Comments on: Here it is….THE healthcare debate: The UK perspective

By: Adam

Adam — Tue, 07 Jun 2011 16:31:13 +0000

Fascinating scenarios. 18 Weeks for the angiogram. Hmm… And 80 pounds per night for a private room seems low. We just paid 500 pounds per night for a private room at the John Radcliffe Hospital in Oxford. The room compared very poorly with Motel 6.

By: Beenish

Beenish — Thu, 07 Apr 2011 11:44:00 +0000

Health care provider may refer to either an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities

By: Sammy O. Henns, MD

Sammy O. Henns, MD — Sat, 27 Mar 2010 16:43:13 +0000

What a complicated health/medical maze you all have to deal with in Britain. In any case, one can see that the main predicating or guiding factor in both system’s health-care delivery is the way the insurance companies control the way medicine is practiced by physicians.

By: Emily

Emily — Wed, 24 Mar 2010 13:02:39 +0000

“Mr. Schnerd continues to have ongoing exertional angina and mentions this at his outpatient appointment He is placed on the waiting list for an angiogram (the target on the NHS pathway is for referral to treatment to be completed in 18 weeks- 18 week RTT time) performed by one of the cardiologists team, which is unchanged. The stent is fine.”

Eighteen weeks is a LONG time! Mr. Schnerd may have to wait up to 4.5 months for an angiogram? What if the stent hadn’t been fine?

Not that the US system is any better; patients without insurance or the means to pay cash have to wait much longer to get appointments and, where I work, are seen by the resident rotating through clinic, rather than having the same attending physician most of the time.

Thanks for the fascinating comparison!

By: Dr. Wes

Dr. Wes — Wed, 24 Mar 2010 03:40:58 +0000

Sarah-

Thanks so much for your help constructing these scenarios from the UK perspective.

From what I see, it seems that the PCT (Primary Care Trust) holds the money and makes the rules in the British system->how much they’ll pay, if they’ll pay, how many procedures they’ll pay for, etc., etc. This seems to be a fundamental difference between the UK’s system and that in the US. Rationing currently does not occur, but our new health care bill will likely visit some form of covert rationing upon our populace to save costs inthe years to come.

I enjoyed attending the session at the recent ACC meeting between the British Cardiovascular Society and the American College of Cardiology. While we clearly have a health care cost crisis in the US, I was surprised to learn that the costs are shooting skyward in the UK as well. According to one talk there, the UK’s annual budget for heath care was about £44B in 2000 and projected to be £112B in 2010 – over 120% increase. With the high British tax rate already in place, one wonders how long these health care cost growth rates will be sustainable. Despite this, it seems there’s a remarkable lack of transparency about costs regarding ICD’s there. I would LOVE to see what an ICD costs the PCT versus what it costs our hospitals. I bet the difference would be staggering! (We’d pay more because, well, they can get it.)

Also, I was struck that primary angioplasty was not implemented in the UK nationally until it as studied between 2005 and 2008 and determined to be cost effective. This slow adoption rate would not be tolerated in the US currently. We have a hard time saying “no.” There is a tacit perception as a professional that if you’re not implementing the latest technology or intervention as soon as it’s available, you’re a laggard. Americans don’t like being laggards.

Well, I’ve carried on too much, but wanted to share some of my thoughts at first blush. It’s been a pleasure working with you on this and I hope we can continue the effort in other ways!

All the best!

-Wes