Difference between Europe and North America

[Ged1975]

Having been on this website for a few months now one thing has struck me is the difference in the health systems in Europe and North America.

In Europe it appears to me that your surgeon is chosen for you, your type of valve is also chosen as were in North America you need to do alot of research i.e. find a surgeon and choose your type of vavle.

I'm not saying that one particular system is better than the other and I am confident the health care standards are extremely high in both cases.

Edit: Sorry this isn't a question or anything, it's just an observation

 

[kfay]

Ged, I think there are a lot of people here in the U.S. who allow their surgeon to be chosen for them by their cardio and who are also very comfortable letting that surgeon making the valve choice for them as well. I think a lot of people here don't even know that they have a choice. I also think that most of the people who are on here (VR.com) are more interested in educating themselves about their options than others. However, not everyone here has insurance that allows them the luxury of choosing the surgeon of their choice.

Kim

 

[Cooker]

Also, I believe Europe has socialized medicine which means fewer choices of doctors etc?. My cardiologist suggested a surgical group and surgeon and he also said with my life style and age he would go mechanical ? He also said if it were him he would go tissue but he rock climbs, sky dives ?.. you know the type ?. I pretty much take a cab to the bathroom

 

[Ged1975]

Also, I believe Europe has socialized medicine which means fewer choices of doctors etc?. My cardiologist suggested a surgical group and surgeon and he also said with my life style and age he would go mechanical ? He also said if it were him he would go tissue but he rock climbs, sky dives ?.. you know the type ?. I pretty much take a cab to the bathroom

That's what worries me. The choice had been made for me to go mechanical rather than tissue because I am only in my early 30s. However I'm very active and love the gym so I'm just hoping I can continue the same activity with a mechanical valve.

 

[Freddie]

That's what worries me. The choice had been made for me to go mechanical rather than tissue because I am only in my early 30s. However I'm very active and love the gym so I'm just hoping I can continue the same activity with a mechanical valve.

Of course you can.
Don't let anyone tell you different.
I've had a black eye, stitches, bruises and a small bump on the head. Not saying that your a klutz like me......but accidents do happen.

Don't let a mechanical stop you on dong the things you love doing.

 

[Bina]

Some people don't know that they can do a bit of research and have some input into who will actually be cutting them open.
My cardio referred me to a major hospital....and then almost as an after thought, he added that "if you call today, I'm sure you will get hold of the chief of cardiac surgery's secretary".
Many people will put more research into which car they will buy, but will not think twice about choosing their surgeon.

 

[Ged1975]

Some people don't know that they can do a bit of research and have some input into who will actually be cutting them open.
My cardio referred me to a major hospital....and then almost as an after thought, he added that "if you call today, I'm sure you will get hold of the chief of cardiac surgery's secretary".
Many people will put more research into which car they will buy, but will not think twice about choosing their surgeon.

That's an excellent point Bina. From my own experience coming from a tiny country were the gene pool is small and as we only have about 3 or 4 major hospitals makes it slightly easier for the patient to go with the flow. However I can fully understand why people in larger countries would do research as there's more choice.

 

[briansmom]

Just wanted to say that my son is only 18 and has a mechanical valve. He has permanent heart damage but still manages to do a lot with his life. He just raced 150 miles in an off-road race car last weekend. Your life will not end even with a mechanical valve.

 

[sue943]

I can only really speak for the NHS and locally as we use the UK for cardiac surgery but I think it is down to there being no financial aspect in the UK. Our cardiologists and cardiac surgeons are going to be paid the same regardless of how many patients they treat. It is my experience that the cardiologist will use the best cardiac surgeon for the job in hand, and they work as a team. I went to St George's Hospital in Tooting (London) and was assigned to Dr Charles Pumphrey (cardiologist) and to Mr John Smith (cardiothoracic surgeon).

Having your surgeon selected for you means you do not have to worry yourself about it, no need to interview or research the surgeons, no need to agonise as to whether you have made a good choice. The other advantage is that they will decide when the time is right for surgery, no cardiologist delaying or surgeons wanting to jump in quickly - it is jointly managed care.

Then of course there is the lack of having to worry about financing the treatment, that has to reduce stress.

 

[Lisa in Katy]

I chose my hospital, surgeon, and date. Getting to choose the date was very important as I wanted to be up and about when my son started Kindergarten in August. The only thing I didn't choose was my valve and in 1998 that would have been difficult without the research options that are available today. Frankly, even today I would let the surgeon choose - he's the expert, that's why I chose him.

I was on an HMO when I had my surgery so it cost me nothing out of pocket and I was in a private room (also a big difference). One thing that is not understood by some about American insurance is that most group plans pay the majority of the costs. Many private plans do as well. We pay a premium out of our paychecks, but it is not very much really. Those on universal plans pay through their taxes. It's not free. People who don't work in both situations are dependent on those who do to provide for them. That jacks up the cost of healthcare in both countries.

 

[Jkm7]

It's true. I had two heart surgeries at Mass General in four years and each time I left with no bill at all. I got one bill the second surgery, a few weeks after I was home. It was for a co-pay of $5.00.

However, some people pay very high insurance premiums. Not everyone is covered under policies at work. Some people are self-employed etc. It has become such a huge issue in the U.S. - benefit packages. Some get great benefits; others get none.

Pay for health care through taxes or pay for it through premiums, it isn't free. Sure some folks may be paying less than others but someone is paying for it. The government IS the people.

 

[abbanabba]

In Australia we don't really have that much choice to start with given our relatively small population. When I was looking for an appropriate cardiologist I did my research and asked for a referral to the one/s I thought would be best able to deal with my complex heart history (and there's only about 3 of them in Aust - I'm just lucky to be living where the one I consider the most qualified is), but when it came to the choice of the surgeon, they were originally going to ship me across to Melbourne since they weren't sure if they'd have someone adequately qualified to do my PVR. Fortunately the surgeon they had in mind moved across to SA which made life a LOT easier... but it was good to know that even in the public heath system, I would have been given access to the person considered best for the job - not just whoever was available.

I guess in some ways having such a large population and choice of doctors/surgeons like you do in the US gives you the chance to select your own healthcare professionals, but I imgine that comes with both many benefits and drawbacks (probably depending on the final outcome!). For the most part though, we certainly have the right to nominate a preferred practitioner here if we wish, but generally if we trust our doctors, we're inclined to trust their judgement for referrals and most treatment.


A : )

 

[Duff Man]

Honestly, I think the members of this site just happen to be the elite valvers. We're the few patients from each city or state that refused to settle for mediocrity. We refused to be kept in the dark and we found this place when we searched for answers. Our system just enables us to take advantage of statistics and information by having a semi free medical market to choose the valve and/or surgeon we think will give us the very best chance for survival. I truly believe most patients in the US take the back seat with their health. They do what a cardiologist's good patient would do by following their Medical Deity's advice.

 

[ChouDoufu]

Having your surgeon selected for you means you do not have to worry yourself about it, no need to interview or research the surgeons, no need to agonise as to whether you have made a good choice. The other advantage is that they will decide when the time is right for surgery, no cardiologist delaying or surgeons wanting to jump in quickly - it is jointly ....

not bad at all, assuming you trust the government. assuming this year's
bureaucrat who got his job because he was someone's cousin actually
has the knowledge necessary to make the decisions. assuming there's
money in the budget or room to fit you in.

if it works, great. all you have to worry about is the person who made the
selection, did they 'agononize' over whether they made the right choice,
or just checked any old box at the end of the day, secure in the knowledge
that as a government peon they are immune from lawsuits.

i like the car example. do you want the epa to select your vehicle? if so,
we'll just buy american, and we'll all be driving gremlins.

 

[Bryan B]

Then of course there is the lack of having to worry about financing the treatment, that has to reduce stress.

First of all I want to state that I mean no disrespect to those who live in countries with government managed health care.

I don't know this for a fact, but my guess is that a single person living in a country with government health care and working full time is paying just as much or more that a single person living in the United States and working full time with a health care program through the company they work for. The difference is that in countries with "free" government health care a person pays for that care through higher taxes, where the person in the United States usually gets basic health care paid for by their company and then has to pay for upgraded care like dental, vision, etc. This example would be for a single person in each country. Again just a guess, but I am guessing that a family (for example a husband, wife, and 2-3 children) may have to pay higher taxes in countries with subsidized health care and in the States the same family would have to pay a portion of the cost for their health insurance the company offers.

I'm not saying one system is better than another, only that neither system is "free" if you work and pay taxes.

And there are some health care plans in the States where you have a very limited choice of doctors and surgeons (which happens to cost less for a company to provide to their employees). Other health care plans offered by companies give you many choices and the option of staying within the network of doctors that the insurance company "contracts" with, or you can go out of network for an increased deductible and choose any doctor or surgeon that you want.

When I had my surgery the hospital I chose (Duke) was within the network, but the surgeon I chose (Dr. Jaggers) was not within the network. He contacted my insurance company and told them that he was willing to be added to their list of surgeons listed within their network. I ended up having to ask the anesthesiologist to do the same thing. I had a maximum out of pocket expense, but it was lower if the physicians I used were all within the network. They seemed to have no problem being added to my insurance company's list of network physicians and it saved me a couple thousand dollars in added deductibles. BUT...I had to be vigilant and do the leg work to keep my costs down while a person in a country with subsidized health care wouldn't have to worry about these types of issues.

 

[abbanabba]

I think the only difference here is that our insurance is NOT tied to our employment, so you have the option of basic or very high level insurance regardless of who you work for. Even without a job, I could have top level insurance providing I could pay for it... or I could be earning top $$$ and still elect to take advantage of the free services offered in the public system. In fact, you can still do this even if you have insurance if you don't want to have to pay the gap. So in Australia, at least, you really pay what you want.

As far as tax goes, we work on a tiered taxation system so those who earn more pay more tax to a point and once you're over a certain wage per year ($50-$60k I think.. which I believe will be raised) you pay an extra 1% income tax if you don't have some form of private health insurance.. but at the end of the day it still costs about the same. Of course private insurance gives you more choices - sometimes - and helps cover extra costs such as dental, optic, private rooms in hospital, etc... but generally you still end up paying extra out of pocket since insurance only covers X amount even with the premiums you pay each year.

Of course, each country is different, but at least we have the freedom to change jobs/employers and not have to worry if the insurance will cover what we need.

 

[lynnconnolly]

For my two cents-worth, I've found that the doctors are always those available, i.e., we don't get to choose - and you can only change if you ask for a second opinion or have an otherwise good reason to - and as to valve selection etc., it tends to be that we're offered whatever the surgeon prefers to use.

That said, we are offered choices but most surgeons will strongly recommend which one/s we have.

Lynn - ps... hey abba, hope you're feeling good?

 

[mrsnuffles]

I had a slightly different experience with the UK healthcare system and choosing your own surgeon. The NHS does allow you to choose which surgeon you have but 9 times out of 10, the cardiologist decides for you. In my case, the surgeon that was chosen for me was not the most experienced in mitral valve repair, but as my cardiologist was relatively new to the job and country, I can excuse her for not knowing that. Using the health care commisions own website on heart surgery statistics, personal recommendations and good old google, I chose another surgeon at another hospital and requested that my GP refer me to him. The whole process of changing surgeons will have added around a month to my wait time, but as I know that I have the best surgeon in my area doing the procedure, I think its worth the wait.

 

[sue943]

Again just a guess, but I am guessing that a family (for example a husband, wife, and 2-3 children) may have to pay higher taxes in countries with subsidized health care and in the States the same family would have to pay a portion of the cost for their health insurance the company offers.
...............
I'm not saying one system is better than another, only that neither system is "free" if you work and pay taxes.

Granted it isn't free in the sense that it is paid out of taxes.

For me it really is free, I pay no taxes as my income isn't high enough.

What strikes me, and I am sure other people not from the US too, is the worry some people appear to have about insurance and perhaps not being insured.

 

[Jkm7]

The state I live in (Massachusetts) is a first in the nation that is requiring all people have health insurance. The state offers varying levels of coverage and predicated on what a person earns determines which level of coverage they will have but there is actually a fine for those who do not participate. There has been national conversation this might serve as a model for potentially National Health Care.

The main problem I have heard about this program is not so much non-compliance is there is now a shortage of PCP's. All these new enrollees have to wait a long time to get a PCP. When we file our income taxes each year, we must attach a statement which we receive from our health insurer verifying we are covered for at least a minimal level of health insurance.