Incentivised medicine!

I'm currently wondering how "fair" it is that some people are able to buy better health care than others, purely because they have the financial ability to do so. I'm not entirely sure what the systems are like in the United States, but in the United Kingdom, we can use the state system if we wish, or we can pay to use the private system although the price is a hefty one at times. Here is my blog entry with just a few of my thoughts on the matter. Sometimes, I feel bad for using the private system because it feels like an abuse and an injust use of money. But, if it's available, legitimate and not frowned upon largely by society then is it alright? I'll never know! But for sure, part of me feels guilty for it.

I'm in the U.S but I'm confused. Why would you feel bad for using something you pay for? Or was it a typo? Or did I simply misunderstand.....I didn't read you blog link, sorry.
In the U.S, every state varies in what healthcare is provided or can be provided. I was actually taking a health insurance class when I had my stroke (I was not literally in class LOL). I was only a couple weeks into the class so my information is limited but I learned enough to know that my state only provides the minimum of what the government requires each state provide.
Medicaid is a state provided insurance program for people or families that meet federal family poverty level guidelines. Minimum requirements are: to be poor (obviously), under the age of 21, disabled, or pregnant. In the state of Texas, these must be met and only those that qualify under these guidelines will receive coverage. I received Medicaid for both pregnancies and it covers anything and everything that involves the baby and that includes a craniotomy for the mother who suffered a stroke due to a burst cerebral avm. Once you have the baby, both mother and child remain on medicaid for the next 2 months (60 days) when the mother is dropped from the program and the baby is transferred to its own plan. If there is a miscarriage, the mother remains covered for the first month after miscarriage. Both my children are covered by state insurance. I don't qualify even though I'm disabled because I'm not on SSI, only SDI, yes there's a difference.
My sister is in Connecticut and their Medicaid is different. Because her kids qualify for Medicaid, she can piggyback off their plan, they don't do this in Texas. If she lived with at least one of the fathers of her four kids, that man would also receive coverage...my husband will never qualify for medicaid in the state of Texas.
Because of my avm and resulting disability, I had to get on a county program because there is no way I could afford a private plan...or even get picked up because of a pre-existing condition which is complete BS and unfair. But, at least me and my husband gets coverage now, even though it's an indigent care program. At least we don't have to worry about denials due to my pre-existing condition or not getting treatment because we have no insurance.
As long as you don't abuse the system, then I don't see why anyone would feel bad about using it. It's why it's there in the first place. It's people that fraud the system that make getting things like disability or housing or foodstamps (I don't know of ya'll have foodstamps or S.N.A.P.S like we have here in the states) difficult. We only had medicaid for the pregnancies and the boys and S.N.A.P.S until we were both working again. But then this stupid stroke happened and now I'm learning what I didn't know about the "system" the hard way. I feel guilty for being on all these government and state programs but without them......there's no telling where I/we would be.
So....yeah, don't feel bad for taking advantage of programs that are put in for reasons such as the ones you have. Took me a long time to get that point out LOL.

It's just that I'm not sure I agree with the principle of being able to buy better health care, as in use private health. But yet, because I am able to do so, I do. I use it because it's convenient for me and has benefits, but I feel sometimes that the principle is morally incorrect. By that, I mean the existence of the private system. But of course, there are things that I can't fault about the private system - I know my thoughts and words won't change anything but was just having a ponder about how money has really gotten into everything these days!

Pre-existing conditions are pains in the necks here too. I was on a basic insurance plan before that covered diagnosis only (I think), meaning that we had to pay for all my surgeries and OP appointments. Think we were spending about £1000 per month at least (excluding X-rays, MRIs, MRAs). But they upgraded us after two years because we are "loyal" customers (we've been with them since 1999). So now they cover everything for around £80 per month subscription. It seems unfair to the people who have to wait for ages - I couldn't imagine waiting months to be seen about my AVM or have my operations because the quality of life would have been so bad near the end.

But then the private system relieves the NHS of pressures. I could go on for a long time, but won't! The U.S. system seems so much more complicated than the one we have here, and I've heard from some people about how hard it is to get care! But thank you for taking the time to inform me about how it works over there - I hope to work in the U.S. some day, as a doctor!

I just finished reading your blog post when I got your response LOL. I actually read your other blog when you post the link. I just have a bad habit of not looking at who posts what on this site. I have to do things in a specific order or I will forget what I want to say LOL. Being a recovered avm'er is horrible sometimes:) I don't know what NHS is but it sounds a lot like the indigent care programs here in the states. In most counties, from what I understand, you don't have the option to have private and county unless your private coverage is extensively limited in which case Medicaid or your county's indigent care program may pick up the slack. From what I understand, not all counties have these programs and so patients are forced to ask/beg for charities through church or privately run fundraisers. If I had not been pregnant during my stroke, I have no idea what would have happened. I don't even know if I would have gotten scans (MRI's/MRA's) that day without Medicaid. But because of the coverage I had, the pregnancy and urgency, I was treated immediately. I received very good care and treatment and was not treated like poor trash. I don't know about over there but the food I ate was delicious in the hospital:) I even got my own menu. My favorite was the chicken cacciatore and I ordered it like every other day LOL. My appointments afterward were made with very little wait time, aside from the offices just being busy in general.
Once I got on the county indigent care program, however, the wait time is forever long between appointments. I've had this neuro appointment since April, I go July 18th LOL. My husband made a dental appointment in June for a toothache that he STILL has....he doesn't go to get it pulled until August! And you have to see your primary care physician for a referral and all that jazz like you were saying in your blog. It's ludicrous what they make you go through. And there is a level of down-your-nose treatment that you have to accept as a patient on this type of program. You are treated as lower class and there's really nothing you can do about it. I compare it to sexual harassment LOL. They tell you, as an employee and a woman, that sexual harassment is unacceptable and that you should report the offender whenever possible, as soon as you are harassed. BUT once you do, you're permanently labeled as an undesirable employee, a rat, a finger pointer. People don't want to hire you and when they do, people (i.e, co-workers, employers) are guarded when they are near you and I imagine that's why people would rather be harassed than to be labeled this way. But I do my best to shrug it off. My husband on the other hand will cuss a doctor out in a heartbeat if he feels mistreated or that he is being judged too harshly. That's why I make him join me in my escapades to the doctors! Without him, I'd probably still be living with horrible migraines and no medicine LOL
Good luck with working in the medical system in the states! Maybe since you've gone/are going through the bad sides of the system (regardless of country) you'll be one f those doctors that makes exceptions and will accept patients outside of your network. Those people are awesome.

In the UK it's slightly different. The NHS (National Health Service) is what the majority of people use - the state system which is totally free and funded by National Insurance (type of tax they whack on everyone!). But the country's needs have changed and the system is under strain, as are the Government in power at the moment. The NHS is "staple", if you like - it's there for each and every person to use and going private is only done by a relatively small minority of people.

That's the thing about getting referred. If you want it done the bog standard way, it's a matter of months. If I pay (which I do at the moment), it's done in days, fact. This is why I've gone the private route; because the facilities are much better and it's quicker to get into. I suppose my issue doesn't lie within the moral correctness of having a private system but more with how desperate the NHS is for some change. Like your husband, there are so many people waiting months for rudimentary health care! I've applied and got a conditional place at medical school and am really not sure of what type of system I'm getting into - but for sure, if things stay this way, it's not gonna be a good one!

It's true that paying gets you treated differently! Because the hospital I go to is the private wing of the Govt hospital, once the people realise you're a private patient, suddenly everything changes and you're number one on their list! This is also what's disturbing for me - just because I pay, it doesn't mean I want to be treated differently. I just want everyone to be treated equally because I hate being made to feel superior as this isn't true; not the case at all.

And for sure, if I go to the US to work, I'm totally going to be one of those doctors you mention! I don't plan on being fully money-orientated and hopefully I'll be a good doctor too. I just hope never to see AVM sufferers, for we all hope it'll be history then! ...since I'm not even in med school yet LOL