New from London UK

[WheelieBear]

Hey there,

Unlike a lot of people on here I didn't suffer a horrendous accident, crashed car, motorbike or heavy object dropped on me.
I'm one of those unfortunate people who have back problems, two burst discs surgically excised from my lower back L2 and L3, after a long
period of severe sciatica which weakened my leg muscles. The surgery (17 yrs ago now) relieved some pain however the damage to nerves
has caused compressive neuropathy, so I just fall over constantly. I also have Osteoporosis and Arthritis.

I use a Drive Prism Sport Scooter outdoors and an Invacare Action 2NG Manual chair indoors to get around.
I also have an old Drive Mercury Mambo Mini Powerchair in the shed which requires 2 12v 36 amp GEL Batteries (too expensive to replace)
After a serious fall I broke 3 bones in my right shoulder and ended up with a cuff tear, after that surgery 5 yrs ago I can't raise my right arm above 90°
or behind my back without severe pain. Hence I struggle outdoors with my manual chair, fine if I want to go round in a counterclockwise circle!

Anyhow, due to the awesome Disability Support System in the UK (Sarcasm), I get very little help. on Middle Rate DLA (Disability Living Allowance),
because, to get max support an employee within the Department for Work and Pensions more or less told me, you need to have No arms and Legs and be Deaf and Blind.
*Sorry no offence was meant to be given for writing this.

So, hello to all of the awesome people here,
let's work together to beat these crazy prices people without medical insurance simply can't afford, in order
to have any quality of life.

WheelieBear (Paul)

[Burgerman]

Anyhow, due to the awesome Disability Support System in the UK (Sarcasm), I get very little help. on Middle Rate DLA (Disability Living Allowance),
because, to get max support an employee within the Department for Work and Pensions more or less told me, you need to have No arms and Legs and be Deaf and Blind.

I see you have discovered the joys of socialism. Try asking for a free NHS provided powerchair.

[martin007]

Hello WheelieBear

[WheelieBear]

Thanks for your replies.

I did vent a bit in my, "Introduce Yourself" post.
Socialism,yeah.

I'm a believer in a Capitalist, competition driven society. I'd still like to think that the clever design engineers making
equipment to HELP us, wouldn't see the disabled as a cash cow or and insurance blank cheque.

Cheers guys

[Burgerman]

No I wish they did! But because of the socialist NHS theres no competition, no end user with the money, to please. And so we get exactly what we get.

[sacharlie]

You complainers should be careful of what you wish for.
The great capitalistic system here in the USA would leave y'all asking "what happened".

[Burgerman]

Your medical system and the way it is paid is as far from capitalist as our is if not even more so. Which is why your pricing and options are so mental.

[sacharlie]

Is medical bankruptcy an issue in the UK?

[Burgerman]

No, but a lack of care, dying on stretchers in corridors with no free beds is most winters. Would you prefer to be dead or in debt? Or waiting years for operations, being unable to get a doctor appointment? Thats the reality of socialist medicine. We go to the US for treatment. Average wait in an emergency room before being seen can be 10 to 20 hours. And thats average. Ambulances get turned away. If you can get one.

And this is the socialist lefty liberal paper! The one that loves anything socialist.
https://www.theguardian.com/society/201 ... heresa-may

[LROBBINS]

John,

Seems to me you have a distorted notion of what the U.S. medical system is like and think that there's massive government involvement. Even for "approval" of chairs, there's almost no regulation. They are almost always approved as "essentially similar to existing devices" with neither engineering documentation nor testing required (the "balancing" chair you tested was an exception because it departed in major ways from "standard", and even then FDA approval was far easier than certification of an airplane, even a 2 seater). The real problem is that the "customer" in this capitalist market is the insurance company. They know nothing at all about wheelchairs, and they simply take what the mfr tells them and then negotiate a discount without ever asking for a cost justification, or making any attempt to calculate a cost of production and marketing estimate of their own. They do track sales and prices paid. Thus, in order to keep the price to the insurance company high, the manufacturers and dealers will never sell significantly under list price to individual users (or the insurance companies would know they're being had).

BTW, the same FDA approval procedure also applies to other medical devices. So, for example, a new pacemaker (or artificial joint, or stent etc.) will be approved because it is "essentially similar to existing devices", and those existing devices were approved because they were "essentially similar to existing devices" back for decades to where there was no approval required at all for the first pacemaker (or other device) because there was no law mandating any FDA review for medical devices. In Europe, certification is passed on to private outfits like the TUV and is probably even less demanding, and in many other countries, they only check (if they check at all) that it either has a CE mark or is approved for sale in the U.S. Pricing for these is based on the same "free market" between seller and the insurance-company purchaser.

The same pricing scheme applies, with one major exception, to hospital and physician services - doctors and hospitals do not have to, in any way, justify why they bill $200 for a pill of acetomenophen (paracetimol). Hospitals will not tell patients in advance what they will be charged, and in most cases it wouldn't matter even if they did as there's likely to be only one hospital in town (or usable by the patient in a large city) anyway. The insurance co. tries to negotiate down from whatever the hospital or doctor says, then declares that only the lowest priced ones are "in network" and will reimburse only that amount. If a patient goes to an "out of network" provider, he/she gets to eat the difference.

The one exception are two government programs - Medicare for the elderly and disabled and Medicaid for the indigent. Medicare pays on a "cost plus" basis, so demands cost justification from providers. Medicaid simply pays Medicare rates. That means that Medicare always pays less than what private insurers pay. Hospitals and doctors are forever grumbling about this and threatening to not accept Medicaid or Medicare patients. BS. You just have to visit a city like Miami, with a high percentage of elderly, to see all the billboards promoting this or that hospital or medical practice to Medicare patients - and guess what, those hospitals are making nice profits and paying their administrators million+ dollar salaries. Of course, Congress saw fit to enact a law forbidding Medicare to negotiate prescription prices - so pharmaceutical companies have almost no constraints on their pricing, especially for in-patent drugs where it's pure monopoly pricing. Not exactly a "free market" for drugs.

Italy has an almost entirely government-run health system, somewhat different from your National Health, but still "socialist". Having lived half a life in the U.S. (where I had, and still have excellent, albeit expensive, employer paid insurance), and half my life in Italy, I do have some basis for comparing costs. For example, a colonoscopy in the U.S. will cost the insurance company on the order of $6,000. My 10% cost-share for a colonoscopy in Italy would be E50, and the government gets charged the remaining E450; total = E500, about 1/10th of the U.S. price. Of course, after age 55 we get one free colonoscopy every 5 years, so I didn't even have to pay the 10% when I needed them.

So, the U.S. system is oligopoly capitalist with almost no government involvement and the Italian system is socialist (with private pay available for those in a rush for elective services - waiting times for non-urgent services can be looong). Guess which one I like better, and guess which one has far better health outcomes for the bulk of the population.

A real capitalist free market, with shopping by individuals who can know real prices and choose suppliers, might be better than either, but if you think anyone has a system like that - dream on.

[Burgerman]

But it would be better than either of the above because those are vastly distorted markets.