Maybe We Shoud Be Glad We Live in America

Just read this depressing article from the BBC. Another Gold Star for the NHS.


Or not …

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Wow! That’s awesome. What great news for PWD in the UK.

That is great news!

The device will be funded for people with Type 1 diabetes from 1 April 2019, from next year’s funding growth for local health groups which will allow access to flash monitoring throughout the country.

That’s wonderful news. I’m glad the NHS has seen fit to do what medical insurance companies have been doing for me for 12-13 years.

If I waited for them, I’d be dead by now

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I suppose we’ll just pretend that all the Americans that currently don’t use one because they can’t afford one don’t exist…

Access to care is limited here as well. It’s just based on income rather than postal code (though there might be a bit of that here too).

Glad to hear that the UK is changing their policies.


@Katers87 I’d bet you there are many more PWD’s in America using CGM within the past 13-14 years than in England.

When you have someone like the NHS doling out the medicine a lot more people suffer. I’m not saying that healthcare in America is perfect (far from it), it’s just a heck of a lot better than England under NHS.

I tend to see this opinion a lot more among people who are on Medicare which has a fairly high approval rating in the US. Also, people with really good insurance through their employer or who are fairly wealthy tend to feel this way.

Whereas my non-D sister (yet still has some big medical costs) who just got kicked off my parents policy is really trying to figure out how to manage to pay for both rent and her employer-subsidized health insurance (or the high deductible of the fully covered plan), nevermind covering food! Hopefully she’ll make more money one day, but she’s going to have it pretty rough for awhile.

Public opinion in the UK is actually pretty positive toward the NHS. If you simply google public opinion of NHS, you’ll see lots of articles documenting this.

I’m not convinced of this. I could post all sorts of anecdotes, but I started wondering if you knew of any sources that had somehow compared the suffering of individuals as a result of the healthcare system between these two countries.

It’s a hard thing to quantify! I’d also be interested in any surveys of people with diabetes in both countries.


My guess is people would pick what they know, because generally we fear what we don’t know. I’m in Canada and generally, I’m quite happy with our system and, sure, I’d make minor changes to it, but largely it works. The system in the US would terrify me if I ever moved there.


That’s probably true for most of Europe.

I doubt that. I think more people have access to healthcare in the UK, but quality may sometimes be lower. What do you think of the so-called iron triangle of health care?

That’s definitely true for me. I would never trade the Dutch system for another country’s system. It may not be perfect, but with regards to quality it is one of the best systems in Europe and insurance policies are not outrageously expensive in my opinion.


I’d probably opt for the UK or Canadian healthcare system over the US- especially if the Freestyle Libre was covered.

I agree with @Thomas that incremental improvements to our healthcare system is the best course of action. I’d prefer large increments though. :grinning: A complete overhaul would cost way too much to get through congress anyway.


It’s not covered yet (in any province), but many people are advocating for it. So I think it will come eventually.

Sometimes, I think it may be significantly cheaper for me paying only for the Dexcom and a portion of some other medications than it is for someone in the US paying for a portion of everything from doctor’s visits to lab tests, all things that are 100% covered here plus the cost of insurance itself.

It would be interesting to do a yearly healthcare cost comparison.

I did a comparison with the Netherlands once, assuming I paid out of pocket for the Dexcom (and couldn’t use Afrezza anymore). I actually emailed Dexcom and requested a quote for how much I would pay while there. They said there’s a small chance I could get it covered under a hospital benefit??? I assumed I couldn’t though. I calculated that I’d spend around a $1,000 more there (I forget the exact amount), but I’d have a much lower salary. However, if there were ever a medical emergency there, I’d be in a much, much better financial situation than I would if I were in the U.S.


Most patients indeed aren’t eligible. Hospitals have a limited budget to spend on CGMs for patients with hypo unawareness, HbA1c > 8% and pregnant women.


The problem is that getting to a Canadian or European type healthcare system would require completely re-engineering what is covered in the US. i.e. in most of the rest of the world there are limits based on therapy, age, etc.

None of those things have been palatable enough to be tackled by our politicians. And when California, arguably the most receptive state to a single payer initiative, investigated the costs they discovered that covering everyone with our current system (i.e. few limitations) would cost over $400 billion, and the initiative was mostly dropped.

So it would seem that change is unlikely unless something really big changes in the coverage assumptions in the US.


I’m a little confused. Are you saying that you would choose the US health care system because you feel that the providers and health outcomes are overall better here (regardless of cost)? Or am I misunderstanding, and your comment wasn’t regarding that part of the discussion?

If that is what you were saying, is that an opinion or fact?

And given the huge regional differences in opinion on this topic, in the end you’d probably get a compromise that satisfies nobody anyway.

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In the opinion of my British and Swedish relatives – which is to say all of them but two – the prevalence of, and reliance on, private health insurance (and the many who profit from it) is the biggest obstacle to a single-payer system. England, Sweden and Canada had the advantage of starting their public health care when nothing else was in place. (The UK and Sweden have private health insurance, but only about 10% of people have it, and in Sweden at least, it may get you to the front of the queue but you get the same service as everyone else, so most people don’t bother. About two-thirds of Canadians have private insurance because a lot isn’t covered by provincial plans.)

Your fellow Americans appear not to agree (unless things have radically changed since 2013).

Again, an eleven-country survey doesn’t support this. For example: “In 2013, more than one-third (37%) of U.S. adults went without recommended care, did not see a doctor when they were sick, or failed to fill prescriptions because of costs, compared with as few as 4 percent to 6 percent in the United Kingdom and Sweden.”


I have been in healthcare for over 41 years and would have to clarify this “finding”.

People put off healthcare for financial reasons because they would rather spend their money on something else. For instance, I have done countless root canals and crowns, each costing thousands of dollars, on teeth that eight or nine months previously could have been treated with a simple restoration often for less than $100. But the patients did not deny themselves the luxury of driving to the dental office in their new Cadillac.


True, but wouldn’t it be better if they didn’t have to make such a choice in the first place?