the uk’s national
health service - the nhs: usa comparison
for those who care about comparative data on health services
One of the central points is that is,
it is very difficult to compare systems. In the United
States, both ‘sides’ of the health care discussion
are trimming mightily, some are even making it up as they
go along! Most are dreadfully uninformed, and are making
little effort to correct that problem. Most are just cheering
for football teams without even knowing the point of the
game.
The reasons for the French and the
British reporting better life expectancy and infant mortality
rates than those in the USA, while their health services
cost less as a percentage of GDP, are complex. One is
the USA being ahead on the fat curve - they have started
to reduce the numbers of morbidly obese people. Another
reason is that, in the States, there are guns for killing
in ghettos and for convenient suicide. These statistics
are very poor and dubious indicators of the state of a
country’s medical services. There are many extraneous factors making
such statistics unreliable.
In the USA, people can choose medical services. People are neurotic, especially about
their own health. There is much corruption in the US health
industry. For instance, the estimate is the drug companies
employ about one sales rep. for every 4.7 medics. The
profits pay for ‘conferences’ in exotic locations.
In the USA, law makers are handsomely bribed to produce
laws that suit large corporations such as big pharma and
the insurance industry.
US medics are extremely cautious, they
order every test they can manage, in order to protect
themselves against law suits. That also ups the bills!
Most advances in medicine originate (or are developed)
in the USA. They are sold cheaper in overseas government-run
systems than in the USA, thus American medicine tends
to subsidise the likes of the NHS.
For examples of corruption in US government
see, for example, Dick
Morris.
“An embarrassed Conservative Party leadership
was forced to rebuke one of its MEPs yesterday after
he spent the last week on a tour of the United States
rubbishing the NHS in a series of interviews.
“Daniel
Hannan, an outspoken and popular Conservative politician,
gave a damning verdict on the British health service,
telling American television viewers: "I wouldn't
wish it on anybody." ” [Quoted from timesonline.co.uk]
- Both the UK and the US health systems
ration.
- Stephen Hawking,
who has motor neurone disease [Gehrig’s disease,
also known as ALS - aminotrophic lateral sclerosis]
and has recently claimed that he owed his life to the
NHS. He is both wealthy in his own right and is enmeshed in Cambridge academic society. Cambridge has one
of the most advanced health centres in the world for that sort of disease.
- In both countries, the richer you
are, the better off you are. But I suspect you are better
off in the UK if you are poor.
- Both the French and British health
systems are packed with medics who should be better
educated. US medics I have met are better trained. The
UK system is filthy compared with anything I have seen
in France. The service is much quicker in France, they
have about twice the medics per head of population.
- All Western societies provide for
the poor, including the USA.
- In my view, a major improvement
in France is that (those) who can afford to, pay about
30% of bills (and that is widely covered by private
insurance). Anything given away ‘free’ is
expensive.
- A major advantage in France is it
is simple and easy to obtain second opinions and to
dump incompetent medics.
If you want the NHS, you’re
welcome, but no serious politician dare say that! Of course the politicians will go private when
it matters, just as they do in education.
- Stephen Hawking is wealthy in his
own right and is not solely dependent on the NHS.
- He is embedded in Cambridge academia,
with access to one of the world centres of excellence
for his type of problem (motor neurone disease).
Research into diseases, such as
motor neurone disease, is an integrated whole with
the patients being the guinea pigs and with high-level
people (neurologists in this case) running the trials.
Statisticians, ethicists, biochemists/big pharmaceutical
companies all working together. Even GPs and generalist
neurologists form links in the teams. Commonly, medics
go on to be part of research teams and work for big
pharma etc.
The results of the labs tie into
the work of researchers looking to patent a treatment
and to develop a start-up with venture capital. Cambridge,
where Hawking is based, is deeply involved in the
process.
I have little doubt that Hawking’s
outcomes would have been different in the extreme if he
were Mister Smith of 7 Back Street Cul-de-sac. Hawking
has a disease which usually kills in less than a decade.
He has survived about 40 years. In these circumstances,
it is very difficult to believe that he receives standard
NHS care.
Of course, Hawking is not treated as
Sam Sawkins would be - I doubt Sam would have a chance
in a million of even obtaining an appointment with some
of Hawking’s medics.
I am advising a person with a similar
nasty. Already I know more than the first-line neurologist,
let alone the general practitioner. And I am still studying
hard!
I have access Sam couldn’t, simply
because I know more and push harder; and I have paid extra
when necessary. There ain’t no equality in the real
world, and certainly not for Hawking. So, in that sense
he is certainly trimming, if not outright lying. Hawking
is not ‘equal’ in the NHS, and he would not
be ‘equal’ in the USA. Nor is Ted Kennedy,
and nor are congressmen, and nor are the star TV anchors
at Fox News.
Any suggestions otherwise are abuse
of rational argument.
Maybe it was a mere coincidence that,
coincidentally with Stephen Hawking’s endorsement
of the NHS, President Obama, somewhat besieged in his
attempt to create a public health system in the USA, rushed
him a US government medal?
In my view, it is clear that Brown
the Clown and Obama are doing the you-scratch-my-back
gavotte.
Extracted from a press release.
“Ten Commandments of Business Failure,
first drawn up by Donald R. Keough, the past president
and former CEO of the Coca-Cola Company.
- Stop taking risks. A 2006 study of change capability
by the Office of Government Commerce gave the NHS
a score of just two out of five points for seven of
the nine categories assessed.
- Be inflexible. Businesses are hamstrung by state
control over factors of production: staff pay is set
centrally; capital expenditure is constrained by the
DH; the National Programme for IT is a top-down programme;
and NICE increasingly decides what treatment can be
offered. Local initiative is crowded out
The complete list is at the
ten commandments of business failure - and the nhs.
health
reports from the world health organisation and others
For those who care about comparative data on the health
services, in contrast to the highly uninformed twittering regarding the British NHS and Obama’s ambitions
to take over another swathe of the USA economy.
- WHO,
1997 figures - see Annex Table 1. I
do not know whether there have been any updates. Governments
tend to hate comparisons and do not cooperate well.
Note carefully the categories, which are almost designed
to generate results that please the WHO.
“Annex Table 1 is designed as a guide for
using Annex Tables 5-7, 9 and 10. Each measure of
goal attainment and performance - disability-adjusted
life expectancy, health equality in terms of child
survival, responsiveness level, responsiveness distribution,
fairness of financial contribution, performance
on level of health, and overall health system performance
-is reported as a league table ranked from the highest
level of achievement or performance to the lowest
level....”
Plenty of double talk. Many other
factors have much greater effects on a nation’s
health than do medical services, for instance ‘race’,
fatness, illegals, poverty. Thus the WHO report is
not a reasonable assessment of a society’s health
services.
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