Smile you are going to live for ever – on a trolley

I am a GP. Yesterday during the height of the A & E rush hour, seven p.m. to midnight, I sent a patient to my local district hospital. She had a complex disorder requiring an MRI scan, extensive blood work, the opinion of a specialist, and a decision on admission. A mistake would have had dire consequences. Within five hours a diagnosis was made, treatment started and the patient allowed home. There was nothing about it which struck me as at all unusual. The only time I recall things being very difficult at my local hospital was during the height of a flu epidemic a few years ago. It did not last long.

The key to the success of the NHS is its system within a system, with urgent decisions being made by doctors strictly on non bureaucratic medical criteria. Crushing central chest pain will have you in A & E within the hour, a serious road accident even quicker, a stroke in 45 mins…If you have a lump in the breast you will be seen in two weeks.Meanwhile non urgent diseases mill about in a therapeutic no mans’ land, at the beck and call of barely literate booking clerks.

So why the press hysteria ? It’s good copy as long as you don’t compare the NHS with other European countries. Why? Because the same problems exist everywhere. The UK is average for A & E waiting times. If you were to fall ill in Ireland tonight you will wait longer on a trolley than you do here, even though they have a health service which insists if you do not have a GP’s letter you must pay €100 to be seen in A & E. In France it is not much better, nor Italy. The demand for health is insatiable leading to patients on trolleys all over the world. As patients get older and migrants flood in the trolley queues will increase – everywhere.

Meanwhile in laboratories scientists are busy deciphering the Great Book of DNA to understand why we get old and how it can it be prevented, how to grow new organs from old, or harvested from pigs, and how to make the demented sane again. This coming year there are plans to graft the head of a paralysed man onto a new body. How in our new bodies we will smile! Using stem cells it is now possible to regrow rotten teeth to their pristine state.

Lefties predict a world in which only the rich will be able to afford such treatments, but like computers, the history of medicine is that treatments get cheaper. A course of penicillin in 1950 cost the NHS £200, today it is 2p.

If we are going to be made afresh and cheaper by the week, will there be any need for babies? Economists worry that in the long term, given profligate money printing governments, there is no way of currencies remaining stable. In future will the most prized paper be a government issued baby licence instead of bonds or gilts ?

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6 Comments on Smile you are going to live for ever – on a trolley

  1. Pharmacotherapy. 2012 Jan;32(1):1-6. doi: 10.1002/PHAR.1005.
    Comparison of prescription drug costs in the United States and the United Kingdom, Part 1: statins.
    Jick H1, Wilson A, Wiggins P, Chamberlin DP.
    Author information
    To compare the annual cost of statins in the United States and in the United Kingdom.
    Matched-cohort cost analysis.
    U.K. General Practice Research Database (GPRD), and MarketScan Commercial Claims and Encounters Database, a large, U.S. self-insured medical claims database.
    We initially identified 1.6 million people in the GPRD who were younger than 65 years of age in 2005. These people were then matched by year of birth and sex with 1.6 million people in the U.S. database. From this matched pool, we estimated that 280,000 people aged 55-64 years from each country in 2005 were prescribed at least one drug. Of these, 91,474 (33%) in the U.S. were prescribed a statin compared with 68,217 (24%) in the U.K. After excluding those who did not receive statins continuously or who switched statins during the year, there remained 61,470 in the U.S. and 45,788 in the U.K. who were prescribed a single statin preparation continuously during 2005 (annual statin users). We estimated and compared drug costs (presented in 2005 U.S. dollars) separately in the two countries.
    Estimated drug costs were determined by random sampling. Estimated annual costs/patient in the U.S. ranged from $313 for generic lovastatin to $1428 for nongeneric simvastatin. In the U.K., annual costs/patient ranged from $164 for generic simvastatin to $509 for nongeneric atorvastatin. The total annual cost of the continuous receipt of statins in the U.S. was $64.9 million compared with $15.7 million in the U.K. In June 2006, after our study results were analyzed, the U.S. Food and Drug Administration approved generic simvastatin. We thus derived cost estimates for simvastatin use during 2006 and found that more than 60% of simvastatin users switched to the generic product, which reduced the cost/pill by more than 50%.
    The cost paid for statins in the U.S. for people younger than 65 years, who were insured by private companies, was approximately 400% higher than comparable costs paid by the government in the U.K. Available generic statins were substantially less expensive than those that were still under patent in both countries.
    © 2012, Pharmacotherapy Publications, Inc.

    PMID: 22392823 DOI: 10.1002/PHAR.1005
    [PubMed – indexed for MEDLINE]

    • Yes Mr. Harris this is a huge problem. I believe it springs from the “EMTALA” legislation of the early 80s; that nobody could be refused treatment on the basis of ability to pay, that is universal health care by any name but, typically, the US Congress refused to provide funding for what it had prescribed. The result was exactly what I experienced at Largo Health Center; I was charged more in order to cover the costs of those who wouldn’t or couldn’t pay.
      Karl Denninger at has been arguing this for ages; the US health care system is a complete clusterfuck. The problem is that US legislators have bought into the myth of the great US individualism. The simple truth is that we need single payer health care. It is essential because we have so many people in this country who are completely unable to organize their lives on a responsible basis; they don’t have car insurance, or health insurance, they don’t pay their utility bills, they expect YT to provide accommodation, transport, electricity, water, sewage and living expenses, if any of these services fail it is YT’s responsibility to put it right. If we were a white only country we could have a private enterprise health care system that would provide the best care at the best price; but we are not a white country, we have minorities; black particularly but also hispanic and asian who regard it as YT’s duty to provide these services at no charge. Anybody surprised at Trump?

  2. Where I live there are huge electronic billboards beside the highways advertising the A & E wait times in various local hospitals. Typically the waits are between two and ten minutes. I did have to take my wife to Largo Medical Center emergency as a result of bad cuts on the ankle resulting from a mishandled weed strimmer. We were met at the door by a nurse who assessed injury severity. My wife was examined, treated and discharged in about 50 minutes; excellent service! Our last stop on the way out was the payment office; $1,735.00 (+ $500.00 to be invoiced later for the doctor). A bargain! The price was that high because being white middle class we were able to pay, the emergency waiting room had many Mexican itinerants and blacks with trivial ailments who would not pay anything.

  3. At least it’s still reassuring to know that if you have symptoms of a serious disease you will be seen quickly, the case being judged on medical & not bureaucratic merits. A few years ago I went to my GP’s with bowel symptoms which could have indicated cancer. He had a special book for entering patients that were to be fast tracked for specialist examination. I was seen within 10 days. Fortunately it turned out to be IBS.

  4. ‘Immigrants flood in.’ Yes they do don’t they? And one good reason is that they get free health care as well as a multitude of other benefits.

    One way of stemming this flood, which is putting such a strain on our services, the green belt and on us personally, is to inform would-be immigrants, including so-called ‘asylum seekers’ that should they make it into this country, or the West in general, that they will get nothing from us. No Housing, no access to benefits- nothing. That would stop this flood in its tracks, I suggest.

    Any judgements of the Court of Human Rights etc denying such an approach should simply be ignored. They are left -liberal devices to ram through their agenda by by-passsing democracy should simply be ignored.

    We are being invaded by hordes of people many of whom actually loathe and despise us and are here solely to get what they can out of us .In such a situation, decisive measures are required.

    • My two sons work and live with their families in UK. They pay all the taxes they are obliged. However, they also pay to have insurance health in Portugal and they use it. Each time they need to go to a doctor, they fly to Portugal. Why? Because the NHS is so bad, with a lot of non qualified professionals, many of them educated in some low level third world university.
      So, they subsidise UK people. Be careful before you attribute all the evil to all immigrants. Choose better and include the millions of English who don’t work, don’t pay taxes and live from benefits…