Think your doctor is finding you the best clinic? - Stark law

[plugger]

No, doctors aren't sending people to the best clinic! Your doctor is probably sending you to the place where that person is the medical director.

Looks like some doctors here in Colorado would have preferred sending their patients elsewhere and finally had to quit their roles as medical directors to get on with other dialysis companies.

The Stark law ( http://en.wikipedia.org/wiki/Stark_Law ) is supposed to prevent doctors from sending people to a facility where the physician has a financial interest, but nephs got an exemption.

Surprise! It is causing problems:
http://www.denverpost.com/news/ci_12830453

"The mud began to fly last year when the second-largest group of Denver kidney doctors, called nephrologists, ended their exclusive affiliation with DaVita and partnered with a Massachusetts dialysis company entering the Denver market. Near the same time, the largest nephrology group in Colorado Springs dumped DaVita in favor of Liberty Dialysis, which recently opened two dialysis centers in the city.

DaVita quickly sued doctors in both cities, plus a nurse battling breast cancer who quit her job at a DaVita dialysis center and took one with Liberty."

I just wanted to also mention the old DialysisEthics website ( http://www.dialysisethics.org/ ) is back up and we are working on a new one.  I'm the new front person of the organization and hope you will drop by.  DialysisEthics fought a hard fight, but now we feel we can tone that down.  We want to be part of the solutions we see coming, rather than continue to point out problems.  So come see what we have been up to over the years and I guarantee we have more surprises!

[KICKSTART]

I guess im lucky im in the UK then.

[Wallyz]

Heh.  Da Vita is actively recruiting from PSKC and NKC around here.  It's time they got a dose of their own medicine.

[kristina]

I guess im lucky im in the UK then.

Why are you lucky to be in the UK?

[KICKSTART]

Because our system isnt like that  , we all go to the same hospital in our area.

[kristina]

Are you sure and how do you know?

[KICKSTART]

 

[Stoday]

In the UK we can choose to go to hospital of our choice, but 99.9% go to the nearest one that offers the treatment they need.

I'm amazed at the inefficiency and inequality of what I read of the US health system on this forum. Not least the difficullty Obama is having in introducing changes that bring the system up to the standards met in other countries of the developed world for serving the whole population.

[kristina]

It is so unfair that you claim everything in the UK is alright and NHS-healthcare is free for everyone in the UK. You do not mention that so many patients are forced to give their dignity in exchange for their “free” health care. You do not mention the many patients who do not receive any NHS-health care because they refuse to take part in this. You do not mention that one of our Health Ministers is currently investigated by the police for fraud and corruption. Many other Members of Parliament are still being investigated. A former Health Minister published a book about her very intimate exploits in the House of Parliament.

Reading this hurt me very much because I did write to her for help and never received an answer. She obviously had no time and no bother.

You do not mention the female patients in the UK who do not receive any NHS- health care because they do not agree with the exchange they are supposed to give for "free" NHS-health care. You do not mention that these victims have no office to write to with their complaint. There is no Ombudsman to investigate or assist, no Health Commission to investigate or assist, no Member of Parliament, there is no office in place to assist us in our human rights and our right for medical care.

You write how amazed you are about the inefficiency and inequality of what you read of the US health system on this forum. What about the inefficiency and inequality of what you read, experience and hear of the health system in the UK? The NHS health system in the UK has been created by very idealistic, gentle and kind-minded people, but unfortunately there have been other people who have taken advantage of this “idealistic, fragile, vulnerable health system” and they have exploited it for their own purpose and so it has mutated and deteriorated almost beyond comprehension.

The UK has one of the highest suicide rates in Europe.

Many people leave the UK every week to try their luck in another country. One needs to be healthy to be able to take such a big step.

I have not received any NHS- health care for many years and I am forced to pay for everything privately. I do not have the money, but in order to have blood-tests etc I am forced to pay. On 11th April 2005 I received by post a letter from the Medical Chairman of my Health Authority, claiming that for my disease of MCTD/SLE there is no specialist to be found in the UK. I received this letter because I made very clear to my Health Authority that I do not wish to exchange my dignity for a NHS-health service and the letter came as a result for my refusal.

[paul.karen]

Stoday,
This isnt a problem about Obama per say.  It is a problem with our congress and the lack of trust we have in our own system.
Most everything the government touches breaks and there is usually more pork (waste) in new bills then there is funds to fix the problems that are set out to be fixed.
Look at our Social security.  All legally working us citizens pay into this system once we start to work.  So we have a little something to fall back on when we retire.  Well this plan will be broke right around the time i retire.  Thus i have paid into this system my whole life and likely wont see a dime of it cause the government has been using these guaranteed funds for pet projects.
Same can be said for Medicare.  This is run by the government.  And on average costs about 3-4 thousand more a month then if you pay for your own insurance.
If we adopt a national healthcare system we will no longer be #1 in our healthcare.  People from around the world come here to be treated due to many factors.  Usually they are the richer people who can afford to pay for top health care.
OK lets say we give an additional 55/70 million people free healthcare.  We dont have enough doctors to cover these extra people.  So bigger wait times less attention from doctors, skipping treatments to cut corners.

Who wants to hear they have a tumor on there brain and you may have less then 10 months to live.  But we wont scan your tumor for 8 months due to the waiting list.
Or we dont think we can start you on dialysis cause well you are over the cutoff age of 65.

Many Americans want to fix the system.  But we know better then to let the government get involved in this system. 
In short it will cost us much more then it does now.

75 to 80% of Americans are happy with the services they get.  Trust me we wont be getting the same kind of coverage as our leaders do.  No gold plans for the working class.
And Obama has passed already Three major bills that NO ONE HAS READ.  The democrats just passed them unread.  You dont start to build a house without first having blueprints made up.  Obama wants to start building and make the blue prints up as he goes.  Which in every case will give you costs overruns along with unseen problems with wiring piping and the foundation itself that should have been laid before the roofers came to finish a job that hasnt even begun yet.
This is only my take.

[KICKSTART]

I dont really want to get into this thread because i dont do politics, but i am puzzled at a few things you have said ..Patients forced to give their dignity for free health care ? Female victims who dont receive health care because they dont agree with the exchange they are supposed to give ? No one to complain to ?  I really havent a clue what you are talking about here. Are you talking about the UK here?

[Zach]

Or we dont think we can start you on dialysis cause well you are over the cutoff age of 65.

What country has a cutoff at age 65 for dialysis?

[paul.karen]

That was an example Zach.
But who knows what could happen when politics decide who gets what.
How old is to old to get a hip replacement.??  If it were someone we loved no age is to old.   But if goverment were to put an age on it we would have no choice in the matter or say.

[Zach]

That was an example Zach.

Yes, it was indeed an example.

[Des]

What country has a cutoff at age 65 for dialysis?

South Arica has.... if you are older than 65 or any age for that matter and you do not qualify for a transplant for any reason whatsoever and you are a non-private patient they send you home to die.
They do not have enough machines in the public hospitals and they (a panel) decide who gets dialysis and who dies.

Okaral can pull us some info?

[paul.karen]

Zach i did a small search and came up wioth many articles.
I wont paste many casue for every article there is one to dispute it thus i rarly post from websites such information.
But a google seach show MANY places where there are cutoff ages on dialysis alone.
Same with people that have cancer ect ect.  Forget a transplant they wont even TREAT patients with ESRD in many places.  All due to cost. 

The costs and consequences of government-run health care show up in survival rates.

In Great Britain and New Zealand, 46 percent of women with breast cancer die.  In the United States, a quarter of breast cancer patients now die from it – that is, 75 percent here survive the disease.
 
Fifty-seven percent of British prostate cancer sufferers die.  A fourth of Canadian patients die of prostate cancer. By contrast, this cancer kills just 19 percent of its American patients.
 
Ten percent of those who undergo major surgery in Great Britain die in the hospital. Only 2.5 percent of such American patients don't survive.
 
New Zealand rations kidney dialysis. Thus, most New Zealanders over age 75 are barred from treatment for end-stage renal failure.
Rationing of care takes the form of waiting lists or restrictions on types of treatment. Bureaucrats aren't responsive to patients, and patients suffer more. The bottom line is that central government gets in the way of private medical care.

[Zach]

Thank you paul.karen for the information.
But it would be a good idea to provide links to the sites from which those facts come.

[Bill Peckham]

New Zealand rations kidney dialysis. Thus, most New Zealanders over age 75 are barred from treatment for end-stage renal failure.

I don't have first hand information about your other data points but I know this was false in 1999 when I dialyzed in Auckland. I've seen a lot of data on NZ since and there is no indication that they ration access to dialysis. I am less familiar with the NZ transplant situation.

NZ has something like 50% of dialyzors at home. The unit I visited in 1999 was geared for self care and had a number of people over 75, including those over 75 with diabetes.

[paul.karen]

?

Could be Bill.
Like i said for any article anyone pulls from a website there are more to disprove it.

Although that was 10 years ago. (your visit)
Without rationing here in the US i cant see how we will save money by adding so many millions more people.
Not to mention where will we get doctors (we already have a shortage) to cover the 50/55 Million+ to be insured.

Plus Des made a statement as well about S. Africa.

Zach your right i should have posted the link i quess.  But any qucik google will show much the same.  Thus i dont like to post links.  I have no reason to make stuff up, im also dealing with this disease.

[Stoday]

I have seen some of the comments about the UK’s NHS elsewhere — in US propaganda that seeks to maintain the status quo. It may have been true to some extent a decade or more ago, but not now. In the last ten years the UK has doubled expenditure on the NHS bringing the standards up to the rest of Europe.
No one has to use the NHS; anyone can use a private hospital and, if they need to do so, pay insurance to cover the cost. I do so, although I intend to stop paying for it at the end of the current year because my recent experience with the NHS shows that I’m wasting my money.

I’ll answer some comments from my personal experience.

The UK has one of the highest suicide rates in Europe.

That’s not true. Using the World Health data published in 2008 the following European countries have a higher suicide rate than the UK (in order from highest to lowest):
Lithuania, Slovenia, Hungary, Latvia, Belgium, Estonia, Finland, France, Poland, Austria, Czech Republic, Denmark, Sweden, Bulgaria, Germany, Slovakia, Romania, Portugal, Ireland, Netherlands, Spain, Italy.

The following are lower than the UK:
Malta, Greece.

in order to have blood-tests etc I am forced to pay.

I have monthly blood tests which cost me nothing.

OK lets say we give an additional 55/70 million people free healthcare.  We dont have enough doctors to cover these extra people.

So you have 55/70 million people who need health care but don’t get it?

In Great Britain and New Zealand, 46 percent of women with breast cancer die.  In the United States, a quarter of breast cancer patients now die from it – that is, 75 percent here survive the disease.
 
2004 statistics are: UK death rate 32%, US death rate 23% (Click )

Bureaucrats aren't responsive to patients, and patients suffer more

Indeed so. It seems to me that the US system has more bureaucrats than the NHS owing to the need to invoice and pay fees.

I can’t find anything to substantiate the major surgery issue nor the prostate mortality.

These 55/70 million people who don’t get health care because there are too few doctors — are they included in the statistics? Or are the statistics “improved” by excluding the deaths of these people?

[BigSky]

These 55/70 million people who don’t get health care because there are too few doctors — are they included in the statistics? Or are the statistics “improved” by excluding the deaths of these people?

These people do have access to healthcare, can and do receive it.   They are the amount that most likely has no health insurance.

The problem is these people most likely go through the emergency room to get their healthcare which raises the costs for everyone.

Its trying to stem the millions of dollars wasted by visits to the ER that are not needed and could be handled by a GP.

[plugger]

The problem is these people most likely go through the emergency room to get their healthcare which raises the costs for everyone.

Its trying to stem the millions of dollars wasted by visits to the ER that are not needed and could be handled by a GP.

And as may have been pointed out, there is the other end of the spectrum: people who wait until the last minute to go to the emergency room because they don't know something is sneaking up on them or they are terrified of the medical bill - I understand they really run costs!

Anyway, if people are interested in this, I would recommend the following:

Physicians for a National Health Program (great FAQs and articles)
http://www.pnhp.org/

[Zach]

I’ll answer some comments from my personal experience.

Thank you, Stoday, for adding your perspective to the discussion.

[kristina]

I have seen some of the comments about the UK’s NHS elsewhere — in US propaganda that seeks to maintain the status quo. It may have been true to some extent a decade or more ago, but not now. In the last ten years the UK has doubled expenditure on the NHS bringing the standards up to the rest of Europe.
No one has to use the NHS; anyone can use a private hospital and, if they need to do so, pay insurance to cover the cost. I do so, although I intend to stop paying for it at the end of the current year because my recent experience with the NHS shows that I’m wasting my money.

I’ll answer some comments from my personal experience.

The UK has one of the highest suicide rates in Europe.


That’s not true. Using the World Health data published in 2008 the following European countries have a higher suicide rate than the UK (in order from highest to lowest):
Lithuania, Slovenia, Hungary, Latvia, Belgium, Estonia, Finland, France, Poland, Austria, Czech Republic, Denmark, Sweden, Bulgaria, Germany, Slovakia, Romania, Portugal, Ireland, Netherlands, Spain, Italy.

The following are lower than the UK:
Malta, Greece.

in order to have blood-tests etc I am forced to pay.

I have monthly blood tests which cost me nothing.

OK lets say we give an additional 55/70 million people free healthcare.  We dont have enough doctors to cover these extra people.

So you have 55/70 million people who need health care but don’t get it?

In Great Britain and New Zealand, 46 percent of women with breast cancer die.  In the United States, a quarter of breast cancer patients now die from it – that is, 75 percent here survive the disease.
 
2004 statistics are: UK death rate 32%, US death rate 23% (Click )

Bureaucrats aren't responsive to patients, and patients suffer more

Indeed so. It seems to me that the US system has more bureaucrats than the NHS owing to the need to invoice and pay fees.

I can’t find anything to substantiate the major surgery issue nor the prostate mortality.

These 55/70 million people who don’t get health care because there are too few doctors — are they included in the statistics? Or are the statistics “improved” by excluding the deaths of these people?

You have written such a lot, and it is very interesting, 
but I still don't know what you have to do in exchange to receive your NHS- health service?
That is what I really wish to know. Thank you for the information, Kristina.

[rose1999]

No one has to use the NHS; anyone can use a private hospital and, if they need to do so, pay insurance to cover the cost.

I have to take issue with this statement as only those who can afford it can take out insurance, and in addition to that it will not cover you for any existing conditions, so a lot of people can't get insurance.  The NHS is good in so far as no-one is turned away because they can't pay but equally, living in a rural area as I do, there is in effect no choice, the nearest hospital is 30 miles away so we can't really choose where to be treated and it is still a lottery at to whether specific treatments are offered by your particular PCT.  There is certainly room for improvement and we have had a lot of negative experiences, but I still wouldn't want to change it for a system where you can only get treatment if you can pay.