[chrisseaton]

I'm from the UK, which is basically fully free-at-point-of-use healthcare (you pay a nominal fee for prescriptions, dentistry, optician) and is often championed as a great option.

Reality is it's pretty grim. Don't know if I'd recommend it to other countries to be honest.

Be careful what you wish for!

[deergomoo]

The NHS is about the only thing this country has that I am even remotely proud of. It is far from perfect—made substantially worse by the last decade of Conservative austerity and piecemeal attempts at privatisation—but the idea that you’d be so disparaging is crazy to me.

I had cancer five years ago, spending the better part of six months receiving inpatient treatment, during which I couldn’t work. I had recently moved jobs beforehand too—I have literally no idea what I would have done under an American-style system.

It’s bursting at the seams (through no fault of its own), and yet still we never bankrupt people with life threatening illnesses, we don’t bill people for ambulances, we don’t force seriously ill people and their families to do battle with blood-sucking insurance companies over byzantine coverage terms.

It’s the last damned thing this nation has actually feels like it exists for the common good of the people. I would recommend it to other countries—wholeheartedly.

[fzeroracer]

I'm from the US born and raised, so I could talk at lengths about how the healthcare system here bankrupted my parents and nearly forced me into generational poverty. Or how poor the care is despite being under decent corporate healthcare. Or how misaligned the incentives are resulting in doctors suggesting nonsensical treatments like holistic care rather than actual treatment.

Most people don't encounter this stuff until it's too late, which is partially where all the praise comes from for the American healthcare system in my opinion.

[chrisseaton]

> doctors suggesting nonsensical treatments like holistic care

Did you know that until 2017 the NHS literally funded homeopathy?

I'm not even joking.

[rootusrootus]

> Reality is it's pretty grim. Don't know if I'd recommend it to other countries to be honest.

As someone who's never experienced the UK health care system, and only know one person who has (as a foreigner, so they paid out of pocket and said the experience was positive, but otherwise not a good data point) ... I'd like to hear a bit more detail about how it's pretty grim, if you're willing to elaborate.

[chrisseaton]

I'd love to get you to listen in to a phone call where I try to get an appointment with my doctor. You'd have to be up at 0800 on the dot, while I desperately try to get into the phone queue. Then you'll hear me beg with the world's rudest receptionist for an appointment, which I won't get.

There's no incentive for these people to be helpful or polite, because they get paid anyway and there's no market, so they aren't.

My American colleagues see a doctor every year for a checkup to catch things like cancer before they're fatal. The NHS would laugh in my face if I said I wanted to see a doctor for a checkup, unless I literally had an arm falling off.

[cameronh90]

There are a lot of problems with the NHS. The GP booking systems are diabolical at the moment, as you point out, and GP receptionists are up there with post office staff for aggressive service. I personally use Babylon GP at Hand and am very satisfied, but that's only available in London I think.

That said the reason we don't do as much in the way of screening and yearly physicals of young healthy individuals is because there's very limited evidence that it's even helpful and sometimes even evidence that it's harmful.

That isn't to say they don't sometimes save a life, but they also cause unnecessary medical procedures and needless medical anxiety. What kind of early cancer detection is really happening at a yearly physical? You could argue that a doctor telling you to lose weight might help reduce obesity or diabetes, but so far that doesn't seem to be working.

Even if you do catch and treat a cancer, was it a slow progressing cancer that never would have caused an issue for the patient? This is particularly significant when you're looking at someone in their 80s.

If you have any health conditions, have a family history of disease, are taking repeat prescriptions or are above 40, you will start being offered regular checkups and screening.

You can also book a private GP or checkup if you want, or even just pay for a periodic blood test. The NHS/NICE has decided the evidence base doesn't exist to support it, but you're free to decide otherwise if you wish.

[ryan_lane]

Most Americans can't afford to go to the doctor for their yearly checkup, and most don't. A large percentage of the country doesn't have insurance.

Also, I'm actually not sure that a yearly physical in the US does much for cancer screenings. The last one I had in the US did blood tests for cholesterol, urine tests for kidney disease, and some other common tests, but I don't remember getting screened for forms of cancer. I think this is dependent on the healthcare provider you go to, and what your insurance covers.

[monocasa]

You don't have a yearly physical with your GP under NHS?

Also, I just spent a total of seven hours last week making calls just to get insurance to even process my prescription that they had previously approved.

[chrisseaton]

There's no way in hell an NHS GP would agree to see me just for a physical without some very specific major problem actually in evidence.

If you never want to see your GP again then yeah petition for the UK system.

[monocasa]

What does a "check up" mean?

There's no way my insurance would pay for random "I don't think anything's wrong but I want to look for something anyway" outside of yearly physicals either.

[chrisseaton]

> outside of yearly physicals

Yearly physical == check up. Same thing. Going to the doctor once a year for a general check that you aren't developing any issues that you weren't aware of yet and to monitor your health.

I don't have either. I haven't seen a doctor for about five years I think, under the NHS system.

If I phoned my NHS GP and said 'it's been a year I'd like you to generally check my physical health' they'd tell me to fuck off.

[colinmhayes]

UK does not have single payer, their system is nationalized. Big difference, especially with capitated plans that medicare is championing. Competition is what makes capitalism great, single payer is the best way to accomplish it among medical providers.