The Scottish National Health Service has some of the worst treatment times in the United Kingdom. Thirty-seven percent of people entering the emergency department in late October had to wait more than four hours to be admitted, transferred or treated. The NHS struggles to hire workers and struggles to treat all those who need care. Supposedly the founding principles of the NHS is that care is free and paid for by tax dollars rather than charging patients for care.
Over the years I have talked to people who faced medical bills for care they needed but could not pay. In a couple cases I told them about CareCredit, the largest medical care lender. For example, the lady who owns the salon where my wife used to go needed eye surgery. She was happy to learn there was an easy way to make payments for surgery. Our dog’s veterinarian and the equine vet that cares for my wife’s horse both take CareCredit. I’ve even met a plastic surgeon who accepts CareCredit. If your budget can’t take an $8,000 hit for a facelift you can finance it over time putting down a couple thousand dollars and maybe pay $200 a months for several years with interest.
Just like a neglected girlfriend, you doctor may dump you if you don’t see her often enough. I don’t have a primary care doctor. My previous doctor was an Internist named Paul Craig. When I last called for an appointment several years ago in mid February his office staff told me he was retiring at the end of the month and was booked through the end of the February. Perhaps my irregular appointments were the reason he retired. I ended up being able to see a specialist who saw me without a referral.
A few years ago, I wrote about a novel experiment in California that used reference prices to encourage CalPERS beneficiaries to choose lower-cost, high-quality facilities when seeking joint replacement. One experiment capped the price CalPERS was willing to pay for joint replacement at $30,000. Patients could seek care at any provider, but they would be responsible for all charges above the reference price. In addition, CalPERS gave beneficiaries a list of high-quality hospitals that would perform the surgery for $30,000. The result after two years was that patients shifted to the lower-cost hospitals. High-cost hospitals began matching prices for CalPERS patients.