One of the reasons the US medical system is so expensive

A few weeks ago I began feeling unwell.  And you know when you feel unwell and it persists you seek medical help to find out what’s going on.  One thing led to another and wound up on Thursday with a cat scan

A few weeks to a cat scan, eh? From feeling ill to getting it?

Friday morning at 7:30 I got a call from my beloved friend, Dr. Bill Howard who said to me the CAT scan shows that you have a tumor on your pancreas and he arranged for me to have an appointment with Dr. John Cameron at Hopkins that very afternoon.  So June and I, Mrs. Reason and I went to Hopkins.  She had stopped by the radiology place to pick up the CD, and Dr. Cameron saw us.  And he looked at the pictures and the technical report from the radiologists and he said you have grade 4 pancreatic cancer that has metastasized to your liver, your parenteral cavity, abdominal cavity, lungs and so on. 

Under 24 hours from scan to seeing the specialist, eh?

I don’t have a schedule yet, because I won’t see the oncologist until Friday.

8 days from even the first scan to plan for chemotherapy treatment.

Yah, the NHS is cheap because you just don\’t get that, do you?


15 thoughts on “One of the reasons the US medical system is so expensive”

  1. Well, in fairness, the NHS isn’t that bad. I had a routine chest X-Ray 3 years back, which showed something suspicious on a lung. I went private, but the consultant told me I needn’t have bothered, it was 1.5 weeks for private and 2.5 weeks for NHS, and another week for an MRI which proved it was benign. What the NHS is really bad at are the non-life threatening issues: I can still remember the anger I felt after a (mis) diagnosis of irreparable knee trouble, when I was told I should stop running at the age of 19 🙁

  2. The last two cat scans I needed were done in one day (that was urgent) and in a couple of weeks (that was less so). One of the troubles with the NHS is that there is a 5%-10% probability that having taken the scans they’ll lose the results. (That figure is an estimate based on my own experience.)

  3. One can’t be sure from the description, but it sounds as if his symptoms were caused by the liver mets and a competent GP would have suspected that. Under the NHS he could have been admitted to hospital and scanned within 24 hours. And with this diagnosis, he would have seen a specialist very quickly.

    On the other hand, the carpets in reception will have been much better in the USA.

  4. The NHS is very good with emergencies. From personal experience I have found their treatment of life threatening disease to be fast and efficient with an impressive clarity in their communications. Their ongoing care is also top rate.

    Other people I know have had similar experiences.

  5. Of course, expedited diagnosis of stage (not grade) IV metastatic pancreatic cancer is unlikely to do much for his life expectancy.

    American healthcare is mostly expensive because it runs a great big protection racket around medics, and the whole nonportable, employment-tied insurance on top of it. The insurers are the only guys with the clout to refuse to pay exhorbitant bills and bet away with it.

  6. In the USA he’ll have better access to the latest drugs (Abraxane, for example), and to the latest particle beam therapies (probably not relevant in this case). Assuming his insurance covers it. And he may get more frequent follow-up scans. The system in the USA is more willing than the NHS to spend vast amounts of money to extend life expectancy by a few weeks.

  7. I’m pregnant, and last week on Thursday the midwife got worried about my platelets, so I saw the anaesthestist yesterday, and have a booking with the obstetrician next week. Which struck me as reasonably fast work, given that the platelet issue seems to boil down to mostly a question of which painkillers I can have.

    Though I did deliberately pick a big teaching hospital at the start of my pregnancy, based on the advice of health economists that these hospitals tend to do better at all sorts of things as they just see so much more of everything.

  8. The last two times I’ve accompanied people to A&E they’ve had brain scans within four hours (car/bike accident; sudden spike headache in person with stroke risk factors)

  9. The question is not how quickly you can get a CAT scan in the NHS in an obviously-urgent, known situation, which is what everybody is describing. Sure, if you have a head injury in a car accident, you’ll get a scan toot-sweet. Such cases will always jump the queue. The question is – how long would would it be before a person with vague feelings of being unwell would get a normal, non-emergency, scheduled CAT scan? Every emergency, queue-jumped scan is a normal, non-emeregency scan deferred.

    Simple math (number of CAT scanners per head of population) shows that it will be a lot longer in the UK than in the US.



  10. So, if the NHS was given more money the sort of situation you identify would not arise? If your analysis is correct, this would seem to be an argument for increasing NHS funding.

  11. @Chum, no if there were more CAT scanners per head of population the situation would not arise. Giving more money to the NHS does not equate to buying more CAT scanners.

  12. @ChrisM: Certainly. However, I assumed that Tim was using the availability of CAT scanners simply as an example of the NHS being financially under-resourced compared to the US healthcare system – “The NHS is cheap because you just don’t get that”.

    So it would seem to follow that if wanted to “get that” (i.e. greater and more immediate access to medical facilities, which Tim seems to think would be a good thing) then in his view the NHS would become less “cheap” -i.e. it would require increased funding. I raised the point because this seemed to me to be a highly unusual position for Tim to adopt.

  13. @ChrisM: On further reflection it occurs to me that Tim’s conclusion may have been intended ironically, in which case my remarks are irrelevant.

  14. @Churm Rincewind.

    Ah, OK, you are saying that more funds are necessary, but not sufficient to get more CAT scanners? Yes, that is quite possible I suppose.

Leave a Reply

Your email address will not be published. Required fields are marked *