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what is health care like in europe?

Discussion in 'Topics in Healthcare' started by razmataz, Dec 2, 2005.

  1. razmataz

    razmataz EtOH Tester
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    can someone explain or link a good site that explains how europe handles healthcare. im having a hard time finding information. is everyone insured? i hear there are long waits to see doctors unless you have $$$$
     
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  3. Fermata

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  4. BooMed

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  5. chef_NU

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    OMG

    Funniest thing I've seen in a while!
     
  6. Bobman479

    Bobman479 New Member

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    Depends on the country really....

    I know in Britian everyone is insured but there is still stratification in their health care system. I.e., if you have the money for private insurance you go to better Hospitals and see better doctors. Anyone who knows the British mindset should not be surprised at this in the least bit.

    However, as you go into more socialized countries in mainland Europe, things become more normalized. Two summers ago I broke my ankle in France. I went to the hospital and they admitted me, x-rayed me, casted me, and gave me crutches... no questions asked. I will admit, I was impressed. There was no wait and the whole process was smooth. France's problems in their healthcare system does not lay in lack of couverage or poor service. That is not to say they do not have problems. I do not like their Med-school system which I consider to be MUCH easier and have a lax mentaility. Their Emergency Medicine SUCKS simply put.... Ok, every now and then they do an exciting surgery but Europe has rarely seen a Noble prize for medicine.

    European medicine does have strong points but certainly it has its week points.... They manage to cover everyone, something we can not say. However, European governments pay a lot for this and as Europe starts to get older some cracks in their socialized programs will probably start to show up....
     
  7. razmataz

    razmataz EtOH Tester
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    do you know what some of the problems are over there in britain and france? if they seem to be able to give coverage to everyone (different levels depending on $$$, but still coverage non the less) what is the difference between what they do and what we do. are our cultures that much different to where less people are injured or sick or something... maybe less gangs... i dont know.....
     
  8. sennp9

    sennp9 I will cure frontbutts.
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    OP: Type socialized healthcare into Google and read your heart out.

    The average family of 4 in Canada pays around $5,000 in taxes to cover medical expenses. So it is not really "free." Some other things are: that this system provides no incentive for doctors to specialize, or be entrepreneurial, being that they get paid similarly. The technology in clinics is, more often than not, "behind the times" since there is literally zero incentive for them to have the latest, most attractive diagnostic equipment. Hundreds of people die on waiting lists for common surgeries. Private healthcare is illegal, therefore, people who can't get medical attention quickly will come to the US to get surgery and pay out the 4$$. So on one end of the spectrum it is free, and on the other end it is so absurdly expensive that few can afford to do it. Essentially, the government monopolized healthcare, yet lose money. (all info is from things I have read on the web, thus I could be completely off the mark)
     
  9. Anastasis

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    I know in the UK everyone gets NHS coverage but generally you need to wait forever to see a doctor. I was an American citizen living there and I got to see a doctor for free about a chest cold, only problem was it took me 6 hrs, yes, six hours, to see one after sitting in a free clinic. One of my friends had to wait a yeah and a half to see a gyn. after being referred and finally the pain was so bad she went private just to get the care she needed.

    As for your questions:
    What's the difference between what we do and what they do?
    Well, their docs go to school straight out of secondary school (they do A-lvls in Bio, chem, etc. An A-level is like an AP test but much more stressful) They spend 5 yrs in med school (though this might vary, I'm not sure) they come out a bit more specialized (like if you're going into OB/GYN you have a different degree than someone who will doing general practice) - basically you're a doctor alot quicker there, for better or worse.

    "are our cultures that much different to where less people are injured or sick or something... "

    Um, well, I don't feel qualified to answer this bit. I lived in Northern Ireland, so people got injuried/shot/knocked out by a brick a bit more commonly than I would suspect in the mainland. I know they had a mentality of not going to the doc as often as we do, but I think figuring out whether that was first or the NHS was first is the chicken and the egg.
     
  10. SMW83

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  11. jrae

    jrae Senior Member
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    I think your sites might be mistaken on a few points. I have family who live in Canada and they have private insurance which pays for private healthcare in the US. While they may have to pay out of pocket for the initial treatment, they are reembursed by the insurance company.
     
  12. Gut Shot

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    Do you really expect Europe to have a homogenous approach to ANYTHING?

    Here's a pair of surveys from 1996 and 1999. Are you thinking more Denmark or more Portugal?

    And let us not forget the Swiss.
     
  13. Gut Shot

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    Well, you got one thing right.
     
  14. Gut Shot

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    It's true, the social democracies of Europe are going to have a tough time coping with their entitlements in the coming decades. It is also true that the US pays, per capita, about two and a half times the industrial world's median expenditure ($5,267 vs. $2,193).
     
  15. CatsandCradles

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    I have a relative living in Germany and he said the waiting was somewhat long - especially for heart surgeries. The doctors just didn't have the incentive to work harder. Too many socialist in the government.

    But I'm rather stunned to hear that Private healthcare is illegal in Canada. Can someone elaborate on this? Is is this true?

    Now I know that many European and Arab head of states/government officials come to the United States for surgeries...that's telling me something...

    I'm under the impression reguardless of where you live, the poorer working class folks are going to not have the care that better off folks might get. :thumbdown:
     
  16. brightblueeyes

    brightblueeyes Senior Member
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    Why do you think French med schools are easier? I'm reasonably familiar with both American and French med schools and from what I've seen it's just the opposite. French Med schools seem to push academic pressure to an extreme. (At least with regard to preparation for their concours and the internat.) And for the med students who also make it into either Inserm or the ENS, things get even more extreme. I know some American students strive to be in their school's Alpha Omega Alpha chapter and many schools require a thesis but if you think that's comparable with French students who do Inserm or the ENS, I think you may not be familiar with French schools.

    Perhaps you're thinking of something I'm overlooking.

    What makes you think that French EM is worse than American EM? You may be right. I have no idea what the differences are.

    I think you're right but it's partly because Medicine is becoming expensive and politicians are balking at the looming size of health-care budgets. I think they should just bite the bullet and accept that it's expensive. The US now spends over 15% of its GDP on healthcare without even making an attempt at universal coverage. So politicians and civil servants in France should take a hard look at that figure and remember it the next time one of them has a fit that French healthcare spending is now approaching two thirds of that (as a percentage of its smaller GDP).
     
  17. QuikClot

    QuikClot Senior Member
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    You are. Private healthcare isn't illegal in Canada, the infant mortality rate and life expectancy are higher, and waiting for critical surgeries is a myth.

    What you have been reading on the web is propaganda by free-market ideolouges afraid universal healthcare will happen here.
     
  18. sennp9

    sennp9 I will cure frontbutts.
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    So what is the system all about then? Plz share. And, is having a higher infant mortality rate really a plus ? :D
     
  19. brightblueeyes

    brightblueeyes Senior Member
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    I have a feeling rsfarrell meant to write that Canada's infant mortality is "better" or "lower"...unless he really can't stand little babies. ;)

    Also, he or she is right about private healthcare not being illegal in Canada; but there's more to it than that. Private healthcare does not have the presence in Canada that it does in the UK or France or Japan (three other countries that attempt universal coverage). Privately owned and operated hospitals that allow patients to pay out-of-pocket for services cannot obtain public funding in Canada, as they contravene the "equal accessibility" tenets of the Canada Health Act.

    rsfarrell is right about the Canadian system being misrepresented by many people with an axe to grind. But even though there don't appear to be long waits for any critical surgeries, there are waiting lists in general. But unlike what some critics suggest, there's no reason to think that simply introducing a parallel and robust private system would help shorten them. Just look at the UK. They have a well established private system and it seems to make their public healthcare waiting lists worse, not better. The problem seems to be the underlying shortage of doctors, not public vs private. Healthcare is expensive and politicians in Canada, France and the UK seem unnerved by the size of their healthcare budgets. (Even though these "out of control" healthcare budgets still cost their taxpayers less than what American taxpayers pay for theirs.)

    France doesn't seem to have the long waiting lists that Canada has but it also has more doctors and what seems to be a well integrated private sector that doesn't (as far as I can tell) draw resources from public healthcare. France has its own share of problems, though. Public healthcare coverage is quite comprehensive (more so than in Canada or any other country I'm familiar with) and this is becoming expensive. The government is in the process of trying to streamline its healthcare system to cut down on unnecessary prescriptions (all covered by the state) and different types of duplication. It's also switched to a gatekeeper system like in most (all?) Anglo-Saxon countries.

    Also, doctors salaries are in the process of being reformed. They're lower than in the UK and Canada and Switzerland and a lot of people (well, all doctors really ;)) would like to see them increased. Family doctors and psychiatrists, in particular, really need an increase.

    The French government sets specific figures on how much it will reimburse people for different Medical costs. Doctors in "secteur 1" are required by law to keep all their charges within those figures. But there's another group of doctors in "secteur 2" who are free to charge whatever they want, even though their patients will only be reimbursed by the amounts fixed by the government. The number of docteurs in "secteur 2" seems to be kept quite low and I'm not sure how someone obtains "secteur 2" status.

    Unlike what I've seen some people suggest on this site, there's pretty much no unemployment for doctors in countries like Canada, the UK and France. However, in Canada there seems to be a problem with one or two specialties in which the number of new job openings is kept artificially low (i.e. Neurosurgery).
     
  20. f_w

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    Oh, the famous 'waiting lists'.

    The ideologues who are so quick to point out that a patient with stable coronary artery disease might have to wait for a couple of months to get his CABG in some european country are happy to ignore the problems at home. I have seen more than one US citizen who had a monthlong delay to get a suspicious breast lesion excised because none of the local surgeons was willing to provide charity care.

    Yes, a 100% publicly financed system will have bottlenecks, but so does the system here (which by the way is far from a 'free market' system. The majority of healthcare delivery is regulated by the goverment and 45% of it is financed out of tax contributions)

    Also, you can't look at how 'europe' organizes healthcare. There are as many systems as there are countries, and their quality is also a reflection of the economic strength of these countries. Some of the systems are combined private/goverment (e.g. the swiss, dutch and german), others are strictly goverment run (with a entirely separate private sector for cash holding layers of society e.g. in the UK).
     
  21. QuikClot

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    This is a good website:

    http://www.pnhp.org/facts/international_health_systems.php?page=all

    As you can see, there are many forms of universal care; the website cited includes thumbnail sketches of 16 systems, some dating back to the 40s, some instituted in the 90s. What they all share is that they work vastly better than our own system. All of these countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Israel, Italy, Luxembourg, the Netherlands, Portugal, Spain, Sweden, and the United Kingdom) pay less for healthcare than America, cover their whole populations, and are ranked better than the US in infant mortality (most live longer, too.)
     
  22. cheech10

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    Just to echo this: I've seen 2 close friends have oncologic surgeries within a week of their diagnosis here in Canada (one TAH-BSO, one mastectomy). On the other hand, there is a wait for surgeries where a delay is not life-threatening: my father waited 9 months for an ACL reconstruction. So while there are waiting lists, they're in reasonable areas for the most part.
     
  23. f_w

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    A relative of mine (in 'europe') was recently diagnosed with renal cell ca. Within a 3 week period after the incidental pickup, he had a complete workup for his primary, a cardiac workup including cath and both surgeries (tumor-nephrectomy, partial liver resection) and is hooked up with a national interferon protocol. And no, he is not rich and he doesn't carry supplemental private insurance. He is in fact in a group typically uncovered in the US system (unemployed, home-owner just shy of 65yrs). In order to get him the same level of care here, I probably would have had to pull some strings and still ended up with a 50k out of pocket bill.

    I am not denying that waiting lists exist. I am also not denying that they exist in areas where a delay at the very least is very unpleasant for the patient (e.g. the waiting lists for joint replacement in parts of the UK). I am denying that rationing of healthcare is a phenomenon limited to goverment funded systems.
     
  24. Gij

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    As some of you said, I also think the bottom line is that US is paying more (compare 9.9% GDP of Canada, 7.7%GDP of UK, 11.1%GDP of Germany and 7.9% Japan to 15% GDP of US) for healthcare than any other industrial country. However, when it comes to the overall quality of healthcare delivered, US is ranked very low (US healthcare was ranked 37th according the world health report 2000. Japan is ranked 10th, Germany 25th and Canada 30th). I know this is not a very detailed comparison, but it tells a lot (I think). US healthcare does much much worse when fairness is measured.
    Having said all this, one thing that I want to say is that when government sets the budget for healthcare prices are not negotiated; they are assigned. This might be a disincentive for doctors to perform hard but financially less rewarding procedures. This I believe is an issue in Canada. How big of an issue is it? I honestly don't know, but I know that it does not outweigh the benefits of having Universal coverage.
     
  25. Gavanshir

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    I found brightblueeyes's post to be the most accurate regarding healthcare in Canada. As she mentioned, if a physician chooses to open a private practice he/she must opt out of the public sector and will no longer receive funding from the government.

    However, despite the "taboo" around private healthcare and its implementation in Canada, it is very widely available and patients have access for almost all types of operations. At almost every step of a typical visit to a hospital, you will be asked to choose to continue within the private or public sector; the former will get you an appointment tomorrow morning and the latter, in a few weeks. I believe the general consensus within politicians in Canada is to find the balance between private and public healthcare in a two-tier system.
     
  26. cheech10

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    Private options may be more available in Quebec, but in Ontario there are very few, and we don't get
    . Of the hundreds of docs I've worked with in Toronto and London, in academic and community settings, only 1 had opted-out. The situation is different in Quebec, with billing numbers being restricted in certain areas, etc., but in most other provinces, there aren't many physicians providing private care.
     
  27. bananaface

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    Another difference is that most physicians are generalists, unlike here. Those in specialties don't get bogged down with primary care issues, because of their strict referral system for non-emergent care.
     
  28. f_w

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    Actually, the only country I know of that has specialized medical schools (pediatric for example) is the former soviet union. In most other countries, you leave medical school with a general degree, just like in the US.

    One difference is that subspecialization is not as strong and early as in the US (a gastroenterologist is still internist and able to treat the general cardiology stuff). People end up with a smaller number of subspecialists involved in their routine care.

    Also, in most european countries, there is a division betweeen oupatient and inpatient work. Hospitals employ physicians who act largely like hospitalists do here. Physicians in private office practice rarely take care of inpatients but rather refer them to the respective inpatient service.
     
  29. AndrewB

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    Canadian socialized healthcare, in general, provides adequately for most people who live in urban areas. However, there is a huge doctor shortage almost everywhere, especially in the rural and Northern areas. Wait lists are long, except for critical surgeries which, in my experience, are often performed same day. Waiting for several hours to see a GP about a sinus infection is the norm. Going to emergency at the hospital at 8PM with a broken wrist means you will be there until the early morning. The severely limited and mis-managed resources of the government are often allocated specifically to keep a hospital from running itself into the ground and not for increasing elective and non-critical operating room hours and providing more beds for patients. The nurses and doctors do the best they can, but Canadian doctors are paid a set fee for every procedure they perform, and as an example, a family doctor may see 40 patients a day but he/she can only bill the medical services plan for a certain number of those because of restrictions put on their salaries. Yearly threshold caps also exist for the amount that can be billed to the government for the services provided by the physician. This obviously reduces the incentive for a physician to see as many patients as possible, but most still do, resulting in an overworked and underpaid physician population. These are just a couple of examples of cost-controls implemented by the government which are eroding the base of healthcare in Canada. Private surgical clinics are slowly emerging and in the next decade or so I think that we will see a fully two-tier system of private and public healthcare options out of necessity.
     
  30. makushin

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    I was in Whitehorse for hockey years ago. My teammate was hurt pretty bad in the game, severe concussion or something along those lines, I know he swalloed his tongue. He had to be flown all the way to Anchorage, Alaska to get care that night. He wasn't able to play hockey anymore. I know this is anecdotal, but it is also typical of my encounters with the system in Canada, and I have spent alot of time there.
     
  31. miss_phonics

    miss_phonics New Member

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    ok, some of this is correct but some isn't. I live in England and I have just got into med school.

    Typically students apply to study Medicine when they are 17/18 whilst they are studying for their A-levels...usually 3 are taken (Biology Chemistry and any other) although some people take 4 or even 5 although only 3 is needed to study Medicine.

    The degree is 5 years long although some med schools offer an intercalated degree where you do an extra year between years 3 and 4 studying another degree, usually biochemistry/anatomy/neuroscience etc. Each student graduates with the same degree and specialisation doesn't occur until after the degree although the degree does contain some parts where students can chose what they want to learn but this doesn't amount to specialisation.

    After the 5/6 years they become Pre-registration house officers (PRHO) for 2 years in which they rotate around the specialities, constantly changing jobs. After the 2 years they become qualified as a proper doctor and become a senior house officer (SHO) for a while. Only after this can they specialise...either going into general practise or applying for a specialised registrar position which would lead to consultancy.

    A doctor can become a consultant by the time they are 35 if they are speedy!

    I don't know enough about the American system to compare but I'm sure you can do that yourselves.

    The health service:

    The great thing about Britain is that everybody is entitled to the same medical care, much of which is very good although admittedly, there are long waiting lists. Patients can go private but they DONT see better doctors...they just don't have to wait as long.

    To see a consultant you have to be referred by your GP and there are long waiting lists with these referrals. However, if you are in need of immediate medical care then you receive it immediately to an excellent standard. Also, if you require a huge amount of healthcare and treatment then your taxes don't go up accordingly as I would imagine Health insurance does...u still pay the same as everyone else.

    The reason you weren't seen for 6 hr is cos it wasn't urgent.


    Sorry to go on....i hope thats cleared up a few things! If you have any questions feel free to ask.

    xx
     

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