What's considered acceptable medical care in your country?

[Guest]

My sister and her man are living most of the year in Portugal as permanent residents, on their way to become citizens. They came to the US in part to celebrate my sister's daughter's birthday (this niece lives near my fiance and myself). My sister's man is originally from Northern Ireland. They came to the restaurant (for dinner) fairly near their house via ride-share, and I inquired as to why they didn't drive. Well, my sister just had foot surgery, but the Northern Irishman, who's 63, said he has trouble seeing at night. Apparently he saw an eye doctor with the National Health Service in Northern Ireland who told him that his problem was that he was "just getting old," and that all he could do was "just not drive at night." I asked him what the doctor said he had--was it cataracts, macular degeneration, or something else? He said "That's just the way NHS doctors are. They don't tell you anything." 

I couldn't believe my ears. Fortunately, they're about to be eligible for Portuguese healthcare, and their understanding is that Portuguese doctors aren't as incompetent as British ones. I'm interested in hearing from men from around the globe. Would an evaluation similar to that done by the NHS "physician" be considered acceptable in your country? Hopefully by Christmas, he'll have been examined by a Portuguese ophthalmologist, and will get an actual diagnosis. Otherwise, I guess he may just have to pay cash in order to be seen by a US ophthalmologist... 🙄

[KeepItReal]

4 hours ago, Unicorn said:

My sister and her man are living most of the year in Portugal as permanent residents, on their way to become citizens. They came to the US in part to celebrate my sister's daughter's birthday (this niece lives near my fiance and myself). My sister's man is originally from Northern Ireland. They came to the restaurant (for dinner) fairly near their house via ride-share, and I inquired as to why they didn't drive. Well, my sister just had foot surgery, but the Northern Irishman, who's 63, said he has trouble seeing at night. Apparently he saw an eye doctor with the National Health Service in Northern Ireland who told him that his problem was that he was "just getting old," and that all he could do was "just not drive at night." I asked him what the doctor said he had--was it cataracts, macular degeneration, or something else? He said "That's just the way NHS doctors are. They don't tell you anything." 

I couldn't believe my ears. Fortunately, they're about to be eligible for Portuguese healthcare, and their understanding is that Portuguese doctors aren't as incompetent as British ones. I'm interested in hearing from men from around the globe. Would an evaluation similar to that done by the NHS "physician" be considered acceptable in your country? Hopefully by Christmas, he'll have been examined by a Portuguese ophthalmologist, and will get an actual diagnosis. Otherwise, I guess he may just have to pay cash in order to be seen by a US ophthalmologist... 🙄

I've lived in a few countries and have had to get physicals and other problems seen to. But always by "private" doctors and not public/government funded services, so my experience may be skewed.  

South Africa surprised me by the level of care I received - expensive by local standards, but not so by US standards. Doctors, dentists were all very good, well trained, communited well and had modern equipment. It has become a mecca for Brits who wants affordable cosmetic surgery, for example. It is quickly becoming the UK's Mexico!

Thailand was hit and miss. A concierge service helped me find better alternatives. Ask around the expat community if you need to see a good doc. Communication was a problem - I had to ask probing questions and instructions for medication was not clear. (Called my US doctor for clarification)

Canada...oh, dear Canada. I love thee so, but stick to hockey my dear friends. At least there you understand the need for skill, speed and finesse! 😋

The care I received in the UK was...fine. My doctor was a young lad from Jamaica. I will give him credit for spending time with me, but it was mostly talking about his wish to live/work in America and not about my inflamed shoulder injury. The equipment was not "state of the art" and he told me had to bring some of his own supplies. The nurse was dismissive and didn't do the usual blood pressure/wellness check - he sighed and did it himself. 

[SirBillybob]

Formal surveillance shows that NHS patient satisfaction is at an all time low.

That said, I am surprised an Ophthalm consult wasn’t in the cards. 

In contrast to Ontario where I lived most of my adult life, in Quebec I pay out of pocket for primary care and urology, both practitioners having ‘opted out’ as is legal here; lab work, and MRI imaging. None of it is tax-credited due to my income level.

I have had a few ultrasounds and dermatology check-ups covered by provincial health insurance. STI testing is covered at community clinics; as an active gay man I feel that is a good compensatory offset. 

I have travelled abroad specifically for specialty inguinal hernia repair accessed on short notice at great expense, as opposed to risking the caprice of acute emergency-based surgical intervention locally. 

—— 
Portugal’s median age, 46, is 5 years higher than UK and USA due to a markedly high baby boom 1960-1985. Like many nations the health care system will be saddled, even more, with a very high proportion of seniors going forward. 

 

Edited September 25, 2023 by SirBillybob

[CuriousByNature]

7 hours ago, KeepItReal said:

Canada...oh, dear Canada. I love thee so, but stick to hockey my dear friends. At least there you understand the need for skill, speed and finesse! 

100%!!!

It's wonderful to go to the hospital here and not be charged a penny.  But you also risk dying in your chair waiting to be seen by an ER doc.  This has happened multiple times due to poor triaging and 12+ hour wait times.

It's great being able to call an ambulance and not be bankrupted by it, as long as you don't expire waiting the 1 or 2 hours it can take for it to arrive.

It's awesome not having to pay for visits to the family doctor, assuming you can manage to find one taking new patients.  And you MIGHT even get to discuss one of your medical concerns fully, since most doctors squeeze in 6 patients per hour to cover their costs and you're often rushed through.  Having more than one issue? Please come back for another appointment...

Yes, we have most of our physical medical health care covered.  But it's not free.  The costs are there in terms of ridiculous wait times, bureaucracy, and sometimes even incompetence. 

Is it the worst system in the world? Absolutely not.   Is it a system worthy of praise and imitation? Also a BIG no.

Edited September 25, 2023 by CuriousByNature

[pubic_assistance]

Medical care is expensive.

Few National Health systems will allow anything but basic care in-network.

Most people with money hire privately for important procedures no matter what country you're living in. Canadians frequently travel to the US for surgery. Great Britain has two systems public&private hospitals to choose from.

As they say..there really is no-such-thing as "free".

[Guest]

15 hours ago, KeepItReal said:

...The care I received in the UK was...fine. My doctor was a young lad from Jamaica. I will give him credit for spending time with me, but it was mostly talking about his wish to live/work in America and not about my inflamed shoulder injury. The equipment was not "state of the art" and he told me had to bring some of his own supplies. The nurse was dismissive and didn't do the usual blood pressure/wellness check - he sighed and did it himself. 

Thanks for the assessment of the British NHS quality. While it's not surprising that the physician has no say in nurse hiring, the frightening aspect is that physicians in the UK can't even have any input when it comes to nurses' job performance. Vitals signs are called vital signs for a reason: they're vital. If a nurse skipped that, I would try to have a friendly talk, and hopefully that would do the trick. If a cordial talk didn't have any effect, I could easily talk to her supervisor, which would generally yield beneficial results. I know that my sister's man from Belfast, as with all people from northern Ireland, is entitled to Irish citizenship (in fact, he usually travels with his Irish/EU passport). I didn't ask him if he could travel to the Republic for medical evaluations. I wonder if the medical care in the Republic of Ireland is better than in the Kingdom of Northern Ireland...

[+ tassojunior]

Surprisingly, Medicaid and Community Heath Centers care in the US is probably better than many countries general healthcare. (not so much Medicare). 

One glaring difference to travelers is CPAP machines for sleep apnea. In the US a huge number of people use them. In Europe almost zero. European doctors and health systems just don't believe in them. ADA-type considerations are rare and there seems to be less concern with prolonging elderly life. 

[pubic_assistance]

10 hours ago, tassojunior said:

there seems to be less concern with prolonging elderly life. 

Living past your natural end, is a very American Pharmaceutical Industry concept.

[Guest]

20 hours ago, tassojunior said:

Surprisingly, Medicaid and Community Heath Centers care in the US is probably better than many countries general healthcare. (not so much Medicare). 

One glaring difference to travelers is CPAP machines for sleep apnea. In the US a huge number of people use them. In Europe almost zero. European doctors and health systems just don't believe in them. ADA-type considerations are rare and there seems to be less concern with prolonging elderly life. 

Interestingly, the Northern Irish man has CPAP from his NHS, so it seems to be available. His physician told him he had the "worst case of OSA" that physician had ever seen. Not a problem with European or US carriers, but apparently a South American airline company refused to let him fly with CPAP because they thought he might die on the flight over (or maybe they didn't want his snoring to disturb other passengers??). He had to switch his ticket to a European or American airline. At least his NHS did take care of that problem. However, upon receiving the diagnosis, the NHS notified the motor vehicles department, which cancelled his driver's license. He was only able to re-apply for a completely new license after his CPAP machine documented 6 months of successful use. Of note, he'd never passed out/fallen asleep from his OSA (though there was, of course, drowsiness at times). 

[+ tassojunior]

31 minutes ago, Unicorn said:

Interestingly, the Northern Irish man has CPAP from his NHS, so it seems to be available. His physician told him he had the "worst case of OSA" that physician had ever seen. Not a problem with European or US carriers, but apparently a South American airline company refused to let him fly with CPAP because they thought he might die on the flight over (or maybe they didn't want his snoring to disturb other passengers??). He had to switch his ticket to a European or American airline. At least his NHS did take care of that problem. However, upon receiving the diagnosis, the NHS notified the motor vehicles department, which cancelled his driver's license. He was only able to re-apply for a completely new license after his CPAP machine documented 6 months of successful use. Of note, he'd never passed out/fallen asleep from his OSA (though there was, of course, drowsiness at times). 

Good Lord,  I hope that idea doesn't catch on here about not driving. The whole idea of a CPAP is to stop one from getting sleepy in the day. 

In June I had trouble on Virgin airlines to London because I told them my "2nd personal" was my CPAP. On US airlines flight attendants and staff are very used to several on every flight. Not EU airlines. I had to sit and wait a half hour while they got their doctor on the phone who questioned me why I use it even though I told them I was not going to use it in flight but I didn't want to check it either. The MD had to verify why I used it and when and said I could always pull it out in cabin and use it so they had to be careful. Thankfully I had plenty of time for my flight. The desk agent said she had never seen one and in Europe they don't use them. Anyway, moral is if flying an EU airline stick your CPAP in your carryon and be quiet about it. I'm surprised at N.Ireland as they are a novelty in Europe. 

[+ tassojunior]

10 hours ago, pubic_assistance said:

Living past your natural end, is a very American Pharmaceutical Industry concept.

For once I'm on the side of the American Pharmaceutical Industry.

(Especially since life expectancy just got drastically lowered).  

[pubic_assistance]

13 hours ago, tassojunior said:

For once I'm on the side of the American Pharmaceutical Industry.

Too many people live past a true active life.

My own father has been sitting in a chair waiting to die for far too long. Keeping his heart beating with dozens of pills, but devoid of any ability to do anything but watch TV, eat and shit.

I find it rather ridiculous and sad.

It's not a life to live.

[Guest]

6 hours ago, pubic_assistance said:

Too many people live past a true active life.

My own father has been sitting in a chair waiting to die for far too long. Keeping his heart beating with dozens of pills, but devoid of any ability to do anything but watch TV, eat and shit.

I find it rather ridiculous and sad.

It's not a life to live.

Maybe not for you or some other people, but that's really for your father to decide. Maybe he enjoys eating and watching TV, or perhaps doing some other activities of which you may not be aware (perhaps conversations with his family, such as yourself?). When I personally decide I'm not enjoying life any more, I have a .38 Special revolver. However, it's not for me to decide whose life is worthwhile for themselves. 

[pubic_assistance]

11 minutes ago, Unicorn said:

that's really for your father to decide

I agree.

I'm not suggesting he should go by MY beliefs.

Just sharing my own confusion about why someone / anyone would want to live artificially past his natural expiration date through pill-popping.

And no...he's really NOT "enjoying" his remaining years. That's what's sad. Just sitting there waiting to die.

 

[+ tassojunior]

I'd rather the government stay out of when one should go. Balancing the budget that way is uncalled for with US life expectancy still plunging rapidly after covid unlike similar countries. 

BTW- are we going to rescind all those cuts made to SSA, Medicare and retirement plans because people were living longer? 

[rvwnsd]

On 9/25/2023 at 11:04 AM, pubic_assistance said:

...As they say..there really is no-such-thing as "free".

Exactly! That's why it's called "single-payer."

[Rudynate]

8 hours ago, pubic_assistance said:

I agree.

I'm not suggesting he should go by MY beliefs.

Just sharing my own confusion about why someone / anyone would want to live artificially past his natural expiration date through pill-popping.

And no...he's really NOT "enjoying" his remaining years. That's what's sad. Just sitting there waiting to die.

 

Dad is disposable - what a grateful son.

[Guest]

4 hours ago, rvwnsd said:

Exactly! That's why it's called "single-payer."

I agree that a single payer system would go a long way to reduce costs, increase efficiency, and increase incentivizing long-term healthcare goals for individuals and their insurers. I firmly believe this can be done without resigning ourselves to the horrors of the UK-NHS, and perhaps, the Canadian systems. From what my sister and her man tell me, the Portuguese system works well. I haven't heard from members who've experienced the healthcare systems of other countries. I wonder how things are in other countries with single-payer systems. Surely some work better than the NHS? I'm still in touch with the young Mexican physician I hired 2.5 years ago when we went around the southwest US shortly after getting our first set of COVID shots. He just finished a couple years of "social service" in which he worked for the government for the underserved. 

I'd love to meet him with my fiance when we go to Puerto Vallarta after Thanksgiving to hear his assessment of how things are in Mexico. Again, I'd love to hear from those in other countries as well. 

[+ Vegas_Millennial]

On 9/24/2023 at 10:49 PM, Unicorn said:

Otherwise, I guess he may just have to pay cash in order to be seen by a US ophthalmologist... 🙄

Thank goodness payment by cash is still an option.  Best of luck to your friend 🤗

[+ Charlie]

BTW, when I lived in in the UK back in the 1970s, although I was only a resident alien and not a citizen, I was able to use the National Health for my medical service without charge. I don't know whether that is still true.

[Guest]

2 hours ago, Charlie said:

BTW, when I lived in in the UK back in the 1970s, although I was only a resident alien and not a citizen, I was able to use the National Health for my medical service without charge. I don't know whether that is still true.

I'd think so, if you mean a permanent resident alien. That's certainly the case for my sister and her man, who are permanent residents, although not yet citizens of Portugal. They have nothing but good things to say about Portugal's public health system and its citizenry. It may not be Europe's richest country, but apparently its people are well-educated and civic-minded. 

[pubic_assistance]

20 hours ago, tassojunior said:

US life expectancy still plunging rapidly after covid

Covid is rough on the morbidly obese.

[+ tassojunior]

My only personal experience was very long ago in Hamburg. The public clinic was fine but I assure you the elderly doc was not gentle. For a simple case of the clap he stuck a metal loop deep down my dick hole instead of taking any of the discharge to test. Told me I should stay out of St. Pauli or he'd have to go deeper next time. I think he was still mad about the war too. 

Edited September 29, 2023 by tassojunior

[+ augustus]

On 9/27/2023 at 4:59 PM, pubic_assistance said:

I agree.

I'm not suggesting he should go by MY beliefs.

Just sharing my own confusion about why someone / anyone would want to live artificially past his natural expiration date through pill-popping.

And no...he's really NOT "enjoying" his remaining years. That's what's sad. Just sitting there waiting to die.

 

It is rough taking care of the elderly.  They can be so difficult especially the women and their mouths.  My aunt was a handful.  Whatever their personalities were younger remains as they get older.  God bless those people that work in Nursing Homes, they are way underpaid particularly the aides.

[pubic_assistance]

1 minute ago, augustus said:

It is rough taking care of the elderly.

I hope to fall out a window before I become a burden.