DEF CON's hacker-in-chief faces fortune in medical bills after paralyzing neck injury Marc Rogers, DEF CON's head of security, faces tens of thousands of dollars in medical bills following an accident that left him with a broken neck and temporary quadriplegia. The prominent industry figure, whose work has spanned roles at tech companies such as Vodafone and Okta, including ensuring the story lines on Mr Robot …
Actually you are wrong it is defiantly not the doctors.
When I had a car accident in the US I asked the nurse "what the hell is going on?" her comment was "are you a kiwi?" "Yes", she said "same here, they are NOT trying to cure you, they are just making sure you can't sue them!"
And she "said it was the insurance companies that determined what treatment could be paid for"
So you are wrong.
When insurance company CEO's start getting shot -- we will know whether it's the insurance companies or the doctors and hospitals in the US that are really at fault... It's a sad state of affairs. After litigating against all 3 for nearly 20 years before we changed the constitution in Texas to let them all off the hook, I can tell you none of the three have clean hands, though the docs usually want to do the right thing, the hospitals just want to call risk-management to CYA and the insurance companies weigh lives against shareholder-value every day. We call that health-care in the US.
Insurance companies are basically unsueable. They have all the $$$ and all the lawyers. That he continued to go and live like a normal human being will be dragged mercilessly into court as "recklessly endangering himself" and that "he might have further exacerbated any remaining injury, which no one can prove ever existed (because there's no MRI scan - duh!) by continuing to act as though he had no injury, which proves he did it to himself". Welcome to post-corporatist USA.
Quite a contrast and compare isn't it!
I'm with you, glad monetary cost is a secondary thought to primary health care this side of the pond.
Never quite understood the astronomical costs of medical care in the US, not that I'm doubting it's expensive, but you've got to think about the profit, not the patient.....That's the motto/mantra isn't it?
Healthcare in the US is priced high by the insurance company's scam. They run the health industry. Every single item, process, review has to be insured at every step of process. Health insurance is the most profitable CEO job there is. (besides maybe weapons and oil) With huge bonuses when you prevent payout to customers that need medical services.
It's why so many people didn't care so much when the guy was shot last month, due to his employment in the evil empire.
Greedy people rule the world, because nobody else wants to.
Dark Tangent should pitch in heavy for him, after all, he got rich off of people like him working for free at the Con.
You could make me the head of Google with all the salary that that entails, and the first thing I would do is move the HQ to country where it's as complicated as paying your taxes and getting healthcare when you need it.
I'm by no means going to try and defend the indefensible - the US healthcare system is one of the worst examples of unconstrained capitalism that I've ever seen but neither am I going to extol the virtues of a solely taxation funded healthcare system (for example the NHS) because, well, there aren't many. In fact, as with almost all publicly funded entities it's become inefficient, bloated, expensive and self-serving with costs rising while the availability & quality of care has declined sharply.
There has to be a better way - some way of blending the benefits from both models while leaving behind their worst excesses. Healthcare should not be based entirely on the ability to pay but funding it solely from general taxation and operating it as a purely public service also doesn't seem to work too well.
You REALLY don't want the US's inefficent private-public model where:
- Hospitals and insurance companies come to a deadlock in payment agreements and they send out duelling letter campaigns to the public to boycott or pressure the other to taking the offer.
- Where people drive themselves to A&E/ER while horrifically injured to avoid the cost of an ambulance ride.
- Where just Medicare (limited to 65+ retirees) manages to cost almost a trillion ($840 billion USD) and only covers 1/6th of the population, while the NHS cares for everyone (67 million souls) for less total (v182 billion/$227 billion USD).
Quite a bit of the expense and inefficiency is from buying EPR software like EPIC and later this year el Reg will no doubt be reporting that the NHS cannot afford to upgrade all its older PCs to run Windows 11.
Most kit in the NHS can already run Windows 11, we already made sure of that when ordering new kit. Other departments still use XP for specific software but those machines AREN'T on the network so can't ever access the Internet.
Each Trust will just have to find the money to upgrade where needed but will be able to do the extended support for a while.
I would like to begin by staying that I could never agree with Nigel Farage on ethical grounds. However the one thing I have heard him say where I completely agreed with the words he uttered was when asked about this subject and he came out and said we need to be more like the rest of Europe.
An odd thing for someone who is meant to be nationalist and racist and all that to say? Well he was an MEP for years. He spent time living in Brussels, in a world where he is surrounded by people who are confused about why the British don't just do the same as everyone else.
Most of Europe has cost effective high quality universal healthcare.
What is this mystical secret formula to high quality universal healthcare at an affordable price? Simple, it's very similar to the US model just with 2 changes: 1. Insurance companies have to offer their products to everyone without discrimination. And 2. They have to charge everyone the same price. - obviously combined with that other thing the US lacks, which is social security for people with no source of income.
There are a lot of people in Europe who literally don't know what a pacemaker is. This is not a language/translation issue, it's because fixing a heart is cheaper than the cost of the long term problems a pacemaker creates. The UK uses them because this month's budget doesn't have the money for the surgery to fix the problem properly, and the cost of care for the rest of their life is someone else's budget.
I once travelled to the Netherlands and forgot my prescription medication. I went to a hospital and because I had no travel insurance I ended up paying €45.38. €45 was an administration fee to register as a new patient, and the remaining 38c was for the 7 day supply of pills. However they did not give me the same pills I was receiving in the UK - they gave me the proper stuff that the UK will only prescribe as a last resort when everything else has been tried and has failed, due to how expensive it is... I literally framed the invoice and have it hanging on the wall.
I live in the Netherlands (and am a Brit)
There's a lot that your comment misses
1) Insurers can and do decline treatment, they regularly say no to some providers and will arbitrarily decline certain essential different types of medicine.
2) Medicine and accessories come and goes from peoples' plans. Last year I had to find, source. pay for essential items myself as they were suddenly not covered (having been covered for years before)
3) There is a deductible (385€ minimum, you can choose to pay more) that you have to pay on top of the ~€180-200 monthly cost.
4) There is a shortage of GPs here https://nltimes.nl/2024/12/30/doctor-shortages-leave-dutch-patients-facing-months-long-waits
5) People on low-to-middle incomes struggle to pay the healthcare costs https://dutchreview.com/news/groceries-or-healthcare-1-in-5-dutchies-avoids-seeing-a-doctor-due-to-high-costs/
6) The many different layers between patent and GP/ provider are all hopeless. Everyone blames the other, and every new government tweaks what's offered and what isn't.
7) Out of network/ out of coverage costs are increasing and this show signs of continuing.
You and Farage can keep flying the flag for it, but be careful what you wish for.
Hey, people still living here... Anyone worried about a healthcare system where in some extreme cases you might have to wait 17 whole weeks to see a specialist???? HAHAHA HA Ha HA HA HA HA
Last waiting list I was on, I needed an appointment with a "specialist team" that had been given a monopoly over a commonly prescribed drug by the local NHS trust. So the doctor with the name of my condition in the subject of the certificate hanging on their wall makes a referral to a doctor (no additional qualifications ) on that team who can write me a prescription.
Long story short, 2 years later the mental health team (I *cough* qualified to skip the queue) assigns me to a nurse who happens to work weekends for the other team to help pay the bills. She goes to the head of the team and tells them I am an intelligent highly skilled person who can't work and is near suicidal waiting for a fucking prescription. I am told I skipped an estimated 3 additional years of waiting because of that bit of luck.
And this is a classic example of what I was saying earlier - bloated, inefficient & self-serving. The NHS, when it works as it was intended to work, is excellent. The concept of healthcare, free at the point of need, is a laudable one and one I firmly believe should be retained. We must never find ourselves in a position where access to essential healthcare is unavailable simply because you can't pay for it.
BUT, and it's a massive but, we also cannot and should not fund everything for everyone. Right now, the NHS is providing everything from paracetamol to brain surgery and it's impossibly stretched by trying to do so. We need to be honest with ourselves about what we should and should not expect the NHS to do, where the limits on free care are and what we do when those limits are reached. Today, it's perfectly possible for someone to want a medical procedure which, in the opinion of their doctor they would benefit from but which is not a medical necessity - should we expect the NHS to foot that bill? Should the patient? Should there be a shared cost? That's the kind of difficult question we as a society really need to start asking.
Then there's the whole issue of NHS management. It's a common complaint that there are more administrators than doctors in the NHS today and it may be true - I don't know. I do know that the continual quest for cost savings is almost certainly producing additional costs of it's own. Take the example above - a person left unable to work (and thereby contribute to society) by the over-management of essential resources in a quest to cut costs. I'd hazard a guess that, when looked at as a whole, the cost of 'saving' the money on prescriptions would be vastly outweighed by the cost of the economic inactivity the delays caused. Not to mention the additional direct costs incurred by the NHS dealing with a patient who has a diagnosis, knows they need treatment, knows what treatment they need but is stuck on a waiting list for nothing more than a bit of paper! How many GP visits, nurse appointments, mental health appointments etc. did 'saving' the money on the drugs actually cost?
It's nonsense like that which paints the NHS in a bad light. There IS a place for a 'cost focussed' approach but it has to look at ALL the costs, direct and indirect, if it's to be effective. The current piecemeal approach just breeds more and more layers of useless middle-management who's only real function seems to be self-perpetuation!
We also need to address the wider issues that produce back-pressure on the NHS, for example the well-documented problems surrounding social care, care of the elderly etc. It costs a lot of money to keep someone in hospital, keeping people who are medically fit to be discharged in hospital beds simply because the necessary post- discharge care isn't available is not good for the patient or the NHS!
“Then there's the whole issue of NHS management. It's a common complaint that there are more administrators than doctors in the NHS today and it may be true - I don't know….”
And yet you repeat that right wing trope (blame the managers, then blame the clinicians – look over there, it’s all their fault - whilst 14+ years of Tory government purposefully underfunding the NHS to undermine it into the pitiful state much of it is today, all to facilitate the transfer of clinical provision to corrupt, exploitative and hideously inefficient American private healthcare organisations.
Both managers and clinicians spend an increasing proportion of their time having to manage significant reductions in service funding, year after year, in the face of spiralling demand from an ageing population. Bricks from straw. They get continuously scapegoated by the right wing mainstream and social media, whose views are then parroted by people who are apparently incapable of finding the first page of a google search to check this disinformation out, despite apparently being an IT professional subscribing to The Register.
For the record (https://www.nhsconfed.org/articles/are-there-too-many-nhs-managers )
- NHS managers make up circa 2 per cent of the workforce compared to 9.5 cent of the UK workforce in 2017 (at 3 per cent in 2023)
- The UK spends less on management compared to comparable international health systems – it spends 2p in the pound on healthcare administration, compared to 5p in Germany and 6p in France.
Have to say I find the NHS-worship among a proportion of the population to be rather ridiculous - and they ALWAYS assume (or claim to assume) that the only alternative is a system like the US.
Part of the problem is that the NHS is a tax-funded monopoly, so there is no competition (other than fully private healthcare, which is too expensive for most) and no incentive to imrprove. Come the next general election, the parties will be promising to throw more money at it, for it to waste, as that's always seen as a vote-winner.
The model is clearly broken, and quite a few of the European systems do appear to perform better in terms of outcomes, without the massive waiting lists which are common on the NHS.
And from my own experience of the NHS over the past few years, one of the most dispiriting aspects is the couldn't-give-a-fuck approach which is far from uncommon. It's not everywhere, and some specialisms aren't like this at all, but it is clear that in some areas they really don't give a toss. And as for the complaints processes, the aim seems to be to drag it out as long as possible, avoid answering questions, and sometimes openly lie even when presented with evidence which proves the lie. And the Ombudsman service is so utterly useless (clearly out of their depth and lacking in understanding of some areas) that it's not worth even bothering.
Those wait times may be longer than elsewhere in Europe but do not seem long for the US (at least where I am). I had to wait 2 weeks for any appointment with my GP, 6 weeks for a morning appointment (since I have to fast for 8 hours before). I generally have to wait a minimum of 12 weeks (sometimes more like 26) to get into my neurologist (a nurse practitioner at the clinic is usually shorter wait but they can't do everything). Cardiologist is again a minimum of 12 weeks (barring critical need). Gastroenterologists do seem shorter here though (it's been a while but 8 weeks iirc).
My heart has a worn out natural pacemaker, worn out AV node and full block of the right bundle. Result is that the heart cannot pace itself at a rate greater than 80bpm, once it tries to go above that, it just gives up due to overload and drops to a ventricle only "escape rhythm" of 40bpm. A simple 2 lead pacemaker has me back up and running with beats up to 120ppm (capped at that because of my advanced years).
I'd be quite interested to know what the alternate heart fix is rather than having a pacemaker fitted.
I am not medically trained and don't know how many different types of issues a heart can have, however I knew a British person who moved to France and when he got all set up there and went to see his new GP they made a big fuss about his pacemaker. The following week (!) it was removed, and after a short recovery period he was back to pretty much his pre-pacemaker self (but a few years older of course) and took up regular exercise to keep himself that way.
I believe the justification from his doctor was that he would have a far better quality of life, and the justification from the insurance company was that they would rather insure a healthy person than someone with a pacemaker.
Unfortunately in that specific case he died of unrelated causes a couple of years later, so sadly the insurance company didn't save money after all... (Yes I am being sarcastic) but the doctor was right at least.
Most of Europe has cost effective high quality universal healthcare.
There are indeed very good quasi-private systems in the EU - many of which revolve around a health-insurance scheme which is regulated into the ground. Germany for instance has private healthcare, but everyone has to buy mandatory insurance from a government-run insurer, so it might as well be a tax - you could call it "National Insurance" for instance. I'm just spitballing here. The private providers toe the lines set by the monopsonist insurer (or don't get paid).
In the general analysis though, whether you run it privately or publicly, or some hybrid like the NHS (e.g. contracting out GP services to private practices), it doesn't seem to make a huge difference to overall cost. They're all "fine". Just don't do what the US does.
The problem the NHS has specifically is not one of public ownership, but of the private sector being shoe-horned into places they add no value and extracting disproprotionate cash. The NHS is highly competitive with European private providers for the actual cost of providing a procedure - assuming you ignore building/facility costs. PFIs of various forms have screwed us over. A public sector body with capital investment funded by Treasury Gilts will see a lower lifetime cost by building their own hospital, compared with renting one in perpetuity from a private provider who has no incentive to cut costs - the Trust can't exactly pick up and move to a new building down the road every 5 years if they fall out with their landlord - not with things like MRI machines and faraday cages built into the fabric of the place. Whereas a private hospital must control their building costs because (at least in cities or relatively populated areas), a patient can go down the road to a different provider, or a national insurer can put them over a barrel and refuse to pay them until they sort their shit out.
The whole public-versus-private question is somewhat overblown. Full privatisation is clearly bad - see the US. Basically any European system (including the UK's) works *fine*. The problem we have is a dollop of Americanism being shoehorned in since the 1980s.
The other major problem the NHS has is being a provider-of-last-resort for services which have been cut elsewhere - see the social care crisis and bed-blocking by pensioners and the homeless who should be discharged to more appropriate care facilities which Cameron/Osborne shut down. European providers don't have to put up with this shit because their governments don't shy away from funding local authority social workers and social care.
here has to be a better way - some way of blending the benefits from both models
"Health economics" is an existing area of study. All existing systems are blended to some extent (even the UK and the USA). I think probably Belgium is about as good as it gets, but all countries are deeply attached to their own choices. Americans still look at the Canadian system, and don't want that, and Canadians look at the American system, and don't want that.
The traditional American view (before their system got so bad, and the UK funding increased so much), was that the method and direction of NHS service limitations was deeply immoral. Not so much the limitations themselves -- all medical system must be limited -- but the moral and ethical nature of those choices. They haven't changed their mind about that, but their own system has become so bad, and UK funding has increased so much, that the "moral and ethical" balance has shifted significantly for a lot of people.
Not strictly true... There are however relatively limited numbers of places in the UK that have private ICU facilities.
So for the most part things done privately are "routine", with relatively low risk.
There is almost no private A&E, and major surgery, which requires ICU based recovery is limited, but it does happen.
Ok so in the UK, anything that is an emergency won't be touched by the insurers BUPA et al. It's off to the local A&E for you and by golly you'll get good treatment, stifled only by a chronic shortage of beds. I've had this two years running for separate issues and I cannot fault it.
However for elective treatment, you're on the wait list plus the NHS will spend the minimum working out what is wrong with you. If you're lucky enough to have health insurance, you can skip the waitlist and choose your consultant (who also works in the NHS) and you'll get better diagnostics too so they can actually fix the problem rather than just trying this and that.
But ... the costs are all agreed up front between the insurers and consultants, so no unexpected bills. You do pay for some things like meds on discharge, but everything else goes through smoothly.
US government per capita expenditure on health is actually slightly higher than UK per capita expenditure but so much of that goes to unnecessary insurance you are left with a crappy and expensive health system.
Get rid of the stupid exploitative and pointless middle layer and the US could have a first rate heath system which would probably cost a bit less than the current system.
neither am I going to extol the virtues of a solely taxation funded healthcare system (for example the NHS) because, well, there aren't many. In fact, as with almost all publicly funded entities it's become inefficient, bloated, expensive and self-serving with costs rising while the availability & quality of care has declined sharply.
I'd love to know what bloat there is in the NHS. Much like British Rail in the 1990s, succesive cuts and the new sectorised org structure had turned it into a fairly lean, mean transport machine. This was amply demonstrated when the new "efficient" RailTrack PLC found there weren't really any levers left to squeeze "more efficiency" other than "defer maintenance", which is the polite way of saying "kill passengers". Strange how the number of passenger deaths on the railways is consistently lower under public ownership than private.
For that matter, the number of preventable deaths is successively lower under the NHS than under the USA's peak capitalist system.
The NHS is currently starved of cash for front-line services, despite their substantial £150+Bn/yr budget for England & Wales.
Readers of the Daily Zeig Heil will attribute that to "paper pushers and immigrants". Of course the NHS has one of the lowest paper-pushing rates in the world - only 2% of staff are management, much lower than many European countries. Arguably they need a bit more paper-pushing to allocate resources effectively. It's insane to expect skilled clinical practitioners to also manage their own professional services. Even one-man-band businesses get an accountant to file their taxes. I'll concede that it's very inefficient and bloated to pay trained nurses to perform admin work.
The reason the NHS under-delivers is largely because they're stuck in unaffordable PFI contracts which we all knew were garbage in 2005 - lifetime cost of renting a hospital for 40 years is way higher than building it yourself. But it keeps the capital cost off the government books this year (or this term) and lets them talk bull about bringing down borrowing (which is irrelevant - they can run as much deficit as they like for capital infrastructure. Noone can borrow cheaper than the Treasury). As a result, we have "health" spending running into the pockets of private developers rather than services.
From Thatcher to Sunak, they've all done it - sell your assets for a one-off income, and then rent them back forever. The only ones taking this seriously are the MoD - securing supply chains with their acquisition of Sheffield Forgemasters and buying back the Married Quarters Estate after 30 years of mismanagement by Annington (I remember UK consumer affairs show "WatchDog" reporting on that in the 2000s where sites lost their local housing manager and handyman who knew the estate and residents, replaced by a call-centre and an indifferent centralised "maintenance" service who did no preventative maintenance and needed to clear all the way up the tree to spend any meaningful money, allowing minor problems to become major problems).
As always the "can it go bust?" rule applies.
If something can't go bust without being bailed out by the government, then it probably ought to be under public ownership to start with. It's highly unlikely you will ever be able to add real value to the sevrice by adding layers of shareholders, or raising capital at commercial rates rather than at BoE Gilt rates.
The vast majority of NHS facilities and services fall into this class.
That sounds a bit far fetched. What happens in real life is that a treatment plan is submitted to the insurance company for approval and once its approved by the company then the treatment can proceed. Obviously you can get treated without insurance company pre-approval but they won't pay the provider(s).
Things are a bit different with emergency treatment because emergency treatment is mandated by Federal law regardless of the insurance status of the patient. This is probably what saved him -- routine care would have gone into the "delay / deny" Black Hole but as soon as the situation became critical the providers could class this as an emergency and just provide necessary treatment. (So the fight just moves to rehab....)
For UK readers who may not understand how the system works its actually worse than you can imagine because a hospital run like a hotel that provides nursing and care services. It doesn't employ specialists like surgeons but rather extends privileges to them which allow these providers to use -- effectively, rent -- the hospital facilities. This means that patients and insurers alike are often dealing with many different entities on a treatment plan. You don't notice this unless one or more of the providers is 'out of network' and bills you, the patient, directly. (Usually this happens months later after the bills have been back and forth between providers and insurers.) There's also a neat 'usual and customary' trick which can leave you, the patient, on the hook but this is too difficult to explain here.
There are alternatives to this mess. I'm a member of a HMO which is a lot like how the NHS used to work before it got broken up, PPO style, into numerous "business units". You show up & you get treated. There may be a small bill but they've been doing away with many of these (possibly because the cost of collection exceeds the actual sums collected).
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This is pretty bad. But I notice some comments about their healthcare as across the pond, I wonder how many of these commenters are in the UK. On the NHS you would probably have a chat with your GP (when you can get one) who may then refer you to the hospital (weeks wait) who see you for 10 minutes to decide if they will do anything. Then after referring you to a 'specialist' department (weeks) you might get seen eventually and if they dont try to kill you off maybe try to do something.
Somewhere in all of that it would have still been an emergency I expect where he would wait hours in A&E before being seen to. I know on the continent they have varying health systems of various success but the UK tends to look down on the US and the US tend to look down on the UK.
So much whataboutery. Let's review:
Whatever the incident was, it left the cyber pro with a broken neck, but he wasn't aware of this at the time. He had no symptoms other than some "manageable neck pain," and nothing out of the ordinary showed up on a routine X-ray and an MRI wasn't possible due to insurance delays.
A week later, Rogers started losing some sensation in his hands and tried to have the MRI rescheduled. While waiting for said approval, he and his family holidayed in northern California and by the time he returned on December 30, he says he lost "about 20 percent sensation and a similar amount of mobility in both arms."
Where I am he would have had an MRI while the US insurance company were still trying to find their arse with both hands.
In the UK I would expect the same but in the worst case is he would have been triaged to the top of the list as soon as he reported losing sensation in his hands by the end of the first week.
In the US health is rationed by money, outside the US healthcare is rationed by need. Some people will seriously go on the internet and argue that the former is fairer than the latter.
@AC
"So much whataboutery"
Just because you dont like a comment does not make it whataboutery. As I made very clear my comment was in response to comments (plural) on this topic looking down on US healthcare and sounding like they might be from the UK where I live.
"Where I am he would have had an MRI while the US insurance company were still trying to find their arse with both hands."
That doesnt sound like you live in the UK. Had he fallen and broke his neck I expect the NHS would probably be pretty good at the emergency care (I would hope) but for a non-emergency but feeling like something is progressively wrong would likely need referrals here which would be weeks or months of being passed around.
"In the UK I would expect the same but in the worst case is he would have been triaged to the top of the list as soon as he reported losing sensation in his hands by the end of the first week."
This is where I am not convinced. Possibly, but I wouldnt bet on it.
"In the US health is rationed by money, outside the US healthcare is rationed by need."
Not quite. You are right about the US healthcare rationed by money, but in the UK it is not rationed by need but by the NHS's ability and willingness to provide. By being so free to access A&E gets full with people who cant see the GP who cant be bothered working, or just want to pop into the hospital because its easy and doesnt cost. Even now instead of a healthcare system based on need, they try to manage need by progressively telling us what to eat and how to live. An oxymoron is the fight on cigarettes which funded the NHS and killed people quicker.
"Some people will seriously go on the internet and argue that the former is fairer than the latter."
It takes an idiot to look at the US and UK systems and argue what is best. The rest of the world exists and we can look to see what actually works.
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I wonder how many of these commenters are in the UK. On the NHS you would probably have a chat with your GP (when you can get one) who may then refer you to the hospital (weeks wait) who see you for 10 minutes to decide if they will do anything. Then after referring you to a 'specialist' department (weeks) you might get seen eventually and if they dont try to kill you off maybe try to do something.
Under the NHS he would have had an MRI when he presented at hospital, to rule out the risk of spinal injury.
The break would have been detected and he'd have been admitted on an urgent basis to the spinal unit.
Non-urgent referrals in the UK can be dreadfully, dreadfully slow (ask me how I know). Turn up with something urgent though and you get seen (provided you don't arrive at the same time as a major incident. These things happen). Likewise if you present with anything that might possibly be cancer if you squint a bit, they shove you on a cancer pathway and you'll get a battery of tests within 10 days (I know two people this has happened to in the past year), because they know that cancer gets rapidly more expensive to sort the longer you leave it (up to the point it becomes impossible to sort), with correspondingly diminishing clinical outcomes.
The more unfortunate thing is a postcode-lottery of GP surgeries. I had a fall and my arm still had limited mobility after 10 days. Called the GP with the vague hope they could refer me rather than taking a ticket in A&E, and they said "Pop down this afternoon to see our bone and muscle specialist". Makes sense with an aging population that more GPs will have an osteo bod in-house. But you won't get that everywhere.
@rg287
"Under the NHS he would have had an MRI when he presented at hospital, to rule out the risk of spinal injury.
The break would have been detected and he'd have been admitted on an urgent basis to the spinal unit."
In an optimal situation, but I doubt it. For example my family member who had a stroke and it was ignored and she was put on a covid ward (didnt have covid) and took ages to be moved and treated. Or another who has a heart condition but the glorious NHS just sent him home. Thankfully due to medical insurance he went private who then actually tested and found a serious condition that required surgery quickly.
"Non-urgent referrals in the UK can be dreadfully, dreadfully slow"
I think we have both been through that joy :)
"The more unfortunate thing is a postcode-lottery of GP surgeries."
Very true. The GP's here are fairly good depending which one you see but I know of some painful ones too.
In an optimal situation, but I doubt it. For example my family member who had a stroke and it was ignored and she was put on a covid ward (didnt have covid) and took ages to be moved and treated.
I can't speak to your specific circumstances, but my family member with a suspected stroke (yeah, 2024 was a year, toasted it the fuck away on NYE) was escorted around their various tests by a dedicated doctor. I suspect it must have been an unusually slow day for them, but you'd not have had better care if you were private. It's very regrettable that your family member didn't get that.
There will always be variation across the country unfortunately, but as a general rule NHS seems to handle urgent pretty superbly. And in the reported case, if doctors wanted an MRI (which they did), then he'd have been wheeled down to radiology for one. Even if there was a queue, there'd have been no question about it being done eventually.
The problem is they've got A&E/Trauma down pretty good. Time-limited things like maternity are pretty decent, along with oncology.
But outside of that, you get the "Good news! It's not cancer. But we don't know what it is. We've referred you to <dept> on a non-urgent basis. Expect an appointment in 3-4 working years".
If he'd broken his neck I'm pretty confident he'd have had an MRI on the spot.
The reason I can be so confident - the Dr's wanted to do an MRI. In the UK, that's all it needs. You get wheeled down to radiology and scanned... it might be a few hours from when the decision was taken based on how busy they are, but it's going to happen, and happen pretty fast. They'd probably also get a CAT scan whilst down there.
Seven years ago I was admitted (directly to MDU with a GP referral) with a recent thunderclap headache and ongoing fatigue. It took a few hours to get a CAT scan, the lumbar puncture took a little longer. But the delay was all based on medical decisions, not insurance decisions. As it turned out I hadn't had a stroke or a bleed on the brain and didn't have meningitis. The actual issue took a little longer to come to light, and there were times when we had consultants from six or seven specialities standing around and researching rare parasites from anywhere I'd been recently (it turned out to be none of those) - it resembled an episode of House MD.
The 'healthcare' system in the US is clearly not fit for purpose. This is what happens when an essential service is run on a for profit basis. It costs twice as much as peer nation systems, yet delivers worse care for the bulk of the population. With the US having one of the lowest life expectancies in the developed world. The massive difference in cost can almost certainly be put down to the armies of admin staff needed at hospitals and health insurers to process and deny claims as well as the profits taken out for shareholder dividends. Remember kids, when you pay for your hospital care, you aren't just paying the doctors. You also need to help pay for your insurance companies CEO to buy a new yacht and that is the most important thing!
And the concept of having to rely on an employer to provide my health insurance is simply bizarre. Why would I want to tie myself to a job I might hate just to ensure I don't die or go bankrupt from medical bills?
In this 2024 comparison of health systems in 10 countries, the US came 10th. By a long way.
https://www.commonwealthfund.org/publications/fund-reports/2024/sep/mirror-mirror-2024
I personally don't mind paying some tax if it means I have access to the system ranked the best in the world, at no cost when I need it.
NHS needs to disband NICE, disband the trusts, concentrate on the 5 regionals bodies (NI, Scot, Wales, N/S England) and centralise procurement (retail warehousing model, one super warehouse supplying regionals), boycott big pharma companies for ripping off the taxpayer, why are we paying pounds for so called named paracetamol, when retail can sell unbranded packs of 20 for pennies.
NICE decides what drugs can and should be used for what, and sets acceptable prices for the drugs the NHS uses. If you remove it then your going to have to set something up with an identical remit. It's an unfortunate fact that we can't afford to pay a million quid a dose of new drugs that claim to (but are not proven to) work wonders and somebody has to decide what gets used and negotiate costs with the manufacturers.
The problem is that the trusts exist to make the admin burden possible to deal with. You could move all of the responsibilities of the local trusts and their staff to the national level but costs will just go up when all the staff end up working in London, and it's rather questionable that this is going to improve anything.
The NHS isn't actually massively overcharged for things. It costs like £3 for buying branded paracetamol from a pharmacy through their supply chain and about 40p for an unbranded knockoff from Aldi. The unbranded knockoff has packs under half the size; so the price ought to be doubled to compare like for like. 80p for a knockoff vs £3 for a brand is comparable prices to what you see in most shops.
This is more a case that Aldi's prices are excellent; this is not exactly an issue like the US with insulin and given that the costs in question are counted in the millions against total spending in the hundreds of billions would tend to show that it's pretty well managed already.
US sounds like hell, a complete shithole of health insewerance instead of a centrally funded health system.
Had 3 rides so far, one was life threatening, all OK after a week.
The most recent was suspected stroke, they appeared to know what they were doing as they did not do a CT in the end, but did not know, had MRI later in week, no fault found.
In the end came down to me getting Covid for a second time, and very weird symptoms, like losing the ability to talk for about 1 hour.
I fully understand his situation, because I was hit with a similar situation 10 years ago (March 12, 2015) during sport. It took 3 surgeries and 4 weeks in hospital - then the rehab was 5 weeks. After that I was able to eat with a tea spoon. It took 3 months to raise my hands over my head, but after 18 months I was able to start work for 4 hours a day (after 18 months "sick pay" ends in Germany, and I was still 60 years at that time).
That situation was the starting point to bring my IT blog at borncity.com "to fly" to fund me. 10 years later, I'm still suffering light nerve and neck pain, but I'm able to run my blogs, do sports and other activities like walking, gardening etc.
So I press two thumbs for Marc that things will go well for him - and I wish Marc a full recovery.
Bottom line: It seems that my financial situation concerning health insurance was better than in NHS. My statutory health insurance took all costs and payd the bill.
Günter Born
I'm sure this will get me downvoted, but it smells like we're missing some of the story here. If I went to the doctor complaining about neck pain and an exam and X-ray showed nothing obviously wrong, and then I went home and didn't seek additional care, why is that the doctor's (or the system's) fault?
From the doctors' perspective: someone shows up at the office complaining of neck pain from _<missing information about the nature of the injury here>_. An X-ray is performed, and apparently nothing is seen that indicates further treatment.
The patient goes home for *3 weeks* during which they apparently decide they're well enough off to go on a vacation.
During the vacation, rapid nerve damage is noted and they seek additional treatment, which they get. Apparently at this point (when the patient's symptoms warranted it), the horrible U.S. healthcare system provided an MRI and the necessary treatment.
Although it seems great fun to preen about the wonders of the NHS and the problems in the US system (where are many), I'm not sure exactly what additional heroics could be expected from either the hospital/clinic or the doctors.
I have had major injuries and illnesses, and in Japan most medical care is provided inexpensively and quickly. amazed at the examples you guys mention from the US and UK.
Of course social security costs are a problem, but I think they are an unavoidable cost of maintaining a workforce in an aging society.
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