Brexit Encore

[Alan Klein]

That's a different thing - probably few doubt that if you can afford it you can obtain the best treatment in the US. That's not the same as having a good health care system for the non-multi-millionaires.

But you were the one who was saying that Europe provides the best of care not America. Now you're acknowledging that America provides the best of care exactly what we've been saying all along.

Additionally that best of care is available to the average person who doesn't have the wealth like Jagger because they are covered with health insurance, Private health insurance.

Of course once the government takes over, the best doctors opt out of that program such as on government Medicare, and the average guy loses the advantage of those best doctors. So on two scores you're proving the point that is better to have competitive private insurance not single Source government insurance.

[faberryman]

The myth of "the best doctors". You can read all about them in in-flight magazines.

[Alan Klein]

The myth of "the best doctors". You can read all about them in in-flight magazines.

It's not a myth. Surveys have shown that hospitals that have surgeons who do more surgeries of a particular type have a better success rate and less death of patients.

 would you choose a surgeon who does the procedure once a week or surgeon who does it three times a day?

[faberryman]

It's not a myth. Surveys have shown that hospitals that have surgeons who do more surgeries of a particular type have a better success rate and less death of patients. would you choose a surgeon who does the procedure once a week or surgeon who does it three times a day?

How many surgeons at how many hospitals did you personally interview before your cancer and heart surgeries? Did you ask them how many of your particular procedure they performed a day and what their complication statistics were? Did you personally interview the anesthesiologists and teams of nurses too? How do you know your doctors were the "best" available? Everybody thinks his doctor is among the best. It's nonsense. There are thousands and thousands of great doctors.

[jeremyrh]

But you were the one who was saying that Europe provides the best of care not America. Now you're acknowledging that America provides the best of care exactly what we've been saying all along.

No, I'm saying that the best health care can be bought in the US. That's not the same as the US providing the best health care.

But Im not discussing this further on a Brexit thread.

[Alan Klein]

No, I'm saying that the best health care can be bought in the US. That's not the same as the US providing the best health care.

But Im not discussing this further on a Brexit thread.

Why not?  The issue of loss of healthcare for Brits if there's a Brexit is a major issue regarding leaving the EU. Understanding how you got there seems important to me and should be to BRits.  It's also a lesson for Americans who try to do health care similarly as Britain.  So readers of this thread who are American should pay attention to the difficulties you're facing because you have a government run health care system.  It would be folly for us to do the same.

There's also the argument that America wants to do something about British Health Care system if there's a Brexit although I'm not yet familiar what the second issue is about.  Maybe you can educate me.  Certainly that has to do with Brexit decisions as well.

[Rob C]

No, I'm saying that the best health care can be bought in the US. That's not the same as the US providing the best health care.

But Im not discussing this further on a Brexit thread.

Frankly, considering the absolute lack of comprehension we meet, you are absolutely right, whether a Brexit thread or otherwise: all you and I get back are repeated mantras based on brainwashing and flawed logic blended into non sequiturs.

It's like discusding religion with a staunch believer - of any of the prescribed options readily available on the soul market.

Better be as I am, and have a personalized version that seems to be borne out by life experiences.

:-)

[Slobodan Blagojevic]

Ok... since Rob shared his experience with the Spanish health care, I thought I'd share mine.

The Good

I had appendicitis while in Barcelona, at the tender age of forty something. Presented that late, it is less abrupt and painful, so it took days to diagnose and by the time I ended up in a hospital, it perforated, so I had to spend a week in the hospital after the operation, on antibiotics (it is usually a two-day affair otherwise). A couple of weeks later, I got a bill in mail: 1,700 euros! For the operation and a week in hospital! A couple of years later, in the US, a late-night scare with my kid in the emergency room ended up costing $2,000 ($100 out of pocket, the rest covered by insurance), even though it was just a stomach flu and not much testing or intervention. Even more recently, a visit to the ER for stitches and x-rays (after a fainting spell) cost $20,000 dollars ($5,000 out of pocket this time). Back to the Spanish bill. After itemizing charges, at the bottom it read: "This is not a bill - for your information only." Sweet!

The Not So Good

My kid, in kindergarten then, had most of her baby teeth rotten by excessive drinking or sweet apple juice that her mother was giving her to induce her to sleep faster. It was an esthetic issue, but also I was not sure if the cavities posed a health threat otherwise. Went to a public hospital first. They told me they'd be happy to pull all her teeth out under a general anesthesia. I freaked out. General anesthesia is, statistically, a rather safe procedure, but still not without risk. A kid in Chicago recently died during a dental procedure even under a local anesthesia. So I asked around. Finally ended up with a private pediatric dentist. She said, instead of pulling them all out, she will repair them all with fillings. The reason? Keeping the baby teeth in place would preserve the proper space for the permanent teeth. Of course, filling them all was expensive, 1,000 euros, but the good thing was that my kid never needed braces later on. Anesthesia? Forget it, she said, we are going to go slow. The first two (paid) session she did absolutely no work, just letting my daughter play with the instruments, sit in the chair, etc. The idea was, the doctor said, to get kids used to dentists and procedures. If they get spooked at that age, they would carry it for the rest of their lives.

[Alan Klein]

How many surgeons at how many hospitals did you personally interview before your cancer and heart surgeries? Did you ask them how many of your particular procedure they performed a day and what their complication statistics were? Did you personally interview the anesthesiologists and teams of nurses too? How do you know your doctors were the "best" available? Everybody thinks his doctor is among the best. It's nonsense. There are thousands and thousands of great doctors.

It's not only the doctor but the hospital.  The best hospitals get the best doctors.  Teaching hospitals are usually better too since they're training new doctors at their associate medical schools. They also do the most procedures so they have the most experience.   For my heart, I went to NY Presbyterian (formerly Columbia Presbyterian) the #4 hospital for bypass heart surgery in the USA, #5 hospital overall in the country.  NY Presbyterian is associated with Columbia and Cornell Medical College in NYC.  Fortunately, I live an hour away by car.  I picked my cardiologist who I had been seeing for about three years.  He is associated with this hospital and had  his office a floor below the surgical wing.  He selected my surgeon, a Japanese who does 2-3 open heart surgeries a day.  I trusted my cardiologist to select the best surgeon for me.  He squeezed me in for the surgery 6 days later and kept me in their heart wing under a EKG monitor (blue tooth) until the operation.  Their heart wing is the latest technology and really great and thorough staff.  I definitely would recommend this hospital for heart surgery if God forbid anyone needs it.  I thank God I'm still alive and seem to be doing well in recovery.  Of course there's no guarantees in life.

I agree it's hard to select a good doctor.  But as I said, you can check where they're affiliated with and check publications.  Get a doctor who's affiliated with a teaching hospitals.  They're the most up-to-date in equipment and procedures and research.  Then if you need surgery, they know the better surgeons and can get you in.  Of course, if you live away from the larger cities, it's hard to find better facilities and doctors who have as much experience.  By the way, I reported here in another post that the guy in the bed next to me was a homeless person who was getting heart surgery for free.  So the hospital doesn't just treat people like me under Medicare, or a money-is-no-object Jagger type, but everyone. 

Here's a rating link showing NY Presbyterian.  https://health.usnews.com/best-hospitals/area/ny/new-york-presbyterian-university-hospital-of-columbia-and-cornell-6210024/heart-bypass-surgery

Here's a general list https://www.usnews.com/info/blogs/press-room/articles/2019-07-30/us-news-releases-30th-annual-2019-20-best-hospitals-rankings

[faberryman]

I trusted my cardiologist to select the best surgeon for me.

Like everybody else. Fortunately, he accepted Medicare, unlike the "best" doctors you have been blathering on about.

[Alan Klein]

Like everybody else. Fortunately, he accepted Medicare, unlike the "best" doctors you have been blathering on about.

But if your specialist is affiliated with a less experienced hospital with less quantities of procedures, the surgeon he recommends won;t be as experienced or accomplished.  Surgery especially is a numbers game.  It's an eye-hand coordination thing. Like photography   You get better with experience.  Plus, the hospitals won't take average doctors or surgeons but those who were best in the medical class with solid experience.  The hospitals want the best to protect  their reputations.

Regarding Medicare, I've been burned at the Hospital for Special Surgery in NYC, the #1 hospital for orthopedics in the USA.  The doctor I went to there did not take Medicare and I had to pay 100% of the bill.  I had to drop him.  I learned my lesson. Now the first question I ask is do you take Medicare?  So the fact is, Medicare does limit my choices of the best.  FOrtunately, NY Presbyterian doesn;t limit access if you're only covered with Medicare.  So I'm fortunate.  But if I need back surgery, I won;t be able to use Hospital for Special Surgery, or at least limit my selection of surgeons and doctors.     Now my daughter did have back surgery at that Hospital.  But being younger and not on Medicare, she had private health insurance that picked up the surgeon and hospital costs less deductibles.  It's only when you have government sponsored Medicare that you get screwed.  My suggestion is stay well all your life and then when you're 95 get run over by a truck.  Getting old and sick sucks. 

[Alan Klein]

Ok... since Rob shared his experience with the Spanish health care, I thought I'd share mine.

The Good

I had appendicitis while in Barcelona, at the tender age of forty something. Presented that late, it is less abrupt and painful, so it took days to diagnose and by the time I ended up in a hospital, it perforated, so I had to spend a week in the hospital after the operation, on antibiotics (it is usually a two-day affair otherwise). A couple of weeks later, I got a bill in mail: 1,700 euros! For the operation and a week in hospital! A couple of years later, in the US, a late-night scare with my kid in the emergency room ended up costing $2,000 ($100 out of pocket, the rest covered by insurance), even though it was just a stomach flu and not much testing or intervention. Even more recently, a visit to the ER for stitches and x-rays (after a fainting spell) cost $20,000 dollars ($5,000 out of pocket this time). Back to the Spanish bill. After itemizing charges, at the bottom it read: "This is not a bill - for your information only." Sweet!

The Not So Good

My kid, in kindergarten then, had most of her baby teeth rotten by excessive drinking or sweet apple juice that her mother was giving her to induce her to sleep faster. It was an esthetic issue, but also I was not sure if the cavities posed a health threat otherwise. Went to a public hospital first. They told me they'd be happy to pull all her teeth out under a general anesthesia. I freaked out. General anesthesia is, statistically, a rather safe procedure, but still not without risk. A kid in Chicago recently died during a dental procedure even under a local anesthesia. So I asked around. Finally ended up with a private pediatric dentist. She said, instead of pulling them all out, she will repair them all with fillings. The reason? Keeping the baby teeth in place would preserve the proper space for the permanent teeth. Of course, filling them all was expensive, 1,000 euros, but the good thing was that my kid never needed braces later on. Anesthesia? Forget it, she said, we are going to go slow. The first two (paid) session she did absolutely no work, just letting my daughter play with the instruments, sit in the chair, etc. The idea was, the doctor said, to get kids used to dentists and procedures. If they get spooked at that age, they would carry it for the rest of their lives.

Glad things worked out for your kid.  I went through the opposite.  WHen I was a kid, the dentist always seemed to hurt me.  I think he was using water instead of Novacaine.  Now I sweat everytime I have to go.

[jeremyrh]

Why not?  The issue of loss of healthcare for Brits if there's a Brexit is a major issue regarding leaving the EU. Understanding how you got there seems important to me and should be to BRits.  It's also a lesson for Americans who try to do health care similarly as Britain.  So readers of this thread who are American should pay attention to the difficulties you're facing because you have a government run health care system.  It would be folly for us to do the same.

There's also the argument that America wants to do something about British Health Care system if there's a Brexit although I'm not yet familiar what the second issue is about.  Maybe you can educate me.  Certainly that has to do with Brexit decisions as well.

Against my better judgement ...

1) Rob's problem arises from the fact that right now he has access to the Spanish health care system, but after Brexit he may not. That has no lessons for the US, unless US and (say) Mexican citizens have a right to reciprocal health care systems - which they don't and nobody is suggesting.
2) The issue about US access to the NHS is around the fear that the NHS would be privatised fpr short term gain and control lost, leading to US-level costs.

[Rob C]

Against my better judgement ...

1) Rob's problem arises from the fact that right now he has access to the Spanish health care system, but after Brexit he may not. That has no lessons for the US, unless US and (say) Mexican citizens have a right to reciprocal health care systems - which they don't and nobody is suggesting.
2) The issue about US access to the NHS is around the fear that the NHS would be privatised fpr short term gain and control lost, leading to US-level costs.

On your point#2, that's probably where Boris is hoping to find the money to finance all his dreamweaving promises, and reduce national debt. He's good at promises, must grant him that, I guess.

:-)

[Alan Klein]

Regarding point #1, I wasn't saying that America would have the same issues regarding health as GB such as the Spaining care.  It's just that when government takes over, you no longer can make independent decisions based on your personal needs.  It's a one size fits all plan.  If the government decides to do something that hurts you, you have nowhere to go.  With private insurance, there's competition and choice.

Regarding point #2, thanks for filling in.  But how can America affect you national health plan?  What kind of American access can there be?  What kind of support does Boris expect from us regarding it?

[RSL]

That's a different thing - probably few doubt that if you can afford it you can obtain the best treatment in the US. That's not the same as having a good health care system for the non-multi-millionaires.

It has nothing to do with multi-millionaires, Jeremy. You're flouting your ignorance. If you can get to the U.S., you can get treatment. If you're a pauper, all you have to do is walk into an emergency room. They're required, by law, to treat you. If you're a pauper your problem would be transportation to the U.S., not the medical system, which, knowing nothing about it, you believe to be inefficient. I wish you could talk with some of the Canadians who come down to Florida in the winter for medical care they can't get in a timely fashion from Canada's "free" health care system. Our system has its flaws, but unlike "free" health care they tend not to be deadly.

[Alan Klein]

It's not ignorance.  It's the fake news liberal press that's spread around the world.  All biased and tainted.  It fools Americans and foreigners alike. 

[jeremyrh]

It's not ignorance.  It's the fake news liberal press that's spread around the world.  All biased and tainted.  It fools Americans and foreigners alike.

As I said before on another topic, I lived in the US quite a while, so I know something of what I'm talking about. Maybe some others could restrict themselves to waiting till they actually have a clue before opening their mouths?

[RSL]

Where, and how long, and what were you doing when you were here, Jeremy? What you just said is meaningless on the face of it. If you were in school, what school? If you were in business, what business? There are plenty of Americans just as ignorant of America as you seem to be. Depends on where they live and what they do.

[faberryman]

But if your specialist is affiliated with a less experienced hospital with less quantities of procedures, the surgeon he recommends won;t be as experienced or accomplished.  Surgery especially is a numbers game.

You don't need to go to a teaching hospital in NYC to get a qualified doctor to perform a heart-bypass. It is routine surgery in hospitals across the nation. Did you actually read US News and World Report's evaluation of NY Presbyterian you linked to? They are rated "poor" in length of stay and incidence of infection. Probably related. Not sure why you are selecting your hospital based on a news magazine survey anyway, but to each his own. Hospitals game the ratings just like schools do in the best colleges survey. I'm glad your procedure went without incident.