Topic: Corona Virus Panic/Discussion Thread

@Th3solution The main thing we can’t get us some of the most expensive anti-cancer drugs. Usually those that prolong life rather than cure the cancer. They can still be bought privately however most people can’t afford to do so.

Some procedures like joint replacements and IVF can have a fairly long waiting list but are available for free when you get to the front of the queue. Nothing preventing you buying them privately but most people don’t.

@Ryall I think a lot of people pay for scans privately and then get the treatment on NHS - you can save 6 months that way if you want to spend a grand or whatever.

@Ryall @kyleforrester87 @nessisonett What about rumors of death panels? Like if you get breast cancer after age 70 then you’re out of luck and not covered, or kidney failure in someone age 75 is not allowed to get dialysis, etc, etc. Basically the rationing of healthcare, or the things that are:
“... are restricted in number due to capacity and resource constraints
[and/or] ...only certain people will benefit from treatments or operation“
Do these things become overly restrictive. Any experiences with friends or loved ones who were denied a treatment which you felt they should have had?
And believe me, I’m not asking as a way to poke holes in the NHS system or elevate the broken American healthcare system, I just am honestly curious. Especially since it’s a hot topic during election years. And if I ever emigrate to England (or Scotland, or Sweden, or Netherlands...) I’d like to know what I’m getting into.

@Th3solution no personal experience of that (fortunately) but my understanding is they’ll always try and treat patients if it has a chance of helping...

“ Cancer is generally treated with some combination of surgery, radiotherapy, chemotherapy and, in some cases, targeted therapies and immunotherapy. All of these treatments are expensive, but are typically available on the NHS because they have proven effective in treating the majority of cancers we see here in the UK. However, when a person’s cancer continues to progress or there is a poor prognosis, they may begin to explore options beyond those in our NHS-funded arsenal. And, as possible new treatments are quickly expanding, there can be many options to consider.”

@Th3solution Honestly, I’ve never known anybody denied cancer care even in their 90s. Obviously if somebody knows of a case that’s fair enough but as far as I’m concerned, the NHS really do give care to whoever needs it.

@nessisonett you do hear of weird rare cancers, where people might take their kids to another country for a treatment that we can’t/won’t do here.

But maybe it happens more often than we actually hear about.

@kyleforrester87 @nessisonett Well, it sounds like the rumors are likely largely overblown here then. I would think if those things happened that you would have heard or had some sort of personal experience with such an issue. Also I would have thought some people would cause a stir over it — “My dear granny was left to die by the NHS because they say she’s too old for treatment! This is ludicrous!” But, like I said earlier, maybe people who are raised in a system for a whole generation wouldn’t think enough to complain about it; If it was just considered normal then people may not talk about it. So more like — “Yeah, granny died last week. The doctor said she was too old for treatment so the cancer got her. Ah well. She lived a good life.”
It’s very interesting to hear the straight opinions of the average citizens. (Not sure if I can call Kyle average, but..) Anyways, not to derail this thread any more than I already have, but that Coronavirus, man it’s a beast, eh?

@Th3solution you have been misinformed in relation to the NHS.

I will give you an example. When my daughter was born although my wife had a terrible labour, she got through it and my daughter was born for free. The next day my wife was concerned as she had noticed me shaking whilst holding her. I too was concerned as this had developed over the last few weeks but I was more concerned with my family. They had to stay on site due to complications when my daughter was delivered (my wife was cut open at the goal end).

The next day I made an appointment to see my doctor and seen him the same day. He was concerned about the pace of my heart so sent me for a blood test which I immediately went to. Then I travelled to Liverpool to see my wife and daughter in hospital.

Later that same evening I got a call from a duty doctor telling me to go to gp out of hours as the blood test was worrying. At 2 in the morning I was being told I potentially had a defected thyroid but the immediate worry was my heart rate so they gave me meds to combat that. I got the script at that point and the drugs were dispensed before 4am. I was booked in for repeat blood tests a day or two later and given information on my racing heart.

My repeat bloods were done and I was given a call from a doctor the following day who had reffered me to an endocrinologist. They contacted me with an appointment the very next day. On that Thursday I was diagnosed with graves desease and have to see them every 2-3 months with my bloods taken a week before. I'm on continual medication so now don't pay for prescriptions (which is about a tenner each time).

That whole debacle took 5 or 6 days, its difficult to recall with so much going on. It was all free and all I had to do was go to my appointments. The only paperwork I compiled was basic ticksheets for each new department I visited (operations last 3 years, family history of x, y, z etc). In that respect the NHS is ace.

If I had to pay, I may never have gone to that initial appointment and put it off for a bit. That would have led to serious complications at best.

The care thereafter has been average most of the time. I won't bore you with the detail but ongoing issues are dealt with adequately by the NHS, but this is where you have the most issues. Different doctors can have wildly different ideas on how to move forward. Hopping between specialists can be a nightmare. Which is the situation I have been in for 4 years.

My wife has had an ongoing issue with dehabilitating migraines, she was seeing one doctor who gave her injections to the back of the neck which was like a miracle for 9-10 weeks she would be migraine free. He left for somewhere else and the new doctor refused my wife the injections. That's the kind of stuff which doesn't work quite as well.

@nessisonett I'm not a fan of free prescriptions if I'm being honest, paying a small levy for your meds does help in the long run, wherever thats with the cost of the medication or keeping pharmacy's afloat. And you just know with free stuff someone somewhere is being indulged with meds they probably don't need.

I know this because my wifes drug store is like a Mexican drug den. The only thing missing is the AK47s and moustachioed men with funny hats.

@themcnoisy Thanks for sharing your story, Noisy. I find this all very fascinating. Especially to read the personal stories like this and what @mookysam went through. I have to admit, there have been times I have not gone to the doctor with symptoms because I don’t want to spend the money. That’s definitely where socialized healthcare would be so useful here. Fortunately I haven’t ever had anything significantly wrong, but your story shows how it could definitely happen and I’m happy for you that it was caught early.
I’d love to see real life stories like this be publicized in my country rather than “If you get prostate cancer in England then they won’t treat you.” Or “If you’re Canadian and you need a heart transplant then you have to come to the U.S.”, etc, etc. Sounds like a great system for the most part.
I’ve got family friends who are former military and the federal government pays for healthcare for our veterans through a system called the Veterans Administration. The VA is a nice way to give care to those who served our country, and they get basically “free” or heavily discounted healthcare for life (depending on when and how long they served) from what I hear it’s decent enough, but I hear complaints about how inefficient it is, and if someone needs to see a specialist or have an elective surgery or get a costly test, they have huge waiting lists and apparently the clinics are overrun and packed. I always figured if/when we get socialized medicine from the federal government that it will run like the VA system, which would definitely not be satisfactory to most Americans. Better than nothing, but the long waits and limited access would cause discontent. It sounds like from your experience with NHS that if done correctly, a socialized system can function very efficiently. Impressive stuff.

@themcnoisy I live a few doors down from a pharmacy in one of the most deprived areas in Glasgow. There’s probably more methadone being shifted there than actual prescription drugs but most round here definitely couldn’t afford meds if they needed them. Fair enough if those that can afford are made to pay but free prescriptions help many people that just don’t have a lot.

@themcnoisy @nessisonett I'm torn on the free scripts one. As an NHS worker now there is very poor adherence to medications in a fair number of the population with chronic diseases, such as hypertension. Perhaps some form of payment, even nominal would increase their value to people and improve adherence. However, when I was at university I worked in a pharmacy in Dundee to help fund it and like Glasgow, its pretty deprived. Less than 1 in 5 scripts were payed for under the old system so it probably wasnt worth the bureaucracy!

@Th3solution When my grandfather died in hospital it was my mother that decided that further treatment would cause unnecessary suffering for no benefit. The NHS would still have been willing to provide treatment and he was over 90.

@nessisonett prescriptions are free to loads of people in England. There's a tick box list on the reverse of every prescription, I'm not aware of every stipulation though unless I grab one!

@R1spam Ahhh OK. 1 in 5 paying is pretty low, that's less than I thought!

You all pay £300 for healthcare? I pay less than half

But I think the system is mostly the same in the Netherlands. And if you're a student, they also cover most of the costs. I think I paid around €20 a month for healthcare.

@themcnoisy it will vary depending on where you live but most people were oaps or qualified for free due to benefits but in a more affluent area, who knows.

@Th3solution I have no idea what the “death panels” you mention are!

For every speciality there will be cancer MDTs (multidisciplinary team meetings) where a radiologist, pathologist, oncologist, a specialist in that area (e.g. a respiratory physician for lung cancer), and normally a surgeon in that field too.

Cases get discussed with all available imaging, pathology etc and decisions made on how confident the diagnosis is (do we need more imaging, a biopsy etc) and what treatment would be warranted (surgery, chemo, palliative). The latter would depend on the extent of disease, patient “fitness”, and patient wishes.

That’s the closest thing I can think of but it’s a whole team deciding and would still discuss that outcome with the patient.

@Thrillho The term “death panels” was coined by Sarah Palin regarding the Affordable Care Act to imply a group of people, either real or representative of the centralized governing body itself, who would be critiquing who was allowed to live and who was left to die, or rather who received treatment or was denied treatment, based on some arbitrary perceived usefulness of that individual to society. In other words rationing of the limited resources. It’s kind of like the article I read that was posted early in this thread by someone I think which talked about Italy doctors having to practice “battle field medicine” because due to the Corona epidemic there were just limits to hospital beds, ventilators, and supplies and it necessitated making a judgement call on who was likely to be saved and who was likely to benefit the most from treatment and who was left to die. I think the article talked about “quality of life years” or some sort of calculable objective number to put on someone’s life.

Anyways, the group discussions you mention of specialists to review a cancer case and come up with the best treatment approach is not what “death panels” refers to. The implication of the term was that it was some pencil pushing bureaucratic committee or analyst that was deciding who would live and die, simply based on cost of care coupled with the person’s perceived value to society. The term is certainly a fear tactic to scare people from socialized medicine as one of the inherent principles of the US culture is individual rights, freedoms, and privileges. It appears that it is not an overt part of UK’s socialized healthcare. Apologies if I implied it was. I mean no disrespect. It seems that the decision making process is probably the same as it would be here as far as if a person is able to get treatment.

@Th3solution You lost me at Sarah Palin. I think it would be hard to take anything she says seriously!