Long live the NHS, and yay for Obamacare - it seems like a step in the right direction at least.
In a system where you can't sue your healthcare provider for egregious malpractice because they're a governmental body and are thus subject to the same citizen-sues-state rules as law enforcement or any other public service, I fear for the quality of our healthcare.
In one instance in the 1970s I had a great uncle who came into a local clinic complaining about crushing chest-pain, and was told to come back the following day because the attending physician was out for the day. He died on the street of a heart attack while walking home. Why he wasn't immediately rushed to a hospital is beyond me.
More recently, my grandmother, who died in 2004, was wait listed for over a year to get medical imaging and biopsy performed on what she (correctly) assumed was a tumor on her neck. By the time the scan was performed it was determined that she had metastasized lymphoma and the tumor was plainly visible to anyone who could fog a mirror. She died in hospice within a couple of months of being diagnosed.
So what are we to sue for there? Clearly both instances of complete and utter NHS incompetence (and sadly, complacency on the part of my UK relatives) but it's incompetence by omission and rationing, not a doctor embedding a scalpel into someone's tibia.
Had either of my relatives lived in the US, they would have had a much better fighting chance at living than they did at the hands of the NHS.
Second clearly sounds like a fuck up. Current "wait to first treatment" target is 2 weeks. What happened when you tried to sue?
I hope you'll forgive me if I sound callous in this post - I certainly don't mean to, but I also recognise that this is a touchy subject when talking about someone's own family.
In the case of your great-uncle the problem is likely that it was the 70s and fourty years ago there was nowhere near the same awareness of the symptoms of cardiac arrest amongst non-physicians. If the doctor wasn't there, chances are it wouldn't have been picked up on. Even had he been rushed to hospital, his chance of survival would have been pretty low - heart attacks are still a major killer in the 2010s where even in London, which has the highest survival rate in the UK for heart attacks that occur outside a hospital, the survival rate is only 30%. Keep in mind though that survival rates have increased significantly over the last fourty years with advances in diagnostics and treatment as well as improved defibrillators etc.
Your grandmother's case is a more clear cut case of failure. Waiting times have long been a problem in the NHS, but it's a matter of resource contention, and it's a problem which they're trying to improve with the guarantee that patients should start treatment within 18 weeks of their first appointment and that tests should be done within six weeks. The only, very rough, numbers I can find for the US suggests that scans and tests are normally done within seven to twenty weeks when cancer is suspected. Even in the US, the problem of resources exists - there's only so many hospitals that can perform certain types of scans, and only so many doctors who are capable of properly interpreting the results. The thing I can't comment on is whether or not the physician who saw your grandmother should have treated it as a higher priority or if, given the symptoms that were presented, it would be reasonable to assume that there was a benign cause and it being cancer was pretty remote possibility. If it's the case that his prognosis was obviously wrong given the symptoms, then there's a case to be made for malpractice, or at least a complaint to the GMC and/or NHS trust.
That's nonsense, hospitals and NHS Trusts are routinely sued for malpractice, along with the doctors involved. There's nothing special about any part of the NHS that makes it impossible for them to be sued - they're not part of the state, they're just state funded. Hell, you can sue most government bodies in the UK since there's no restrictions on suing the state, only against suing the Crown.
It makes your 'multiple relatives' claim seem somewhat suspect.
That's not to say there aren't horrible things about Obamacare (i.e. terrible business model) but yes, it's a start.
Neither of those is to say that necessarily Obamacare is the wrong solution but its certainly not the only path.
Insurance is designed to protect the policy holder from an unlikely, catastrophic event they cannot afford otherwise - coverage of everyday costs is not insurance. Notice your insurance company doesn't pay to rotate your tires or change your oil.
Health care, no matter which country you go to, is more of the latter than the former. They aren't primarily insuring against unlikely catastrophic events - that's only a small part of their purpose - they are very obvious ways to spread costs around.
You can't treat health insurance like real insurance, even if they share a name.
They are extremely unpopular for many reasons, which center primarily around paying out of pocket for normal services:
For the purposes of this argument I'm going to use "health plan" to refer to what most people call "insurance" - to avoid confusing the two concepts.
- The out of pocket costs for a no-plan person is extremely inflated. Where your insurance company might pay $60 for a doctor's visit, the cost for someone not on a health plan may be $200-300. This makes the notion of paying out of pocket for routine services unrealistic for the majority of the population.
- These out of pocket costs are expensive because the status quo is for everyone to be on an employer-sponsored health plan. Those who can afford to pay, are on a health plan - the bulk of those who aren't on a plan are financially compromised and likely to default on their debts. This encourages a wild inflation of quoted cost to compensate.
- This further drives people to health plans. Barring the ultra-rich, no one is able to afford health care at "free market" prices, making health plans the only reasonable route forward.
In short, what's wrong with people paying out of pocket for basic services is that "basic services" at market rates will set you back $300 for sore throat.
For example, in some locales you can subscribe to a "direct primary care" practice for a family of four (2 adults, 2 kids) for around $150 per month, and visit your primary care provider as much as you need, paying only for supplies or possibly a token per-visit amount. This, combined with a legitimate "insurance" plan with a high deductible, might set a family back less than half as much as a traditional all-inclusive health plan. (This is what I had in Seattle, with Qliance as my direct primary care provider.)
My son recently needed a physical to start school. As a self-pay patient now located in Denver, I called around to independent clinics in my area and was able to get a fairly good price ($110 total out of pocket, paid up front.) My wife was recently able to be treated for an ear infection for around $80.
If you're actually paying out of pocket it can be a little bit of work, but there are ways to get your costs down to close to "free market" levels.