I have to repeatedly go to a doctor to get prescription refills for a drug that I have to self-manage. The doctor provides no input day-to-day, where a mis-dose is a death sentence (the first time I nearly put myself into a coma, doc was like "oh yeah that can happen: I can give you glucagon shots as a scrip". Thanks for the heads up!). But cool, to get the drugs that keep me alive, I have to talk to a doctor that will look at my Dexcom charts and mumble some things.
So no surprise that the ADA is a fully industry-captured organization, even though I'm certain that there are good people doing good work for the right reasons.
“A1c is good. Charts are good. No changes.”
“And that’ll be 700 dollars?”
“Yup. See you soon.”
Of course it doesn’t actually cost that much (copay wise at least), but the point stands. I manage my disease super well. I don’t need the middle men.
I’m becoming much more radical on universal healthcare the longer I’m on my own.
1. I can reorder prescriptions on the NHS app when I’m running out. They get delivered to my preferred pharmacy or if I was away from home I can specify a local pharmacy. The prescription will be delivered there.
2. Prescriptions normally cost 9.90GBP per “item” (where an item is one type of medicine so may be multiple physical boxes of pills for example). This is a fixed cost and is independent of the type of medicine or how much it costs to the NHS. But…
3. You can get a prepayment certificate for 114.50 GBP per year which means you don’t have to pay per item. I have this so every time I go to the pharmacy I check one box and sign the bottom of a form and my drugs are free. The cert is a simple online purchase and took me about 5 minutes to apply and get accepted for. Zero friction. I have never been asked to show the certificate just state that I have one check a box and sign and we’re done. If I did have to show it, the “certificate” is just an email with a number so not hard.
4. The same app I used in #1 has messages from my GP in it so if there was ever a thing when they needed to talk to me, arrange a blood test, deliver test results etc it’s all in there (and I don’t pay a penny for any of those things either). Everything that’s in the NHS app is also on the NHS website which has excellent accessibility etc so works just fine on Linux for me when I don’t have my mobile device.
5. If you want to go outside the NHS you can go to a private practicioner and get a private prescription. That’s delivered to the same pharmacy you just have to give them this number that gets texted to you with the prescription and pay (a bit) more money for it. I had to do this recently and it cost me 22GBP for an “item”. You can also have private health insurance (I do) which means seeing specialists is easier than on the NHS and there is generally no wait time for tests etc. Private health insurance in the UK is much cheaper than it is in the US.
Bottom line: At least here in the UK the NHS may have bureaucracy internally but that doesn’t affect me at all as a “customer”. My healthcare is super-easy and convenient and far, far less expensive than healthcare in the US. You guys have the worst of all worlds. Both my wife and I have had medical treatment in the US and it manages to be eye-wateringly expensive and simultaneously worse than what I get for free on the NHS.
That's it. No open enrollment, no surprise bills, no trying to figure out which ppo or hmo works best, no wondering if it's in network or not or any of that BS.
And to call it out in a thread where someone has literally shared that they're forced to attend a pointless appointment at an exorbitant cost like that isn't itself some form of wasteful bureaucracy. But if the time and money is going to a corporation instead of the government it's better :/
At this point, China is doing capitalism better than us in its consumer industries. They actually have real competition, so fierce at times that the government worries about what it calls “involution”, or destructive competition (which Marx predicted as the end state of capitalism). Of course, its healthcare system is not run through capitalist competition like its consumer industries; it is fully state managed.
Some real competition might actually help if we’re going to keep pretending to be capitalists. Or we could move from socialism for the rich to socialism for the people. I don’t really care which as long as we move on from the current dysfunctional system.
NHS experience: you might have to wait two weeks to see the doctor, and it will be a ten minute appointment. (Which in this case might be fine.) If you can use a nurse things tend to be much easier.
From what I read, healthcare had always been super complicated and bureaucratic in the US. Nobody here knows what "network" or "deductibles" even mean.
Going to the doctor or calling an ambulance is similar to calling the police in some sense. You don't think about "network" or cost when calling the police, right? We do neither for health care related things.
Btw. getting down voted for an honest question is a bad thing in my opinion. People should talk to each other and ask questions.
I am always imagining the doctors working together with the food industry that pours sugar into everything and the insulin producers. It’s a perfectly symbiotic relationship.
I don't really see how you can possibly have it both ways.
Partisans strongly dislike non-partisan positions, because they are even more dangerous to them than the partisan counterpart.
Probably the average CoC enforcement.
Some discussion then: https://news.ycombinator.com/item?id=48433410