Quote:
Originally Posted by woj
I don't think the difference between survival rates between UK and US is because US health care customers are more informed and are able to better manage their health care or are more open about their family history, etc...
one of the reasons why early detection may be more common in the US is simple, US doctors have in a way skin in the game, there is $$ to be made...
let me illustrate with an example: imagine 50 year old man going to a doctor with a flu...
UK:
the doctor is overworked, gets flat salary from NHS or whatever they call it... so he talks with the guy for 5 minutes prescribes him some antibiotics, sends him on his way... thought of mentioning prostate exam crosses his mind, but figures "fuck that, I'll have to fill out a form, and it's 6pm already with 20 people still waiting to see me, so I'll mention it next time since chances of him having cancer are pretty slim anyway..."...
US:
the doctor has pretty free schedule, he is self employed, so he collects $100 or whatever for each visit... he talks with the guy for 5 minutes prescribes him some antibiotics, and on the way out... "by the way, I see you are 50 years old, at this age it's good idea to perform a prostate exam.. talk to my secretary and make an appointment and we'll do it next week"... patient gets "upsold", doctor makes more $$, but as a result he gets better healthcare = everyone is happy
so paradox of free healthcare that many seek, is that as more and more people have free healthcare, the situation turns more from one labeled as "US" to one labeled as "UK"... and no one really wins as a result, on average everyone ends up with worse healthcare (as illustrated by cancer survival rates earlier)
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In this example, the type/quality of healthcare can play a major role. Every time I have gone to the doctor and been offered something like a flu shot or cancer screening etc. it has always been by the nurse who comes in first and takes vitals, asks questions, checks basics etc that offers it to me. Mostly, the doctor comes in, we talk for a few minutes and they leave and then the nurse comes back and finishes up.
I can see where if offering a screening or mentioning it to a patient meant more paper work it could create doctors who are less interested in offering them because of the headache of the process. If done correctly, however, we could have a system where people are offered screenings and early detection in prioroitized and still not have doctors who are swamped with patients. Of course, that would require a high-quality system and "government run" and "high-quality" typically don't go together.