Re: N.American vs. British/European health systems

[Guest guest]

Thanks for that reference, Rog. I was interested to see that most

of the European countries rank higher than Canada (whose public health

system does pay a lot of the costs for a resurface here, if you don't

mind waiting 18 months or longer), and Canada ranks higher than the

U.S.A. Yet the first Canadian O.S. I saw (who is fairly young, but

had never even heard of resurfacing) told me that " we don't trust a

lot of the results coming out of Europe; their trials aren't very

scientifically sound " . And when he called a colleague who specializes

in hips to check on my information, he was told that at the big

American orthopedic conference last year, the concept of resurfacing

was hardly mentioned. The second O.S. had at least heard of it, but

didn't plan on doing it anytime soon, as he already has a huge waiting

list of THR patients.

My experience in England (where incidentally, the BHR operation

was almost half the cost of having it done in the U.S., even though I

was in the hospital for a week instead of just 2 or 3 days) was that

they were super careful about everything: drugs, identifying the

correct leg, chest X-rays and EKG's and lots of other tests

beforehand, several X-rays afterwards, a nurse by my side constantly

for about 18 hours after the operation, and all my vital signs

monitored very often for at least 2 days post-op, by which time I

could march down the hall with my walker and tell them if I had a

problem...

I was really happy I went to Birmingham because to the staff there

this was a common operation, and they all knew how to deal with it, to

the point of having printed handouts to give you on exercises, what to

bring to the hospital, side effects that might happen, etc. Even

though the nurses and other staff encouraged me to get up and walk

with aids, take a shower by myself, etc., they were also very helpful

and caring, not totally rushed off their feet, and they would offer to

do little things to make me more comfortable, reassure me about my

worries, etc. I didn't get this kind of soliticitousness from the

doctors, mind you! And I wasn't very happy about the general

anaesthetic and the ventilator, but I do have only an 11 cm. incision.

Anyway, I'm sure I benefited from being a private patient in a

private hospital (I understand the waiting lists for the British NHS

public system are just as bad as the waits in Canada), but from what

I've read on this board, my care in the U.K. was as good as (if not

better than) any treatment available in the U.S. or elsewhere. The

nurses told me that people come from all over the world to have their

surgery done by McMinn or Treacy in Birmingham.

Another plus was that I was given a fixed price in advance, and

any extra drugs or return visits for problems that cropped up in the

next month would also have been included, so I didn't get any nasty

surprises. Because I was staying an hour away from the Birmingham

hospital after my discharge, they also arranged for me to get my

staples removed at another Nuffield hospital closer to Coventry. Yes,

it's too bad that I don't have any follow-up care other than from my

GP here in Vancouver (I'm still on the waiting list for an OS who does

resurfacing; maybe my other hip will need it by the time I get to see

him!), but I was told by McMinn's office that he (and Mr.Treacy)

trained the surgeons here, and would contact them and arrange for me

to see one of them promptly if I had any serious problems.

So for those who haven't had resurfacing yet, and are wondering

whether to opt for a resurface or a THR, don't be afraid to go to

Europe despite what some American and Canadian O.S.'s may tell you

about European health technology. Sometimes anecdotal results are all

we have in the short time we have to make life-changing decisions, and

from what I've learned from everyone who's had one, if you are a

suitable candidate for a resurf, it's the option to try first. At 12

weeks post-op, I can't testify to the longevity of my resurfacing, but

I do know the recovery time compared to a THR was a lot shorter, and

friends who have had a THR are amazed at how well I can walk at a time

when they were still trying to adjust to their reconfigured hips.

The other big " plus " about Europe is that both McMinn and DeSmet

will look at your X-rays fairly promptly, no charge, and tell you

whether or not you can have a resurfacing. Then at least you can make

a more informed choice, even if you go somewhere else for the surgery.

They also have so many years of experience that they are able to

resurf patients that O.S.'s in Canada and the U.S. think are too

difficult or too old, and there are several on this board who have

benefitted from going abroad when they would have been limited to a

THR in North America.

n

rBHR Oct.17/03 McMinn

> I would just like to point out that it is a misconception that the

UK is way behind in quality and technology - the World Health

Organisation's ranking of the World's health systems ranks us as 18th

with the USA 37th - source

http://www.photius.com/rankings/healthranks.html

>

> Rog

[Guest guest]

Dear Mr. Dailey

" at the risk of offending my 'compassionate conservative' friends " -I

think you can be more responsible than that. You start out your

posting wonderfully, and I appreciated it. Then you place a

political swipe in there. " God bless the thinkers " - please take

your own advice and think before you post. You are entitled to your

political views, and yes you have the right to post them where ever

you wish - and of course so do I. But lets have the courtesy of not

diminishing the value of this site by making it a political forum

even in the littlest bit.

Joe

> >> I would just like to point out that it is a misconception that

the

> > UK is way behind in quality and technology - the World Health

> > Organisation's ranking of the World's health systems ranks us as

18th

> > with the USA 37th - source

> > http://www.photius.com/rankings/healthranks.html

> >>

> >> Rog

[Guest guest]

Very interesting report, Rog. As it points out, every country

could do a lot better in different areas. I note that Singapore has a

much younger population (and its size is very small), so it's not

really comparable to a very large country with a more evenly

distributed range of ages.

You might not be aware that the author of the report is a

member of a VERY right wing organization in Vancouver. So she probably

has a bias towards allowing private healthcare, but even some of the

biggest supporters of strictly public healthcare feel that our system

needs a major rethink, as the way it is financed is discouraging

hospitals from doing surgeries. In my province, at least, the

hospitals get a block budget every year, rather than being paid so

much per patient service, although the doctors are paid on a fee for

service basis. Since surgeries use a lot of resources, hospitals can

treat a lot more patients if they do more of the less expensive

treatments, and less surgery. In fact, the way the funding is

structured, if a hospital just paid for its staff and overhead, and

took no patients, they would look like budgetting stars, from a

" bottom line " mentality point of view.

Of course, our government also considers services provided, but

they haven't really got a handle on the damage caused by long waiting

lists for " elective " surgeries such as resurfacings and THR's, and for

diagnostic services such as MRI's and CT scans. The number of patients

who " vote with their feet " by paying for such services in countries

where private health care is allowed, shows that we have some serious

problems to deal with. And with the baby boomers all getting older,

the demand on the health care system will only get worse in the next

few years. Ironically, resurfacing, which could save a lot of money

paid for other services such as drugs, physiotherapy, cortisone

injections, disintegration of other joints such as knees, etc., is not

widely available.

n

> Hi n

> Another site may interest you which is Canadian is

http://www.davidgratzer.com/report1/toc.html