There are real trade-offs with screening, and screening too much has harms as well as too little, although I'm not qualified to make a judgement on where that line sits relative to where it is in the UK.
Doctors won't see me unless I'm dying, or at least tell them I am. And I am, if I understand things correctly, which I might not tbh, in a high risk group for prostate cancer, given that I was diagnosed with chronic prostatitis at 22. I've even asked for checkups but was denied. And where I live you can't really pay for health care (but you can pay to skip the line, which I guess is almost the same thing).
I am in the US with health insurance through my employer and I get blood tests every 6-12 months to check for abnormalities as well as a standard interview for how I'm feeling and whatnot. Also have a few prescriptions that require 3-month checkins.
When I lived for a while in the UK, my GP strongly suggested close monitoring for a couple of things, and we saw improvements in some measures with lifestyle changes. Others were “we’ll keep an eye on it, if it gets bad, off you go for an inpatient visit to get you an extra 10 good years”.
Back in the Netherlands I have to get pushy and even a bit obnoxious at my GP before they even consider the concern, let alone schedule a blood test.
But it's not true. We get regular bowel cancer screening - you get it every 2 years once you hit 50 - https://www.nhs.uk/tests-and-treatments/bowel-cancer-screeni...
And there are also regular health checks available once you hit 40 - https://www.nhs.uk/tests-and-treatments/nhs-health-check/
Not everyone chooses to get them, of course. But ACA insurance plans here offer at least one annual physical exam free of charge (considered preventative care).
The NHS isn't perfect, but one of the things it does well because of it's structure is minimise costs holistically. It's cheaper to treat conditions early, so usually implements appropriate screening to catch things. If they don't do regular checkups like this it's because they're of minimal value.
In the US case specifically, I always wonder how much of the benefit is just “here’s a free appointment with a doctor once a year”.
The idea behind physicals is they're considered preventative care... catching problems early, often before there's any overt symptoms. For example, checking your cholesterol and A1c levels before they progress to heart failure or diabetes.
Once you're showing symptoms, you've left the realm of preventative care and it's now diagnostic/treatment for a established issue.
(ACA only provides 100% free coverage for visits that are 100% within the "preventative care" box.)
I think I'd prefer the UK system where if you worry something is wrong you can see a doctor free of charge.
I think that there's a working assumption amongst US folk that because the NHS is is publicly funded, it must be terrible.
US healthcare plans offer an annual physical exam every year at all ages. Looking at the UK NHS website, it seems to be only offered there after age 40, and limited to once every 5 years? Am I reading that right?
I thought it was relatively uncontroversial that the major problem with US healthcare is not quality but cost. And the UK NHS is widely regarded as one of the lower quality implementations of single payer in any modern social democracy [0].
[0] https://www.usnews.com/news/best-countries/rankings/health (#23, but Canada is actually worse!)
> it's entirely possible you'd simply never see a doctor again in your life until you're ready for your prostate exam in older life
Local councils are responsible for arranging invitations for those not currently registered with GPs, so it ought to be more or less universal - though there are inevitably a few people who'll slip through the net.
It's pretty basic, but the evidence suggests it's been reasonably effective at dealing with the "he didn't see a doctor for 40 years and then just dropped dead from a heart attack" stereotype.
Fixing hole in tooth is far cheaper than replacing a full tooth, for example.
It's entirely possible to do this in the US, too, but it's not the default path. I know some people who think it's a point of pride to brag that they haven't been to a doctor in 20 years. I know other people who never miss their annual checkup and are frustrated that their doctors won't order every test they hear about from their podcasts. The US approach to healthcare is varied and confusing to outsiders, even if you remove all of the unreasonably complex insurance stuff from the equation.
> There are no regular checkups or preventative care on the NHS for mid life adults unless you're proactive
If you wanted to request an annual checkup, could you ask for one and get it without problem? Or would they require a specific reason to visit?
That advertising is illegal in almost all other first world countries.
Is it? If find it to be very much in line with the "personal freedom above all else" which permeates US culture.
There are about four incentives altogether, and the money is loaded on a Prepaid Visa card that is branded by the insurance carrier. The funds are not restricted, and you can spend them on anything where Visa is accepted. The cards are sometimes cycled out and replaced, but I do not know if the funds had an expiration date. There were no fees to hold the funds, and no fees to spend them.
It is not customary in the UK to see a doctor at regular intervals for checkups?
This isn’t quite true. There is a free “NHS Health check” for adults aged 40-72, which you’re supposed to do every 5 years and includes basic checks like blood pressure and cholesterol. I certainly get messages from my GP nagging me about it from time to time.