The NHS

I'm in a private hospital paid for by my insurance right now, so I thought I'd give some input into what it can be like. I broke my leg two days ago and went to the hospital. Because the first day was all outpatient, I have to pay it myself and then claim it back on the app. The next day I went for a further consultation and a CT scan and the doctor confirmed that I'd need an operation, so he booked me in for one on Friday as we had to wait for the swelling to go down. The doctor then had to send a request to the insurance company for a guarantee letter, confirming that they will cover the cost of the operation and 3-5 days in hospital. This didn't arrive back until more than four hours later, and only then after I phoned them to complain, during which I was receiving no medication or treatment of course. When it arrived, they agreed to pay for the operation, but only included 1 night in the hospital (even though my operation was 2 days away and I'd obviously need to stay in afterwards too) insisting that the doctor updates them and applies to the insurance company again for any further days. So we've got a situation where somebody in Ireland who is most likely not medically trained dictating to a orthopedic surgeon who's actually diagnosed my injury how many days in hospital they're willing to pay for, even though they've agreed to pay for the operation that necessitates these days in hospital in the first place. Never mind, I'm sure the doctor doesn't have anything better to do that fill in another form with exactly the same information he sent yesterday.
 
I'm With Stupid said:
I'm in a private hospital paid for by my insurance right now, so I thought I'd give some input into what it can be like. I broke my leg two days ago and went to the hospital. Because the first day was all outpatient, I have to pay it myself and then claim it back on the app. The next day I went for a further consultation and a CT scan and the doctor confirmed that I'd need an operation, so he booked me in for one on Friday as we had to wait for the swelling to go down. The doctor then had to send a request to the insurance company for a guarantee letter, confirming that they will cover the cost of the operation and 3-5 days in hospital. This didn't arrive back until more than four hours later, and only then after I phoned them to complain, during which I was receiving no medication or treatment of course. When it arrived, they agreed to pay for the operation, but only included 1 night in the hospital (even though my operation was 2 days away and I'd obviously need to stay in afterwards too) insisting that the doctor updates them and applies to the insurance company again for any further days. So we've got a situation where somebody in Ireland who is most likely not medically trained dictating to a orthopedic surgeon who's actually diagnosed my injury how many days in hospital they're willing to pay for, even though they've agreed to pay for the operation that necessitates these days in hospital in the first place. Never mind, I'm sure the doctor doesn't have anything better to do that fill in another form with exactly the same information he sent yesterday.
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Insurance companies know exactly how many days specific procedures should need. I work in medical insurance and many consultants take the piss believe me. Dermatologist: ‘Oh you’re insured, by the why I’ve also noticed you’ve got a few dodgy moles there I’ll just excise them all and charge £400 lol’
 
dronefromsector7G said:
Insurance companies know exactly how many days specific procedures should need. I work in medical insurance and many consultants take the piss believe me. Dermatologist: ‘Oh you’re insured, by the why I’ve also noticed you’ve got a few dodgy moles there I’ll just excise them all and charge £400 lol’
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Well yeah. That's the problem with an insurance system, and in the middle is a patient who's being told that they need something by the doctor, and then being told by the insurer that they won't pay for it. Anyone arguing for this system and claiming that it's more efficient is full of shit.
 
dronefromsector7G said:
Insurance companies know exactly how many days specific procedures should need. I work in medical insurance and many consultants take the piss believe me. Dermatologist: ‘Oh you’re insured, by the why I’ve also noticed you’ve got a few dodgy moles there I’ll just excise them all and charge £400 lol’
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I can believe it. 20 years ago I was diagnosed with a rare condition and had private health care through the company I worked for. I ended up with a specialist at the Alexandra in Cheadle, as it required some treatment and a major operation, and he would often ask me to attend his clinic and then simply pass over some recent research into the condition that he had printed out off the internet. A 10 min meeting but an hour charged @ £125 when he could simply have emailed me the link. Lazy c**t never even came to visit when I was having my op in there, I could see his office from my room.

The insurance company never queried his invoices, but had the gall to ring me the day before I went in to say they hadn't promised to pay for the op or the earlier treatments.
 
I'm With Stupid said:
Well yeah. That's the problem with an insurance system, and in the middle is a patient who's being told that they need something by the doctor, and then being told by the insurer that they won't pay for it. Anyone arguing for this system and claiming that it's more efficient is full of shit.
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In USA the software is used by doctors to evaluate whether a certain type of treatment can be funded by insurance before treatment.
 
Like any big organisation you have some great people and you have some not so great. However the pressure and lack of resources they have to work with, when essentially saving lives, isn’t fair or just.

The system isn’t perfect but it’s an institutional right and one of the few things that makes this country great. Sadly it’s been ravaged by politics and is on the brink IMO.
 
It needs substantial changes, took an hour and 45 minutes for an ambulance for my mum the other week, which isn't on.

Ultimately it needs more streamlined funding and a more streamlined setup, A&E departments need to be teamed with walk-in centres to lighten the load and we need to offer salaries that attract the best in the world to come and work in it, and start a public re-education on how to use their health services and putting systems in place in schools to encourage youngsters to enter our public services.

That being said, we won't do that as there is no-one in our political system with the ruthless compassion to make it happen (who doesn't also come with 99 other things wrong with them that will ruin everyone's lives anyway).
 
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