Thursday, October 26, 2017

Health care across the pond

Daily News (West Bend, Wis.)
Published: Sept. 29, 2017



Health care across the pond
UW-WC lecture discusses the UK’s approach to a contentious topic
In the United Kingdom, which consists of England, Scotland, Wales and Northern Ireland, the power is in the hands of the patient when it comes to health care.
“People don’t have to say, ‘I don’t know if I can afford that,’ and just don’t go to doctors. You know you’re never going to lose your house,” said Patricia Conry, a certified legal nurse consultant, who gave a presentation about the United Kingdom health care system as part of the University of Wisconsin-Washington County’s fall lecture series Wednesday evening on campus.
“The national health care system is there for everybody,” she added.
Conry, who grew up near London and moved to the U.S. more than 30 years ago, gave her presentation in front of a capacity room of about 150 people at UW-WC and outlined all the characteristics to the U.K.’s health care system, comparing it to the one in the U.S.
Conry said, in 1942, Aneurin Bevan, the Minister of Health from 1945-51, proposed a national health care system where good health care should be available to all, with access based on clinical conditions, not ability to pay.
Six years later — July 5, 1948 — the National Health Care System for the U.K. became operational. Since then, it has evolved into one of the largest singlepayer health care systems in the world.
The U.K. government provides health care and pays for it through taxes.
One example Conry showed was for a person who works reading gas meters with a monthly income of $1,639. About $140 is deducted for income tax, and about $110 is deducted for national insurance and national health system taxes.
The taxes, plus borrowing, equates to about $209 billion available for health care throughout the United Kingdom.
About $150 billion goes to England, $15 billion to Scotland, $8.6 billion to Wales and $5 billion to Northern Ireland.
The government also sets the framework for the NHS and is accountable to the Parliament for its operation. Hospitals are owned and operated by the government, and the NHS is the largest employer in the U.K. with about 1.7 million staff.
The principle of putting patients first remains at the core and coverage starts when citizens are born, Conry said.
And the list of services available to patients at little to no cost include immunizations, blood tests, injections, admission and inpatient care at hospitals, daily physician visits, nursing care, medication, IVs, dressings, blood tests, dental extractions, hospital consultations with specialists, radiology, outpatient surgeries, orthopedic care, cast application, infusions, MRIs, CTs, cancer chemotherapy, diabetes, oral surgery and maternity.
Can’t make it to the doctor? Doctors can and will go to the patient.
And the care is available to all, including noncitizens.
“Our constitution says it’s the people’s right (to get health care); the people come first,” Conry said.
When looking at dental costs, in the U.K., procedures including cleaning cost consumers about $25. In the U.S., the average is anywhere between $75-$200, according to the website www. health.costhelper.com.
A root canal, in the U.K., costs about $70. In the U.S., it is more than $300. Crowns, in the U.K., cost about $300. In the U.S., it is about $1,100 or more.
“We negotiate prices,” Conry said when asked why the vast differences in prices. “The clinical commissioning groups negotiate until they get the best price, but they make sure the quality is there.”
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Funding growing thin
The United Kingdom is not any different from most countries. Just like in the U.S., the U.K. is also facing a growing, but also aging population.
Therefore, more money is being spent on more long-term treatments. In addition, Conry said the U.K. is often too nice when it comes to providing care to overseas visitors.
Those two elements have led to a financing problem in the region.
“It is underfunded,” Conry said, adding costs of medicines are growing by more than $600 million per year.
“All these people, that don’t pay the taxes, go to England and expect health care,” Conry said.
She added the region added about 500,000 citizens last year and were almost immediately covered.
The government is looking to implement a waiting period — potentially three to six months — to help curb some of the mounting costs.
In addition, the Brexit debate could have a factor on the future of the U.K.’s health care system.
Each year, the U.K. pays about 350 million pounds per week to the European Union, or about $471 million.
“We can have that for health care,” Conry said.
“Part of the problem is we’ve been over generous to many, many people that have come into the country,” she said. “Our problem, is we never pursue them (for money).”
“We’re not very good about that,” she added. “I think we feel embarrassed about charging people.”
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Can similar system be implemented in U.S.?
After the lecture, one of the attendees asked Conry: Can this be done in the U.S.?
It’d be hard and a long, long process.
One of the first things that would need to change, Conry said, is greed.
“Big insurance companies, they’re not going to get that money,” she said. “And they may not like that.”
“We need a little more tax from the people,” she added. “It’d take a lot of work. It can’t happen overnight.”
Could it be done? She joked, “Maybe, if they put me in charge.”
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The UW-WC fall lecture series focusing on the U.K. continues Wednesday with “Survey of Scottish Photography,” led by Graeme Reid from the Museum of Wisconsin Art in West Bend.

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