[brian]

Sick Around the World

Can the U.S. learn anything from the rest of the world about how to run a health care system?

In Sick Around the World, FRONTLINE teams up with veteran Washington Post foreign correspondent T.R. Reid to find out how five other capitalist democracies -- the United Kingdom, Japan, Germany, Taiwan and Switzerland -- deliver health care, and what the United States might learn from their successes and their failures.

Reid's first stop is the U.K., where the government-run National Health Service (NHS) is funded through taxes. "Every single person who's born in the U.K. will use the NHS," says Whittington Hospital CEO David Sloman, "and none of them will be presented a bill at any point during that time." Often dismissed in America as "socialized medicine," the NHS is now trying some free-market tactics like "pay-for-performance," where doctors are paid more if they get good results controlling chronic diseases like diabetes. And now patients can choose where they go for medical procedures, forcing hospitals to compete head to head.

Read and watch the full story with links below:

You can watch the entire program online, just visit the following pages and click on "Watch Online"

Introduction: http://www.pbs.org/wgbh/pages/frontl.../synopsis.html

Site Map of Sick Around the World online features:
http://www.pbs.org/wgbh/pages/frontl...c/sitemap.html

Graphs: US Health Stats Compared to Other Countries:
http://www.pbs.org/wgbh/pages/frontl...tc/graphs.html

[elkpark]

I watched the documentary last night and thought it was excellent. Looks at the heathcare systems of several other developed countries that work better than ours, cost a lot less, and get better results.

I wish more Americans would wake up to the idea that we are not the be-all and end-all of healthcare.

[akor]

I live and work in Italy. I work in the healthcare system, a large regional hospital with level 1 trauma in Florence. I have been living in Italy for 17 yrs and have given birth to two sons and have been hospitalized twice for different reasons costing me nothing. I am pleased with the public healthcare service. My nephew was over and had to have an emergency appendectomy....he was amazed that he did not have to pay anything...We have to pay a minimal "ticket" for scheduled visits and exams...Yet, our family doctor gets paid by the government and we don't pay a thing when we need to visit her! Certainly, every system has it's snares...sometimes you have to wait for a specialists appointment or you just fall into the wrong hands which can happen anywhere..It is hard to immagine a healthcare system being run by the insurance companies: it is a human right to receive healthcare!

[classicdame]

I watched it on TV and found it interesting but lacking in some details (due to time I am sure). For instance, I know that nurses and MD's and other health care providers are paid far less than in the USA. How do these countries attract people into those jobs if the pay is poor, or is it on a level with other jobs requiring the same amount of education? My experience in traveling is that Americans do not walk enough. But I live in Texas and my state is larger than 5 European countries put together. We think nothing of driving 50-60 miles one way to work. There is little or no public transportation and no other way for me to get to work, unless I get a taxi (expensive!).

[Mijourney]

Originally Posted by elkpark

I watched the documentary last night and thought it was excellent. Looks at the heathcare systems of several other developed countries that work better than ours, cost a lot less, and get better results.

I wish more Americans would wake up to the idea that we are not the be-all and end-all of healthcare.

Elkpark, I agree with your sentiments. I happen to believe that the U.S. healthcare system is about profit and not health as it is in many of the other capitalist democracies. Health was taken out of the equation in the U.S. years ago. That's the reason you hear politicians and others say that receiving health care in this country is not a right but a priviledge.

[hajiagambo]

We can't afford that because we use our money to stick our nose where it does not belong. Uncle Sam prefers to use our hard earn income taxes to destroy and rebuild and to fight senseless wars.

[eltrip]

Excellent program that provided a place for the "average American" to start to look & consider other options. This program did what I think we need to do - look at other programs to see which programs work, which ones don't & figure out how to pay for it. If Taiwan can spend 6% of its GDP to provide health care to all of its citizens, it causes me to wonder what we're actually getting for the 22% of our GDP spent to provide health care for 50-75% of our citizens?

[classicdame]

universal coverage - this is an idea whose time has come. Americans are spoiled though. We want perfection from healthcare providers, even if we do not pay for it. That means the best equipment and best personnel. None of which are cheap. What are we willing to compromise on - salaries????? No thanks.

[cmonkey]

Originally Posted by classicdame

universal coverage - this is an idea whose time has come. Americans are spoiled though. We want perfection from healthcare providers, even if we do not pay for it. That means the best equipment and best personnel. None of which are cheap. What are we willing to compromise on - salaries????? No thanks.

We're not *getting* perfection, though, so would it really hurt to try and change things for the better?

[misswoosie]

Hi
this might be a long one-I have so much to say.
First of all the information on the programme website about UK is less than accurate when it talks about payment for healthcare.
Here goes
1.Dental care is free for children under 16.
Cost examples for EVERYONE else (unless unemployed I think)
$50 for check and clean
$280 is the maximum payment for any one treatment, but my mother aged 70 had to pay $560 for 2 crowns!
So, some co payments is not particularly true, as we pay per treatment, for every treatment-there is no yearly or monthly cut off.
2.Eye test-$40 (again free for children and unemployed) Eye glasses available on the NHS at low cost (around$100) but only for children and unemployed. Most eyeglasses cost around $200 from private retailers.
3. I work in the NHS as a nurse and earn $46,000 pa after 25 years,with a post grad degree working as a Specialist nurse with extended clinical skills.Each month I have $300 deducted from my salary (it is a percentage payment that EVERYONE who works pays,no difference if you work for the government) towards state pension and healthcare. Our state pension pays around $130 per week to all over 65yrs, but it is debatable whether it will survivr the next 10 years. I also pay 6% each month towards NHS pension,which will be payable no sooner than age 60.
My husband pays the same percentage deducted from his salary.
4.Prescriptions are free for children, over 65s AND unemployed. Everyone else pays $15 PER ITEM-doesn't matter what it is or how many items on the script.Doctors will only provide prescriptions for 1 month at a time-so someone on 4 medications will pay $60 per month for 12 months-so $720.Insulin is free.
5.GPs (family physicians) are paid according to the number of patients they have registered with them,which isn't entirely the same as per patient treated as they may never see some patients and may not see patients with chronic conditions as often as they should.Average wait to see GP unless URGENT is 2-3 weeks.
They are paid around $200,000 pa and hospital senior physicians are paid $140-$180,000.
If we excel in preventative medicine why is our life expectancy at birth about the same as the other 4 countries. Maybe because our treatment is poorer.
6.Most NHS consultants treat private patients (there are private insurance companies offering health insurance-and people will pay for treatment privately if the wait on the NHS is too long ie 18 months for cataract surgery (after waiting 6 weeks to see the consultant).The private patients will jump the line , but often be treated in the NHS hospitals.
6.As for our hospitals!
They are often dirty with insufficient beds and insufficient nurses.
On average a qualified nurse on a ward has 10-15 patients to look after.
Investigations are often not done within guideline timeframes for example our national guideline for CT scan following acute stroke is 24 hours-often people wait 72 hours. In the US most stroke patients are scanned within minutes or 2-3 hours I think.
As you can see from the CT and MRI scanner graph we are very low! Our 360 bedded acute hospital does not have MRI and only one CT scanner. Wait for outpatient MRI scan in our area is around 8 weeks.URGENT in patient scans (done at hospital 14 miles away) AROUND 1 WEEK.
7.SHORTAGE of cleaning staff,porters,Speech therapists,basic equipment (pillows, blankets)etc etc
8. Nursing salaries are much lower. Our cost of living here is around that of New York or California and we are not in London but a MEDIUM city with POP 250,000.Gas is around $8 per gallon,1100 sq ft 3 bed 1 bath townhouse on v small lot in reasonable are $500,000. Small car eg Ford Focus $23,000 (new).
As a band 6 qualified 25 years(highest for nurse is band 8 for a Nurse consultant,nurse practitioners band 7,unit co-ordinators band 6,new staff nurse band 5-$38,000) I earn $46,000 pa.We are paid time plus 30% for Saturdays and after 9pm before 7am, and time plus 60% for Sundays and holidays.
Policemen earn $68,000 after 9 years service! Teachers around the same.

Sorry if this bores you to death, but its important to be properly informed. At least if you formally pay towards your healthcare you have more power and there seems to be more effort to provide a better service. No service is perfect, but as a nurse and patient through ER on 2 occasions our socialist service is far from it.