Why cant we have a health system like canada?
1) Getting a GP appointment:
- I can't choose my own GP, I must go in area - even if it is 40 miles from where I work
- I may have to wait to get to see a GP even if I am really, really sick
- on a bad day the appointment might only be 7 minutes long
2) Getting a consultant referral
- I had to go through all the things the doctor could do before he would refer me - most of which I had tried before but because I had shifted countries was not on my medical records
- I am now waiting for a first appointment and indicative waiting times in my area range from 29 - 75 days for the specialist I need
3) Getting the best treatment
- our area pays for one operation and one option for what I need done.
- Cost benefit calculations do not take into account anything other than the raw cost of doing the operation, because the time in recovery and nursing care are in separate budgets. After care is not even considered
- there is a better option for me, given my family history and my individualised risk factors, but my chances of getting this better option is virtually nill despite the fact I can prove to them it would cost them less in the long run
Oh, by the way, I work for the health service, so I know how to work the system - and I will definately have a go at arguing my own case before the exceptions panel if they will let me - but I am a pretty clued up consumer and I have had to advocate for others as part of my job to get them the right treatment!
There is also the issue of treatments being restricted when there is not proof of risk-benefit and value for quality of life - so some people don't get the latest meds because there is not enough evidence for them.
Also, with an increasingly sick society, can we afford a national health service.
I prefer the middle ground - a basic service, which people can choose to top up if they want to/can afford to.
That is what Australia has, and it seems to work really well
Posted 01/12/2005
Robert R. Blandford, PhD
Davis and Silberg[1] have discussed the implications for US health policy of the recent Medicare prescription drug legislation. This same legislation also provides for Health Savings Accounts (HSAs). HSAs make it possible for individuals to accumulate an account on which they may draw to pay cash to medical providers. The legislation also prescribes that holders of HSAs must maintain a catastrophic health insurance policy.
Davis and Silberg also point out that many Americans are uninsured. The HSA legislation contains no direct attack on this problem. However, in an attempt to provide universal healthcare, I have developed an "Approach to National Health Care"[2] in which HSAs are mandatory for all wage earners. This approach further requires that almost every citizen have access to healthcare by providing a voucher at birth to each person born in the United States. The voucher is to be adequate to pay for care out of pocket, and to buy catastrophic insurance, until the citizen is well embarked on a job through which he or she can accumulate an HSA.
The approach also has a safety net, analogous to Medicaid, for those few individuals who both exhaust these sources of payment for healthcare and who also exhaust most of their own personal wealth. New mechanisms for providing health information to patients are also suggested, as is a legislative road map from our present condition to universal care.
Both Democrats and Republicans should find elements of this approach to universal healthcare appealing. Democrats should approve of the fact that it is universal and fiscally progressive; Republicans should approve of the fact that almost all citizens obtain their care in the context of a free market. Both sides should approve of the likely result that costs will be reduced as the proportion of third-party payments is reduced.
Doctors should approve of the fact that they will generally be dealing directly with their patients on financial matters, rather than through third-party regulator-negotiator-payers.
I believe that this is one of the "new ideas that show potential for improving efficiency, quality, or access," which Davis and Silberg urged that we keep a watchful eye for in case such new ideas might light the way to promising national policy changes. I urge legislators to look into using my approach as a way to reach across the aisles and actually solve the problems of delivering healthcare to all which bedevil the United States.
While the quality of American care is better, fewer and fewer people can afford it Thus a slightly lower overall quality available to all would be better.
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March 22nd, 2010 at March 22, 2010 | | Permalink