tom169

5000 requests a second isn't the busiest database I've seen.

steveq

I shudder to think what rates Amazon's databases are being accessed at.

petitefrancaise

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.

uk_grenada

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.

uk_grenada

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.

Giantaxe

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.

petitefrancaise

you're living in cloud cuckoo land. Your quacktor friend makes a "little less" money does he? If only the NHS had only a "little less" budget than the US one, that might be reasonable to expect. I bet his salary hasn't been halved? Although if he'd gone to France for example ( commonly cited as having one of the best healthcare systems in the world) he actually would have been paid a LOT less. Nurses work for love do they? Live on principals?

GeoffM

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.

morpeth

We had a family member who was in an accident and was passed out sent to nearest hospital. Hospital performed a procedure which insurance company wouldn't cover, but hospital said had to be paid because patient consented- records showed patient couldn't have consented at time stated. Took quite a while to sort out, finally a threat of legal action took care of it.

steveq

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.

scrubbedexpat099

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.

GeoffM

In my case it was for ruling out anything other than IBS. Had a camera down the throat too. Thankfully negative, though that leaves the great mystery of IBS. I had it before coming to the US but here it's a lot worse, and there's no obvious cause (ie types of food to avoid).

NYer

I've never heard that statistic. It sounds typically alarmist for this forum.

Giantaxe

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.

vikingsail

The coding game is a common smokescreen used to try and charge a deductible. I had the same situation. They did relent but it did take an appeal which cost far more for them than if they had just been sensible. However,there is a lot of $$ for them across all patients. It sums up the mess the system is in.

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