How the NHS rates against American Health Care

72% of NHS patients complain that the stethoscope is too cold

The inimitable Siger forwarded an article to me about a recent report by the UK's Patient's Association - which claims that hundreds of thousands of patients have suffered 'neglectful, demeaning, painful and sometimes downright cruel' treatment at the hands of the NHS doctors and nurses.

"The report disclosed a horrifying catalogue of elderly people left in pain, in soiled bed clothes, denied adequate food and drink, and suffering from repeatedly cancelled operations, missed diagnoses and dismissive staff."

It's a fascinating article and one that will no-doubt yield bundles of ammunition for American conservatives intent on criticizing Obama's much-lauded 'public' health care option (even though what he's proposing is very far from the almost Soviet-style National Health Service in the UK.)

But what interested me was in the conclusion of the article.

Chris Beasley, Chief Nursing Officer at the Department of Health, is quoted in defending the NHS, citing that: "...recent patient experience surveys show that 93 percent of patients rate their overall care as good or excellent."

Why is this so interesting?

Because Fox News, that bastion of 'fair and balanced' reporting, recently cited that 89% percent of Americans had been similarly satisfied with the most recent treatment they'd received. This actually increased to 93% for those patients who'd recently suffered a serious illness.

Which is, somewhat coincidentally, the same percentage as those satisfied with their treatment from the NHS.

You can take that observation how you will - either as an indication that both systems are comparably successful, or to allege that both the NHS and Fox News are using conspicuously slanted statistics to support their agenda!

But what's really interesting is looking at the other end of these much-touted facts and figures - like the Fox News analysis which concludes that 'only' five million Americans are both uninsured and 'very dissatisfied' with the quality of health care they receive - roughly around 2% of the population.

According to the NHS article, the patients receiving what they determined as 'poor' care extrapolated to over one million people - also roughly about 2% of the population.

The same figure. Again.

To my mind, it just goes to reinforce the fact that there isn't a right and a wrong answer to providing health care for a nation's citizens. The best and worth of both seem comparable - whereas we really know they're not.

On the one hand, the American system can be criticized for being monstrously expensive and not covering enough of its citizens. Per capita, it costs twice as much to offer health care to the population of the United States - yet Fox News reports that 13.4% of Americans are still left without coverage.

The World Health Organization rank the United States as having the 37th best coverage in the world; not exactly a figure to boast about.

The United Kingdom, on the other hand, is ranked 18. Britain also has a lower rate of infant mortality and a longer average life expectancy. The cost of giving medical coverage to Britain's citizens is several thousand dollars less per person than in America (and, of course, covers everybody and costs its citizens nothing.)

But in many ways, such statistics tell us nothing.

Because while Britain's health care is cheaper and covers more people, many people argue that this is an indirect benefit of America's privately funded health care system.

It's a fact that many of the worlds leading pharmaceutical companies are based in the United States - and most of the new and exciting drugs and treatments emerge from the American health care system. The US system absorbs the related costs of researching and developing these new treatments (perhaps explaining why their health care costs so much more.)

And without having to pay for 'inventing' them, British patients do eventually benefit from these new drugs and treatments - just not immediately. The NHS generally offers only 'generic' medication, the copyrights of which have expired, meaning that most commonly prescribed medication is as much as a decade 'behind' the new and exciting drugs available in America.

But at least they don't have to pay for that development - or the research, marketing or related bumf. That cuts a huge chunk out of the related costs of running a universal health care system.

Perhaps that's not a fair analysis - in many way, it makes the NHS seem like a parasite, sucking drugs, treatments and developments from better funded health care systems - but it does offer an explanation for the gross disparity between the costs of running universal health care in Britain and the price of America's privately funded system.

America's race to develop new treatments also explains why some areas of medicine - like the treatment of cancer - are notably 'better' in America than in the UK.

So there's a truth we don't discuss much in the health care debate - that no nation's policy towards medicine exists entirely in a vacuum.

Some British people have to come to America to get the medical treatment that's simply not available to them at home. Meanwhile, drugs developed in America make a huge impact when they're eventually adopted by the NHS.

Because of that, the two systems are inextricably linked - as are the health care systems of Canada and other nations with a publicly funded system that benefits from America's private one.

This means that the discussion about changing the way America looks after the health of her 300 million citizens in reality affects far more people than just those with a US passport.

Curing America's Ills: Is Universal Healthcare the answer?

When I first arrived in America, I was gung ho about the American system of health care.

Private health insurance seemed like a sensible enough idea - despite universal healthcare in Britain, more and more people were turning 'private' anyway, so why not just roll out the system across the entire country?

Likewise, my wife and I had a great experience with the birth of our baby, staying in a wonderful hospital and getting the level of care we couldn't have dreamed of on the NHS.

However... As time goes by, I'm starting to see some serious flaws with the health care business.

The American system of private health care is overly complex, overly beauracratic and wildly inflexible. I'm not suggesting we roll out universal health care in America, but I think it's time Republicans and Conservatives listened to the facts and stopped trying to tell everybody that the health care system is fine as it is, 'cos it ain't.

Health care and pharmaceuticals are the largest money making operations in America. They dwarf the oil companies and represent something astonishing, like 20% of the country's GDP.

The problem? Americans are getting ripped off.

An excellent example of this is in regards to drugs. For some reason, US citizens pay far more for prescription and generic drugs than people living in neighbouring Canada or Mexico - sometimes as much as 10 times as much.

In Canada, where we can at least be confident that the drugs are the same ones we get in America, there's no justifiable reason for this. More and more Americans are buying drugs from Canadian 'online pharmacies' simply because the cost of getting prescriptions filled in America is criminal.

The pharmaceutical companies are in cahoots with the insurance companies and have jacked up the price of American drugs as high as they can. It's extortion, plain and simple. The typical flag-wavers for the pharma industry, the Republicans, are promoting the very opposite of the 'free market' that conservatives supposedly support.

The second rip off is health insurance itself. This is partly the fault of profiteering insurance companies, who have been jacking up the price of insurance year after year, far above the rate of inflation (one year, it was as much as 25%.) In addition, they're slowly whittling away the benefits this insurance gives, meaning that Americans pay more and get less.

But another contributing factor is America's de facto universal health care. Even if you don't have health insurance, you can still walk into a hospital and receive thousands of dollars worth of treatment - it's mandated by state law across America. The cost of that 'free' treatment is swallowed up by the hospital, which dutifully passes it onto the only people who can mediate the cost - the poor, ignorant schlubs who actually pay for their medical insurance.

Again, Republicans are against the concept of universal healthcare for people who can't afford it, failing to realise that this system already exists and they're already paying above the odds for it.

Say what you will about the inefficiencies of government beauracracy, but it'd be a damn sight cheaper for working and middle class people if the taxpayer picked up the burden of America's clandestine 'free' health care system, rather than the people who pay for it via their overpriced health insurance premiums.

The final complaint about America's health care system is simply that it's cruel, inflexible and twisted.

You may only go to doctors who accept your health insurance program. If you go to an 'outside' providor, you will be liable for thousands of dollars worth of bills. Often, you are not told who is 'in' or 'out' of your program until after the fact.

Health insurance providors reserve the right to retroactively refuse to cover certain treatments you receive. Rode in an ambulance? If they decide you should have taken a cab, expect a bill for $3,000. Had an MRI? It's entirely within their rights to refuse to pay for it. It's like walking into a restuarant and being expected to order a three course meal without being told how much it costs in advance.

If health care is a 'business' and patients are 'customers,' you would expect that the same rules of business should apply as they do in every other consumer industry on Earth.

Maybe private health care knows it's days are numbered - that's why they are ripping the consumer off for as much as they can while they can; more and more each year.

Premiums cost more. Coverage offers less. Drugs are more expensive. More and more 'nonessential' costs are being shifted to the patient (which is why more and more of them are declaring bankruptcy because of medical costs.)

Like a greedy vampire, the American health care system is sucking their consumer base for more and more each month - willfully ignorant to the fact that sooner or later, they'll suck them dry and kill their only source of nutrition.

I was against the idea of universal health care when I arrived in America, but a year and a half of witnessing how badly run the health care system is has convinced me that it might not be so bad after all.

In Defence of Barry Obama #2

America's talk radio is dominated by the conservatives - and when they're attacking Barack Obama (which is pretty much all the time) they love to throw words around like 'socialist' and 'Marxist.'

As a Brit, I find the whole idea of labelling Obama a socialist to be laughable. These poor Republicans have no concept of what a real socialist is.

Back when I was a boy (before Tony Blair made the Labour Party all cute and fluffy) there was a real socialist movement in the UK. The sort of thing that would have driven the likes of talk radio presenters Sean Hannity, Mark Levin and Mike Reagan running for cover.

Fear Comrade Obama

Part of the right wing campaign of mischaracterization stems from the conservative's desire to frighten voters.

Although 'the Red Menace' disappeared when the Cold War did, America still remembers the days of the McCarthy witchhunts and the fear that your next door neighbour could be a 'red.'

Socialism and Marxism are dirty words (whereas in England, they just make you think of angry young students trying to flog you copies of The Socialist Worker.)

There are two pieces of ammunition the right wing use to label Obama as a socialist. One of them is his call for 'Universal Health Care.'

The Spectre of the NHS

To the conservatives, the idea of 'Universal Health Care' is interpreted as some kind of nationalized health program akin to the National Health Service we have in the UK. The only problem is that Barack Obama isn't advocating anything of the sort.

'Universal Health Care' does not mean government run health care. It simply means 'health care for all.' And that's the crux of his health care policy. Obama wants to make affordable health care available for everybody, with guaranteed eligibility for those with 'pre-existing conditions.'

In addition to giving the 'uncoverable' access to medical treatment, he also wants to reduce the overall cost of health care by an average of $2,500 per family. He intends to do this by cutting the costs of actual medical treatment and reducing drug costs by eliminating patents pharmaceutical companies have.

I'm not in agreement with Obama's ideas. The idea of eliminating patents has the disadvantage of removing any incentive pharmaceutical companies have for developing new drugs, so like many of Obama's policies, it's blissfully naive. I think John McCain's health care strategy is more realistic and practical.

However, nothing Obama proposes could be interpreted as 'socialised' health care - even the government sponsored health coverage for children and those with pre-existing conditions.

What the conservatives attack as 'nationalised' government health care for the uninsured is nothing of the sort. In fact, Barack Obama isn't advocating anything that doesn't already exist.

Despite all the propaganda, America does offer free medical treatment to millions of uninsured people every single year - hospitals are forbidden by law from turning away the sick or injured. Because hospitals have to absorb the costs of treating these uninsured people, treatment costs go up and, as a result, so do insurance costs. We pay for it in our high premiums.

By actually organising and regulating health care for the people who fall through the cracks of the current medical system, Obama will hopefully save hospitals millions of dollars and those economies will be passed on to us, the consumer. Sure, we still have to pay for giving these people health care - but I'd rather pay less through taxation than more through health insurance premiums.

Misrepresented

Barack Obama is a lot of unlikeable things - misguided and idealistic in some respects (the other 'socialist' strategy the right wing attack him for, taxing the oil companies and redistributing that money to the tax payer, is certainly some kind of off-colour social engineering program.)

But he's not a socialist - no matter how much the right wing try to convince us he is.

Some Thoughts about Universal Health Care

When it comes to the ongoing debate about American health care, I'm definitely in the privatised, American camp. I've seen the British version of 'universal health care' and it's not pretty.

So far, Tina and my experiences with the American health care system have been much more positive than what we experienced in England - even if they cost more.

Our experiences

Tina's expecting a baby - so that means plenty of visits to Robert Woods Johnson Hospital for scans, checkups and advice. After the contributions of my job's health insurance package, we've been left with about $1,000 to pay out of our own pockets.

In England, the NHS would not have charged us any money. However, the treatment we've received in America has been in a beautiful, clean, well-appointed new hospital with very modern equipment. We weren't left waiting for very long and the doctors and nurses have held our hand through the entire process.

At the Royal Hampshire Infirmary, in Winchester, we had a couple of terrible experiences, being expected to wait about four hours for treatment in a dirty hospital, with old equipment and a doctor who once gave Tina a potentially life-threatening misdiagnosis (delivered in a rude and offhand manner.)

Even worse, two new mothers from Winchester recently died from the same form of streptococcal infection they'd coincidentally picked up while in the maternity ward of the Royal Hampshire Infirmary.

Clearly, private health insurance offers us (Tina and myself) a much higher standard of health care that we could receive back home

The Downside of Private Health Care

That being said, Tina and I are in the enviable situation of having a good health care package and living close to an excellent hospital.

The reason health care is such an important issue in the upcoming presidential election is because almost 50 million Americans - close to 20% of the entire US population - have no health care coverage at all.

This is because private health care is rocketing in price - and many companies, like Wal-Mart, don't offer an adequate health care package even to full time employees.

Now, even if you're a stuffy old Tory, like me, you can't help but admit that this is wrong. Adequate health care is a basic human right. That shouldn't be a political issue for either the Democrats or Republicans. It's only the best means to accomplish this goal which should be up for discussion. In theory...

In theory.

Because currently, the debate's taken a rather surreal twist and more and more conservative Republicans are railing against any notion of 'universal health care' as proposed by Barack Obama, Senator Clinton or even their own candidate, John McCain.

In fact, in his daily radio show, conservative pundit Mark Levin often claims that Obama and Clinton are pitching a 'socialised' medical system along the same lines as Britain's National Health Service - and he enjoys using the dismal state of the NHS as an example of why it would never work.

But the problem with the conservative argument (as is increasingly common with any conservative argument is that it's utter rubbish.

American 'socialism.'

Pundits love to label the likes of Hillary Clinton as a 'socialist' or 'Marxist' when they have no real concept of the term. For a Brit - at least one who's lived long enough to remember the socialist Labor party (before Tony Blair came along) - the idea of calling Obama or Clinton a socialist is completely laughable.

Neither Democratic candidate wants to introduce a nationalised health service along the lines of the NHS. Instead, the 'universal health care' they're suggesting would simply mean that everybody in America (hence 'universal') would have access to affordable medical care (hence 'health care.')

For those in poverty, that could be some kind of system like Medicare or Medicaid. For low income families, it could be some form of subsidized or Federal health insurance.

Additionally, Obama, Clinton and McCain want the consumer cost of private medical insurance to be reduced by opening up competition - meaning consumers wouldn't be limited to the health insurance package their employer offers - and could seek more competitive quotes out-of-state.

Also, big companies like Wal-Mart would be forced to do what they should have done from the very beginning - offer their full-time employees adequate health care.

Whatever happens, the intended result of universal health care would be a system in which everybody in America has access to medical treatment. And apparently the conservative Republicans loath this idea!

Why?

The major argument conservatives have against any form of universal health care is that it would be tax-payer funded. They're worried that their hard-earned income would be taxed in order to pay for the health care of low income families (read: other people. Conservatives don't like giving money for the benefit of other people.)

There is a simple and indisputable reason why this argument is idiotic. America already has a system of 'universal health care' that's funded by the tax-payer (and subsidized by the health insurance consumer.)

Federal law forbids hospitals from turning away patients. If a visitor to a hospital doesn't have health insurance - or the means to pay their bills - it's the government or hospital that eventually has to pay up for that patient's treatment.

Which means the tax payer already pays $15 billion a year towards the health care of people without insurance. What's worse, hospitals and doctors cover the expense of 'writing off' uninsured patients by charging paying customers more - which in turn dramatically hikes up health insurance premiums.

So whether it's through tax-dollars or an increase in health insurance premiums, at the end of the day, the bad-tempered conservatives are already paying for other people's health care.

It seems stubborn and idiotic for them not to open their minds to a more efficient (i.e. cheaper) way of doing what they're already doing now.

The Simple Maths

Health insurance premiums have skyrocketed over the last few years - and one of the major reasons is because hospitals and doctors have needed to recoup their losses from treating uninsured patients.

Since about 20% of Americans have no health insurance - plus the millions of illegal immigrants and undocumented workers - the current situation works something like this:

Four people go to the hospital and have treatment that costs $300.

One of those four people has no health insurance. So to cover their costs, the hospital is forced to split that loss amongst the other three paying customers.

$300 ÷ 3 = $100 each added to their bill.

That bill ends up being $400 instead of $300. Basically, they're paying 25% more.

And it's a spiralling problem. As health insurance premiums increase, more and more people can't afford insurance, which means doctors and hospitals have to increase their costs to cover them.

That, in turn, increases insurance premiums again, which again means that more people 'drop out' of health insurance programs...

And do you see where I'm going with this?

Something needs to be done.

This situation needs to be addressed - and conservatives can't stick their head in the sand and pretend otherwise.

Currently, all three of the presidential candidates have interesting and promising solutions to the health care crisis.

Senator John McCain

John McCain's solution is within Republican party lines.

While he rejects any form of government funded or subsidized universal health care, he wants to offer a $5,000 tax rebate for families with private medical insurance (helping considerably towards the cost.)

In addition, he wants to reduce health insurance premiums by opening up competition between states. Currently, health insurance providers can operate in one state alone - meaning there are a limited number of suppliers in each state.

McCain's idea is to allow consumers to select insurance from companies based all across the United States, forcing suppliers to offer more affordable premiums.

In addition, Senator McCain wants to allow consumers to opt-out of their company's health-insurance package and take their employer's contribution elsewhere - again forcing health insurance companies to offer more competitive rates, rather than 'signing up' big businesses and forcing a big, fat premium out of every employee.

"In health care," John McCain explains, "I believe in enhancing the freedom of individuals to receive necessary and desired care."

Basically: We help those with the means to help themselves.

Senator Hillary Rodham Clinton

Even though her opponents (like talk show host Mark Levin) accuse Hillary of being a socialist, the universal health care package she champions is very different from the National Health Service in England.

In fact, she spent [wasted - Editorial Bear] millions of dollars while her husband was in the White House investigating - and ultimately ruling out - a single-payer health care system like we have in Britain or Canada.

Clinton advocates government subsidies for low-income families, meaning that they will be able to afford health insurance.

She also wants to set up a federal health care system, which Americans can 'buy into' instead of their employer's health insurance package. This will force private health insurance companies to make their premiums more competitive and offer health care coverage to people with pre-existing conditions - people who would normally be refused private health insurance.

Because of the subsidies and the setting up of a federal health care system, Hillary Clinton's solution to America's health care crisis is the most expensive. However, with costs of $110 billion per year (in contrast, the war in Iraq costs $144 billion per year) this can be paid for by eliminating the controversial 'Bush tax cuts.')

However, it's the thought of killing this tax break which makes Hillary's plan so unpopular with the conservatives.

Clinton's election promise: "One of the goals that I will be presenting is health insurance for every child and universal health care for every American."

Senator Barack Obama

Obama similarly believes in real 'universal health care' and on the face of it, many of his ideas are similar to Hillary Clinton's.

Most importantly, the idea that every American should have access to affordable health insurance even if they have a pre-existing condition.

"I am absolutely determined that by the end of the first term of the next president, we should have universal health care in this country."

Critics of Obama have pointed out his lack of specific details when it comes to a proposed universal health care package - but it will still be rooted within the existing system of private health insurance providers (with some government intervention.)

Obama's plan will ultimately hope to reduce health care costs for all Americans, while providing low-income families or those with pre-existing conditions access to the medical care they are currently excluded from.

It's been a long time coming...

Whichever candidate ends up the White House, I'm confident that they will introduce improvements to the existing health care system and allow more people to have access to better care at a cheaper price.

One thing to note is that none of the candidates - not even Hillary Clinton - plans to eliminate the concept of private health insurance. They just want to regulate and streamline it.

Hopefully this means that the advantages of private medical insurance - driving the development of cutting-edge new technology and pharmaceuticals - will remain, while the disadvantages (the high insurance premiums and difficulty getting medical coverage for pre-existing conditions) will be addressed.

Having experienced both socialised and privatised heath care, I am convinced that the private system offers the consumer a better service. However, just like in any privatised industry, the demand to make money often threatens to overwhelm the mandate to provide a service.

I just hope that whichever presidential candidate makes it to the White House, they ensure that the patient always comes before the shareholder.