Friday, January 2, 2015

What Obamacare will likely bring to US hospitals

Socialized medicine, single-payer medical care, and a government-administered health care system are relatively new to the USA, but common elsewhere.  The Telegraph has a hard-hitting five-part article on the pressures facing National Health Service hospitals in England.  Here's a brief excerpt.

If you want to tell the story of the NHS, there are a million places to start. You could start with the politics – Labour attempting to “weaponise” the issue ahead of the election, the Tories to defuse it.

You could start with the money – the struggles over scarce resources, the debates over how many more billions will be needed as the population ages.

Or you could start with the individual stories – with the people passing through the lobby of the Queen Elizabeth Hospital in Birmingham, one cold December morning. The girlfriend feeding crisps to a paralysed young man. The white-haired lady lingering over her tea, complaining as she stands up. The young family, sitting together, heads bowed. The little girl, horizontal in a wheelchair, breath mask clamped to her face, being wheeled out by her father.

But here’s where I’m going to start: in a small green-painted room off one of the main corridors of that same hospital, where 10 women and two men are studying the spreadsheet projected on the walls and firing jargon back and forth.

“Four in urology with a decision to admit.” “306 is gone, 728 still waiting.” “With all that agreed, does that give you any ITU capacity?” “They’re desperate to bring the liver over from Worcester.” “Time to be seen is at 1hr 54.”

This is the “Ops Centre” of one of the country’s biggest hospitals, where I am spending the week as a fly on the wall. At this and other daily bed meetings, the senior nurses and managers get together to work out who is in the hospital, and where they need to go next.

They go through, ward by ward, listing spare beds and allocating them to the people in A&E. They can see who’s been waiting longest, where the pressure points are, and what needs to be done to resolve them.

This, then, is the story about the NHS that I want to tell. It’s the story of the NHS as a system – a system that takes millions of patients through from the GP surgery and A&E department to treatment, recovery and discharge.

It’s the story of how that system is starting to creak and increasingly crack under the strain.

There's much more at the link.  Essential reading to understand how the US health care system is likely to be reshaped - and encounter ever greater problems - over the next few years.



Old NFO said...

It IS a sad story, money driven rather than care giving. It's not going to end well here either.

C. S. P. Schofield said...

The Cartoonist Giles (Carl Giles) was a British institution. He was a also a card carrying red from a young age.

Everything I needed to know about a National Health system is summed up by the fact that Giles was making fun of the system's flaws and failures as early as the mid 1950's.

Anonymous said...

One of the most difficult lessons for me to learn as a new nurse manager was that the health care business is just that...a business. I learned it by having my job cut due to financial mismanagement by my boss. I took the lessons learned by watching what not to do and did the opposite at my new job as a manager. It worked, but still not why I became a nurse. And this was before Obamacare became law.

NornIron Lad said...

The NHS isn't perfect but most Brits earing under $500,000 per year (i.e. most of us) love it, and grumble about it, the way most people do about a deeply respected body run by flawed, ordinary, human beings.

However it has suffered from a politically driven re-organization almost every year since the 80's when dear old Maggie decided to introduce 'efficiencies' based on US practice. The Daily Telegraph is a right wing paper with a long history of supporting measures to increase commercial involvement in healthcare.

The A&E services have come under brutal presure in recent years as health care for the aging population has been underfunded and the old end up 'dumped' on hospital A&E and then general ward facilities as they cannot (or will not) be cared for at home or by (commercial) nursing homes (because the state run ones were all closed or sold off).

Accepting the Telegraph's view on how most Brits view the NHS would be like taking the Washington Post as gospel on American attitudes to gun control.

Anonymous said...

I am Glad that Nornlron lad has pointed out the great benefits of the NHS. Yes it is under pressure but any system which had experianced a 15% increase in numbers in 6mths would struggle. The differance is that as people who have relatives in the USA
1. If you are a diabetic you get the drugs you need free for life whatever your income, you don't get refused Insurance Cover or Medicare when you turn 18 and come of your mums health insurance. Then have no job to pay for the expensive drugs and die.
2. You don't turn up to be told you have Thoroid Cancer but can not be operated or treated untill the Tumaor is X inches big, by which time it will be untretable.

I could go on with a long list of examples, but yes the NHS costs and yes because of Baby Boomers taking tax cuts in the 1980's/90's we don't have a health fund to now cover their huge needs, but it is free at point of service for all and provides medical care for all, not bad for a system which is run by beurocratic socialist communists. Unlike the good old USA where 25% of your population are not taxed but are so poor they are free to die young any which way they please.