American treatment Vs. UK treatment

[slowpoke115]

I remember reading a journal a few years ago basically saying care for diabetes in america is really poor compared to the rest of the World, it was put down to lack of free health care and the whole "I can't be bothered attitude" and the fact that the nation faces a bit of a food addiction, which can't help! I think it still remains a fact that america has the highest rate of type one diabetic amputees in the World.

Just wondering if this is complete **** or whether Americans are as lazy as the article made out, biased opinion but I'd assume diabetic care isn't as good as other places. I hear Switzerland has brilliant care? Having said all this in the UK our doctors live off the government so i imagine our doctors are less devoted to their work, then again they have no control over patients.

Just interested ofcourse :)

[caryj]

All of the doctors I have seen over the years are far more commited to their research than their patients. Which is fine for me--I don't require much hand-holding.

But the study you speak of sounds like it is a very biased opinion. I know plenty of T1s who lead very active lives (a couple of ironman triathletes too).

The difference in our healthcare system are quite apparent -- those without the means do not get proper care (the best, most advanced) -- this is the horrible truth in the US.

[Ailsa]

It would be interesting to hear from some Americans on that, but my impression is that it's pretty good. I base that on the high percentage of pump users which is clearly the best available treatment.
Only a small minority use pumps here as you have to purchase the pump & consumables yourself, & I gather the UK is pretty much the same. Lantus is not available to all who need it here either . To get it funded (only recently possible) you have to apply & have a good reason. Having T1 in itself is not considered a good reason!!!!!

I think the "food addiction" is a world wide problem these days, & is really a T2 thing.
If you look at stats in the Uk for amputations I'd surprised if they're much different to the US. I know its a major problem here. My personal opinion is that a lot ot T2s (certainly not all) don't take their condition as seriously as they need to - & of course there are also some T1s who fit that criteria. That's not something you can blame anyones health care system on. It's about personal choice.

[Harold]

Maybe it was true a few years ago, but not any more. Funny you mention Free Health Care since that is probably the reason it has become better here. Any bureaucratic system has a hard time changing, and the longer it has been in place the more resistant to change it becomes. A lot has changed in the last few years and self management is probably the biggest one. The free health care system, which is not free, has been slower to catch on to self management and be implemented, than here in the States. Unfortuanately we still have Doctors and patients that are slow to catch on. Doctors that think they can manage diabetes better, seeing a patient once or twice a year, than someone that lives with it day in and day out and has the tools and will to manage it themselves. We have been Empowered! There are also so many patients that fall into the doctor will take care of it and all I have to do is take the magic pills that cures it. Also the ratio of the population with diabetes is increasing a lot faster in some of the other countries now and are catching or surpassing the US.

BTW type 2 is the leading cause of amputations in the US, and I expect it will pass land mines in the rest of the world someday.

[Cyborg]

I think we have great health care here in the U.S. I wish it was not so commercialized and expensive, but it is very good.

With 300 million Americans, there are lots of us. There are many overweight people and I'm not sure what the exact cause is. Perhaps too many conveniences such as cars, computers, tv's, etc..., but also perhaps not enough time to work, raise a family, exercise, etc... Ultimately they are all excuses, IMO.

[Funnygrl]

I think that there are plus sides and down sides to healthcare in the US. 40 million people don't have insurance here. As in any type of healthcare insurance. I doubt those people that have diabetes among that group do a good job managing it.

I do have insurance. As a result, when I asked to go on the pump, my doctor faxed over a script, I paid a $10 copay, and I had my pump the next week. That's a very rosey picture of getting a pump here though.

I can also see any specialist I want without a referrel. I saw three endocrinologists before I found one I liked. Now I have a great team on my side, plus the best resources to manage my disease.

[JediSkipdogg]

I agree that there are many pros and cons to both countries system. Personally, I think there needs to be a little of each. There needs to be the free enterprise system like we have in the US. But there needs to be tighter control on prices and visits like the UK has. I think if the government in the US just tightened control on prices of drugs, we'd have a great system. When a drug company can say they are still recovering drug costs on a drug 20 years down the road, that's bogus, even when they make billions in profits a year and the research for one drug only cost about a hundred million or so.

[Cyborg]

Hey, with Canada right next door with it's cheaper drugs, there's no reason why we end up paying so much for our meds in the U.S. Oh, except maybe of GREED...

[Catareta]

The NHS is great if you are not complicated... they are understaffed, and have a severe lack of resources...

I was offered Lantus as soon as I changed my Endo...and I am thankful. The pump situation here is strange. Because each PCT (Primary Care Trust) has certain funds, diabetes in my area gets about £20,000 pa... that'll pay for 3-4pumps for quite a large population...

[DeusXM]

From what I've read, American healthcare is right up there with the best in the world. Obviously there is the issue of getting what you pay for, but to write off Americans as either lazy or let down by their healthcare system is inaccurate and in many respects, rather racist. I'm sure a spot poll here would reveal that the American posters here on average have lower A1Cs than us in Britain, mostly because many of the Americans here use pumps. However, that's not reflective either way of a system being 'better' - the reason so many Americans have pumps compared to those in the UK is because in Britain we've got so detached from the idea of actually paying for healthcare that buying a pump is a much stranger and daunting concept for us than our US cousins.

In response to the NHS's merits, like all systems it's only as good as the people behind it. I'm fortunate in that I have a very active team that lets me get on with my way of managing and supports me. They still don't quite fully buy my objection to their advice that we should eat high-carb meals all the time, but they're happy to let me do my own thing. In fact, really the quality of healthcare when it comes to diabetes is less to the health system and more to do with the individual patient, now I think about it.

[Simon]

We do have the option of private health care here in the UK but most don't bother. To go private once you're diabetic would be way too expensive. If you have insurance before being diagnosed however then it's worth sticking with it.

[Funnygrl]

From what I've read, American healthcare is right up there with the best in the world. Obviously there is the issue of getting what you pay for, but to write off Americans as either lazy or let down by their healthcare system is inaccurate and in many respects, rather racist. I'm sure a spot poll here would reveal that the American posters here on average have lower A1Cs than us in Britain, mostly because many of the Americans here use pumps. However, that's not reflective either way of a system being 'better' - the reason so many Americans have pumps compared to those in the UK is because in Britain we've got so detached from the idea of actually paying for healthcare that buying a pump is a much stranger and daunting concept for us than our US cousins.

In response to the NHS's merits, like all systems it's only as good as the people behind it. I'm fortunate in that I have a very active team that lets me get on with my way of managing and supports me. They still don't quite fully buy my objection to their advice that we should eat high-carb meals all the time, but they're happy to let me do my own thing. In fact, really the quality of healthcare when it comes to diabetes is less to the health system and more to do with the individual patient, now I think about it.
If the Americans that visit this forum have lower a1cs, that doesn't tell you anything about Americans in general.

I have a low A1c. My father who has type 2 probably doesn't. But you would never see him on this forum. Why? Because he doesn't think he has diabetes. Nor does he think dwelling on diabetes is a good idea. And I think there are more Americans like him than like me.

[corwin]

I think you get what you pay for no matter where you are. When I was working in the US my employer paid tons of money for a great insurance plan I almost never used. Here in Israel I pay much more money to health insurance, only they don't call it health insurance, they call it taxes, this way I get whatever I want for almost no money. People in the UK pay higher taxes but they get tons of "free" stuff. So someone with great health insurance in the US will probably be better off the someone who just take what the NHS gives for free but if you have no health insurance in the US you'll have easier time in the UK. No matter where you are, you always get what you (or other tax payers) pay for.

[DeusXM]

If the Americans that visit this forum have lower a1cs, that doesn't tell you anything about Americans in general.

True, but let's look at it in context. The sorts of people who visit this forum (irrespective of nationality) are the sorts of people who are going to actively manage their diabetes. In other words, all of us here come from pretty much the same starting point, but overall I would say the Americans get a better end result. Therefore it might be wise to say that their healthcare system isn't inherantly better or worse but perhaps provides more opportunities to do well should those opportunities be taken.

I'm fully aware of how we're a distinct bunch here - AFAIK I've the lowest A1C of everyone in my clinic (if the evidence of the carb-counting seminar I went on is anything to go by). I'm not about to get into a debate as to which health service is better - I've made it clear before that I believe the NHS to be the best idea Britain ever had and I refuse to hear an unjustified bad word against it. I would say though that perhaps we need a clarification of the orginal question. It's quite obvious that American healthcare must be excellent - you cannot criticise the US healthcare system on the grounds that people don't make full use of it.

Perhaps a better way to think of this is how healthcare relates to costs. A system such as the NHS encourages people to seek healthcare solutions because cost isn't an issue. However, once those solutions are found, there's little incentive to perfect a treatment regime. In the US, the initial high cost of healthcare perhaps puts people off seeking treatment (or in worse cases, excludes them from it), but once they have that treatment, I would have thought that they'd seek the best value from it.

Basically I'm just being a bit cautious what I say here because it's far too easy to take potshots at American stereotypes - I'm certainly guilty of it from time to time but hopefully it's not too often.

[mg_2204]

In response to the NHS's merits, like all systems it's only as good as the people behind it. I'm fortunate in that I have a very active team.

I like what you wrote!

And so true! Back when I was diagnosed, the care I received in Canada was not even worthy of the name. I experienced something totally different when I lived in UK. My team was very active too. They were passionate about diabetes. Now that I am back in Canada I have found a doctor and will soon be due for my big check up. Again, the team seems to be as dedicated as the one I had in UK. I feel I am in good hands. A person with diabetes needs a good health care team, simple as that.

Thanks for your insight.

[rzrbks]

The upside, from my perspective is that the people with money are taken care of based on the amount they can pay.

Ins. in the US is so very different from place to place, even just (literally) a few yards apart. Where a person works determines what is available. I have "so, so" care available. Blood strips covered, up to a certain amount; tests and A1c are paid for at 80%, insulin I pay for. Next door, literally 35 feet away, they have no health Ins. coverage and neither do most of the businesses in this strip mall. So, the people would be paying all expenses out their pocket, unless they went to ER and then all of us with Ins. pay for their care by paying higher premiums----much higher costs than if we had NHS.

Thank goodness, the major corporations are finally coming to their collective corporate senses and seeing that a NHS or some sort is the best way to go. UNtil they finally start to push for a NHS, openly, however, there will not be one.

There are too many people who still buy into the scare raised during the 90s

[grace girl]

I wander through the American health care system with no insurance. I have the same quality treatments available to me as those who have insurance, I just have to pay more for it. I could be on the pump if I chose...from what I understand if I didn't want to, or couldn't pay for it up front, all pump companies will GLADLY finance you. My choice not to go on the pump had nothing to do with the financial aspect. I have never felt that I wasn't getting quality care due to lack of insurance. At one point I had the best insurance around, so I've seen both sides of the coin.
I do think that the financial end of it is a problem. My pharmacist has told me numerous times that they (pharmacists) have a problem with Eli Lily (humalog) because their prices are sooo much higher than the makers of novalog, even though they make basically the same insulins. For what it actually costs them to produce the stuff, what they charge is akin to price gouging.
I also find it interesting when the endo's office tells me before the visit what the general fee will be, and then when the endo sees on my chart that I have no insurance she cuts the fee in half. I've seen this at every endo and the CDE that I went to. They are well able to lower costs because they are all milking the insurance industry. I'm not a defender of the insurance companies, but I know that outrageous billing practices are going to be paid for by all of us one way or another.
As to how fast or slow new treatments are accepted, I'm beginning to think that it's more of an individual thing with the doctor and his willingness to be progressive. I've seen a pattern of how doctors are easliy locked into a certain mindset and nothing will bring them out of it. My first endo was all up on the pump and the latest technological advances, yet he wasn't at all interested in how MDI could be used to one's advantage. It was ancient history to him. My new endo is also up on the pump, but she's also well aware of what can be done with MDI, and has no problem thinking there.

What I can't explain is this: my mother has excellent health insurance. She has a fairly serious, delibitating physical problem, and she's been through 4 doctors, 7 neurologists and a variety of specialists and none of them seem to be able to complete performing the BASIC tests to rule out certain conditions. She is now facing traveling over 500 miles to a major medical facility to see if someone can finally help her. Most of those doctors she has seen have written her off as a menapausal female. I have yet to understand how menapause could cause one to require a walker, make their head shake like it was on a spring, or be unable to write legibly any longer, but that's another story. I must admit that I've wondered more than once that if she didn't have such great insurance that will so willingly pay for whatever these doctors dream up, if she would have already gotten a diagnosis as to what is actually wrong with her.

So, I don't know if I've answered the original question or not, but after the day I've had if was nice to rant for a bit. Thanks.

[modbom]

I'm an insured American who's endocrinologist founded the Diabetes dept at Mt Sinai in NYC. That all sounds nice but 90% of what I know about this disease comes from books and forums like this and my own personal experience. I think with our particular disease it's all up to us. The medical system can help pay for our drugs and supplies but after that we all have access to the same info. I bet that anyone of us on this forum could help a newly diagnosed diabetic with their management better than their docter can. Heck that's exactly what we do right?

[Noemie]

I'm an insured American who's endocrinologist founded the Diabetes dept at Mt Sinai in NYC. That all sounds nice but 90% of what I know about this disease comes from books and forums like this and my own personal experience. I think with our particular disease it's all up to us. The medical system can help pay for our drugs and supplies but after that we all have access to the same info. I bet that anyone of us on this forum could help a newly diagnosed diabetic with their management better than their docter can. Heck that's exactly what we do right?
I agree. A new diabetic will get more and better info from us i think.

Personally, i had bad experience after bad experience with the NHS. Ok it's free to get treatment in the UK, but there is one essential thing missing : human beings. All the medical people i've met from the NHS only think about quotas and getting their bonus (according to a GP i met while on hol abroad they get a 10% bonus on their salary for each diabetic patient they c).

i cant even count anymore the number of time i have been told i should cut down on testing my BG and cut down on my insulin not for my own health but to save money to the NHS. Well, at least they dont hide what they think, do they???

omg, just hinking of it piss me off so much. you should c me typing right now, there is smoke comin out of the keyboard!!!

Here is a real life example of what the NHS spirit is:
Since it was out on the market years and years ago, i was using the Ascencia Esprit meter. In July last year, i requested my monthly repeat prescription for it. Yeah, it would be too much to ask for a prescription for 2 months at a time. You never know, i could be cured when i wake up tomorrow!!!
So back to the story, i requested my pres. 48 hours later (it does take 48 hours to print a prescription. you have to receive the piece of paper that the patient gives you: 12 hours - switch on you computer, go into the program, go into the patient's file, tick the repeat item requested - 12 hours, put paper in the printer - 2 hours, switch on the printer -2 hours... u know what i mean). so 48hours later i pick the prescription. as i had been requested the same one for years i didnt bother checkin. I go to the pharmacy and realise that gave me the wrong strips for my meter. they show me that they gave what was on the prescription.
Ok, a mistake can happen. so i request the pres again. i check when i get it. Wrong again. so i take some time off work to go and ask for the prescription face to face. They refuse to print it again although it's wrong!!! I start loosing patience. I had been waiting for a week with all this waste of time. I start speaking a bit loud, but still not swearing and not screaming. I'm told i will not be seen by the doc and he will not issue any other prescription.

To make a long story short(er than i am making it lol) i ended in tears at the pharmacy tryin to find out why i couldnt get my strips. The pharmacist spent like 15 minutes on the phone to the NHS and managed to find out that the strips i was using had stopped bein covered by the NHS since the last time i got some.

So the GP, instead of telling me straight away to get a new meter, instead of giving time to check what meter were available and all, decided to print wrong prescriptions for a meter i never had and get a bonus for every prescritption printed.
Couldnt he take 1 minute to call me and tell me i had to change of meter or by the strips myself? or couldnt he send me the wrong prescription with a note explaining that this was for another meter, i could either buy it or get another one he would write a presc for?
Couldnt he be a human being at least for a minute instead of being the machine he daily is??

Just in case you hadnt notice, im really really pissed of at the NHS. and when i start talking about it i cant stop.
gimme 10 yrs and i'll write a book as big as Les Miserables just about GPs and nurses in NHS diabetic clinics in London and the South East.
I wish i could afford to go private.
Sorry about all the blabla and congrats to those who managed to read it! lol

[DeusXM]

To be honest, it's totally dependent on your surgery. I've never had any problems whatsoever with the NHS - they've always given me what I want, when I want. They've also never, ever asked me to cut down on strips or insulin.

It sounds to me like you've have a very bad experience with your GP. For all diabetes-related matters, you should consult your local hospital clinic and talk to the specialised staff there. If you'd called them to explain the problems you were having at your GP's, you would have probably got a straight answer in seconds. In fact, they'd have probably given you a new monitor and strips there and then. My clinic at hospital hands out diabetes supplies like most people hand out sweets - every time I go I end up coming back with some sort of 'present', be it a new insulin pen, or monitor, some different size needles...they can't seem to stop giving me stuff. It's got the the point I've got 4 spare monitors under the bed (all with batteries and strips), 8 Novopens, several packs of Levemir and Insulatard (which I'm not on), a few Humapens, several Glucagon kits and now it looks like they're trying to force me onto a pump too.

Like any large group of people, there are good and bad staff in the NHS. It sounds like you've been very unlucky, but I promise you that there are some fantastic people in the NHS who will move heaven and earth to make sure you're happy - and because they work in the NHS, they're in it to help you, rather than just to make a quick buck.

[kimbo]

In general I am very happy with the care in the uk.I have had very close monitoring ,we are exempt from paying for any meds even meds not related to our diabetes.The only thing I havent been happy about is they do not test to confirm the type because its too expensive.They first thought I was slow onset t1,then said I was t2 ,now agree with my suspicions that I could be slow onset t1 but said it doesnt matter which as long as i get good control.I would just like to know what is going on with my own body.

[Noemie]

To be honest, it's totally dependent on your surgery. I've never had any problems whatsoever with the NHS - they've always given me what I want, when I want. They've also never, ever asked me to cut down on strips or insulin.


Yeah, i think u r right. But it's hard to agree cause i had about 8 different GP, nurses... (i move a lot) in Canterbury and London and it's always the same!!!
Definately will try again the hospital see if they have some new staff.
Something else that i cant stand is the fact that u cant get a GP close to your office. I work in Central and live in South and i hate having to take time off work just cause i need to tell them what the latest b***s*** they've made.
Will follow ur advise a post a new thread called I LUV THE NHS if it works
But i feel like it ld b a miracle

In general I am very happy with the care in the uk.I have had very close monitoring ,we are exempt from paying for any meds even meds not related to our diabetes.The only thing I havent been happy about is they do not test to confirm the type because its too expensive.They first thought I was slow onset t1,then said I was t2 ,now agree with my suspicions that I could be slow onset t1 but said it doesnt matter which as long as i get good control.I would just like to know what is going on with my own body.


Do you think Deux's advise could work for you as well? Goin to the hospital to see a different doc than the one u c at present

[kimbo]

Re testing,its not the doctors fault ,it is the system here.I suggested paying for the test myself but they didnt know who could do it.

[ann landwaart]

sorry to be so simple, but is insuline and test strips and the rest covered by national health, and is there a limit, what costs are for a patient.

[DeusXM]

Insulin, test strips, insulin pens, ketostix, pen needles, syringes and insulin pumps are all covered by the NHS. To some extent, monitors are too - although you can purchase monitors, most PCTs will give you one if you ask. All these are provided free of charge - and if you have diabetes, you are medically exempt from any prescription charges, irrespective of whether the prescription is for diabetes-related medication.

Some PCTs operate arbitrary limits on the number of test strips, but there is no official NHS policy on this and if you lean on the restrictive PCTs, they crumble pretty quickly.