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The truth is that the NHS is very bad not due to funding, but for structural reasons.

The fact I can't even see a GP I'm not registered with (not even an option to pay extra) is ridiculous. You have absolutely no control over your health at all.

With private, you get exactly what you want, whenever you want it.



> With private, you get exactly what you want, whenever you want it.

In the US this isn't how it works. You can't see whoever you want unless you have a really, really good plan. Otherwise, you need referrals. And lots of specialists won't see you without a referral anyway.

And, the wait is often on the order of months. I know that's something people complain about in the UK but I assure you, it happens that way in the US too even though we're paying 10x as much.

I know private in the UK is quite good. What you need to understand is that the only reason it's any good at all is because of the NHS. It has to remain competitive. If you go full private, then it very quickly decays.


A specialist also requires a referral in the UK. There are also much more medicines which are prescription-only than in the US.

That's why in practice we have all these (private) services to get easy GP appointments via phone, video or even online forms. While everyone knows those appointments can't realistically do any real medical work, they serve to give you prescriptions and referrals.

It's just a gatekeeping mechanism, that you can more easily bypass if you have money. The more you pay, the more they care about your user experience and how streamlined it is.


In the US if I want to see my primary care doctor I need to wait 2 months for the appointment.

I pay $500 per month for the privilege (and a $50 copay)

So I’m paying $1000 in the time period where I’m getting no service.


Where in the US are you? I was able to book a visit with my primary the very next day less than a month ago.


Not the person you replied to but I'm in North Texas and I just recently had to reschedule my physical. And yup, the next appointment is 2 months out.

I also had cancer in the past and you might think that that would mean I get faster appointments. I do not.

And I have a very, very, very good PPO plan.


> I also had cancer in the past and you might think that that would mean I get faster appointments. I do not.

Sadly you do not may be because lower life expectancy -> lower return on treatment "investment".


That was my thinking... even for specialists, I can generally get into a new one within a few weeks.

My SO is on state Medicaid (cancer) and does experience the kinds of waits mentioned above... so I guess it does follow similarly for government/state backed healthcare, where I'm mostly out of pocket.

But even when I had relatively typical coverage, I didn't have issues getting into a doctor more often than not. I think getting my sleep study was the longest wait I had for anything, they were months backed up with appointments... but my kidney and retina specialists were somewhat easy to get started with.


As usual when people say "the US", we're papering over the fact that the United States is really 50 countries in a trench coat.


> the United States is really 50 countries in a trench coat.

Appropriate attire... when you're in a trench :)


You can absolutely see a GP you’re not registered with if you are travelling and need to. I have done it multiple times. I have been offered it same or next day after calling 111.


You can call any GP surgery to get emergency treatment for up to 14 days if you're not registered with a GP surgery or are away from home. https://www.nhs.uk/nhs-services/gps/gp-appointments-and-book...


While away from home, my son (5 yo) cut his finger and was in need of disinfectant and a bandage (steri strips).

Pharmacy was useless, no medical skills or knowledge of their own products. Asked me to figure out myself what I needed and put it on my son myself.

Local GP surgery sent us away: no registration, no visit. Me saying this was an emergency just made them suggest A&E.

A&E is where we ended up, and while that definitely works, going to the emergency services of a large hospital for every little thing is not only a waste of my time but also of resources. It seems however to be the NHS way: whenever the littlest of troubles arise, just go to the hospital, or even call an ambulance.


Sorry for being too American to understand, but why would you need to talk to any medical professional to put a bandaid on your kid? Is this about NHS being paying for the bandaid? About medical expertise to apply a bandaid?


Not all disinfectants are child safe, and the wound was serious enough to require steri-strips (an alternative to sutures) -- it was not a matter of a bandaid.


1. Water is child safe

2. Steri-strips are available over the counter at any supermarket or pharmacy (in the U.S.)


You would have been best served by a Minor Injury Unit but not every town has one, so A&e is not excessive. The great majority of people going there do not need the full capabilities of it (resuscitation etc).


The chemist can sell you the right stuff for that.


You call 111 if you don't want to bother the 999 guys. 111 will tell you what you need to do, including "go to A&E".

What is wrong with going to A&E for an (as you said yourself) emergency?

A pharmacist dispenses medications and should know about their safe usage. They won't tell you how to bandage a wound.


Getting a minor wound bandaged up is not what A&E is meant for, it's for life-threatening injuries.

Going to A&E and waiting there also means you're losing 4 to 6 hours.

111 you just get some robot asking you a never-ending list of inane questions before someone tells you to either self-care at home or go to A&E.

A pharmacist should be able to administer the supplies they sell, particularly wound dressing and care. It's a requirement in some other European countries like France (where pharmacists are doctors), but in the UK the reality is that most are unable to do so.


111 do a lot more than that, they will get you a GP visit even if the GP claims to not have slots, and they will get medical professionals to come to you.

If it was in hours, I'm surprised they didn't get a nurse appointment for the cut.


Pharmacy. Not pharmacist.

Pharmacies provide much more than just medicine.


A pharmacist is someone who is a chemical practitioner though?

“Man, these cryptographers didn’t know a thing about tailwind. Useless!”


And 111 was unable to help, even the GP they assigned to you turned you away?


With private, you get exactly what you want, whenever you want it... If you can afford it.


Pending availability of specialists, willingness to travel, etc.


If you're in a major metro area it's generally not too bad.


Compared to the system of no access


Same system, for the not-wealthy.


So naive. Private only works this way in Britain because it doesn’t have to be responsible for anything. It’s a luxury good and works accordingly.

We have insurance, it’s amazing! But it’s fake. If you want to know how a whole system of this would work, look at the US


* if available in your area or within your means of travel, which may include flying to another state


If only there were some system where the incentives could freely flow through and permeate every level of the sector. Where those organisations that provide sub-standard care die and those that excel receive outsized funding...


Unfortunately, a system with these qualities doesn't exist in practice. You just end up with the same too-big-to-fail macro organization minimizing their point-of-care labor spend and maximizing their management spend either way.




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