Thanks, Neil -- I found some stats, but they were five years old. Looks like you found more current info.

I have been following this thread with interest. I am an ob-gyn in practice for 27 years and trust me, our system is seriously broken, and anyone who doesn't see this is not looking. My patients are losing insurance coverage along with jobs, can't afford Cobra (which is temporary, expensive extension of your health insurance from your recent employer) or finding that any policy they are able to afford covers very little. Heaven forbid there should be a pre-existing condition! The insurance companies are profit-driven which translates into denial of legitimate claims or endless appeals and delays until you are paid. Usually 1/3 to 1/2 of your billed services. The percentage drops every year. In 2008 I made the least profit I have ever taken out of my practice. This is with very little change in my billing amounts. Even with PD I am working hard and would love to cut back but can't afford to. And if anyone thinks there are "free market" forces somehow applicable here that is some kind of nostalgic fable. I sign a contract with your insurer that says that I will accept their reimbursements and I cannot bill my patient for services that are denied by their insurer. So I am out the cost of the bone density study that I ordered for my post-menopausal breast cancer patient who can't take estrogen and whose mother died of complications of osteoporosis. Her insurer claims that the bone density study is "investigational"!!! That's it, case closed, I eat the unpaid bill. After a lengthy appeal no doubt.

My best friend from medical school works in the VA system. She has been there a while so makes a generous salary, 5 weeks paid vacation, 1 week paid CME, she will have a pension, great benefits, Federal holidays, etc etc. So what exactly is it about the government-run system I am supposed to be afraid of? She likes her practice and takes care of patients who need her.

I have to hire an extra person to spend the day begging the insurance co's to pay for legitimate services. It is hard to budget when you don't know when or if you will be reimbursed. And yet the insurance companies make a profit--why?? What service does a bureaucrat from BCBS provide for my patient, and why does that entitle them to large executive pays and profits?
I don't doubt that a public plan will not be without its drawbacks but the current system with no checks on insurance co. power is not superior. Lucky you if you are happy with your current plan but I see a bigger picture of many hard-working people who aren't able to obtain or afford coverage and they aren't all illegals or deadbeats.

I'm sorry to be so lengthy but I don't post too often and it's mainly when I feel strongly about something. One last thing: another of my med school (Duke) classmates practices in Canada, and the system works pretty well in her viewpoint. She is a psychiatrist who has practiced in both countries. I see the propaganda about how terrible the Canadian system is and I think it is all being funded by ins cos and big pharma and they have the clout to get whatever they want I'm afraid. Sigh. The status quo.

thanks for the post - good to have your perspective. i'm just learning the details, but i think medicaid workers don't always get their paychecks on time, but when the money is there.

paula

I've been following this thread with interest as well and did post a little earlier re the Canadian system. My comments may have been lighthearted previously but after the previous exchange, I can safely say that I am glad to be practicing as a family physician here in Canada. There is no insurance company deciding for me what is a necessary investigation and covering the costs (or not) accordingly. I simply order whatever my clinical judgement has decided is in the best interest of the patient. The patient never has to be concerned regarding payment. Sure we don't have MRIs in every clinic and if you need your shoulder instability investigated, you may have to wait, but your clinician is worried about a potential tumor, then your scan is expedited and given first priority.

Universal health care essentially covers all your health care costs from cradle to grave regardless of your socioeconomic status (this does not include some ancillary services such as physio or psychology which has some restrictions in terms of public funding and patients must rely on third party health insurance). Anyone can have access to the top physicians in any field and benefit from the same standard of care without having to worry about how they are going to pay for it.

Every system has its limitations and Canadian health care is not above that. There are always issues with longer wait times for nonemergency cases and a shortage of health care professionals to name a couple. And although we may complain at times, overall Canadians are fairly proud of universal health care and it is undoubtedly part of our national identity.

I was 22 years in a government run healthcare system - for the US military. On the whole, we received excellent care. But because it was "free" care, the waiting room was always full (i'd say if there had been a co-pay of any kind, half of the people in the waiting room would have stayed away). You would just show up if you were sick - and wait and wait. There was no choice of doctors. If they had the equipment, you would get the prescribed test. If treatment were deemed urgent, they would medivac you to a specialist. And of course if you were a General or an Admiral (active duty or retired) (or the wife of...) you would go to the head of the line and receive special treatment.

However, the VA medical care given to my dad was so awful that my dad quit going there. Their "approved" treatments didn't cover the medicines or tests he needed. His treatment there was nothing short of a nightmare. If that is the kind of gov't run health care we have to look forward to, I dread it.

No, ours in the U.K is certainly not like that.When people can moan about car parking fees in the hospital car park or the cost of a bus fare there.(I heard that one today)we have not got a lot to worry about. It was Mrs Thatcher's Government that upset the applecart by devolving power rather than it being centralised. So access to certain services, such as physiotherapy or a specialist P.D nurse, can vary from area to area.It comes back to the fact that whoever you are and however much you earn you get the same medical care as your next door neighbour.Nobody has to fear the medical expense of being ill.
I take holiday health insurance out for when I go abroad: if they are any example of insurance companies and healthcare then I fear for some of you.

Chasmo: you were indeed correct.It has been revealed, in the Observer newspaper, that a MEP (representative in European Parliament)called Hannan, wrote a book in 2005 which stated that "the NHS was no longer relevant to the 21st century."He gave an interview recently in which he spoke on Fox news saying the NHS was a "60 year old mistake" The leader of the opposition party, of whom he is a member, slapped him down and labelled him as "eccentric" This has all come back into the news as other opposition members were co authors of the original book.They have now publically moved to distance themselves from his views and refute the idea that they do not support the NHS.The British Prime Minister has broken off his holiday to say that that the future ,and implied safety,of the NHS would be at the heart of the next election.
This all seems to have been brought to the attention of the public in preparation for the election next year sometime...date yet to be announced. I suspect it will run and run. It appears that everyone,except Hannan, is bending over backwards to publically proclaim that they support the NHS.

I support a friend who has progressive MS, and is very unwell. She has nurses coming in daily to admiinister her medication, they are delightful, very helpful and relaxed, she sees three specialists who are the best in this region in their field, and any medical equipment she needs is delivered to her. Her house has adaptations, and she is treated in every respect very well, including being given the right to choose her treament options. We share a neuro and urologist. I have had for the last few months a physiotherapist come and help me out with specific exercises tailored to help me in the right ways. I also have a PD nurse who comes, at the moment every few months to help me tune up my medications, and check that I am doing alright and my needs are met. Yes. if I want to see my GP for something I have to make sure I call in first and go through a triage process, and yes if I go to outpatients for an emergency I will have to wait, perhaps several hours. But it all comes at no cost to me, through indirect taxation over my lifetime, and I am glad of it. My city also has a specific conductive education programme for PWP which I can opt into for no charge at all, I have chosen not to right yet, as freezing is not too bad now, and it will be more beneficial in a while. There has at no time been an issue of not getting the medication I need, when I was working I paid a nominal amount for them, now I am not working they are free. A few years ago my brother-in-law collapsed at work, with a brain haemorrage, When found he was swiftly helicoptered to the best hospital in England, where they operated on him, and he recuperated there for 4 weeks. Again, all paid for in the same way. All our major politicians are supporting the NHS, and after some shaky years are really understanding how blessed we are to have it, even though it is sometimes cumbersome, and can be frustrating. Don't believe the horror stories, we hear the same about other systems, it is media hype, and in the main there are no more disasters than anywhere else. What is radically different is that EVERYONE gets treated................

The article that triggered this thread is about uneven coverage across the UK, it is gradually improving, and there are historic reasons for that. They are in fact a different issue altogether from whether or not socialised medicine is good or bad.........
Lindy

you see items like this....

http://news.bbc.co.uk/1/hi/world/8200844.stm

The first guy is fantastic :

Guy: "you (UK) have the highest death rate and lowest recovery rate in Europe"

Interviewer: "have you ever experienced it"

Guy: "I don't need to or I'd be dead"

No arguing with that logic.

By all accounts the UK is now the great antichrist to the US, remember we shipped off Benny Hill and David and Victoria Beckham to you, all preludes to the great NHS export. Serves you right for casting off the benevolent rule of the Queen and empire, we never forget, you'll be back

Neil.

"Bring out your dead ..." (Monty Python)