I have compared the British National Health care system to the U.S.A.’s healthcare before, especially as this country has become so divided about health care since President Obama’s health care reform efforts began.
We usually avoid getting into political arguments in this blog but I am going to share these two experiences with you just for some perspective as we are all affected by the escalating cost of health care and health care insurance whether we are a health care provider, an employee or an employer.
United Kingdom: Last week I was in the U.K. due to a family bereavement. My father is 83 and has some major health issues and quite frail at this time. My sister was concerned about his well-being and called his family doctor for advice. The doctor came by that afternoon to my father’s home and my sister was able to pick up a prescription the same day at the local pharmacy. This is not typical, most people have to go to the doctor’s office but exceptions are made sometimes. Nurse practitioners visit infirm patients in their homes under the GP’s (local doctor’s) care.
U.S.A.: This week, here in California, my 95 year old mother-in-law was in medical distress and her care giver called her doctor who was not available at all that day and the nurse told the care giver to take her to urgent care or the emergency room. Obviously this was not an option, she would not have tolerated the journey, let alone sitting in a waiting room, so we had to call 911 and ask for an ambulance. Two vehicles arrived, with at least seven personnel. She was taken to the local hospital where she received basic treatment for an upper respiratory issue. This treatment could have easily been done in her own home by a nurse practitioner.
Just think about the cost of the second experience compared to the cost of the first one. Which makes more economical sense and for the families involved which created less stress and lost work hours? The actual cost of my father’s treatment was probably less than $200 while my mother-in-laws was already into $000’s when two emergency vehicles with seven highly trained personnel turned up at the door.
Home visits by GP’s in the UK have a basis on ethical, legal and financial considerations.Some of the circumstances when GP’s have an ethical responsibility to visit their patient at home include: When they’re confined due to illness or disability or when urgent treatment could be administered more quickly by visiting them (Source: Dr. Rob Hicks). Patients also have legal rights over the type of care they receive as under the NHS Constitution 2010 – health services must reflect the needs and preferences of patients, their families and their carers.
In areas of the UK, General Practitioners have ultimate responsibility for providing care and balancing the total area health budget. The rationale being that GP’s, who are responsible for 90% of the public’s contact with the NHS, were best placed to make difficult monetary decisions over treatment and reduce expensive hospital admissions by providing better community based care. GP’s are in charge of managing the budget for all prescription costs, running GP surgeries, commissioning services from local hospitals and budgeting for new local care plans, such as community nurses.
As a result, hospital procedures have been reduced. In one instance, a single hospital’s emergency admissions budget was cut by 6%, a reduction of £6m in a single financial year, reflecting the fact that better community care is stabilizing many patients with long-term illnesses, avoiding traumatic hospital admissions and meeting the needs of the vulnerable patients while reducing healthcare costs.
The U.K. is not in the top 9 countries based on health care systems rated round the world. Japan and France are though! (Neither is the U.S.A. in the Top 9 just in case anyone thought it might be)
Just a personal perspective!