PCa and Universal Health Care

I was hoping that guys outside of the USA could give me some insight into:

1. Their opinion of the quality of their PCa treatment,

2. Their opinion of the quality of their Health Care System.

I ask these questions because of a book written by T.R. Reid ("The Healing of America") where the author makes a case for Universal Health Care in the USA.  He makes two points that really were not in line with what I understood:

1.  Health costs in the USA run at 18% of GDP; while health care cost in the industrialized nations that have Universal Health Care Systems run half of that (i.e. 5 - 11% in Taiwan, South Korea, Australia, Great Britian, France, Canada, Germany, etc.), and,

2.) Folks in these countries are very happy with their coverage and they can not understand why the USA does not adopt Universal Health Care.  It is this last point I am asking about.  How do you guys like your health care systems, and how do you rate your PCa diagnoses and treatments?

I would hope that the request for information about other health care systems, as opposed to opinions on the advisability of universal health care, would be sanctioned. The facts would be helpful to our thinking on the subject. We can draw our own conclusions without bickering.

Nellie

(Moderator hat on)

David has a point - so long as we are talking about facts, and keeping the politics / advocacy out, it works. But rule 11 wants us to have a reasonable and calm discussion.

That said, Moderator hat off, and lets see where it goes.

First off, I really apologize if I broke rule 11.  If the moderators feel this thread should be deleted please do.

Second, thanks for the replies, and to overthepond, it was Napper's post that really got me thinking.  Combined with reading Reid's book, it got me thinking.  I really felt that the health care in the USA was the best and cheapest in the world.  Now I am unsure, and I was looking for what non-USA guys/gals thought of their Universal Care Coverage.

The U.S. Healthcare system is like the story of Goldilocks and the three bears. What you want is the right health care for your needs, no more, no less. In a profit-driven system, the health care available to you is influenced by financial considerations. If you are uninsured, or underinsured, you may not be able to get the health care that you need. You may be undertreated. If you have gold-plated insurance, well, there are hospitals and clinics marketing themselves to you on TV, the internet, magazine ads, and even on billboards. They want to do expensive treatments on you. If you are a 75 year old with early prostate cancer, there will be somebody willing to cut it out or radiate it, even though there is no chance that it will kill you. That's too much treatment, overtreatment.

Universal Health care at its best should be an effort to try to see that everyone in a country gets the right treatment, not too much or too little, just right. This would be based on the state of medical evidence, so, of course, not everyone would be able to get every treatment that they want, some controversial treatments might not be funded. At its worst, universal health care would be an effort to ration care, and control expense by delaying or refusing to pay for necessary and appropriate treatment. I think that is what is being asked on this thread. Do those people who live in places with universal health care (most of the developed world outside the US) find that they've been able to get the care they need?

As a Canadian I am delighted with the care and access I had to doctors, tests, hospitals, etc. without a penny out of my pocket except a $25 charge for a semi-private room and a couple of nights in a hotel as I elected to go to Edmonton to be operated on by a particular surgeon. (The air I covered with points --- add another $400 if you wish.)

And, it's nice to know that the handyman who works at our place, who has a prostate issue, is getting exactly the same service.

When I consulted with two U.S. based doctors at major U.S. health institutions, who I knew personally, both prostate surgeons, one open, one da Vinci, they said they'd be delighted to "do" me, but at the same time they wouldn't hesitate to lie down on the table of the guy I was talking to here --- and there were a number of surgeons in my home city they wouldn't hesitate to use. Same with the hospitals here.

As I read some of the problems U.S. members have had with doctors and health care --- those with insurance --- I think that both systems have lots of good medicine being practiced, and some not so good medicine. Both systems have whoever pays the bills acting as a gate keeper. When my brother-in-law had surgery in San Diego I was surprised to find all the men and women going around the hospital with clip boards checking on patients. I was told they weren't medical people. They were insurance people auditing and I heard one challenge a doctor why a patient was sill in hospital after 4 days, when the average stay for this proceedure was 2.5 days --- or some such. In Winnipeg, where I live, you have to wait months for a knee replacement. And flashing cash doesn't get you to the front of the line. Annoying to those with cash, a comfort to those without.

In our system we have some excellent doctors who love to practice here because they need never take cost into consideration --- the patient's ability to pay --- when deciding on treatment, or referring to a specialist. On the other hand, we have lost some great doctors to the U.S. who want to earn bigger incomes.

I think it a shame that discussion of what sort of health care payer system works best is a political issue to some. It is really a total health care issue and deserves respectful discussion and exchange of information. Unfortunately, it quickly becomes a "he said -- she said" sort of squabble that soon leaves fact far behind and flourishes on anicdotal evidence and passions fed by individual experiences extrapolated to being the reality for all.

Sheldon AKA Sleepless

I have been very pleased with the diagnosis - care and treatment of my prostate cancer here in Canada. With our health care system in Ontario ( OHIP) we can choose whatever doctor, associated hospital (which they have access rights to) and form of treatment.
A number of our hospitals are teaching hospitals - the surgeon does the big stuff and the interns learn at their side or in the operating room theatre - if it is setup as such.
We are limited to the frequency of testing - unless sanctioned by attending physician, and depending on the seriousness of the surgery - may have to wait a bit for an open operating room.
I found a local urologist/surgeon in two days - had an appointment in 2 weeks - biopsy within a month - surgery 3 weeks later - 3 days in hospital - and visiting nurse (daily for one week post-op) - and cath removed 3 weeks later...
There was no money out of pocket - but all was documented - and we Canadians pay for it through our taxes -
My doctor does 6-12 surgeries a week and then follow-ups, regular appts on thursday and friday.

wishing you all the best,
Bronson

I have lived and worked in many countries that have universal care including England, Japan, China, Taiwan, Indonesia, Singapore, and Malaysia. Care ranged from excellent to life threatening. In several of these we were covered by a special insurance that would airlift my family and I to a country that had US style treatment, safety, and effectiveness. In Beijing, there was no way I would even consider having a flue shot. Finally in 1999, as we were leaving, the first-US Sino joint venture hospital came to Beijing to treat expats and select wealthy Chinese.

In 1996 my wife had her first bout with breast cancer and needed surgery, chemotherapy, and radiation. We were living in Malaysia and our best friend ran the premier US-Malaysian joint venture hospital and he said do the treatment in the states. He went on to greatly improve some hospitals in Singapore and now Thailand to world class hospitals that primarily cater to the local wealthy people, Europeans, Canadians, Brits, and uninsured Americans who desire American quality with Asian costs.

What hasn't been mentioned is treatment success. For my wife (two times breast cancer 1996 and 2010) and myself with PCa, the statistics of success and longevity in the UK are far worse than America. John T did a post on the relative statistics a few months ago. UK is public provider and public payor. I believe this is the combination with the poorest patient success statistics. Canada, France, Germany and others are private providers and public payor. My understanding is that this is a more effective system for the patient.

Dreamerboy,

I didn't remember that there was "no" public health care system in Ireland (I visited there for work while a resident of Italy, and had to do some paperwork for a coverage card to extend my national coverage as an Italian employee).

I looked it up on Wikipedia (as much as I don't like it), and it seems that they are redoing parts of their system the last few years. Much like Italy, they were going to a co-pay system for specific services, depending on your situation, income, and age. So it seems that there are costs to be considered.

As we were talking about costs of PSA tests on another thread, I looked back at my paperwork from Italy - I had a fixed fee to pay to the USSL (local hospital system) for each blood draw regardless of what / how many tests were run. If I had been unemployed / retired but still legally present in the country, the fee would have been waived.