.............

we spend more in healthcare because we have resources available for use and because we have to cover our arses in case we get sued. also every patient wants the latest and greatest 3D MRI at the price and bill rate of a CXR

there is roughly 1 mri CT machine per region in ireland and uk, here even a po dunk community hospital has one. their guidelines for use are delinieated on a sheet in the ER..basically if it ain't bleeding, paralyzed, oozing a rainbow colored mush it doesn't get scanned.

you can't compare the health systems, maybe life expentancy, but the health systems have too many variables... if you wanna compare systems maybe compare ours with the brits "private" hospitals in terms of costs per patient and outcomes. in these private hospitals those who pay for private insurance or actually can afford out of pocket are treated rapidly, efficiently, and receive the proper diagnostic tests and treatments... isn't socialized medicine supposed to offer the same care to all?

the rates for cost in the nhs are set by the govt budget, hmmm i wonder why it always comes out looking like they spend less?

you wanna lower costs? put caps on what lawyers make in malpractice suits. if we didn't have to worry about patients wanting to hit the medical lottery with frivolous claims then maybe we wouldn't have to do a CT, trops, echo, on every patient in the ER and consult derm for every pimple and swollen hair folicle....

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OBGYN PGY II
I see light at the end of the tunnel!!!...wait a minute its just another freakin tunnel!

they cahrge less because they actually get paid what they charge....

they need to simplify it here. you are 100% right it is pure **... what most people don't understand is that most services have to be inflated in order to get actual cost of what you wanna get paid. the $1000 bill from your surgeon that you see isn't what he gest paid, he gets whatever the contract is, some specify the amount paid as a % of usual and customary...so the inflated price that is usual and customary of $1000 gets paid at 50% you will end up getting $500

every charge needs to be artificially inflated to make the isurance companies think they are saving money...and those bastards use their size to contract even lower rates. BCBS for example will pay about $600 to UI for a hospital stay wether it is 1 day or 1 month, then you bill other items individually, wonder why one tylenol is $20? you gotta nickel and dime those MF's in order to try and break even


ok enough of a rant..insurance companies are pure evil, you think lawyers are bad? you should be in some formulary negotiations..it is scary the amount of money they can take off or add on......

the insurance companies make these deals with pharm companies so that say insurance X agrees to make all the drugs from drug company Y preferred formulary..

since they have so many memebers in their various HMO, PPO, POS etc plans they get a huge discount on pharm co Y products...which they DON'T pass on to their members BTW so that magically whatever your co pay is for that company's drug almost covers their cost so they charge you for rx benefits but you still basically pay 99% of the cost of the rx!!!!

it is a sick and twisted payor system that rewards monopolies on brands between insurers and drug companies

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OBGYN PGY II
I see light at the end of the tunnel!!!...wait a minute its just another freakin tunnel!

Its a shame that the richest country in the world and we cannot provide primary coverage to millions of our citizns. Waiting in line for subpar service is better than none whatsoever. Frivilous law suits are a large player, but the biggest problem is Greed!!!!! Nobody is willing to pay a little extra in taxes, until they or someone they know cannot afford health insurance. Although in my opinion we wouldn't be paying much more if we centralized malpractice insurance and put a cap on frivilous lawsuits. There are billions of dollars wasted each year on billing................it goes on and on. Last report I read is that now 50% of the middle class is not insured or under insured. I don't think that the US is far behind the rest of the world in Socializing medicine in one way or another.

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Cogito, ergo sum

I agree about our poor cuisine but that's not the same as diet or lifestyle, as evinced by U.S. obesity rates (though, sadly, we're catching up).
Where do you get your visits to the doctor figures from?
Flawed design? The authors point out that- "These differences between countries or across SES groups within each country are not due to biases in self-reported disease because biological markers of disease exhibit exactly the same patterns. To illustrate, among those aged 55 to 64 years, diabetes prevalence is twice as high in the United States and only one fifth of this difference can be explained by a common set of risk factors. Similarly, among middle-aged adults, mean levels of C-reactive protein are 20% higher in the United States compared with England and mean high-density lipoprotein cholesterol levels are 14% lower.The study is, as the british co-author has suggested, just one piece in a complex "jigsaw". He also cautions-"We cannot blame either bad lifestyle or inadequate medical care as the main culprits in these socio-economic differences in health...We should look for explanation to the circumstances in which people live and work...We have to take a much broader look at social determinants of health in both countries."
The students rotating- they were experts in epidemiology?

I'm slowly getting used to this term "socialized medicine". I'm still not sure what it means. But I know that almost every time someone from the U.S. utters it they mean something pejorative. NHS healthcare is free to all, regardless of income at the point of treatment (it is, of course paid for by taxation). That does not prevent anyone from buying, with insurance or directly, whatever private treatment they think they need.
I don't understand your point about NHS "rates of cost". The WHO stats. on relative expenditure on healthcare are I think unambiguous: brits spend a lot less on healthcare both "socialized" and private (and that's per capita and as as a percentage of GDP). Are you suggesting that Tony Blair has a secret slush fund for NHS spending so that he can brag to George Bush how cost-efficient our health care is?

Experts? No, biut I do remember patients being told it would take 2-3 years to get them scheduled for tonsillectomies.

Doesn't sound particularly efficient to me, nor was it an uncommon circumstance.

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bleh

Current ENT waiting times for a number of NHS Trusts don't indicate anything like 2-3 years.
But whatever the waiting times, past or present, neither I nor the study in question are suggesting that the NHS is efficient! It has become something of a national sport to bemoan the state of the health service. We are, as a nation, hyper-critical of the NHS. This is, in part, a function of the deep affection in which it is held- despite its inadequacies.

My experiences were in Ireland. But my point is that, yes, as students we do have direct, firsthand knowledge of many things going on, although that doesn't make us 'experts' perhaps in the view of some, they are still valid experiences...

...regarldess of how things are 'reported', which we all know is not always accurate. It is most definately in the best interests of many people to paint a rosier picture than the one that really exists, in order to keep their livelihoods.

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bleh

Ireland! I was worried that the hospitals in the U.K. really were cooking the books on a grand scale!
I don't deny the validity of your or anyone else's first hand experiences. However, the post I responded to conflated criticism of the study's methodology with some pretty hair-raising statements about "laughable" screening and "many" people dying in wait for treatment. I think it was appropriate to challenge the hearsay evidence in that case.