Wednesday, 2 March 2011

Sap rising, a new job and the NHS

I’m starting this month mildly optimistic. Those who have laden our societies with inequality and our economies with debt are being repudiated wherever the public is permitted to speak or vote. No longer dulled by panic, policy makers are realising there are other options than doing as they are told by their bankers, and their duty to their enraged public requires them to at least evaluate other options before caving into further banker demands. Emboldened by examples of bravery and solidarity in the Middle East, many publics are re-evaluating their relationship to the state and the service they receive from their political elites, and then finding a new voice to demand better.

The corrupt political machine that surrendered Irish sovereignty to a more corrupt banking system has been voted out of office. Denmark has allowed a bank to fail, imposing real losses for the first time in this crisis on bank bondholders. The governor of Wisconsin is being reminded that he works for the people of his state, within the bounds of its constitution and its laws. Signs of a shift toward accountability perhaps? It is spring, and I choose to hope.

I am in England, where a fine mist softens the air and birds sing in the budding trees outside my window. Contributing to my good humour is the imminence of a new challenge that will not require me to travel further than central London. I spent much of the autumn looking at the world, looking at my country, and searching for a way to make a difference here at home that will endure as a lasting contribution to economic stability. I have been fortunate enough to identify such a role, seek appointment, and be given the chance to fulfil my aims. It will be another adventure, but one I pursue in familiar surroundings and among friends.

Wish me luck.

And now a word about healthcare, a subject I rarely write about. I saw a chart at Wall Street Cheat Sheet this week that forced me to realise how blessed I am to be British. If I were an American, I would be shamed by this - especially when more than 30 percent of citizens have no entitlement to healthcare.

Here's an example of what I get for the money spent on the NHS.

In December I received a form letter from the NHS (National Health Service) saying that the time had come around again for a routine diagnostic procedure to detect a condition fairly common to people my age. It was the run-up to Christmas and I did nothing at the time. Yesterday I received a reminder that I had not had the test, urging me to schedule it. My GP (general practitioner doctor) is at the surgery (doctor’s office) on the high street five minutes’ walk from my door. I called the surgery’s appointments line, and the friendly receptionist gave me an appointment for later in the morning. I showed up, was seen within five minutes, and back home twenty minutes later. The doctor was even happy to chat about another minor matter that had been on my mind. The test results will be sent by post within two weeks. This was as easy, convenient, stress-free and professional as anyone could ever wish. And no one ever mentioned money.

The NHS is one reason why there is unlikely to be a revolution in Britain. Each of us living here can actually see the benefits of having a government that provides for the people in the ways that truly count. I never have to worry about whether I can afford a medical procedure. When my children are sick, they are seen quickly, often the same day. I can get urgent care 24 hours a day. I have even been pleasantly surprised by a Sunday house call. When I took my children to the emergency room (long ago now), they were seen and treated with all the professionalism and concern any loving parent might wish. All of this is provided by my government, and I never worry even for a moment about the cost. As a taxpayer, I enjoy a tangibly better life because my government provides for my care and the care of my family whenever it is required.

The NHS is far from perfect, but it is a great deal better than any insurance-intermediated system I could imagine. And it is infinitely better than no insurance and no entitlement to healthcare at all.

Not all taxes impoverish me. Some of what I pay enriches me too.

I've just received a form in the post to permit me to register for patient management over the internet. I'll be able to book and change appointments online with my doctor or other doctors at the surgery, and I can request prescription renewals. This is my NHS delivering value and efficiency to me as a taxpayer, and I am again grateful.


Detlef Guertler said...

All the best for being a banker in London, London Banker.
Just an addition to the healthcare chart. The primary source is USA Inc., a book from Mary Meeker's KPCB, that tries to handle the USA as a turnaround expert handles an ailing company.

Anonymous said...

We would have our own NHS if we were not paying for yours. Where do you think the technology, drugs and R&D come from? I'll give you a hint, it isn't the British taxpayer...
(The next war, will be to end the Marshal Plan;-)

London Banker said...
This comment has been removed by the author.
Hayes said...

All I can say is wow, a long time follower of LB but the above post seems to depict an existence right off of an Andy Warhol canvas of the American Dream.

In America none are denied health care, in Canada those with serious afflictions are often sent to the US for treatment depending on the length of the waiting list (that is if they can find a way to get on the waiting list). In Canada, if you are female, those GPs accepting new patients will gladly accept an application for further consideration to determine if you would make a suitable patient.

The reference to 'change' with the Middle East being held up as an example likely has little meaning for refugees massing at the borders of Libya, though from the comfort of an English garden perhaps it is indeed a wonderful world.

All the best LB, but please take off those rose colored glasses periodically.

London Banker said...

@ Hayes
"Nationwide across the U.S. the average wait time to see a family doctor was 20 days. The average wait time to see a family practitioner in Los Angeles, California was 59 days and in Boston, Massachusetts it was 63 days."
Lots more on wait times in this article comparing the US and Canadian systems. All I can say, is my wait time yesterday was 40 minutes, and that's something I value from my government.

It is patently ridiculous to say none in the US are denied healthcare, when lack of insurance means treatments are not scheduled and prescription drugs are unaffordable. Which of us has the rose coloured spectacles? The data would indicate it's not me.

London Banker said...

@ Detlef
Many thanks for the cite.

@ Anon 11:14
Take a look at global patents, especially pharmaceuticals, and you'll find that it is British taxes subsidizing your corporate US healthcare profiteering. The UK punches well above its weight in global pharmaceutical innovations.

And the Marshall Plan involved loans that were finally repaid in full in the last decade.

(deleted and republished with edits for civility)

Hayes said...

LB not sure the Hawkins study is more credible than personal anecdotes, suffice to say if you have an non emerg orthopedic need in Canada, best to hope that you have a calendar that includes the following year and even the year after, that is if you can get by the GP gatekeeper, and you'll get the sawbones they give you.

In most US locations, which I am familiar with you are talking days or a couple of weeks depending on the orthopedic area of specialty. Though if you want the top knee guy in a region e.g. the Northeast, it could be a couple of months or more.

To imply, as Hawkins does, that it takes 59 days to see a GP in LA is utter nonsense and misleading; 59 hours perhaps and likely next day though you would probaly have to move from the "a's" to the "b's" in the yellow pages before getting that next day appt.

Anonymous said...

Wait times for important surgeries in Canada are very short. One of my coworkers had open-heart surgery booked, from diagnosis to the scalpel, in just three days.

Oh yeah, no insurance idiots to talk to, either.

It's true that a non-essential knee replacement will mean you're waiting for a year. But any Canadian is eligible for such treatment.

When it comes to medical treatment, give me rationing over auctioning any day.

Anonymous said...

anon 3 March 2011 19:45

agree completely, catastrophic emegrency in a major urban center in Canada is second to none e.g. stroke

but non catastrophic translates to rationing and that is not just elective such as knee but latent medical issues of a very serious nature. In the US such issues would/could be addressed in a timely manner e.g. days. In Canada to see a specialist and/or get tests such as a CT/MRI in a non-catastrophic circumstance can take months and even years.

balaji @ IT Consulting Job said...

Yes i agree. Most of Mnc project move to SAP Basis...

Anonymous said...

Woah! So the new job's in the NHS then? LB is clearly fortunate to inhabit a pocket of NHS excellence. Not many patients in other parts of the country would report such unqualified satisfaction. People have been telling us how fortunate we are in having the NHS ever since it was founded. For a while it might even have been true - but if you want to see a really good health system try France.

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