hospitalizing them when it turns into pneumonia, this can be translated into all sorts of other services.

Furthermore, most indications seem to be that UHC would SAVE us money. Billions and billions and billions of dollars. Honestly, I believe opposition to UHC is simply ideological in nature. I'm not pushing it because it expands the welfare state, I'm pushing it because it's proven to work. I think that if you were shown a private sector method that could save us 20-50% of the money we spend on health care annually, and that it could do so while providing similar or superior health outcomes, you would be all over it.

But yes, sadly Obama is not pushing for UHC. That's the only reason I wanted McCain to win actually, I figured that under him the system would get so bad that people would simply demand UHC. Now we'll likely get another band-aid instead of solving the problem.

I fail to see a significant difference between UHC and a massive employer's group health plan. You have lots and lots of healthy people paying into the system, who get coverage when they need it (get sick), and who subsidize the people who are regularly ill (long-term diseases/disorders, cancer, etc..) The only real difference is the size, in which case, a larger group gets you better negotiating power.

Righties don't complain about huge group health plans. Why do they complain about UHC?
I think you have UHC confused with universal (insurance) coverage.
 

Mark R

Diamond Member
Oct 9, 1999
8,513
13
81
This story is an interesting one, although this hospital was unrepresentative of NHS hospitals in general. However, it illustrates potential pitfalls with micromanagement by central government, as it was desiret to placate central government, that drove the hospitals management to bad decisions. That said, as is the norm for disasters such as this, the blame cannot be sensibly pointed at one group only - there were failures at a wide range of levels, the extent of which are only now starting to come out of the woodwork.

The primary problem was that this hospital placed achieving 'foundation trust' status above all other goals. Being a foundation trust, means that the hospital gets much more control over its budget and strategic planning - however, a foundation trust must have a clear track record of good performance, and they must prove that they can operate within their budget. The catch was how the performance was measured, central government had prescribed specific targets (e.g. all patients attending the ER must have a decision made about treatment within 4 hours - i.e. they either get admitted into hospital or get sent home) - if all the targets get met, the hospital gets promoted.

It is from the pig-headed stubborness to address targets above all else, that seems to have been the downfall here. The hospital was already short on money, so to save money they started firing front-line staff, or redeploying them. Hence the reason they had receptionists performing triage, a job normally done by a fully qualified nurse. Similarly, there was a pig-headed stubborness to meet the targets at all costs. E.g. the 4 hour waiting time means the time from walking in the door, to either walking out, or getting a hospital bed in the appropriate department. If there is a delay (e.g. because the appropriate department will not be ready for another hour) then a manager would force a decision (e.g. admit the patient to an inappropriate department, and transfer later) which may not always be idea (e.g. it may be better to stay in the ER for another hour, looked after by the same doctor/nurse team, rather than be transferred to a deparment unfamiliar with the condition, only to be transferred later to a 3rd department with a 3rd set of staff).

Other targets too have been unhelpful - e.g. there is a cancer target which specifies maximum time before treatment. It states that if a GP suspects a patient to have cancer, that patient must be formally assessed by a specialist within 2 weeks, have all investigations needed to confirm/refute the diagnosis within 4 weeks and have started treatment within 8 weeks. The problem is that it fails to recognise that not all cancer requires urgent treatment. E.g. there is a very common blood disorder in the elderly called Chronic lymphocytic leukemia. Technically, it is leukemia, a type of cancer. However, this disease occurs virtually only in the elderly (older than 70), causes no symptoms in the early stages (so is often a chance finding on a blood test), takes 10-20 years to progress, and has no treatment except for relief of symptoms. The problem is that hematologists are completly swamped because GPs are forced to make maximum priority referals for every case of CLL, and because the times/dates of the appointments in the clinic are used for the targets, management often will not allow these appointements to be delayed to see urgent non-cancer cases.
 

chess9

Elite member
Apr 15, 2000
7,748
0
0
Originally posted by: Mark R
This story is an interesting one, although this hospital was unrepresentative of NHS hospitals in general. However, it illustrates potential pitfalls with micromanagement by central government, as it was desiret to placate central government, that drove the hospitals management to bad decisions. That said, as is the norm for disasters such as this, the blame cannot be sensibly pointed at one group only - there were failures at a wide range of levels, the extent of which are only now starting to come out of the woodwork.

The primary problem was that this hospital placed achieving 'foundation trust' status above all other goals. Being a foundation trust, means that the hospital gets much more control over its budget and strategic planning - however, a foundation trust must have a clear track record of good performance, and they must prove that they can operate within their budget. The catch was how the performance was measured, central government had prescribed specific targets (e.g. all patients attending the ER must have a decision made about treatment within 4 hours - i.e. they either get admitted into hospital or get sent home) - if all the targets get met, the hospital gets promoted.

It is from the pig-headed stubborness to address targets above all else, that seems to have been the downfall here. The hospital was already short on money, so to save money they started firing front-line staff, or redeploying them. Hence the reason they had receptionists performing triage, a job normally done by a fully qualified nurse. Similarly, there was a pig-headed stubborness to meet the targets at all costs. E.g. the 4 hour waiting time means the time from walking in the door, to either walking out, or getting a hospital bed in the appropriate department. If there is a delay (e.g. because the appropriate department will not be ready for another hour) then a manager would force a decision (e.g. admit the patient to an inappropriate department, and transfer later) which may not always be idea (e.g. it may be better to stay in the ER for another hour, looked after by the same doctor/nurse team, rather than be transferred to a deparment unfamiliar with the condition, only to be transferred later to a 3rd department with a 3rd set of staff).

Other targets too have been unhelpful - e.g. there is a cancer target which specifies maximum time before treatment. It states that if a GP suspects a patient to have cancer, that patient must be formally assessed by a specialist within 2 weeks, have all investigations needed to confirm/refute the diagnosis within 4 weeks and have started treatment within 8 weeks. The problem is that it fails to recognise that not all cancer requires urgent treatment. E.g. there is a very common blood disorder in the elderly called Chronic lymphocytic leukemia. Technically, it is leukemia, a type of cancer. However, this disease occurs virtually only in the elderly (older than 70), causes no symptoms in the early stages (so is often a chance finding on a blood test), takes 10-20 years to progress, and has no treatment except for relief of symptoms. The problem is that hematologists are completly swamped because GPs are forced to make maximum priority referals for every case of CLL, and because the times/dates of the appointments in the clinic are used for the targets, management often will not allow these appointements to be delayed to see urgent non-cancer cases.

Good points!

I would also note that many trusts suspect that the budget they are given is subject to political considerations. This is, of course, stoutly denied by Labour. I've heard that wealthy counties, like West Sussex-a bastion of Tories and other wrongheaded political types-get less money.

Also, if you put a time limit on the cancer process you have effectively said to the GP: "Don't look for cancer." Don't do any blood tests, urine tests, or oncology biopsies. Of course, most physicians are, fortunately, much more responsible than that, but many feel pressured to keep down costs.

In 2005 I went to the East Surrey Hospital with a friend who was having a lung infection gone wild. Frankly, I've seen the U.S. Marines put on better field hospitals in 'Nam. To their credit, they were re-building the place, but YIPERS, what a pit! She would have been better off going to her VET!

-Robert
 

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