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Monday, October 29, 2007

Socialized Heathcare- Lessons to Learn From Britain and NHS

When I hear people say "it would be nice if our government paid for our healthcare" I inevitably cringe.

Nice to think about not having to pay your high medical costs, of the insurance rates or pay for those expensive medications, but when you follow that train of thought to the natural conclusion, you find that state run healthcare doesn't work... a lesson that other countries teach us.

Today we see reports of 70,000 Britons will travel abroad for their healthcare because the NHS (National Health Service) isn't all wine and roses.

Record numbers of Britons are travelling abroad for medical treatment to escape the NHS - with 70,000 patients expected to fly out this year.

And by the end of the decade 200,000 "health tourists" will fly as far as Malaysa and South Africa for major surgery to avoid long waiting lists and the rising threat of superbugs, according to a new report.

The first survey of Britons opting for treatment overseas shows that fears of hospital infections and frustration of often waiting months for operations are fuelling the increasing trend.

Patients needing major heart surgery, hip operations and cataracts are using the internet to book operations to be carried out thousands of miles away.

India is the most popular destination for surgery, followed by Hungary, Turkey, Germany, Malaysia, Poland and Spain. But dozens more countries are attracting health tourists.

Research by the Treatment Abroad website shows that Britons have travelled to 112 foreign hospitals, based in 48 countries, to find safe, affordable treatment.

The problem with socialized medicine is that the level of care decreases, as I can tell you from my own experiences working first with Doctors and then in the health insurance industry.

Medicaid for example, people pay a modest sum, have no co-pay and receive their treatment....sounds good huh?

Well, the doctors have to sign a contract agreeing to accept only a small portion of what is billed to Medicaid, to be allowed to see those patients, and then the a majority of time is spent on the phone trying get Medicaid to actually pay for the services rendered.

The result?

Less quality and more quantity.

The problem is compounded when dealing with Medicaid or state funded health insurance.

Socialized medicine does not work, the quality of care goes down, the conditions of the offices and hospitals become dangerous because the money is not there to ensure that they are adequate.

On Wednesday, figures are expected to show rising numbers of hospital infections. Cases of the superbug Clostridium difficile, which have risen five-fold in the past decade, are expected to increase beyond the 55,000 cases reported last year.

On the same day, statistics will show that vast sums have been spent on pay, with GPs' earnings rising by more than 50 per cent in three years to an average of more than £110,000.

New research shows that growing NHS bureaucracy has left nurses with little time to see patients – most spending long periods dealing with paperwork.

Katherine Murphy, of the Patients' Association, said the health tourism figures reflected shrinking public faith in the Government's handling of the NHS.

"The confidence that the public has in NHS hospitals has been shattered by the growth of hospital infections and this Government's failure to make a real commitment to tackling it," she told The Sunday Telegraph.

"People are simply frightened of going to NHS hospitals, so I am not surprised the numbers going abroad are increasing so rapidly.

The Telegraph case some actual case studies:

Case 1: Russ Aiton

I'm sorry to say that Third World standards are what we now find in British hospitals'

When Russ Aiton was told he had the choice of an agonisingly long wait for a heart bypass on the NHS, or a bill of between £17,000 and £24,000 to have it done privately, he turned to the internet in frustration.

Within minutes Mr Aiton and his wife Joy had found a company that would get him the surgery within weeks for a fraction of the cost, 5,000 miles away in India.

Despite his long-standing loyalty to the NHS – he used to work for Sheffield Children's Hospital as a management consultant and Mrs Aiton still works for the service as an occupational therapist – Mr Aiton felt he had no choice but to go overseas. He now says it was the best decision of his life.

"I was diagnosed 18 months ago with heart disease and chronic atrial fibrillation – an irregular heartbeat – and my condition soon began to worse," he said.

He went to India, received his care, now feels like he has "a new lease on life".

Upon returning he found that 90 people in his country had died of Clostridium difficile.

Lets take a look at France and the question of what happens when healthcare for all becomes healthcare for none because it is no longer sustainable.

What's not to love about a health care system that offers full coverage for everyone, regardless of income, age or health? Even filmmaker and activist critic Michael Moore lavishes praise on the French health care system. But researcher Alice Teil says it's far from perfect:

"It's true we really have good access, but what if the system is not sustainable anymore?" says Teil. "It's going to break. It's going to blow. And then no more accessibility for anybody."

Tiel says the cost of France's socialized health care is growing faster than its economy. Workers pay about fifty percent of their paycheck each month into healthcare, retirement and unemployment and more companies are outsourcing jobs to avoid those costs. Quality of care also suffers in France, says Teil, because hospitals and doctors resist government requirements to report their success and failures.

"Providers think that if the government sets new measures, it's just to control them and take away resources," says Teil. "With a system with no transparency like in France - when you don't have these measures - you don't have any incentives to be the best. Because nobody will know anyway that you're the best."

By contrast, Tiel says privately-owned hospitals in the U.S. are motivated to measure and report their quality of care, which leads to better care.

Can you afford to live on half your paycheck so that the "government" (meaning you) can pay for everyones healthcare?

Canadians are also having to outsource their cancer patients because of shortages.

Quebec is following Ontario's lead in treating some of its cancer patients. It's sending them south of the border.

Quebec's Health Minister Pauline Marois says sending patients to the U.S. is the only way to ease a backlog in the province's hospitals. Marois says 285 cancer patients in Quebec have been waiting for radiation treatment for more than eight weeks.

Two months is widely regarded as the maximum acceptable time between diagnosis and treatment of breast and prostate cancer.

In Ontario, shortages of doctors and hospital beds are forcing people that need brain surgery to be "outsourced" also.

A shortage of neurosurgeons and hospital beds meant 36 severely ill Ontario patients had to travel to the United States for urgent surgery over five months ending in August.

A summer spike in emergency cases left no choice but to send the patients to Buffalo, Ann Arbor and Detroit to ensure the quickest and most appropriate care, according to CritiCall, the referral service in charge of tracking available beds in the Ontario health system.

From April through to August, 564 patients needed to be transferred to another hospital to receive neurological treatment. Of that group, 36 were sent south of the border, said Kris Bailey, executive director of CritiCall. "This last quarter has been quite high," she said.

The problem is blamed on shortages of trained doctors and nurses as well as critical care beds and available operating rooms.

When no bed can be found for Greater Toronto patients needing urgent treatment for sudden bleeding in the brain or traumatic head injuries, they may get sent to an Ottawa or a Kingston hospital.

Times Online takes Michael Moore to task for his Sicko movie which they show to be deliberate lies and dishonesty.

By ignoring these problems, and similar ones in France’s even more generous and expensive health service, Moore is lying about the answer to that question. I wonder whether the grotesquely fat film-maker is aware of the delicious irony that in our state-run system, the government and the NHS have been having serious public discussion about the necessity of refusing to treat people who are extremely obese.

One can only wonder why Sicko is so dishonestly biased. It must be partly down to Moore’s personal vainglory; he has cast himself as a high priest of righteous indignation, the people’s prophet, and he has an almost religious following. He’s a sort of docu-evangelist, dressed like a parody of the American man of the people, with jutting jaw, infantile questions and aggressively aligned baseball cap.

However, behind the pleasures of righteous indignation for him and his audience, there is something more sinister. There’s money in indignation, big money. It is just one of the many extreme sensations that are lucrative for journalists to whip up, along with prurience, disgust and envy. Michael Moore is not Mr Valiant-for-truth. He is Mr Worldly-wiseman, laughing behind his hand at all the gawping suckers in Vanity Fair. Don’t go to his show.

The next time you hear Hillary Clinton go on about Hillarycare, think about or search out the countries that already have Hillarycare and take a good hard look at what it does to the country, who actually is treating these patients (outsourced) and the quality of care the citizens of those countries are getting.

Healthcare for all, paid for by the Government, sure sounds good on paper and makes a great soundbite for a dishonest politician because no one bothers to ask the hard question of "how would ours look any different than theirs"?

It wouldn't.

That isn't a truth they will admit to though.