Is cancer a non-starting precondition?

[Notmuchlonger]

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Originally Posted by Alan My and DW's families' recent experiences this year to see a GP for non-emergencies (bladder infections, stomach viruses, fevers etc) have been next day or within a few days in England and there have been plenty of examples this year unfortunately. We were over in May and my Aunt, visiting from Australia got sick and we called and made an appointment next day - she had flu, and was shocked to find to find that she was charged 75 pounds for the visit and drugs. In 2007 I was in England running some meetings when one of my managers from Spain took ill late in the afternoon. Since his very strong accent was very hard to interpret I made the call to the 800 NHS after hours care number, discussed his situation and got an appointment at an after-hours clinic close by, drove him there an hour later for a 7pm appointment- he saw the Doc with no wait and got a prescription which we filled at the clinic and it did the trick - no charge as he was had an EU card. Very impressive. I hear all the horror stories in the press about the UK NHS and simply cringe. There is plenty wrong with it but it works for the most part. Now, if you need a new knee, you'll have many weeks to wait unless you have insurance, which many folks have including us when we used to live there. Can be up to 18 weeks according to this recent article.

I dont know if the system is any good or not. However, waiting for 18 weeks to see a Dr is way too long.

[youbet]

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Originally Posted by Alan if you need a new knee, you'll have many weeks to wait unless you have insurance, which many folks have including us when we used to live there. Can be up to 18 weeks according to this recent article.

That seems to be an issue....... Why should you have to have insurance in order to avoid the wait time? It sounds a bit like an oxymoron. "We have great national health care........ and we buy insurance just to make sure....."

Perhaps I'm misunderstanding what you're saying Alan?

[Alan]

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Originally Posted by Notmuchlonger I dont know if the system is any good or not. However, waiting for 18 weeks to see a Dr is way too long.

That's why you have health insurance or have the money to pay - the NHS is not the only option and many UK employers provide Health insurance as an employee benefit. You have to compare apples with apples - what does a US person do if they need a new Knee and doesn't have insurance?

What does a US person do if they have cancer and don't have insurance? In June my sister in England was diagnosed with cervical cancer from a routine test. By end of August she had already had follow-up tests, and 2 surgeries. (she is now declared clear and is on a 6 month check-up regime instead of annual). She has no insurance and over here would probably now be bankrupt or dead as she probably wouldn't even be paying for her annual check-up.

[Buckeye]

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Originally Posted by Notmuchlonger I dont know if the system is any good or not. However, waiting for 18 weeks to see a Dr is way too long.

Wasn't the 18 weeks specific to getting a knee replaced? People usually put it off for years. Waiting 18 weeks to get it done once you decide to do it (and it is medically necessary) doesn't seem like a huge deal. It sounded like routine care appointments were instant to a day or two.

[Alan]

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Originally Posted by youbet That seems to be an issue....... Why should you have to have insurance in order to avoid the wait time? It sounds a bit like an oxymoron. "We have great national health care........ and we buy insurance just to make sure....." Perhaps I'm misunderstanding what you're saying Alan?

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"We have great national health care........ and we buy insurance just to make sure....."

If you are going to quote me please use my words - I believe I actually said -

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There is plenty wrong with it but it works for the most part.

I never said we had great national health care - but it doesn't leave folks bankrupt and the UK has a much higher life expectancy than the USA. I heard that in 2008 62% of all personal bankruptcies in the US were due to medical bills and 50% of those people actually had insurance.

When I moved to the USA in 1987 I thought the system here was fantastic, and the treatment still is fantastic for those able to get good insurance.

[Martha]

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Originally Posted by Alan . I heard that in 2008 62% of all personal bankruptcies in the US were due to medical bills and 50% of those people actually had insurance.

The "medical bankrutpcy" issue is complex.

Maybe there are more recent figures, but the message about medical bills causing most bankruptcies started with a Harvard study from 2005. The study abstract said:

"In 2001, 1.458 million American families filed for bankruptcy. To investigate medical contributors to bankruptcy, we surveyed 1,771 personal bankruptcy filers in five federal courts and subsequently completed in-depth interviews with 931 of them. About half cited medical causes, which indicates that 1.9-2.2 million Americans (filers plus dependents) experienced medical bankruptcy. Among those whose illnesses led to bankruptcy, out-of-pocket costs average $11,854 since the start of illness; 75.7 percent had insurance at the onset of illness. Medical debtors were 42 percent more likely than other debtors to experience lapses in coverage. Even middle-class insured families often fall prey to financial catastrophe when sick."

The full report: MarketWatch: Illness And Injury As Contributors To Bankruptcy -- Himmelstein et al., 10.1377/hlthaff.w5.63 -- Health Affairs

When this study came out some conservatives claimed that it was a myth that bankruptcies are often caused by medical problems and cited their own review through the US Trustee's office of bankruptcy petitions which showed 78% of bankruptcy petitions show medical debt of less that $5000. (sorry, I have since lost the citation).

However, the US Trustee's review tells only part of the story. First of all, there are plenty of people that have so little that garnishment of wages resulting from a $5000 medical bill can send them into bankruptcy. Also, even if medical bills are paid by insurance, the medical problems can mean loss of time from work that might not be paid or even the loss of a job. Also, people live on such tight budgets that the slightest little slip can mean a bankruptcy. So, it is a muddy analysis but medical issues, both bills and illness, do contribute to bankruptcy filings. Along with job loss, divorce and living on the edge.

[Peter]

I'd like to reinforce what Alan has been saying about the UK NHS. My mother is in her late 80's and has various medical problems. She receives prompt and excellent care, including home visits by her doctor! On occasion I've taken her for hospital check-ups and found the facilities to be clean and well-run.

Yes, you will have to wait for major non-urgent procedures. And yes, you can call this rationing if you wish. But we already have rationing here ... it's called nearly 50 million people without health insurance.

Peter

[youbet]

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Originally Posted by Alan If you are going to quote me please use my words - I believe I actually said -

Oooops..... Sorry Alan. Looking back at my post, it does read as though I'm quoting you. Didn't mean that. I was trying to give an example of someone touting the health plan yet buying insurance "just in case." Didn't mean to have it look as though you said it.

[Alan]

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Originally Posted by youbet Oooops..... Sorry Alan. Looking back at my post, it does read as though I'm quoting you. Didn't mean that. I was trying to give an example of someone touting the health plan yet buying insurance "just in case." Didn't mean to have it look as though you said it.

No worries mate

[Meadbh]

Wait times are unfortunately not measured consistently across Canada because each Province is responsible for healthcare and they all do it differently. Also, there are no comprehensive data for family doctors, because they work independently. Here is a link to hospital related data, but it's quite confusing.

Wait Time Information

My own experience has been that routine visits to my family doctor, and even tests, are usually available within days. If there is a delay, it's usually due to my schedule, not hers. Scheduling an annual checkup takes a few weeks, because she needs to allow more time.

There are numerous improvement projects going on, and some of them I am involved in. For example, Open Access (same day appointments) is spreading for clinics.