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Logseman · 03-31-2010, 10:26 AM

I come from Spain, and it happens to be that both my parents work in the health sector (my father as a doctor, my mother as supporting staff), so I would like to give my two cents as well.

Spain has a full-fledged state-run health sector, though it allows private hospitals as well. Health care is considered one of the columns of Spain's welfare state, alongside with education, and a privatisation of any kind is something unthinkable. However, the health care system is not run by the central state itself, but it's been decentralized to the Autonomous Communities (I'll shorten them as regions for clarity's sake)

The results of such policy are the following:

underpaid doctors: since the state has a huge market power and there is no competition between regions, it can pay less... but Medicine egresates go to other EU countries where they have salaries thrice as high or higher than the Spanish ones, forcing Spain to bring less expensive workers from Latin America and East Europe. Still, there is a patent scarcity of health care workers and the issue won't be solved soon;
the remaining doctors are burnt out, for they're overloaded with work, or are prone to fall to similar mental health conditions, as I have sadly lived at home with my father's burnout syndrome;
that scarcity of human ressources causes long waiting lists for operations which lead patients to use tricks to circumvent them (though bribes are not used as far as I can tell);
subsidies on medicines eat up the budget, more so when we have large colonies of ancient European citizens living as "residential tourists", receiving their payments from their home countries but causing the expenses in Spain. A clearing compensation fund for this issue has been vetoed repeteadly by said home countries, mainly the United Kingdom and Germany;
suppliers are paid "late, bad and never" as we say in my country: it's the easiest form in which state hospitals can obtain financing, by delaying payments to suppliers;
private hospitals are run by people connected to the political clique, if not by politicians themselves: we have an egregious case in my home region where many politicians are stockholders of the main regionwide private health care company;
said private hospitals will definitely not treat anyone without an insurance or whose cost of treatment is suspected to rise a bit, since they can always dump the patients in the state-run hospital and cash in the money for "compensation" on treatments that may or may not have been given to the patient;
patients are not provided the health care they ask for, thus they may resort to other choices outside of the system, which are usually dangerous. While this is not a problem in my opinion (as my view is that you should be allowed to take the health care you wish or none at all), some will find it disturbing that people can choose to take regular doses of two aminoacids to cure their cancer instead of going to their oncologist (said aminoacid case happened in my home region);
efforts are made, however, to encomprise patients in the health care system as much as possible, and to maintain them living beyond any sort of reason. People with common flus are brought to urgency rooms instead of being encouraged to treat themselves or bear the flu, while patients with huge records who refuse to follow their treatment (your typical junkie who keeps smoking crack, or the old drunkard who'll never die from his cyrrhosis) are still admitted in the system as if they wouldn't be happier dying in the street as they deserve.

I needn't go on to keep enumerating my thoughts on steps which imply bringing more of the state and big pharma inside health care. I hope that my point has been made sufficiently.

03-31-2010, 10:26 AM	#58
Logseman Orisa Posts: 2,001 Karma: 1035571 Join Date: Feb 2010 Location: Ireland Device: Onyx Poke 5	I come from Spain, and it happens to be that both my parents work in the health sector (my father as a doctor, my mother as supporting staff), so I would like to give my two cents as well. Spain has a full-fledged state-run health sector, though it allows private hospitals as well. Health care is considered one of the columns of Spain's welfare state, alongside with education, and a privatisation of any kind is something unthinkable. However, the health care system is not run by the central state itself, but it's been decentralized to the Autonomous Communities (I'll shorten them as regions for clarity's sake) The results of such policy are the following: underpaid doctors: since the state has a huge market power and there is no competition between regions, it can pay less... but Medicine egresates go to other EU countries where they have salaries thrice as high or higher than the Spanish ones, forcing Spain to bring less expensive workers from Latin America and East Europe. Still, there is a patent scarcity of health care workers and the issue won't be solved soon; the remaining doctors are burnt out, for they're overloaded with work, or are prone to fall to similar mental health conditions, as I have sadly lived at home with my father's burnout syndrome; that scarcity of human ressources causes long waiting lists for operations which lead patients to use tricks to circumvent them (though bribes are not used as far as I can tell); subsidies on medicines eat up the budget, more so when we have large colonies of ancient European citizens living as "residential tourists", receiving their payments from their home countries but causing the expenses in Spain. A clearing compensation fund for this issue has been vetoed repeteadly by said home countries, mainly the United Kingdom and Germany; suppliers are paid "late, bad and never" as we say in my country: it's the easiest form in which state hospitals can obtain financing, by delaying payments to suppliers; private hospitals are run by people connected to the political clique, if not by politicians themselves: we have an egregious case in my home region where many politicians are stockholders of the main regionwide private health care company; said private hospitals will definitely not treat anyone without an insurance or whose cost of treatment is suspected to rise a bit, since they can always dump the patients in the state-run hospital and cash in the money for "compensation" on treatments that may or may not have been given to the patient; patients are not provided the health care they ask for, thus they may resort to other choices outside of the system, which are usually dangerous. While this is not a problem in my opinion (as my view is that you should be allowed to take the health care you wish or none at all), some will find it disturbing that people can choose to take regular doses of two aminoacids to cure their cancer instead of going to their oncologist (said aminoacid case happened in my home region); efforts are made, however, to encomprise patients in the health care system as much as possible, and to maintain them living beyond any sort of reason. People with common flus are brought to urgency rooms instead of being encouraged to treat themselves or bear the flu, while patients with huge records who refuse to follow their treatment (your typical junkie who keeps smoking crack, or the old drunkard who'll never die from his cyrrhosis) are still admitted in the system as if they wouldn't be happier dying in the street as they deserve. I needn't go on to keep enumerating my thoughts on steps which imply bringing more of the state and big pharma inside health care. I hope that my point has been made sufficiently. Last edited by Logseman; 03-31-2010 at 10:30 AM.