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Comment by lm28469 | Hacker News Reader

You have to wonder where we fucked up because clearly it wasn't like that even 30 years ago. A few generation ago you had family doctors who knew pretty much everything about you from your birth to their retirement (or death even). Even I had that as a kid, and I'm not 40 yet.

Now we have 10 minutes online consultations with random doctors we'll never see again. Last time I went to mine they refused a preventative blood check, the reason? "it's too expensive and you're healthy anyways". I went to a private lab and paid for it, it ended up costing less than 10 euros, meanwhile I pay 500+ a month for health insurance.

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In the UK, the answer is that the NHS is simply overwhelmed. There are too many people and not enough doctors so the whole system has been whittled down to the point where it is stateless and transactional. And still another net 600,000 people come here every year and we wonder why it’s getting worse!

> still another net 600,000 people

.. many of whom are NHS employees, since we don't train enough locally.

https://www.nhsconfed.org/articles/immigration-harming-nhs

"Recent NHS data shows that across all NHS staff in England (1.4 million), more than 17 per cent (264,815) are from overseas. Percentages for nurses are much higher – nearly 27 per cent of NHS nurses are from outside the UK (99,856 of the 372,605 nurses and health visitors recorded).

Further, the workforce plan is supported by the government, for example, having set a target to recruit between 51,000 and 57,000 international nurses by 2023/24"

Yet they still artificially limit the number of medical school places available to UK applicants, to a number far below what we need.

This is not the case. Medical school places are up over a third since 2017. We import the amount of doctors we graduate every year, but we haven't meaningfully increased the amount of specialists and GP's we train in over a decade.

There is no shortage of doctors. There is a shortage of consultants/GPs.

In the US you can blame private equity for that. Buying up practices and pushing them to turn a profit by maximizing patient load and minimizing interaction times etc...

We have far more doctors per capita than we did in 1960.

> In the US you can blame private equity for that...

Only partly. Where I'm living (SE Michigan), one of the two huge local hospitals is owned & operated by a major research university. The other one by a major Catholic non-profit.

My (older) family & friends have been on the receiving end of lots of "the system cares only about itself, and many of the individual doctors obviously feel the same" horrors at both of those hospitals.

And it's been that way for decades, minimum.

Yeah it's possible for a non-profit to cause some of the same problems.

But I guarantee you PE is still involved in that health system to a major extent. Many if not most of the doctors are going to be employees of private groups that the University hospital contracts out to.

I get the sense that you're only interested in finding PE anywhere near "the scene of the crime". Not the causality for bungled cases.

30 years ago, when there was vastly less PE in the medical field, those hospitals had the same problems. If Dr. Fubar was socially adroit with his fellow MD's, then it really didn't matter that he was a disaster for his patients.

The subthread was about people not having a single family physician. And private equity consolidating physician practices is a very well documented contributor to that. Bungled cases can have all sorts of causes, and I never said private equity was the cause of all of them.

I never said private equity was the cost of any bungled cases despite the fact that they surely are.

What I said you can blame private equity on is this

> A few generation ago you had family doctors who knew pretty much everything about you from your birth to their retirement (or death even). Even I had that as a kid, and I'm not 40 yet.

But to be fair. It's not just PE, it's consolidation in general, which can be lead by large non-profit hospital groups as well.

Has it been proven that getting "preventative blood check" is of any actual benefit if you have no other symptoms?

Blood tests are not for curiosity or entertainment.

By that logic preventative anything is useless, the whole point is to know if what I'm doing right now is going in the right direction or not.

Better catch diabetes or cholesterol when it's not a problem yet, when the symptoms are bad enough for you to notice by yourself you're already in deep shit.

its not useless if its studied that it prevents diabetes or cholesterol.

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