medicine and the profit motive

[Sportsman]

As I might have mentioned I recently spent some time in a French hospital. I went in to get my blood sugar stabilised and to control my diabetes.

Whilst I was in I stayed in a very pleasant private room with ensuite bathroom etc although I have to say the food was no great improvement on what I've had elsewhere in hospital.

During the three days I was in I was not only seen and treated by the doctors involved with my diabetes but I also got to see an ophthalmic specialist who checked the retina in both eyes, a cardiac specialist who ran ECGs and other tests, a neurologist who has set up a series of appointments concerned with pain control of my diabetic neuropathy and an orthopaedic specialist who has arranged for me to attend a day hospital three days a week for a range of therapies on my spinal problems.

This is rather more than would have happened in any NHS hospital that I have been in and I wondered why they seemed so keen to treat my other problems. Then of course, it dawned on me, they were charging for it and the more treatment I had the more they could charge.

It might help to explain how treatment is paid for in France. In a public hospital such as this prices are set by the government. Generally speaking the patient pays and then is refunded by the government. They pay 70% of the cost back to you. For long or expensive hospital stays then they just pay the 70% direct to the hospital. As a diabetic I don't have to pay anything as I get all treatment free anyway. Most people will have a form of private medical insurance called a mutuelle or top up policy which pays the outstanding 30% so apart from your Social Security payments and your top-up insurance cost to you as the patient is nothing.

advantage to you as the patient is that the hospital/doctors are motivated and go out of their way to provide you with top-class treatment.

 

In the NHS, apart from your National Insurance contributions and of course an assortment of taxes treatment is free. There is no profit motive for the hospital/doctors to provide any more than the bare minimum they can get away with and to be honest this is very often exactly what they do.

 

There has been much concern recently about privatisation of the health service but is it necessarily such a bad thing?

The combination of private/public seems to work here and in comparison with the UK certainly seems to be just as cost-effective for the patient.

 

 

[corydoras]

Dave

 

I've always found French health care to be very meticulous. My mum-in-law dragged me of to her doctor one Christmas; I had been suffering from a bad cold and it had left me with a chest infection. I didn't really want to go but she insisted. Her GP gave me one of the most thourgh medicals since the one I had when I went to sea.

 

BTW a lot of French people don't pay fir their mutuelle, it's part of their pay packet. My ex's mutuell pays for one new pair of spectacles every year (including frames)

[Vagabond]

There has been much concern recently about privatisation of the health service but is it necessarily such a bad thing?

The combination of private/public seems to work here and in comparison with the UK certainly seems to be just as cost-effective for the patient.

 

 

Our experience of NHS treatment here in the affluent rural South East at GP level has always been good. However, horror stories of neglect and poor treatment in local NHS hospitals abound, so that we have already taken the decision that should either of us require hospitalisation, private medicine is the way to go.

 

What would be interesting is a breakdown of what proportion of the French health budget is absorbed by administration as compared to the NHS - I would expect the French service to be more cost-effective than the NHS in order to provide the level of care you describe.

[Ken L]

The thing is that in Europe, the shear buying power of state health services drives down costs in both the private and public healthcare sectors.

Compare Europe to the US and the perils of a free market in things that you have to have (like prompt resolution of medical problems) is clear to see. A new hip joint (just the physical thing) is about $300 in Europe. The same item might be $1300 in the US.

[Phone]

Ken,

 

Which planet's US are you talking about?????

 

Routine hip replacement surgery on a healthy patient without insurance may cost as little as $11,000 — or up to nearly $126,000 [if insured].

 

In the US you cannot buy "just the physical thing".

 

Phone

[Ken L]

I was pulling the figures from memory as it was a couple of weeks since I'd read the article but I dug it out just for you Phone.

I was on planet New York Times. but memory is imperfect and I was massively understating the quoted costs for "just the physical thing".

Edited November 2, 2013 by Ken L

[Sportsman]

Our experience of NHS treatment here in the affluent rural South East at GP level has always been good. However, horror stories of neglect and poor treatment in local NHS hospitals abound, so that we have already taken the decision that should either of us require hospitalisation, private medicine is the way to go.

 

What would be interesting is a breakdown of what proportion of the French health budget is absorbed by administration as compared to the NHS - I would expect the French service to be more cost-effective than the NHS in order to provide the level of care you describe.

A long time ago (1088) I had some surgery done privately at our local Nuffield hospital in Essex.

It was the worst hospital experience I have had.

I was virtually locked away in my private room, not seeing anyone for hours at a time.

I developed a post operative pneumonia that was allowed to get much worse than it should have because no-one noticed.

Back up services such as physiotherapy were rudimentary at best,

They charge for everything. I wondered what the button near the door was that was pressed by people walking into the room. I found out when I got the bill. Physio walks in, presses button, says "how are we today then?" walks out and £30.00 on the bill (and that was then)

I was paying myself on this occasion so when I was leaving they presented me with the bill. It was like one of those comedy sketches. The hold out a folded bit of paper that looks OK and then they let go of one end and the paper concertinas down so that it is resting on the floor. That actually happened

[gozzer]

A long time ago (1088) I had some surgery done privately at our local Nuffield hospital in Essex.

 

I think things might have improved a little in the last 925yrs, since your last visit Dave.

 

John.

[garylee]

A long time ago (1088) I had some surgery done privately at our local Nuffield hospital in Essex

Shurely you mean 1066 sportsmam.

[Sportsman]

Wow, don't time fly