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From Men's Journal:
Every time you walk into a physician's office, you run the risk of overtreatment: Tests you don't need, medications that are ineffective (or dangerous), procedures that cause more problems than they solve. In many cases the best thing for your health is to do nothing.
Make no mistake: A good doctor is, or should be, your most trusted resource if you're sick. If you're not sick and he wants to treat you anyway, that doesn't necessarily make him a bad doctor. But it does make him a player in a system that operates according to the unspoken and often unexamined assumption that more treatment is better for the patient. It's unquestionably better for the financial health of the stakeholders in the system: the doctors, the pharmaceutical industry, the health-insurance companies, and the hospitals. If you don't know how the game is played, the odds go up that you'll wind up the loser.
What do you people think, will people change if they know this?
(Score: 2, Informative) by dublet on Wednesday September 24 2014, @04:01PM
Don't really have these sorts of problems in the NHS, as there's no financial incentive for doctors to give you any particular treatment over another. GPs get paid per patient they have, AFAIK.
"If anyone needs me, I'm in the angry dome. [dublet.org]"
(Score: -1, Flamebait) by Anonymous Coward on Wednesday September 24 2014, @04:24PM
Yes on the NHS everyone gets treated equally incompetantly while civil servants pocket most of the funding. Isn't socialism wonderful.
(Score: 3, Interesting) by Anonymous Coward on Wednesday September 24 2014, @04:47PM
I'd like some statistics on the equally incompetent treatment across the entire NHS, it sounds terrible.
I have friends and family in the UK and there must be a gagging order to stop people talking about the shameful service. Apart from relatively minor issues and personal annoyance with a specific nurse or doctor, incompetence is not something that i've seen leveled across the service as a whole.
A good friend of mine was very appreciative of an emergency surgery within an hour of being admitted to hospital, and no fear of astronomical bills and arguments with insurance companies. A elder family member is also very pleased with the cancer treatment received, with the reservation the annual checkups can be a little tedious, but it did catch the cancer a second time very early. yet again, no paperwork to fill out or bills to pay at the end of it.
So please enlighten me as to the incompetence across the NHS which the socialized system is to blame. On that, it must be good news that the NHS is now using US private-healthcare consultants to see how they can move away from this apparently dreaded socialized medicine and move the money from the civil servants into the hands of outsourcing multinationals.
(Score: 3, Informative) by isostatic on Wednesday September 24 2014, @04:56PM
I have friends and family in the UK and there must be a gagging order to stop people talking about the shameful service.
It is, bloody shameful. In some parts of the UK you have to PAY TO PARK YOUR CAR when you visit the hospital for your free CT scan.
(Score: 2, Informative) by turgid on Wednesday September 24 2014, @08:01PM
I rely heavily on the NHS for my on-going well-being. Let me just add to your comment that I've only been let down by them on very rare occasions (caused by bad apples - i.e. unprofessional staff) but I am constantly impressed by the level of care and respect I receive from the NHS. Without them, I'd have ended up dead a long time ago.
I refuse to engage in a battle of wits with an unarmed opponent [wikipedia.org].
(Score: 3, Insightful) by VLM on Wednesday September 24 2014, @09:34PM
"caused by bad apples - i.e. unprofessional staff"
The thing I've never understood about the american neocon's loud trumpeting (farting, I guess?) of anecdotes involving people like that, is they assume we're dumb enough to think that a purely profit oriented faceless soul less corporate monopoly would somehow care enough to get rid of jerks, and we're dumb enough to have forgotten the last 50000 times things didn't work out so well under those conditions.
(Score: 2) by Wootery on Wednesday September 24 2014, @08:10PM
Indeed, but we Brits do at least have the sense to treat that as scandalous.
(Well, sometimes, anyway. Whether the practice has categorically ended, I don't know.)
(Score: 2) by monster on Thursday September 25 2014, @03:12PM
That's outrageous! What will be next, force people to use their legs and (gasp) walk? Oh!, the humanity!
(Score: 3, Interesting) by Zinho on Wednesday September 24 2014, @07:27PM
I'd like some statistics on the equally incompetent treatment across the entire NHS, it sounds terrible.
Well, you'll have some trouble there; apparently the NIH doesn't keep track of that sort of thing.
There was a pilot study [nih.gov] done on negative patient outcomes in London hospitals:
almost 11% of patients experienced an adverse event, over half of which were deemed preventable judged by ordinary standards of care. More worryingly, at least a third of these events led to disability or death. This was a pilot study but there is no reason to believe that the results are unrepresentative. The frightening extrapolation of these data suggests that in England and Wales adverse events lead to an extra 3 million bed days at a minimum cost of £1bn per year.
To be fair, the U.S. has a similar problem with reporting such "adverse events", and other studies (cited in my previous link) found them in 5-10% of U.S. hospitalizations.
And, since I'm human and these numbers have little emotional impact on me, I'll share a personal anecdote. My sister, a U.S. citizen married to a Brit, gave birth in a British hospital and nearly became a statistic for a story like this. She was hemorrhaging postpartum, which was not detected for over three hours because the nurses on duty neglected to check on her status during that time. A visiting family member noticed that my sister was becoming listless, pale, and incoherent in her speech, and called a nurse. She could have bled out while the hospital focused on the newborn, and was lucky enough to have family close who detected what the hospital should have but did not.
I'm not going to pretend that my story is representative of all NIH hospitals, I know that anecdote is not the singular of data. Obviously, your relatives had good outcomes, as you stated in your anecdotes. I would encourage you, however, to not bury your head in the sand and pretend that shameful service is impossible under the NIH.
Regarding the American attitude towards Socialist medicine, I think I can give you a tutorial on our mindset. Capitalism has so pervaded our culture that we assume financial incentives are the only significant ones. It's hard for us to imagine that without the threat of increased malpractice insurance rates or other financial penalties that doctors would care about patient outcomes. The perception in the States is that British doctors don't get fired or face loss of license even in the event of gross negligence in their practice. If there is no downside personally to the doctor for malpractice, what motivation does the doctor have to practice well?
That last question wasn't rhetorical, by the way. I delivered your statistics, please return the favor by clearly explaining for citizens of the U.S.A. in the audience what incentives/penalties are in place in the N.I.H. to reduce "adverse effects" due to malpractice.
"Space Exploration is not endless circles in low earth orbit." -Buzz Aldrin
(Score: 1, Informative) by Anonymous Coward on Wednesday September 24 2014, @08:11PM
Thanks for your reply. I am in no way saying the NHS is perfect, there are many problems and people are failed by the service every day to varying degrees.
My point in general was, I don't think this is unique or because socialized system in the UK. Humans make mistakes and fail, not all treatments are available, passing the buck happens to meet targets, the list goes on. I was using my anecdotes as a counterpoint to the blanket assertion of the original AC that the NHS fails everyone.
However for all the horror stories from the NHS, they don't seem to hold up against the horrors of the U.S. system, which everyone seems to have a story of. I've seen healthcare systems all over the world, and if i was in a top income bracket in the US, I no doubt would think very highly of the system over there. Saying that, one of my US horror stories is about a high income family being essentially bankrupted, after cancer treatments (unsuccessful) of the main breadwinner (supposedly covered by insurance through their employer).
But in answer to your question
From 2012 [theguardian.com]:
While the system may have its flaws, there are still consequences of not providing adequate care (perhaps not enough), and even if you're a doctor or nurse, you're not above the law.
The problem now as i see it, reforms that are happening are not being made to improve the quality of care, they are being made to drive down the cost and enable for-profit corporations to provide more services, but only the bits they can make money on. The government will have to pick up the tab for the rest of it, as it always has. The NHS is not long for this world it feels, and that's not a good thing. As mentioned before, they're getting U.S consultants in to help carve it up for maximum profitability.
(Score: 3, Interesting) by Zinho on Wednesday September 24 2014, @09:46PM
Excellent reply, that's exactly what I was looking for.
I'm sorry to hear that you're importing the worst part of our medical culture; having businessmen take over hospitals here has been a bigger disaster than their takeovers of the tech sector - at least when HP gets driven into the ground no one dies.
I'm holding out hope that regardless of the system in place the doctors who are healing people for the love of humanity will stick around and keep being motivated for the right reasons. The stats I quoted seemed to put the U.S. and U.K. at about the same level of outcome, and I'd like to take that as evidence that the horror stories we've heard about each others' systems fall within the (unfortunate) norm. Medicine is hard. =(
"Space Exploration is not endless circles in low earth orbit." -Buzz Aldrin
(Score: 2) by cafebabe on Thursday September 25 2014, @01:56AM
Form follows function. Private healthcare in the US has spawned a large industry of medical software. Through the NHS wanting to modernize and computerize and through software houses seeking additional sales, US medical software is now widely deployed in the NHS. This has stratified the NHS in addition facilitating financial settlement between administrative boundaries. Unfortunately, this fails and it has now become routine for parts of the NHS to sue other parts.
1702845791×2
(Score: 2) by c0lo on Wednesday September 24 2014, @11:12PM
Outsourcing multinationals? How about out-of-network doctors [nytimes.com]?
The effect [nytimes.com]:
What are you doing to yourself, guys?
https://www.youtube.com/watch?v=aoFiw2jMy-0
(Score: 1) by Whoever on Thursday September 25 2014, @02:36AM
I would agree with you that NHS treatment is generally very good. In fact, one experience I had was a diagnostic treatment in the USA (which found nothing), followed by seeing an NHS doctor who provided an actual treatment for my condition and also remarked that the diagnostic treatment I received in the USA wasn't indicated based on my symptoms. Relatives on mine have received excellent care for cancer.
On the other hand, there is this:
http://en.wikipedia.org/wiki/Stafford_Hospital_scandal [wikipedia.org]
(Score: 3, Interesting) by urza9814 on Thursday September 25 2014, @03:08PM
Yeah and I live in the US with decent health insurance (Cigna) and when I had a severe flu I was told "We can give you an appointment in six months." Yeah, that's a big help...
People talk about high costs and long waits as the reason to avoid socialized healthcare...yet I'm paying about $200/month for insurance and still paying out of pocket at clinics for all my healthcare because I can't get in to see an actual doctor.
Oh, and the best part? I work for a healthcare company.
(Score: 3, Funny) by isostatic on Wednesday September 24 2014, @04:53PM
That's why the average life expectancy is higher in the USA than the UK, it's why Stephen Hawking would never have survived under the NHS, it's why countries such as the UK, Cuba, Norway, France have higher infant mortalities than the USA.
(Score: 4, Insightful) by hoochiecoochieman on Wednesday September 24 2014, @05:42PM
That's simply a lie [wikipedia.org].
Couldn't you find a better example? Hawking is not even by far a regular patient, he's extremely, extremely exceptional. He's the subject of bleeding-edge experiences. WTF?
Another lie [wikipedia.org].
It's funny that you compare the richest country in the world to... Cuba, a very poor country with no resources and an economic embargo for decades. It's like the schoolyard bully winning at arm wrestling by a very close margin against the weakest guy in the school and then bragging about it.
More ironically, in this case (infant mortality) the weak guy kicks the bully right in the ass. Couldn't you come up with an indicator where you win? Just like... the health care cost. In that category, you win big time! The most expensive health care in the world! America! Fuck Yeah!
(Score: 3, Informative) by rcamera on Wednesday September 24 2014, @06:00PM
fyi - hawking is british and actually credits the NHS with saving his life [telegraph.co.uk]. did you know oxford isn't in the good 'ol us-of-a?
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(Score: 0, Flamebait) by wantkitteh on Wednesday September 24 2014, @07:10PM
"A big whoosh" - is that what you call it when you complete fail to put any actual indication of sarcasm in your writing? I suggest learning the basics of forming sentences and punctuation before you attempt such difficult things as the lowest form of wit.
(Score: 1, Flamebait) by isostatic on Wednesday September 24 2014, @08:20PM
Funny how Americans can't sport sarcasm unless it is covered in massive glowing lights. Sigh.
(Score: 2) by hoochiecoochieman on Thursday September 25 2014, @09:06AM
Dude, you really fooled me! And I'm not an American.
Ok, ok, I reckon I had a knee-jerk reaction, but this wasn't an easy one to spot. I should have seen that it was too stupid to be sincere. But there are actually people out there who are that stupid.
(Score: 2, Informative) by rcamera on Thursday September 25 2014, @06:00PM
but on the more serious side, the infant mortality rate isn't a fair comparison. in the US, we consider a live birth to be... well... anyone that's born alive. many other countries don't count a "live birth" unless the fetus meets certain weight or gestation duration requirements. we count preemies in our IMR - they don't.
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(Score: 2) by EvilJim on Thursday September 25 2014, @12:25AM
Funny... his voicebox doesn't seem to have a british accent
(Score: 2) by wonkey_monkey on Wednesday September 24 2014, @04:29PM
That doesn't stop drug reps taking GPs out to lunch (both literally and perhaps metaphorically) - hence the existence of http://www.nofreelunch.org/ [nofreelunch.org]
Just make sure the doctor doesn't rifle through his complimentary pen collection before putting you on DangerousSideeffect-a-thol!
systemd is Roko's Basilisk
(Score: 0) by Anonymous Coward on Thursday September 25 2014, @03:28PM
I clicked the "Click for HELP!" link at the bottom of the opening blurb.. it 404's.
Apparently, no help for you!
(Score: 2) by Alfred on Wednesday September 24 2014, @04:40PM
Their financial incentive sounds like moving through more patients faster, leading to incomplete consideration and possible missed diagnosis.
(I intentionally did not put misdiagnosis)
There probably is a cap to the number of patients a doc can see and charge for in a month.