Health system in USA
#78
Re: Health system in USA
Porferic...
As a department head in the nhs, over a 5 year period i had visits from ICT delegations working in health services seeking to emulate our patient processes and systems from:
Atlanta, Chicago, Los Angeles, Houston
Japan
Korea
The Netherlands
Denmark
Norway
Those are the ones i remember.
No system as large as the NHS can be perfect, 1.2 million employees, 200 billion pounds a year, but its outcomes - its bang per buck are undeniably world class.
The cost of the NHS put another way is 800 pounds per user per year. Can you get within a coubtry mile of that? Many civilised countries have a national health service, they tend to cost say 50% more than the uk’s, and in some ways parts of them are definitely better objectively. But none approach the scale and bredth of the NHS.
The busiest database in europe is the central nhs patient record system, 100 million live records, 5000 accesses a second at times.
As a department head in the nhs, over a 5 year period i had visits from ICT delegations working in health services seeking to emulate our patient processes and systems from:
Atlanta, Chicago, Los Angeles, Houston
Japan
Korea
The Netherlands
Denmark
Norway
Those are the ones i remember.
No system as large as the NHS can be perfect, 1.2 million employees, 200 billion pounds a year, but its outcomes - its bang per buck are undeniably world class.
The cost of the NHS put another way is 800 pounds per user per year. Can you get within a coubtry mile of that? Many civilised countries have a national health service, they tend to cost say 50% more than the uk’s, and in some ways parts of them are definitely better objectively. But none approach the scale and bredth of the NHS.
The busiest database in europe is the central nhs patient record system, 100 million live records, 5000 accesses a second at times.
The NHS is far, far from perfect. It has been underfunded for many, many years and is not at all well regarded in most places. The idea that you can have a world class, or even EU class of healthcare when you spend only ?9% of GDP on it (compared to 11-12% in EU countries) is laughable.
In the USA, too many fingers in this pie all out to make profits. It's not going to change anytime soon.
#79
I still dont believe it..
Joined: Oct 2013
Location: 12 degrees north
Posts: 2,777
Re: Health system in USA
NB the core patient record is an amazon EC application, as is www.gov.uk itself but the DB servers themselves while at 3 UK data centres and in the Amazon EU farm, live within a ring fenced environment fir a he NHS. Some of the big data hogs for the supplemental/local info like MRI data are in Google’s cloud. It all works very efficiently.
#80
I still dont believe it..
Joined: Oct 2013
Location: 12 degrees north
Posts: 2,777
Re: Health system in USA
And I know for a fact that NHS people have recently been in the USA trying to find out more about this ****ed up system.
The NHS is far, far from perfect. It has been underfunded for many, many years and is not at all well regarded in most places. The idea that you can have a world class, or even EU class of healthcare when you spend only ?9% of GDP on it (compared to 11-12% in EU countries) is laughable.
In the USA, too many fingers in this pie all out to make profits. It's not going to change anytime soon.
The NHS is far, far from perfect. It has been underfunded for many, many years and is not at all well regarded in most places. The idea that you can have a world class, or even EU class of healthcare when you spend only ?9% of GDP on it (compared to 11-12% in EU countries) is laughable.
In the USA, too many fingers in this pie all out to make profits. It's not going to change anytime soon.
Of course in the hierarchy senior surgeons make a fortune, I asked a max fax surgeon from Chicago why he worked in the uk, he said overall he might make a little less salary but it was sooo worth it for the freedoms he enjoyed to do good work.
#81
Lost in BE Cyberspace
Joined: Jan 2006
Location: San Francisco
Posts: 12,865
Re: Health system in USA
My supposedly "free" screening colonoscopy is now standing at $4,500 of charges to me. The reason? During the colonoscopy they took a biopsy of my rectum - which thankfully came back negative - and, because the doctor added a code for "disease of the rectum and anus" to the code for "screening colonoscopy" my insurance company claims this wasn't a screening colonoscopy at all but a diagnostic test. Wtf? How could this be anything other than a screening given that it was performed on the screening schedule recommended by HHS, I have no prior history of "disease of the rectum and anus", and the biopsy was negative?
I will probably win this one on appeal after I've spent a few more hours of the 'phone trying to convince the doctor and anesthesiologist to resubmit their separate claims to the insurance company with just the code for a screening colonoscopy. But what a complete waste of time and money this is for everyone concerned. I echo prior comments that those not exposed to the US system can have no clue just how ****ed up it is. I mean, the idea of providing "free" colonoscopies is to ensure widespread uptake. I can eat the $4.5k here if my appeal is rejected, but you can bet that millions will avoid such screening tests once they've been burned like this.
I will probably win this one on appeal after I've spent a few more hours of the 'phone trying to convince the doctor and anesthesiologist to resubmit their separate claims to the insurance company with just the code for a screening colonoscopy. But what a complete waste of time and money this is for everyone concerned. I echo prior comments that those not exposed to the US system can have no clue just how ****ed up it is. I mean, the idea of providing "free" colonoscopies is to ensure widespread uptake. I can eat the $4.5k here if my appeal is rejected, but you can bet that millions will avoid such screening tests once they've been burned like this.
Last edited by Giantaxe; Apr 21st 2018 at 11:22 pm.
#82
Re: Health system in USA
Interesting that you would equate the quality of healthcare simply with spend, there’s a lot more to it than that, believe it or not there are a lot of nhs staff who believe in its principles and are actually content to take a magnificent pension arrangement, 6 weeks holiday a year, a truly benign employer / job for life if you don’t screw up and a slightly inferior salary.
Of course in the hierarchy senior surgeons make a fortune, I asked a max fax surgeon from Chicago why he worked in the uk, he said overall he might make a little less salary but it was sooo worth it for the freedoms he enjoyed to do good work.
Of course in the hierarchy senior surgeons make a fortune, I asked a max fax surgeon from Chicago why he worked in the uk, he said overall he might make a little less salary but it was sooo worth it for the freedoms he enjoyed to do good work.
#83
BE Forum Addict
Joined: Feb 2010
Location: Temecula, CA
Posts: 4,759
Re: Health system in USA
My supposedly "free" screening colonoscopy is now standing at $4,500 of charges to me. The reason? During the colonoscopy they took a biopsy of my rectum - which thankfully came back negative - and, because the doctor added a code for "disease of the rectum and anus" to the code for "screening colonoscopy" my insurance company claims this wasn't a screening colonoscopy at all but a diagnostic test. Wtf? How could this be anything other than a screening given that it was performed on the screening schedule recommended by HHS, I have no prior history of "disease of the rectum and anus", and the biopsy was negative?
I will probably win this one on appeal after I've spent a few more hours of the 'phone trying to convince the doctor and anesthesiologist to resubmit their separate claims to the insurance company with just the code for a screening colonoscopy. But what a complete waste of time and money this is for everyone concerned. I echo prior comments that those not exposed to the US system can have no clue just how ****ed up it is. I mean, the idea of providing "free" colonoscopies is to ensure widespread uptake. I can eat the $4.5k here if my appeal is rejected, but you can bet that millions will avoid such screening tests once they've been burned like this.
I will probably win this one on appeal after I've spent a few more hours of the 'phone trying to convince the doctor and anesthesiologist to resubmit their separate claims to the insurance company with just the code for a screening colonoscopy. But what a complete waste of time and money this is for everyone concerned. I echo prior comments that those not exposed to the US system can have no clue just how ****ed up it is. I mean, the idea of providing "free" colonoscopies is to ensure widespread uptake. I can eat the $4.5k here if my appeal is rejected, but you can bet that millions will avoid such screening tests once they've been burned like this.
I won, of course, and it was "only" $100, but both are not the point.
#84
Lost in BE Cyberspace
Joined: Jul 2016
Posts: 10,005
Re: Health system in USA
Not quite on that scale but the insurance tried to imply that I gave my consent for one extra biopsy when I had mine done. I am legally not able to give consent while dosed up on anesthesia drugs via an IV...
I won, of course, and it was "only" $100, but both are not the point.
I won, of course, and it was "only" $100, but both are not the point.
#85
Re: Health system in USA
Not quite on that scale but the insurance tried to imply that I gave my consent for one extra biopsy when I had mine done. I am legally not able to give consent while dosed up on anesthesia drugs via an IV...
I won, of course, and it was "only" $100, but both are not the point.
I won, of course, and it was "only" $100, but both are not the point.
#86
Account Closed
Joined: Mar 2004
Posts: 2
Re: Health system in USA
I can not help think I need to take advantage of those span emails I occasionally get offering 'genuine' ID documents at very reasonable cost to be used for any medical interactions.
#87
BE Forum Addict
Joined: Feb 2010
Location: Temecula, CA
Posts: 4,759
Re: Health system in USA
Why do they bugger people around so much with "colonoscopies" - I had one of the new gene scan tests, ( no history, over 50, no family with history either) - and the doctors lost the paper work, twice, failed to submit it to the insurance company, and now I have a bill for $650 for the tests- and NO RESULT. I only found out this tale of woe last week. My insurers and the gene scan folks are being very nice about it, and I am currently writing letters to the doctors and their payment dept.
#88
Forum Regular
Joined: Apr 2017
Posts: 227
Re: Health system in USA
I've never heard that statistic. It sounds typically alarmist for this forum.
#89
Lost in BE Cyberspace
Joined: Jan 2006
Location: San Francisco
Posts: 12,865
Re: Health system in USA
How so? The over 65's have by far the highest demand on health services/costs. No insurance company is going to rush to insure them, so in the days before Medicare only those with coverage from a previous job would have insurance. Not hard to see where that would lead. And I'd wager that if Medicare didn't exist today, an even higher percentage would end up in bankruptcy after their first significant illness.
#90
Re: Health system in USA
My supposedly "free" screening colonoscopy is now standing at $4,500 of charges to me. The reason? During the colonoscopy they took a biopsy of my rectum - which thankfully came back negative - and, because the doctor added a code for "disease of the rectum and anus" to the code for "screening colonoscopy" my insurance company claims this wasn't a screening colonoscopy at all but a diagnostic test. Wtf? How could this be anything other than a screening given that it was performed on the screening schedule recommended by HHS, I have no prior history of "disease of the rectum and anus", and the biopsy was negative?
I will probably win this one on appeal after I've spent a few more hours of the 'phone trying to convince the doctor and anesthesiologist to resubmit their separate claims to the insurance company with just the code for a screening colonoscopy. But what a complete waste of time and money this is for everyone concerned. I echo prior comments that those not exposed to the US system can have no clue just how ****ed up it is. I mean, the idea of providing "free" colonoscopies is to ensure widespread uptake. I can eat the $4.5k here if my appeal is rejected, but you can bet that millions will avoid such screening tests once they've been burned like this.
I will probably win this one on appeal after I've spent a few more hours of the 'phone trying to convince the doctor and anesthesiologist to resubmit their separate claims to the insurance company with just the code for a screening colonoscopy. But what a complete waste of time and money this is for everyone concerned. I echo prior comments that those not exposed to the US system can have no clue just how ****ed up it is. I mean, the idea of providing "free" colonoscopies is to ensure widespread uptake. I can eat the $4.5k here if my appeal is rejected, but you can bet that millions will avoid such screening tests once they've been burned like this.
It's nicely summed up here but trying to convince an insurance company administrator is hard. The issue has even made it to the legislature in CA with no effect.
Coding and reimbursement for colonoscopy | The Bulletin
Last edited by vikingsail; Apr 23rd 2018 at 10:22 pm.