The National Health Service - how do other countries provide care???

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Specializes in A and E, Medicine, Surgery.

I went to visit my 93year old grandmother today. One of her carers told her the doctor would be visiting later. She gets confused and immediately started worrying that she didn't have enough money to pay the Doctor. We reassured her but it got me thinking about the UK's system of health care.

On July the 5th 1948 the UK government introduced a system of health care that was free to all dependent only on citizenship. Care was unlimited and treatment was on diagnosis rather than financial means. The UK at that point desperately needed change as disease was rife and the poor were dependent on the charity of some doctors or worse still the workhouse. Hospital care was refunded but had to be paid upfront.

The NHS has not been without it's problem's primarily because it is chronically short of cash but 60years later it does mean that any patient regardless of age, financial status, employment etc will receive equal care on the basis of diagnosis.

I realise that worldwide there are many differences. I recently had a fantastic American patient in the UK on holiday - he had chest pains so needed, baseline assessment, chest xray, bloods, ECG and a doctor's consultation all of which as an emergency are free which he couldn't believe. On the flip side I went to India recently and although hospital care is free patients need to pay for medication and the cost of this often is prohibititive meaning that the mortality rate amongst the poor remains unacceptably high.

I would be so interested to hear of how other countries provide health care and what works about these systems and also what doesn't. Maybe we can come up with a worldwide effective system that promotes equality and inclusion :)

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

Who will pay?

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I am American, so it's sort of funny... When I was 17, I went to Canada for a month. I remember my Mom who had been living there for years, got sick and needed to pay $500 out of pocket to be seen at the emergency room.

Then when I went to England, I moved there. At the time I was 18 and pregnant, also married to a England citizen. I had my visa and all that. I never paid seeing the family doctor or when I went into labor to have my son (when I was 19). So my health care there was all free, which did surprise me!

When my husband and I broke up I came back to America which our son, who has duel citizenship. I had nowhere else to turn for us and needed to get Medicaid for my son. Turns out I could receive it too. So, I didn't have to pay for health care or medications. They sure do treat you like crap though.

Fast forward a little bit. I went to Australia December 2008 (came back January 2009). However, while I was there, I busted my ear drum and got an ear infection from it. Very painful! To see a doctor, I only had to pay about $150 (I think) to see a doctor but they ended up being very nice about everything and not charging me! So all I had to pay for were my medications.

Fast forward a bit more. I just turned 24 last Saturday and now I am on private insurance. I have a small co-pay for both seeing the doctor and getting medications.

Fun times.

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Specializes in Pediatric Home Care.

Kinda weird that your mom had to pay to be seen at the emergency room in Canada since everything in the Emergency room is covered (I live in Ontario). I have lived in Canada all my life and never once have I had to pay to go to the hospital's emergency room. Granted I had to pay for some medications that were not covered by my Ontario Drug Plan but never the less I have never paid for an emergency room visit

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

Again.

Who is going to pay?

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Specializes in Pediatric Home Care.

What do u mean who is going to pay?

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Kinda weird that your mom had to pay to be seen at the emergency room in Canada since everything in the Emergency room is covered (I live in Ontario). I have lived in Canada all my life and never once have I had to pay to go to the hospital's emergency room. Granted I had to pay for some medications that were not covered by my Ontario Drug Plan but never the less I have never paid for an emergency room visit

My Mom is American and had no health insurance, lol. Her stupidity though!

Oh and she was living in Pictou, Nova Scotica at the time.

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Specializes in Pediatric Home Care.

OH Ok, that clears it up!

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
What do u mean who is going to pay?

I mean. This global idea.

Who will pay for EVERYTHING.

There is NOTHING free.

EVER.

So.

Not to sound like the pragmatic person that I am...can't help it...who will pay for the medicines? the doctors? the nurses? the hospitals?

WHO will pay?

:confused:

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Specializes in Advanced Practice, surgery.

Jo I don't think this is a discussion about who pays for care more than an enquiry about how other countries health systems operate. I wouldn't like to see this turn into a debate about the pros and cons of any particular system as we have lots of those threads in the healthcare reform forum, but am interested to learn how different health systems work

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
Jo I don't think this is a discussion about who pays for care more than an enquiry about how other countries health systems operate. I wouldn't like to see this turn into a debate about the pros and cons of any particular system as we have lots of those threads in the healthcare reform forum, but am interested to learn how different health systems work

I understand. But you will have to figure who will pay for what. What I see that will ensue is how horrible OUR system is compared to everyone who has NHS, but yet can only compare the LEVEL of care..and not the finances that supports it.

It's all encompassing and is the basis of what is trouble OUR own system now.

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Specializes in Advanced Practice, surgery.

I disagree Jo, no where in the OP do I see any reference to the US system of healthcare, and in fact Snoopy has gone on to highlight some of the problems she sees with the NHS. I could add to these, and will do later but it's not all about US healthcare is it, I have no idea how many countries health systems work, I have preconceptions about some countries healthcare systems mainly from discussions here, but I am not naive enough to believe that this is

all there is. It would be good if those ideas could be shared here. However if this thread does turn into another debate about healthcare reform in the US I think we have lost a great opportunity to share the different systems that we all work in.

Why don't you start with telling me how healthcare in the US works, what's good and not so good about it, what changes if any you would like to see.

I'll do the same in a little while, (got to get a ham joint out of the oven first, I can smell burning and that's not a good sign ;))

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