Sunday - August 30, 2009

HEALTH CARE.  UK vs USA.  UK free, even for those who CAN PAY. How nice.

I hadn’t intended to get into the health care thing at this point in the evening but I noticed some comments on the subject here and then there was this from the Mail this morning.

I think you will find it interesting because the reporter had been living in the states and works for the BBC.  I’m pretty sure you’ll see a flaw or two but what’s amazing really is, he doesn’t.

I do think there’s a real problem back home, nobody will say with certainty that our health care is perfect.  And much of his criticism with regard to ins. companies is I believe valid, as I know from personal experience. 
He seems to have a problem with the profit motive as if it’s somehow immoral.  He had the money, as one commenter points out in the comments section of The Mail, to have a nice vacation and then comes home to the UK and immediately wants his medical freebees for his son. I guess he’s entitled and if that’s so, and it appears to be the case, well.  Can’t argue with the guy.
But here ... you read it and give us your take.

NHS vs USA: The great healthcare face-off as seen by the BBC’s former man in Washington
By JUSTIN WEBB

We can prick Sam’s fingers for free. This, for me, is the true glory of the NHS. For the parents of a child with a life-threatening auto-immune disease - type 1 diabetes - the relentlessness of the task of keeping his blood sugar under control can be overwhelming. Doubly so when - on top of everything else - stony-faced pharmacists are telling you that you have used your allocation of test strips.
But that, until we left America to return to the UK this summer, was normal life.
‘I am not doing this for fun,’ I felt like yelling. ‘We got through a box of strips last night because we couldn’t get him under control. He is not bleeding on your precious strips for the hell of it.’

Sam himself, as a nine-year-old student of drama, used to be amused by our adult tantrums at American pharmacy counters.
But for us it was no joke. We had good insurance, which in theory guaranteed us any healthcare we needed with no questions asked. So the initial hospital bills when Sam was diagnosed - thousands of dollars’ worth - were eventually paid.

But there’s small print. And in the small print there are annual limits on expenditure and constant payments that the ill person needs to make before any service is provided. If you need a weekly supply of drugs and kit, as Sam does, you have what amounts to a constant battle to get it.
So we were in combat with the organisation that, in theory, was looking after our son’s health. The view of the insurance company was that Sam was a nuisance. A perfectly healthy little fellow, who cost them no more than the odd flu shot, suddenly became a major expense. And, as in any other business, expenses are to be minimised.

So when our eight years in America came to an end this summer, our final holiday in California had to begin with a call to the insurance company. May we please - pretty please - have extra supplies of the insulin that keeps Sam alive and the testing paraphernalia that goes with it?
We were going to be on the road for a few weeks and then return to the UK. All right, came the answer, after a morning on the phone. But we were made to feel really rather lucky. ‘Just this once’, was the unspoken warning.

California was stunning. Big Sur, Lake Tahoe, Los Angeles: there is no finer place on Earth. So when we flew from San Francisco to start our new life in South London, we were not exactly throwing our hats in the air.
Until the news about the test strips. For despite reports this week that the NHS is so underfunded that women are giving birth in hospital corridors, the situation is not all grim.
Presenting ourselves at the local NHS GP clinic we signed on and explained Sam’s condition. Not an eyebrow was raised. Prescriptions were written there and then.
‘Have what you need.’ Those were the words the doctor used. I will remember them for ever. We can prick Sam’s fingers as often as we deem it to be necessary. We are free of the tyranny of the insurance company.

And this is not profligacy, either - better control of diabetes (any type of diabetes) reduces the complications that maim and cost huge sums to treat - so the NHS, by encouraging Sam to test his blood often, is doing him and future taxpayers a favour.
Rule Britannia. And yet ... There is another side to the American healthcare system that any fair-minded assessment must include. Mine certainly should because Sam benefits from it every day.

AN AMERICAN HEALTH BENEFIT

Boon: Sam Webb kayaking this summer while wearing his insulin pump, only available in the U.S.
There is a company based in New England that makes his life a million times more enjoyable than it would otherwise be. The company makes a special kind of insulin pump that has no tubes. Sam forgets it is there. In California he went kayaking with it on.
Guys, as the Americans would say, this company is not a charity. It is run for profit. In fact, I saw it tipped recently as a smart move for investors playing the markets.
In other words, the same profit motive that is such an upsetting part of the insurance industry (those bloody test strips) leads to innovation that, in the UK, just does not exist.
I rang the boss of the company and asked him about the chance of a UK launch. Zero. No money to be made here.
The NHS spends its money on test strips and basic care. Fancy American pumps are out. In fact, pumps of any kind are out for many British children. Injections are cheaper.
So to spell it out: the British system provides the basic care and does it with no fuss and no cost to the hard-pressed family. Having a child with type 1 diabetes will make you sadder, perhaps wiser, but it will not make you poorer. And, medically, Sam is as well looked after here as he would be in any fancy American hospital.

But American technology and zest for lifestyle improvements in the area of diabetes, as in every other area of human endeavour (a zest born out of zest for profit), add something to Sam’s life. That something is denied to those who depend wholly on the NHS.
So the argument goes on and as a family who have lived with both systems we can only say that we are grateful to the doctors and nurses on both sides of the Atlantic who devote their efforts to making Sam - and hundreds of thousands of other children with type 1 diabetes - healthier and happier than they could otherwise be.

When I went to the White House earlier this year for Barack Obama’s first interview with a British broadcaster, we talked while the cameras were being set up. Not about the Middle East, which was the big topic of the moment, or the world economy, or even the whereabouts of the bust of Winston Churchill that used to sit in the Oval Office.

We talked instead about type 1 diabetes. Mr Obama has friends whose children suffer from it. He was knowledgeable and sympathetic. He wrote a note to Sam and to his sisters, Martha and Clara. ‘Dream big dreams,’ he wrote.
His dream for America’s health service is that it resembles the NHS when it comes to fairness. Test strips for all who need them.
But he claims as well that the best of the American system - the innovation and the choices available to well-insured Americans - will not be put in jeopardy.
Is that a realistic dream? This is the question at the heart of America’s debate.

MAIL on SUNDAY

Here are just a couple of Sunday Mail replies.

Posted by peiper     on 08/30/2009 at 12:40 PM   
Filed Under: • Health-Medicine •  
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