Comment by madaxe_again | Hacker News Reader

Comment by madaxe_again | Hacker News Reader

I was hospitalised in France last year - and coming from the UK, which has a social healthcare system too, I was likewise blown away by the quality of care.

I was staying in a remote house, miles from the nearest village, an hour from the nearest hospital. After about four days of continuous vomiting in 40 degree heat I caved and called a doctor, in the hope of getting a prescription for antiemetics over the phone. It's Sunday. I figure it's a long shot but can't hurt.

Well, I call and she says "sorry, can't give you a prescription over the phone - but the doctor will be with you in ten minutes". I was sat there expecting a call back when the doctor shows up at my house. Checks me over, says I need IV fluids pronto, do you want an ambulance for €20 or do you want to get yourself there.

Wife gives me a ride to the hospital an hour away. The place has recently undergone big budget cuts so they've mothballed a big chunk of it, and it looked a bit sad, but inside everything was new and clean, and I'm seen within a few minutes of arriving. By a consultant surgeon who was called in to arrive a few minutes before me. I'm given fluids, blood tests, a CT and an MRI, and about six hours later an functioning again, and they're saying I can stay or leave, my choice, and here's a folder of information for you to follow up on back home.

All of this cost less than €60, and I honestly felt like I had all of France mustered and rallied to my care.

I had a similar experience earlier this year in the U.K., and the contrast was significant - in the U.K. one feels like an irritation and an inconvenience. "Bloody hell, what's a patient doing here? This is a hospital!". I still got decent treatment, of course, but it was all with a grumbling, discontented overtone - and despite it being a new (15 yr) old hospital, unbelievable amounts of equipment didn't work. There was a diabetic guy on a sugar monitor/drip on my ward that kept crashing - so their solution was to have him wake up and reboot it every 20 minutes so he didn't die. They didn't have another one available.

It's just astonishing to see how two supposedly similar socialised healthcare systems can end up so very different in their output.

Britain spends about 20% less than France on healthcare per capita. The British National Health Service is ruthlessly efficient, for better and for worse; it's really good at keeping people alive cheaply, but it's terrible at everything else. Efficiency inevitably means that resources are spread as thinly as possible, that equipment is used until it disintegrates, that hospitals are purely functional production lines for medical procedures.

British people have both a strong sentimental attachment to the NHS and a strong aversion to taxation. They're willing to overlook the flaws of the service if it means they don't have to pay more for it. I can't say it's an unreasonable position.

http://data.worldbank.org/indicator/SH.XPD.PCAP

France was ranked 1st in the world by WHO. The UK was ranked 18th. But France was also fourth in the world in per capita expenditures.

So they have socialised health care and they also fund it very generously.

https://en.wikipedia.org/wiki/World_Health_Organization_rank...

Well ever since Thatcher i get the impression that the UK has been trying to dismantle the NHS. Supposedly one of the first things done in Scotland after getting more internal autonomy was to reverse the changes from back then.

Increasing private provision in the NHS would probably make it more similar to the French system!

There's a lot of talk about privatisation of the NHS, but personally I'm really not ideologically attached to the idea of a state-owned health service provided coverage is still universal and free at the point of use.

The current system - a bunch of clinical commissioning groups buying care from GPs employed by their surgeries not "The NHS" and from a bunch of separate hospital and mental health trusts not "The NHS" is pretty much what you describe.

We see a lot of private provision via the NHS (NHS patients going into private hospitals) in mental healthcare, and it's almost all lousy. (Even worse than the NHS MH care, and that's saying something.)

When you have 1 million patient contacts every 36 hours the gap between "good enough" and "good" is a lot of people and a lot of harm.

In the UK (Wales) I got to see a hospital, a relative-in-law was terminally ill. The hospital was like a knock off slaughterhouse with thick dust everywhere and blood stains on the walls that stayed for weeks. After that I decided to get a check up every time before I go to the UK to not need the hospital there. I hope not all hospitals are like that there.

Yes, Wales has been underfunding the NHS.

Infact most of the NHS is being deliberately underfunded. Its partly what the junior doctor strikes about.

Health is devolved in the UK. That means there are 4 separate NHS systems - one in England, another in Wales, another in Scotland, and another in Northern Ireland.

I agree that there are severe problems with the Welsh NHS.

Didn't know that but I guess the problems are not limited to Wales. My uncles and cousins are expats in the UK, some in Wales and some in London and they come to Turkey (where we're from) whenever they need the dentist. Whenever they got their teeth done there they had to get it fixed here. What I saw in the hospital is that the medical staff work like salesmen, whereas here there is great respect and love towards doctors and other medical staff, and these in turn work with great devotion. A virtuous circle absent there, unfortunately.

I guess it can be attributed to work conditions of health care professionals in both systems. May be they are better paid and not overworked and hence have a better attitude towards patients under their care as a result.

I'm not sure if they're better paid, but I did get the impression they were infinitely happier than their British equivalents - quality of life probably accounts for an awful lot. I don't know though, I'm basing my assumption off a few French medics I know who definitely don't make great money, but do have some pretty great quality of living - near Swiss border, one has a cabin in the woods and a fishing pond, the other paraglides seemingly non-stop. I think there's a different approach to on/off in France, and working hours are definitely far more strictly limited.

Yep, this happened to me last year as well.

- Severe diarrhea accompanied with excruciating abdominal cramps (hot knife w/ twisting, etc)

- Call ambulance. Taken to Saint-Anne within 15 minutes.

- Given IV fluids, pain-killers and anti-spasmatics

- Released one hour later; was able to walk home (I live near Denfert-Rochereau)

- Total time in care: 2 hours. Total bill: 0 (after reimbursements).

Say what you will about France, but they care for their own.

The system in France is very different from the system in the U.K. Instead of having a national health service that employs the doctors, they have a system a lot like Obamacare, but with national price controls.

For details on the French system see The Healing of America by T.R. Reid. It also covers the U.K. and several other countries.

> I had a similar experience earlier this year in the U.K., and the contrast was significant - in the U.K. one feels like an irritation and an inconvenience. "Bloody hell, what's a patient doing here? This is a hospital!".

I'm 50. I remember what London was like way before Labour first got into power.

Lets look at today. Immigration is way out of control. London has probably 10 million people? It's busting at the seams.

I even travel to the south near the beach. Waiting for a doctor there? Sometimes up to a month.

I can remember when I would call a doctor and be seen the next day. Not any more.

The reason for the attitude is that doctors and nurses are at breaking point. I'm sorry if the down voters don't like hearing this but it's true.

Incidentally I voted to leave. But I think it's too late. We should have left before Labour got into power with Tony Blair. Like the Democrats in the US, they wanted immigrants from all over to change the political landscape and keep them in power. Regardless of native population.

The uk hospital was in North Wales - the most overwhelmingly white corner of the country that suffers from a decreasing and aging population. Most of the doctors and nurses were immigrants, from the EU and beyond.

I'm not even going to venture to disagree with you, I'll just provide those facts.

>> Like the Democrats in the US, they wanted immigrants from all over to change the political landscape and keep them in power. Regardless of native population.

You're being downvoted to unreadability anyway, but I feel I should clarify this just for the sake of people who are unaware of it: immigrants to the UK don't get a vote in parliamentary elections and therefore Blair's Labour could bring in the entire population of Asia, he still wouldn't have got a single vote out of them.

And he couldn't have just given them all British citizenship either: in general one needs to have residence before being elligible for citizenship.

Residency is obtained automatically after five years of living in the UK (if you can prove it anyway). Parliamentary elections happen every four years. We now have a Tory government, the second after ten ish years of Labour. Clearly, if Blair had a cunning plan it wasn't cunning enough.

And even if the numbers don't move you, think of it this way: if immigrants had any say in the governing of the UK, the country would not have just jumped off a cliff with a weight tied around its neck (a.k.a. Brexit).

Just to make even clearer, residents cannot vote in general elections, unless they are from the commonwealth.

If doctors and nurses are at breaking point, its down to them been underfunded and under resourced. Blaming this on immigration is unhelpful and wrong!!

It's not a zero-sum game, there aren't a finite number of hospitals and doctors. 26% of our doctors are immigrants. Immigrants pay tax, which we can spend on more hospitals and doctors. They're disproportionately young, so they have a disproportionately low need for healthcare. Immigrants are part of the solution, not part of the problem.

We simply don't spend enough on healthcare. We have an ageing population with increasing medical needs, but our spending hasn't increased commensurately. As more people reach retirement age, the ratio of workers to pensioners falls. We don't want to pay more in tax, so inevitably we'll end up spreading our resources more thinly.

Family of a medic here.

There are a number of problems with this statement.

First, immigrants are overwhelmingly young and healthy. They are overwhelmingly in work (and therefore paying National insurance....)

So, to answer your questions directly:

1) you can't get an appointment because GPs are either going bankrupt, or retiring faster than they can be replaced.

2) Baby boomers are all starting to succumb to chronic problems like diabetes, cancer, dementia etc. This costs a very large amount.

3) Diabetes costs 20% of the total NHS budget[1].

3) Social care budgets have been slashed, which means that old people come in to hospital for X, go home too early and with no support and come back with either a compound fracture or pneumonia.

4) The increase in NHS demand is 4% annually.

5) the "funding increase" comes from the cut in community & social care.

6) the degradation is entirely down to the lack of funding since 2010

[1]http://www.nhs.uk/news/2012/04april/Pages/nhs-diabetes-costs...

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