What Can We Learn from the UK Health System?

January 22, 2015
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uk health systemsThere’s no perfect health system in the world, at least not that we’ve heard of. The US is plagued by high costs and uneven coverage across the country. Other systems like those in Canada and the UK have long wait times and can be glacially slow to adopt new technologies (aka pilotitis). However, taking a closer look into those systems can provide an interesting alternate viewpoint.

uk health systemsThere’s no perfect health system in the world, at least not that we’ve heard of. The US is plagued by high costs and uneven coverage across the country. Other systems like those in Canada and the UK have long wait times and can be glacially slow to adopt new technologies (aka pilotitis). However, taking a closer look into those systems can provide an interesting alternate viewpoint.  We’ve recently been turned on to the Inside Health podcast from the BBC, where topics range from those of national healthcare administration and benefits to specific health issues. Unlike many health publications, Inside Health frequently features patients talking about their experiences with the system.

Here’s a snapshot of questions posed on recent episodes:

  • Should medical screening with MRIs and CT scans be done proactively? This session talked about the risk of over-screening patients who are not visibly ill. While early detection is key to catch and treat many types of cancer, the screens often catch issues like tumors that would have gone away on their own, and therefore cause undue stress, cost, and discomfort to patients.
  • Should fruit juice be removed from food guidelines? Citing that calories that are drunk rather than eaten are not recognized by the body (aka empty calories) and that most fruit juice has all the fiber (aka the best part of the fruit) removed, the guest argued that fruit juice should not be part of the 5-6 services of fruit and vegetables recommended per day.
  • How should private hospitals be regulated? This story was particularly interesting, as it seems that the many private hospitals that are cropping up to take excess demand from the UK’s National Health Service, are not regulated in the same way as government-run hospitals. In this episode they examined some cases of knee and hip replacements gone wrong due to the lack of proper follow-on care. Since private often denotes more expensive and hopefully better quality it was curious to hear that they were not following standards.
  • Should healthcare professionals be fit? This controversial question was asked about whether healthcare professionals should be held to higher health standards, especially with respect to obesity, to set a good example for patients.
  • Should doctors be paid based on specific quality measures? This segment examined financial incentives for primary care physicians to complete certain tests and concluded that doctors will ignore financial incentives if they don’t believe the tests are in the best interests of the patients. However, in the example they cited, the incentive was $50 for doing a standard depression screening test which might be argued is not enough compensation for the hassle of the additional charting and follow up that the depression screen would have caused, not to mention the impact on patients who might not have actually been depressed.
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You may notice a slightly paternalistic (or is that maternalistic?) bent to these topics, which is understandable as the UK has a national health system. However, all of them are topical and relevant to discussion occurring in the US right now. (Remember the uproar over soda sizes in New York?) Segments are short and conversational and feature real patients. Plus they are all delivered with the dulcet tones of the BBC broadcasters so you feel smarter just by listening. If you’re looking for insight, and inquiry in healthcare, this is a great podcast to add to your list.