Notes on the UK's health care system:
1. Nobody pays any part of a medical bill.
2. No insurance premiums, no co-payment.
3. There are private health insurance plans, but virtually nobody uses them.
2. No insurance premiums, no co-payment.
3. There are private health insurance plans, but virtually nobody uses them.
4. Health care system is financed through heavy taxation.
5. There are numerous treatments and medications that aren't covered by the National Health Service (NHS).
6. The UK system is infamous for its long waiting lines.
7. No billing, no paperwork since everything is covered by the government, so it's surprisingly cost-efficient.
8. Lower child mortality, longer life spans, and better recovery from major diseases.
9. The system only pays for what it deems necessary medical care.
10. The government owns the hospitals, compensates health care professionals, buys medicines, and pays the bills.
11. This is the "socialized medicine" model. The same system we use to provide medical services to Native Americans, veterans, and military personnel and their dependents.
12. Physicians can still see patients on the side and charge their own fees, but few people take advantage of private services outside of the NHS network.
13. The NHS is the largest employer in Europe (over a million full-time employees).
14. The only fee is for prescription drugs ($10), but this fee is waived for children, senior citizens, pregnant women, and the chronically ill. Patients are, however, often required to pay for eyeglasses, contact lenses, false teeth, and some dental bills.
15. Government regulations are vast in an effort to contain costs.
16. A major reason for the cost-efficiency is the lack of billing offices and the bureaucracy required to review insurance claims that exists in the U.S.
17. General practitioners (GP) are private businesspeople, but most are paid solely by the government.
18. Every UK citizen must register with a GP. To see a specialist, you must be referred by a GP. This "gatekeeper" system is utilized to a large degree by U.S. insurance companies, and it is very effective at controlling costs.
19. GPs receive a set fee for each person that chooses them as their practitioner. Thus, there is an economic incentive to have more people, but more people means more treatments and procedures because the NHS pays GPs per patient enrolled, regardless of whether they come in for treatment. For this reason, prevention is always first priority, since less people coming in for treatment means less resources used.
20. There are tons of campaigns promoting preventive behavior.
21. Waiting lines for specialist care are the biggest complaint in the UK system.
22. Anything life-threatening doesn't require a long wait.
23. Primary and preventive care is not rationed.
24. The NHS controls its budget by covering only certain medications, tests, and procedures. This type of rationing also takes place in the U.S., but decisions are made by insurance companies behind closed doors.In the UK these negotiations are constantly in the news, open to public critique. The agency within the NHS that makes these decisions is called the National Institute for Health and Clinical Excellence (NICE).
25. The UK's health care system operates on very egalitarian principles: how can we provide the best care to the most people.
26. Physicians make house calls.
27. Annual physicals are considered pointless. They prefer to do screenings and tests for disease, but only those that would be considered appropriate according to your family history and other factors affecting your potential for disease.
28. If your complaint isn't detrimental to your quality of life, you probably won't get any treatment, unless you want to wait along time and pay for it yourself.
29. About 60% of physicians are GPs (35% of physicians are GPs in the U.S.). This is because GPs in the UK normally make more than specialists, since they make more money if they see more patients. Many GPs also see patient privately on the side.
30. GPs earn additional income through the Index of Quality Indicators, which pays GPs for good performance. This replaces the fee-for-service model so common in the U.S. Doctors are simply paid more for taking the necessary steps to keep their patients healthy.
31. Malpractice insurance is much cheaper in the UK than in the U.S.
32. In the UK, anybody sued for malpractice is off the hook if they can prove that they were following NICE guidelines. This also leads less GPs to practice defensive medicine, suggesting multiple screenings and test simply to cover their behind like in the U.S.
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