You do realize that the US has this problem alone.
It doesn't require innovation or technology.
Just proper policy on pricing, like every other western nation has. The market will fix the efficiency, but not as long as the medical field itself can set the prices, since life and death choices are the ultimate i-will-rob-a-bank-for-this price elasticity.
You aren't spending nearly as much as Americans and for that money you treat everyone.
Are large organisation inefficient? Yes. Is it frustration when you look at it? Yes. Does this mean the US situation where they are spending 3 to 5 times as much to provide the same level of care to only a part of the population, is objectively worse than the UK situation? Yes.
(I removed the quoted line, because the tone of voice is suboptimal - but it doesn't change the argument)
I agree the sum total cost may be significantly different but I was simply acknowledging that inefficient health care administration wasn't purely an American phenomenon.
It is not unique to healthcare either. It is simple a common aspect of large organisations that have too many stake holders that need to coordinate to get things done.
It is an interesting organisational problem.
But inefficient does not mean expensive. Generally you see a lot of inefficiency, much like with code, when it is not the hot path. If you would fix all the obvious inefficiencies it will not drastically reduce cost (actually: it would mean the hospitals have more money, so anybody selling anything to them would up their prices)
Inefficiency only makes a difference when the price is based on cost not on negotiation position (i.e. value based). So in a red ocean as they say, there is a strong economic incentive to fix all in efficiencies and squeeze the last dollar out of it. This is referred to a race to the bottom.
But health care is the opposite of a red ocean. And no price is too high if it means survival, so the consumer (i.e. the patient) needs a much better negotiation position. For example: having all patients collectively negotiating the price. If only over time the invisible hand of the market would have created structures for this purpose again and again everywhere in the world. Oh wait! It did. It's called government.
Could the rating organizations be biased to weigh disseminated coverage and care more than individual quality of care? Just a question, since I seem to get that impression these types of quality of life surveys.
As a USer with good insurance, it's a hard pill to swallow to trade next day doctor appointments, same day urgent care (not ER) with very short waits, and quick schedules for surgical procedures for the broader coverage other countries offer with more rationed care.
Purely anecdotal but I've never had a problem getting a GP (Doctor) appointment for the next day (and get same day if they're not busy). Not sure what would be urgent enough to warrant same day but not ER?
That said I am fairly healthy and can probably count the number of doctor visits in the last 10 years on one hand so I may have just been lucky in my limited experiences.
Standards have got considerably worse in many measures recently.
When people talk about the winter crisis it's differently to previous winter crises -- A&Es turning away ambos because the corridors are full isn't something that used to happen.
In the past Ambos have been turned away, but that's because the beds were full. Those A&Es still had emergency capacity (in the corridors).
Before this an A&E would tell an Ambo that the beds are full, and to go to a different hospital.
This leaves some spare in the system for when things are very busy - you put people in corridors.
But now all the corridors are full. We've had A&Es declare major incidents.
We've even seen, and I don't think we've seen it before, triage on resus. That alone is a big flag that things are fucked.
> And before this, what? Ambos queuing up, patients treated in ambos, patients waiting a long time for ambos, etc, et
Right, you think we'll go from fully working NHS to fully broken NHS in the blink of an eye. These things you mention were fixed once, and they've been getting steadily worse (as the Conservatives de-funded social care, and privatised drug & alcohol services, and cut MH services, and defunded the rest of the NHS) - the crisis started a few years ago, and is building year on year.
They haven't destroyed the NHS since the NHS still exists.
However, this aside, do you have any ideas regarding turning around this perceived calamity?
Personally, I think the solution is politically unpalatable but I am not so narrow minded as to think there may be a solution that doesn't simply resort to giving doctors and nurses a bonanza pay rise.
As far as I know it's not. Here are two pieces of anecdotal evidence:
- cycle responders in London [1]. I can't see how private companies can get enough "client density" to afford the fleet in a congested city centre to reduce response time. Moreover, centralized dispatch is inherently more efficient.
- centralized and somewhat open control of life-saving procedures' efficiency [2][3]. In this particular case it's children heart surgery. NHS not only applied country-wide risk-adjusted statistical model, they also did a project to communicate it to patients. I'm not sure if it's possible in the US healthcare system.
From the POV of a recent immigrant it looks like most dissatisfaction with NHS stems from their approach to mundane and/or chronic problems, that's where you see GP resistance and long waiting times. They seem very good at not letting people die. Arguably it's a reasonable tradeoff given their constrained resources.
It doesn't require innovation or technology.
Just proper policy on pricing, like every other western nation has. The market will fix the efficiency, but not as long as the medical field itself can set the prices, since life and death choices are the ultimate i-will-rob-a-bank-for-this price elasticity.