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Socialised Medicine the myths and the facts



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May 14, 2009 07:53 PM

Socialised Medicine the myths and the facts

by madwife2002 Staff
Updated May 20, 2009 at 10:16 AM by Joe V

Having worked in a country which has socialised medicine I can certainly see the pit falls and the benefits. What I dont understand is the fear behind having socialised medicine In my opinion socialised medicine has more positive benefits than negative benefits.

The first and the most obvious concern is the cost to the patient and their family, we all know how devestating an illness can be for pts and their family many times I have witnessed the despair when a diagnoses meant further treatment which insurances question and in some cases wont cover. I have seen pts needing costly drugs to keep them alive and being unable to afford them, causing repeated admissions to repair the damage so called none compliance has caused. The first question in none compliance is were the pts actually refusing to take their medication or was it simply they could not afford to buy their medication because they dont have enough money and other bills need to be paid first? If the real reason is the cost then surely it would be more simple of we provided these medications at a more effective price or that all medications cost $5 no matter what they had? Outrageous I hear you shout but the cost of the repeated admission is far more costly than by helping prevent a repeat admission, by providing medicine they can afford.

How about blood tests could these not be done in the doctors office before the pt leaves for home and forgets to go and have a blood draw, or simply cannot get to the lab to have them drawn. I have personnally waited in doctors office hours (and paid for the priviledge) then been sent to the lab, miles away to sit and wait for blood work to be done. Why could the doctors not employ somebody to be at the office to draw blood on pts?
We should be looking at improving preventative medicine rather than patch it up and see.

Many times I have seen pts discharged with a new diagnoses of diabetes, no follow up at home can be organised because in my city nothing exists to assist these people. There should be a diabetic home nurse who monitors these pts in their own home-rationale, this would again help prevent admissions for diabetic complications, and none compliance.

So you wonder what has this got to do with socialised medicine. Well, in the UK if you have certain illnesses for example
  • Children
  • Over 60 for women and over 65 for men
  • Diabetes
  • Asthma
  • Thyroid problems, etc...
then you get all your medicines for free.

There are in place specialised RN's who focus is on preventative care in the community. There are telephone help lines which anybody can utilise for free.

Maternity care is free a midwife will be assigned to you for the duration of your pregnancy and upto 6 weeks later. The cost of the birth-nothing no matter how you deliver.

I have been asked what kind of care do you recieve in a socilaised medicine country and I ask them, I am a product of socialised medicine you tell me how my care differs from nurses who have paid outrageous amounts of money to train as a nurse?

Of course even in the UK you can have private care if you chose to pay, this is an advantage if you need hip replacements, knee replacements, eye surgeries-other wise you may have to wait. There are initiatives in place to reduce waiting times for surgeries in the NHS and I hear that dr's can now book surgeries from their office at hospitals all over the UK which helps reduce waiting times, plus hospitals get fined if they dont meet their quota.
I agree MRI's and CT's are not as freely available, but again iinitiatives are in place to improve the waiting times.
Emergency care no different all patients will recieve emergency care.

Poor conditions yes there are poor hospitals and there are excellent hospitals, no different to Phoenix AZ.

Questions??


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262 Comments
No. 1
from caramel
Old May 16, 2009, 03:36 PM

Default Re: Socialised Medicine the myths and the facts
Hey madwife. i agree with you completely . i am not sure why people are so against it. i have heard a lot of nurses say, if we get socialized medicine nurses will not be paid as well as they do. so if its not broken ,don't fix it which is totally stupid.
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No. 2
Old May 20, 2009, 02:08 PM

Default Re: Socialised Medicine the myths and the facts
Yes, I do have a question that I have been wondering about for a long time regarding coverage in countries with socialized medicine.

My son is a hemophiliac and his medications (Recombinate, Factor VIII) are unaffordable (unless you are a millionaire) without private medical insurance here. Because he does have insurance, it is provided for a very small copay. This coverage is from his dad's employer and will last as long as he is a college student and under 25, but that is not much longer. He is hoping to get a good job after graduation but it is uncertain.

His protocol is prophylaxis--he gives himself an IV infusion every other day to prevent spontaneous bleeding. He needs this protocol because when he was on the "treat only when bleeding occurs" protocol that many hemophiliacs are on, he had frequent crippling joint bleeding in the knee and elbow, a subdural hematoma, an ab bleed as big as your fist, and a shoulder joint bleed as big as a football pad which could have cost him his arm.

No private insurance company would cover my son except under an employer's group policy. If in the future my son does not have coverage, it is my understanding that the local county cannot afford prophylaxis though it may provide emergency treatment if bleeding occurs. However a bleed normally requires multiple treatments 12 hours apart.

Would this medication be provided under the UK system? As prophylaxis? Also, do they cover most kinds of chemotherapy?

Thanks.
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No. 3
from Shaka
Old May 20, 2009, 10:23 PM

Default Re: Socialised Medicine the myths and the facts
I have several questions...
1) What are the salaries for health providers?
2) What are the waiting times for procedures needed, on average?
3) What are the working conditions...i.e. nurse/patient ratio, hours worked on average, acuity of patients cared for in a patient mix?
4) Is there a cap for some health problems...i.e. alcoholism, drug addiction, psyche diagnoses?
5) How much are taxes in the UK and how much goes to health care?
6) Are you in the UK working? and if not why? (don't mean to be personal) just want to know.

Thanks for your perspective...
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No. 4
from Colta
Old May 21, 2009, 07:58 AM

Default Re: Socialised Medicine the myths and the facts
This is a very interesting thread topic. Coming from Canada, we have socialized health care as well, but I do not believe that it is a comprehensive here as it is in the UK.
But kudos to the author of this thread for the brilliant idea.
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No. 5
from limestone
Old May 21, 2009, 09:32 AM

Default Re: Socialised Medicine the myths and the facts
I'm Canadian. The best thing about our health care system is that in your daily life, you never have to think about affording care or not. You see your doctor or receive hospital care and you never get a bill. Our health care covers us no matter what province we are in when we need the care.

Catastrophic injury or illness? Same thing--you receive the care and no bills.

As nurses, we are paid well. And we don't have to worry about our patients' insurance covering this or that--we just look after them.

No system is perfect--there some community services that should be covered, especially for the elderly who need help with ADL's but I think that will come eventually. We could use better coverage for dental and drugs than we currently have, but people can get private insurance plans for that at relatively low cost.

Where health care is FOR PROFIT, that's when it becomes exclusionary and expensive. That's when it becomes an expense like any other in daily life. I would be so afraid to live in the USA where my coverage was a matter of ongoing concern.
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No. 6
from gonzo1
Old May 21, 2009, 10:32 AM

Default Re: Socialised Medicine the myths and the facts
My GERD is acting up really bad due to the economy and work related stress. I got the ER doc to write me a script for nexium because it works really well for me.
When I went to get it filled the cost would be 178$ for 30 pills. I don't have any insurance right now and can't afford that. So it is OTC pepcid for now.
This is just rediculous.
I'm in between travel jobs right now and per diem shifts have dried up. I never thought I would have this problem as a nurse.
I do believe everyone should have access to free healthcare. I think we would see a big improvement if people were receiving preventive care instead of patch up the leaks care.
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No. 7
from Mimi2RN
Old May 21, 2009, 07:42 PM

Default Re: Socialised Medicine the myths and the facts
I'm from the UK, so I appreciate the fact that you don't have to worry about getting medical care.

My biggest worry about retirement is paying for a supplementary policy for my husband and myself, as well as as prescription plan. Of course, Medicare costs as much as my insurance right now for both of us. We won't have any dental or vision coverage. My brother and his wife came here to live, and left after two years because they couldn't deal with medical bills.

I wouldn't mind paying more in taxes if we didn't have to pay for our health care. At least we wouldn't be support big business. Insurance companies are not non-profit!

My youngest son has never had health insurance since he grew up. He has always worked, but most restaurants don't provide benefits. We need socialized medicine, and the sooner the better!
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No. 8
from sharrie
Old May 22, 2009, 04:17 AM

Default Re: Socialised Medicine the myths and the facts
Originally Posted by ambermichelle View Post
Would this medication be provided under the UK system? As prophylaxis? Also, do they cover most kinds of chemotherapy?

Thanks.
Yes your sons treatment would be covered in the UK, the NHS tends to be proactive when it comes to preventative and prophylaxis treatments.

Chemotherapy is covered, but we are guided by something called the National Institute for Clinical Excellence, this is an organisation made up of clinicians who review current literature and evaluate new treatments before recommending them. You may find some of the very expensive cancer drugs (the life prolonging drugs) are not covered because they are not always effective and because NHS resources are limited cost effectiveness is considered. This does not mean that you are not treated if you need chemo, what it means is there are a few expensive and rarely used drugs that will not be recommended for use because of cost effectiveness

Originally Posted by Shaka View Post
I have several questions...
1) What are the salaries for health providers? depends on expereince and what job you do, a nurse can earn from £20,710 as a newly qualified nurse on the lowest band to £39,000 as a ward manager / charge nurse. Senior nurses and Lead Nurses / specialists can earn from £39,000 up to £60,000 per year. We have 29 days paid holiday a year and 8 paid bank holidays. We get full sick pay for up to 6 months should you need it and then half pay for the next 6 months.
2) What are the waiting times for procedures needed, on average? we have waiting time targets, so your emergency care would be seen and treated straight away, there is a target of 4 hours in the emergency units for non urgent pateints and if your classed as a catagory 1 then you must be treated within the hour. Urgent treatment (so for cancers for example) you must be seen, assessed diagnosed and treated within 31 days. For Elective procedures which are non urgent (hernias, gall bladders, some orthopaedic surgery) there is a target of 26 weeks, so this would be from GP referral to outpatient appointment to definative treatment.
3) What are the working conditions...i.e. nurse/patient ratio, hours worked on average, acuity of patients cared for in a patient mix? We work 37.5 hours a week, this is the standard contract for a NHS nurse, you can if you want work extra but there are no implications for you job if you choose not to. Nurse / patient ratio depends on where you work. In ICU you will get a 1:1 ratio, on hospital wards it can be anything from 7 :1 in some good areas to 15:1 in others. It really does depend on where you work.
4) Is there a cap for some health problems...i.e. alcoholism, drug addiction, psyche diagnoses? No

5) How much are taxes in the UK and how much goes to health care? If I earn £40,000 per year I pay £10,000 in deductions in income tax and national insurance. (I think this is about 30% )
6) Are you in the UK working? and if not why? (don't mean to be personal) just want to know. Madwife doesn't work in the UK, but I do

Thanks for your perspective...
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No. 9
from Shaka
Old May 22, 2009, 10:04 AM

Default Re: Socialised Medicine the myths and the facts
Originally Posted by sharrie View Post
Yes your sons treatment would be covered in the UK, the NHS tends to be proactive when it comes to preventative and prophylaxis treatments.

Chemotherapy is covered, but we are guided by something called the National Institute for Clinical Excellence, this is an organisation made up of clinicians who review current literature and evaluate new treatments before recommending them. You may find some of the very expensive cancer drugs (the life prolonging drugs) are not covered because they are not always effective and because NHS resources are limited cost effectiveness is considered. This does not mean that you are not treated if you need chemo, what it means is there are a few expensive and rarely used drugs that will not be recommended for use because of cost effectiveness

I appreciate the information Sharrie, I am not familiar with pounds vs dollars, maybe someone could convert it for me.
Shaka
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