I've always been a loyal supporter of the NHS and a critic of private medicine, which provides swift treatment if you've got the money, but leaves those who can't afford it at the mercy of a declining public health service.
I'm very conscious that with rapidly lengthening waiting times for both consultations and surgery, there might come a day when I face a choice between waiting indefinitely for the NHS to attend to me or going private and getting the sort of care that should be standard practice.
I don't mean waits of a few weeks or months. I mean years. Some people in Northern Ireland are waiting up to seven years for a medical procedure. Some are waiting over three years for pain management appointments. There were long waits before Covid, but now they're totally off the scale.
So suppose I needed a hip replacement, a knee replacement, cataract surgery or some other operation, and I was told I'd have to wait years? And suppose things would get worse in the meantime? And suppose a private clinic could treat me tomorrow? I would seriously consider going private, despite my socialist principles.
I had to wait 18 months for a routine prostate operation under the NHS. I could have gone private but it wasn't urgent and I wasn't in pain so I was prepared to put up with the long wait.
But I can see myself being forced into some agonising decisions.
Sorry to come down on you hard - but then that is what is expected of me: If you can afford it there is no need to agonize. "Socialist principles" or not.
ReplyDeleteThe NHS is the most amazing health care system. And I say this as a "foreigner". In all my life here I can't fault them. Be it giving birth (ENGLISH father-of-son wanted me to go private - no thanks), be it anything. That, currently, Brexshite and Covid Hysteria do impact on waiting lists aka quality of life for those living DESPITE Covid of that there is no doubt. And that is shameful. But it's not the fault of the NHS that the politics of Covid have hijacked healthcare, that Johnson & Co don't make available the necessary resources, and that British desire for "sovereignty" (as if they didn't have it) drives out those bloody foreign doctors, nurses and other careworkers the system relies on.
Anyway, Nick, life is short. If you can - do. After all, you don't have children to better their lot when your time is up; neither can you take your dosh with you. Might as well make the most of it whilst you can still enjoy it. There is no shame in it.
All the best, to both of you,
U
I’m seeing the emergence of more doctors here in the U.S. setting up private practices, charging a fee, after leaving medical groups to which they once had to belong. Clearly, this will have ramifications for our health care delivery in the future.
ReplyDeleteJoared: I'm sorry to hear that, I didn't know that was the case. I can only hope the consequences aren't too severe.
DeleteAfter the NHS, the French system of healthcare was a let down - despite all the praise it gets. Might be fine in a city but out n the sticks it was another question. Then we moved to
ReplyDeleteCosta Rica where the health system was based on the NHS, and leans heavily on prevention as well as cure. American expats always want to go private, but our experience has been that there is absolutely no need, the CAJA is very good indeed....and when things go wrong in the private hospitals, the patient ends up with the CAJA in any case! COVID put my first cataract op back by a year...but that is all. Would I go private if I felt something was urgent...I really don't know as so far the CAJA has coped with us very well.
Fly: Interesting to know that the Costa Rica health service seems much better than the British one! It also seems to have coped much better with Covid.
DeleteIt's such a sticky wicket isn't it. And when we are privileged (with resources) it's hard not to take the easier, softer route into private care. There's a horrible two tier system in Ireland that has killed countless people waiting for breast cancer surgery, etc.
ReplyDeleteIn a republic that is unconscionable. Here in Canada, the wealthy take off for the Mayo Clinic(including prime ministers) which is an in your face raspberry for the peasants. It enrages me.
XO
WWW
www: One thing that makes me wary about a united Ireland is the state of the health service down south, which seems to be almost as bad as the current NHS. And yes, the wealthy can always book into a private clinic and dodge the shambles that ordinary mortals have to deal with.
DeleteIt’s a complicated problem with so many variables. I have two family members in the medical field and they both feel as though health care is a complete disaster, after working for numerous hospital systems (some that no longer exist). Does private care even truly exist? With insurance, we are forced to use specific hospital systems, which have become such a monopoly. I live in one of the biggest health care cities in the US and we basically only have two systems because they’ve bought up all the smaller hospitals. Care has gone downhill fast because doctors are retiring earlier and earlier due to so many factors (cost of malpractice insurance, insurance methods, long hours). That means longer delays for care and few choices. At least from my experience though, surgery wait time is generally one month. I can’t imagine the stress of waiting longer than that.
ReplyDeleteBijoux: Intriguing that your experience of health care in the States is also pretty negative. Many of our doctors are facing similar burdens - the cost of insurance, long hours, staff shortages. A lot of doctors are going part-time, which means an extra burden on the remaining full-timers.
DeleteWe had nothing but good experiences with out health care providers in recent years. In 1988, Karen saw a Dr. Teeter, who snottily attributed all of her problems to normal womens' issues. She finally saw someone else in the same clinic who diagnosed her properly and set her up with a specialist in Little Rock. Her lupus has been in medicated remission for over 2 years and her fibromyalgia and polymyositis have been well under control. Other than Teeter, though, we've had no issues with providers and are always able to get in in short order, often the same day.
ReplyDeleteGranted, we pay for our insurance and many are unable to, so do without. That is the major problem I see here, even after Obamacare. It needs to be fixed.
My personal physician, Nathan Henderson, earlier in the year left the clinic to work elsewhere. I think it was blowback on his strong positions on COVID and the pandemic (he had done a local op ed in a newspaper and on Facebook). Recently, he texted me that he was returning to the clinic. Yay!
Oh, and that Dr. Teeter? He was recently filling in for the hole that Henderson left in small local branch of the clinic. Karen had avoided seeing him since 1988, but since she need to see a doctor and it was a minor issue, she scheduled with him. I guess time and retirement has mellowed him. There were no issues and he was able to giver the helps she needed.
Mike: Glad you're doing well with your medical treatment. And glad to hear Dr Teeter has mellowed! I'd never heard of polymyositis - it looks nasty. It's scandalous that there are so many people in the US who have no insurance coverage and often end up in debt after massive medical bills.
DeleteMy brother-in-law left medicine in Minneapolis because he could no longer afford to pay for malpractice insurance. Too, bad, because he was one of the good ones who didn't charge an arm and a leg to treat people. He changed to teaching special ed kids.
ReplyDeleteLinda: That's a shame, especially since he didn't sting people financially. I hope he's enjoying his new job.
DeleteThat is depressing that NHS is having severe problems. Another blogger has been having problems with care which I thought could be Covid delays. We have not been doing routine screenings due to an overload of Covid cases.
ReplyDeleteWe have a crazy system with insurance companies in the States. Me and my family get good medical care. We have good insurance and income which helps tremendously. How long this last is like all things. Our population is getting older and needs more healthcare as a result. Any system can breakdown.
Ann: The insurance system in the States seems to be incredibly unfair. A pity Obama wasn't able to push through much more radical changes.
DeleteThe people who needed healthcare the most fought it tooth and nail. I have reached the conclusion that many of my fellow Americans are uneducated louts. That said, I'm friends or related to many of the worst ones.
DeleteAnn: Jenny and I are equally mystified as to why those who need help the most consistently vote for governments that probably aren't going to help them.
DeleteI'd go private if I had to, and if I could afford it - it'd get me out of the queue and allow someone who really couldn't afford to go private to get their treatment quicker. I guess this is how you have to look at it, Nick.
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Ms Scarlet: Good point about getting someone else further up the queue. But there's one snag with private treatment. If anything goes seriously wrong they don't have much emergency back-up and you could be in trouble.
DeleteIt seems from reading many online accounts that healthcare in many places is on the verge of collapse. That is sad news for those who really need help and cannot wait such long periods to receive it. It’s good that you were able to hold off fir your procedure and hopefully without any long term effects because of a delay, Nick.
ReplyDeleteBeatrice: No long term effects as far as I'm aware. I get the same impression, that many health care systems are in dire straits and needing an urgent overhaul to get them working properly.
Delete20 years ago I waited three years for orthopaedic surgery, my recent surgery was done after a year wait (almost to the day)
ReplyDeleteI don't have enough money to pay for private insurance so I take what I get. In general terms, Medicare here has been very good to me but the convenience of the private system is unbeatable
Kylie: A three-year wait is bad. A one-year wait is an improvement at any rate. A lot of NHS consultants do private work on the side, which is a dubious arrangement to say the least.
DeleteAs a health care provider, I wish the US would go to a national health systems. As it stands now, we are in a stranglehold by the insurance companies, who make health care decisions for providers. And you are stuck with whatever health insurance company your place of business chooses, no matter how lousy the coverage. And that is if you are lucky enough to be in a work situation that even provides insurance, as so many are not.
ReplyDeleteAgent: US health care is obviously very deficient. It's tragic that Obama wasn't able to get the radical reforms he wanted. And I hadn't picked up on the fact that even if you have workplace insurance, you can't choose the company or the coverage, which might be inadequate.
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